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Kennedy Wiradjuri M, Ninomiya MM, Ninomiya MM, Brascoupé Anishinabeg/Haudenausanee S, Smylie Mѐtis J, Calma Kungarakan Iwaidja T, Mohamed Narrunga Kaurna J, Stewart Taungurung PJ, Maddox Bagumani Modewa R. Knowledge translation in Indigenous health research: voices from the field. Med J Aust 2024; 221:61-67. [PMID: 38946651 DOI: 10.5694/mja2.52357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 05/07/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVES To better understand what knowledge translation activities are effective and meaningful to Indigenous communities and what is required to advance knowledge translation in health research with, for, and by Indigenous communities. STUDY DESIGN Workshop and collaborative yarning. SETTING Lowitja Institute International Indigenous Health Conference, Cairns, June 2023. PARTICIPANTS About 70 conference delegates, predominantly Indigenous people involved in research and Indigenous health researchers who shared their knowledge, experiences, and recommendations for knowledge translation through yarning and knowledge sharing. RESULTS Four key themes were developed using thematic analysis: knowledge translation is fundamental to research and upholding community rights; knowledge translation approaches must be relevant to local community needs and ways of mobilising knowledge; researchers and research institutions must be accountable for ensuring knowledge translation is embedded, respected and implemented in ways that address community priorities; and knowledge translation must be planned and evaluated in ways that reflect Indigenous community measures of success. CONCLUSION Knowledge translation is fundamental to making research matter, and critical to ethical research. It must be embedded in all stages of research practice. Effective knowledge translation approaches are Indigenous-led and move beyond Euro-Western academic metrics. Institutions, funding bodies, and academics should embed structures required to uphold Indigenous knowledge translation. We join calls for reimaging health and medical research to embed Indigenous knowledge translation as a prerequisite for generative knowledge production that makes research matter.
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Raggi A, Bernard RM, Toppo C, Sabariego C, Salvador Carulla L, Lukersmith S, Hakkaart-van Roijen L, Merecz-Kot D, Olaya B, Antunes Lima R, Gutiérrez-Marín D, Vorstenbosch E, Curatoli C, Cacciatore M. The EMPOWER Occupational e-Mental Health Intervention Implementation Checklist to Foster e-Mental Health Interventions in the Workplace: Development Study. J Med Internet Res 2024; 26:e48504. [PMID: 38488846 PMCID: PMC10980995 DOI: 10.2196/48504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/29/2023] [Accepted: 12/21/2023] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Occupational e-mental health (OeMH) interventions significantly reduce the burden of mental health conditions. The successful implementation of OeMH interventions is influenced by many implementation strategies, barriers, and facilitators across contexts, which, however, are not systematically tracked. One of the reasons is that international consensus on documenting and reporting the implementation of OeMH interventions is lacking. There is a need for practical guidance on the key factors influencing the implementation of interventions that organizations should consider. Stakeholder consultations secure a valuable source of information about these key strategies, barriers, and facilitators that are relevant to successful implementation of OeMH interventions. OBJECTIVE The objective of this study was to develop a brief checklist to guide the implementation of OeMH interventions. METHODS Based on the results of a recently published systematic review, we drafted a comprehensive checklist with a wide set of strategies, barriers, and facilitators that were identified as relevant for the implementation of OeMH interventions. We then used a 2-stage stakeholder consultation process to refine the draft checklist to a brief and practical checklist comprising key implementation factors. In the first stage, stakeholders evaluated the relevance and feasibility of items on the draft checklist using a web-based survey. The list of items comprised 12 facilitators presented as statements addressing "elements that positively affect implementation" and 17 barriers presented as statements addressing "concerns toward implementation." If a strategy was deemed relevant, respondents were asked to rate it using a 4-point Likert scale ranging from "very difficult to implement" to "very easy to implement." In the second stage, stakeholders were interviewed to elaborate on the most relevant barriers and facilitators shortlisted from the first stage. The interview mostly focused on the relevance and priority of strategies and factors affecting OeMH intervention implementation. In the interview, the stakeholders' responses to the open survey's questions were further explored. The final checklist included strategies ranked as relevant and feasible and the most relevant facilitators and barriers, which were endorsed during either the survey or the interviews. RESULTS In total, 26 stakeholders completed the web-based survey (response rate=24.8%) and 4 stakeholders participated in individual interviews. The OeMH intervention implementation checklist comprised 28 items, including 9 (32.1%) strategies, 8 (28.6%) barriers, and 11 (39.3%) facilitators. There was widespread agreement between findings from the survey and interviews, the most outstanding exception being the idea of proposing OeMH interventions as benefits for employees. CONCLUSIONS Through our 2-stage stakeholder consultation, we developed a brief checklist that provides organizations with a guide for the implementation of OeMH interventions. Future research should empirically validate the effectiveness and usefulness of the checklist.
