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Åhsberg J, Tersbøl BP, Puplampu P, Kwashie A, Commey JO, Adusi-Poku Y, Moseholm E, Andersen ÅB, Kenu E, Lartey M, Johansen IS, Bjerrum S. Use of the urine Determine LAM test in the context of tuberculosis diagnosis among inpatients with HIV in Ghana: a mixed methods study. Front Public Health 2024; 11:1271763. [PMID: 38249371 PMCID: PMC10797072 DOI: 10.3389/fpubh.2023.1271763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/30/2023] [Indexed: 01/23/2024] Open
Abstract
Background The urine Determine LAM test has the potential to identify tuberculosis (TB) and reduce early mortality among people living with HIV. However, implementation of the test in practice has been slow. We aimed to understand how a Determine LAM intervention was received and worked in a Ghanaian in-hospital context. Design/Methods Nested in a Determine LAM intervention study, we conducted a two-phase explanatory sequential mixed methods study at three hospitals in Ghana between January 2021 and January 2022. We performed a quantitative survey with 81 healthcare workers (HCWs), four qualitative focus-group discussions with 18 HCWs, and 15 in-depth HCW interviews. Integration was performed at the methods and analysis level. Descriptive analysis, qualitative directed content analysis, and mixed methods joint display were used. Results The gap in access to TB testing when relying on sputum GeneXpert MTB/Rif alone was explained by difficulties in obtaining sputum samples and an in-hospital system that relies on relatives. The Determine LAM test procedure was experienced as easy, and most eligible patients received a test. HCWs expressed that immediate access to Determine LAM tests empowered them in rapid diagnosis. The HCW survey confirmed that bedside was the most common place for Determine LAM testing, but qualitative interviews with nurses revealed concerns about patient confidentiality when performing and disclosing the test results at the bedside. Less than half of Determine LAM-positive patients were initiated on TB treatment, and qualitative data identified a weak link in the communication of the Determine LAM results. Moreover, HCWs were reluctant to initiate Determine LAM-positive patients on TB treatment due to test specificity concerns. The Determine LAM intervention did not have an impact on the time to TB treatment as expected, but patients were, in general, initiated on TB treatment rapidly. We further identified a barrier to accessing TB treatment during weekends and that treatment by tradition is administrated early in the morning. Conclusion The Determine LAM testing was feasible and empowered HCWs in the management of HIV-associated TB. Important gaps in routine care and Determine LAM-enhanced TB care were often explained by the context. These findings may inform in-hospital quality improvement work and scale-up of Determine LAM in similar settings.
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Affiliation(s)
- Johanna Åhsberg
- Research Center of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Mycobacterial Centre for Research Southern Denmark, MyCRESD, Department of Infectious Diseases, Odense University Hospital Odense, Odense, Denmark
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
| | - Britt Pinkowski Tersbøl
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Peter Puplampu
- Department of Medicine and Therapeutics, Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | | | - Yaw Adusi-Poku
- National Tuberculosis Control Programme, Ghana Health Service, Korle-Bu, Accra, Ghana
| | - Ellen Moseholm
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Åse Bengård Andersen
- Department of Infectious Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ernest Kenu
- Department of Epidemiology and Disease Control, University of Ghana, Accra, Ghana
| | - Margaret Lartey
- Department of Medicine and Therapeutics, Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Isik Somuncu Johansen
- Research Center of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Mycobacterial Centre for Research Southern Denmark, MyCRESD, Department of Infectious Diseases, Odense University Hospital Odense, Odense, Denmark
| | - Stephanie Bjerrum
- Research Center of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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Fang J, Brown GTL. Academic Success at Social Costs: An Exploratory Study on Social Networks of Chinese Students under Academic Streaming. Eur J Investig Health Psychol Educ 2024; 14:164-180. [PMID: 38248131 PMCID: PMC10814072 DOI: 10.3390/ejihpe14010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/19/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
In universities that require students to reside in dormitories, there are two types of social networks-study/classroom-based and social/dorm room-based. The academic streaming system may disrupt study/classroom connections, but its impact on students' social networks is unknown. Using self-reported surveys, this study examines ego network measures of network sizes, turnover, multiplexity, and diversity among 382 students (44% female, 56% male). Surveys were administered before and after the university employed a first-semester grade-point average to demote or promote students into an honours college. Follow-up interviews were conducted with 11 honours students staying within their track and 11 students who were re-streamed to the non-honours track. Quantitative results showed that students in the non-honours college and who remained there had increasingly overlapping friendship circles between study and social environments, along with more diverse social connections, indicating stronger networks. In contrast, honours participants experienced fewer overlapping networks across domains and less dispersed social ties, especially after the academic replacement process. Qualitative results showed that the honours students faced a trade-off between academic success and social engagement in maintaining their elite status. Re-streamed students experienced otherness in social groups and decreased psychological wellbeing. This study contributes to the application of network analysis in education and provides insights into the unintended consequences of educational practice on students' social networks.
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Affiliation(s)
- Jinjing Fang
- Faculty of Education and Social Work, The University of Auckland, Auckland 1142, New Zealand;
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103
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Palazzo CC, Leghi BE, Diez-Garcia RW. Does feeling what you eat change how you eat? Implications of an intervention to promote consciousness of eating experiences. Front Psychol 2024; 14:1229105. [PMID: 38239476 PMCID: PMC10795314 DOI: 10.3389/fpsyg.2023.1229105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/06/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction This work aims to understand the experience of participating in the Food and Nutrition Education Program workshops with Sensory and Cognitive Exercises (PESC) and measure its impact on eating behavior. Methods The PESC consists of four workshops with exercises stimulating perception and reflection on bodily sensations triggered in eating situations. It was developed to promote consciousness of eating experiences in women who reported difficulty in controlling their body weight and who increased over 5% of their body weight in the previous year. This is a mixed-methods study designed as a controlled trial. The intervention group (n = 19) was evaluated before the first workshop (T0) and after the last workshop (T1) and the control group (n = 18), which did not participate in the workshops, was evaluated twice (T0 and T1), with an interval of 3 to 4 weeks. At T0 and T1, it was applied the Intuitive Eating Scale (IES-2) and the Three Factor Eating Questionnaire (TFEQ-R21). In T1, the intervention group also participated in a qualitative interview. Results After participating in the PESC, the intervention group showed an increase in the IES-2 total score (95% Confidence Interval = (0.10, 0.39)) and a decrease in the emotional eating scale score (95% Confidence Interval = (-16.03; -3.85)). The interviews' analysis revealed the participants' self-observation process, which led to the perception of their practices, priorities, intentions, eating difficulties, and the connection between these aspects and environmental issues. The following themes were considered: Food management/control, Body dissatisfaction, Reflection/re-signification, and Different ways of being in familiar contexts. Discussion The results allow us to infer that, after participating in the PESC, the intention to manage food intake became more effective, less susceptible to oscillations imposed by the external environment, and more supported by internal resources.
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Affiliation(s)
- Carina Carlucci Palazzo
- Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
- Laboratory of Food Practices and Behaviour – PrátiCA, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Barbara Esteves Leghi
- Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
- Laboratory of Food Practices and Behaviour – PrátiCA, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Rosa Wanda Diez-Garcia
- Laboratory of Food Practices and Behaviour – PrátiCA, University of São Paulo (USP), Ribeirão Preto, Brazil
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
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104
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Hart J, Edwards AD, Stainthorpe A. Insights into implementation planning for point-of-care testing to guide treatment of chronic obstructive pulmonary disease exacerbation: a mixed methods feasibility study. Front Health Serv 2024; 3:1302653. [PMID: 38235389 PMCID: PMC10792000 DOI: 10.3389/frhs.2023.1302653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/11/2023] [Indexed: 01/19/2024]
Abstract
The purpose of this mixed methods feasibility study was to gain insights into unmet clinical needs, stakeholder preferences and potential barriers and enablers to adoption for planning the implementation of point-of-care testing for earlier detection and guided treatment of chronic obstructive pulmonary disease (COPD) acute exacerbation in the NHS in England. Exacerbations of COPD cause considerable mortality and morbidity. Earlier identification of exacerbations and guided treatment would lead to reduced exacerbation duration, reduced hospitalizations and mortality, improve health-related quality of life, reduce unnecessary treatments (including inappropriate antibiotic prescribing) which could save the NHS over £400 per patient. During the early stages of product design, we took a multi-disciplinary approach to evidence generation, gaining insights from key stakeholders to test the product concept and inform evidence-based implementation planning. Primary data was collected from 11 health care and service professionals involved in the management of acute COPD exacerbations. Overall, participants agreed that by earlier differentiation of acute exacerbation from stable COPD, patients could be started on appropriate treatment. To implement point-of-care testing into clinical practice, evidence is required to demonstrate the accuracy of differentiating between exacerbation etiologies and to provide information on the beneficial impact to the system in terms of optimized management, reduced long-term side effects, admission avoidance, and cost-effectiveness. This research provides an evidence base for future implementation planning of point-of-care testing for earlier detection and guided treatment of COPD acute exacerbation. Moreover, the technology developers can decide whether to refine the product design and value proposition thereby de-risking product development.
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Affiliation(s)
- Julie Hart
- School of Pharmacy, University of Reading, Reading, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, Oxford Academic Health Science Network, Oxford, United Kingdom
| | | | - Andrew Stainthorpe
- Oxford University Hospitals NHS Foundation Trust, Oxford Academic Health Science Network, Oxford, United Kingdom
- Research Health Limited, Corsham, United Kingdom
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105
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Cooray N, Ho C, Bestman A, Adams S, Nassar N, Keay L, Brown J. Exploring the Potential of a Behavior Theory-Informed Digital Intervention for Infant Fall Prevention: Mixed Methods Longitudinal Study. JMIR Pediatr Parent 2024; 7:e47361. [PMID: 38170580 PMCID: PMC10794959 DOI: 10.2196/47361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Falls are the most common hospitalized injury mechanism in children aged ≤1 years, and currently, there are no targeted prevention interventions. The prevention of falls in children of this age requires changes in the behavior of their caregivers, and theoretically informed digital behavior change interventions (DBCIs) may provide a unique mechanism for achieving effective intervention. However, user acceptance and the ability of DBCIs to effect the required changes in behavior are critical to their likelihood of success. OBJECTIVE This study aims to evaluate a behavior theory-informed digital intervention developed following a user-centered approach for user experience, the potential for this intervention to prevent infant falls, and its impact on behavioral drivers underpinning fall risk in young children. METHODS Parents of infants aged <1 year were recruited and asked to use the intervention for 3 months. A pre-post longitudinal design was used to examine the change in the potential to reduce the risk of falls after a 3-month exposure to the intervention. Postintervention data on behavioral drivers for fall prevention, user acceptability, and engagement with the app were also collected. Interviews were conducted to explore user experiences and identify areas for further improvement of the intervention. RESULTS A total of 62 parents participated in the study. A statistically significant effect on the potential to reduce falls was observed after the intervention. This effect was higher for new parents. Parents agreed that the intervention targeted most of the target behavior drivers. The impact of behavior drivers and intervention on the potential for fall prevention had a positive correlation. The intervention demonstrated good levels of acceptability. Feedback from participants was mostly positive, and the primary area identified for further improvement was widening the scope of the intervention. CONCLUSIONS This study demonstrated the promise of a newly developed digital intervention to reduce the risk of infant falls, particularly among new parents. It also showed a positive influence of the DBCI on the drivers of parental behaviors that are important for fall reduction among infants. The acceptability of the app was high, and important insights were gained from users about how to further improve the app.
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Affiliation(s)
- Nipuna Cooray
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
| | - Catherine Ho
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
| | - Amy Bestman
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
| | - Susan Adams
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
- Department of Paediatric Surgery, Sydney Children's Hospital, Randwick, Australia
| | - Natasha Nassar
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lisa Keay
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, Australia
| | - Julie Brown
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
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Kaittila A, Isoniemi H, Viitasalo K, Moisio M, Raijas A, Toikka E, Tuominen J, Hakovirta M. A Pilot Randomized Controlled Trial of Intervention for Social Work Clients with Children Facing Complex Financial Problems in Finland (FinSoc): A Study Protocol. J Evid Based Soc Work (2019) 2024; 21:32-49. [PMID: 37712670 DOI: 10.1080/26408066.2023.2257174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
PURPOSE Social work clients often face complex financial problems. We have developed a financial social work intervention, FinSoc, to increase financial literacy and economic self-efficacy and reduce financial anxiety among parents with financial problems in Finland. The aim of this pilot randomized controlled trial is to explore the feasibility, acceptability, and preliminary effectiveness of the intervention. This paper, a study protocol, describes the design and implementation of the trial. Study protocols are articles detailing a priori the research plan, rationale, proposed methods and plans for how a clinical trial will be conducted. METHOD This study is a pilot randomized controlled trial with a mixed methods approach applying both quantitative measures and qualitative interviews. Participating social work clients with children are randomly assigned to either the treatment or the waiting list control group at a ratio of 1:1. The treatment group receives the intervention and the control group receives services as usual. The quantitative data from social work clients are collected at three measurement points. Qualitative interviews are conducted post-intervention with both clients receiving, and professionals implementing the intervention. The feasibility is assessed through recruitment and retention rates and the interviews with social work professionals providing the intervention. Acceptability is assessed through feedback from participants on satisfaction with the intervention and usefulness of the specific intervention components. Potential effectiveness is measured by financial literacy, economic self-efficacy and financial anxiety. DISCUSSION The intervention is hypothesized to increase financial literacy and economic self-efficacy and reduce financial anxiety among social work clients with children. The results of this pilot study will increase the evidence base of financial social work and offer new insights for developing interventions for clients experiencing financial difficulties.
