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Vernon-Wilson E, Tetui M, DeMarco M, Grindrod K, Waite NM. Connect, collaborate and tailor: a model of community engagement through infographic design during the COVID-19 pandemic. BMC Public Health 2024; 24:2551. [PMID: 39300382 DOI: 10.1186/s12889-024-20037-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Across the globe, racial and ethnic minorities have been disproportionately affected by COVID-19 with increased risk of infection and burden from disease. Vaccine hesitancy has contributed to variation in vaccine uptake and compromised population-based vaccination programs in many countries. Connect, Collaborate and Tailor (CCT) is a Public Health Agency of Canada funded project to make new connections between public health, healthcare professionals and underserved communities in order to create culturally adapted communication about COVID-19 vaccines. This paper describes the CCT process and outcomes as a community engagement model that identified information gaps and created tailored tools to address misinformation and improve vaccine acceptance. METHODS Semi-structured interviews with CCT participants were undertaken to evaluate the effectiveness of CCT in identifying and addressing topics of concern to underserved and ethnic minority communities. Interviews also explored CCT participants' experiences of collaboration through the development of new partnerships between ethnic minority communities, public health and academic researchers, and the evolution of co-operation sharing ideas and creating infographics. Thematic analysis was used to produce representative themes. The activities described were aligned with the levels of public engagement described in the IAP2 spectrum (International Association for Public Participation). RESULTS Analysis of interviews (n = 14) revealed that shared purpose and urgency in responding to the COVID-19 pandemic motivated co-operation among CCT participants. Acknowledgement of past harm, present health, and impact of social inequities on public service access was an essential first step in establishing trust. Creating safe spaces for open dialogue led to successful, iterative cycles of consultation and feedback between participants; a process that not only helped create tailored infographics but also deepened engagement and collaboration. Over time, the infographic material development was increasingly directed by community representatives' commentary on their groups' real-time needs and communication preferences. This feedback noticeably guided the choice, style, and presentation of infographic content while also directing dissemination strategies and vaccine confidence building activities. CONCLUSIONS The CCT process to create COVID-19 vaccine communication materials led to evolving co-operation between groups who had not routinely worked together before; strong community engagement was a key driver of change. Ensuring a respectful environment for open dialogue and visibly using feedback to create information products provided a foundation for building relationships. Finally, our data indicate participants sought reinforcement of close cooperative ties and continued investment in shared responsibility for community partnership-based public health.
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Cid A, Patten A, Beazely MA, Grindrod K. Adapting the Opening Minds Stigma Scale for Healthcare Providers to Measure Opioid-Related Stigma. PHARMACY 2024; 12:105. [PMID: 39051389 PMCID: PMC11270195 DOI: 10.3390/pharmacy12040105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/25/2024] [Accepted: 07/02/2024] [Indexed: 07/27/2024] Open
Abstract
The opioid crisis in Canada continues to cause a devastating number of deaths. Community-based naloxone programs have been identified as one of the solutions for combatting this crisis; however, there are disparities in which pharmacies stock and offer naloxone. Opioid-related stigma is a major barrier for limited naloxone distribution through pharmacies. Therefore, the development of anti-stigma interventions is crucial to improve naloxone distribution in Canada. However, there is no validated tool to specifically measure opioid-related stigma. The Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) is a validated scale used to measure mental illness-related stigma. This study will adapt the OMS-HC by using four different opioid-related terminologies to determine which is the most stigmatizing to use in an opioid-related anti-stigma intervention. Pharmacy students completed four versions of the adapted OMS-HC. The average OMS-HC scores and Cronbach's α co-efficient were calculated for each version. The term "opioid addiction" was found to be the most stigmatizing term among participants and will be used in the adapted version of the OMS-HC in a future anti-stigma interventions.
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Tetui M, Tennant R, Adil M, Bala A, Burns C, Waite N, Grindrod K. "Flying a plane and building it at the same time": Lessons learned from the dynamic implementation of mass vaccination clinics in the Region of Waterloo, Ontario, Canada. Health Res Policy Syst 2023; 21:102. [PMID: 37784061 PMCID: PMC10546698 DOI: 10.1186/s12961-023-01036-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 08/12/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Vaccination plays a critical role during pandemics, and mass vaccination clinics are often an imperative public health measure. These clinics usually consist of multi-disciplinary teams, which can pose significant coordination challenges, yet also present an opportunity for collectively contributing towards mitigating the impact of infection within communities. This study explores the coordination dynamics of the Region of Waterloo's coronavirus disease of 2019 (COVID-19) mass vaccination clinics in Ontario, Canada, between July 2021 and April 2022. METHODS This qualitative study included 16 purposively selected participants working in mass vaccination clinics. Participants were individually interviewed for 40-60 min. An inductive and iterative thematic analysis was undertaken, including open coding, grouping, labelling, regrouping and making sense of the themes. RESULTS Three interrelated themes were created: (1) unpredictable work environment, which was comprised of changing clinic processes and the impact of clinic adjustments to the running of the clinics; (2) clinic cohesion challenges, which included staff role disparities, limited job preparation and clinic system silos; and (3) adaptable and supportive work environment, which was comprised of staff adaptability, dispositional flexibility and a supportive work environment. While the first two themes created a precarious situation in the clinics, the third countered it, leading to a largely successful clinic implementation. CONCLUSIONS The rapid evolution and high transmissibility of COVID-19 in communities required a public health response that felt like flying and building a plane simultaneously - a seemingly impossible yet necessary task. However, an adaptable and supportive work environment was critical for establishing an atmosphere that can overcome challenges from a constantly changing pandemic and the guidance of public health officials. Such lessons gained from understanding the dynamic experiences in mass vaccination clinics are essential for improving the development and operation of future immunization campaigns.
