scholarly journals Making connections: nationwide implementation of video telehealth tablets to address access barriers in veterans

JAMIA Open ◽  
2019 ◽  
Vol 2 (3) ◽  
pp. 323-329 ◽  
Author(s):  
Donna M Zulman ◽  
Emily P Wong ◽  
Cindie Slightam ◽  
Amy Gregory ◽  
Josephine C Jacobs ◽  
...  
Keyword(s):  
Rural Areas ◽  
Chronic Conditions ◽  
Implementation Strategies ◽  
Access Barriers ◽  
Department Of Veterans Affairs ◽  
Implementation Barriers ◽  
Home Based ◽  
Regional Leadership ◽  
Facility Level ◽  
The Impact

Abstract Background Video telehealth technology has the potential to enhance access for patients with clinical, social, and geographic barriers to care. We evaluated the implementation of a US Department of Veterans Affairs (VA) initiative to distribute tablets to high-need Veterans with access barriers. Methods In this mixed methods implementation study, we examined tablet adoption (ie, facility-level tablet distribution rates and patient-level tablet utilization rates) and reach (ie, sociodemographic and clinical characteristics of tablet recipients) between 5/1/16 and 9/30/17. Concurrently, we surveyed 68 facility telehealth coordinators to determine the most common implementation barriers and facilitators, and then conducted interviews with telehealth coordinators and regional leadership to identify strategies that facilitated tablet distribution and use. Results 86 VA facilities spanning all 18 geographic regions, distributed tablets to 6 745 patients. Recipients had an average age of 56 years, 53% lived in rural areas, 75% had a diagnosed mental illness, and they had a mean (SD) of 5 (3) chronic conditions. Approximately 4 in 5 tablet recipients used the tablet during the evaluation period. In multivariate logistic regression, tablet recipients were more likely to use their tablets if they were older and had fewer chronic conditions. Implementation barriers included insufficient training, staffing shortages, and provider disinterest (described as barriers by 59%, 55%, and 33% of respondents, respectively). Site readiness assessments, local champions, licensure modifications, and use of mandates and incentives were identified as strategies that may influence widespread implementation of home-based video telehealth. Conclusion VA’s initiative to distribute video telehealth tablets to high-need patients appears to have successfully reached individuals with social and clinical access barriers. Implementation strategies that address staffing constraints and provider engagement may enhance the impact of such efforts.

LEARNING ABOUT WOMEN. ECONOMIC DEVELOPMENT, ENTREPRENEURSHIP AND THE ENVIRONMENT IN INDIA: A CASE STUDY

2007 ◽  
Vol 12 (04) ◽  
pp. 467-478 ◽  
Author(s):  
NANCY BERTAUX ◽  
ELAINE CRABLE
Keyword(s):  
Economic Development ◽  
Service Learning ◽  
Rural Women ◽  
Rural Areas ◽  
Indian Women ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Home Based ◽  
The Impact

On a recent semester-long stay in India, students from Xavier University (Cincinnati, Ohio) learned about a variety of social and economic development issues, with an emphasis on the role and status of women. This study describes and assesses the impact and effectiveness of their learning with a particular focus on their exposure to Meerut Seva Samaj (MSS), one economic development initiative concentrating on rural women. The Indian economy has recently witnessed an increase in entrepreneurship among women. Entrepreneurship often allows women to engage in home-based work so that they still can attend to their domestic duties, while also helping to financially support the family. Banks, companies, and NGOs (non-governmental organizations) are finding that offering micro-credit, or small loans, and other types of entrepreneurial assistance can help women start businesses. Meerut Seva Samaj provides a concrete example of how Indian women, especially in rural areas, can become successful entrepreneurs with the help of technology, training and other resources. MSS also assists local communities in the use of biogas, an environmentally friendly energy source that improves the environment and fertility of land in rural areas. The study places this service learning case study from India in the context of the literature on women, economic development, entrepreneurship and environmental issues.

scholarly journals Home-Based Exercise Program With Telephone Coaching: A Feasibility Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 403-403
Author(s):  
Emma Gulley ◽  
Joe Verghese ◽  
Emmeline Ayers ◽  
Tanya Verghese ◽  
Anne Felicia Ambrose
Keyword(s):  
Older Adults ◽  
Feasibility Study ◽  
Functional Decline ◽  
Exercise Program ◽  
Implementation Strategies ◽  
Control Program ◽  
Community Dwelling ◽  
Home Based ◽  
Telephone Coaching ◽  
The Impact

