scholarly journals Evaluation of the Balanced Menus Challenge: a healthy food and sustainability programme in hospitals in Maryland

2014 ◽  
Vol 18 (13) ◽  
pp. 2341-2349 ◽  
Author(s):  
Tarah D Ranke ◽  
C Louise Mitchell ◽  
Diane Marie St. George ◽  
Christopher R D’Adamo
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Cost Effective ◽  
Washington Dc ◽  
Previous Survey ◽  
Structured Interviews ◽  
Health Care Settings ◽  
Retrospective Assessment ◽  
Good Nutrition ◽  
National Effort

AbstractObjectiveThe Balanced Menus Challenge (BMC) is a national effort to bring the healthiest, most sustainably produced meat available into health-care settings to preserve antibiotic effectiveness and promote good nutrition. The present study evaluated the outcomes of the BMC in the Maryland/Washington, DC region.DesignThe BMC is a cost-effective programme whereby participating hospitals reduce meat purchases by 20 % of their budget, then invest the savings into purchasing sustainably produced meat. A mixed-methods retrospective assessment was conducted to assess (i) utilization of the BMC ‘implementation toolkit’ and (ii) achievement of the 20 % reduction in meat purchases. Previous survey data were reviewed and semi-structured interviews were conducted.SettingHospitals located in the Maryland/Washington, DC region, USA, that adopted the BMC.SubjectsTwelve hospitals signed the BMC in the Maryland/Washington, DC region and six were available for interview.ResultsThree hospitals in the Maryland/Washington, DC region that signed the BMC tracked their progress and two achieved a reduction in meat procurement by ≥20 %. One hospital demonstrated that the final outcome goal of switching to a local and sustainable source for meat is possible to achieve, at least for a portion of the meal budget. The three hospitals that reduced meat purchases also received and used the highest number of BMC implementation tools. There was a positive correlation between receipt and usage of implementation tools (r=0·93, P=0·005).ConclusionsThe study demonstrates that hospitals in the Maryland/Washington, DC region that sign the BMC can increase the amount of sustainably produced meat purchased and served.

scholarly journals Does Sense make sense? Mixed methods study of a Dutch sexual health program

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Joosten ◽  
L Jochems ◽  
C Wijsen ◽  
T Heijman ◽  
A Timen
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Young People ◽  
Sexual Health ◽  
Health Care Professionals ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Open Atmosphere ◽  
Study Results

Abstract In the Netherlands, the Sense program addresses several key elements of sexual health for young people <25 year. This program offers free consultations at the PHS concerning STI, contraceptives, pregnancy or sexuality. The performance of this program has not been studied yet. This mixed methods study investigates facilitators and barriers of a Sense consultation from the perspective of clients and health care professionals (HCP) and investigates the outcome of the consultation at three points in time. Semi-structured interviews were conducted after consultation among 16 clients and 6 HCP. Questionnaires were collected directly after consultation and at 3, 6 and 12 months after consultation. Two cohorts were recruited; clients with STI consultation only and clients with questions related to sexuality, contraception and pregnancy (Sense consultation, SC). Satisfaction of the consultation and applicability of the given advice was measured. In the follow up presence of STI, pregnancy, sexual problem and contraceptive use was measured. A minority of the interviewed clients were familiar with Sense, highly valued the expertise of the HCP and the open atmosphere during the consultation. Reasons for visiting Sense included expertise, more anonymity and feeling more comfortable than at the GP. The questionnaire after consultation was returned by 144 STI clients and 32 SC clients. Both type of consultation were highly valued and advice was easily applicable. The follow up cohort included 97 STI clients and 23 SC clients. Response rate of the 3- and 6 month-questionnaires was 61%. Results of the full one year follow-up are expected in September 2019. Study results provide evidence for a highly valued Sense program, by both clients and HCP. Sense is a platform to discuss STI, contraception and sexuality in an open atmosphere, though familiarity with Sense is low. A major conclusion is that an STI consultation provides the opportunity to address questions related to sexuality. Key messages The Sense program is highly valued by young people, and yet the program is not widely known among young people. There is need for more publicity to the program to enable more young people to use this program and to improve the sexual health care of young Dutch people.

scholarly journals Occupational Screening for Latent Tuberculosis Infection

2021 ◽  
Vol 1 (9) ◽  
Author(s):  
Sara D. Khangura ◽  
Melissa Severn
Keyword(s):  
Health Care ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Cost Effective ◽  
Tuberculosis Infection ◽  
Economic Evaluations ◽  
Repeated Testing ◽  
Health Care Settings ◽  
Targeted Testing ◽  
The Cost

In people at risk of occupational exposure to tuberculosis, targeted testing for latent tuberculosis infection (e.g., testing for high-risk individuals, testing after tuberculosis exposure) appears to be more cost-effective than repeated testing, such as testing once a year or every 3 years (findings based on 2 economic evaluations that assessed the cost-effectiveness of repeated latent tuberculosis infection screening in workers of health care settings).

