scholarly journals The Physical Health Care Fidelity Scale: Psychometric Properties

2020 ◽  
Vol 47 (6) ◽  
pp. 901-910 ◽  
Author(s):  
Torleif Ruud ◽  
Tordis Sørensen Høifødt ◽  
Delia Cimpean Hendrick ◽  
Robert E. Drake ◽  
Anne Høye ◽  
...  
Keyword(s):  
Health Care ◽  
Physical Health ◽  
Interrater Reliability ◽  
Evidence Based ◽  
Implementation Support ◽  
Fidelity Scale ◽  
Wide Variability ◽  
Physical Health Care ◽  
Mental Health Programs ◽  
Distribution Sensitivity

Abstract Mental health programs need an instrument to monitor adherence to evidence-based physical health care for people with serious mental illness. The paper describes the Physical Health Care Fidelity Scale and study interrater reliability, frequency distribution, sensitivity to change and feasibility. Four fidelity assessments were conducted over 18 months at 13 sites randomized to implementation support for evidence-based physical health care. We found good to excellent interrater reliability, adequate sensitivity for change, good feasibility and wide variability in fidelity across sites after 18 months of implementation. Programs were more successful in establishing Policies stating physical health care standards than in implementing these Policies. The Physical Health Care Fidelity Scale measures and guides implementation of evidence-based physical health care reliably. Trial registration: ClinicalTrials.gov Identifier: NCT03271242

scholarly journals The Antipsychotic Medication Management Fidelity Scale: Psychometric properties

2020 ◽  
Vol 47 (6) ◽  
pp. 911-919 ◽  
Author(s):  
Torleif Ruud ◽  
Karin Drivenes ◽  
Robert E. Drake ◽  
Vegard Øksendal Haaland ◽  
Matthew Landers ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Antipsychotic Medication ◽  
Interrater Reliability ◽  
Medication Management ◽  
Evidence Based ◽  
Sensitivity To Change ◽  
Implementation Support ◽  
Fidelity Scale ◽  
Distribution Sensitivity ◽  
Evidence Based Guidelines

Abstract The paper describes the Antipsychotic Medication Management Fidelity Scale and its psychometric properties, including interrater reliability, frequency distribution, sensitivity to change and feasibility. Fidelity assessors conducted fidelity reviews four times over 18 months at eight sites receiving implementation support for evidence-based antipsychotic medication management. Data analyses shows good to fair interrater reliability, adequate sensitivity to change over time and good feasibility. At 18 months, item ratings varied from poor to full fidelity on most items. Use of the scale can assess fidelity to evidence-based guidelines for antipsychotic medication management and guide efforts to improve practice. Further research should improve and better calibrate some items, and improve the procedures for access to information. Trial registration: ClinicalTrials.gov Identifier: NCT03271242.

scholarly journals The Effect of Intensive Implementation Support on Fidelity for Four Evidence-Based Psychosis Treatments: A Cluster Randomized Trial

2021 ◽  
Author(s):  
Torleif Ruud ◽  
Robert E. Drake ◽  
Jūratė Šaltytė Benth ◽  
Karin Drivenes ◽  
Miriam Hartveit ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Training ◽  
Medication Management ◽  
Effect Sizes ◽  
Evidence Based ◽  
Illness Management ◽  
Implementation Support ◽  
Illness Management And Recovery ◽  
Physical Health Care ◽  
Cluster Randomized

Abstract Purpose Service providers need effective strategies to implement evidence-based practices (EBPs) with high fidelity. This study aimed to evaluate an intensive implementation support strategy to increase fidelity to EBP standards in treatment of patients with psychosis. Methods The study used a cluster randomized design with pairwise assignment of practices within each of 39 Norwegian mental health clinics. Each site chose two of four practices for implementation: physical health care, antipsychotic medication management, family psychoeducation, illness management and recovery. One practice was assigned to the experimental condition (toolkits, clinical training, implementation facilitation, data-based feedback) and the other to the control condition (manual only). The outcome measure was fidelity to the EBP, measured at baseline and after 6, 12, and 18 months, analyzed using linear mixed models and effect sizes. Results The increase in fidelity scores (within a range 1–5) from baseline to 18 months was significantly greater for experimental sites than for control sites for the combined four practices, with mean difference in change of 0.86 with 95% CI (0.21; 1.50), p = 0.009). Effect sizes for increase in group difference of mean fidelity scores were 2.24 for illness management and recovery, 0.68 for physical health care, 0.71 for antipsychotic medication management, and 0.27 for family psychoeducation. Most improvements occurred during the first 12 months. Conclusions Intensive implementation strategies (toolkits, clinical training, implementation facilitation, data-based feedback) over 12 months can facilitate the implementation of EBPs for psychosis treatment. The approach may be more effective for some practices than for others.