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Nanyonjo A, Nelson D, Sayers E, Lall P, Vernon-Wilson E, Tetui M, Grindrod K, Kane R, Gussy M, Siriwardena N. Community efforts to promote vaccine uptake in a rural setting: a qualitative interview study. Health Promot Int 2023; 38:daad088. [PMID: 37549195 PMCID: PMC10406424 DOI: 10.1093/heapro/daad088] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Vaccine hesitancy has been identified as one of the top 10 threats to global health. The causes of low vaccine uptake are many and vary at micro and macro levels. However, rural and remote coastal areas in the UK experience unique vaccine inequalities due to high levels of deprivation and their unique and complex access-related problems. This study aimed to explore community efforts to promote vaccine uptake during the COVID-19 pandemic and understand how the COVID-19 vaccination campaign was experienced by the public. We conducted an exploratory descriptive qualitative study using semi-structured interviews with decision-makers, health professionals and community members in Lincolnshire, a predominantly rural county with a long coastline, a large population of white minority ethnicities, and those living in caravan and temporary housing. Data were analysed using conventional content analysis. Overcoming the various access barriers to vaccination uptake involved working with local media stations, local communities and local community groups, translation of information, bringing vaccines closer to the people through pop-up and mobile clinics and provision of transport and ensuring confidentiality. There is a need to employ inclusive targeted non-conventional care interventions whilst dealing with complex problems as occur in rural and remote coastal regions.
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Tetui M, Tennant R, Patten A, Giilck B, Burns CM, Waite N, Grindrod K. Role satisfaction among community volunteers working in mass COVID-19 vaccination clinics, Waterloo Region, Canada. BMC Public Health 2023; 23:1199. [PMID: 37344794 DOI: 10.1186/s12889-023-15597-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 04/04/2023] [Indexed: 06/23/2023] Open
Abstract
INTRODUCTION Unpaid community volunteers are a vital public health resource in times of crisis. In response to the COVID-19 pandemic, community volunteers were mobilized to support mass vaccination efforts in many countries. To have this group's continued engagement, it is essential to understand the community volunteer experience, including the opportunities and challenges they encounter and how these contribute to their role satisfaction. This qualitative study investigated the factors contributing to community volunteers' role satisfaction at COVID-19 mass vaccination clinics in the Region of Waterloo, Canada. METHODS Qualitative data were analyzed from 20 volunteers (aged 48-79 years) who had worked at one of four COVID-19 vaccination clinics in the Region of Waterloo, Canada. Data were analyzed thematically using an inductive coding process followed by an iterative process of grouping and identifying linkages and relationships within the themes. RESULTS Four interrelated themes were developed from the inductive analysis process. The theme of community volunteers feeling valued or disesteemed in their role depends on the interaction between the three themes of role description, role preparation, and clinic context. CONCLUSIONS For volunteers in crises such as the COVID-19 pandemic, volunteer role satisfaction depends on how their contributions are valued, the clarity of their role descriptions, volunteer-specific training, and the sentiments of volunteers and staff within the clinic context. Greater role satisfaction can help with retention as volunteers become more resilient and adaptable to the complex dynamic circumstances of a crisis response. Activities such as training and materials development for role preparations should be explicitly planned and well-resourced, even in crisis/pandemic situations. Building clinic managers' or supervisors' skills in communication during crisis/pandemic situations and the skills for the creation of team cohesion are critical investment areas.