scholarly journals Point-of-Care Mobile Application to Guide Health Care Professionals in Conducting Substance Use Screening and Intervention: A Mixed-Methods User Experience Study

ACI Open ◽  
2019 ◽  
Vol 03 (01) ◽  
pp. e1-e12
Author(s):  
Megan O'Grady ◽  
Sandeep Kapoor ◽  
Evan Gilmer ◽  
Charles Neighbors ◽  
Joseph Conigliaro ◽  
...  
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Mixed Methods ◽  
User Experience ◽  
Point Of Care ◽  
Health Care Settings ◽  
Health Technologies ◽  
Patient Interactions ◽  
System Usability Scale ◽  
Substance Use Services

Background Well-documented barriers have limited the widespread, sustained adoption of screening and intervention for substance use problems in health care settings. mHealth applications may address provider-related barriers; however, there is limited research on development and user experience of such applications. Objective This user experience study examines a provider-focused point-of-care app for substance use screening and intervention in health care settings. Method This mixed-methods study included think-aloud tasks, task success ratings, semistructured interviews, and usability questionnaires (e.g., System Usability Scale [SUS]) to examine user experience among 12 health coaches who provide substance use services in emergency department and primary care settings. Results The average rate of successful task completion was 94% and the mean SUS score was 76 out of 100. Qualitative data suggested the app enhanced participants' capability to complete tasks efficiently and effectively. Participants reported being satisfied with the app's features, content, screen layout, and navigation and felt it was easy to learn and could benefit patient interactions. Despite overwhelmingly positive user experience reports, there were some concerns that the app could negatively affect patient interactions due to reductions in eye contact and ability to build rapport. Conclusion Using the “Fit between Individuals, Task, and Technology” framework to guide interpretation, overall results indicate acceptable user experience and usability for this provider-focused point-of-care mobile app for substance use screening and intervention as well as favorable potential for adoption by health care practitioners. Such mobile health technologies may help to address well-known challenges related to implementing substance use services in health care settings.

scholarly journals Interpreters’ Self-Perceptions of Their Use of Self When Interpreting in Health and Behavioural Health Settings

Refuge ◽  
2016 ◽  
Vol 32 (3) ◽  
pp. 119-124
Author(s):  
Nicole Dubus
Keyword(s):  
Health Care ◽  
Great Promise ◽  
Use Of Self ◽  
Structured Interviews ◽  
Health Care Settings ◽  
Safe Environment ◽  
Self Perceptions ◽  
Behavioural Health ◽  
The Individual ◽  
Constant Comparative Analysis

This study examines interpreters’ self-perception of their use of self when interpreting in health and behavioural health-care settings. Constant comparative analysis was used to analyze the individual, semi-structured interviews of thirty-six interpreters. Interpreters identified specific skills and techniques, that they developed on their own, (1) to create a safe environment for provider and client, and (2) to increase the effectiveness of the intervention. Interpreters are vital members of care teams. Interpreters might be under-utilized if only seen as a language conduit. Embracing interpreters as members of the inter professional team may hold great promise for addressing challenges in providing culturally effective services.

scholarly journals Healthcare access for asylum seekers and refugees in England: a mixed methods study exploring service users’ and health care professionals’ awareness

2019 ◽  
Vol 30 (3) ◽  
pp. 527-532 ◽  
Author(s):  
Louise J Tomkow ◽  
Cara Pippa Kang ◽  
Rebecca L Farrington ◽  
Ruth E Wiggans ◽  
Rebecca J Wilson ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Professionals ◽  
Asylum Seekers ◽  
Negative Impact ◽  
Healthcare Access ◽  
Political Climate ◽  
Structured Interviews ◽  
Language Difficulties ◽  
Asylum Seekers And Refugees

Abstract Background With the aim of decreasing immigration, the British government extended charging for healthcare in England for certain migrants in 2017. There is concern these policies amplify the barriers to healthcare already faced by asylum seekers and refugees (ASRs). Awareness has been shown to be fundamental to access. This article jointly explores (i) health care professionals’ (HCPs) awareness of migrants’ eligibility for healthcare, and (ii) ASRs’ awareness of health services. Methods Mixed methods were used. Quantitative survey data explored HCPs’ awareness of migrants’ eligibility to healthcare after the extension of charging regulations. Qualitative data from semi-structured interviews with ASRs were analyzed thematically using Saurman’s domains of awareness as a framework. Results In total 514 HCPs responded to the survey. Significant gaps in HCPs’ awareness of definitions, entitlements and charging regulations were identified. 80% of HCP respondents were not confident defining the immigration categories upon which eligibility for care rests. Only a small minority (6%) reported both awareness and understanding of the charging regulations. In parallel, the 18 ASRs interviewed had poor awareness of their eligibility for free National Health Service care and suitability for particular services. This was compounded by language difficulties, social isolation, frequent asylum dispersal accommodation moves, and poverty. Conclusion This study identifies significant confusion amongst both HCP and ASR concerning eligibility and healthcare access. The consequent negative impact on health is concerning given the contemporary political climate, where eligibility for healthcare depends on immigration status.