Developing an Evidence-Based Specialist Nursing Role to Improve the Physical Health Care of People with Mental Illness

2019 ◽  
Vol 40 (10) ◽  
pp. 832-838 ◽  
Author(s):  
Brenda Happell ◽  
Chris Platania-Phung ◽  
Andrew Watkins ◽  
Brett Scholz ◽  
Jackie Curtis ◽  
...  
Keyword(s):  
Health Care ◽  
Mental Illness ◽  
Physical Health ◽  
Evidence Based ◽  
Nursing Role ◽  
People With Mental Illness ◽  
Physical Health Care

scholarly journals Adapting the Comprehensive Unit Safety Program (CUSP) implementation strategy to increase delivery of evidence-based cardiovascular risk factor care in community mental health organizations: protocol for a pilot study

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Emma Elizabeth McGinty ◽  
David Thompson ◽  
Karly A. Murphy ◽  
Elizabeth A. Stuart ◽  
Nae-Yuh Wang ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Pilot Study ◽  
Physical Health ◽  
Care Coordination ◽  
Implementation Strategy ◽  
Evidence Based ◽  
Specialty Mental Health ◽  
Physical Health Care ◽  
Cardiovascular Care

Abstract Background People with serious mental illnesses (SMI) such as schizophrenia and bipolar disorder experience excess mortality driven in large part by high rates of poorly controlled and under-treated cardiovascular risk factors. In the USA, integrated “behavioral health home” models in which specialty mental health organizations coordinate and manage physical health care for people with SMI are designed to improve guideline-concordant cardiovascular care for this group. Such models have been shown to improve cardiovascular care for clients with SMI in randomized clinical trials, but real-world implementation has fallen short. Key implementation barriers include lack of alignment of specialty mental health program culture and physical health care coordination and management for clients with SMI and lack of structured protocols for conducting effective physical health care coordination and management in the specialty mental health program context. This protocol describes a pilot study of an implementation intervention designed to overcome these barriers. Methods This pilot study uses a single-group, pre/post-study design to examine the effects of an adapted Comprehensive Unit Safety Program (CUSP) implementation strategy designed to support behavioral health home programs in conducting effective cardiovascular care coordination and management for clients with SMI. The CUSP strategy, which was originally designed to improve inpatient safety, includes provider training, expert facilitation, and implementation of a five-step quality improvement process. We will examine the acceptability, appropriateness, and feasibility of the implementation strategy and how this strategy influences mental health organization culture; specialty mental health providers’ self-efficacy to conduct evidence-based cardiovascular care coordination and management; and receipt of guideline-concordant care for hypertension, dyslipidemia, and diabetes mellitus among people with SMI. Discussion While we apply CUSP to the implementation of evidence-based hypertension, dyslipidemia, and diabetes care, this implementation strategy could be used in the future to support the delivery of other types of evidence-based care, such as smoking cessation treatment, in behavioral health home programs. CUSP is designed to be fully integrated into organizations, sustained indefinitely, and used to continually improve evidence-based practice delivery. Trial registration ClinicalTrials.gov, NCT04696653. Registered on January 6, 2021

Improving the physical health of long-stay psychiatric in-patients

2004 ◽  
Vol 10 (2) ◽  
pp. 107-115 ◽  
Author(s):  
Irene Cormac ◽  
David Martin ◽  
Michael Ferriter
Keyword(s):  
Health Care ◽  
General Population ◽  
Physical Health ◽  
Research Evidence ◽  
Psychiatric Patients ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Physical Health Care

Research evidence has shown that morbidity and mortality rates are higher in psychiatric patients than in the general population. This article describes factors that affect the physical health of psychiatric patients living in institutions and the steps that can be taken to review, monitor and improve their physical health. The physical health care of long-stay patients should reach the same standards as those expected in the general population.

