scholarly journals The Rush Caregiver Initiative: A Model for Caregiver Health and Wellness in Age-Friendly Health Systems

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 307-307
Author(s):  
Leslie Pelton ◽  
Ellen Carbonell ◽  
Robyn Golden
Keyword(s):  
Family Care ◽  
Well Being ◽  
Lessons Learned ◽  
System Level ◽  
Evidence Based ◽  
Health And Wellness ◽  
Evidence Based Practices ◽  
Caregiver Health ◽  
Clinically Significant

Abstract The Rush Caregiver Health and Well-Being Initiative (Caregiver Initiative) draws together evidence-based practices into a single framework to improve care for older adults and caregivers. The Caregiver Initiative has two components: system-level and caregiver level interventions. The complexities of system change take place within leadership, data management, and provider teams throughout the health care system, and solutions to resistance have been developed. Caregiver-level interventions start with an assessment using evidence-based tools, and offer an opportunity to participate in a Teach-Back Clinic, Family Care Planning sessions, and/or Goals of Medical Care meetings, all connected to the 4Ms of an Age-Friendly Health System. Contact and follow-up issues were addressed, and as of February 2021, 191 caregivers have enrolled. Outcomes to date show statistically and clinically significant reductions in depression, anxiety, and caregiver burden. This presentation will highlight lessons learned in the development of the model and caregiver outcomes to date.

Less is more: Implementing the ‘Minimal Intervention Needed for Change (MINC)’ approach to increase contextual fit of speech-language interventions

2021 ◽  
Author(s):  
Maura Curran ◽  
Rouzana Komesidou ◽  
Tiffany P. Hogan
Keyword(s):  
Clinical Settings ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Minimal Intervention ◽  
Less Is More ◽  
Resource Limitations ◽  
Practice Method ◽  
Core Components ◽  
Contextual Fit ◽  
Clinically Significant

AbstractPurpose: Speech-Language Pathologists (SLPs) and researchers face difficulties in moving evidence-based practices from clinical research into widespread practice, in part due to a mismatch between the design of typical intervention research studies and the realities of clinical settings. SLPs must adapt interventions from the literature or established programs to fit the needs of specific clients and settings. Researchers must design studies that better reflect clinical practice. Method: Here, we provide an overview of the Minimal Intervention Needed for Change (MINC) approach; a systematic approach to developing and adapting interventions that focuses on achieving meaningful outcomes within specific contexts. We outline the principles of MINC, and illustrate this process through use of a case study.Results: MINC can support systematic development and adaptation of interventions in clinical and research settings, particularly settings with resource limitations. Conclusions: Researchers should work to align research intervention work with typical clinical settings. This involves both targeting outcomes that are functional and clinically significant and acknowledging resource limitations. SLPs should adapt evidence-based interventions systematically and carefully to meet the needs of clients and settings while retaining the core components of intervention that result in meaningful change for clients.

scholarly journals Risk and resilience during COVID-19: A new study in the Zigler paradigm of developmental science

2020 ◽  
pp. 1-16
Author(s):  
Suniya S. Luthar ◽  
Ashley M. Ebbert ◽  
Nina L. Kumar
Keyword(s):  
Mental Health ◽  
High Stress ◽  
Well Being ◽  
Lessons Learned ◽  
Risk And Resilience ◽  
Community Based ◽  
Science And Policy ◽  
Mixed Methods Approach ◽  
Clinically Significant ◽  
Home And School

Abstract When children are exposed to serious life adversities, Ed Zigler believed that developmental scientists must expediently strive to illuminate the most critical directions for beneficial interventions. In this paper, we present a new study on risk and resilience on adolescents during COVID-19, bookended – in introductory and concluding discussions – by descriptions of programmatic work anchored in lessons learned from Zigler. The new study was conducted during the first two months of the pandemic, using a mixed-methods approach with a sample of over 2,000 students across five high schools. Overall, rates of clinically significant symptoms were generally lower as compared to norms documented in 2019. Multivariate regressions showed that the most robust, unique associations with teens’ distress were with feelings of stress around parents and support received from them. Open ended responses to three questions highlighted concerns about schoolwork and college, but equally, emphasized worries about families’ well-being, and positive outreach from school adults. The findings have recurred across subsequent school assessments, and strongly resonate with contemporary perspectives on resilience in science and policy. If serious distress is to be averted among youth under high stress, interventions must attend not just to the children's mental health but that of salient caregiving adults at home and school. The article concludes with some specific recommendations for community-based initiatives to address mental health through continued uncertainties of the pandemic.

