scholarly journals Engaging Stakeholders in a Pragmatic Trial of Home-Delivered Meals for Persons with Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 919-919
Author(s):  
Jill Harrison ◽  
Kathleen McAuliff ◽  
Kali Thomas
Keyword(s):  
Pragmatic Trial ◽  
Lessons Learned ◽  
Advisory Panel ◽  
Age In Place ◽  
Meals On Wheels ◽  
Potential Benefits ◽  
Facilitators And Barriers ◽  
Home Placement ◽  
The Impact ◽  
Research Team Member

Abstract Gathering stakeholder feedback is essential to designing and implementing relevant and actionable research. Additionally, stakeholders, particularly those directly impacted by an intervention, bring unique insights and experiences. This paper presents the process and findings of a research endeavor to co-design a pragmatic clinical trial with a Stakeholder Advisory Panel (SAP) in an effort to understand facilitators and barriers to conducting the research and implementing study findings. The proposed trial compares the impact of frozen, drop-shipped meals versus daily home-delivered meals provided by Meals on Wheels (MOW) programs on the ability of individuals living with dementia to age in place. We recruited nine SAP members, who were compensated for their time. The SAP is composed of a) MOW clients with dementia, b) family members of MOW clients with dementia, c) paid or volunteer MOW drivers, and d) MOW staff. A research team member facilitated two 90-minute meetings with the SAP members via Zoom. The topics of the meetings included potential benefits and challenges with each mode of meal delivery, the importance of the primary outcome (time to nursing home placement), topics of interest to include in interviews with clients and caregivers, and how participants would explain the study to a friend. Audio of the Zoom meetings was transcribed, and meeting summaries were shared with the SAP. Benefits of forming and engaging a SAP, as well as key lessons learned from SAP members and how recommendations were reflected in changes to the study protocol will be discussed.

scholarly journals An Evaluation of a Scottish Higher Education ‘Student Transitions’ Enhancement Theme: Stakeholders’ Perceptions and Recommendations for Future Activities

2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Ashley Dennis ◽  
Lisi Gordon ◽  
Stella Howden ◽  
Divya Jindal-Snape
Keyword(s):  
Higher Education ◽  
Academic Staff ◽  
Learning Experience ◽  
Phase 1 ◽  
Lessons Learned ◽  
Education Student ◽  
Quality Assurance Agency ◽  
Facilitators And Barriers ◽  
The Impact ◽  
Student Transitions

The Quality Assurance Agency Enhancement Themes identify specific development themes to enhance the student learning experience in Scottish higher education (HE). This evaluation explored the second year of the ‘Student Transitions’ theme through the questions: How do stakeholders perceive the impact of the ‘Student Transitions’ work and, what are the facilitators and barriers to the successful development of projects? Data were collected during two overlapping phases. In Phase 1, 30 individuals, with national or institutional leadership roles associated with the current Enhancement Theme participated in semi-structured telephone interviews. In Phase 2, 43 online questionnaires were completed by institutionally nominated individuals. Professional, support and academic staff, and student representatives from all 19 Scottish Universities participated. Data were analysed using a thematic framework approach and descriptive statistics. Themes developed were: perceived impact; facilitators and barriers, such as support, engagement and sustainability. These themes were explored across institutions and sector wide. Participants felt ‘Student Transitions’ work was fundamental for Universities. Participants considered that Theme work had enhanced reflection on, and engagement with transition issues. Capturing direct impact was challenging for participants and it was proposed that it may take several years to evidence the outcomes of the work at the level of student experience. Broadly, participants reported that the sector was supportive and collaborative where ideas and resources for the ‘Student Transitions’ work had been openly shared. Challenges to advancing Enhancement Theme activities include limited time and other agendas competing for limited resources e.g. the Teaching Excellence Framework (TEF). The findings highlight the complexity of integrating the Theme within institutions and broadly across the sector. Key recommendations and lessons learned surround 1) defining and measuring impact; 2) enhancing engagement; 3) and Theme integration.

