Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial
Objective To determine the effectiveness of a client or care‐provider strategy to improve the implementation of external cephalic version. Design Cluster randomized controlled trial. Setting Twenty‐five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands....
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Veröffentlicht in: | Acta obstetricia et gynecologica Scandinavica 2015-05, Vol.94 (5), p.518-526 |
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container_title | Acta obstetricia et gynecologica Scandinavica |
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creator | Vlemmix, Floortje Rosman, Ageeth N. Rijnders, Marlies E. Beuckens, Antje Opmeer, Brent C. Mol, Ben W.J. Kok, Marjolein Fleuren, Margot A.H. |
description | Objective
To determine the effectiveness of a client or care‐provider strategy to improve the implementation of external cephalic version.
Design
Cluster randomized controlled trial.
Setting
Twenty‐five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands.
Population
Singleton breech presentation from 32 weeks of gestation onwards.
Methods
We randomized clusters to a client strategy (written information leaflets and decision aid), a care‐provider strategy (1‐day counseling course focused on knowledge and counseling skills), a combined client and care‐provider strategy and care‐as‐usual strategy. We performed an intention‐to‐treat analysis.
Main outcome measures
Rate of external cephalic version in various strategies. Secondary outcomes were the percentage of women counseled and opting for a version attempt.
Results
The overall implementation rate of external cephalic version was 72% (1169 of 1613 eligible clients) with a range between clusters of 8–95%. Neither the client strategy (OR 0.8, 95% CI 0.4–1.5) nor the care‐provider strategy (OR 1.2, 95% CI 0.6–2.3) showed significant improvements. Results were comparable when we limited the analysis to those women who were actually offered intervention (OR 0.6, 95% CI 0.3–1.4 and OR 2.0, 95% CI 0.7–4.5).
Conclusions
Neither a client nor a care‐provider strategy improved the external cephalic version implementation rate for breech presentation, neither with regard to the number of version attempts offered nor the number of women accepting the procedure. |
doi_str_mv | 10.1111/aogs.12609 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1673376887</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1673376887</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4319-d83dde419887555f9ded78cb150f69c6117055d9b9c7d764cbb8a1686bbc93873</originalsourceid><addsrcrecordid>eNp9kU1vFSEUhonR2Gt14w8wJG6MyVSYDz7cNY1eG5vbxI-4JAycqVRmuAJTW3-Cv1rm3rYLF7KBA8_7wuFF6DklR7SMNzpcpCNaMyIfoBVlhFSkpfVDtCKE0Io1rTxAT1K6LFXNW_EYHdQdEzXnYoX-nI5bDyNMWWcXJhwGbLwrJb6CmOaEjY5QbWO4chYiTjnqDBcOEs4Bu3E5AAzXGeKkPTaw_a69MzvxYrfQ6S3WxXROBSobkw2j-w0WmzDlGLwvyxyd9k_Ro0H7BM9u50P09f27LycfqrPz9enJ8Vll2obKyorGWmipFIJ3XTdIC5YL09OODEwaRiknXWdlLw23nLWm74WmTLC-N7IRvDlEr_a-5fE_Z0hZjS4Z8F5PEOakKONNw5nYoS__QS_DvHS6o2rO6pbVhXq9p0wMKUUY1Da6UccbRYlaElJLQmqXUIFf3FrO_Qj2Hr2LpAB0D_xyHm7-Y6WOz9ef70yrvcaVT76-1-j4Q5VmeKe-bdblhs2ndiM-qnXzFzqyrVI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1672762462</pqid></control><display><type>article</type><title>Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Vlemmix, Floortje ; Rosman, Ageeth N. ; Rijnders, Marlies E. ; Beuckens, Antje ; Opmeer, Brent C. ; Mol, Ben W.J. ; Kok, Marjolein ; Fleuren, Margot A.H.</creator><creatorcontrib>Vlemmix, Floortje ; Rosman, Ageeth N. ; Rijnders, Marlies E. ; Beuckens, Antje ; Opmeer, Brent C. ; Mol, Ben W.J. ; Kok, Marjolein ; Fleuren, Margot A.H.</creatorcontrib><description>Objective
To determine the effectiveness of a client or care‐provider strategy to improve the implementation of external cephalic version.
