scholarly journals Process evaluation of the development and remote recruitment for Essential Coaching for Every Mother during COVID-19

Author(s):  
Justine Dol ◽  
Gail Tomblin Murphy ◽  
Douglas McMillan ◽  
Megan Aston ◽  
Marsha Campbell-Yeo

AbstractBackgroundWith the sudden decrease in in-person support and increase in perinatal mental health concerns during the coronavirus pandemic, innovative strategies, such as mHealth, are more important than ever. This study has two objectives: (1) to describe the modification of Essential Coaching for Every Mother during the coronavirus pandemic, and (2) to describe the process evaluation of recruitment and retention of pregnant and postpartum women for a pre-post intervention study.MethodsFor objective 1, modified messages were piloted with mothers and postpartum healthcare providers simultaneously. Semi-structured interviews were conducted with a subset of 10 participants from the original development study. For objective 2, three methods were used for recruitment: social media, posters in hospital, and media outreach. First time mothers were eligible for enrollment antenatally (37+ weeks) and postnatally (<3 weeks). Eligibility screening occurred remotely via text message with participants initiating contact. Data were collected via TextIt and REDCap. Outcomes were days to recruit 75 participants, eligibility vs. ineligibility rates, dropout and exclusion reasons, survey completion rates, perinatal timing of enrollment, and recruitment sources.ResultsFor objective 1, three mothers (M age=30.67 years) and seven healthcare providers (M age = 46.0 years) participated in the modification of the messages. Participants felt the messages were appropriate and relevant related to changes in postpartum care during the coronavirus pandemic. Nine messages were modified related to coronavirus and five messages were added to the program. For objective 2, recruitment ran July 15th-September 19th (67 days) with 200 screened and 88 enrolled, 70% antenatally. It took 50 days to enroll 75 participants. Mothers recruited antenatally (n=53) were more likely to receive all intervention message (68% vs. 19%). Mothers recruited postnatally (n=35) missed more messages on average (13.8 vs. 6.4). Participants heard about the study through family/friends (31%), news (20%), Facebook groups (16%), Facebook ads (14%), posters (12%), or other ways (7%).ConclusionAntenatal recruitment resulted in participants enrolling earlier and receiving more of the study messages. Word of mouth and media outreach were successful, followed by advertisement on Facebook. Remote recruitment was a feasible way to recruit for Essential Coaching for Every Mother.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 774-775
Author(s):  
Yvonne Johnston ◽  
Chelsea Reome-Nedlik

Abstract This session presents findings from a STEADI process evaluation that was conducted within a primary care setting in New York State. This process evaluation used mixed methods including quantitative analysis of surveys with clinic staff as well as qualitative methods such as intercept interviews with healthcare providers and clinic staff, and structured interviews with key stakeholders. The RE-AIM framework guided development of the process evaluation tools. The process evaluation was conducted over a 2-month period approximately 18 months post-implementation. Facilitators included: (a) Adoption - physician champion and administrative support; (b) Implementation - wellness coordinators, preparation and training, and organizational quality measures; (c) Maintenance - feedback from patients, local and national recognition, and impact on fall-related outcomes. Barriers included: (a) Adoption – organizational priorities and complexity of electronic health records; (b) Implementation – resistance to change and competing patient care demands; (c) Maintenance - staff turnover and follow through of referrals.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1250-1254
Author(s):  
Kurvatteppa Halemani ◽  
Merlin Cheema ◽  
Shabana Khatun ◽  
Yadidya ◽  
Bhumika Singh ◽  
...  