Patient-Centered Empowerment Through Evidence-Based Engagement in Sensitive Clinical Settings

2020 ◽  
pp. 155-175
Author(s):  
Iris Reychav ◽  
Roger W. McHaney ◽  
Lin Zhu ◽  
Rami Moshonov
Keyword(s):  
Pap Test ◽  
Well Being ◽  
Clinical Settings ◽  
Evidence Based ◽  
Coding System ◽  
Educational Materials ◽  
Patient Centered ◽  
Shared Information ◽  
The Relationship

Patient-centered empowerment is enhanced through evidence-based engagement in stressful medical situations. The current study provided expert-vetted educational materials in dynamic text and video formats using the 5S approach. The materials are relevant, reliable, and readable for patients with abnormal Pap test results. Findings indicated patients that understood the information better were more engaged. Engagement was measured using a coding system that kept track of explicitly shared information, requested recommendations, and tacit knowledge during patient-physician interaction. Other outcomes were that dynamic text had a greater impact on engagement in both initial and follow-up meetings. Important findings included that those who found the dynamic text relevant had their social well-being, self-esteem, optimism, and acceptance improved in initial meetings. Those who found the dynamic text reliable were more confident in the relationship with their physician in follow-up meetings and felt their social well-being was improved in both initial and follow-up meetings.

scholarly journals Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-216086
Author(s):  
David T Arnold ◽  
Fergus W Hamilton ◽  
Alice Milne ◽  
Anna J Morley ◽  
Jason Viner ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Acute Infection ◽  
Holistic Approach ◽  
Well Being ◽  
Supplementary Oxygen ◽  
Exercise Tests ◽  
Persistent Symptoms ◽  
Blood Tests ◽  
Clinically Significant

The longer-term consequences of SARS-CoV-2 infection are uncertain. Consecutive patients hospitalised with COVID-19 were prospectively recruited to this observational study (n=163). At 8–12 weeks postadmission, survivors were invited to a systematic clinical follow-up. Of 131 participants, 110 attended the follow-up clinic. Most (74%) had persistent symptoms (notably breathlessness and excessive fatigue) and limitations in reported physical ability. However, clinically significant abnormalities in chest radiograph, exercise tests, blood tests and spirometry were less frequent (35%), especially in patients not requiring supplementary oxygen during their acute infection (7%). Results suggest that a holistic approach focusing on rehabilitation and general well-being is paramount.

Working Conditions in Self-Contained Settings for Students With Emotional Disturbance

2016 ◽  
Vol 51 (2) ◽  
pp. 83-94 ◽  
Author(s):  
Elizabeth A. Bettini ◽  
Michelle M. Cumming ◽  
Kristen L. Merrill ◽  
Nelson C. Brunsting ◽  
Carl J. Liaupsin
Keyword(s):  
Special Education ◽  
Emotional Disturbance ◽  
Working Conditions ◽  
Special Education Teachers ◽  
School Leaders ◽  
Well Being ◽  
Narrative Review ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Students With Emotional Disturbance

Students with emotional disturbance (ED) depend upon special education teachers (SETs) to use evidence-based practices (EBPs) to promote their well-being. SETs, in turn, depend upon school leaders to provide working conditions that support learning and implementation of academic and social EBPs. We conducted an integrative narrative review of research examining working conditions SETs experience serving students with ED in self-contained schools and classes, to better understand whether SETs in these settings experience conditions necessary to effectively implement academic and social EBPs. Our findings suggest that conditions necessary for learning and implementing EBPs are seldom present in these settings. In addition, the extant research on SETs’ working conditions in these settings is largely disconnected from research investigating teachers’ use of EBPs.

scholarly journals Therapist Financial Strain and Turnover: Interactions with System-Level Implementation of Evidence-Based Practices

2019 ◽  
Vol 46 (6) ◽  
pp. 713-723
Author(s):  
Danielle R. Adams ◽  
Nathaniel J. Williams ◽  
Emily M. Becker-Haimes ◽  
Laura Skriner ◽  
Lauren Shaffer ◽  
...  
Keyword(s):  
Financial Strain ◽  
System Level ◽  
Evidence Based ◽  
Evidence Based Practices

Adopting Evidence-Based Caregiver Training Programs in the Real World: Outcomes and Lessons Learned From the STAR-C Oregon Translation Study

2015 ◽  
Vol 36 (5) ◽  
pp. 519-536 ◽  
Author(s):  
Susan M. McCurry ◽  
Rebecca G. Logsdon ◽  
Jennifer Mead ◽  
Kenneth C. Pike ◽  
David M. La Fazia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lessons Learned ◽  
Post Treatment ◽  
Caregiver Training ◽  
Evidence Based ◽  
Caregiver Depression ◽  
Translation Study ◽  
Pre Treatment

Objectives: This article describes the translation and evaluation of STAR–Community Consultants program (STAR-C), an evidence-based dementia caregiver training program, within the Oregon Department of Human Services. Method: Staff from two regional Area Agencies on Aging (AAAs) were trained to implement all aspects of STAR-C, including screening, recruitment of caregiver/care-receiver dyads, and treatment delivery. Mailed assessments of caregiver depression, burden, and care-receiver mood, behavior, and quality of life were collected at pre-treatment, post-treatment, and 6-month follow-up. Results: One hundred fifty-one dyads entered the program; 96 completed the 8-week intervention. Significant positive post-treatment effects were obtained for caregiver depression, burden, and reactivity to behavior problems, and care-receiver depression and quality of life. At 6-month follow-up, improvements in caregiver reactivity and care-receiver depression were maintained. Caregivers reported high levels of satisfaction with the program. Discussion: STAR-C was successfully and effectively implemented by participating AAAs. Recommendations for replication, including training, recruitment, and assessment procedures are provided.

