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Hansen-Ruiz CS, Luschen K, Huber J, Scott E. Understanding Stakeholder Dissemination Preferences for an Agriculture, Forestry, and Fishing Injury Surveillance System. J Agromedicine 2024; 29:235-245. [PMID: 38100079 DOI: 10.1080/1059924x.2023.2293832] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Researchers and epidemiologists are working to improve the capture of agriculture, forestry, and fishing (AgFF) injuries in a variety of ways. A critical component of any surveillance system is the dissemination of information. The purpose of this paper is to report on a survey conducted with AgFF injury surveillance stakeholders to understand preferred dissemination strategies. The survey was distributed using REDCap via web link to organizational stakeholders, which included advisory board members, safety trainers, industry managers and workers, and research collaborators. In total, there were 75 respondents (21% response rate). Occupation and industry influenced preference in update methods. Regarding the length and breadth of updates, 63% of respondents prefer reports (one to five pages), followed by 57% desiring a summary (less than one page), while only 24% wanted a detailed analysis. Social media and news preferences were also different among stakeholders. Surveillance data were desired for 1) trend analysis, 2) tailoring activities and solutions for education, training, outreach and interventions and 3) for research purposes such as grant proposals and evaluation. The dissemination of injury surveillance data should be tailored to the intended audience. Greater attention needs to be paid to the ways in which we share our findings.
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Affiliation(s)
- Cristina S Hansen-Ruiz
- Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing, Bassett Medical Center, Cooperstown, NY, USA
| | - Kevin Luschen
- Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing, Bassett Medical Center, Cooperstown, NY, USA
| | - John Huber
- Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing, Bassett Medical Center, Cooperstown, NY, USA
| | - Erika Scott
- Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing, Bassett Medical Center, Cooperstown, NY, USA
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2
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Francis CJ, Johnson A, Wilson RL. Supported decision-making interventions in mental healthcare: A systematic review of current evidence and implementation barriers. Health Expect 2024; 27:e14001. [PMID: 38433012 PMCID: PMC10909645 DOI: 10.1111/hex.14001] [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: 08/22/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND There is a growing momentum around the world to foster greater opportunities for the involvement of mental health service users in their care and treatment planning. In-principle support for this aim is widespread across mental healthcare professionals. Yet, progress in mental health services towards this objective has lagged in practice. OBJECTIVES We conducted a systematic review of quantitative, qualitative and mixed-method research on interventions to improve opportunities for the involvement of mental healthcare service users in treatment planning, to understand the current research evidence and the barriers to implementation. METHODS Seven databases were searched and 5137 articles were screened. Articles were included if they reported on an intervention for adult service users, were published between 2008 and October 2023 and were in English. Evidence in the 140 included articles was synthesised according to the JBI guidance on Mixed Methods Systematic Reviews. RESULTS Research in this field remains exploratory in nature, with a wide range of interventions investigated to date but little experimental replication. Overarching barriers to shared and supported decision-making in mental health treatment planning were (1) Organisational (resource limitations, culture barriers, risk management priorities and structure); (2) Process (lack of knowledge, time constraints, health-related concerns, problems completing and using plans); and (3) Relationship barriers (fear and distrust for both service users and clinicians). CONCLUSIONS On the basis of the barriers identified, recommendations are made to enable the implementation of new policies and programs, the designing of new tools and for clinicians seeking to practice shared and supported decision-making in the healthcare they offer. PATIENT OR PUBLIC CONTRIBUTION This systematic review has been guided at all stages by a researcher with experience of mental health service use, who does not wish to be identified at this point in time. The findings may inform organisations, researchers and practitioners on implementing supported decision-making, for the greater involvement of people with mental ill health in their healthcare.
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Affiliation(s)
| | - Amanda Johnson
- Head of School, Dean of Nursing and MidwiferyUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Rhonda L. Wilson
- University of NewcastleNewcastleNew South WalesAustralia
- Massey UniversityPalmerston NorthNew Zealand
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3
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Clark EC, Burnett T, Blair R, Traynor RL, Hagerman L, Dobbins M. Strategies to implement evidence-informed decision making at the organizational level: a rapid systematic review. BMC Health Serv Res 2024; 24:405. [PMID: 38561796 PMCID: PMC10983660 DOI: 10.1186/s12913-024-10841-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Achievement of evidence-informed decision making (EIDM) requires the integration of evidence into all practice decisions by identifying and synthesizing evidence, then developing and executing plans to implement and evaluate changes to practice. This rapid systematic review synthesizes evidence for strategies for the implementation of EIDM across organizations, mapping facilitators and barriers to the COM-B (capability, opportunity, motivation, behaviour) model for behaviour change. The review was conducted to support leadership at organizations delivering public health services (health promotion, communicable disease prevention) to drive change toward evidence-informed public health. METHODS A systematic search was conducted in multiple databases and by reviewing publications of key authors. Articles that describe interventions to drive EIDM within teams, departments, or organizations were eligible for inclusion. For each included article, quality was assessed, and details of the intervention, setting, outcomes, facilitators and barriers were extracted. A convergent integrated approach was undertaken to analyze both quantitative and qualitative findings. RESULTS Thirty-seven articles are included. Studies were conducted in primary care, public health, social services, and occupational health settings. Strategies to implement EIDM included the establishment of Knowledge Broker-type roles, building the EIDM capacity of staff, and research or academic partnerships. Facilitators and barriers align with the COM-B model for behaviour change. Facilitators for capability include the development of staff knowledge and skill, establishing specialized roles, and knowledge sharing across the organization, though staff turnover and subsequent knowledge loss was a barrier to capability. For opportunity, facilitators include the development of processes or mechanisms to support new practices, forums for learning and skill development, and protected time, and barriers include competing priorities. Facilitators identified for motivation include supportive organizational culture, expectations for new practices to occur, recognition and positive reinforcement, and strong leadership support. Barriers include negative attitudes toward new practices, and lack of understanding and support from management. CONCLUSION This review provides a comprehensive analysis of facilitators and barriers for the implementation of EIDM in organizations for public health, mapped to the COM-B model for behaviour change. The existing literature for strategies to support EIDM in public health illustrates several facilitators and barriers linked to realizing EIDM. Knowledge of these factors will help senior leadership develop and implement EIDM strategies tailored to their organization, leading to increased likelihood of implementation success. REVIEW REGISTRATION PROSPERO CRD42022318994.
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Affiliation(s)
- Emily C Clark
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Trish Burnett
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Rebecca Blair
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Robyn L Traynor
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Leah Hagerman
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Maureen Dobbins
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada.
- School of Nursing, McMaster University, Health Sciences Centre, 2J20, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.
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Wingood M, Gell NM, Vincenzo JL, Peters DM. Exploring the implementation potential of physical activity assessment and prescription tools in physical therapy practice: a mixed-method study. Physiother Theory Pract 2023; 39:2676-2687. [PMID: 35844146 PMCID: PMC9845423 DOI: 10.1080/09593985.2022.2100849] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/04/2022] [Accepted: 06/29/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Despite the benefits of physical activity (PA), especially related to aging, physical therapists do not perform regular PA prescriptions secondary to various barriers, including lack of tools. Therefore, we developed the Inventory of Physical Activity Barriers (IPAB). OBJECTIVE Explore potential solutions that could address the current lack of PA prescription among United States-based physical therapists treating patients 50 years and older. METHOD A convergent parallel mixed-method design consisting of focus groups and self-report questionnaires. Descriptive statistics were used for all quantitative variables. Focus groups were thematically coded. RESULTS The 26 participants had 8.6 years (SD = 6.4) of clinical experience, 88.4% (n = 23) reported they regularly have PA conversations with patients, 65.4% (n = 17) regularly assess PA levels, and 19.2% (n = 5) regularly provide PA prescriptions. We identified three themes: 1) opportunities and challenges related to PA prescriptions; 2) lack of standardization in PA assessments and interventions; and 3) implementation potential for innovative solutions that address the current informal PA assessments and interventions. CONCLUSION Physical therapists are amenable to incorporating innovative solutions that support physical activity prescription behavior. Therefore, we recommend the continued development and implementation of PA assessment and prescription tools.
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Affiliation(s)
- Mariana Wingood
- University of Vermont, Department of Rehabilitation and Movement Science, 106 Carrigan Dr. Rowell Building, Burlington, VT 05405, USA
| | - Nancy M. Gell
- University of Vermont, Department of Rehabilitation and Movement Science, 106 Carrigan Dr. Rowell Building, Burlington, VT 05405, USA
| | - Jennifer L. Vincenzo
- University of Arkansas for Medical Sciences, Department of Physical Therapy, 1125 N College Ave, Fayetteville, AR 72701, USA
| | - Denise M. Peters
- University of Vermont, Department of Rehabilitation and Movement Science, 106 Carrigan Dr. Rowell Building, Burlington, VT 05405, USA
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Thapa P, Narasimhan P, Jayasuriya R, Hall JJ, Mukherjee PS, Das DK, Beek K. Barriers and facilitators to informal healthcare provider engagement in the national tuberculosis elimination program of India: An exploratory study from West Bengal. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001390. [PMID: 37792715 PMCID: PMC10550149 DOI: 10.1371/journal.pgph.0001390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 08/26/2023] [Indexed: 10/06/2023]
Abstract
India has a high burden of Tuberculosis (TB), accounting for a significant portion of global cases. While efforts are being made to engage the formal private sector in the National TB Elimination Program (NTEP) of India, there remains a significant gap in addressing the engagement of Informal Healthcare Providers (IPs), who serve as the first point of contact for healthcare in many communities. Recognizing the increasing evidence of IPs' importance in TB care, it is crucial to enhance their engagement in the NTEP. Therefore, this study explored various factors influencing the engagement of IPs in the program. A qualitative study was conducted in West Bengal, India, involving 23 IPs and 11 Formal Providers (FPs) from different levels of the formal health system. Thematic analysis of the data was conducted following a six-step approach outlined by Braun and Clarke. Three overarching themes were identified in the analysis, encompassing barriers and facilitators to IPs' engagement in the NTEP. The first theme focused on IPs' position and capacity as care providers, highlighting their role as primary care providers and the trust and acceptance extended by the community. The second theme explored policy and system-level drivers and prohibitors, revealing barriers such as role ambiguity, competing tasks, and quality of care issues. Facilitators such as growing recognition of IPs' importance in the health system, an inclusive incentive system, and willingness to collaborate were also identified. The third theme focused on the relationship between the formal and informal systems, highlighting a need to strengthen the relationship between the two. This study sheds light on factors influencing the engagement of IPs in the NTEP of India. It emphasizes the need for role clarity, knowledge enhancement, and improved relationships between formal and informal systems. By addressing these factors, policymakers and stakeholders can strengthen the engagement of IPs in the NTEP.
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Affiliation(s)
- Poshan Thapa
- School of Population Health, University of New South Wales, Sydney, Australia
- School of Population and Global Health, McGill University, Montreal, Canada
| | | | - Rohan Jayasuriya
- School of Population Health, University of New South Wales, Sydney, Australia
| | - John J. Hall
- School of Population Health, University of New South Wales, Sydney, Australia
| | | | | | - Kristen Beek
- School of Population Health, University of New South Wales, Sydney, Australia
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Chanyalew MA, Yitayal M, Atnafu A, Tilahun B. Assessment of data demand for informed-decisions among health facility and department heads in public health facilities of Amhara Region, northwest Ethiopia. Health Res Policy Syst 2023; 21:62. [PMID: 37365611 DOI: 10.1186/s12961-023-01006-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 05/18/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Evidence-based decision-making is a foundation of health information systems; however, routine health information is not mostly utilized by decision makers in the Amhara region. Therefore, this study aimed to explore the facility and department heads' perceptions towards the demand for and use of routine health information for decision making. METHODS A phenomenological qualitative study was done in eight districts of the Amhara region from June 10/2019 to July 30/2019. We obtained written informed consent and recruited 22 key informants purposively. The research team prepared a codebook, assigned codes to ideas, identified salient patterns, grouped similar ideas, and developed themes from the data. Thus, data were analyzed thematically using OpenCode software. RESULTS The study revealed that health workers collected many data, but little was demanded and utilized to inform decisions. The majority of respondents perceived that data were collected merely for reporting. Lack of skills in data management, analysis, interpretation, and use were the technical attributes. Individual attributes included low staff motivation, carelessness, and lack of value for data. Poor access to data, low support for Health Information System, limited space for archiving, and inadequate finance were related to organizational attributes. The contextual (social-political) factors also influenced the use of eHealth applications for improved data demand and use among health care providers. CONCLUSION In this study, health workers collect routine health data merely for reporting, and they did not demand and use it mostly to inform decisions and solve problems. Technical, individual, organizational, and contextual attributes were contributors to low demand and use of routine health data. Thus, we recommend building the technical capacity of health workers, introducing motivation mechanisms and ensuring accountability systems for better data use.
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Affiliation(s)
- Moges Asressie Chanyalew
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia.
