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Finley EP, Frankfurt SB, Kamdar N, Goodrich DE, Ganss E, Chen CJ, Eickhoff C, Krauss A, Connelly B, Seim RW, Goodman M, Geraci J. Partnership building for scale-up in the Veteran Sponsorship Initiative: Strategies for harnessing collaboration to accelerate impact in suicide prevention. Health Serv Res 2024. [PMID: 38689547 DOI: 10.1111/1475-6773.14309] [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] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE To evaluate the implementation and trust-building strategies associated with successful partnership formation in scale-up of the Veteran Sponsorship Initiative (VSI), an evidence-based suicide prevention intervention enhancing connection to U.S. Department of Veterans Affairs (VA) and other resources during the military-to-civilian transition period. DATA SOURCES AND STUDY SETTING Scaling VSI nationally required establishing partnerships across VA, the U.S. Department of Defense (DoD), and diverse public and private Veteran-serving organizations. We assessed partnerships formalized with a signed memorandum during pre- and early implementation periods (October 2020-October 2022). To capture implementation activities, we conducted 39 periodic reflections with implementation team members over the same period. STUDY DESIGN We conducted a qualitative case study evaluating the number of formalized VSI partnerships alongside directed qualitative content analysis of periodic reflections data using Atlas.ti 22.0. DATA COLLECTION/EXTRACTION METHODS We first independently coded reflections for implementation strategies, following the Expert Recommendations for Implementing Change (ERIC) taxonomy, and for trust-building strategies, following the Theoretical Model for Trusting Relationships and Implementation; a second round of inductive coding explored emergent themes associated with partnership formation. PRINCIPAL FINDINGS During this period, VSI established 12 active partnerships with public and non-profit agencies. The VSI team reported using 35 ERIC implementation strategies, including building a coalition and developing educational and procedural documents, and trust-building strategies including demonstrating competence and credibility, frequent interactions, and responsiveness. Cultural competence in navigating DoD and VA and accepting and persisting through conflict also appeared to support scale-up. CONCLUSIONS VSI's partnership-formation efforts leveraged a variety of implementation strategies, particularly around strengthening stakeholder interrelationships and refining procedures for coordination and communication. VSI implementation activities were further characterized by an intentional focus on trust-building over time. VSI's rapid scale-up highlights the value of partnership formation for achieving coordinated interventions to address complex problems.
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Affiliation(s)
- Erin P Finley
- Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Sheila B Frankfurt
- VISN 17 Center of Excellence (CoE) on Research for Returning War Veterans, Waco, Texas, USA
- Central Texas Veterans Health Care System, Temple, Texas, USA
| | - Nipa Kamdar
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
| | - David E Goodrich
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
- Transitioning Servicemember and Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, New York, New York, USA
| | - Elyse Ganss
- Transitioning Servicemember and Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, New York, New York, USA
- Teacher's College, Columbia University, New York, New York, USA
| | - Chien J Chen
- Veterans Health Administration National Center for Healthcare Advancement and Partnerships, Washington, DC, USA
| | - Christine Eickhoff
- Veterans Health Administration National Center for Healthcare Advancement and Partnerships, Washington, DC, USA
| | - Alison Krauss
- VISN 17 Center of Excellence (CoE) on Research for Returning War Veterans, Waco, Texas, USA
- Central Texas Veterans Health Care System, Temple, Texas, USA
| | - Brigid Connelly
- Transitioning Servicemember and Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, New York, New York, USA
- Teacher's College, Columbia University, New York, New York, USA
- Denver Center of Innovation for Veteran-Centered and Value-Driven Care, VA Eastern Colorado Health Care System, Aurora, Colorado, USA
| | - Richard W Seim
- VISN 17 Center of Excellence (CoE) on Research for Returning War Veterans, Waco, Texas, USA
- Central Texas Veterans Health Care System, Temple, Texas, USA
| | - Marianne Goodman
- Transitioning Servicemember and Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, New York, New York, USA
| | - Joseph Geraci
- VISN 17 Center of Excellence (CoE) on Research for Returning War Veterans, Waco, Texas, USA
- Transitioning Servicemember and Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, New York, New York, USA
- Teacher's College, Columbia University, New York, New York, USA
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Sowers DJ, Wilkinson KM. Speech-Language Pathologists' Approach to Alternative Access for Augmentative and Alternative Communication for Children With Motor Impairments. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:774-790. [PMID: 38085653 DOI: 10.1044/2023_ajslp-23-00129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
PURPOSE This study examined the processes that speech-language pathologists (SLPs) use during an augmentative and alternative communication (AAC) assessment with children with motor impairments to determine alternative access solutions. These children often are the most vulnerable to a poor fit of their AAC system, which alternative access is an integral part. Although there is an abundance of information as to what types of considerations should be made during these assessments, there is no guidance as to how the assessment is completed. The goal of this study is to build evidence about the process. METHOD A collective case design was used to gain detailed insights into the decision-making process. Interviews and vignette responses were two components of the data collection. Each of the five SLPs, or cases, who participated in the study transcripts was analyzed in isolation as part of a within-case analysis. Once each SLP's process was understood, a cross-case comparison was completed to ascertain similarities or differences across the five. RESULTS The cross-case assertions are presented in this article. Although the SLPs individually reported a lack of defined process, a clear systemization became evident when considered collectively. The SLPs all focused on the child, isolated motor access skills, and used a process of experimentation over time to build their final recommendations. CONCLUSIONS These results have implications for SLPs working with children with motor impairments who may benefit from AAC intervention. The shared framework can serve as a roadmap to other SLPs, especially those with less experience with these types of complex cases. The varying teaming approaches to support these cases are also discussed.
