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Mazzucca-Ragan S, Brownson CA, Crouch MM, Davis S, Duffany KO, Erwin PC, Leiferman JA, McCormick LC, Walker JT, Brownson RC. Equipping the Public Health Workforce of the Future: Evaluation of an Evidence-Based Public Health Training Delivered Through Academic-Health Department Partnerships. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024:00124784-990000000-00329. [PMID: 39121436 DOI: 10.1097/phh.0000000000001985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2024]
Abstract
OBJECTIVE Maintaining a skilled public health workforce is essential but challenging given high turnover and that few staff hold a public health degree. Situating workforce development within existing structures leverages the strengths of different organizations and can build relationships to address public health challenges and health equity. We implemented and evaluated an innovative, sustainable model to deliver an established evidence-based public health (EBPH) training collaboratively among Prevention Research Centers (PRC), local and state health departments, and Public Health Training Centers (PHTC). DESIGN Quantitative data: quasi-experimental, 1-group pre-post. Qualitative data: cross-sectional. Data were collected between December 2021 and August 2022. SETTING Four US sites, each a partnership between a PRC, local or state health department, and a PHTC. PARTICIPANTS Governmental public health staff and representatives from other organizations that implement public health programs in practice settings. MAIN OUTCOME MEASURES Course participants completed a pre- and postcourse survey self-rating 14 skills on a 5-point Likert scale. Differences were analyzed using mixed effects linear models. In-depth interviews (n = 15) were conducted with course faculty and partners to understand: (1) resources contributed, (2) barriers and facilitators, (3) benefits and challenges, and (4) resources needed to sustain this model. Interviews were transcribed verbatim, and a thematic analysis identified themes. RESULTS Statistically significant increases in all skills were observed from pre- to postcourse (n = 241 at post, 90% response). The skills with the largest increases were understanding economic evaluation enough to inform decision-making (mean change = 1.22, standard error [SE] = 0.05) and developing an action plan (mean change = 1.07, SE = 0.07). Facilitators to delivering the course included having a shared goal of workforce development, existing course curricula, and dedicated funding for delivering the course. CONCLUSIONS Collaborative delivery of the EBPH training can ameliorate the effects of high staff turnover, strengthen academic-practice relationships, and promote population-wide health and health equity.
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Affiliation(s)
- Stephanie Mazzucca-Ragan
- Author Affiliations: Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, Missouri (Dr Mazzucca-Ragan and Mrs Brownson); New England Public Health Training Center, Yale University, New Haven, Connecticut (Mrs Crouch); Rocky Mountain Public Health Training Center, Colorado School of Public Health, Aurora, Colorado (Mrs Davis); Yale-Griffin Prevention Research Center, Yale University, New Haven, Connecticut (Dr Duffany); School of Public Health, University of Alabama at Birmingham, Alabama, Birmingham (Dr Erwin); Rocky Mountain Prevention Research Center, Colorado School of Public Health, Aurora, Colorado (Dr Leiferman); Region IV Public Health Training Center, University of Alabama at Birmingham, School of Public Health, Alabama, Birmingham (Dr McCormick); Center for the Study of Community Health, University of Alabama at Birmingham, Alabama, Birmingham (Dr Walker); Prevention Research Center, Brown School at Washington University in St. Louis (Dr Brownson), St. Louis, Missouri; and Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri (Dr Brownson)
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Brady J, Mizelle E, Modly L, Smith A, Bradford E, Mac V, Ferranti E, Smith D. Training Nursing Students on Heat-Related Illness First Aid to Protect Farmworkers. Nurse Educ 2024; 49:E234-E235. [PMID: 38266183 DOI: 10.1097/nne.0000000000001588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Affiliation(s)
- Jessica Brady
- Author Affiliations: Student (Ms Brady) and Assistant Professor (Dr Mizelle), College of Nursing, East Carolina University, Greenville, North Carolina; Assistant Clinical Professor (Dr Modly), Student (Ms Bradford), Adjunct Assistant Professor (Dr Mac), and Assistant Professor (Dr Ferranti), Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia; and Student (Ms A. Smith) and Assistant Professor (Dr Smith), M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania
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Cooperman NA, Shen J, Gordon AJ, Garland EL. Commentary With Study Protocol: Implementation and Effectiveness of Mindfulness-Oriented Recovery Enhancement (MORE) as an Adjunct to Methadone Treatment for Opioid Use Disorder (IMPOWR-MORE). SUBSTANCE USE & ADDICTION JOURNAL 2024:29767342241261890. [PMID: 38907675 DOI: 10.1177/29767342241261890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
Traditional methadone treatment (MT) for opioid use disorder (OUD) fails to systematically address the physical pain, emotion dysregulation, and reward processing deficits that co-occur with OUD, and novel interventions that address these issues are needed to improve MT outcomes. Mindfulness-Oriented Recovery Enhancement (MORE) remediates the hedonic dysregulation in brain reward systems that is associated with OUD. Our pilot and phase 2 randomized controlled trials of MORE were the first to demonstrate MORE's feasibility, acceptability, and efficacy as delivered in MT clinics; MORE significantly reduced drug use (eg, benzodiazepines, barbiturates, cocaine, marijuana, opioids, and other drugs), craving, depression, anxiety, and pain among people with OUD. However, uptake of novel, efficacious interventions like MORE may be slow in MT because time and resources are often limited. Therefore, to best address potential implementation issues and to optimize future MORE implementation and dissemination, in this study, we will utilize a Type 2, Hybrid Implementation-Effectiveness study design. We will not only evaluate MORE's effectiveness but also assess barriers and facilitators to integrating MORE into MT. MT clinicians will receive training in (1) a higher intensity MORE implementation strategy consisting of training in the full MORE treatment manual or (2) a minimal intensity implementation strategy consisting of a simple, scripted mindfulness practice (SMP) extracted from the MORE treatment manual with minimal training. We aim to: (1) using a Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, examine barriers and facilitators to implementation of MORE and SMP in MT, and evaluate strategies for optimizing training, fidelity, and engagement, (2) optimize existing MORE and SMP training and implementation toolkits, including adaptable resources that can accelerate the translation of evidence into practice, and (3) compared to usual MT, evaluate the relative effectiveness of MORE plus MT or SMP plus MT (N = 450).
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Affiliation(s)
- Nina A Cooperman
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Jincheng Shen
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Adam J Gordon
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
| | - Eric L Garland
- College of Social Work, University of Utah, Salt Lake City, UT, USA
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Rivera Nales CJ, Triplett NS, Woodard GS, Meza R, Valdivieso A, Goel V, Dorsey S, Berliner L, Martin P. CBT+ Training Initiative in Washington State Community Mental Health: An Evaluation of Child Clinical Outcomes. Community Ment Health J 2024; 60:649-661. [PMID: 37880492 DOI: 10.1007/s10597-023-01194-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 09/23/2023] [Indexed: 10/27/2023]
Abstract
The Washington State CBT+ Initiative offers a flexible training and consultation approach for community mental health providers in evidence-based practices for four child mental health targets: cognitive behavioral therapy for depression, anxiety, trauma, and behavioral difficulties. As part of consultation, clinicians used an online system to track delivery of treatment components and clinical outcomes using standardized symptom measures. The current study used these clinician-input data to examine symptom change for children using paired sample t-tests. Additionally, we explored if time elapsed or number of sessions between measurements related to symptom change using simple linear regression. Children had significant symptom reduction across all four targets. For most measures, children did not show greater improvements with increased length of time or increased number of sessions between assessment measures. Findings suggest that children treated by a CBT+ trained clinician may demonstrate symptom reduction for their primary clinical problem. Findings add to support for flexible training approaches for community mental health clinicians.
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Affiliation(s)
- Cristian J Rivera Nales
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Noah S Triplett
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Grace S Woodard
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Rosemary Meza
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Alejandro Valdivieso
- Department of Clinical and Counseling Psychology, Columbia University, New York, NY, USA
| | - Vanshika Goel
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Shannon Dorsey
- Department of Psychology, University of Washington, Seattle, WA, USA
| | | | - Prerna Martin
- Department of Psychiatry, University of California Los Angeles, Los Angeles, CA, USA
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D'Aprano A, Hunter SA, Fry R, Savaglio M, Carmody S, Boffa J, Cooke L, Dent A, Docksey A, Douglas J, Dunn A, Halfpenny N, Hewett M, Lipscomb A, Manahan E, Morton B, Mosse H, Ross D, Skouteris H. 'All Aboriginal and Torres Strait Islander children should have access to the ASQ-TRAK': Shared vision of an implementation support model for the ASQ-TRAK developmental screener. Health Promot J Austr 2024; 35:433-443. [PMID: 37431858 DOI: 10.1002/hpja.773] [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: 02/09/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/12/2023] Open
Abstract
ISSUE ADDRESSED The ASQ-TRAK, a strengths-based approach to developmental screening, has high acceptability and utility across varied Aboriginal and Torres Strait Islander contexts. While substantive knowledge translation has seen many services utilise ASQ-TRAK, we now need to move beyond distribution and support evidence-based scale-up to ensure access. Through a co-design approach, we aimed to (1) understand community partners' perspectives of barriers and enablers to ASQ-TRAK implementation and (2) develop an ASQ-TRAK implementation support model to inform scale-up. METHODS The co-design process had four phases: (i) partnership development with five community partners (two Aboriginal Community Controlled Organisations); (ii) workshop planning and recruitment; (iii) co-design workshops; and (iv) analysis, draft model and feedback workshops. RESULTS Seven co-design meetings and two feedback workshops with 41 stakeholders (17 were Aboriginal and Torres Strait Islander), identified seven key barriers and enablers, and a shared vision - all Aboriginal and Torres Strait Islander children and their families have access to the ASQ-TRAK. Implementation support model components agreed on were: (i) ASQ-TRAK training, (ii) ASQ-TRAK support, (iii) local implementation support, (iv) engagement and communications, (v) continuous quality improvement and (vi) coordination and partnerships. CONCLUSIONS This implementation support model can inform ongoing processes necessary for sustainable ASQ-TRAK implementation nationally. This will transform the way services provide developmental care to Aboriginal and Torres Strait Islander children, ensuring access to high quality, culturally safe developmental care. SO WHAT?: Well-implemented developmental screening leads to more Aboriginal and Torres Strait Islander children receiving timely early childhood intervention services, improving developmental trajectories and optimising long-term health and wellbeing.
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Affiliation(s)
- Anita D'Aprano
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sue-Anne Hunter
- Sue-Anne Hunter Cultural Consultant, Melbourne, Victoria, Australia
| | - Rebecca Fry
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Melissa Savaglio
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sarah Carmody
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John Boffa
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Louise Cooke
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Abigail Dent
- Aboriginal Children's Healing Team, Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
| | - Amanda Docksey
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Josie Douglas
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
- Central Land Council, Alice Springs, Northern Territory, Australia
| | - Adam Dunn
- Aboriginal Team, Take Two, Berry Street, Richmond, Victoria, Australia
| | - Nick Halfpenny
- MacKillop Family Services, Melbourne, Victoria, Australia
| | - Meg Hewett
- Department of Education, Connected Beginnings Program, Darwin, Northern Territory, Australia
| | - Adrienne Lipscomb
- Aboriginal Children's Healing Team, Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
| | - Esmai Manahan
- MacKillop Family Services, Melbourne, Victoria, Australia
| | - Belinda Morton
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Holly Mosse
- Aboriginal Team, Take Two, Berry Street, Richmond, Victoria, Australia
- Uniting, University of Warwick, Melbourne, Victoria, Australia
| | - Dawn Ross
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Warwick Business School, University of Warwick, Coventry, UK
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Fraboni F, Morandini S, Zappalà S, Guglielmi D, Mariani MG, De Angelis M, Pietrantoni L. Occupational safety in homecare organizations: the design and implementation of a train-the-trainer program. Home Health Care Serv Q 2024; 43:87-113. [PMID: 38104310 DOI: 10.1080/01621424.2023.2292193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Homecare workers face significant occupational risks, necessitating effective safety training programs. This paper presents a comprehensive Train-the-Trainer (TTT) program developed to enhance occupational safety in homecare organizations. Through an analysis of 229 reported safety events, the frequency and type of incidents, such as injuries during handling, road crashes, slips, trips, and falls, were identified and primarily attributed to human errors and violations. Based on the results, a TTT program was designed and implemented. The TTT successfully engaged Health, Safety, and Environment managers, fostering collaborative activities, knowledge sharing, and resource discussions. The program modules address critical areas, including distractions and inattentions, fatigue, time pressure, frustration and aggressiveness, and safety behaviors. This innovative approach provides valuable insights for organizations seeking to improve homecare workers' safety. The findings add to the broader comprehension of occupational safety in the homecare sector, proposing a pragmatic framework for future interventions.
