scholarly journals Building Implementation Science in Nutrition

2020 ◽  
Vol 11 (5) ◽  
pp. 1392-1398
Author(s):  
Andrea M Warren ◽  
Edward A Frongillo ◽  
Rahul Rawat
Keyword(s):  
Experiential Learning ◽  
Implementation Science ◽  
Expert Knowledge ◽  
Ways Of Knowing ◽  
Population Level ◽  
Target Population ◽  
Learning Needs ◽  
Policies And Programs ◽  
Object Of Study ◽  
Oriented Research

ABSTRACT The field of nutrition has been investing in the development of many nutrition-specific and -sensitive policies and programs aimed at improving population-level malnutrition in all its forms. When there is a need to learn about a new system, programmatic context, or target population to understand how to effectively deploy an intervention to help improve nutrition, it is important to be able to ask a broad range of questions, both in topic and in scope. Our aim is to provide a simple and conceptually clear definition and principles to elaborate the science of implementation for nutrition to distinguish it from other ways of knowing and learning and to serve as a guide to the articulation of implementation science questions and methods. Implementation science is a body of systematized knowledge about how to improve implementation that 1) is distinguished by its aims to learn about the process of implementation, 2) uses methods that derive from and fit with the aims, and 3) is built with tacit (as well as expert) knowledge and experiential learning. Implementation science aims to generate the learning needed to improve implementation through facilitating collaboration among stakeholders to articulate and pursue the aims; capturing and using tacit knowledge and experiential learning from stakeholders, systems, providers, and recipients; and applying a mix of methods suited to the aims. This elaboration of the science provides a simple way to help those who already do, or want to do, implementation science understand and communicate how this science is unique and the value that it adds to the current landscape of nutrition priorities, innovations, and the attendant complex learning needs that follow. Implementation science encompasses both discovery- and mission-oriented research, and centers implementation as the object of study for the purposes of broad-based learning.

scholarly journals Developing a Dementia Care Training Curriculum for Registered Dietitians

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 443-444
Author(s):  
Joy Douglas ◽  
Christine Ferguson ◽  
Beth Nolan
Keyword(s):  
Experiential Learning ◽  
Healthcare Providers ◽  
Dementia Care ◽  
Learning Needs ◽  
Training Curriculum ◽  
Registered Dietitians ◽  
Development Team ◽  
Average Percentage ◽  
Before And After ◽  
Care Training

Abstract Research supports the need for healthcare providers who are trained in providing care to older adults with dementia. However, few training options exist for Registered Dietitians (RDs) seeking dementia care training that is specific to nutrition. The purpose of this project was to adapt an existing dementia care training curriculum to meet the learning needs of RDs. The development team included two experts in dementia training and two RDs with expertise in gerontological nutrition. The new training module was based on the existing Positive Approach to Care™ (PAC) curriculum, which incorporates Kolb’s Experiential Learning Theory and the Adult Experiential Learning Cycle. The development team first identified learning objectives for content that would be relevant to RDs who work with persons living with dementia, and modified components of the existing PAC curriculum to meet these objectives. After a preliminary pilot, the 2-hour program was presented to 20 RDs using a combination of lecture presentation, experiential learning, and skill-building techniques. Participants were provided written materials to reinforce the concepts presented. Participants answered five dementia-specific questions before and after the training, and overall, the average percentage of correct answers improved following the training. Two weeks following the training, participants completed an open-ended survey to provide feedback on the training. Participants responded favorably to the mixed learning formats in the training. When asked to rank their preferred learning methods, participants indicated lecture-based learning and experiential learning as their top preferred methods. These findings indicate that the adapted curriculum may improve dementia knowledge among RDs.

scholarly journals Reducing youth suicide: systems modelling and simulation to guide targeted investments across the determinants

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jo-An Occhipinti ◽  
Adam Skinner ◽  
Frank Iorfino ◽  
Kenny Lawson ◽  
Julie Sturgess ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Suicide Attempts ◽  
Expert Knowledge ◽  
Population Level ◽  
Modelling And Simulation ◽  
Decision Makers ◽  
Public Health Issue ◽  
Coordinated Care ◽  
Systems Modelling