Lessons Learned and Implications of Function Focused Care based Programs of Various Nursing Care Settings: A Thematic Synthesis

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Vluggen S ◽  
◽  
Heinen M ◽  
Metzelthin S ◽  
Huisman-de Waal G ◽  
...  
Keyword(s):  
Behavior Change ◽  
Focus Groups ◽  
Goal Setting ◽  
Lessons Learned ◽  
Thematic Synthesis ◽  
Clinical Nursing ◽  
Setting Process ◽  
Facilitators And Barriers ◽  
The Impact ◽  
Educational Component

Background and Objective: Function-Focused Care (FFC) aims to optimize daily functioning of older people by changing clinical nursing practice of care professionals. Recently, three multicomponent FFC-programs were implemented in the Dutch home, nursing home, and hospital care setting. Process evaluations were conducted including eight focus groups with 45 care professionals and one focus group with 8 involved researchers. The objective was to synthesize findings and provide lessons learned and implications to optimize future programs. Methods: A thematic synthesis was conducted of nine focus groups using the COREQ checklist. Deductive coding analysis was applied using Nvivo Software. Results: Six themes emerged from the focus groups: four related to those components to be preserved in future programs (policy and environment, education, goal setting, and coaching), and two related to the impact of FFCprograms, and its facilitators and barriers in practice. FFC-related policy and a facilitating environment were considered prerequisites to successfully implement FFC. Education sessions could be improved by being more interactive, containing sufficient behavior change components, and tailoring its content to participants’ needs. Goal setting was poorly delivered and should receive more attention in practice. Coaching was considered pivotal to consolidate FFC in practice. Conclusions and relevance to clinical practice: We suggest to develop an advanced FFC-program for various care settings, which allows for tailoring to setting-specific elements and requirements of participants. Lessons learned include addressing all FFC-components jointly, including a comprehensive interactive educational component that primarily focusses on behavior change in care professionals. Managers should support FFC in practice by ensuring sufficient time and staff resources.

Characteristics of Physician Relocation Following Hurricane Katrina

2009 ◽  
Vol 95 (1) ◽  
pp. 6-12
Author(s):  
Kusuma Madamala ◽  
Claudia R. Campbell ◽  
Edbert B. Hsu ◽  
Yu-Hsiang Hsieh ◽  
James James
Keyword(s):  
Hurricane Katrina ◽  
Gulf Coast ◽  
General Medicine ◽  
The United States ◽  
Lessons Learned ◽  
Bivariate Analysis ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Factors Associated ◽  
The Impact

ABSTRACT Introduction: On Aug. 29, 2005, Hurricane Katrina made landfall along the Gulf Coast of the United States, resulting in the evacuation of more than 1.5 million people, including nearly 6000 physicians. This article examines the relocation patterns of physicians following the storm, determines the impact that the disaster had on their lives and practices, and identifies lessons learned. Methods: An Internet-based survey was conducted among licensed physicians reporting addresses within Federal Emergency Management Agency-designated disaster zones in Louisiana and Mississippi. Descriptive data analysis was used to describe respondent characteristics. Multivariate logistic regression was performed to identify the factors associated with physician nonreturn to original practice. For those remaining relocated out of state, bivariate analysis with x2 or Fisher exact test was used to determine factors associated with plans to return to original practice. Results: A total of 312 eligible responses were collected. Among disaster zone respondents, 85.6 percent lived in Louisiana and 14.4 percent resided in Mississippi before the hurricane struck. By spring 2006, 75.6 percent (n = 236) of the respondents had returned to their original homes, whereas 24.4 percent (n = 76) remained displaced. Factors associated with nonreturn to original employment included family or general medicine practice (OR 0.42, 95 percent CI 0.17–1.04; P = .059) and severe or complete damage to the workplace (OR 0.24, 95 percent CI 0.13–0.42; P < .001). Conclusions: A sizeable proportion of physicians remain displaced after Hurricane Katrina, along with a lasting decrease in the number of physicians serving in the areas affected by the disaster. Programs designed to address identified physician needs in the aftermath of the storm may give confidence to displaced physicians to return.