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Affiliation(s)
- Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | | | - Claudia Toppo
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Carla Sabariego
- Swiss Paraplegic Research, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, Switzerland
| | - Luis Salvador Carulla
- Health Research Institute, University of Canberra, Canberra, Australia
- Healthcare Information Systems (CTS553), University of Cadiz, Cadiz, Spain
| | - Sue Lukersmith
- Health Research Institute, University of Canberra, Canberra, Australia
| | | | | | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Rodrigo Antunes Lima
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Desirée Gutiérrez-Marín
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Ellen Vorstenbosch
- Swiss Paraplegic Research, Nottwil, Switzerland
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Chiara Curatoli
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Martina Cacciatore
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
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McClam M, Workman L, Dias EM, Walker TJ, Brandt HM, Craig DW, Gibson R, Lamont A, Weiner BJ, Wandersman A, Fernandez ME. Using cognitive interviews to improve a measure of organizational readiness for implementation. BMC Health Serv Res 2023; 23:93. [PMID: 36707829 PMCID: PMC9881511 DOI: 10.1186/s12913-022-09005-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/22/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Organizational readiness is a key factor for successful implementation of evidence-based interventions (EBIs), but a valid and reliable measure to assess readiness across contexts and settings is needed. The R = MC2 heuristic posits that organizational readiness stems from an organization's motivation, capacity to implement a specific innovation, and its general capacity. This paper describes a process used to examine the face and content validity of items in a readiness survey developed to assess organizational readiness (based on R = MC2) among federally qualified health centers (FQHC) implementing colorectal cancer screening (CRCS) EBIs. METHODS We conducted 20 cognitive interviews with FQHC staff (clinical and non-clinical) in South Carolina and Texas. Participants were provided a subset of items from the readiness survey to review. A semi-structured interview guide was developed to elicit feedback from participants using "think aloud" and probing techniques. Participants were recruited using a purposive sampling approach and interviews were conducted virtually using Zoom and WebEx. Participants were asked 1) about the relevancy of items, 2) how they interpreted the meaning of items or specific terms, 3) to identify items that were difficult to understand, and 4) how items could be improved. Interviews were transcribed verbatim and coded in ATLAS.ti. Findings were used to revise the readiness survey. RESULTS Key recommendations included reducing the survey length and removing redundant or difficult to understand items. Additionally, participants recommended using consistent terms throughout (e.g., other units/teams vs. departments) the survey and changing pronouns (e.g., people, we) to be more specific (e.g., leadership, staff). Moreover, participants recommended specifying ambiguous terms (e.g., define what "better" means). CONCLUSION Use of cognitive interviews allowed for an engaged process to refine an existing measure of readiness. The improved and finalized readiness survey can be used to support and improve implementation of CRCS EBIs in the clinic setting and thus reduce the cancer burden and cancer-related health disparities.
