Sustaining acute speech–language therapists’ implementation of recommended aphasia practices: A mixed methods follow‐up evaluation of a cluster RCT

Abstract Background The survival rate after childhood cancer has improved to 80%. The majority of childhood cancer survivors (CCS) will experience late complications which require follow up care, including access to their individual cancer treatment summary. The need to understand CCS needs and preferences in terms of ways to receive information e.g. digitally, becomes important. This study aims to through a mixed methods approach a) examine how CCS’ health awareness was impacted by viewing their personalized digital treatment summary and follow-up recommendations, b) explore E health literacy, and c) determine self-reported survivorship experiences and health care usage. Methods Survivors with a recent visit to the Late effects clinic were eligible for the study (n = 70). A representative sample of primary diagnoses were invited (n = 28). 16 CCS were enrolled. Recent medical visits, e health literacy and impressions of the digital treatment summary were assessed by a survey in conjunction with viewing their digital treatment summary on a computer screen. Their experience of reading and understanding their digital treatment summary in the context of their health related survivorship experiences were assessed in focus groups. The transcribed data was analyzed with conventional qualitative content analysis. Results The self-reported medical problems largely reflected that, only 6,3% reported no cancer-related reasons for seeking medical attention. Of the medical specialists, the primary care physician was the most frequently visited specialist (68.8%). High E health literacy was not associated with treatment features but with educational level (p = 0.003, CI: 3.9–14.6) and sex (p = 0.022, CI: − 13.6- -1.3). All survivors graded the digital treatment summary above average in terms of being valuable, agreeable and comprehensive. The focus group interviews identified three themes: 1) The significance of information, 2) The impact of awareness; and 3) Empowerment. Conclusions Reading the treatment summaries furthered the survivors understanding of their health situation and consequently aided empowerment. A digital treatment summary, provided by knowledgeable health care professionals, may increase the self-managed care and adherence to follow-up recommendations. Further insights into e health literacy in larger samples of CCS may determine to what extent health-related information can be communicated via digital resources to this at risk population.

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How Does Green Dot Bystander Training in High School and Beyond Impact Attitudes Toward Violence and Sexism in a Prospective Cohort?

Journal of Interpersonal Violence ◽

10.1177/08862605211006354 ◽

2021 ◽

pp. 088626052110063

Author(s):

Ann L. Coker ◽

Heather M. Bush ◽

Zhengyan Huang ◽

Candace J. Brancato ◽

Emily R. Clear ◽

...

Keyword(s):

High School ◽

Prospective Cohort ◽

Controlled Trial ◽

Ambivalent Sexism ◽

Cluster Rct ◽

Attitudes Toward Violence ◽

Scale Scores ◽

Cluster Randomized ◽

Over Time

Bystander interventions are recognized as “promising” programming to reduce sexual violence. Gaps in current evaluations include limited follow-up post-training (beyond 24 months) and knowledge of additional bystander training during follow-up. In this prospective cohort study, nested in a cluster randomized controlled trial (RCT), three cohorts of high school (HS) seniors were recruited (Fall 2013-2015) and followed through Spring 2018 ( n = 1,831). Training was based on their school cluster RCT assignment and receipt of additional Green Dot (GD) training after HS. Training was hypothesized to be associated with lower scores indicating less acceptance of violence or sexism. Sixty percent reported GD training after HS (68.7% of 986 in intervention and 50% of 845 in control conditions). No significant differences ( p < .05) were observed by GD training for four of the five violence acceptance or sexism attitudinal measures at recruitment or final surveys. For “ambivalent sexism” alone was there a significant reduction in scale scores over time in the intervention versus control condition. Additional GD training after the RCT significantly reduced neither violence acceptance nor sexism scores over time. GD training does not appear to have a consistent longer-term impact on reducing violence acceptance and sexism.

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Mixed-methods evaluation of the NHS Genomic Medicine Service for paediatric rare diseases: study protocol

NIHR Open Research ◽

10.3310/nihropenres.13236.1 ◽

2021 ◽

Vol 1 ◽

pp. 23

Author(s):

Celine Lewis ◽

James Buchannan ◽

Angus Clarke ◽

Emma Clement ◽

Bettina Friedrich ◽

...

Keyword(s):