Abstract Background Reducing suicidal behaviour (SB) is a critical public health issue globally. The complex interplay of social determinants, service system factors, population demographics, and behavioural dynamics makes it extraordinarily difficult for decision makers to determine the nature and balance of investments required to have the greatest impacts on SB. Real-world experimentation to establish the optimal targeting, timing, scale, frequency, and intensity of investments required across the determinants is unfeasible. Therefore, this study harnesses systems modelling and simulation to guide population-level decision making that represent best strategic allocation of limited resources. Methods Using a participatory approach, and informed by a range of national, state, and local datasets, a system dynamics model was developed, tested, and validated for a regional population catchment. The model incorporated defined pathways from social determinants of mental health to psychological distress, mental health care, and SB. Intervention scenarios were investigated to forecast their impact on SB over a 20-year period. Results A combination of social connectedness programs, technology-enabled coordinated care, post-attempt assertive aftercare, reductions in childhood adversity, and increasing youth employment projected the greatest impacts on SB, particularly in a youth population, reducing self-harm hospitalisations (suicide attempts) by 28.5% (95% interval 26.3–30.8%) and suicide deaths by 29.3% (95% interval 27.1–31.5%). Introducing additional interventions beyond the best performing suite of interventions produced only marginal improvement in population level impacts, highlighting that ‘more is not necessarily better.’ Conclusion Results indicate that targeted investments in addressing the social determinants and in mental health services provides the best opportunity to reduce SB and suicide. Systems modelling and simulation offers a robust approach to leveraging best available research, data, and expert knowledge in a way that helps decision makers respond to the unique characteristics and drivers of SB in their catchments and more effectively focus limited health resources.

scholarly journals If You Make it Free, Will They Come? Using a Physical Activity Accessibility Model to Understand the Use of a Free Children’s Recreation Pass

2019 ◽  
Vol 16 (7) ◽  
pp. 493-503 ◽  
Author(s):  
Andrew F. Clark ◽  
Joannah Campbell ◽  
Patricia Tucker ◽  
Piotr Wilk ◽  
Jason A. Gilliland
Keyword(s):  
Physical Activity ◽  
Urban Areas ◽  
Population Level ◽  
Target Population ◽  
Activity Levels ◽  
Physical Activity Interventions ◽  
Grade 5 ◽  
Longitudinal Data Collection ◽  
The Relationship

Background: Children’s sedentary lifestyles and low physical activity levels may be countered using population-level interventions. This study examines factors influencing the use of a free community-wide physical activity access pass for grade 5 students (G5AP). Methods: A natural experiment with longitudinal data collection. A sample of 881 children completed the 9-month follow-up survey self-reporting where they used the G5AP. Two analyses were conducted: Getis-Ord GI* geographic cluster analysis of the spatial distribution of users, and logistic regression examining the relationship between use and accessibility (informational, economic, and geographic) and mobility options, while accounting for intrapersonal and interpersonal factors. Results: Overall, 44.9% of children used the G5AP with clusters of high use in urban areas and low use in the suburbs. Other factors significantly related to G5AP included gender (girls), informational accessibility (active recruitment), economic accessibility (median household income), geographic accessibility (facilities within 1.6 km of home), and mobility options (access to Boys & Girls Club bus). Conclusions: This study found that a diverse population of children used the G5AP. To continue being successful, community-based physical activity interventions need to ensure that the intervention increases geographic, economic, and informational accessibility and provides mobility options that are available to the target population.

scholarly journals Differential Impacts of Caries Classification in Children and Adults: A Comparison of ICDAS and DMF-T

2016 ◽  
Vol 27 (6) ◽  
pp. 761-766 ◽  
Author(s):  
Rosa Ana Melgar ◽  
Joanna Tatith Pereira ◽  
Patrícia Blaya Luz ◽  
Fernando Neves Hugo ◽  
Fernando Borba de Araujo
Keyword(s):  
Pediatric Population ◽  
Clinical Care ◽  
Population Level ◽  
Target Population ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Epidemiological Surveys ◽  
Dmft Index ◽  
Cavitated Lesions