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Affiliation(s)
- Dawn J Sowers
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
| | - Krista M Wilkinson
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
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Zelčāne E, Pipere A. Finding a path in a methodological jungle: a qualitative research of resilience. Int J Qual Stud Health Well-being 2023; 18:2164948. [PMID: 36606329 PMCID: PMC9828684 DOI: 10.1080/17482631.2023.2164948] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023] Open
Abstract
Qualitative research provides an in-depth understanding of lived experiences. However, these experiences can be hard to apprehend by using just one method of data analysis. A good example is the experience of resilience. In this paper, the authors describe the chain of the decision-making process in the research of the construct of "resilience". s The authors justify the implications of a multi-method, pluralistic approach, and show how the triangulation of two or more qualitative methods and integration of several qualitative data analysis methods can improve a deeper understanding of the resilience among people with chronic pain. By combining the thematic analysis, narrative analysis, and critical incident technique, lived experiences can be seen from different perspectives.Therefore, the thematic analysis describes the content and answers to "what" regarding resilience, the narrative analysis describes the dynamics of resilience, and answers to "how", while the critical incident technique clarifies the most significant experience and the answers to "why" changes happen. This integrative approach could be used in the analysis of other psychological constructs and can serve as an example of how the rigour of qualitative research could be provided.
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Affiliation(s)
- Elīna Zelčāne
- Department of Health Psychology and Paedagogy, Riga Stradiņš University, Riga, Latvia
| | - Anita Pipere
- Department of Health Psychology and Paedagogy, Riga Stradiņš University, Riga, Latvia
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Geraldina AM, Suen MW, Suanrueang P. Online mental health services during COVID-19 pandemic in Indonesia: Challenges from psychologist perspective. PLoS One 2023; 18:e0285490. [PMID: 37352238 PMCID: PMC10289369 DOI: 10.1371/journal.pone.0285490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/25/2023] [Indexed: 06/25/2023] Open
Abstract
COVID-19 are causing many psychological impacts and change many aspects of human life. Mental health services also experiencing changes because of COVID-19 outbreak. In Indonesia, COVID-19 outbreak prompted the rapid development of online mental health services. These online mental health services which will help people to connect with professional mental healthcare providers using technology were created in response to this pandemic. Therefore, converting mental health services into online services in a state of urgency is challenging. This qualitative case study aims to provide a map of the service challenges that professional healthcare providers face while providing online services at present time by interviewing eight Indonesian psychologists as one of the mental health professionals who provided the online mental health services. Semi-structured interviews were done using interview guidelines with open-ended questions, and any other complementary data was collected using questionnaire. The data gathered from interviews was first performed through triangulation and then analyzed using thematic network analysis, which resulted in the following challenges: (1) building engagement; (2) risk of getting distracted during the sessions; (3) maintaining professional boundaries during the sessions; (4) keeping the personal information and confidentiality of the sessions; (5) perceived efficacy; and (6) attitudes towards online sessions. According to the results, the relevant organization can use this finding to contribute and develop the online mental health services both in this COVID-19 situation and in the future.
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Affiliation(s)
- Alma Marikka Geraldina
- Department of Healthcare Administration Specialty in Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Department of Psychology, Asia University, Taichung, Taiwan
- Faculty of Psychology, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Mein-Woei Suen
- Department of Psychology, Asia University, Taichung, Taiwan
- Gender Equality Education and Research Center, Asia University, Taichung, Taiwan
- Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Passakorn Suanrueang
- Department of Healthcare Administration Specialty in Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Department of Psychology, Asia University, Taichung, Taiwan
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Shaw SE, Paparini S, Murdoch J, Green J, Greenhalgh T, Hanckel B, James HM, Petticrew M, Wood GW, Papoutsi C. TRIPLE C reporting principles for case study evaluations of the role of context in complex interventions. BMC Med Res Methodol 2023; 23:115. [PMID: 37179308 PMCID: PMC10182844 DOI: 10.1186/s12874-023-01888-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 03/15/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Guidance and reporting principles such as CONSORT (for randomised trials) and PRISMA (for systematic reviews) have greatly improved the reporting, discoverability, transparency and consistency of published research. We sought to develop similar guidance for case study evaluations undertaken to explore the influence of context on the processes and outcomes of complex interventions. METHODS A range of experts were recruited to an online Delphi panel, sampling for maximum diversity in disciplines (e.g. public health, health services research, organisational studies), settings (e.g. country), and sectors (e.g. academic, policy, third sector). To inform panel deliberations, we prepared background materials based on: [a] a systematic meta-narrative review of empirical and methodological literatures on case study, context and complex interventions; [b] the collective experience of a network of health systems and public health researchers; and [c] the established RAMESES II standards (which cover one kind of case study). We developed a list of topics and issues based on these sources and encouraged panel members to provide free text comments. Their feedback informed development of a set of items in the form of questions for potential inclusion in the reporting principles. We circulated these by email, asking panel members to rank each potential item twice (for relevance and validity) on a 7-point Likert scale. This sequence was repeated twice. RESULTS We recruited 51 panel members from 50 organisations across 12 countries, who brought experience of a range of case study research methods and applications. 26 completed all three Delphi rounds, reaching over 80% consensus on 16 items covering title, abstract, definitions of terms, philosophical assumptions, research question(s), rationale, how context and complexity relates to the intervention, ethical approval, empirical methods, findings, use of theory, generalisability and transferability, researcher perspective and influence, conclusions and recommendations, and funding and conflicts of interest. CONCLUSION The 'Triple C' (Case study, Context, Complex interventions) reporting principles recognise that case studies are undertaken in different ways for different purposes and based on different philosophical assumptions. They are designed to be enabling rather than prescriptive, and to make case study evaluation reporting on context and complex health interventions more comprehensive, accessible and useable.
