scholarly journals Hearing Norton Sound: mixed methods protocol of a community randomised trial to address childhood hearing loss in rural Alaska

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023081 ◽  
Author(s):  
Susan D Emmett ◽  
Samantha Kleindienst Robler ◽  
Joseph J Gallo ◽  
Nae-Yuh Wang ◽  
Alain Labrique ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Mixed Methods ◽  
Focus Groups ◽  
Randomised Trial ◽  
Trial Registration ◽  
Community Leaders ◽  
Stakeholder Groups ◽  
Study Results ◽  
Rural Alaska ◽  
Childhood Hearing Loss

IntroductionChildhood hearing loss has implications for school achievement, economic outcomes and quality of life. This study will engage rural Alaska communities in research to improve the school hearing screening and referral process, partnering with stakeholders to develop a locally derived, evidence-based solution to improve timely identification and treatment of childhood hearing loss.Methods and analysisMixed methods community randomised trial in 15 communities in the Norton Sound region of northwest Alaska. Data collection will span from April 2017 until February 2020. Qualitative and mixed methods components are described in this protocol and the community randomised trial in the companion protocol. Focus groups and community events will be held leading up to the randomised trial to obtain community perspectives on childhood hearing loss in Alaska and elicit community input during trial protocol refinement (exploratory sequential stage). Stakeholder groups, including parents, children, teachers, school administrators and community health aides, will participate, along with community leaders, tribal leaders and community members. The randomised trial will be combined with qualitative, semi-structured interviews to elicit stakeholder perspectives on the intervention (explanatory sequential stage). The five stakeholder groups described above will participate in interviews. The study will conclude with additional focus groups and community events to discuss results and provide community insight for future implementation. Concluding focus groups will include policymakers, healthcare administrators, and tribal and community leaders in addition to the stakeholder groups. Informed consent and child assent will be required. Recordings will be transcribed and deidentified, with only stakeholder group recorded. Analyses will include categorical coding as well as narrative and thematic analysis.Ethics and disseminationThe Hearing Norton Sound study has been approved by the Institutional Review Boards of Alaska Area, Norton Sound, and Duke University, with trial registration on clinicaltrials.gov. Study results will be distributed with equal emphasis on scientific and community dissemination.Trial registration numberNCT03309553; Results.

scholarly journals Hearing Norton Sound: a community randomised trial protocol to address childhood hearing loss in rural Alaska

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023078 ◽  
Author(s):  
Susan D Emmett ◽  
Samantha Kleindienst Robler ◽  
Nae-Yuh Wang ◽  
Alain Labrique ◽  
Joseph J Gallo ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Randomised Trial ◽  
Test Validity ◽  
Hearing Screening ◽  
Referral Process ◽  
Rural Alaska ◽  
Children With Hearing Loss ◽  
K 12 ◽  
Childhood Hearing Loss

IntroductionThe population in rural Alaska experiences a disproprionately high burden of infection-mediated hearing loss. While the state mandates school hearing screening, many children with hearing loss are not identified or are lost to follow-up before ever receiving treatment. A robust, tribally owned healthcare system exists in Alaska, but children with hearing loss must first be identified and referred for existing infrastructure to be used. This trial will evaluate a new school hearing screening and referral process in rural Alaska, with the goal of improving timely identification and treatment of childhood hearing loss.Methods and analysisComparative effectiveness community randomised trial testing digital innovations to improve school hearing screening and referral in 15 communities in the Norton Sound region of northwest Alaska, with data collection from October 2017 to February 2020. All children (K-12) attending school in Bering Strait School District with parental informed consent and child assent will be eligible (target recruitment n=1500). Participating children will undergo both the current school hearing screen and new mobile health (mHealth) screen, with screening test validity evaluated against an audiometric assessment. Communities will be cluster randomised to continue the current primary care referral process or receive telemedicine referral for follow-up diagnosis and treatment. The primary outcome will be time to International Statistical Classification of Diseases, 10th Revision, ear/hearing diagnosis from screening date, measured in days. Secondary outcomes will include: sensitivity and specificity of current school and mHealth screening protocols measured against a benchmark audiometric assessment (air and bone conduction audiometry, tympanometry and digital otoscopy); hearing loss prevalence; hearing-related quality of life; and school performance (AIMSweb). Intention-to-treat analysis will be used.Ethics and disseminationThis study has been approved by the Institutional Review Boards of Alaska Area, Norton Sound and Duke University and is registered on clinicaltrials.gov. Results will be distributed with equal emphasis on scientific and community dissemination.Trial registration numberNCT03309553; Pre-results.