Mixed Methods ◽

Rare Diseases ◽

Qualitative Interviews ◽

Genomic Medicine ◽

Research Programme ◽

Early Years ◽

Genomic Testing ◽

Medicine Service ◽

Recommendations For Practice

Background: A new nationally commissioned NHS England Genomic Medicine Service (GMS) was recently established to deliver genomic testing with equity of access for patients affected by rare diseases and cancer. The overarching aim of this research is to evaluate the implementation of the GMS during its early years, identify barriers and enablers to successful implementation, and provide recommendations for practice. The focus will be on the use of genomic testing for paediatric rare diseases. Methods: This will be a four-year mixed-methods research programme using clinic observations, interviews and surveys. Study 1 consists of qualitative interviews with designers/implementers of the GMS in Year 1 of the research programme, along with documentary analysis to understand the intended outcomes for the Service. These will be revisited in Year 4 to compare intended outcomes with what happened in practice, and to identify barriers and facilitators that were encountered along the way. Study 2 consists of clinic observations (pre-test counselling and results disclosure) to examine the interaction between health professionals and parents, along with follow-up interviews with both after each observation. Study 3 consists of a longitudinal survey with parents at two timepoints (time of testing and 12 months post-results) along with follow-up interviews, to examine parent-reported experiences and outcomes. Study 4 consists of qualitative interviews and a cross-sectional survey with medical specialists to identify preparedness, facilitators and challenges to mainstreaming genomic testing. The use of theory-based and pre-specified constructs will help generalise the findings and enable integration across the various sub-studies. Dissemination: We will disseminate our results to policymakers as findings emerge, so any suggested changes to service provision can be considered in a timely manner. A workshop with key stakeholders will be held in Year 4 to develop and agree a set of recommendations for practice.

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An Affair to Remember: A Mixed-Methods Survey Examining Therapists’ Experiences Treating Infidelity

The Family Journal ◽

10.1177/10664807211061826 ◽

2021 ◽

pp. 106648072110618

Author(s):

Taylor J. Irvine ◽

Paul R. Peluso

Keyword(s):

Mixed Methods ◽

Mixed Methods Study ◽

Personal History ◽

Future Research ◽

Present Survey ◽

Training Standards ◽

Recovery Treatment ◽

And Training

In this mixed-methods study, we analyzed data from 351 couple therapists who completed our Therapists' Experiences Treating Infidelity (TETI) survey. The present survey is a follow-up of previous iterations that examined therapists' attitudes toward infidelity and affair recovery treatment. Our TETI survey provided additional questions pertaining to therapists' personal history with affairs and perceptions on current research and training standards. Results showed that various therapist and couple factors serve to impede affair recovery treatment. Additionally, this survey revealed several similarities in therapists' attitudes from prior surveys, despite decades having passed between when the present survey and previous versions. In this article, we (a) outline findings from this mixed-methods survey, (b) discuss implications for the field, and (c) offer directions for future research.

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Explaining patient delay in healthcare seeking and loss to diagnostic follow-up among patients with presumptive tuberculosis in Tanzania: a mixed-methods study

BMC Health Services Research ◽

10.1186/s12913-019-4030-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Grace Mhalu ◽

Mitchell G. Weiss ◽

Jerry Hella ◽

Francis Mhimbira ◽

Enos Mahongo ◽

...

Keyword(s):

Mixed Methods ◽

Patient Delay ◽

Mixed Methods Study ◽

Healthcare Seeking

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A mixed-methods feasibility study of an arts-based intervention for patients receiving maintenance haemodialysis

BMC Nephrology ◽

10.1186/s12882-020-02162-4 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Claire Carswell ◽

Joanne Reid ◽

Ian Walsh ◽

William Johnston ◽

Helen McAneney ◽

...

Keyword(s):

Mixed Methods ◽

Process Evaluation ◽

Healthcare Professionals ◽

Phase 1 ◽

Well Being ◽

Patient Choice ◽

Control Group ◽

Cluster Rct ◽

Definitive Trial ◽

Qualitative Process Evaluation

Abstract Background Haemodialysis can negatively impact quality of life and mental health. Arts-based interventions used successfully in other settings to improve health and well-being, could help address the impact of haemodialysis. This study aimed to evaluate the feasibility and acceptability of conducting a randomised controlled trial (RCT) of an arts-based intervention for patients receiving haemodialysis. Methods A parallel convergent mixed-methods design was used, including a pilot cluster RCT and qualitative process evaluation. Phase 1 evaluated recruitment and retention rates through a pilot cluster RCT at a single haemodialysis unit in Northern Ireland. Participants included patients who received haemodialysis for ESKD, were over the age of 18 and had the capacity to consent. These participants were randomised to the intervention or control group according to their haemodialysis shift. The intervention involved six one-hour, one-to-one facilitated arts sessions during haemodialysis. Phase 2 explored intervention and trial acceptability through a qualitative process evaluation using semi-structured interviews based on the RE-AIM framework. Participants included 13 patients who participated in phase 1 of the study, including 9 participants from the experimental group and four participants from the control group, and nine healthcare professionals who were present on the unit during implementation. Results Out of 122 outpatient haemodialysis patients, 94 were assessed as eligible for participation. Twenty-four participants were randomised, meaning 80% of the target sample size was recruited and the attrition rate at 3 months was 12.5% (n = 3). Participants viewed the arts as more accessible and enjoyable than anticipated following implementation. All participants who started the intervention (n = 11) completed the full six sessions. Qualitative benefits of the intervention suggest improvements in mental well-being. Patient choice and facilitation were important factors for successful implementation. Conclusion An arts-based intervention for patients receiving haemodialysis is acceptable for both patients and healthcare professionals, and a definitive trial is feasible. The intervention may help improve mental-wellbeing in patients receiving haemodialysis, but this requires further investigation in a definitive trial. Trial registration The trial was prospectively registered on clinicaltrials.gov on 14/8/2018, registration number NCT03629496.