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Affiliation(s)
- Sara E Shaw
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK.
| | - Sara Paparini
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Jamie Murdoch
- School of Life Course and Population Sciences, King's College London, London, UK
| | - Judith Green
- Wellcome Centre for Cultures & Environments of Health, University of Exeter, Exeter, UK
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK
| | - Benjamin Hanckel
- Institute for Culture and Society, Western Sydney University, Sydney, Australia
| | - Hannah M James
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK
| | - Mark Petticrew
- Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Gary W Wood
- Independent Research Consultant, Birmingham, UK
| | - Chrysanthi Papoutsi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK
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Copeland L, Littlecott HJ, Couturiaux D, Hoddinott P, Segrott J, Murphy S, Moore G, Evans RE. Adapting population health interventions for new contexts: qualitative interviews understanding the experiences, practices and challenges of researchers, funders and journal editors. BMJ Open 2022; 12:e066451. [PMID: 36288840 PMCID: PMC9615984 DOI: 10.1136/bmjopen-2022-066451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Research on the adaptation of population health interventions for implementation in new contexts is rapidly expanding. This has been accompanied by a recent increase in the number of frameworks and guidance to support adaptation processes. Nevertheless, there remains limited exploration of the real-world experiences of undertaking intervention adaptation, notably the challenges encountered by different groups of stakeholders, and how these are managed. Understanding experiences is imperative in ensuring that guidance to support adaptation has practical utility. This qualitative study examines researcher and stakeholder experiences of funding, conducting and reporting adaptation research. SETTING Adaptation studies. PARTICIPANTS Participants/cases were purposefully sampled to represent a range of adapted interventions, types of evaluations, expertise and countries. Semistructured interviews were conducted with a sample of researchers (n=23), representatives from research funding panels (n=6), journal editors (n=5) and practitioners (n=3). MEASURES A case study research design was used. Data were analysed using the framework approach. Overarching themes were discussed within the study team, with further iterative refinement of subthemes. RESULTS The results generated four central themes. The first three relate to the experience of intervention adaptation (1) involving stakeholders throughout the adaptation process and how to integrate the evidence base with experience; (2) selecting the intervention and negotiating the mismatch between the original and the new context; and (3) the complexity and uncertainty when deciding the re-evaluation process. The final theme (4) reflects on participants' experiences of using adaptation frameworks in practice, considering recommendations for future guidance development and refinement. CONCLUSION This study highlights the range of complexities and challenges experienced in funding, conducting and reporting research on intervention adaptation. Moving forward, guidance can be helpful in systematising processes, provided that it remains responsive to local contexts and encourage innovative practice.
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Affiliation(s)
- Lauren Copeland
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Hannah J Littlecott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
- Pettenkofer School of Public Health (PSPH), Institute for Medical Information Processing, Biometry and Epidemiology, LMU, Munchen, Bayern, Germany
| | - Danielle Couturiaux
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
| | - Jeremy Segrott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Simon Murphy
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Graham Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Rhiannon E Evans
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
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Sangeetha J, Mohan S, Hariharasudan A, Nawaz N. Strategic analysis of intimate partner violence (IPV) and cycle of violence in the autobiographical text - When I Hit You. Heliyon 2022; 8:e09734. [PMID: 35761928 PMCID: PMC9233205 DOI: 10.1016/j.heliyon.2022.e09734] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/03/2021] [Accepted: 06/10/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives Intimate Partner Violence (IPV) is a globally recognized societal problem that requires intensive research to raise public awareness. Aim Accordingly, the purpose of the study is to analyze IPV at the physical, psychological, and social aspects of abuse. Method The methodology of the study correlates IPV to the personal experiences of notable Indian writer, Meena Kandasamy, according to the autobiographical account of her abusive married life in the award-winning novel When I Hit You, which depicts the horrible treatment of women by their perpetrators within a closed sphere. To substantiate, the selected autobiographical work is compared with Lenore Edna Walker’s prominent Cycle of Violence theory, which best describes why women become victims and also the abuser’s tactics in controlling the women in a violent relationship. Results The study’s findings suggest that IPV, a serious global problem, requires government intervention and severe legal enforcement to protect women’s lives from the clutches of the abuser.
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Affiliation(s)
- J. Sangeetha
- Research Scholar, Kalasalingam Academy of Research and Education, Anand Nagar, Krishnankoil, 626126, Tamil Nadu, India
| | - S. Mohan
- Faculty of English, Kalasalingam Academy of Research and Education, Anand Nagar, Krishnankoil, 626126, Tamil Nadu, India
| | - A. Hariharasudan
- Faculty of English, Kalasalingam Academy of Research and Education, Anand Nagar, Krishnankoil, 626126, Tamil Nadu, India
- Corresponding author.
| | - Nishad Nawaz
- Department of Business Management, College of Business Administration, Kingdom University, Riffa, 40434, Bahrain
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"I see your punitive measure and I raise you a person-centered bar": Supervisory Strategies to Promote Adoption of Person-Centered Care. Community Ment Health J 2021; 57:1595-1603. [PMID: 33566270 PMCID: PMC8353014 DOI: 10.1007/s10597-021-00783-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/22/2021] [Indexed: 10/22/2022]
Abstract
Person-centered care remains a high priority within community mental health services. Clinical supervision is an embedded resource for professional development and promotion of high quality care. This study examined supervisory strategies during the implementation of person-centered care planning (PCCP) across two northeastern US States. A criterion sample of supervisor-provider teams participated in qualitative interviews (N = 34) and direct observation from 2016 to 2017. Modified grounded theory analyses were conducted and three supervisory strategies were identified. Supervisory attunement to providers (knowing their audience), active collaborative engagement with providers (practicing together), and infusing reminders and opportunities for feedback (chipping away) were critical strategies to engage providers in adopting PCCP. These strategies changed providers' practice patterns by improving supervisors' calibration to dynamic contextual and individual needs during implementation and communicating supervisors' expectations of PCCP enactment. Workplace-based clinical supervision holds promise as a key intervention point to embed high quality care.