Listening-Related Fatigue in Children With Hearing Loss: Perspectives of Children, Parents, and School Professionals

2021 ◽  
pp. 1-12
Author(s):  
Hilary Davis ◽  
David Schlundt ◽  
Kemberlee Bonnet ◽  
Stephen Camarata ◽  
Benjamin Hornsby ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Focus Groups ◽  
Process Analysis ◽  
Pediatric Population ◽  
Theoretical Framework ◽  
Negative Consequences ◽  
Profound Hearing Loss ◽  
School Professionals ◽  
Stakeholder Groups ◽  
Children With Hearing Loss

Purpose Children with hearing loss (CHL) are considered at risk for listening-related fatigue and its negative consequences. We collected data via focus groups and interviews from three stakeholder groups—CHL, their parents, and teachers/school professionals—in order to define the construct of listening-related fatigue from the perspective of CHL and key stakeholders. This is an important first step in our long-term goal to construct and validate a measure (i.e., scale) of listening-related fatigue for the pediatric population, with a focus on CHL. This article provides an overview of the data gathering process, analysis of qualitative reports, and the development of a theoretical framework for understanding the experience of listening-related fatigue in CHL. Method We conducted focus groups and interviews in school-age children exhibiting bilateral, moderate-to-profound hearing loss ( n = 43), their parents ( n = 17), and school professionals who work with CHL ( n = 28). The discussions were audio-recorded, transcribed, and coded using a hierarchical coding system. Qualitative analysis was conducted using an iterative inductive–deductive approach. Results We identified primary themes from the focus group/interview discussions to develop a theoretical framework of listening-related fatigue in CHL. The framework demonstrates the complex interaction among situational determinants that impact fatigue, symptoms or manifestations of fatigue, and the utilization of, and barriers to, coping strategies to reduce listening-related fatigue. Conclusions Participant discussion suggests that listening-related fatigue is a significant problem for many, but not all, CHL. Qualitative data obtained from these stakeholder groups help define the construct and provide a framework for better understanding listening-related fatigue in children.

scholarly journals The candidate perspective of the clinical competency test (CCT) of the MICGP examination: a mixed-methods study

BJGP Open ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. bjgpopen18X101605 ◽  
Author(s):  
Tony Foley ◽  
Kathleen McLoughlin ◽  
Elaine K Walsh ◽  
Paul Leggett ◽  
Muríosa O'Reilly ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
General Practitioners ◽  
Clinical Skills ◽  
Mixed Methods Study ◽  
Clinical Competency ◽  
Online Questionnaire ◽  
Clinical Skills Assessment ◽  
Time Restrictions ◽  
Study Results

BackgroundThe clinical competency test (CCT) was introduced by the Irish College of General Practitioners (ICGP) in 2015. Similar to the clinical skills assessment (CSA) of the Membership of the Royal College of General Practitioners exam (MRCGP), the CCT is a modified objective structured clinical examination (OSCE).AimThe aim of this study was to evaluate the MICGP CCT from the candidates' perspective, to gain an insight into their views of its fairness, relevance, and acceptability.Design & settingThis mixed-methods study was conducted with GP registrars in Ireland.MethodThe study was conducted in two phases. Firstly, focus groups were conducted with participants who had previously undertaken the CCT to explore their experience of the CCT. Secondly, findings from the focus groups informed the development of an online questionnaire, which was sent to all GP registrars who completed the CCT in the 2017 summer sitting.ResultsTwo focus groups were held with a total of nine participants. Following this, the online questionnaire was emailed to 134 registrars. Of these, 83 registrars completed the questionnaire in full. Registrars reported that the CCT is a fair exam and is relevant to daily general practice. They considered the exam to be a comprehensive assessment that has a positive educational impact. However, they were challenged by time restrictions, and found it financially and emotionally stressful.ConclusionThis is the first study to evaluate the candidate’s perspective of an exiting GP membership exam in the UK or Ireland. The CCT is well-regarded by registrars. The study results will help to inform the future development of the CCT exam.

