scholarly journals Implementation of an Evidence-Based Intervention with Safety Net Clinics to Improve Mammography Appointment Adherence Among Underserved Women

2021 ◽  
Author(s):  
Jennifer Holcomb ◽  
Suja S. Rajan ◽  
Gayla M. Ferguson ◽  
Jiali Sun ◽  
Gretchen H. Walton ◽  
...  
Keyword(s):  
Implementation Research ◽  
Safety Net ◽  
Baseline Period ◽  
Evidence Based ◽  
Intervention Period ◽  
Peace Of Mind ◽  
Appointment Adherence ◽  
Underserved Women ◽  
Safety Net Clinics ◽  
Inner Setting

Abstract The Peace of Mind Program is an evidence-based intervention to improve mammography appointment adherence in underserved women. The aim of this study was to assess effectiveness of the intervention and implementation of the intervention in safety net clinics. The intervention was implemented through a non-randomized stepped wedge cluster hybrid study design with 19 Federally Qualified Health Centers and charity care clinics within the Greater Houston area. A multivariable generalized estimating equation logistic regression was conducted to examine mammography appointment adherence. A survey assessing Consolidated Framework for Implementation Research constructs was also conducted with clinic staff prior to adoption and eight weeks post implementation. One-sided t-tests were conducted to analyze mean score changes between the surveys. A total of 4402 women (baseline period = 2078; intervention period = 2324) were included in the final regression analysis. Women in the intervention period were more likely to attend or reschedule their mammography appointment (OR = 1.30; p < 0.01) than those in the baseline period receiving usual care. Women who completed the intervention were more likely to attend or reschedule their mammography appointment than those who did not complete the intervention (OR = 1.62; p < 0.01). The mammography appointment no-show rates for those in the baseline period, in the intervention period, and who completed the intervention were, respectively, 22%, 19%, and 15%. A total of 15 clinics prior to adoption and eight clinics completed the survey at 8 weeks post implementation A statistically significant mean score decrease was observed in Inner Setting and in two Inner Setting CFIR constructs, Culture–Effort, and Implementation Climate. While the intervention improved mammography appointment adherence, there are opportunities to further integrate Consolidated Framework for Implementation Research constructs. Trial registration: Clinical trials registration number: NCT02296177.

scholarly journals Peace of Mind Program (PMP): Impact of the Dissemination and Implementation of an Evidence-based Intervention (EBI) to Improve Mammography Appointment Adherence in Safety Net Clinics

2021 ◽  
Author(s):  
Jennifer Holcomb ◽  
Suja S Rajan ◽  
Gayla M Ferguson ◽  
Jiali Sun ◽  
Gretchen H Walton ◽  
...  
Keyword(s):  
Implementation Research ◽  
Safety Net ◽  
Baseline Period ◽  
Evidence Based ◽  
Intervention Period ◽  
Peace Of Mind ◽  
Appointment Adherence ◽  
Adoption And Implementation ◽  
Safety Net Clinics ◽  
Inner Setting

Abstract Backgroundhe Peace of Mind Program – an adapted evidence-based intervention to improve mammography appointment adherence in underserved women – was expanded to safety net clinics. This study assessed effectiveness of the intervention in improving mammography appointment adherence and implementation of the intervention. MethodsThe intervention was implemented through a non-randomized stepped wedge cluster design with 19 Federally Qualified Health Centers and charity care clinics in the Greater Houston area. Clinics were their own control during the baseline period and conducted at least three mammography drives during the baseline and intervention period. A multivariable generalized estimating equation logistic regression was conducted to examine mammography appointment adherence. To examine adoption and implementation of the intervention, two surveys assessing Consolidated Framework for Implementation Research constructs were conducted with clinic leadership and staff. One-sided t-tests were conducted to analyze mean score changes between the adoption and implementation survey. Results total of 4402 women (baseline period = 2078; intervention period = 2324) were included in the final analysis. Women in the intervention period were more likely to attend or reschedule their mammography appointment (OR = 1.30; p < 0.01). Similarly, for those in the intervention period, women who completed the intervention were more likely to attend or reschedule their mammography appointment than those who did not complete the intervention (OR = 1.62; p < 0.01). The mammography appointment no-show rates for those in the baseline period, in the intervention period, and who completed the intervention were, respectively, 22%, 19%, and 15%. In terms of the adoption and implementation survey, a statistically significant mean score decrease was observed in Inner Setting overall and in two Inner Setting constructs, Culture – Effort and Implementation Climate. ConclusionsThis study provided a pragmatic approach to translating an evidence-based mammography intervention into practice in safety net clinics. While the intervention improved mammography appointment adherence, there our opportunities to further integrate Consolidated Framework for Implementation Research constructs in future implementation of the intervention. Future research on the effects of implementation moderators particularly Inner Setting constructs would be of value to implementation practitioners.

