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Thompson CA, Willis T, Farrin A, Gordon A, Dafu-O'Reilly A, Noakes C, Khaliq K, Kemp A, Hall T, Bojke C, Spilsbury K. CONTACT: a non-randomised feasibility study of bluetooth-enabled wearables for contact tracing in UK care homes during the COVID-19 pandemic. Pilot Feasibility Stud 2024; 10:125. [PMID: 39358817 PMCID: PMC11445870 DOI: 10.1186/s40814-024-01549-6] [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: 08/08/2023] [Accepted: 09/20/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND The need for effective non-pharmaceutical infection prevention measures such as contact tracing in pandemics remains in care homes, but traditional approaches to contact tracing are not feasible in care homes. The CONTACT intervention introduces Bluetooth-enabled wearable devices (BLE wearables) as a potential solution for automated contact tracing. Using structured reports and reports triggered by positive COVID-19 cases in homes, we fed contact patterns and trends back to homes to support better-informed infection prevention decisions and reduce blanket application of restrictive measures. This paper reports on the evaluation of feasibility and acceptability of the intervention prior to a planned definitive cluster randomised trial of the CONTACT BLE wearable intervention. METHODS CONTACT was a non-randomised mixed-method feasibility study over 2 months in four English care homes. Recruitment was via care home research networks, with individual consent. Data collection methods included routine data from the devices, case report forms, qualitative interviews (with staff and residents), field observation of care, and an adapted version of the NoMaD survey instrument to explore implementation using Normalisation Process Theory. Quantitative data were analysed using descriptive statistical methods. Qualitative data were thematically analysed using a framework approach and Normalisation Process Theory. Intervention and study delivery were evaluated against predefined progression criteria. RESULTS Of 156 eligible residents, 105 agreed to wear a device, with 102 (97%) starting the intervention. Of 225 eligible staff, 82% (n = 178) participated. Device loss and damage were significant: 11% of resident devices were lost or damaged, ~ 50% were replaced. Staff lost fewer devices, just 6%, but less than 10% were replaced. Fob wearables needed more battery changes than card-type devices (15% vs. 0%). Structured and reactive feedback was variably understood by homes but unlikely to be acted on. Researcher support for interpreting reports was valued. Homes found information useful when it confirmed rather than challenged preconceived contact patterns. Staff privacy concerns were a barrier to adoption. Study procedures added to existing work, making participation burdensome. Study participation benefits did not outweigh perceived burden and were amplified by the pandemic context. CONTACT did not meet its quantitative or qualitative progression criteria. CONCLUSION CONTACT found a large-scale definitive trial of BLE wearables for contact tracing and feedback-informed IPC in care homes unfeasible and unacceptable - at least in the context of shifting COVID-19 pandemic demands. Future research should co-design interventions and studies with care homes, focusing on successful intervention implementation as well as technical effectiveness. TRIAL REGISTRATION ISRCTN registration: 11204126 registered 17/02/2021.
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Affiliation(s)
- Carl A Thompson
- School of Healthcare, University of Leeds, Baines Wing, Leeds, LS2 9JT, UK.