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Vernon-Wilson E, Tetui M, Nanyonjo A, Adil M, Bala A, Nelson D, Sayers E, Waite N, Grindrod K. Unintended consequences of communicating rapid COVID-19 vaccine policy changes- a qualitative study of health policy communication in Ontario, Canada. BMC Public Health 2023; 23:932. [PMID: 37221519 DOI: 10.1186/s12889-023-15861-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The success of the COVID-19 vaccination roll-out depended on clear policy communication and guidance to promote and facilitate vaccine uptake. The rapidly evolving pandemic circumstances led to many vaccine policy amendments. The impact of changing policy on effective vaccine communication and its influence in terms of societal response to vaccine promotion are underexplored; this qualitative research addresses that gap within the extant literature. METHODS Policy communicators and community leaders from urban and rural Ontario participated in semi-structured interviews (N = 29) to explore their experiences of COVID-19 vaccine policy communication. Thematic analysis was used to produce representative themes. RESULTS Analysis showed rapidly changing policy was a barrier to smooth communication and COVID-19 vaccine roll-out. Continual amendments had unintended consequences, stimulating confusion, disrupting community outreach efforts and interrupting vaccine implementation. Policy changes were most disruptive to logistical planning and community engagement work, including community outreach, communicating eligibility criteria, and providing translated vaccine information to diverse communities. CONCLUSIONS Vaccine policy changes that allow for prioritized access can have the unintended consequence of limiting communities' access to information that supports decision making. Rapidly evolving circumstances require a balance between adjusting policy and maintaining simple, consistent public health messages that can readily be translated into action. Information access is a factor in health inequality that needs addressing alongside access to vaccines.
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AlShurman BA, Tetui M, Nanyonjo A, Butt ZA, Waite NM, Vernon-Wilson E, Wong G, Grindrod K. Understanding the COVID-19 Vaccine Policy Terrain in Ontario Canada: A Policy Analysis of the Actors, Content, Processes, and Context. Vaccines (Basel) 2023; 11:782. [PMID: 37112694 PMCID: PMC10143674 DOI: 10.3390/vaccines11040782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
(1) Background: Canada had a unique approach to COVID-19 vaccine policy making. The objective of this study was to understand the evolution of COVID-19 vaccination policies in Ontario, Canada, using the policy triangle framework. (2) Methods: We searched government websites and social media to identify COVID-19 vaccination policies in Ontario, Canada, which were posted between 1 October 2020, and 1 December 2021. We used the policy triangle framework to explore the policy actors, content, processes, and context. (3) Results: We reviewed 117 Canadian COVID-19 vaccine policy documents. Our review found that federal actors provided guidance, provincial actors made actionable policy, and community actors adapted policy to local contexts. The policy processes aimed to approve and distribute vaccines while continuously updating policies. The policy content focused on group prioritization and vaccine scarcity issues such as the delayed second dose and the mixed vaccine schedules. Finally, the policies were made in the context of changing vaccine science, global and national vaccine scarcity, and a growing awareness of the inequitable impacts of pandemics on specific communities. (4) Conclusions: We found that the triad of vaccine scarcity, evolving efficacy and safety data, and social inequities all contributed to the creation of vaccine policies that were difficult to efficiently communicate to the public. A lesson learned is that the need for dynamic policies must be balanced with the complexity of effective communication and on-the-ground delivery of care.
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Tennant R, Tetui M, Grindrod K, Burns CM. Multi-Disciplinary Design and Implementation of a Mass Vaccination Clinic Mobile Application to Support Decision-Making. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2022; 11:60-69. [PMID: 36654771 PMCID: PMC9842226 DOI: 10.1109/jtehm.2022.3224740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/26/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022]
Abstract
Mass vaccination clinics are complex systems that combine professionals who do not typically work together. Coordinating vaccine preparation and patient intake is critically important to maintain patient flow equilibrium, requiring continuous communication and shared decision-making to reduce vaccine waste. OBJECTIVES (1) To develop a mobile application (app) that can address the information needs of vaccination clinic stakeholders for end-of-day doses decision-making in mass immunization settings; and (2) to understand usability and clinical implementation among multi-disciplinary users. METHODS Contextual inquiry guided 71.5 hours of observations to inform design characteristics. Rapid iterative testing and evaluation were performed to validate and improve the design. Usability and integration were evaluated through observations, interviews, and the system usability scale. RESULTS Designing the app required consolidating contextual factors to support information and workload needs. Twenty-four participants used the app at four clinics who reported its effectiveness in reducing stress and improving communication efficiency and satisfaction. They also discussed positive workflow changes and design recommendations to improve its usefulness. The average system usability score was 87 (n = 22). DISCUSSION There is significant potential for mobile apps to improve workflow efficiencies for information sharing and decision-making in vaccination clinics when designed for established cultures and usability, thereby providing frontline workers with greater time to focus on patient care and immunization needs. However, designing and implementing digital systems for dynamic settings is challenging when healthcare teams constantly adapt to evolving complexities. System-level barriers to adoption require further investigation. Future research should explore the implementation of the app within global contexts.