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Affiliation(s)
| | | | - Katri Viitasalo
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Meri Moisio
- INVEST Flagship, University of Turku, Turku, Finland
| | - Anu Raijas
- Bank of Finland Museum, Bank of Finland, Helsinki, Finland
| | - Enna Toikka
- Department of Social Research, University of Turku, Turku, Finland
| | - Jarno Tuominen
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Mia Hakovirta
- INVEST Flagship, University of Turku, Turku, Finland
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Hough E, Reed J, O'Reilly M, Lucey M. Evaluating the effectiveness of a clinical nurse specialist triage role in a specialist palliative care community service. Int J Palliat Nurs 2024; 30:29-38. [PMID: 38308601 DOI: 10.12968/ijpn.2024.30.1.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Abstract
BACKGROUND In 2017, a clinical nurse specialist (CNS) triaging role was created within a specialist palliative care community service (SPCCS) in Ireland to enhance the triage process. The aim of this study is to evaluate the effectiveness of the role regarding data collection and reporting. Structured feedback from healthcare professionals (HCPs) was obtained on the effects, challenges and sustainability of this role. METHODS This study used a mixed-methods approach. A quantitative analysis of referrals triaged by the SPCCS CNS over 2 years (2018-2019) was performed. Two focus groups with HCP's within the same service were completed in January 2020 and one-to-one interviews were conducted. The quantitative and qualitative results were merged using a triangulation protocol. RESULTS In 2017, new health service executive (HSE) standards to categorise the urgency of patient assessment were introduced. Quantitatively, an improvement within the triage process was seen, with an increase in compliance with national access standards. In 2018, compliance was 89.1%. In 2019, this was 96.8%, an improvement of 7.7%. A data discrepancy of 9.5% of referrals was noted over the first 9 months of 2018. After this, data documentation and congruency were seen to improve for the final 3 months of 2018 to 100% and remained at 100%. Qualitative data highlighted the benefits and challenges of the Triage CNS role. Mixed-methods correlation revealed corroboration between both using a triangulation protocol. CONCLUSION The triage CNS role was pivotal as an initial point of referral contact. Increased compliance with national access standards occurred resulting in improvements in case and case-load management, information gathering, documentation, data collection and analysis.
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Affiliation(s)
- Emer Hough
- Clinical Nurse Specialist, Milford Care Centre, Castletroy, Limerick, Ireland
| | - Jacqueline Reed
- Nurse Tutor, Milford Care Centre, Castletroy, Limerick, Ireland
| | - Martina O'Reilly
- Head of Education, Quality and Research, Milford Care Centre, Castletroy, Limerick, Ireland
| | - Michael Lucey
- Consultant in Palliative Medicine, Milford Care Centre, Castletroy, Limerick, Ireland
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108
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Ule A, Erjavec K, Klopčič M. Farmers' preferences for breeding goal traits and selection indexes for Slovenian dairy cattle. J Dairy Sci 2024; 107:412-422. [PMID: 37690711 DOI: 10.3168/jds.2022-23202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 07/25/2023] [Indexed: 09/12/2023]
Abstract
The aim of the study was to determine the role played by farmers' sociodemographic factors in the characteristics of dairy farmers' breeding goals and how they are clustered in Slovenia. Understanding how farmers formulate their breeding objectives is crucial because their perspectives may diverge from those of the stakeholders engaged in selection and breeding. Involving farmers in the process of setting breeding goals can improve the use of selection tools and confidence in the selection process. For a more complete picture of how farmers view breeding work, their expectations, and the changes they would prefer to see in the future in terms of new traits and a total merit index, a mixed methods approach was used. Initially, 3 focus groups with 30 participants were conducted on the following main topics: farmers' needs and attitudes regarding genomic selection, the main barriers and advantages to adopting genomic selection, the design of a total merit index, and preferences for breeding goals. To generalize the results to the whole population, an additional online questionnaire was sent to dairy farmers affiliated with Slovenian breeding associations, with 212 farmers responding. Based on how the farmers distributed weights across the trait categories in the total merit index, a cluster analysis identifies 3 distinct groups of farmers. Milk production proved to be an important common factor for all farmers, especially production-focused ones. Functionality-focused farmers expressed the strongest preference for fertility (22%), longevity (18%), and animal health (18%), whereas resilience-focused farmers concentrated on fertility (13%), health (13%), longevity (11%), and workability (11%). Yet, the results also showed that dairy farmers hold quite similar preferences for breeding goal traits, with animal health and welfare, reproductive traits, dominating across the sample and environmental and meat traits being the least important. The quantitative analysis of the preference for new environmental traits showed that farmers express less importance to them due to pressure and negative public opinion about the environmental impact of dairy farming. The focus group participants, although acknowledging that adaptation to climate change and heat stress will be essential, were even more negative about traits related to greenhouse gas emissions, which can be attributed to negative public opinion and constraints on agricultural activity.
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Affiliation(s)
- A Ule
- Department of Animal Science, Biotechnical Faculty, University of Ljubljana, 1230 Domžale, Slovenia
| | - K Erjavec
- Faculty of Economics and Informatics, University of Novo mesto, 8000 Novo mesto, Slovenia
| | - M Klopčič
- Department of Animal Science, Biotechnical Faculty, University of Ljubljana, 1230 Domžale, Slovenia.
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Funk KA, Stillman M, Wang Q, Manser ST, Rogers EA. Association of Burnout With Primary Care Clinician Perception of Team-Based Scheduling Support. J Prim Care Community Health 2024; 15:21501319231222372. [PMID: 38361419 PMCID: PMC10874136 DOI: 10.1177/21501319231222372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/17/2023] [Accepted: 12/02/2023] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Primary care clinician burnout is pervasive and detrimental. How components of teamwork and clinic culture might contribute to burnout remains unsettled. OBJECTIVE To examine associations between primary care clinician perceptions of specific components of teamwork and of organizational culture, and perceived stress and burnout. METHODS Cross-sectional survey study of primary care clinicians from 5 county health system clinics. Measures: Perceptions of teamwork related to coordination of care, and clinic provision of chronic disease self-management support; values alignment and workplace equity; and demographics. DATA ANALYSIS Descriptive statistics and Spearman's correlations to examine associations, controlling for clinic and examining response variability by clinic. RESULTS Of 72 clinicians, 64% were female and 32% non-white. About 56% had worked at least 4 years and half worked 5 to 6 half days/week or more in their clinic. Clinicians who reported having someone on the clinician's care team routinely schedule follow-up appointments for patients with complex chronic illnesses reported lower stress and burnout. Those who perceived greater values alignment with their clinic and greater personal and employee equitable treatment had lower stress and burnout. CONCLUSIONS Teamwork among clinicians and non-clinical staff, a component of teamwork that is not well-considered in current literature, could be an important piece of the puzzle to decrease the persistent and challenging issue of stress and burnout among primary care clinicians.
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Affiliation(s)
- Kylee A. Funk
- University of Minnesota College of Pharmacy, Department of Pharmaceutical Care and Health Systems, Minneapolis, MN, USA
| | - Martin Stillman
- Hennepin Healthcare, Minneapolis, MN, USA
- University of Minnesota Medical School, Department of Medicine, Minneapolis, MN, USA
| | - Qi Wang
- University of Minnesota Clinical and Translational Science Institute, Minneapolis, MN, USA
| | - Sarah Turcotte Manser
- University of Minnesota Medical School, Department of Medicine, Minneapolis, MN, USA
| | - Elizabeth A. Rogers
- University of Minnesota Medical School, Department of Medicine, Minneapolis, MN, USA
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Brown MJ, James T, Kaur A, Addo PNO, Nkwonta CA, Hansen NB, Onwuegbuzie AJ. Childhood sexual abuse and antiretroviral therapy adherence among older adults living with HIV: a mixed methods study. AIDS Care 2024; 36:17-25. [PMID: 37666211 PMCID: PMC10841262 DOI: 10.1080/09540121.2023.2254036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 08/25/2023] [Indexed: 09/06/2023]
Abstract
Findings on the association between childhood sexual abuse (CSA) and antiretroviral therapy (ART) adherence have been varied, with some studies showing a relationship, or a lack thereof. However, to our knowledge, no study has examined this association among older adults living with HIV (OALH). Therefore, the purpose of this study was to examine the association between CSA and ART adherence among OALH using a mixed methods approach. This study, which involved a concurrent design, had two phases. The first phase comprised in-depth, semi-structured interviews of 24 adults aged 50 and older living with HIV in South Carolina. The second phase included data from 91 OALH. Thematic analysis and multivariable regression models, adjusting for age, gender, race, and income, were used to determine the association between CSA and ART adherence. The main theme emerging from the qualitative data was that CSA was not linked with ART adherence. However, contrastingly, quantitative analyses revealed a negative statistically significant association between CSA and ART adherence (adjusted β: -3.35; 95% CI: -5.37, -1.34). This difference in findings could be due to the hidden impact of trauma and/or the use of different study populations. Future research should assess mediating pathways between CSA and ART adherence.
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Affiliation(s)
- Monique J. Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Titilayo James
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Amandeep Kaur
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Prince Nii Ossah Addo
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | | | - Nathan B. Hansen
- Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, Georgia
| | - Anthony J. Onwuegbuzie
- Faculty of Education, University of Cambridge, Cambridge, England
- Faculty of Education, University of Johannesburg, Johannesburg, South Africa
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111
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Keenan L, Bramham J, Downes M. Parent-Report Sleep Disturbances and Everyday Executive Functioning Difficulties in Children with Tourette Syndrome. Dev Neuropsychol 2024; 49:39-60. [PMID: 38224316 DOI: 10.1080/87565641.2023.2300428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/22/2023] [Indexed: 01/16/2024]
Abstract
There is an increasing need to identify and treat sleep disturbances in Tourette syndrome (TS), a neurodevelopmental condition characterized by tics. This study explored sleep, tics, and executive functioning in children with TS (n=136) and neurotypical controls (n=101) through parent-report scales and open-ended questions. 85% of children with TS scored in the clinical range for a sleep disorder. Higher tic severity predicted increased sleep disturbances and executive difficulties. Qualitative insights indicated a bidirectional link between sleep and tics, which warrants consideration in clinical settings. Further research is needed to explore causal links.
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Affiliation(s)
- Lisa Keenan
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Michelle Downes
- School of Psychology, University College Dublin, Dublin, Ireland
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Grattan ES, Hart E, Woodbury M, Nichols M. Impact of Spatial Neglect on Activity and Participation: A Mixed-Methods Study. OTJR (Thorofare N J) 2024; 44:88-97. [PMID: 37599440 DOI: 10.1177/15394492231188314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Post-stroke neglect is disabling, yet it is unclear whether existing assessments capture the extent neglect affects activity and participation. The objective of the study is to explore stroke survivor and caregiver perspectives on how neglect affects activity and participation and to compare their experiences to neglect assessments items. We conducted an explanatory sequential mixed-methods study by conducting semi-structured interviews with stroke survivors (n = 7) and caregivers (n = 7) analyzed using thematic analysis. Stroke survivors completed the Catherine Bergego Scale (CBS) and Behavioral Inattention Test (BIT). Descriptive analyses characterized participant's neglect. The standardized CBS and BIT tests indicated that stroke survivors demonstrated mild-to-moderate (CBS) or no-to-mild (BIT) neglect. In contrast, the qualitative data revealed serious safety concerns and significant ongoing difficulties participating in school, work, and family activities because of neglect. Current assessments may not measure the impact of neglect on activity or participation in life for stroke survivors.
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Affiliation(s)
- Emily S Grattan
- University of Pittsburgh, PA, USA
- VA Pittsburgh Healthcare Center, Pittsburgh, PA, USA
| | - Emerson Hart
- Medical University of South Carolina, Charleston, USA
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113
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Li Q, Zeng J, Zhao B, Perrin N, Wenzel J, Liu F, Pang D, Liu H, Hu X, Li X, Wang Y, Davidson PM, Shi L, Campbell JC. Nurses' preparedness, opinions, barriers, and facilitators in responding to intimate partner violence: A mixed-methods study. J Nurs Scholarsh 2024; 56:174-190. [PMID: 37565409 DOI: 10.1111/jnu.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/15/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Intimate partner violence (IPV) is associated with multiple adverse health consequences. Nurses (including midwives) are well positioned to identify patients subjected to IPV, and provide care, support, and referrals. However, studies about nursing response to IPV are limited especially in low- and middle-income countries (LMICs). The study aimed to examine nurses' perceived preparedness and opinions toward IPV and to identify barriers and facilitators in responding to IPV. DESIGN An explanatory sequential mixed-methods study was conducted by collecting quantitative data first and explaining the quantitative findings with qualitative data. METHODS The study was conducted in two tertiary general hospitals in northeastern (Shenyang city) and southwestern (Chengdu city) China with 1500 and 1800 beds, respectively. A total of 1071 survey respondents (1039 female [97.0%]) and 43 interview participants (34 female [79.1%]) were included in the study. An online survey was administered from September 3 to 23, 2020, using two validated scales from the Physician Readiness to Manage Intimate Partner Violence Survey. In-depth, semistructured interviews were conducted from September 15 to December 23, 2020, guided by the Consolidated Framework for Implementation Research. RESULTS The survey respondents largely agreed with feeling prepared to manage IPV, e.g., respond to discourses (544 [50.8%] of 1071) and report to police (704 [65.7%] of 1071). The findings of surveyed opinions (i.e., Response competencies; Routine practice; Actual activities; Professionals; Victims; Alcohol/drugs) were mixed and intertwined with social desirability bias. The quantitative and qualitative data were consistent, contradicted, and supplemented. Key qualitative findings were revealed that may explain the quantitative results, including lack of actual preparedness, absence of IPV-related education, training, or practice, and socially desirable responses (especially those pertaining to China's Anti-domestic Violence Law). Commonly reported barriers (e.g., patients' reluctance to disclose; time constraints) and facilitators (e.g., patients' strong need for help; female nurses' gender advantage), as well as previously unreported barriers (e.g., IPV may become a workplace taboo if there are healthcare professionals known as victims/perpetrators of IPV) and facilitators (e.g., nurses' responses can largely meet the first-line support requirements even without formal education or training on IPV) were identified. CONCLUSIONS Nurses may play a unique and important role in responding to IPV in LMICs where recognition is limited, education and training are absent, policies are lacking, and resources are scarce. Our findings support World Health Organization recommendations for selective screening. CLINICAL RELEVANCE The study highlights the great potential of nurses for IPV prevention and intervention especially in LMICs. The identified barriers and facilitators are important evidence for developing multifaceted interventions to address IPV in the health sector.