Design
Cluster randomized controlled trial.
Setting
Twenty‐five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands.
Population
Singleton breech presentation from 32 weeks of gestation onwards.
Methods
We randomized clusters to a client strategy (written information leaflets and decision aid), a care‐provider strategy (1‐day counseling course focused on knowledge and counseling skills), a combined client and care‐provider strategy and care‐as‐usual strategy. We performed an intention‐to‐treat analysis.
Main outcome measures
Rate of external cephalic version in various strategies. Secondary outcomes were the percentage of women counseled and opting for a version attempt.
Results
The overall implementation rate of external cephalic version was 72% (1169 of 1613 eligible clients) with a range between clusters of 8–95%. Neither the client strategy (OR 0.8, 95% CI 0.4–1.5) nor the care‐provider strategy (OR 1.2, 95% CI 0.6–2.3) showed significant improvements. Results were comparable when we limited the analysis to those women who were actually offered intervention (OR 0.6, 95% CI 0.3–1.4 and OR 2.0, 95% CI 0.7–4.5).
Conclusions
Neither a client nor a care‐provider strategy improved the external cephalic version implementation rate for breech presentation, neither with regard to the number of version attempts offered nor the number of women accepting the procedure.</description><identifier>ISSN: 0001-6349</identifier><identifier>EISSN: 1600-0412</identifier><identifier>DOI: 10.1111/aogs.12609</identifier><identifier>PMID: 25682778</identifier><identifier>CODEN: AOGSAE</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Breech delivery ; breech presentation ; Breech Presentation - therapy ; Cluster Analysis ; Decision Support Techniques ; Directive Counseling ; external cephalic version ; Female ; Humans ; implementation ; Middle Aged ; mode of delivery ; Netherlands ; Outcome Assessment (Health Care) ; Patient Education as Topic ; Pregnancy ; Treatment Outcome ; Version, Fetal ; Young Adult</subject><ispartof>Acta obstetricia et gynecologica Scandinavica, 2015-05, Vol.94 (5), p.518-526</ispartof><rights>2015 Nordic Federation of Societies of Obstetrics and Gynecology</rights><rights>2015 Nordic Federation of Societies of Obstetrics and Gynecology.</rights><rights>Acta Obstetricia et Gynecologica Scandinavica © 2015 Nordic Federation of Societies of Obstetrics and Gynecology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4319-d83dde419887555f9ded78cb150f69c6117055d9b9c7d764cbb8a1686bbc93873</citedby><cites>FETCH-LOGICAL-c4319-d83dde419887555f9ded78cb150f69c6117055d9b9c7d764cbb8a1686bbc93873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Faogs.12609$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Faogs.12609$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27928,27929,45578,45579</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25682778$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vlemmix, Floortje</creatorcontrib><creatorcontrib>Rosman, Ageeth N.</creatorcontrib><creatorcontrib>Rijnders, Marlies E.</creatorcontrib><creatorcontrib>Beuckens, Antje</creatorcontrib><creatorcontrib>Opmeer, Brent C.</creatorcontrib><creatorcontrib>Mol, Ben W.J.</creatorcontrib><creatorcontrib>Kok, Marjolein</creatorcontrib><creatorcontrib>Fleuren, Margot A.H.</creatorcontrib><title>Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial</title><title>Acta obstetricia et gynecologica Scandinavica</title><addtitle>Acta Obstet Gynecol Scand</addtitle><description>Objective
To determine the effectiveness of a client or care‐provider strategy to improve the implementation of external cephalic version.
Design
Cluster randomized controlled trial.
Setting
Twenty‐five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands.
