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Wang L, Liu H, Wang L, Zhang Y, Guo W, Wu P, Chang X, Wang L, Xu W, Zhao L. Evaluating an oral health programme for the prevention of dental decay among school-aged children in China: protocol for a mixed-methods study based on the RE-AIM framework. BMJ Open 2022; 12:e061601. [PMID: 36180124 PMCID: PMC9528611 DOI: 10.1136/bmjopen-2022-061601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The objective of the Comprehensive Intervention of Oral Disease for Children (CIODC) in China is to prevent dental decay for school-aged children and provide free prevention services in pilot areas beginning in 2008. It is a potentially affordable, acceptable and effective prevention strategy to use for more school-aged children in the future. There is a shortage of robust evidence regarding the cost-effectiveness, feasibility and scalability of prevention strategies for dental decay for school-aged children in China. This study aims to provide a comprehensive evaluation, including an economic evaluation and process evaluation, to better understand how and why the public health programme may be effective and economical. METHODS AND ANALYSIS Mixed methods will be used in this study. Cost-effectiveness analysis (CEA) will be conducted from a societal perspective, based on a modelling study over 6 years (from age 7 to 12) in terms of the incremental cost-effectiveness ratios per dental decay averted. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework informed the process evaluation. An estimated 48-80 semistructured interviews with service providers, patient parents/caregivers and decision-makers under the logic model will be used in the progress evaluation to describe the feasibility and sustainability of CIODC. ETHICS AND DISSEMINATION The study has all necessary ethical approvals from the Ethics Committee of Anhui Medical University (number 2021H030). All participants will provide informed consent prior to participation. Findings will be disseminated through conference presentations and scientific publications in peer-reviewed journals.
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Affiliation(s)
- Lidan Wang
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
- Center for Health Policy Research, Anhui Medical University, Hefei, Anhui Province, China
| | - Hueiming Liu
- The George Institute for Global Health, Newtown, New South Wales, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW, Australia
| | - Li Wang
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
| | - Yanqun Zhang
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
| | - Wei Guo
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
| | - Peilin Wu
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
| | - Xiangxiang Chang
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
| | - Li Wang
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
- Center for Health Policy Research, Anhui Medical University, Hefei, Anhui Province, China
| | - Wenhua Xu
- Stomatologic Hospital & College, Anhui Medical University, Hefei, Anhui, China
| | - Linhai Zhao
- School of Health Service and Management, Anhui Medical University, Hefei, Anhui, China
- Center for Health Policy Research, Anhui Medical University, Hefei, Anhui Province, China
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Wang A, Turnbull L, Williams J, Thomas S, Saunders S, Levin A, Djurdjev O, Copland M, Singh S, Hemmett J. Systematic Evaluation of a Provincial Initiative to Improve Transition to Home Dialysis Therapies. Can J Kidney Health Dis 2020; 7:2054358120949811. [PMID: 32922826 PMCID: PMC7457697 DOI: 10.1177/2054358120949811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/05/2020] [Indexed: 11/15/2022] Open
Abstract
Background: The transition from choosing to initiating home dialysis therapies (HDTs) is not clearly standardized for patients and staff, causing increased anxiety and suboptimal self-management for chronic kidney disease (CKD) patients. At BC Renal, a “Transition to HDTs” guidebook (the Guide) was designed, outlining a step-wise approach to transitioning to HDTs for patients, to help address some of these concerns. Objective: We used the Logic Model evaluation framework to assess the value of the Guide to improve patient and staff experience with transitioning to HDTs. Design: This is a prospective cohort quality improvement study. Setting: This study took place at home dialysis programs in British Columbia, Canada, with 2 pilot sites and 2 control sites. Patients: Patients above age 18 who attended kidney care clinics and identified HDT as their renal replacement treatment of choice were included in this study. Measurements: Patient demographics were obtained from British Columbia Renal Patient Records and Outcomes Management Information System, with differences analyzed using Mann-Whitney U test and chi-square test where applicable. Patient surveys were based on Likert rating scales, analyzed using Cochran-Armitage trend test. All tests were 2-sided, with P < .05 considered significant. Methods: The study enrolled patients from December 2018 to April 2019 at 2 pilot and 2 control sites. Patients were followed up for 8 months. The intervention strategies included (1) training of front-line staff to use the Guide and (2) dissemination of the guide to patients. Evaluation tools measuring data at baseline and at the 8-month point included (1) qualitative and quantitative patient surveys, (2) qualitative staff surveys, (3) structured feedback session with renal care staff, and (4) transition rate and time between choosing and starting a HDT. Results: In total, 108 patients were enrolled: 43 patients at pilot sites and 65 in control sites. Twenty-three of 65 in control vs 18 of 43 in pilot transitioned to a HDT by 8-month follow-up. Transition time was 80 vs 89 days in pilot vs control group, but it was not statistically different (P = .37). The proportion of patients that transitioned to a HDT was 42% vs 35% in pilot vs control group (P = .497). Patients’ anxiety, illness knowledge, and activation of resources were not significantly different between patients who successfully transitioned at control and pilot sites. During interviews, patients confirmed that the Guide was effective and helped retain knowledge. The staff felt that the intervention did not increase their workload and that the Guide was a good communication tool, but was used inconsistently. Limitations: We had a small sample size and limited number of patients enrolled who chose home hemodialysis, with none in the control group. The results are therefore more applicable to peritoneal dialysis. Conclusions: The Logic Model was useful to evaluate our multi-intervention strategy. While there were no statistically significant differences in transition time, rate, and patient anxiety with or without the Guide, qualitative opinions from patients indicate that the Guide was a useful supplement. In addition, feedback from renal care staff suggested that the Guide served as a framework for communicating the transition process with patients, and was perceived as a useful tool. Future work is required to standardize the Guide’s utilization. Trial registration: As this is a quality improvement evaluation study, trial registration is not applicable.
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Affiliation(s)
- Alice Wang
- The University of British Columbia, Vancouver, Canada
| | | | | | | | | | - Adeera Levin
- The University of British Columbia, Vancouver, Canada
| | | | - Michael Copland
- Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Suneet Singh
- The University of British Columbia, Vancouver, Canada
| | - Juliya Hemmett
- The University of British Columbia, Vancouver, Canada.,Foothills Medical Centre, University of Calgary, AB, Canada
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Saarijärvi M, Wallin L, Moons P, Gyllensten H, Bratt EL. Transition program for adolescents with congenital heart disease in transition to adulthood: protocol for a mixed-method process evaluation study (the STEPSTONES project). BMJ Open 2019; 9:e028229. [PMID: 31377699 PMCID: PMC6687006 DOI: 10.1136/bmjopen-2018-028229] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Today, the majority of young persons living with chronic conditions in high-income countries survive into adulthood and will need life-long medical follow-up. Therefore, transition programmes have been developed to facilitate transfer to adult care, and to support self-management and independence during adulthood. The Swedish Transition Effects Project Supporting Teenagers with chrONic mEdical conditionS (STEPSTONES) project aims to evaluate the effectiveness of a person-centred transition programme for empowering adolescents with congenital heart disease in transition to adulthood. To understand how the transition programme causes change and how outcomes are created, process evaluation is imperative to assess implementation, context and mechanisms of impact. This protocol aims to describe the process evaluation of the STEPSTONES transition programme. METHODS AND DESIGN Medical Research Council guidance for process evaluation of complex interventions will be the guiding framework for this mixed-method study. The combination of qualitative and quantitative data will capture different aspects of programme delivery. The sample will consist of participants in the STEPSTONES randomised controlled trial (RCT), persons implementing the programme and healthcare professionals. Quantitative data will consist of protocols and routine monitoring documents from the RCT, data collected from patient registries and sociodemographic data to assess the implementation of the intervention. This data will be analysed with quantitative content analysis, along with descriptive and inferential statistics. Qualitative data will consist of participatory observations, logbooks and interviews with persons implementing the programme, participants and healthcare professionals. Analyses will be performed using qualitative content analysis to investigate mechanism of impact, context and delivery. Quantitative and qualitative data will be integrated in the final stage by using a triangulation protocol according to mixed-method guidelines. ETHICS AND DISSEMINATION The study is approved by the Regional Ethical Review Board in Gothenburg, Sweden. Results will be presented in open access, peer-reviewed journals and at international scientific conferences.