Abstract The aim of this study was to describe and compare findings regarding the prevalence and severity of dental caries when using ICDAS and DMFT/dmft in an epidemiological study with children and their mothers. This cross-sectional study evaluated 150 preschoolers and their mothers. Data were collected with ICDAS and then transformed into DMFT/dmft. ICDAS scores related to caries were analyzed according to three different cut-off-points: CP1 (0-healthy/1-6-caries), CP2 (0-1-healthy/2-6-caries) and CP3 (0-2-healthy/3-6-caries), representing the D/d of DMFT/dmft. ICDAS codes regarding restorations, except sealants, were considered the F/f and the code 97 as the M/m of DMFT/dmft index. Prevalence of caries and its severity with ICDAS were 92%, 84% and 31.3% in children and 97.3%, 96.6% and 80% in adults according to CP1/CP2/CP3, respectively. Admitting CP3 as the standard for data transformation of ICDAS in DMFT/dmft, it was observed that DMFT/dmft index would underestimate 60% of non-cavitated lesions in children and 16.6% in adults. The DMFT/dmft underestimated the presence of disease to disregard non-cavitated lesions for the pediatric population evaluated. The choice of which is the best index for epidemiological surveys will depend on the purpose of the research and the target population: if it is to estimate the needs of the population to determine clinical care in children and adults, the DMFT/dmft may be sufficient. However, if the objective is to have a more comprehensive diagnosis of caries at the population level in order to develop preventive strategies, to halt and reverse the disease, the detection of non-cavitated-lesions becomes important, mainly in young children.

scholarly journals Learning Needs Assessment for Multi-stakeholder Implementation Science Training in LMIC Settings: Findings and Recommendations

2021 ◽  
Author(s):  
Mallory Wolfe Turner ◽  
Stephanie Bogdewic ◽  
Erum Agha ◽  
Carrie Blanchard ◽  
Rachel Sturke ◽  
...  
Keyword(s):  
Implementation Science ◽  
Sampling Strategy ◽  
Structured Interview ◽  
Learning Needs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Novel Approach ◽  
Research Findings ◽  
Multi Stakeholder ◽  
Context Specific

Abstract Background: Despite significant progress in the field of implementation science (IS), current training programs are inadequate to meet the global need, especially in low-and middle-income countries (LMICs). Even when training opportunities exist, there is a “knowledge-practice gap,” where implementation research findings are not useful to practitioners in a field designed to bridge that gap. This is a critical challenge in LMICs where complex public health issues must be addressed. This paper describes results from a formal assessment of learning needs, priority topics, and delivery methods for LMIC stakeholders.Methods: We first reviewed a sample of articles published recently in Implementation Science to identify IS stakeholders and assigned labels and definitions for groups with similar roles. We then employed a multi-step sampling approach and a random sampling strategy to recruit participants (n=39) for a semi-structured interview that lasted 30-60 minutes. Stakeholders with inputs critical to developing training curricula were prioritized and selected for interviews. We created memos from audio recorded interviews and used a deductively created codebook to conduct thematic analysis. We calculated kappa coefficients for each memo and used validation techniques to establish rigor including incorporating feedback from reviewers and member checking.Results: Participants included program managers, researchers, and physicians working in over 20 countries, primarily LMICs. The majority had over ten years of implementation experience but fewer than five years of IS experience. Three main themes emerged from the data, pertaining to past experience with IS, future IS training needs, and contextual issues. Most respondents (even with formal training) described their IS knowledge as basic or minimal. Preferences for future training were heterogeneous, but findings suggest that curricula must encompass a broader set of competencies than just IS, include mentorship/apprenticeship, and center the LMIC context.Conclusion: This work is the first to explicitly explore and highlight the need for fundamental, widespread, and context specific training in IS and capacity building in basic operational research for key stakeholders in LMICs. Therefore, we propose the novel approach of intelligent swarming as a solution to help build IS capacity in LMICs through the lens of sustainability and equity.

scholarly journals Prevalence of Smokeless Tobacco Use in India and Its Association With Occupations: A LASI Study

2021 ◽  
Author(s):  
Bhavna Bharati ◽  
Kirti Sundar Sahu ◽  
Sanghamitra Pati
Keyword(s):  
Data Analysis ◽  
Smokeless Tobacco ◽  
Tobacco Cessation ◽  
Population Level ◽  
Target Population ◽  
Descriptive Statistics ◽  
Ageing Study ◽  
Weighted Data ◽  
Socio Demographic Factors ◽  
Associated Variables

More than two-thirds of death in developing countries are due to non-communicable diseases (NCDs), and tobacco is a leading risk factor. Among different socio-demographic factors, occupation and its corelates have impact on use of smokeless tobacco (SLT) and the evidence in India is limited. The objectives of this study are to find out the overall preva-lence of SLT use and its pattern of association with various occupation and associated variables. Methods: This study used data from Longitudinal Ageing Study in India (LASI) wave 1. Current and ever users of SLT are taken into consideration as target population. For the data analysis, survey-weighted tools have been applied for descriptive statistics and multivariable logistic re-gression model. The weighted data analysis has been done using R. Results and Discussion: From the sample size of 65561, 38% have ever used either smoking or SLT, of them, 40 % use to-bacco in smoke form, 51 % use SLT and 9 % take both. At the population level, 22.8% and 20.4% are ever and current users of SLT respectively. Type, place, and workload in the occupation found to be significantly associated with SLT use. Workplace tobacco-cessation-policy for infor-mal-workers is required to manage this issue.