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Copeland L, Littlecott H, Couturiaux D, Hoddinott P, Segrott J, Murphy S, Moore G, Evans R. The what, why and when of adapting interventions for new contexts: A qualitative study of researchers, funders, journal editors and practitioners' understandings. PLoS One 2021; 16:e0254020. [PMID: 34242280 PMCID: PMC8270163 DOI: 10.1371/journal.pone.0254020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/17/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The adaptation of interventions for new contexts is a rapidly developing research area. To date there is no consensus-based guidance to support decision-making and recommend adaptation processes. The ADAPT study is developing such guidance. This aim of the qualitative component of the study was to explore stakeholders' understandings of adaptation, as to date there has limited consideration of how different concepts and meanings shape decision-making and practice. METHODS A case study research design was used. Participants/cases were purposefully sampled based on study outcome, study design, expertise, context and country. Semi-structured interviews were conducted with a sample of researchers (n = 23); representatives from research funding panels (n = 6); journal editors (n = 5) and practitioners (n = 3). Data were analysed using the Framework approach. Overarching themes were discussed with the ADAPT study team, with further iterative refinement of subthemes. RESULTS The results generated four central themes. Four themes related to stakeholders' understanding: 1) definitions of adaptation and related concepts; 2) rationales for undertaking adaptation; 3) the appropriate timing for adaptation; and 4) ensuring fidelity when implementing adapted interventions. CONCLUSION The findings highlight the lack of clarity around key concepts and uncertainty about central decision-making processes, notably why interventions should be adapted, when and to what extent. This has informed the ADAPT study's guidance, shaping the scope and nature of recommendations to be included and surfacing key uncertainties that require future consideration.
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Affiliation(s)
- Lauren Copeland
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Hannah Littlecott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Danielle Couturiaux
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Pat Hoddinott
- Primary Care, Stirling University, Stirling, Scotland, United Kingdom
| | - Jeremy Segrott
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Centre for Trials Research, Cardiff University, Cardiff, Wales, United Kingdom
| | - Simon Murphy
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Graham Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Rhiannon Evans
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, Wales, United Kingdom
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The Selection Process and Criteria of Impact Accelerators. An Exploratory Study. SUSTAINABILITY 2021. [DOI: 10.3390/su13126617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Start-up accelerators, a relatively new and competitive type of business incubators, are nowadays considered to be a highly effective way of providing venture support. Start-ups who have been supported through accelerators have an approximately 23% higher survival rate than other new businesses. This positive effect can be explained by the highly selective process accelerators apply when deciding on which venture projects to support. It comes as no surprise that understanding this process and the respective selection criteria is at the core of accelerator/incubator literature within entrepreneurship research. Existing research is however limited to the investigation of commercial accelerators which provide support to start-ups having an economic purpose only. Hence those academic findings cannot be simply extrapolated to accelerators supporting ventures combining economic goals with social and ecological purpose. Given the growing meaning of sustainability entrepreneurship and hence the increasing number of sustainability-oriented accelerators, the above limitation seems to be an important research gap. This paper addresses the above gap by investigating the selection processes and criteria of so-called impact accelerators focusing on the support of start-ups expected to create not only economic outcomes but also positive social and/or environmental impact. Building on existing accelerator literature, we qualitatively investigate the selection processes and criteria of nine European impact accelerators. By comparing our findings with existing research, we identify important differences between the selection approach of commercial and impact accelerators thus contributing to sustainability entrepreneurship research and practice.
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Rice JG, Bjargardóttir HB, Sigurjónsdóttir HB. Child Protection, Disability and Obstetric Violence: Three Case Studies from Iceland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E158. [PMID: 33379294 PMCID: PMC7796032 DOI: 10.3390/ijerph18010158] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/18/2020] [Accepted: 12/25/2020] [Indexed: 11/16/2022]
Abstract
This contribution is a collective re-analysis of three research projects in Iceland focused on parenting with a disability which draws upon data spanning a twenty-year period. The core purpose of these projects is to understand why parents with primarily intellectual disabilities encounter such difficulties with the child protection system. Our aim with this contribution is to identify, through a longitudinal and comparative framework, why these difficulties persist despite a changing disability rights environment. A case study methodology has been employed highlighting three cases, one from each research project, which focus narrowly on disabled parents' struggles with the child protection system in the context of the maternity ward. The findings, framed in the concept of structural violence, indicate poor working practices on the part of healthcare and child protection, a lack of trust, and that context is still ignored in favour of disability as the explanatory framework for the perceived inadequacies of the parents. We contend that child protection authorities continue to remain out of step with developments in disability and human rights. The contribution concludes to make a case as to why the concept of obstetric violence is a useful framework for criticism and advocacy work in this area.
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Affiliation(s)
- James Gordon Rice
- School of Social Sciences, University of Iceland, 105 Reykjavík, Iceland;
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Goldman J, Kuper A, Baker GR, Bulmer B, Coffey M, Jeffs L, Shea C, Whitehead C, Shojania KG, Wong B. Experiential Learning in Project-Based Quality Improvement Education: Questioning Assumptions and Identifying Future Directions. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:1745-1754. [PMID: 32079957 DOI: 10.1097/acm.0000000000003203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE Project-based experiential learning is a defining element of quality improvement (QI) education despite ongoing challenges and uncertainties. The authors examined stakeholders' perceptions and experiences of QI project-based learning to increase understanding of factors that influence learning and project experiences. METHOD The authors used a case study approach to examine QI project-based learning in 3 advanced longitudinal QI programs, 2 at the University of Toronto and 1 at an academic tertiary-care hospital. From March 2016 to June 2017, they undertook 135 hours of education program observation and 58 interviews with learners, program directors, project coaches, and institutional leaders and reviewed relevant documents. They analyzed data using a conventional and directed data analysis approach. RESULTS The findings provide insight into 5 key factors that influenced participants' project-based learning experiences and outcomes: (1) variable emphasis on learning versus project objectives and resulting benefits, tensions, and consequences; (2) challenges integrating the QI project into the curriculum timeline; (3) project coaching factors (e.g., ability, capacity, role clarity); (4) participants' differing access to resources and ability to direct a QI project given their professional roles; and (5) workplace environment influence on project success. CONCLUSIONS The findings contribute to an empirical basis toward more effective experiential learning in QI by identifying factors to target and optimize. Expanding conceptualizations of project-based learning for QI education beyond learner-initiated, time-bound projects, which are at the core of many QI educational initiatives, may be necessary to improve learning and project outcomes.