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Affiliation(s)
- Maria McClam
- grid.254567.70000 0000 9075 106XCenter for Applied Research and Evaluation, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Lauren Workman
- grid.254567.70000 0000 9075 106XCenter for Applied Research and Evaluation, Arnold School of Public Health, University of South Carolina, Columbia, SC USA ,grid.254567.70000 0000 9075 106XDepartment of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Emanuelle M. Dias
- grid.267308.80000 0000 9206 2401The University of Texas Health Science Center at Houston School of Public Health, Houston, TX USA
| | - Timothy J. Walker
- grid.267308.80000 0000 9206 2401The University of Texas Health Science Center at Houston School of Public Health, Houston, TX USA
| | - Heather M. Brandt
- grid.240871.80000 0001 0224 711XSt. Jude Children’s Research Hospital, Memphis, TN USA
| | - Derek W. Craig
- grid.267308.80000 0000 9206 2401The University of Texas Health Science Center at Houston School of Public Health, Houston, TX USA
| | - Robert Gibson
- grid.410427.40000 0001 2284 9329Augusta University, Augusta, GA USA
| | | | - Bryan J. Weiner
- grid.34477.330000000122986657Department of Global Health, University of Washington, Seattle, WA USA
| | | | - Maria E. Fernandez
- grid.267308.80000 0000 9206 2401The University of Texas Health Science Center at Houston School of Public Health, Houston, TX USA
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Walker JR, Anding JD, Dudensing RM, Lavinghouze SR, Jauregui V, Coats K. From Evidence-Based Implementation Guides to Meaningful Action: Public Health Practitioners Use Readiness Assessments to Build Bridges to Successful Community Prevention Implementation. Health Promot Pract 2022; 23:118S-127S. [PMID: 36374596 PMCID: PMC10861172 DOI: 10.1177/15248399221116308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Readiness has been cited as a determining factor in whether a community can effectively implement, support, and sustain an initiative. Through readiness assessments and technical assistance, public health practitioners can be the bridge between the gap of reaching goals outlined in Healthy People 2030, or another funder's guides, and actionable, successful, implementation. Readiness assessments are practical tools for implementing change in public health. Here we discuss three readiness assessment activities that we developed for four Texas counties: a partnership mapping tool, an Ease and Impact score, and a round table discussion. Through the assessments, we ascertained both readiness and the relevance of Policy, Systems and Environment opportunities. We used readiness assessments to translate our funder's implementation guide to meet the needs of four counties. Data allowed us to determine whether communities were ready to move forward with minimal technical assistance, needed further assessment to better understand relevance and feasibility within the community to implement the initiative, or whether this opportunity was not a good fit at the time. We adapted readiness tools based on components of the R = MC2 framework so we could assess the readiness (motivation [M]; general organizational capacity [C]; and innovation-specific capacities [C]) of the participant groups and based on that assessment, we provided appropriate, tailored technical assistance. Public health practitioners and local supporters can use readiness tools and technical assistance to build a bridge from implementation guide(s) to effective community program implementation.
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Affiliation(s)
| | - Jenna D. Anding
- Texas A&M AgriLife Extension Service, College Station, TX, USA
| | | | | | | | - Kelsey Coats
- Texas A&M AgriLife Extension Service, College Station, TX, USA
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Dash K, Breckman R, Lees-Haggerty K, Elman A, Lachs M, Stoeckle RJ, Fulmer T, Rosen T. Developing a tool to assess and monitor institutional readiness to address elder mistreatment in hospital emergency departments. J Elder Abuse Negl 2021; 33:311-326. [PMID: 34496716 DOI: 10.1080/08946566.2021.1965930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hospital emergency departments (EDs) lack the tools and processes required to facilitate consistent screening and intervention in cases of elder abuse and neglect. To address this need, the National Collaboratory to Address Elder Mistreatment has developed a clinical care model that ED's can implement to improve screening, referral, and linkage to coordinated care and support services for older adults who are at risk of mistreatment. To gauge ED readiness to change and facilitate adoption of the care model, we developed an organizational assessment tool, the Elder Mistreatment Emergency Department Assessment Profile (EM-EDAP). Development included a phased approach in which we reviewed evidence on best practice; consulted with multidisciplinary experts; and sought input from ED staff. Based on this formative research, we developed a tool that can be used to guide EDs in focusing on practice improvements for addressing elder mistreatment that are most responsive to local needs and opportunities.