Abstract Exercise is crucial to maintain mobility, reduce falls and delay functional decline in older adults, but effective implementation strategies are lacking. Self-directed home-based exercise therapy is recommended by clinicians to overcome barriers such as cost, travel and availability. However, non-adherence is a major challenge due to lack of motivation, real time feedback or social support. To overcome these barriers, we conducted a feasibility study to evaluate a home-based exercise program with telephone coaching to improve mobility in frail older adults. Four non-demented, frail community-dwelling older adults were taught one of two exercise routines at our research center. The first involved complex exercises with internal and external cueing techniques that have been associated with neuroplasticity in previous studies (N=3). The second was a lesser cognitively demanding control program that included aerobic, balance and strengthening exercises (N=1). One week later, the participants were asked to repeat the exercises in their own home. The research assistant coached the patient over the telephone. A board-certified physiatrist was present during the home session to monitor adherence and fidelity to the protocol as well as address safety. The study produced qualitative findings regarding recruitment strategies, exercise feasibility, and other logistical issues relating to participant understanding, safety, and monitoring. Based on direct observation of participants at home, safety assessment protocols, instructions, and exercises were all refined. Building on this data, we plan to design a clinical trial to evaluate the impact of complex exercises designed to promote neuroplasticity and reduce cognitive and motoric decline in older adults.

scholarly journals The impact of chronic diseases and primary care access on health status among elderly populations in rural China

2019 ◽  
Author(s):  
Yixing Yang ◽  
Tai zhang ◽  
Zhaoquan Huang ◽  
Dong Gao ◽  
Zhenyou Guo ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Status ◽  
Rural Areas ◽  
Chronic Conditions ◽  
Rural China ◽  
The Elderly ◽  
Primary Care Access ◽  
Care Access ◽  
Descriptive System ◽  
The Impact

Abstract Objective This study aimed to examine the patterns of chronic conditions and the role of primary care access on health status among rural elderly.Methods 6451 elderly aged ≥ 60 years from 5540 households in 116 villages in western rural areas of China were randomly selected and assessed the their health status using the EQ-5D-3L instrument. EQ-5D descriptive system and visual analogue scale (VAS) score were descriptive analyses by patterns of chronic conditions. We identified the impact of multimorbidity and primary care access on health status using multilevel linear model.Results 55% of the pooled sample reported at least one chronic condition, and 30.2% had more than one. Hypertension, rheumatoid arthritis and chronic bronchitis were the most frequently reported conditions. After adjustment for sociodemographic status and patterns of chronic conditions, primary care access significantly associated with health status for the elderly in late life.Conclusion Primary care access and health services should take priority action for rural elderly, especially elderly with multimobidity in lower household income, living in mountainous areas where distance to township hospital is long.

Tailoring implementation for a cancer self-management support intervention for patients starting chemotherapy.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 287-287 ◽  
Author(s):  
Ryan Lawrence Kirkby ◽  
Doris Howell ◽  
Melanie Lynn Powis ◽  
Heidi Amernic ◽  
Lesley Moody ◽  
...  
Keyword(s):  
Communication Networks ◽  
Qualitative Data ◽  
Implementation Strategies ◽  
Self Management ◽  
Management Support ◽  
Implementation Barriers ◽  
Implementing Change ◽  
Tailored Implementation ◽  
Administrative Leaders ◽  
The Impact

287 Background: Multiple implementation strategies are described in the literature; however, there is limited consensus on how to best tailor implementation to organizational and clinician readiness. We undertook a mixed-methods evaluation to inform tailored implementation of self-management support (SMS) in ambulatory cancer care as the first phase of a pilot randomized trial of the intervention in patients starting chemotherapy. Methods: Validated surveys, focus groups and interviews were undertaken with key stakeholders (oncologists, nurses, allied health, and administrative leaders) in the lung, colorectal and lymphoma disease site groups at 3 regional cancer centres in Ontario, Canada. Median responses to individual survey questions were classified as an enabler, barrier or neutral based on predetermined cut-offs. Enablers and barriers were triangulated with qualitative data and mapped to the Consolidated Framework for Implementation Research domains. Implementation strategies to address barriers were identified using the Expert Recommendations for Implementing Change tool. Results: Survey respondents represented all stakeholder groups (n = 78; respondent rate = 50%). Minimal variation was noted across stakeholders and centres. Overall, respondents held positive beliefs about the value of SMS, were familiar with the principles of SMS and felt there was a tangible fit among the intervention, individual beliefs, and existing workflows. Suboptimal communication networks and access to information about the adoption of SMS, as well as a lack of organizational commitment to implementing the intervention were identified as key implementation barriers. Qualitative data reinforced quantitative findings, namely that stakeholders value SMS but were unsure if it would translate into reduced treatment toxicities. 46 implementation strategies were identified based on perceived barriers, of which 28 (61%) were common to all 3 centres. Conclusions: Stakeholders at cancer centres acknowledged that SMS is valuable, but potential barriers to integration of SMS into routine ambulatory practice exist. The impact of the tailored implementation plans will be evaluated as part of the trial.

