Caring for Providers to Improve Patient Experience Study Phase 2 in Migori County
NCT ID: NCT05019131
Last Updated: 2025-05-07
Study Results
Results available
Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.
View full resultsBasic Information
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Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
83 participants
Study Classification
INTERVENTIONAL
Study Start Date
2021-08-16
Study Completion Date
2023-08-31
Brief Summary
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The activities described in this proposal are aimed at addressing health care provider stress and unconscious bias to improve quality of maternal health care, particularly related to the person-centered dimensions of care-i.e. care that is respectful and responsive to women's needs, preferences, and values. The investigators focus on health provider stress and unconscious bias because they are key drivers of poor-quality care that are often not addressed in interventions designed to improve quality of maternal health care. The investigators plan to (1) design an intervention that enables providers to identify and manage their stress and unconscious bias; (2) pilot the intervention to assess its feasibility and acceptability; and (3) assess preliminary effect of the intervention on: (a) provider knowledge, attitudes, and behaviors related to stress and unconscious bias; and (b) provider stress levels.
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Detailed Description
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Poor person-centered maternal health care (PCMHC) contributes to high maternal and neonatal mortality in sub-Saharan Africa (SSA), and disparities in PCMHC are driving disparities in use of maternal health services., However, little research exists on how to improve PCMHC and reduce disparities. The investigators seek to fill this gap with this project. They propose targeting health provider stress and unconscious bias as fundamental factors driving both poor PCMHC and disparities in PCMHC. Health care provider stress and unconscious bias are important to consider because: (1) providers in low-resource settings often work under very stressful conditions; (2) unconscious bias is prevalent in every society including SSA; and (3) these factors are mutually reinforcing drivers of poor quality care and disparities in person-centered care. In the first phase of the project (CPIPE1), they conducted research to examine (1) the factors associated with PCMHC and identified provider stress and unconscious bias as key contributing factors. They also examined the levels of provider stress and unconscious bias and the types of stressors and biases in Migori County, Kenya. The results of that research will be used to inform this phase (CPIPE2), the aims of which are to: (1) design a multicomponent theory and evidence-based intervention that enables providers to identify and manage their stress and unconscious bias; (2) pilot the intervention to assess its feasibility and acceptability; and (3) assess preliminary effect of the intervention on: (a) provider knowledge, attitudes, and behaviors related to stress and unconscious bias; and (b) provider stress levels using a pretest-posttest control group design. They will use the results of the pilot to refine the intervention and develop an R01 proposal for a multi-site evaluation with a larger sample and longer follow up to assess impact on PCMHC. This study will yield valuable information to inform quality improvement efforts for PCMHC.
Conditions
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Maternal Health
Mental Health
Healthcare Provider
Adverse Outcomes
Stress
Stress, Psychological
Stress, Emotional
Quality of Care
Burnout
Discrimination, Social
Study Design
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Allocation Method
NON_RANDOMIZED
Intervention Model
PARALLEL
Primary Study Purpose
HEALTH_SERVICES_RESEARCH
Blinding Strategy
NONE
Study Groups
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Intervention arm
1. Training: The investigators will develop a training for providers that addresses the following topics: Stress \& positive coping mechanisms; Unconscious bias awareness and mitigation; Person-centered maternity care; Dealing with difficult situations; and Teamwork and communication;
2. Peer support and mentorship: The investigators will identify what works best for these groups in terms of group composition, size, and how the groups want to interact.
3. Leadership engagement: To ensure leadership buy in, support and sustainability of the intervention, the investigators will engage leadership of the County.
4. Embedded champions: To facilitate ongoing engagement, the investigators will identify local leaders, and invite them to training where they will be taught how to facilitate peer support groups and serve as champions.
Group Type
EXPERIMENTAL
Training
Intervention Type
BEHAVIORAL
trainings to reduce conscious bias and stress
Peer support and mentorship
Intervention Type
BEHAVIORAL
facilitated peer and mentorship opportunities
Leadership engagement
Intervention Type
BEHAVIORAL
Engaged leadership at the county and facility levels
Embedded champions
Intervention Type
BEHAVIORAL
Facilitate local champions to promote intervention
Control arm
Will not receive any training during the intervention period
Group Type
NO_INTERVENTION
No interventions assigned to this group
Interventions
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Training
trainings to reduce conscious bias and stress
Intervention Type
BEHAVIORAL
Peer support and mentorship
facilitated peer and mentorship opportunities
Intervention Type
BEHAVIORAL
Leadership engagement
Engaged leadership at the county and facility levels
Intervention Type
BEHAVIORAL
Embedded champions
Facilitate local champions to promote intervention
Intervention Type
BEHAVIORAL
Eligibility Criteria
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Inclusion Criteria
* Providers working in maternity units of the intervention facilities are all eligible.
Exclusion Criteria
* Inability to attend scheduled training.
Minimum Eligible Age
18 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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Kenya Medical Research Institute
OTHER
Sponsor Role
collaborator
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
NIH
Sponsor Role
collaborator
University of California, San Francisco
OTHER
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Patience Afulani, PhD, MD, MPH
Role: PRINCIPAL_INVESTIGATOR
University of California, San Francisco
Locations
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Migori County hospital and sub-county hospitals
Migori, , Kenya
Site Status
Countries
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Kenya
References
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Provided Documents
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Document Type: Study Protocol and Statistical Analysis Plan
Document Type: Informed Consent Form
Other Identifiers
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A135552
Identifier Type: -
Identifier Source: org_study_id
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