- Amhara National Regional Sate Health Bureau, Bahir Dar, Ethiopia.
| | - Mezgebu Yitayal
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Atnafu
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia
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7
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Factors contributing to poor healthcare data quality: qualitative study from Southern Ethiopia. HEALTH AND TECHNOLOGY 2023. [DOI: 10.1007/s12553-023-00741-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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8
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Moffat A, Cook EJ, Chater AM. Examining the influences on the use of behavioural science within UK local authority public health: Qualitative thematic analysis and deductive mapping to the COM-B model and Theoretical Domains Framework. Front Public Health 2022; 10:1016076. [PMID: 36339139 PMCID: PMC9632167 DOI: 10.3389/fpubh.2022.1016076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/22/2022] [Indexed: 01/28/2023] Open
Abstract
Background Behavioural science and its contribution towards improving public health is receiving increased recognition. Yet, the translation of these insights into public health practice is under-researched. This study explored the factors influencing the use of behavioural science within public health at a local authority level. Methods Fourteen local authority staff (n = 13 female) in the south of England participated in semi-structured interviews, which were analysed inductively to identify key themes. These were later mapped deductively to the COM-B model and Theoretical Domains Framework. Findings Nine themes were identified as factors that influence the use of behavioural science in local authority public health: (1) "Limited past experience," (2) "Narrow understanding," (3) "Perceived value of behavioural science," (4) "Translational gap from theory-to-practice," (5) "No protected time," (6) "Old ways of working," (7) "Political influence and organisational culture," (8) "Relationships with key stakeholders," (9) "Access to behavioural science resources". Deductive mapping of these themes revealed that five of the COM constructs (excluding Physical Capability) and eleven of the TDF domains influenced behavioural science use, with "Social influences" and "Knowledge" being the most prominent. Discussion Use of behavioural science within local authority public health practice is limited and inconsistent. For it to be successfully implemented, there must be an understanding of its role and value, alongside strategies to overcome a translational gap from theory to practice. Public health teams would benefit from protected time to enable application and strategies to break old habits of using a common-sense approach. System-wide buy-in, particularly related to senior leadership and system partners is needed, which would benefit from organisational and political culture change. Training opportunities, practical resources and expert in-house support should be considered a priority across public health teams.
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Affiliation(s)
- Abby Moffat
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom,*Correspondence: Abby Moffat
| | - Erica Jane Cook
- School of Psychology, University of Bedfordshire, Luton, United Kingdom
| | - Angel Marie Chater
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom,Centre for Behaviour Change, University College London, London, United Kingdom
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Mahdavi M, Sajjadi Khasraghi J, Sajadi HS, Yazdizadeh B, Nikooee S, Ehsani-Chimeh E, Dargahi H, Doshmangir L, Ghaffari S, Toyserkanmanesh R, Majdzadeh R. Developing Framework and Strategies for Capacity Building to Apply Evidence-Informed Health Policy-Making in Iran: Mixed Methods Study of SAHSHA Project. Int J Health Policy Manag 2022; 11:2236-2247. [PMID: 34814672 PMCID: PMC9808291 DOI: 10.34172/ijhpm.2021.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/10/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND SASHA, which stands for "evidence-informed health policy-making (EIHP)" in Persian, is a national project to draw a roadmap for strengthening EIHP in Iran. As a part of SASHA, this research aimed to develop evidence-based and context-aware policy options for increasing the capacity of decision-makers to apply EIHP in Iran. METHODS This was a qualitative study, which was informed by a literature review of pull efforts' capacity building programs. Based on the review, we developed policy options and validated them through an expert panel that involved twelve experts. Data were analyzed using a content analysis method. RESULTS We extracted data from 11 articles. The objectives of capacity building programs were: single-skill development, personal/professional development, and organizational development. According to these objectives, the contents and training methods of the programs vary. Capacity building programs have shown positive impacts on individual knowledge/attitudes to use EIHP. However, the impacts of programs at the organizational or the health system level remain under-researched. We followed several threads from the literature review through to the expert panel that included training the management team, instead of training managers, training for problem-solving skills, and designing tailored programs. Barriers of capacity building for EIHP regard the context of the health system (weak accountability and the widespread conflict of interest) and healthcare organizational structures (decision support systems, knowledge management infrastructures, and lack of management team). Experts suggested interventions on the barriers, particularly on resolving the conflict of interests before launching new programs. A proposed framework to increase the capacity of health policy-makers incorporates strategies at three levels: capacity building program, organizational structure, and health system context. CONCLUSION To prepare the context of Iranian healthcare organizations for capacity building programs, the conflict of interests needs to be resolved, decision-makers should be made more accountable, and healthcare organizations need to provide more knowledge management infrastructures and decision support systems.
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Affiliation(s)
- Mahdi Mahdavi
- The Bernard Lown Scholar in Cardiovascular Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Haniye Sadat Sajadi
- Knowledge Utilization Research Center, University Research and Development Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Yazdizadeh
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sima Nikooee
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ehsani-Chimeh
- National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Dargahi
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Doshmangir
- Tabriz Health Services Management Research Center, Department of Health Policy & Management, Tabriz University of Medical Sciences, Tabriz, Iran
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Reza Majdzadeh
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Thaler L, Paquin-Hodge C, Leloup AG, Wallace A, Oliverio S, Freiwald S, Israel M, Steiger H. Barriers and Facilitators to the Implementation of an Eating Disorders Knowledge Exchange Program for Non-specialist Professionals. J Behav Health Serv Res 2022; 50:365-380. [PMID: 36180648 PMCID: PMC9524729 DOI: 10.1007/s11414-022-09822-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 11/30/2022]
Abstract
Despite availability of evidence-based treatments for eating disorders (EDs), individuals with EDs often do not receive informed treatment. Training of non-specialized clinicians by experienced professionals through knowledge exchange (KE) programs is an effective way to enhance accessibility to evidence-based treatments for EDs. The authors conducted a qualitative analysis of factors that facilitated or impeded the uptake of an ED-focused KE program. Semi-structured interviews were conducted with mental health professionals (n = 43) and managers (n = 11) at 13 community mental-health sites at which the KE program was offered. Data were analyzed using a qualitative content analysis. Key facilitators identified were management support for the program and building competence through ongoing supervision of clinicians. Main barriers were limited access to ED patients to treat and having insufficient time to apply ED interventions in front-line settings. The results provide insights into the practical imperatives involved in implementing a KE initiative for ED treatment.
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Affiliation(s)
- Lea Thaler
- Eating Disorders Continuum, Douglas University Institute, Montreal West Island Integrated Health and Social Services Centre, 6603-05 LaSalle BlvdH4H 1R3, QC, Verdun, Montreal, Canada. .,Psychiatry Department, McGill University, Montreal, QC, Canada.
| | - Chloé Paquin-Hodge
- Eating Disorders Continuum, Douglas University Institute, Montreal West Island Integrated Health and Social Services Centre, 6603-05 LaSalle BlvdH4H 1R3, QC, Verdun, Montreal, Canada.,Psychiatry Department, McGill University, Montreal, QC, Canada
| | | | - Aimée Wallace
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Stephanie Oliverio
- Eating Disorders Continuum, Douglas University Institute, Montreal West Island Integrated Health and Social Services Centre, 6603-05 LaSalle BlvdH4H 1R3, QC, Verdun, Montreal, Canada.,Research Centre, Douglas University Institute, Montreal, QC, Canada
| | - Shiri Freiwald
- Eating Disorders Continuum, Douglas University Institute, Montreal West Island Integrated Health and Social Services Centre, 6603-05 LaSalle BlvdH4H 1R3, QC, Verdun, Montreal, Canada
| | - Mimi Israel
- Eating Disorders Continuum, Douglas University Institute, Montreal West Island Integrated Health and Social Services Centre, 6603-05 LaSalle BlvdH4H 1R3, QC, Verdun, Montreal, Canada.,Psychiatry Department, McGill University, Montreal, QC, Canada
| | - Howard Steiger
- Eating Disorders Continuum, Douglas University Institute, Montreal West Island Integrated Health and Social Services Centre, 6603-05 LaSalle BlvdH4H 1R3, QC, Verdun, Montreal, Canada.,Psychiatry Department, McGill University, Montreal, QC, Canada.,Department of Psychology, McGill University, Montreal, QC, Canada
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11
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Abubaker-Sharif M, Shusted C, Myers P, Myers R. Primary Care Physician Perceptions of Shared Decision Making in Lung Cancer Screening. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1099-1107. [PMID: 33230673 DOI: 10.1007/s13187-020-01925-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 06/11/2023]
Abstract
The Centers for Medicare and Medicaid Services (CMS) supports lung cancer screening (LCS) with annual low-dose computed tomography (LDCT) for patients who undergo shared decision-making (SDM) about LCS. Unfortunately, SDM and LCS rates are low in primary care, and, as a result, the potential benefits of LCS are not being realized. The research team interviewed 16 primary care physicians in a large urban medical center (7 in Family and Community Medicine and 9 in Internal Medicine) on their views of SDM and LCS. Interview audio-recordings were transcribed. Coders analyzed the interview transcripts independently using direct content analysis to identify major themes and subthemes. Results of interview analyses show that physicians were aware of LCS but believed that they and their patients would benefit from receiving more information about screening guidelines. Physicians knew about SDM and felt that SDM performance could help to identify issues that are important to patients and may affect their receptivity to LCS. However, many physicians expressed concerns about the time required for SDM and completing SDM about LCS when other issues need to be addressed. They also acknowledged the challenge of engaging patients, especially those with low health literacy, in SDM. In practice, some physicians reported instead of engaging eligible patients in SDM, they simply encourage them to screen. Importantly, most physicians said that they would like to receive training in SDM. Findings from this study indicate that primary care physicians support the dissemination of information about LCS and understand the importance of SDM. Physicians also feel that performing SDM in routine care is challenging but are receptive to additional training in SDM. Health systems should take steps to support SDM and LCS performance in primary care.
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Affiliation(s)
| | - Christine Shusted
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, The Jane and Leonard Korman Respiratory Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Pamela Myers
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, 19107, USA.
| | - Ronald Myers
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, 19107, USA
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Reichmann S, Wieser B. Open science at the science-policy interface: bringing in the evidence? Health Res Policy Syst 2022; 20:70. [PMID: 35725491 PMCID: PMC9208144 DOI: 10.1186/s12961-022-00867-6] [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: 10/28/2021] [Accepted: 05/16/2022] [Indexed: 12/04/2022] Open
Abstract
Part of the current enthusiasm about open science stems from its promises to reform scientific practice in service of the common good, to ensure that scientific outputs will be found and reused more easily, and to enhance scientific impact on policy and society. With this article, we question this optimism by analysing the potential for open science practices to enhance research uptake at the science–policy interface. Science advice is critical to help policy-makers make informed decisions. Likewise, some interpretations of open science hold that making research processes and outputs more transparent and accessible will also enhance the uptake of results by policy and society at large. However, we argue that this hope is based on an unjustifiably simplistic understanding of the science–policy interface that leaves key terms (“impact”, “uptake”) undefined. We show that this understanding—based upon linear models of research uptake—likewise grounds the influential “evidence–policy gap” diagnosis which holds that to improve research uptake, communication and interaction between researchers and policy-makers need to be improved. The overall normative stance of both discussions has sidelined empirical description of the science–policy interface, ignoring questions about the underlying differences between the policy domain and academia. Importantly, both open science and literature on closing the evidence–policy gap recommend improving communication (in terms of either the content or the means) as a viable strategy. To correct some of these views, we combine insights from policy theory with a narrative review of the literature on the evidence–policy gap in the health domain and find that removing barriers to access by itself will not be enough to foster research uptake.
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Murphy A, Šubelj M, Babarczy B, Köhler K, Chapman E, Truden-Dobrin P, Oliver K, Nahrgang S, Reinap M, Kuchenmüller T. An evaluation of the evidence brief for policy development process in WHO EVIPNet Europe countries. Health Res Policy Syst 2022; 20:54. [PMID: 35525967 PMCID: PMC9077836 DOI: 10.1186/s12961-022-00852-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 04/13/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Evidence briefs for policy (EBPs) represent a potentially powerful tool for supporting evidence-informed policy-making. Since 2012, WHO Evidence-Informed Policy Network (EVIPNet) Europe has been supporting Member States in developing EBPs. The aim of this study was to evaluate the process of developing EBPs in Estonia, Hungary and Slovenia. METHODS We used a rapid appraisal approach, combining semi-structured interviews and document review, guided by the Medical Research Council (MRC) process evaluation framework. Interviews were conducted with a total of 20 individuals familiar with the EBP process in the three study countries. Data were analysed thematically, and emerging themes were related back to the MRC framework components (implementation, mechanisms of impact, and context). We also reflected on the appropriateness of this evaluation approach for EVIPNet teams without evaluation research expertise to conduct themselves. RESULTS The following themes emerged as important to the EBP development process: how the focus problem is prioritized, who initiates this process, EBP team composition, EBP team leadership, availability of external support in the process, and the culture of policy-making in a country. In particular, the EBP process seemed to be supported by early engagement of the Ministry of Health and other stakeholders as initiators, clear EBP team roles and expectations, including a strong leader, external support to strengthen EBP team capacity and cultural acceptance of the necessity of evidence-informed policy-making. Overall, the evaluation approach was considered feasible by the EBP teams and captured rich qualitative data, but may be limited by the absence of external reviewers and long lag times between the EBP process and the evaluation. CONCLUSIONS This process occurs in a complex system and must be conceptualized in each country and each EBP project in a way that fits local policy-making culture, priorities, leadership and team styles, roles and available resources. The use of a rapid appraisal approach, combining qualitative interviews and document review, is a feasible method of process evaluation for EVIPNet member countries.