A PROPOSED EVALUATION PLAN TO ASSESS THE IMPACT OF A YOUTH DEVELOPMENT PROGRAMME FACILITATED BY THE STATE INFORMATION TECHNOLOGY AGENCY (SITA) IN RURAL SOUTH AFRICA

2017 ◽  
Vol 14 (1) ◽  
pp. 174-181
Author(s):  
Maura Mbunyuza-deHeer Menlah
Keyword(s):  
Information Technology ◽  
Youth Development ◽  
Rural Areas ◽  
Secondary Data ◽  
The State ◽  
State Information ◽  
Evaluation Plan ◽  
Lessons Learnt ◽  
Slow Development ◽  
The Impact

This article reports on a proposed evaluation plan that has been developed to assess the work done by the State Information Technology Agency (SITA). The SITA programme was implemented in response to the South African government’s call to improve the lives of the populations in some rural areas through technology. The programme was meant to address slow development in  rural  areas  that  lack  technological  innovations  and  advances.  In  the proposed evaluation plan a review is made of secondary data, deciding how strategic priorities are to be determined, as well as analysis of the rural context environment. The researcher gives an account of how the evaluation strategies are to be piloted and rolled out thereafter. Lessons learnt are recorded and reported upon. A proposed evaluation plan will be developed, based on the lessons learnt in line with the objectives of the project.

Status, Impact, and Factor Determining Rural Non-farm Economy of India: A Review

2020 ◽  
pp. 68-76
Keyword(s):  
Rural Areas ◽  
Present Status ◽  
Economic Activity ◽  
Rural Livelihoods ◽  
Pivotal Role ◽  
Inclusive Development ◽  
Farm Sector ◽  
Income Inequalities ◽  
Review Study ◽  
The Impact

The rural non-farm sector (RNFS) involves a spectrum of economic activity in rural areas and encompasses all rural productive entities other than farm holdings. It has the potential to play a pivotal role in holistic and inclusive development of India’s rural areas by increasing the employment and wages of rural labour, which can reduce income inequalities. The review was carried out in order to explain the present status of RNFE state wise as well as overall to get a comprehensive view on the topic. The review study also focuses to disaggregate RNFE on the basis of gender, size of landholding and castes. Literature depicting the impact of RNFE on rural livelihoods especially in employment and poverty and factors determining it also been compiled to get an overall idea on the study.

Regional determinants in the development of the Lviv startup ecosystem

2019 ◽  
pp. 74-86
Author(s):  
Marianna Kokhan ◽  
Anastasiya Mazur
Keyword(s):  
Global Market ◽  
Scientific Development ◽  
Local Policy ◽  
It Industry ◽  
Successful Development ◽  
Corporate Universities ◽  
Regional Leadership ◽  
Focus Strategy ◽  
The Impact ◽  
The City

The article considers the concept of startups and ecosystems of startup development. It investigates the innovativeness ratings of countries and regional ecosystems of startups and the factors influencing the successful development of startups. The article considers the ranking of the best regional startup ecosystems in the world. It covers the experience of the leading regions, whose effectiveness is driven by attention to financing, networking, expanding access to markets, attracting and nurturing talents, accumulating experience and scientific development. Particular attention is given to the impact of the specialization and effectiveness of the regional focus strategy. Based on the methodology and results of the Global Startup Ecosystem Ranking 2019, authors have empirically investigated the startup ecosystem of the Lviv city. Authors described and systemized the startups operating in the city, the elements, and dynamics of the urban startup infrastructure. The preconditions for successful development of startups - financing, talents, experience, connectedness, access to markets - have been identified. The effectiveness of the activity of city authorities, the local policy of promoting the startup environment development - documents, measures and results – have been investigated. The main factors of Lviv’s regional leadership in the development of digital startups in Ukraine are: the dynamic development of the IT industry, the development of digital competencies and the concentration of talent in leading universities, the development of corporate universities and innovative infrastructure, the development of infrastructure and comfort in the city. For the development of the Lviv startup ecosystem, it is recommended to focus the efforts on further accumulation and transfer of experience, retention of talents, improvement of technology transfer systems, focusing on areas of exclusive competence while expanding access to finance and the global market.