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Affiliation(s)
- Joanne Goldman
- J. Goldman is assistant professor, Department of Medicine, scientist, Centre for Quality Improvement and Patient Safety, and cross-appointed researcher, Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0003-1589-4070
| | - Ayelet Kuper
- A. Kuper is associate professor, Department of Medicine, scientist and associate director, Wilson Centre for Research in Education, University Health Network, University of Toronto, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - G Ross Baker
- G.R. Baker is professor and program lead, Quality Improvement and Patient Safety, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Beverly Bulmer
- B. Bulmer is vice president, Education, St. Michael's Hospital, Unity Health Toronto, and lecturer, Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Maitreya Coffey
- M. Coffey is associate professor, Department of Paediatrics, University of Toronto, medical officer for patient safety, Hospital for Sick Children, Toronto, Ontario, Canada, and associate clinical director, Children's Hospitals Solutions for Patient Safety, Cincinnati, Ohio
| | - Lianne Jeffs
- L. Jeffs is research and innovation lead scholar in residence and senior clinician scientist, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, associate professor, Lawrence S. Bloomberg Faculty of Nursing, Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, and affiliate scientist, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Christine Shea
- C. Shea is program director and lecturer, Quality Improvement and Patient Safety, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Cynthia Whitehead
- C. Whitehead is professor, Department of Family and Community Medicine, director and scientist, Wilson Centre for Research in Education, University Health Network, University of Toronto, and vice president of education, Women's College Hospital, Toronto, Ontario, Canada
| | - Kaveh G Shojania
- K.G. Shojania is professor and vice chair, Department of Medicine, Faculty of Medicine, University of Toronto, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0002-9942-0130
| | - Brian Wong
- B. Wong is associate professor, Department of Medicine, University of Toronto, director, Centre for Quality Improvement and Patient Safety, Faculty of Medicine, University of Toronto, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Gagnon M, Guta A, Upshur R, Murray SJ, Bungay V. "It gets people through the door": a qualitative case study of the use of incentives in the care of people at risk or living with HIV in British Columbia, Canada. BMC Med Ethics 2020; 21:105. [PMID: 33109165 PMCID: PMC7590593 DOI: 10.1186/s12910-020-00548-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/16/2020] [Indexed: 11/22/2022] Open
Abstract
Background There has been growing interest in the use of incentives to increase the uptake of health-related behaviours and achieve desired health outcomes at the individual and population level. However, the use of incentives remains controversial for ethical reasons. An area in which incentives have been not only proposed but used is HIV prevention, testing, treatment and care—each one representing an interconnecting step in the "HIV Cascade." Methods The main objective of this qualitative case study was to document the experiences of health care and service providers tasked with administrating incentivized HIV testing, treatment, and care in British Columbia, Canada. A second objective was to explore the ethical and professional tensions that arise from the use of incentives as well as strategies used by providers to mitigate them. We conducted interviews with 25 providers and 6 key informants, which were analyzed using applied thematic analysis. We also collected documents and took field notes. Results Our findings suggest that incentives target populations believed to pose the most risk to public health. As such, incentives are primarily used to close the gaps in the HIV Cascade by getting the "right populations" to test, start treatment, stay on treatment, and, most importantly, achieve (and sustain) viral suppression. Participants considered that incentives work because they "bring people through the door." However, they believed the effectiveness of incentives to be superficial, short-lived and one-dimensional—thus, failing to address underlying structural barriers to care and structural determinants of health. They also raised concerns about the unintended consequences of incentives and the strains they may put on the therapeutic relationship. They had developed strategies to mitigate the ensuing ethical and professional tensions and to make their work feel relational rather than transactional. Conclusions We identify an urgent need to problematize the use of incentives as a part of the "HIV Cascade" agenda and interrogate the ethics of engaging in this practice from the perspective of health care and service providers. More broadly, we question the introduction of market logic into the realm of health care—an area of life previously not subject to monetary exchanges.
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Affiliation(s)
- Marilou Gagnon
- Canadian Institute for Substance Use Research, University of Victoria, 2300 McKenzie Ave, Victoria, BC, V8N 5M8, Canada.
| | - Adrian Guta
- School of Social Work, University of Windsor, 167 Ferry Street, Windsor, ON, N9A 0C5, Canada
| | - Ross Upshur
- Dalla Lana Chair in Clinical Public Health, Dalla Lana School of Public Health, 678-155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Stuart J Murray
- Canada Research Chair in Rhetoric and Ethics, Department of English Language and Literature, Carleton University, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada
| | - Vicky Bungay
- Canada Research Chair in Gender, Equity and Community Engagement, School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T2B5, Canada
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Bergström A, Ehrenberg A, Eldh AC, Graham ID, Gustafsson K, Harvey G, Hunter S, Kitson A, Rycroft-Malone J, Wallin L. The use of the PARIHS framework in implementation research and practice-a citation analysis of the literature. Implement Sci 2020; 15:68. [PMID: 32854718 PMCID: PMC7450685 DOI: 10.1186/s13012-020-01003-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. Despite a growing number of citations of theoretical frameworks including PARIHS, details of how theoretical frameworks are used remains largely unknown. This review aimed to enhance the understanding of the breadth and depth of the use of the PARIHS framework. METHODS This citation analysis commenced from four core articles representing the key stages of the framework's development. The citation search was performed in Web of Science and Scopus. After exclusion, we undertook an initial assessment aimed to identify articles using PARIHS and not only referencing any of the core articles. To assess this, all articles were read in full. Further data extraction included capturing information about where (country/countries and setting/s) PARIHS had been used, as well as categorizing how the framework was applied. Also, strengths and weaknesses, as well as efforts to validate the framework, were explored in detail. RESULTS The citation search yielded 1613 articles. After applying exclusion criteria, 1475 articles were read in full, and the initial assessment yielded a total of 367 articles reported to have used the PARIHS framework. These articles were included for data extraction. The framework had been used in a variety of settings and in both high-, middle-, and low-income countries. With regard to types of use, 32% used PARIHS in planning and delivering an intervention, 50% in data analysis, 55% in the evaluation of study findings, and/or 37% in any other way. Further analysis showed that its actual application was frequently partial and generally not well elaborated. CONCLUSIONS In line with previous citation analysis of the use of theoretical frameworks in implementation science, we also found a rather superficial description of the use of PARIHS. Thus, we propose the development and adoption of reporting guidelines on how framework(s) are used in implementation studies, with the expectation that this will enhance the maturity of implementation science.
