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Parmar J, Hafeez S, L'Heureux T, Charles L, Tite J, Tian PGJ, Anderson S. Family physicians' preferences for education to support family caregivers: a sequential mixed methods study. BMC PRIMARY CARE 2024; 25:80. [PMID: 38454343 PMCID: PMC10918970 DOI: 10.1186/s12875-024-02320-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND One in four Canadians is a family caregiver. Family caregivers (carers, care-partners) are relatives or chosen family, friends, or neighbors who provide 75 to 90% of the care for people with physical or mental illness, disabilities, or frailty living in community homes and assist with 15 to 30% of the care in congregate care. However, a recent (2022) Statistics Canada population health study reports 44% of family caregivers are distressed. Family physicians and primary care teams are well-positioned to support family caregivers; yet, family caregiver needs assessments tend to be ad hoc and their most common needs remain unmet. Research recommends training healthcare professionals to enhance their knowledge and skills to support family caregivers. METHODS The objective of this sequential mixed methods research, a survey followed by qualitative interviews, was to explore family physicians' desire and preferences for education about supporting family caregivers. 85 family physicians completed the online survey and eight took part in the interviews. Results from the survey and interviews were compared, contrasted, and interpreted together. RESULTS Primary care physicians expressed a desire to be better equipped to assess and support FCGs' needs. Even though most physicians (61%) were very/confident about addressing family caregivers' needs, 72% were highly/interested in education to support family caregivers of their patients. Topics with the most interest were assessing family caregivers needs in an organized way, assisting family caregivers to access resources, and address system and practice barriers to support family caregivers. The overarching theme running through the interviews was physicians hope for education to help change the patient-focused culture to inclusion of FCGs. The three themes reflect physicians' conviction about including family caregivers in patient care: We need to take care of their caregivers, Practice and system barriers thwart including family caregivers, and Practical education might help. CONCLUSIONS This study of family physicians' preferences for education to support family caregivers will inform the development of education about supporting family caregivers for family physicians and trainees.
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Affiliation(s)
- Jasneet Parmar
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Sara Hafeez
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Tanya L'Heureux
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Lesley Charles
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Josephine Tite
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Peter George J Tian
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Sharon Anderson
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, Canada.
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Wood JJ, Wood KS, Rosenau KA, Cho AC, Johnson AR, Muscatello VS, Tien IS, Straus J, Wolpe S, Zeldin A, Kazlauskas K, McLeod BD. Practitioner Adherence and Competence in MEYA, a Free Online Self-Instruction Program in Modular Psychotherapy and Counseling for Children's Autism-Related Clinical Needs. J Autism Dev Disord 2024:10.1007/s10803-023-06226-w. [PMID: 38277075 DOI: 10.1007/s10803-023-06226-w] [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] [Accepted: 12/19/2023] [Indexed: 01/27/2024]
Abstract
The quality of care in public schools and other community settings for school-aged youths on the autism spectrum is variable and often not evidence-based. Training practitioners in these settings to deliver evidence-based practices (EBPs) may improve the quality of care. We developed a free internet-based training and clinical guidance system synthesizing multiple EBPs for youth on the autism spectrum addressing a range of mental health needs and autism-related behaviors, entitled Modular EBPs for Youth on the Autism Spectrum (MEYA; meya.ucla.edu). A multiple baseline study was conducted with seven practitioners recruited from mental health practice settings across the United States who were providing services to children on the autism spectrum (aged 6 to 17 years). Practitioners were randomly assigned to undergo baseline conditions of 2 to 8 weeks. Once online training in MEYA commenced, practitioners engaged in algorithm-guided self-instruction in EBPs for autism. Participants video-recorded sessions. Independent coders used the MEYA Fidelity Scale (MEYA-FS) to rate adherence and competence in EBPs for autism. Practitioners also completed measures pertaining to implementation outcomes and parents rated youth outcomes on personalized target behaviors. Five of seven practitioners increased their adherence to MEYA practices (i.e., MEYA-FS scores) following MEYA training. Findings for competence were similar, though somewhat less robust. Practitioners generally viewed MEYA as feasible, understandable, and acceptable. Most youth outcomes improved during MEYA. A randomized, controlled trial of MEYA would be helpful in characterizing its effectiveness for supporting practitioner EBP implementation and youth outcomes in school and community service settings.
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Affiliation(s)
- Jeffrey J Wood
- Department of Education, University of California Los Angeles, Los Angeles, USA.
