TY - JOUR
T1 - Improving effective contraception uptake through provision of bridging contraception within community pharmacies
T2 - findings from the Bridge-it Study process evaluation
AU - Patterson, Susan
AU - McDaid, Lisa
AU - Saunders, Kristina
AU - Battison, Claire
AU - Glasier, Anna
AU - Radley, Andrew
AU - Stephenson, Judith M
AU - Johnstone, Anne
AU - Morelli, Alessandra
AU - Sally, Deirdre
AU - Stewart, Nicola
AU - Cameron, Sharon Tracey
N1 - Funding Information:
Contributors SP led on data collection and analysis, and on the initial draft of the manuscript. LM was a coinvestigator of the Bridge-it study, and led on the process evaluation, contributing to study design, supervising the project and its staff, and made significant contributions to drafting and revising the manuscript. KS contributed to data collection and analysis, and commented on and approved the final version of the manuscript. AG, AR and JMS were coinvestigators, and contributed to conception and design of the study, and commented on and approved the final version of the manuscript. CB, AJ, AM, DS and NS recruited participants, facilitated data collection, were responsible for day-to-day management of the main study within the three sites, and commented on and approved the final version of the manuscript. STC was the chief investigator and guarantor of the Bridge-it study, and contributed to conception and design of the study, and drafting and revising the manuscript. Funding Funding for the research was provided by the National Institute for Health Research’s Health Technology Assessment Programme. HTA Project: 15/113/01. LM and SP are funded by the UK Medical Research Council and Chief Scientist Office of the Scottish Government Health and Social Care Directorates at the MRC/CSO Social & Public Health Sciences Unit, University of Glasgow (MC_UU_12017/11, SPHSU11; MC_UU_00022/3, SPHSU18).
Funding Information:
Competing interests STC reports grants from the National Institute for Health Research (Health Technology Assessment (NIHR HTA) Programme), during the conduct of the study. AG is a consultant to HRA Pharma. AR reports receiving research grants from Gilead Sciences, Bristol-Myers Squibb, AbbVie and Roche; honorariums from Gilead Sciences; and personal fees from AbbVie. AM reports grants from NIHR HTA during the conduct of this study. AM is a clinical support bank midwife for SH:24 and a research midwife at Oxford University. All other authors declare no competing interests.
Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
PY - 2022/2/11
Y1 - 2022/2/11
N2 - OBJECTIVE: To present process evaluation results from the Bridge-it Study, a pragmatic cluster randomised cross-over trial to improve effective contraception uptake through provision of the progestogen only pill (POP) plus sexual and reproductive health (SRH) clinic rapid-access to women presenting to community pharmacies for emergency contraception (EC).RESEARCH DESIGN AND METHODS: A multimethod process evaluation was conducted to assess intervention implementation, mechanisms of change and contextual factors. Data were gathered from screening logs (n=599), observations of pharmacist training, analysis of data from 4-month follow-up questionnaires (n=406), monitoring of contemporaneous events and qualitative interviews with 22 pharmacists, 5 SRH clinical staff and 36 study participants in three participating UK sites in Lothian, Tayside and London.RESULTS: The intervention was largely delivered as intended and was acceptable. Pharmacists', SRH clinical staff and participants' accounts highlighted that providing a supply of POP with EC from the pharmacy as routine practice may have positive impacts on contraceptive practices in the short term, and potentially longer term. Key mechanisms of change included ease of access, increased awareness of contraception and services, and greater motivation and perceptions of self-efficacy. Few participants took up the offer to attend an SRH service (rapid-access component), and existing barriers within the SRH context were apparent (eg, lack of staff). Participant accounts highlight persistent barriers to accessing and using routine effective contraception remain.CONCLUSIONS: Implementation appeared to be acceptable and feasible, highlighting the potential for provision of POP within EC consultations as routine practice in community pharmacies. However, lack of engagement with the rapid access component of the intervention and existing barriers within the SRH context suggest that signposting to SRH services may be sufficient. Wider implementation should consider ways to address key implementation challenges to increase effectiveness and sustainability, and to overcome persistent barriers to accessing and using effective contraception.TRIAL REGISTRATION NUMBER: ISRCTN70616901.
AB - OBJECTIVE: To present process evaluation results from the Bridge-it Study, a pragmatic cluster randomised cross-over trial to improve effective contraception uptake through provision of the progestogen only pill (POP) plus sexual and reproductive health (SRH) clinic rapid-access to women presenting to community pharmacies for emergency contraception (EC).RESEARCH DESIGN AND METHODS: A multimethod process evaluation was conducted to assess intervention implementation, mechanisms of change and contextual factors. Data were gathered from screening logs (n=599), observations of pharmacist training, analysis of data from 4-month follow-up questionnaires (n=406), monitoring of contemporaneous events and qualitative interviews with 22 pharmacists, 5 SRH clinical staff and 36 study participants in three participating UK sites in Lothian, Tayside and London.RESULTS: The intervention was largely delivered as intended and was acceptable. Pharmacists', SRH clinical staff and participants' accounts highlighted that providing a supply of POP with EC from the pharmacy as routine practice may have positive impacts on contraceptive practices in the short term, and potentially longer term. Key mechanisms of change included ease of access, increased awareness of contraception and services, and greater motivation and perceptions of self-efficacy. Few participants took up the offer to attend an SRH service (rapid-access component), and existing barriers within the SRH context were apparent (eg, lack of staff). Participant accounts highlight persistent barriers to accessing and using routine effective contraception remain.CONCLUSIONS: Implementation appeared to be acceptable and feasible, highlighting the potential for provision of POP within EC consultations as routine practice in community pharmacies. However, lack of engagement with the rapid access component of the intervention and existing barriers within the SRH context suggest that signposting to SRH services may be sufficient. Wider implementation should consider ways to address key implementation challenges to increase effectiveness and sustainability, and to overcome persistent barriers to accessing and using effective contraception.TRIAL REGISTRATION NUMBER: ISRCTN70616901.
U2 - 10.1136/bmjopen-2021-057348
DO - 10.1136/bmjopen-2021-057348
M3 - Article
C2 - 35149574
SN - 2044-6055
VL - 12
SP - e057348
JO - BMJ Open
JF - BMJ Open
IS - 2
M1 - e057348
ER -