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Affiliation(s)
| | - Sofia Morandini
- Department of Psychology, University of Bologna, Bologna, Italy
| | | | - Dina Guglielmi
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Education Studies, University of Bologna, Bologna, Italy
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West NT, Harmon BE, Rawlett KE, Short SJ, Spanier AJ, Mathews S, Kimble K, McGehee C, Ratliff ML, Puett RC. Perceptions of mindfulness practices as a support for individuals managing caregiving responsibilities and chronic disease: A qualitative study. Chronic Illn 2024; 20:159-172. [PMID: 37077138 DOI: 10.1177/17423953231170401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
OBJECTIVES Explore the lived experience of individuals managing and/or caregiving for someone with a chronic disease and their perceptions of developing a mindfulness program for stress reduction. METHODS Sixteen participants with chronic disease and/or caregivers participated. Participants completed eligibility screening, demographic questionnaires, and semi-structured interviews (30-60 min each) online or by phone. Interviews (n = 16) were audio recorded, transcribed, and analyzed using thematic analysis and NVivo® 12. Survey data were analyzed using SPSS® 28. RESULTS Four themes emerged: (a) Chronic disease management and stress-perspectives on life's stressors; (b) Stress reduction techniques/perceptions of mindfulness-knowledge and implementation of stress reduction practices and familiarity with mindfulness; (c) Mindfulness program acceptability, barriers, and facilitators-interest, barriers, and facilitators to attending; (d) Mindfulness program structure-logistics to increase access and appeal to diverse audiences. DISCUSSION Mindfulness has the potential for addressing the complexities of stress associated with disease management. Targeting mindfulness programs for populations with chronic disease management and caregiving responsibilities should include: Consideration of group formats with participation limited to this population, structuring programs to overcome barriers (i.e., culturally appropriate location), and equipping members of the community being served as instructors to ensure culturally relevant instruction.
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Affiliation(s)
- Nathan T West
- Institute of Social and Economic Research, University of Alaska Anchorage, Anchorage, AK, USA
| | - Brook E Harmon
- Department of Nutrition and Health Care Management, Beaver College of Health Sciences, Appalachian State University, Boone, NC, USA
| | - Kristen E Rawlett
- Department of Family and Community Health, School of Nursing, University of Maryland, Baltimore, MD, USA
| | - Sarah J Short
- Department of Educational Psychology, University of Wisconsin, Madison, WI, USA
- Center for Healthy Minds, University of Wisconsin, Madison, WI, USA
| | - Adam J Spanier
- Department of Pediatrics, Division of General Pediatrics, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Shifali Mathews
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA
| | | | - Chad McGehee
- Center for Healthy Minds, University of Wisconsin, Madison, WI, USA
- Department of Athletics, University of Wisconsin, Madison, WI, USA
| | - Macy L Ratliff
- Center for Healthy Minds, University of Wisconsin, Madison, WI, USA
| | - Robin C Puett
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA
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Wippold GM, Tucker CM, Farishta A, Kim E, Hill R, Burwell A, Sapia P. An in-person and technology-implemented holistic health promotion program for older Black adults in low-income communities. J Natl Med Assoc 2024; 116:83-92. [PMID: 38172041 PMCID: PMC10922434 DOI: 10.1016/j.jnma.2023.12.008] [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: 10/10/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
The COVID-19 pandemic halted many in-person programs of research and required researchers to pivot to technology-enhanced approaches. To date, there are no examples or guidelines on how to use technology to implement health promotion programs rooted in the community-based participatory research (CBPR) model among low-income older Black adults. The aims of this paper are (a) to describe and report on the health-related outcomes of an in-person CBPR model-based health promotion intervention program for older Black adults in a low-income community, and (b) to describe the process of adapting this program to a technology-enhanced and Zoom-delivered format and provide preliminary evidence on the health-related outcomes and acceptability of this program. This paper highlights the potential benefits of a technology-enhanced and Zoom-delivered health promotion program among low-income older Black adults and provides recommendations to optimize such efforts to foster these benefits. These recommendations are aligned with the four domains of the CBPR model (i.e., contexts, partnership processes, intervention and research, and outcomes). We conclude that CBPR model-based, technology implemented health promotion interventions for low-income older Black adults are acceptable to such adults and should attend to the values, perspectives, and preferences of these individuals. The information in this manuscript is relevant to health promotion specialists at this seemingly ongoing though post-pandemic era because technology-enhanced interventions are scalable and cost-effective and those anchored in CBPR are well-positioned to promote health equity.
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Affiliation(s)
| | | | | | - Erin Kim
- University of Florida, Gainesville, FL, USA
| | - Rhonda Hill
- UF College of Community Health and Family Medicine (Jacksonville), Jacksonville, FL, USA
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McCreedy EM, Dewji A, Dionne L, Zhu E, Baier RR, Reddy A, Olson MB, Rudolph JL. Pragmatic Implementation of a Music Intervention in Nursing Homes Before and During COVID-19. J Am Med Dir Assoc 2024; 25:314-320. [PMID: 38036026 PMCID: PMC10872256 DOI: 10.1016/j.jamda.2023.10.021] [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: 07/15/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVES We conducted 2 trials of a music intervention for managing behaviors in nursing home (NH) residents with dementia, before (2019) and during (2021) the pandemic. In this report, we compare adherence fidelity across the trials using the Framework for Implementation Fidelity (FIF). DESIGN Cross-sectional, descriptive implementation comparison. SETTING AND PARTICIPANTS Fifty-four NHs randomized to receive the intervention (27 pre-COVID, 27 during COVID) METHODS: We compare the trials on the following FIF criteria: coverage (number of residents receiving the intervention); duration (minutes of music received per exposed day); frequency (percentage of residents with nursing staff use of music in the past week); and details of content (adherence to core components of the intervention). We report NH-level performance in each domain and compare characteristics of NHs in the bottom (low) and top (high) terciles of adherence. RESULTS Across FIF domains, adherence fidelity was lower during COVID compared with pre-COVID: coverage, residents exposed (COVID: 7.5, SD 5.6; pre-COVID: 12.7, SD 3.6); duration, music minutes per exposed day (COVID: 2.5, SD 5.1; pre-COVID: 27.1, SD 23.9); frequency, percentage of residents with nursing use of intervention in the past week (COVID: 15.0, SD 31.5; pre-COVID 40.4, SD 25.6); and details of content, compliance with core components of the intervention (COVID: 8.3, SD 1.9; pre-COVID 9.6, SD 2.0). In both trials, high-adherence fidelity NHs had better nursing staff ratios, greater percentages of Medicare residents, and lower percentages of Black residents, compared with low-fidelity NHs. CONCLUSIONS AND IMPLICATIONS Adherence fidelity was worse in the COVID vs pre-COVID trial, despite adaptations between trials intended to reduce staff burden and increase clinical targeting of the intervention. Results may point to the long-term effects of COVID on quality improvement capacity in NHs and/or a lack of available resources in most NHs to implement complex behavioral interventions without direct research support.
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Affiliation(s)
- Ellen M McCreedy
- Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI, USA; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA; Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI, USA.
| | - Aleena Dewji
- Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI, USA; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA
| | - Laura Dionne
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, USA
| | - Enya Zhu
- Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI, USA; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA
| | - Rosa R Baier
- Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI, USA; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA; Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI, USA
| | - Ann Reddy
- Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI, USA
| | - Miranda B Olson
- Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI, USA; Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI, USA
| | - James L Rudolph
- Center for Gerontology & Healthcare Research, Brown University School of Public Health, Providence, RI, USA; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA; US Department of Veterans Affairs Medical Center, Providence, RI, USA
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Nexø MA, Kingod NR, Eshøj SH, Kjærulff EM, Nørgaard O, Andersen TH. The impact of train-the-trainer programs on the continued professional development of nurses: a systematic review. BMC MEDICAL EDUCATION 2024; 24:30. [PMID: 38178050 PMCID: PMC10768131 DOI: 10.1186/s12909-023-04998-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Train-the-trainer (TTT) programs are widely applied to disseminate knowledge within healthcare systems, but evidence of the effectiveness of this educational model remains unclear. We systematically reviewed studies evaluating the impact of train-the-trainer models on the learning outcomes of nurses. METHODS The reporting of our systematic review followed PRISMA 2020 checklist. Records identified from MEDLINE, Embase, CINAHL, and ERIC were independently screened by two researchers and deemed eligible if studies evaluated learning outcomes of a train-the-trainer intervention for trainers or trainees targeting nurses. Study quality was assessed with Joanna Briggs Institute's critical appraisal tools and data of study characteristics extracted (objective, design, population, outcomes, results). Heterogeneity of outcomes ruled out meta-analysis; a narrative synthesis and vote counting based on direction of effects (p < 0.05) synthesized the results. All records were uploaded and organized in EPPI-Reviewer. RESULTS Of the 3800 identified records 11 studies were included. The included studies were published between 1998 and 2021 and mostly performed in the US or Northern Europe. Nine studies had quasi-experimental designs and two were randomized controlled trials. All evaluated effects on nurses of which two also included nurses' assistants. The direction of effects of the 13 outcomes (knowledge, n = 10; skills, n = 2; practice, n = 1) measured in the 11 included studies were all beneficial. The statistical analysis of the vote counting showed that train-the-trainer programs could significantly (p < 0.05) improve trainees' knowledge, but the number of outcomes measuring impact on skills or practice was insufficient for synthesis. CONCLUSIONS Train-the-trainer models can successfully disseminate knowledge to nurses within healthcare systems. Considering the nurse shortages faced by most Western healthcare systems, train-the-trainer models can be a timesaving and sustainable way of delivering education. However, new comparative studies that evaluate practice outcomes are needed to conclude whether TTT programs are more effective, affordable and timesaving alternatives to other training programs. TRIAL REGISTRATION The protocol was registered in Research Registry ( https://www.researchregistry.com , unique identifying number 941, 29 June 2020).
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Affiliation(s)
- Mette Andersen Nexø
- Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark.
| | - Natassia Rosewood Kingod
- Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark
| | - Signe Hornsleth Eshøj
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, Building 24 Q, 1 Floor, Copenhagen K, Denmark
| | - Emilie Mølholm Kjærulff
- Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, Building 24 Q, 1 Floor, Copenhagen K, Denmark
| | - Ole Nørgaard
- Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark
| | - Tue Helms Andersen
- Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, Denmark
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Oladeji BD, Ayinde OO, Bello T, Kola L, Faregh N, Abdulmalik J, Zelkowitz P, Seedat S, Gureje O. Cascade training for scaling up care for perinatal depression in primary care in Nigeria. Int J Ment Health Syst 2023; 17:41. [PMID: 37986025 PMCID: PMC10658820 DOI: 10.1186/s13033-023-00607-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/06/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Task-shared care is a demonstrated approach for integrating mental health into maternal and child healthcare (MCH) services. Training and continued support for frontline providers is key to the success of task sharing initiatives. In most settings this is provided by mental health specialists. However, in resource constrained settings where specialists are in short supply, there is a need to explore alternative models for providing training and supportive supervision to frontline maternal care providers. This paper reports on the impact of a cascade training (train-the-trainers) approach in improving the knowledge and attitudes of primary healthcare workers (PHCW) to perinatal depression. METHODS Senior primary health care providers selected from across participating local government areas were trained to provide training to other PHCWs. The training sessions facilitated by these trainers were observed and rated for fidelity by specialist trainers, while the trainees provided their impression of and satisfaction with the training sessions using predesigned assessment forms. Training outcomes assessed included knowledge of depression (using mhGAP training questions and knowledge of depression questionnaire) and attitude towards providing care for depression (revised depression attitude questionnaire (R-DAQ)) measured pre and post training as well as six months after training. RESULTS Trainees were 198 PHCWs (94.4% female), who routinely provide MCH services in 28 selected primary care clinics and had between 6- and 34-years' experience. Training was provided by 11 trained trainers who were general physicians or senior nurses. Training sessions were rated high in fidelity and on training style. Sessions were rated excellent by 77.8% of the trainees with the trainers described as knowledgeable, effective and engaging. Knowledge of depression mean score improved from a pre-training level of 12.3 ± 3.5 to 15.4 ± 3.7, immediately post-training and 14.7 ± 3.2, six months post-training (both comparisons: p < 0.001). The proportion of PHCW workers endorsing statements indicative of positive attitudes on the professional confidence and the generalist perspective modules of the R-DAQ also increased with training. CONCLUSION Our findings suggest that cascade training can be an effective model for rapidly providing training and upskilling frontline PHCWs to deliver care for women with perinatal depression in resource limited settings. TRIAL REGISTRATION This study was retrospectively registered 03 December 2019. https://doi.org/10.1186/ISRCTN 94,230,307.
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Affiliation(s)
- Bibilola D Oladeji
- Department of Psychiatry of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Olatunde O Ayinde
- Department of Psychiatry of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Toyin Bello
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Lola Kola
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Neda Faregh
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Jibril Abdulmalik
- Department of Psychiatry of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Oye Gureje
- Department of Psychiatry of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Cai C, Qu D, Liu D, Liu B, Zhang X, Chen P, Chen D, Yin C, Sun S, Tong Y, An J, Chen R. Effectiveness of a localised and systematically developed gatekeeper training program in preventing suicide among Chinese adolescents. Asian J Psychiatr 2023; 89:103755. [PMID: 37672951 DOI: 10.1016/j.ajp.2023.103755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023]
Abstract
To combat the pressing issue of contemporary suicide rates, an effective Life Gatekeeper training program was developed to educate school teachers in identifying and intervening with at-risk students. Two single-arm sequential studies evaluated the program's effectiveness, spanning implementation science stages from design to refinement. The initial study employed face-to-face training (FTF), followed by a standardized video-based 'Train-the-trainer' (TTT) approach. In Study 1, post-intervention and one-month follow-up results showed improved suicide literacy, reduced stigma, and increased willingness to intervene among gatekeepers. The revised TTT program (study 2) also yielded reduced stigmatization and improved intervention competence. In addition, six out of twenty teachers exhibited gatekeeper behaviors. In conclusion, both delivery methods proved effective, particularly the practical application of the TTT version, although further research is warranted to examine long-term effectiveness of the program.
