“It's second best”: A mixed-methods evaluation of the experiences and attitudes of people with musculoskeletal pain towards physiotherapist delivered telehealth during COVID-19 pandemic

BACKGROUND EasySeating is a mobile health (mHealth) app that supports the prescription of wheelchair and postural support devices (WPSD). It can be used by occupational therapists (OT) and physiotherapists (PT) who prescribe WPSD. The app offers a standardization of the prescription procedure, showing images, metrics and details that guide the prescriber to decide on the best equipment. It was developed with an iterative mixed-methods evaluation approach. Objective: The aim of this study was to investigate the processes involved in the prescription of WPSD and to propose, develop and evaluate a mHealth to support OT and PT prescribers. OBJECTIVE The aim of this study was to investigate the processes involved in the prescription of WPSD and to propose, develop and evaluate a mHealth to support OT and PT prescribers. METHODS This study was divided into three phases and was carried out as an iterative process composed of user consulting/testing (using a mixed-methods evaluation approach), system (re)design and software development. The first phase consisted of the collection of qualitative and quantitative data to map and understand the users requirements and of the development of the first prototype (v1) of the app. This data collection was performed through semi-structured interviews with 14 OT and PT prescribers, 5 specialized technicians and 5 WPSD users. The second phase aimed at improving the overall functionality of the app and consisted in the development, test and evaluation of the prototypes v1, v2, v3 and v4. A total of 59 prescribers tested and evaluated these prototypes by means of open interviews, semi-structured questionnaires and focus groups. The third phase focused in the usability aspects of the app. It consisted in the development and test of the prototype v5. Eight technology specialists assessed its usability through heuristics evaluation. RESULTS Data collected in phase one indicated there is a lack of standardization on the prescription of postural support devices (PSD). A divergent nomenclature for the PSDs was also found and classified in eight categories. These information guided the development of the first prototype of the EasySeating app. Phase two results pointed that the prescribers value the insertion of the app into their clinical practice, as it accelerates and increases the quality of the evaluation process and improves the organization of the prescription information. Significant suggestions for the improvement of the app were given during the users tests, including the use of images to represent the PSDs. The usability tests from the third phase revealed two strong issues that must be solved: the need of greater feedback and failures in the persistence of the input data. CONCLUSIONS This study demonstrated that there is a lack of systematization of the WPSD prescription process. The evaluation of the developed EasySeating app demonstrated that there is a potential to standardize, integrate and organize the WPSD prescription information, supporting and facilitating the decision making process of the prescribers. CLINICALTRIAL This study was approved by the Research Ethics Board of the Universidade de São Paulo (registered protocol n°53929516.6.0000.0065) URL - http://plataformabrasil.saude.gov.br/login.jsf

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An Educational Intervention to Improve Simulation Facilitation by Nurse Educators in a Large Canadian Academic Hospital: A Mixed Methods Evaluation

Clinical Simulation in Nursing ◽

10.1016/j.ecns.2021.01.001 ◽

2021 ◽

Author(s):

Jennifer Dale-Tam ◽

Prudy Menard ◽

Glenn Posner

Keyword(s):

Mixed Methods ◽

Educational Intervention ◽

Nurse Educators ◽

Academic Hospital ◽

Mixed Methods Evaluation

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A Mixed-Methods Evaluation of a School Wellness Initiative: An Examination of Longer Lunch Periods and More Physical Activity Opportunities

Journal of the Academy of Nutrition and Dietetics ◽

10.1016/j.jand.2021.03.010 ◽

2021 ◽

Author(s):

Juliana F.W. Cohen ◽

Michael Scott ◽

Melanie Sutton ◽

Katie Cueva ◽

Eleanor T. Shonkoff ◽

...

Keyword(s):

Physical Activity ◽

Mixed Methods ◽

School Wellness ◽

Mixed Methods Evaluation ◽

Wellness Initiative

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Effects of transition on HIV and non-HIV services and health systems in Kenya: a mixed methods evaluation of donor transition

BMC Health Services Research ◽

10.1186/s12913-021-06451-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Daniela C. Rodríguez ◽

Diwakar Mohan ◽

Caroline Mackenzie ◽

Jess Wilhelm ◽

Ezinne Eze-Ajoku ◽

...

Keyword(s):

Mixed Methods ◽

Service Delivery ◽

Health Systems ◽

Local Level ◽

Health Facilities ◽

Government Support ◽

Hiv Care ◽

Local Context ◽

Mixed Methods Evaluation ◽

The Us

Abstract Background In 2015 the US President’s Emergency Plan for AIDS Relief (PEPFAR) initiated its Geographic Prioritization (GP) process whereby it prioritized high burden areas within countries, with the goal of more rapidly achieving the UNAIDS 90–90-90 targets. In Kenya, PEPFAR designated over 400 health facilities in Northeastern Kenya to be transitioned to government support (known as central support (CS)). Methods We conducted a mixed methods evaluation exploring the effect of GP on health systems, and HIV and non-HIV service delivery in CS facilities. Quantitative data from a facility survey and health service delivery data were gathered and combined with data from two rounds of interviews and focus group discussions (FGDs) conducted at national and sub-national level to document the design and implementation of GP. The survey included 230 health facilities across 10 counties, and 59 interviews and 22 FGDs were conducted with government officials, health facility providers, patients, and civil society. Results We found that PEPFAR moved quickly from announcing the GP to implementation. Despite extensive conversations between the US government and the Government of Kenya, there was little consultation with sub-national actors even though the country had recently undergone a major devolution process. Survey and qualitative data identified a number of effects from GP, including discontinuation of certain services, declines in quality and access to HIV care, loss of training and financial incentives for health workers, and disruption of laboratory testing. Despite these reports, service coverage had not been greatly affected; however, clinician strikes in the post-transition period were potential confounders. Conclusions This study found similar effects to earlier research on transition and provides additional insights about internal country transitions, particularly in decentralized contexts. Aside from a need for longer planning periods and better communication and coordination, we raise concerns about transitions driven by epidemiological criteria without adaptation to the local context and their implication for priority-setting and HIV investments at the local level.

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