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Saini S, Leung V, Si E, Ho C, Cheung A, Dalton D, Daneman N, Grindrod K, Ha R, McIsaac W, Oberai A, Schwartz K, Shiamptanis A, Langford BJ. Documenting the indication for antimicrobial prescribing: a scoping review. BMJ Qual Saf 2022; 31:787-799. [PMID: 35552253 DOI: 10.1136/bmjqs-2021-014582] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/05/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Documenting an indication when prescribing antimicrobials is considered best practice; however, a better understanding of the evidence is needed to support broader implementation of this practice. OBJECTIVES We performed a scoping review to evaluate antimicrobial indication documentation as it pertains to its implementation, prevalence, accuracy and impact on clinical and utilisation outcomes in all patient populations. ELIGIBILITY CRITERIA Published and unpublished literature evaluating the documentation of an indication for antimicrobial prescribing. SOURCES OF EVIDENCE A search was conducted in MEDLINE, Embase, CINAHL and International Pharmaceutical Abstracts in addition to a review of the grey literature. CHARTING AND ANALYSIS Screening and extraction was performed by two independent reviewers. Studies were categorised inductively and results were presented descriptively. RESULTS We identified 123 peer-reviewed articles and grey literature documents for inclusion. Most studies took place in a hospital setting (109, 89%). The median prevalence of antimicrobial indication documentation was 75% (range 4%-100%). Studies evaluating the impact of indication documentation on prescribing and patient outcomes most commonly examined appropriateness and identified a benefit to prescribing or patient outcomes in 17 of 19 studies. Qualitative studies evaluating healthcare worker perspectives (n=10) noted the common barriers and facilitators to this practice. CONCLUSION There is growing interest in the importance of documenting an indication when prescribing antimicrobials. While antimicrobial indication documentation is not uniformly implemented, several studies have shown that multipronged approaches can be used to improve this practice. Emerging evidence demonstrates that antimicrobial indication documentation is associated with improved prescribing and patient outcomes both in community and hospital settings. But setting-specific and larger trials are needed to provide a more robust evidence base for this practice.
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Tong CE, Lopez KJ, Chowdhury D, Arya N, Elliott J, Sims-Gould J, Grindrod K, Stolee P. Understanding racialised older adults' experiences of the Canadian healthcare system, and codesigning solutions: protocol for a qualitative study in nine languages. BMJ Open 2022; 12:e068013. [PMID: 36216419 PMCID: PMC9557314 DOI: 10.1136/bmjopen-2022-068013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Racialised immigrant older adults (RIOAs) in Canada have poorer self-rated health and are more likely to report chronic conditions, while they concurrently experience well-documented challenges in navigating and accessing the healthcare system. There is strong evidence that patient and caregiver engagement in their healthcare leads to improved management of chronic disease and better health outcomes. International research suggests that engagement has the potential to reduce health disparities and improve quality of care. We aim to (1) describe what role(s) RIOAs are/are not taking in their own healthcare, from the perspectives of participant groups (RIOAs, caregivers and healthcare providers (HCPs)); and (2) develop a codesign process with these participants, creating linguistically aligned and culturally aligned tools, resources or solutions to support patient engagement with RIOAs. METHODS AND ANALYSIS Using a cross-cultural participatory action research approach, our work will consist of three phases: phase 1, strengthen existing partnerships with RIOAs and appropriate agencies and cultural associations; phase 2, on receipt of informed consent, in-depth interviews with RIOAs and caregivers (n=~45) and HCPs (n=~10), professionally interpreted as needed. Phase 3, work with participants, in multiple interpreted sessions, to codesign culturally sensitive and linguistically sensitive/aligned patient engagement tools. We will conduct this research in the Waterloo-Wellington region of Ontario, in Arabic, Bangla, Cantonese, Hindi, Mandarin, Punjabi, Tamil and Urdu, plus English. Data will be transcribed, cleaned and entered into NVivo V.12, the software that will support team-based analysis. Analysis will include coding, theming and interpreting the data, and, preparing narrative descriptions that summarise each language group and each participant group (older adults, caregivers and HCPs), and illustrate themes. ETHICS AND DISSEMINATION Ethics clearance was obtained through the University of Waterloo Office of Research Ethics (ORE #43297). Findings will be disseminated through peer-reviewed publications, presentations and translated summary reports for our partners and participants.