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Affiliation(s)
- Adrianna Murphy
- grid.8991.90000 0004 0425 469XDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH United Kingdom
| | - Maja Šubelj
- grid.414776.7National Institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia ,grid.8954.00000 0001 0721 6013Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Balázs Babarczy
- grid.452133.20000 0004 0636 7321National Public Health Center, Albert Flórián út 2-6, Budapest, 1097 Hungary
| | - Kristina Köhler
- WHO Country Office in Estonia, Paldiski mnt 81, 10614 Tallinn, Estonia
| | - Evelina Chapman
- grid.420226.00000 0004 0639 2949WHO Regional Office for Europe, Marmorvej 51, 2100 Copenhagen, Denmark
| | - Polonca Truden-Dobrin
- grid.414776.7National Institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia
| | - Kathryn Oliver
- grid.8991.90000 0004 0425 469XDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH United Kingdom
| | - Saskia Nahrgang
- grid.420226.00000 0004 0639 2949WHO Regional Office for Europe, Marmorvej 51, 2100 Copenhagen, Denmark
| | - Marge Reinap
- grid.420226.00000 0004 0639 2949WHO Regional Office for Europe, Marmorvej 51, 2100 Copenhagen, Denmark
| | - Tanja Kuchenmüller
- grid.420226.00000 0004 0639 2949WHO Regional Office for Europe, Marmorvej 51, 2100 Copenhagen, Denmark
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Liu X, Gong X, Gao X, Wang Z, Lu S, Chen C, Jin H, Chen N, Yang Y, Cai M, Shi J. Impact of Contextual Factors on the Attendance and Role in the Evidence-Based Chronic Disease Prevention Programs Among Primary Care Practitioners in Shanghai, China. Front Public Health 2022; 9:666135. [PMID: 35186856 PMCID: PMC8847253 DOI: 10.3389/fpubh.2021.666135] [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: 02/09/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The implementation of evidence-based approaches by general practitioners (GPs) is new in the primary care setting, and few quantitative studies have evaluated the impact of contextual factors on the attendance of these approaches. METHODS In total, 892 GPs from 75 community healthcare centers (CHCs) in Shanghai completed our survey. We used logistic regression to analyze factors affecting the number of evidence-based chronic disease programs attended by GPs and whether they had held the lead position in such a program. RESULTS A total of 346 (38.8%) of the practitioners had never participated in any evidence-based chronic disease prevention (EBCDP) program. The EBCDP interventions in which the GPs had participated were predominantly related to hypertension, diabetes, and cardiovascular disease. However, the proportion of GPs in the lead role was relatively low, between 0.8% (programs involving prevention and control of asthma) and 5.0% (diabetes). Organizational factors and areas were significantly associated with evidence-based practices (EBPs) of the GP, while monthly income and department were the most significantly related to GPs who have the lead role in a program. The results indicated that GPs who had taken the lead position had higher scores for policy and economic impeding factors. GPs who were men, had a higher income, and worked in prevention and healthcare departments and urban areas were more likely to take the lead position. CONCLUSION Evidence-based programs for chronic diseases should be extended to different types of diseases. Personal, organizational, political, and economic factors and the factors of female sex, lower income, department type, and suburban area environment should be considered to facilitate the translation of evidence to practice.
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Affiliation(s)
- Xin Liu
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xin Gong
- Department of Heart Failure, Shanghai East Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Xiang Gao
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhaoxin Wang
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai General Practice and Community Health Development Research Center, Shanghai, China
| | - Sheng Lu
- Department of Orthopedics (Spine Surgery), The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chen Chen
- Shanghai Jing'an District Jiangning Road Community Health Service Center, Shanghai, China
| | - Hua Jin
- Shanghai General Practice and Community Health Development Research Center, Shanghai, China.,Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.,Academic Department of General Practice, Tongji University School of Medicine, Shanghai, China
| | - Ning Chen
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Yang
- School of Medicine, Tongji University, Shanghai, China
| | - Meiyu Cai
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jianwei Shi
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai General Practice and Community Health Development Research Center, Shanghai, China.,Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
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15
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Byrne-Davis L, Turner R, Amatya S, Ashton C, Bull E, Chater A, Lewis L, Shorter G, Whittaker E, Hart J. Using behavioural science in public health settings during the COVID-19 pandemic: The experience of public health practitioners and behavioural scientists. Acta Psychol (Amst) 2022; 224:103527. [PMID: 35149259 PMCID: PMC8818379 DOI: 10.1016/j.actpsy.2022.103527] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/21/2022] [Accepted: 01/31/2022] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION The emergence of COVID-19 and the importance of behaviour change to limit its spread created an urgent need to apply behavioural science to public health. Knowledge mobilisation, the processes whereby research leads to useful findings that are implemented to affect positive outcomes, is a goal for researchers, policy makers and practitioners alike. This study aimed to explores the experience of using behavioural science in public health during COVID-19, to discover barriers and facilitators and whether the rapidly changing context of COVID-19 influenced knowledge mobilisation. METHODS We conducted a semi-structured interview study, with ten behavioural scientists and seven public health professionals in England, Scotland, Wales, The Netherlands and Canada. We conducted an inductive thematic analysis. RESULTS We report three key themes and 10 sub-themes: 1.Challenges and facilitators of translation of behavioural science into public health (Methods and frameworks supported translation, Lack of supportive infrastructure, Conviction and sourcing of evidence and Embracing behavioural science) 2. The unique context of translation (Rapid change in context, the multi-disciplinary team and the emotional toll). 3. Recommendations to support future behavioural science translation (Embedding experts into teams, Importance of a collaborative network and showcasing the role of behavioural science). DISCUSSION Barriers and facilitators included factors related to relationships between people, such as networks and teams; the expertise of individual people; and those related to materials, such as the use of frameworks and an overwhelming amount of evidence and literature. CONCLUSION People and frameworks were seen as important in facilitating behavioural science in practice. Future research could explore how different frameworks are used. We recommend a stepped competency framework for behavioural science in public health and more focus on nurturing networks to facilitate knowledge mobilisation in future emergencies.
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Ricciardi R. Perspectives: Envisioning healthcare quality and safety in 2030. J Res Nurs 2022; 26:168-175. [PMID: 35251238 DOI: 10.1177/1744987121992911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sahakian T, Daouk-Öyry L, Kroon B, Kooij DTAM, Alameddine M. The neglected contexts and outcomes of evidence-based management: a systematic scoping review in hospital settings. J Health Organ Manag 2021; 36:48-65. [PMID: 34985223 DOI: 10.1108/jhom-03-2021-0101] [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: 11/17/2022]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic highlighted the necessity of practicing Evidence-based Management (EBMgt) as an approach to decision-making in hospital settings. The literature, however, provides limited insight into the process of EBMgt and its contextual nuances. Such insight is critical for better leveraging EBMgt in practice. Therefore, the authors' aim was to integrate the literature on the process of EBMgt in hospital settings, identify the gaps in knowledge and delineate areas for future research. DESIGN/METHODOLOGY/APPROACH The authors conducted a systematic scoping review using an innovative methodology that involved two systematic searches. First using EBMgt terminology and second using terminology associated with the EBMgt concept, which the authors derived from the first search. FINDINGS The authors identified 218 relevant articles, which using content analysis, they mapped onto the grounded model of the EBMgt process; a novel model of the EBMgt process developed by Sahakian and colleagues. The authors found that the English language literature provides limited insight into the role of managers' perceptions and motives in EBMgt, the practice of EBMgt in Global South countries, and the outcomes of EBMgt. Overall, this study's findings indicated that aspects of the decision-maker, context and outcomes have been neglected in EBMgt. ORIGINALITY/VALUE The authors contributed to the EBMgt literature by identifying these gaps and proposing future research areas and to the systematic review literature by developing a novel scoping review method.
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Affiliation(s)
- Tina Sahakian
- Evidence-based Healthcare Management Unit, American University of Beirut Medical Center, Beirut, Lebanon.,Department of Human Resource Studies, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Lina Daouk-Öyry
- Evidence-based Healthcare Management Unit, American University of Beirut Medical Center, Beirut, Lebanon.,Suliman S Olayan School of Business, American University of Beirut, Beirut, Lebanon
| | - Brigitte Kroon
- Department of Human Resource Studies, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Dorien T A M Kooij
- Department of Human Resource Studies, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Mohamad Alameddine
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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18
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Shafaghat T, Zarchi MKR, Nasab MHI, Kavosi Z, Bahrami MA, Bastani P. Force field analysis of driving and restraining factors affecting the evidence-based decision-making in health systems; comparing two approaches. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:419. [PMID: 35071625 PMCID: PMC8719555 DOI: 10.4103/jehp.jehp_1142_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 04/02/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND All policies and decisions need evidence examined by scientific methods. Moving toward evidence-based decision-making (EBDM) as a change in organizations, especially health systems (HSs), is inevitable. This study was conducted to identify the factors affecting EBDM in HSs from two approaches and to score them. MATERIALS AND METHODS A mixed-method study was carried out using the force field analysis regarding the change toward EBDM in HS in 2020. This study included six steps to identify and score the key driving forces (DFs) and restraining forces (RFs) to change toward the EBDM in HS: first, finding forces from literature; second, selecting key DFs and RFs through focus group discussion; third, scoring the first group of DFs and RFs by the experts through electronic forms; fourth, determining key DFs and RFs from the managers' perspective using qualitative interviews; fifth, scoring the second group of DFs and RFs by the experts; and sixth, comparison between forces resulted from two approaches. RESULTS According to the literature and experts' opinions, "relevant, reliable, interpretable, and understandable evidence" and "interaction between researchers and decision-makers" were the strongest forces to change, and "lack of organizational commitment and support" and "lack of relevant/high-quality evidence" were the strongest forces against the change toward EBDM in HS. Further, based on managers' perspective and scores by the experts, "suitable supervision and control" and "reforming the planning and decision-making system" were the strongest forces to change, and "inadequate knowledge of the managers and staff about the principles and contents of EBDM" and "issues beyond the authorities of managers" were the strongest forces against the change toward EBDM in HS. CONCLUSIONS Based on the findings, HSs' managers can focus to reduce RFs and promote DFs for implementing EBDM strategies, so they can provide better services by making more efficient decisions.
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Affiliation(s)
- Tahereh Shafaghat
- Student Research Committee, Department of Health Care Management, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Kazem Rahimi Zarchi
- Department of Health Care Management, Health Policy and Management Research Center, School of Public Health, Shahid Saoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hasan Imani Nasab
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Zahra Kavosi
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahammad Amin Bahrami
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peivand Bastani
- Health Human Recourses Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
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Zdunek K, Alexander D, Schröder-Bäck P, Rigby M, Blair M. Factors influencing the uptake of evidence in child health policy-making: results of a survey among 23 European countries. Health Res Policy Syst 2021; 19:136. [PMID: 34743712 PMCID: PMC8573924 DOI: 10.1186/s12961-021-00786-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 10/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background The ability to successfully transfer knowledge across international boundaries to improve health across the European Region is dependent on an in-depth understanding of the many factors involved in policy creation. Across countries we can observe various approaches to evidence usage in the policy-making process. This study, which was a part of the Models of Child Health Appraised (MOCHA) project assessing patterns of children’s primary care in Europe, focused on how and what kind of evidence is used in child health policy-making processes in European countries and how it is applied to inform policy and practice. Method In this study, a qualitative approach was used. The data were analysed in accordance with the thematic analysis protocol. The MOCHA project methodology relies on experienced country agents (CA) recruited for the project and paid to deliver child health data in each of 30 European countries. CAs are national experts in the child health field who defined the country-specific structured information and data. A questionnaire designed as a semi-structured survey instrument asked CAs to indicate the sources of evidence used in the policy-making process and what needed to be in place to support evidence uptake in policy and practice. Results In our data we observed two approaches to evidence usage in child health policy formulation. The scientific approach in our understanding refers to the so-called bottom-up initiatives of academia which identify and respond to the population’s needs. Institutional approaches can be informed by scientific resources as well; however, the driving forces here are governmental institutions, whose decisions and choices are based not only on the population needs but also on political, economic and organizational factors. The evidence used in Europe can also be of an external or internal nature. Various factors can affect the use of evidence in child health policy-making. Facilitators are correlated with strong scientific culture development, whereas barriers are defined by a poor tradition of implementing changes based on reliable evidence. Conclusions Focusing on the facilitators and actively working to reduce the barriers can perceivably lead to faster and more robust policy-making, including the development of a culture of scientific grounding in policy creation. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-021-00786-y.