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Affiliation(s)
- Kim Dash
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Risa Breckman
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine/Ne York Presbyterian Hospital, New York, NY, USA
| | - Kristin Lees-Haggerty
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Alyssa Elman
- Department of Emergency Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| | - Mark Lachs
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine/Ne York Presbyterian Hospital, New York, NY, USA
| | - Rebecca Jackson Stoeckle
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Terry Fulmer
- The John A. Hartford Foundation, New York, NY, USA
| | - Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
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6
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Herbuela VRDM, Karita T, Carvajal TM, Ho HT, Lorena JMO, Regalado RA, Sobrepeña GD, Watanabe K. Early Detection of Dengue Fever Outbreaks Using a Surveillance App (Mozzify): Cross-sectional Mixed Methods Usability Study. JMIR Public Health Surveill 2021; 7:e19034. [PMID: 33646128 PMCID: PMC7978406 DOI: 10.2196/19034] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/18/2020] [Accepted: 02/03/2021] [Indexed: 01/10/2023] Open
Abstract
Background While early detection and effective control of epidemics depend on appropriate surveillance methods, the Philippines bases its dengue fever surveillance system on a passive surveillance method (notifications from barangay/village health centers, municipal or city health offices, hospitals, and clinics). There is no available mHealth (mobile health) app for dengue fever that includes all the appropriate surveillance methods in early detection of disease outbreaks in the country. Objective This study aimed to evaluate the usability of the Mozzify app in terms of objective quality (engagement, functionality, aesthetics, information) and app subjective and app-specific qualities and compare total app mean score ratings by sociodemographic profile and self and family dengue fever history to see what factors are associated with high app mean score rating among school-based young adult samples and health care professionals. Individual interviews and focus group discussions were also conducted among participants to develop themes from their comments and suggestions to help structure further improvement and future development of the app. Methods User experience sessions were conducted among participants, and the Mobile Application Rating Scale (MARS) professional and user versions (uMARS) were administered followed by individual interviews and focus group discussions. Descriptive statistical analysis of the MARS and uMARS score ratings was performed. The total app mean score ratings by sociodemographic and dengue fever history using nonparametric mean difference analyses were also conducted. Thematic synthesis was used to develop themes from the comments and suggestions raised in individual interviews and focus group discussions. Results Mozzify obtained an overall >4 (out of 5) mean score ratings in the MARS and uMARS app objective quality (4.45), subjective (4.17), and specific (4.55) scales among 948 participants (79 health care professionals and 869 school-based samples). Mean difference analyses revealed that total app mean score ratings were not significantly different across ages and gender among health care professionals and across age, income categories, and self and family dengue fever history but not gender (P<.001) among the school-based samples. Thematic syntheses revealed 7 major themes: multilanguage options and including other diseases; Android version availability; improvements on the app’s content, design, and engagement; inclusion of users from low-income and rural areas; Wi-Fi connection and app size concerns; data credibility and issues regarding user security and privacy. Conclusions With its acceptable performance as perceived by health care professionals and school-based young adults, Mozzify has the potential to be used as a strategic health intervention system for early detection of disease outbreaks in the Philippines. It can be used by health care professionals of any age and gender and by school-based samples of any age, socioeconomic status, and dengue fever history. The study also highlights the feasibility of school-based young adults to use health-related apps for disease prevention.
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Affiliation(s)
- Von Ralph Dane Marquez Herbuela
- Center for Marine Environmental Studies, Ehime University, Matsuyama, Japan.,Department of Civil and Environmental Engineering, Graduate School of Science and Engineering, Ehime University, Matsuyama, Japan
| | - Tomonori Karita
- Department of Special Needs Education, Graduate School of Education, Ehime University, Matsuyama, Japan
| | - Thaddeus Marzo Carvajal
- Center for Marine Environmental Studies, Ehime University, Matsuyama, Japan.,Biological Control Research Unit, Center for Natural Science and Environmental Research, De La Salle University, Manila, Philippines
| | - Howell Tsai Ho
- College of Arts, Sciences and Education, Trinity University of Asia, Quezon City, Philippines
| | | | - Rachele Arce Regalado
- Guidance Counseling and Testing Department, University of Santo Tomas-Angelicum College, Quezon City, Philippines
| | | | - Kozo Watanabe
- Center for Marine Environmental Studies, Ehime University, Matsuyama, Japan.,Biological Control Research Unit, Center for Natural Science and Environmental Research, De La Salle University, Manila, Philippines
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Suresh M, Roobaswathiny A, Lakshmi Priyadarsini S. A study on the factors that influence the agility of COVID-19 hospitals. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2021. [DOI: 10.1080/20479700.2020.1870355] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- M. Suresh
