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Toor JSK, Lavoie JG, Mudryj A. Inuit youth health and wellbeing programming in Canada. Int J Circumpolar Health 2024; 83:2376799. [PMID: 38988226 PMCID: PMC11351917 DOI: 10.1080/22423982.2024.2376799] [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] [Received: 03/04/2024] [Revised: 06/17/2024] [Accepted: 07/02/2024] [Indexed: 07/12/2024] Open
Abstract
Inuit youth face challenges in maintaining their wellbeing, stemming from continued impacts of colonisation. Recent work documented that urban centres, such as Winnipeg Canada, have large Inuit populations comprised of a high proportion of youth. However, youth lack culturally appropriate health and wellbeing services. This review aimed to scan peer-reviewed and grey literature on Inuit youth health and wellbeing programming in Canada. This review is to serve as an initial phase in the development of Inuit-centric youth programming for the Qanuinngitsiarutiksait program of research. Findings will support further work of this program of research, including the development of culturally congruent Inuit-youth centric programming in Winnipeg. We conducted an environmental scan and used an assessment criteria to assess the effectiveness of the identified programs. Results showed that identified programs had Inuit involvement in creation framing programming through Inuit knowledge and mostly informed by the culture as treatment approach. Evaluation of programs was diffcult to locate, and it was hard to discren between programming, pilots or explorative studies. Despite the growing urban population, more non-urban programming was found. Overall, research contributes to the development of effective strategies to enhance the health and wellbeing of Inuit youth living in Canada.
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Affiliation(s)
- Jeevan S K Toor
- Institute for Global Health, University College London, London, UK
| | - Josée G Lavoie
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Adriana Mudryj
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Rathbone AL, Neill S, Prime S, Thomas N, Everett K. Supporting parents with acutely ill children: Environment scan and user evaluation of mobile applications (the SuPa kids project). Int J Med Inform 2024; 189:105504. [PMID: 38833841 DOI: 10.1016/j.ijmedinf.2024.105504] [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] [Received: 10/24/2023] [Revised: 05/07/2024] [Accepted: 05/25/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Children are one of the biggest users of emergency departments in the UK, sometimes utilising services when experiencing acute illnesses that can be managed at home. mHealth can be an efficacious way for parents/guardians to manage acute illnesses. It has also become a ubiquitous resource to promote public health interests within a resource constrained health system. However, to be effective, co-design is necessary with concepts such as usefulness, ease of use, trustworthiness and security underpinning the utility of mHealth interventions for acute childhood illness. OBJECTIVE The objective of this study was to conduct an environmental scan of mHealth apps for parental assessment and management of acute childhood illnesses in 0- to 5-year-olds, review the content and functionality of each identified app against the list of desired attributes identified in previous research and synthesise publicly available reviews from end users to demonstrate the quality of current apps in the marketplace and identify areas for improvement. METHOD App characteristics were mapped to an a priori defined list of desirable attributes. End user reviews were mapped to a modified Technology Acceptance Model framework that included overarching themes of: Perceived Usefulness (PU), Perceived Ease of Use (PEU), Perceived Trustworthiness (PT) and Perceived Security (PS) using reflexive thematic analysis. RESULTS Overall, 15 apps were included in the analysis (Table 2). Fourteen of the 15 apps were available on both the iOS and Android platforms. 'Baby Illness, Prevention, Cure' was only available on the Android store. All apps were free to download and did not restrict access to information or features via in-app purchases. Baby and child first aid (British Red Cross) was the earliest app to be released (2014). This app was updated annually, with the most recent update being 2022. The most recent apps to be released (2018) were 'AskFirst' (formerly Ask NHS), 'Essex Child Health' and 'The Lullaby Trust Baby Check', updated in 2022, 2020 and 2019, respectively. No individual app met all the desirable attributes highlighted by parents in previous research. Both 'Healthier Together', and 'The Lullaby Trust Baby Check' included all but one desirable attributes (video), as did the ''CATCH (Common Approach to Children's Health), which did not utilise a traffic light system. Apps that were locality specific were not rated by users (Berkshire Child Health, Cheshire Child Health, Child Health Guide Newham, Child Health HMR, Oldham Child Illness and Walsall Healthy Child). All other apps were rated from 2/5 to 5/5 stars. When considering localities, the 'CATCH' app was only supported in Halton, Cheshire, Knowsley, Liverpool, St Helens and Vale Royal. Further investigation evidenced no correlation between inclusion of the desirable attributes and app rating. CONCLUSION Overall, this research has highlighted several aspects of best practise when developing mHealth apps for the management of acute childhood illnesses, for increasing PU, PEU, PT and PS; and also, places importance on co-design.
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Affiliation(s)
| | - Sarah Neill
- University of Plymouth-School of Nursing and Midwifery, United Kingdom.
| | - Samantha Prime
- University of Plymouth-Peninsula Medical School (Faculty of Health), United Kingdom.
| | - Nicole Thomas
- University of Plymouth-School of Health Professions (Faculty of Health), United Kingdom.
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Graham ND, Graham ID, Vanderspank-Wright B, Nadalin-Penno L, Fergusson DA, Squires JE. Planning for implementation success: insights from conducting an implementation needs assessment. JBI Evid Implement 2024:02205615-990000000-00126. [PMID: 39189751 DOI: 10.1097/xeb.0000000000000458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
AIM The aim of this paper is to provide insights into conducting an implementation needs assessment using a case example in a less-research-intensive setting. DESIGN AND METHODS In the case example, an implementation needs assessment was conducted, including1 an environmental scan of the organization's website and preliminary discussions with key informants to learn about the implementation context, and2 a formal analysis of the evidence-practice gap (use of sedation interruptions) deploying a chart audit methodology using legal electronic reports. RESULTS Our needs assessment was conducted over 5 months and demonstrated how environmental scans reveal valuable information that can inform the evidence-practice gap analysis. A well-designed gap analysis, using suitable indicators of best practice, can reveal compliance rates with local protocol recommendations, even with a small sample size. In our case, compliance with the prescribed practices for sedation interruptions ranged from 65% (n=53) to as high as 84% (n=69). CONCLUSIONS Implementation needs assessments provide valuable information that can inform implementation planning. Such assessments should include an environmental scan to understand the local context and identify both current recommended best practices and local best practices for the intervention of interest. When addressing an evidence-practice gap, analyses should quantify the difference between local practice and desired best practice. IMPACT The insights gained from the case example presented in this paper are likely transferrable to implementation research or studies conducted in similar, less-research-intensive settings. SPANISH ABSTRACT http://links.lww.com/IJEBH/A257.
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Affiliation(s)
- Nicole D Graham
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Ian D Graham
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Letitia Nadalin-Penno
- Faculty of Environmental and Health Sciences, Canadore College, North Bay, ON, Canada
| | - Dean A Fergusson
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Janet E Squires
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
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Mahon S, Reifferscheid L, Kenzie L, MacDonald SE. Regional differences in pediatric pneumococcal vaccine schedules for Indigenous children in Canada: an environmental scan. BMC Health Serv Res 2024; 24:990. [PMID: 39187809 PMCID: PMC11348588 DOI: 10.1186/s12913-024-11400-6] [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] [Received: 10/26/2023] [Accepted: 08/05/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Streptococcus pneumoniae bacteria causes substantial morbidity and mortality worldwide, especially in children under 5 years of age. Prevention of these outcomes by pneumococcal conjugate vaccines (PCV) is an important public health initiative, supported by publicly funded vaccination programs in Canada. While the National Advisory Committee on Immunization (NACI) provides national recommendations for vaccination schedules, decisions on vaccination program delivery are made regionally, creating potential for variability across the country. In addition, defining the groups that are most at risk has become a complex endeavor for provinces and territories in Canada, specifically considering Indigenous children. METHODS In this environmental scan, we reviewed policy documents, provincial/territorial and international PCV schedules, and scientific literature, and consulted with vaccination program stakeholders and experts from across the country, in order to understand the evolution of PCV vaccination guidelines and policies in Canada and identify whether and how the needs of Indigenous children are addressed. RESULTS As of March 2023, most regions do not specify particular vaccination requirements for Indigenous children; however, three provinces identify Indigenous children as "high risk" and use varying language to recommend a four dose, rather than the routine three dose, schedule. Our results also draw attention to evidence gaps supporting a differing practice for Indigenous populations. CONCLUSIONS Future PCV program innovation requires inclusive and clear policies as well as definitive evidence-based policies and practices in order to improve equitable population health.