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Affiliation(s)
- Quanlei Li
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jing Zeng
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Bing Zhao
- School of Nursing, Shenyang Medical College, Shenyang, China
| | - Nancy Perrin
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jennifer Wenzel
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fuqin Liu
- College of Nursing, Texas Woman's University, Dallas, Texas, USA
| | - Dong Pang
- School of Nursing, Peking University, Beijing, China
| | - Huaping Liu
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Xiuying Hu
- Innovation Center of Nursing Research, West China Hospital, Sichuan University, Chengdu, China
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yanyan Wang
- Nursing Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, and Science and Technology Department, West China Hospital, Sichuan University, Chengdu, China
| | | | - Leiyu Shi
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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114
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Ramos AK, Dinkel D, Trinidad N, Carvajal-Suarez M, Schmeits K, Molina D, Boron JB. Acceptability of Intergenerational Physical Activity Programming: A Mixed Methods Study of Latino Aging Adults in Nebraska. J Aging Health 2024; 36:14-24. [PMID: 36961752 DOI: 10.1177/08982643231166167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Objective: This study explored Hispanic/Latino aging adults' interest in and preferences for intergenerational physical activity programming. Methods: We used an exploratory sequential (Qual-QUAN) mixed methods design consisting of three focus groups (N = 13 participants; M age = 62.5 years old) and a quantitative survey (N = 105 participants; M age = 57.3 years old). Results: We found that most participants were interested in intergenerational physical activity programs: (1) to promote overall health and well-being, (2) increase opportunities for socialization and relationships, and (3) foster motivation and energy. Preferences for programming included cultural tailoring, bilingual and Spanish-language offerings, and being conducted in-person. Barriers to physical activity included cost, scheduling, transportation, and limited awareness of community resources. Discussion: Innovative public health initiatives incorporating an intergenerational approach may promote physical activity among aging adults. This study has implications for developing and refining intergenerational programming with Hispanic/Latino communities.
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Affiliation(s)
- Athena K Ramos
- Department of Health Promotion, Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, NE, USA
| | - Danae Dinkel
- School of Health & Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Natalia Trinidad
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Marcela Carvajal-Suarez
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Karen Schmeits
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Diana Molina
- Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Julie B Boron
- Department of Gerontology, College of Public Affairs and Community Service, University of Nebraska, Omaha, NE, USA
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Moore SA, Sridhar A, Taormina I, Rajadhyaksha M, Azad G. The perspective of school leaders on the implementation of evidence-based practices: A mixed methods study. Implement Res Pract 2024; 5:26334895231220279. [PMID: 38322802 PMCID: PMC10775739 DOI: 10.1177/26334895231220279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Background School leaders play an integral role in the use of implementation strategies, which in turn support special education teachers in the implementation of evidence-based practices (EBPs). In this convergent mixed methods study, we explored school leaders' perceptions of the facilitators and barriers to EBP implementation, particularly for students receiving special education, as well as the importance and feasibility of 15 implementation strategies. Method School leaders (N = 22, principals, assistant principals, school psychologists, etc.) participated in a semistructured interview that included three parts-qualitative questions, quantitative ratings of strategies' importance and feasibility, and discussion of the top three implementation strategies. Data strands were analyzed independently and then integrated to generate meta-inferences. Results The qualitative data identified facilitators such as access to resources about the intervention (e.g., professional development) and collaboration and teamwork, while barriers centered on lack of school supports, culture/climate, and organizational factors (e.g., lack of communication). The quantitative data indicated that the implementation strategy provide ongoing consultation/coaching was rated as important and feasible. Monitor the progress of the implementation effort was rated as important but less feasible, while conduct educational meetings and change the environment were rated as feasible, but less important. Build partnerships to support implementation was rated as less important and feasible. There was convergence and divergence in mixed methods findings. Conclusion This study underscores the critical need to increase school leaders' knowledge and skills related to implementation science to better leverage implementation strategies that address the confluence of relevant implementation determinants.
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Affiliation(s)
- Stephanie A. Moore
- School of Education, University of California Riverside, Riverside, CA, USA
| | - Aksheya Sridhar
- Psychology Department, Michigan State University, East Lansing, MI, USA
| | - Isabella Taormina
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physician and Surgeons, New York, NY, USA
| | | | - Gazi Azad
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physician and Surgeons, New York, NY, USA
- Center for Autism and the Developing Brain, Weill Cornell Medicine, New York, NY, USA
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Regan C, Rosen PV, Andermo S, Hagströmer M, Johansson UB, Rossen J. The acceptability, usability, engagement and optimisation of a mHealth service promoting healthy lifestyle behaviours: A mixed method feasibility study. Digit Health 2024; 10:20552076241247935. [PMID: 38638403 PMCID: PMC11025415 DOI: 10.1177/20552076241247935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/28/2024] [Indexed: 04/20/2024] Open
Abstract
Objective Mobile health (mHealth) services suffer from high attrition rates yet represent a viable strategy for adults to improve their health. There is a need to develop evidence-based mHealth services and to constantly evaluate their feasibility. This study explored the acceptability, usability, engagement and optimisation of a co-developed mHealth service, aiming to promote healthy lifestyle behaviours. Methods The service LongLife Active® (LLA) is a mobile app with coaching. Adults were recruited from the general population. Quantitative results and qualitative findings guided the reasoning for the acceptability, usability, engagement and optimisation of LLA. Data from: questionnaires, log data, eight semi-structured interviews with users, feedback comments from users and two focus groups with product developers and coaches were collected. Inductive content analysis was used to analyse the qualitative data. A mixed method approach was used to interpret the findings. Results The final sample was 55 users (82% female), who signed up to use the service for 12 weeks. Engagement data was available for 43 (78%). The action plan was the most popular function engaged with by users. The mean scores for acceptability and usability were 3.3/5.0 and 50/100, respectively, rated by 15 users. Users expressed that the service's health focus was unique, and the service gave them a 'kickstart' in their behaviour change. Many ways to optimise the service were identified, including to increase personalisation, promote motivation and improve usability. Conclusion By incorporating suggestions for optimisation, this service has the potential to support peoples' healthy lifestyle behaviours.
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Affiliation(s)
- Callum Regan
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Phillip Von Rosen
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Susanne Andermo
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Sport Science, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Maria Hagströmer
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
| | - Unn-Britt Johansson
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Jenny Rossen
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
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Helgøy KV, Bonsaksen T, Mørk G. Occupational therapy students' experiences and perceptions of journal club participation. Scand J Occup Ther 2024; 31:2328712. [PMID: 38652886 DOI: 10.1080/11038128.2024.2328712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 03/06/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Journal clubs can be used as a learning activity for developing students' skills in critical appraisal and are perceived as suitable for increasing students' exposure to research methods. AIMS/OBJECTIVES To explore how undergraduate occupational therapy students experienced journal club and how they perceived their learning outcomes from participating in this learning activity. MATERIALS AND METHODS A mixed methods study comprised of a survey followed by two focus groups was conducted. Seventeen occupational therapy students completed the survey, four of whom also participated in a total of two focus groups. RESULTS The participants perceived journal clubs as suitable and they suggested that emphasis on this learning activity be increased. Across the two focus groups, four integrated themes were identified: 'organisational prerequisites'; 'potential for learning'; 'learning barriers'; and 'journal club as an integrated learning activity'. CONCLUSIONS AND SIGNIFICANCE Journal clubs were described as having the potential for increasing students' learning regarding research methods, promoting skills in reading and critically reviewing research articles and having relevance for professional practice. Some barriers were identified, and changes are suggested for future educational practice.
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Affiliation(s)
| | - Tore Bonsaksen
- Department of Health, Faculty of Health Sciences, VID Specialized University, Stavanger, Norway
- Department of Health and Nursing Science, Faculty of Social and Health Sciences, Inland Norway University of Applied Science, Elverum, Norway
| | - Gry Mørk
- Department of Health, Faculty of Health Sciences, VID Specialized University, Stavanger, Norway
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Brunet J, Price J, Baillot A, Dann E, Vani MF. Feasibility and acceptability of study methods and psychosocial interventions for body image among women diagnosed with breast cancer: A systematic review and narrative synthesis. Psychooncology 2024; 33:e6278. [PMID: 38282235 DOI: 10.1002/pon.6278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/02/2023] [Accepted: 12/13/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE This systematic review aimed to summarize evidence for the feasibility and acceptability of psychosocial interventions for body image among women diagnosed with breast cancer and the study methods used to evaluate the interventions in question. METHODS Articles were identified via MEDLINE, CINAHL, CENTRAL, PsychINFO, and EMBASE. Inclusion criteria were: (1) peer-reviewed publication in English from 2000 onward with accessible full-text, (2) reported data on the feasibility and/or acceptability of psychosocial interventions and/or study methods, (3) included at least one measure of body image or reported a body-related theme, and (4) sample comprised women diagnosed with breast cancer. All study designs were eligible. Two reviewers independently performed study selection, data extraction, and quality assessment. RESULTS Sixty-two articles were included. Participants and comparator groups varied as did interventions. Feasibility and acceptability of the interventions and study methods were inconsistently operationalized and reported across studies. Evidence of feasibility and acceptability was heterogeneous within and across studies, though mostly positive. CONCLUSION Published psychosocial interventions for body image and study methods are generally feasible and acceptable. Findings should be used to advance the development, implementation, and evaluation of interventions designed to improve outcomes (body image or otherwise) for women diagnosed with breast cancer. SYSTEMATIC REVIEW REGISTRATION This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; ID: CRD42021269062, 11 September 2021).
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada
| | - Jenson Price
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Aurélie Baillot
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada
- Département des Sciences Infirmières, Université du Québec en Outaouais, Gatineau, Québec, Canada
- Centre de Recherche en Médecine Psychosociale, Gatineau, Québec, Canada
| | - Erica Dann
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Madison F Vani
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Samuels E, Janevic MR, Harper AE, Lyden AK, Jay GM, Champagne E, Murphy SL. Updating and evaluating a research best practices training course for social and behavioral research professionals. J Clin Transl Sci 2023; 8:e12. [PMID: 38384926 PMCID: PMC10877512 DOI: 10.1017/cts.2023.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/20/2023] [Accepted: 12/14/2023] [Indexed: 02/23/2024] Open
Abstract
Introduction The clinical and translational research workforce involved in social and behavioral research (SBR) needs to keep pace with clinical research guidance and regulations. Updated information and a new module on community and stakeholder engagement were added to an existing SBR training course. This article presents evaluation findings of the updated course for the Social and Behavioral Workforce. Methods and Materials Participants working across one university were recruited. Course completers were sent an online survey to evaluate the training. Some participants were invited to join in a focus group to discuss the application of the training to their work. We performed descriptive statistics and conducted a qualitative analysis on focus group data. Results There were 99 participants from diverse backgrounds who completed the survey. Most reported the training was relevant to their work or that of the study teams they worked with. Almost half (46%) indicated they would work differently after participating. Respondents with community or stakeholder engaged research experience vs. those without were more likely to report that the new module was relevant to study teams they worked with (t = 5.61, p = 0.001), and that they would work differently following the training (t = 2.63, p = 0.01). Open-ended survey responses (n = 99) and focus group (n = 12) data showed how participants felt their work would be affected by the training. Conclusion The updated course was rated highly, particularly by those whose work was related to the new course content. This course provides an up-to-date resource for the training and development for the Social and Behavioral Workforce.
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Affiliation(s)
- Elias Samuels
- Michigan Institute of Clinical and Health Research,
University of Michigan, Ann Arbor,
MI, USA
| | - Mary R. Janevic
- Department of Health Behavior and Health Education, School of
Public Health, University of Michigan, Ann Arbor,
MI, USA
- Department of Physical Medicine and Rehabilitation,
University of Michigan, Ann Arbor,
MI, USA
| | - Alexandra E. Harper
- Department of Physical Medicine and Rehabilitation,
University of Michigan, Ann Arbor,
MI, USA
| | - Angela K. Lyden
- Michigan Institute of Clinical and Health Research,
University of Michigan, Ann Arbor,
MI, USA
- Clinical Trials Support Office, University of
Michigan, Ann Arbor, MI, USA
| | - Gina M. Jay
- Department of Physical Medicine and Rehabilitation,
University of Michigan, Ann Arbor,
MI, USA
| | - Ellen Champagne
- Michigan Institute of Clinical and Health Research,
University of Michigan, Ann Arbor,
MI, USA
| | - Susan L. Murphy
- Michigan Institute of Clinical and Health Research,
University of Michigan, Ann Arbor,
MI, USA
- Department of Health Behavior and Health Education, School of
Public Health, University of Michigan, Ann Arbor,
MI, USA
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Chacón-Moscoso S, Anguera MT, Sanduvete-Chaves S, Lozano-Lozano JA. Methodological procedure based on quantitizing/liquefying: a case study to assess work climate in an emergency department. Front Psychol 2023; 14:1247577. [PMID: 38196562 PMCID: PMC10774222 DOI: 10.3389/fpsyg.2023.1247577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024] Open
Abstract
Introduction In the assessment of health organizations, results-based indicators are mainly used, with no consideration of internal work dynamics. This type of assessment forfeits much of the rich, useful information needed to make decisions on improving the organization. In order to address this, a rigorous procedure based on mixed methods is laid out here on gathering, analyzing, and interpreting data associated with the implementation process. Methods A 55-year-old doctor was selected at random from among the staff who volunteered to be interviewed at the emergency department at a public hospital located in southern Spain for an interview. Qualitative data obtained from the in-depth interview (indirect observation) were progressively systematized (liquefied and quantitized) based on a theoretical framework until a code matrix was obtained, without losing or distorting any information. Afterwards, data quality was controlled using Cohen's kappa (κ) coefficient. A quantitative polar coordinate analysis was then carried out using the free software HOISAN (v. 1.6.3.3) to obtain robust results, vectorizing the relationships between codes and specifying whenever such relationships were statistically significant (and if they resulted in behavior activation or inhibition). Finally, a supplementary quantitative and qualitative assessment was carried out. Results and discussion The proposed method was applied to the needs assessment of teams in order to evaluate that work climate in the hospital's emergency department Health Services of a hospital. Data quality control yielded an adequate result (κ = 0.82). Significant activation and inhibition of behaviors occurred, both prospectively and retrospectively. For instance, We seek to understand the needs of our clients and We readily adapt to new circumstances showed a significant activation (vector length = 3.43, p < 0.01) both prospectively (Zsum = 0.48) and retrospectively (Zsum = 3.4).An adequate method to obtain detailed information about group dynamics in a work environment is presented, based on an in-depth interview. Practical applications for implementations to improve the functioning of organizations are presented.