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Affiliation(s)
- Kinga Zdunek
- Department of Health Education, Faculty of Health Sciences, Medical University of Lublin, 1 Chodźki Street (Collegium Universum), 20-093, Lublin, Poland.
| | - Denise Alexander
- Section of Paediatrics, Imperial College London, London, UK.,School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Peter Schröder-Bäck
- Department of International Health, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Postbus 616, 6200 MD, Maastricht, The Netherlands
| | - Michael Rigby
- School of Social, Political and Global Studies and School of Primary, Community and Social Care, Keele University, Keele, UK.,Lavender Hill, 6 Carrighill Lower, Calverstown, Co., Kildare, R56 DT91, Ireland
| | - Mitch Blair
- Department of Primary Care and Public Health, Imperial College London, London, UK.,Department of Paediatrics, St Mary's Medical School Building, Imperial College London, London, W2 1PG, UK
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20
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Van Loon MS, Widdershoven G, Van Leeuwen K, Bosmans J, Metselaar S, Ostelo R. 'Implementing a broad quality of life tool for determining care wishes and needs of older adults living at home. Home Health Care Serv Q 2021; 40:262-275. [PMID: 34467831 DOI: 10.1080/01621424.2021.1968986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim was to investigate the views of stakeholders on the practical relevance of a broad quality of life (QoL) outcome tool for care in older adults: the Extended Quality of Life Tool (EQLT). We conducted individual interviews and focus groups with a variety of stakeholders involved in the care for older adults which were analyzed using a framework analysis. Stakeholders considered relevant: focus on the client perspective; perspective on QoL broader than health; the possibility to take diversity into account; and the possibility to determine a minimum level of QoL. Three facilitators for implementation of the tool were mentioned as well as four barriers. The EQLT can support conversations with clients about their needs and wishes, thus enabling decisions about care services based on a broad set of domains of QoL. Implementation of the tool should take into account the facilitators and barriers identified in the current study.
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Affiliation(s)
- M S Van Loon
- Amsterdam UMC, Department of Ethics, Law & Humanities, Amsterdam Public Health Research Institute, Vu University Amsterdam, Amsterdam, the Netherlands.,Department of Health Sciences, Faculty of Science, Vu University Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - G Widdershoven
- Amsterdam UMC, Department of Ethics, Law & Humanities, Amsterdam Public Health Research Institute, Vu University Amsterdam, Amsterdam, the Netherlands
| | - K Van Leeuwen
- Department of Health Sciences, Faculty of Science, Vu University Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - J Bosmans
- Department of Health Sciences, Faculty of Science, Vu University Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - S Metselaar
- Amsterdam UMC, Department of Ethics, Law & Humanities, Amsterdam Public Health Research Institute, Vu University Amsterdam, Amsterdam, the Netherlands
| | - R Ostelo
- Department of Health Sciences, Faculty of Science, Vu University Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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21
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Yimgang D, Danhoundo G, Kusi-Appiah E, Sunder V, Campbell S, Yaya S. A scoping review of researchers' involvement in health policy dialogue in Africa. Syst Rev 2021; 10:190. [PMID: 34174957 PMCID: PMC8236190 DOI: 10.1186/s13643-021-01745-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Improving evidence-informed policy dialogue to support the development and implementation of national health policies is vital, but there is limited evidence on researchers' roles in policy dialogue processes in Africa. The objective of this study is to examine researchers' involvement in health policy dialogue in Africa. METHODS The database search of this scoping review was conducted from inception to January 24, 2021, by an expert searcher/librarian to determine the extent of evidence, barriers, and facilitators of researchers' involvement in health policy dialogues in Africa. PROSPERO, Wiley Cochrane Library, OVID Medline, OVID EMBASE, OVID PsycINFO, OVID Global Health, EBSCO CINAHL, BASE (Bielefeld Academic Search Engine), and Google/Google Scholar were searched using key words representing the concepts "policy dialogue", "health", and "Africa". No limits were applied. A narrative summary of results was presented. RESULTS There were 26 eligible studies representing 21 African countries. Significant discrepancies in researchers' involvement existed across countries. In 62% of the countries, there was suboptimal involvement of researchers in policy dialogues due to no or partial participation in policy dialogues. Major barriers included limited funding, lack of evidence in the public health field of interest, and skepticism of policymakers. The presence of an interface for exchange, demand for scientific evidence, and donors' funding were the most reported facilitators. CONCLUSIONS To improve the uptake of evidence in health policy-making processes, an environment of trust and communication between policymakers and researchers must be established. Policymakers need to demonstrate that they value research, by providing adequate funding, promoting knowledge translation activities, and supporting personal and professional development opportunities for researchers.
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Affiliation(s)
| | | | | | | | | | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, Ontario, K1N 6 N5, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
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22
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Glegg SMN, Ryce A, Miller KJ, Nimmon L, Kothari A, Holsti L. Organizational supports for knowledge translation in paediatric health centres and research institutes: insights from a Canadian environmental scan. Implement Sci Commun 2021; 2:49. [PMID: 33985591 PMCID: PMC8117660 DOI: 10.1186/s43058-021-00152-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Organizational supports are thought to help address wide-ranging barriers to evidence-informed health care (EIHC) and knowledge translation (KT). However, little is known about the nature of the resources and services that exist within paediatric health care and research settings across Canada to facilitate evidence use in health care delivery. This survey examined existing supports for EIHC/KT within these organizations to inform the design of similar EIHC/KT support programmes. METHODS A national environmental scan was conducted using a bilingual online survey distributed to leaders at Canadian paediatric academic health science centres and their affiliated research institutes. Participants were invited through email, social media and webinar invitations and snowball sampling. Supports of interest included personnel, resources, services, organizational structures or processes, and partnerships or collaborations; barriers and successes were also probed. Data were compiled by site, reported using descriptive statistics, or grouped thematically. Supports were described using the AIMD (Aims, Ingredients, Mechanism, Delivery) framework. RESULTS Thirty-one respondents from 17 sites across seven provinces represented a 49% site response rate. Eleven (65%) sites reported an on-site library with variable staffing and services. Ten (59%) sites reported a dedicated KT support unit or staff person. Supports ranged from education, resource development and consultation to protocol development, funded initiatives and collaborations. Organizations leveraged internal and external supports, with the majority also employing supports for clinical research integration. Supports perceived as most effective included personnel, targeted initiatives, leadership, interdepartmental expertise, external drivers and logistical support. Barriers included operational constraints, individual-level factors and lack of infrastructure. CONCLUSIONS This first survey of organizational supports for EIHC/KT identified the range of supports in place in paediatric research and health care organizations across Canada. The diversity of supports reported across sites may reflect differences in resource capacity and objectives. Similarities in EIHC/KT and research integration supports suggest common infrastructure may be feasible. Moreover, stakeholder engagement in research was common, but not pervasive. Tailored support programmes can target multi-faceted barriers. Findings can inform the development, refinement and evaluation of EIHC/KT support programmes and guide the study of the effectiveness and sustainability of these strategies.
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Affiliation(s)
- Stephanie Miranda Nadine Glegg
- Rehabilitation Sciences, The University of British Columbia, T325 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada. .,Sunny Hill Health Centre at BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada. .,BC Children's Hospital Research Institute, 938 W. 28th Ave, Vancouver, BC, V5Z 4H4, Canada.
| | - Andrea Ryce
- Sunny Hill Health Centre at BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Kimberly J Miller
- Sunny Hill Health Centre at BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada.,BC Children's Hospital Research Institute, 938 W. 28th Ave, Vancouver, BC, V5Z 4H4, Canada
| | - Laura Nimmon
- Department of Occupational Science and Occupational Therapy, The University of British Columbia, T325 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Anita Kothari
- School of Health Studies, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada
| | - Liisa Holsti
- BC Children's Hospital Research Institute, 938 W. 28th Ave, Vancouver, BC, V5Z 4H4, Canada.,Department of Occupational Science and Occupational Therapy, The University of British Columbia, T325 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
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Shafaghat T, Imani Nasab MH, Bahrami MA, Kavosi Z, Roozrokh Arshadi Montazer M, Rahimi Zarchi MK, Bastani P. A mapping of facilitators and barriers to evidence-based management in health systems: a scoping review study. Syst Rev 2021; 10:42. [PMID: 33516269 PMCID: PMC7847165 DOI: 10.1186/s13643-021-01595-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare settings are complex, and the decision-making process is usually complicated, too. Precise use of best evidence from different sources for increasing the desired outcomes is the result of EBM. Therefore, this study aimed to map the potential facilitators and barriers to EBM in health systems to help the healthcare managers to better implement EBM in their organizations. METHODS The present study was a scoping review (SR) conducted in 2020 based on the integration of the frameworks presented by Arksey and O'Malley (2005) and Levac et al. (2010) considering the Joanna Briggs Institute guideline (2015). These frameworks consist of 6 steps. After finalizing the search strategy, 7 databases were searched, and the PRISMA-ScR was used to manage the retrieval and inclusion of the evidence. Microsoft Excel 2013 was used to extract the data, and the graphic description was presented. The summative analysis approach was used applying MAXQDA10. RESULTS According to the systematic search, 4815 studies were retrieved after eliminating duplicates and unrelated articles, 49 articles remained to extract EBM facilitators and barriers. Six main aspects attitude toward EBM, external factors, contextual factors, resources, policies and procedures, and research capacity and data availability were summarized as EBM facilitators. The barriers to EBM were similarly summarized as attitude toward EBM, external factors, contextual factors, policies and procedures, limited resources, and research capacity and data availability. The streamgraphs describe that the international attention to the sub-aspects of facilitators and barriers of EBM has been increased since 2011. CONCLUSIONS The importance of decision-making regarding complex health systems, especially in terms of resource constraints and uncertainty conditions, requires EBM in the health system as much as possible. Identifying the factors that facilitate the use of evidence, as well as its barriers to management and decision-making in the organization, can play an important role in making systematic and reliable decisions that can be defended by the officials and ultimately lead to greater savings in organization resources and prevent them from being wasted.
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Affiliation(s)
- Tahereh Shafaghat
- Student Research Committee, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hasan Imani Nasab
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad Amin Bahrami
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kavosi
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Roozrokh Arshadi Montazer
- Student Research Committee, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Kazem Rahimi Zarchi
- Health Policy and Management Research Center, Department of Health Care Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Peivand Bastani
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.
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Abou Hashish EA, Alsayed S. Evidence-Based Practice and its Relationship to Quality Improvement: A Cross-Sectional Study among Egyptian Nurses. Open Nurs J 2020. [DOI: 10.2174/1874434602014010254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Implementing Evidence-Based Practice (EBP) and Quality Improvement (QI) were recognized as the core competencies that should be held by all healthcare professionals, especially nurses, as front-line healthcare providers. Assessment of the current level of knowledge, skills, and attitude of nurses, regarding EBP and QI, is important for the design of strategies that could enhance the competence of nurses in such practices and, in turn, promote patient care quality.
Objective:
This study aimed to assess the attitudes, knowledge, and skills of nurses in Evidence-Based Practice (EBP) and Quality Improvement (QI), in addition, to studying the relationship between EBP and QI.
Methods:
A cross-sectional study was conducted using a convenient sample of nurses (N=300) who work in three Egyptian hospitals in Alexandria city, representing the university, governmental, and private health sectors. The EBP and QI questionnaires were used in addition to a demographic form for the studied nurses. Statistical analysis was carried out using ANOVAs, student t-test, Pearson correlation, and Regression analysis (R2).
Results:
Nurses displayed positive attitudes toward both EBP and QI. However, they perceived themselves to be lacking sufficient EBP knowledge and need to improve their QI skills. There was a strong positive correlation between EBP and QI with a predictive power of QI on EBP (r= 0.485, R2 = 0.273, p<0.001).
Conclusion:
Nurses need educational support for enhancing their attitude, knowledge, and skills related to EBP and QI. To prepare for educational programs, hospitals and nursing administrators should consider the characteristics of nurses, work schedules, and obstacles in the use of EBP. Hospital managers should also implement effective strategies to resolve the barriers and boost facilitators to increase the use of EBP among Egyptian nurses and promote QI.