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Affiliation(s)
- Sarah Mahon
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | | | - Lisa Kenzie
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Shannon E MacDonald
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
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Benjamins MR, Poonsapaya J, Laflamme E, G De Maio F. Racial Health Equity Plans in the 30 Largest US Cities. J Racial Ethn Health Disparities 2024; 11:1933-1945. [PMID: 37540303 DOI: 10.1007/s40615-023-01662-x] [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] [Received: 03/07/2023] [Revised: 05/10/2023] [Accepted: 05/24/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Racial inequities in life expectancy vary significantly across US cities, with city-level gaps ranging from zero to more than 10 years. Given that these inequities are rooted in racism and maintained through social structures and policies, population-level solutions are needed. Local health departments (LHD) are well-situated to lead these types of changes. METHODS We conducted an environmental scan and document review of formal health plans of the LHDs with jurisdictions covering the 30 most populous US cities. We assessed the inclusion of equity priorities and specific and measurable equity goals. Secondary outcomes related to organizational structures, data, formal declarations, and other practices were also assessed. Data were collected between January and August 2022. RESULTS The extent of focus on racial equity in the identified strategic health plans varied. Less than half of the cities with a formal public health plan (13 of 29) listed racial health equity as an area of focus. Only seven cities (all of which had a health plan focusing on racial health equity) had specific goals related to racial health equity. Twenty-five LHDs provided local data on racial health inequities. All but seven cities had declared racism a public health crisis. About half of the LHDs had positions or divisions focused on racial equity, or specified equity as an area of focus for Covid-19 efforts. CONCLUSIONS These findings reveal that few large cities translate growing support for anti-racism into their formal planning. While most LHDs acknowledge (and provide data pointing to) gaps in racial health equity in their jurisdictions, more attention is needed to incorporate specific and measurable racial health equity goals into strategic plans, and provide adequate structure and resources to attain those goals.
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Affiliation(s)
- Maureen R Benjamins
- Sinai Urban Health Institute, 1500 S. Fairfield Ave, Chicago, IL, 60608, USA.
| | - Jennifer Poonsapaya
- Sinai Urban Health Institute, 1500 S. Fairfield Ave, Chicago, IL, 60608, USA
| | | | - Fernando G De Maio
- American Medical Association, Chicago, IL, USA
- DePaul University, Chicago, IL, USA
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O'Brien KK, McDuff K, Chattu VK, Churchill K, Colantonio A, Davenport TE, Gross DP, Jaglal S, Kho M, Leighton J, Premnazeer M, Rendely A, Scali O, Skoretz S, Wasilewski M, Cameron JI. A framework of research priorities in COVID rehabilitation from the Rehabilitation Science Research Network for COVID: an international consultation involving qualitative and quantitative research. Disabil Rehabil 2024:1-10. [PMID: 39049529 DOI: 10.1080/09638288.2024.2382904] [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: 11/17/2023] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE To identify research priorities related to COVID rehabilitation from the perspectives of persons with lived experiences, clinicians, researchers, community organization and policy representatives. MATERIALS & METHODS We conducted five international consultations to identify key issues and research priorities in COVID rehabilitation using (i) web-based questionnaires, (ii) synchronous discussions, and (iii) content analysis of COVID rehabilitation research conference presentations. We collated responses and notes and then analyzed data using content analytical techniques. RESULTS The Framework of Research Priorities in COVID Rehabilitation includes five priorities that span health and disability across COVID-19 and Long COVID illness trajectories: (1) understanding experiences of episodic disability; (2) assessing episodic disability; (3) identifying and examining safe approaches to rehabilitation; (4) examining the role, implementation, and impact of models of rehabilitation care; and (5) examining access to safe, timely and appropriate rehabilitation and other health care provider services. The Framework identifies target populations, methodological considerations, and highlights the importance of integrated knowledge translation and exchange in advancing scientific evidence, clinical education, practice, and COVID rehabilitation policy. CONCLUSIONS This Framework provides a foundation to advance COVID, disability and rehabilitation research to advance the health and well-being of persons with COVID-19, Long COVID, and their caregivers.Implications for rehabilitationPersons with COVID-19 or Long COVID and their caregivers may experience multi-dimensional forms of disability spanning physical, cognitive, emotional health challenges, difficulties with daily function, and social inclusion, which individually and/or collectively may be unpredictable, episodic and/or chronic in nature.Rehabilitation has a role in preventing or mitigating disability and enhancing health outcomes for persons with COVID-19, Long COVID and their caregivers.The Framework of Research Priorities COVID Rehabilitation includes five overlapping research priorities spanning health and disability across COVID trajectories: (1) understanding experiences of episodic disability; (2) assessing episodic disability; (3) identifying and examining safe approaches to rehabilitation; (4) examining the role, implementation, and impact of models of rehabilitation care; and (5) examining access to safe, timely and appropriate rehabilitation and other health care provider services.The research priorities in the Framework represent a comprehensive approach to examine disability and rehabilitation across COVID illness trajectories and the broad continuums of rehabilitation care to provide a coordinated and collaborative approach to advancing evidence in COVID disability and rehabilitation.This Framework provides a foundation for international and interdisciplinary collaborations, to advance COVID disability and rehabilitation research to enhance health outcomes of persons with COVID-19, Long COVID, and their caregivers.
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Affiliation(s)
- Kelly K O'Brien
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kiera McDuff
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Vijay Kumar Chattu
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Katie Churchill
- Rehabilitative Care Alliance, Ottawa, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto Rehab Institute, University Health Network, Toronto, ON, Canada
| | - Todd E Davenport
- Department of Physical Therapy, School of Health Sciences, University of the Pacific, Stockton, CA, USA
| | - Douglas P Gross
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Susan Jaglal
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Michelle Kho
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Jaylyn Leighton
- St. John's Rehab Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Meera Premnazeer
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Alexandra Rendely
- Toronto Rehab Institute, University Health Network, Toronto, ON, Canada
| | - Orianna Scali
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Stacey Skoretz
- School of Audiology & Speech Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Marina Wasilewski
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Jill I Cameron
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Ali S, Alizai H, Hagos DJ, Rubio SR, Calabia D, Serrano Jimenez P, Senthil VA, Appel L. mHealth Apps for Dementia, Alzheimer Disease, and Other Neurocognitive Disorders: Systematic Search and Environmental Scan. JMIR Mhealth Uhealth 2024; 12:e50186. [PMID: 38959029 PMCID: PMC11255539 DOI: 10.2196/50186] [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] [Received: 08/25/2023] [Revised: 01/30/2024] [Accepted: 04/23/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Lifestyle behaviors including exercise, sleep, diet, stress, mental stimulation, and social interaction significantly impact the likelihood of developing dementia. Mobile health (mHealth) apps have been valuable tools in addressing these lifestyle behaviors for general health and well-being, and there is growing recognition of their potential use for brain health and dementia prevention. Effective apps must be evidence-based and safeguard user data, addressing gaps in the current state of dementia-related mHealth apps. OBJECTIVE This study aims to describe the scope of available apps for dementia prevention and risk factors, highlighting gaps and suggesting a path forward for future development. METHODS A systematic search of mobile app stores, peer-reviewed literature, dementia and Alzheimer association websites, and browser searches was conducted from October 19, 2022, to November 2, 2022. A total of 1044 mHealth apps were retrieved. After screening, 152 apps met the inclusion criteria and were coded by paired, independent reviewers using an extraction framework. The framework was adapted from the Silberg scale, other scoping reviews of mHealth apps for similar populations, and background research on modifiable dementia risk factors. Coded elements included evidence-based and expert credibility, app features, lifestyle elements of focus, and privacy and security. RESULTS Of the 152 apps that met the final selection criteria, 88 (57.9%) addressed modifiable lifestyle behaviors associated with reducing dementia risk. However, many of these apps (59/152, 38.8%) only addressed one lifestyle behavior, with mental stimulation being the most frequently addressed. More than half (84/152, 55.2%) scored 2 points out of 9 on the Silberg scale, with a mean score of 2.4 (SD 1.0) points. Most of the 152 apps did not disclose essential information: 120 (78.9%) did not disclose expert consultation, 125 (82.2%) did not disclose evidence-based information, 146 (96.1%) did not disclose author credentials, and 134 (88.2%) did not disclose their information sources. In addition, 105 (69.2%) apps did not disclose adherence to data privacy and security practices. CONCLUSIONS There is an opportunity for mHealth apps to support individuals in engaging in behaviors linked to reducing dementia risk. While there is a market for these products, there is a lack of dementia-related apps focused on multiple lifestyle behaviors. Gaps in the rigor of app development regarding evidence base, credibility, and adherence to data privacy and security standards must be addressed. Following established and validated guidelines will be necessary for dementia-related apps to be effective and advance successfully.
