Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04181021
Other study ID # 2019VCAT
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date November 25, 2019
Est. completion date January 26, 2021

Study information

Verified date August 2021
Source Ibis Reproductive Health
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Stigma around abortion and other reproductive health care is pervasive in most contexts and has been documented to have implications for the quality of care. This study aims to assess how Values Clarification and Attitude Transformation (VCAT) workshops for providers of abortion and family planning services influences service provision of abortion and family planning services, including the quality and person-centeredness of care provided. A secondary aim is to measure how provider attitudes, knowledge, and behavioral intent change over time as a result of the VCAT workshop.This study will be conducted across multiple regions in Ethiopia.


Description:

This two-arm, parallel design stratified cluster randomized control trial aims to assess how Values Clarification and Attitude Transformation (VCAT) workshops on influences service provision to clients seeking abortion and family planning services. The study aims to assess whether the experiences and quality of care of abortion clients of any age and family planning clients under the age of 20 change as a potential consequence of the VCAT workshop. A secondary aim is to measure how provider attitudes, knowledge, and behavioral intent change over time in relation to the VCAT workshops. This study will be conducted at socially franchised facilities in the Blue Star network in Ethiopia run by Marie Stopes Ethiopia. This study is a mixed methods study with two concurrent quantitative study designs that account for the need for different recruitment and data collection strategies for the two target populations, clients and providers, and a qualitative component for both target populations. The unit of randomization is the facility. Facilities will be randomized with a 1:1 ratio between intervention and control within strata defined by eligible client volume, using a disproportionate allocation by client volume. Facilities will not be blinded to treatment assignment group after baseline. To measure client experience of person-centered quality care, cross-sectional surveys with adolescent clients under 20 years old who receive family planning or abortion services, and with abortion clients of any age will be collected at two time points (before and after VCAT workshops). Clients will only be recruited from "high" volume facilities. Providers and promoters will be followed longitudinally for up to 6 months. A subsample of abortion clients who participated in the survey will be interviewed. Using preliminary analysis of provider responses, semi-structured in-depth interviews (IDI) with a subset of providers who took part in the VCAT training will be conducted. Providers from facilities who demonstrated significant change in outcomes of interest and those who did not will be purposively sample. Additionally, service volume and referrals of abortion and family planning clients will be analyzed for all facilities using routine service statistics to assess whether there was a potential change in volumes related to the VCAT workshops.


Recruitment information / eligibility

Status Completed
Enrollment 217
Est. completion date January 26, 2021
Est. primary completion date January 26, 2021
Accepts healthy volunteers No
Gender Female
Age group N/A and older
Eligibility Eligibility Criteria for clients: - Be willing to participate - Speak a language that is spoken by a study staff member - Be able to give informed consent - Have obtained abortion services (any age) or family planning services (<20 years old) from one of the participating social franchise facilities during one of the study periods Eligibility Criteria for providers: - Be trained to provide medication abortion and/or surgical abortion or be a community-based promoter employed by participating Blue Star facilities - Speak one of the study languages, including English, Amharic, Oromiffa, and Tigrinya. - Be willing to be randomized to either participate in VCAT training or be in the control arm. - Be willing to participate in the study - Be able to provide informed consent - Have a private space in the clinic for clients to complete the client survey and in-depth interview - Not have participated in 2018 pilot VCAT trainings - Work at a facility that has been a part of the social franchise network for at least six months prior to the study Eligibility criteria for promoters - Speak a language spoken by a study staff member - Be willing to participate in the study - Be willing to be randomized to participate in the VCAT training for community-based promoters

Study Design


Related Conditions & MeSH terms


Intervention

Behavioral:
Values Clarification and Attitudes Transformation (VCAT) Workshop
VCAT is a participatory workshop aimed to provide accurate information about abortion and family planning and space to engage in critical self-reflection, provoke dialogue on beliefs, values and professional ethics and responsibilities around providing abortion and contraceptive care, and provide a deeper understanding of the range of circumstances in which women seek abortion and contraception.