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Li KS, Nagallo N, McDonald E, Whaley C, Grindrod K, Boluk K. Implementing Technology Literacy Programs in Retirement Homes and Residential Care Facilities: Conceptual Framework. JMIR Aging 2022; 5:e34997. [PMID: 35984689 PMCID: PMC9440411 DOI: 10.2196/34997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/31/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background The COVID-19 pandemic caused widespread societal disruption, with governmental stay-at-home orders resulting in people connecting more via technology rather than in person. This shift had major impacts on older adult residents staying in retirement homes and residential care facilities, where they may lack the technology literacy needed to stay connected. The enTECH Computer Club from the University of Waterloo in Ontario, Canada created a knowledge translation toolkit to support organizations interested in starting technology literacy programs (TLPs) by providing guidance and practical tips. Objective This paper aimed to present a framework for implementing TLPs in retirement homes and residential care facilities through expanding on the knowledge translation toolkit and the framework for person-centered care. Methods Major concepts relating to the creation of a TLP in retirement homes and residential care facilities were extracted from the enTECH knowledge translation toolkit. The domains from the framework for person-centered care were modified to fit a TLP context. The concepts identified from the toolkit were sorted into the three framework categories: “structure,” “process,” and “outcome.” Information from the knowledge translation toolkit were extracted into the three categories and synthesized to form foundational principles and potential actions. Results All 13 domains from the framework for person-centered care were redefined to shift the focus on TLP implementation, with 7 domains under “structure,” 4 domains under “process,” and 2 domains under “outcome.” Domains in the “structure” category focus on developing an organizational infrastructure to deliver a successful TLP; 10 foundational principles and 25 potential actions were identified for this category. Domains in the “process” category focus on outlining procedures taken by stakeholders involved to ensure a smooth transition from conceptualization into action; 12 foundational principles and 9 potential actions were identified for this category. Domains in the “outcome” category focus on evaluating the TLP to consider making any improvements to better serve the needs of older adults and staff; 6 foundational principles and 6 potential actions were identified for this category. Conclusions Several domains and their foundational principles and potential actions from the TLP framework were found to be consistent with existing literatures that encourage taking active steps to increase technology literacy in older adults. Although there may be some limitations to the components of the framework with the current state of the pandemic, starting TLPs in the community can yield positive outcomes that will be beneficial to both older adult participants and the organization in the long term.
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Tetui M, Grindrod K, Waite N, VanderDoes J, Taddio A. Integrating the CARD (Comfort Ask Relax Distract) system in a mass vaccination clinic to improve the experience of individuals during COVID-19 vaccination: a pre-post implementation study. Hum Vaccin Immunother 2022; 18:2089500. [PMID: 35723609 PMCID: PMC9620984 DOI: 10.1080/21645515.2022.2089500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Many people have negative experiences with vaccination due to stress-related reactions including fear and pain. We used a pre-post study design to evaluate the impact of implementing a modified version of the CARD (Comfort-Ask-Relax-Distract) system on stress-related reactions in individuals aged 12 y or older undergoing COVID-19 vaccinations in mass vaccination clinics. Vaccine recipients reported their level of pain, fear and dizziness during vaccination. Clinic staff reported their attitudes about CARD and use of CARD interventions. CARD improved client symptoms across genders and ages with an average reduction in needle pain, fear and dizziness of 75%, 40% and 44%, respectively. CARD was more effective in younger individuals. Clinic staff reported positive attitudes about CARD and uptake of selected CARD interventions. In summary, the modified CARD system reduced stress-related responses in a general population undergoing COVID-19 vaccinations in a mass vaccination clinic, was feasible and acceptable to staff. Future implementation efforts are recommended that include more diverse cultural contexts and incorporate education of individuals about CARD ahead of time.
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Tennant R, Tetui M, Grindrod K, Burns CM. Understanding Human Factors Challenges on the Front Lines of Mass COVID-19 Vaccination Clinics: Human-Systems Modelling Study (Preprint). JMIR Hum Factors 2022; 9:e39670. [DOI: 10.2196/39670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/15/2022] [Accepted: 10/06/2022] [Indexed: 11/05/2022] Open
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Hussein R, Killeen R, Grindrod K. Effectiveness of social giving on the engagement of pharmacy professionals with a computer-based education platform: a pilot randomized controlled trial. BMC MEDICAL EDUCATION 2022; 22:253. [PMID: 35392902 PMCID: PMC8988535 DOI: 10.1186/s12909-022-03310-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Computer-based education is gaining popularity in healthcare professional development education due to ease of distribution and flexibility. However, there are concerns regarding user engagement. This pilot study aims to: 1) assess the feasibility and acceptability of a social reward and the corresponding study design; and 2) to provide preliminary data on the impact of social reward on user engagement. METHODS A mixed method study combing a four-month pilot randomized controlled trial (RCT), surveys and interviews. The RCT was conducted using a computer-based education platform. Participants in the intervention group had access to a social reward feature, where they earned one meal for donation when completing a quiz with a passing score. Participants in the control group did not have access to this feature. Feasibility and acceptability of the social reward were assessed using surveys and telephone interviews. Feasibility of the RCT was assessed by participant recruitment and retention. User engagement was assessed by number of quizzes and modules completed. RESULTS A total of 30 pharmacy professionals were recruited with 15 users in each arm. Participants reported high acceptability of the intervention. The total number of quizzes completed by the intervention group was significantly higher compared to the control group (n = 267 quizzes Vs. n = 97 quizzes; p-value 0.023). CONCLUSION The study demonstrates the feasibility and acceptability of a web-based trial with pharmacy professionals and the social reward intervention. It also shows that the social reward can improve user engagement. A future definitive RCT will explore the sustainability of the intervention.