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Affiliation(s)
- Suad Ali
- Faculty of Health, York University, Toronto, ON, Canada
- Knowledge, Innovation, Talent, Everywhere, OpenLab, University Health Network, Toronto, ON, Canada
- Women's Brain Health Initiative, Toronto, ON, Canada
| | - Hira Alizai
- Faculty of Health, York University, Toronto, ON, Canada
| | | | | | - Dale Calabia
- Faculty of Health, York University, Toronto, ON, Canada
| | | | | | - Lora Appel
- Faculty of Health, York University, Toronto, ON, Canada
- Knowledge, Innovation, Talent, Everywhere, OpenLab, University Health Network, Toronto, ON, Canada
- Michael Garron Hospital, Toronto, ON, Canada
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Brickley B, Advocat J, Chai TL, Bowden M, Rieger E, Ball L, Ng R, Gunatillaka N, Sturgiss EA. What next for behaviour change professional development in general practice? Insights from an environmental scan and workshops. BJGP Open 2024; 8:BJGPO.2023.0187. [PMID: 38331469 PMCID: PMC11300966 DOI: 10.3399/bjgpo.2023.0187] [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: 09/21/2023] [Revised: 12/10/2023] [Accepted: 12/12/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND A key role of general practice professionals (that is, GPs, and general practice nurses [GPNs]) is to support patients to change behaviours. Traditional approaches to assisting patients with, and learning about, behaviour change have modest outcomes. AIM To explore behaviour change with GPs and GPNs and the availability of related professional development (PD) opportunities. DESIGN & SETTING Multi-methods study comprising an environmental scan survey of behaviour change tools and PD opportunities, and online workshops with Australian GPs and GPNs. METHOD Survey data were analysed using qualitative content analysis, informing the design of the workshops. Workshop data included observation, note-taking, and collaborative reflection, which were analysed thematically and synthesised with survey data. RESULTS The survey had 18 complete responses. For the two virtual workshops, workshop 1 had 16 participants and workshop 2 had eight participants. There was diversity in awareness of existing behaviour change tools and resources. Preferences for future tools and PD opportunities related to specific aspects of its design, content, activities, and delivery. The following three themes developed from the workshop data: recognising the importance of relationships; recognising the importance of continuity; and keeping context in mind. In the absence of tools and resources, GPs and GPNs discussed behaviour change as something that occurs best through a patient-centred alliance that is continuing, respectful, grounded in trust and an understanding of their patient, and prioritises patient autonomy. CONCLUSION Future general practice behaviour change PD should support clinicians to 'assist' patients and recognise the social and contextual influences on behaviour.
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Affiliation(s)
- Bryce Brickley
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Darwin, Northern Territory, Australia
| | - Jenny Advocat
- School of Primary and Allied Health Care, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Australia
| | - Tze Lin Chai
- School of Primary and Allied Health Care, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Australia
| | - Mitchell Bowden
- School of Primary and Allied Health Care, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Australia
| | - Elizabeth Rieger
- Australian National University Research School of Psychology, Canberra, Australia
| | - Lauren Ball
- The University of Queensland, Centre for Community Health & Wellbeing, Brisbane, Australia
| | - Raeann Ng
- School of Primary and Allied Health Care, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Australia
| | - Nilakshi Gunatillaka
- School of Primary and Allied Health Care, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Australia
| | - Elizabeth Ann Sturgiss
- School of Primary and Allied Health Care, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Australia
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Jose A, Sasseville M, Gorus E, Giguère A, Bourbonnais A, Abbasgholizadeh Rahimi S, Balley C, Buyl R, Gagnon MP. Existing Digital Health Technology Index Summary Report for Older Adults Living with Neurocognitive Disorders (Mild and Major) and Their Informal Caregivers: An Environmental Scan. Geriatrics (Basel) 2024; 9:85. [PMID: 39051249 PMCID: PMC11270236 DOI: 10.3390/geriatrics9040085] [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: 04/13/2024] [Revised: 06/01/2024] [Accepted: 06/19/2024] [Indexed: 07/27/2024] Open
Abstract
Digital health has added numerous promising solutions to enhance the health and wellness of people with neurocognitive disorders (NCDs) and their informal caregivers. (1) Background: It is important to obtain a comprehensive view of currently available technologies, their outcomes, and conditions of success to inform recommendations regarding digital health solutions for people with NCDs and their caregivers. This environmental scan was performed to identify the features of existing digital health solutions relevant to the targeted population. This work reviews currently available digital health solutions and their related characteristics to develop a decision support tool for older adults living with mild or major neurocognitive disorders and their informal caregivers. This knowledge will aid the development of a decision support tool to assist older adults and their informal caregivers in their search for adequate digital health solutions according to their needs and preferences based on trustable information. (2) Methods: We conducted an environmental scan to identify digital health solutions from a systematic review and targeted searches in the grey literature covering the regions of Canada and Europe. Technological tools were scanned based on a preformatted extraction grid. We assessed their relevance based on selected attributes and summarized the findings. (3) Results: We identified 100 available digital health solutions. The majority (56%) were not specific to NCDs. Only 28% provided scientific evidence of their effectiveness. Remote patient care, movement tracking, and cognitive exercises were the most common purposes of digital health solutions. Most solutions were presented as decision aid tools, pill dispensers, apps, web, or a combination of these platforms. (4) Conclusions: This environmental scan allowed for identifying current digital health solutions for older adults with mild or major neurocognitive disorders and their informal caregivers. Findings from the environmental scan highlight the need for additional approaches to strengthen digital health interventions for the well-being of older adults with mild and major NCDs and their informal and formal healthcare providers.
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Affiliation(s)
- Ambily Jose
- VITAM Research Center in Sustainable Health, Quebec City, QC G1J 2G1, Canada; (A.J.); (M.S.); (A.G.); (C.B.)
| | - Maxime Sasseville
- VITAM Research Center in Sustainable Health, Quebec City, QC G1J 2G1, Canada; (A.J.); (M.S.); (A.G.); (C.B.)
- Faculty of Nursing Sciences, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Ellen Gorus
- Department of Gerontology, Frailty in Ageing Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Anik Giguère
- VITAM Research Center in Sustainable Health, Quebec City, QC G1J 2G1, Canada; (A.J.); (M.S.); (A.G.); (C.B.)
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montreal, QC H3T 1J4, Canada;
| | - Samira Abbasgholizadeh Rahimi
- Department of Family Medicine, McGill University, Montreal, QC H3A 0G4, Canada;
- Mila-Quebec AI Institute, Montreal, QC H2S 3H1, Canada
| | - Clémence Balley
- VITAM Research Center in Sustainable Health, Quebec City, QC G1J 2G1, Canada; (A.J.); (M.S.); (A.G.); (C.B.)
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Marie-Pierre Gagnon
- VITAM Research Center in Sustainable Health, Quebec City, QC G1J 2G1, Canada; (A.J.); (M.S.); (A.G.); (C.B.)
- Faculty of Nursing Sciences, Université Laval, Quebec City, QC G1V 0A6, Canada
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Atuluru P, Weinstein ER, Serrano LP, Doblecki-Lewis S, Rogers BG, Harkness A. A Rapid Environmental Scan of South Florida HIV Organizations' Mpox Messaging During the August 2022 Peak of the U.S. Outbreak. AIDS Behav 2024; 28:1546-1558. [PMID: 37870691 PMCID: PMC11113002 DOI: 10.1007/s10461-023-04176-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2023] [Indexed: 10/24/2023]
Abstract
The 2022 outbreak of mpox disproportionately impacted men who have sex with men and people living with HIV. As such, HIV organizations were uniquely situated to reach populations affected by mpox. However, the extent to which these organizations pivoted to address mpox, and what form mpox messaging took, is unknown. We conducted a rapid environmental scan of 29 HIV or sexual health organizations to assess the frequency and content of mpox messaging in August 2022, the peak of the mpox outbreak in Miami, FL. Approximately half of the organizations provided mpox messaging, most of which was accurate. Only 5% of the messages were in Spanish and 4% in Spanish and Haitian Creole. Our findings suggest HIV organizations' pivot to mpox messaging may have been delayed overall and in reaching Spanish- and Haitian Creole-speaking communities. Results could inform modifications to mpox messaging campaigns and future outbreaks that disproportionately affect minoritized communities.
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Affiliation(s)
- Pranusha Atuluru
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Lorenzo P Serrano
- Department of Biological Science, Florida International University, Miami, FL, USA
| | | | - Brooke G Rogers
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Audrey Harkness
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, Coral Gables, Miami, FL, 33146, USA.