Population
Singleton breech presentation from 32 weeks of gestation onwards.
Methods
We randomized clusters to a client strategy (written information leaflets and decision aid), a care‐provider strategy (1‐day counseling course focused on knowledge and counseling skills), a combined client and care‐provider strategy and care‐as‐usual strategy. We performed an intention‐to‐treat analysis.
Main outcome measures
Rate of external cephalic version in various strategies. Secondary outcomes were the percentage of women counseled and opting for a version attempt.
Results
The overall implementation rate of external cephalic version was 72% (1169 of 1613 eligible clients) with a range between clusters of 8–95%. Neither the client strategy (OR 0.8, 95% CI 0.4–1.5) nor the care‐provider strategy (OR 1.2, 95% CI 0.6–2.3) showed significant improvements. Results were comparable when we limited the analysis to those women who were actually offered intervention (OR 0.6, 95% CI 0.3–1.4 and OR 2.0, 95% CI 0.7–4.5).
Conclusions
Neither a client nor a care‐provider strategy improved the external cephalic version implementation rate for breech presentation, neither with regard to the number of version attempts offered nor the number of women accepting the procedure.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Breech delivery</subject><subject>breech presentation</subject><subject>Breech Presentation - therapy</subject><subject>Cluster Analysis</subject><subject>Decision Support Techniques</subject><subject>Directive Counseling</subject><subject>external cephalic version</subject><subject>Female</subject><subject>Humans</subject><subject>implementation</subject><subject>Middle Aged</subject><subject>mode of delivery</subject><subject>Netherlands</subject><subject>Outcome Assessment (Health Care)</subject><subject>Patient Education as Topic</subject><subject>Pregnancy</subject><subject>Treatment Outcome</subject><subject>Version, Fetal</subject><subject>Young Adult</subject><issn>0001-6349</issn><issn>1600-0412</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1vFSEUhonR2Gt14w8wJG6MyVSYDz7cNY1eG5vbxI-4JAycqVRmuAJTW3-Cv1rm3rYLF7KBA8_7wuFF6DklR7SMNzpcpCNaMyIfoBVlhFSkpfVDtCKE0Io1rTxAT1K6LFXNW_EYHdQdEzXnYoX-nI5bDyNMWWcXJhwGbLwrJb6CmOaEjY5QbWO4chYiTjnqDBcOEs4Bu3E5AAzXGeKkPTaw_a69MzvxYrfQ6S3WxXROBSobkw2j-w0WmzDlGLwvyxyd9k_Ro0H7BM9u50P09f27LycfqrPz9enJ8Vll2obKyorGWmipFIJ3XTdIC5YL09OODEwaRiknXWdlLw23nLWm74WmTLC-N7IRvDlEr_a-5fE_Z0hZjS4Z8F5PEOakKONNw5nYoS__QS_DvHS6o2rO6pbVhXq9p0wMKUUY1Da6UccbRYlaElJLQmqXUIFf3FrO_Qj2Hr2LpAB0D_xyHm7-Y6WOz9ef70yrvcaVT76-1-j4Q5VmeKe-bdblhs2ndiM-qnXzFzqyrVI</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Vlemmix, Floortje</creator><creator>Rosman, Ageeth N.</creator><creator>Rijnders, Marlies E.</creator><creator>Beuckens, Antje</creator><creator>Opmeer, Brent C.</creator><creator>Mol, Ben W.J.</creator><creator>Kok, Marjolein</creator><creator>Fleuren, Margot A.H.</creator><general>Blackwell Publishing Ltd</general><general>John Wiley & Sons, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201505</creationdate><title>Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial</title><author>Vlemmix, Floortje ; Rosman, Ageeth N. ; Rijnders, Marlies E. ; Beuckens, Antje ; Opmeer, Brent C. ; Mol, Ben W.J. ; Kok, Marjolein ; Fleuren, Margot A.H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4319-d83dde419887555f9ded78cb150f69c6117055d9b9c7d764cbb8a1686bbc93873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Breech delivery</topic><topic>breech presentation</topic><topic>Breech Presentation - therapy</topic><topic>Cluster Analysis</topic><topic>Decision Support Techniques</topic><topic>Directive Counseling</topic><topic>external cephalic version</topic><topic>Female</topic><topic>Humans</topic><topic>implementation</topic><topic>Middle Aged</topic><topic>mode of delivery</topic><topic>Netherlands</topic><topic>Outcome Assessment (Health Care)</topic><topic>Patient Education as Topic</topic><topic>Pregnancy</topic><topic>Treatment Outcome</topic><topic>Version, Fetal</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vlemmix, Floortje</creatorcontrib><creatorcontrib>Rosman, Ageeth N.