scholarly journals PROVIDER PERSPECTIVES ON IMPLEMENTING A PERSON-CENTERED COMMUNICATION TOOL

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S50-S50
Author(s):  
Alexandra Heppner ◽  
Nytasia Hicks ◽  
Sarina Poth ◽  
Kimberly Van Haitsma ◽  
Katherine Abbott
Keyword(s):  
A Priori ◽  
Relative Advantage ◽  
Communication Tool ◽  
Telephone Interviews ◽  
Effective Implementation ◽  
Coding Scheme ◽  
Provider Perspectives ◽  
Evidence Strength ◽  
Positive Intervention

Abstract The PAL Card QIP Project sought to understand the intervention characteristics associated with effective implementation. Telephone interviews were conducted with n=26 NH providers who completed the project. Calls were recorded, transcribed verbatim and checked for accuracy. The Consolidated Framework for Implementation Research was utilized as an a priori coding scheme to identify factors associated with effective implementation of the PAL Card project. Major themes emerging from the data related to the evidence strength and quality of the intervention as well as the relative advantage to not assessing preferences (“turns out she doesn't even like TV and we have just been having her watch TV”), adaptability (tailoring for their needs), trialability (expanding offering of intervention after initial success), and complexity of the intervention (sharing the work across departments, difficulty using unfamiliar technology). Providers reported positive intervention characteristics of the PAL cards, however, barriers remain that require additional strategies to successfully implement.

scholarly journals “My Patients Asked Me if I Owned a Fruit Stand in Town or Something.” Barriers and Facilitators of Personalized Dietary Advice Implemented in a Primary Care Setting

2021 ◽  
Vol 11 (8) ◽  
pp. 747
Author(s):  
Heather L. Rogers ◽  
Silvia Núñez Fernández ◽  
Susana Pablo Hernando ◽  
Alvaro Sanchez ◽  
Carlos Martos ◽  
...  
Keyword(s):  
Primary Care ◽  
Implementation Strategies ◽  
Barriers And Facilitators ◽  
Relative Advantage ◽  
Dietary Advice ◽  
Effective Implementation ◽  
Evidence Strength ◽  
Audio Recordings ◽  
Participant Group

Primary care is especially well positioned to address prevention of non-communicable diseases. However, implementation of health promotion activities such as personalized dietary advice is challenging. The study aim was to understand barriers and facilitators of the personalized dietary advice component of a lifestyle intervention in primary care, as perceived by health center professionals and program participants. Thirteen focus groups were conducted with 49 professionals and 47 participants. Audio recordings were transcribed. Professional group text was coded using the Consolidated Framework for Implementation Research (CFIR). Participant group text was coded via an inductive approach with thematic analysis. Across most CFIR domains, both barriers and facilitators were equally present, except for ‘characteristics of individuals’, which were primarily facilitators. Intervention characteristics was the most important domain, with barriers in design and packaging (e.g., the ICT tool) and complexity. Facilitators included high evidence strength and quality, adaptability, and relative advantage. Participants described the importance of more personalized advice, the value of follow-up with feedback, and the need to see outcomes. Both professionals and patients stated that primary care was the place for personalized dietary advice intervention, but that lack of time, workload, and training were barriers to effective implementation. Implementation strategies targeting these modifiable barriers could potentially increase intervention adoption and intervention effectiveness.

scholarly journals WE READ HIS PAL CARD AT THE FUNERAL: EVALUATING THE IMPLEMENTATION OF A PERSON-CENTERED COMMUNICATION TOOL

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S49-S50
Author(s):  
Katherine M Abbott ◽  
Howard Degenholtz
Keyword(s):  
Communication Tool ◽  
Improvement Project ◽  
Team Members ◽  
Effective Implementation ◽  
Centered Care ◽  
Evidenced Based ◽  
Department Of Aging ◽  
Qualitative Responses ◽  
Validated Instrument

Abstract This symposium describes the development and implementation of an interdisciplinary and novel person-centered care (PCC) communication tool in nursing homes (NH). PCC is a philosophy that recognizes “knowing the person” and honoring individual preferences. The communication tool is based on an assessment of NH resident likes and dislikes via the Preferences for Everyday Living Inventory (PELI). The PELI is an evidenced-based, validated instrument that can be used to enhance the delivery of PCC. In 2016, the Ohio Department of Medicaid (ODM) mandated NHs use the PELI as one of the factors that determine the quality portion of their daily Medicaid reimbursement rate. The Preferences for Activity and Leisure (PAL) Card was developed to communicate important resident preferences across care team members. In 2018, the PAL Card Project was approved by the Ohio Department of Aging as a Quality Improvement Project. The first presentation will describe the implementation of PAL Cards with n=43 NH providers. The second presentation will present data regarding the acceptability, feasibility, and appropriateness of the communication tool as rated by providers. The final presentation explores provider qualitative responses regarding the characteristics of the PAL Card communication tool related to effective implementation. The Discussant, Dr. Howard Degenholtz will discuss the implications of initiatives to address the quality of resident care.