scholarly journals Implementation of evidence-based practices for complex mood disorders in primary care safety net clinics.

2018 ◽  
Vol 36 (3) ◽  
pp. 267-280 ◽  
Author(s):  
John C. Fortney ◽  
Jeffrey M. Pyne ◽  
Susan Ward-Jones ◽  
Ian M. Bennett ◽  
Joan Diehl ◽  
...  
Keyword(s):  
Primary Care ◽  
Mood Disorders ◽  
Safety Net ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Safety Net Clinics

scholarly journals Adoption of an Evidence-Based Intervention for Mammography Screening Adherence in Safety Net Clinics

2021 ◽  
Vol 9 ◽  
Author(s):  
Jennifer Holcomb ◽  
Gayla Ferguson ◽  
Isabel Roth ◽  
Gretchen Walton ◽  
Linda Highfield
Keyword(s):  
Scale Up ◽  
Cancer Control ◽  
Safety Net ◽  
Academic Community ◽  
Health Centers ◽  
Research Network ◽  
Evidence Based ◽  
Community Partner ◽  
Federally Qualified Health Centers ◽  
Safety Net Clinics

Through an academic-community partnership, an evidence-based intervention to reduce mammography appointment no-show rates in underserved women was expanded to safety net clinics. The partnership implemented four strategies to improve the adoption and scale-up of evidence-based interventions with Federally Qualified Health Centers and charity care clinics: (1) an outreach email blast targeting the community partner member clinics to increase program awareness, (2) an adoption video encouraging enrollment in the program, (3) an outreach webinar educating the community partner member clinics about the program, encouraging enrollment and outlining adoption steps, and (4) an adoption survey adapted from Consolidated Framework for Implementation Research constructs from the Cancer Prevention and Control Research Network for cancer control interventions with Federally Qualified Health Centers. The development of academic-community partnerships can lead to successful adoption of evidence-based interventions particularly in safety net clinics.

Oxygen radicals participate in alloxan-induced pulmonary EDEMA

1990 ◽  
Vol 48 (3) ◽  
pp. 298-299
Author(s):  
Tomoo Kawada ◽  
Michio Arakawa ◽  
Kenjiro Kambara ◽  
Takashi Segawa ◽  
Fumio Ando ◽  
...  
Keyword(s):  
Pulmonary Edema ◽  
Oxygen Radicals ◽  
Bolus Injection ◽  
Physiological Saline ◽  
Baseline Period ◽  
Alveolar Epithelial Cells ◽  
Control Group ◽  
Intervention Period ◽  
Lung Water ◽  
Electron Microscopic

