Table 1.

Summary of illustrative examples of immediate postpartum LARC implementation in domains of the Consolidated Framework for Implementation Research (CFIR) and associated implementation strategies

CFIR domain	CFIR construct within domain	Immediate postpartum LARC example	Associated implementation strategy	Implementation strategy label [14]
Intervention characteristics	Evidence strength and quality	Strong evidence of safety and efficacy of immediate postpartum LARC; provider misperceptions about the impact of expulsion rates and interference with lactation	Provider outreach and education at provider professional meetings	Conduct educational meetings
Outer setting	External policies and incentives	State reimbursement strategies differ from typical reimbursement practices	ASTHO Multi-State Learning Community for immediate postpartum LARC	Create a learning collaborative
Inner setting	Readiness for implementation	Lack of devices stocked at facilities	Stocking devices in secured, automated medication dispensing system on labor and delivery floor; bed-side tackle boxes stocked and available on postpartum floor	Change physical structure and equipment
Characteristics of individuals	Personal Attributes of Patients	Women’s knowledge, preferences, and prior experiences with healthcare and contraception	Incorporate women’s perspectives about implementation efforts, specifically counseling and consent	Involve patients/consumers; obtain and use patient/consumer feedback
	Provider Self-efficacy	Lack of provider skills to insert immediate postpartum IUDs	Outreach trainings to perinatal centers with special pelvic models for hands-on training	Conduct educational outreach visits; make training dynamic
Process	Planning	Facility-specific protocols for immediate postpartum LARC are needed to support implementation	Develop toolkits to facilitate implementation in birthing facilities	Identify and prepare provider champions