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11
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Godard-Sebillotte C, Navani S, Hacker G, Vedel I. Considering inequities in national dementia strategies: breadth, depth, and scope. Int J Equity Health 2024; 23:75. [PMID: 38627768 PMCID: PMC11022480 DOI: 10.1186/s12939-024-02166-8] [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: 12/08/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Considering that dementia is an international public health priority, several countries have developed national dementia strategies outlining initiatives to address challenges posed by the disease. These strategies aim to improve the care, support, and resources available to meet the needs of persons living with dementia and their care partners and communities. Despite the known impact of social determinants of health on dementia risk, care, and outcomes, it is unclear whether dementia strategies adequately address related inequities. This study aimed to describe whether and how national dementia strategies considered inequities associated with social determinants of health. METHODS We conducted an environmental scan of the national dementia strategies of countries that are part of the Organisation for Economic Cooperation and Development (OECD). Included strategies had to be accessible in English or French. Sub-national or provincial plans were excluded. We synthesised information on strategies' considerations of inequity through a thematic analysis. RESULTS Of the 15 dementia strategies that met inclusion criteria, 13 mentioned at least one inequity (M = 2.4, median = 2, range:0-7) related to Race/Ethnicity; Religion; Age; Disability; Sexual Orientation/Gender Identity; Social Class; or Rurality. Age and disability were mentioned most frequently, and religion most infrequently. Eleven strategies included general inequity-focused objectives, while only 5 had specific inequity-focused objectives in the form of tangible percentage changes, deadlines, or allocated budgets for achieving equity-related goals outlined in their strategies. CONCLUSIONS Understanding if and how countries consider inequities in their dementia strategies enables the development of future strategies that adequately target inequities of concern. While most of the strategies mentioned inequities, few included tangible objectives to reduce them. Countries must not only consider inequities at a surface-level; rather, they must put forth actionable objectives that intend to lessen the impact of inequities in the care of all persons living with dementia.
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Affiliation(s)
- Claire Godard-Sebillotte
- The Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
- Department of Medicine, Division of Geriatrics, McGill University, Montreal, QC, Canada.
| | - Sanjna Navani
- The Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Georgia Hacker
- The Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Isabelle Vedel
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- Department of Family Medicine, McGill University, Montreal, QC, Canada
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12
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Castro A, Lalonde-LeBlond G, Freitas Z, Arnaert A, Bitzas V, Kildea J, Moffatt K, Phillips D, Wiseblatt L, Hall AJ, Després V, Tsimicalis A. In-Home Respite Care Services Available to Families With Palliative Care Needs in Quebec: Novel Digital Environmental Scan. JMIR Nurs 2024; 7:e53078. [PMID: 38625735 PMCID: PMC11061788 DOI: 10.2196/53078] [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: 10/25/2023] [Accepted: 02/12/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Caregiving dyads in palliative care are confronted with complex care needs. Respite care services can be highly beneficial in alleviating the caregiving burden, supporting survivorship and dying at home. Yet, respite care services are difficult to locate and access in the province of Quebec, Canada, particularly when navigating ubiquitous sources of online health information of varying quality. OBJECTIVE This project aimed to (1) compile a list of at-home palliative respite care services in Quebec, Canada; (2) describe key accessibility features for each respite care service; (3) identify accessibility gaps and opportunities; and (4) describe a novel method for conducting environmental scans using internet search engines, internet-based community health databases, and member checking. METHODS A novel environmental scan methodology using 2 internet-based targeted databases and 1 internet search engine was conducted. Results were screened and data were extracted, descriptively analyzed, and geographically schematized. RESULTS A total of 401 services were screened, and 52 at-home respite care services specific to palliative populations were identified, compiled, and analyzed. These respite care services were characterized by various types of assistance, providers, fees, and serviced geographical regions. Accessibility was explored through the lens of service amenability, availability, eligibility, and compatibility. The data revealed important barriers to accessing respite care services, such as a lack of readily available information on service characteristics, limited availability, and a time-consuming, technical search process for potential respite care users and clinicians to identify appropriate services. CONCLUSIONS Both methodological and contextual knowledge have been gained through this environmental scan. Few methodologies for conducting internet-based environmental scans have been clearly articulated, so we applied several learnings from other scans and devised a methodology for conducting an environmental scan using the mixed methods of internet search engines, internet-based community health databases, and member checking. We have carefully reported our methods, so that others conducting community health environmental scans may replicate our process. Furthermore, through this scan, we identified assorted respite care services and pinpointed needs in the provision of these services. The findings highlighted that more easily accessible and centralized information about respite care services is needed in Quebec. The data will enable the creation of a user-friendly tool to share with community support services across Quebec and ultimately help alleviate the added burden caregivers and clinicians face when looking for respite care services in fragmented and complex digital spaces.
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Affiliation(s)
- Aimee Castro
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | | | - Zelda Freitas
- Professional Practice Directorate of Rehabilitation and Multidisciplinary Services, CIUSSS West-Central Montreal, Montreal, QC, Canada
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Antonia Arnaert
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Vasiliki Bitzas
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Geriatrics and Palliative Care, CIUSSS West-Central Montreal, Montreal, QC, Canada
| | - John Kildea
- Medical Physics Unit, McGill University, Montreal, QC, Canada
| | - Karyn Moffatt
- School of Information Studies, McGill University, Montreal, QC, Canada
| | - Devon Phillips
- Palliative Care McGill, McGill University, Montreal, QC, Canada
| | | | - Audrey-Jane Hall
- Palliative Home-Care Society of Greater Montreal, Montreal, QC, Canada
| | - Véronique Després
- St-Raphaël Palliative Care Home and Day Centre, Montreal, QC, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Nursing Research, Shriners Hospitals for Children-Canada, Montreal, QC, Canada
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Fathi L, Umble K, Waters AR, Kent EE. An Environmental Scan and Qualitative Inquiry of Cancer Patient Navigation Services in North Carolina. RESEARCH SQUARE 2024:rs.3.rs-4189013. [PMID: 38659951 PMCID: PMC11042433 DOI: 10.21203/rs.3.rs-4189013/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background and Objectives Patient navigation services reduce barriers to accessing cancer care and lead to improved outcomes for patients. North Carolina (NC) has thousands of cancer patients seeking cancer care services each year. We sought to complete a digital environmental scan and qualitative inquiry of cancer patient navigation services throughout the state to better inform patients, hospitals administrators, and state officials about the current state of patient navigation programs for cancer patients throughout NC. Methods For seven cancer hospitals in NC, two steps were used: an environmental scan of publicly available information on the hospitals' websites about navigation services, and key informant interviews with navigation staff at each site. Results The website scans revealed information about navigation services was incomplete. Each hospital had a page dedicated to cancer navigation, but many did not outline the specific services available to patients. Interviews revealed that navigation services are available to cancer patients across diagnoses, although only a subset of patients receive services. Cancer navigators reported that their work includes care coordination, patient advocacy, emotional support, and addressing non-medical barriers to health care access (transportation, finances, childcare, etc.). Each navigation service had a unique configuration and referral pattern. Conclusions Cancer hospitals throughout NC are working to address barriers to care commonly faced by patients, with some programs offering more robust services compared to others. Hospitals would benefit from updating their websites at regular intervals to fully report the services available to patients through their programs, including direct and clear patient navigation contact methods.
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Affiliation(s)
| | - Karl Umble
- University of North Carolina at Chapel Hill
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Smith M, Kurup S, Devaraja K, Shanawaz S, Reynolds L, Ross J, Bezjak A, Gupta AA, Kassam A. Adapting an Adolescent and Young Adult Program Housed in a Quaternary Cancer Centre to a Regional Cancer Centre: Creating Equitable Access to Developmentally Tailored Support. Curr Oncol 2024; 31:1266-1277. [PMID: 38534928 PMCID: PMC10969112 DOI: 10.3390/curroncol31030095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/15/2024] [Accepted: 02/23/2024] [Indexed: 05/26/2024] Open
Abstract
Adolescents and young adults (AYAs) with cancer, representing those between 15 and 39 years of age, face distinctive challenges balancing their life stage with the physical, emotional, and social impacts of a cancer diagnosis. These challenges include fertility concerns, disruptions to educational and occupational pursuits, issues related to body image and sexual health, and the need for age-appropriate psychosocial support within their communities. The Princess Margaret Cancer Centre (PM), a quaternary care center, established a specialized AYA program in 2014, offering holistic and developmentally tailored psychosocial support and currently, efforts are underway to expand this to other regions in the province to address the need for equitable access. The establishment process involves securing funding, conducting an environmental scan, identifying service gaps, developing clinical pathways, and implementing AYA supportive care. An accessible AYA program should also consider social determinants of health, social location, intersectionality, and an interdisciplinary health approach in understanding health inequities in AYA oncology care. This paper describes the processes implemented and challenges faced in creating a community-based AYA program beyond major resource-rich cities and efforts to address intersectionality.
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Affiliation(s)
- Marlie Smith
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2C4, Canada; (M.S.); (K.D.); (S.S.); (A.A.G.)