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Affiliation(s)
- Salvador Chacón-Moscoso
- Departamento de Psicología Experimental, Facultad de Psicología, Universidad de Sevilla, Seville, Spain
- Departamento de Psicología, Universidad Autónoma de Chile, Santiago, Chile
| | | | - Susana Sanduvete-Chaves
- Departamento de Psicología Experimental, Facultad de Psicología, Universidad de Sevilla, Seville, Spain
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Keller J, Kayira J, Chawla L, Rhoades JL. Forest Bathing Increases Adolescents' Mental Well-Being: A Mixed-Methods Study. Int J Environ Res Public Health 2023; 21:8. [PMID: 38276796 PMCID: PMC10815422 DOI: 10.3390/ijerph21010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/04/2023] [Accepted: 12/13/2023] [Indexed: 01/27/2024]
Abstract
Previous research has demonstrated that practicing forest bathing has significant positive effects on adult psychological well-being. Considering the ongoing adolescents' mental health crisis of increasing anxiety and depression, determining whether forest bathing has similar effects on adolescents is an important expansion of forest bathing research. This study investigated the possibility that forest bathing could improve adolescents' mental well-being and sought to determine participants' experiences of forest bathing. It used a convergent, parallel, mixed-methods design that was partially co-created with 24 participants aged 16-18 as part of a youth participatory action research (YPAR) project in which participants practiced forest bathing three times over 3 weeks. As measured using the Warwick-Edinburgh Mental Well-Being Survey, the mean participant mental well-being increased significantly after forest bathing, with moderate to large effect sizes. Participants described reduced stress and increased feelings of relaxation, peace, and happiness. These findings correlate with previous forest bathing research involving adult participants. It is recommended that educators and others who work with adolescents consider forest bathing as a simple, low-cost way to improve adolescents' mental well-being.
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Affiliation(s)
- Jennifer Keller
- Department of Environmental Studies, Antioch University, New England, Keene, NH 03431, USA;
| | - Jean Kayira
- Department of Environmental Studies, State University of New York College of Environmental Science and Forestry, Suracuse, NY 13201, USA;
| | - Louise Chawla
- Program in Environmental Design, University of Colorado Boulder, Boulder, CO 80309, USA;
| | - Jason L. Rhoades
- Department of Environmental Studies, Antioch University, New England, Keene, NH 03431, USA;
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Tuda D, Bochicchio L, Stefancic A, Hawes M, Chen JH, Powell BJ, Cabassa LJ. Using the matrixed multiple case study methodology to understand site differences in the outcomes of a Hybrid Type 1 trial of a peer-led healthy lifestyle intervention for people with serious mental illness. Transl Behav Med 2023; 13:919-927. [PMID: 37844273 PMCID: PMC10724107 DOI: 10.1093/tbm/ibad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
Site differences in implementation trial outcomes are common but often not examined. In a Hybrid Type 1 trial examining the effectiveness-implementation of a peer-led group life-style balance (PGLB) intervention for people with serious mental illness (SMI) in three supportive housing agencies, we found that PGLB recipients' physical health outcomes differed by study sites. The matrixed multiple case study methodology was used to explore how implementation outcomes and changes in context of usual care (UC) services contributed to these site differences. Two implementation outcomes (i.e. PGLB fidelity ratings and intervention recipients' acceptability of PGLB and UC) and changes in healthcare services integration at the study sites were examined. ANOVAs were used to examine site differences in fidelity ratings and client satisfaction. Directed content analysis was used to analyze leadership interviews to identify changes in the context of UC services. Site 3 showed a trend approaching significance (P = .05) towards higher fidelity ratings. High levels of satisfaction with PGLB were reported at all sites. Significant differences in PGLB recipients' satisfaction with UC were found, with Site 3 reporting the lowest levels of satisfaction. Agency leaders reported an increase in prioritizing client's health throughout the trial with sites differing in how these priorities were put into action. Differences in PGLB recipients' satisfaction with UC, and changes in healthcare service integration seemed to have contributed to the site differences in our trial. The matrixed multiple case study methodology is a useful approach to identify implementation outcomes contributing to the heterogeneity of multisite implementation trial results.
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Affiliation(s)
- Daniela Tuda
- George Warren Brown School of Social Work, Washington University in St. Louis Campus Box 1196, One Brookings Drive, St. Louis, MO 63130-4899, USA
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
| | - Lauren Bochicchio
- School of Nursing, Columbia University, 560 West 168th Street, New York, NY 10032, USA
| | - Ana Stefancic
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 98, New York, NY 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
| | - Mark Hawes
- George Warren Brown School of Social Work, Washington University in St. Louis Campus Box 1196, One Brookings Drive, St. Louis, MO 63130-4899, USA
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
| | - Jun-Hong Chen
- George Warren Brown School of Social Work, Washington University in St. Louis Campus Box 1196, One Brookings Drive, St. Louis, MO 63130-4899, USA
| | - Byron J Powell
- George Warren Brown School of Social Work, Washington University in St. Louis Campus Box 1196, One Brookings Drive, St. Louis, MO 63130-4899, USA
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
- Center for Dissemination and Implementation, Institute for Public Health, Washington University in St. Louis, 600 S Taylor Ave, St. Louis, MO 63110, USA
- Division of Infectious Diseases, John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis, 660 S Euclid Ave, St. Louis, MO 63110, USA
| | - Leopoldo J Cabassa
- George Warren Brown School of Social Work, Washington University in St. Louis Campus Box 1196, One Brookings Drive, St. Louis, MO 63130-4899, USA
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
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Butcher MB, Haakenstad MK, Noonan CJ, Fyfe-Johnson AL. Identifying Challenges and Solutions to Early Childhood Education and the Perceived Importance of Outdoor Time: A Mixed Methods Approach in a Socioeconomically Diverse Population. Int J Environ Res Public Health 2023; 20:7166. [PMID: 38131717 PMCID: PMC10871083 DOI: 10.3390/ijerph20247166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/24/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
The current literature supports the positive relationship between time in nature and the improvement in children's health and identifies early childhood education (ECE) settings as an avenue for intervention. Unfortunately, access to both outdoor time and ECE opportunities is lower in communities facing economic adversity. Efforts are needed to identify the best approaches to incorporate outdoor time in ECE settings, especially in communities facing socioeconomic adversity. The objectives of this research were to use a mixed methods approach to identify (1) barriers and solutions to the integration of outdoor time in ECE settings, (2) if outdoor time is a priority in ECE settings compared to other ECE priorities, and (3) how socioeconomic status influences ECE priorities and barriers for outdoor time, and health outcomes. Fourteen focus groups were conducted (n = 50) in the United States (US) with participants from three stakeholder groups: outdoor educators, parents of children attending outdoor preschool, and community members with children. Participants completed a survey (n = 49) to evaluate demographics, views on ECE and outdoor time, and health characteristics. Exploratory analyses of F as an effect modifier were conducted. The survey results showed that parents prioritized social and emotional learning and outdoor time when selecting an ECE setting for their child. The barriers identified include financial challenges and the limited availability of ECE programs. The solutions discussed included increased availability and financial support. Low income was correlated with higher rates of anxiety and increased outdoor time was a potential protective factor. These insights inform interventions to enhance outdoor time in ECE settings, with the goal of reducing disparities and promoting children's overall health.
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Affiliation(s)
| | | | | | - Amber L. Fyfe-Johnson
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99202, USA; (M.B.B.); (M.K.H.)
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Coyne P, Woodruff SJ. Taking a Break: The Effects of Partaking in a Two-Week Social Media Digital Detox on Problematic Smartphone and Social Media Use, and Other Health-Related Outcomes among Young Adults. Behav Sci (Basel) 2023; 13:1004. [PMID: 38131860 PMCID: PMC10740995 DOI: 10.3390/bs13121004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023] Open
Abstract
Despite their increasing popularity, especially among young adults, there is a dearth of research examining the effectiveness of digital detoxes focused on restricting or limiting social media use. As such, the purpose of this exploratory study was to create and carry out a social media digital detox among young adults and evaluate its effectiveness with regards to smartphone and social media addiction, as well as several health-related outcomes. Additionally, the study also sought to obtain an understanding of participants' experiences and perceptions regarding the digital detox via semi-structured exit interviews in order to improve and maximize the effectiveness of future social media digital detox interventions. Thirty-one young adults completed a two-week social media digital detox (preceded by a two-week baseline period and followed up by a two-week follow-up period), whereby their social media use was limited to 30 min per day. A series of one-way repeated measures analyses of variance revealed that a two-week social media detox improved smartphone and social media addiction, as well as sleep, satisfaction with life, stress, perceived wellness, and supportive relationships. Thematic analysis of exit interviews also revealed eight themes: feelings, effort to detox, adjustment period, the Goldilocks effect, screen to screen, post-detox binge, progress not perfection, and words of wisdom, all of which provide contextualization of the quantitative findings and valuable insights for future detoxes. In conclusion, the findings of this exploratory study provide initial support for the use of social media digital detoxes, suggesting that limiting usage can have beneficial effects with regards to smartphone and social media addiction, as well as many other health-related outcomes.
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Affiliation(s)
- Paige Coyne
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI 48202, USA
| | - Sarah J. Woodruff
- Department of Kinesiology, University of Windsor, Windsor, ON N9B 3P4, Canada;
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Haakenstad MK, Butcher MB, Noonan CJ, Fyfe-Johnson AL. Outdoor Time in Childhood: A Mixed Methods Approach to Identify Barriers and Opportunities for Intervention in a Racially and Ethnically Mixed Population. Int J Environ Res Public Health 2023; 20:7149. [PMID: 38131701 PMCID: PMC10743276 DOI: 10.3390/ijerph20247149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/25/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023]
Abstract
A growing body of literature suggests that outdoor time is beneficial for physical and mental health in childhood. Profound disparities exist in access to outdoor spaces (and the health benefits thereof) for children in communities of color. The objectives of this research were to: (1) identify challenges and solutions to outdoor time for children; (2) assess the importance of outdoor time for children; and (3) evaluate results stratified by race/ethnicity. Using a convergent mixed methods approach, we conducted a thematic analysis from 14 focus groups (n = 50) with outdoor educators, parents with children attending outdoor preschools, and community members with children. In addition, 49 participants completed a survey to identify challenges and solutions, perceived importance, and culturally relevant perspectives of outdoor time. The main challenges identified for outdoor time were safety concerns, inclement weather, lack of access to outdoor spaces, and parent work schedules. The primary proposed solution was integrating outdoor time into the school day. Nearly all participants, independent of racial identity, reported that outdoor time improved physical and mental health. Overall outdoor time was lower in participants from communities of color (~8 h/week) compared to their White counterparts (~10 h/week). While 50% of people of color (POC) reported that outdoor time was an important cultural value, only 18% reported that people in their respective culture spent time outside. This work contributes to accumulating knowledge that unique barriers to outdoor time exist for communities of color, and the children that live, learn, and play in these communities. Increasing outdoor time in school settings offers a potential solution to reduce identified barriers and to promote health equity in childhood.
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Affiliation(s)
- Magdalena K. Haakenstad
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
| | - Maria B. Butcher
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99202, USA;
| | - Carolyn J. Noonan
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
| | - Amber L. Fyfe-Johnson
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
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Ezzat AM, King MG, De Oliveira Silva D, Pazzinatto MF, Caneiro JP, Gourd S, McGlasson R, Malliaras P, Dennett A, Russell T, Kemp JL, Barton CJ. Co-development and evaluation of the Musculoskeletal Telehealth Toolkit for physiotherapists. Musculoskeletal Care 2023. [PMID: 38047755 DOI: 10.1002/msc.1840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 12/05/2023]
Abstract
INTRODUCTION In-person physiotherapy services are not readily available to all individuals with musculoskeletal conditions, especially those in rural regions or with time-intensive responsibilities. The COVID-19 pandemic highlighted that telehealth may facilitate access to, and continuity of care, yet many physiotherapists lack telehealth confidence and training. This project co-developed and evaluated a web-based professional development toolkit supporting physiotherapists to provide telehealth services for musculoskeletal conditions. METHODS A mixed-methods exploratory sequential design applied modified experience-based co-design methods (physiotherapists [n = 13], clinic administrators [n = 2], and people with musculoskeletal conditions [n = 7]) to develop an evidence-informed toolkit. Semi-structured workshops were conducted, recorded, transcribed, and thematically analysed, refining the toolkit prototype. Subsequently, the toolkit was promoted via webinars and social media. The usability of the toolkit was examined with pre-post surveys examining changes in confidence, knowledge, and perceived telehealth competence (19 statements modelled from the theoretical domains framework) between toolkit users (>30 min) and non-users (0 min) using chi-squared tests for independence. Website analytics were summarised. RESULTS Twenty-two participants engaged in co-design workshops. Feedback led to the inclusion of more patient-facing resources, increased assessment-related visual content, streamlined toolkit organisation, and simplified, downloadable infographics. Three hundred and twenty-nine physiotherapists from 21 countries completed the baseline survey, with 172 (52%) completing the 3-month survey. Toolkit users had greater improvement in knowledge, confidence, and competence than non-users in 42% of statements. Seventy-two percentage of toolkit users said it changed their practice, and 95% would recommend the toolkit to colleagues. During the evaluation period, the toolkit received 5486 total views. DISCUSSION The co-designed web-based Musculoskeletal Telehealth Toolkit is a professional development resource that may increase physiotherapist's confidence, knowledge, and competence in telehealth.
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Affiliation(s)
- Allison M Ezzat
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthew G King
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
- Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Danilo De Oliveira Silva
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Marcella F Pazzinatto
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - J P Caneiro
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Stephanie Gourd
- Australian Catholic University, Melbourne, Victoria, Australia
| | | | - Peter Malliaras
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine, Nursing, and Health Science, Monash University, Clayton, Victoria, Australia
| | - Amy Dennett
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Victoria, Australia
| | - Trevor Russell
- RECOVER Injury Research Centre, The University of Queensland, Herston, Queensland, Australia
| | - Joanne L Kemp
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
- Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Christian J Barton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
- Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
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O'Rourke HM, Jeffery N, Walsh B, Quark S, Sidani S. Understanding Acceptability of Group Leisure Activities Used to Address Loneliness Among People Living With Dementia: An Exploratory Mixed-Methods Study. Can J Aging 2023; 42:565-575. [PMID: 37492945 DOI: 10.1017/s0714980823000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
This mixed-methods complementarity study explored family members', friends', and health care providers' perspectives of acceptability of group leisure activities as an intervention for loneliness experienced by older adults living with dementia. A sample of 25 family members, friends, and health care providers of people living with dementia in ON rated the acceptability of group leisure activities (adapted Treatment Perception and Preference questionnaire) and discussed their ratings in an interview. Quantitative (descriptive statistics) and qualitative (conventional content analysis) results were integrated to understand acceptability. Participants viewed group leisure activities as effective, logical, and suitable for use with people living with dementia. Participants described the need for flexible programs, careful facilitation, and attention to activity selection. Group leisure activities were seen as low risk, but stigmas related to dementia could prevent participation. The findings inform the design of acceptable group leisure activities, promoting their use to address loneliness in people living with dementia.