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Strengthening health policy development and management systems in low- and middle- income countries: South Africa's approach. HEALTH POLICY OPEN 2020. [DOI: 10.1016/j.hpopen.2020.100010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Endriyas M, Alano A, Mekonnen E, Kawza A, Lemango F. Decentralizing evidence-based decision-making in resource limited setting: A case of SNNP region, Ethiopia. PLoS One 2020; 15:e0236637. [PMID: 32730355 PMCID: PMC7392275 DOI: 10.1371/journal.pone.0236637] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 07/11/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Access to and the use of accurate, valid, reliable, timely, relevant, legible and complete information is vital for safe and reliable healthcare. Though the study area has been implementing standardized Health Management Information System (HMIS), there was a need for information on how well structures were utilizing information and this study was designed to assess HMIS data utilization. METHODS Facility based retrospective study was conducted in Southern Nations Nationalities and People's Region (SNNPR) in April, 2017. We included data from 163 sample facilities. Data use was evaluated by reviewing eight items from performance monitoring system that included activities from problem identification to monitoring of proposed action plans. Each item reviewed was recoded to yes or no and summed to judge overall performance. RESULTS About half (52%) of woredas, 26.2% health centers (HCs), 25% hospitals and 6.2% health posts (HPs) reviewed their performance monthly but only 20% woredas, 6.2% HCs, 1.5% HPs and no hospital prepared action plans after reviewing performance. Summary of 8 items assessed showed that majority of facilities (87.5% hospitals, 81.5% HPs and 70.8% HCs) were poor in data utilization. CONCLUSIONS Only about half of woredas and below one-fifth of health facilities were utilizing HMIS data and a lot to move to catch-up country's information revolution plan. Lower health care systems should be supported in evidence-based decision-making and progress should be monitored routinely quantitatively and/or qualitatively.
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Miller KJ, Park JE, Ramanathan K, Abel J, Zhao Y, Mamdani A, Pak M, Fung A, Gao M, Humphries KH. Examining Coronary Revascularization Practice Patterns for Diabetics: Perceived Barriers, Facilitators, and Implications for Knowledge Translation. Can J Cardiol 2020; 36:1236-1243. [PMID: 32621887 DOI: 10.1016/j.cjca.2019.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/25/2019] [Accepted: 11/07/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The FREEDOM trial provided robust evidence that coronary artery bypass grafting (CABG) was superior to percutaneous coronary intervention (PCI) for coronary revascularization in patients with diabetes mellitus (DM) and multivessel coronary artery disease (MV-CAD). The present study examined practice pattern changes and perceived barriers and facilitators to implementing FREEDOM trial evidence in British Columbia (BC). METHODS Using a population-based database of cardiac procedures in BC, PCI:CABG ratios from 2007-2014 were compared before and after publication of the FREEDOM trial in the 4 tertiary cardiac centres that provided both CABG and PCI. Surveys of barriers and facilitators to implementation of evidence in practice were completed by 57 health care providers (HCPs) attending educational outreach sessions conducted in 2016-17 at 5 tertiary cardiac centres in BC. RESULTS The overall PCI:CABG ratio declined from 1.59 (95% confidence interval [CI] 1.48-1.70, range 1.16-1.86) before publication to 0.88 (95% CI 0.75-1.01, range 0.56-0.82) after publication (P < 0.01). This decline from before to after publication was significant in 3 centres, but not in the fourth centre (from 1.62 to 1.49; P = 0.61). Barriers were identified at the levels of evidence (applicability, credibility), HCP (awareness/knowledge, practice behaviours), patient (knowledge/misconceptions, preferences), and systems (siloing of care, financial disincentives, resource limitations, geography). Facilitators were additional studies/guidelines, education/dissemination, shared decision making, a heart team approach, changes to remuneration models, and increased resources. CONCLUSIONS Following publication of the FREEDOM trial, the proportion of patients with DM and MV-CAD undergoing CABG increased in BC; however, practice patterns varied across cardiac centres. HCPs attributed these practice variations to multilevel barriers and facilitators. Future knowledge translation strategies should be multifaceted and tailored to identified determinants.
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Affiliation(s)
- Kimberly J Miller
- British Columbia Centre for Improved Cardiovascular Health, Vancouver, British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
| | - Julie E Park
- British Columbia Centre for Improved Cardiovascular Health, Vancouver, British Columbia, Canada
| | - Krishnan Ramanathan
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - James Abel
- Division of Cardiothoracic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yinshan Zhao
- British Columbia Centre for Improved Cardiovascular Health, Vancouver, British Columbia, Canada
| | - Avanish Mamdani
- British Columbia Centre for Improved Cardiovascular Health, Vancouver, British Columbia, Canada
| | - Melissa Pak
- British Columbia Centre for Improved Cardiovascular Health, Vancouver, British Columbia, Canada
| | - Anthony Fung
- Division of Cardiothoracic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Min Gao
- British Columbia Centre for Improved Cardiovascular Health, Vancouver, British Columbia, Canada
| | - Karin H Humphries
- British Columbia Centre for Improved Cardiovascular Health, Vancouver, British Columbia, Canada; Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
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Munn Z, McArthur A, Mander GTW, Steffensen CJ, Jordan Z. Evidence-based healthcare, knowledge translation, implementation science and radiography: What does it all mean? Radiography (Lond) 2020; 26 Suppl 2:S8-S13. [PMID: 32620353 DOI: 10.1016/j.radi.2020.05.008] [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] [Received: 04/17/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 12/30/2022]
Abstract
Evidence-based healthcare is an approach to practice whereby decision making and service delivery considers the best available evidence, patient choice, local resources and clinical expertise. Although sound in theory, compliance with evidence-based practice is often far from optimal. To address this, related fields such as knowledge translation and implementation science have emerged, which largely focus on methods and techniques to facilitate the transfer of evidence into practice. This introductory article explains the key concepts of evidence-based healthcare by using the JBI Model as a framework to highlight the lifecycle of evidence-based information. Throughout the article we refer to exemplars from medical radiation to highlight these concepts.
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Affiliation(s)
- Z Munn
- JBI, University of Adelaide, Australia.
| | | | - G T W Mander
- Dept Medical Imaging, Toowoomba Hospital, Darling Downs Health, QLD Health, Australia
| | | | - Z Jordan
- JBI, University of Adelaide, Australia
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Miranda ÉDS, Figueiró AC, Potvin L. Are public health researchers in Brazil ready and supported to do knowledge translation? CAD SAUDE PUBLICA 2020; 36:e00003120. [PMID: 32267381 DOI: 10.1590/0102-311x00003120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/27/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | - Louise Potvin
- École de Santé Publique de l'Université de Montréal, Montréal, Canada
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30
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Dagenais C, Dupont D, Brière FN, Mena D, Yale-Soulière G, Mc Sween-Cadieux E. Codifying explicit and tacit practitioner knowledge in community social pediatrics organizations: Evaluation of the first step of a knowledge transfer strategy. EVALUATION AND PROGRAM PLANNING 2020; 79:101778. [PMID: 31923748 DOI: 10.1016/j.evalprogplan.2020.101778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 10/09/2019] [Accepted: 01/02/2020] [Indexed: 06/10/2023]
Abstract
In this article, we the present the evaluation of the first phase of a KT initiative, the codification of the tacit and explicit knowledge of community social pediatrics (CSP) practitioners. As increasing numbers of professionals began working in the CSP field, it became necessary to capture the know-how to make it better understood. This first phase of the initiative took advantage of one of the KM stages, the codifying process that is absent from KT models. The evaluation aim to answer the question: "What is the CSPs practitioners level of familiarity with the codification document, as well as their perceptions of its utility and its contribution to the understanding of the CSP model". The results, show that most respondents had consulted the codification document and were able to describe in detail parts of it. The results also show that they considered it to be a useful and necessary tool to guide practices and helpful in understanding the model. The results of this evaluation is paving the way for the next steps of the KT initiative.
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Affiliation(s)
| | - Didier Dupont
- Research Professional Consultant in Social Science and Humanities, Canada
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Khalid AF, Lavis JN, El-Jardali F, Vanstone M. Supporting the use of research evidence in decision-making in crisis zones in low- and middle-income countries: a critical interpretive synthesis. Health Res Policy Syst 2020; 18:21. [PMID: 32070370 PMCID: PMC7027202 DOI: 10.1186/s12961-020-0530-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/21/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Decision-makers in crisis zones are faced with the challenge of having to make health-related decisions under limited time and resource constraints and in light of the many factors that can influence their decisions, of which research evidence is just one. To address a key gap in the research literature about how best to support the use of research evidence in such situations, we conducted a critical interpretive synthesis approach to develop a conceptual framework that outlines the strategies that leverage the facilitators and address the barriers to evidence use in crisis zones. METHODS We systematically reviewed both empirical and non-empirical literature and used an interpretive analytic approach to synthesise the results and develop the conceptual framework. We used a 'compass' question to create a detailed search strategy and conducted electronic searches in CINAHL, EMBASE, MEDLINE, SSCI and Web of Science. A second reviewer was assigned to a representative sample of articles. We purposively sampled additional papers to fill in conceptual gaps. RESULTS We identified 21 eligible papers to be analysed and purposively sampled an additional 6 to fill conceptual gaps. The synthesis resulted in a conceptual framework that focuses on evidence use in crisis zones examined through the lens of four systems - political, health, international humanitarian aid and health research. Within each of the four systems, the framework identifies the most actionable strategies that leverage the facilitators and address the barriers to evidence use. CONCLUSIONS This study presents a new conceptual framework that outlines strategies that leverage the facilitators and address the barriers to evidence use in crisis zones within different systems. This study expands on the literature pertaining to evidence-informed decision-making.
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Affiliation(s)
- Ahmad Firas Khalid
- Health Policy PhD Program, McMaster University, Hamilton, ON, Canada.
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
| | - John N Lavis
- Health Policy PhD Program, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
- Department of Political Science, McMaster University, Hamilton, ON, Canada
| | - Fadi El-Jardali
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Health Management & Policy, American University of Beirut, Beirut, Lebanon
- enter for Systematic Review in Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
| | - Meredith Vanstone
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
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Klaassen LA, Friesen-Storms JHHM, Bours GJJW, Dirksen CD, Boersma LJ, Hoving C. Perceived facilitating and limiting factors for healthcare professionals to adopting a patient decision aid for breast cancer aftercare: A cross-sectional study. PATIENT EDUCATION AND COUNSELING 2020; 103:145-151. [PMID: 31471071 DOI: 10.1016/j.pec.2019.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 06/30/2019] [Accepted: 07/23/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Effective healthcare innovations are often not adopted and implemented. An implementation strategy based on facilitators and barriers for use as perceived by healthcare professionals could increase adoption rates. This study therefore aimed to identify the most relevant facilitators and barriers for use of an innovative breast cancer aftercare decision aid (PtDA) in healthcare practice. METHODS Facilitators and barriers (related to the PtDA, adopter and healthcare organisation) were assessed among breast cancer aftercare health professionals (n = 81), using the MIDI questionnaire. For each category, a backward regression analysis was performed (dependent = intention to adopt). All significant factors were then added to a final regression analysis to identify to most relevant determinants of PtDA adoption. RESULTS Expecting higher compatibility with daily practice and clinical guidelines, more positive outcomes of use, higher perceived relevance for the patient and increased self-efficacy were significantly associated with a higher intention to adopt. Self-efficacy and perceived patient relevance remained significant in the final model. CONCLUSIONS Low perceived self-efficacy and patient relevance are the most important barriers for health professions to adopt a breast cancer aftercare PtDA. PRACTICE IMPLICATIONS To target self-efficacy and perceived patient relevance, the implementation strategy could apply health professional peer champions.
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Affiliation(s)
- Linda A Klaassen
- Maastricht University, Department of Radiotherapy/GROW School for Oncology and Developmental Biology/CAPHRI Care and Public Health, Research Institute, P. O. Box 616, 6200 MD Maastricht, the Netherlands.
| | - Jolanda H H M Friesen-Storms
- Zuyd University of Applied Sciences, Zuyd Health, Research Centre Autonomy and Participation for Persons with a Chronic Illness, Nursing Department, Heerlen, the Netherlands; Maastricht University, Department of Family Medicine/CAPHRI Care and Public Health, Research Institute, Nieuw Eyckholt 300, 6419 DJ Heerlen, Maastricht, the Netherlands.
| | - Gerrie J J W Bours
- Zuyd University of Applied Sciences, Zuyd Health, Research Centre for Community Care, Nursing Department, Heerlen, the Netherlands; Maastricht University, Department of Health Services Research/CAPHRI Care and Public Health Research Institute, Nieuw Eyckholt 300, 6419 DJ Heerlen, Maastricht, the Netherlands.
| | - Carmen D Dirksen
- Maastricht University Medical Centre +, Department of KEMTA/CAPHRI Care and Public Health Research Institute, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands.
| | - Liesbeth J Boersma
- Department of Radiation Oncology (MAASTRO Clinic)/GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre +, P.O. Box 3035, 6202 NA Maastricht, the Netherlands.
| | - Ciska Hoving
- Maastricht University, Department of Health Promotion/CAPHRI Care and Public Health Research Institute, P. O. Box 616, 6200 MD Maastricht, the Netherlands.