- Adolescent and Young Adult Program, Department of Supportive Care, Stronach Regional Cancer Centre, Southlake Regional Health Centre, Newmarket, ON L3Y 2P9, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
| | - Simone Kurup
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2C4, Canada; (M.S.); (K.D.); (S.S.); (A.A.G.)
| | - Kaviya Devaraja
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2C4, Canada; (M.S.); (K.D.); (S.S.); (A.A.G.)
| | - Shaayini Shanawaz
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2C4, Canada; (M.S.); (K.D.); (S.S.); (A.A.G.)
| | - Lorrie Reynolds
- Central Regional Cancer Program, Stronach Regional Cancer Centre, Southlake Regional Health Centre, Newmarket, ON L3Y 2P9, Canada;
| | - Jill Ross
- Childhood Cancer Care, Pediatric Oncology Group of Ontario, Toronto, ON M5G 1V2, Canada;
| | - Andrea Bezjak
- Department of Radiation Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2C4, Canada;
| | - Abha A. Gupta
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2C4, Canada; (M.S.); (K.D.); (S.S.); (A.A.G.)
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Alisha Kassam
- Department of Pediatrics, Southlake Regional Health Centre, Newmarket, ON L3Y 2P9, Canada;
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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Charlton P, Nagel DA, Azar R, Kean T, Campbell A, Lamontagne ME, Déry J, Kelly KJ, Fahim C. 'Snapshot in time': a cross-sectional study exploring stakeholder experiences with environmental scans in health services delivery research. BMJ Open 2024; 14:e075374. [PMID: 38309766 PMCID: PMC10840033 DOI: 10.1136/bmjopen-2023-075374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/21/2023] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVE To describe stakeholder characteristics and perspectives about experiences, challenges and information needs related to the use of environmental scans (ESs). DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A web-based survey platform was used to disseminate an online survey to stakeholders who had experience with conducting ESs in a health services delivery context (eg, researchers, policy makers, practitioners). Participants were recruited through purposive and snowball sampling. The survey was disseminated internationally, was available in English and French, and remained open for 6 weeks (15 October to 30 November 2022). ANALYSIS Descriptive statistics were used to describe the characteristics and experiences of stakeholders. Thematic analysis was used to analyse the open-text questions. RESULTS Of 47 participants who responded to the survey, 94% were from Canada, 4% from the USA and 2% from Australia. Respondents represented academic institutions (57%), health agency/government (32%) and non-government organisations or agencies (11%). Three themes were identified: (a) having a sense of value and utility; (b) experiencing uncertainty and confusion; and (c) seeking guidance. The data suggest stakeholders found value and utility in ESs and conducted them for varied purposes including to: (a) enhance knowledge, understanding and learning about the current landscape or state of various features of health services delivery (eg, programmes, practices, policies, services, best practices); (b) expose needs, service barriers, challenges, gaps, threats, opportunities; (c) help guide action for planning, policy and programme development; and (d) inform recommendations and decision-making. Stakeholders also experienced conceptual, methodological and practical barriers when conducting ESs, and expressed a need for methodological guidance delivered through published guidelines, checklists and other means. CONCLUSION ESs have value and utility for addressing health services delivery concerns, but conceptual and methodological challenges exist. Further research is needed to help advance the ES as a distinct design that provides a systematic approach to planning and conducting ESs.
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Affiliation(s)
- Patricia Charlton
- Adjunct Faculty, Faculty of Nursing, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Daniel A Nagel
- College of Nursing, University of Manitoba Rady Faculty of Health Sciences, Winnipeg, Manitoba, Canada
| | - Rima Azar
- Psychology Department, Mount Allison University, Sackville, New Brunswick, Canada
| | - Terri Kean
- Faculty of Nursing (Retired), University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Alyson Campbell
- Faculty of Nursing, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | | | - Julien Déry
- Interdisciplinary Center for Research in Rehabilitation and Social Integration, Laval University, Quebec city, Quebec, Canada
| | - Katherine Jennifer Kelly
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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Nava M, English AS, Fulmer L, Sanchez K. An action research partnership in an urban Texas county to explore barriers and opportunities for collaborative community health needs assessments. Front Public Health 2023; 11:1244143. [PMID: 37900035 PMCID: PMC10613110 DOI: 10.3389/fpubh.2023.1244143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/19/2023] [Indexed: 10/31/2023] Open
Abstract
Background The Affordable Care Act mandated triennial community health needs assessments (CHNAs) for greater nonprofit hospital accountability in responding to community health needs. Over 10 years later, hospital spending on community benefits remains largely unchanged. While greater collaboration in CHNA implementation can increase hospital investment in community-based initiatives, nonprofit hospitals in conservative states are subject to policy, political, and economic factors that inhibit public health partnerships and magnify existing disparities in health care access. This participatory action research study explores the decision-making environment of collaborative CHNA implementation within a group of nonprofit hospitals in a north Texas urban county. Methods In 2017 faculty from an urban anchor institution initiated an academic-community partnership with a coalition of nonprofit hospitals, public health departments, and academic institutions. An interdisciplinary research team engaged in multi-method document review and qualitative data collection to describe historical barriers for local CHNA processes and develop practical strategies for joint CHNA initiatives. Local CHNA documents were first reviewed through team-based content analysis and results applied to develop a qualitative study protocol. Key informants were recruited from county-based nonprofit hospitals, community-based nonprofit organizations, and public health systems. Seventeen senior- and mid-level professionals participated in semi-structured research interviews to describe their perspectives relating to CHNA-related planning and implementation decisions. Through iterative data collection and analysis, the research team explored CHNA-related knowledge, experiences, and processes. A constructivist lens was subsequently applied to examine historical barriers and future opportunities for local collaboration. Results Findings reveal CHNA implementation is a multi-stage cyclical process in organizational environments with accountability to a wide range of public and private stakeholders. This promotes varied levels of inclusivity and conservatism in data collection and community benefit implementation. Decisions to collaborate are hindered by competing priorities, including compliance with existing guidelines, administrative simplicity, alignment with health care service delivery, and efficient resource use. Efforts to promote greater CHNA collaboration may be facilitated through intentional alignment with organizational priorities and clearly communicated benefits of participation for leaders in both public and private nonprofit health systems. Discussion We consider implications for policymakers and health systems in restrictive political environments and advance a conceptual framework for greater CHNA collaboration.
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Affiliation(s)
- Marcela Nava
- School of Social Work, The University of Texas at Arlington, Arlington, TX, United States
| | - Amanda S. English
- Institute for Implementation Science, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Linda Fulmer
- Institute for Implementation Science, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Katherine Sanchez
- Institute for Implementation Science, The University of Texas Health Science Center at Houston, Houston, TX, United States
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Neville HL, Shaw J, VanIderstine C, Burgess S, Dearing M, Isenor JE, Toombs K, Bowles SK. Environmental scan of current strategies to decrease sedative-hypnotic drug use and promote sleep in hospital patients. Int J Clin Pharm 2023; 45:1062-1073. [PMID: 37773305 DOI: 10.1007/s11096-023-01632-7] [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] [Received: 04/27/2023] [Accepted: 07/29/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Sedative-hypnotic drugs are often initiated in hospital to manage insomnia and anxiety. Guidelines discourage their use, particularly in older adults, due to risks of falls, fractures, and delirium. AIM To identify publicly available resources to decrease the use of sedative-hypnotic drugs and promote sleep in hospital. METHOD An advanced Google search with 6 search strategies was conducted. Key websites were also identified and searched. Hospital- or community-based resources using non-pharmacologic measures to reduce sedative-hypnotic drug use and/or to promote sleep were included if they were publicly available in English within the past 5 years. Full text screening and data extraction was performed independently by 2 reviewers; a third reviewer resolved disagreements by consensus. RESULTS A total of 79 resources met inclusion criteria, with 65 (82.3%) providing education and 31 (39.2%) describing sleep hygiene strategies. Other resources included deprescribing (17, 21.5%), relaxation training (13, 16.5%), cognitive behavioural therapy for insomnia (9, 11.4%), and policies (7, 8.9%). The resources primarily targeted patients (59, 74.7%) followed by healthcare providers (9, 11.4%). There were 9 resources (11.4%) that applied to both community and hospital settings, and another 2 (2.5%) designed specifically for hospital. CONCLUSION Many resources were available to patients and healthcare providers to reduce inappropriate or ineffective use of sedative-hypnotic drugs and promote better sleep. Specific resources for the hospital setting were infrequent and recommended that clinicians stop hospital-initiated sedatives when patients are discharged. Identified resources can be adapted by healthcare organizations to develop sedative-hypnotic prescribing programs and policies.