</creatorcontrib><creatorcontrib>Rijnders, Marlies E.</creatorcontrib><creatorcontrib>Beuckens, Antje</creatorcontrib><creatorcontrib>Opmeer, Brent C.</creatorcontrib><creatorcontrib>Mol, Ben W.J.</creatorcontrib><creatorcontrib>Kok, Marjolein</creatorcontrib><creatorcontrib>Fleuren, Margot A.H.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Acta obstetricia et gynecologica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vlemmix, Floortje</au><au>Rosman, Ageeth N.</au><au>Rijnders, Marlies E.</au><au>Beuckens, Antje</au><au>Opmeer, Brent C.</au><au>Mol, Ben W.J.</au><au>Kok, Marjolein</au><au>Fleuren, Margot A.H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial</atitle><jtitle>Acta obstetricia et gynecologica Scandinavica</jtitle><addtitle>Acta Obstet Gynecol Scand</addtitle><date>2015-05</date><risdate>2015</risdate><volume>94</volume><issue>5</issue><spage>518</spage><epage>526</epage><pages>518-526</pages><issn>0001-6349</issn><eissn>1600-0412</eissn><coden>AOGSAE</coden><abstract>Objective
To determine the effectiveness of a client or care‐provider strategy to improve the implementation of external cephalic version.
Design
Cluster randomized controlled trial.
Setting
Twenty‐five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands.
Population
Singleton breech presentation from 32 weeks of gestation onwards.
Methods
We randomized clusters to a client strategy (written information leaflets and decision aid), a care‐provider strategy (1‐day counseling course focused on knowledge and counseling skills), a combined client and care‐provider strategy and care‐as‐usual strategy. We performed an intention‐to‐treat analysis.
Main outcome measures
Rate of external cephalic version in various strategies. Secondary outcomes were the percentage of women counseled and opting for a version attempt.
Results
The overall implementation rate of external cephalic version was 72% (1169 of 1613 eligible clients) with a range between clusters of 8–95%. Neither the client strategy (OR 0.8, 95% CI 0.4–1.5) nor the care‐provider strategy (OR 1.2, 95% CI 0.6–2.3) showed significant improvements. Results were comparable when we limited the analysis to those women who were actually offered intervention (OR 0.6, 95% CI 0.3–1.4 and OR 2.0, 95% CI 0.7–4.5).
Conclusions
Neither a client nor a care‐provider strategy improved the external cephalic version implementation rate for breech presentation, neither with regard to the number of version attempts offered nor the number of women accepting the procedure.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>25682778</pmid><doi>10.1111/aogs.12609</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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ispartof | Acta obstetricia et gynecologica Scandinavica, 2015-05, Vol.94 (5), p.518-526 |
issn | 0001-6349 1600-0412 |
language | eng |
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source | MEDLINE; Access via Wiley Online Library |
subjects | Adolescent Adult Breech delivery breech presentation Breech Presentation - therapy Cluster Analysis Decision Support Techniques Directive Counseling external cephalic version Female Humans implementation Middle Aged mode of delivery Netherlands Outcome Assessment (Health Care) Patient Education as Topic Pregnancy Treatment Outcome Version, Fetal Young Adult |
title | Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial |
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