Abstract
Objective
Contraception is an important issue in the lives of women, their partners, and society.
Canadians and their health care providers play a critical role in contraceptive decision
making that influences individuals and Canadian society. The purpose of this study
was to gather data on contraception-related knowledge, counselling, and prescribing
practices of Canadian health care providers.
Methods
This project reported on the outcomes of an educational initiative, designed as a
quality improvement initiative (time series level II-3), focused on Canadian health
care providers’ contraception-related knowledge, counselling, and prescribing practices.
Outcomes were intended to inform the development of tools, resources, and educational
programming. Part 1 was an online program to identify educational and knowledge gaps
for health care providers. Part 2 was a practice assessment exploring and measuring
health care providers’ contraceptive counselling and prescribing practices.
Results
A total of 4300 health care providers completed the program between July 6, 2015 and
August 30, 2016. Knowledge significantly increased; post-test scores were higher than
pretest scores. After completion, all participants felt more comfortable, knowledgeable,
and inclined to change their practice around prescribing intrauterine contraception
(IUC). The 4300 providers reported on their contraception counselling experiences
with 10 patients following participation in Part 1. Forty percent of patients were
using oral contraceptives, and 53% were dissatisfied with their current type of contraception.
After counselling, patients reported being most comfortable with IUC (55%). Both short-
and long-acting types of contraception were most often discussed or offered (74% of
the time), followed by long-acting reversible contraception only (21%) and short-acting
methods only (5%).
Conclusion
This training program filled an education need for patients and gave providers tools
to change their behaviour and practice around IUC prescribing. On the basis of these
data, a practice assessment model was deemed a successful way to change behaviour.
Résumé
Objectif
La question de la contraception est importante pour les femmes, leurs partenaires
et la société. Les décisions en matière de contraception prises par les Canadiennes
et leurs fournisseurs de soins de santé ont une influence capitale, individuellement
et à l'échelle de la société. L'objectif de cette étude était de rassembler des données
sur les connaissances liées à la contraception, le counseling et les pratiques de
prescription des fournisseurs de soins de santé canadiens.
Méthodologie
Ce projet détaille les résultats d'un programme de formation conçu comme une initiative
d'amélioration de la qualité (séries chronologiques, niveau II-3) visant les connaissances
sur la contraception, le counseling et les pratiques de prescription des fournisseurs
de soins de santé du Canada. Les résultats serviront à la conception d'outils, de
ressources et de programmes éducatifs. La première partie était un programme en ligne
évaluant les lacunes dans les connaissances des fournisseurs sur le sujet, alors que
la deuxième était une évaluation du counseling et des pratiques de prescription en
matière de contraception du fournisseur.
Résultats
Au total, 4 300 fournisseurs de soins de santé ont participé au programme entre le
6 juillet 2015 et le 30 août 2016. Le niveau de connaissances a significativement
augmenté lors des évaluations post-tests, comparativement aux prétests. Après avoir
terminé le programme, tous les candidats se sentaient plus à l'aise, avaient de meilleures
connaissances et étaient prêts à modifier leurs pratiques de prescription de la contraception
intra-utérine (CIU). Les 4 300 fournisseurs ont rapporté leur expérience de counseling
avec 10 patientes après leur participation à la première partie. Quarante pour cent
des patientes utilisaient une méthode de contraception orale, et 53 % d'entre elles
étaient insatisfaites. Après le counseling, les patientes ont déclaré se sentir le
plus à l'aise avec la CIU (55 %). Le plus souvent, les méthodes de contraception à
court terme et celles à long terme ont toutes deux été abordées ou suggérées (dans
74 % des cas), suivies par une mention de la contraception réversible à action prolongée
seulement (21 %) et des méthodes à court terme seulement (5 %).
Conclusion
Ce programme de formation a répondu au besoin d'informer les patientes et a donné
aux fournisseurs des outils pour modifier leur comportement et leurs pratiques de
prescription de la CIU. D'après ces résultats, on peut conclure qu'un modèle d'évaluation
des pratiques est un moyen efficace de modifier des comportements.
Key Words
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Article info
Publication history
Published online: March 18, 2019
Accepted:
November 24,
2018
Received:
June 28,
2018
Footnotes
Competing interests: The authors declare that they have no competing interests.
Each author has indicated that they meet the journal's requirements for authorship.
Identification
Copyright
© 2019 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc.
