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Petro-Petro J, Arango-Paternina CM, Patiño-Villada FA, Ramirez-Villada JF, Brownson RC. Implementation processes of social network interventions for physical activity and sedentary behavior among children and adolescents: a scoping review. BMC Public Health 2024; 24:1101. [PMID: 38649855 PMCID: PMC11034017 DOI: 10.1186/s12889-024-18615-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/16/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The characteristics of the implementation process of interventions are essential for bridging the gap between research and practice. This scoping review aims to identify the implementation process of social network interventions (SNI) to address physical activity and sedentary behaviors in children and adolescents. METHODS The scoping review was conducted adhering to the established guidelines. The search was carried out in the ERIC, EBSCO, EMBASE, SCOPUS, and Lilacs databases in April 2023. Social network intervention studies in children and adolescents were included, addressing physical activity or sedentary behaviors. Replicability (TIDieR), applicability (PRECIS-2), and generalizability (RE-AIM) were the explored components of the implementation process. Each component was quantitatively and separately analyzed. Then, a qualitative integration was carried out using a narrative method. RESULTS Most SNI were theoretically framed on the self-determination theory, used social influence as a social mechanism, and used the individual typology of network intervention. Overall, SNI had strong replicability, tended to be pragmatic, and three RE-AIM domains (reach, adoption (staff), and implementation) showed an acceptable level of the generalizability of findings. CONCLUSIONS The analyzed SNI for physical activity and sedentary behaviors in adolescents tended to be reported with high replicability and were conducted pragmatically, i.e., with very similar conditions to real settings. The RE-AIM domains of reach, adoption (staff), and implementation support the generalizability of SNI. Some domains of the principles of implementation strategies of SNI had acceptable external validity (actor, action targets, temporality, dose, and theoretical justification).
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Affiliation(s)
- Jose Petro-Petro
- Instituto de Educación Física, Universidad de Antioquia, Carrera 75 Nº 65-87 - Bloque 45, Medellín, Colombia.
- Departamento de Cultura Física, Universidad de Córdoba, Montería, Colombia.
| | - Carlos Mario Arango-Paternina
- Research Group on Physical Activity for Health (AFIS), Instituto Universitario de Educación Física y Deportes; Universidad de Antioquia, Ciudadela Robledo, Medellín, Colombia
| | - Fredy Alonso Patiño-Villada
- Research Group on Physical Activity for Health (AFIS), Instituto Universitario de Educación Física y Deportes; Universidad de Antioquia, Ciudadela Robledo, Medellín, Colombia
| | - Jhon Fredy Ramirez-Villada
- Research Group on Physical Activity for Health (AFIS), Instituto Universitario de Educación Física y Deportes; Universidad de Antioquia, Ciudadela Robledo, Medellín, Colombia
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University, St. Louis, MO, USA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine; Washington University, St. Louis, MO, USA
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Ellis KR, Raji D, Pennings JS, Thorpe RJ, Bruce MA. Caregiving and Obesity among Black American Adults. SOCIAL WORK RESEARCH 2024; 48:38-47. [PMID: 38455109 PMCID: PMC10915901 DOI: 10.1093/swr/svae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/19/2022] [Accepted: 01/26/2023] [Indexed: 03/09/2024]
Abstract
Black American adults often report higher rates of obesity and caregiving compared with other racial or ethnic groups. Consequently, many Black American caregivers and care recipients are obese or have obesity-related chronic conditions (e.g., diabetes, hypertension). This study investigated associations between caregiving and obesity among Black Americans, including the role of health behaviors and chronic conditions. The sample included data from 2015 and 2017 Behavioral Risk Factor Surveillance System for non-Hispanic Black (NHB) or African American adult caregivers (n = 2,562) and noncaregivers (n = 7,027). The association between obesity (dependent variable) and caregiving status, fruit consumption, vegetable consumption, physical activity, and number of chronic conditions (independent variables) were evaluated using hierarchical binomial logistic regressions. Caregiving, being female, and chronic conditions were associated with higher odds of obesity, while physical activity was associated with lower odds of obesity. Physical activity, diet, and chronic conditions did not account for differences in obesity among caregiving and noncaregiving Black Americans. Increasing understanding of health behaviors and chronic disease burden of NHB caregivers has implications for programs aiming to improve obesity-related outcomes for caregivers and recipients. Future research should investigate multilevel factors that contribute to observed differences.
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Affiliation(s)
- Katrina R Ellis
- PhD, MPH, MSW, is assistant professor, School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI 48109, USA
| | - Dolapo Raji
- MPH, MHI, is research associate specialist intermediate, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jacquelyn S Pennings
- PhD, PStat, is research associate professor, Department of Orthopaedic Surgery, Department of Biostatistics, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Roland J Thorpe
- PhD, is professor, Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Baltimore, MD, USA
| | - Marino A Bruce
- PhD, is associate dean for research and clinical professor, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA
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Yudkin JS, Messiah SE, Allicock MA, Barlow SE. Integration of e-Health Strategies for Post-COVID-19 Pandemic Pediatric Weight Management Programs. Telemed J E Health 2024; 30:321-330. [PMID: 37552819 DOI: 10.1089/tmj.2023.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
Background: The COVID-19 pandemic catalyzed a renewed urgency to address the obesity pandemic and accelerated the use of technology to treat pediatric obesity. Yet, there are significant incongruities between the existing literature on technology for obesity management and the current health care system that may lead to suboptimal outcomes and increased costs. This study reviewed the types of e-health strategies currently in use, highlighted inconsistencies and overlap in terminology, and identified future research directions in e-health for childhood obesity, including gaps in implementation science. Methods: This narrative literature review synthesized seminal articles from the literature, as well as recent articles, using PubMed and Google Scholar that focused on the use of technology in treating pediatric obesity. This inclusive strategy was intended to elucidate the heterogeneity in how different disciplines are using digital health terminology in pediatric obesity research. Results: Both the prevalence of e-health interventions and its associated terminology are increasing in the peer-reviewed literature, especially since the beginning of the COVID-19 pandemic. Yet, their definitions and usage are unstandardized, leading to a lack of cohesion in the research and between disciplines. There is a gap in implementation science outcomes, including reimbursement, that may significantly impact external validity and uptake. Conclusion: A more systematic and precise approach to researching e-health that can assess specific technologies and combinations of technologies, their short-term and long-term effect sizes, and feasibility can produce the necessary data that may lead to reimbursement policies and, ultimately, improved pediatric weight management outcomes.
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Affiliation(s)
- Joshua S Yudkin
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
| | - Sarah E Messiah
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
- Center for Pediatric Population Health, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, Texas, USA
- Department of Pediatrics, McGovern Medical School, Houston, Texas, USA
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Marlyn A Allicock
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
- Center for Pediatric Population Health, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, Texas, USA
| | - Sarah E Barlow
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Children's Health, Children's Medical Center Dallas, Dallas, Texas, USA
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Yudkin JS, Koym K, Hamad Y, Malthaner LQ, Burgess RM, Ortiz LN, Dhurjati N, Mitha S, Calvi G, Hill K, Brownell M, Wei E, Swartz K, Atem FD, Galeener CA, Messiah SE, Barlow SE, Allicock MA. Family-based pediatric weight management interventions in US primary care settings targeting children ages 6-12 years old: A systematic review guided by the RE-AIM framework. Transl Behav Med 2024; 14:34-44. [PMID: 37632769 DOI: 10.1093/tbm/ibad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2023] Open
Abstract
Obesity is a pandemic that disproportionately affects children from vulnerable populations in the USA. Current treatment approaches in primary care settings in the USA have been reported to be insufficient at managing pediatric obesity, primarily due to implementation challenges for healthcare systems and barriers for families. While the literature has examined the efficacy of pediatric obesity interventions focused on internal validity, it lacks sufficient reporting and analysis of external validity necessary for successful translation to primary care settings. We conducted a systematic review of the primary-care-setting literature from January 2007 to March 2020 on family-based pediatric weight management interventions in both English and/or Spanish for children ages 6-12 years in the USA using the Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. A literature search, using PRISMA guidelines, was conducted in January 2022 using the following electronic databases: Medline Ovid, Embase, and Cochrane Library. 22 270 records were screened, and 376 articles were reviewed in full. 184 studies were included. The most commonly reported dimensions of the RE-AIM framework were Reach (65%), Efficacy/Effectiveness (64%), and Adoption (64%), while Implementation (47%) and Maintenance (42%) were less often reported. The prevalence of reporting RE-AIM construct indicators ranged greatly, from 1% to 100%. This systematic review underscores the need for more focus on external validity to guide the development, implementation, and dissemination of future pediatric obesity interventions based in primary care settings. It also suggests conducting additional research on sustainable financing for pediatric obesity interventions.
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Affiliation(s)
- Joshua S Yudkin
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Kelsey Koym
- Texas Medical Center Library, Houston, TX, USA
| | - Yasmin Hamad
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Lauren Q Malthaner
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Rebecca Meredith Burgess
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | | | - Nalini Dhurjati
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Sharmin Mitha
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Gabriela Calvi
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Kristina Hill
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
- Children's Health, Children's Medical Center Dallas, Dallas, TX, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | | | - Elena Wei
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Kyle Swartz
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Folefac D Atem
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Carol A Galeener
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Sarah E Messiah
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
| | - Sarah E Barlow
- Children's Health, Children's Medical Center Dallas, Dallas, TX, USA
- Department of Pediatrics, Division of Pediatric Gastroenterology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Marlyn A Allicock
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, TX, USA
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Yudkin JS, Allicock MA, Atem FD, Galeener CA, Messiah SE, Barlow SE. The Use of Electronic Health Record Data to Identify Variation in Referral, Consent, and Engagement in a Pediatric Intervention for Overweight and Obesity: A Cross-Sectional Study. Popul Health Manag 2023; 26:365-377. [PMID: 37792388 DOI: 10.1089/pop.2023.0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Clinical weight management programs face low participation. The authors assessed whether using electronic health record (EHR) data can identify variation in referral, consent, and engagement in a pediatric overweight and obesity (OW/OB) intervention. Using Epic EHR data collected between August 2020 and April 2021, sociodemographic and clinical diagnostic data (ie, International Classification of Disease [ICD] codes from visit and problem list [PL]) were analyzed to determine their association with referral, consent, and engagement in an OW/OB intervention. Bivariate analyses and multivariable logistic regression modeling were performed, with Bayesian inclusion criterion score used for model selection. Compared with the 581 eligible patients, referred patients were more likely to be boys (60% vs. 54%, respectively; P = 0.04) and have a higher %BMIp95 (119% vs. 112%, respectively; P < 0.01); consented patients were more likely to have a higher %BMIp95 (120% vs. 112%, respectively; P < 0.01) and speak Spanish (71% vs. 59%, respectively; P = 0.02); and engaged patients were more likely to have a higher %BMIp95 (117% vs. 112%, respectively; P = 0.03) and speak Spanish (78% vs. 59%, respectively; P < 0.01). The regression model without either ICD codes or PL diagnoses was the best fit across all outcomes, which were associated with baseline %BMIp95 and health clinic location. Neither visit nor PL diagnoses helped to identify variation in referral, consent, and engagement in a pediatric OW/OB intervention, and their role in understanding participation in such interventions remains unclear. However, additional efforts are needed to refer and engage younger girls with less extreme cases of OW/OB, and to support non-Hispanic families to consent.