- Department of Psychiatry, University of California Los Angeles, Los Angeles, USA.
| | - Karen S Wood
- Department of Psychiatry, University of California Los Angeles, Los Angeles, USA
| | - Kashia A Rosenau
- Department of Medicine, University of California Los Angeles, Los Angeles, USA
| | - An Chuen Cho
- Department of Education, University of California Los Angeles, Los Angeles, USA
| | - Amanda R Johnson
- Department of Education, University of California Los Angeles, Los Angeles, USA
| | | | - Ingrid S Tien
- Department of Education, University of California Los Angeles, Los Angeles, USA
| | - Jolie Straus
- Department of Education, University of California Los Angeles, Los Angeles, USA
| | - Samara Wolpe
- Department of Education, University of California Los Angeles, Los Angeles, USA
| | | | | | - Bryce D McLeod
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
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Davey-Rothwellh M, Owczarzak J, Collins K, Dolcini MM, Tobin K, Mitchell F, Jones A, Latkin C. Lessons Learned from Implementing the SHIELD Intervention: A Peer Education Intervention for People Who Use Drugs. AIDS Behav 2021; 25:3472-3481. [PMID: 33913060 DOI: 10.1007/s10461-021-03275-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 11/25/2022]
Abstract
HIV prevention and care peer education interventions have demonstrated effectiveness at changing HIV risk and care behaviors among a variety of at-risk populations in different settings. However, little is known about the implementation of this type of intervention in community-based settings. Further, there is limited information available regarding the facilitators and barriers to implementing peer education interventions in community-based settings. In this study, we explore implementation facilitators, barriers, and strategies to overcome these barriers among 12 organizations that implemented the SHIELD intervention, an evidenced-based peer education intervention for people who use drugs. Guided by the Consolidated Framework for Implementation Research, we identified several facilitators and barriers at the outer, inner individuals, and intervention level of the implementation process. Future evidence-based public health programs should, in addition to addressing effectiveness, be relevant to the needs and lives of clients.
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Affiliation(s)
- Melissa Davey-Rothwellh
- Johns Hopkins Bloomberg School of Public Health, Health, Behavior, and Society, Baltimore, MD, USA.
- Johns Hopkins Bloomberg School of Public Health, Health, Behavior, and Society, 2213 McElderry Street, 2nd Floor, Baltimore, MD, 21212, USA.
| | - Jill Owczarzak
- Johns Hopkins Bloomberg School of Public Health, Health, Behavior, and Society, Baltimore, MD, USA
| | - Karina Collins
- Johns Hopkins Bloomberg School of Public Health, Health, Behavior, and Society, Baltimore, MD, USA
| | - M Margaret Dolcini
- Oregon State University, College of Public Health and Health Sciences, School of Social and Behavioral Health Sciences, Corvallis, OR, USA
| | - Karin Tobin
- Johns Hopkins Bloomberg School of Public Health, Health, Behavior, and Society, Baltimore, MD, USA
| | - Frances Mitchell
- Johns Hopkins Bloomberg School of Public Health, Health, Behavior, and Society, Baltimore, MD, USA
| | - Abenea Jones
- Pennsylvania State University, College of Health and Human Development, Health and Family Studies, University Park, PA, USA
| | - Carl Latkin
- Johns Hopkins Bloomberg School of Public Health, Health, Behavior, and Society, Baltimore, MD, USA
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Morrow A, Chan P, Tiernan G, Steinberg J, Debono D, Wolfenden L, Tucker KM, Hogden E, Taylor N. Building capacity from within: qualitative evaluation of a training program aimed at upskilling healthcare workers in delivering an evidence-based implementation approach. Transl Behav Med 2021; 12:6320108. [PMID: 34255088 PMCID: PMC8765000 DOI: 10.1093/tbm/ibab094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Translating evidence into complex health systems is an ongoing challenge. Building the capacity of healthcare workers in behavioral and implementation science methods may facilitate the use of evidence-based implementation approaches, leading to sustainable and effective translation. The aim was to describe the development, contents and evaluation of a training workshop aimed at upskilling hospital-embedded staff to deliver an evidence-based implementation approach. The Hide and Seek Project (HaSP) is a cluster randomized controlled trial testing two implementation approaches for improving hereditary cancer referral at eight Australian hospitals. Healthcare workers were recruited as “Implementation Leads” and trained via a one-day workshop—TRAining in evideNce-baSed ImpLementATion for hEalth (TRANSLATE). The purpose of TRANSLATE was to upskill Implementation Leads in the delivery of HaSP, as well as implementation science methods more broadly. Implementation Leads participated in semi-structured evaluation interviews, which were analyzed using inductive thematic analysis. Nine Implementation Leads from various professional backgrounds completed the training. Four key themes were identified: (i) training day reactions, (ii) learning, (iii) implementation barriers and facilitators, and (iv) building health system capacity for implementation. Participants reported high levels of satisfaction, and anticipated that the knowledge and skills may be useful in the future. We describe a novel training program focused on the delivery of evidence-based implementation within health systems. Guided by insights from this study, methods to deliver the training on a larger scale and across different contexts are being explored. The prolonged impact of TRANSLATE will be further evaluated at trial completion. Trial registration: ANZCTR, ACTRN12618001072202. Registered on June 27, 2018
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Affiliation(s)
- April Morrow
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Camperdown New South Wales, Australia
| | - Priscilla Chan
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, New South Wales, Australia
| | - Gabriella Tiernan
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, New South Wales, Australia
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Camperdown New South Wales, Australia
| | - Deborah Debono
- Centre for Health Services Management, School of Public Health, University of Technology Sydney, New South Wales, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
| | - Katherine M Tucker
- Hereditary Cancer Centre, Prince of Wales Hospital, New South Wales, Australia.,Prince of Wales Clinical School, UNSW Sydney, New South Wales, Australia
| | - Emily Hogden
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, New South Wales, Australia
| | - Natalie Taylor
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Camperdown New South Wales, Australia
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