The Impact of Competitive Quasi-Market on Service Delivery in Benue State University, Makurdi Nigeria

GIS Business ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. 85-98
Author(s):  
Idoko Peter
Keyword(s):  
Service Delivery ◽  
A Priori ◽  
Least Square ◽  
Secondary Source ◽  
State University ◽  
Ordinary Least Square ◽  
Negative Effect ◽  
The Impact ◽  
The Relationship

This research the impact of competitive quasi market on service delivery in Benue State University, Makurdi Nigeria. Both primary and secondary source of data and information were used for the study and questionnaire was used to extract information from the purposively selected respondents. The population for this study is one hundred and seventy three (173) administrative staff of Benue State University selected at random. The statistical tools employed was the classical ordinary least square (OLS) and the probability value of the estimates was used to tests hypotheses of the study. The result of the study indicates that a positive relationship exist between Competitive quasi marketing in Benue State University, Makurdi Nigeria (CQM) and Transparency in the service delivery (TRSP) and the relationship is statistically significant (p<0.05). Competitive quasi marketing (CQM) has a negative effect on Observe Competence in Benue State University, Makurdi Nigeria (OBCP) and the relationship is not statistically significant (p>0.05). Competitive quasi marketing (CQM) has a positive effect on Innovation in Benue State University, Makurdi Nigeria (INVO) and the relationship is statistically significant (p<0.05) and in line with a priori expectation. This means that a unit increases in Competitive quasi marketing (CQM) will result to a corresponding increase in innovation in Benue State University, Makurdi Nigeria (INVO) by a margin of 22.5%. It was concluded that government monopoly in the provision of certain types of services has greatly affected the quality of service experience in the institution. It was recommended among others that the stakeholders in the market has to be transparent so that the system will be productive to serve the society effectively

scholarly journals Physiological parameters of mental health predict the emergence of post-traumatic stress symptoms in physicians treating COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
T. Dolev ◽  
S. Zubedat ◽  
Z. Brand ◽  
B. Bloch ◽  
E. Mader ◽  
...  
Keyword(s):  
Mental Health ◽  
Sleep Quality ◽  
Traumatic Stress ◽  
A Priori ◽  
Treatment Strategies ◽  
Physiological Measures ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Post Traumatic

AbstractLack of established knowledge and treatment strategies, and change in work environment, may altogether critically affect the mental health and functioning of physicians treating COVID-19 patients. Thus, we examined whether treating COVID-19 patients affect the physicians’ mental health differently compared with physicians treating non-COVID-19 patients. In this cohort study, an association was blindly computed between physiologically measured anxiety and attention vigilance (collected from 1 May 2014 to 31 May 31 2016) and self-reports of anxiety, mental health aspects, and sleep quality (collected from 20 April to 30 June 2020, and analyzed from 1 July to 1 September 2020), of 91 physicians treating COVID-19 or non-COVID-19 patients. As a priori hypothesized, physicians treating COVID-19 patients showed a relative elevation in both physiological measures of anxiety (95% CI: 2317.69–2453.44 versus 1982.32–2068.46; P < 0.001) and attention vigilance (95% CI: 29.85–34.97 versus 22.84–26.61; P < 0.001), compared with their colleagues treating non-COVID-19 patients. At least 3 months into the pandemic, physicians treating COVID-19 patients reported high anxiety and low quality of sleep. Machine learning showed clustering to the COVID-19 and non-COVID-19 subgroups with a high correlation mainly between physiological and self-reported anxiety, and between physiologically measured anxiety and sleep duration. To conclude, the pattern of attention vigilance, heightened anxiety, and reduced sleep quality findings point the need for mental intervention aimed at those physicians susceptible to develop post-traumatic stress symptoms, owing to the consequences of fighting at the forefront of the COVID-19 pandemic.

scholarly journals Determining the influence of intervention characteristics on implementation success requires reliable and valid measures: Results from a systematic review

2021 ◽  
Vol 2 ◽  
pp. 263348952199419
Author(s):  
Cara C Lewis ◽  
Kayne Mettert ◽  
Aaron R Lyon
Keyword(s):  
Systematic Review ◽  
Psychometric Properties ◽  
Systematic Reviews ◽  
Quality Measures ◽  
Measure Development ◽  
Relative Advantage ◽  
Design Quality ◽  
High Quality ◽  
Evidence Strength

