{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T18:49:36Z","timestamp":1757616576425,"version":"3.44.0"},"reference-count":49,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/100010805","name":"Forskningsr\u00e5det i Syd\u00f6stra Sverige","doi-asserted-by":"publisher","award":["Diarienummer : FORSS-752041"],"award-info":[{"award-number":["Diarienummer : FORSS-752041"]}],"id":[{"id":"10.13039\/100010805","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2019,5,16]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Many women find it difficult to choose and initiate a contraceptive method at the time of an abortion. There is a gap between regular clinical practice and existing evidence on motivational and person-centred counselling, as well as on use of long-acting reversible contraception (LARC). This study aims to describe and evaluate a Quality Improvement Collaborative (QIC) designed to enhance contraceptive services, with regard to changes in healthcare professionals\u2019 (HCPs\u2019) counselling in clinical practice, and in women\u2019s subsequent choice of, and access to, contraception.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Three multiprofessional teams working in abortion services from three hospitals in Sweden, and two women contributing with user experience, participated in a QIC during the period March\u2013November 2017. Using a case study design, we collected and analysed both quantitative and qualitative data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Teams agreed on QIC goals, including that \u226550% of women would start LARC within 30 days post-abortion, and tested multiple evidence-based changes, aided by the two women\u2019s feedback. During the QIC, participating HCPs reported that they gained new knowledge and developed skills in contraceptive counselling at the time of an abortion. The teams welcomed the development of a performance feedback system regarding women\u2019s post-abortion contraception. While the majority of women counselled during the QIC chose LARC, only 20%\u201340% received it within 30 days post-abortion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The QIC, incorporating user feedback, helped HCPs to develop capability in providing contraceptive services at the time of an abortion. Timely access to LARC remains a challenge in the present setting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2018-200299","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T14:45:15Z","timestamp":1562683515000},"page":"190-199","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Collaboratively seeking to improve contraceptive counselling at the time of an abortion: a case study of quality improvement efforts in Sweden"],"prefix":"10.1136","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3597-9004","authenticated-orcid":false,"given":"Helena","family":"Kilander","sequence":"first","affiliation":[{"name":"Department of Medical and Health Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"Department of Obstetrics and Gynaecology, Region J\u00f6nk\u00f6ping County, Eksj\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Brynhildsen","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Clinical and Experimental Medicine, Link\u00f6ping, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siw","family":"Alehagen","sequence":"additional","affiliation":[{"name":"Department of Medical and Health Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Fagerkrantz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gyneacology, Norrk\u00f6ping, Region Ostergotland, Link\u00f6ping, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Thor","sequence":"additional","affiliation":[{"name":"J\u00f6nk\u00f6ping Academy for Improvement of Health and Welfare, J\u00f6nk\u00f6ping University, J\u00f6nk\u00f6ping, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,7,9]]},"reference":[{"key":"2025090512344014000_45.3.190.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30380-4"},{"key":"2025090512344014000_45.3.190.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2014.00382.x"},{"key":"2025090512344014000_45.3.190.3","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2016-101487"},{"key":"2025090512344014000_45.3.190.4","unstructured":"Socialstyrelsen . [In Swedish: National Board of Health and Welfare], Statistics on induced abortions 2017 [In Swedish: Abortstatistik 2017]. Available: https:\/\/www.socialstyrelsen.se\/publikationer2018\/2018-5-17 [Accessed 3 Oct 2018]."},{"key":"2025090512344014000_45.3.190.5","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s11524-015-9946-3","article-title":"Repeat abortions in New York City, 2010","volume":"92","author":"Toprani","year":"2015","journal-title":"J Urban Health"},{"key":"2025090512344014000_45.3.190.6","unstructured":"Scotland N . Information Services Division Scotland. Abortion statistics, 2017. 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