Optimizing electronic capture of patient-reported outcome measures in oncology clinical trials: lessons learned from a qualitative study

2020 ◽  
Vol 9 (17) ◽  
pp. 1195-1204
Author(s):  
Florence D Mowlem ◽  
Brad Sanderson ◽  
Jill V Platko ◽  
Bill Byrom
Keyword(s):  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Lessons Learned ◽  
Structured Interviews ◽  
Patient Reported ◽  
Oncology Clinical Trials ◽  
Anticancer Treatment ◽  
Fit For Purpose ◽  
The Impact ◽  
Electronic Implementation

Aim: To understand the impact of anticancer treatment on oncology patients’ ability to use electronic solutions for completing patient-reported outcomes (ePRO). Materials & methods: Semi-structured interviews were conducted with seven individuals who had experienced a cancer diagnosis and treatment. Results: Participants reported that the following would impact the ability to interact with an ePRO solution: peripheral neuropathy of the hands (4/7), fatigue and/or concentration and memory issues (6/7), where they are in a treatment cycle (5/7). Approaches to improve usability included: larger, well-spaced buttons to deal with finger numbness, the ability to pause a survey and complete at a later point and presenting the recall period with every question to reduce reliance on memory. Conclusion: Symptoms associated with cancers and anticancer treatments can impact the use of technologies. The recommendations for optimizing the electronic implementation of patient-reported outcome instruments in this population provides the potential to improve data quality in oncology trials and places patient needs at the forefront to ensure ‘fit-for-purpose’ solutions.

Examining the Type of Legal Representation and Its Influence on Disaggregated Dispositions in Juvenile Court

2021 ◽  
pp. 154120402110276
Author(s):  
Caitlin M. Brady ◽  
Jennifer H. Peck
Keyword(s):  
Juvenile Court ◽  
Alcohol Treatment ◽  
Public Defender ◽  
Legal Representation ◽  
Out Of Home Placement ◽  
Home Placement ◽  
Court Processing ◽  
Community Sanctions ◽  
The Impact ◽  
Drug And Alcohol

While prior studies of juvenile court outcomes have examined the impact of legal representation on out-of-home placement versus community sanctions, previous research has not fully explored the variation within sanctions that youth receive. The current study examines the influence of type of legal representation (public defender or private attorney) when predicting juvenile adjudications and dispositions. Using a sample of delinquent referrals from a Northeast state between 2009 and 2014, results showed that youth do receive different outcomes (e.g., probation, drug and alcohol treatment, accountability-oriented dispositions, etc.) based on the type of legal representation. The findings have important implications for juvenile court processing related to how courtroom actors impact case outcomes.

scholarly journals The Impact of COVID-19 Related Lockdown on the Prevalence of Spousal Violence Against Women in Kurdistan Region of Iraq

2021 ◽  
pp. 088626052199792
Author(s):  
Kazhan I. Mahmood ◽  
Sherzad A. Shabu ◽  
Karwan M. M-Amen ◽  
Salar S. Hussain ◽  
Diana A. Kako ◽  
...  
Keyword(s):  
Violence Against Women ◽  
Emotional Abuse ◽  
Physical Violence ◽  
Lessons Learned ◽  
Spousal Violence ◽  
Kurdistan Region ◽  
Gender Based Violence ◽  
Effective Prevention ◽  
Gender Based ◽  
The Impact