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Bowen S, Botting I, Graham ID, MacLeod M, de Moissac D, Harlos K, Leduc B, Ulrich C, Knox J. Experience of Health Leadership in Partnering With University-Based Researchers in Canada - A Call to "Re-imagine" Research. Int J Health Policy Manag 2019; 8:684-699. [PMID: 31779297 PMCID: PMC6885864 DOI: 10.15171/ijhpm.2019.66] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 07/28/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Emerging evidence that meaningful relationships with knowledge users are a key predictor of research use has led to promotion of partnership approaches to health research. However, little is known about health system experiences of collaborations with university-based researchers, particularly with research partnerships in the area of health system design and health service organization. The purpose of the study was to explore the experience and perspectives of senior health managers in health service organizations, with health organization-university research partnerships. METHODS In-depth, semi-structured interviews (n = 25) were conducted with senior health personnel across Canada to explore their perspectives on health system research; experiences with health organization-university research partnerships; challenges to partnership research; and suggested actions for improving engagement with knowledge users and promoting research utilization. Participants, recruited from organizations with regional responsibilities, were responsible for system-wide planning and support functions. RESULTS Research is often experienced as unhelpful or irrelevant to decision-making by many within the system. Research, quality improvement (QI) and evaluation are often viewed as separate activities and coordinated by different responsibility areas. Perspectives of senior managers on barriers to partnership differed from those identified in the literature: organizational stress and restructuring, and limitations in readiness of researchers to work in the fast-paced healthcare environment, were identified as major barriers. Although the need for strong executive leadership was emphasized, "multi-system action" is needed for effective partnerships. CONCLUSION Common approaches to research and knowledge translation are often not appropriate for addressing issues of health service design and health services organization. Nor is the research community providing expertise to many important activities that the healthcare system is taking to improve health services. A radical rethinking of how we prepare health service researchers; position research within the health system; and fund research activities and infrastructure is needed if the potential benefits of research are to be achieved. Lack of response to health system needs may contribute to research and 'evidence-informed' practice being further marginalized from healthcare operations. Interventions to address barriers must respond to the perspectives and experience of health leadership.
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Affiliation(s)
- Sarah Bowen
- Applied Research and Evaluation Consultant, Centreville, NS, Canada
| | - Ingrid Botting
- Department of Community Health Sciences, University of Manitoba Winnipeg, Winnipeg, MB, Canada
| | - Ian D. Graham
- Ottawa Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Martha MacLeod
- School of Nursing, University of Northern British Columbia, Prince George, BC, Canada
| | | | | | - Bernard Leduc
- Hôpital Montfort, University of Ottawa, Ottawa, ON, Canada
| | - Catherine Ulrich
- Northern Health, Prince George, BC, Canada
- University of Northern British Columbia, Prince George, BC, Canada
| | - Janet Knox
- Nova Scotia Health Authority, Halifax, NS, Canada
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Norris KC, Duru OK, Alicic RZ, Daratha KB, Nicholas SB, McPherson SM, Bell DS, Shen JI, Jones CR, Moin T, Waterman AD, Neumiller JJ, Vargas RB, Bui AAT, Mangione CM, Tuttle KR. Rationale and design of a multicenter Chronic Kidney Disease (CKD) and at-risk for CKD electronic health records-based registry: CURE-CKD. BMC Nephrol 2019; 20:416. [PMID: 31747918 PMCID: PMC6868861 DOI: 10.1186/s12882-019-1558-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 09/12/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a global public health problem, exhibiting sharp increases in incidence, prevalence, and attributable morbidity and mortality. There is a critical need to better understand the demographics, clinical characteristics, and key risk factors for CKD; and to develop platforms for testing novel interventions to improve modifiable risk factors, particularly for the CKD patients with a rapid decline in kidney function. METHODS We describe a novel collaboration between two large healthcare systems (Providence St. Joseph Health and University of California, Los Angeles Health) supported by leadership from both institutions, which was created to develop harmonized cohorts of patients with CKD or those at increased risk for CKD (hypertension/HTN, diabetes/DM, pre-diabetes) from electronic health record data. RESULTS The combined repository of candidate records included more than 3.3 million patients with at least a single qualifying measure for CKD and/or at-risk for CKD. The CURE-CKD registry includes over 2.6 million patients with and/or at-risk for CKD identified by stricter guide-line based criteria using a combination of administrative encounter codes, physical examinations, laboratory values and medication use. Notably, data based on race/ethnicity and geography in part, will enable robust analyses to study traditionally disadvantaged or marginalized patients not typically included in clinical trials. DISCUSSION CURE-CKD project is a unique multidisciplinary collaboration between nephrologists, endocrinologists, primary care physicians with health services research skills, health economists, and those with expertise in statistics, bio-informatics and machine learning. The CURE-CKD registry uses curated observations from real-world settings across two large healthcare systems and has great potential to provide important contributions for healthcare and for improving clinical outcomes in patients with and at-risk for CKD.
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Affiliation(s)
- Keith C Norris
- David Geffen School of Medicine at University of California, Los Angeles, CA, 90095, USA.
- UCLA Department of Medicine, Division of General Internal Medicine, 1100 Glendon Ave. Suite 900, Los Angeles, CA, 90024, USA.
| | - O Kenrik Duru
- David Geffen School of Medicine at University of California, Los Angeles, CA, 90095, USA
| | - Radica Z Alicic
- Providence St. Joseph Health, Providence Medical Research Center, Spokane, Washington, USA
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Kenn B Daratha
- Providence St. Joseph Health, Providence Medical Research Center, Spokane, Washington, USA
| | - Susanne B Nicholas
- David Geffen School of Medicine at University of California, Los Angeles, CA, 90095, USA
| | - Sterling M McPherson
- Providence St. Joseph Health, Providence Medical Research Center, Spokane, Washington, USA
- Washington State University Elson S. Floyd College of Medicine, Spokane, Washington, USA
| | - Douglas S Bell
- David Geffen School of Medicine at University of California, Los Angeles, CA, 90095, USA
| | - Jenny I Shen
- David Geffen School of Medicine at University of California, Los Angeles, CA, 90095, USA
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Cami R Jones
- Providence St. Joseph Health, Providence Medical Research Center, Spokane, Washington, USA
| | - Tannaz Moin
- David Geffen School of Medicine at University of California, Los Angeles, CA, 90095, USA
- VA Greater Los Angeles, Los Angeles, USA
| | - Amy D Waterman
- David Geffen School of Medicine at University of California, Los Angeles, CA, 90095, USA
| | - Joshua J Neumiller
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, USA
| | - Roberto B Vargas
- Charles R. Drew University of Medicine and Science, Los Angeles, USA
- RAND Corporation, Santa Monica, CA, USA
| | - Alex A T Bui
- David Geffen School of Medicine at University of California, Los Angeles, CA, 90095, USA
| | - Carol M Mangione
- David Geffen School of Medicine at University of California, Los Angeles, CA, 90095, USA
| | - Katherine R Tuttle
- Providence St. Joseph Health, Providence Medical Research Center, Spokane, Washington, USA
- University of Washington School of Medicine, Seattle, Washington, USA
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Hilal N, Harb S, Jamal D, El-Jardali F. The use of evidence in decision making by hospital managers in Lebanon: A cross-sectional study. Int J Health Plann Manage 2019; 35:e45-e55. [PMID: 31692068 DOI: 10.1002/hpm.2925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Knowledge synthesis products have emerged as support agents for decision making in clinical practice and policy. However, their use for evidence-informed decision making remains limited in health care management especially in low- and middle-income countries. This study assesses the use of evidence by middle and senior managers in Lebanese hospitals. METHODS This multihospital cross-sectional study used a self-administered web survey of middle and senior managers. Hospitals were purposively selected, and data were analyzed using descriptive statistics and thematic analysis. RESULTS Hospital participation rate was 25%, while adjusted managers' response rate was 44.8%. Prevalence of using evidence was 70%, while prevalence of evidence-seeking behavior was 90%. Evidence was mainly used in design of policies, protocols, and procedures; nursing issues; or procurement decisions. Facilitators for evidence-informed decision making included upper management support and organizational culture, whereas limited resources such as funding, time, and training hindered use of evidence. CONCLUSIONS Findings indicate that utilization of evidence was comparable with that of high-income countries. Training and continuous education were crucial for advancing evidence-informed decision making among hospital managers. However, neither the quality nor the sources of evidence used for decision making were assessed in this study. Future studies should assess the quality and sources of evidence utilized in decision making.
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Affiliation(s)
- Nadeen Hilal
- Department of Internal Medicine, Ain Wazein Medical Village, Lebanon
| | - Sara Harb
- Geriatrics Medical Center, Ain Wazein Medical Village, Lebanon
| | - Diana Jamal
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Fadi El-Jardali
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Vincenten J, MacKay JM, Schröder-Bäck P, Schloemer T, Brand H. Factors influencing implementation of evidence-based interventions in public health systems - a model. Cent Eur J Public Health 2019; 27:198-203. [PMID: 31580554 DOI: 10.21101/cejph.a5234] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 07/23/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Evidence that health interventions work is not enough to ensure implementation into policy and practice. The complexity of public health systems requires more diverse actions. This paper proposes a conceptual model to enhance understanding of interlinking factors that influence the evidence implementation process. METHODS A literature review was conducted to explore factors that influence the process of evidence implementation in complex public health systems, including research findings and observations from 32 case studies of injury prevention interventions underway in 24 countries and results from evidence research networks. Concepts and themes identified through a critical review were organised, ordered and interlinked to build the model. RESULTS An Evidence Implementation Model for Public Health Systems and four concepts or themes: Evidence implementation target; Actors involved in implementation; Knowledge transfer; and Barriers and facilitators to evidence implementation were developed to provide a simplified, yet broad framework that highlights multiple factors and back and forth inter-linkages within and between the concepts that influence the uptake of evidence into public health systems policy and practice. CONCLUSIONS Understanding the factors discussed within and amongst the four concepts of this model should ultimately help to positively influence the uptake of evidence into real world public health systems. This model has relevance for decision makers, researchers, knowledge brokers, and implementers.
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Affiliation(s)
- Joanne Vincenten
- Department of International Health, School CAPHRI - Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - J Morag MacKay
- Safe Kids Worldwide, Washington DC, United States of America
| | - Peter Schröder-Bäck
- Department of International Health, School CAPHRI - Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Tamara Schloemer
- Department of International Health, School CAPHRI - Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Helmut Brand
- Department of International Health, School CAPHRI - Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.,Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
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Tenkku Lepper L, King D, Doll J, Gonzalez S, Mitchell A, Hartje J. Partnering with the Health Professions to Promote Prevention of an Alcohol-Exposed Pregnancy: Lessons Learned from an Academic⁻Organizational Collaborative. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101702. [PMID: 31096556 PMCID: PMC6572076 DOI: 10.3390/ijerph16101702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/03/2019] [Accepted: 05/10/2019] [Indexed: 11/24/2022]
Abstract
Background: Evidence-based strategies exist to train healthcare professionals to ask their patients and clients about alcohol use, and are successful. Implementation of these strategies utilizing a system-level approach has not been conducted nationwide. This case study reports on the success of academic partnerships with national health professional organizations to increase adoption of evidence-based strategies to prevent alcohol-exposed pregnancies. Methods: Authors reviewed and summarized multi-level strategies created as part of the developmental phase of this project in order to report successes and challenges. We applied the three principles of reflection, sense-making, and reciprocal learning, as identified in the practice change literature, to synthesize our experience. Results: There were five primary lessons learned as a result of this work: Development of technology-based training websites requires significant time to design, implement, and test; project ‘mission-drift’ is inevitable, but not necessarily unwelcome; time and effort is required to create and sustain functioning workgroups when there are different organizational cultures; and changing real-world practice is hard to do, yet changing the conversation on screening and brief intervention is possible. Conclusions: Use of multi-level strategies within an academic–professional organization model was successful in promoting awareness and education of healthcare professionals in the prevention of alcohol-exposed pregnancies.
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Affiliation(s)
| | - Diane King
- Center for Behavioral health Research and Services, University of Alaska Anchorage, Anchorage, AK 99508, USA.
| | - Joy Doll
- Center for Interprofessional Practice, Education and Research, Creighton University, Omaha, NE 68178, USA.
| | - Sandra Gonzalez
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77098, USA.
| | - Ann Mitchell
- School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261, USA.
| | - Joyce Hartje
- Center for the Application of Substance Abuse Technologies (CASAT), University of Nevada, Reno, NV 89557, USA.
