scholarly journals ‘Going the distance’: an independent cohort study of engagement and dropout among the first 100 000 referrals into a large-scale diabetes prevention program

2020 ◽  
Vol 8 (2) ◽  
pp. e001835
Author(s):  
Elizabeth Howarth ◽  
Peter J Bower ◽  
Evangelos Kontopantelis ◽  
Claudia Soiland-Reyes ◽  
Rachel Meacock ◽  
...  
Keyword(s):  
Cohort Study ◽  
Service Delivery ◽  
Diabetes Prevention ◽  
Large Scale ◽  
Service Providers ◽  
Intraclass Correlation ◽  
Prevention Programs ◽  
Case Mix ◽  
Out Of Hours ◽  
The Impact

IntroductionDiabetes prevention programs (DPPs) are effective, in a pre-diabetic population, in reducing weight, lowering glycated hemoglobin and slowing the progression to diabetes. Little is known about the relationship between participation in DPPsand participant characteristics or service delivery. We investigated uptake and retention in England’s NHS DPP, reporting on variability among patient subgroups, providers, and sites.Research design and methodsThis prospective cohort study included 99 473 adults with non-diabetic hyperglycemia referred to the English DPP between 2016 and 2017. The program seeks to change health behaviors by offering at least 16 hours of group education and exercise. Multilevel logistic regression models were used to analyze variation in uptake, retention, and completion.ResultsUptake among 99 473 adults referred to the program was 56% (55 275). Among 55 275 who started the program, 34% (18 562) achieved the required dose and 22% (12 127) completed the full course. After adjustment for variation in case mix, substantial heterogeneity in uptake and retention was seen across four service providers (uptake OR 1.77 (1.33, 2.34), 4.30 (3.01, 6.15), and 1.45 (1.07, 1.97) compared with the reference provider) and between sites (uptake for typical individuals ranged from 0.32 to 0.78 across the middle 95% of sites, intraclass correlation coefficient (ICC) 0.07). Higher levels of retention and completion were seen where some out-of-hours provision was offered (retention OR 1.32 (1.25, 1.39)).ConclusionsThis study provides the first independent assessment of participation in the English DPP and the first study internationally to examine the impact of DPP service delivery on participation. When implementing a large-scale DPP, heterogeneity in service provision between different providers and sites can result in variable participation beyond that attributable to case mix, with potential consequences for effectiveness and health inequalities. Extending out-of-hours provision may improve participation in prevention programs.

scholarly journals Co-creating a large-scale adolescent health survey integrated with access to digital health interventions

2020 ◽  
Author(s):  
Roshini Peiris-John ◽  
Lovely Dizon ◽  
Kylie Sutcliffe ◽  
Kristy Kang ◽  
Theresa Fleming
Keyword(s):  
Adolescent Health ◽  
Health Survey ◽  
Large Scale ◽  
Service Providers ◽  
Digital Health ◽  
Health Interventions ◽  
Future Research ◽  
Health Providers ◽  
Health And Wellbeing ◽  
The Impact

Aim This paper describes how we engaged with adolescents and health providers to integrate access to digital health interventions as part of a large-scale secondary school health and wellbeing survey in New Zealand. Methods We conducted nine participatory, iterative co-design sessions involving 29 adolescents, and two workshops with young people (n = 11), digital and health service providers (n = 11) and researchers (n = 9) to gain insights into end-user perspectives on the concept and how best to integrate digital interventions in to the survey. Results Students’ perceived integrating access to digital health interventions into a large-scale youth health survey as acceptable and highly beneficial. They did not want personalized/normative feedback, but thought that every student should be offered all the help options. Participants identified key principles: assurance of confidentiality, usability, participant choice and control, and language. They highlighted wording as important for ease and comfort, and emphasised the importance of user control. Participants expressed that it would be useful and acceptable for survey respondents to receive information about digital help options addressing a range of health and wellbeing topics. Conclusion The methodology of adolescent-practitioner-researcher collaboration and partnership was central to this research and provided useful insights for the development and delivery of adolescent health surveys integrated with digital help options. The results from the ongoing study will provide useful data on the impact of digital health interventions integrated in large-scale surveys, as a novel methodology. Future research on engaging with adolescents once interventions are delivered will be useful to explore benefits over time.