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Affiliation(s)
- Anna Bergström
- Department of Women’s and Children’s health, Uppsala Global Health Research on Implementation and Sustainability (UGHRIS), Uppsala, Sweden
- Institute for Global Health, University College London, London, UK
| | - Anna Ehrenberg
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Ann Catrine Eldh
- Department of Medicine and Health, Linköping University, Linköping, Sweden
- Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden
| | - Ian D. Graham
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Kazuko Gustafsson
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- University Library, Uppsala University, Uppsala, Sweden
| | - Gillian Harvey
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Sarah Hunter
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Alison Kitson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Green Templeton College, University of Oxford, Oxford, UK
| | - Jo Rycroft-Malone
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancashire, UK
| | - Lars Wallin
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- Department of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Halsall T, Lachance L, Kristjansson AL. Examining the implementation of the Icelandic model for primary prevention of substance use in a rural Canadian community: a study protocol. BMC Public Health 2020; 20:1235. [PMID: 32795290 PMCID: PMC7426669 DOI: 10.1186/s12889-020-09288-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/23/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Icelandic Prevention Model (IPM) is a collaborative upstream model that was designed to influence risk and protective factors related to substance use within the community, school, peer and family contexts. By engaging whole communities, the IPM has been found to be effective in reducing youth substance use behaviours across Iceland. As an extension to the IPM's participatory approach, this research will examine how youth involvement can enhance outcomes. In addition, this research will evaluate whether the IPM approach is beneficial for mental health promotion and general youth wellbeing. METHODS The present research protocol applies the bioecological model within a participatory mixed-method case study design to examine the implementation of the IPM in a rural community in Canada. This study was designed to identify whether the Icelandic substance use prevention model is effective in reducing substance use and promoting mental health and development for Canadian youth. It will also explore how to engage youth within the approach and how this adaptation influences implementation and outcomes. DISCUSSION The findings from this study will contribute to our understanding of upstream prevention of youth substance use and will be used to support scaling of the IPM across Canada.
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Affiliation(s)
- Tanya Halsall
- Youth Research Unit, The Royal's Institute of Mental Health Research affiliated with the University of Ottawa, 1145 Carling Ave, Ottawa, Ontario, K1Z 7K4, Canada.
| | - Lisa Lachance
- Faculty of Health, Dalhousie University, 6299 South St, Halifax, NS, B3H 4R2, Canada
| | - Alfgeir L Kristjansson
- School of Public Health, RC Byrd Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA
- Icelandic Center for Social Research and Analysis, Reykjavik University, 1 Menntavegur, 101, Reykjavík, Iceland
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Dos Santos LM. How Does COVID-19 Pandemic Influence the Sense of Belonging and Decision-Making Process of Nursing Students: The Study of Nursing Students' Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5603. [PMID: 32756506 PMCID: PMC7432888 DOI: 10.3390/ijerph17155603] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 12/13/2022]
Abstract
Financial consideration, internal and external influence, personal goal, and educational achievement always influence the decision-making process and behavior of individuals. Using nursing students as the population, the researcher employed the Social Cognitive Career Theory as the theoretical framework to examine the nursing human resources shortages and how would the COVID-19 pandemic influence the experiences, sense of belonging, and career decision-making process of 58 nursing students in South Korea. The researcher categorized the sharing into two groups, which were before the influence of the COVID-19 pandemic, and the changes during the COVID-19 pandemic. The results indicated that financial consideration was the significant reason why South Korean nursing students decided to study nursing regardless of the COVID-19 pandemic. More importantly, almost all participants decided to leave the nursing profession due to the COVID-19 pandemic and the consideration between financial factor and personal sacrifice. The outcomes of this study provided a blueprint for human resources professionals, government leaders, policymakers, school leaders, and hospital managers to reform their current curriculum and human resources planning to overcome the potential human resources gaps in the soon future due to the COVID-19 pandemic.
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Abstract
Following global trends, nature-based tourism in the Aysén region of Chilean Patagonia has grown dramatically in recent years. This growth has challenged traditional economic activities derived from commodification of natural resources, including ranching, logging, and mining. A qualitative research study conducted in 2016–2017 used semi-structured interviews and focus groups to investigate how local residents perceived the changes that accompany rural development around the nationally protected area of Cerro Castillo, projected to be one of the region’s protected areas that will drive economic development through tourism in coming decades. Results identified several themes reminiscent of the rural transition that took place in the western United States in the mid to late-1900s. During this era, the remote, rugged, wild frontier lands of the sparsely populated intermountain west shifted from an economy grounded in extractive industries to a service-based one, geared towards amenity migrants and tourists seeking recreation opportunities and closeness to nature. Patterns and lessons are drawn between similar transitions across geographies and timescales, which may assist planners with understandings of trends and tendencies as tourism continues to influence rural transition in Patagonia.