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Affiliation(s)
- Chengxi Cai
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Dongyu Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Bowen Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Xuan Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Peiyu Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Dongyang Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Chen Yin
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Yongsheng Tong
- Beijing Huilongguan Hospital, Beijing, China; Peking University HuiLongGuan Clinical Medical School, Beijing, China; WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Jing An
- Beijing Huilongguan Hospital, Beijing, China; Peking University HuiLongGuan Clinical Medical School, Beijing, China; WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China.
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China.
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Wray TB, Kemp JJ, Adams Larsen M. Virtual reality (VR) treatments for anxiety disorders are unambiguously successful, so why are so few therapists using it? Barriers to adoption and potential solutions. Cogn Behav Ther 2023; 52:603-624. [PMID: 37376984 PMCID: PMC10592498 DOI: 10.1080/16506073.2023.2229017] [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: 03/05/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
Anxiety disorders are a significant cause of disability globally, yet only one in ten sufferers receives adequate quality treatment. Exposure-based therapies are effective in reducing symptoms associated with a number of anxiety disorders. However, few therapists use exposure techniques to treat these conditions, even when they are adequately trained in them, often because of concerns about provoking distress, drop out, logistical barriers, and other concerns. Virtual reality exposure therapy (VRET) can address many of these concerns, and a large body of research decisively shows that VRET is as efficacious for treating these conditions as in vivo exposures. Yet, use of VRET remains low. In this article, we discuss several factors we believe are contributing to low VRET adoption among therapists and raise potential solutions to address them. We consider steps that VR experience developers and researchers might take, such as leading studies of VRET's real-world effectiveness and treatment optimization trials and continuing to improve the fit of platforms with clinicians' workflows. We also discuss steps to address therapist reservations using aligned implementation strategies, as well as barriers for clinics, and the roles that professional organizations and payers could have in improving care by encouraging adoption of VRET.
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Affiliation(s)
- Tyler B. Wray
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, Providence, RI
| | - Joshua J. Kemp
- Pediatric Anxiety Research Center, Warren Alpert Medical School of Brown University, Providence, RI
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Mfinanga S, Kanyama C, Kouanfack C, Nyirenda S, Kivuyo SL, Boyer-Chammard T, Phiri S, Ngoma J, Shimwela M, Nkungu D, Fomete LN, Simbauranga R, Chawinga C, Ngakam N, Heller T, Lontsi SS, Aghakishiyeva E, Jalava K, Fuller S, Reid AM, Rajasingham R, Lawrence DS, Hosseinipour MC, Beaumont E, Bradley J, Jaffar S, Lortholary O, Harrison T, Molloy SF, Sturny-Leclère A, Loyse A. Reduction in mortality from HIV-related CNS infections in routine care in Africa (DREAMM): a before-and-after, implementation study. Lancet HIV 2023; 10:e663-e673. [PMID: 37802567 DOI: 10.1016/s2352-3018(23)00182-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/16/2023] [Accepted: 07/19/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Four decades into the HIV epidemic, CNS infection remains a leading cause of preventable HIV-related deaths in routine care. The Driving Reduced AIDS-associated Meningo-encephalitis Mortality (DREAMM) project aimed to develop, implement, and evaluate pragmatic implementation interventions and strategies to reduce mortality from HIV-related CNS infection. METHODS DREAMM took place in five public hospitals in Cameroon, Malawi, and Tanzania. The main intervention was a stepwise algorithm for HIV-related CNS infections including bedside rapid diagnostic testing and implementation of WHO cryptococcal meningitis guidelines. A health system strengthening approach for hospitals was adopted to deliver quality care through a co-designed education programme, optimised clinical and laboratory pathways, and communities of practice. DREAMM was led and driven by local leadership and divided into three phases: observation (including situational analyses of routine care), training, and implementation. Consecutive adults (aged ≥18 years) living with HIV presenting with a first episode of suspected CNS infection were eligible for recruitment. The primary endpoint was the comparison of 2-week all-cause mortality between observation and implementation phases. This study completed follow-up in September, 2021. The project was registered on ClinicalTrials.gov, NCT03226379. FINDINGS From November, 2016 to April, 2019, 139 eligible participants were enrolled in the observation phase. From Jan 9, 2018, to March 25, 2021, 362 participants were enrolled into the implementation phase. 216 (76%) of 286 participants had advanced HIV disease (209 participants had missing CD4 cell count), and 340 (69%) of 494 participants had exposure to antiretroviral therapy (ART; one participant had missing ART data). In the implementation phase 269 (76%) of 356 participants had a probable CNS infection, 203 (76%) of whom received a confirmed microbiological or radiological diagnosis of CNS infection using existing diagnostic tests and medicines. 63 (49%) of 129 participants died at 2 weeks in the observation phase compared with 63 (24%) of 266 in the implementation phase; and all-cause mortality was lower in the implementation phase when adjusted for site, sex, age, ART exposure (adjusted risk difference -23%, 95% CI -33 to -13; p<0·001). At 10 weeks, 71 (55%) died in the observation phase compared with 103 (39%) in the implementation phase (-13%, -24 to -3; p=0·01). INTERPRETATION DREAMM substantially reduced mortality from HIV-associated CNS infection in resource-limited settings in Africa. DREAMM scale-up is urgently required to reduce deaths in public hospitals and help meet Sustainable Development Goals. FUNDING European and Developing Countries Clinical Trials Partnership, French Agency for Research on AIDS and Viral Hepatitis. TRANSLATIONS For the French and Portuguese translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Sayoki Mfinanga
- National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania; Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Cecilia Kanyama
- University of North Carolina Project-Malawi, Kamuzu Central Hospital, Lilongwe, Malawi
| | | | | | - Sokoine Lesikari Kivuyo
- National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania
| | - Timothée Boyer-Chammard
- Unité de Mycologie Moléculaire, Institut Pasteur, Université de Paris, Centre National de la Recherche Scientifique, Paris, France
| | | | | | | | | | | | - Rehema Simbauranga
- National Institute for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania
| | - Chimwemwe Chawinga
- University of North Carolina Project-Malawi, Kamuzu Central Hospital, Lilongwe, Malawi
| | | | | | | | - Elnara Aghakishiyeva
- Institute for Infection and Immunity, St George's University of London, London, UK
| | | | - Sebastian Fuller
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Anne-Marie Reid
- Leeds Institute of Medical Education, University of Leeds, Leeds, UK
| | | | - David S Lawrence
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Mina C Hosseinipour
- University of North Carolina Project-Malawi, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Emma Beaumont
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene and Tropical Medicine, London, UK
| | - John Bradley
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Shabbar Jaffar
- UCL Institute for Global Health, University College London, London, UK
| | - Olivier Lortholary
- Unité de Mycologie Moléculaire, Institut Pasteur, Université de Paris, Centre National de la Recherche Scientifique, Paris, France; Necker-Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Institut Hospitalier Universitaire Imagine, Paris, France
| | - Thomas Harrison
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Síle F Molloy
- Institute for Infection and Immunity, St George's University of London, London, UK
| | - Aude Sturny-Leclère
- Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, France
| | - Angela Loyse
- Unité de Mycologie Moléculaire, Institut Pasteur, Université de Paris, Centre National de la Recherche Scientifique, Paris, France; Institute for Infection and Immunity, St George's University of London, London, UK.
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15
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Ekberg K, Timmer BH, Francis A, Hickson L. Improving the implementation of family-centred care in adult audiology appointments: a feasibility intervention study. Int J Audiol 2023; 62:900-912. [PMID: 35801354 DOI: 10.1080/14992027.2022.2095536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE There is mounting evidence for implementing family-centred care (FCC) in adult audiology services, however FCC is not typically observed in adult clinical practice. This study implemented an intervention to increase family member attendance and involvement within adult audiology appointments. DESIGN The study involved a mixed method design over three key phases: Standard Care, Intervention I (increasing family member attendance), and Intervention II (increasing family member involvement). STUDY SAMPLE Staff from four private audiology clinics within one organisation participated in the intervention. Data was collected from different clients in each phase (n = 27 Standard Care, n = 30 Intervention I, and n = 23 Intervention II). RESULTS Family member attendance increased from 26% of appointments in Standard Care to 40% at Intervention I, and 48% at Intervention II. Family member involvement also showed improvement on some measures (video analysis) although talk time did not significantly increase. Significant improvements in client satisfaction with services were found (Net Promoter Score and Measure of Processes of Care). CONCLUSION The implementation of FCC in audiology clinics needs to be an ongoing, whole-of-clinic approach, including staff in all roles. Increasing family member attendance at adult audiology appointments can lead to benefits to client satisfaction with services.
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Affiliation(s)
- Katie Ekberg
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Barbra H Timmer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Sonova Holding, Stafa, Switzerland
| | - Anna Francis
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Louise Hickson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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16
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Simpson A, Stein M, Rosenberg M, Ward B, Derbyshire A, Thornton AL, Jackson B. Early childhood educator outcomes from online professional development for physical literacy: A randomised controlled trial. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 68:102464. [PMID: 37665906 DOI: 10.1016/j.psychsport.2023.102464] [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: 07/29/2022] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION Early childhood is recognised as a critical window of opportunity for physical literacy development, however early childhood educators typically lack the training required to effectively provide appropriate physical literacy opportunities for children. We examined the effects of an online physical literacy professional development program-relative to continuing with 'standard' practice-on early childhood educators' physical literacy knowledge and application. METHODS We conducted a parallel two-arm randomised controlled trial, in which 88 early childhood educators were randomly assigned to an online professional development program designed to support educators' physical literacy instructional skills (intervention arm; n = 37), or a 'standard practice' control condition (n = 51). Data were collected prior to and after the four-week intervention period. We measured educators' physical literacy knowledge and application (our primary outcome) through independent coding of open-ended survey responses, and educators' self-reported perceptions of values, confidence, behaviours, and barriers (secondary outcomes). Between-group differences were assessed through analysis of covariance. RESULTS One intervention arm participant withdrew from the study, resulting in 87 participants included in analysis. Educators in the intervention arm scored significantly higher on post-intervention physical literacy knowledge (d = 0.62) and application (d = 0.33) than those in the control arm. Educators in the intervention arm also scored significantly higher than controls on confidence in teaching physical activity (d = 0.42) and significantly lower than controls on perceived personal barriers to physical activity (d = 0.53). Thirteen participants in the intervention arm (36%) did not begin the online professional development program. CONCLUSION Improvements in physical literacy instructional outcomes indicate the potential for further investigation into broader implementation of online professional development programs of this nature in the future.
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Affiliation(s)
- Aaron Simpson
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Australia; Telethon Kids Institute, Perth, Western Australia, Australia.
| | - Michelle Stein
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Australia
| | - Michael Rosenberg
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Australia
| | - Brodie Ward
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Australia
| | - Amanda Derbyshire
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Australia
| | - Ashleigh L Thornton
- Telethon Kids Institute, Perth, Western Australia, Australia; Division of Paediatrics, School of Medicine, The University of Western Australia, Australia; Kids Rehab WA, Perth Children's Hospital, Australia
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Australia; Telethon Kids Institute, Perth, Western Australia, Australia
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Karega P, Mwaura DK, Mwangi KW, Wanjiku M, Landi M, Kibet CK. Building awareness and capacity of bioinformatics and open science skills in Kenya: a sensitize, train, hack, and collaborate model. Front Res Metr Anal 2023; 8:1070390. [PMID: 37324282 PMCID: PMC10267827 DOI: 10.3389/frma.2023.1070390] [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: 10/14/2022] [Accepted: 05/10/2023] [Indexed: 06/17/2023] Open
Abstract
We have applied the sensitize-train-hack-community model to build awareness of and capacity in bioinformatics in Kenya. Open science is the practice of science openly and collaboratively, with tools, techniques, and data freely shared to facilitate reuse and collaboration. Open science is not a mandatory curriculum course in schools, whereas bioinformatics is relatively new in some African regions. Open science tools can significantly enhance bioinformatics, leading to increased reproducibility. However, open science and bioinformatics skills, especially blended, are still lacking among students and researchers in resource-constrained regions. We note the need to be aware of the power of open science among the bioinformatics community and a clear strategy to learn bioinformatics and open science skills for use in research. Using the OpenScienceKE framework-Sensitize, Train, Hack, Collaborate/Community-the BOSS (Bioinformatics and Open Science Skills) virtual events built awareness and empowered researchers with the skills and tools in open science and bioinformatics. Sensitization was achieved through a symposium, training through a workshop and train-the-trainer program, hack through mini-projects, community through conferences, and continuous meet-ups. In this paper, we discuss how we applied the framework during the BOSS events and highlight lessons learnt in planning and executing the events and their impact on the outcome of each phase. We evaluate the impact of the events through anonymous surveys. We show that sensitizing and empowering researchers with the skills works best when the participants apply the skills to real-world problems: project-based learning. Furthermore, we have demonstrated how to implement virtual events in resource-constrained settings by providing Internet and equipment support to participants, thus improving accessibility and diversity.