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Affiliation(s)
- Hannah M O'Rourke
- Faculty of Nursing, University of Alberta Level 3, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Nicole Jeffery
- School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
| | - Brittany Walsh
- Faculty of Nursing, University of Alberta Level 3, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Sheylenne Quark
- Faculty of Nursing, University of Alberta Level 3, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Souraya Sidani
- School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
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Verma SJ, Gulati P, Injety RJ, Arora D, Dhasan A, Singhania A, Khatter H, Sharma M, Sylaja PN, Pandian JD. Secondary prevention by structured semi-interactive stroke prevention package in INDIA (SPRINT INDIA): Findings from the process evaluation of a randomized controlled trial. Eur Stroke J 2023; 8:1053-1063. [PMID: 37585729 PMCID: PMC10683732 DOI: 10.1177/23969873231192291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/02/2023] [Indexed: 08/18/2023] Open
Abstract
INTRODUCTION Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in INDIA Trial delivered secondary stroke awareness intervention to sub-acute stroke patients in form of workbook, videos and SMS across 31 centres in 12 languages. Trial was stopped for futility due to fewer vascular outcomes than anticipated. Trial results indicated that trial intervention, did not lead to reduction in vascular events. We carried out process evaluation, to evaluate trial implementation and participant's perspectives, to comprehend the trial's futile outcomes. MATERIALS AND METHODS Using mixed methods approach, qualitative interviews and quantitative data from case report forms, workbooks and questionnaires were analysed to measure intervention fidelity and contamination. Using purposive sampling, 115 interviews of patient-caregiver dyads and health professionals at 11 centres and 2 focus group discussions were held. RESULTS AND DISCUSSION Iterative thematic analysis of qualitative data was done with RE-AIM and realist models. There was good fidelity to intervention and adherence to protocol; however, there was dilution of inclusion criteria by randomly enrolling uneducated and caregiver-dependent patients. Centre coordinators provided counselling to both arms, not specified by protocol, causing bias. Coordinators found it difficult to keep patients motivated to view intervention which was corroborated by fidelity questionnaire showing decreased viewing of intervention for a year. Cardiovascular protection improved in routine care by virtue of participating in trial. No contamination of intervention was reported. CONCLUSION The intervention was acceptable by patients and caregivers, which could be made a community-based programme. Reasons identified for decreased viewing were repetitive content and non-availability of personal cellular device.
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Affiliation(s)
- Shweta Jain Verma
- Department of Neurology, Christian Medical College, Ludhiana, Punjab, India
| | - Puja Gulati
- School of Pharmacy, Desh Bhagat University, Mandi Gobindgarh, Punjab, India
| | - Ranjit J Injety
- Department of Neurology, Christian Medical College, Ludhiana, Punjab, India
| | - Deepti Arora
- Department of Neurology, Christian Medical College, Ludhiana, Punjab, India
| | - Aneesh Dhasan
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Anusha Singhania
- Department of Neurology, Christian Medical College, Ludhiana, Punjab, India
| | - Himani Khatter
- Department of Neurology, Christian Medical College, Ludhiana, Punjab, India
| | - Meenakshi Sharma
- Non-Communicable Diseases Section, Indian Council of Medical Research, New Delhi, India
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Smit AK, Vos RC, Bijl RW, Busch KJG, Verkleij SM, Kiefte-de Jong JC, Numans ME, Bonten TN. Implementation of a group-based lifestyle intervention programme (Healthy Heart) in general practices in The Netherlands: a mixed-methods study. BJGP Open 2023; 7:BJGPO.2023.0064. [PMID: 37402548 DOI: 10.3399/bjgpo.2023.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/01/2023] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Lifestyle intervention programmes target behavioural risk factors that contribute to cardiovascular diseases (CVDs). Unfortunately, sustainable implementation of these programmes can be challenging. Gaining insights into the barriers and facilitators for successful implementation is important for maximising public health impact of these interventions. The Healthy Heart (HH) programme is an example of a combined lifestyle intervention programme. AIM To analyse the reach, adoption, and implementation of the HH programme. DESIGN & SETTING A mixed-methods study conducted in a general practice setting in The Netherlands. METHOD Quantitative data were collected from the Healthy Heart study (HH study), a non-randomised cluster stepped-wedge trial to assess the effect of the HH programme on patients at high risk of developing CVDs at practice level. Qualitative data were obtained through focus groups. RESULTS Out of 73 approached general practices, 55 implemented the HH programme. A total of 1082 patients agreed to participate in the HH study, of whom 64 patients were referred to the HH programme and 41 patients participated. Several barriers for participation were identified such as time investment, lack of risk perception, and being confident in changing lifestyle on their own. Important barriers for healthcare providers (HCPs) to refer a patient were time investment, lack of information to sufficiently inform patients, and preconceived notions regarding which patients the programme was suitable for. CONCLUSION This study has offered insights from a patient and HCP perspective regarding barriers and facilitators for implementation of the group-based lifestyle intervention programme. The identified barriers and facilitators, and the suggested improvements, can be used by others who wish to implement a similar programme.
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Affiliation(s)
- Anne K Smit
- Department of Public Health and Primary Care (V-0-P), Leiden University Medical Center, Leiden, The Netherlands
| | - Rimke C Vos
- Department of Public Health and Primary Care (V-0-P), Leiden University Medical Center, Leiden, The Netherlands
| | - Rozemarijn W Bijl
- Department of Public Health and Primary Care (V-0-P), Leiden University Medical Center, Leiden, The Netherlands
| | - Karin J G Busch
- Primary Care Group The Hague (Hadoks), Hague, The Netherlands
| | - Sanne M Verkleij
- Department of Public Health and Primary Care (V-0-P), Leiden University Medical Center, Leiden, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Public Health and Primary Care (V-0-P), Leiden University Medical Center, Leiden, The Netherlands
| | - Mattijs E Numans
- Department of Public Health and Primary Care (V-0-P), Leiden University Medical Center, Leiden, The Netherlands
| | - Tobias N Bonten
- Department of Public Health and Primary Care (V-0-P), Leiden University Medical Center, Leiden, The Netherlands
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Javdani S, Larsen SE, Allen NE, Blackburn AM, Griffin B, Rieger A. Mixed methods in community psychology: A values-forward synthesis. Am J Community Psychol 2023; 72:355-365. [PMID: 37786971 PMCID: PMC10843471 DOI: 10.1002/ajcp.12703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/20/2023] [Accepted: 08/01/2023] [Indexed: 10/04/2023]
Abstract
Mixed methods research (MMR) combines multiple traditions, methods, and worldviews to enrich research design and interpretation of data. In this virtual special issue, we highlight the use of MMR within the field of community psychology. The first MMR studies appeared in flagship community psychology journals over 30 years ago (in 1991). To explore the uses of MMR in the field, we first review existing literature by identifying all papers appearing in either Journal of Community Psychology or American Journal of Community Psychology in which the word "mixed" appeared. A total of 88 publications were identified. Many of these papers illustrate the pragmatic use of MMR to evaluate programs and to answer different research questions using different methods. We coded articles based on Green et al.'s classifications of the purpose of the mixing: triangulation, development, complementarity, expansion, and initiation. Complementarity was the most frequently used purpose (46.6% of articles), and nearly a quarter of articles mixed for multiple purposes (23.86%). We also coded for any community psychology values advanced by the use of mixed methods. We outline three themes here with corresponding exemplars. These articles illustrate how MMR can highlight ecological analysis and reconsider dominant, individual-level paradigms; center participant and community member experiences; and unpack paradoxes to increase the usefulness of research findings.
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Affiliation(s)
- Shabnam Javdani
- Department of Applied Psychology, New York University, New York, New York, USA
| | - Sadie E. Larsen
- Department of Psychiatry and Behavioral Medicine, Medical College of WI, Milwaukee, Wisconsin, USA
- National Center for PTSD, Executive Division, White River Junction, Vermont, USA
| | - Nicole E. Allen
- Department of Human and Organizational Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Allyson M. Blackburn
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Breana Griffin
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Agnes Rieger
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
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Abstract
Background: There is general agreement that trust between patients and providers influences patient knowledge, behaviors, and adherence to provider-recommendations--with subsequent impacts on patient health-related outcomes and provider practices. There is less academic agreement on the processes by which trust is formulated and changed over time and how trust with ongoing healthcare providers can influence health-related outcomes over time.Methods: This opinion draws on social constructionism and symbolic interactionism to posit the possibility that trust can emanate through the communication process, during which a patient and provider transmit and attend to words, images, and paralanguage to convey their states of being and to induce responses, usually acknowledgement, suasion, or physical behaviors, from one another.Results: Theoretical bases for this construct are provided as are qualitative, quantitative, and mixed measurement approaches for multiple healthcare settings.Conclusions: A mechanistic approach to understand how trust is established through patient-provider communication and how trust informs patient health-related outcomes can contribute over time to improve communication in healthcare encounters.
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Affiliation(s)
- William N Elwood
- Office of Behavioral and Social Sciences Research (OBSSR), Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health (NIH), Bethesda, MD, USA
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Allemang B, Samuel S, Greer K, Schofield K, Pintson K, Patton M, Farias M, Sitter KC, Patten SB, Mackie AS, Dimitropoulos G. Transition readiness of youth with co-occurring chronic health and mental health conditions: A mixed methods study. Health Expect 2023; 26:2228-2244. [PMID: 37452518 PMCID: PMC10632650 DOI: 10.1111/hex.13821] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND A large proportion of youth with chronic conditions have mental health comorbidities. However, the effect of these comorbidities on paediatric-adult transition readiness, and the relevance of widely used tools for measuring transition readiness, are unknown. OBJECTIVE The objectives of this study were to describe and explore the transition readiness of youth with co-occurring chronic health and mental health conditions using a combination of quantitative data obtained from participants completing the Transition Readiness Assessment Questionnaire (TRAQ) and qualitative data. DESIGN AND PARTICIPANTS A three-phase sequential explanatory mixed methods design was employed, with the qualitative strand taking priority. First, the TRAQ scores (range 1-5) of youth with co-occurring conditions (n = 61) enroled in a multisite randomized controlled trial were measured, followed by qualitative interviews with a sample of youth (n = 9) to explain the quantitative results. Results from both strands were then integrated, yielding comprehensive insights. RESULTS Median TRAQ scores ranged from 2.86 on the appointment keeping subscale to 5.00 on the talking with providers subscale. The qualitative results uncovered the complexities faced by this group concerning the impact of a mental health comorbidity on transition readiness and self-management skills across TRAQ domains. The integrated findings identified a diverse and highly individualized set of strengths and challenges amongst this group that did not align with overarching patterns as measured by the TRAQ. CONCLUSIONS This mixed methods study generated novel understandings about how youth with co-occurring conditions develop competencies related to self-care, self-advocacy and self-management in preparation for paediatric-adult service transitions. Results demonstrated the assessment of transition readiness using a generic scale does not address the nuanced and complex needs of youth with co-occurring chronic health and mental health conditions. Our findings suggest tailoring transition readiness practices for this group based on youths' own goals, symptoms, coping mechanisms and resources. PATIENT OR PUBLIC INVOLVEMENT This study was conducted in collaboration with five young adult research partners (YARP) with lived experience transitioning from paediatric to adult health/mental health services. The YARP's contributions across study phases ensured the perspectives of young people were centred throughout data collection, analysis, interpretation and presentation of findings. All five YARP co-authored this manuscript.
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Affiliation(s)
- Brooke Allemang
- Department of Social WorkUniversity of CalgaryCalgaryAlbertaCanada
| | - Susan Samuel
- Department of Pediatrics, Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Katelyn Greer
- Department of Social WorkUniversity of CalgaryCalgaryAlbertaCanada
| | | | - Karina Pintson
- Department of Social WorkUniversity of CalgaryCalgaryAlbertaCanada
| | - Megan Patton
- Department of Pediatrics, Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Marcela Farias
- Department of Social WorkUniversity of CalgaryCalgaryAlbertaCanada
| | | | - Scott B. Patten
- Department of Psychiatry, Mathison Centre for Mental Health Research and EducationUniversity of CalgaryCalgaryAlbertaCanada
- Department of Psychiatry, Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Andrew S. Mackie
- Department of PediatricsStollery Children's HospitalEdmontonAlbertaCanada
| | - Gina Dimitropoulos
- Department of Social WorkUniversity of CalgaryCalgaryAlbertaCanada
- Department of Psychiatry, Mathison Centre for Mental Health Research and EducationUniversity of CalgaryCalgaryAlbertaCanada
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O'Brien E, Walsh A, Boland F, Collins C, Harkins V, Smith SM, O'Herlihy N, Clyne B, Wallace E. GP preferences for, access to, and use of evidence in clinical practice: a mixed-methods study. BJGP Open 2023; 7:BJGPO.2023.0107. [PMID: 37442591 DOI: 10.3399/bjgpo.2023.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 06/11/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND GPs aim to provide patient-centred care combining clinical evidence, clinical judgement, and patient priorities. Despite a recognition of the need to translate evidence to support patient care, barriers exist to the use of evidence in practice. AIM To ascertain the needs and preferences of GPs regarding evidence-based guidance to support patient care. The study also aimed to prioritise content and optimise structure and dissemination of future evidence-based guidance. DESIGN & SETTING This was a convergent parallel mixed-methods study in collaboration with the national GP professional body in the Republic of Ireland (Irish College of General Practitioners [ICGP]). Quantitative and qualitative findings were integrated at the interpretive level. METHOD A national GP survey was administered via the ICGP (December 2020) and seven GP focus groups were undertaken (April-May 2021). RESULTS Of 3496 GPs, a total of 509 responders (14.6%) completed the survey and 40 GP participants took part in focus groups. Prescribing updates, interpretation of test results, chronic disease management, and older person care were the preferred topics for future evidence-based guidance. GPs reported that they required rapid access to up-to-date and relevant evidence summaries online for use in clinical practice. Access to more comprehensive reviews for the purposes of continuing education and teaching was also a priority. Multimodal forms of dissemination were preferred to increase uptake of evidence in practice. CONCLUSION GPs indicated that rapid access to up-to-date, summarised evidence-based resources, available from their professional organisation, is preferred. Evidence should reflect the disease burden of the population and involve multifaceted dissemination approaches.
