Implementation in Residential Youth Care: Providers’ Perspectives on Organizational Facilitators and Barriers

2021 ◽  
pp. 1-24
Author(s):  
Linda Vaskinn ◽  
Pamela M. Waaler ◽  
Anneli Mellblom ◽  
Cato A. Bjorkli ◽  
John Kjobli
Keyword(s):  
Youth Care ◽  
Care Providers ◽  
Residential Youth Care ◽  
Facilitators And Barriers

scholarly journals Implementation in Residential Youth Care: Providers Perspectives on Effective Leadership Behavior

2020 ◽  
pp. 1-23
Author(s):  
Linda Vaskinn ◽  
Anneli Mellblom ◽  
Pamela M. Waaler ◽  
Oda Skagseth ◽  
Cato Bjørkli ◽  
...  
Keyword(s):  
Effective Leadership ◽  
Leadership Behavior ◽  
Youth Care ◽  
Care Providers ◽  
Residential Youth Care

Facilitators and Barriers to Clinical Pathway Uptake and Utilization among Primary Care Providers in Saskatchewan – A Qualitative Study

2021 ◽  
Author(s):  
Gary Groot ◽  
Shaliny Ollegasagrem ◽  
Mahasti Khakpour ◽  
Adel Panahi ◽  
Donna Goodridge ◽  
...  
Keyword(s):  
Wound Care ◽  
Clinical Pathways ◽  
Complex Interventions ◽  
Family Physicians ◽  
Standardize Patient ◽  
Primary Care Providers ◽  
System Level ◽  
It Services ◽  
Care Providers ◽  
Facilitators And Barriers

Abstract Background: Clinical Pathways (CPWs) are multidisciplinary, evidence based, complex interventions designed to standardize patient care. In Saskatchewan, development, implementation, and evaluation of seven provincial CPWs (Hip & Knee, Spine, Pelvic Floor, Prostate Assessment, Fertility Care, Lower Extremity Wound Care, and Acute Stroke) present significant challenges, leading to lower uptake and utilization. This study aimed to identify facilitators and barriers to CPW uptake and utilization by Family Physicians in Saskatchewan. Methods: A qualitative interpretive approach was used consisting of eight one-on-one key informant (KI) interviews and five focus groups (FG) in identifying the facilitators and barriers to CPWs. KIs had been involved in the design and implementation of CPWs. FGs were held with 30 Family Physicians in two urban and two rural Saskatchewan cities. All interviews were audio recorded and transcribed. Inductive, thematic analysis of the interviews based on the Theoretical Domain Framework (TDF) for behavioral changes was used to identify facilitators and barriers to CPW uptake and utilization by Family Physicians.Results: KI interviews informed the FG interview guide. From 5 FG discussions, 51 themes emerged and were mapped under 14 TDF domains. Family Physicians notably emphasized the barriers for utilizing CPWs. Major barriers were: system-level (knowledge & communication, social/professional identity, Family Physician engagement and education); objective clarification (goals, belief about consequences of implementing CPW) and technical and resource related (administrative, access to local specialists, enforcement and incentives). The most prominent barrier was lack of systematic CPW promotion and inconsistencies in communication between: organization to practitioner; organization to organization; and practitioner to practitioner. Facilitators were recognized to mitigate barriers and ranged from need for optimized and integrated IT services (i.e. Electronic Medical Records), to optimism towards CPW usage and patient outcomes. Conclusions: Informed by data from KIs and FGs, this exploratory study identified specific improvements required to promote uptake of CPWs based on perceived facilitators and barriers. Recommendations are provided to enhance uptake among FPs. These initial findings will inform the creation of a theory-based, province -wide survey instrument to further evaluate CPWs.

scholarly journals Perceptions, Facilitators And Barriers of Physical Activity Among People Living With HIV: A Qualitative Study

2021 ◽  
Author(s):  
Brenda Kitilya ◽  
Erica Sanga ◽  
George PrayGod ◽  
Robert Peck ◽  
Bazil B Kavishe ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care Providers ◽  
Gender Stereotypes ◽  
Ecological Model ◽  
People Living With Hiv ◽  
Activity Levels ◽  
Care Providers ◽  
Middle Income ◽  
Facilitators And Barriers ◽  
Living With Hiv

