Table 4 Top ten research topics most selected to prioritize for future study in four categories
|  | Number of survey #2 respondents who selected this practice in the top 5 (n = 48) | Mean ranking of priority, scales 1–5 |
|---|---|---|
Category A. Contextual determinants likely to exert the greatest influence on implementation in maternity care | ||
1. Reimbursement policies | 37 | 2.55 |
2. Implicit bias and racism | 33 | 2.29 |
3. Unit culture (norms, values, and basic assumptions) | 26 | 3.08 |
4. Organizational capacity for quality improvement/implementation | 26 | 2.86 |
5. Resources of communities (e.g., internet access, transportation) | 23 | 3.14 |
6. Stigma for stigmatized conditions/procedures (e.g., abortion, SUD, mental health) | 19 | 2.84 |
7. The medico-legal environment | 16 | 3.75 |
8. Provider workload | 16 | 2.93 |
9. Provider knowledge about a clinical practice | 9 | 3.13 |
10. Infrastructure of the birth setting | 8 | 3.00 |
Category B. Implementation strategies most important to test for effectiveness in maternity care | ||
1. Building a coalition of partners in the implementation effort | 28 | 2.68 |
2. Altering incentives to promote adoption of practices | 25 | 2.30 |
3. Facilitation (e.g., guidance and interactive problem solving to support clinical practice change) | 22 | 3.19 |
4. Audit provider performance and provide feedback | 20 | 2.94 |
5. Perinatal quality improvement collaboratives | 18 | 2.82 |
6. Preparing patients to be active participants | 18 | 3.12 |
7. Accessing new funding to facilitate implementation (e.g., federal grants) | 17 | 2.94 |
8. Standardized protocols | 17 | 2.65 |
9. Electronic medical record changes | 14 | 3.77 |
10. Digital decision support tools | 13 | 3.18 |
Category C. Research questions related to strategies that would most help advance the field of implementation research in maternal health | ||
1. How can implementation strategies be selected and/or adopted specifically to promote equity? | 36 | 2.36 |
2. What implementation strategies lead to sustainability in the improved implementation of evidence-based practices in maternity care? | 33 | 2.61 |
3. What are best practices for engaging patients and communities in implementation work, to optimize patient-centeredness and equity? | 30 | 2.42 |
4. What process should be followed to build multi-component implementation interventions (i.e., bundles of strategies) in maternity care? | 24 | 3.23 |
5. How can resource-intensive implementation strategies be adapted to promote effectiveness and sustainability? | 20 | 3.67 |
6. What is the effectiveness of individual implementation strategies in maternity care settings in the USA? | 16 | 3.00 |
7. What is the acceptability of various implementation strategies among maternity care providers? | 16 | 3.07 |
8. How can we best incentivize QI leaders to adopt an implementation science approach (e.g., measure barriers/facilitators, map to strategies, measure effectiveness)? | 14 | 3.11 |
9. How does the relative effectiveness of implementation strategies vary by evidence-based practice? | 13 | 3.38 |
10. What is the effectiveness of adaptive implementation strategies on the use of evidence-based practices? | 12 | 3.44 |
Category D. Research goals related to methods and measures that would most help advance the field of implementation research in maternal health | ||
1. Improve the extent to which implementation science frameworks and measures address social determinants of health and equity | 28 | 1.96 |
2. Develop approaches for involving patients in implementation and implementation research | 27 | 2.87 |
3. Integrate implementation science methods with routine QI approaches in maternity care | 24 | 3.09 |
4. Develop implementation outcomes measures that capture outcomes for both mother and baby | 20 | 1.81 |
5. Generate rapid measures that reduce participant burden and increase participation among maternity care stakeholders | 20 | 2.89 |
6. Develop community- and patient-level measures for determinants and outcomes of implementation | 20 | 3.21 |
7. Adapt determinants frameworks to capture common determinants of implementation in maternity care settings | 16 | 2.94 |
8. Develop approaches to measure and assess costs and heterogeneous reimbursements in maternity care | 13 | 4.00 |
9. Incorporate common transitions of care for maternity patients in implementation frameworks and measures | 11 | 3.22 |
10. Assess and model contextual moderators of implementation strategies and intervention effects | 11 | 3.80 |