scholarly journals Critical reflection for researcher–community partnership effectiveness: the He Pikinga Waiora process evaluation tool guiding the implementation of chronic condition interventions in Indigenous communities

2019 ◽  
Vol 25 (5) ◽  
pp. 478 ◽  
Author(s):  
Moana Rarere ◽  
John Oetzel ◽  
Bridgette Masters-Awatere ◽  
Nina Scott ◽  
Ray Wihapi ◽  
...  

Critically reflecting on researcher–community partnerships is a key component in implementing chronic condition interventions in Indigenous communities. This paper draws on the results and learnings from a process evaluation that measures how well two research–community partnerships have followed the He Pikinga Waiora (HPW) Implementation Framework while co-designing chronic condition interventions in primary care. The HPW framework is centred on Indigenous self-determination and knowledge surrounded by community engagement, cultural centredness, systems thinking and integrated knowledge translation. The evaluation included in-depth interviews and online surveys with 10 team members. The findings demonstrate that the HPW framework was followed well, with strengths particularly in community engagement and relationship building. Areas for improvement included systems thinking and integrated knowledge translation to support sustainability of the interventions. The need for partnerships to use process evaluation results to support critical reflection is asserted, which helps build strong trust and synergy, power sharing and effective and sustainable implementation practices. It is concluded that the HPW framework is well suited to evaluating implementation of health interventions in primary care as it assists in the facilitation of better collaboration between researchers and Indigenous communities, and encourages the implementation team to reflect on power and privilege.

2019 ◽  
Vol 19 (4) ◽  
pp. 448
Author(s):  
Moana Rarere ◽  
John Oetzel ◽  
Bridgette Masters-Awatere ◽  
Nina Scott ◽  
Ray Wihapi ◽  
...  

2021 ◽  
Author(s):  
Selena Davis ◽  
Marcy Antonio ◽  
Mindy Smith ◽  
Paul Burgener ◽  
Danielle C. Lavallee ◽  
...  

BACKGROUND Patient-centred measurement (PCM) aims to improve overall quality of care through the collection and sharing of patients’ values and perspectives. Yet, the use of PCM in care team decisions remains limited. Integrated knowledge translation (IKT) offers a collaborative, adaptive approach to explore best practices for incorporating PCM into primary care practices by involving knowledge users, including patients and providers, in the exploratory process. OBJECTIVE (i) test the feasibility of using patient-generated data (PGD) in team-based care; (ii) describe use of these data for team-based mental health care; and (iii) summarize patient and provider care experiences with PCM. METHODS We conducted a multi-methods exploratory study in a rural team-based primary care clinic using IKT to co-design, implement and evaluate use of PCM in team-based mental health care. Care pathways, workflows, and quality improvement activities were iteratively adjusted to improve integration efforts. Patient and provider experiences were evaluated using individual interviews relating use of PCM and patient portal in practice. All meeting notes, interview summaries, and emails were analyzed to create a narrative evaluation. RESULTS During co-design, a care workflow was developed for incorporating electronically-collected PGD from the patient portal into the electronic medical record (EMR), and customized educational tools and resources were added. During implementation, care pathways and patient workflows for PCM were developed. Patients found portal use easy, educational, and validating, but data entries were not used during care visits. Providers saw the portal as extra work and lack of portal/EMR integration was a major barrier. The IKT approach was invaluable for addressing workflow changes and understanding ongoing barriers to PCM use and quality improvement. CONCLUSIONS Although the culture towards PCM is changing, use of PCM during care was not successful. Patients felt validated and supported through portal use and could be empowered to bring these data to their visits. Training, modeling, and adaptable PCM methods are needed before PCM can be integrated into routine care.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Eva Seckler ◽  
Verena Regauer ◽  
Melanie Krüger ◽  
Anna Gabriel ◽  
Joachim Hermsdörfer ◽  
...  

Abstract Background Community-dwelling older people are frequently affected by vertigo, dizziness and balance disorders (VDB). We previously developed a care pathway (CPW) to improve their mobility and participation by offering standardized approaches for general practitioners (GPs) and physical therapists (PTs). We aimed to assess the feasibility of the intervention, its implementation strategy and the study procedures in preparation for the subsequent main trial. Methods This 12-week prospective cohort feasibility study was accompanied by a process evaluation designed according to the UK Medical Research Council’s Guidance for developing and evaluating complex interventions. Patients with VDB (≥65 years), GPs and PTs in primary care were included. The intervention consisted of a diagnostic screening checklist for GPs and a guide for PTs. The implementation strategy included specific educational trainings and a telephone helpline. Data for mixed-method process evaluation were collected via standardized questionnaires, field notes and qualitative interviews. Quantitative data were analysed using descriptive statistics, qualitative data using content analysis. Results A total of five GP practices (seven single GPs), 10 PT practices and 22 patients were included in the study. The recruitment of GPs and patients was challenging (response rates: GP practices: 28%, PT practices: 39%). Ninety-one percent of the patients and all health professionals completed the study. The health professionals responded well to the educational trainings; the utilization of the telephone helpline was low (one call each from GPs and PTs). Familiarisation with the routine of application of the intervention and positive attitudes were emphasized as facilitators of the implementation of the intervention, whereas a lack of time was mentioned as a barrier. Despite difficulties in the GPs’ adherence to the intervention protocol, the GPs, PTs and patients saw benefit in the intervention. The patients’ treatment adherence to physical therapy was good. There were minor issues in data collection, but no unintended consequences. Conclusion Although the process evaluation provided good support for the feasibility of study procedures, the intervention and its implementation strategy, we identified a need for improvement in recruitment of participants, the GP intervention part and the data collection procedures. The findings will inform the main trial to test the interventions effectiveness in a cluster RCT. Trial registration Projektdatenbank Versorgungsforschung Deutschland (German registry Health Services Research) VfD_MobilE-PHY_17_003910, date of registration: 30.11.2017; Deutsches Register Klinischer Studien (German Clinical Trials Register) DRKS00022918, date of registration: 03.09.2020 (retrospectively registered).


2011 ◽  
Vol 15 (1) ◽  
pp. 34-56 ◽  
Author(s):  
Sheila T. Moodie ◽  
Marlene P. Bagatto ◽  
Linda T. Miller ◽  
Anita Kothari ◽  
Richard Seewald ◽  
...  

IFLA Journal ◽  
2017 ◽  
Vol 43 (3) ◽  
pp. 288-301 ◽  
Author(s):  
Fiona Blackburn

Two examples of community engagement in Australian public libraries, drawn from the author’s experience, are analysed using Sung and Hepworth’s (2013) community engagement model for public libraries and Overall’s (2009) definition of cultural competence in a library and information science framework. The examples are examined for the community engagement characteristics identified by Sung and Hepworth; each is also considered for cultural competence, using the domains which Overall posits are the sites where this competence occurs or is developed. A virtuous circle of community engagement is extrapolated from the second example. ‘Hierarchical equivalence’ between organizations, a group’s proportional presence in a population and the nature of each group’s aims, are suggested as further factors in sustainable community engagement. That culture is an asset on which communities draw to engage with libraries and the broader community, and that communities will respond to engagement approaches if they offer the possibility of meeting community aspirations, is evident in both examples.


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