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Affiliation(s)
- Joshua S Yudkin
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA
| | - Marlyn A Allicock
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA
| | - Folefac D Atem
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA
| | - Carol A Galeener
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA
| | - Sarah E Messiah
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA
- Center for Pediatric Population Health, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA
- Department of Pediatrics, McGovern Medical School, Houston, Texas, USA
| | - Sarah E Barlow
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Children's Health, Children's Medical Center Dallas, Dallas, Texas, USA
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Trivedi KK, Schaffzin JK, Deloney VM, Aureden K, Carrico R, Garcia-Houchins S, Garrett JH, Glowicz J, Lee GM, Maragakis LL, Moody J, Pettis AM, Saint S, Schweizer ML, Yokoe DS, Berenholtz S. Implementing strategies to prevent infections in acute-care settings. Infect Control Hosp Epidemiol 2023; 44:1232-1246. [PMID: 37431239 PMCID: PMC10527889 DOI: 10.1017/ice.2023.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
This document introduces and explains common implementation concepts and frameworks relevant to healthcare epidemiology and infection prevention and control and can serve as a stand-alone guide or be paired with the "SHEA/IDSA/APIC Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2022 Updates," which contain technical implementation guidance for specific healthcare-associated infections. This Compendium article focuses on broad behavioral and socio-adaptive concepts and suggests ways that infection prevention and control teams, healthcare epidemiologists, infection preventionists, and specialty groups may utilize them to deliver high-quality care. Implementation concepts, frameworks, and models can help bridge the "knowing-doing" gap, a term used to describe why practices in healthcare may diverge from those recommended according to evidence. It aims to guide the reader to think about implementation and to find resources suited for a specific setting and circumstances by describing strategies for implementation, including determinants and measurement, as well as the conceptual models and frameworks: 4Es, Behavior Change Wheel, CUSP, European and Mixed Methods, Getting to Outcomes, Model for Improvement, RE-AIM, REP, and Theoretical Domains.
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Affiliation(s)
| | - Joshua K. Schaffzin
- Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Valerie M. Deloney
- Society for Healthcare Epidemiology of America (SHEA), Arlington, Virginia
| | | | - Ruth Carrico
- Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, Kentucky
| | | | - J. Hudson Garrett
- Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, Kentucky
| | - Janet Glowicz
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Grace M. Lee
- Stanford Children’s Health, Stanford, California
| | | | - Julia Moody
- Clinical Services Group, HCA Healthcare, Nashville, Tennessee
| | | | - Sanjay Saint
- VA Ann Arbor Healthcare System and University of Michigan, Ann Arbor, Michigan
| | | | - Deborah S. Yokoe
- University of California San Francisco School of Medicine, UCSF Medical Center, San Francisco, California
| | - Sean Berenholtz
- Clinical Services Group, HCA Healthcare, Nashville, Tennessee
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Parcesepe AM, Stockton M, Remch M, Wester CW, Bernard C, Ross J, Haas AD, Ajeh R, Althoff KN, Enane L, Pape W, Minga A, Kwobah E, Tlali M, Tanuma J, Nsonde D, Freeman A, Duda SN, Nash D, Lancaster K. Availability of screening and treatment for common mental disorders in HIV clinic settings: data from the global International epidemiology Databases to Evaluate AIDS (IeDEA) Consortium, 2016-2017 and 2020. J Int AIDS Soc 2023; 26:e26147. [PMID: 37535703 PMCID: PMC10399924 DOI: 10.1002/jia2.26147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 07/17/2023] [Indexed: 08/05/2023] Open
Abstract
INTRODUCTION Common mental disorders (CMDs) are highly prevalent among people with HIV. Integrating mental healthcare into HIV care may improve mental health and HIV treatment outcomes. We describe the reported availability of screening and treatment for depression, anxiety and post-traumatic stress disorder (PTSD) at global HIV treatment centres participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) Consortium in 2020 and changes in availability at sites in low- or middle-income countries (LMICs) between 2016/2017 and 2020. METHODS In 2020, 238 sites contributing individual-level data to the IeDEA Consortium and in 2016/2017 a stratified random sample of IeDEA sites in LMICs were eligible to participate in site surveys on the availability of screening and treatment for CMDs. We assessed trends over time for 68 sites across 27 LMICs that participated in both surveys. RESULTS Among the 238 sites eligible to participate in the 2020 site survey, 227 (95%) participated, and mental health screening and treatment data were available for 223 (98%) sites across 41 countries. A total of 95 sites across 29 LMICs completed the 2016/2017 survey. In 2020, 68% of sites were in urban settings, and 77% were in LMICs. Overall, 50%, 14% and 12% of sites reported screening with a validated instrument for depression, anxiety and PTSD, respectively. Screening plus treatment in the form of counselling was available for depression, anxiety and PTSD at 46%, 13% and 11% of sites, respectively. Screening plus treatment in the form of medication was available for depression, anxiety and PTSD at 36%, 11% and 8% of sites, respectively. Among sites that participated in both surveys, screening for depression was more commonly available in 2020 than 2016/2017 (75% vs. 59%, respectively, p = 0.048). CONCLUSIONS Reported availability of screening for depression increased among this group of IeDEA sites in LMICs between 2016/2017 and 2020. However, substantial gaps persist in the availability of mental healthcare at HIV treatment sites across global settings, particularly in resource-constrained settings. Implementation of sustainable strategies to integrate mental health services into HIV care is needed.
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Affiliation(s)
- Angela M. Parcesepe
- Department of Maternal and Child HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- University of North Carolina at Chapel HillCarolina Population CenterChapel HillNorth CarolinaUSA
| | | | - Molly Remch
- Department of EpidemiologyUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - C. William Wester
- Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Charlotte Bernard
- University of BordeauxNational Institute for Health and Medical ResearchResearch Institute for Sustainable DevelopmentBordeaux Population Health Research CentreBordeauxFrance
| | - Jeremy Ross
- TREAT Asia/amfARThe Foundation for AIDS ResearchBangkokThailand
| | - Andreas D. Haas
- University of BernInstitute of Social and Preventive MedicineBernSwitzerland
| | - Rogers Ajeh
- Clinical Research Education and Networking ConsultancyYaoundeCameroon
| | - Keri N. Althoff
- Johns Hopkins UniversityBloomberg School of Public HealthBaltimoreMarylandUSA
| | - Leslie Enane
- Department of PediatricsThe Ryan White Center for Pediatric Infectious Disease and Global HealthIndiana University School of MedicineIndianapolisIndianaUSA
| | - William Pape
- Groupe Haitien d''Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO)Port au PrinceHaiti
| | - Albert Minga
- Centre Medical de Suivi de Donneurs de Sang/CNTS/PRIMO‐CIAbidjanCote D''Ivoire
| | - Edith Kwobah
- Department of Mental HealthMoi Teaching and Referral HospitalEldoretKenya
| | - Mpho Tlali
- Centre for Infectious Disease Epidemiology & Research (CIDER)School of Public Health & Family MedicineUniversity of Cape TownCape TownSouth Africa
| | - Junko Tanuma
- Division of the AIDS Medical Information of AIDS Clinical CareNational Center for Global Health and MedicineTokyoJapan
| | | | - Aimee Freeman
- Johns Hopkins UniversityBloomberg School of Public HealthBaltimoreMarylandUSA
| | - Stephany N. Duda
- Department of Biomedical InformaticsVanderbilt University School of MedicineNashvilleTennesseeUSA
| | - Denis Nash
- City University of New YorkInstitute for Implementation Science in Population HealthNew YorkNew YorkUSA
| | | | - the IeDEA Consortium
- Department of Maternal and Child HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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Pistollato F, Campia I, Daskalopoulos EP, Bernasconi C, Desaintes C, Di Virgilio S, Kyriakopoulou C, Whelan M, Deceuninck P. Gauging innovation and health impact from biomedical research: survey results and interviews with recipients of EU-funding in the fields of Alzheimer's disease, breast cancer and prostate cancer. Health Res Policy Syst 2023; 21:66. [PMID: 37386455 DOI: 10.1186/s12961-023-00981-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 04/05/2023] [Indexed: 07/01/2023] Open
Abstract
Biomedical research on Alzheimer's disease (AD), breast cancer (BC) and prostate cancer (PC) has globally improved our understanding of the etiopathological mechanisms underlying the onset of these diseases, often with the goal to identify associated genetic and environmental risk factors and develop new medicines. However, the prevalence of these diseases and failure rate in drug development remain high. Being able to retrospectively monitor the major scientific breakthroughs and impact of such investment endeavors is important to re-address funding strategies if and when needed. The EU has supported research into those diseases via its successive framework programmes for research, technological development and innovation. The European Commission (EC) has already undertaken several activities to monitor research impact. As an additional contribution, the EC Joint Research Centre (JRC) launched in 2020 a survey addressed to former and current participants of EU-funded research projects in the fields of AD, BC and PC, with the aim to understand how EU-funded research has contributed to scientific innovation and societal impact, and how the selection of the experimental models may have underpinned the advances made. Further feedback was also gathered through in-depth interviews with some selected survey participants representative of the diverse pre-clinical models used in the EU-funded projects. A comprehensive analysis of survey replies, complemented with the information derived from the interviews, has recently been published in a Synopsis report. Here we discuss the main findings of this analysis and propose a set of priority actions that could be considered to help improving the translation of scientific innovation of biomedical research into societal impact.
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Affiliation(s)
- Francesca Pistollato
- European Commission, Joint Research Centre (JRC), Directorate F-Health, Consumers and Reference Materials, Via E. Fermi 2749, 21027, Ispra, VA, Italy
| | - Ivana Campia
- European Commission, Joint Research Centre (JRC), Directorate F-Health, Consumers and Reference Materials, Via E. Fermi 2749, 21027, Ispra, VA, Italy
| | - Evangelos P Daskalopoulos
- European Commission, Joint Research Centre (JRC), Directorate F-Health, Consumers and Reference Materials, Via E. Fermi 2749, 21027, Ispra, VA, Italy
| | - Camilla Bernasconi
- European Commission, Joint Research Centre (JRC), Directorate F-Health, Consumers and Reference Materials, Via E. Fermi 2749, 21027, Ispra, VA, Italy
| | | | - Sergio Di Virgilio
- European Commission, DG Research & Innovation (DG RTD), Brussels, Belgium
| | | | - Maurice Whelan
- European Commission, Joint Research Centre (JRC), Directorate F-Health, Consumers and Reference Materials, Via E. Fermi 2749, 21027, Ispra, VA, Italy
| | - Pierre Deceuninck
- European Commission, Joint Research Centre (JRC), Directorate F-Health, Consumers and Reference Materials, Via E. Fermi 2749, 21027, Ispra, VA, Italy.
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9
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Branas CC. The culture of experimentation in epidemiology-50 years later. Int J Epidemiol 2022; 51:1705-1710. [PMID: 36107135 PMCID: PMC9749712 DOI: 10.1093/ije/dyac181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/05/2022] [Indexed: 01/21/2023] Open
Affiliation(s)
- Charles C Branas
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA
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10
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Needs Assessment and Best Practices for Digital Trainings for Health Professionals in Ethiopia Using the RE-AIM Framework: COVID-19, Case Study. Disaster Med Public Health Prep 2022; 17:e292. [PMID: 36226522 DOI: 10.1017/dmp.2022.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study is aimed to assess the implementation science outcomes of the coronavirus disease (COVID-19) e-health educational intervention in Ethiopia targeting health care workers via the RE-AIM (Reach, Effectiveness, Adaption, Implementation, Maintenance) framework. METHODS A series of three 1-hour medical seminars focused on COVID-19 prevention and treatment education were conducted between May and August 2020. Educational content was built from medical sites previously impacted by COVID-19. Post-seminar evaluation information was collected from physician and other participants by a survey instrument. Cross-sectional evaluation results are reported here by RE-AIM constructs. RESULTS The medical seminars reached 324 participants. Key success metrics include that 90% reporting the information delivered in a culturally sensitive/tailored manner (effectiveness), 80% reporting that they planned to share the information presented with someone else (adoption and implementation), and 64% reporting using information presented in their daily clinical responsibilities 6 months after the first medical seminars (maintenance). CONCLUSION Grounded in a theoretical framework and following evidence-based best practices, this intervention advances the field of dissemination and implementation science by demonstrating how to transition health care training and delivery from an in-person to digital medium in low-resource settings like Ethiopia.