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Hasanpoor E, Hajebrahimi S, Janati A, Abedini Z, Haghgoshayie E. Barriers, Facilitators, Process and Sources of Evidence for Evidence-Based Management among Health Care Managers: A Qualitative Systematic Review. Ethiop J Health Sci 2019; 28:665-680. [PMID: 30607082 PMCID: PMC6308777 DOI: 10.4314/ejhs.v28i5.18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Evidence-based management (EBMgt) improves managerial decisions as a bridge from theory to practice. For reason that it has a critical impact on organization performance. The purpose of this study was to identify factors affecting EBMgt among managers. Methods The following electronic databases were used: PubMed, Web of Science, Cochrane, ProQuest, Embase and Scopus. In addition, we searched Google Scholar, Emerald, Academy of Management (AOM), and the website for the Center for Evidence-Based Management (CEBMa) for articles related to EBMgt. We used data sources published up to September 2017, without language restriction. We appraised the methodological quality of studies using the checklists of SRQR and MMAT. The synthesis involved interpretative analysis based on the principles of meta-synthesis. Results Of 26,011 identified studies, 26 met the full inclusion criteria. Of the 26 studies assessed, the frequency of qualitative studies and mixed-methods were 20 and 6, respectively, and the quality of 3 studies was weak. A total of 23 studies from 7 countries were included: Canada (n=8), USA (n=6), Australia (n=4), UK (n=3), Iran (n=1, Brazil (n=1); none were from Africa. Meta-synthesis findings of 23 studies identified four main factors: facilitators (5 main themes), barriers (5 main themes), sources of evidence (4 main themes), and the process of decision making in EBMgt (1 main theme). Conclusions EBMgt is crucial to improve the quality of management decisions, and hence, to improve service delivery, effectiveness and efficiency. Furthermore, to increase the benefit and utilization of EBMgt, training organizations and research institutes must more actively involve managers in setting research plans.
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Affiliation(s)
- Edris Hasanpoor
- Department of Healthcare Management, Maragheh University of Medical Sciences, Maragheh, Iran.,Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Hajebrahimi
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Janati
- Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Abedini
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elaheh Haghgoshayie
- Department of Healthcare Management, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
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Dall-Hansen D, Odgaard E. Sygeplejestuderendes bachelorprojekter kan bidrage til at evidensbasere praksis. ACTA ACUST UNITED AC 2019. [DOI: 10.18261/issn.1903-2285-2019-01-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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40
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Carter AJE, Jensen JL, Petrie DA, Greene J, Travers A, Goldstein JP, Cook J, Fidgen D, Swain J, Richardson L, Cain E. State of the Evidence for Emergency Medical Services (EMS) Care: The Evolution and Current Methodology of the Prehospital Evidence-Based Practice (PEP) Program. ACTA ACUST UNITED AC 2019; 14:57-70. [PMID: 30129435 PMCID: PMC6147365 DOI: 10.12927/hcpol.2018.25548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Emergency medical services (EMS) leaders and clinicians need to incorporate evidence into safe and effective clinical practice. Access to high-quality evidence, and the time to synthesize it, can be barriers to evidence-based practice. The Prehospital Evidence-Based Practice (PEP) program is an online, freely accessible, repository of critically appraised evidence specific to EMS. This paper describes the evolution and current methodology of the PEP program. Methods/design: The purpose of PEP is to identify, catalog and critically appraise relevant studies. Following regular systematic searches, two trained appraisers critically appraise included studies and assign a score on three-point level of evidence (LOE) and direction of evidence (DOE) scales. Each clinical intervention is plotted on a 3 × 3 (LOE × DOE) evidence matrix, which provides a summary recommendation. Discussion: The PEP program is a unique knowledge translation tool, specific to EMS. End-users can easily identify which clinical interventions are, or are not, supported by evidence.
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Affiliation(s)
- Alix J E Carter
- Medical Director, Research, Emergency Health Services, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS
| | - Jan L Jensen
- Performance Manager, Emergency Health Services, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS
| | - David A Petrie
- Medical Director, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS
| | - Jennifer Greene
- Paramedic Knowledge Translation Coordinator, Emergency Health Services, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS
| | - Andrew Travers
- Provincial Medical Director, Emergency Health Services, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS
| | - Judah P Goldstein
- Research Coordinator, Emergency Health Services, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS
| | - Jolene Cook
- Medical Oversight Physician, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS
| | - Dana Fidgen
- Manager, Emergency Health Services, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS
| | - Janel Swain
- Provincial Ground Clinical Supervisor, Emergency Health Services, Halifax, NS
| | - Luke Richardson
- Medical Resident, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS
| | - Ed Cain
- Emergency Medicine Physician, Emergency Medicine, Division of EMS, Dalhousie University, Halifax, NS
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Lunden A, Teräs M, Kvist T, Häggman-Laitila A. Transformative agency and tensions in knowledge management-A qualitative interview study for nurse leaders. J Clin Nurs 2018; 28:969-979. [PMID: 30357993 DOI: 10.1111/jocn.14694] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 10/16/2018] [Indexed: 01/20/2023]
Abstract
AIM To describe Finnish nurse leaders' perceptions of and experiences with knowledge management. BACKGROUND Health science research has traditionally focused on knowledge transfer and research evidence instead of knowledge management, culture and organisational learning. Systematic reviews indicate a lack of awareness about nurse leaders' activities in knowledge management. DESIGN Qualitative interview study according to the consolidated criteria for reporting qualitative research (see Supporting Information Table S1). METHODS Data were collected at a Finnish public, social and healthcare organisation from 33 persons in 2015 and 2017 through 35 individual interviews and seven focus groups. Data were analysed by thematic analysis. RESULTS Nurse leaders' daily knowledge management activities included assurance of smooth work functions and decisions about sudden changes. When managing knowledge promotion, nurse leaders focused on the near future and served information providers, coaches and developers of operating culture. Anticipatory management of knowledge requirements emphasised nurse leaders' roles as assessors and visionaries. Tensions while managing knowledge were related to the following: changes in clients' service needs, insufficient structures and tools to support the assessment and joint development of competence, time and information management, the operating culture, and nurse leader support. Participants reported only few attempts to solve tensions and therefore little to no transformative agency. CONCLUSION Nurse leaders prioritised daily knowledge management over management of knowledge promotion and anticipatory management of knowledge requirements. Knowledge management in nursing is a complex task requiring a command of different kinds of agency and related leadership styles. The structures, processes and tools supporting knowledge management should be developed to ensure that activities are systematic. RELEVANCE TO CLINICAL PRACTICE A description of nurse leaders' perceptions of and experiences with knowledge management could improve recognition of nurse leaders' agencies for knowledge management, identification of related tensions and application of lessons learned from tensions. This description could also promote nurses' professional competence and supplement nurse leaders' training.
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Affiliation(s)
- Anne Lunden
- Department of Social Services and Health Care, City of Helsinki, Helsinki, Finland.,Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Marianne Teräs
- Department of Education, Stockholm University, University of Stockholm, Stockholm, Sweden
| | - Tarja Kvist
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Arja Häggman-Laitila
- Department of Social Services and Health Care, City of Helsinki, Helsinki, Finland.,Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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42
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Yearwood AC. Applying a logical theory of change for strengthening research uptake in policy: a case study of the Evidence Informed Decision Making Network of the Caribbean. Rev Panam Salud Publica 2018; 42:e91. [PMID: 31093119 PMCID: PMC6385801 DOI: 10.26633/rpsp.2018.91] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 02/07/2018] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Health policymakers in the Caribbean face challenges with research use in decision-making. Although copious approaches to strengthen evidence-informed policy can be found in the literature, these strategies should be applied and evaluated in specific settings. We developed a theory of change for strengthening research uptake in health policy, and the interventions were implemented as the Evidence Informed Decision Making Network of the Caribbean (EvIDeNCe). We assessed the model's logic and evaluated whether the expected outcome was achieved. METHODS The model was mapped in three stages: problem identification; goal determination; and backward linking of interventions. Beneficiaries were surveyed to assess the design logic and to evaluate the main outcome. RESULTS A total of 137 respondents completed evaluation questionnaires. The inclusion of evidence briefs, stakeholder dialogues, a research database, and training programs for policymakers in the model was validated. Respondents also reported their intention to act on research evidence to which they were exposed. After respondents had participated in stakeholder dialogues, the mean intention-to-use score was 6.4 on a scale of 1 (strongly disagree) to 7 (strongly agree), and 6.3 on the same scale, after exposure to training. CONCLUSIONS This work provides initial validation of EvIDeNCe as a consolidated strategy to strengthen the application of research in policy in the Caribbean. To our knowledge, it is the first study to develop and apply a comprehensive model of this type to the Caribbean. The findings support results from similar initiatives in other countries, but additional work is needed to evaluate the overall impact of the initiative.
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Affiliation(s)
- Andrea C. Yearwood
- Caribbean Public Health Agency, Policy Planning and Research Department, Port-of-Spain, Trinidad and Tobago
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Jessani NS, Siddiqi SM, Babcock C, Davey-Rothwell M, Ho S, Holtgrave DR. Factors affecting engagement between academic faculty and decision-makers: learnings and priorities for a school of public health. Health Res Policy Syst 2018; 16:65. [PMID: 30045730 PMCID: PMC6060478 DOI: 10.1186/s12961-018-0342-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/22/2018] [Indexed: 12/02/2022] Open
Abstract
Background Schools of public health (SPHs) are increasingly being recognised as important contributors of human, social and intellectual capital relevant to health policy and decision-making. Few studies within the implementation science literature have systematically examined knowledge exchange experiences within this specific organisational context. The purpose of this study was therefore to elicit whether documented facilitators and barriers to engaging with government decision-makers resonates within an academic SPH context. We sought to understand the variations in such experiences at four different levels of government decision-making. Furthermore, we sought to elicit intervention priorities as identified by faculty. Methods Between May and December 2016, 211 (34%) of 627 eligible full-time faculty across one SPH in the United States of America participated in a survey on engagement with decision-makers at the city, state, federal and global government levels. Surveys were administered face-to-face or via Skype. Descriptive data as well as tests of association and logistic regression analyses were conducted using STATA. Results Over three-quarters of respondents identified colleagues with ties to decision-makers, institutional affiliation and conducting policy-relevant research as the highest facilitators. Several identified time constraints, academic incentives and financial support as important contributors to engagement. Faculty characteristics, such as research areas of expertise, career track and faculty rank, were found to be statistically significantly associated with facilitators. The top three intervention priorities that emerged were (1) creating incentives for engagement, (2) providing funding for engagement and (3) inculcating an institutional culture around engagement. Conclusions The data suggest that five principal categories of factors – individual characteristics, institutional environment, relational dynamics, research focus and funder policies – affect the willingness and ability of academic faculty to engage with government decision-makers. This study suggests that SPHs could enhance the relevance of their role in health policy decision-making by (1) periodically measuring engagement with decision-makers; (2) enhancing individual capacity in knowledge translation and communication, taking faculty characteristics into account; (3) institutionalising a culture that supports policies and practices for engagement in decision-making processes; and (4) creating a strategy to expand and nurture trusted, relevant networks and relationships with decision-makers.
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Affiliation(s)
- Nasreen S Jessani
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America.
| | - Sameer M Siddiqi
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America
| | - Carly Babcock
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America
| | - Melissa Davey-Rothwell
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America
| | - Shirley Ho
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America
| | - David R Holtgrave
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America
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Busert LK, Mütsch M, Kien C, Flatz A, Griebler U, Wildner M, Stratil JM, Rehfuess EA. Facilitating evidence uptake: development and user testing of a systematic review summary format to inform public health decision-making in German-speaking countries. Health Res Policy Syst 2018; 16:59. [PMID: 29986706 PMCID: PMC6038322 DOI: 10.1186/s12961-018-0307-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 04/02/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Systematic reviews are an important source of evidence for public health decision-making, but length and technical jargon tend to hinder their use. In non-English speaking countries, inaccessibility of information in the native language often represents an additional barrier. In line with our vision to strengthen evidence-based public health in the German-speaking world, we developed a German language summary format for systematic reviews of public health interventions and undertook user-testing with public health decision-makers in Germany, Austria and Switzerland. METHODS We used several guiding principles and core elements identified from the literature to produce a prototype summary format and applied it to a Cochrane review on the impacts of changing portion and package sizes on selection and consumption of food, alcohol and tobacco. Following a pre-test in each of the three countries, we carried out 18 user tests with public health decision-makers in Germany, Austria and Switzerland using the 'think-aloud' method. We analysed participants' comments according to the facets credibility, usability, understandability, usefulness, desirability, findability, identification and accessibility. We also identified elements that hindered the facile and satisfying use of the summary format, and revised it based on participants' feedback. RESULTS The summary format was well-received; participants particularly appreciated receiving information in their own language. They generally found the summary format useful and a credible source of information, but also signalled several barriers to a positive user experience such as an information-dense structure and difficulties with understanding statistical terms. Many of the identified challenges were addressed through modifications of the summary format, in particular by allowing for flexible length, placing more emphasis on key messages and relevance for public health practice, expanding the interpretation aid for statistical findings, providing a glossary of technical terms, and only including graphical GRADE ratings. Some barriers to uptake, notably the participants' wish for actionable recommendations and contextual information, could not be addressed. CONCLUSIONS Participants welcomed the initiative, but user tests also revealed their problems with understanding and interpreting the findings summarised in our prototype format. The revised summary format will be used to communicate the results of Cochrane reviews of public health interventions.