Disorientation as a Learning Objective: Applying Transformational Learning Theory in Participatory Action Pedagogy

2020 ◽  
pp. 0739456X2095638
Author(s):  
Barbara Brown Wilson
Keyword(s):  
Learning Theory ◽  
Transformational Learning ◽  
Ways Of Knowing ◽  
Learning Needs ◽  
Ethical Challenges ◽  
Participatory Action ◽  
Land Use Patterns ◽  
Use Patterns ◽  
Transformational Learning Theory ◽  
Challenges And Opportunities

As the field of planning stretches toward redressing the injustices of past land use patterns through reparative practices, student learning needs to include socio-emotional, as well as technical and intellectual, skill-building. Pedagogy should increase the planner’s ability to recognize systems of oppression and center lived expertise in decision-making processes. Transformational learning theory considers the mechanisms through which place-based learning expands student worldviews through exposure to other ways of knowing. Reflecting on a participatory action course through the analytical lens of transformational learning theory, this paper considers the pedagogical and ethical challenges and opportunities for planning education through collaborative action.

scholarly journals Social Impact Assessment of HealthyAIR Tool for Real-Time Detection of Pollution Risk

2020 ◽  
Vol 12 (23) ◽  
pp. 9856
Author(s):  
Antonia Moreno Cano ◽  
Rafael Romón Sagredo ◽  
Rocío García-Carrión ◽  
Begonya Garcia-Zapirain
Keyword(s):  
Social Impact ◽  
Real Life ◽  
Target Population ◽  
End Users ◽  
Social Impact Assessment ◽  
Health Prevention ◽  
Pollution Risk ◽  
Impact Pathways ◽  
The Social ◽  
Policies And Programs

Background: HealthyAIR is a tool that detects pollution risk in real life. The target population is people with cardiorespiratory complications who are especially susceptible to the current COVID-19. The goal is to empower people by controlling air pollution everywhere to minimize the risk of having a seizure. Methods: We measured the social impact of the HealthyAIR tool using a Likert scale survey with two groups: professionals (engineers/healthcare) and end-users. We assessed the data in accordance with the indicators for social impact defined for the Key Impact Pathways introduced by the European Commission for Horizon Europe, and the criteria of the Social Impact Open Repository (SIOR). Results: Professionals highlight the fact that they “totally agree” (33.33%) and “agree” (26.67%) that HealthyAIR could help authorities improve their health prevention policies and programs. Users considered the tool to be “very useful” (38.46%) and “quite useful” (42.31%), which denotes its necessity. Conclusions: professionals and end users see HealthyAIR as a great preventative tool, with the former seeing it as a way to avoid seizures in their patients who, in this COVID-19 era, are particularly sensitive to any cardiorespiratory health problem. However, users suggest improving the user’s manual to make it more understandable.

scholarly journals Periodontal Status and Risk Factors among Adults of Sebha City (Libya)

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Syed Wali Peeran ◽  
A. J. A. Ranjith Singh ◽  
G. Alagamuthu ◽  
Syed Ali Peeran ◽  
P. G. Naveen Kumar
Keyword(s):  
Risk Factors ◽  
Smoking Status ◽  
Adult Population ◽  
Population Level ◽  
Target Population ◽  
Tooth Brushing ◽  
Chi Square ◽  
Periodontal Status ◽  
Significant Difference ◽  
Chi Square Test

The present study was aimed at assessing the periodontal status and risk factors like age, gender, tooth brushing habit, and smoking among the adult population of Sebha city, Libya. 452 adults, aged 35–54 years, comprised the study sample. 266 (58.84%) were females and 186 (41.15%) were males. Data was collected by interview and clinical examination using CPI of CPITN index. Chi-square test and ANOVA were used for statistical analysis at 5% level of significance. Results indicate that 76.32% used toothbrush and paste; 8.84% were current smokers and were all males. Majority, 52.65% were, detected with shallow pockets followed by 30.08% with calculus, 12.17% had deep pockets, 3.31% had bleeding, and only 1.33% were healthy. Age, gender, current smoking status and frequency of tooth brushing showed statistically significant difference with CPI codes. Health professionals can utilize this data to identify individuals at risk and to target population level interventions.

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