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Kuo GM, Trinkley KE, Rabin B. Research and Scholarly Methods: Implementation Science Studies. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022; 5:995-1004. [PMID: 36212610 PMCID: PMC9534307 DOI: 10.1002/jac5.1673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/14/2022] [Indexed: 11/08/2022]
Abstract
Traditional research focuses on efficacy or effectiveness of interventions but lacks evaluation of strategies needed for equitable uptake, scalable implementation, and sustainable evidence-based practice transformation. The purpose of this introductory review is to describe key implementation science (IS) concepts as they apply to medication management and pharmacy practice, and to provide guidance on literature review with an IS lens. There are five key ingredients of IS, including: (1) evidence-based intervention; (2) implementation strategies; (3) IS theory, model, or framework; (4) IS outcomes and measures; and (5) stakeholder engagement, which is key to a successful implementation. These key ingredients apply across the three stages of IS research: (1) pre-implementation; (2) implementation; and (3) sustainment. A case example using a combination of IS models, PRISM (Practical, Robust Implementation and Sustainability model) and RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance), is included to describe how an IS study is designed and conducted. This case is a cluster randomized trial comparing two clinical decision support tools to improve guideline-concordant prescribing for patients with heart failure and reduced ejection fraction. The review also includes information on the Standards for Reporting Implementation Studies (StaRI), which is used for literature review and reporting of IS studies,as well as IS-related learning resources.
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Affiliation(s)
- Grace M Kuo
- Texas Tech University Health Sciences Center and Professor Emerita at University of California San Diego; Address: 1300 S. Coulter Street, Suite 104, Amarillo, TX 79106
| | - Katy E Trinkley
- University of Colorado Skaggs Schools of Medicine and Pharmacy and Pharmaceutical Sciences at the Anschutz Medical Campus; Aurora, Colorado
| | - Borsika Rabin
- Herbert Wertheim School of Public Health and Human Longevity Science and Co-Director of the UC San Diego ACTRI Dissemination and Implementation Science Center at University of California San Diego; La Jolla, California
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12
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Guerin R, Glasgow R, Tyler A, Rabin B, Huebschmann A. Methods to improve the translation of evidence-based interventions: A primer on dissemination and implementation science for occupational safety and health researchers and practitioners. SAFETY SCIENCE 2022; 152:105763. [PMID: 37854304 PMCID: PMC10583726 DOI: 10.1016/j.ssci.2022.105763] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Objective A limited focus on dissemination and implementation (D&I) science has hindered the uptake of evidence-based interventions (EBIs) that reduce workplace morbidity and mortality. D&I science methods can be used in the occupational safety and health (OSH) field to advance the adoption, implementation, and sustainment of EBIs for complex workplaces. These approaches should be responsive to contextual factors, including the needs of partners and beneficiaries (such as employers, employees, and intermediaries). Methods By synthesizing seminal literature and texts and leveraging our collective knowledge as D&I science and/or OSH researchers, we developed a D&I science primer for OSH. First, we provide an overview of common D&I terminology and concepts. Second, we describe several key and evolving issues in D&I science: balancing adaptation with intervention fidelity and specifying implementation outcomes and strategies. Next, we review D&I theories, models, and frameworks and offer examples for applying these to OSH research. We also discuss widely used D&I research designs, methods, and measures. Finally, we discuss future directions for D&I science application to OSH and provide resources for further exploration. Results We compiled a D&I science primer for OSH appropriate for practitioners and evaluators, especially those newer to the field. Conclusion This article fills a gap in the OSH research by providing an overview of D&I science to enhance understanding of key concepts, issues, models, designs, methods and measures for the translation into practice of effective OSH interventions to advance the safety, health and well-being of workers.
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Affiliation(s)
- R.J. Guerin
- Division of Science Integration, National Institute for
Occupational Safety and Health, Centers for Disease Control and Prevention, 1090
Tusculum Ave., MS C-10, Cincinnati, OH 45226, USA
| | - R.E. Glasgow
- Dissemination and Implementation Science Program,
University of Colorado Adult and Child Center for Outcomes Research and Delivery
Science, Anschutz Medical Campus, Aurora, CO 80045, USA
- University of Colorado Department of Family Medicine,
Anschutz Medical Campus, Aurora, CO 80045, USA
| | - A. Tyler
- Dissemination and Implementation Science Program,
University of Colorado Adult and Child Center for Outcomes Research and Delivery
Science, Anschutz Medical Campus, Aurora, CO 80045, USA
- University of Colorado Department of Pediatrics, Section
of Hospital Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - B.A. Rabin
- Herbert Wertheim School of Public Health and Human
Longevity Science, University of California San Diego, La Jolla, CA 92037, USA
- UC San Diego Altman Clinical and Translational Research
Institute Dissemination and Implementation Science Center, University of California
San Diego, La Jolla, CA 92037, USA
| | - A.G. Huebschmann
- Dissemination and Implementation Science Program,
University of Colorado Adult and Child Center for Outcomes Research and Delivery
Science, Anschutz Medical Campus, Aurora, CO 80045, USA
- University of Colorado Division of General Internal
Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA
- University of Colorado Ludeman Family Center for
Women’s Health Research, Anschutz Medical Campus, Aurora, CO 80045, USA
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13
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Schulte PA, Guerin RJ, Cunningham TR, Hodson L, Murashov V, Rabin BA. Applying Translational Science Approaches to Protect Workers Exposed to Nanomaterials. Front Public Health 2022; 10:816578. [PMID: 35757639 PMCID: PMC9226388 DOI: 10.3389/fpubh.2022.816578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Like nanotechnology, translational science is a relatively new and transdisciplinary field. Translational science in occupational safety and health (OSH) focuses on the process of taking scientific knowledge for the protection of workers from the lab to the field (i.e., the worksite/workplace) and back again. Translational science has been conceptualized as having multiple phases of research along a continuum, beyond scientific discovery (T0), to efficacy (T1), to effectiveness (T2), to dissemination and implementation (D&I) (T3), to outcomes and effectiveness research in populations (T4). The translational research process applied to occupational exposure to nanomaterials might involve similar phases. This builds on basic and efficacy research (T0 and T1) in the areas of toxicology, epidemiology, industrial hygiene, medicine and engineering. In T2, research and evidence syntheses and guidance and recommendations to protect workers may be developed and assessed for effectiveness. In T3, emphasis is needed on D&I research to explore the multilevel barriers and facilitators to nanotechnology risk control information/research adoption, use, and sustainment in workplaces. D&I research for nanomaterial exposures should focus on assessing sources of information and evidence to be disseminated /implemented in complex and dynamic workplaces, how policy-makers and employers use this information in diverse contexts to protect workers, how stakeholders inform these critical processes, and what barriers impede and facilitate multilevel decision-making for the protection of nanotechnology workers. The T4 phase focuses on how effective efforts to prevent occupational exposure to nanomaterials along the research continuum contribute to large-scale impact in terms of worker safety, health and wellbeing (T4). Stakeholder input and engagement is critical to all stages of the translational research process. This paper will provide: (1) an illustration of the translational research continuum for occupational exposure to nanomaterials; and (2) a discussion of opportunities for applying D&I science to increase the effectiveness, uptake, integration, sustainability, and impact of interventions to protect the health and wellbeing of workers in the nanotechnology field.
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Affiliation(s)
- Paul A. Schulte
- Advanced Technologies and Laboratories (ATL) International, Inc., Gaithersburg, MD, United States
| | - Rebecca J. Guerin
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, United States
| | - Thomas R. Cunningham
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, United States
| | - Laura Hodson
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, United States
| | - Vladimir Murashov
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington, DC, United States
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14
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Mwenesi H, Mbogo C, Casamitjana N, Castro MC, Itoe MA, Okonofua F, Tanner M. Rethinking human resources and capacity building needs for malaria control and elimination in Africa. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000210. [PMID: 36962174 PMCID: PMC10021507 DOI: 10.1371/journal.pgph.0000210] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Despite considerable success in controlling malaria worldwide, progress toward achieving malaria elimination has largely stalled. In particular, strategies to overcome roadblocks in malaria control and elimination in Africa are critical to achieving worldwide malaria elimination goals-this continent carries 94% of the global malaria case burden. To identify key areas for targeted efforts, we combined a comprehensive review of current literature with direct feedback gathered from frontline malaria workers, leaders, and scholars from Africa. Our analysis identified deficiencies in human resources, training, and capacity building at all levels, from research and development to community involvement. Addressing these needs will require active and coordinated engagement of stakeholders as well as implementation of effective strategies, with malaria-endemic countries owning the relevant processes. This paper reports those valuable identified needs and their concomitant opportunities to accelerate progress toward the goals of the World Health Organization's Global Technical Strategy for Malaria 2016-2030. Ultimately, we underscore the critical need to re-think current approaches and expand concerted efforts toward increasing relevant human resources for health and capacity building at all levels if we are to develop the relevant competencies necessary to maintain current gains while accelerating momentum toward malaria control and elimination.
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Affiliation(s)
| | - Charles Mbogo
- Kenya Medical Research Institute (KEMRI)–Wellcome Trust Research Program, Nairobi, Kenya
- Center for Geographic Medicine Research, Coast (CGMR(C), Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
| | - Núria Casamitjana
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic–University of Barcelona, Barcelona, Spain
| | - Marcia C. Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Maurice A. Itoe
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Friday Okonofua
- Department of Obstetrics and Gynaecology, School of Medicine, University of Benin, Benin City, Nigeria
| | - Marcel Tanner
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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15
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Ugalde A, White V, Rankin NM, Paul C, Segan C, Aranda S, Wong Shee A, Hutchinson AM, Livingston PM. How can hospitals change practice to better implement smoking cessation interventions? A systematic review. CA Cancer J Clin 2022; 72:266-286. [PMID: 34797562 DOI: 10.3322/caac.21709] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/27/2021] [Accepted: 10/07/2021] [Indexed: 01/07/2023] Open
Abstract
Smoking cessation reduces the risk of death, improves recovery, and reduces the risk of hospital readmission. Evidence and policy support hospital admission as an ideal time to deliver smoking-cessation interventions. However, this is not well implemented in practice. In this systematic review, the authors summarize the literature on smoking-cessation implementation strategies and evaluate their success to guide the implementation of best-practice smoking interventions into hospital settings. The CINAHL Complete, Embase, MEDLINE Complete, and PsycInfo databases were searched using terms associated with the following topics: smoking cessation, hospitals, and implementation. In total, 14,287 original records were identified and screened, resulting in 63 eligible articles from 56 studies. Data were extracted on the study characteristics, implementation strategies, and implementation outcomes. Implementation outcomes were guided by Proctor and colleagues' framework and included acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. The findings demonstrate that studies predominantly focused on the training of staff to achieve implementation. Brief implementation approaches using a small number of implementation strategies were less successful and poorly sustained compared with well resourced and multicomponent approaches. Although brief implementation approaches may be viewed as advantageous because they are less resource-intensive, their capacity to change practice in a sustained way lacks evidence. Attempts to change clinician behavior or introduce new models of care are challenging in a short time frame, and implementation efforts should be designed for long-term success. There is a need to embrace strategic, well planned implementation approaches to embed smoking-cessation interventions into hospitals and to reap and sustain the benefits for people who smoke.