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Affiliation(s)
- Pauline Karega
- International Center of Insect Physiology and Ecology, Nairobi, Kenya
- Department of Biochemistry, University of Nairobi, Nairobi, Kenya
| | | | | | - Margaret Wanjiku
- Department of Biology, San Diego State University, San Diego, CA, United States
| | - Michael Landi
- Department of Bioinformatics, Swedish University of Agricultural Sciences, Uppsala, Sweden
- International Institute of Tropical Agriculture, Nairobi, Kenya
| | - Caleb K. Kibet
- International Center of Insect Physiology and Ecology, Nairobi, Kenya
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Greiner MG, Shulman M, Opara O, Potter K, Voronca DC, Tafessu HM, Hefner K, Hamilton A, Scheele C, Ho R, Dresser L, Jelstrom E, Fishman M, Ghitza UE, Rotrosen J, Nunes EV, Bisaga A. Surmounting Withdrawal to Initiate Fast Treatment with Naltrexone (SWIFT): A stepped wedge hybrid type 1 effectiveness-implementation study. Contemp Clin Trials 2023; 128:107148. [PMID: 36931426 PMCID: PMC10895892 DOI: 10.1016/j.cct.2023.107148] [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: 11/07/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Extended-release injectable naltrexone (XR-NTX) is an effective treatment for opioid use disorder (OUD), but initiation remains a barrier to implementation. Standard practice requires a 10- to 15-day inpatient admission prior to XR-NTX initiation and involves a methadone or buprenorphine taper followed by a 7- to 10-day washout, as recommended in the Prescribing Information for XR-NTX. A 5- to 7-day rapid induction approach was developed that utilizes low-dose oral naltrexone and non-opioid medications. METHODS The CTN-0097 Surmounting Withdrawal to Initiate Fast Treatment with Naltrexone (SWIFT) study was a hybrid type I effectiveness-implementation trial that compared the effectiveness of the standard procedure (SP) to the rapid procedure (RP) for XR-NTX initiation across six community inpatient addiction treatment units, and evaluated the implementation process. Sites were randomized to RP every 14 weeks in an optimized stepped wedge design. Participants (target recruitment = 450) received the procedure (SP or RP) that the site was implementing at time of admission. The hypothesis was RP will be non-inferior to SP on proportion of inpatients who receive XR-NTX, with a shorter admission time for RP. Superiority testing of RP was planned if the null hypothesis of inferiority of RP to SP was rejected. DISCUSSION If RP for XR-NTX initiation is shown to be effective, the shorter inpatient stay could make XR-NTX more feasible and have an important public health impact expanding access to OUD pharmacotherapy. Further, a better understanding of facilitators and barriers to RP implementation can help with future translatability and uptake to other community programs. TRIAL REGISTRATION NCT04762537 Registered February 21, 2021.
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Affiliation(s)
- Miranda G Greiner
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, United States of America
| | - Matisyahu Shulman
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, United States of America
| | - Onumara Opara
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, United States of America
| | - Kenzie Potter
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, United States of America
| | | | - Hiwot M Tafessu
- The Emmes Company, LLC, Rockville, MD, United States of America
| | - Kathryn Hefner
- The Emmes Company, LLC, Rockville, MD, United States of America
| | - Amy Hamilton
- The Emmes Company, LLC, Rockville, MD, United States of America
| | | | - Rachel Ho
- The Emmes Company, LLC, Rockville, MD, United States of America
| | - Lauren Dresser
- The Emmes Company, LLC, Rockville, MD, United States of America
| | - Eve Jelstrom
- The Emmes Company, LLC, Rockville, MD, United States of America
| | - Marc Fishman
- Johns Hopkins University School of Medicine and Maryland Treatment Centers, Baltimore, MD, United States of America
| | - Udi E Ghitza
- National Institute on Drug Abuse (NIDA), Bethesda, MD, United States of America
| | - John Rotrosen
- New York University Grossman School of Medicine, New York, NY, United States of America
| | - Edward V Nunes
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, United States of America
| | - Adam Bisaga
- New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, United States of America.
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Linz MS, Dossou-Kitti E, Padmanaban V, Maloney M, Jalloh S, Balarezo LL, Sule H, Johnston PF, Sifri ZC. Train the Trainer in Bleeding Control: A Two-Year Pilot Study in Low-Income and Middle-Income Countries. J Surg Res 2023; 284:17-23. [PMID: 36527766 DOI: 10.1016/j.jss.2022.11.065] [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: 08/05/2022] [Revised: 10/12/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Traumatic hemorrhage represents a major cause of mortality in low-income and middle-income countries (LMICs). Thus, LMICs can benefit from improvements to prehospital hemorrhage management. One strategy is implementation of a bleeding control course using the "train the trainer" model (TTT) to increase course availability. The Stop the Bleed (STB) campaign provides laypeople with basic knowledge and skills of hemorrhage control. While the feasibility and success of the STB course have been demonstrated in the United States, course dissemination in LMICs has been slower and its feasibility using the TTT model has not been established. MATERIALS AND METHODS From December 2017 to January 2019, instructors from the International Surgical Health Initiative conducted seven surgical humanitarian trips and taught 10 index 1-h STB training sessions across six LMICs. LMIC instructors were encouraged to continue providing STB courses following departure of the visiting instructors. Course data were collected from sign-in sheets and analyzed using Microsoft Excel. RESULTS Ten index courses conducted by United States-trained STB experts trained 35 LMIC instructors over 2 y. Six of 35 offered 12 additional courses, certifying 323 new trainees, an 823% increase from the initial cohort. Overall, implementation of the TTT model yielded 22 STB courses in six LMICs, producing 358 new trainees. CONCLUSIONS This pilot study shows the STB TTT model was feasible and effective in expanding bleeding control trainer capacity in four of six LMICs. Use of the TTT model in LMICs may represent a means to increase STB course availability and is one strategy to improve prehospital hemorrhage control in LMICs.
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Affiliation(s)
| | | | - Vennila Padmanaban
- Rutgers New Jersey Medical School, Department of Surgery, Newark, New Jersey
| | - Monica Maloney
- University of Connecticut School of Medicine, Department of Surgery, Farmington, Connecticut
| | - Samba Jalloh
- University of Sierra Leone College of Medicine and Allied Health Sciences, Freetown, Sierra Leone
| | | | - Harsh Sule
- Rutgers New Jersey Medical School, Department of Emergency Medicine, Newark, New Jersey
| | | | - Ziad C Sifri
- Rutgers New Jersey Medical School, Department of Surgery, Newark, New Jersey
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20
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Noble H, Ordoñez WJN, Zavala Wong G, Rodríguez MJ, Ortega Checa D, Warne M, Senturia K, Jin Y, Peterson R, Nicole LaGrone L. Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons' Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment. J Am Coll Surg 2023; 236:484-494. [PMID: 36729680 PMCID: PMC9924957 DOI: 10.1097/xcs.0000000000000530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/14/2022] [Accepted: 10/26/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Investing in continued medical education strengthens surgical systems. This study assessed the effectiveness of an evidence-based practice (EBP) tutorial and access to UpToDate (UTD) to improve EBP and understand how and why providers practice using evidence. STUDY DESIGN This is a mixed-methods, implementation study at 9 public hospitals in Peru consisting of a didactic session for surgeons on EBP and Google Translate and support of applications for UTD access. Change in clinical knowledge scores (CKS), access and use of UTD, and impact of language pre-and postintervention were measured. Qualitative interviews uncovered reasons for these changes. RESULTS Intervention participants had lower CKS at follow-up compared with baseline (odds ratio [OR] of higher score 0.41 [0.18,0.98]; p = 0.044), and this effect was modified (p = 0.003) to the extent that the reverse was true for control participants (OR 2.30 [1.13,4.71]; p = 0.022). Participants with 1 to 20 years of experience had significantly improved CKS compared with students/residents (1 to 10 years: OR 4.5 [1.1,18]; 11 to 20 years: OR 4.9 [1.4,17]); there was no evidence of a different CKS between providers with >20 years of experience compared with students/residents (OR 1.3 [0.5,3.7]). Administrative disconnect, usability, motivation, education, time, resources, and age influenced point-of-care medical information systems impact on knowledge and EBP. Participants reporting low English proficiency translated medical literature mostly used Google Translate. Those with low/no English reading proficiency had higher odds of reporting a negative impact on research than those with working (p = 0.007) or professional (p < 0.001) proficiency. CONCLUSIONS Providing education on EBP, free UTD access, and translation solutions did not correlate with increased CKS due to complex barriers to using point-of-care medical information systems.
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Affiliation(s)
- Helen Noble
- From the Northern Pacific Global Health Fogarty International Program (Noble)
| | | | | | - Manuel J Rodríguez
- Department of Surgery (Rodriguez), Universidad Peruana Cayetano Heredia, Lima, Perú
| | - David Ortega Checa
- Sociedad de Cirujanos Generales del Perú, Lima, Perú (Ordoñez, Ortega Checa)
- Department of Surgery, Hospital Rebagliati, Lima, Perú (Ortega Checa)
| | - Maria Warne
- Department of Surgery, University of Colorado Health, Medical Center of the Rockies, Loveland, CO (Warne, LaGrone)
| | - Kirsten Senturia
- Department of Health Services (Senturia), University of Washington, Seattle, WA
| | - Ying Jin
- University of Colorado Anschutz Medical Campus, Aurora, CO (Jin, Peterson)
| | - Ryan Peterson
- University of Colorado Anschutz Medical Campus, Aurora, CO (Jin, Peterson)
| | - Lacey Nicole LaGrone
- Department of Surgery, University of Colorado Health, Medical Center of the Rockies, Loveland, CO (Warne, LaGrone)
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21
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D'Aprano A, Brookes I, Browne L, Bartlett C. Uptake of the culturally appropriate ASQ-TRAK developmental screening tool in the Australian Aboriginal and Torres Strait Islander context. Child Care Health Dev 2023; 49:54-61. [PMID: 35305034 PMCID: PMC10084340 DOI: 10.1111/cch.13006] [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: 01/25/2021] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Recently in Australia, access to culturally safe developmental practices for Aboriginal and Torres Strait Islander families has been enhanced by the availability of a culturally appropriate developmental screening tool, the Ages and Stages Questionnaire - Talking about Raising Aboriginal Kids (ASQ-TRAK). This paper aims (i) to describe the uptake of the ASQ-TRAK developmental screening tool in Aboriginal Community Controlled Organizations and mainstream services in Australia and (ii) to explore the extent to which organizations using the ASQ-TRAK have engaged training for staff. METHODS A retrospective review of ASQ-TRAK sales and training records from January 2015 to May 2020 to determine the ASQ-TRAK distribution by jurisdiction and service type and the number of services that have engaged training. RESULTS Five hundred ASQ-TRAK kits have been distributed across 77 agencies. Of those, 100 kits (20%) have been purchased by Aboriginal Community Controlled Organizations. Most have been distributed in the Northern Territory (NT) (178, 36%), Western Australia (165, 33%) and South Australia (64, 13%). Of the 15 ASQ-TRAK training workshops, nine have been in the NT. Of the 196 practitioners trained, 25 were identified as facilitators for their organization. CONCLUSION Despite substantive research translation across Australia, with evidence of its acceptability in different contexts, most Aboriginal Community Controlled Organizations have not yet accessed the ASQ-TRAK, and most organizations have not participated in training. There is an imperative to progress knowledge translation to improve quality and accessibility of culturally appropriate developmental care. Adequately resourced ASQ-TRAK implementation support is needed to ensure sustainable implementation at scale.