We know that alloxan causes increased-permeability pulmonary edema and that alloxan generates oxygen radicals (H2O2, O2−, ·OH) in blood. Therefore, we hypothesize that alloxan-generated oxygen radicals damage pulmonary capillary endothelial cells, and, possibly, alveolar epithelial cells as well. We examined whether oxygen radical scavengers, such as catalase or dimethylsulfoxide (DMSO), protected against alloxaninduced pulmonary edema.Five dogs in each following group were anesthetized: control group: physiological saline (20ml/kg/h); alloxan group: physiological saline + alloxan (75mg/kg) bolus injection at the beginning of the experiment; catalase group: physiological saline + catalase (150,000u/kg) bolus injection before injection of alloxan; DMSO group: physiological saline + DMSO (0.4mg/kg) bolus injection before alloxan. All dogs had 30-min baseline period and 3-h intervention period. Hemodynamics and circulating substances were measured at the specific points of time. At the end of intervention period, the dogs were killed and had the lungs removed for electron microscopic study and lung water measurement with direct destructive method.

scholarly journals Measures of organizational culture, organizational climate, and implementation climate in behavioral health: A systematic review

2021 ◽  
Vol 2 ◽  
pp. 263348952110188
Author(s):  
Byron J Powell ◽  
Kayne D Mettert ◽  
Caitlin N Dorsey ◽  
Bryan J Weiner ◽  
Cameo F Stanick ◽  
...  
Keyword(s):  
Organizational Culture ◽  
Organizational Climate ◽  
Psychometric Properties ◽  
Behavioral Health ◽  
Implementation Research ◽  
Learning Climate ◽  
Evidence Based ◽  
Implementation Climate ◽  
Relative Priority ◽  
Evidence Based Practices

Background: Organizational culture, organizational climate, and implementation climate are key organizational constructs that influence the implementation of evidence-based practices. However, there has been little systematic investigation of the availability of psychometrically strong measures that can be used to assess these constructs in behavioral health. This systematic review identified and assessed the psychometric properties of measures of organizational culture, organizational climate, implementation climate, and related subconstructs as defined by the Consolidated Framework for Implementation Research (CFIR) and Ehrhart and colleagues. Methods: Data collection involved search string generation, title and abstract screening, full-text review, construct assignment, and citation searches for all known empirical uses. Data relevant to nine psychometric criteria from the Psychometric and Pragmatic Evidence Rating Scale (PAPERS) were extracted: internal consistency, convergent validity, discriminant validity, known-groups validity, predictive validity, concurrent validity, structural validity, responsiveness, and norms. Extracted data for each criterion were rated on a scale from −1 (“poor”) to 4 (“excellent”), and each measure was assigned a total score (highest possible score = 36) that formed the basis for head-to-head comparisons of measures for each focal construct. Results: We identified full measures or relevant subscales of broader measures for organizational culture ( n = 21), organizational climate ( n = 36), implementation climate ( n = 2), tension for change ( n = 2), compatibility ( n = 6), relative priority ( n = 2), organizational incentives and rewards ( n = 3), goals and feedback ( n = 3), and learning climate ( n = 2). Psychometric evidence was most frequently available for internal consistency and norms. Information about other psychometric properties was less available. Median ratings for psychometric properties across categories of measures ranged from “poor” to “good.” There was limited evidence of responsiveness or predictive validity. Conclusion: While several promising measures were identified, the overall state of measurement related to these constructs is poor. To enhance understanding of how these constructs influence implementation research and practice, measures that are sensitive to change and predictive of key implementation and clinical outcomes are required. There is a need for further testing of the most promising measures, and ample opportunity to develop additional psychometrically strong measures of these important constructs. Plain Language Summary Organizational culture, organizational climate, and implementation climate can play a critical role in facilitating or impeding the successful implementation and sustainment of evidence-based practices. Advancing our understanding of how these contextual factors independently or collectively influence implementation and clinical outcomes requires measures that are reliable and valid. Previous systematic reviews identified measures of organizational factors that influence implementation, but none focused explicitly on behavioral health; focused solely on organizational culture, organizational climate, and implementation climate; or assessed the evidence base of all known uses of a measure within a given area, such as behavioral health–focused implementation efforts. The purpose of this study was to identify and assess the psychometric properties of measures of organizational culture, organizational climate, implementation climate, and related subconstructs that have been used in behavioral health-focused implementation research. We identified 21 measures of organizational culture, 36 measures of organizational climate, 2 measures of implementation climate, 2 measures of tension for change, 6 measures of compatibility, 2 measures of relative priority, 3 measures of organizational incentives and rewards, 3 measures of goals and feedback, and 2 measures of learning climate. Some promising measures were identified; however, the overall state of measurement across these constructs is poor. This review highlights specific areas for improvement and suggests the need to rigorously evaluate existing measures and develop new measures.