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Affiliation(s)
- Anna Ugalde
- School of Nursing and Midwifery, Center for Quality and Patient Safety Research and Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Victoria White
- School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Nicole M Rankin
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Catherine Segan
- Cancer Council Victoria, Melbourne, Victoria, Australia
- Center for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Sanchia Aranda
- Department of Nursing, University of Melbourne, Parkville, Victoria, Australia
| | - Anna Wong Shee
- Ballarat Health Services, Ballarat, Victoria, Australia
- Department of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Alison M Hutchinson
- School of Nursing and Midwifery, Center for Quality and Patient Safety Research and Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Monash Health, Melbourne, Victoria, Australia
| | - Patricia M Livingston
- School of Nursing and Midwifery, Center for Quality and Patient Safety Research and Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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16
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Kuwamura Y, Yoshida S, Kurahash K, Sumikawa M, Yumoto H, Uemura H, Matsuhisa M. Effectiveness of a Diabetes Oral Nursing Program Including a Modified Diabetes Oral Health Assessment Tool for Nurses (M-DiOHAT©) : A 12-Month Follow-Up Intervention Study. THE JOURNAL OF MEDICAL INVESTIGATION 2022; 69:86-96. [PMID: 35466152 DOI: 10.2152/jmi.69.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
PURPOSE This study aimed to evaluate the effectiveness of a diabetes oral nursing intervention program for individuals with diabetes. METHODS Fifty-six participants with diabetes underwent a diabetes oral nursing intervention program. The program's effect was evaluated through questionnaires and small interviews. The modified diabetes oral health assessment tool (M-DiOHAT©) was used to assess and educate four factors;oral conditions, behaviors, perceptions and knowledge about diabetes and periodontal disease, and health information-sharing, among participants at baseline, 3, 6, and 12 months later. Primary outcomes included changes in the M-DiOHAT© total scores. Secondary outcomes included scores on the motivation stage of changes in oral health behaviors' scales, dental visits, number of present teeth, hemoglobin A1c (HbA1c), and participants' comments. RESULTS The M-DiOHAT© total score and the motivation stage score significantly improved with the narrative comment of "being motivated to practice oral health behaviors" between the baseline and 12 months later. Eight participants visited the dentist, whereas no differences were observed in the number of present teeth or HbA1c. CONCLUSIONS This program improved participants' M-DiOHAT© total score, motivation stage score, and dental visits. These results suggest the program improved oral health perceptions and behaviors among individuals with diabetes. J. Med. Invest. 69 : 86-96, February, 2022.
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Affiliation(s)
- Yumi Kuwamura
- Department of Women' Health Nursing, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Sumiko Yoshida
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Kiyoe Kurahash
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Masuko Sumikawa
- Department of Nursing, School of Health Sciences, Sapporo Medical University, Hokkaido, Japan
| | - Hiromichi Yumoto
- Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hirokazu Uemura
- Department of Health and Welfare System, College of Nursing Art and Science, University of Hyogo, Akashi, Japan
| | - Munehide Matsuhisa
- Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan
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Yudkin JS, Bakshi P, Craker K, Taha S. The Comprehensive Communal Trauma Intervention Model (CCTIM), an Innovative Transdisciplinary Population-Level Model for Treating Trauma-Induced Illness and Mental Health in Global Vulnerable Communities: Palestine, a Case Study. Community Ment Health J 2022; 58:300-310. [PMID: 33811577 DOI: 10.1007/s10597-021-00822-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 03/27/2021] [Indexed: 10/21/2022]
Abstract
This paper explores how Western medicine may not fully understand and address post-traumatic stress disorder (PTSD) and other trauma-induced illnesses in a culturally appropriate manner in marginalized communities and offers a theoretical framework to develop comprehensive, effective, and sustainable solutions that comprehensively address and treat the trauma on both a collective and individual level. Focused on Palestinians, this paper discusses the collective trauma Palestinians experienced and how it manifests in transgenerational effects on the body and mind that may be post-traumatic stress disorder (PTSD) or perhaps another distinct condition that is yet to be codified in the Western medical lexicon. It describes local alternatives to Western medical diagnostic tools like the "ease to disease" diagnostic scale and the sociopolitical context-in this case, the Palestinian fight for karamah, or dignity-from which such alternatives arise. Based on these findings, a novel theoretical framework, the comprehensive communal trauma intervention model (CCTIM), a truly transdisciplinary population-level model for treating mental health in vulnerable communities globally, is proposed. It articulates the need to address the root cause of collective trauma, make modifications to the healthcare system, and cultivate strategic equity-oriented and research-based partnerships.
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Affiliation(s)
- Joshua S Yudkin
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Sciences Center At Houston School of Public Health, 6011 Harry Hines Blvd, Dallas, TX, 75235, USA.
| | - Parul Bakshi
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, 63130, USA
| | - Kelsey Craker
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Sciences Center At Houston School of Public Health, 6011 Harry Hines Blvd, Dallas, TX, 75235, USA
| | - Sari Taha
- Medicine, An-Najah National Universities, Nablus, Palestine, Israel
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18
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Fernald DH, Zittleman L, Gilchrist EC, Brou LI, Brou LI, Niebauer L, Ledonne C, Sutter C, Felzien M, Westfall JM, Green LA. UPSTREAM! Together evaluation results from community efforts to prevent mental, emotional, and behavioral health problems. EVALUATION AND PROGRAM PLANNING 2021; 89:102000. [PMID: 34555734 DOI: 10.1016/j.evalprogplan.2021.102000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 03/08/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Abstract
Mental, emotional, and behavioral (MEB) health problems are prevalent globally. Despite effective programs that can prevent MEB problems and promote mental health, there has not been widespread adoption. UPSTREAM! Together was a planning project in three Colorado communities. Communities partnered with academic and policy entities to 1) translate evidence about MEB problem prevention into locally-relevant messages and materials and 2) develop long-term plans for broad implementation of interventions to prevent high-priority MEB problems. Community members recognized the need to talk about MEB problems to prevent them. The UPSTREAM! communities localized messages designed to start conversations and sustain attention on preventing MEB problems. The communities understood that prevention takes sustained community attention and advocacy, knowing that important outcomes may be years away. Long-term implementation plans aimed to strengthen families and enhance social connections among youth. Despite community readiness and capacity to implement evidence-based programs, there were few funding opportunities, delaying program implementation and revealing gaps between funding policies and community readiness. This community-engaged experience suggests an achievable approach, acceptable to communities, and worthy of further development and testing. Policies that cultivate and support local expertise may help to increase wider community adoption of evidence-based programs that promote mental health among youth.
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Affiliation(s)
- Douglas H Fernald
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States.
| | - Linda Zittleman
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Emma C Gilchrist
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States; Eugene S. Farley, Jr. Health Policy Center, Aurora, CO, United States
| | - Lina I Brou
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Lina I Brou
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Linda Niebauer
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States; Eugene S. Farley, Jr. Health Policy Center, Aurora, CO, United States
| | - Charlotte Ledonne
- San Luis Valley Area Health Education Center, Alamosa, CO, United States
| | - Christin Sutter
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States; High Plains Research Network Community Advisory Council, Sterling, CO, United States
| | - Maret Felzien
- High Plains Research Network Community Advisory Council, Sterling, CO, United States
| | - John M Westfall
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States; Eugene S. Farley, Jr. Health Policy Center, Aurora, CO, United States
| | - Larry A Green
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States; Eugene S. Farley, Jr. Health Policy Center, Aurora, CO, United States
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Stakeholder-Identified Interventions to Address Cancer Survivors' Psychosocial Needs after Completing Treatment. Curr Oncol 2021; 28:4961-4971. [PMID: 34940055 PMCID: PMC8700656 DOI: 10.3390/curroncol28060416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/14/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Abstract
The interventions used in cancer-survivorship care do not always address outcomes important to survivors. This study sought to understand stakeholders’ views on the key concerns of cancer survivors after treatment and the interventions needed to meet survivors’ and families’ psychosocial needs after completing cancer treatment. We conducted a descriptive qualitative study using semi-structured interviews with stakeholders (survivors, family/friend caregivers, oncology providers, primary care providers, and cancer system decision-/policy-makers) from across Canada. For the data analysis, we used techniques commonly employed in descriptive qualitative research, such as coding, grouping, detailing, and comparing the data. There were 44 study participants: 11 survivors, seven family/friend caregivers, 18 health care providers, and eight decision-/policy-makers. Stakeholder-relevant interventions to address survivors’ psychosocial needs were categorized into five groups, as follows: information provision, peer support, navigation, knowledge translation interventions, and caregiver-specific supports. These findings, particularly interventions that deliver timely and relevant information about the post-treatment period and knowledge translation interventions that strive to integrate effective tools and programs into survivorship care, have implications for future research and practice.
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20
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Kostalova B, Ribaut J, Dobbels F, Gerull S, Mala-Ladova K, Zullig LL, De Geest S. Medication adherence interventions in transplantation lack information on how to implement findings from randomized controlled trials in real-world settings: A systematic review. Transplant Rev (Orlando) 2021; 36:100671. [PMID: 34773910 DOI: 10.1016/j.trre.2021.100671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/19/2021] [Accepted: 09/19/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Growing numbers of randomized controlled trials (RCTs) are showing the effectiveness of interventions to improve medication adherence in transplantation recipients. However, real-world implementation is still a major challenge. This systematic review assesses the range of information available in RCTs supporting these interventions' clinical adoption in adult transplant populations. METHODS We included RCTs of interventions that a) targeted any phase of medication adherence in solid organ or allogeneic stem cell transplantation recipients and b) were published between January 2015 and November 2020. We excluded study protocols, conference abstracts and studies focusing only on pediatric populations. We identified relevant database and trial registries as well as traced references backward and citations forward. Implementation-relevant information was evaluated using adapted versions of Peters' ten criteria: 1. healthcare/organizational context; 2. social/economic/policy context; 3. patient involvement; 4. other stakeholder involvement; 5. sample representativeness; 6. trial conducted in a real-world-setting; 7. presence of feasibility study; 8. implementation strategy; 9. process evaluation; 10. implementation outcomes, using a stoplight color-rating system. RESULTS Screening 17'004 titles/abstracts resulted in 23 eligible RCTs, including 2'339 patients (n = 19-209/study). All included studies focused on the implementation phase of medication adherence. The best-reported criteria were feasibility study (43%), representative sample (17%) and conducted in a real-world-setting (17%). Least reported were context (9%), implementation strategies (4%), process evaluation (4%). CONCLUSIONS RCTs testing medication adherence interventions tend to report limited implementation-relevant information. This hinders their translation to real-world transplant settings. Integrating implementation science principles early in the conceptualization of RCTs would fuel real-world-translation, reducing research waste.
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Affiliation(s)
- Barbora Kostalova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Akademika Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic.
| | - Janette Ribaut
- Institute of Nursing Science, Department of Public Health, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland; Department of Theragnostic, Hematology, University Hospital of Basel, Petersgraben 4, 4031 Basel, Switzerland.
| | - Fabienne Dobbels
- Institute of Nursing Science, Department of Public Health, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland; Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 blok d, box 7001, 3000 Leuven, Belgium.
| | - Sabine Gerull
- Department of Theragnostic, Hematology, University Hospital of Basel, Petersgraben 4, 4031 Basel, Switzerland; Department of Hematology, Cantonal Hospital of Aarau, Tellstrasse 25, 5001 Aarau, Switzerland.
| | - Katerina Mala-Ladova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Akademika Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic.
| | - Leah L Zullig
- Department of Population Health Science, Duke University, 215 Morris St, Durham, NC 27701, USA; Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, 508 Fulton St, Durham, NC 27705, USA.
| | - Sabina De Geest
- Institute of Nursing Science, Department of Public Health, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland; Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 blok d, box 7001, 3000 Leuven, Belgium.