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Affiliation(s)
- Anita D'Aprano
- Department of PaediatricsUniversity of MelbourneMelbourneVictoria
- Melbourne Children's Research InstituteMelbourneVictoria
- Menzies School of Health ResearchDarwinNorthern Territory
| | - Isabel Brookes
- Department of PaediatricsUniversity of MelbourneMelbourneVictoria
| | - Linda Browne
- Department of PaediatricsUniversity of MelbourneMelbourneVictoria
| | - Claire Bartlett
- Department of PaediatricsUniversity of MelbourneMelbourneVictoria
- College of EducationCharles Darwin UniversityDarwinNorthern TerritoryAustralia
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22
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Valldejuli K, Vollmann S. Cross-cultural art therapy in the virtual realm: reimagining cultural proficiency in Kenya. INTERNATIONAL JOURNAL OF ART THERAPY 2022. [DOI: 10.1080/17454832.2022.2130381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
| | - Sarah Vollmann
- Portland Institute for Loss and Transition, Lexington, MA, USA
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23
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Robinson LE, Palmer KK, Santiago-Rodríguez ME, Myers ND, Wang L, Pfeiffer KA. Protocol for a multicenter-cluster randomized clinical trial of a motor skills intervention to promote physical activity and health in children: the CHAMP afterschool program study. BMC Public Health 2022; 22:1544. [PMID: 35964114 PMCID: PMC9375271 DOI: 10.1186/s12889-022-13849-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Promoting health-enhancing and sustainable physical activity levels across childhood and adolescence contribute to positive health outcomes as an adult. This study will aim to: a) examine the immediate (pre- to post-intervention) and sustained (1-year post-intervention follow-up) effects of the Children's Health Activity Motor Program-Afterschool Program (CHAMP-ASP) on physical activity, motor competence, and perceived motor competence relative to the comparison ASP, b) examine the immediate and sustained effects of CHAMP-ASP on secondary health outcomes, specifically health-related physical fitness (i.e., cardiorespiratory fitness, muscular strength, percent body fat) and weight status compared to children in the comparison ASP, and c) determine if perceived motor competence mediates the effect of CHAMP-ASP on moderate-to-vigorous physical activity. METHODS This multicenter cluster randomized trial will be implemented by ASP staff and will be conducted in ASPs located in two city-based cohorts: East Lansing/Lansing and Ann Arbor/Ypsilanti, Michigan. Children (N = 264) who are K-2 graders will participate 35 min/day X 3 days/week for 19 weeks (1995 min) in their afterschool movement program (i.e., CHAMP-ASP vs. comparison). The research team will train ASP staff to implement the program, which will be delivered within the existing ASP offering. Measures of physical activity (accelerometer), motor competence (process and product measures of fundamental motor skills), health-related fitness, perceived motor competence, and anthropometry will be collected pre-, immediately post-, and one-year post-intervention. Random-effects models will be used to assess the clustered longitudinal effect of the intervention on outcome measures. DISCUSSION The long-term goal is to provide a sustainable, ecologically-relevant, and evidence-based program during the early elementary years that can be delivered by ASP staff, is health-enhancing, and increases physical activity in children. Findings hold the potential to help shape public health and educational policies and interventions that support healthy development and active living during the early years. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT05342701 . ETHICS AND DISSEMINATION Ethical approval was obtained through the Health Sciences and Behavioral Sciences IRB, University of Michigan (HUM00208311). The CHAMP-ASP study is funded by the National Institutes of Health. Findings will be disseminated via print, online media, dissemination events, and practitioner and/or research journals.
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Affiliation(s)
- Leah E. Robinson
- grid.214458.e0000000086837370School of Kinesiology, University of Michigan, Ann Arbor, MI 48109 USA
| | - Kara K. Palmer
- grid.214458.e0000000086837370School of Kinesiology, University of Michigan, Ann Arbor, MI 48109 USA
| | | | - Nicholas D. Myers
- grid.17088.360000 0001 2150 1785Department of Kinesiology, College of Education, Michigan State University, East Lansing, MI 48824 USA
| | - Lu Wang
- grid.214458.e0000000086837370School of Public Health, University of Michigan, Ann Arbor, MI 48109 USA
| | - Karin A. Pfeiffer
- grid.17088.360000 0001 2150 1785Department of Kinesiology, College of Education, Michigan State University, East Lansing, MI 48824 USA
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24
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Oloko M, Reed MG, Robson JP. Fostering food preservation practice: Lessons from a community train-the-trainer program on Canada's west coast. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.887720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Local food systems programs in Canada's rural and remote communities support residents to improve their access to healthy food by strengthening various social practices within the system. Designing programs to strengthen social practices can help address food insecurity by providing a support structure where people can build competencies and access materials necessary to engage in practices like food preservation, and make meanings that will encourage them to sustain their engagement. The elements needed for successfully establishing a social practice–competencies, materials, and meanings–must be present. Unfortunately, food preservation programs in Canada's local food systems have not fully embedded structures to bring all three elements of social practice together or undertake a participant-focused program assessment. Consequently, we do not know the potential of local food preservation to meet peoples' various needs or the challenges that program participants experience practicing food preservation. This paper uses a social practice framework to determine the extent to which a community food preservation program on Canada's west coast strengthened the three elements of social practice. Findings from interviews show that in line with the paper's three objectives, participants of a community train-the-trainer program (1) built and shared food preservation competencies, (2) accessed materials to practice food preservation, and (3) formed meanings to support their continuous engagement in food preservation. The paper shows how a social practice framework can support a participant-focused program evaluation and provide a practical and straightforward tool for assessing food systems programs.
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25
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Meyer AE, Rodriguez-Quintana N, Miner K, Bilek EL, Vichich J, Smith SN, Koschmann E. Developing a statewide network of coaches to support youth access to evidence-based practices. IMPLEMENTATION RESEARCH AND PRACTICE 2022; 3:26334895221101215. [PMID: 37091092 PMCID: PMC9924236 DOI: 10.1177/26334895221101215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: A national shortage of mental health providers for youth exists in the United States. Implementation support for mental health services in schools, where students are most likely to access care, can help to fill these gaps. Coaching consists of in vivo modeling and support during service delivery and is effective in supporting the implementation of evidence-based practices (EBPs). This implementation report describes the recruitment and training of community providers to become coaches as a part of a modified train-the-trainer model of implementation support. Method: An EBP implementation program, Transforming Research into Action to Improve the Lives of Students (TRAILS), trained community providers in Michigan to increase knowledge of cognitive behavioral therapy (CBT) and position them as coaches in schools. The development of the coach network involved five stages prior to the initiation of a randomized controlled trial: (1) recruitment, (2) a one-day clinical training, (3) 12 weeks of individualized consultation, (4) evaluation, and (5) training in the coaching protocol. Results: A total of 347 individuals attended an initial training, and 187 were paired with a consultant. Eighty-six clinicians from 47 of Michigan's 83 counties successfully became coaches by completing all required elements of training. Coaches showed significant improvements in the use and knowledge of CBT across consultation. Conclusion: Statewide networks of trained mental health professionals can address gaps in mental healthcare for youth. This article demonstrates one strategy for strengthening and leveraging community expertise to support the implementation of EPBs in schools. Plain Language Summary Although youth face many barriers in accessing effective mental health care, schools are one setting where they can more easily receive treatment. Research shows that training and supports are needed for school mental health professionals to provide effective care. Coaching, which involves in vivo support for school mental health professionals, is one helpful strategy. We describe the process of recruiting and training community clinicians to become coaches. The Transforming Research into Action to Improve the Lives of Students (TRAILS) program successfully recruited and trained a network of 86 community clinicians to become coaches. Clinicians attended two day-long trainings and participated in 12 weeks of personalized consultation. Clients to whom these clinicians provided CBT showed significant symptom improvement. Clinicians also reported that they increased their knowledge and use of core CBT strategies, including psychoeducation, exposure, and behavioral activation. Community mental health professionals who are trained as coaches can address gaps in access to care for youth. We demonstrate one strategy for strengthening and leveraging clinicians’ knowledge of CBT to support the school-based implementation of CBT.
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Affiliation(s)
- Allison E Meyer
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | | | - Kristen Miner
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Emily L Bilek
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Jennifer Vichich
- Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Shawna N Smith
- Department of Health Management & Policy, School of Public Health, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
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26
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Vaccarello C, Kratochwill TR, Asmus JM. Effects of a Problem-Solving Team Consultation on the Problem-Solving Process: An Evaluation of Concept Knowledge, Implementation Integrity, and Student Outcomes. JOURNAL OF EDUCATIONAL AND PSYCHOLOGICAL CONSULTATION 2022. [DOI: 10.1080/10474412.2022.2068020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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27
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Monds LA, Bravo M, Mills L, Malcolm A, Gilliver R, Wood W, Harrod ME, Read P, Nielsen S, Dietze PM, Lenton S, Bleeker AM, Lintzeris N. The Overdose Response with Take Home Naloxone (ORTHN) project: Evaluation of health worker training, attitudes and perceptions. Drug Alcohol Rev 2022; 41:1085-1094. [PMID: 35442514 DOI: 10.1111/dar.13474] [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: 08/03/2021] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Naloxone is a life-saving medication that reverses opioid overdose; naloxone can be provided on a 'take-home' basis so naloxone can be administered outside of the health-care setting. The Overdose Response and Take Home Naloxone (ORTHN) project established a model of care for take-home naloxone (THN) interventions across alcohol and other drug and harm reduction services in NSW, Australia. This paper evaluates the staff training and credentialing program, and examines staff attitudes and perspectives regarding the provision of THN interventions in these settings. METHODS Staff across seven services were trained through a 'train-the-trainer' credentialing model to deliver ORTHN, including naloxone supply. Staff were surveyed regarding their experience, attitudes and knowledge on THN prior to and after training, and after 6 months. At the 6 months follow up, staff were asked about the interventions they provided, barriers and enablers to uptake, and opinions regarding future rollout. RESULTS A total of 204 staff were trained and credentialed to provide the ORTHN intervention. Most (60%) were nurses, followed by needle syringe program workers and allied health/counsellors (32%). Linear and logistic regression analyses indicated that the training program was associated with significant improvements in staff knowledge and attitudes towards overdose and THN; however, only attitudinal improvements were maintained over time. There were high rates of staff satisfaction with the ORTHN intervention and training. DISCUSSION/CONCLUSIONS The ORTHN program is 'fit for purpose' for broad implementation in these settings. A number of potential barriers (e.g. time, medication and staffing costs) and enablers (e.g. peer engagement, regulatory framework for naloxone supply) in implementing THN interventions were identified.
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Affiliation(s)
- Lauren A Monds
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Maria Bravo
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Llewellyn Mills
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Annie Malcolm
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Rosie Gilliver
- Kirketon Road Centre, South Eastern Sydney Local Health District, Sydney, Australia
| | - William Wood
- Medically Supervised Injecting Centre, Sydney, Australia
| | | | - Phillip Read
- Kirketon Road Centre, South Eastern Sydney Local Health District, Sydney, Australia.,The Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Suzanne Nielsen
- Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Paul M Dietze
- National Drug Research Institute, Melbourne, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
| | - Simon Lenton
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Anne M Bleeker
- Alcohol, Tobacco and Other Drug Association, Canberra, Australia
| | - Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
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28
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McCabe LA, Ruberti MR, Endres T. Sustaining program implementation: A co-constructed technical assistance process to support continuous high-quality implementation of the Therapeutic Crisis Intervention program. EVALUATION AND PROGRAM PLANNING 2022; 91:102049. [PMID: 35217287 DOI: 10.1016/j.evalprogplan.2022.102049] [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: 03/03/2020] [Revised: 06/24/2021] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
Strategies for sustaining a program beyond initial implementation remain one of the most poorly understood aspects of high-quality program implementation. This paper describes the Quality Improvement and Fidelity Assessment Process (QIFAP), a program purveyor-agency partnership that uses a unique, multi-step method for supporting sustained implementation of the Therapeutic Crisis Intervention (TCI) system to manage crises in child serving organizations. It outlines the steps of the process and highlights how specific activities are linked to current knowledge and principles from implementation science. The QIFAP occurs over a period of about three months, during which time program developers and agency representatives conduct staff surveys, a two-day site visit, and fidelity assessments in order to gather information, discuss findings, and plan steps for improving the TCI system in the organization. The process is guided by principles that emphasize the importance of organization leadership, building relationships, co-learning, using an individualized approach, data informed decision making, acknowledging risk, and congruence. We describe ways in which the strategies and approaches within the QIFAP are rooted in implementation science literature. Thus, the model represents an illustration of how research-based knowledge can work in practice to support long-term, high-quality program implementation.
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Affiliation(s)
- Lisa A McCabe
- Bronfenbrenner Center for Translational Research, Cornell University, 1201 Martha Van Rensselaer Hall, Ithaca, NY 14853, USA.
| | - Mary R Ruberti
- Bronfenbrenner Center for Translational Research, Cornell University, 1201 Martha Van Rensselaer Hall, Ithaca, NY 14853, USA.
| | - Thomas Endres
- Bronfenbrenner Center for Translational Research, Cornell University, 1201 Martha Van Rensselaer Hall, Ithaca, NY 14853, USA
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29
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Abrudan M, Matimba A, Nikolic D, Hughes D, Argimón S, Kekre M, Underwood A, Aanensen DM. Train-the-Trainer as an Effective Approach to Building Global Networks of Experts in Genomic Surveillance of Antimicrobial Resistance (AMR). Clin Infect Dis 2021; 73:S283-S289. [PMID: 34850831 PMCID: PMC8634536 DOI: 10.1093/cid/ciab770] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Advanced genomics and sequencing technologies are increasingly becoming critical for global health applications such as pathogen and antimicrobial resistance (AMR) surveillance. Limited resources challenge capacity development in low- and middle-income countries (LMICs), with few countries having genomics facilities and adequately trained staff. Training research and public health experts who are directly involved in the establishment of such facilities offers an effective, but limited, solution to a growing need. Instead, training them to impart their knowledge and skills to others provides a sustainable model for scaling up the much needed capacity and capability for genomic sequencing and analysis locally with global impact. We designed and developed a Train-the-Trainer course integrating pedagogical aspects with genomic and bioinformatics activities. The course was delivered to 18 participants from 12 countries in Africa, Asia, and Latin America. A combination of teaching strategies culminating in a group project created a foundation for continued development at home institutions. Upon follow-up after 6 months, at least 40% of trainees had initiated training programs and collaborations to build capacity at local, national, and regional level. This work provides a framework for implementing a training and capacity building program for the application of genomics tools and resources in AMR surveillance.