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Affiliation(s)
- Emer O'Brien
- Department of General Practice, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Aisling Walsh
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fiona Boland
- Data Science Centre, School of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Velma Harkins
- Irish College of General Practitioners, Dublin, Ireland
| | - Susan M Smith
- Department of General Practice, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Discipline of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | | | - Barbara Clyne
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Emma Wallace
- Department of General Practice, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Department of General Practice, University College Cork, Cork, Ireland
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Huang Y, Trollor JN, Foley KR, Arnold SR. "I've Spent My Whole Life Striving to Be Normal": Internalized Stigma and Perceived Impact of Diagnosis in Autistic Adults. Autism Adulthood 2023; 5:423-436. [PMID: 38116050 PMCID: PMC10726184 DOI: 10.1089/aut.2022.0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background Receiving an autism diagnosis in adulthood often leads to improved self-understanding and deeper self-reflection, which can have major impacts on people's well-being and sense of identity. However, autism diagnosis also exposes individuals to societal stigma, which may become internalized over time. This study aimed to explore relationships between psychological and service-related impacts of diagnosis and internalized stigma using mixed methods. Methods One hundred forty-three autistic adults completed an online survey involving impact of diagnosis domains of Self-Understanding, Well-being, Clinician Support, and Service Access, internalized stigma, and open-ended questions on beliefs about autism diagnosis. Results On average, participants reported mild levels of internalized stigma and positive impact of diagnosis in all domains except Service Access. Older age at diagnosis was positively associated with Clinician Support only. The path analysis model showed positive relationships between impact of diagnosis domains, with Self-Understanding having a positive effect on Well-being via lowered internalized stigma. We developed four themes of Continuity and Acceptance, Late Diagnosis as Regret and Freedom, Coming to Terms with Being Autistic, and Stigma Resistance from qualitative data. Conclusions Self-understanding protects against the development of internalized autism stigma. Diagnosticians and service providers play an important role in improving self-understanding and well-being in autistic adults. More research is needed to understand the role of age at diagnosis and mechanisms behind positive identity development after autism diagnosis.
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Affiliation(s)
- Yunhe Huang
- Department of Developmental Disability Neuropsychiatry (3DN), University of New South Wales Sydney, Sydney, New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Julian N. Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), University of New South Wales Sydney, Sydney, New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Kitty-Rose Foley
- Department of Developmental Disability Neuropsychiatry (3DN), University of New South Wales Sydney, Sydney, New South Wales, Australia
- Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia
| | - Samuel R.C. Arnold
- Department of Developmental Disability Neuropsychiatry (3DN), University of New South Wales Sydney, Sydney, New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
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Anderson AM, McHugh GA, Comer C, Joseph J, Smith TO, Yardley L, Redmond AC. Supporting patients to prepare for total knee replacement: Evidence-, theory- and person-based development of a 'Virtual Knee School' digital intervention. Health Expect 2023; 26:2549-2570. [PMID: 37606150 PMCID: PMC10632615 DOI: 10.1111/hex.13855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023] Open
Abstract
INTRODUCTION Digital delivery of pre-operative total knee replacement (TKR) education and prehabilitation could improve patient outcomes pre- and post-operatively. Rigorously developing digital interventions is vital to help ensure they achieve their intended outcomes whilst mitigating their potential drawbacks. OBJECTIVE To develop a pre-operative TKR education and prehabilitation digital intervention, the 'Virtual Knee School' (VKS). METHODS The VKS was developed using an evidence-, theory- and person-based approach. This involved a mixed methods design with four phases. The first three focused on planning the VKS. The final phase involved creating a VKS prototype and iteratively refining it through concurrent think-aloud interviews with nine patients who were awaiting/had undergone TKR. Meta-inferences were generated by integrating findings from all the phases. ISRCTN registration of the overall project was obtained on 24 April 2020 (ISRCTN11759773). RESULTS Most participants found the VKS prototype acceptable overall and considered it a valuable resource. Conversely, a minority of participants felt the prototype's digital format or content did not meet their individual needs. Participants' feedback was used to refine the prototype's information architecture, design and content. Two meta-inferences were generated and recommend: 1. Comprehensive pre-operative TKR education and prehabilitation support should be rapidly accessible in digital and non-digital formats. 2. Pre-operative TKR digital interventions should employ computer- and self-tailoring to account for patients' individual needs and preferences. CONCLUSIONS Integrating evidence, theory and stakeholders' perspectives enabled the development of a promising VKS digital intervention for patients awaiting TKR. The findings suggest future research evaluating the VKS is warranted and provide recommendations for optimising pre-operative TKR care. PATIENT OR PUBLIC CONTRIBUTION Patient and Public Involvement (PPI) was central throughout the project. For example, PPI representatives contributed to the project planning, were valued members of the Project Advisory Group, had key roles in developing the VKS prototype and helped disseminate the project findings.
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Affiliation(s)
- Anna M. Anderson
- Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
- NIHR Leeds Biomedical Research CentreLeedsUK
- Present address:
Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | | | - Christine Comer
- Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
- Musculoskeletal and Rehabilitation ServicesLeeds Community Healthcare NHS TrustLeedsUK
| | - Judith Joseph
- Centre for Clinical and Community Applications of Health PsychologyUniversity of SouthamptonSouthamptonUK
| | - Toby O. Smith
- School of Health SciencesUniversity of East AngliaNorwichUK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal SciencesUniversity of OxfordOxfordUK
- Present address:
Warwick Medical SchoolUniversity of WarwickWarwickUK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health PsychologyUniversity of SouthamptonSouthamptonUK
- School of Psychological ScienceUniversity of BristolBristolUK
| | - Anthony C. Redmond
- Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
- NIHR Leeds Biomedical Research CentreLeedsUK
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Ungar M, Theron L, Höltge J. Multisystemic approaches to researching young people's resilience: Discovering culturally and contextually sensitive accounts of thriving under adversity. Dev Psychopathol 2023; 35:2199-2213. [PMID: 37128831 DOI: 10.1017/s0954579423000469] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
As our understanding of the process of resilience has become more culturally and contextually grounded, researchers have had to seek innovative ways to account for the complex, reciprocal relationship between the many systems that influence young people's capacity to thrive. This paper briefly traces the history of a more contextualized understanding of resilience and then reviews a social-ecological model to explain multisystemic resilience. A case study is then used to show how a multisystemic understanding of resilience can influence the design and implementation of resilience research. The Resilient Youth in Stressed Environments study is a longitudinal mixed methods investigation of adolescents and emerging adults in communities that depend on oil and gas industries in Canada and South Africa. These communities routinely experience stress at individual, family, and institutional levels from macroeconomic factors related to boom-and-bust economic cycles. Building on the project's methods and findings, we discuss how to create better studies of resilience which are able to capture both emic and etic accounts of positive developmental processes in ways that avoid the tendency to homogenize children's experience. Limitations to doing multisystemic resilience research are also highlighted, with special attention to the need for further innovation.
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Affiliation(s)
- Michael Ungar
- Canada Research Chair in Child, Family and Community Resilience, Dalhousie University, 6420 Coburg Rd., Halifax, NSB3H 4R2, Canada
| | - Linda Theron
- Department of Educational Psychology, Faculty of Education, University of Pretoria, South Africa
| | - Jan Höltge
- Department of Psychology, University of Hawai'i, USA
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South A, Bailey J, Bierer BE, Burnett E, Cragg WJ, Diaz-Montana C, Gillies K, Isaacs T, Joharatnam-Hogan N, Snowdon C, Sydes MR, Copas AJ. Site staff perspectives on communicating trial results to participants: Cost and feasibility results from the Show RESPECT cluster randomised, factorial, mixed-methods trial. Clin Trials 2023; 20:649-660. [PMID: 37515519 PMCID: PMC10638850 DOI: 10.1177/17407745231186088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2023]
Abstract
BACKGROUND/AIMS Sharing trial results with participants is an ethical imperative but often does not happen. Show RESPECT (ISRCTN96189403) tested ways of sharing results with participants in an ovarian cancer trial (ISRCTN10356387). Sharing results via a printed summary improved patient satisfaction. Little is known about staff experience and the costs of communicating results with participants. We report the costs of communication approaches used in Show RESPECT and the views of site staff on these approaches. METHODS We allocated 43 hospitals (sites) to share results with trial participants through one of eight intervention combinations (2 × 2 × 2 factorial; enhanced versus basic webpage, printed summary versus no printed summary, email list invitation versus no invitation). Questionnaires elicited data from staff involved in sharing results. Open- and closed-ended questions covered resources used to share results and site staff perspectives on the approaches used. Semi-structured interviews were conducted. Interview and free-text data were analysed thematically. The mean additional site costs per participant from each intervention were estimated jointly as main effects by linear regression. RESULTS We received questionnaires from 68 staff from 41 sites and interviewed 11 site staff. Sites allocated to the printed summary had mean total site costs of sharing results £13.71/patient higher (95% confidence interval (CI): -3.19, 30.60; p = 0.108) than sites allocated no printed summary. Sites allocated to the enhanced webpage had mean total site costs £1.91/patient higher (95% CI: -14, 18.74; p = 0.819) than sites allocated to the basic webpage. Sites allocated to the email list had costs £2.87/patient lower (95% CI: -19.70, 13.95; p = 0.731) than sites allocated to no email list. Most of these costs were staff time for mailing information and handling patients' queries. Most site staff reported no concerns about how they had shared results (88%) and no challenges (76%). Most (83%) found it easy to answer queries from patients about the results and thought the way they were allocated to share results with participants would be an acceptable standard approach (76%), with 79% saying they would follow the same approach for future trials. There were no significant effects of the randomised interventions on these outcomes. Site staff emphasised the importance of preparing patients to receive the results, including giving opt-in/opt-out options, and the need to offer further support, particularly if the results could confuse or distress some patients. CONCLUSIONS Adding a printed summary to a webpage (which significantly improved participant satisfaction) may increase costs to sites by ~£14/patient, which is modest in relation to the cost of trials. The Show RESPECT communication interventions were feasible to implement. This information could help future trials ensure they have sufficient resources to share results with participants.
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Affiliation(s)
- Annabelle South
- MRC CTU at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Julia Bailey
- Department of Primary Care and Population Health, University College London, London, UK
| | - Barbara E Bierer
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Eva Burnett
- MRC CTU at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - William J Cragg
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Carlos Diaz-Montana
- MRC CTU at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Talia Isaacs
- UCL Institute of Education, University College London, London, UK
| | - Nalinie Joharatnam-Hogan
- MRC CTU at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Claire Snowdon
- London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew R Sydes
- MRC CTU at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Andrew J Copas
- MRC CTU at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
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Allen LN, Azab H, Jonga R, Gordon I, Karanja S, Thaker N, Evans J, Ramke J, Bastawrous A. Rapid methods for identifying barriers and solutions to improve access to community health services: a scoping review. BJGP Open 2023; 7:BJGPO.2023.0047. [PMID: 37474255 DOI: 10.3399/bjgpo.2023.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/15/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The advancement of universal health coverage (UHC) is largely based on identifying and addressing barriers to accessing community health services. Traditional qualitative research approaches provide excellent insights but have unfeasibly high resource requirements for most care providers. AIM To identify, categorise, and evaluate methods that have been used to identify barriers to and/or solutions for improving access to community-based health services, grounded in engagement with affected communities, excluding approaches that take >14 days. DESIGN & SETTING This was a scoping review. METHOD Following Joanna Briggs Institute (JBI) guidelines, a search was undertaken using the Cochrane Library, Ovid MEDLINE, Ovid Embase, Ovid Global Health, and Google Scholar. An information specialist designed the search, and dual independent review and data charting were used. RESULTS In total, 44 studies were included from 30 countries, reporting on 18 different clinical services. Thirty studies used self-described 'rapid' approaches; however, the majority of these did not justify what they meant by this term. Nearly half of the studies used mixed- or multi-methods and triangulation to verify early findings. All of the qualitative studies used interviews and/or focus groups, which were often supplemented with observations, document review, and mapping activities. The use of in situ snowball and convenience sampling; community members as data collectors and cultural guides; collaborative summarisation (review of findings with community members and end-users); and deductive framework analysis expedited the research processes. There were no data on costs. CONCLUSION There are a wide range of methods that can be used to deliver timely information about barriers to access. The methods employed in the articles reviewed tended to use traditional data collection approaches in innovative ways.
