Objective
Safety-net clinics such as health department family planning (HD) and federally qualified health centers (FQHCs) provide free or low-cost contraceptive care to low-income and uninsured populations. Integration of contraceptive focused training within safety-net clinics is essential to deliver comprehensive, patient-centered contraceptive care. In SC, HDs receive Title X funding, which requires providing training to staff. However, due to different funding policies, trainings may be less available to FQHC staff which creates gap in care. This study examined perceptions of impact of trainings on overall performance and patient care among safety-net clinics in South Carolina (SC) that received externally funded contraceptive trainings for healthcare providers and clinic staff. The key focus of this study was to identify the perceptions of training among clinical staff and providers in HDs and FQHCs in SC. Our study showed that when equal funding opportunities were provided, it expanded the opportunity of positive impact.
Method
Key informant interviews were conducted among 58 individuals, 31 HD and 27 FQHC clinic staff and system leaders in 2019. Interview questions assessed the respondent’s perception of trainings on overall performance and patient care. Formal informed consent was obtained before the interview and participation was voluntary. Interviews were conducted privately via phone by study staff at East Tennessee State University. The interview recordings were transcribed and coded with QSR International’s NVivo 12 qualitative data analysis software. A codebook was developed, and inter-rater reliability and consensus coding methodologies were utilized to ensure consistency of coding.
Results
The majority of HD and FQHC respondents identified improved quality of services and infrastructure as positive impacts of provided trainings (N=14 and N=12, respectively). Additionally, four respondents from FQHC sectors mentioned that training increased capacity for contraceptive provision. Challenges with staffing capacity such as not having time for training were mentioned as a negative perception among both sectors.
Perception of impact of training on patient care were positive among most respondents (N=44). Most respondents from both sectors indicated improved capacity for patient counseling as a positive impact of training (N=26). Two FQHC respondents mentioned that training led to implementing best practices.
Conclusion
Positive perception of contraceptive training on overall performance and patient care have been identified throughout this study. Federal funding provides support for training implementation but restrictions in funding due to policy changes and different funding mechanisms limit some clinics. Although external funding provides support; this does not ensure the sustainability of trainings after completion of the funding period which can create gaps in care and contraceptive provision. Future research should focus on training sustainability models such as Train-the-Trainer to ensure continuity of positive impact in local and state levels.
| Identifer | oai:union.ndltd.org:ETSU/oai:dc.etsu.edu:asrf-1779 |
| Date | 18 March 2021 |
| Creators | Rahman, Aurin, Beatty, Kate, Khoury, Amal, Smith, Michael, Ventura, Liane, Ariyo, Oluwatosin, Slawson, Deborah L |
| Publisher | Digital Commons @ East Tennessee State University |
| Source Sets | East Tennessee State University |
| Detected Language | English |
| Type | text |
| Source | Appalachian Student Research Forum |
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