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21
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Barlow SE, Lorenzi A, Reid A, Huang R, Yudkin JS, Messiah SE. The Implementation and Five-Year Evolution of a Childhood Healthy Weight Program: Making a Health Care-Community Partnership Work. Child Obes 2021; 17:432-441. [PMID: 33945306 DOI: 10.1089/chi.2021.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Sustained implementation of moderate to high-intensity interventions to treat childhood obesity meets many barriers. This report uses the Centers for Disease Control and Prevention's (CDC's) Replicating Effective Programs framework to describe and evaluate the implementation of a 5-year health care-community collaborative program. Methods: Interviews with program leadership provided information on setting, organizational culture, program creation and adaptation, and costs. Administrative data were used for number of sessions and their characteristics; referrals; and 2018-2019 participant enrollment, attendance, completion numbers, and completer outcomes. Results: Preconditions for this program were high childhood obesity prevalence, and the complementary strengths of the health care organization (primary care treatment referral stream, population health orientation, alternative Medicaid funding) and the community organization (accessible space and time, staffing model, and organization mission). Preimplementation steps included collaborative design of a curriculum and allocation of administrative tasks. Implementation led to simultaneous deployment in as many as 17 community locations, with sessions offered free to families weekday evenings or weekends, delivered in English or Spanish. From 2018 to 2019, 2746 children were referred from nearly 300 providers, 832 (30.3%) enrolled, and 553 (66.3%) attended at least once, with 392 (70.8% of attenders and 47.1% of enrolled) completing the program. Outcomes in completers included improvement in %BMIp95 [-2.34 (standard deviation, SD 4.19)] and Progressive Aerobic Cardiovascular Endurance Run (PACER) laps [2.46 (SD 4.74)], p < 0.0001 for both. Evolution, including in referral process, Spanish program material and delivery, and range of ages, occurred continuously rather than at discrete intervals. Major system disruptions also affected the implementation. Maintenance of the program relied on the health care organization's administrative team and the collaboration with the community organization. Conclusion: This program's collaboration across organizations and ongoing adaptation were necessary to build and sustain a program with broad reach and positive health outcomes. The lessons learned may be helpful for other programs.
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Affiliation(s)
- Sarah E Barlow
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Dallas, TX, USA
| | - Anna Lorenzi
- Enterprise Care Management, Children's Health, Dallas, TX, USA
| | - Aleksei Reid
- Enterprise Care Management, Children's Health, Dallas, TX, USA
| | - Rong Huang
- Research Administration, Children's Health, Dallas, TX, USA
| | - Joshua S Yudkin
- School of Public Health, University of Texas Health Science Center, Dallas, TX, USA
| | - Sarah E Messiah
- School of Public Health, University of Texas Health Science Center, Dallas, TX, USA.,Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, TX, USA
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22
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Stockton MA, Minnick CE, Kulisewa K, Mphonda SM, Hosseinipour MC, Gaynes BN, Maselko J, Pettifor AE, Go V, Udedi M, Pence BW. A Mixed-Methods Process Evaluation: Integrating Depression Treatment Into HIV Care in Malawi. GLOBAL HEALTH, SCIENCE AND PRACTICE 2021; 9:611-625. [PMID: 34593585 PMCID: PMC8514021 DOI: 10.9745/ghsp-d-20-00607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 06/08/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Depression is highly prevalent among people living with HIV in Malawi. Depression can undermine engagement in HIV care and worsen HIV morbidity and mortality. The Ministry of Health integrated a pilot depression management program into HIV care at 2 clinics. This program included a measurement-based care protocol for prescribing antidepressants and an adapted Friendship Bench psychotherapy protocol for providing problem solving. Early evaluations indicated successful integration of the initial stages of training and depression screening, diagnosis, and treatment initiation. This follow-up mixed-method investigation contextualizes our previous findings and shares insights from the implementation experience. METHODS We conducted a mixed-methods process evaluation drawing on both patient clinical data and qualitative interviews with patients and clinic staff. We focus on the following implementation outcomes: fidelity, acceptability, and sustainability. RESULTS Although fidelity to depression screening and treatment initiation was high, fidelity to the follow-up treatment protocol was poor. Antidepressants and problem-solving therapy were acceptable to patients, but clinic staff found delivering treatment challenging given constrained human resources and infrastructure. The program was not sustained after the project. Key identified needs included substantial support to supervise the implementation of the program, continue to build and maintain the capacity of providers, integrate the program into the electronic medical records system, and ensure the availability of Friendship Bench counselors. CONCLUSIONS Although initial steps were successful, sustained integration of this depression treatment program into HIV care in this setting met greater challenges. Implementation science studies that support both implementation and evaluation should recognize the potential for clinical implementers to rely on evaluation staff for clinical support and consider distancing evaluation staff from the actual program implementation. Further research is needed to test enhanced implementation strategies for integrating evidence-based mental health interventions into existing health care systems in a sustainable fashion, particularly in low-resource settings.
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Affiliation(s)
- Melissa A Stockton
- Epidemiology Department, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Caroline E Minnick
- University of North Carolina Project-Malawi, Tidziwe Centre, Lilongwe, Malawi
| | - Kazione Kulisewa
- Department of Mental Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Steven M Mphonda
- University of North Carolina Project-Malawi, Tidziwe Centre, Lilongwe, Malawi
| | - Mina C Hosseinipour
- University of North Carolina Project-Malawi, Tidziwe Centre, Lilongwe, Malawi
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Joanna Maselko
- Epidemiology Department, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Audrey E Pettifor
- Epidemiology Department, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Vivian Go
- Epidemiology Department, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael Udedi
- University of North Carolina Project-Malawi, Tidziwe Centre, Lilongwe, Malawi
- Noncommunicable Diseases and Mental Health Unit, Ministry of Health, Lilongwe, Malawi
| | - Brian W Pence
- Epidemiology Department, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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23
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Huybrechts I, Declercq A, Verté E, Raeymaeckers P, Anthierens S. The Building Blocks of Implementation Frameworks and Models in Primary Care: A Narrative Review. Front Public Health 2021; 9:675171. [PMID: 34414155 PMCID: PMC8369196 DOI: 10.3389/fpubh.2021.675171] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/08/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Our aim is to identify the core building blocks of existing implementation frameworks and models, which can be used as a basis to further develop a framework for the implementation of complex interventions within primary care practices. Within the field of implementation science, various frameworks, and models exist to support the uptake of research findings and evidence-based practices. However, these frameworks and models often are not sufficiently actionable or targeted for use by intervention designers. The objective of this research is to map the similarities and differences of various frameworks and models, in order to find key constructs that form the foundation of an implementation framework or model that is to be developed. Methods: A narrative review was conducted, searching for papers that describe a framework or model for implementation by means of various search terms, and a snowball approach. The core phases, components, or other elements of each framework or model are extracted and listed. We analyze the similarities and differences between the frameworks and models and elaborate on their core building blocks. These core building blocks form the basis of an overarching model that we will develop based upon this review and put into practice. Results: A total of 28 implementation frameworks and models are included in our analysis. Throughout 15 process models, a total of 67 phases, steps or requirements are extracted and throughout 17 determinant frameworks a total of 90 components, constructs, or elements are extracted and listed into an Excel file. They are bundled and categorized using NVivo 12© and synthesized into three core phases and three core components of an implementation process as common elements of most implementation frameworks or models. The core phases are a development phase, a translation phase, and a sustainment phase. The core components are the intended change, the context, and implementation strategies. Discussion: We have identified the core building blocks of an implementation framework or model, which can be synthesized in three core phases and three core components. These will be the foundation for further research that aims to develop a new model that will guide and support intervention designers to develop and implement complex interventions, while taking account contextual factors.
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Affiliation(s)
- Ine Huybrechts
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.,Department of Family Medicine and Chronic Care, Free University of Brussels, Brussels, Belgium
| | - Anja Declercq
- LUCAS - Centre for Care Research and Consultancy & CESO - Centre for Sociological Research, Catholic University of Leuven, Leuven, Belgium
| | - Emily Verté
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.,Department of Family Medicine and Chronic Care, Free University of Brussels, Brussels, Belgium
| | - Peter Raeymaeckers
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Sibyl Anthierens
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
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24
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Heggie R, Boyd K, Wu O. How has implementation been incorporated in health technology assessments in the United Kingdom? A systematic rapid review. Health Res Policy Syst 2021; 19:118. [PMID: 34407834 PMCID: PMC8371806 DOI: 10.1186/s12961-021-00766-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/26/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Health interventions in a clinical setting may be complex. This is particularly true of clinical interventions which require systems reorganization or behavioural change, and/or when implementation involves additional challenges not captured within a clinical trial setting. Medical Research Council guidance on complex interventions highlights the need to consider economic evaluation alongside implementation. However, the extent to which this guidance has been adhered to, and how, is unclear. The failure to incorporate implementation within the evaluation of an intervention may hinder the translation of research findings into routine practice. This will have consequences for patient care. This study examined the methods used to address implementation within health research conducted through funding from the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme. METHODS We conducted a rapid review using a systematic approach. We included all NIHR HTA monographs which contained the word "implementation" within the title or abstract published between 2014 and 2020. We assessed the studies according to existing recommendations for specifying and reporting implementation approaches in research. Additional themes which were not included in the recommendation, but were of particular relevance to our research question, were also identified and summarized in a narrative synthesis. RESULTS The extent to which implementation was formally incorporated, and defined, varied among studies. Methods for examining implementation ranged from single stakeholder engagement events to the more comprehensive process evaluation. There was no obvious pattern as to whether approaches to implementation had evolved over recent years. Approximately 50% (22/42) of studies included an economic evaluation. Of these, two studies included the use of qualitative data obtained within the study to quantitatively inform aspects relating to implementation and economic evaluation in their study. DISCUSSION A variety of approaches were identified for incorporating implementation within an HTA. However, they did not go far enough in terms of incorporating implementation into the actual design and evaluation. To ensure the implementation of clinically effective and cost-effective interventions, we propose that further guidance on how to incorporate implementation within complex interventions is required. Incorporating implementation into economic evaluation provides a step in this direction.
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Affiliation(s)
- Robert Heggie
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK.
| | - Kathleen Boyd
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK
| | - Olivia Wu
- Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK
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25
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Yudkin JS. A Renewed Call to Safeguard Public Health Epistemology. Int J Public Health 2021; 66:1604009. [PMID: 34335144 PMCID: PMC8284856 DOI: 10.3389/ijph.2021.1604009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/20/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Joshua S Yudkin
- University of Texas Health Science Center at Houston, Houston, TX, United States
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26
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Mizota Y, Yamamoto S. Rainbow of KIBOU project: Effectiveness of invitation materials for improving cancer screening rate using social marketing and behavioral economics approaches. Soc Sci Med 2021; 279:113961. [PMID: 34000582 DOI: 10.1016/j.socscimed.2021.113961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 01/27/2023]
Abstract
Studies to date have shown that individual invitation (call) and re-invitation (recall) are effective in improving cancer screening rate. Also, by dividing subjects into segments and sending unique messages to each segment, the cancer screening rate is further improved. However, this approach is not realistic in the local governments due to limited resources, so we used social marketing and nudge techniques to develop cancer screening recommendation materials that do not need to send separately. This study therefore aimed to verify the effect of these materials in the real world. We compared the cancer screening rates in municipalities within Japan that used the invitation materials we developed (colorectal, breast, lung, cervical and stomach cancer), with those from the previous year. In addition, the usefulness of the materials in the real world was examined multilaterally using RE-AIM framework (Reach, Effectiveness, Adaption, Implementation, Maintenance). From 2015 to 2018, 4.3 million residents (Reach) from 787 municipalities (Adaption) were sent invitation materials for cancer screening. Of 167 municipalities that were compared, 141 (83%) showed an increase in screening rate when our materials were used. Overall, the screening rate improved by 2.6% or 1.44 fold (p < 0.001) (Effectiveness). However, the screening rate varied greatly depending on how screening is provided. Of the four years studied, 75 municipalities used the same materials for two or more years (Implementation). The material developed in this study improved the cancer screening rate in the real world, and it may be possible to further improve the screening rate if the number of opportunities for screening and its capacity is increased at the timing of sending materials. The materials can be found on the website (http://rokproject.jp/kenshin/) and free electronic files are available to municipalities wishing to use them.