The pandemic COVID-19 is a highly infected disease caused by a novel coronavirus or SARS-Cov-2. The virus was reported for the first time  December 2019 in, China's Wuhan province. Later the virus has broken down into the world and claimed millions of lives. In India, the disease was reported for the first time in Kerala on 30th January 2020. a cross-section one group pre-test & post-test research design was used among the 40 final year BSc nursing students, College of Nursing SGPGIMS, Lucknow India. Samples were selected based on purposive sampling technique and sample criteria. An instrument, the first tool included demographic characteristics Similarly, second instrument used for knowledge assessment. After pre-test assessment, a teaching session was held at the seminar room, college of nursing SGPGIMS Lucknow, India. Subsequently post assessment was held after intervention.  A total of 40 participants responded to the study. Demographic variables like 30(75%) participants had less than 22 years of age, 22(55%) were girls, 14(35%) families income found INR 10000-15000, and the majority of participants obtained COVID-19 related knowledge from news paper16(40%). A gender was found significant with pretest knowledge, and other variables weren't found significant (P=0.05). Knowledge mean & standard deviation in pre & post-intervention, 11.90±2.16 vs15.82±1.39. The mean difference was found in a pre-test & post-test-1 &post-test-2, 3.9, 5.02, & 1.1, respectively. The effectiveness of the training program was checked by paired t-test -10.20 & -13.93, P=0.00.  The study revealed that the teaching session was efficient in the COVID-19 program among BSc nursing students.


Author(s):  
Valeria Cardenas ◽  
Anna Rahman ◽  
Yujun Zhu ◽  
Susan Enguidanos

Background: Despite some insurance plans now paying for home-based palliative care, recent reports have suggested that insurance coverage for palliative care may be insufficient in expanding patient access to home-based palliative care. Aim: To identify patients’ and caregivers’ perceived barriers to home-based palliative care and their recommendations for overcoming these barriers. Design: We conducted a qualitative study using semi-structured individual interviews. Our interview protocol elicited participants’ perspectives on home-based palliative care services; positive and negative aspects of the palliative program explanation; and suggestions for improving messaging around home-based palliative care. Setting/Participants: Twenty-five participants (patients, proxies, and their caregivers) who were eligible for a randomized controlled trial of home-based palliative care were interviewed by telephone. Results: Themes related to home-based palliative care referral barriers included reluctance to have home visits, enrollment timing, lack of palliative care knowledge, misconceptions about palliative care, and patients’ self-perceived health condition. Themes related to recommendations for overcoming these obstacles included ensuring that palliative care referrals come from healthcare providers or insurance companies and presenting palliative care services more clearly. Conclusion: Findings reinforce the need for additional palliative care education among patients with serious illness (and their caregivers) and the importance of delivering palliative care information and referrals from trusted sources.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Daniel Hind ◽  
Kate Allsopp ◽  
Prathiba Chitsabesan ◽  
Paul French

Abstract Background A 2017 terrorist attack in Manchester, UK, affected large numbers of adults and young people. During the response phase (first seven weeks), a multi-sector collaborative co-ordinated a decentralised response. In the subsequent recovery phase they implemented a centralised assertive outreach programme, ‘The Resilience Hub’, to screen and refer those affected. We present a process evaluation conducted after 1 year. Methods Case study, involving a logic modelling approach, aggregate routine data, and semi-structured interviews topic guides based on the Inter-Agency Collaboration Framework and May’s Normalisation Process Theory. Leaders from health, education and voluntary sectors (n = 21) and frontline Resilience Hub workers (n = 6) were sampled for maximum variation or theoretically, then consented and interviewed. Framework analysis of transcripts was undertaken by two researchers. Results Devolved government, a collaborative culture, and existing clinical networks meant that, in the response phase, a collaboration was quickly established between health and education. All but one leader evaluated the response positively, although they were not involved in pre-disaster statutory planning. However, despite overwhelming positive feedback there were clear difficulties. (1) Some voluntary sector colleagues felt that it took some time for them to be involved. (2) Other VCSE organisations were accused of inappropriate, harmful use of early intervention. (3) The health sector were accused of overlooking those below the threshold for clinical treatment. (4) There was a perception that there were barriers to information sharing across organisations, which was particularly evident in relation to attempts to outreach to first responders and other professionals who may have been affected by the incident. (5) Hub workers encountered barriers to referring people who live outside of Greater Manchester. After 1 year of the recovery phase, 877 children and young people and 2375 adults had completed screening via the Resilience Hub, 79% of whom lived outside Greater Manchester. Conclusions The psychosocial response to terrorist attacks and other contingencies should be planned and practiced before the event, including reviews of communications, protocols, data sharing procedures and workforce capacity. Further research is needed to understand how the health and voluntary sectors can best collaborate in the wake of future incidents.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahboobeh Asadi ◽  
Mahnaz Noroozi ◽  
Mousa Alavi