Abstract BackgroundPeople Living with HIV (PLWH) have low levels of physical activity. Understanding of perceptions, facilitators and barriers of physical activity in this population is of importance for future perspectives in developing contextual based intervention to improve physical activity in PLWH. MethodThis study explored perceptions, facilitators and barriers of physical activity in PLWH using sixteen in-depth interviews and three focus group discussions conducted in Mwanza, Tanzania. The interviews and discussions were audio recorded, transcribed and translated into English. Transcripts were coded and analysed deductively using thematic content analysis. The themes were interpreted and presented using the social ecological model. ResultsForty-three PLWH age 23-61 years old participated in this study. The findings showed that, PLWH perceived physical activity was beneficial to their health and that their perceptions and practices were rooted within the existing gender stereotypes and roles in the community. In addition to that, house-chores and income generating activities were perceived as sufficient physical activity to achieve adequate levels of physical activity. As facilitators, social support and interactions from family and friends were appraised positively as motivating factors of physical activity in this population. Indeed, at individual to community/environmental levels, PLWH reported barriers of physical activity were lack of time, money, and availability of facilities, as well as lack of social groups participating in physical activity in the communities and inadequate information on physical activity from health care providers at ART clinics. HIV disease was not reported as a main barrier of physical activity but rather stipulated from family members as a reason not to support physical activity in PLWH. ConclusionThe findings demonstrated differing perceptions, facilitators and barriers of physical activity among PLWH. Interventions addressing physical activity awareness, gender stereotypes and roles relating to physical activity performances from individual to community level, building supportive environment and infrastructures are needed to elevate physical activity levels in PLWH particularly in low and -middle income countries.

Strategies and Challenges: Qualitative Lessons Learned From Georgia Produce Prescription Programs

2021 ◽  
pp. 152483992110285
Author(s):  
Taylor Newman ◽  
Jung Sun Lee
Keyword(s):  
Nutrition Education ◽  
Health Care Providers ◽  
Lessons Learned ◽  
Comparative Case Study ◽  
Care Providers ◽  
Farmers Market ◽  
Study Approach ◽  
Field Notes ◽  
Facilitators And Barriers ◽  
Nutrition Educators

Produce prescription programs (PPPs) have grown in numbers in the past decade, empowering health care providers to promote health by issuing subsidies for produce to vulnerable patients. However, little research has been conducted on the facilitators that make it easier for PPPs to succeed or the barriers that programs face, which could provide guidance on how to improve future PPP design and implementation. The study sought to identify the facilitators and barriers affecting positive outcomes in Georgia PPPs called Fruit and Vegetable Prescription (FVRx) Programs. A process evaluation with a qualitative comparative case study approach was conducted. Fifteen FVRx providers, ranging from nutrition educators to farmers market managers, were interviewed in a focus group interview or on the phone between 2016 and 2017. Two nutrition education classes and an FVRx best practices meeting were observed, and program documents were collected. Interview transcripts, field notes from observations, and documents were then thematically analyzed. Four overall themes were determined regarding facilitators and barriers experienced by FVRx programs: (1) creating accessible programming may encourage FVRx participation, (2) provider dedication to the program is important, (3) participants’ challenging life circumstances can make participation difficult, and (4) the sustainability of the program is a concern. The findings of this study suggest helpful strategies and challenges for providers to consider when developing and implementing PPPs in Georgia and beyond. Research on the long-term program impact is needed, and policy options for sustainable, scaling up of PPPs should be explored.

scholarly journals Pharmacists’ Perceptions on Their Role, Activities, Facilitators, and Barriers to Practicing in a Post-Intensive Care Recovery Clinic

2019 ◽  
Vol 55 (2) ◽  
pp. 119-125
Author(s):  
Antoinette B. Coe ◽  
Rebecca E. Bookstaver ◽  
Andrew C. Fritschle ◽  
Michael T. Kenes ◽  
Pamela MacTavish ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Direct Patient Care ◽  
Care Providers ◽  
Medication Regimen ◽  
Medication Reviews ◽  
Facilitators And Barriers

Background: Complex medication regimen changes burden intensive care unit (ICU) survivors and their caregivers during the transition to home. Intensive care unit recovery clinics are a prime setting for pharmacists to address patients’ and their caregivers’ medication-related needs. The purpose of this study was to describe ICU recovery clinic pharmacists’ activities, roles, and perceived barriers and facilitators to practicing in ICU recovery clinics across different institutions. Methods: An expert panel of ICU recovery clinic pharmacists completed a 15-item survey. Survey items addressed the pharmacists’ years in practice, education and training, activities performed, their perceptions of facilitators and barriers to practicing in an ICU recovery clinic setting, and general ICU recovery clinic characteristics. Descriptive statistics were used. Results: Nine ICU recovery clinic pharmacists participated. The average number of years in practice was 16.5 years (SD = 13.5, range = 2-38). All pharmacists practiced in an interprofessional ICU recovery clinic affiliated with an academic medical center. Seven (78%) pharmacists always performed medication reconciliation and a comprehensive medication review in each patient visit. Need for medication education was the most prevalent item found in patient comprehensive medication reviews. The main facilitators for pharmacists’ successful participation in an ICU recovery clinic were incorporation into clinic workflow, support from other health care providers, and adequate space to see patients. The ICU recovery clinic pharmacists perceived the top barriers to be lack of dedicated time and inadequate billing for services. Conclusions: The ICU recovery clinic pharmacists address ICU survivors’ medication needs by providing direct patient care in the clinic. Strategies to mitigate pharmacists’ barriers to practicing in ICU recovery clinics, such as lack of dedicated time and adequate billing for pharmacist services, warrant a multifaceted solution, potentially including advocacy and policy work by national pharmacy professional organizations.