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Cid A, Patten A, Beazely M, Grindrod K, Yessis J, Chang F. Protocol for the Optimizing Naloxone Dispensing in Pharmacies (ONDP) Online Continuing Education Program: A Randomized Controlled Trial. PHARMACY 2022; 10:pharmacy10010024. [PMID: 35202073 PMCID: PMC8875968 DOI: 10.3390/pharmacy10010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 12/10/2022] Open
Abstract
The number of opioid-related deaths in Canada has steadily increased since 2016 and the COVID-19 pandemic has worsened this trend. Naloxone has been pivotal for reducing opioid-related harms and death, and pharmacists play a crucial role in ensuring the supply of naloxone to Canadians through community pharmacies. However, naloxone dispensing by pharmacists is not optimal; in fact, in Ontario, only 50% of pharmacists offer naloxone, despite national guidelines that pharmacists should offer naloxone to everyone with an opioid prescription. When asked why pharmacists do not proactively offer naloxone, recent research has identified that pharmacists need continuing education to boost confidence and knowledge on how to start conversations with patients. The study involves a delayed start, double-blind randomized controlled trial, for Canadian licensed pharmacists and pharmacy technicians. The goals of the program are to increase Canadian pharmacy professional’s knowledge, confidence, and motivation to proactively offer naloxone, as well as to decrease stigma associated with naloxone. The program incorporates behaviour change techniques from the Theoretical Domains Framework and the Theory of Planned Behaviour. The intervention program includes three modules that focus on improving pharmacists’ communication skills by teaching them how to proactively offer naloxone, while the control group will complete a reading assignment on the naloxone consensus guidelines. The program will involve a process and outcome evaluation in addition to a contribution analysis. This program is important for breaking down previously identified barriers and knowledge gaps for why pharmacists currently do not proactively offer naloxone. This study will provide important new information about what behaviour change techniques are successful in improving confidence and motivation in the pharmacy profession and in an online environment. Findings from this study can be used to produce a national naloxone education program that can also be implemented into current pharmacy school curriculum.
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McNeil H, McMurray J, Byrne K, Grindrod K, Stolee P. Engagement of older adults in regional health innovation: The ECOTECH concept mapping project. SAGE Open Med 2022; 10:20503121211073333. [PMID: 35083046 PMCID: PMC8785349 DOI: 10.1177/20503121211073333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: Regional health innovation ecosystems can activate collaboration and support planning, self-management and development and commercialization of innovations. We sought to understand how older adults and their caregivers can be meaningfully engaged in regional health innovation ecosystems focused on health and aging–related technology innovation. Methods: A six-phase concept mapping technique gathered data over six time points across Canada. Brainstorming conducted online and in person identified engagement ideas. Statements were sorted by similarity and rated by participants on importance and feasibility. Qualitative approaches and multidimensional scaling, hierarchical cluster analysis, descriptive statistics and t tests were used for analysis. Results: Sixty-two unique ideas were assembled into a seven-cluster framework of priorities for engagement in regional health innovation ecosystems including public forums, co-production and partnerships, engagement, linkage and exchange, developing cultural capacity, advocacy and investment in the ecosystem. Conclusions: This study identified a framework of priorities for directions and strategies for older adult and caregiver engagement in regional health innovation ecosystems. Next steps include collaborations to develop regional health innovation ecosystems that actively engage older adults and their caregivers in health and aging–related technology innovation.