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Affiliation(s)
- Monica Abrudan
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK, and Wellcome Genome Campus, Hinxton, UK
| | - Alice Matimba
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, UK
| | - Dusanka Nikolic
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, UK
| | - Darren Hughes
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, UK
| | - Silvia Argimón
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK, and Wellcome Genome Campus, Hinxton, UK
| | - Mihir Kekre
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK, and Wellcome Genome Campus, Hinxton, UK
| | - Anthony Underwood
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK, and Wellcome Genome Campus, Hinxton, UK
| | - David M Aanensen
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, UK, and Wellcome Genome Campus, Hinxton, UK
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Kekre M, Arevalo SA, Valencia MF, Lagrada ML, Macaranas PKV, Nagaraj G, Oaikhena AO, Olorosa AM, Aanensen DM. Integrating Scalable Genome Sequencing Into Microbiology Laboratories for Routine Antimicrobial Resistance Surveillance. Clin Infect Dis 2021; 73:S258-S266. [PMID: 34850836 PMCID: PMC8634525 DOI: 10.1093/cid/ciab796] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Antimicrobial resistance (AMR) is considered a global threat, and novel drug discovery needs to be complemented with systematic and standardized epidemiological surveillance. Surveillance data are currently generated using phenotypic characterization. However, due to poor scalability, this approach does little for true epidemiological investigations. There is a strong case for whole-genome sequencing (WGS) to enhance the phenotypic data. To establish global AMR surveillance using WGS, we developed a laboratory implementation approach that we applied within the NIHR Global Health Research Unit (GHRU) on Genomic Surveillance of Antimicrobial Resistance. In this paper, we outline the laboratory implementation at 4 units: Colombia, India, Nigeria, and the Philippines. The journey to embedding WGS capacity was split into 4 phases: Assessment, Assembly, Optimization, and Reassessment. We show that on-boarding WGS capabilities can greatly enhance the real-time processing power within regional and national AMR surveillance initiatives, despite the high initial investment in laboratory infrastructure and maintenance. Countries looking to introduce WGS as a surveillance tool could begin by sequencing select Global Antimicrobial Resistance Surveillance System (GLASS) priority pathogens that can demonstrate the standardization and impact genome sequencing has in tackling AMR.
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Affiliation(s)
- Mihir Kekre
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Old Road Campus, Oxford, United Kingdom
- Wellcome Genome Campus, Hinxton, United Kingdom
| | - Stefany Alejandra Arevalo
- Colombian Integrated Program for Antimicrobial Resistance Surveillance—Coipars, CI Tibaitatá, Corporación Colombiana de Investigación Agropecuaria (AGROSAVIA), Tibaitatá–Mosquera, Cundinamarca, Colombia
| | - María Fernanda Valencia
- Colombian Integrated Program for Antimicrobial Resistance Surveillance—Coipars, CI Tibaitatá, Corporación Colombiana de Investigación Agropecuaria (AGROSAVIA), Tibaitatá–Mosquera, Cundinamarca, Colombia
| | | | | | - Geetha Nagaraj
- Central Research Laboratory, Kempegowda Institute of Medical Sciences, Bengaluru, India
| | - Anderson O Oaikhena
- Department of Pharmaceutical Microbiology, University of Ibadan, Ibadan, Nigeria
| | | | - David M Aanensen
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Old Road Campus, Oxford, United Kingdom
- Wellcome Genome Campus, Hinxton, United Kingdom
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Gichane MW, Wechsberg WM, Ndirangu J, Howard B, Bonner CP, Browne FA, Zule WA. Sustainability of a gender-focused HIV and alcohol risk-reduction intervention in usual care settings in South Africa: a mixed methods analysis. AIDS Care 2021; 33:11-17. [PMID: 34538158 DOI: 10.1080/09540121.2021.1966694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Intervention sustainability is a critical yet understudied aspect of implementation science research. To address this gap, we examined the sustainability of the Women's Health CoOp (WHC), a gender-focused, evidence-based, HIV and alcohol risk-reduction intervention, after an implementation trial. We used a mixed methods design consisting of questionnaires (n = 12), 3 focus groups (n = 11), and a semistructured interview conducted with interventionists implementing the WHC in clinics and substance use treatment programs in Cape Town, South Africa. Five out of 8 facilities implemented the WHC beyond the 6-month implementation period, and 4 were still implementing the WHC as of October 2019. Sustainability ranged from approximately 8 months to more than 3 years. At the most recent assessment, interventionists delivered the intervention to 0-20 participants in the past month. Qualitative findings indicate that long-term sustainability would require support from upper management, staff dedicated to the WHC, and booster trainings. The WHC was sustained postimplementation. Integrating the program into usual care would be feasible; however, human resources, financial, and institutional support would be needed for sustainability. To move implementation science forward, it is essential to determine sustainability beyond the presence and involvement of researchers.
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Affiliation(s)
| | - Wendee M Wechsberg
- RTI International, Research Triangle Park, NC, USA.,Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Psychology, North Carolina State University, Raleigh, NC, USA.,Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | | | | | - Courtney Peasant Bonner
- RTI International, Research Triangle Park, NC, USA.,Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Felicia A Browne
- RTI International, Research Triangle Park, NC, USA.,Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Bai Y, McArthur C, Ioannidis G, Giangregorio L, Straus S, Papaioannou A. Strategies for the implementation of an electronic fracture risk assessment tool in long term care: a qualitative study. BMC Geriatr 2021; 21:467. [PMID: 34418976 PMCID: PMC8379826 DOI: 10.1186/s12877-021-02388-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/12/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Older adults in long-term care (LTC) homes experience high rates of fractures, which are detrimental to their quality of life. The purpose of this study is to identify and make recommendations on strategies to implementing an evidence-based Fracture Risk Clinical Assessment Protocol (CAP) in LTC. METHODS Following the Behaviour Change Wheel framework, we conducted six focus group interviews with a total of 32 LTC stakeholders (e.g. LTC physicians) to identify barriers and facilitators, suggest implementation strategies, and discuss whether the identified strategies were affordable, practicable, effective, acceptable, safe, and if they promote equity (APEASE). The interviews were transcribed verbatim and analyzed using thematic content analysis. RESULTS Themes of implementation strategies that met the APEASE criteria were minimizing any increase in workload, training on CAP usage, education for residents and families, and persuasion through stories. Other strategy themes identified were culture change, resident-centred care, physical restructuring, software features, modeling in training, education for staff, social rewards, material rewards, public benchmarking, and regulations. CONCLUSIONS To implement the Fracture Risk CAP in LTC, we recommend using implementation strategies centred around minimizing any increase in workload, training on CAP usage, providing education for residents and families, and persuading through stories. Through improving implementation of the fracture risk CAP, results from this work will improve identification and management of LTC residents at high fracture risk and could inform the implementation of guidelines for other conditions in LTC homes.
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Affiliation(s)
- Yuxin Bai
- McMaster University, 1280 Main Street West, L8S 4L8 Hamilton, Ontario Canada
- GERAS Centre for Aging Research, 88 Maplewood Avenue, L8M 1W9 Hamilton, Ontario Canada
| | - Caitlin McArthur
- Dalhousie University, PO Box 15000, 6299 South St, NS B3H 4R2 Halifax, Canada
| | - George Ioannidis
- McMaster University, 1280 Main Street West, L8S 4L8 Hamilton, Ontario Canada
- GERAS Centre for Aging Research, 88 Maplewood Avenue, L8M 1W9 Hamilton, Ontario Canada
| | - Lora Giangregorio
- University of Waterloo, 200 University Avenue West, N2L 3G1 Waterloo, Ontario Canada
- Schlegel-UW Research Institute for Aging, 150 Laurelwood Drive, N2J 0E2 Waterloo, Ontario Canada
| | - Sharon Straus
- University of Toronto, 27 King’s College Circle, M5S 1A4 Toronto, Ontario Canada
| | - Alexandra Papaioannou
- McMaster University, 1280 Main Street West, L8S 4L8 Hamilton, Ontario Canada
- GERAS Centre for Aging Research, 88 Maplewood Avenue, L8M 1W9 Hamilton, Ontario Canada
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Jacob RR, Brownson CA, Deshpande AD, Eyler AA, Gillespie KN, Hefelfinger J, Erwin PC, Macchi M, Brownson RC. Long-Term Evaluation of a Course on Evidence-Based Public Health in the U.S. and Europe. Am J Prev Med 2021; 61:299-307. [PMID: 34020850 PMCID: PMC10288838 DOI: 10.1016/j.amepre.2021.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
The evidence-based public health course equips public health professionals with skills and tools for applying evidence-based frameworks and processes in public health practice. To date, training has included participants from all the 50 U.S. states, 2 U.S. territories, and multiple other countries besides the U.S. This study pooled follow-up efforts (5 surveys, with 723 course participants, 2005-2019) to explore the benefits, application, and barriers to applying the evidence-based public health course content. All analyses were completed in 2020. The most common benefits (reported by >80% of all participants) were identifying ways to apply knowledge in their work, acquiring new knowledge, and becoming a better leader who promotes evidence-based approaches. Participants most frequently applied course content to searching the scientific literature (72.9%) and least frequently to writing grants (42.7%). Lack of funds for continued training (35.3%), not having enough time to implement evidence-based public health approaches (33.8%), and not having coworkers trained in evidence-based public health (33.1%) were common barriers to applying the content from the course. Mean scores were calculated for benefits, application, and barriers to explore subgroup differences. European participants generally reported higher benefits from the course (mean difference=0.12, 95% CI=0.00, 0.23) and higher frequency of application of the course content to their job (mean difference=0.17, 95% CI=0.06, 0.28) than U.S. participants. Participants from later cohorts (2012-2019) reported more overall barriers to applying course content in their work (mean difference=0.15, 95% CI=0.05, 0.24). The evidence-based public health course represents an important strategy for increasing the capacity (individual skills) for evidence-based processes within public health practice. Organization-level methods are also needed to scale up and sustain capacity-building efforts.
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Affiliation(s)
- Rebekah R Jacob
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri.
| | - Carol A Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Anjali D Deshpande
- Department of Epidemiology, Iowa College of Public Health, The University of Iowa, Iowa City, Iowa
| | - Amy A Eyler
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Kathleen N Gillespie
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri
| | - Jennie Hefelfinger
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia
| | - Paul C Erwin
- School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Marti Macchi
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri; Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri
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Shaw L, Kiegaldie D, Morris ME. Educating health professionals to implement evidence-based falls screening in hospitals. NURSE EDUCATION TODAY 2021; 101:104874. [PMID: 33774527 DOI: 10.1016/j.nedt.2021.104874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/10/2021] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE International evidence-based guidelines advise traditional Falls Risk Assessment Tools (FRATs) should not be routinely used to predict the risk of a patient falling in hospital. However, disinvestment from existing services can be challenging. This study applied evidence-based approaches to education design to implement best practice guidelines. DESIGN Mixed methods using questionnaires to evaluate health professionals' knowledge of evidence-based falls risk assessment and mitigation, followed by semi-structured interviews with individual health professionals. SETTING Five Australian hospitals. PARTICIPANTS There were two cohorts per hospital; Cohort 1 (C1) comprised 10 clinical leaders from nursing and allied health professions. Cohort 2 (C2) included clinicians involved in routine hospital falls screening and prevention. METHODS 46 clinical leaders received a 3-h high quality education workshop on the latest evidence in hospital falls risk assessment and how to implement a new falls screening and management tool. They were also taught the practical skills to deliver a 1-h education session to C2 (n = 129). RESULTS The education workshop significantly changed C1's views about evidence-based guidelines for falls screening and prevention. C1 were significantly more likely than C2 to feel confident in assessing falls risk and judging and implementing the best mitigation strategies. After the workshop, C1 were prepared and motivated to educate others on falls prevention and were satisfied with the skills gained. Six months after the workshop, C1 reported feeling more prepared for preventing falls. CONCLUSION Health professionals benefitted from an interactive education workshop on how to use a new evidence-based hospital falls screening tool to help mitigate risk. An abridged version of the workshop did not result in long lasting effects. Education is an important element aiding disinvestment from non-evidence-based services, and implementation of clinical guidelines.
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Affiliation(s)
- L Shaw
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, Moorabbin, Vic 3189, Australia; Healthscope, Melbourne, Victoria, 3004, Australia.
| | - D Kiegaldie
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, Moorabbin, Vic 3189, Australia; Faculty of Medicine, Nursing & Health Sciences, Monash University, Australia; Healthscope, Holmesglen Private Hospital, 488 South Road, Moorabbin, Victoria 3189, Australia.
| | - M E Morris
- ARCH, School Allied Health, Human Services and Sport, La Trobe University, Victoria 3086, Australia; Healthscope, Melbourne, Victoria, 3004, Australia.
