COVID‐19 diagnostic testing among underserved Latino communities: Barriers and facilitators

Abstract Background: Nitrate contamination in groundwater disproportionately impacts agricultural Latino communities, creating a significant hazard for Latinos that rely on private wells. Private well users must conduct water testing and other well stewardship behaviors to ensure their well water is safe to drink. This study sought to identify the barriers and facilitators of private well water testing in rural, agricultural Latino communities. Methods: We conducted four focus groups with private well users, two in Spanish and two in English. We recruited 37 participants from the Lower Yakima Valley, Washington State, a rural, agricultural community with a large Latino population and elevated nitrate concentrations in groundwater. A semi-structured interview guide was developed to capture testing barriers and facilitators guided by the Risk, Attitudes, Norms, Ability, and Self-Regulation (RANAS) model. Inductive thematic analysis was conducted by two coders to identify common themes. Results: Themes emerged around barriers and facilitators to well stewardship behaviors, including well testing, treatment, and maintenance. Barriers included limited actionable information, economic limitations, lack of technical support, and challenges related to landlords and neighbors. Facilitators of well stewardship included concerns about well water contamination, knowledge of agricultural sources of contamination, do-it-yourself (DIY) home repair experience, and responsibility to protect family. Conclusions: Well stewardship programs in rural, agricultural Latino communities may want to prioritize communication that provides actionable information on well water testing, treatment, and maintenance and emphasizes the responsibility to protect family in its messaging. Additionally, programs that provide financial and technical assistance and well maintenance education that builds on DIY home repair experience may be effective in these communities.

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Barriers and facilitators and the need for a clinical guideline for microbiological diagnostic testing in the hospital: a qualitative and quantitative study

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-019-03516-z ◽

2019 ◽

Vol 38 (5) ◽

pp. 913-920 ◽

Cited By ~ 2

Author(s):

Saskia J. Bogers ◽

Frederike V. van Daalen ◽

Sacha D. Kuil ◽

Menno D. de Jong ◽

Suzanne E. Geerlings

Keyword(s):

Quantitative Study ◽

Clinical Guideline ◽

Diagnostic Testing ◽

Barriers And Facilitators ◽

Qualitative And Quantitative ◽

Qualitative And Quantitative Study

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Implementation of a Clostridioides difficile prevention bundle: Understanding common, unique, and conflicting work system barriers and facilitators for subprocess design

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.150 ◽

2019 ◽

Vol 40 (8) ◽

pp. 880-888 ◽

Cited By ~ 2

Author(s):

Jackson S. Musuuza ◽

Ann Schoofs Hundt ◽

Pascale Carayon ◽

Karly Christensen ◽

Caitlyn Ngam ◽

...

Keyword(s):

Systems Engineering ◽

Diagnostic Testing ◽

Barriers And Facilitators ◽

Successful Implementation ◽

Work System ◽

Clostridioides Difficile ◽

Contact Isolation ◽

Management Procedures ◽

Algorithmic Approaches ◽

Environmental Disinfection

AbstractObjective:Clostridioides difficile (C. difficile) poses a major challenge to the healthcare system. We assessed factors that should be considered when designing subprocesses of a C. difficile infection (CDI) prevention bundle.Design:Phenomenological qualitative study.Methods:We conducted 3 focus groups of environmental services (EVS) staff, physicians, and nurses to assess their perspectives on a CDI prevention bundle. We used the Systems Engineering Initiative for Patient Safety (SEIPS) model to examine 5 subprocesses of the CDI bundle: diagnostic testing, empiric isolation, contact isolation, hand hygiene, and environmental disinfection. We coded transcripts to the 5 SEIPS elements and ensured scientific rigor. We sought to determine common, unique, and conflicting factors across stakeholder groups and subprocesses of the CDI bundle.Results:Each focus group lasted 1.5 hours on average. Common work-system barriers included inconsistencies in knowledge and practice of CDI management procedures; increased workload; poor setup of aspects of the physical environment (eg, inconvenient location of sinks); and inconsistencies in CDI documentation. Unique barriers and facilitators were related to specific activities performed by the stakeholder group. For instance, algorithmic approaches used by physicians facilitated timely diagnosis of CDI. Conflicting barriers or facilitators were related to opposing objectives; for example, clinicians needed rapid placement of a patient in a room while EVS staff needed time to disinfect the room.Conclusions:A systems engineering approach can help to holistically identify factors that influence successful implementation of subprocesses of infection prevention bundles.

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Gastroesophageal Reflux Disease: A Gastroenterologist's Perspective

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd21.3.89 ◽

2011 ◽

Vol 21 (3) ◽

pp. 89-99

Author(s):

Michael F. Vaezi

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Best Practice ◽

Clinical Care ◽

Diagnostic Testing ◽

Diagnostic Tools ◽

Swallowing Function ◽

Atypical Symptoms

Gastroesophageal reflux disease (GERD) is a commonly diagnosed condition often associated with the typical symptoms of heartburn and regurgitation, although it may present with atypical symptoms such as chest pain, hoarseness, chronic cough, and asthma. In most cases, the patient's reduced quality of life drives clinical care and diagnostic testing. Because of its widespread impact on voice and swallowing function as well as its social implications, it is important that speech-language pathologists (SLPs) understand the nature of GERD and its consequences. The purpose of this article is to summarize the nature of GERD and GERD-related complications such as GERD-related peptic stricture, Barrett's esophagus and adenocarcinoma, and laryngeal manifestations of GERD from a gastroenterologist's perspective. It is critical that SLPs who work with a multidisciplinary team understand terminology, diagnostic tools, and treatment to ensure best practice.

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