| | - Thomas Willis
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Amanda Farrin
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Adam Gordon
- Academic Centre for Healthy Ageing, Queen Mary University, London, E1 2AD, UK
| | | | - Catherine Noakes
- School of Civil Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - Kishwer Khaliq
- School of Civil Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - Andrew Kemp
- School of Electronics and Electrical Engineering, University of Leeds, LS2 9JT, Leeds, UK
| | - Tom Hall
- South Tyneside Council, South Shields, NE33 2RL, UK
| | - Chris Bojke
- School of Medicine, Academic Unit of Health Economics, University of Leeds, Leeds, LS2 9JT, UK
| | - Karen Spilsbury
- School of Healthcare, University of Leeds, Baines Wing, Leeds, LS2 9JT, UK
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Ashtari N, Abbasi J, Barnert E. Perspectives of California Legislators on Institutional Barriers and Facilitators to Non-Partisan Research Evidence Use in State Health Policymaking. J Gen Intern Med 2024; 39:1704-1712. [PMID: 38102408 PMCID: PMC11255140 DOI: 10.1007/s11606-023-08547-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Bridging the translational gap between research evidence and health policy in state legislatures requires understanding the institutional barriers and facilitators to non-partisan research evidence use. Previous studies have identified individual-level barriers and facilitators to research evidence use, but limited perspectives exist on institutional factors within legislatures that influence non-partisan research evidence use in health policymaking. OBJECTIVE We describe the perspectives of California state legislators and legislative staff on institutional barriers and facilitators of non-partisan research evidence use in health policymaking and explore potential solutions for enhancing use. DESIGN Case study design involving qualitative interviews. PARTICIPANTS We interviewed 24 California state legislators, legislative office staff, and legislative research staff. APPROACH Semi-structured recorded interviews were conducted in person or by phone to identify opportunities for enhancing non-partisan research evidence use within state legislatures. We conducted thematic analyses of interview transcripts to identify (1) when research evidence is used during the policymaking process, (2) barriers and facilitators operating at the institutional level, and (3) potential solutions for enhancing evidence use. RESULTS Institutional barriers to non-partisan research evidence use in health policymaking were grouped into three themes: institutional policies, practices, and priorities. Interviews also revealed institutional-level facilitators of research evidence use, including (1) access and capacity to engage with research evidence, and (2) perceived credibility of research evidence. The most widely supported institutional-level solution for enhancing evidence-based health policymaking in state legislatures involved establishing independent, impartial research entities to provide legislators with trusted evidence to inform decision-making. CONCLUSIONS Potential institutional-level changes within state legislatures may enhance evidence use in health policymaking, leading to improved health outcomes and lower healthcare costs for states.
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Affiliation(s)
- Neda Ashtari
- UCLA David Geffen School of Medicine, Los Angeles, CA, 90024, USA.
- Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
| | - Justin Abbasi
- UCLA David Geffen School of Medicine, Los Angeles, CA, 90024, USA
| | - Elizabeth Barnert
- UCLA David Geffen School of Medicine, Los Angeles, CA, 90024, USA
- Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA, 90024, USA
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Thompson CA, Daffu-O'Reilly A, Willis T, Gordon A, Noakes C, Khaliq K, Farrin A, Kemp A, Hall T, Bojke C, Spilsbury K. 'Smart' BLE wearables for digital contact tracing in care homes during the COVID-19 pandemic-a process evaluation of the CONTACT feasibility study. Implement Sci Commun 2023; 4:155. [PMID: 38049924 PMCID: PMC10694939 DOI: 10.1186/s43058-023-00533-0] [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: 08/07/2023] [Accepted: 11/21/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Rapid and mass transmission of the SARS-CoV-2 virus amongst vulnerable people led to devastating effects from COVID-19 in care homes. The CONTACT intervention introduced Bluetooth Low Energy 'smart' wearable devices (BLE wearables) as a basis for automated contact tracing in, and feedback on infection risks and patterns to, care homes to try and improve infection prevention and control (IPC). We planned a cluster randomised controlled trial (RCT) of CONTACT. To be feasible, homes had to adopt CONTACT's technology and new ways of working. This paper reports on the process evaluation conducted alongside CONTACT's feasibility study and explains why it lacked the feasibility and acceptability for a definitive RCT. METHODS This mixed method process evaluation used Normalisation Process Theory (NPT) qualitative (interviews, field notes, study case report forms and documents, and observation) and quantitative (survey instruments, counts of activity) data to plan, implement, and analyse the mechanisms, effects, and contextual factors that shaped the feasibility and acceptability of the CONTACT intervention. RESULTS Thirteen themes within four core NPT constructs explained CONTACT's lack of feasibility. Coherence: the home's varied in the scale and extent of commitment and understanding of the technology and study procedures. Leadership credibility was important but compromised by competing priorities. Management and direct care staff saw CONTACT differently. Work to promote (cognitive participation) and enact (collective action) CONTACT was burdensome and failed to be prioritised over competing COVID-19-related demands on time and scarce human and cognitive resources. Ultimately, staff appraisal of the value of CONTACT-generated information and study procedures (reflexivity) was that any utility for IPC was insufficient to outweigh the perceived burden and complexity involved. CONCLUSIONS Despite implementation failure, dismissing BLE wearables' potential for contact tracing is premature. In non-pandemic conditions, with more time, better co-design and integration of theory-driven implementation strategies tailored to care homes' unique contexts, researchers could enhance normalisation in readiness for future pandemic challenges. TRIAL REGISTRATION ISRCTN registration: 11,204,126 registered 17/02/2021.
