ARM@DA: A realist inquiry into maternity care at a distance
Study of remote consultation in maternity care
Funder:NIHR Health Services and Delivery Research Programme
The project: The ARM@DA project is an evidence synthesis project using a realist approach. The project aim is to understand how digital clinical consultations can work to support safe, personalised and appropriate maternity care and to clarify when they might be most appropriately used, for whom, when, and in what contexts.
During the Covid-19 pandemic, maternity services shifted many of their appointments and contacts from face to face to ‘remote’ by using telephone calls, text messages and video calls, supported by various digital platforms. Services are now considering whether and how to continue using digital technology for maternity contacts. It is vital that future services are based on a good understanding of service user’s and health professionals’ experiences of remotely delivered care. In particular, it is critical that remote consultations do not exacerbate inequalities in care.
This project aims to review the research evidence on remote consultation in maternity care to identify best practice and to understand implementation challenges. The project will be informed by extensive stakeholder engagement at every stage.
A realist synthesis will be conducted over an 18-month period in 4 highly iterative phases: (i) refining the review focus and generating initial programme theories, (ii) exploring and developing the programme theories in light of evidence, (iii) testing/refining the programme theories, and, (iv) constructing actionable recommendations in ways that can be rapidly adopted into practice and clearly define a future research agenda. The review will draw upon three sources of evidence: (i) literature (published and unpublished research, audit, evaluation and theory), (ii) stakeholder expertise and insights, and (iii) key informant interviews. The review will be registered on Prospero and will follow the RAMESES (Realist and Meta-narrative Evidence Synthesis Evolving Standards) quality procedures and will comply with RAMESES reporting guidance.
This review will create an evidence-based and theoretically informed framework for safe, appropriate and acceptable digital consultations in maternity care that can be used by NHS stakeholders to guide future service development, policy, practice and research.
For more information contact: catrin.evans@nottingham.ac.uk
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