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Affiliation(s)
- Luke N Allen
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Hagar Azab
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Ronald Jonga
- Department of Audit and Clinical Effectiveness, Northampton Foundation trust, Northampton, UK
| | - Iris Gordon
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah Karanja
- Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Nam Thaker
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Jennifer Evans
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Jacqueline Ramke
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrew Bastawrous
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
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Schwab J, Wachinger J, Munana R, Nabiryo M, Sekitoleko I, Cazier J, Ingenhoff R, Favaretti C, Subramonia Pillai V, Weswa I, Wafula J, Emmrich JV, Bärnighausen T, Knauf F, Knauss S, Nalwadda CK, Sudharsanan N, Kalyesubula R, McMahon SA. Design Research to Embed mHealth into a Community-Led Blood Pressure Management System in Uganda: Protocol for a Mixed Methods Study. JMIR Res Protoc 2023; 12:e46614. [PMID: 38032702 PMCID: PMC10722357 DOI: 10.2196/46614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Uncontrolled hypertension is a leading risk factor for cardiovascular diseases. In Uganda, such diseases account for approximately 10% of all deaths, with 1 in 5 adults having hypertension (>90% of the hypertensive cases are uncontrolled). Although basic health care in the country is available free of cost at government facilities, regularly accessing medication to control hypertension is difficult because supply chain challenges impede availability. Clients therefore frequently suspend treatment or buy medication individually at private facilities or pharmacies (incurring significant costs). In recent years, mobile health (mHealth) interventions have shown increasing potential in addressing health system challenges in sub-Saharan Africa, but the acceptability, feasibility, and uptake conditions of mobile money approaches to chronic disease management remain understudied. OBJECTIVE This study aims to design and pilot-test a mobile money-based intervention to increase the availability of antihypertensive medication and lower clients' out-of-pocket payments. We will build on existing local approaches and assess the acceptability, feasibility, and uptake of the designed intervention. Furthermore, rather than entering the study setting with a ready-made intervention, this research will place emphasis on gathering applied ethnographic insights early, which can then inform the parameters of the intervention prototype and concurrent trial. METHODS We will conduct a mixed methods study following a human-centered design approach. We will begin by conducting extensive qualitative research with a range of stakeholders (clients; health care providers; religious, cultural, and community leaders; academics; and policy makers at district and national levels) on their perceptions of hypertension management, money-saving systems, and mobile money in the context of health care. Our results will inform the design, iterative adaptation, and implementation of an mHealth-facilitated pooled financing intervention prototype. At study conclusion, the finalized prototype will be evaluated quantitatively via a randomized controlled trial. RESULTS As of August 2023, qualitative data collection, which started in November 2022, is ongoing, with data analysis of the first qualitative interviews underway to inform platform and implementation design. Recruitment for the quantitative part of this study began in August 2023. CONCLUSIONS Our results aim to inform the ongoing discourse on novel and sustainable pathways to facilitate access to medication for the management of hypertension in resource-constrained settings. TRIAL REGISTRATION German registry of clinical trials DRKS00030922; https://drks.de/search/en/trial/DRKS00030922. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46614.
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Affiliation(s)
- Josephine Schwab
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Jonas Wachinger
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Richard Munana
- African Community Center for Social Sustainability, Nakaseke District, Uganda
| | - Maxencia Nabiryo
- Department of Community Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Isaac Sekitoleko
- African Community Center for Social Sustainability, Nakaseke District, Uganda
| | | | - Rebecca Ingenhoff
- Department of Nephrology and Medical Intensive Care, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Caterina Favaretti
- Professorship of Behavioral Science for Disease Prevention and Health Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Vasanthi Subramonia Pillai
- Professorship of Behavioral Science for Disease Prevention and Health Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Ivan Weswa
- African Community Center for Social Sustainability, Nakaseke District, Uganda
| | - John Wafula
- African Community Center for Social Sustainability, Nakaseke District, Uganda
| | - Julius Valentin Emmrich
- mTOMADY gGmbh, Berlin, Germany
- Department of Neurology with Experimental Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix Knauf
- Department of Nephrology and Medical Intensive Care, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, United States
| | - Samuel Knauss
- mTOMADY gGmbh, Berlin, Germany
- Department of Neurology with Experimental Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christine K Nalwadda
- Department of Community Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nikkil Sudharsanan
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Professorship of Behavioral Science for Disease Prevention and Health Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Robert Kalyesubula
- African Community Center for Social Sustainability, Nakaseke District, Uganda
- Department of Physiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Shannon A McMahon
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
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Agarwal D, Bailie CR, Rana S, Balan L, Grills NJ, Mathias K. Scaling a group intervention to promote caregiver mental health in Uttarakhand, India: A mixed-methods implementation study. Glob Ment Health (Camb) 2023; 10:e85. [PMID: 38161744 PMCID: PMC10755371 DOI: 10.1017/gmh.2023.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/24/2023] [Accepted: 11/16/2023] [Indexed: 01/03/2024] Open
Abstract
Caregivers are integral to health and social care systems in South Asian countries yet are themselves at higher risk of mental illness. Interventions to support caregiver mental health developed in high-income contexts may be contextually inappropriate in the Global South. In this mixed-methods study, we evaluated the implementation and scaling of a locally developed mental health group intervention for caregivers and others in Uttarakhand, India. We describe factors influencing implementation using the updated Consolidated Framework for Implementation Research, and selected implementation outcomes. Key influencing factors we found in common with other programs included: an intervention that was relevant and adaptable; family support and stigma operating in the outer setting; training and support for lay health worker providers, shared goals, and relationships with the community and the process of engaging with organisational leaders and service users within the inner setting. We identified further factors including the group delivery format, competing responsibilities for caregivers and opportunities associated with the partnership delivery model as influencing outcomes. Implementation successfully reached target communities however attrition of 20% of participants highlights the potential for improving outcomes by harnessing enablers and addressing barriers. Findings will inform others implementing group mental health and caregiver interventions in South Asia.
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Affiliation(s)
- Disha Agarwal
- Project Burans, Herbertpur Christian Hospital, Atten Bagh, India
| | - Christopher R. Bailie
- Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Samson Rana
- Project Burans, Herbertpur Christian Hospital, Atten Bagh, India
| | - Laxman Balan
- Project Burans, Herbertpur Christian Hospital, Atten Bagh, India
| | - Nathan J. Grills
- Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Kaaren Mathias
- Project Burans, Herbertpur Christian Hospital, Atten Bagh, India
- Te Kaupeka Oranga, University of Canterbury, Christchurch, New Zealand
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Bosak J, Drainoni ML, Christopher M, Medley B, Rodriguez S, Bell S, Kim E, Stotz C, Hamilton G, Bigsby C, Gillen F, Kimball J, McClay C, Powers K, Walt G, Battaglia T, Chassler D, Sprague Martinez L, Lunze K. Community advisory board members' perspectives on their contributions to a large multistate cluster RCT: a mixed methods study. J Clin Transl Sci 2023; 8:e1. [PMID: 38384918 PMCID: PMC10879854 DOI: 10.1017/cts.2023.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/27/2023] [Accepted: 10/29/2023] [Indexed: 02/23/2024] Open
Abstract
Background Community advisory boards (CABs) are an established approach to ensuring research reflects community priorities. This paper examines two CABs that are part of the HEALing Communities Study which aims to reduce overdose mortality. This analysis aimed to understand CAB members' expectations, experiences, and perspectives on CAB structure, communication, facilitation, and effectiveness during the first year of an almost fully remote CAB implementation. Current literature exploring these perspectives is limited. Methods We collected qualitative and survey data simultaneously from members (n = 53) of two sites' CABs in the first 9 months of CAB development. The survey assessed trust, communication, and relations; we also conducted 32 semi-structured interviews. We analyzed the survey results descriptively. The qualitative data were analyzed using a deductive codebook based on the RE-AIM PRISM framework. Themes were drawn from the combined qualitative data and triangulated with survey results to further enrich the findings. Results CAB members expressed strong commitment to overall study goals and valued the representation of occupational sectors. The qualitative data described a dissonance between CAB members' commitment to the mission and unmet expectations for influencing the study within an advisory role. Survey results indicated lower satisfaction with the research teams' ability to create a mutually beneficial process, clear communication, and sharing of power. Conclusion Building a CAB on a remote platform, within a study utilizing a community engagement strategy, still presents challenges to fully realizing the potential of a CAB. These findings can inform more effective operationalizing of community-engaged research through enhanced CAB engagement.
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Affiliation(s)
- Julie Bosak
- Boston Medical Center, Boston, MA, USA
- Boston University School of Public Health, Boston, MA, USA
| | - Mari-Lynn Drainoni
- Boston Medical Center, Boston, MA, USA
- Boston University School of Public Health, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | | | - Bethany Medley
- Columbia University, New York, NY, USA
- Community Advisory Board Member, Boston, MA, USA
| | | | | | - Erin Kim
- Columbia University, New York, NY, USA
| | | | - Greer Hamilton
- Boston University School of Social Work, Boston, MA, USA
| | | | | | - Jennifer Kimball
- Boston Medical Center, Boston, MA, USA
- Community Advisory Board Member, Boston, MA, USA
| | | | - Kim Powers
- Boston Medical Center, Boston, MA, USA
- Community Advisory Board Member, Boston, MA, USA
| | | | - Tracy Battaglia
- Boston Medical Center, Boston, MA, USA
- Boston University School of Public Health, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | | | | | - Karsten Lunze
- Boston Medical Center, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
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142
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Lim K, Quintero Silva L, Raj M. Family Caregivers' Role in Navigating Diet: Perspectives from Caregivers of Older Asian Americans. J Appl Gerontol 2023:7334648231214908. [PMID: 37991403 DOI: 10.1177/07334648231214908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
Family caregivers uphold significant healthcare responsibilities including language translation and diet management. This study sought to understand family caregivers' experiences and challenges navigating and managing their older Asian American relative's diet. We conducted an exploratory sequential mixed-methods study with family caregivers involving (1) qualitative interviews (n = 40) and (2) a nationwide survey (n = 100). Interviewees discussed their role and challenges with (a) applying American/Western clinical dietary recommendations to their relative's traditional meal preferences and (b) managing misalignment between their relative's traditional dietary preferences and the food offered in hospitals and long-term care environments. Survey responses triangulated; almost 65% of family caregivers prepared and brought traditional meals to healthcare facilities upon observing a lack of culturally relevant food options. Culturally relevant nutrition training for family caregivers can help them support their relative in community settings. Creating an inclusive healthcare system requires transforming the food environment within healthcare facilities.
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Affiliation(s)
| | | | - Minakshi Raj
- University of Illinois Urbana Champaign, Champaign, IL, USA
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143
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Barnes IL, Quinn JE. Passive Acoustic Sampling Enhances Traditional Herpetofauna Sampling Techniques in Urban Environments. Sensors (Basel) 2023; 23:9322. [PMID: 38067696 PMCID: PMC10708638 DOI: 10.3390/s23239322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/20/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023]
Abstract
Data are needed to assess the relationships between urbanization and biodiversity to establish conservation priorities. However, many of these relationships are difficult to fully assess using traditional research methods. To address this gap and evaluate new acoustic sensors and associated data, we conducted a multimethod analysis of biodiversity in a rapidly urbanizing county: Greenville, South Carolina, USA. We conducted audio recordings at 25 points along a development gradient. At the same locations, we used refugia tubes, visual assessments, and an online database. Analysis focused on species identification of both audio and visual data at each point along the trail to determine relationships between both herpetofauna and acoustic indices (as proxies for biodiversity) and environmental gradient of land use and land cover. Our analysis suggests the use of a multitude of different sampling methods to be conducive to the completion of a more comprehensive occupancy measure. Moving forward, this research protocol can potentially be useful in the establishment of more effective wildlife occupancy indices using acoustic sensors to move toward future conservation policies and efforts concerning urbanization, forest fragmentation, and biodiversity in natural, particularly forested, ecosystems.
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144
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Zavala E, Rahman A, Kalbarczyk A, de Boer M, Khaled N, Chakraborty B, Rahman H, Ali H, Haque R, Ayesha K, Siddiqua TJ, Afsana K, Christian P, Thorne-Lyman AL. Acceptability of a balanced energy protein (BEP) supplement for pregnant women in Bangladesh. Matern Child Nutr 2023:e13587. [PMID: 37991138 DOI: 10.1111/mcn.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 11/23/2023]
Abstract
Balanced energy protein (BEP) supplementation in pregnancy is recommended in the context of undernutrition for the reduction of small-for-gestational age neonates and stillbirths. To inform an effectiveness trial, we evaluated the acceptability of a packaged, ready-to-eat fortified BEP product among women of reproductive age and their health care providers (HCPs) in rural Bangladesh and explored the feasibility of adhering to daily supplementation. We implemented a formative study using focus groups discussions with women (n = 29) and HCPs (n = 17) to introduce the product and investigate components of acceptability. A "trials of improved practice" activity was conducted in subset of women (n = 16) to evaluate adherence to BEP over a 2-week period, followed by focus group discussions to identify challenges with adherence and strategies employed. Contributors to BEP acceptability included the product's sensory attributes, such as taste, smell and texture; the attractive packaging and informative labelling; and the perceived benefits of use. Participants also identified household and community level factors influencing the adoption of BEP, such as trust in the provider, cultural beliefs on supplement use in pregnancy, and family member tasting and approval. Over the 2-week period, women consumed over 80% of the supplements provided to them and identified strategies for adherence, including visual aids and reminders from family members or providers. HCPs recommended targeted communication messages for mothers-in-law to foster a supportive home environment. Findings informed changes to the BEP product to improve acceptability and shaped the content of communication messages to optimise adherence in a forthcoming effectiveness trial.
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Affiliation(s)
- Eleonor Zavala
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Atiya Rahman
- Humanitarian Hub, James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Anna Kalbarczyk
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mary de Boer
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nazrana Khaled
- Humanitarian Hub, James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Barnali Chakraborty
- Humanitarian Hub, James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Hafizur Rahman
- The JiVitA Maternal and Child Health and Nutrition Research Project, Rangpur, Bangladesh
| | - Hasmot Ali
- The JiVitA Maternal and Child Health and Nutrition Research Project, Rangpur, Bangladesh
| | - Rezwanul Haque
- The JiVitA Maternal and Child Health and Nutrition Research Project, Rangpur, Bangladesh
| | - Kaniz Ayesha
- The JiVitA Maternal and Child Health and Nutrition Research Project, Rangpur, Bangladesh
| | - Towfida J Siddiqua
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- The JiVitA Maternal and Child Health and Nutrition Research Project, Rangpur, Bangladesh
| | - Kaosar Afsana
- Humanitarian Hub, James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Parul Christian
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Andrew L Thorne-Lyman
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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145
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Moya-Salazar J, Quispe-Pariona R, Cañari B, Moya-Salazar B, Goicochea-Palomino EA. Community and hospital academic performance of working nurse interns: A mixed-methods study in Peru. SAGE Open Med 2023; 11:20503121231208643. [PMID: 38020796 PMCID: PMC10655787 DOI: 10.1177/20503121231208643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction and Objective Nursing is a professional career that requires patient-specialized care. To this end, it requires a high academic performance during undergraduate studies. However, some factors that can influence the academic performance of nursing students have been noticed during the internship. We aimed to determine the hospital and community-academic performance of nurse interns who work. Materials and Methods We designed a 3-year mixed study carried out with students of the Universidad Norbert Wiener. We interviewed 15 students about their academic performance, the consequences of studying while working, internship, family, and academic activities. Using the quantitative approach, we analyzed the evaluations of 321 students between 2016 and 2018. Results The qualitative approach showed that students had certain difficulties in their clinical internship because they worked and studied simultaneously. Despite this, their academic performance was remarkable in both internship programs, and 10% of students had an outstanding performance. This performance is subject to personal, economic, and family factors that affect students in their last year of undergraduate studies. Conclusions Working nursing interns had a remarkable academic performance during community and hospital internships. This performance is influenced by personal, financial, and family factors that affect students in their final year of undergraduate study.