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Venturo-Conerly K, Roe E, Wasil A, Osborn T, Ndetei D, Musyimi C, Mutiso V, Wasanga C, Weisz JR. Training and Supervising Lay Providers in Kenya: Strategies and Mixed-Methods Outcomes☆☆☆. COGNITIVE AND BEHAVIORAL PRACTICE 2021. [DOI: 10.1016/j.cbpra.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Roberts LR, Anderson BA. Enhancing Traditional Birth Attendant Training in Guatemala. INTERNATIONAL JOURNAL OF CHILDBIRTH 2021. [DOI: 10.1891/ijcbirth-d-20-00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDThis article describes the follow-up study to Simulation Learning Among Low Literacy Guatemalan Traditional Birth Attendants, published in the International Journal of Childbirth in 2017. This current study had two purposes: (a) to implement and evaluate the use of enhanced training modalities (active-learning strategies and use of technology in a remote area), and (b) to pilot training-of-trainer (ToT) methods. The current study builds upon the previous study in which we conducted and evaluated a simulation-based training among low-literacy Guatemala traditional birth attendants (TBAs).MATERIALS AND METHODSIn the current study, we conducted a focus group with experienced TBAs (n = 8) to elicit concepts and issues important to address in the training. The 60-hour training designed for low-resource settings, was enhanced with active-learning strategies, technology, and ToT modules. We assessed pre–posttest knowledge and attitudes by paper-pencil format, and pre–post skills by demonstration using simulation.RESULTSTraining participants (N = 31) included the eight experienced TBAs from the focus group. Knowledge, skills, and attitudes all improved, with statistical significance achieved in many parameters. Evaluation of the training was positive and enhancement strategies were noted as particularly helpful. Two participants participated in the additional ToT modules and are now collaborating to provide short educational programs to other TBAs in their regions.CONCLUSIONTraining enhancement strategies have the potential to increase safe practice among TBAs where skilled birth attendants are lacking. Adding ToT modules enhances sustainability and exemplifies the importance of locally prepared trainers in a time when global interaction is severely limited.
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Singh S, Charani E, Devi S, Sharma A, Edathadathil F, Kumar A, Warrier A, Shareek PS, Jaykrishnan AV, Ellangovan K. A road-map for addressing antimicrobial resistance in low- and middle-income countries: lessons learnt from the public private participation and co-designed antimicrobial stewardship programme in the State of Kerala, India. Antimicrob Resist Infect Control 2021; 10:32. [PMID: 33573697 PMCID: PMC7878026 DOI: 10.1186/s13756-020-00873-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/22/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The global concern over antimicrobial resistance (AMR) is gathering pace. Low- and middle-income countries (LMICs) are at the epicentre of this growing public health threat and governmental and healthcare organizations are at different stages of implementing action plans to tackle AMR. The South Indian state of Kerala was one of the first in India to implement strategies and prioritize activities to address this public health threat. STRATEGIES Through a committed and collaborative effort from all healthcare related disciplines and its professional societies from both public and private sector, the Kerala Public Private Partnership (PPP) has been able to deliver a state-wide strategy to tackle AMR A multilevel strategic leadership model and a multilevel implementation approach that included developing state-wide antibiotic clinical guidelines, a revision of post-graduate and undergraduate medical curriculum, and a training program covering all general practitioners within the state the PPP proved to be a successful model for ensuring state-wide implementation of an AMR action plan. Collaborative work of multi-professional groups ensured co-design and development of disease based clinical treatment guidelines and state-wide infection prevention policy. Knowledge exchange though international and national platforms in the form of workshops for sharing of best practices is critical to success. Capacity building at both public and private institutions included addressing practical and local solutions to the barriers e.g. good antibiotic prescription practices from primary to tertiary care facility and infection prevention at all levels. CONCLUSION Through 7 years of stakeholder engagement, lobbying with government, and driving change through co-development and implementation, the PPP successfully delivered an antimicrobial stewardship plan across the state. The roadmap for the implementation of the Kerala PPP strategic AMR plan can provide learning for other states and countries aiming to implement action plans for AMR.
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Affiliation(s)
- Sanjeev Singh
- Amrita Institute of Medical Sciences, Amrita Vishwavidyapeetham, Kochi, India.
| | - Esmita Charani
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College, London, UK
| | - Sarada Devi
- Trivandrum Medical College, Trivandrum, India
| | - Anuj Sharma
- Technical Focal Point, Antimicrobial Resistance, Laboratory and Infection Prevention and Control, WHO Country Office, Delhi, India
| | - Fabia Edathadathil
- Amrita Institute of Medical Sciences, Amrita Vishwavidyapeetham, Kochi, India
| | - Anil Kumar
- Amrita Institute of Medical Sciences, Amrita Vishwavidyapeetham, Kochi, India
| | | | - P S Shareek
- Sree Uthradom Thirunal Hospital, Trivandrum, India
| | | | - K Ellangovan
- Ministry of Health and Family Welfare, Government of Kerala, Trivandrum, India
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Dickson KS, Suhrheinrich J. Concordance between Community Supervisor and Provider Ratings of Fidelity: Examination of Multi-Level Predictors and Outcomes. JOURNAL OF CHILD AND FAMILY STUDIES 2021; 30:542-555. [PMID: 34149272 PMCID: PMC8211028 DOI: 10.1007/s10826-020-01877-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 06/12/2023]
Abstract
Fidelity is conceptualized as a key mechanism impacting treatment outcomes, yet community examination of fidelity is limited, partly due to limited feasible training methods and tools. Provider-report tools represent a feasible method for improving routine fidelity monitoring. Additional work examining the effectiveness of these methods and concordance with other fidelity sources is needed. Further, provider and client factors impact both intervention implementation and concordance, but their impact on fidelity measurement is poorly understood. Using a train-the-trainer methodology, we examine concordance between three methods of assessing fidelity (trained independent coders, supervisor evaluation and provider self-report) using a fidelity assessment tool adapted for community use. Multilevel models examined predictors (provider- and child- level factors) and outcomes (provider average fidelity) of concordance. Results suggest supervisors and providers are able to use the fidelity tool, but demonstrated variable concordance, with higher concordance with trained coders for supervisors than providers. Provider credentials and child language were marginally predictive of rater concordance. Higher supervisor accuracy was associated with higher provider fidelity. Findings inform broader efforts to improve the development and implementation of feasible fidelity tools for routine use in community settings and highlight multi-level factors impacting the adoption and implementation of such tools.
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Affiliation(s)
- Kelsey S. Dickson
- San Diego State University, 5500 Campanile Drive, San Diego, CA 92182 USA
- Child and Adolescent Services Research Center, 3020 Children’s Way MC5033, San Diego, CA 92123 USA
| | - Jessica Suhrheinrich
- San Diego State University, 5500 Campanile Drive, San Diego, CA 92182 USA
- Child and Adolescent Services Research Center, 3020 Children’s Way MC5033, San Diego, CA 92123 USA
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Rodriguez NM, Casanova F, Pages G, Claure L, Pedreira M, Touchton M, Knaul F. Community-based participatory design of a community health worker breast cancer training intervention for South Florida Latinx farmworkers. PLoS One 2020; 15:e0240827. [PMID: 33075111 PMCID: PMC7571710 DOI: 10.1371/journal.pone.0240827] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/02/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Community health worker (CHW)-led education is an important strategy to increase awareness and access to breast cancer screening in medically-underserved communities. This study aimed to develop a context-specific, culturally-appropriate training intervention for South Florida CHWs to educate Latinx immigrant farmworkers on breast cancer and early detection. METHODS A community-based participatory research (CBPR) study, conducted 2017-2019, informed the design of a training curriculum for CHWs and educational dissemination materials. Twenty-two CHWs were trained and knowledge gains were measuring using a one-group pre-and post-test design. Triangulated evaluation consisted of field observations of CHW-client interactions, CHW self-reports, and rapid assessment surveys of community members. RESULTS A community stakeholder-informed breast cancer training curriculum resulted in significant, sustained breast cancer knowledge gains among CHWs when comparing pre-, post-, and 4-6 month post-training follow-up test scores. Field observations of educational material dissemination, CHW self-reported evaluations, and community rapid assessment surveys at three health fairs demonstrated this was an effective strategy to engage female Latinx farmworkers in breast cancer education. CONCLUSIONS Community and key stakeholder participation in the development of a breast cancer educational intervention allowed for tailored design priorities around knowledge-based content, comprehensiveness, relevance, appropriateness, and ease of dissemination to community members. This model of participatory CHW training intervention design can enable future train-the-trainer approaches to disseminate and scale-up evidence-based health education interventions.
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Affiliation(s)
- Natalia M. Rodriguez
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, United States of America
| | - Felicia Casanova
- Department of Sociology, College of Arts and Sciences, University of Miami, Miami, Florida, United States of America
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
| | - Gabriela Pages
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
| | - Layla Claure
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
| | - Marian Pedreira
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
| | - Michael Touchton
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
| | - Felicia Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
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Bampoh V, Thongkhamkitcharoen M, Dicker S, Dalal W, Frerich E, Mann E, Porta C, Siddons N, Stauffer WM, Hoffman S. Nursing practice and global refugee migration: initial impressions from an Intergovernmental‐Academic Partnership. Int Nurs Rev 2020; 67:334-340. [DOI: 10.1111/inr.12588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 04/03/2020] [Accepted: 04/16/2020] [Indexed: 11/26/2022]
Affiliation(s)
- V. Bampoh
- International Organization for Migration/United Nations Migration Agency Addis Ababa Ethiopia
| | | | - S. Dicker
- International Organization for Migration/United Nations Migration Agency New York USA
| | - W. Dalal
- International Organization for Migration/United Nations Migration Agency Nairobi Kenya
| | - E. Frerich
- Minnesota Department of Health Saint PaulMNUSA
| | - E. Mann
- University of Minnesota Center for Global Health and Social Responsibility MinneapolisMNUSA
| | - C. Porta
- University of Minnesota School of Nursing MinneapolisMNUSA
| | - N. Siddons
- University of Minnesota School of Medicine Minneapolis MNUSA
| | - WM Stauffer
- Director, Human Migration and Health, Center for Global Health and Social Responsibility, Departments of Medicine and Pediatrics Minneapolis MNUSA
| | - S.J. Hoffman
- University of Minnesota School of Nursing Minneapolis MNUSA
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Jahangiri L, Akiva G, Lakhia S, Turkyilmaz I. Understanding the complexities of digital dentistry integration in high-volume dental institutions. Br Dent J 2020; 229:166-168. [PMID: 32811935 DOI: 10.1038/s41415-020-1928-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The purpose of this article is to detail the primary challenges faced by large dental institutions as they incorporate digital dentistry into their mainstream workflow. Integration of digital technology is easier in private practices with smaller patient volumes and fewer trained staff required. Additionally, in private practices, scanning, designing and milling frequently occur in a single location, which does not require an external digital data transfer. However, large dental institutions must overcome several barriers which are uniquely generated by their large-scale operation. Numerous individuals must be comprehensively and efficiently trained to operate the advanced technologies. The digital software must seamlessly integrate with existing software and an internal infrastructure must be established capable of handling massive data inputs. High-volume production in large dental institutions requires the involvement of external laboratories to meet demand. This outsourcing presents a new challenge of safe digital data transfer in accordance with patient privacy and protection regulations set forth by governing agencies. It is vital for large dental institutions to recognise the unique challenges thrust upon them as they attempt to incorporate a digital workflow. With proper forethought and planning an appropriate infrastructure may be established allowing for a smooth and safe transition to the digital era.
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Affiliation(s)
- Leila Jahangiri
- Clinical Professor and Chair, New York University College of Dentistry, Department of Prosthodontics, New York, USA
| | - Guy Akiva
- Director, Information Technology Infrastructure and Systems Support, New York University College of Dentistry, New York, USA
| | - Samantha Lakhia
- Third-year dental student, New York University College of Dentistry, New York, USA
| | - Ilser Turkyilmaz
- Clinical Associate Professor, New York University College of Dentistry, Department of Prosthodontics, New York, USA.
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Implementation of a Vascular Access Experience Program to Train Unit-Based Vascular Access Champions. JOURNAL OF INFUSION NURSING 2020; 43:193-199. [DOI: 10.1097/nan.0000000000000373] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mathur P, Comstock E, Makuza JD, Emmanuel B, Sebeza J, Kiromera A, Wilson E, Kattakuzhy S, Nelson A, Kottilil S, Riedel DJ. Implementation of a unique hepatitis C care continuum model in Rwanda. J Public Health (Oxf) 2020; 41:e203-e208. [PMID: 29982813 DOI: 10.1093/pubmed/fdy115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/22/2018] [Accepted: 06/13/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There has been an evolution in the treatment of chronic hepatitis C (HCV) due to highly effective direct-acting antivirals, however, restriction of treatment to medical specialists hinders escalation of HCV treatment. This is particularly true in resource-limited settings (RLS), which disproportionately represent the burden of HCV worldwide. The ASCEND study in Washington, DC, demonstrated that complete task-shifting can safely and effectively overcome a low provider-to-patient ratio and expand HCV treatment. However, this model has not been applied internationally to RLS. METHOD The validated ASCEND model was translated to an international clinical program in Kigali, Rwanda, aimed at training general medicine providers on HCV management and obtaining HCV prevalence data. RESULTS The didactic training program administered to 11 new HCV providers in Rwanda increased provider's knowledge about HCV management. Through the training program, 26% of patients seen during the follow-up period were screened for HCV and a prevalence estimate of 2% was ascertained. Of these patients, 30% were co-infected with hepatitis B. CONCLUSION The ASCEND paradigm can be successfully implemented in RLS to escalate HCV care, in a self-sustaining fashion that educates more providers about HCV management, while increasing the public's awareness of HCV and access to treatment.