Locations

Country Name City State
Ethiopia Blue Star facilities Multiple Addis Ababa, Oromiya, Tigray, Snnpr, Amhara

Sponsors (3)

Lead Sponsor Collaborator
Ibis Reproductive Health Marie Stopes Ethiopia, Marie Stopes International

Country where clinical trial is conducted

Ethiopia, 

Outcome

Type Measure Description Time frame Safety issue
Primary Person-centered abortion and family planning scale A validated scale measuring the dimensions of respectful and supportive care, communication and autonomy, and structural quality. The score is on a scale from 0 to 69 and higher scores represent more person-centered care. 1.5 months
Primary Percent of clients reporting essential person-centered care components Percent of clients reporting having received kind and compassionate care from their provider, not feeling like they were treated differently based on age, marital status, or other characteristic, not feeling judged by their provider, having received respectful care, and feeling involved in the decisions around their care 1.5 months
Secondary Percent of providers that agree they could support a woman having an abortion or using family planning if they didn't agree with their decision Agreement with the following four measures that capture agreement with providing abortion and family planning even in cases where providers may have conflicted values: I feel comfortable performing a safe abortion procedure for anyone who requests it regardless of the reason,I support a client's decision to have a safe abortion even if I didn't agree with her decision, I could provide family planning to a client even if I thought they were too young to be using contraception, I feel comfortable removing IUDs or implants even if I think the client shouldn't have it removed 6 months
Secondary Level of knowledge around interpretation for legal grounds for abortion in Ethiopia Proportion knowing the legal indications for abortion in Ethiopia, the legal grounds for denial of abortion services, and the correct interpretation of the law around abortion services for married women, minors, women seeking services under the rape and incest clause, and women requesting an abortion under the grounds that the pregnancy is a risk to their health 6 months
Secondary Volume of patients Volume of abortion and family planning clients under age 20 1 year
Secondary Patient referrals by promoters Number of referrals for safe abortion care and for family planning among clients under the age of 20 1 year
Secondary Percent of providers who believe that women should have access to safe, comprehensive abortion care regardless of COVID-19 in Ethiopia 9 months
See also
  Status Clinical Trial Phase
Completed NCT02577601 - Impact of Combined Hormonal Contraceptives on UPA Phase 4
Completed NCT03153644 - Improving Contraceptive Care for Women With Medical Conditions
Completed NCT04112095 - Adherence With Continuous-dose Oral Contraceptive: Evaluation of Self-Selection and Use Phase 3
Recruiting NCT05521646 - Implementing Best Practice Postpartum Contraceptive Services Through a Quality Improvement Initiative N/A
Active, not recruiting NCT04291001 - Ovarian Function With ENG Implant and UPA Use Early Phase 1
Completed NCT04568980 - Assessment of Contraceptive Safety and Effectiveness in Cystic Fibrosis
Completed NCT03438682 - Real World Effectiveness and Safety of Hysteroscopic (Essure®) Compared to Laparoscopic Sterilization
Active, not recruiting NCT01948882 - Evaluation of Safety and Effectiveness of the Essure (Model ESS505) Device to Prevent Pregnancy in Women N/A
Enrolling by invitation NCT04997499 - Adolescent Subcutaneous (SQ) Injection Video Validation N/A
Recruiting NCT03589040 - Darunavir and Rilpivirine Interactions With Etonogestrel Contraceptive Implant Phase 2
Completed NCT04463680 - Rifampin and the Contraceptive Implant Phase 4
Completed NCT03154125 - Sayana® Press Extension Study Phase 3
Withdrawn NCT03725358 - A Cluster-RCT to Increase the Uptake of LARCs Among Adolescent Females and Young Women in Cameroon. N/A
Completed NCT02957630 - "E4/DRSP Endocrine Function, Metabolic Control and Hemostasis Study" Phase 1/Phase 2
Completed NCT02718222 - Impact and Performance of Institutionalizing Immediate Post-partum IUD Services N/A
Completed NCT02456584 - Pharmacodynamics and Pharmacokinetics Study of Existing DMPA Contraceptive Methods Phase 1
Recruiting NCT02121067 - LNG-IUS at 2 Weeks Postpartum Phase 4
Terminated NCT02169869 - Immediate Postplacental IUD Insertion N/A
Recruiting NCT02292056 - Medication Safety and Contraceptive Counseling for Reproductive Aged Women With Psychiatric Conditions N/A
Withdrawn NCT01930994 - Kenya Sino-implant (II) PK Study N/A