There is increasing concern about the impact of the COVID-19 pandemic and the lockdown’s social and economic consequences on gender-based violence. This study aimed to assess the impact of the COVID-19 pandemic on gender-based violence by comparing the prevalence of spousal violence against women before and during the COVID-19 related lockdown periods. This study was conducted in the Kurdistan Region of Iraq using a self-administered online questionnaire survey after the COVID-19 lockdown period in June 2020. Data were collected from a sample of 346 married women about the occurrence, frequency, and forms of spousal violence before and during the lockdown period. Significant increases in violence were observed from the pre-lockdown period to the lockdown period for any violence (32.1% to 38.7%, p = .001), emotional abuse (29.5% to 35.0%, p = .005), and physical violence (12.7% to 17.6%, p = .002). Regarding emotional abuse, humiliation (24.6% to 28.3%, p = .041) and scaring or intimidation (14.2% to 21.4%, p < .001) significantly increased during the lockdown. For physical violence, twisting the arm or pulling hair (9.0% to 13.0%, p = .004) and hitting (5.2% to 9.2%, p = .003) significantly increased during the lockdown. Forcing to have sexual intercourse also significantly increased during lockdown (6.6% to 9.5%., p = .021). The concerned authorities and women’s rights organizations should collaborate to enhance the prevention of violence against women. An effective prevention strategy should emphasize recognizing and acknowledging the extent of the problem, raising awareness about the problem and the available resources to address it, and ensuring social and economic stability. Lessons learned about the increased prevalence of spousal violence against women during the COVID-19 pandemic and the need to adopt appropriate strategies to prevent and address it will be valuable for similar future crises.

Evaluating and Motivating Activation in Long Term Care: Lessons From a Pilot Study

2021 ◽  
Vol 10 (1) ◽  
pp. 42-46
Author(s):  
J. Jbilou ◽  
A. El Bouazaoui ◽  
B. Zhang ◽  
J.L. Henry ◽  
L McDonald ◽  
...  
Keyword(s):  
Long Term Care ◽  
Driving Simulator ◽  
Care Home ◽  
Lessons Learned ◽  
Term Care ◽  
Care Facilities ◽  
Technological Intervention ◽  
The Impact ◽  
Research Recommendations

Older adults living in long-term care facilities typically receive insufficient exercise and have long periods of the day when they are not doing anything other than sitting or lying down, watching television, or ruminating (Wilkinson et al., 2017). We developed an intervention called the Experiential Centivizer, which provides residents with opportunities to use a driving simulator, watch world travel videos, and engage in exercise. We assessed the impact of the intervention on residents of a long-term care home in Fredericton, NB, Canada. In this paper, we report on the results observed and highlight the lessons learned from implementing a technological intervention within a long-term care setting. Practical and research recommendations are also discussed to facilitate future intervention implementation in long-term care.

scholarly journals Enhancing Behavioral Health Competencies for Senior Center Staff: Lessons Learned From Workforce Training Efforts

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 1-1
Author(s):  
Bronwyn Keefe ◽  
Jennifer Tripken
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Behavioral Health ◽  
Lessons Learned ◽  
Organizational Level ◽  
Senior Center ◽  
Senior Centers ◽  
Knowledge And Skills ◽  
Center Staff ◽  
The Impact

Abstract Increases in the numbers of older adults with mental health and substance use concerns compel us to identify best practices in training to address these issues. Senior Centers are an ideal location for behavioral health education programs as they are the go-to place for many older adults. This session will describe a program funded by The Retirement Research Foundation and offered in collaboration with Center for Aging and Disability Education and Research at Boston University and NCOA to increase senior center staff knowledge and skills. Approximately 250 senior center staff in Illinois, Florida, and Wisconsin completed an online certificate in Behavioral Health and Aging. Results show that 100% of respondents felt that the training was useful for their job; 93% felt that they will be a more effective worker as a result of the training; and 97% felt that the information they learned in the training will make a difference with the people they serve. We held key informant interviews to assess the impact of training and participants stated that their knowledge, skills, and behaviors were influenced by the program. At the organizational level, leaders reported new programming related to behavioral health and revised practices and protocols. This presentation will cover: (1) the extent to which training participants mastered the competencies needed for effective practice; (2) knowledge and skills gained from the training program; (3) Senior Centers’ capacity to identify and refer older adults to mental health services; and (4) organizational changes related to behavioral health programming with older adults.

scholarly journals Times of change in complex environments - Evaluating hospital co-payments in Palestine refugee camps

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S V Valente de Almeida ◽  
H Ghattas ◽  
G Paolucci ◽  
A Seita
Keyword(s):  
Length Of Stay ◽  
Policy Change ◽  
Negative Binomial ◽  
Negative Impact ◽  
Average Length ◽  
Lessons Learned ◽  
Policy Impact ◽  
Average Length Of Stay ◽  
Ex Post ◽  
The Impact

