Mapping of Triangulated Findings Using BCW to Identify Proposed Implementation Strategies for the E-MOTIVE Intervention
Summary of Findings | COM-B | Intervention Types From BCW | Proposed Implementation Strategies for E-MOTIVE Trial Context |
---|---|---|---|
Need for earlier PPH detection from accurate blood loss measurement |
Capability(physical and psychological) |
EducationTrainingEnablement |
Training of new skills to use the calibrated drape: new blood loss collection and measurement tool to prompt and facilitate earlier detection.Training of core or new skills to deliver MOTIVE bundle including simulation practice drills. |
Need for training on using the new calibrated drape | |||
Uncertainty about administering tranexamic acid when not trained to do so | |||
Using the intervention brings challenges for staff including new skills and confidence building to deliver intervention as intended | |||
Need for sufficient staff and adequate stocks of PPH drugs and equipment | Opportunity (social and environmental) |
Environmental restructuringModelingEnablement |
Introduce PPH trolley or carry case to organize PPH drugs and equipment in 1 place accompanied by a checklist detailing the medicines and equipment to be stocked (country and site specific).Team-based training with simulation practice and drills to encourage and enable better coordination, teamwork, and communication when managing a PPH. |
Need for teamwork to implement intervention | |||
Intervention use will bring about positive changes to PPH treatment | Motivation (reflective) |
EducationPersuasionModelingEnablement |
Introduce audit and feedback to monitor MOTIVE bundle uptake.Introduce a person in leadership role to “champion” the E-MOTIVE intervention implementation. |
Uncertainty about how using the calibrated drape will fit in with current methods for collecting blood | |||
Perceptions that intervention use can potentially reduce PPH mortality |
Abbreviations: BCW, Behavior Change Wheel; COM-B, capability, opportunity, motivation-behavior; E-MOTIVE, early detection of PPH using a calibrated drape, followed by massage of uterus, oxytocic drugs administration, tranexamic acid administration, intravenous fluids administration, examination for identifying and managing the source of bleeding, and escalation to more advanced care, if bleeding continues despite treatment; PPH, postpartum hemorrhage.