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Affiliation(s)
- Heather L Neville
- Nova Scotia Health Authority, 1276 South Park Street, Halifax, Nova Scotia, B3H 2Y9, Canada.
| | - Jenna Shaw
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Carter VanIderstine
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health, Halifax, Nova Scotia, Canada
| | | | | | - Jennifer E Isenor
- College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kent Toombs
- Nova Scotia Health, Halifax, Nova Scotia, Canada
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Garcia Gonzalez-Moral S, Beyer FR, Oyewole AO, Richmond C, Wainwright L, Craig D. Looking at the fringes of MedTech innovation: a mapping review of horizon scanning and foresight methods. BMJ Open 2023; 13:e073730. [PMID: 37709340 PMCID: PMC10503360 DOI: 10.1136/bmjopen-2023-073730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/21/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Horizon scanning (HS) is a method used to examine signs of change and may be used in foresight practice. HS methods used for the identification of innovative medicinal products cannot be applied in medical technologies (MedTech) due to differences in development and regulatory processes. The aim of this study is to identify HS and other methodologies used for MedTech foresight in support to healthcare decision-making. METHOD A mapping review was performed. We searched bibliographical databases including MEDLINE, Embase, Scopus, Web of Science, IEEE Xplore and Compendex Engineering Village and grey literature sources such as Google, CORE database and the International HTA database. Our searches identified 8888 records. After de-duplication, and manual and automated title, abstracts and full-text screening, 49 papers met the inclusion criteria and were data extracted. RESULTS Twenty-five single different methods were identified, often used in combination; of these, only three were novel (appearing only once in the literature). Text mining or artificial intelligence solutions appear as early as 2012, often practised in patent and social media sources. The time horizon used in scanning was not often justified. Some studies regarded experts both as a source and as a method. Literature searching remains one of the most used methods for innovation identification. HS methods were vaguely reported, but often involved consulting with experts and stakeholders. CONCLUSION Heterogeneous methodologies, sources and time horizons are used for HS and foresight of MedTech innovation with little or no justification provided for their use. This review revealed an array of known methods being used in combination to overcome the limitations posed by single methods. The review also revealed inconsistency in methods reporting, with a lack of any consensus regarding best practice. Greater transparency in methods reporting and consistency in methods use would contribute to increased output quality to support informed timely decision-making.
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Affiliation(s)
- Sonia Garcia Gonzalez-Moral
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona R Beyer
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anne O Oyewole
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Richmond
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Wainwright
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn Craig
- NIHR Innovation Observatory at Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Engel L, Rampling T, Brautigan EJ, Bazin T, Dilts K, Williams T, Dyck TM, Jack EM, Colquhoun H. Review and Consultations of Canadian Financial Education Programs for Individuals with Disabilities. Can J Occup Ther 2023; 90:257-268. [PMID: 36221894 PMCID: PMC10422852 DOI: 10.1177/00084174221129947] [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: 08/12/2023]
Abstract
Background. Individuals or persons who live with a disability (PWD) can experience unique financial occupation challenges. Financial education programs can address some challenges. Purpose. The aim of this study was to describe and critically appraise current financial education programs for PWD in Canada. Method. This environmental scan framed by scoping review methods included a critical appraisal of Canadian programs' online content and provider consultations. Researchers used four search methods to identify programs, interviewed service providers from four Canadian programs, and thematically analyzed interview transcripts. Findings. Researchers identified 134 programs; 50 (37.3%) included services. The online content of only 26 (19%) programs explicitly addressed accessibility; 106 (79%) programs' content was at least college reading level. The qualitative results include three themes: (a) individualized approach, (b) "getting the word out", and (c) service growth. Implications. There are financial education programs specific to PWD in Canada. Accessibility, individualization, advocacy, and development are needed.
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Affiliation(s)
- Lisa Engel
- Lisa Engel, Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, R129-771 McDermot Avenue, Winnipeg, MB R3E 0T6, Canada.
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Hamadi A, Clemens KK, Ernst J, Attalla D, Moist L. North American Weight Management Programs for People Living With Chronic Kidney Disease: An Environmental Scan. Can J Kidney Health Dis 2023; 10:20543581231183369. [PMID: 37426489 PMCID: PMC10328043 DOI: 10.1177/20543581231183369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/14/2023] [Indexed: 07/11/2023] Open
Abstract
Background The availability and accessibility of patient-centered weight management programs is critical to mitigate the increasing prevalence of obesity in people living with chronic kidney disease (CKD). Little is known about the availability of contemporary programs that can safely and effectively support individuals living with obesity and CKD across North America. Objective We sought to identify weight management programs specific to those with CKD and explore their safety, affordability, and adaptability to this patient population. We also identified the barriers and facilitators of identified programming including their accessibility to real-world patients (eg, cost, access, support, and time). Design Environmental scan of weight management programs. Setting North America. Patient People living with CKD. Methods We identified weight management programs and associated barriers and facilitators, via an Internet-based search of commercial, community-based, and medically supervised weight management programming. We also conducted a gray literature search and contacted weight management experts and program facilitators to explore strategies as well as their barriers and facilitators. Results We identified 40 weight management programs available to people living with CKD across North America. Programs were commercial (n = 7), community-based (n = 9), and medically supervised (Canada n = 13, U.S n = 8) in origin. Three programs were specifically tailored to CKD (n = 3). In addition to formal programs, we also identified online nutritional resources and guidelines for weight loss in CKD (n = 8), and additional strategies (self-management tools, group orientated programs, moderate energy restrictions in conjunction with exercise and Orlistat) for weight loss from the gray literature (n = 3). Most common barriers were difficulty accessing some of the suggested nutritious food options due to the high cost, lack of support from family, friends and health practitioners, the time commitment required to participate, and the exclusion from weight management programs due to unique dietary needs for the CKD population. Most common facilitators were programs that were patient-centered, evidence-based, and offered both group and individual formats. Limitations Although our search criteria were broad, it is possible that we did not capture all weight management programs available across North America. Conclusions This environmental scan has generated a resource list of existing safe and effective programs for or adaptable to people with CKD. This information will inform future efforts to develop and deliver CKD-specific weight management programs to patients living with comorbid disease. Engaging people living with CKD to understand the acceptability of these programs, is an important focus for future research.
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Affiliation(s)
- Amani Hamadi
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Kristin K Clemens
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Division of Endocrinology and Metabolism, Department of Medicine, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- St. Joseph's Health Care London, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Jaclyn Ernst
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Division of General Internal Medicine, Department of Medicine, Western University, London, Ontario, Canada
| | - David Attalla
- York Weight Loss & Internal Medicine, Sharon, Ontario, Canada
| | - Louise Moist
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada
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Gallant AJ, Steenbeek A, Halperin SA, Parsons Leigh J, Curran JA. Identifying and addressing the impacts of the COVID-19 pandemic on school-based immunisation programmes in the Canadian Maritimes: a mixed methods study protocol. BMJ Open 2023; 13:e073172. [PMID: 37369397 PMCID: PMC10410997 DOI: 10.1136/bmjopen-2023-073172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic highlighted the importance of keeping up to date on routine vaccinations. Throughout the pandemic, many routine vaccine programmes in Canada were paused or cancelled, including school-based immunisation programmes (SBIP). This resulted in decreased coverage for many vaccine-preventable diseases. While the effects of the pandemic on SBIP have been described in other provinces, its effects in the Maritime region (ie, Nova Scotia, New Brunswick and Prince Edward Island) have yet to be understood. We aim to determine how these programmes were affected by COVID-19 and associated public health measures in the Canadian Maritimes by (1) identifying and describing usual and interim catch-up programmes; (2) exploring stakeholders' perceptions of SBIP through interviews; and (3) designing recommendations with stakeholders to address gaps in SBIP and vaccine coverage. METHODS AND ANALYSIS A sequential, explanatory mixed methods study design will be used to address the objectives during the study period (September 2022-December 2023). First, an environmental scan will describe changes to SBIP and vaccine coverage over a period of five school years (2018/2019-2022/2023). Findings will inform semistructured interviews (n=65) with key stakeholders (eg, health officials, healthcare providers, school officials and parents and adolescents) to explore perceptions of SBIP and changes in parental vaccine hesitancy during the pandemic. These data will be integrated to design recommendations to support SBIP during two stakeholder engagement meetings. Analysis will be guided by the behaviour change wheel, a series of complementary tools and frameworks to simplify behaviour diagnosis and analysis in public health research. ETHICS AND DISSEMINATION Ethics approval for this study has been obtained from Dalhousie University's Health Sciences Research Ethics Board (Ref: 2022-6395). Informed consent will be obtained from participants prior to participating in an interview or stakeholder engagement meeting. Study findings will be disseminated through conference presentations, publications and infographics.