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Affiliation(s)
- Yuri Mizota
- Center for Cancer Information and Control Services, National Cancer Center, 5-1-1, Tsukij, Chuo-ku, Tokyo, 104-0045, Japan; Health Service Division, Health Service Bureau, Ministry of Health, Labour, and Welfare, 1-2-2, Kasumigaseki, Chiyoda-ku, Tokyo, 100-8916, Japan; Shizuoka Graduate University of Public Health, 4-27-2, Kitaando, Aoiku, Shizuoka, 420-0881, Japan.
| | - Seiichiro Yamamoto
- Center for Cancer Information and Control Services, National Cancer Center, 5-1-1, Tsukij, Chuo-ku, Tokyo, 104-0045, Japan; Shizuoka Graduate University of Public Health, 4-27-2, Kitaando, Aoiku, Shizuoka, 420-0881, Japan; Centre for the Fourth Industrial Revolution Japan, World Economic Forum, ARK Mori Building, 37th Floor 1-12-32, Akasaka, Minato-ku, Tokyo, 107-6037, Japan.
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27
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Boelig RC, Wanees M, Zhan T, Berghella V, Roman A. Improving Utilization of Aspirin for Prevention of Preeclampsia in a High-Risk Urban Cohort: A Prospective Cohort Study. Am J Perinatol 2021; 38:544-552. [PMID: 33099285 PMCID: PMC8491097 DOI: 10.1055/s-0040-1718580] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study aimed to evaluate the utilization of aspirin for preeclampsia prevention before and after implementation of a screening tool during nuchal translucency (NT) ultrasound. STUDY DESIGN One-year prospective cohort study of patients at high risk for preeclampsia after the implementation of a screening tool (postscreen) administered to all patients at check in for NT (11-13 weeks) ultrasound. Prospective cohort was compared with one-year retrospective cohort (prescreen) the year prior (2017). All patients who presented for NT ultrasound in both cohorts were evaluated for the presence of one or more risk factor for preeclampsia with screening tool collected prospectively and chart review retrospectively. Provider recommendation for aspirin determined by documentation in prenatal record. Primary outcome was rate of provider recommendation for aspirin pre versus post screening tool, compared by Chi-square test and adjusted for potential confounders with multiple regression analysis. RESULTS Pre- (n = 156) and postscreen (n = 136) cohorts were similar except for race and multifetal gestation. Prescreen, rate of provider recommendation for aspirin was 74%. Of those with prior preeclampsia, 96% were recommended aspirin, compared with 64% of patients with other risk factors (p < 0.001). Postscreen, provider recommendation of aspirin improved to 95% (p < 0.001). Rate of preeclampsia/gestational hypertension were similar between cohorts; however, there was a reduced adjusted risk in overall preterm birth <37 weeks (adjusted odds ratio [aOR] = 0.50 [0.25-0.99]) and preterm birth <34 weeks (aOR = 0.33 [0.13-0.88]) postscreening tool implementation. CONCLUSION Prior to implementation of a simple screening questionnaire, approximately 25% of high risk patients did not receive the recommendation of aspirin for preeclampsia prevention. High-risk patients who lack a history of preeclampsia were less likely to be advised of aspirin prophylaxis. Use of a simple universal screening tool at time of NT ultrasound significantly improved utilization of aspirin for preeclampsia prevention and may improve patient outcomes. KEY POINTS · Despite recommendations, aspirin use for preeclampsia prevention is suboptimal.. · High-risk patients who lack a history preeclampsia were less likely to be advised of aspirin use.. · A simple universal screening tool can significantly improve aspirin utilization..
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Affiliation(s)
- Rupsa C Boelig
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Mariam Wanees
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Tingting Zhan
- Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Vincenzo Berghella
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Amanda Roman
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
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Martínez-Gimeno ML, Fernández-Martínez N, Escobar-Aguilar G, Moreno-Casbas MT, Brito-Brito PR, Caperos JM. SUMAMOS EXCELENCIA ® Project: Results of the Implementation of Best Practice in a Spanish National Health System (NHS). Healthcare (Basel) 2021; 9:374. [PMID: 33800670 PMCID: PMC8066682 DOI: 10.3390/healthcare9040374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022] Open
Abstract
The use of certain strategies for the implementation of a specific recommendation yields better results in clinical practice. The aim of this study was to assess the effectiveness of an evidence-based model using clinical audits (GRIP model), for the implementation of recommendations in pain and urinary incontinence management as well as fall prevention, in the Spanish National Health System during the period 2015-2018. A quasi-experimental study has been conducted. The subjects were patients treated in hospitals, primary care units and nursing home centers. There were measures related to pain, fall prevention and urinary incontinence. Measurements were taken at baseline and at months 3, 6, 9, and 12. The sample consisted of 22,114 patients. The frequency of pain assessment increased from 59.9% in the first cycle to a mean of 71.6% in the last cycle, assessments of risk of falling increased from 56.8% to 87.8% in the last cycle; and finally, the frequency of assessments of urinary incontinence increased from a 43.4% in the first cycles to a mean of 62.2% in the last cycles. The implementation of specific evidence-based recommendations on pain, fall prevention, and urinary incontinence using a model based on clinical audits improved the frequency of assessments and their documentation.
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Affiliation(s)
- María-Lara Martínez-Gimeno
- San Juan de Dios Foundation, San Rafael-Nebrija Health Sciences Center, Nebrija University, 28036 Madrid, Spain;
- SALBIS Research Group, Faculty of Health Sciences, University of Leon, 24401 Ponferrada, Spain
| | - Nélida Fernández-Martínez
- Department of Biomedical Sciences, Faculty of Veterinary Medicine, University of León, 24071 Leon, Spain;
| | - Gema Escobar-Aguilar
- San Juan de Dios Foundation, San Rafael-Nebrija Health Sciences Center, Nebrija University, 28036 Madrid, Spain;
| | - María-Teresa Moreno-Casbas
- Nursing and Healthcare Research Unit (Investen-isciii), Carlos III Health Institute, 28029 Madrid, Spain;
| | - Pedro-Ruyman Brito-Brito
- Training and Research in Care, Primary Care Management of Tenerife, The Canary Islands Health Service, 38204 Santa Cruz de Tenerife, Spain;
- Department of Nursing, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain
| | - Jose-Manuel Caperos
- UNINPSI, Department of Psychology, Universidad Pontificia Comillas, 28015 Madrid, Spain;
- Fundación San Juan de Dios, 28036 Madrid, Spain
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Mehta KM, Ward VC, Darmstadt GL. Best practices in global health evaluation: Reflections on learning from an independent program analysis in Bihar, India. J Glob Health 2021; 10:020395. [PMID: 33403103 PMCID: PMC7750022 DOI: 10.7189/jogh.10.020395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Kala M Mehta
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Victoria C Ward
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Gary L Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
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Geest SD, Zúñiga F, Brunkert T, Deschodt M, Zullig LL, Wyss K, Utzinger J. POTENCIANDO LA ATENCIÓN DE SALUD PARA EL FUTURO EN SUIZA: LA CIENCIA DE LA IMPLEMENTACIÓN PARA ATRAVESAR EL "VALLE DE LA MUERTE". TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2019-e004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | - Thekla Brunkert
- University of Basel, Switzerland; University of Manitoba, Canada
| | - Mieke Deschodt
- University of Basel, Switzerland; KU Leuven, Belgium; UHasselt, Belgium
| | - Leah L Zullig
- Duke University, USA; Center of Innovation to Accelerate Discovery and Practice Transformation, USA
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute, Switzerland; University of Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Switzerland; University of Basel, Switzerland
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Islam MM, Farag E, Hassan MM, Bansal D, Awaidy SA, Abubakar A, Al-Rumaihi H, Mkhize-Kwitshana Z. Helminth Parasites among Rodents in the Middle East Countries: A Systematic Review and Meta-Analysis. Animals (Basel) 2020; 10:E2342. [PMID: 33317021 PMCID: PMC7764038 DOI: 10.3390/ani10122342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/30/2020] [Accepted: 10/30/2020] [Indexed: 12/17/2022] Open
Abstract
Rodents can be a source of zoonotic helminths in the Middle East and also in other parts of the world. The current systematic review aimed to provide baseline data on rodent helminths to recognize the threats of helminth parasites on public health in the Middle East region. Following a systematic search on PubMed, Scopus, and Web of Science, a total of 65 research studies on rodent cestodes, nematodes, and trematodes, which were conducted in the countries of the Middle East, were analyzed. The study identified 44 rodent species from which Mus musculus, Rattus norvegicus, and Rattus rattus were most common (63%) and recognized as the primary rodent hosts for helminth infestation in this region. Cestodes were the most frequently reported (n = 50), followed by nematodes (49), and trematodes (14). The random effect meta-analysis showed that the pooled prevalence of cestode (57.66%, 95%CI: 34.63-80.70, l2% = 85.6, p < 0.001) was higher in Saudi Arabia, followed by nematode (56.24%, 95%CI: 11.40-101.1, l2% = 96.7, p < 0.001) in Turkey, and trematode (15.83%, 95%CI: 6.25-25.1, l2% = 98.5, p < 0.001) in Egypt. According to the overall prevalence estimates of individual studies, nematodes were higher (32.71%, 95%CI: 24.89-40.54, l2% = 98.6, p < 0.001) followed by cestodes (24.88%, 95%CI: 19.99-29.77, l2% = 94.9, p < 0.001) and trematodes (10.17%, 95%CI: 6.7-13.65, l2% = 98.3, p < 0.001) in the rodents of the Middle East countries. The review detected 22 species of helminths, which have zoonotic importance. The most frequent helminths were Capillaria hepatica, Hymenolepis diminuta, Hymenolepis nana, and Cysticercus fasciolaris. There was no report of rodent-helminths from Bahrain, Jordan, Lebanon, Oman, United Arab Emirates, and Yemen. Furthermore, there is an information gap on rodent helminths at the humans-animal interface level in Middle East countries. Through the One Health approach and countrywide detailed studies on rodent-related helminths along with their impact on public health, the rodent control program should be conducted in this region.
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Affiliation(s)
- Md Mazharul Islam
- Department of Animal Resources, Ministry of Municipality and Environment, Doha, P.O. Box 35081, Qatar
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu Natal, Durban 4000, South Africa
| | - Elmoubashar Farag
- Ministry of Public Health, Doha, P.O. Box 42, Qatar; (D.B.); (H.A.-R.)
| | - Mohammad Mahmudul Hassan
- Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Khulshi, Chattogram 4225, Bangladesh;
| | - Devendra Bansal
- Ministry of Public Health, Doha, P.O. Box 42, Qatar; (D.B.); (H.A.-R.)
| | | | - Abdinasir Abubakar
- Infectious Hazard Preparedness (IHP) Unit, WHO Health Emergencies Department (WHE), World Health Organization, Regional Office for the Eastern Mediterranean, Cairo 11371, Egypt;
| | - Hamad Al-Rumaihi
- Ministry of Public Health, Doha, P.O. Box 42, Qatar; (D.B.); (H.A.-R.)
| | - Zilungile Mkhize-Kwitshana
- School of Life Sciences, College of Agriculture, Engineering & Science, University of KwaZulu Natal, Durban 40000, South Africa;
- South African Medical Research Council, Cape Town 7505, South Africa
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Mylona EK, Shehadeh F, Kalligeros M, Benitez G, Chan PA, Mylonakis E. Real-Time Spatiotemporal Analysis of Microepidemics of Influenza and COVID-19 Based on Hospital Network Data: Colocalization of Neighborhood-Level Hotspots. Am J Public Health 2020; 110:1817-1824. [PMID: 33058702 DOI: 10.2105/ajph.2020.305911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To identify spatiotemporal patterns of epidemic spread at the community level.Methods. We extracted influenza cases reported between 2016 and 2019 and COVID-19 cases reported in March and April 2020 from a hospital network in Rhode Island. We performed a spatiotemporal hotspot analysis to simulate a real-time surveillance scenario.Results. We analyzed 6527 laboratory-confirmed influenza cases and identified microepidemics in more than 1100 neighborhoods, and more than half of the neighborhoods that had hotspots in a season became hotspots in the next season. We used data from 731 COVID-19 cases, and we found that a neighborhood was 1.90 times more likely to become a COVID-19 hotspot if it had been an influenza hotspot in 2018 to 2019.Conclusions. The use of readily available hospital data allows the real-time identification of spatiotemporal trends and hotspots of microepidemics.Public Health Implications. As local governments move to reopen the economy and ease physical distancing, the use of historic influenza hotspots could guide early prevention interventions, while the real-time identification of hotspots would enable the implementation of interventions that focus on small-area containment and mitigation.