Abstract We measure the impact introducing a of 10% co-payment component on hospitalisation costs for Palestine refugees from Lebanon in public and private hospitals. This ex-post analysis provides a detailed insight on the direction and magnitude of the policy impact in terms of demand and supply for healthcare. The data was collected by the United Nations Relief and Works Agency for Palestine Refugees in the Near East and include episode level information from all public, private and Red Crescent Hospitals in Lebanon, between April 2016 and October 2017. This is a complete population episode level dataset with information from before and after the policy change. We use multinomial logit, negative binomial and linear models to estimate the policy impact on demand by type of hospital, average length of stay and treatment costs for the patient and the provider. After the new policy was implemented patients were 18% more likely to choose a (free-of-charge) PRCS hospital for secondary care, instead of a Private or Public hospital, where the co-payment was introduced. This impact was stronger for episodes with longer stays, which are also the more severe and more expensive cases. Average length of stay decreased in general for all hospitals and we could not find a statistically significant impact on costs for the provider nor the patient. We find evidence that the introduction of co-payments is hospital costs led to a shift in demand, but it is not clear to what extent the hospitals receiving this demand shift were prepared for having more patients than before, also because these are typically of less quality then the others. Regarding costs, there is no evidence that the provider managed to contain costs with the new policy, as the demand adapted to the changes. Our findings provide important information on hospitalisation expenses and the consequences of a policy change from a lessons learned perspective that should be taken into account for future policy decision making. Key messages We show that in a context of poverty, the introduction of payment for specific hospital types can be efficient for shifting demand, but has doubtable impact on costs containment for the provider. The co-payment policy can have a negative impact on patients' health since after its implementation demand increased at free-of-charge hospitals, which typically have less resources to treat patients.

scholarly journals The interplay between environmental exposures and COVID-19 risks in the health of children

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Peter D. Sly ◽  
Brittany A. Trottier ◽  
Catherine M. Bulka ◽  
Stephania A. Cormier ◽  
Julius Fobil ◽  
...  
Keyword(s):  
Air Pollution ◽  
Air Quality ◽  
Disease Severity ◽  
Research Effort ◽  
Severe Disease ◽  
Environmental Exposures ◽  
Research Strategy ◽  
Lessons Learned ◽  
Research Questions ◽  
The Impact

Abstract Background An unusual feature of SARS-Cov-2 infection and the COVID-19 pandemic is that children are less severely affected than adults. This is especially paradoxical given the epidemiological links between poor air quality and increased COVID-19 severity in adults and that children are generally more vulnerable than adults to the adverse consequences of air pollution. Objectives To identify gaps in knowledge about the factors that protect children from severe SARS-Cov-2 infection even in the face of air pollution, and to develop a transdisciplinary research strategy to address these gaps. Methods An international group of researchers interested in children’s environmental health was invited to identify knowledge gaps and to develop research questions to close these gaps. Discussion Key research questions identified include: what are the effects of SAR-Cov-2 infection during pregnancy on the developing fetus and child; what is the impact of age at infection and genetic susceptibility on disease severity; why do some children with COVID-19 infection develop toxic shock and Kawasaki-like symptoms; what are the impacts of toxic environmental exposures including poor air quality, chemical and metal exposures on innate immunity, especially in the respiratory epithelium; what is the possible role of a “dirty” environment in conveying protection – an example of the “hygiene hypothesis”; and what are the long term health effects of SARS-Cov-2 infection in early life. Conclusion A concerted research effort by a multidisciplinary team of scientists is needed to understand the links between environmental exposures, especially air pollution and COVID-19. We call for specific research funding to encourage basic and clinical research to understand if/why exposure to environmental factors is associated with more severe disease, why children appear to be protected, and how innate immune responses may be involved. Lessons learned about SARS-Cov-2 infection in our children will help us to understand and reduce disease severity in adults, the opposite of the usual scenario.

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