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dc.contributor.authorKrasne, Margaret
dc.date.accessioned2019-12-04T08:29:18Z
dc.date.created2019-05
dc.date.issued2019-08-15
dc.date.submitted2019
dc.identifier.citationKrasne, Margaret. 2019. Integration of the Opportunity-Ability-Motivation Behavior Change Framework Into a Coaching-Based WHO Safe Childbirth Checklist Program in India. Doctoral dissertation, Harvard Medical School.
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:41971518*
dc.description.abstractObjective: To evaluate whether integration of the Opportunity-Ability-Motivation plus Supplies (OAMS) framework into coaching improved the delivery of essential birth practices in a low-resource setting. Methods: This prospective mixed-methods study used routine coaching visit data obtained from the first eight intervention facilities of the BetterBirth trial in Uttar Pradesh, India, between December 19, 2014, and October 21, 2015. The 8-month intervention was peer coaching that integrated the OAMS framework to support uptake of the WHO Safe Childbirth Checklist. Descriptive statistics were used to measure nonadherence to essential birth practices. The frequency and accuracy of coaches’ coding of barriers and the appropriateness of chosen resolution strategies to measure feasibility, acceptability, and fidelity of using OAMS, were assessed. Results: Coaches observed 666 deliveries, including 12 602 practices. Overall, essen- tial practice nonadherence decreased from 15.6% (262/1675 practices observed) to 4.5% (4/88 practices) (P<0.001). Of the 1048 barriers identified, opportunity (556 [53.1%]) and motivation (287 [27.4%]) were the most frequently reported categories; the frequency of both decreased over time (P=0.003 and P<0.001, respectively). The coaches appropriately categorized 930 (99.8%) of 932 barriers and provided an appro- priate strategy for 800 (85.8%). The commonest reason for unaddressed barriers was lack of coaching opportunities. Conclusion: Successful integration of OAMS framework into delivery attendant coach- ing enabled coaches to rapidly diagnose barriers to practice adherence and develop responsive strategies. ClinicalTrials.gov: NCT2148952 (WHO Universal Trial Number: U11111-1315-647).
dc.description.sponsorshipScholarly Project
dc.format.mimetypeapplication/pdf
dc.language.isoen
dash.licenseLAA
dc.subjectchecklist
dc.subjectchildbirth
dc.subjectimplementation
dc.subjectevaluation
dc.titleIntegration of the Opportunity-Ability-Motivation Behavior Change Framework Into a Coaching-Based WHO Safe Childbirth Checklist Program in India
dc.typeThesis or Dissertation
dash.depositing.authorKrasne, Margaret
dc.date.available2019-12-04T08:29:18Z
thesis.degree.date2019
thesis.degree.grantorHarvard Medical School
thesis.degree.grantorHarvard Medical School
thesis.degree.levelDoctoral
thesis.degree.levelDoctoral
thesis.degree.nameDoctor of Medicine
thesis.degree.nameDoctor of Medicine
dc.type.materialtext
dash.identifier.vireo
dash.author.emailmdkrasne@gmail.com


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