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Affiliation(s)
- Markus Saarijärvi
- Institute of Health and Care Sciences, Goteborgs Universitet, Goteborg, Sweden
- Department of Public Health and Primary Care, KU Leuven, Leuven, Vlaanderen, Belgium
| | - Lars Wallin
- Institute of Health and Care Sciences, Goteborgs Universitet, Goteborg, Sweden
- School of Education, Health and Social Studies, Hogskolan Dalarna, Falun, Dalarna, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Philip Moons
- Institute of Health and Care Sciences, Goteborgs Universitet, Goteborg, Sweden
- Department of Public Health and Primary Care, KU Leuven, Leuven, Vlaanderen, Belgium
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Goteborgs Universitet, Goteborg, Sweden
- Centre for Person-Centered Care, Goteborgs Universitet, Goteborg, Sweden
| | - Ewa-Lena Bratt
- Institute of Health and Care Sciences, Goteborgs Universitet, Goteborg, Sweden
- Department of Pediatric Cardiology, Drottning Silvias barn- och ungdomssjukhus i Goteborg, Goteborg, Sweden
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Jull J, Graham ID, Kristjansson E, Moher D, Petkovic J, Yoganathan M, Tugwell P, Welch VA. Taking an integrated knowledge translation approach in research to develop the CONSORT-Equity 2017 reporting guideline: an observational study. BMJ Open 2019; 9:e026866. [PMID: 31366641 PMCID: PMC6678066 DOI: 10.1136/bmjopen-2018-026866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE We describe the use of an integrated knowledge translation (KT) approach in the development of the CONsolidated Standards Of Reporting Trials extension for equity ('CONSORT-Equity 2017'), and advisory board-research team members' ('the team') perceptions of the integrated KT process. DESIGN This is an observational study to describe team processes and experience with a structured integrated KT approach to develop CONSORT-Equity 2017. Participant observation to describe team processes and a survey were used with the 38 team members. SETTING Use of the CONSORT health research reporting guideline contributes to an evidence base for health systems decision-making, and CONSORT-Equity 2017 may improve reporting about health equity-relevant evidence. An integrated KT research approach engages knowledge users (those for whom the research is meant to be useful) with researchers to co-develop research evidence and is more likely to produce findings that are applied in practice or policy. PARTICIPANTS Researchers adopted an integrated KT approach and invited knowledge users to form a team. RESULTS An integrated KT approach was used in the development of CONSORT-Equity 2017 and structured replicable steps. The process for co-developing the reporting guideline involved two stages: (1) establishing guiding features for co-development and (2) research actions that supported the co-development of the reporting guideline. Stage 1 consisted of four steps: finding common ground, forming an advisory board, committing to ethical guidance and clarifying theoretical research assumptions. Bound by the stage 1 guiding features of an integrated KT approach, stage 2 consisted of five steps during which studies for consensus-based reporting guidelines were conducted. Of 38 team members, 25 (67.5%) completed a survey about their perceptions of the integrated KT approach. CONCLUSIONS An integrated KT approach can be used to engage a team to co-develop reporting guidelines. Further study is needed to understand the use of an integrated KT approach in the development of reporting guidelines.
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Affiliation(s)
- Janet Jull
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ian D Graham
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | - David Moher
- Ottawa Methods Centre, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Jennifer Petkovic
- Bruyere Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Peter Tugwell
- Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Vivian A Welch
- Institute of Population Health, University of Ottawa, Ottawa, Canada
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Phillips KC, Clarke-Farr PC, Matsha TE, Meyer D. Biomarkers as a predictor for diabetic retinopathy risk and management: A review. AFRICAN VISION AND EYE HEALTH 2018. [DOI: 10.4102/aveh.v77i1.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Di Battista EM, Bracken RM, Stephens JW, Rice S, Thomas M, Williams SP, Mellalieu SD, Morgan K, Cottrell C, Davies V, Newbury‐Davies L, Street L, Judd F, Evans C, James J, Jones C, Williams C, Smith S, Thornton J, Williams S, Williams R, Williams M. Workplace delivery of a dietitian‐led cardiovascular disease and type 2 diabetes prevention programme: A qualitative study of participants’ experiences in the context of Basic Needs Theory. NUTR BULL 2017. [DOI: 10.1111/nbu.12292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E. M. Di Battista
- Aneurin Bevan University Health Board Caerleon UK
- University of South Wales Pontypridd UK
| | | | | | - S. Rice
- Hywel Dda Health Board Llanelli UK
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Sousa SRAE, Shoemaker SJ, do Nascimento MMG, Costa MS, Ramalho de Oliveira D. Development and validation of a logic model for comprehensive medication management services. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2017; 26:250-257. [DOI: 10.1111/ijpp.12392] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 07/04/2017] [Indexed: 11/30/2022]
Abstract
Abstract
Objectives
To develop and validate a theoretical logic model for comprehensive medication management (CMM) services.