Development of Large-Scale User/Client Application for Automobile Networking Sector

2021 ◽  
Vol 23 (06) ◽  
pp. 1061-1067
Author(s):  
Aishrith P Rao ◽  
◽  
Dr. Minal Moharir ◽  
Keyword(s):  
Service Delivery ◽  
Feedback Loop ◽  
Large Scale ◽  
Service Providers ◽  
Indian Subcontinent ◽  
Young Generation ◽  
Client Application ◽  
Current State ◽  
Milestone Payment ◽  
Pain Points

Large Scale User Applications have been prevalent in the 5G era especially in sectors such as automobile, employee tracking features, e-commerce management, etc., especially with services that connect users with their pain points. One of the pain points observed in the subcontinent regarding an overlooked scenario was driving schools and the business of driving services. The current state of driving schools tends to confuse the user base with miscommunications, late service delivery, licensing formalities, and also the payment structure in the absence of a feedback loop. This project attempts to create a full-fledged driving service solution for the 38-lakh user base in the Indian Subcontinent, so as to acquire driving service providers and connect them with the target audience. This would prompt a smoother process of user onboarding as well as improve the service quality with an integrated milestone payment loop. The results observed through the launch of the application on the Play Store were positive and the young generation aged 18-15 were highly enthusiastic about using the service.

The impact of technological innovation upon servitization

2019 ◽  
Vol 30 (7) ◽  
pp. 1097-1114 ◽  
Author(s):  
Bang-Ning Hwang ◽  
Mu-Yen Hsu
Keyword(s):  
Service Delivery ◽  
Technological Innovation ◽  
Large Scale ◽  
Manufacturing Firms ◽  
Multivariate Logistic Regression Model ◽  
Technological Innovations ◽  
Manufacturing Firm ◽  
Content Type ◽  
The Impact ◽  
The Relationship

Purpose For most manufacturing firms, technological innovations are usually the key strategies to gain their competitive advantages. However, competing strategically through service provision is becoming an important strategy for most industries. A growing demand for packaged product and service delivery is blurring the traditional boundaries between manufacturing and service firms. This trend is called “servitization.” Prior research had different perspectives on the relationship between technological innovations and servitization. Some argued that as servitization exerts the innovative convergence of products and services, the possession of appropriate readiness and absorption capacity through technological innovations for a manufacturing firm is critical to the success of servitization. In contrast, some argued that the knowledge gained from developing technological innovations cannot be applied to the creation of services due to the fundamental difference between technology and service. These contradicting arguments motivated the authors to study the relationship between technological innovations and servitization a step further. The paper aims to discuss these issues. Design/methodology/approach To address the research gap, the authors conducted an empirical study based on the large-scale samples from the second Taiwan Community Innovation Survey (Taiwan CIS). A multivariate logistic regression model was applied in the research. Findings The authors found that different types of technological innovations, namely product innovation and process innovation, have different impacts on servitization. The innovativeness level of the technological innovation moderates the relationship between technological innovation and servitization. Based on the above findings, this research specifically explains the causes of the contradictory results of the prior research. Originality/value The values of this research are twofold. Its academic contribution rests on bridging the literature of innovation and servitization, and on providing a model to clarify the relationships among technological innovation type, level of innovativeness and servitization. Its practical contribution lies in its establishment of a guideline that illuminates manufacturing firms reinforcing service delivery through their existing technological innovation trajectory.

scholarly journals Communicative characteristics of general practitioner-led and nurse-led telephone triage at two Danish out-of-hours services: an observational study of 200 recorded calls

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028434 ◽  
Author(s):  
Emil Vilstrup ◽  
Dennis Schou Graversen ◽  
Linda Huibers ◽  
Morten Bondo Christensen ◽  
Anette Fischer Pedersen
Keyword(s):  
General Practitioner ◽  
Observational Study ◽  
Large Scale ◽  
Patient Flow ◽  
Clinical Decision ◽  
Secondary Outcome ◽  
Telephone Triage ◽  
Out Of Hours ◽  
Safety Issues ◽  
The Impact