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Affiliation(s)
- Carl A Thompson
- School of Healthcare, University of Leeds, Leeds, LS2 9JT, UK.
| | | | - Thomas Willis
- Trials Research, Leeds Institute of Clinical, University of Leeds, Leeds, LS2 9JT, UK
| | - Adam Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 3NE, UK
| | - Catherine Noakes
- School of Civil Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - Kishwer Khaliq
- School of Civil Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - Amanda Farrin
- Trials Research, Leeds Institute of Clinical, University of Leeds, Leeds, LS2 9JT, UK
| | - Andrew Kemp
- School of Electronics and Electrical Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - Tom Hall
- South Tyneside Council, South Shields, NE33 2RL, UK
| | - Chris Bojke
- Academic Unit of Health Economics, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Karen Spilsbury
- School of Healthcare, University of Leeds, Leeds, LS2 9JT, UK
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Richards A, Raymond-Flesch M, Hughes SD, Zhou Y, Koester KA. Lessons Learned with a Triad of Stakeholder Advisory Boards: Working with Adolescents, Mothers, and Clinicians to Design the TRUST Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:483. [PMID: 36980041 PMCID: PMC10047518 DOI: 10.3390/children10030483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/18/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023]
Abstract
Optimal care for pediatric and adolescent patients is carried out under a triadic engagement model, whereby the patient, caregiver, and clinician work in collaboration. Seeking input from all triad members in the development and implementation of clinical trials and interventions may improve health outcomes for children and adolescents. Sufficient evidence demonstrating how to effectively engage stakeholders from all branches of this triadic model is lacking. We address this gap by describing the successes and challenges our team has encountered while convening advisory groups with adolescent patients, parent stakeholders, and their clinicians to assist in the development and deployment of a technology-based intervention to promote the utilization of sexual and reproductive health services by increasing adolescent-clinician alone-time. Each stakeholder group contributed in unique and complementary ways. Working with advisors, our team aligned the priorities of each group with the goals of the research team. The results were improvements made in the content, design, and delivery of the TRUST intervention. While we were largely successful in the recruitment and engagement of adolescent patients and clinicians, we had less success with parents. Future research will need to explore additional strategies for recruitment and engagement of parents, particularly in rural, minority, and underserved communities.
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Affiliation(s)
- Alexis Richards
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California San Francisco, San Francisco, CA 94107, USA
| | - Marissa Raymond-Flesch
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA 94107, USA
| | - Shana D. Hughes
- Vitalant Research Institute and Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA 94105, USA
| | - Yinglan Zhou
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA 94158, USA
| | - Kimberly A. Koester
- Department of Medicine, Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA 94158, USA
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Skouteris H, Green R, Chung A, Bergmeier H, Amir LH, Baidwan SK, Chater A, Chamberlain C, Emond R, Gibbons K, Gooey M, Hatzikiriakidis K, Haycraft E, Hills AP, Higgins DJ, Hooper O, Hunter S, Kappelides P, Kleve S, Krakouer J, Lumeng JC, Manios Y, Mansoor A, Marmot M, Mâsse LC, Matvienko‐Sikar K, Mchiza ZJ, Meyer C, Moschonis G, Munro ER, O'Connor TM, O'Neil A, Quarmby T, Sandford R, Schneiderman JU, Sherriff S, Simkiss D, Spence A, Sturgiss E, Vicary D, Wickes R, Wolfenden L, Story M, Black MM. Nurturing children's development through healthy eating and active living: Time for policies to support effective interventions in the context of responsive emotional support and early learning. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6719-e6729. [PMID: 36401560 PMCID: PMC10946933 DOI: 10.1111/hsc.14106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Fostering the growth, development, health, and wellbeing of children is a global priority. The early childhood period presents a critical window to influence lifelong trajectories, however urgent multisectoral action is needed to ensure that families are adequately supported to nurture their children's growth and development. With a shared vision to give every child the best start in life, thus helping them reach their full developmental potential, we have formed the International Healthy Eating Active Living Matters (HEALing Matters) Alliance. Together, we form a global network of academics and practitioners working across child health and development, and who are dedicated to improving health equity for children and their families. Our goal is to ensure that all families are free from structural inequality and oppression and are empowered to nurture their children's growth and development through healthy eating and physical activity within the context of responsive emotional support, safety and security, and opportunities for early learning. To date, there have been disparate approaches to promoting these objectives across the health, community service, and education sectors. The crucial importance of our collective work is to bring these priorities for early childhood together through multisectoral interventions, and in so doing tackle head on siloed approaches. In this Policy paper, we draw upon extensive research and call for collective action to promote equity and foster positive developmental trajectories for all children. We call for the delivery of evidence-based programs, policies, and services that are co-designed to meet the needs of all children and families and address structural and systemic inequalities. Moving beyond the "what" is needed to foster the best start to life for all children, we provide recommendations of "how" we can do this. Such collective impact will facilitate intergenerational progression that builds human capital in future generations.
