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Kwan BM, Brownson RC, Glasgow RE, Morrato EH, Luke DA. Designing for Dissemination and Sustainability to Promote Equitable Impacts on Health. Annu Rev Public Health 2022; 43:331-353. [PMID: 34982585 PMCID: PMC9260852 DOI: 10.1146/annurev-publhealth-052220-112457] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Designing for dissemination and sustainability (D4DS) refers to principles and methods for enhancing the fit between a health program, policy, or practice and the context in which it is intended to be adopted. In this article we first summarize the historical context of D4DS and justify the need to shift traditional health research and dissemination practices. We present a diverse literature according to a D4DS organizing schema and describe a variety of dissemination products, design processes and outcomes, and approaches to messaging, packaging, and distribution. D4DS design processes include stakeholder engagement, participatory codesign, and context and situation analysis, and leverage methods and frameworks from dissemination and implementation science, marketing and business, communications and visualarts, and systems science. Finally, we present eight recommendations to adopt a D4DS paradigm, reflecting shifts in ways of thinking, skills and approaches, and infrastructure and systems for training and evaluation.
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Affiliation(s)
- Bethany M Kwan
- Department of Family Medicine and Adult & Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA;
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Russell E Glasgow
- Department of Family Medicine and Adult & Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA;
| | - Elaine H Morrato
- Parkinson School of Health Sciences and Public Health and Institute for Translational Medicine, Loyola University Chicago, Maywood, Illinois, USA
| | - Douglas A Luke
- Center for Public Health Systems Science, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
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Elimian KO, Aderinola O, Gibson J, Myles P, Ochu CL, King C, Okwor T, Gaudenzi G, Olayinka A, Zaiyad HG, Ohonsi C, Ebhodaghe B, Dan-Nwafor C, Nwachukwu W, Abdus-Salam IA, Akande OW, Falodun O, Arinze C, Ezeokafor C, Jafiya A, Ojimba A, Aremu JT, Joseph E, Bowale A, Mutiu B, Saka B, Jinadu A, Hamza K, Ibeh C, Bello S, Asuzu M, Mba N, Oladejo J, Ilori E, Alfvén T, Igumbor E, Ihekweazu C. Assessing the capacity of symptom scores to predict COVID-19 positivity in Nigeria: a national derivation and validation cohort study. BMJ Open 2021; 11:e049699. [PMID: 34479936 PMCID: PMC8421116 DOI: 10.1136/bmjopen-2021-049699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES This study aimed to develop and validate a symptom prediction tool for COVID-19 test positivity in Nigeria. DESIGN Predictive modelling study. SETTING All Nigeria States and the Federal Capital Territory. PARTICIPANTS A cohort of 43 221 individuals within the national COVID-19 surveillance dataset from 27 February to 27 August 2020. Complete dataset was randomly split into two equal halves: derivation and validation datasets. Using the derivation dataset (n=21 477), backward multivariable logistic regression approach was used to identify symptoms positively associated with COVID-19 positivity (by real-time PCR) in children (≤17 years), adults (18-64 years) and elderly (≥65 years) patients separately. OUTCOME MEASURES Weighted statistical and clinical scores based on beta regression coefficients and clinicians' judgements, respectively. Using the validation dataset (n=21 744), area under the receiver operating characteristic curve (AUROC) values were used to assess the predictive capacity of individual symptoms, unweighted score and the two weighted scores. RESULTS Overall, 27.6% of children (4415/15 988), 34.6% of adults (9154/26 441) and 40.0% of elderly (317/792) that had been tested were positive for COVID-19. Best individual symptom predictor of COVID-19 positivity was loss of smell in children (AUROC 0.56, 95% CI 0.55 to 0.56), either fever or cough in adults (AUROC 0.57, 95% CI 0.56 to 0.58) and difficulty in breathing in the elderly (AUROC 0.53, 95% CI 0.48 to 0.58) patients. In children, adults and the elderly patients, all scoring approaches showed similar predictive performance. CONCLUSIONS The predictive capacity of various symptom scores for COVID-19 positivity was poor overall. However, the findings could serve as an advocacy tool for more investments in resources for capacity strengthening of molecular testing for COVID-19 in Nigeria.
