Caring for providers to improve patient experience (CPIPE): intervention development process

Afulani, Patience A.; Oboke, Edwina N.; Ogolla, Beryl A.; Getahun, Monica; Kinyua, Joyceline; Oluoch, Iscar; Odour, James; Ongeri, Linnet

doi:10.1080/16549716.2022.2147289

Cited by 10 publications

(9 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cognitive Theory, 22 and Trauma Informed System framework, 23 and designed through iterative research and stakeholder feedback described previously. 24 In this report, we describe the piloting of the intervention and highlight challenges and successes observed during implementation as well as lessons learnt.…”

Section: Socialmentioning

confidence: 99%

Implementation of the caring for providers to improve patient experience (CPIPE) intervention in Migori County, Kenya: challenges, successes, and lessons

Ogolla¹,

Ongeri²,

Oboke³

et al. 2023

Preprint

View full text Add to dashboard Cite

Key drivers of poor Person-Centered Maternal Care (PCMC)—respectful and responsive care—include provider stress and unconscious bias. The Caring for Providers to Improve Patient Experience (CPIPE) intervention, a 5-component intervention including provider training, peer support, mentorship, embedded champions, and leadership engagement, was successfully piloted over 6-months in two health facilities in Migori County. Didactic and interactive content to promote PCMC and address stress, burnout, difficult situations, and bias, was delivered during a 2-day training. Facility-based embedded champions then led monthly refreshers and facilitated peer support groups. Twenty-four mentors provided mentorship across various topics with paired mentees. We engaged facility and county leadership through a community advisory board (CAB). CPIPE increased provider awareness and commitment to avoid bias and provide PCMC to all women; increased awareness of techniques for managing stress and difficult situations; created a supportive workplace culture and facilitated advocacy with leadership to address sources of stress, provide mental health supports, and provide PCMC. Challenges included limited training time, hierarchical facility culture which hindered cross-cadre activities, varying levels of site engagement, competing demands, and leadership changes. CPIPE is an innovative and practical intervention which centers the experiences of the providers and the care of vulnerable women. The pilot success underscores the timeliness, relevance, and feasibility of similar interventions in resource-constrained settings. CPIPE advances the evidence base for interventions to improve patient and provider experiences of maternal care.

show abstract

Section: Socialmentioning

confidence: 99%

Implementation of the caring for providers to improve patient experience (CPIPE) intervention in Migori County, Kenya: challenges, successes, and lessons

Ogolla¹,

Ongeri²,

Oboke³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The development of the intervention has been previously described in detail. 47 CPIPE is a theory and evidence-based intervention that was designed through an iterative process of formative research and feedback from stakeholders, and informed by the Ecological Perspective, 48 Social Cognitive Theory, 49 and Trauma Informed System framework. 50 It leverages 5 strategies: provider simulation-enhanced training, peer support, mentorship, embedded champions, and leadership engagement (Fig.…”

Section: Introductionmentioning

confidence: 99%

A cluster randomized controlled trial to assess the impact of the ‘Caring for Providers to Improve Patient Experience’ intervention on person-centered maternity care in Kenya and Ghana: Study Protocol