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Affiliation(s)
- Poonam Mathur
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Emily Comstock
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, MD, USA
| | | | - Benjamin Emmanuel
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, MD, USA
| | | | | | - Eleanor Wilson
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Sarah Kattakuzhy
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Amy Nelson
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Shyamasundaran Kottilil
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - David J Riedel
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, School of Medicine, Baltimore, MD, USA
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Serrano N, Diem G, Grabauskas V, Shatchkute A, Stachenko S, Deshpande A, Gillespie KN, Baker EA, Vartinaien E, Brownson RC. Building the capacity - examining the impact of evidence-based public health trainings in Europe: a mixed methods approach. Glob Health Promot 2020; 27:45-53. [PMID: 30943109 PMCID: PMC7132830 DOI: 10.1177/1757975918811102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Since 2002, a course entitled 'Evidence-Based Public Health (EBPH): A Course in Noncommunicable Disease (NCD) Prevention' has been taught annually in Europe as a collaboration between the Prevention Research Center in St Louis and other international organizations. The core purpose of this training is to strengthen the capacity of public health professionals, in order to apply and adapt evidence-based programmes in NCD prevention. The purpose of the present study is to assess the effectiveness of this EBPH course, in order to inform and improve future EBPH trainings. METHODS A total of 208 individuals participated in the European EBPH course between 2007 and 2016. Of these, 86 (41%) completed an online survey. Outcomes measured include frequency of use of EBPH skills/materials/resources, benefits of using EBPH and barriers to using EBPH. Analysis was performed to see if time since taking the course affected EBPH effectiveness. Participants were then stratified by frequency of EBPH use (low v. high) and asked to participate in in-depth telephone interviews to further examine the long-term impact of the course (n = 11 (6 low use, 5 high use)). FINDINGS The most commonly reported benefits among participants included: acquiring knowledge about a new subject (95%), seeing applications for this knowledge in their own work (84%), and becoming a better leader to promote evidence-based decision-making (82%). Additionally, not having enough funding for continued training in EBPH (44%), co-workers not having EBPH training (33%) and not having enough time to implement EBPH approaches (30%) were the most commonly reported barriers to using EBPH. Interviews indicated that work-place and leadership support were important in facilitating the use of EBPH. CONCLUSION Although the EBPH course effectively benefits participants, barriers remain towards widely implementing evidence-based approaches. Reaching and communicating with those in leadership roles may facilitate the growth of EBPH across countries.
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Affiliation(s)
- Natalicio Serrano
- Prevention Research Center in St Louis, Brown School, Washington University in St Louis, St Louis, MO, USA
| | - Gunter Diem
- Vorarlberg Public Health Society, Vorarlberg, Austria
| | - Vilius Grabauskas
- Department of Preventive Medicine, Lithuanian Health Sciences University, Kaunas, Lithuania
| | - Aushra Shatchkute
- Former Regional Adviser, Chronic Diseases, CINDI Coordinator, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Sylvie Stachenko
- School of Public Health, University of Alberta, Edmonton, Canada
| | | | | | - Elizabeth A. Baker
- College for Public Health & Social Justice, St Louis University, St Louis, MO, USA
| | | | - Ross C. Brownson
- Prevention Research Center in St Louis, Brown School, Washington University in St Louis, St Louis, MO, USA
- National Institute for Health and Welfare, Helsinki, Finland
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Weng YH, Yang CY, Chiu YW. Perceptions of Evidence-Based Decision-Making Among Full-Time Teachers and Senior Undergraduates in Public Health: A Nationwide Survey in Taiwan. Asia Pac J Public Health 2020; 32:209-214. [PMID: 32449364 DOI: 10.1177/1010539520921723] [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: 11/16/2022]
Abstract
Using current best evidence to make decisions can improve outcomes of public health. Thus, establishing the capacities of evidence-based public health (EBPH) has become one of the core competences. To better scale up EBPH movement, efforts should focus on introduction of EBPH into school curriculum. However, data indicating the extent to which EBPH is used in universities are scant. In the current study, we conducted a nationwide questionnaire survey to investigate the perceptions toward EBPH among full-time teachers and senior undergraduates at all universities with a Department of Public Health in Taiwan. A structured questionnaire was distributed by post to all potential participants of nine universities in 2017. Questions included items related to awareness, knowledge, skills, behaviors, and barriers of EBPH. Results showed teachers were more aware of EBPH than students. In addition, teachers more often had sufficient knowledge and skills of EBPH, and more often applied the findings to decision-making after critical appraisal than students. Furthermore, personal barriers toward EBPH were more common in students than teachers. In conclusion, there are differences in awareness, knowledge, skills, behaviors, and barriers of EBPH between teachers and students. The data suggest that an initiative of systematically teaching EBPH to undergraduates is important.
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Affiliation(s)
- Yi-Hao Weng
- Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan
| | - Chun-Yuh Yang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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Porteny T, Alegría M, del Cueto P, Fuentes L, Markle SL, NeMoyer A, Perez GK. Barriers and strategies for implementing community-based interventions with minority elders: positive minds-strong bodies. Implement Sci Commun 2020; 1:41. [PMID: 32885198 PMCID: PMC7427860 DOI: 10.1186/s43058-020-00034-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND By 2040, one out of three older adults in the USA are expected to belong to a racial/ethnic minority group. This population has an increased risk of mental and physical disability with significant barriers to access care. Community-based organizations (CBOs) often provide programming to serve minority and immigrant elders. Limited resources and other barriers such as lack of trained staff make it difficult to implement evidence-based interventions (EBIs) in CBOs for long-term adoption. Yet little is known about what factors can facilitate adoption of EBIs in CBOs serving minority elders. METHODS Positive-Minds-Strong Bodies (PM-SB), an evidence-based intervention offered in four languages, aims to reduce mental and physical disability for minority and immigrant elders through the efforts of community health workers and exercise trainers. The intervention consists of cognitive behavior therapy and exercise training sessions delivered over 6 months. During a recent clinical trial of this intervention, we elicited feedback from CBO staff to determine how best to facilitate the implementation and long-term sustainability of PM-SB within their agencies. We surveyed 30 CBO staff members, held four focus groups, and conducted 20 in-depth interviews to examine staff perspectives and to reveal factors or changes needed to facilitate long-term adoption in prospective CBOs. RESULTS Participants reported that staff motivation and implementation could be improved through the following changes: increasing patient compensation for treatment sessions, decreasing levels of organizational accountability, and reducing staff demands embedded in the intervention. Although most staff perceived that PM-SB improved their agency's ability to address the health and well-being of elders, capacity-building strategies such as a "train-the-trainer" initiative were identified as priorities to address staff turnover for sustainability. Adapting the intervention to get financial reimbursement also emerged as vital. CONCLUSIONS Augmenting financial incentives, streamlining procedures, and simplifying staff accountability were suggested strategies for facilitating the transition from a disability prevention clinical trial in minority and immigrant elders to a scalable implementation in routine services at CBOs. TRIAL REGISTRATION ClinicalTrials.gov, NCT02317432.
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Affiliation(s)
- Thalia Porteny
- Interfaculty Initiative in Health Policy, Graduate School of Arts and Science, Harvard University, 1350 Massachusetts Avenue, Suite 350, Cambridge, MA 02138-3654 USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114 USA
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215 USA
| | - Paola del Cueto
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114 USA
| | - Larimar Fuentes
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114 USA
| | - Sheri Lapatin Markle
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114 USA
| | - Amanda NeMoyer
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114 USA
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115 USA
| | - Giselle K. Perez
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215 USA
- Health Policy Research Center at the Mongan Institute, Massachusetts General Hospital, 100 Cambridge Street, Boston, MA 02114 USA
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Mark K, Steel K, Stevenson J, Evans C, McCormick D, Willocks L, McCallum A, Jones L, Johannessen I, Templeton K, Koch O, Mackintosh C. Coronavirus disease (COVID-19) Community Testing Team in Scotland: A 14-day review, 6 to 20 February 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32234116 PMCID: PMC7118345 DOI: 10.2807/1560-7917.es.2020.25.12.2000217] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In response to the outbreak of COVID-19, we set up a team to carry out sampling in the community. This enabled individuals to remain in self-isolation in their own homes and to prevent healthcare settings and services from being overwhelmed by admissions for sampling of suspected cases. There is evidence that this is a cost effective, safe and necessary service to complement COVID-19 testing in hospitals.
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Affiliation(s)
- Kate Mark
- NHS Lothian Directorate of Public Health, Edinburgh, Scotland
| | - Katie Steel
- NHS Lothian Analytic Services, Edinburgh, Scotland
| | - Janet Stevenson
- NHS Lothian Directorate of Public Health, Edinburgh, Scotland
| | - Christine Evans
- NHS Lothian Directorate of Public Health, Edinburgh, Scotland
| | | | - Lorna Willocks
- NHS Lothian Directorate of Public Health, Edinburgh, Scotland
| | - Alison McCallum
- NHS Lothian Directorate of Public Health, Edinburgh, Scotland
| | - Laura Jones
- NHS Lothian Paediatric Services, Edinburgh, Scotland
| | | | | | - Oliver Koch
- NHS Lothian Regional Infectious Diseases Unit, Edinburgh Scotland
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Using acceptance and commitment training to enhance the effectiveness of behavioral skills training. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Archer A, Berry I, Bajwa U, Kalda R, Di Ruggiero E. Preferred modalities for delivering continuing education to the public health workforce: a scoping review. Health Promot Chronic Dis Prev Can 2020; 40:116-125. [PMID: 32270669 PMCID: PMC7197640 DOI: 10.24095/hpcdp.40.4.03] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Continuing education (CE) can help public health professionals maintain and further develop their knowledge and skills to adapt to the changing public health landscape. This scoping review aims to identify the preferred modalities for delivering CE to public health professionals and to determine how equity has been incorporated into public health training. METHODS Using the PRISMA extension for Scoping Reviews as a guide, we searched four databases for peer-reviewed primary research studies that evaluated public health workforce CE modalities. RESULTS The review included 33 studies published between 1 January 2000 and 6 August 2019 from over 11 countries. Most articles broadly described their training audience as public health professionals employed by government or non-governmental organizations. Delivery methods included online, in-person or blended learning (combining online and in-person instruction). Learners strongly preferred self-directed approaches. Organizational support, including protected time for professional development during work hours, was an important enabler of training completion. Commonly cited barriers included course duration and a high number of contact hours. CONCLUSION Findings suggest that there is no single preferred training modality. We identified three elements that influence modality preference: design, delivery and organizational support. Modality should be determined by participants' location, needs and previous experiences to ensure the content is relevant and delivered in a way that equips learners to apply the knowledge gained.
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Affiliation(s)
- Anya Archer
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Isha Berry
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Uttam Bajwa
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Robyn Kalda
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Erica Di Ruggiero
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Beshara S, Herron D, Moles RJ, Chaar B. Status of Pharmacy Ethics Education in Australia and New Zealand. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:7452. [PMID: 32313274 PMCID: PMC7159001 DOI: 10.5688/ajpe7452] [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: 11/13/2018] [Accepted: 08/01/2019] [Indexed: 06/11/2023]
Abstract
Objective. To explore models of teaching in, resources available to, and delivery of a standardized course in pharmacy ethics. Methods. An email invitation was sent to the educator responsible for teaching pharmacy ethics at each of 19 institutions in Australia and New Zealand. Over a six- to eight-week period, semi-structured interviews were conducted in person, by email, or by phone, and were audio-recorded where possible, transcribed verbatim, and entered into data analysis software. Using an inductive analysis approach, themes related to the topics and issues discussed in the interview process were identified. Results. Of the educators invited to participate, 17 completed an interview and were included in this study. Participants reported a paucity of resources available for teaching pharmacy ethics at schools in Australia and New Zealand. Compounding this issue was the lack of expertise and ad-hoc process educators used to create their courses. Assessment methods varied between institutions. Participants felt schools needed to move toward a more standardized pharmacy ethics course with clear and defined guidelines. Conclusion. This study identified many areas in pharmacy ethics that need improvement and revealed the need to develop resources and course structure that adhere to the highest level of Miller's pyramid, while using known frameworks to evaluate ethical competency.
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Affiliation(s)
| | - David Herron
- James Cook University, College of Medicine and Dentistry, Queensland, Australia
| | - Rebekah J. Moles
- The University of Sydney, Sydney Pharmacy School, Sydney, Australia
| | - Betty Chaar
- The University of Sydney, Sydney Pharmacy School, Sydney, Australia
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