ObjectivesOut-of-hours (OOH) telephone triage is used to manage patient flow, but knowledge of the communicative skills of telephone triagists is limited. The aims of this study were to compare communicative parameters in general practitioner (GP)-led and nurse-led OOH telephone triage and to discuss differences in relation to patient-centred communication and safety issues.DesignObservational study.SettingTwo Danish OOH settings: a large-scale general practitioner cooperative in the Central Denmark Region (n=100 GP-led triage conversations) and Medical Helpline 1813 in the Capital Region of Denmark (n=100 nurse-led triage conversations with use of a clinical decision support system).Participants200 audio-recorded telephone triage conversations randomly selected.Primary and secondary outcome measuresConversations were compared with regard to length of call, distribution of speaking time, question types, callers’ expression of negative affect, and nurses’ and GPs’ responses to callers’ negative affectivity using the Mann-Whitney U test and the Student’s t-test.ResultsCompared with GPs, nurses had longer telephone contacts (137s vs 264 s, p=0.001) and asked significantly more questions (5 vs 9 questions, p=0.001). In 36% of nurse-led triage conversations, triage nurses either transferred the call to a physician or had to confer the call with a physician. Nurses gave the callers significantly more spontaneous talking time than GPs (23.4s vs 17.9 s, p=0.01). Compared with nurses, GPs seemed more likely to give an emphatic response when a caller spontaneously expressed concern; however, this difference was not statistically significant (36% vs 29%, p=0.6).ConclusionsWhen comparing communicative parameters in GP-led and nurse-led triage, several differences were observed. However, the impact of these differences in the perspective of patient-centred communication and safety needs further research. More knowledge is needed to determine what characterises good quality in telephone triage communication.

scholarly journals Measurement of Glycated Hemoglobin A1c from Dried Blood by Turbidimetric Immunoassay

2009 ◽  
Vol 3 (5) ◽  
pp. 1203-1206 ◽  
Author(s):  
Ramakrishnan Lakshmy ◽  
Ruby Gupta
Keyword(s):  
Whole Blood ◽  
Large Scale ◽  
Hemoglobin A1c ◽  
Glycated Hemoglobin ◽  
Intraclass Correlation ◽  
Dried Blood Spots ◽  
Sample Collection ◽  
Blood Spots ◽  
Glycated Hemoglobin A1c ◽  
The Impact

Background: Glycated hemoglobin A1c (A1C) is an important marker in the diagnosis and treatment of diabetes. Dried blood measurement of A1C is useful in large scale epidemiological evaluation of A1C, especially to assess the impact of intervention programs. The possibility of using dried blood for measurement of A1C by the immunoturbidimetric method was explored in the present study. Method: Blood was collected from 30 patients, and blood spots were prepared and dried. The dried blood spot samples were kept for different lengths of time at 4°C to assess stability. Glycated hemoglobin was measured in whole blood and dried blood on the day of collection as well as on days 10 and 15 by immunoturbidimetric method. Results: The A1C values of 30 samples analyzed for comparison between whole blood estimation and dried blood ranged from 4.6% to 9.9%. The mean A1C on the day of sample collection was 6.01% ± 1.58% in fresh whole blood samples and 5.94% ± 1.58 % in dried blood spots. A linear and highly correlated relationship was observed between dried blood A1C values and those in whole blood ( r = 0.986 and intraclass correlation value = 0.993). Glycated hemoglobin values on day 10 and day 15 were comparable with the values on day 1 with a shift in mean of just 1% on day 10 and 3.04% on day 15. Conclusion: In conclusion, dried blood can be used for measurement of A1C by immunoturbidimetric method, and further stability of A1C measurement from dried blood for up to 15 days at 4°C makes it an ideal matrix for transportation in developing countries like India.

scholarly journals Assessing the Impact of Service Quality on Customers and Operators: Empirical Study

