Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol
| dc.contributor.author | Bohren, Meghan A | |
| dc.contributor.author | Lorencatto, Fabiana | |
| dc.contributor.author | Coomarasamy, Arri | |
| dc.contributor.author | Althabe, Fernando | |
| dc.contributor.author | Devall, Adam J | |
| dc.contributor.author | Evans, Cherrie | |
| dc.contributor.author | Oladapo, Olufemi T | |
| dc.contributor.author | Lissauer, David | |
| dc.contributor.author | Akter, Shahinoor | |
| dc.contributor.author | Forbes, Gillian | |
| dc.contributor.author | Thomas, Eleanor | |
| dc.contributor.author | Galadanci, Hadiza | |
| dc.contributor.author | Qureshi, Zahida | |
| dc.contributor.author | Fawcus, Sue | |
| dc.contributor.author | Hofmeyr, G J | |
| dc.contributor.author | Al-beity, Fadhlun A | |
| dc.contributor.author | Kasturiratne, Anuradhani | |
| dc.contributor.author | Kumarendran, Balachandran | |
| dc.contributor.author | Mammoliti, Kristie-Marie | |
| dc.contributor.author | Vogel, Joshua P | |
| dc.contributor.author | Gallos, Ioannis | |
| dc.contributor.author | Miller, Suellen | |
| dc.date.accessioned | 2021-10-11T08:52:58Z | |
| dc.date.available | 2021-10-11T08:52:58Z | |
| dc.date.issued | 2021-07-14 | |
| dc.date.updated | 2021-07-18T03:08:35Z | |
| dc.description.abstract | Background: Postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide. When PPH occurs, early identification of bleeding and prompt management using evidence-based guidelines, can avert most PPH-related severe morbidities and deaths. However, adherence to the World Health Organization recommended practices remains a critical challenge. A potential solution to inefficient and inconsistent implementation of evidence-based practices is the application of a ‘clinical care bundle’ for PPH management. A clinical care bundle is a set of discrete, evidence-based interventions, administered concurrently, or in rapid succession, to every eligible person, along with teamwork, communication, and cooperation. Once triggered, all bundle components must be delivered. The E-MOTIVE project aims to improve the detection and first response management of PPH through the implementation of the “E-MOTIVE” bundle, which consists of (1) Early PPH detection using a calibrated drape, (2) uterine Massage, (3) Oxytocic drugs, (4) Tranexamic acid, (5) Intra Venous fluids, and (6) genital tract Examination and escalation when necessary. The objective of this paper is to describe the protocol for the formative phase of the E-MOTIVE project, which aims to design an implementation strategy to support the uptake of this bundle into practice. Methods: We will use behaviour change and implementation science frameworks [e.g. capability, opportunity, motivation and behaviour (COM-B) and theoretical domains framework (TDF)] to guide data collection and analysis, in Kenya, Nigeria, South Africa, Sri Lanka, and Tanzania. There are four methodological components: qualitative inter views; surveys; systematic reviews; and design workshops. We will triangulate findings across data sources, participant groups, and countries to explore factors influencing current PPH detection and management, and potentially influencing E-MOTIVE bundle implementation. We will use these findings to develop potential strategies to improve implementation, which will be discussed and agreed with key stakeholders from each country in intervention design workshops. Discussion: This formative protocol outlines our strategy for the systematic development of the E-MOTIVE implementation strategy. This focus on implementation considers what it would take to support roll-out and implementation of the E-MOTIVE bundle. Our approach therefore aims to maximize internal validity in the trial alongside future scalability, and implementation of the E-MOTIVE bundle in routine practice, if proven to be effective. Trial registration: ClinicalTrials.gov: NCT04341662 Plain language summary Excessive bleeding after birth is the leading cause of maternal death globally. The World Health Organization (WHO) has recommended several treatment options for bleeding after birth. However, these treatments are not used regularly, or consistently for all women. A key underlying issue is that it is challenging for health workers to identify when women are bleeding too much, because measuring the amount of blood loss is