Perio Millennium The journey of periodontology from then to now

2021 ◽  
Vol 13 (3) ◽  
pp. 235-240
Author(s):  
Patnaik R ◽  
Nayak A
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Oral Cavity ◽  
Physical Health ◽  
Well Being ◽  
Periodontal Health ◽  
Healthcare Facilities ◽  
Gradual Evolution ◽  
History Of ◽  
Physical Health Care

Since the beginning of the civilisation, humans have been in a constant process of development. Along with lifestyle, healthcare developments have also been embraced in a remarkable journey through ages. With evolving lifestyle, the survival of disease-causing pathogens has also parallelly developed by sudden mutations and gradual evolution of species for their survival, demanding an improvement in healthcare facilities which include physical, mental and social well-being. The physical health care has seen an interesting journey in terms of both systemic and oral health. While we speak of health, the contribution of periodontal health is an appreciable factor determining the health of the oral cavity. Periodontal healthcare has existed, evolved and advanced with every passing day. This manuscript aimed at reviewing the history of periodontology from its earliest evidence up to the impending future of periodontology, exploring its existence from an era of prehistoric civilisation to an era which is yet to present itself.

scholarly journals Integrated care to address the physical health needs of people with severe mental illness: a rapid review

2016 ◽  
Vol 4 (13) ◽  
pp. 1-130 ◽  
Author(s):  
Mark Rodgers ◽  
Jane Dalton ◽  
Melissa Harden ◽  
Andrew Street ◽  
Gillian Parker ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Physical Health ◽  
Integrated Care ◽  
Health Needs ◽  
Rapid Review ◽  
Advisory Group ◽  
Service Users ◽  
Physical Health Care ◽  
Facilitators And Barriers

BackgroundPeople with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests that this discrepancy is driven by a combination of clinical risk factors, socioeconomic factors and health system factors.Objective(s)To explore current service provision and map the recent evidence on models of integrated care addressing the physical health needs of people with severe mental illness (SMI) primarily within the mental health service setting. The research was designed as a rapid review of published evidence from 2013–15, including an update of a comprehensive 2013 review, together with further grey literature and insights from an expert advisory group.SynthesisWe conducted a narrative synthesis, using a guiding framework based on nine previously identified factors considered to be facilitators of good integrated care for people with mental health problems, supplemented by additional issues emerging from the evidence. Descriptive data were used to identify existing models, perceived facilitators and barriers to their implementation, and any areas for further research.Findings and discussionThe synthesis incorporated 45 publications describing 36 separate approaches to integrated care, along with further information from the advisory group. Most service models were multicomponent programmes incorporating two or more of the nine factors: (1) information sharing systems; (2) shared protocols; (3) joint funding/commissioning; (4) colocated services; (5) multidisciplinary teams; (6) liaison services; (7) navigators; (8) research; and (9) reduction of stigma. Few of the identified examples were described in detail and fewer still were evaluated, raising questions about the replicability and generalisability of much of the existing evidence. However, some common themes did emerge from the evidence. Efforts to improve the physical health care of people with SMI should empower people (staff and service users) and help remove everyday barriers to delivering and accessing integrated care. In particular, there is a need for improved communication between professionals and better information technology to support them, greater clarity about who is responsible and accountable for physical health care, and awareness of the effects of stigmatisation on the wider culture and environment in which services are delivered.Limitations and future workThe literature identified in the rapid review was limited in volume and often lacked the depth of description necessary to acquire new insights. All members of our advisory group were based in England, so this report has limited information on the NHS contexts specific to Scotland, Wales and Northern Ireland. A conventional systematic review of this topic would not appear to be appropriate in the immediate future, although a more interpretivist approach to exploring this literature might be feasible. Wherever possible, future evaluations should involve service users and be clear about which outcomes, facilitators and barriers are likely to be context-specific and which might be generalisable.FundingThe research reported here was commissioned and funded by the Health Services and Delivery Research programme as part of a series of evidence syntheses under project number 13/05/11. For more information visitwww.nets.nihr.ac.uk/projects/hsdr/130511.

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