Contextual factors influencing the implementation of the obstetrics hemorrhage initiative in Florida.

OBJECTIVE: The purpose of this study was to explore the multilevel contextual factors that influenced the implementation of the Obstetric Hemorrhage Initiative (OHI) among hospitals in Florida. STUDY DESIGN: A qualitative evaluation was conducted via in-depth interviews with multidisciplinary hospital staff (n=50) across 12 hospitals. Interviews were guided by the Consolidated Framework for Implementation Research and analyzed in Atlas.ti using rigorous qualitative analysis procedures. RESULT: Factors influencing OHI implementation were present across process (leadership engagement; engaging people; planning; reflecting), inner setting (for example, knowledge/beliefs; resources; communication; culture) and outer setting (for example, cosmopolitanism) levels. Moreover, factors interacted across levels and were not mutually exclusive. Leadership and staff buy-in emerged as important components influencing OHI implementation across disciplines. CONCLUSION: Key contextual factors found to influence OHI implementation experiences can be useful in informing future quality improvement interventions given the institutional and provider-level behavioral changes needed to account for evolving the best practices in perinatology.

Teaching women's health from a public health perspective: development of an innovative undergraduate course.

INTRODUCTION: A review of women's health courses across academic disciplines revealed gaps in addressing the full range of issues that impact women throughout the lifespan. METHODS: We designed an undergraduate course in women's health that is taught from a public health perspective, but includes a multidisciplinary approach that addresses health issues across the lifespan. Details related to syllabi, curriculum development, and course delivery are reviewed. RESULTS: Curriculum and topics were developed by reviewing existing women's health courses and identifying strengths and gaps. Course readings are drawn from a textbook, peer-reviewed scientific literature, news/media articles, and popular press. Classes included a mix of lectures, class/group discussions, group activities, videos and/or short media clips, student presentations (individual and group), and invited guest speakers. Of special interest are the innovative and varied student assessments that this course offers and the breadth of knowledge and critical skills that students acquire. DISCUSSION: Although the particular health topics women face may vary by geographic location, the theoretical underpinnings and lifespan approach will stay the same. Students learn health literacy and critical appraisal skills, appreciate the many dimensions of health, and recognize diverse antecedent factors and disparities that influence health. Utilizing this type of course structure, coupled with innovative and flexible student assignments, would be applicable to other courses in any country or setting such as men's, population, or mental health. The presented framework and experiences can facilitate college health professionals in future course development activities and assist in enabling students to be informed health advocates.