Background: Despite their inclusion in Rogers’ seminal diffusion of innovations theory, few implementation studies empirically evaluate the role of intervention characteristics. Now, with growing evidence on the role of adaptation in implementation, high-quality measures of characteristics such as adaptability, trialability, and complexity are needed. Only two systematic reviews of implementation measures captured those related to the intervention or innovation and their assessment of psychometric properties was limited. This manuscript reports on the results of eight systematic reviews of measures of intervention characteristics with nuanced data regarding a broad range of psychometric properties. Methods: The systematic review proceeded in three phases. Phase I, data collection, involved search string generation, title and abstract screening, full text review, construct assignment, and citation searches. Phase II, data extraction, involved coding psychometric information. Phase III, data analysis, involved two trained specialists independently rating each measure using PAPERS (Psychometric And Pragmatic Evidence Rating Scales). Results: Searches identified 16 measures or scales: zero for intervention source, one for evidence strength and quality, nine for relative advantage, five for adaptability, six for trialability, nine for complexity, and two for design quality and packaging. Information about internal consistency and norms was available for most measures, whereas information about other psychometric properties was most often not available. Ratings for psychometric properties fell in the range of “poor” to “good.” Conclusion: The results of this review confirm that few implementation scholars are examining the role of intervention characteristics in behavioral health studies. Significant work is needed to both develop new measures (e.g., for intervention source) and build psychometric evidence for existing measures in this forgotten domain. Plain Language Summary Intervention characteristics have long been perceived as critical factors that directly influence the rate of adopting an innovation. It remains unclear the extent to which intervention characteristics including relative advantage, complexity, trialability, intervention source, design quality and packaging, evidence strength and quality, adaptability, and cost impact implementation of evidence-based practices in behavioral health settings. To unpack the differential influence of these factors, high quality measures are needed. Systematic reviews can identify measures and synthesize the data regarding their quality to identify gaps in the field and inform measure development and testing efforts. Two previous reviews identified measures of intervention characteristics, but they did not provide information about the extent of the existing evidence nor did they evaluate the host of evidence available for identified measures. This manuscript summarizes the results of nine systematic reviews (i.e., one for each of the factors listed above) for which 16 unique measures or scales were identified. The nuanced findings will help direct measure development work in this forgotten domain.

scholarly journals Case-finding for COPD clinic acceptability to patients in GPs across Hampshire: a qualitative study

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Danielle Rose ◽  
Emma Ray ◽  
Rachael H. Summers ◽  
Melinda Taylor ◽  
Helen Kruk ◽  
...  
Keyword(s):  
Negative Impact ◽  
Case Finding ◽  
Lifestyle Changes ◽  
Self Management ◽  
Mortality And Morbidity ◽  
Telephone Interviews ◽  
Shared Information ◽  
Risk Patients ◽  
Perceived Effects

AbstractDespite high mortality and morbidity, COPD remains under-diagnosed. Case-finding strategies are possible, but patients’ perspectives are unexplored. Using qualitative methods, we explored the patient perspective of a case-finding intervention among at-risk patients in primary care. Semi-structured telephone interviews were transcribed and thematic analysis utilised. Seven patients without (mean age 64.5 years (58–74), n = 4) and 8 with obstructed spirometry (mean age 63.5 (53–75), n = 4) were interviewed. Themes identified were motives, challenges and concerns regarding attending the clinic. These included wanting to be well; to help with research; concern over negative impact to life from COPD diagnosis; perceived utility of the clinic; quality of information given; staff manner, approachability and knowledge; and perceived effects of the clinic on lifestyle, self-management and symptoms. The intervention was generally deemed useful and reassuring, although shared information was too detailed or irrelevant for some. Several reported positive lifestyle changes, improved symptoms and improved self-management.

scholarly journals A qualitative inquiry of access to and quality of primary healthcare in seven communities in East and West Africa (SevenCEWA): perspectives of stakeholders, healthcare providers and users

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Soter Ameh ◽  
Bolarinwa Oladimeji Akeem ◽  
Caleb Ochimana ◽  
Abayomi Olabayo Oluwasanu ◽  
Shukri F. Mohamed ◽  
...  
Keyword(s):  
Health Insurance ◽  
West Africa ◽  
Primary Healthcare ◽  
A Priori ◽  
Healthcare Providers ◽  
Health Coverage ◽  
Health Seeking ◽  
East And West ◽  
Universal Health