difficult. Maternal health experts have proposed a new clinical ‘care bundle’ for caring for women with excessive bleeding after birth. A care bundle is a way to group together multiple treatments (e.g. 3–5 treatments). These treatments are then given to the woman at the same time, or one after another in quick succession, and supported by strategies to improve teamwork, communication, and cooperation. This is a research protocol for the preliminary phase of our study (“E-MOTIVE”), which means that it is a description of what we plan to do and how we plan to do it. The aim of our study is to develop a strategy for how we will test whether the E-MOTIVE bundle works through collaborative activities with midwives and doctors in five countries (Kenya, Nigeria, South Africa, Sri Lanka, and Tanzania) to develop a strategy for how we will test whether the E-MOTIVE bundle works. We plan to do this by conducting interviews and surveys with midwives and doctors, and reviewing other research conducted on PPH to understand what works in different settings. We will discuss our research findings in a workshop, with midwives and doctors in the study countries to co-create a strategy that will work for them, based on their needs and preferences. | |
| dc.identifier.apacitation | Bohren, M. A., Lorencatto, F., Coomarasamy, A., Althabe, F., Devall, A. J., Evans, C., ... Miller, S. (2021). Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. <i>Reproductive Health</i>, 18(1), 149. http://hdl.handle.net/11427/35145 | en_ZA |
| dc.identifier.chicagocitation | Bohren, Meghan A, Fabiana Lorencatto, Arri Coomarasamy, Fernando Althabe, Adam J Devall, Cherrie Evans, Olufemi T Oladapo, et al "Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol." <i>Reproductive Health</i> 18, 1. (2021): 149. http://hdl.handle.net/11427/35145 | en_ZA |
| dc.identifier.citation | Bohren, M.A., Lorencatto, F., Coomarasamy, A., Althabe, F., Devall, A.J., Evans, C., Oladapo, O.T. & Lissauer, D. et al. 2021. Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. <i>Reproductive Health.</i> 18(1):149. http://hdl.handle.net/11427/35145 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Bohren, Meghan A AU - Lorencatto, Fabiana AU - Coomarasamy, Arri AU - Althabe, Fernando AU - Devall, Adam J AU - Evans, Cherrie AU - Oladapo, Olufemi T AU - Lissauer, David AU - Akter, Shahinoor AU - Forbes, Gillian AU - Thomas, Eleanor AU - Galadanci, Hadiza AU - Qureshi, Zahida AU - Fawcus, Sue AU - Hofmeyr, G J AU - Al-beity, Fadhlun A AU - Kasturiratne, Anuradhani AU - Kumarendran, Balachandran AU - Mammoliti, Kristie-Marie AU - Vogel, Joshua P AU - Gallos, Ioannis AU - Miller, Suellen AB - Background: Postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide. When PPH occurs, early identification of bleeding and prompt management using evidence-based guidelines, can avert most PPH-related severe morbidities and deaths. However, adherence to the World Health Organization recommended practices remains a critical challenge. A potential solution to inefficient and inconsistent implementation of evidence-based practices is the application of a ‘clinical care bundle’ for PPH management. A clinical care bundle is a set of discrete, evidence-based interventions, administered concurrently, or in rapid succession, to every eligible person, along with teamwork, communication, and cooperation. Once triggered, all bundle components must be delivered. The E-MOTIVE project aims to improve the detection and first response management of PPH through the implementation of the “E-MOTIVE” bundle, which consists of (1) Early PPH detection using a calibrated drape, (2) uterine Massage, (3) Oxytocic drugs, (4) Tranexamic acid, (5) Intra Venous fluids, and (6) genital tract Examination and escalation when necessary. The objective of this paper is to describe the protocol for the formative phase of the E-MOTIVE project, which aims to design an implementation strategy to support the uptake of this bundle into practice. Methods: We will use behaviour change and implementation science frameworks [e.g. capability, opportunity, motivation and behaviour (COM-B) and theoretical domains framework (TDF)] to guide data collection and analysis, in Kenya, Nigeria, South Africa, Sri Lanka, and Tanzania. There are four methodological components: qualitative inter views; surveys; systematic reviews; and