Methods
The components of a logic model were constructed after a literature review and interviews with 4 CMM professionals. To validate the logic model, a panel of 17 CMM experts participated in three online Delphi method rounds to achieve consensus on the model. The consensus between the experts on each component of the logic model was evaluated using the Content Validity Index and Inter-rater Agreement in each of the rounds.
Key findings
A logic model for CMM services containing 51 items was constructed and validated. Both the items of each component of the model and the linkage between the main components were agreed upon among the experts.
Conclusions
A logic model for CMM services was developed and validated. It is an innovative tool that, if used as a theoretical framework for the implementation of CMM, can ensure greater reproducibility of CMM services in different scenarios of practice and levels of care.
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Affiliation(s)
- Samuel R A e Sousa
- School of Pharmacy, Federal University of Minas Gerais (FAFAR/UFMG), Belo Horizonte, Minas Gerais, Brazil
| | | | - Mariana M G do Nascimento
- School of Pharmacy, Federal University of Minas Gerais (FAFAR/UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Marianne S Costa
- School of Pharmacy, Federal University of Minas Gerais (FAFAR/UFMG), Belo Horizonte, Minas Gerais, Brazil
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Lai AY, Stewart SM, Mui MW, Wan A, Yew C, Lam TH, Chan SS. An Evaluation of a Train-the-Trainer Workshop for Social Service Workers to Develop Community-Based Family Interventions. Front Public Health 2017; 5:141. [PMID: 28713801 PMCID: PMC5491537 DOI: 10.3389/fpubh.2017.00141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 06/06/2017] [Indexed: 11/20/2022] Open
Abstract
Introduction Evaluation studies on train-the-trainer workshops (TTTs) to develop family well-being interventions are limited in the literature. The Logic Model offers a framework to place some important concepts and tools of intervention science in the hands of frontline service providers. This paper reports on the evaluation of a TTT for a large community-based program to enhance family well-being in Hong Kong. Methods The 2-day TTT introduced positive psychology themes (relevant to the programs that the trainees would deliver) and the Logic Model (which provides a framework to guide intervention development and evaluation) for social service workers to guide their community-based family interventions. The effectiveness of the TTT was examined by self-administered questionnaires that assessed trainees’ changes in learning (perceived knowledge, self-efficacy, attitude, and intention), trainees’ reactions to training content, knowledge sharing, and benefits to their service organizations before and after the training and then 6 months and 1 year later. Missing data were replaced by baseline values in an intention-to-treat analysis. Focus group interviews were conducted approximately 6 months after training. Results Fifty-six trainees (79% women) joined the TTT. Forty-four and 31 trainees completed the 6-month and 1-year questionnaires, respectively. The trainees indicated that the workshop was informative and well organized. The TTT-enhanced trainees’ perceived knowledge, self-efficacy, and attitudes toward the application of the Logic Model and positive psychology constructs in program design. These changes were present with small to large effect size that persisted to the 1 year follow-up. The skills learned were used to develop 31 family interventions that were delivered to about 1,000 families. Qualitative feedback supported the quantitative results. Conclusion This TTT offers a practical example of academic-community partnerships that promote capacity among community social service workers. Goals included sharing basic tools of intervention development and evaluation, and the TTT offered, therefore, the potential of learning skills that extended beyond the lifetime of a single program. Clinical trial registration The research protocol was registered at the National Institutes of Health (identifier number: NCT01796275).