Abstract Background Universal health coverage is one of the Sustainable Development Goal targets known to improve population health and reduce financial burden. There is little qualitative data on access to and quality of primary healthcare in East and West Africa. The aim of this study was to describe the viewpoints of healthcare users, healthcare providers and other stakeholders on health-seeking behaviour, access to and quality of healthcare in seven communities in East and West Africa. Methods A qualitative study was conducted in four communities in Nigeria and one community each in Kenya, Uganda and Tanzania in 2018. Purposive sampling was used to recruit: 155 respondents (mostly healthcare users) for 24 focus group discussions, 25 healthcare users, healthcare providers and stakeholders for in-depth interviews and 11 healthcare providers and stakeholders for key informant interviews. The conceptual framework in this study combined elements of the Health Belief Model, Health Care Utilisation Model, four ‘As’ of access to care, and pathway model to better understand the a priori themes on access to and quality of primary healthcare as well as health-seeking behaviours of the study respondents. A content analysis of the data was done using MAXQDA 2018 qualitative software to identify these a priori themes and emerging themes. Results Access to primary healthcare in the seven communities was limited, especially use of health insurance. Quality of care was perceived to be unacceptable in public facilities whereas cost of care was unaffordable in private facilities. Health providers and users as well as stakeholders highlighted shortage of equipment, frequent drug stock-outs and long waiting times as major issues, but had varying opinions on satisfaction with care. Use of herbal medicines and other traditional treatments delayed or deterred seeking modern healthcare in the Nigerian sites. Conclusions There was a substantial gap in primary healthcare coverage and quality in the selected communities in rural and urban East and West Africa. Alternative models of healthcare delivery that address social and health inequities, through affordable health insurance, can be used to fill this gap and facilitate achieving universal health coverage.

scholarly journals Impact of flooding on health-related quality of life in England: results from the National Study of Flooding and Health

2020 ◽  
Vol 30 (5) ◽  
pp. 942-948
Author(s):  
Charlotte Robin ◽  
Charles Beck ◽  
Ben Armstrong ◽  
Thomas David Waite ◽  
G James Rubin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
A Priori ◽  
National Study ◽  
Health Related Quality ◽  
Euroqol Group ◽  
Related Quality ◽  
Health Related ◽  
Anxiety Depression ◽  
The Impact

Abstract Background Flooding can have extensive effects on the health and wellbeing of affected communities. The impact of flooding on psychological morbidity has been established; however, the wider impacts of flooding exposure, including on health-related quality of life (HRQoL), have not been described. Methods Using data from the English National Study of Flooding and Health cohort, HRQoL 2 and 3 years post-flooding was assessed with the EuroQol Group EQ-5D-5L tool. Associations between exposure groups (flooding and disruption from flooding) and HRQoL were assessed, using ordinal and linear regression, adjusting for a priori confounders. Results For both 2 and 3 years post-flooding, the median HRQoL scores were lower in the flooded and disrupted groups, compared with unaffected respondents. A higher proportion of flooded and disrupted respondents reported HRQoL problems in most dimensions of the EQ-5D-5L, compared with unaffected respondents. In year 2, independent associations between exposure to flooding and experiencing anxiety/depression [adjusted odds ratio (aOR) 7.7; 95% CI 4.6–13.5], problems with usual activities (aOR 5.3; 95% CI 2.5–11.9) and pain/discomfort (aOR 2.4; 95% CI 1.5–3.9) were identified. These problems persisted 3 years post-flooding; associations between exposure to flooding and experiencing anxiety/depression (aOR 4.3; 95% CI 2.5–7.7), problems with usual activities (aOR 2.9; 95% CI 1.5–6.1) and pain/discomfort (aOR 2.5; 95% CI 1.5–4.2) were identified. Conclusions Exposure to flooding and disruption from flooding significantly reduces HRQoL. These findings extend our knowledge of the impacts of flooding on health, with implications for multi-agency emergency response and recovery plans.

scholarly journals Interim Evaluation of the Tier 1 Program (Secondary 1 Curriculum) of the Project P.A.T.H.S.: First Year of the Full Implementation Phase

2008 ◽  
Vol 8 ◽  
pp. 47-60 ◽  
Author(s):  
Daniel T. L. Shek ◽  
Hing Keung Ma ◽  
Rachel C. F. Sun
Keyword(s):  
Implementation Process ◽  
First Year ◽  
Perceived Benefits ◽  
Implementation Quality ◽  
Implementation Phase ◽  
Telephone Interviews ◽  
Full Implementation ◽  
Tier 1 ◽  
Negative Comments

To understand the implementation quality of the Tier 1 Program (Secondary 1 Curriculum) of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in the full implementation phase, 100 schools were randomly selected to participate in personal and/or telephone interviews regarding the quality of the implementation process of the Tier 1 Program. In the interviews, the participants described the responses of the students to the program, the perceived benefits of the program, the perceived good aspects of the program, and the areas requiring improvement, difficulties encountered in the implementation process, and perceived attributes of the worker-support scheme (“Co-Walker Scheme”). Results showed that most workers perceived that the students had positive responses to the program and the program was beneficial to the students. They also identified several good aspects in the program, although negative comments on the program design and difficulties in the implementation process were also recorded. Roughly half of the respondents had positive comments on the “Co-Walker Scheme”. In sum, the respondents generally regarded the program as beneficial to the students and they were satisfied with the Tier 1 Program (Secondary 1 Curriculum) in the full implementation phase, although some implementation difficulties were also expressed.

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