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Affiliation(s)
- Allyson J Gallant
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Audrey Steenbeek
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jeanna Parsons Leigh
- School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Janet A Curran
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
- Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada
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22
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Kelly KJ, Mears K, Doak S, Macartney G, Burns M, Loo J, Michael L, Jia BB, Montelpare W. Characteristics of immunisation support programmes in Canada: a scoping review and environmental scan. BMJ Open 2023; 13:e070400. [PMID: 36990478 PMCID: PMC10069581 DOI: 10.1136/bmjopen-2022-070400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE To identify, characterise and map the existing knowledge about programmes that provide immunisation support to Canadians and barriers and facilitators to their delivery. DESIGN Scoping review and environmental scan. INTRODUCTION Vaccine hesitancy may be associated with unmet support needs of individuals. Immunisation support programmes that provide multicomponent approaches can improve vaccine confidence and equitable access. INCLUSION CRITERIA Canadian programmes that focus on providing information about immunisation for the general public, but excluding articles targeting health professionals. The primary concept involves mapping the characteristics of programmes and our secondary concept examines barriers and facilitators to programme delivery. METHODS The Joanna Briggs Institute (JBI) methodology guided this review, reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A search strategy was developed and translated for six databases in November 2021 (updated October 2022). Unpublished literature was identified through the Canadian Agency for Drugs and Technologies in Health Grey Matters checklist and other relevant sources. Stakeholders (n=124) from Canadian regional health authorities were also contacted by email for publicly accessible information. Two independent raters screened and extracted data from identified material. Results are presented in tabular form. RESULTS The search strategy and environmental scan resulted in 15 287 sources. A total of 161 full-text sources were reviewed after applying eligibility criteria, resulting in 50 articles. Programmes were delivered in multiple Canadian provinces, focusing on various vaccine types. All programmes aimed to increase vaccine uptake and were mostly provided in person. Multidisciplinary delivery teams based on collaborations among multiple entities were credited as a facilitator to programme delivery across settings. Limitations on programme resources, attitudes of programme staff and participants, and systems organisation were identified as barriers to delivery. CONCLUSIONS This review highlighted characteristics of immunisation support programmes across various settings and described multiple facilitators and barriers. These findings can inform future interventions that aim to support Canadians in making decisions about immunisation.
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Affiliation(s)
- Katherine Jennifer Kelly
- Health Research Network, Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Kim Mears
- Data and Research Services, Robertson Library, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Sarah Doak
- Health Research Network, Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Gail Macartney
- Faculty of Nursing, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Margie Burns
- Faculty of Nursing, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Janet Loo
- Faculty of Nursing, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Laurie Michael
- Health Research Network, Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Bei Bei Jia
- Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - William Montelpare
- Health Research Network, Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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23
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Morgenroth DC, Knowlton T, Apkon S, Blauwet CA, Burns AS, Córdova Vallejos C, Frontera W, Hearn SL, Jayabalan P, Lim PA, Moroz A, Perret D, Powell D, Puderbaugh M, Rivers E, Sowa G, Verduzco-Gutierrez M, Celnik PA. Challenges and Opportunities in Academic Physiatry: An Environmental Scan. Am J Phys Med Rehabil 2023; 102:159-165. [PMID: 36634238 PMCID: PMC10233907 DOI: 10.1097/phm.0000000000002127] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
ABSTRACT Environmental scans determine trends in an organization's or field's internal and external environment. The results can help shape goals, inform strategic decision making, and direct future actions. The Association of Academic Physiatrists convened a strategic planning group in 2020, composed of physiatrists representing a diversity of professional roles, career stages, race and ethnicity, gender, disability status, and geographic areas of practice. This strategic planning group performed an environmental scan to assess the forces, trends, challenges, and opportunities affecting both the Association of Academic Physiatrists and the entire field of academic physiatry (also known as physical medicine and rehabilitation, physical and rehabilitation medicine, and rehabilitation medicine). This article presents aspects of the environmental scan thought to be most pertinent to the field of academic physiatry organized within the following five themes: (1) Macro/Societal Trends, (2) Technological Advancements, (3) Diversity and Global Outreach, (4) Economy, and (5) Education/Learning Environment. The challenges and opportunities presented here can provide a roadmap for the field to thrive within the complex and evolving healthcare systems in the United States and globally.
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Affiliation(s)
- David C. Morgenroth
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA, USA
| | | | - Susan Apkon
- Department of PM&R, Children’s Hospital Colorado/University of Colorado, Aurora, CO, USA
| | - Cheri A. Blauwet
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston MA, USA
| | - Anthony S. Burns
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Cecilia Córdova Vallejos
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Walter Frontera
- Department of Physical Medicine, Rehabilitation and Sports Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, USA
| | - Sandra L. Hearn
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Prakash Jayabalan
- Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Peter A. Lim
- Physical Medicine and Rehabilitation Service, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Alex Moroz
- Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Danielle Perret
- University of California, Irvine, Department of Physical Medicine and Rehabilitation, Orange, CA, USA
| | - Danielle Powell
- University of Alabama Heersink School of Medicine, Department of Physical Medicine and Rehabilitation, Birmingham, AL, USA
| | - Matt Puderbaugh
- Department of Physical Medicine and Rehabilitation, Hennepin Healthcare, Minneapolis, MN, USA
| | - Evan Rivers
- Physical Medicine and Rehabilitation Service, Tennessee Valley Healthcare System, Nashville, TN, USA
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical System, Nashville, TN, USA
| | - Gwendolyn Sowa
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- UPMC Rehabilitation Institute, Pittsburgh, PA, USA
| | - Monica Verduzco-Gutierrez
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Pablo A. Celnik
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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24
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Fahim C, Kasperavicius D, Beckett R, Quinn de Launay K, Chandraraj A, Crupi A, Theivendrampillai S, Straus SE. Funding change: An environmental scan of research funders’ knowledge translation strategic plans and initiatives across 10 high-income countries/regions. Facets (Ott) 2023. [DOI: 10.1139/facets-2022-0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Knowledge translation (KT) is the science and practice of dissemination and implementation of evidence. We describe how research funders operationalize and evaluate KT initiatives, identify challenges and opportunities, and suggest strategic considerations for KT support. We conducted an environmental scan, which included a systematic search of published and grey literature and a focus group with Canadian funders. A total of 130 published articles and 2415 grey literature sources were screened; 212 unique data sources were included. Published literature commonly described KT initiatives related to “KT practice and science funding.” These initiatives commonly provided funds for infrastructure development (e.g., clinical technologies, database subscriptions) to facilitate translational or applied research to address regional health priorities. Of the articles, 44% outlined an evaluation plan; few provided validated KT metrics. In the grey literature, 364 initiatives were described; the most commonly described initiatives related to “exchange and integrated KT.” Focus group participants hoped to see increased resources to support KT, exchange opportunities with policy/decision-makers, and evaluate KT initiatives. Funders completed various KT initiatives, which tended to engage stakeholders to set research priorities, collaborate with a range of stakeholders, build KT capacity, and mandate KT requirements. We provide six considerations for funders to support KT.
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Affiliation(s)
- Christine Fahim
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 30 Bond St, Toronto, M5B 1W8, Canada
| | - Danielle Kasperavicius
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 30 Bond St, Toronto, M5B 1W8, Canada
| | - Robyn Beckett
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 30 Bond St, Toronto, M5B 1W8, Canada
| | - Keelia Quinn de Launay
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 30 Bond St, Toronto, M5B 1W8, Canada
| | - Arthana Chandraraj
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 30 Bond St, Toronto, M5B 1W8, Canada
| | - Amanda Crupi
- Canadian Institutes of Health Research, 160 Elgin Street, 10th Floor, Ottawa, K1A 0W9, Canada
| | - Suvabna Theivendrampillai
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 30 Bond St, Toronto, M5B 1W8, Canada
| | - Sharon E. Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, Unity Health Toronto, 30 Bond St, Toronto, M5B 1W8, Canada
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25
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Kelley AT, Incze MA, Baylis JD, Calder SG, Weiner SJ, Zickmund SL, Jones AL, Vanneman ME, Conroy MB, Gordon AJ, Bridges JF. Patient-centered quality measurement for opioid use disorder: Development of a taxonomy to address gaps in research and practice. Subst Abus 2022; 43:1286-1299. [PMID: 35849749 PMCID: PMC9703846 DOI: 10.1080/08897077.2022.2095082] [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] [Indexed: 10/17/2022]
Abstract
Background: Evidence-based treatment is provided infrequently and inconsistently to patients with opioid use disorder (OUD). Treatment guidelines call for high-quality, patient-centered care that meets individual preferences and needs, but it is unclear whether current quality measures address individualized aspects of care and whether measures of patient-centered OUD care are supported by evidence. Methods: We conducted an environmental scan of OUD care quality to (1) evaluate patient-centeredness in current OUD quality measures endorsed by national agencies and in national OUD treatment guidelines; and (2) review literature evidence for patient-centered care in OUD diagnosis and management, including gaps in current guidelines, performance data, and quality measures. We then synthesized these findings to develop a new quality measurement taxonomy that incorporates patient-centered aspects of care and identifies priority areas for future research and quality measure development. Results: Across 31 endorsed OUD quality measures, only two measures of patient experience incorporated patient preferences and needs, while national guidelines emphasized providing patient-centered care. Among 689 articles reviewed, evidence varied for practices of patient-centered care. Many practices were supported by guidelines and substantial evidence, while others lacked evidence despite guideline support. Our synthesis of findings resulted in EQuIITable Care, a taxonomy comprised of six classifications: (1) patient Experience and engagement, (2) Quality of life; (3) Identification of patient risks; (4) Interventions to mitigate patient risks; (5) Treatment; and (6) Care coordination and navigation. Conclusions: Current quality measurement for OUD lacks patient-centeredness. EQuIITable Care for OUD provides a roadmap to develop measures of patient-centered care for OUD.