Afulani,

Getahun,

Ongeri

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

Background Poor person-centered maternal care (PCMC) contributes to high maternal mortality and morbidity, directly and indirectly, through lack of, delayed, inadequate, unnecessary, or harmful care. While evidence on poor PCMC prevalence, as well as inequities, expanded in the last decade, there is still a significant gap in evidence-based interventions to address PCMC. We describe the protocol for a trial to test the effectiveness of the “Caring for Providers to Improve Patient Experience” (CPIPE) intervention, which includes five strategies for provider behavior change, targeting provider stress and bias as intermediate factors to improve PCMC and to address inequities. Methods The trial will assess the effect of CPIPE on PCMC, as well as on intermediate and distal outcomes, using a two-arm cluster randomized controlled trial in 40 health facilities in Migori and Homa Bay Counties in Kenya and Upper East and Northeast Regions in Ghana. Twenty facilities in each country will be randomized to 10 intervention and 10 control sites. The primary intervention targets are all healthcare workers who provide maternal health services. The intervention impact will also be assessed first among providers, and then among women who give birth in health facilities. The primary outcome is PCMC measured with the PCMC scale, via multiple cross-sectional surveys of mothers who gave birth in the preceding 12 weeks in study facilities at baseline (prior to the intervention), midline (6 months after intervention start), and endline (12 months post-baseline) (N = 2000 across both countries at each time point). Additionally, 400 providers in the study facilities across both countries will be followed longitudinally at baseline, midline, and endline, to assess intermediate outcomes. The trial incorporates a mixed-methods design; survey data alongside in-depth interviews (IDIs) with healthcare facility leaders, providers, and mothers to qualitatively explore factors influencing the outcomes. Finally, we will collect process and cost data to assess intervention fidelity and cost-effectiveness. Discussion This trial will be the first to rigorously assess an intervention to improve PCMC that addresses both provider stress and bias and will advance the evidence base for interventions to improve PCMC and contribute to equity in maternal and neonatal health.

show abstract

“…We piloted CPIPE to assess its feasibility, acceptability, and preliminary effectiveness. The intervention development and the implementation process are described elsewhere [46,47]. In this manuscript, we aim to assess the effect of the pilot intervention on key study outcomes.…”

Section: Introductionmentioning

confidence: 99%

Mixed Methods Evaluation of the ‘Caring for Providers to Improve Patient Experience’ intervention

Afulani,

Getahun,

Okiring

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

ObjectiveTo assess the impact of the “Caring for Providers to Improve Patient Experience (CPIPE)” intervention, which sought to improve person-centered maternal care (PCMC) by addressing two key drivers—provider stress and bias.MethodsCPIPE was successfully piloted over 6-months in two health facilities in Migori County, Kenya in 2022. The evaluation employed a mixed-methods pretest-posttest-non-equivalent-control-group design. Data are from surveys with 80 providers (40 intervention; 40 control) at baseline and endline, and in-depth-interviews with 20 intervention providers. We conducted bivariate, multivariate, and difference-in-difference analysis of quantitative data and thematic analysis of qualitative data.ResultsIn the intervention group, average knowledge scores increased from 7.8(SD=2.4) at baseline to 9.5(SD=1.8) at endline for stress(p=0.001), and from 8.9(SD=1.9) to 10.7(SD=1.7) for bias(p=0.001); perceived stress scores decreased from 20.9(SD=3.9) to 18.6(SD=5.3)(p=0.019), and burnout from 3.6(SD=1.0) to 3.0(SD=1.0)(p=0.001); with no significant change in the control group. Qualitative data indicated CPIPE had impact at multiple levels. At the individual level, it improved provider knowledge, skills, self-efficacy, attitudes, behaviors, and experiences. At the interpersonal level, it improved provider-provider and patient-provider relationships leading to a supportive work environment and improved PCMC. At the institutional level, it created a system of accountability for providing PCMC and nondiscriminatory care; and collective action and advocacy to address sources of stress.ConclusionCPIPE impacted multiple outcomes in the theory of change leading to improvements in both provider and patient experience, including for the most vulnerable patients. These findings will contribute to global efforts to prevent burnout and promote PCMC and equity.Clinical trial registrationClinicalTrials.gov Identifier:NCT05019131https://www.clinicaltrials.gov/study/NCT05019131?term=Afulani&checkSpell=false&rank=1

show abstract

Caring for providers to improve patient experience (CPIPE): intervention development process

Cited by 10 publications

References 87 publications

Implementation of the caring for providers to improve patient experience (CPIPE) intervention in Migori County, Kenya: challenges, successes, and lessons

Implementation of the caring for providers to improve patient experience (CPIPE) intervention in Migori County, Kenya: challenges, successes, and lessons

A cluster randomized controlled trial to assess the impact of the ‘Caring for Providers to Improve Patient Experience’ intervention on person-centered maternity care in Kenya and Ghana: Study Protocol

Mixed Methods Evaluation of the ‘Caring for Providers to Improve Patient Experience’ intervention

Contact Info

Product

Resources

About