- Amrita School of Business, Amrita Vishwa Vidyapeetham, Coimbatore, India
| | - A. Roobaswathiny
- Amrita School of Business, Amrita Vishwa Vidyapeetham, Coimbatore, India
| | - S. Lakshmi Priyadarsini
- Department of Zoology, Government Victoria College, Palakkad, University of Calicut, Palakkad, India
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8
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Bueno M, Stevens B, Rao M, Riahi S, Lanese A, Li S. Usability, acceptability, and feasibility of the Implementation of Infant Pain Practice Change (ImPaC) Resource. PAEDIATRIC & NEONATAL PAIN 2020; 2:82-92. [PMID: 35547024 PMCID: PMC8975234 DOI: 10.1002/pne2.12027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/17/2020] [Accepted: 05/11/2020] [Indexed: 11/07/2022]
Abstract
The Implementation of Infant Pain Practice (ImPaC) Resource is an eHealth tool designed to support infant pain practice change and ultimately enhance pain outcomes. The aim of this study was to determine users' perspectives on usability, acceptability, and feasibility of the ImPaC Resource. A descriptive prospective mixed‐methods quality improvement study was conducted at a pediatric hospital in Canada. Individual “think aloud” interviews were conducted in a nonclinical environment (Phase A); “near live” testing was conducted while users interacted with the Resource in clinical setting (Phase B); individual “think‐aloud” interviews were conducted in a nonclinical environment (Phase C). Outcomes included usability (System Usability Scale—SUS), acceptability (Acceptability E‐Scale—AES), and feasibility. Interview transcripts were coded per a priori themes using deductive content analysis to create a structured categorization matrix. In Phase A, 10 clinicians interacted with the Resource in individual sessions. Median SUS score was 73.75 (range 52.5‐92.5). In Phase B, four clinicians implemented the Resource in the neonatal intensive care unit (NICU) over 4 months. Median SUS score was 85 (82.5‐92.5), and median AES score was 24 (21‐24). In Phase C, an enhanced prototype was produced, and the same users from Phase B navigated the Resource in individual sessions. Median SUS score was 88.75 (85‐95), and median AES score was 27.5 (25‐29). Users considered the Resource as feasible for implementation, easy to navigate, engaging, intuitive, comprehensive, and evidence‐based. Users highlighted the potential transferability of the Resource to other contexts and settings. The enhanced version of the ImPaC Resource was usable, acceptable, feasible, and met users' expectations and requirements. Results lead the way for evaluation of the Resource in a nationwide cluster randomized trial including 18 NICUs. This knowledge‐rich platform is expected to enhance infant pain practices and outcomes in diverse clinical settings.
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Affiliation(s)
- Mariana Bueno
- Child Health Evaluative SciencesPeter Gilgan Centre for Research and Learning (PGCRL)The Hospital for Sick ChildrenTorontoONCanada
| | - Bonnie Stevens
- Child Health Evaluative SciencesPeter Gilgan Centre for Research and Learning (PGCRL)The Hospital for Sick ChildrenTorontoONCanada
- Lawrence S. Bloomberg Faculty of Nursing & Faculties of Medicine and DentistryUniversity of TorontoTorontoONCanada
| | - Megha Rao
- Child Health Evaluative SciencesPeter Gilgan Centre for Research and Learning (PGCRL)The Hospital for Sick ChildrenTorontoONCanada
- School of KinesiologyThe University of Western OntarioLondonONCanada
| | - Shirine Riahi
- Child Health Evaluative SciencesPeter Gilgan Centre for Research and Learning (PGCRL)The Hospital for Sick ChildrenTorontoONCanada
| | - Alexa Lanese
- Child Health Evaluative SciencesPeter Gilgan Centre for Research and Learning (PGCRL)The Hospital for Sick ChildrenTorontoONCanada
| | - Shelly‐Anne Li
- Child Health Evaluative SciencesPeter Gilgan Centre for Research and Learning (PGCRL)The Hospital for Sick ChildrenTorontoONCanada
- Lawrence S. Bloomberg Faculty of Nursing & Faculties of Medicine and DentistryUniversity of TorontoTorontoONCanada
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9
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Puchalski Ritchie LM, Straus SE. Assessing Organizational Readiness for Change Comment on "Development and Content Validation of a Transcultural Instrument to Assess Organizational Readiness for Knowledge Translation in Healthcare Organizations: The OR4KT". Int J Health Policy Manag 2019; 8:55-57. [PMID: 30709104 PMCID: PMC6358647 DOI: 10.15171/ijhpm.2018.101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 10/08/2018] [Indexed: 11/17/2022] Open
Abstract
This commentary provides an overview of the organizational readiness for change (ORC) literature over the last decade, with respect to prevailing definitions, theories, and tools to guide assessment of ORC in preparation for implementation. The development of the OR4KT by Gagnon et al is an important contribution to this body of work. This commentary highlights the strengths of the OR4KT including development based on two systematic reviews conducted by the authors to synthesize OR theory and measurement tools, and applicability to a wider range of high-income country healthcare settings through inclusion of input from a diverse group of international experts and transcultural adaptation of the tool, in the context of the literature to date. Limitations and future directions for further development of the tool are also discussed and include application of quantitative psychometric approaches and evaluation of the tool in a broader range of healthcare settings.