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Affiliation(s)
- Agnes Y Lai
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Sunita M Stewart
- Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, United States
| | - Moses W Mui
- The Hong Kong Council of Social Service, Hong Kong, Hong Kong
| | - Alice Wan
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Carol Yew
- United Centre of Emotional Health and Positive Living, United Christian Nethersole Community Health Service, Hong Kong, Hong Kong
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Sophia S Chan
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong
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Coorey GM, Neubeck L, Usherwood T, Peiris D, Parker S, Lau AYS, Chow C, Panaretto K, Harris M, Zwar N, Redfern J. Implementation of a consumer-focused eHealth intervention for people with moderate-to-high cardiovascular disease risk: protocol for a mixed-methods process evaluation. BMJ Open 2017; 7:e014353. [PMID: 28077414 PMCID: PMC5253559 DOI: 10.1136/bmjopen-2016-014353] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Technology-mediated strategies have potential to engage patients in modifying unhealthy behaviour and improving medication adherence to reduce morbidity and mortality from cardiovascular disease (CVD). Furthermore, electronic tools offer a medium by which consumers can more actively navigate personal healthcare information. Understanding how, why and among whom such strategies have an effect can help determine the requirements for implementing them at a scale. This paper aims to detail a process evaluation that will (1) assess implementation fidelity of a multicomponent eHealth intervention; (2) determine its effective features; (3) explore contextual factors influencing and maintaining user engagement; and (4) describe barriers, facilitators, preferences and acceptability of such interventions. METHODS AND ANALYSIS Mixed-methods sequential design to derive, examine, triangulate and report data from multiple sources. Quantitative data from 3 sources will help to inform both sampling and content framework for the qualitative data collection: (1) surveys of patients and general practitioners (GPs); (2) software analytics; (3) programme delivery records. Qualitative data from interviews with patients and GPs, focus groups with patients and field notes taken by intervention delivery staff will be thematically analysed. Concurrent interview data collection and analysis will enable a thematic framework to evolve inductively and inform theory building, consistent with a realistic evaluation perspective. Eligible patients are those at moderate-to-high CVD risk who were randomised to the intervention arm of a randomised controlled trial of an eHealth intervention and are contactable at completion of the follow-up period; eligible GPs are the primary healthcare providers of these patients. ETHICS AND DISSEMINATION Ethics approval has been received from the University of Sydney Human Research Ethics Committee and the Aboriginal Health and Medical Research Council (AH&MRC) of New South Wales. Results will be disseminated via scientific forums including peer-reviewed publications and national and international conferences. TRIAL REGISTRATION NUMBER ANZCTR 12613000715774.
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Affiliation(s)
- Genevieve M Coorey
- The George Institute for Global Health, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Lis Neubeck
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
- Sydney Nursing School, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine, Nursing and Health Sciences, School of Nursing & Midwifery, Flinders University, Adelaide, Australia
| | - Timothy Usherwood
- The George Institute for Global Health, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - David Peiris
- The George Institute for Global Health, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Sharon Parker
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Annie Y S Lau
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Clara Chow
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cardiovascular Division, The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Kathryn Panaretto
- Centre for Chronic Disease, School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicholas Zwar
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Julie Redfern
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cardiovascular Division, The George Institute for Global Health, Sydney, New South Wales, Australia
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Williams C, Wan TTH. A remote monitoring program evaluation: a retrospective study. J Eval Clin Pract 2016; 22:978-984. [PMID: 27263499 DOI: 10.1111/jep.12577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 05/07/2016] [Accepted: 05/09/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Using an integrated model, the Donabedian Quality and Logic Model, we examined a remote monitoring heart failure disease management program. METHOD This quantitative research used post-test only case matched design. The sample consisted of 210 participants from 23 home health care agencies. RESULTS Logistic regression results indicated statistical significance, there was an inverse relationship between caregiver support and the complexity of decision making; X2 (3, n = 210) = 29.984, P = 0.012. The DTreg suggested that participants who were advised to go to the ER had a 1.00 probability of doing so, and those who were instructed otherwise had a 0.37 probability of going to the ER. Among participants who experienced a hospital readmission, there was 0.50 probability that patient education or other clinical intervention was implemented prior to the admission. CONCLUSION As home health care agencies consider disease management programs, it is important to gain a comprehensive understanding of the potential of innovative programs and the resources they require. While the agency invested the resources required by the remote monitoring program, the study demonstrated that caregiver support was a critical structural component of the program and may affect change in nurses' decision making to mitigate hospital utilization. We recommend that home health care agencies take greater consideration of the family and social support in implementing a remote monitoring system.