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Affiliation(s)
- Evangelia K Mylona
- At the time of the study, all authors were with the Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI. Philip A. Chan was also with the Rhode Island Department of Health Division of Preparedness, Response, Infectious Disease, and Emergency Medical Services, Providence
| | - Fadi Shehadeh
- At the time of the study, all authors were with the Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI. Philip A. Chan was also with the Rhode Island Department of Health Division of Preparedness, Response, Infectious Disease, and Emergency Medical Services, Providence
| | - Markos Kalligeros
- At the time of the study, all authors were with the Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI. Philip A. Chan was also with the Rhode Island Department of Health Division of Preparedness, Response, Infectious Disease, and Emergency Medical Services, Providence
| | - Gregorio Benitez
- At the time of the study, all authors were with the Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI. Philip A. Chan was also with the Rhode Island Department of Health Division of Preparedness, Response, Infectious Disease, and Emergency Medical Services, Providence
| | - Philip A Chan
- At the time of the study, all authors were with the Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI. Philip A. Chan was also with the Rhode Island Department of Health Division of Preparedness, Response, Infectious Disease, and Emergency Medical Services, Providence
| | - Eleftherios Mylonakis
- At the time of the study, all authors were with the Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI. Philip A. Chan was also with the Rhode Island Department of Health Division of Preparedness, Response, Infectious Disease, and Emergency Medical Services, Providence
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Hlaing WM, Schmidt RD, Ahn S, Samet JM, Brownson RC. A Snapshot of Doctoral Training in Epidemiology: Positioning Us for the Future. Am J Epidemiol 2020; 189:1154-1162. [PMID: 32383443 DOI: 10.1093/aje/kwaa069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/18/2020] [Accepted: 04/21/2020] [Indexed: 12/18/2022] Open
Abstract
Although epidemiology core competencies are established by the Association of Schools and Programs of Public Health for masters-level trainees, no equivalent currently exists for the doctoral level. Thus, the objective of the Doctoral Education in Epidemiology Survey (2019) was to collect information on doctoral-level competencies in general epidemiology (doctoral) degree programs and other pertinent information from accredited programs in the United States and Canada. Participants (doctoral program directors or knowledgeable representatives of the program) from 57 institutions were invited to respond to a 39-item survey (18 core competencies; 9 noncore or emerging topic-related competencies; and 12 program-related items). Participants from 55 institutions (96.5%) responded to the survey, of whom over 85% rated 11 out of 18 core competencies as "very important" or "extremely important." More than 80% of the programs currently emphasize 2 of 9 noncore competencies (i.e., competency to ( 1) develop and write grant proposals, and ( 2) assess evidence for causality on the basis of different causal inference concepts). "Big data" is the most frequently cited topic currently lacking in doctoral curricula. Information gleaned from previous efforts and this survey should prompt a dialog among relevant stakeholders to establish a cohesive set of core competencies for doctoral training in epidemiology.
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Mawani FN, Ibrahim S. Building Roads Together: a peer-led, community-based walking and rolling peer support program for inclusion and mental health. Canadian Journal of Public Health 2020; 112:142-151. [PMID: 32876932 DOI: 10.17269/s41997-020-00374-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/17/2020] [Indexed: 11/17/2022]
Abstract
SETTING The program founder selected Regent Park for Building Roads Together© pilot program implementation because it is one of 31 neighbourhoods identified by the City of Toronto as a Neighbourhood Improvement Area based on a low Neighbourhood Equity Benchmark score indicating that it faces serious inequities requiring immediate action. In addition, Regent Park has a higher than average proportion of residents who are recent immigrants, and is Canada's first social housing development undergoing a 25-year process of transformation to a mixed-income community. Community partners confirmed that Building Roads Together responded to community needs and complemented existing programs and supports. INTERVENTION Building Roads Together is an award-winning community-based peer support walking and rolling program designed to promote inclusion and reduce health inequities. Strong bodies of evidence demonstrate that peer support, walking, and exposure to green space, each on their own or in combination, reduce social isolation and improve health and mental health. The program founder designed Building Roads Together based on this research evidence; a needs assessment including interviews, focus groups, and meetings; and her lived experience. OUTCOMES The needs assessment informed program design, including name, goals, approach, and curriculum. Building Roads Together includes the following phases: (1) Community engagement; (2) Partnership development; (3) Neighbourhood-based Walk the Talk Advisory Groups; (4) Peer Walking/Rolling Group Leadership Training; (5) Mentoring/Support; (6) Peer Walking/Rolling Groups. The training curriculum combines peer leadership, inclusion, and communication skills; practical skills required to create and manage a walking group; and information about urban green space. IMPLICATIONS In partnership with the Centre for Learning & Development Toronto and the Regent Park Community Health Centre, the program founder trained 42 peer walking group leaders and mentored multiple walking groups.
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Affiliation(s)
- Farah N Mawani
- Building Roads Together, Farahway Global @ Centre for Social Innovation - Regent Park, Toronto, Canada. .,MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria St, Toronto, ON, M5B 1T8, Canada.
| | - Sureya Ibrahim
- Centre of Learning & Development, TD Centre of Learning, 540 Dundas St. E, Toronto, ON, M5A 3S4, Canada
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Andrade KRCD, Pereira MG. Knowledge translation in the reality of Brazilian public health. Rev Saude Publica 2020; 54:72. [PMID: 32725095 PMCID: PMC7371410 DOI: 10.11606/s1518-8787.2020054002073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/29/2019] [Indexed: 11/19/2022] Open
Abstract
The term knowledge translation has been used to describe the process of applying research results to the real world, in order to enhance the quality and effectiveness of health care and services. The aim of this article is to discuss the incorporation of knowledge translation in the Brazilian public health. The article addresses the basic activities of knowledge translation and lists challenges and perspectives in Brazilian scenario. Brazil began to move towards understanding the process of translating scientific knowledge into practice. Investing in pilot studies to adapt the so-called effective interventions to the Brazilian scenario may be an alternative. Increasing the qualification of Brazilian researchers in the design and evaluation of implementation studies is relevant to improve this field in the country.
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Affiliation(s)
| | - Maurício Gomes Pereira
- Departamento de Medicina, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil
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Stockton MA, Udedi M, Kulisewa K, Hosseinipour MC, Gaynes BN, Mphonda SM, Maselko J, Pettifor AE, Verhey R, Chibanda D, Lapidos-Salaiz I, Pence BW. The impact of an integrated depression and HIV treatment program on mental health and HIV care outcomes among people newly initiating antiretroviral therapy in Malawi. PLoS One 2020; 15:e0231872. [PMID: 32374724 PMCID: PMC7202614 DOI: 10.1371/journal.pone.0231872] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 04/01/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Depression is highly prevalent among patients newly starting antiretroviral treatment (ART) in Malawi and many other countries. Untreated depression at ART initiation can disrupt the HIV care continuum. Effective approaches for depression screening and treatment exist for low-resource settings, but they are rarely applied. Identifying effective implementation strategies are critical. METHODS A pilot program integrated depression screening and treatment into routine HIV care using existing staff at two public health clinics in Malawi in two phases; a screening-only "control" phase and an active "intervention" phase. During the intervention phase, providers prescribed antidepressants or referred patients for Friendship Bench problem-solving therapy. We evaluated the program's impact on retention in HIV care, viral suppression, and depression remission at 6 months using tabular comparisons and log-binomial models to estimate adjusted risk ratios and mean differences among the intervention group relative to the control group. RESULTS Nearly all consenting participants were screened for depression appropriately and 25% had mild to severe depressive symptoms. During the intervention phase, 86% of participants with mild depressive symptoms started Friendship Bench therapy and 96% of participants with moderate to severe depressive symptoms started antidepressants. Few participants in the intervention group received consistent depression treatment over their first 6 months in care. In the adjusted main analysis, program exposure did not demonstrably affect most HIV or mental health outcomes, though the probability of currently being on ART at 6 months was significantly lower among the intervention group than the control group [RR 0.6(95%CI: 0.4-0.9)]. CONCLUSIONS While it is feasible to integrate depression screening and treatment initiation into ART initiation, providing ongoing depression treatment over time is challenging. Similar implementation science studies focused on maintaining depression management will be increasingly important as we strive to understand and test the best ways to implement evidence-based depression treatment within HIV care.
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Affiliation(s)
- Melissa A. Stockton
- Epidemiology Department, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | - Michael Udedi
- NCDs & Mental Health Unit, Ministry of Health, Lilongwe, Malawi
- Department of Mental Health, University of Malawi, College of Medicine, Blantyre, Malawi
| | - Kazione Kulisewa
- Department of Mental Health, University of Malawi, College of Medicine, Blantyre, Malawi
| | - Mina C. Hosseinipour
- University of North Carolina Project-Malawi, Tidziwe Centre, Lilongwe, Malawi
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States of America
| | - Bradley N. Gaynes
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States of America
| | - Steven M. Mphonda
- University of North Carolina Project-Malawi, Tidziwe Centre, Lilongwe, Malawi
| | - Joanna Maselko
- Epidemiology Department, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | - Audrey E. Pettifor
- Epidemiology Department, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | - Ruth Verhey
- Friendship Bench Zimbabwe, Milton Park, Harare, Zimbabwe
| | - Dixon Chibanda
- Friendship Bench Zimbabwe, Milton Park, Harare, Zimbabwe
| | - Ilana Lapidos-Salaiz
- United States Agency for International Development (USAID), Arlington, VA, United States of America
| | - Brian W. Pence
- Epidemiology Department, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, United States of America
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Windle M, Lee HD, Cherng ST, Lesko CR, Hanrahan C, Jackson JW, McAdams-DeMarco M, Ehrhardt S, Baral SD, D’Souza G, Dowdy DW. From Epidemiologic Knowledge to Improved Health: A Vision for Translational Epidemiology. Am J Epidemiol 2019; 188:2049-2060. [PMID: 30927354 DOI: 10.1093/aje/kwz085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 12/18/2022] Open
Abstract
Epidemiology should aim to improve population health; however, no consensus exists regarding the activities and skills that should be prioritized to achieve this goal. We performed a scoping review of articles addressing the translation of epidemiologic knowledge into improved population health outcomes. We identified 5 themes in the translational epidemiology literature: foundations of epidemiologic thinking, evidence-based public health or medicine, epidemiologic education, implementation science, and community-engaged research (including literature on community-based participatory research). We then identified 5 priority areas for advancing translational epidemiology: 1) scientific engagement with public health; 2) public health communication; 3) epidemiologic education; 4) epidemiology and implementation; and 5) community involvement. Using these priority areas as a starting point, we developed a conceptual framework of translational epidemiology that emphasizes interconnectedness and feedback among epidemiology, foundational science, and public health stakeholders. We also identified 2-5 representative principles in each priority area that could serve as the basis for advancing a vision of translational epidemiology. We believe an emphasis on translational epidemiology can help the broader field to increase the efficiency of translating epidemiologic knowledge into improved health outcomes and to achieve its goal of improving population health.