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Affiliation(s)
- Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
- Warwick Business SchoolUniversity of WarwickCoventryUK
| | - Rachael Green
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | - Alexandra Chung
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | - Heidi Bergmeier
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | - Lisa H. Amir
- Judith Lumley Centre, School of Nursing and MidwiferyLa Trobe UniversityVictoriaBundooraAustralia
| | | | - Angel Marie Chater
- Centre for Health, Wellbeing and Behaviour ChangeUniversity of BedfordshireLutonUK
| | - Catherine Chamberlain
- Judith Lumley Centre, School of Nursing and MidwiferyLa Trobe UniversityVictoriaBundooraAustralia
- Centre for Health EquityThe University of MelbourneVictoriaMelbourneAustralia
- Ngangk Yira Research Centre for Aboriginal Health and Social EquityMurdoch UniversityMurdochAustralia
- The Lowitja InstituteCollingwoodVictoriaAustralia
| | | | - Kay Gibbons
- Institute for Health & SportVictoria UniversityVictoriaMelbourneAustralia
| | - Michelle Gooey
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | - Kostas Hatzikiriakidis
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | - Emma Haycraft
- School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Andrew P. Hills
- School of Health SciencesUniversity of TasmaniaTasmaniaLauncestonAustralia
| | | | - Oliver Hooper
- School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | | | - Pam Kappelides
- Department of ManagementLa Trobe UniversityVictoriaBundooraAustralia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, School of Clinical SciencesMonash UniversityVictoriaClaytonAustralia
| | - Jacynta Krakouer
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityVictoriaMelbourneAustralia
| | | | - Yannis Manios
- Department of Nutrition and DieteticsHarokopio University of AthensAthensGreece
- Institute of Agri‐food and Life SciencesHellenic Mediterranean University Research CentreHeraklionGreece
| | - Athar Mansoor
- The Hong Kong University of Science and TechnologyHong KongHong Kong
| | | | - Louise C. Mâsse
- BC Children's Hospital Research Institute/School of Population and Public HealthUniversity of British ColumbiaBritish ColumbiaVancouverCanada
| | | | - Zandile June‐Rose Mchiza
- Non‐communicable Disease Research Unit, South African Medical Research Council & School of Public Health, Faculty of Community and Health SciencesUniversity of the Western CapeBellvilleSouth Africa
| | - Caroline Meyer
- Executive Office, Warwick Medical SchoolUniversity of WarwickCoventryUK
| | - George Moschonis
- Department of Food, Nutrition and Dietetics, School of Allied Health, Human Services and SportLa Trobe UniversityVictoriaBundooraAustralia
| | - Emily R. Munro
- Tilda Goldberg Centre for Social Work and Social CareUniversity of BedfordshireLutonUK
| | - Teresia Margareta O'Connor
- USDA/ARS Children's Nutrition Research Center, Department of PediatricsBaylor College of MedicineTexasHoustonUSA
| | - Adrienne O'Neil
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of MedicineDeakin UniversityVictoriaGeelongAustralia
| | | | - Rachel Sandford
- School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Janet U. Schneiderman
- Department of Nursing, Suzanne Dworak‐Peck School of Social WorkUniversity of Southern CaliforniaCaliforniaLos AngelesUSA
| | | | - Doug Simkiss
- Executive Office, Warwick Medical SchoolUniversity of WarwickCoventryUK
- Birmingham Community Healthcare NHS Foundation TrustBirminghamUK
- Aston UniversityBirminghamUK
| | - Alison Spence
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityGeelongVictoriaAustralia
| | - Elizabeth Sturgiss
- School of Primary and Allied Health CareMonash UniversityFrankstonVictoriaAustralia
| | | | - Rebecca Wickes
- Griffith Criminology InstituteGriffith UniversityBrisbaneQueenslandAustralia
| | - Luke Wolfenden
- School of Medicine and Public Health, College of Health, Medicine and WellbeingThe University of NewcastleCallaghanNew South WalesAustralia
