Implementation research priorities for addressing the maternal health crisis in the USA: results from a modified Delphi study among researchers.
Delphi method
Implementation science
Maternal health
Priority setting
Research priorities
Journal
Implementation science communications
ISSN: 2662-2211
Titre abrégé: Implement Sci Commun
Pays: England
ID NLM: 101764360
Informations de publication
Date de publication:
21 Jul 2023
21 Jul 2023
Historique:
received:
02
02
2023
accepted:
21
06
2023
medline:
22
7
2023
pubmed:
22
7
2023
entrez:
21
7
2023
Statut:
epublish
Résumé
Maternal health outcomes in the USA are far worse than in peer nations. Increasing implementation research in maternity care is critical to addressing quality gaps and unwarranted variations in care. Implementation research priorities have not yet been defined or well represented in the plans for maternal health research investments in the USA. This descriptive study used a modified Delphi method to solicit and rank research priorities at the intersection of implementation science and maternal health through two sequential web-based surveys. A purposeful, yet broad sample of researchers with relevant subject matter knowledge was identified through searches of published articles and grant databases. The surveys addressed five implementation research areas in maternal health: (1) practices to prioritize for broader implementation, (2) practices to prioritize for de-implementation, (3) research questions about implementation determinants, (4) research questions about implementation strategies, and (5) research questions about methods/measures. Of 160 eligible researchers, 82 (51.2%) agreed to participate. Participants were predominantly female (90%) and White (75%). Sixty completed at least one of two surveys. The practices that participants prioritized for broader implementation were improved postpartum care, perinatal and postpartum mood disorder screening and management, and standardized management of hypertensive disorders of pregnancy. For de-implementation, practices believed to be most impactful if removed from or reduced in maternity care were cesarean delivery for low-risk patients and routine discontinuation of all psychiatric medications during pregnancy. The top methodological priorities of participants were improving the extent to which implementation science frameworks and measures address equity and developing approaches for involving patients in implementation research. Through a web-based Delphi exercise, we identified implementation research priorities that researchers consider to have the greatest potential to improve the quality of maternity care in the USA. This study also demonstrates the feasibility of using modified Delphi approaches to engage researchers in setting implementation research priorities within a clinical area.
Sections du résumé
BACKGROUND
BACKGROUND
Maternal health outcomes in the USA are far worse than in peer nations. Increasing implementation research in maternity care is critical to addressing quality gaps and unwarranted variations in care. Implementation research priorities have not yet been defined or well represented in the plans for maternal health research investments in the USA.
METHODS
METHODS
This descriptive study used a modified Delphi method to solicit and rank research priorities at the intersection of implementation science and maternal health through two sequential web-based surveys. A purposeful, yet broad sample of researchers with relevant subject matter knowledge was identified through searches of published articles and grant databases. The surveys addressed five implementation research areas in maternal health: (1) practices to prioritize for broader implementation, (2) practices to prioritize for de-implementation, (3) research questions about implementation determinants, (4) research questions about implementation strategies, and (5) research questions about methods/measures.
RESULTS
RESULTS
Of 160 eligible researchers, 82 (51.2%) agreed to participate. Participants were predominantly female (90%) and White (75%). Sixty completed at least one of two surveys. The practices that participants prioritized for broader implementation were improved postpartum care, perinatal and postpartum mood disorder screening and management, and standardized management of hypertensive disorders of pregnancy. For de-implementation, practices believed to be most impactful if removed from or reduced in maternity care were cesarean delivery for low-risk patients and routine discontinuation of all psychiatric medications during pregnancy. The top methodological priorities of participants were improving the extent to which implementation science frameworks and measures address equity and developing approaches for involving patients in implementation research.
CONCLUSIONS
CONCLUSIONS
Through a web-based Delphi exercise, we identified implementation research priorities that researchers consider to have the greatest potential to improve the quality of maternity care in the USA. This study also demonstrates the feasibility of using modified Delphi approaches to engage researchers in setting implementation research priorities within a clinical area.
Identifiants
pubmed: 37480135
doi: 10.1186/s43058-023-00461-z
pii: 10.1186/s43058-023-00461-z
pmc: PMC10360260
doi:
Types de publication
Journal Article
Langues
eng
Pagination
83Investigateurs
Megan Allyse
(M)
Ian Bennet
(I)
Debra Bingham
(D)
Kacie Blackman
(K)
Sarah Brewer
(S)
Jerry Cochran
(J)
Andreea Creanga
(A)
Shayna Cunningham
(S)
Ellen Daley
(E)
Carla DeSisto
(C)
Narges Farahi
(N)
Linda Franck
(L)
Sarah Goff
(S)
Stacey Griner
(S)
Sadia Haider
(S)
Anna Hansen
(A)
Samantha Harden
(S)
Kimberly Harper
(K)
Lisa Hofler
(L)
Sarah Horvath
(S)
Jeanette Ickovics
(J)
Jennifer Johnson
(J)
Heather Kaplan
(H)
Charlan Kroelinger
(C)
Elysia Larson
(E)
Huynh-Nhu Mimi Le
(HM)
Henry Lee
(H)
Ann McAlearney
(A)
Danielle McCarthy
(D)
Lois McCloskey
(L)
Cristian Meghea
(C)
Emily Miller
(E)
Elizabeth Libby Mollard
(EL)
Tiffany Moore Simas
(T)
Eydie Moses-Kolko
(E)
Gina Novick
(G)
Abigail Palmer Molina
(A)
Divya Patel
(D)
Neena Qasba
(N)
Nandini Raghuraman
(N)
Amy Romano
(A)
Melissa Rosenstein
(M)
Sangini Sheth
(S)
Melissa Simon
(M)
Sharla Smith
(S)
Sindhu Srinivas
(S)
Carolyn Sufrin
(C)
Rachel Tabak
(R)
Erika Thompson
(E)
Cheryl Vamos
(C)
Daniel Walker
(D)
Jackie Wallace
(J)
Jin Xiao
(J)
Lynn Yee
(L)
Chloe Zera
(C)
Nikki Zite
(N)
Informations de copyright
© 2023. The Author(s).
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