Abstract Background Numerous changes occur in different aspects of women’s lives in the postpartum period. Women’s adjusting with problems and taking advantage of this opportunity can develop their personality. In this regard, accurate knowledge of their experiences and feelings is necessary to help them to benefit from this period. Therefore, the present study aimed to explore the experiences related to postpartum changes in women. Methods In the present qualitative study, 23 participants, including women of childbearing age who gave birth and healthcare providers (midwives and obstetricians) in Isfahan, Iran were selected using purposive sampling with a maximum variation strategy. Data were collected through in-depth semi structured interviews, field notes, and daily notes, and simultaneously analyzed using the conventional qualitative content analysis. Results The data analysis results led to the extraction of three main categories including “feeling of decreased female attractiveness” (with two sub-categories of “ feeling of decreased beauty” and “feeling of decreased sexual function”), “feeling of insolvency and helplessness” (with two sub-categories of “physical burnout”, and “mental preoccupations”) and “beginning a new period in life” (with three sub-categories of “changing the meaning of life”, “feeling of maturity” and “deepening the communication”). Conclusions Findings of this study can provide a good context for designing interventions to improve the women’s quality of life by explaining and highlighting their experiences in the postpartum period. In this regard, providing sufficient empathy, social and psychological support from family members (especially husband), performing appropriate educational interventions and also regular assessment of women’s psychological state by healthcare providers in postpartum period can reduce their concerns and help to improve their health.


BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Katharine W. Buek ◽  
Dagoberto Cortez ◽  
Dorothy J. Mandell

Abstract Background Perinatal care nurses are well positioned to provide the education and support new fathers need to navigate the transition to fatherhood and to encourage positive father involvement from the earliest hours of a child’s life. To effectively serve fathers in perinatal settings, it is important to understand the attitudes, beliefs, and behaviors of healthcare providers that may encourage and engage them, or alternatively alienate and discourage them. Methods This qualitative study involved structured interviews with ten NICU and postpartum nurses from hospitals in two large Texas cities. The interview protocol was designed to elicit descriptive information about nurses’ attitudes and beliefs, sense of efficacy and intention for working with fathers, as well as their father-directed behaviors. Nurses were recruited for the study using a purposive sampling approach. Interviews were conducted by telephone and lasted approximately 25 to 35 min. Data were analyzed using a qualitative descriptive approach. Results Overall, study participants held very positive subjective attitudes toward fathers and father involvement. Nevertheless, many of the nurses signaled normative beliefs based on race/ethnicity, gender, and culture that may moderate their intention to engage with fathers. Participants also indicated that their education as well as the culture of perinatal healthcare are focused almost entirely on the mother-baby dyad. In line with this focus on mothers, participants comments reflected a normative belief that fathers are secondary caregivers to their newborns, there to help when the mother is unavailable. Conclusions Nurse attitudes and practices that place mothers in the role of primary caregiver may be interpreted by fathers as excluding or disregarding them. Further research is needed to validate the results of this small-scale study, and to assess whether and how provider attitudes impact their practices in educating and engaging fathers in newborn care.


2021 ◽  
Vol 26 (2) ◽  
pp. 56-63
Author(s):  
Claire McCarthy ◽  
Sarah Meaney ◽  
Marie Rochford ◽  
Keelin O’Donoghue

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shannen M. C. van Duijn ◽  
Angela K. Siteyi ◽  
Sherzel Smith ◽  
Emmanuel Milimo ◽  
Leon Stijvers ◽  
...  