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Faisal S, Ivo J, Tennant R, Prior KA, Grindrod K, McMillan C, Patel T. Integration of a smart multidose blister package for medication intake: A mixed method ethnographic informed study of older adults with chronic diseases. PLoS One 2022; 17:e0262012. [PMID: 35061773 PMCID: PMC8782488 DOI: 10.1371/journal.pone.0262012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022] Open
Abstract
Smart adherence products are marketed to assist with medication management. However, little is known about their in-home integration by older adults. It is necessary to investigate the facilitators and barriers older adults face when integrating these products into their medication taking routines before effectiveness can be examined. The aim of this study was to (a) examine the integration of a smart multidose blister package and (b) understand medication intake behaviour of adults with chronic diseases using an integrated theoretical model comprised of the Technology Acceptance Model (TAM), Theory of Planned Behaviour (TPB) and Capacity, Opportunity, Motivation and Behaviour (COM-B) Model. An ethnographic-informed study was conducted with older adults using the smart multidose blister package to manage their medications for eight weeks. Data was collected quantitatively and qualitatively using in-home observations, photo-elicitation, field notes, semi-structured interviews, system usability scale (SUS) and net promoter scale (NPS). The interview guide was developed with constructs from the TAM, TPB and COM-B Model. Data were analyzed using the Qualitative Analysis Guide of Leuven (QUAGOL) framework to generate themes and sub-themes which were mapped back to TAM, TBP and COM-B Model. Ten older adults with an average age of 76 years, of which 80% were female, participated in the study. On average, participants reported five medical conditions, while the average number of medications was 11.1. The mean SUS was 75.50 and overall NPS score was 0. Qualitative analysis identified three themes; (1) factors influencing medication intake behaviour (2) facilitators to the product use and, (3) barriers to the product use. The smart blister package was found to be easy to use and acceptable by older adults. Clinicians should assess an older adult’s medication intake behavior as well as barriers and facilitators to product use prior to recommending an adherence product for managing medications.
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Cid A, Patten A, Grindrod K, Beazely MA. Frequently asked questions about naloxone: Part 3. Can Pharm J (Ott) 2022; 155:9-11. [PMID: 35035636 DOI: 10.1177/17151635211056571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Faisal S, Ivo J, McMillan C, Grindrod K, Patel T. In-home medication management by older adults: a modified ethnography study using digital photography walkabouts. Age Ageing 2022; 51:6399894. [PMID: 34718366 DOI: 10.1093/ageing/afab207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Medication mismanagement can lead to non-optimal management of chronic diseases and poor health outcomes. OBJECTIVE The purpose of this study was to better understand meanings associated with in-home medication management and storage practices of older adults with chronic diseases. METHODS A modified ethnographic approach using digital photography walkabouts, observation protocols and field notes were used to document in-home medication organisation and storage locations. Thematic analysis was used to generate themes and sub-themes. RESULTS Data from multiple home visits of 10 participants (mean age = 76 years; 80% females) including 30 photographs, 10 observation protocols and field notes were analysed. The average number of medications used was reported to be 11.1 (range: 5-20). Themes and sub-themes include choice of storage location (sub-themes: impact on medication behaviour, visibility of medications and storage with other items), knowledge regarding appropriate medication storage conditions (sub-themes: impact on safety of patient and impact on stability of medications) and systems to manage in-home medication intake. DISCUSSION In-home medication management reflects older adults perspectives regarding privacy, medication taking routine, knowledge about safe and effective storage and organisation systems. The lack of knowledge causing inappropriate medication storage not only impacts the stability of medications, but also increases risk of medication errors and safety, ultimately affecting medication intake behaviours.
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Mercer K, Carter C, Burns C, Tennant R, Guirguis L, Grindrod K. Including the Reason for Use on Prescriptions Sent to Pharmacists: Scoping Review. JMIR Hum Factors 2021; 8:e22325. [PMID: 34842545 PMCID: PMC8663503 DOI: 10.2196/22325] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/17/2020] [Accepted: 08/02/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In North America, although pharmacists are obligated to ensure prescribed medications are appropriate, information about a patient's reason for use is not a required component of a legal prescription. The benefits of prescribers including the reason for use on prescriptions is evident in the current literature. However, it is not standard practice to share this information with pharmacists. OBJECTIVE Our aim was to characterize the research on how including the reason for use on a prescription impacts pharmacists. METHODS We performed an interdisciplinary scoping review, searching literature in the fields of health care, informatics, and engineering. The following databases were searched between December 2018 and January 2019: PubMed, Institute of Electrical and Electronics Engineers (IEEE), Association for Computing Machinery (ACM), International Pharmaceutical Abstracts (IPA), and EMBASE. RESULTS A total of 3912 potentially relevant articles were identified, with 9 papers meeting the inclusion criteria. The studies used different terminology (eg, indication, reason for use) and a wide variety of study methodologies, including prospective and retrospective observational studies, randomized controlled trials, and qualitative interviews and focus groups. The results suggest that including the reason for use on a prescription can help the pharmacist catch more errors, reduce the need to contact prescribers, support patient counseling, impact communication, and improve patient safety. Reasons that may prevent prescribers from adding the reason for use information are concerns about workflow and patient privacy. CONCLUSIONS More research is needed to understand how the reason for use information should be provided to pharmacists. In the limited literature to date, there is a consensus that the addition of this information to prescriptions benefits patient safety and enables pharmacists to be more effective. Future research should use an implementation science or theory-based approach to improve prescriber buy-in and, consequently, adoption.