Impact of Elected Women Representatives of Panchayati Raj in Physical and Financial and Business Assets Development of Rural Women: A Study among the Rural Women’s of Tiruvannamalai District, Tamil Nadu[1]

2017 ◽  
Vol 4 (24) ◽  
Author(s):  
Kalaichelvi Sivaraman ◽  
Rengasamy Stalin
Keyword(s):  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Direct Democracy ◽  
Tamil Nadu ◽  
Local Level ◽  
Rural And Urban Areas ◽  
The Government ◽  
The Impact ◽  
Panchayati Raj

This research paper is the part of Research Project entitled “Impact of Elected Women Representatives in the Life and Livelihood of the Women in Rural Areas: With Special Reference to Tiruvannamalai District, Tamil Nadu” funded by University of Madras under UGC-UPE Scheme.The 73rd and 74th amendments of the Constitution of India were made by the government to strengthen the position of women and to create a local-level legal foundation for direct democracy for women in both rural and urban areas. The representation for women in local bodies through reservation policies amendment in Constitution of India has stimulated the political participation of women in rural areas. However, when it’s comes to the argument of whether the women reservation in Panchayati Raj helps or benefits to the life and livelihood development of women as a group? The answer is hypothetical because the studies related to the impact of women representatives of Panchayati Raj in the life and livelihood development of women was very less. Therefore, to fill the gap in existing literature, the present study was conducted among the rural women of Tiruvannamalai district to assess the impact of elected women representatives in the physical and financial and business development of the women in rural areas. The findings revealed that during the last five years because of the women representation in their village Panjayati Raj, the Physical Asset of the rural women were increased or developed moderately (55.8%) and Highly (23.4%) and the Financial and Business Asset of the rural women were increased or developed moderately (60.4%) and Highly (18.7%).

Impact of Pseudomonas putida on the Growth Parameters of Fenugreek (Trigonella foenum- graecum L.): A Traditional Herbal Boon for Rural Areas

2017 ◽  
Vol 5 (2) ◽  
pp. 93-96
Author(s):  
Shashi Kant Shukla ◽  
◽  
Awadhesh Kumar ◽  
Anupam Dikshit ◽  
◽  
...  
Keyword(s):  
Pseudomonas Putida ◽  
Rural Areas ◽  
Growth Parameters ◽  
Leguminous Plant ◽  
Food Protein ◽  
Botany Department ◽  
Medicinal Value ◽  
Randomized Design ◽  
Trigonella Foenum Graecum L ◽  
The Impact

The present study aims the impact of Pseudomonas putida on different growth parameters of Trigonella sp., a leguminous plant to support the requirement of food, protein along with their medicinal value in the rural areas of India. A pot experiment was arranged based on completely randomized design with four replications at Biological Product Laboratory, Botany Department, University of Allahabad. Treatments were given at the seed level with one of control. Results indicated that application of P. putida significantly improved vegetative growth and showed an edge on the growth of the fenugreek as compared to the control.

scholarly journals Does Social Support Affect the Health of the Elderly in Rural China? A Meta-Analysis Approach

2019 ◽  
Vol 16 (18) ◽  
pp. 3471 ◽  
Author(s):  
Natuya Zhuori ◽  
Yu Cai ◽  
Yan Yan ◽  
Yu Cui ◽  
Minjuan Zhao
Keyword(s):  
Social Support ◽  
Rural Areas ◽  
Rural China ◽  
Statistical Significance ◽  
Empirical Studies ◽  
Relevant Literature ◽  
The Elderly ◽  
Significant Difference ◽  
Meta Regression ◽  
The Impact

As the trend of aging in rural China has intensified, research on the factors affecting the health of the elderly in rural areas has become a hot issue. However, the conclusions of existing studies are inconsistent and even contradictory, making it difficult to form constructive policies with practical value. To explore the reasons for the inconsistent conclusions drawn by relevant research, in this paper we constructed a meta-regression database based on 65 pieces of relevant literature published in the past 25 years. For more valid samples to reduce publication bias, we also set the statistical significance of social support to the health of the elderly in rural areas as a dependent variable. Finally, combined with multi-dimensional social support and its implications for the health of the elderly, meta-regression analysis was carried out on the results of 171 empirical studies. The results show that (1) subjective support rather than objective support can have a significant impact on the health of the elderly in rural areas, and there is no significant difference between other dimensions of social support and objective support; (2) the health status of the elderly in rural areas in samples involving western regions is more sensitive to social support than that in samples not involving the western regions; (3) among the elderly in rural areas, social support for the older male elderly is more likely to improve their health than that for the younger female elderly; and (4) besides this, both data sources and econometric models greatly affect the heterogeneity of the effect of social support on the health of the elderly in rural areas, but neither the published year nor the journal is significant. Finally, relevant policies and follow-up studies on the impact of social support on the health of the elderly in rural areas are discussed.

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