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Affiliation(s)
- Lisa M Puchalski Ritchie
- Department of Medicine, University of Toronto, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michaels Hospital, University of Toronto, Toronto, ON, Canada.,Department of Emergency Medicine, University Health Network, Toronto, ON, Canada
| | - Sharon E Straus
- Department of Medicine, University of Toronto, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michaels Hospital, University of Toronto, Toronto, ON, Canada
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Tremblay M, Vallée C, Carignan M, Provencher V, Delli-Colli N, Poulin V, Giguère A, Careau E, Giroux D. Design and implementation of the Competency Assessment Tool (CAT): user experience usability study. Inform Health Soc Care 2018; 45:57-76. [PMID: 30543137 DOI: 10.1080/17538157.2018.1550414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The decision on patients' competency to manage their affairs and take care of themselves requires a rigorous evaluation process and consistency among practice settings. Research indicates there is a lack of resources to guide healthcare and social service professionals in the interprofessional decision-making process that such an evaluation requires. A web-based tool, the Competency Assessment Tool (CAT), was designed to assist professionals in that process. The authors conducted a usability study with a beta version of the CAT. The objectives of this study were to: (1) explore what is needed to support its use in community-based and specialized settings; and (2) identify barriers to and facilitators of implementation. A major concern was the perceived onerous nature of the tool. Participants indicated a need for different versions of the tool, depending on the complexity of the evaluation. They want to be directed to areas in the tool based on their field of expertise and want adjustments to functionalities related to collaborative work. This study highlights the importance of the awareness of User Experience (UX) considerations at the outset of the design process, to limit the impact of required modifications and facilitate implementation in the workplace.
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Affiliation(s)
- Mélanie Tremblay
- Centre de recherche et d'intervention sur la réussite scolaire (CRIRES), Université Laval, Québec, Canada
| | - Catherine Vallée
- Centre de recherche sur les soins et services de première ligne, Université Laval, Québec, Canada
| | - Maude Carignan
- Centre d'excellence sur le vieillissement de Québec (CEVQ), Université Laval, Québec, Canada
| | - Véronique Provencher
- Centre de recherche sur le Vieillissement de Sherbrooke, Université de Sherbrooke, Sherbrooke, Canada
| | - Nathalie Delli-Colli
- Centre de recherche sur le Vieillissement de Sherbrooke, Université de Sherbrooke, Sherbrooke, Canada
| | - Valérie Poulin
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Anik Giguère
- Centre d'excellence sur le vieillissement de Québec (CEVQ), Université Laval, Québec, Canada
| | - Emmanuelle Careau
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Université Laval, Québec, Canada
| | - Dominique Giroux
- Centre d'excellence sur le vieillissement de Québec (CEVQ), Université Laval, Québec, Canada
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Organizational Readiness to Implement the Chronic Disease Self-Management Program in Dialysis Facilities. Geriatrics (Basel) 2018; 3:geriatrics3020031. [PMID: 31011069 PMCID: PMC6319202 DOI: 10.3390/geriatrics3020031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/05/2018] [Accepted: 06/07/2018] [Indexed: 12/26/2022] Open
Abstract
A gap exists between the development and uptake of evidence-based health promotion programs in health care settings. One reason for this gap is lack of attention to organizational readiness. The objective of this study was to assess organizational readiness to implement the Chronic Disease Self-Management Program in dialysis facilities. Survey data were collected from dialysis staff using a semi-structured Organizational Readiness for Implementing Change questionnaire. Change efficacy and change commitment scale ratings were all above 3.0, indicating a moderate level of readiness among staff. Profession and level of education were significantly associated with mean change efficacy scale ratings. Textual data revealed benefits to patients, implementation barriers and facilitators, and the influence of facility environment and culture. The findings of the current study suggest that additional efforts to advance the implementation of evidence-based health promotion programs in dialysis facilities are needed.