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Affiliation(s)
- Kelly Osezele Elimian
- Nigeria Centre for Disease Control, Abuja, Nigeria
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Jack Gibson
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Puja Myles
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | | | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Tochi Okwor
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Giulia Gaudenzi
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | | | | | | | | | - Oluwatosin Wuraola Akande
- Nigeria Centre for Disease Control, Abuja, Nigeria
- Department of Epidemiology and Community Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | | | | | | | | | | | | - Emmanuel Joseph
- Kaduna State Infectious Disease Control Center Community Medicine, Kaduna, Nigeria
| | | | | | - Babatunde Saka
- Lagos State Government Ministry of Health, Ikeja, Nigeria
| | | | - Khadeejah Hamza
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Christian Ibeh
- Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Shaibu Bello
- Department of Medical Education, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Michael Asuzu
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Nwando Mba
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - John Oladejo
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Elsie Ilori
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ehimario Igumbor
- Nigeria Centre for Disease Control, Abuja, Nigeria
- School of Public Health, University of the Western Cape, Bellville, South Africa
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Butame SA, De Leon JM, Lee SJ, Naar S, Genn L, Dark T, Kapogiannis BG. Barriers and Facilitators to the Collection and Aggregation of Electronic Health Record HIV Data: An Analysis of Study Recruitment Venues Within the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). Eval Health Prof 2021; 44:168-176. [PMID: 33657900 DOI: 10.1177/0163278721998413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Electronic health record (EHR) data can be leveraged for prospective cohort studies and pragmatic clinical trials, targeting youth living with HIV (YLH). Using EHRs in this manner may minimize the need for costly research infrastructure in service to lowering disease burden. This study characterizes HIV prevention and care continua variables and identifies factors likely to impede or facilitate EHR use for research and interventions. We conducted telephone-based qualitative interviews with National Experts (n = 10) and Key Stakeholders (n = 19) from subject recruitment venues (SRVs), providing care services to YLH and youth at risk for HIV. We found 17 different EHR systems being used for various purposes (e.g., workflow management and billing). Thematic content analysis of interviews highlighted six broad categories of perspectives on barriers to and facilitators of EHR use: specific variable collection, general use barriers, and facilitators, general data collection barriers and facilitators, EHRs for surveillance and research, EHRs for personnel and resource management and capture of HIV specific variables. These findings may inform implementation strategies of future studies, in which we conduct routine monitoring of the youth HIV prevention and care continua using EHRs and test an eHealth intervention.
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Affiliation(s)
- Seyram A Butame
- Center for Translational Behavioral Science, 7823Florida State University, Tallahassee, FL, USA
| | - Jessica M De Leon
- Division of Research & Graduate Programs, 7823Florida State University College of Medicine, Tallahassee, FL, USA
| | - Sung-Jae Lee
- Department of Psychiatry and Biobehavioral Sciences, 25808Fielding School of Public Heath, University of California Los Angeles, CA, USA
| | - Sylvie Naar
- Center for Translational Behavioral Science, 7823Florida State University, Tallahassee, FL, USA
| | - Leah Genn
- Center for Translational Behavioral Science, 7823Florida State University, Tallahassee, FL, USA
| | - Tyra Dark
- Center for Translational Behavioral Science, 7823Florida State University, Tallahassee, FL, USA
| | - Bill G Kapogiannis
- Maternal and Pediatric Infectious Disease Branch (MPIDB), 2511Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Washington, DC, USA
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Does Participation in Sports Influence the Prevalence of and Initiation into Multiple Substance Misuse in Adolescence? A Two-Year Prospective Analysis. CHILDREN-BASEL 2020; 7:children7090109. [PMID: 32842639 PMCID: PMC7552612 DOI: 10.3390/children7090109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/11/2020] [Accepted: 08/20/2020] [Indexed: 11/17/2022]
Abstract
Concurrent smoking and harmful drinking (CSHD) in adolescence is an important public health and social problem, while participation in sports is considered as being protective against CSHD. This study aimed to prospectively evaluate the influence of various facets of sports participation on the prevalence of and initiation into CSHD of adolescents. Participants were adolescents from southern Croatia (n = 711, 43.6% females, 16 years of age at study baseline), who were tested at baseline and at follow-up (two years later). Variables included gender, age, sports factors (participation in individual and team sports, sport experience, competitive success, intensity of involvement in sports), and CSHD. The CSHD prevalence did not increase significantly over the course of the study (from 5.6% to 7.5%, p > 0.05). Binomial logistic regression with age and gender as covariates suggested that team sports participation correlated to CSHD prevalence at baseline, and follow-up, with higher risk for CSHD among those adolescents who quit team sports (OR = 9.18 and 2.68, 95%CI = 2.04–22.26 and 1.05–6.83 for baseline and follow-up, respectively), and those never involved in team sports (OR = 9.00 and 3.70, 95%CI = 2.07–39.16 and 1.57–8.72 for baseline and follow-up, respectively). A higher risk of CSHD at baseline was seen among those adolescents who were involved in sports for longer (OR = 1.66, 95%CI = 1.16–2.38). The results are discussed in the context of the fact that the study included adolescents at the age of rigid sports selection (the transition from youth to professional-level sports). Since the majority of participants began CSHD at an earlier age, further studies in subjects of a younger age range are warranted.
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