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Cid A, Patten A, Grindrod K, Beazely MA. Frequently asked questions about naloxone: Part 2. Can Pharm J (Ott) 2021; 154:385-387. [PMID: 34777648 PMCID: PMC8581805 DOI: 10.1177/17151635211045966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/27/2021] [Indexed: 11/16/2022]
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Cid A, Patten A, Grindrod K, Beazely MA. Frequently asked questions about naloxone: Part 1. Can Pharm J (Ott) 2021; 154:301-304. [PMID: 34484479 DOI: 10.1177/17151635211034528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 11/17/2022]
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Grindrod K, Waite N, Constantinescu C, Watson KE, Tsuyuki RT. COVID-19 vaccine hesitancy: Pharmacists must be proactive and move the middle. Can Pharm J (Ott) 2021; 154:133-135. [PMID: 34104261 DOI: 10.1177/17151635211005763] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Stolee P, Elliott J, Giguere AM, Mallinson S, Rockwood K, Sims Gould J, Baker R, Boscart V, Burns C, Byrne K, Carson J, Cook RJ, Costa AP, Giosa J, Grindrod K, Hajizadeh M, Hanson HM, Hastings S, Heckman G, Holroyd-Leduc J, Isaranuwatchai W, Kuspinar A, Meyer S, McMurray J, Puchyr P, Puchyr P, Theou O, Witteman H. Transforming primary care for older Canadians living with frailty: mixed methods study protocol for a complex primary care intervention. BMJ Open 2021; 11:e042911. [PMID: 33986044 PMCID: PMC8126280 DOI: 10.1136/bmjopen-2020-042911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Older Canadians living with frailty are high users of healthcare services; however, the healthcare system is not well designed to meet the complex needs of many older adults. Older persons look to their primary care practitioners to assess their needs and coordinate their care. They may need care from a variety of providers and services, but often this care is not well coordinated. Older adults and their family caregivers are the experts in their own needs and preferences, but often do not have a chance to participate fully in treatment decisions or care planning. As a result, older adults may have health problems that are not properly assessed, managed or treated, resulting in poorer health outcomes and higher economic and social costs. We will be implementing enhanced primary healthcare approaches for older patients, including risk screening, patient engagement and shared decision making and care coordination. These interventions will be tailored to the needs and circumstances of the primary care study sites. In this article, we describe our study protocol for implementing and testing these approaches. METHODS AND ANALYSIS Nine primary care sites in three Canadian provinces will participate in a multi-phase mixed methods study. In phase 1, baseline information will be collected through questionnaires and interviews with patients and healthcare providers (HCPs). In phase 2, HCPs and patients will be consulted to tailor the evidence-based interventions to site-specific needs and circumstances. In phase 3, sites will implement the tailored care model. Evaluation of the care model will include measures of patient and provider experience, a quality of life measure, qualitative interviews and economic evaluation. ETHICS AND DISSEMINATION This study has received ethics clearance from the host academic institutions: University of Calgary (REB17-0617), University of Waterloo (ORE#22446) and Université Laval (#MP-13-2019-1500 and 2017-2018-12-MP). Results will be disseminated through traditional means, including peer-reviewed publications and conferences and through an extensive network of knowledge user partners. TRIAL REGISTRATION NUMBER NCT03442426;Pre-results.
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Hussein R, Killeen R, He Z, Grindrod K. Assessing pharmacists' knowledge and compliance with narcotic inventory management using a computer-based educational platform. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:265-270. [PMID: 33890668 DOI: 10.1093/ijpp/riab013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 03/25/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Pharmacy professionals are required to take all necessary steps to protect commonly misused drugs such as opioids at their pharmacies to minimize the risk of diversion. The aim of this study is to assess Canadian pharmacy professionals' knowledge and compliance with federal and provincial regulations using the computer-based educational platform Pharmacy5in5. METHODS A Narcotic Inventory module was created and reviewed by experts representing provincial and federal regulators. Descriptive statistics were used to analyze users' performance in quizzes. Binomial regression and logistic regression models were used to investigate the effect of demographic factors on users' performance. P-values less than 0.05 were considered statistically significant. KEY FINDINGS The analysis included data collected over a period of three months. A total of 792 users accessed the Narcotic Inventory module on the Pharmacy5in5 website between July 2019 and November 2019. Most of the users were licenced pharmacists (64%), female (72%), received their training in Canada (68%), and were practising in Ontario (80%). Users performed best on the quiz addressing the steps for reconciliation of inventory (93%), and worst on the quiz reviewing how to prepare for a Health Canada visit (66%). CONCLUSIONS Overall, pharmacy professionals showed adequate knowledge of the CDSA and provincial/territorial regulations regarding opioids inventory management. Conversely, the study highlighted poor compliance with the reporting of losses and theft of controlled substances by pharmacy professionals. Innovative approaches are needed to influence pharmacy professionals' behaviours to improve their compliance with best practices concerning inventory management to reduce drug diversion.
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