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A systematic review of the relationship between staff perceptions of organizational readiness to change and the process of innovation adoption in substance misuse treatment programs. J Subst Abuse Treat 2017; 80:6-25. [PMID: 28755775 DOI: 10.1016/j.jsat.2017.06.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 05/31/2017] [Accepted: 06/01/2017] [Indexed: 01/07/2023]
Abstract
Translating innovation, such as contemporary research evidence, into policy and practice is a challenge, not just in substance misuse treatment programs, but across all spheres of healthcare. Organizational readiness to change (ORC) has been described as a fundamental concept, and an important determinant of the process of innovation adoption. The aim of this review was to describe the relationship between staff perceptions of ORC and the process of innovation adoption: exposure, adoption, implementation and integration into practice, in substance misuse treatment programs. This systematic review was conducted in accordance with PRISMA guidelines and fourteen papers were identified as being eligible for inclusion. This review was designed to include all constructs of ORC, but only one tool was used in all of the included papers. Despite this, the heterogeneity of studies in this review made a direct comparison of ORC related variables challenging. None of the included papers clearly related to one stage of the process of innovation adoption, and all of the included papers related to the early stages of the process. Only one paper attempted to measure the sustained integration of an innovation into practice. Overall, the papers were assessed as being low in terms of evidential hierarchy and the quality of the papers was assessed as being on average fair. ORC measurements provide us with a measure of organizational functioning which can be important in terms of predicting how successfully new innovations are adopted. Motivation for change was high in programs where staff identified more program deficits and these staff could also identify more specific needs, but were less likely to have exposure to new innovations. Better program resources and specific staff attributes, increase the likely hood of successful innovation adoption. A good organizational climate is potentially the strongest predictor for the adoption of new practices. It may be beneficial to measure ORC in conjunction with other variables such as program size, location, staff workloads and financial resources. More evidence is required on how to address ORC deficits once they are identified in practice.
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Main CJ, Nicholas MK, Shaw WS, Tetrick LE, Ehrhart MG, Pransky G. Implementation Science and Employer Disability Practices: Embedding Implementation Factors in Research Designs. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:448-464. [PMID: 27796914 PMCID: PMC5104783 DOI: 10.1007/s10926-016-9677-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Purpose For work disability research to have an impact on employer policies and practices it is important for such research to acknowledge and incorporate relevant aspects of the workplace. The goal of this article is to summarize recent theoretical and methodological advances in the field of Implementation Science, relate these to research of employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration culminating in an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, MA, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results A 4-phase implementation model including both outer and inner contexts was adopted as the most appropriate conceptual framework, and aligned well with the set of process evaluation factors described in both the work disability prevention literature and the grey literature. Innovative interventions involving disability risk screening and psychologically-based interventions have been slow to gain traction among employers and insurers. Research recommendations to address this are : (1) to assess organizational culture and readiness for change in addition to individual factors; (2) to conduct process evaluations alongside controlled trials; (3) to analyze decision-making factors among stakeholders; and (4 ) to solicit input from employers and insurers during early phases of study design. Conclusions Future research interventions involving workplace support and involvement to prevent disability may be more feasible for implementation if organizational decision-making factors are imbedded in research designs and interventions are developed to take account of these influences.
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Affiliation(s)
- Chris J Main
- Arthritis Care UK Primary Care Center, Keele University, North Staffordshire, UK
| | - Michael K Nicholas
- Pain Management Research Institute, Sydney Medical School - Northern, Royal North Shore Hospital, St. Leonards, NSW, 2065, Australia.
| | - William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | | | - Glenn Pransky
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
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Timmings C, Khan S, Moore JE, Marquez C, Pyka K, Straus SE. Ready, Set, Change! Development and usability testing of an online readiness for change decision support tool for healthcare organizations. BMC Med Inform Decis Mak 2016; 16:24. [PMID: 26907792 PMCID: PMC4765048 DOI: 10.1186/s12911-016-0262-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 02/17/2016] [Indexed: 11/10/2022] Open
Abstract
Background To address challenges related to selecting a valid, reliable, and appropriate readiness assessment measure in practice, we developed an online decision support tool to aid frontline implementers in healthcare settings in this process. The focus of this paper is to describe a multi-step, end-user driven approach to developing this tool for use during the planning stages of implementation. Methods A multi-phase, end-user driven approach was used to develop and test the usability of a readiness decision support tool. First, readiness assessment measures that are valid, reliable, and appropriate for healthcare settings were identified from a systematic review. Second, a mapping exercise was performed to categorize individual items of included measures according to key readiness constructs from an existing framework. Third, a modified Delphi process was used to collect stakeholder ratings of the included measures on domains of feasibility, relevance, and likelihood to recommend. Fourth, two versions of a decision support tool prototype were developed and evaluated for usability. Results Nine valid and reliable readiness assessment measures were included in the decision support tool. The mapping exercise revealed that of the nine measures, most measures (78 %) focused on assessing readiness for change at the organizational versus the individual level, and that four measures (44 %) represented all constructs of organizational readiness. During the modified Delphi process, stakeholders rated most measures as feasible and relevant for use in practice, and reported that they would be likely to recommend use of most measures. Using data from the mapping exercise and stakeholder panel, an algorithm was developed to link users to a measure based on characteristics of their organizational setting and their readiness for change assessment priorities. Usability testing yielded recommendations that were used to refine the Ready, Set, Change! decision support tool . Conclusions Ready, Set, Change! decision support tool is an implementation support that is designed to facilitate the routine incorporation of a readiness assessment as an early step in implementation. Use of this tool in practice may offer time and resource-saving implications for implementation. Electronic supplementary material The online version of this article (doi:10.1186/s12911-016-0262-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Caitlyn Timmings
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, M5B 1W8, Canada.