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Abstract
The number of biomedical PhD scientists undergoing training and graduating far exceeds the number of academic faculty positions and academic research jobs. This trend compels biomedical PhD scientists to increasingly seek career paths outside of academia. Prior studies have used quantitative methodology to determine trends and outcomes of single factors contributing to this shift, but there is a literature gap in studies considering multiple factors and in qualitative work focusing on biomedical PhD scientists’ experiences and their processes of career navigation. This paper draws on a social cognitive career theory (SCCT) framework and incorporates case study data from a southeastern Tier 1 research university to explore a nexus of factors influencing PhD scientists’ employment sector preferences and job search processes. It simultaneously concludes that relationships with faculty, particularly the mentor advisor, are essential to the opportunities available to these professionals and to the career paths they choose.
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Affiliation(s)
- Andrea M. Zimmerman
- Department of Education, Northeastern University, Boston, Massachusetts, United States of America
- * E-mail:
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Neris RR, Zago MMF, Ribeiro MÂ, Porto JP, Anjos ACYD. Experience of the spouse of a woman with breast cancer undergoing chemotherapy: a qualitative case study. ESCOLA ANNA NERY 2018. [DOI: 10.1590/2177-9465-ean-2018-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Abstract Objective: To identify the meaning attributed to the experience of a spouse of a woman with breast cancer undergoing chemotherapy. Methods: Descriptive study, with a theoretical-methodological orientation based on medical anthropology and utilizing an ethnographic case study strategy. Data were collected through semi-structured interviews and participant observation. Results: The meanings revealed that the diagnosis cause suffering. Chemotherapy was seen as giving hope of healing the wife's cancer. During this process, the spouse had to deal with the strong adverse effects of the treatment and subordinate to his wife to reduce the conflict experienced by the couple, which violated the rules of his masculinity. Religion and family were important support networks on this path. Final considerations and implications for practice: The results showed the importance of considering cultural aspects of spouses when they are faced with disease in their wives. The way spouses deal with breast cancer will depend on their cultural systems. Nursing care must be comprehensive and extend to spouses whose wives have breast cancer.
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Morgan SJ, Pullon SRH, Macdonald LM, McKinlay EM, Gray BV. Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus. QUALITATIVE HEALTH RESEARCH 2017; 27:1060-1068. [PMID: 27217290 DOI: 10.1177/1049732316649160] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.
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Affiliation(s)
| | | | | | | | - Ben V Gray
- 1 University of Otago, Wellington, New Zealand
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Kean B, Oprescu F, Gray M, Burkett B. Commitment to physical activity and health: a case study of a Paralympic Gold medallist. Disabil Rehabil 2017; 40:2093-2097. [PMID: 28475409 DOI: 10.1080/09638288.2017.1323234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Physical activity has been documented as both beneficial and detrimental for individuals with multiple sclerosis (MS). The varied experience highlights challenges associated with physical activity and MS, requiring a greater understanding of the experiences of exercise for individuals with MS. OBJECTIVE The purpose of this study was to explore how physical activity played a role in the life of a Paralympic Gold medallist. Carol was diagnosed with MS and went onto achieve the highest accolade in Paralympic sport. METHODS Narrative inquiry, within a single-case design, explored how physical activity played a role in Carol's life. The narrative was analysed through the lens of a salutogenic framework, which explores how individuals create health despite adverse circumstances. FINDINGS Carol's physical activity pathway explores life before and after her diagnosis, motivations to return to exercise and pathway to Paralympic Gold. Carol's experiences highlight how physical activity played a role during various stages of her life. Exercise had a significant role in Carol's life prior to diagnosis, it assisted in the management of MS and she cycled the elite level, winning a Paralympic Gold medal in para-cycling. Implications for Rehabilitation Physical activity has been reported as beneficial for multiple sclerosis management; however, there can be a fine line between the benefits and an overload that can harm. An elite athlete with multiple sclerosis maintained and sustained physical activity to the highest level in elite sport, incorporating a positive health outlook throughout different stages of her life. The case highlights how commitment and self-awareness of capabilities and limits may be useful self-management tools in increasing physical activity for individuals living with multiple sclerosis.
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Affiliation(s)
- Bridie Kean
- a Centre of Excellence for Applied Sport Science Research, Queensland Academy of Sport , Brisbane , Australia.,b School of Health and Sport Sciences, Faculty of Science, Health, Education and Engineering , University of the Sunshine Coast , Sippy Downs , Australia
| | - Florin Oprescu
- b School of Health and Sport Sciences, Faculty of Science, Health, Education and Engineering , University of the Sunshine Coast , Sippy Downs , Australia
| | - Marion Gray
- b School of Health and Sport Sciences, Faculty of Science, Health, Education and Engineering , University of the Sunshine Coast , Sippy Downs , Australia
| | - Brendan Burkett
- b School of Health and Sport Sciences, Faculty of Science, Health, Education and Engineering , University of the Sunshine Coast , Sippy Downs , Australia
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Bullock A, Barnes E, Morris ZS, Fairbank J, de Pury J, Howell R, Denman S. Getting the most out of knowledge and innovation transfer agents in health care: a qualitative study. HEALTH SERVICES AND DELIVERY RESEARCH 2016. [DOI: 10.3310/hsdr04330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BackgroundKnowledge and innovation transfer (KIT) is recognised internationally as a complex, dynamic process that is difficult to embed in organisations. There is growing use of health service–academic–industry collaborations in the UK, with knowledge brokers linking producers with the users of knowledge and innovation.AimFocusing on KIT ‘agent’ roles within Academic Health Science Networks in England and Partnerships in Wales, we show how individual dispositions, processes and content contribute to desired outcomes.MethodsWe studied the KIT intentions of all Academic Health Science Networks in England, and the South East Wales Academic Health Science Partnership. Using a qualitative case study design, we studied the work of 13 KIT agents purposively sampled from five networks, by collecting data from observation of meetings, documentation, KIT