Abstract
In Brief Objective To test the effectiveness of an evidence-based protocol for urinary incontinence in increasing identification of women with the condition and improving their outcomes. Design Prospective formative evaluation study. Setting Twenty-one public, private, and other women's health care sites. Participants Women in ambulatory care settings (N = 1474) provided descriptive statistics. Clinical outcomes were tested in 132 cases for whom pre- and posttreatment data were available. Interventions Standardized screening and baseline follow-up forms were used to minimize time burden on clinicians; bladder and pelvic floor muscle training materials were provided to clinicians for distribution. Main outcome measures Self-reported frequency, volume, and quality of life related to incontinence and cost of self-management were used to assess protocol effectiveness. Results Frequency of incontinence episodes, estimated volume lost per episode, and the cost of self-management decreased. Quality of life improved, as reflected in decreased bother attributed to incontinence and in the number of women avoiding activities such as shopping, exercising, or travel because of incontinence. Conclusions This simple program of pelvic floor muscle and bladder training, as it has been systematically implemented in a variety of ambulatory women's health care settings, has benefitted women's continence status. The results of this project strongly support widespread application. Outcomes of a multisite research project on noninvasive interventions to manage urinary incontinence in women.
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