| | - Sobia Khan
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, M5B 1W8, Canada.
| | - Julia E Moore
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, M5B 1W8, Canada.
| | - Christine Marquez
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, M5B 1W8, Canada.
| | - Kasha Pyka
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, M5B 1W8, Canada.
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, M5B 1W8, Canada. .,University of Toronto, 563 Spadina Crescent, Toronto, M5S 2J7, Canada.
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Briggs AM, Jordan JE, Speerin R, Jennings M, Bragge P, Chua J, Slater H. Models of care for musculoskeletal health: a cross-sectional qualitative study of Australian stakeholders' perspectives on relevance and standardised evaluation. BMC Health Serv Res 2015; 15:509. [PMID: 26573487 PMCID: PMC4647615 DOI: 10.1186/s12913-015-1173-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence and impact of musculoskeletal conditions are predicted to rapidly escalate in the coming decades. Effective strategies are required to minimise 'evidence-practice', 'burden-policy' and 'burden-service' gaps and optimise health system responsiveness for sustainable, best-practice healthcare. One mechanism by which evidence can be translated into practice and policy is through Models of Care (MoCs), which provide a blueprint for health services planning and delivery. While evidence supports the effectiveness of musculoskeletal MoCs for improving health outcomes and system efficiencies, no standardised national approach to evaluation in terms of their 'readiness' for implementation and 'success' after implementation, is yet available. Further, the value assigned to MoCs by end users is uncertain. This qualitative study aimed to explore end users' views on the relevance of musculoskeletal MoCs to their work and value of a standardised evaluation approach. METHODS A cross-sectional qualitative study was undertaken. Subject matter experts (SMEs) with health, policy and administration and consumer backgrounds were drawn from three Australian states. A semi-structured interview schedule was developed and piloted to explore perceptions about musculoskeletal MoCs including: i) aspects important to their work (or life, for consumers) ii) usefulness of standardised evaluation frameworks to judge 'readiness' and 'success' and iii) challenges associated with standardised evaluation. Verbatim transcripts were analysed by two researchers using a grounded theory approach to derive key themes. RESULTS Twenty-seven SMEs (n = 19; 70.4 % female) including five (18.5 %) consumers participated in the study. MoCs were perceived as critical for influencing and initiating changes to best-practice healthcare planning and delivery and providing practical guidance on how to implement and evaluate services. A 'readiness' evaluation framework assessing whether critical components across the health system had been considered prior to implementation was strongly supported, while 'success' was perceived as an already familiar evaluation concept. Perceived challenges associated with standardised evaluation included identifying, defining and measuring key 'readiness' and 'success' indicators; impacts of systems and context changes; cost; meaningful stakeholder consultation and developing a widely applicable framework. CONCLUSIONS A standardised evaluation framework that includes a strong focus on 'readiness' is important to ensure successful and sustainable implementation of musculoskeletal MoCs.
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Affiliation(s)
- Andrew M Briggs
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Australia.
| | | | - Robyn Speerin
- New South Wales Agency for Clinical Innovation, PO Box 699, Chatswood, NSW, 2057, Australia.
| | - Matthew Jennings
- New South Wales Agency for Clinical Innovation, PO Box 699, Chatswood, NSW, 2057, Australia.
- Liverpool Hospital, South Western Sydney Local Health District, Locked bag 7103, Liverpool Business Centre, Liverpool, NSW, 1871, Australia.
| | - Peter Bragge
- BehaviourWorks Australia, Monash Sustainability Institute, 8 Scenic Boulevard, Monash University, Melbourne, VIC, 3800, Australia.
| | - Jason Chua
- Department of Health, Government of Western Australia, PO Box 8172, Perth Business Centre, Perth, 6849, Australia.
| | - Helen Slater
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Australia.
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