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Affiliation(s)
- Cynthia Williams
- Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - Thomas T H Wan
- College of Health and Public Affairs, University of Central Florida, Orlando, FL, USA
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The perceptions and perspectives of patients and health care providers on chronic diseases management in rural South Africa: a qualitative study. BMC Health Serv Res 2015; 15:143. [PMID: 25880727 PMCID: PMC4399424 DOI: 10.1186/s12913-015-0812-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 03/23/2015] [Indexed: 11/29/2022] Open
Abstract
Background Preventive health care represents the future for health care delivery in South Africa to improve management of chronic diseases as this has been implemented for some time in several countries to tackle the increasing burden of chronic diseases. Individual person’s health is unique, as they move in and out of chronic and acute health care phases, there is need to integrate chronic and acute care constructs to improve continuity of care and maximize health and improve wellbeing. The aim of this study was to determine the perceptions and perspectives of chronic patients’ and nurses regarding chronic disease management in terms of barriers, facilitators and their experiences. Methods To meet our aim we used qualitative methods involving the collection of information by means of focus group discussions in Dikgale Health and Demographic Surveillance System (HDSS). All data was recorded, transcribed verbatim and analysed using data-driven thematic analysis. Results Our study showed that chronic disease patients have a first contact with health care professionals at the primary health care level in the study area. The main barriers mentioned by both the health care workers and chronic disease patients are lack of knowledge on chronic diseases, shortage of medication and shortage of nurses in the clinics which causes patients to wait for a long periods in a clinic. Health care workers are poorly trained on the management of chronic diseases. Lack of supervision by the district and provincial health managers together with poor dissemination of guidelines has been found to be a contributing factor to lack of knowledge in nurses among the clinics within the study area. Both patients and nurses mentioned the need to involve community health workers and traditional healers and integrate their services in order to early detect and manage chronic diseases in the community. Conclusions Nurses and chronic disease patients mentioned similar barriers to chronic disease management. Concerted action is needed to strengthen the delivery of medications at the clinics, improve the chronic disease knowledge for both nurses and patients by conducting in-service trainings or workshops, increase the involvement of community health workers and establish a link (through formal referral system) with traditional healers.
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Schuurs S, Amsters D, Bayliss C, Maugham L, Mason O, Slattery P. Using programme theory to evaluate delivery of health services: A methodology accessible to clinicians. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2014. [DOI: 10.12968/ijtr.2014.21.7.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: With healthcare providers experiencing increasing demand to evaluate clinical service delivery, it is necessary to explore evaluation methodologies that can accommodate the complexities and contextual factors in health-care systems and human systems in general. Methodologies must also be comprehensible to clinicians. Programme theory is one such methodology. Content: This paper presents a brief description of programme theory methodology and a case study of the use of this approach in a custom wheelchair seating service for people with spinal cord injury. Conclusions: Programme theory is a useful methodology for examining how a service operates and whether it achieves what it sets out to do. It is essential that clinicians challenge and test their assumptions about their services and act on information obtained in order to continuously improve service delivery.
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Affiliation(s)
- Sarita Schuurs
- Research Officer, Spinal Outreach Team, Princess Alexandra Hospital, Brisbane
| | - Delena Amsters
- Senior Research Officer, Spinal Outreach Team, Princess Alexandra Hospital, Brisbane
| | - Carey Bayliss
- Physiotherapist, Spinal Outreach Team, Princess Alexandra Hospital, Brisbane
| | - Lucy Maugham
- Physiotherapist, Spinal Outreach Team, Princess Alexandra Hospital, Brisbane
| | - Oliver Mason
- Rehabilitation Engineer, Royal Brisbane and Women's Hospital, Brisbane
| | - Peter Slattery
- Director of the Rehabilitation Engineering Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia and Adjunct Associate Professor, Faculty of Science and Engineering, QUT, Australia
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