Educating primary healthcare providers about kidney disease

Health behaviour during midlife is linked to health outcomes in older age. Primary healthcare providers (PHCPs) are ideally placed to provide health-promoting information opportunistically to women in midlife. The aim of this study was to explore PHCPs views about the menopause-related care needs of migrant women from low- and middle-income countries and what they perceive as barriers and enablers for providing this. Of the 139 PHCPs who responded to an anonymous online survey, less than one-third (29.9%) routinely offered menopause-related information during consultations with migrant women. Most agreed that short appointments times (70.8%), lack of culturally and linguistically appropriate menopause information (82.5%) and lack of confidence in providing menopause-related care (32.5%) are barriers for providing comprehensive menopause-related care to migrant women. To overcome these, a menopause-specific Medicare item number and a one-stop website with health information in community languages were suggested. These findings suggest that menopause-related care is not routinely offered by PHCPs to migrant women from low- and middle- income countries and that their capacity to do this may be improved with adequate educational and structural support.

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The relationship between primary healthcare providers and their external supervisors in Rwanda

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v9i1.1508 ◽

2017 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Michael Schriver ◽

Vincent K. Cubaka ◽

Laetitia Nyirazinyoye ◽

Sylvere Itangishaka ◽

Per Kallestrup

Keyword(s):

Primary Healthcare ◽

Healthcare Providers ◽

Relationship Building ◽

Performance Evaluations ◽

Supervisory Relationship ◽

Group Discussions ◽

Healthcare Facilities ◽

Performance Based Financing ◽

The Relationship ◽

Primary Healthcare Providers

Background: External supervision of Rwandan primary healthcare facilities unfolds as an interaction between supervisors and healthcare providers. Their relationship has not been thoroughly studied in Rwanda, and rarely in Africa.Aim: To explore perceived characteristics and effects of the relationship between providers in public primary healthcare facilities and their external supervisors in Rwanda.Setting: We conducted three focus group discussions with primary healthcare providers (n = 16), three with external supervisors (n = 15) and one mixed (n = 5).Methods: Focus groups were facilitated under low-moderator involvement. Findings were extracted thematically and discussed with participating and non-participating providers and supervisors.Results: While external supervision is intended as a source of motivation and professional development in addition to its managerial purpose, it appeared linked to excessive evaluation anxiety among Rwandan primary healthcare providers. Supervisors related this mainly to inescapable evaluations within performance-based financing, whereas providers additionally related it to communication problems.Conclusion: External supervision appeared driven by systematic performance evaluations, which may prompt a strongly asymmetric supervisory power relation and challenge intentions to explore providers’ experienced work problems. There is a risk that this may harm provider motivation, calling for careful attention to factors that influence the supervisory relationship. It is a dilemma that providers most in need of supervision to improve performance may be most unlikely to benefit from it. This study reveals a need for provider-oriented supportive supervision including constructive attention on providers who have performance difficulties, effective relationship building and communication, objective and diligent evaluation and two-way feedback channels.

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Childhood Cancer Early Detection Training Program for Primary Healthcare Providers

Journal of Global Oncology ◽

10.1200/jgo.18.12500 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 135s-135s ◽

Cited By ~ 1

Author(s):

B. Ntacyabukura

Keyword(s):

Early Detection ◽

Health Care Providers ◽

Primary Healthcare ◽

Healthcare Providers ◽

Signs And Symptoms ◽

Health Centers ◽

Childhood Cancers ◽

Care Providers ◽

Train The Trainer ◽

Primary Healthcare Providers

Background and context: Over 250,000 new pediatric cancer cases are diagnosed yearly worldwide. Health care providers (mainly nurses) at health centers (HC) level are the children´s first opportunity for correctly recognizing and responding to early signs and symptoms of childhood cancers by appropriately referring them to district hospitals but studies show that 83% of nurses did not receive training on pediatric cancers. Insufficient knowledge about the warning signs and symptoms of pediatric cancer usually leads to improper diagnosis or delay to diagnosis and hence loss of many lives of these children. After realizing that majority in our community lack information on childhood cancers, our efforts since 2017 has been concentrated on training primary healthcare providers to recognize early signs and symptoms of childhood cancers. Aim: Improve survival of children with cancer by early detection of symptoms and signs and prompt referral by nurses at health centers. Strategy/Tactics: The program is consisted of trainings in selected regions of Rwanda. The first step is a “train the trainer workshop” where volunteering medical students and doctors are trained to train the nurses and community health workers. A two days workshop is organized subsequently in each province bringing together at least with one nurse from each selected health center. These trained nurses go back with materials to train their colleagues. They are followed up every three months with a survey to assess how much they retain the learned knowledge and the impact made. Prior to trainings, RCCR and pediatric oncologists develop training materials that include training curriculum for both the trainers and for the trainees (nurses), educational and awareness material (posters, fliers, brochures). Trained nurses are kept in RCCR database for their follow-up and track any case of a childhood cancer at their health facilities. Program/Policy process: The program is run in 4 phases, Phase 1: Develop training materials materials Phase 2: Recruitment and train the trainer phase Phase 3: Selection of health center and recruitment of healthcare providers Phase 4: The execution phase. Trainings are carried out in selected health centers. Phase 5: Post training follow-up. Outcomes: In 2017, the program was conducted in 4 health centers and around 90 health care providers were trained with more than 800 posters, 950 brochures and 300 flyers distributed. According to reports, after the training, the number of referrals from health centers increased and the posttraining showed how accurate nurses were in stating their differential diagnoses. What was learned: Childhood cancers are curable when detected and treated early, there is a need to build strong partnerships with private and public sectors to address the challenge of early detection and late presentation at the hospital because the program of training primary healthcare providers showed a good impact.