design workshops. We will triangulate findings across data sources, participant groups, and countries to explore factors influencing current PPH detection and management, and potentially influencing E-MOTIVE bundle implementation. We will use these findings to develop potential strategies to improve implementation, which will be discussed and agreed with key stakeholders from each country in intervention design workshops. Discussion: This formative protocol outlines our strategy for the systematic development of the E-MOTIVE implementation strategy. This focus on implementation considers what it would take to support roll-out and implementation of the E-MOTIVE bundle. Our approach therefore aims to maximize internal validity in the trial alongside future scalability, and implementation of the E-MOTIVE bundle in routine practice, if proven to be effective. Trial registration: ClinicalTrials.gov: NCT04341662 Plain language summary Excessive bleeding after birth is the leading cause of maternal death globally. The World Health Organization (WHO) has recommended several treatment options for bleeding after birth. However, these treatments are not used regularly, or consistently for all women. A key underlying issue is that it is challenging for health workers to identify when women are bleeding too much, because measuring the amount of blood loss is difficult. Maternal health experts have proposed a new clinical ‘care bundle’ for caring for women with excessive bleeding after birth. A care bundle is a way to group together multiple treatments (e.g. 3–5 treatments). These treatments are then given to the woman at the same time, or one after another in quick succession, and supported by strategies to improve teamwork, communication, and cooperation. This is a research protocol for the preliminary phase of our study (“E-MOTIVE”), which means that it is a description of what we plan to do and how we plan to do it. The aim of our study is to develop a strategy for how we will test whether the E-MOTIVE bundle works through collaborative activities with midwives and doctors in five countries (Kenya, Nigeria, South Africa, Sri Lanka, and Tanzania) to develop a strategy for how we will test whether the E-MOTIVE bundle works. We plan to do this by conducting interviews and surveys with midwives and doctors, and reviewing other research conducted on PPH to understand what works in different settings. We will discuss our research findings in a workshop, with midwives and doctors in the study countries to co-create a strategy that will work for them, based on their needs and preferences. DA - 2021-07-14 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Reproductive Health KW - Maternal health KW - Postpartum hemorrhage KW - Obstetric hemorrhage KW - Care bundle KW - Formative research KW - Maternal mortality KW - Behavior change KW - Implementation KW - Intervention development LK - https://open.uct.ac.za PY - 2021 T1 - Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol TI - Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol UR - http://hdl.handle.net/11427/35145 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s12978-021-01162-3 | |
| dc.identifier.uri | http://hdl.handle.net/11427/35145 | |
| dc.identifier.vancouvercitation | Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, et al. Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Reproductive Health. 2021;18(1):149. http://hdl.handle.net/11427/35145. | en_ZA |
| dc.language.iso | en | en_US |
| dc.language.rfc3066 | en | |
| dc.rights.holder | The Author(s) | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_US |
| dc.source | Reproductive Health | en_US |
| dc.source.journalissue | 1 | en_US |
| dc.source.journalvolume | 18 | en_US |
| dc.source.pagination | 149 | en_US |
| dc.source.uri | https://reproductive-health-journal.biomedcentral.com/ | |
| dc.subject | Maternal health | en_US |
| dc.subject | Postpartum hemorrhage | en_US |
| dc.subject | Obstetric hemorrhage | en_US |
| dc.subject | Care bundle | en_US |
| dc.subject | Formative research | en_US |
| dc.subject | Maternal mortality | en_US |
| dc.subject | Behavior change | en_US |
| dc.subject | Implementation | en_US |
| dc.subject | Intervention development | en_US |
| dc.title | Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol | en_US |
| dc.type | Journal Article | en_US |