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Affiliation(s)
- Michael Windle
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Hojoon D Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Sarah T Cherng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Catherine R Lesko
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Colleen Hanrahan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - John W Jackson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Mara McAdams-DeMarco
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Gypsyamber D’Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - David W Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
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Quinn AK, Neta G, Sturke R, Olopade CO, Pollard SL, Sherr K, Rosenthal JP. Adapting and Operationalizing the RE-AIM Framework for Implementation Science in Environmental Health: Clean Fuel Cooking Programs in Low Resource Countries. Front Public Health 2019; 7:389. [PMID: 31921753 PMCID: PMC6932973 DOI: 10.3389/fpubh.2019.00389] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/02/2019] [Indexed: 12/27/2022] Open
Abstract
Introduction: The use of models and frameworks to design and evaluate strategies to improve delivery of evidence-based interventions is a foundational element of implementation science. To date, however, evaluative implementation science frameworks such as Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) have not been widely employed to examine environmental health interventions. We take advantage of a unique opportunity to utilize and iteratively adapt the RE-AIM framework to guide NIH-funded case studies of the implementation of clean cooking fuel programs in eleven low- and middle-income countries. Methods: We used existing literature and expert consultation to translate and iteratively adapt the RE-AIM framework across several stages of the NIH Clean Cooking Implementation Science case study project. Checklists and templates to guide investigators were developed at each stage. Results: The RE-AIM framework facilitated identification of important emerging issues across this set of case studies, in particular highlighting the fact that data associated with certain important outcomes related to health and welfare are chronically lacking in clean fuel programs. Monitoring of these outcomes should be prioritized in future implementation efforts. As RE-AIM was not originally designed to evaluate household energy interventions, employing the framework required adaptation. Specific adaptations include the broadening of Effectiveness to encompass indicators of success toward any stated programmatic goal, and expansion of Adoption to include household-level uptake of technology. Conclusions: The RE-AIM implementation science framework proved to be a useful organizing schema for 11 case studies of clean fuel cooking programs, in particular highlighting areas requiring emphasis in future research and evaluation efforts. The iterative approach used here to adapt an implementation science framework to a specific programmatic goal may be of value to other multi-country program efforts, such as those led by international development agencies. The checklists and templates developed for this project are publicly available for others to use and/or further modify.
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Affiliation(s)
- Ashlinn K. Quinn
- Fogarty International Center, U.S. National Institutes of Health, Bethesda, MD, United States
| | - Gila Neta
- National Cancer Institute, U.S. National Institutes of Health, Bethesda, MD, United States
| | - Rachel Sturke
- Fogarty International Center, U.S. National Institutes of Health, Bethesda, MD, United States
| | | | - Suzanne L. Pollard
- Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Kenneth Sherr
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Joshua P. Rosenthal
- Fogarty International Center, U.S. National Institutes of Health, Bethesda, MD, United States
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An implementation science primer for psycho-oncology: translating robust evidence into practice. ACTA ACUST UNITED AC 2019. [DOI: 10.1097/or9.0000000000000014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Morgan J, Kennedy ED, Pesik N, Angulo FJ, Craig AS, Knight NW, Bunnell RE. Building Global Health Security Capacity: The Role for Implementation Science. Health Secur 2019; 16:S5-S7. [PMID: 30480494 DOI: 10.1089/hs.2018.0119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Juliette Morgan
- Juliette Morgan, MD, was, during the preparation of this publication, Associate Director for Science, Division of Global Health Protection, Center for Global Health, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Erin D Kennedy
- Erin D. Kennedy, DVM, MS, MPH, is Associate Director for Science, Epidemiology, Informatics, Surveillance, and Laboratory Branch, Division of Global Health Protection, Center for Global Health, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Nicki Pesik
- Nicki Pesik, MD, is Associate Director for Infectious Disease Preparedness, National Center for Emerging and Zoonotic Infectious Diseases, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Frederick J Angulo
- Frederick J. Angulo, DVM, PhD, was Associate Director for Science, Division of Global Health Protection, Center for Global Health, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Allen S Craig
- Allen S. Craig, MD, is Deputy Director, National Center for Immunization and Respiratory Diseases, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Nancy W Knight
- Nancy W. Knight, MD, is a captain in the US Public Health Service and Director, Division of Global Health Protection, Center for Global Health, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Rebecca E Bunnell
- Rebecca E. Bunnell, PhD, is Deputy Director for Science, Policy, and Communications, Division of Global Health Protection, Center for Global Health, the Centers for Disease Control and Prevention , Atlanta, GA
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Udedi M, Stockton MA, Kulisewa K, Hosseinipour MC, Gaynes BN, Mphonda SM, Pence BW. The effectiveness of depression management for improving HIV care outcomes in Malawi: protocol for a quasi-experimental study. BMC Public Health 2019; 19:827. [PMID: 31242877 PMCID: PMC6595692 DOI: 10.1186/s12889-019-7132-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 06/09/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Depression, prevalent among people living with HIV (PLWH) in Malawi, is associated with negative HIV patient outcomes and likely affects HIV medical management. Despite the high prevalence of depression, its management has not been integrated into HIV care in Malawi or most low-income countries. METHODS This study employs a pre-post design in two HIV clinics in Lilongwe, Malawi, to evaluate the effect of integrating depression management into routine HIV care on both mental health and HIV outcomes. Using a multiple baseline design, this study is examining mental health and HIV outcome data of adult (≥18 years) patients newly initiating ART who also have depression, comparing those entering care before and after the integration of depression screening and treatment into HIV care. The study is also collecting cost information to estimate the cost-effectiveness of the program in improving rates of depression remission and HIV treatment engagement and success. DISCUSSION We anticipate that the study will generate evidence on the effect of depression management on HIV outcomes and the feasibility of integrating depression management into existing HIV care clinics. The results of the study will inform practice and policy decisions on integration of depression management in HIV care clinics in Malawi and related settings, and will help design a next-step strategy to scale-up integration to a larger scale. TRIAL REGISTRATION ClinicalTrials.gov ID [ NCT03555669 ]. Retrospectively registered on 13 June 2018.
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Affiliation(s)
- Michael Udedi
- NCDs and Mental Health Unit, Ministry of Health, P. O. Box 30377, Capital City, Lilongwe 3, Malawi
- Department of Mental Health, University of Malawi, College of Medicine, P/Bag 360, Chichiri, Blantyre 3, Malawi
| | - Melissa A. Stockton
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC 27599 USA
| | - Kazione Kulisewa
- Department of Mental Health, University of Malawi, College of Medicine, P/Bag 360, Chichiri, Blantyre 3, Malawi
| | - Mina C. Hosseinipour
- Tidziwe Centre, University of North Carolina Project-Malawi, Private Bag A-104, Lilongwe, Malawi
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 333 S Columbia St, Chapel Hill, NC 27516 USA
| | - Bradley N. Gaynes
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 333 S Columbia St, Chapel Hill, NC 27516 USA
| | - Steven M. Mphonda
- Tidziwe Centre, University of North Carolina Project-Malawi, Private Bag A-104, Lilongwe, Malawi
| | - Brian W. Pence
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 135 Dauer Dr, Chapel Hill, NC 27599 USA
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Kuller LH. Epidemiologists of the Future: Data Collectors or Scientists? Am J Epidemiol 2019; 188:890-895. [PMID: 30877293 DOI: 10.1093/aje/kwy221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 09/18/2018] [Accepted: 09/21/2018] [Indexed: 12/16/2022] Open
Abstract
Epidemiology is the study of epidemics. It is a biological science that includes expertise in many disciplines in social and behavioral sciences. Epidemiology is also a key component of preventive medicine and public health. Unfortunately, over recent years, academic epidemiology has lost its relationship with preventive medicine, as well as much of its focus on epidemics. The new "-omics" technologies to measure risk factors and phenotypes, and advances in genomics (e.g., host susceptibility) consistent with good epidemiology methods will likely enhance epidemiology research. There is a need based on these new technologies to modify training, especially for the first-level doctorate epidemiologist.
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Affiliation(s)
- Lewis H Kuller
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Training in Cardiovascular Epidemiology and Prevention: A 50-Year Journey From Makarska to Goa. Glob Heart 2019; 13:355-362. [PMID: 30509551 DOI: 10.1016/j.gheart.2018.09.526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The first International Ten-Day Teaching Seminar on Cardiovascular Epidemiology and Prevention was held in Makarska, in the former Yugoslavia in August 1968. The goals of the Seminar were to help bridge the gap between cardiology and cardiovascular epidemiology, promote international collaboration, and provide training in cardiovascular epidemiology and prevention. The 50th Seminar took place in Goa, India in June 2018. This perspective article provides an overview of the major accomplishments of the Seminar as well as its persisting challenges. It also addresses unique opportunities as the Seminar embarks on the next phase of international training seminars in cardiovascular epidemiology and prevention. In particular, this article highlights strategies that offer the opportunity to significantly increase the number of Seminar participants annually, especially from low- and middle-income countries and Small Island Developing States where the burden and trend in cardiovascular diseases and cardiometabolic risk factors pose the greatest concerns. It also discusses the importance of using big data for descriptive, predictive, and prescriptive analytics at the local level, and the need to leverage information technology and digital platforms to create greater access to and sharing of lessons learned. The article also highlights the opportunity to embrace active dissemination and implementation research and the science of health care delivery as important components of training in cardiovascular disease epidemiology and prevention.
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Social media for pediatric research: what, who, why, and #? Pediatr Res 2018; 84:597-599. [PMID: 30140067 DOI: 10.1038/s41390-018-0140-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/27/2018] [Indexed: 11/09/2022]
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Niehaus WN, Silver JK, Katz MS. The PM&R Journal Implements a Social Media Strategy to Disseminate Research and Track Alternative Metrics in Physical Medicine and Rehabilitation. PM R 2017; 10:538-543. [PMID: 29253533 DOI: 10.1016/j.pmrj.2017.12.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 12/11/2017] [Indexed: 11/28/2022]
Abstract
Implementation science is an evolving part of translating evidence into clinical practice and public health policy. This report describes how a social media strategy for the journal PM&R using metrics, including alternative metrics, contributes to the dissemination of research and other information in the field of physical medicine and rehabilitation. The primary goal of the strategy was to disseminate information about rehabilitation medicine, including but not limited to new research published in the journal, to health care professionals. Several different types of metrics were studied, including alternative metrics that are increasingly being used to demonstrate impact in academic medicine. A secondary goal was to encourage diversity and inclusion of the physiatric workforce-enhancing the reputations of all physiatrists by highlighting their research, lectures, awards, and other accomplishments with attention to those who may be underrepresented. A third goal was to educate the public so that they are more aware of the field and how to access care. This report describes the early results following initiation of PM&R's coordinated social media strategy. Through a network of social media efforts that are strategically integrated, physiatrists and their associated institutions have an opportunity to advance their research and clinical agendas, support the diverse physiatric workforce, and educate the public about the field to enhance patient awareness and access to care.
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Affiliation(s)
- William N Niehaus
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine, 12631 E 17th Ave, Academic Office One, Aurora, CO 80045.,Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; Massachusetts General Hospital; and Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Radiation Medicine, Lowell General Hospital, Lowell, MA
| | - Julie K Silver
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine, 12631 E 17th Ave, Academic Office One, Aurora, CO 80045.,Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; Massachusetts General Hospital; and Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Radiation Medicine, Lowell General Hospital, Lowell, MA
| | - Matthew S Katz
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine, 12631 E 17th Ave, Academic Office One, Aurora, CO 80045.,Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; Massachusetts General Hospital; and Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Radiation Medicine, Lowell General Hospital, Lowell, MA
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