Building Healthy Children: A preventive intervention for high-risk young families

2021 ◽  
pp. 1-16
Author(s):  
Elizabeth M. Demeusy ◽  
Elizabeth D. Handley ◽  
Jody Todd Manly ◽  
Robin Sturm ◽  
Sheree L. Toth
Keyword(s):  
High Risk ◽  
Child Maltreatment ◽  
Preventive Intervention ◽  
Well Being ◽  
Psychological Aggression ◽  
Evidence Based ◽  
Healthy Children ◽  
Young Mothers ◽  
Inconsistent Parenting

Abstract The Building Healthy Children (BHC) home-visiting preventive intervention was designed to provide concrete support and evidence-based intervention to young mothers and their infants who were at heightened risk for child maltreatment and poor developmental outcomes. This paper presents two studies examining the short- and long-term effectiveness of this program at promoting positive parenting and maternal mental health, while preventing child maltreatment and harsh parenting. It also examines the intervention's sustained effect on child symptomatology and self-regulation. At baseline, young mothers and their infants were randomly assigned to receive BHC or Enhanced Community Standard. Families were assessed longitudinally across four time points. Data were also collected from the child's teacher at follow-up. Mothers who received BHC evidenced significant reductions in depressive symptoms at mid-intervention, which was associated with improvements in parenting self-efficacy and stress as well as decreased child internalizing and externalizing symptoms at postintervention. The follow-up study found that BHC mothers exhibited less harsh and inconsistent parenting, and marginally less psychological aggression. BHC children also exhibited less externalizing behavior and self-regulatory difficulties across parent and teacher report. Following the impactful legacy of Dr. Edward Zigler, these findings underline the importance of early, evidence-based prevention to promote well-being in high-risk children and families.

scholarly journals Blended Learning Immersion Teacher Education: Evidence-Based Practices and Data-Driven Instruction

2021 ◽  
pp. 1-30
Author(s):  
T.J. Ó Ceallaigh ◽  
Keyword(s):  
Blended Learning ◽  
Teacher Development ◽  
Teacher Educators ◽  
Lessons Learned ◽  
Data Driven ◽  
Evidence Based ◽  
Learning Approaches ◽  
Evidence Based Practices ◽  
Data Driven Instruction ◽  
Policy Practice

The practice of blending different learning approaches and strategies in higher-level education is not new, yet our understanding of how to design the most effective and efficient blend remains incomplete. Challenges are further compounded when students are not fully proficient in the language of instruction. However, teacher educators learn about teaching through learning about student learning. Evidence-based practices and data-driven instruction create conditions for success in blended learning design and implementation. This chapter reviews the impact of a blended learning professional development (PD) initiative, with a dual focus on language and content, on Irish-medium immersion (IMI) teacher development. Findings provide unique insights in relation to the effectiveness of a blended learning PD experience as indicated by student motivation, autonomy and success. Linguistic and pedagogical capacity were fostered and community cultivated. Lessons learned and tutor reflections are also shared in an attempt to advance learning in the field and to cultivate future innovation in policy, practice and possibilities.

scholarly journals Outer-context determinants in the sustainment phase of a reimbursement-driven implementation of evidence-based practices in children’s mental health services

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Joyce H. L. Lui ◽  
Lauren Brookman-Frazee ◽  
Teresa Lind ◽  
Kenny Le ◽  
Scott Roesch ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Health Expenditures ◽  
Regulatory Compliance ◽  
State Mental Health ◽  
System Level ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Ebp Implementation ◽  
State Mental

Abstract Background Although there is increasing investment to implement evidence-based practices (EBPs) in public systems across the USA, continued or sustained use of EBPs after initial implementation remains a challenge. The low integration of EBPs in routine practice severely limits their public health impact, highlighting the need to understand factors that affect the return on costly investments in EBP implementation. This study aims to (1) characterize trajectories of EBP delivery volume through a reimbursement-driven implementation and (2) examine impacts of system-level policy regulatory activity and state-level mental health services funding on the implementation reimbursement strategy. Methods This study involved secondary data analyses. Psychotherapy administrative claims and regulatory site visit data from the Los Angeles County Department of Mental Health and California state mental health expenditures were extracted from 2010 to 2017. Multilevel regression examined EBP claims volume over time with state expenditures and regulatory compliance as predictors. Results EBP claims volume trajectories demonstrated a rapid initial increase, followed by a period of decrease, and a small increase in the final year. State mental health expenditures increased across time reflecting increased funding availability. State mental health expenditures and system regulatory compliance were inversely related to EBP claims volume. Conclusions The impact of reimbursement-driven EBP implementation strategy is sensitive to multiple outer-context determinants. At the system level, commitment to fidelity of implementation regulations resulted in reduced use of the reimbursement strategy. Alternative reimbursement streams not tied to EBPs coupled with an expanded array of reimbursable services also impacted the use of the reimbursement strategy to implement EBPs.

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