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Affiliation(s)
- Jeel Moya-Salazar
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
- School of Biomedical Engineering, Faculty of Engineering, Universidad Tecnológica del Perú, Lima, Peru
| | - Roxana Quispe-Pariona
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
- Nursing Department, Hospital Nacional Cayetano Heredia, Lima, Peru
| | - Betsy Cañari
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
- Qualitative Unit, Nesh Hubbs, Lima, Peru
| | - Belén Moya-Salazar
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
- Qualitative Unit, Nesh Hubbs, Lima, Peru
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146
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O'Neill L, Brennan L, Sheill G, Connolly D, Guinan E, Hussey J. Moving Forward With Telehealth in Cancer Rehabilitation: Patient Perspectives From a Mixed Methods Study. JMIR Cancer 2023; 9:e46077. [PMID: 37943595 PMCID: PMC10667979 DOI: 10.2196/46077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 09/03/2023] [Accepted: 09/18/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic accelerated the use of telehealth in cancer care and highlighted the potential of telehealth as a means of delivering the much-needed rehabilitation services for patients living with the side effects of cancer and its treatments. OBJECTIVE This mixed methods study aims to explore patients' experiences of telehealth and their preferences regarding the use of telehealth for cancer rehabilitation to inform service development. METHODS The study was completed in 2 phases from October 2020 to November 2021. In phase 1, an anonymous survey (web- and paper-based) exploring the need, benefits, barriers, facilitators, and preferences for telehealth cancer rehabilitation was distributed to survivors of cancer in Ireland. In phase 2, survivors of cancer were invited to participate in semistructured interviews exploring their experiences of telehealth and its role in cancer rehabilitation. Interviews were conducted via telephone or video call following an interview guide informed by the results of the survey and transcribed verbatim, and reflexive thematic analysis was performed using a qualitative descriptive approach. RESULTS A total of 48 valid responses were received. The respondents were at a median of 26 (range 3-256) months after diagnosis, and 23 (48%) of the 48 participants had completed treatment. Of the 48 respondents, 31 (65%) reported using telehealth since the start of the pandemic, 15 (31%) reported having experience with web-based cancer rehabilitation, and 43 (90%) reported a willingness for web-based cancer rehabilitation. A total of 26 (54%) of the 48 respondents reported that their views on telehealth had changed positively since the start of the pandemic. Semistructured interviews were held with 18 survivors of cancer. The mean age of the participants was 58.9 (SD 8.24) years, 56% (10/18) of the participants were female, and 44% (8/18) of the participants were male. Reflexive thematic analysis identified 5 key themes: telehealth improves accessibility to cancer rehabilitation for some but is a barrier for others, lived experiences of the benefits of telehealth in survivorship, the value of in-person health care, telehealth in cancer care and COVID-19 (from novelty to normality), and the future of telehealth in cancer rehabilitation. CONCLUSIONS Telehealth is broadly welcomed as a mode of cancer rehabilitation for patients living with and beyond cancer in Ireland. However, issues regarding accessibility and the importance of in-person care must be acknowledged. Factors of convenience, time savings, and cost savings indicate that telehealth interventions are a desirable patient-centered method of delivering care when performed in suitable clinical contexts and with appropriate populations.
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Affiliation(s)
- Linda O'Neill
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin 8, Ireland
- Trinity St James's Cancer Institute, Dublin, Ireland
| | - Louise Brennan
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin 8, Ireland
- Trinity St James's Cancer Institute, Dublin, Ireland
| | - Grainne Sheill
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin 8, Ireland
- Trinity St James's Cancer Institute, Dublin, Ireland
| | - Deirdre Connolly
- Trinity St James's Cancer Institute, Dublin, Ireland
- Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin, Ireland
| | - Emer Guinan
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin 8, Ireland
- Trinity St James's Cancer Institute, Dublin, Ireland
| | - Juliette Hussey
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin 8, Ireland
- Trinity St James's Cancer Institute, Dublin, Ireland
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147
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Babayan K, Keilty K, Esufali J, Grajales Iii FJ. An After-Hours Virtual Care Service for Children With Medical Complexity and New Medical Technology: Mixed Methods Feasibility Study. JMIR Pediatr Parent 2023; 6:e41393. [PMID: 37938869 PMCID: PMC10666005 DOI: 10.2196/41393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 01/11/2023] [Accepted: 03/04/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Family caregivers (FCs) of children with medical complexity require specialized support to promote the safe management of new medical technologies (eg, gastrostomy tubes) during hospital-to-home transitions. With limited after-hours services available to families in home and community care, medical device complications that arise often lead to increased FC stress and unplanned emergency department (ED) visits. To improve FC experiences, enable safer patient discharge, and reduce after-hours ED visits, this study explores the feasibility of piloting a 24/7 virtual care service (Connected Care Live) with families to provide real-time support by clinicians expert in the use of pediatric home care technologies. OBJECTIVE This study aims to establish the economic, operational, and technical feasibility of piloting the expansion of an existing nurse-led after-hours virtual care service offered to home and community care providers to FCs of children with newly inserted medical devices after hospital discharge at Toronto's Hospital for Sick Children (SickKids). METHODS This exploratory study, conducted from October 2020 to August 2021, used mixed data sources to inform service expansion feasibility. Semistructured interviews were conducted with FCs, nurses, and hospital leadership to assess the risks, benefits, and technical and operational requirements for sustainable and cost-effective future service operations. Time and travel savings were estimated using ED visit data in SickKids' electronic medical records (Epic) with a chief complaint of "medical device problems," after-hours medical device inquiries from clinician emails and voicemails, and existing service operational data. RESULTS A total of 30 stakeholders were interviewed and voiced the need for the proposed service. Safer and more timely management of medical device complications, improved caregiver and provider experiences, and strengthened partnerships were identified as expected benefits, while service demand, nursing practice, and privacy and security were identified as potential risks. A total of 47 inquiries were recorded over 2 weeks from March 26, 2021, to April 8, 2021, with 51% (24/47) assessed as manageable via service expansion. This study forecasted annual time and travel savings of 558 hours for SickKids and 904 hours and 22,740 km for families. Minimal technical and operational requirements were needed to support service expansion by leveraging an existing platform and clinical staff. Of the 212 ED visits related to "medical device problems" over 6 months from September 1, 2020, to February 28, 2021, enteral feeding tubes accounted for nearly two-thirds (n=137, 64.6%), with 41.6% (57/137) assessed as virtually manageable. CONCLUSIONS Our findings indicate that it is feasible to pilot the expansion of Connected Care Live to FCs of children with newly inserted enteral feeding tubes. This nurse-led virtual caregiver service is a promising tool to promote safe hospital-to-home transitions, improve FC experiences, and reduce after-hours ED visits.
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Affiliation(s)
- Katherine Babayan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Krista Keilty
- Connected Care Program, Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Studies, SickKids Research Institute, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Jessica Esufali
- Connected Care Program, Hospital for Sick Children, Toronto, ON, Canada
| | - Francisco J Grajales Iii
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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148
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Vicario EF, Annis J, Namakula P, Kasozi GK, Mihelcic JR. Do Sanitation Marketing Activities Increase Households' Likelihoods of Reaching Improved Sanitation or Involving Women in Decision Making? Environ Sci Technol 2023; 57:16851-16861. [PMID: 37874361 DOI: 10.1021/acs.est.3c04125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Poor sanitation causes 30% of diarrheal deaths globally, and much of the world has struggled to finance top-down interventions. Sanitation marketing is a demand-led approach that uses a mixture of social and commercial marketing methods and direct sales to households. However, little is known about its impacts on household decision making. This mixed-methods study uses data from eight focus groups and 86,666 household surveys from participants in a five-year sanitation marketing program in Uganda. Logistic regression models identified 10 variables predicting attainment of improved (limited or basic) sanitation and four variables predicting female involvement in decision making. Triggering session attendance increased chances of reaching improved sanitation by 15-28%, depending on who attended, and by 19% if the household found the session motivational. Although women were engaged in decision-making conversations, they were not viewed as primary decision makers, even in female-headed households. Women were more likely to become involved in decision making if they had attended triggering sessions with men (+70%) or engaged with sales promoters alone (+74%) or with men (+78%). For both outcomes, joint activity engagement was more effective than male or female engagement alone. This work highlights two sanitation marketing activities as pathways to improving latrine coverage and women's decision-making agency.
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Affiliation(s)
- Elizabeth F Vicario
- Department of Civil and Environmental Engineering, University of South Florida, 4202 E. Fowler Ave., Tampa, Florida 33620, United States
| | - Jonathan Annis
- USAID Uganda Sanitation for Health Activity, Tetra Tech, Plot 12A, Farady Road, Bugolobi, Kampala, Uganda
| | - Patricia Namakula
- USAID Uganda Sanitation for Health Activity, Tetra Tech, Plot 12A, Farady Road, Bugolobi, Kampala, Uganda
| | - Gloria K Kasozi
- United States Agency for International Development, Uganda Mission, Kampala, Uganda
| | - James R Mihelcic
- Department of Civil and Environmental Engineering, University of South Florida, 4202 E. Fowler Ave., Tampa, Florida 33620, United States
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Schwalbe D, Sodemann M, Iachina M, Nørgård BM, Chodkiewicz NH, Ammentorp J. Causes of Patient Nonattendance at Medical Appointments: Protocol for a Mixed Methods Study. JMIR Res Protoc 2023; 12:e46227. [PMID: 37723870 PMCID: PMC10656653 DOI: 10.2196/46227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/29/2023] [Accepted: 09/15/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Approximately one-third of patient appointments in Danish health care result in failures, leading to patient risk and sizable resource waste. Existing interventions to alleviate no-shows often target the patients. The underlying reason behind these interventions is a view that attendance or nonattendance is solely the patient's problem. However, these interventions often prove to be ineffective and can perpetuate social biases and health inequalities, leaving behind patients who are more vulnerable or disadvantaged (in terms of social, economical, and linguistic factors, etc). A more holistic understanding of no-shows is needed to optimize processes, reduce waste, and support patients who are vulnerable. OBJECTIVE This study aims to gain a deep and more comprehensive understanding of the causes, mechanisms, and recurring patterns and elements contributing to nonattendance at Danish hospitals in the Region of Southern Denmark. It emphasizes the patient perspective and analyzes the relational and organizational processes surrounding no-shows in health care. In addition, the study aims to identify effective communicative strategies and organizational processes that can support the development and implementation of successful interventions. METHODS The study uses mixed quantitative-qualitative methods, encompassing 4 analytical projects focusing on nonattendance patterns, patient knowledge and behavior, the management of hospital appointments, and in situ communication. To address the complexity of no-shows in health care, the study incorporates various data sources. The quantitative data sources include the electronic patient records, Danish central registries, Danish National Patient Registry, and Register of Medicinal Product Statistics. Baseline characteristics of patients at different levels are compared using chi-square tests and Kruskal-Wallis tests. The qualitative studies involve observational data, individual semistructured interviews with patients and practitioners, and video recordings of patient consultations. RESULTS This paper presents the protocol of the study, which was funded by the Novo Nordisk Foundation in July 2022. Recruitment started in February 2023. It is anticipated that the quantitative data analysis will be completed by the end of September 2023, with the qualitative investigation starting in October 2023. The first study findings are anticipated to be available by the end of 2024. CONCLUSIONS The existing studies of nonattendance in Danish health care are inadequate in addressing relational and organizational factors leading to hospital no-shows. Interventions have had limited effect, highlighting the Danish health care system's failure to accommodate patients who are vulnerable. Effective interventions require a qualitative approach and robust ethnographic data to supplement the description and categorization of no-shows at hospitals. Obtaining comprehensive knowledge about the causes of missed patient appointments will yield practical benefits, enhancing the safety, coherence, and quality of treatment in health care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/46227.
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Affiliation(s)
- Daria Schwalbe
- Centre for Patient Communication (CFPK), Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
- Centre for Culture and the Mind (DNRF Centre of Excellence), Department of English, German and Romance Studies, University of Copenhagen, Copenhagen, Denmark
| | - Morten Sodemann
- The Migrant Health Outpatient Clinic, Odense University Hospital, Odense, Denmark
- Research Unit of Infectious Diseases, Department of Clinical Studies, University of Southern Denmark, Odense, Denmark
| | - Maria Iachina
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Bente Mertz Nørgård
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Nina Høy Chodkiewicz
- Centre for Patient Communication (CFPK), Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Jette Ammentorp
- Centre for Patient Communication (CFPK), Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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150
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So M, Sedarski E, Parries M, Sick B. "Many people know nothing about us": narrative medicine applications at a student-run free clinic. J Interprof Care 2023; 37:1018-1026. [PMID: 37293751 DOI: 10.1080/13561820.2023.2218885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/10/2023]
Abstract
Narrative medicine is an approach to healthcare that acknowledges the stories of patients' lives both within and beyond the clinical setting. Narrative medicine has been increasingly recognized as a promising tool to support modern educational needs in health professions training, such as interprofessional practice, while enhancing quality of care. Here, we describe the development, implementation, and application of a narrative medicine program at the University of Minnesota Phillips Neighborhood Clinic. First, in a qualitative analysis of patient stories (n = 12) we identified themes regarding the value of the storytelling experience; patients' personal journeys; and patients' experiences in healthcare and other systems. Second, an interprofessional educational activity for student volunteers (n = 57) leveraging a patient narrative was observed to be satisfactory, significantly improve attitudes toward the underserved, and enhance quality of care from the perspectives of trainees. Together, findings from the two studies imply the potential benefits of broader incorporation of narrative medicine into interprofessional service settings, for both learners and patients.
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Affiliation(s)
- Marvin So
- LifeLong Medical Care, William Jenkins Health Center, Richmond, California, US
- University of Minnesota Medical School, Minneapolis, Minnesota, US
| | - Emma Sedarski
- University of Minnesota College of Pharmacy, Minneapolis, Minnesota, US
| | - Megan Parries
- University of Minnesota College of Pharmacy, Minneapolis, Minnesota, US
| | - Brian Sick
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, US
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