| | - Mary Story
- Duke Global Health InstituteDurhamNorth CarolinaUSA
| | - Maureen M. Black
- School of MedicineUniversity of MarylandCollege ParkMarylandUSA
- Research Triangle Institute InternationalResearch Triangle ParkNorth CarolinaUSA
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Clarke D, Gombert-Waldron K, Honey S, Cloud G, Harris R, Macdonald A, McKevitt C, Robert G, Jones F. Co-designing organisational improvements and interventions to increase inpatient activity in four stroke units in England: a mixed-methods process evaluation using normalisation process theory. BMJ Open 2021; 11:e042723. [PMID: 33500286 PMCID: PMC7839845 DOI: 10.1136/bmjopen-2020-042723] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To explore facilitators and barriers to using experience-based co-design (EBCD) and accelerated EBCD (AEBCD) in the development and implementation of interventions to increase activity opportunities for inpatient stroke survivors. DESIGN Mixed-methods process evaluation underpinned by normalisation process theory (NPT). SETTING Four post-acute rehabilitation stroke units in England. PARTICIPANTS Stroke survivors, family members, stroke unit staff, hospital managers, support staff and volunteers. Data informing our NPT analysis comprised: ethnographic observations, n=366 hours; semistructured interviews with 76 staff, 53 stroke survivors and 27 family members pre-EBCD/AEBCD implementation or post-EBCD/AEBCD implementation; and observation of 43 co-design meetings involving 23 stroke survivors, 21 family carers and 54 staff. RESULTS Former patients and families valued participation in EBCD/AEBCD perceiving they were equal partners in co-design. Staff engaged with EBCD/AEBCD, reporting it as a valuable improvement approach leading to increased activity opportunities. The structured EBCD/AEBCD approach was influential in enabling coherence and cognitive participation and legitimated staff involvement in the change process. Researcher facilitation of EBCD/AEBCD supported cognitive participation, collective action and reflexive monitoring; these were important in implementing and sustaining co-design activities. Observations and interviews post-EBCD/AEBCD cycles confirmed creation and use of new social spaces and increased activity opportunities in all units. EBCD/AEBCD facilitated engagement with wider hospital resources and local communities, further enhancing activity opportunities. However, outside of structured group activity, many individual staff-patient interactions remained task focused. CONCLUSIONS EBCD/AEBCD facilitated the development and implementation of environmental changes and revisions to work routines which supported increased activity opportunities in stroke units providing post-acute and rehabilitation care. Former stroke patients and carers contributed to improvements. NPT's generative mechanisms were instrumental in analysis and interpretation of facilitators and barriers at the individual, group and organisational level, and can help inform future implementations of similar approaches.
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Affiliation(s)
- David Clarke
- Academic Unit for Ageing and Stroke Research, Leeds Institute of Health Sciences, University of Leeds Faculty of Medicine and Health, Leeds, UK
| | - Karolina Gombert-Waldron
- Faculty of Health and Social Care Sciences, Kingston University and St George's, University of London, London, UK
| | - Stephanie Honey
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Geoffrey Cloud
- Department of Clinical Neuroscience, CCS, Monash University Melbourne and Alfred Health, Melbourne, Victoria, Australia
| | - Ruth Harris
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | | | | | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Fiona Jones
- Faculty of Health Social Care and Education, St Georges University of London, London, UK
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