scholarly journals Provider self-efficacy in delivering evidence-based psychosocial interventions: A scoping review

2021 ◽  
Vol 2 ◽  
pp. 263348952098825
Author(s):  
Cheri J Shapiro ◽  
Kathleen Watson MacDonell ◽  
Mariah Moran
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Implementation Research ◽  
Self Efficacy ◽  
Psychosocial Interventions ◽  
Health Interventions ◽  
Evidence Based ◽  
Health Providers ◽  
Plain Language ◽  
Mental Health Interventions

Background: Among the many variables that affect implementation of evidence-based interventions in real-world settings, self-efficacy is one of the most important factors at the provider level of the social ecology. Yet, research on the construct of provider self-efficacy remains limited. Objectives: This scoping review was conducted to enhance understanding of the construct of provider self-efficacy and to examine how the construct is defined and measured in the context of implementation of evidence-based mental health interventions. Design: Online databases were used to identify 190 papers published from 1999 to June of 2018 that included search terms for providers, evidence-based, and self-efficacy. To be eligible for the scoping review, papers needed to focus on the self-efficacy of mental health providers to deliver evidence-based psychosocial interventions. A total of 15 publications were included in the review. Results: The construct of provider self-efficacy is not clearly defined but is typically described as confidence to deliver a specific intervention or practice. A range of measures are used to assess provider self-efficacy across both provider and intervention types. Conclusions: Standardized definition and measurement of provider self-efficacy is needed to advance practice and implementation research. Plain language abstract: Provider self-efficacy is known to influence implementation of evidence-based mental health interventions. However, the ways in which provider self-efficacy is defined and measured in implementation research literature is not well understood; furthermore, it is not clear what types of providers and interventions are represented in this literature. This scoping review adds to current research by revealing that there is no agreed upon definition or measure of provider self-efficacy in the context of implementation of evidence-based interventions, and that the research includes multiple types of providers (e.g., social workers, counselors, psychologists) and interventions. Self-efficacy appears to change as a function of training and support. To further research in this area, a common definition and agreed upon measures of this construct are needed.

Challenges of Using Videos in Exam Rooms of Safety-Net Clinics to Encourage Patient Self-Disclosure of Intimate Partner Violence and to Increase Provider Screening

2021 ◽  
pp. 107780122110001
Author(s):  
Paula Tavrow ◽  
Brittnie Bloom ◽  
Mellissa Withers
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Safety Net ◽  
Intimate Partner ◽  
High Turnover ◽  
Management Tools ◽  
Self Disclosure ◽  
Female Victims ◽  
Safety Net Clinics ◽  
Main Components

Identifying intimate partner violence (IPV) in clinics allows for early intervention. We tested a comprehensive approach in five safety-net clinics to encourage female victims to self-identify and providers to screen. The main components were (a) short, multilingual videos for female patients; (b) provider training; and (c) management tools. Although videos were viewed 2,150 times, only 9% of eligible patients watched them. IPV disclosure increased slightly (6%). Lack of internal champions, high turnover, increased patient load, and technological challenges hindered outcomes. Safety-net clinics need feasible methods to encourage IPV screening. Management champions and IT support are essential for video-based activities.

Medicaid Managed Care's Impact On Safety-Net Clinics In California

2000 ◽  
Vol 19 (1) ◽  
pp. 194-202 ◽  
Author(s):  
Andrew B. Bindman ◽  
Kevin Grumbach ◽  
Susannah Bernheim ◽  
Karen Vranizan ◽  
Michael Cousineau
Keyword(s):  
Safety Net ◽  
Safety Net Clinics
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