agent audio-diaries, and semistructured interviews with KIT agents, their line managers and those they supported (‘Links’). We also used a consensus method in a meeting of experts (nominal group technique) to discuss the measurement of outcomes of KIT agent activity.FindingsThe case study KIT agents were predominantly from a clinical background with differing levels of experience and expertise, with the shared aim of improving services and patient care. Although outside of recognised career structures, the flexibility afforded to KIT agents to define their role was an enabler of success. Other helpful factors included (1) time and resources to devote to KIT activity; (2) line manager support and a team to assist in the work; and (3) access and the means to use data for improvement projects. The organisational and political context could be challenging. KIT agents not only tackled local barriers such as siloed working, but also navigated shifting regional and national policies. Board-level support for knowledge mobilisation together with a culture of reflection (listening to front-line staff), openness to challenges and receptivity to research all enabled KIT agents to achieve desired outcomes. Nominal group findings underscored the importance of relating measures to specific intended outcomes. However, the case studies highlighted that few measures were employed by KIT agents and their managers. Using social marketing theory helped to show linkages between processes, outcomes and impact, and drew attention to how KIT agents developed insight into their clients’ needs and tailored work accordingly.LimitationsLevel of KIT agent participation varied; line managers and Links were interviewed only once; and outcomes were self-reported.ConclusionsSocial marketing theory provided a framework for analysing KIT agent activity. The preparatory work KIT agents do in listening, understanding local context and building relationships enabled them to develop ‘insight’ and adapt their ‘offer’ to clients to achieve desired outcomes.Future workThe complexity of the role and the environment in which it is played out justifies more research on KIT agents. Suggestions include (1) longitudinal study of career pathways; (2) how roles are negotiated within teams and how competing priorities are managed; (3) how success is measured; (4) the place of improvement methodologies within KIT work; (5) the application of social marketing theory to comparative study of similar roles; and (6) patients as KIT agents.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Alison Bullock
- The Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), Cardiff University, Cardiff, UK
| | - Emma Barnes
- The Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), Cardiff University, Cardiff, UK
| | | | | | | | - Rosamund Howell
- Aneurin Bevan University Health Board, Clinical Research and Innovation Centre, St Woolos Hospital, Newport, UK
| | - Susan Denman
- School of Medicine, Cardiff University, Cardiff, UK
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Aldrich RM, White NA, Conners BL. Translating Occupational Justice Education Into Action: Reflections From an Exploratory Single Case Study. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2016; 36:227-233. [PMID: 27591434 DOI: 10.1177/1539449216667278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is a growing body of scholarly literature about occupational justice, human rights, and power redistribution ready to be integrated into occupational science and occupational therapy education. As students around the world become familiar with the concepts and intents underlying occupational justice, it will be important to investigate their translation of occupational justice understandings into actions outside the classroom. This exploratory single case study describes curricular, university, and regional factors related to one former student's engagement in social protests following her occupational justice education. Based on her reflections, we emphasize the need to provide classroom opportunities where students can apply and critically reflect on (a) knowledge about occupational justice and (b) unintended consequences and potential professional tensions that may arise in relation to pursuing occupational justice. Future research will benefit from broader comparative studies that analyze personal, contextual, and programmatic differences among instances of occupational justice education and students' engagement in occupational reconstructions.
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Martin A, O'Meara P, Farmer J. Consumer perspectives of a community paramedicine program in rural Ontario. Aust J Rural Health 2015; 24:278-83. [DOI: 10.1111/ajr.12259] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Angela Martin
- La Trobe Rural Health School; College of Science, Health and Engineering; La Trobe University; Bendigo Victoria Australia
| | - Peter O'Meara
- La Trobe Rural Health School; College of Science, Health and Engineering; La Trobe University; Bendigo Victoria Australia
| | - Jane Farmer
- La Trobe Rural Health School; College of Science, Health and Engineering; La Trobe University; Bendigo Victoria Australia
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Morse JM, Gervais P, Pooler C, Merryweather A, Doig AK, Bloswick D. The Safety of Hospital Beds: Ingress, Egress, and In-Bed Mobility. Glob Qual Nurs Res 2015; 2:2333393615575321. [PMID: 28462302 PMCID: PMC5371163 DOI: 10.1177/2333393615575321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 01/27/2015] [Accepted: 01/27/2015] [Indexed: 11/16/2022] Open
Abstract
To explore the safety of the standard and the low hospital bed, we report on a microanalysis of 15 patients' ability to ingress, move about the bed, and egress. The 15 participants were purposefully selected with various disabilities. Bed conditions were randomized with side rails up or down and one low bed with side rails down. We explored the patients' use of the side rails, bed height, ability to lift their legs onto the mattress, and ability to turn, egress, and walk back to the chair. The standard bed was too high for some participants, both for ingress and egress. Side rails were used by most participants when entering, turning in bed, and exiting. We recommend that side rails be reconsidered as a means to facilitate in-bed movement, ingress, and egress. Furthermore, single deck height settings for all patients are not optimal. Low beds as a safety measure must be re-evaluated.
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Kirkpatrick H, Boblin S, Ireland S, Robertson K. The Nurse as Bricoleur in Falls Prevention: Learning from a Case Study of the Implementation of Fall Prevention Best Practices. Worldviews Evid Based Nurs 2014; 11:118-25. [DOI: 10.1111/wvn.12026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Helen Kirkpatrick
- BPSO Co-ordinator, St. Joseph's Healthcare Hamilton, and Assistant Clinical Professor; McMaster University School of Nursing; Hamilton ON Canada
| | - Sheryl Boblin
- Associate Professor, McMaster University School of Nursing; Hamilton ON Canada
| | - Sandra Ireland
- Assistant Clinical Professor, McMaster University School of Nursing; Hamilton ON Canada
| | - Kim Robertson
- Risk Management Specialist, St. Joseph's Health Care Hamilton; Hamilton ON Canada
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