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“We Had to Keep Pushing”: Caregivers' Perspectives on Autism Screening and Referral Practices of Black Children in Primary Care

Intellectual and Developmental Disabilities ◽

10.1352/1934-9556-56.5.321 ◽

2018 ◽

Vol 56 (5) ◽

pp. 321-336 ◽

Cited By ~ 5

Author(s):

Sarah Dababnah ◽

Wendy E. Shaia ◽

Karen Campion ◽

Helen M. Nichols

Keyword(s):

Primary Care ◽

Primary Healthcare ◽

Racial Bias ◽

Healthcare Providers ◽

Black Children ◽

Autism Spectrum ◽

Theory Approach ◽

Early Intervention Services ◽

Primary Healthcare Providers

Abstract Black children with autism spectrum disorder (ASD) are diagnosed later than their White peers, are more likely to be misdiagnosed, and are less likely to receive early intervention services or a developmental evaluation by three years old. Using a grounded theory approach, we solicited the perspectives of parents and other primary caregivers of Black children with ASD on barriers and facilitators to ASD screening and referrals in primary care. A socioeconomically diverse sample of 22 female caregivers participated. Four themes emerged. First, while some caregivers noted their child's primary healthcare providers facilitated a timely ASD diagnosis, other participants reported these providers ignored early concerns about child developmental delays. Second, many participants felt racial bias negatively impacted caregiver-primary healthcare provider interactions. Third, legal/custodial issues slowed caregivers' abilities to follow up on referrals from their primary healthcare providers. Finally, caregivers described denial, shame, and stigma relating to ASD in the Black community as possible factors for delayed follow up to referrals. Differences based on socioeconomic status are discussed. Efforts to improve family-centered, culturally relevant care for all Black caregivers raising children with or at-risk for ASD are needed, particularly for those families experiencing the multiple effects of poverty.

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Influencers on deprescribing practice of primary healthcare providers in Nova Scotia: An examination using behavior change frameworks

Medicine Access Point of Care ◽

10.1177/2399202620922507 ◽

2020 ◽

Vol 4 ◽

pp. 239920262092250

Author(s):

Natalie Kennie-Kaulbach ◽

Rachel Cormier ◽

Olga Kits ◽

Emily Reeve ◽

Anne Marie Whelan ◽

...

Keyword(s):

Primary Care ◽

Nova Scotia ◽

Behavior Change ◽

Primary Healthcare ◽

Healthcare Providers ◽

Primary Care Providers ◽

System Level ◽

Care Providers ◽

Behavior Change Wheel ◽

Primary Healthcare Providers

Background: Deprescribing is a complex process requiring consideration of behavior change theory to improve implementation and uptake. Aim: The aim of this study was to describe the knowledge, attitudes, beliefs, and behaviors that influence deprescribing for primary healthcare providers (family physicians, nurse practitioners (NPs), and pharmacists) within Nova Scotia using the Theoretical Domains Framework version 2 (TDF(v2)) and the Behavior Change Wheel. Methods: Interviews and focus groups were completed with primary care providers (physicians, NPs, and pharmacists) in Nova Scotia, Canada. Coding was completed using the TDF(v2) to identify the key influencers. Subdomain themes were also identified for the main TDF(v2) domains and results were then linked to the Behavior Change Wheel—Capability, Opportunity, and Motivation components. Results: Participants identified key influencers for deprescribing including areas related to Opportunity, within TDF(v2) domain Social Influences, such as patients and other healthcare providers, as well as Physical barriers (TDF(v2) domain Environmental Context and Resources), such as lack of time and reimbursement. Conclusion: Our results suggest that a systematic approach to deprescribing in primary care should be supported by opportunities for patient and healthcare provider collaborations, as well as practice and system level enhancements to support sustainability of deprescribing practices.

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