Facilitators and barriers to utilization of medications for opioid use disorder in primary care in South Carolina

2020 ◽  
Vol 56 (1) ◽  
pp. 14-39
Author(s):  
Sarah M Oros ◽  
Lillian M Christon ◽  
Kelly S Barth ◽  
Carole R Berini ◽  
Bennie L Padgett ◽  
...  
Keyword(s):  
Primary Care ◽  
South Carolina ◽  
Focus Group ◽  
Primary Care Providers ◽  
Opioid Use Disorder ◽  
Care Providers ◽  
Opioid Use ◽  
Focus Group Interviews ◽  
Facilitators And Barriers ◽  
Group Interviews

Objective Utilization of medications for opioid use disorder (MOUD) has not been widely adopted by primary care providers. This study sought to identify interprofessional barriers and facilitators for use of MOUD (specifically naltrexone and buprenorphine) among current and future primary care providers in a southeastern academic center in South Carolina. Method Faculty, residents, and students within family medicine, internal medicine, and a physician assistant program participated in focus group interviews, and completed a brief survey. Survey data were analyzed quantitatively, and focus group transcripts were analyzed using a deductive qualitative content analysis, based upon the theory of planned behavior. Results Seven groups ( N = 46) completed focus group interviews and surveys. Survey results indicated that general attitudes towards MOUD were positive and did not differ significantly among groups. Subjective norms around prescribing and controllability (i.e., beliefs about whether prescribing was up to them) differed between specialties and between level of training groups. Focus group themes highlighted attitudes about MOUD (e.g., “opens the flood gates” to patients with addiction) and perceived facilitators and barriers of using MOUD in primary care settings. Participants felt that although MOUD in primary care would improve access and reduce stigma for patients, prescribing requires improved provider education and an integrated system of care. Conclusions The results of this study provide an argument for tailoring education to specifically address the barriers primary care prescribers perceive. Results promote the utilization of active, hands-on learning approaches, to ultimately promote uptake of MOUD prescribing in the primary care setting in South Carolina.

scholarly journals Barriers, access and management of paediatric epilepsy with telehealth

2020 ◽  
pp. 1357633X2096953
Author(s):  
Kari Gali ◽  
Sucheta Joshi ◽  
Sarah Hueneke ◽  
Alexis Katzenbach ◽  
Linda Radecki ◽  
...  
Keyword(s):  
Primary Care Providers ◽  
Multidisciplinary Teams ◽  
Care Providers ◽  
Test Analysis ◽  
American Academy Of Pediatrics ◽  
Institutional Infrastructure ◽  
Facilitators And Barriers ◽  
Paediatric Epilepsy ◽  
Significant Opportunity ◽  
Out Of Pocket Costs

Access to paediatric neurology care is complex, resulting in significant wait times and negative patient outcomes. The goal of the American Academy of Pediatrics National Coordinating Center for Epilepsy's project, Access Improvement and Management of Epilepsy with Telehealth (AIM-ET), was to identify access and management challenges in the deployment of telehealth technology. AIM-ET organised four paediatric neurology teams to partner with primary-care providers (PCP) and their multidisciplinary teams. Telehealth visits were conducted for paediatric epilepsy patients. A post-visit survey assessed access and satisfaction with the telehealth visit compared to an in-person visit. Pre/post surveys completed by PCPs and neurologists captured telehealth visit feasibility, functionality and provider satisfaction. A provider focus group assessed facilitators and barriers to telehealth. Sixty-one unique patients completed 75 telehealth visits. Paired t-test analysis demonstrated that telehealth enhanced access to epilepsy care. It reduced self-reported out-of-pocket costs ( p<0.001), missed school hours ( p<0.001) and missed work hours ( p<0.001), with 94% equal parent/caregiver satisfaction. Focus groups indicated developing and maintaining partnerships, institutional infrastructure and education as facilitators and barriers to telehealth. Telehealth shortened travelling distance, reduced expenses and time missed from school and work. Further, it provides significant opportunity in an era when coronavirus disease 2019 limits in-person clinics.

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