Along with the launch of the first provincial model of CAHC in 2007, a 7-hour training program in hormonal contraception was initiated and delivered by two trainers (a physician and a nurse).
As previously reported (Guilbert, Guilbert, et ah, 2011; Guilbert, Robitaille, Guilbert, Morin, & and the Group of experts in Family Planning of the National Institute of Public Health of Quebec, 2013), impediments to implementation include: the high degree of inter-professional collaboration required by the CAHC; the difficulty in sharing tasks previously "owned" by physicians; and the requirement of an independent CAHC in each health, education or other organization.
In the case of the new practice by the nurses under study here, their expanded role was conditional on the agreement of a local CAHC (Ordre des infirmieres et infirmiers du Quebec, 2007b; Ordre des infirmieres et infirmiers du Quebec, 2009b; Ordre des infirmieres et infirmiers du Quebec, 2012b).
Most of them (96%) did so under a CAHC using << liaison forms >> and implemented within two years of training (85%) serving an average of 5.
Those who stated that they favoured interpersonal contact to receive additional information on CAHC were 3.
The variables were: favouring interpersonal contact to receive additional information on CAHC (negative association), organizational innovativeness (positive association), perceived simplicity (positive association) and perceived influence of opinion leaders (positive association).
Only 22% (49/227) of GMFs had adopted a local CAHC - GMFs being major distributors of health services for adults.
The provincial model of CAHC of 2012 has now integrated this nursing practice and allows the initiation of contraception for a full year (Ordre des infirmieres et infirmiers du Quebec, 2012b; Gouvernement du Quebec, 2013).
Although the new practice could not be tested before the local CAHC was approved in the health organization, mentoring and support may have provided a "triability space" (Greenhalgh et al.