Abstract Background In sub-Saharan Africa, the material and human capacity to diagnose patients reporting with fever to healthcare providers is largely insufficient. Febrile patients are typically treated presumptively with antimalarials and/or antibiotics. Such over-prescription can lead to drug resistance and involves unnecessary costs to the health system. International funding for malaria is currently not sufficient to control malaria. Transition to domestic funding is challenged by UHC efforts and recent COVID-19 outbreak. Herewith we present a digital approach to improve efficiencies in diagnosis and treatment of malaria in endemic Kisumu, Kenya: Connected Diagnostics. The objective of this study is to evaluate the feasibility, user experience and clinical performance of this approach in Kisumu. Methods Our intervention was performed Oct 2017–Dec 2018 across five private providers in Kisumu. Patients were enrolled on M-TIBA platform, diagnostic test results digitized, and only positive patients were digitally entitled to malaria treatment. Data on socio-demographics, healthcare transactions and medical outcomes were analysed using standard descriptive quantitative statistics. Provider perspectives were gathered by 19 semi-structured interviews. Results In total 11,689 febrile patients were digitally tested through five private providers. Malaria positivity ranged from 7.4 to 30.2% between providers, significantly more amongst the poor (p < 0.05). Prescription of antimalarials was substantially aberrant from National Guidelines, with 28% over-prescription (4.6–63.3% per provider) and prescription of branded versus generic antimalarials differing amongst facilities and correlating with the socioeconomic status of clients. Challenges were encountered transitioning from microscopy to RDT. Conclusion We provide full proof-of-concept of innovative Connected Diagnostics to use digitized malaria diagnostics to earmark digital entitlements for correct malaria treatment of patients. This approach has large cost-saving and quality improvement potential.


Author(s):  
Nooreddine Iskandar ◽  
Tatiana Rahbany ◽  
Ali Shokor

Abstract Background: Due to the common instability caused by political and security issues, Lebanese hospitals have experienced acts of terrorism multiple times. The most recent Beirut Explosion even forced several hospitals to cease operations for the first time in decades—but studies show the preparedness levels for such attacks in similar countries are low. Objective: The aim of this study is to explore the experience of Lebanese hospitals with terrorist attacks. Methods: This qualitative study used semi-structured interviews with various stakeholders to assess their experience with terrorist bombings. Data was analyzed using the thematic analysis method. Results: The researchers found that Lebanese hospitals vary greatly in their structures and procedures. Those differences are a function of 3 contextual factors: location, culture, and accreditation status. Hospitals found near ‘dangerous zones’ were more likely to be aware and to have better response to such events. A severe lack of communication, unity of command, and collaboration between stakeholders has made the process fragmented. Conclusion: The researchers recommend a larger role for the Ministry of Public Health (MOPH) in this process, and the creation of a platform where Lebanese organizations can share their experiences to improve preparedness and resilience of the Lebanese healthcare system in the face of terrorism.


Author(s):  
Godwin Iretomiwa Simon

This article examines the contextual challenges that characterize the video on demand (VOD) market in Africa. It provides critical analysis of the creative strategies employed by Nigeria-based streaming services to navigate the peculiar business environment on the continent. This research is on the background of the poor Internet infrastructure and economic divides in many African countries including Nigeria. Streaming services operating in these markets must understand a context where Internet access is complicated on the levels of availability and/or affordability, including significant lack of confidence in e-payment facilities. All these, together with epileptic power supply and poor standard of living, indicate that streaming services must innovate to capture subscribers within the continent. Despite the harsh operational environment, streaming services in Nigeria have continued to increase in number within the past 5 years. This is attributed to the transnational reach of the streaming services as they are patronized by Africans in diaspora across the globe, while they also enjoy popularity within African countries. This article specifically focuses on the innovative strategies employed by Nigerian streaming services to operate within their African markets in the context of their peculiar challenges. In so doing, it extends extant scholarship about Internet-distributed video using the African context. This article is situated within the Media Industry Studies framework and draws from semi-structured interviews with 7 streaming executives in Nigeria and 10 creative professionals in the Nigerian Video Film Industry (Nollywood). It also relies on desk research of press reports, industry publications, as well as the interfaces of streaming portals. This article underscores the necessity of contextualized research with the digital turn in video distribution. Through contextualized analysis of VOD market realities in a less studied terrain like Africa, it aligns with scholarly call to expand theories of Internet-distributed video to marginal contexts.


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