scholarly journals Invisible rights: Barriers and facilitators to access and use of interpreter services in health care settings by Polish migrants in Norway

2018 ◽  
Vol 47 (7) ◽  
pp. 755-764 ◽  
Author(s):  
Elżbieta Anna Czapka ◽  
Jennifer Gerwing ◽  
Mette Sagbakken
Keyword(s):  
Health Care ◽  
Health Personnel ◽  
Ad Hoc ◽  
Health Condition ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Health Care Settings ◽  
Interpreter Services ◽  
Polish Migrants

Aims: Polish migration to Norway is a relatively new phenomenon. Many Polish migrants do not speak Norwegian or have insufficient knowledge of the language, which makes it difficult or impossible to communicate with health personnel. The main aim of the study was to identify barriers and facilitators to Polish migrants’ access and use of interpreter services in health care settings in Norway. Methods: Nineteen semi-structured interviews with Polish migrants were carried out in 2013 and 2014. Thematic analysis was performed to identify barriers and facilitators related to the use of interpreter services. Results: Participants often received information regarding their health condition and treatment in a language they did not fully understand. They reported that their access to interpretation services was limited or denied for a variety of reasons, such as reluctance of health personnel to book an interpreter and overestimation of patient’s language skills. In many cases, using friends, relatives or bilingual staff instead of professional interpreters compromised the quality of interpretation. Conclusions: Even though migrants are entitled to free interpreter services, Polish migrants experience several barriers accessing interpreters in health care settings. A variety of practices such as selective use and use of unqualified and ad hoc interpreters reveals a failure to meet recommended standards of interpretation services. Not involving professional interpreters in language-discordant consultations constitutes a serious threat to practitioners’ ability to work as competent professionals, potentially risking the quality and safety of health care for these patients.

scholarly journals Policy Considerations for Geriatric Social Workers in Healthcare Settings During COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 382-382
Author(s):  
Terri Lewinson ◽  
Tiffany Washington
Keyword(s):  
Health Care ◽  
Social Work ◽  
Social Workers ◽  
Interprofessional Education ◽  
Work Practice ◽  
Work Conditions ◽  
Social Work Practice ◽  
Structured Interviews ◽  
Health Care Settings ◽  
The Impact

Abstract Social workers are essential to the delivery of health care with older adults the during COVID-19 pandemic. This paper focuses on the impact of policies in health care systems that affect geriatric social work practice. Semi-structured interviews were conducted with 55 social workers from a variety of health care settings. Data were analyzed to identify the scope of social work practice in health care settings during the COVID-19 pandemic, and how policies in their respective settings impacted their work. Conditions that impeded participants’ ability to provide quality care and work within their scope of practice included inconsistent expectations of interdisciplinary team members, disparate access to resources, restriction of opportunities to address emotional distress experienced by workers. Recommendations for policy enhancements in health care settings include interprofessional education on effective team communication, protocol development for the equitable distribution of resources among essential workers, and trauma-informed in-service trainings for health care administrators.

scholarly journals Optimal strategies to screen health care workers for COVID-19 in the US: a cost-effectiveness analysis

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Sigal Maya ◽  
Guntas Padda ◽  
Victoria Close ◽  
Trevor Wilson ◽  
Fareeda Ahmed ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Workers ◽  
Cost Effective ◽  
Health Care Settings ◽  
Testing Strategies ◽  
Effectiveness Analysis ◽  
Care Workers ◽  
Antigen Testing ◽  
Quality Adjusted Life

Abstract Background Transmission of SARS-CoV-2 in health care facilities poses a challenge against pandemic control. Health care workers (HCWs) have frequent and high-risk interactions with COVID-19 patients. We undertook a cost-effectiveness analysis to determine optimal testing strategies for screening HCWs to inform strategic decision-making in health care settings. Methods We modeled the number of new infections, quality-adjusted life years lost, and net costs related to six testing strategies including no test. We applied our model to four strata of HCWs, defined by the presence and timing of symptoms. We conducted sensitivity analyses to account for uncertainty in inputs. Results When screening recently symptomatic HCWs, conducting only a PCR test is preferable; it saves costs and improves health outcomes in the first week post-symptom onset, and costs $83,000 per quality-adjusted life year gained in the second week post-symptom onset. When screening HCWs in the late clinical disease stage, none of the testing approaches is cost-effective and thus no testing is preferable, yielding $11 and 0.003 new infections per 10 HCWs. For screening asymptomatic HCWs, antigen testing is preferable to PCR testing due to its lower cost. Conclusions Both PCR and antigen testing are beneficial strategies to identify infected HCWs and reduce transmission of SARS-CoV-2 in health care settings. IgG tests’ value depends on test timing and immunity characteristics, however it is not cost-effective in a low prevalence setting. As the context of the pandemic evolves, our study provides insight to health-care decision makers to keep the health care workforce safe and transmissions low.

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