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Affiliation(s)
- Laura K. Busert
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Margot Mütsch
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Christina Kien
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria
| | - Aline Flatz
- Cochrane Switzerland, Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Biopôle 2, Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - Ursula Griebler
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria
| | - Manfred Wildner
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Jan M. Stratil
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Eva A. Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - on behalf of Cochrane Public Health Europe
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria
- Cochrane Switzerland, Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Biopôle 2, Route de la Corniche 10, 1010 Lausanne, Switzerland
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Mallidou AA, Atherton P, Chan L, Frisch N, Glegg S, Scarrow G. Core knowledge translation competencies: a scoping review. BMC Health Serv Res 2018; 18:502. [PMID: 29945609 PMCID: PMC6020388 DOI: 10.1186/s12913-018-3314-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/19/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Knowledge translation (KT) is the broad range of activities aimed at supporting the use of research findings leading to evidence-based practice (EBP) and policy. Recommendations have been made that capacity building efforts be established to support individuals to enact KT. In this study, we summarized existing knowledge on KT competencies to provide a foundation for such capacity building efforts and to inform policy and research. Our research questions were "What are the core KT competencies needed in the health sector?" and "What are the interventions and strategies to teach and reinforce those competencies?" METHODS We used a scoping review approach and an integrated KT process by involving an Advisory Group of diverse stakeholders. We searched seven health and interdisciplinary electronic databases and grey literature sources for materials published from 2003 to 2017 in English language only. Empirical and theoretical publications in health that examined KT competencies were retrieved, reviewed, and synthesized. RESULTS Overall, 1171 publications were retrieved; 137 were fully reviewed; and 15 empirical and six conceptual academic, and 52 grey literature publications were included and synthesized in this scoping review. From both the academic and grey literature, we categorized 19 KT core competencies into knowledge, skills, or attitudes; and identified commonly used interventions and strategies to enhance KT competencies such as education, organizational support and hands-on training. CONCLUSIONS These initial core KT competencies for individuals provide implications for education, policy, knowledge brokering, and future research, and on the need for future evaluation of the KT competencies presented. We also discuss the essential role of organizational support and culture for successful KT activities/practice.
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Affiliation(s)
- Anastasia A. Mallidou
- School of Nursing, University of Victoria, B236 – HSD Building, 3800 Finnerty Road (Ring Road), Victoria, BC V8P 5C2 Canada
| | - Pat Atherton
- School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2 Canada
| | - Liza Chan
- Alberta Innovates – Health Solutions & University of Alberta, 1500, 10104 103 Ave, Edmonton, AB T5J 4A7 Canada
| | - Noreen Frisch
- School of Nursing, University of Victoria, B236 – HSD Building, 3800 Finnerty Road (Ring Road), Victoria, BC V8P 5C2 Canada
| | - Stephanie Glegg
- Sunny Hill Health Centre for Children, 3644 Slocan Street, Vancouver, BC V5M 3E8 Canada
| | - Gayle Scarrow
- Michael Smith Foundation for Health Research, 200 - 1285 West Broadway, Vancouver, BC V6H 3X8 Canada
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Orava T, Provvidenza C, Townley A, Kingsnorth S. Screening and assessment of chronic pain among children with cerebral palsy: a process evaluation of a pain toolbox. Disabil Rehabil 2018; 41:2695-2703. [DOI: 10.1080/09638288.2018.1471524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Taryn Orava
- Holland Bloorview Kids Rehabilitation Hospital, Teaching and Learning Institute, Toronto, Canada
| | - Christine Provvidenza
- Holland Bloorview Kids Rehabilitation Hospital, Teaching and Learning Institute, Toronto, Canada
| | - Ashleigh Townley
- Holland Bloorview Kids Rehabilitation Hospital, Teaching and Learning Institute, Toronto, Canada
| | - Shauna Kingsnorth
- Holland Bloorview Kids Rehabilitation Hospital, Teaching and Learning Institute, Toronto, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute University of Toronto, Toronto, Canada
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47
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Hromas R, Leverence R, Mramba LK, Jameson JL, Lerman C, Schwenk TL, Zimmermann EM, Good ML. What a medical school chair wants from the dean. J Healthc Leadersh 2018; 10:33-44. [PMID: 29872359 PMCID: PMC5973440 DOI: 10.2147/jhl.s158937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Economic pressure has led the evolution of the role of the medical school dean from a clinician educator to a health care system executive. In addition, other dynamic requirements also have likely led to changes in their leadership characteristics. The most important relationship a dean has is with the chairs, yet in the context of the dean’s changing role, little attention has been paid to this relationship. To frame this discussion, we asked medical school chairs what characteristics of a dean’s leadership were most beneficial. We distributed a 26-question survey to 885 clinical and basic science chairs at 41 medical schools. These chairs were confidentially surveyed on their views of six leadership areas: evaluation, barriers to productivity, communication, accountability, crisis management, and organizational values. Of the 491 chairs who responded (response rate =55%), 88% thought that their dean was effective at leading the organization, and 89% enjoyed working with their dean. Chairs indicated that the most important area of expertise of a dean is to define a strategic vision, and the most important value for a dean is integrity between words and deeds. Explaining the reasons behind decisions, providing good feedback, admitting errors, open discussion of complex or awkward topics, and skill in improving relations with the teaching hospital were judged as desirable attributes of a dean. Interestingly, only 23% of chairs want to be a dean in the future. Financial acumen was the least important skill a chair thought a dean should hold, which is in contrast to the skill set for which many deans are hired and evaluated. After reviewing the literature and analyzing these responses, we assert that medical school chairs want their dean to maintain more traditional leadership than that needed by a health care system executive, such as articulating a vision for the future and keeping their promises. Thus, there appears to be a mismatch between what medical school chairs perceive they need from their dean and how the success of a dean is evaluated.
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Affiliation(s)
- Robert Hromas
- The Office of the Dean, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Robert Leverence
- The Office of the Dean, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Lazarus K Mramba
- Department of Medicine, College of Medicine, University of Florida Health, Gainesville, FL, USA
| | - J Larry Jameson
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Caryn Lerman
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas L Schwenk
- Department of Family Medicine, School of Medicine, University of Nevada Reno, Reno, NV, USA
| | - Ellen M Zimmermann
- Department of Medicine, College of Medicine, University of Florida Health, Gainesville, FL, USA
| | - Michael L Good
- Department of Anesthesiology, College of Medicine, University of Florida Health, Gainesville, FL, USA
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48
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Lobo R, Crawford G, Hallett J, Laing S, Mak DB, Jancey J, Rowell S, McCausland K, Bastian L, Sorenson A, Tilley PJM, Yam S, Comfort J, Brennan S, Doherty M. A research and evaluation capacity building model in Western Australia. Health Promot Int 2018; 33:468-478. [PMID: 28028011 DOI: 10.1093/heapro/daw088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Evaluation of public health programs, services and policies is increasingly required to demonstrate effectiveness. Funding constraints necessitate that existing programs, services and policies be evaluated and their findings disseminated. Evidence-informed practice and policy is also desirable to maximise investments in public health. Partnerships between public health researchers, service providers and policymakers can help address evaluation knowledge and skills gaps. The Western Australian Sexual Health and Blood-borne Virus Applied Research and Evaluation Network (SiREN) aims to build research and evaluation capacity in the sexual health and blood-borne virus sector in Western Australia (WA). Partners' perspectives of the SiREN model after 2 years were explored. Qualitative written responses from service providers, policymakers and researchers about the SiREN model were analysed thematically. Service providers reported that participation in SiREN prompted them to consider evaluation earlier in the planning process and increased their appreciation of the value of evaluation. Policymakers noted benefits of the model in generating local evidence and highlighting local issues of importance for consideration at a national level. Researchers identified challenges communicating the services available through SiREN and the time investment needed to develop effective collaborative partnerships. Stronger engagement between public health researchers, service providers and policymakers through collaborative partnerships has the potential to improve evidence generation and evidence translation. These outcomes require long-term funding and commitment from all partners to develop and maintain partnerships. Ongoing monitoring and evaluation can ensure the partnership remains responsive to the needs of key stakeholders. The findings are applicable to many sectors.
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Affiliation(s)
- Roanna Lobo
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia
| | - Jonathan Hallett
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia
| | - Sue Laing
- Sexual Health and Blood-borne Virus Program, Communicable Disease Control Directorate, Western Australian Department of Health, Perth, Western Australia
| | - Donna B Mak
- Sexual Health and Blood-borne Virus Program, Communicable Disease Control Directorate, Western Australian Department of Health, Perth, Western Australia.,School of Medicine, University of Notre Dame, Fremantle, Western Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia
| | | | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia
| | - Lisa Bastian
- Sexual Health and Blood-borne Virus Program, Communicable Disease Control Directorate, Western Australian Department of Health, Perth, Western Australia
| | | | - P J Matt Tilley
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia
| | - Simon Yam
- Western Australian AIDS Council, Perth, Western Australia
| | - Jude Comfort
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia
| | - Sean Brennan
- Sexual Health and Blood-borne Virus Program, Communicable Disease Control Directorate, Western Australian Department of Health, Perth, Western Australia
| | - Maryanne Doherty
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia
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49
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Harris C, Allen K, Ramsey W, King R, Green S. Sustainability in Health care by Allocating Resources Effectively (SHARE) 11: reporting outcomes of an evidence-driven approach to disinvestment in a local healthcare setting. BMC Health Serv Res 2018; 18:386. [PMID: 29843702 PMCID: PMC5975394 DOI: 10.1186/s12913-018-3172-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 05/01/2018] [Indexed: 11/12/2022] Open
Abstract
Background This is the final paper in a thematic series reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was established to explore a systematic, integrated, evidence-based organisation-wide approach to disinvestment in a large Australian health service network. This paper summarises the findings, discusses the contribution of the SHARE Program to the body of knowledge and understanding of disinvestment in the local healthcare setting, and considers implications for policy, practice and research. Discussion The SHARE program was conducted in three phases. Phase One was undertaken to understand concepts and practices related to disinvestment and the implications for a local health service and, based on this information, to identify potential settings and methods for decision-making about disinvestment. The aim of Phase Two was to implement and evaluate the proposed methods to determine which were sustainable, effective and appropriate in a local health service. A review of the current literature incorporating the SHARE findings was conducted in Phase Three to contribute to the understanding of systematic approaches to disinvestment in the local healthcare context. SHARE differed from many other published examples of disinvestment in several ways: by seeking to identify and implement disinvestment opportunities within organisational infrastructure rather than as standalone projects; considering disinvestment in the context of all resource allocation decisions rather than in isolation; including allocation of non-monetary resources as well as financial decisions; and focusing on effective use of limited resources to optimise healthcare outcomes. Conclusion The SHARE findings provide a rich source of new information about local health service decision-making, in a level of detail not previously reported, to inform others in similar situations. Multiple innovations related to disinvestment were found to be acceptable and feasible in the local setting. Factors influencing decision-making, implementation processes and final outcomes were identified; and methods for further exploration, or avoidance, in attempting disinvestment in this context are proposed based on these findings. The settings, frameworks, models, methods and tools arising from the SHARE findings have potential to enhance health care and patient outcomes. Electronic supplementary material The online version of this article (10.1186/s12913-018-3172-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Claire Harris
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. .,Centre for Clinical Effectiveness, Monash Health, Melbourne, VIC, Australia.
| | - Kelly Allen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Centre for Clinical Effectiveness, Monash Health, Melbourne, VIC, Australia
| | - Wayne Ramsey
- Medical Services and Quality, Monash Health, Melbourne, VIC, Australia
| | - Richard King
- Medicine Program, Monash Health, Melbourne, VIC, Australia
| | - Sally Green
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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50
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Behboodi Moghadam Z, Ordibeheshti Khiaban M, Esmaeili M, Salsali M. Motherhood challenges and well-being along with the studentship role among Iranian women: A qualitative study. Int J Qual Stud Health Well-being 2018. [PMID: 28628417 PMCID: PMC5510199 DOI: 10.1080/17482631.2017.1335168] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This study purposed to explore and describe the experiences of Iranian female students with the role of motherhood. This 2015 qualitative study used purposeful sampling to select 20 student mothers aged 24–50 who were studying at a state or non-state university in an urban area in northwest Iran. Data was collected through individual semi-structured interviews and analysed using a qualitative content analysis approach. Three main themes were developed during data analysis: “simultaneous management”, “facilities”, and “barriers”. The management of maternal and family affairs by female students in universities where motherhood is not supported is a challenge. The significance of mother-student roles must be emphasized and support and education provided for women to gain skills useful in playing these roles. Policy makers should devise strategies for bringing change to the traditional perspective that motherhood and educational responsibilities cannot be met at the same time by one person.
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Affiliation(s)
- Zahra Behboodi Moghadam
- a Department of Reproductive Health, School of Nursing and Midwifery , Tehran University of Medical Sciences , Tehran , Iran
| | - Maryam Ordibeheshti Khiaban
- a Department of Reproductive Health, School of Nursing and Midwifery , Tehran University of Medical Sciences , Tehran , Iran
| | - Maryam Esmaeili
- b Department of Critical Care Nursing, School of Nursing and Midwifery , Tehran University of Medical Sciences , Tehran , Iran
| | - Mahvash Salsali
- c Department of Medical and Surgical Nursing, School of Nursing and Midwifery , Tehran University of Medical Sciences , Tehran , Iran
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