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The impact of the Safer Anaesthesia from Education (SAFE) Obstetric Anaesthesia training course in Ethiopia: A mixed methods longitudinal cohort study

Anaesthesia and Intensive Care ◽

10.1177/0310057x20940330 ◽

2020 ◽

Vol 48 (4) ◽

pp. 297-305

Author(s):

Jolene N Moore ◽

Wayne W Morriss ◽

Gebrehiwot Asfaw ◽

Gosa Tesfaye ◽

Aaliya R Ahmed ◽

...

Keyword(s):

Cohort Study ◽

Mixed Methods ◽

Maternal Mortality ◽

Longitudinal Cohort Study ◽

Structured Interviews ◽

Middle Income ◽

Longitudinal Cohort ◽

Obstetric Anaesthesia ◽

The Impact

Summary Reducing maternal mortality remains a global priority, particularly in low- and middle-income countries (LMICs). The Safer Anaesthesia from Education (SAFE) Obstetric Anaesthesia (OB) course is a three-day refresher course for trained anaesthesia providers addressing common causes of maternal mortality in LMICs. This aim of this study was to investigate the impact of SAFE training for a cohort of anaesthesia providers in Ethiopia. We conducted a mixed methods longitudinal cohort study incorporating a behavioural questionnaire, multiple-choice questionnaires (MCQs), structured observational skills tests and structured interviews for anaesthesia providers who attended one of four SAFE-OB courses conducted in two regions of Ethiopia from October 2017 to May 2018. Some 149 participants from 60 facilities attended training. Behavioural questionnaires were completed at baseline ( n = 101, 69% response rate). Pre- and post-course MCQs ( n = 121, n = 123 respectively) and pre- and post-course skills tests ( n = 123, n = 105 respectively) were completed, with repeat MCQ and skills tests, and semi-structured interviews completed at follow-up ( n = 88, n = 76, n = 49 respectively). The mean MCQ scores for all participants improved from 80.3% prior to training to 85.4% following training ( P < 0.0001) and skills test scores improved from 56.5% to 83.2% ( P < 0.0001). Improvements in MCQs and skills were maintained at follow-up 3–11 months post-training compared to baseline ( P = 0.0006, < 0.0001 respectively). Participants reported improved confidence, teamwork and communication at follow-up. This study suggests that the SAFE-OB course can have a sustained impact on knowledge and skills and can improve the confidence of anaesthesia providers and communication within surgical teams.

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Exploring the factors motivating continued Lay First Responder participation in Uganda: a mixed-methods, 3-year follow-up

Emergency Medicine Journal ◽

10.1136/emermed-2020-210076 ◽

2020 ◽

Vol 38 (1) ◽

pp. 40-46

Author(s):

Peter G Delaney ◽

Zachary J Eisner ◽

T Scott Blackwell ◽

Ibrahim Ssekalo ◽

Rauben Kazungu ◽

...

Keyword(s):

Mixed Methods ◽

Low Income ◽

First Responders ◽

Prehospital Emergency Care ◽

Structured Interviews ◽

Economic Implications ◽

Taxi Drivers ◽

Financial Benefits ◽

Motorcycle Taxi

BackgroundThe WHO recommends training lay first responders (LFRs) as the first step towards establishing emergency medical services (EMS) in low-income and middle-income countries. Understanding social and financial benefits associated with responder involvement is essential for LFR programme continuity and may inform sustainable development.MethodsA mixed-methods follow-up study was conducted in July 2019 with 239 motorcycle taxi drivers, including 115 (75%) of 154 initial participants in a Ugandan LFR course from July 2016, to evaluate LFR training on participants. Semi-structured interviews and surveys were administered to samples of initial participants to assess social and economic implications of training, and non-trained motorcycle taxi drivers to gauge interest in LFR training. Themes were determined on a per-question basis and coded by extracting keywords from each response until thematic saturation was achieved.ResultsThree years post-course, initial participants reported new knowledge and skills, the ability to help others, and confidence gain as the main benefits motivating continued programme involvement. Participant outlook was unanimously positive and 96.5% (111/115) of initial participants surveyed used skills since training. Many reported sensing an identity change, now identifying as first responders in addition to motorcycle taxi drivers. Drivers reported they believe this led to greater respect from the Ugandan public and a prevailing belief that they are responsible transportation providers, increasing subsequent customer acquisition. Motorcycle taxi drivers who participated in the course reported a median weekly income value that is 24.39% higher than non-trained motorcycle taxi counterparts (p<0.0001).ConclusionsA simultaneous delivery of sustained social and perceived financial benefits to LFRs are likely to motivate continued voluntary participation. These benefits appear to be a potential mechanism that may be leveraged to contribute to the sustainability of future LFR programmes to deliver basic prehospital emergency care in resource-limited settings.

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