2016 ◽  
Vol 11 (9) ◽  
pp. 207
Author(s):  
Mohammad Sultan Ahmad Ansari ◽  
Jamal Ahmad Farooquie ◽  
Said Gattoufi
Keyword(s):  
Customer Satisfaction ◽  
Service Quality ◽  
Service Delivery ◽  
Customer Loyalty ◽  
Service Providers ◽  
Operational Performance ◽  
Service Delivery System ◽  
Telecom Service ◽  
The Impact ◽  
Original Equipment Manufacturers

The aim of this paper is to evaluate the impact of Service Quality on Customer Satisfaction, Customer Loyalty and Operational Performance of telecom service industry in Sultanate of Oman. It also investigate how technology adds value to service delivery system and improvement of Service Quality. The empirical data were collected by administering 1,450 questionnaires and out of which 888 completed and usable responses were retrieved. The study is first of kind that evaluated well-established chain of service i.e. services provided by Original Equipment Manufacturers to Telecom Service Providers and further service provided by the Telecom Service Providers to the End Users. The feedback was taken on forward and backward chain to evaluate comprehensive service chain, instead of evaluating an individual chain i.e. Service provided by Original Equipment Manufacturers to Telecom Service Providers or vice versa or from Telecom Service Providers to the End Users. Questionnaires feedback was taken from comprehensive chain of services, i.e. forward and backward chain feedback was considered. Research findings suggest that technological support would improve service delivery system and service organizations shall put special emphasize on Service Quality for achieving critical success, which would improve overall Customer Satisfaction, Customer Loyalty, Operational Performance and Firm Profitability.

scholarly journals Effectiveness of a community-based intervention to improve nutrition in young children in Senegal: a difference in difference analysis

2009 ◽  
Vol 12 (5) ◽  
pp. 667-673 ◽  
Author(s):  
Harold Alderman ◽  
Biram Ndiaye ◽  
Sebastian Linnemayr ◽  
Abdoulaye Ka ◽  
Claudia Rokx ◽  
...  
Keyword(s):  
Rural Areas ◽  
Large Scale ◽  
Service Providers ◽  
Growth Promotion ◽  
Difference In Difference ◽  
Health Seeking ◽  
Community Based ◽  
Regional Trends ◽  
Community Growth ◽  
The Impact

AbstractThere are few studies of community growth promotion as a means of addressing malnutrition that are based on longitudinal analysis of large-scale programmes with adequate controls to construct a counterfactual. The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006. The project, designed to extend nutrition and growth promotion intervention into rural areas through non-governmental organisation service providers, significantly lowered the risk of a child having a weight more than 2 sd below international norms. The odds ratio of being underweight for children in programme villages after introduction of the intervention was 0·83 (95% CI 0·686, 1·000), after controlling for regional trends and village and household characteristics. Most measured aspects of health care and health seeking behaviour improved in the treatment relative to the control.

scholarly journals Impact of the New Public Management Paradigm on the Operation of Federal Establishments in Borno State, Nigeria

2017 ◽  
Author(s):  
Usman D Umaru
Keyword(s):  
Quality Of Service ◽  
Service Delivery ◽  
Public Service ◽  
Public Management ◽  
New Public Management ◽  
Service Providers ◽  
Chi Square ◽  
New Public ◽  
The Impact

The study examined the impact of the New Public Management Paradigm on the operation of Federal establishments in Borno State, Nigeria. To achieve this objective, the collected data were analysed using Chi-square, Correlation and ANOVA. The study revealed that there is a significant improvement in the performance of the staff and the quality of service delivery in the Federal establishments under study. The study concluded that the outsourcing of services has improved the quality of service delivery. However, the policy was not being properly implemented because in some of the Federal establishments under study, the same services outsourced were being carried out by very few retained staff. They were not enough to do the job and the outsource firms given the contract, did not provide enough qualified staff to augment the short-fall. The study recommended that qualified service providers (outsourcing firms) in the relevant cadres be allowed to do the job or as an alternative, the Federal government can encourage the setting up of Independent Units in all its establishments to compete with the outsourcing firms in carrying out outsourcing services at a fee, in order to attain qualitaty service delivery.   Keywords: New Public Management, Public service, Outsourcing and Service delivery.

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