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Affiliation(s)
- A. Taylor Kelley
- Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Vulnerable Veteran Innovative Patient-aligned Care Team (VIP), VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Michael A. Incze
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jacob D. Baylis
- Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Vulnerable Veteran Innovative Patient-aligned Care Team (VIP), VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Spencer G. Calder
- Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Vulnerable Veteran Innovative Patient-aligned Care Team (VIP), VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Saul J. Weiner
- Center of Innovation for Complex Chronic Healthcare, Jesse Brown VA Chicago Health Care System, Chicago, Illinois, USA
- Division of Academic Internal Medicine and Geriatrics, Department of Medicine, The University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Susan L. Zickmund
- Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Audrey L. Jones
- Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Vulnerable Veteran Innovative Patient-aligned Care Team (VIP), VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Megan E. Vanneman
- Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Molly B. Conroy
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Adam J. Gordon
- Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Vulnerable Veteran Innovative Patient-aligned Care Team (VIP), VA Salt Lake City Health Care System, Salt Lake City, Utah, USA
- Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - John F.P. Bridges
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Patel A, Louie-Poon S, Kauser S, Lassi Z, Meherali S. Environmental scan of mobile apps for promoting sexual and reproductive health of adolescents in low- and middle-income countries. Front Public Health 2022; 10:993795. [PMID: 36504952 PMCID: PMC9727173 DOI: 10.3389/fpubh.2022.993795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background Adolescence is a period of emotional, mental, and physical change. To increase health seeking behaviors, reduce risky sexual behavior, and improve sexual and reproductive health (SRH) knowledge, adolescents require support and access to SRH services. Providing evidence-informed SRH knowledge to adolescents in low- and middle-income countries (LMICs) can be a challenge as they face unique barriers such as lack of confidentiality, fear of refusal, and stigma from cultural norms. Increasing availability of mobile apps necessitates a comprehensive evaluation of the quality and classification of these SRH mobile applications so that accurate and evidence-based information is reaching its users. Failure to provide SRH services can have damaging effects throughout their development. Objective Provide an overview of current adolescent SRH (ASRH) mobile applications targeting adolescents in LMICs by evaluating their quality and classifying their characteristics. Methods 21 search terms related to ASRH mobile apps was developed. These terms were searched in the Apple IOS store and Google Play stores. Inclusion and exclusion criteria were used to screen these apps. Resulting apps were assessed using the Mobile App Rating Scale (MARS) tool. Data extracted was used to rank order each app and identify any gaps in quality. Results Search strategy yielded 2,165 mobile apps. Of these, only 8 were assessed using the MARS tool. Functionality subdomain scored highest at 4.6, while Information scored lowest at 2.5. None of the assessed apps contained information on the MARS items: Evidence base and Goals. Too Shy to Ask had the highest individual app mean score of 4.1, while e-SRHR scored lowest at 2.3. Conclusions The goal of this study is to classify and rate the quality of mobile apps designed to promote ASRH behaviors and knowledge in LMICs. Numerous apps were reviewed and all of them failed to provide evidence-based and goal oriented SRH information. Strengths include ease of use, navigation, and gestural designs. Weaknesses include evidence base, goals, willingness to pay, customization, and interactivity. These findings can be potentially used to guide future app development and educate decision makers responsible for policy changes.
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Jose A, Sasseville M, Dequanter S, Gorus E, Giguère A, Bourbonnais A, Abbasgholizadeh Rahimi S, Buyl R, Gagnon MP. Existing eHealth Solutions for Older Adults living with Neurocognitive Disorders (Mild and Major) or Dementia and their Informal Caregivers: Protocol for an Environmental Scan (Preprint). JMIR Res Protoc 2022; 11:e41015. [DOI: 10.2196/41015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
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Middour-Oxler B, Hirschmann K, Chace C, Collins L, Gordon C, Mann M, Swope C, George C. “Acquiring the Skills Needed to Communicate What Is in Our Teams’ Heart: Love, Compassion and Partnership”: Qualitative Analysis of Intact Multidisciplinary Teams’ Experience of Relationship-Centered Communication Training. J Patient Exp 2022; 9:23743735221103025. [PMID: 35677227 PMCID: PMC9168940 DOI: 10.1177/23743735221103025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The Partnership Enhancement Program (PEP) is a 6-hour relationship-centered
communication training for intact cystic fibrosis (CF) teams. The aim of this
study was to analyze qualitative responses from survey participants regarding
their takeaways from the training. A total of 210 professionals participated in
20 pilot workshops at 19 care centers in the United States from November 2018 to
December 2019. After the workshop, qualitative feedback was captured by PEP
facilitators during a feedback gathering session or submitted immediately in
writing by participants. The manuscript team used grounded theory and
qualitative methods of coding to identify recurring themes across participant
responses. Thematic analysis revealed 5 primary themes and a web of
interconnected subthemes. Primary themes include the acquisition of skills to
improve communication, strengthened patient/provider connection, improved
quality of communication, improved team building, and the ability to change and
enhance practice. Participants who completed PEP training endorse acquiring
communication skills that increase coproduction of care with patients and
caregivers as well as improve relationships across the healthcare system.
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Affiliation(s)
- Brandi Middour-Oxler
- Children’s Healthcare of Atlanta + Emory University Cystic Fibrosis Care Center, Atlanta, GA, USA
| | | | - Carol Chace
- Children’s National Hospital, Washington, DC, USA
| | | | - Chandra Gordon
- University of Kansas Health System, Kansas City, KS, USA
| | - Michelle Mann
- Texas Children’s Hospital and Baylor College of Medicine, Houston, TX, USA
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Sikstrom L, Maslej MM, Hui K, Findlay Z, Buchman DZ, Hill SL. Conceptualising fairness: three pillars for medical algorithms and health equity. BMJ Health Care Inform 2022; 29:e100459. [PMID: 35012941 PMCID: PMC8753410 DOI: 10.1136/bmjhci-2021-100459] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/14/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Fairness is a core concept meant to grapple with different forms of discrimination and bias that emerge with advances in Artificial Intelligence (eg, machine learning, ML). Yet, claims to fairness in ML discourses are often vague and contradictory. The response to these issues within the scientific community has been technocratic. Studies either measure (mathematically) competing definitions of fairness, and/or recommend a range of governance tools (eg, fairness checklists or guiding principles). To advance efforts to operationalise fairness in medicine, we synthesised a broad range of literature. METHODS We conducted an environmental scan of English language literature on fairness from 1960-July 31, 2021. Electronic databases Medline, PubMed and Google Scholar were searched, supplemented by additional hand searches. Data from 213 selected publications were analysed using rapid framework analysis. Search and analysis were completed in two rounds: to explore previously identified issues (a priori), as well as those emerging from the analysis (de novo). RESULTS Our synthesis identified 'Three Pillars for Fairness': transparency, impartiality and inclusion. We draw on these insights to propose a multidimensional conceptual framework to guide empirical research on the operationalisation of fairness in healthcare. DISCUSSION We apply the conceptual framework generated by our synthesis to risk assessment in psychiatry as a case study. We argue that any claim to fairness must reflect critical assessment and ongoing social and political deliberation around these three pillars with a range of stakeholders, including patients. CONCLUSION We conclude by outlining areas for further research that would bolster ongoing commitments to fairness and health equity in healthcare.
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Affiliation(s)
- Laura Sikstrom
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Anthropology, University of Toronto, Toronto, Ontario, Canada
| | - Marta M Maslej
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Katrina Hui
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Zoe Findlay
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Z Buchman
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sean L Hill
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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