Information-seeking to Support Personal and Community Wellbeing: Report of a study of New Zealand Men Using Focus Groups

2016 ◽  
Author(s):  
Peta Wellstead
Keyword(s):  
New Zealand ◽  
Focus Groups ◽  
Support Services ◽  
Information Seeking ◽  
Service Providers ◽  
Structural Constraints ◽  
Health And Wellbeing ◽  
Study Results ◽  
Groupes De Discussion

This paper reports part of an ongoing study exploring the information behaviour of New Zealand men during periods of diminished health and wellbeing. Focus groups were used for this iteration of the study. Results indicate that New Zealand men face both personal and structural constraints to their information-seeking during periods when their health and wellbeing may be compromised. This study highlights that service providers need to develop more effective information delivery mechanisms and support services for men. These services need to be appealing to men and reflect men’s information seeking preferences. The role of LIS professionals in supporting this endeavour is discussed. Cet article présente une étude en cours explorant le comportement informationnel d’ hommes néo-zélandais durant des périodes où leur état de santé et de bien-être est amoindri. Des groupes de discussion ont été utilisés pour cette itération de l'étude. Les résultats indiquent que les hommes en Nouvelle-Zélande font face à des contraintes à la fois  personnelles et structurelles dans leur recherche d'information pendant les périodes où leur santé et leur bien-être peuvent être affaiblis. Cette étude met en évidence le besoin pour les fournisseurs de services de développer des mécanismes de diffusion de l'information plus efficaces et des services de soutien pour les hommes. Ces services doivent être attrayants et refléter les préférences des hommes dans leurs recherches d’information. Le rôle des professionnels de l'information dans le soutien à cette entreprise est discuté.

The Development of an Online Tobacco Tracker Tool to Crowdsource Campus Environmental Reports for Smoke and Tobacco Free College Policies: A Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Sabrina F. Loureiro ◽  
Kim M. Pulvers ◽  
Melissa M. Gosdin ◽  
Keavagh R. Clift ◽  
Myra J. Rice ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Positive Reinforcement ◽  
The United States ◽  
College Campuses ◽  
Policy Enforcement ◽  
Sequential Mixed Methods ◽  
Effective Policy ◽  
Online Tracking ◽  
One Year

BACKGROUND College campuses in the United States have begun implementing Smoke and Tobacco-Free policies to discourage the use of tobacco. Smoke and Tobacco-Free policies, however, are contingent upon effective policy enforcement. OBJECTIVE To develop an empirically-derived online tracking tool (Tracker) for crowdsourcing campus environmental reports of tobacco use and waste to support smoke and tobacco-free college policies. METHODS An exploratory sequential mixed methods approach was utilized to inform the development and evaluation of the Tracker. In October 2018, three focus groups across two California universities were conducted and themes were analyzed, guiding Tracker development. After one year of implementation, users were asked in April 2020 to complete a survey about their experience. RESULTS In the focus groups, two major themes emerged: barriers and facilitators to tool utilization. Further Tracker development was guided by focus group input to address these barriers (e.g. information, policing, and logistical concerns) and facilitators (e.g. environmental motivators, positive reinforcement). Amongst 1,163 Tracker reports, those who completed the user survey (n=316) reported the top motivations to using the tool were having a cleaner environment (79%) and health concerns (69%). CONCLUSIONS Environmental concerns, a motivator which emerged in focus groups, shaped the Tracker’s development and was cited by the majority of users surveyed as a top motivator for utilization.

scholarly journals Correction to: Economic Evaluations of Childhood Hearing Loss Screening Programmes: A Systematic Review and Critique

2019 ◽  
Vol 17 (3) ◽  
pp. 419-419
Author(s):  
Rajan Sharma ◽  
Yuanyuan Gu ◽  
Teresa Y. C. Ching ◽  
Vivienne Marnane ◽  
Bonny Parkinson
Keyword(s):  
Systematic Review ◽  
Hearing Loss ◽  
Economic Evaluations ◽  
Childhood Hearing Loss

scholarly journals A theoretically informed, mixed-methods study of pharmacists’ aspirations and readiness to implement pharmacist prescribing

2021 ◽  
Author(s):  
Derek Stewart ◽  
Abdulrouf Pallivalapila ◽  
Binny Thomas ◽  
Yolande Hanssens ◽  
Wessam El Kassem ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Tertiary Care ◽  
Pharmacy Practice ◽  
Principal Component ◽  
Management Support ◽  
Pharmacist Prescribing ◽  
Facilitators And Barriers ◽  
Physician Resistance ◽  
Inner Setting

AbstractBackground Studies have highlighted advancing clinical pharmacy practice in Qatar. Objective To explore pharmacists’ aspirations and readiness to implement pharmacist prescribing. Setting Hamad Medical Corporation (HMC), the main provider of secondary and tertiary care. Method A sequential explanatory mixed-methods design. Questionnaire items were derived from the Consolidated Framework of Implementation Research (CFIR), in domains of: awareness/support; readiness; implementation; and facilitators and barriers. Following piloting, all pharmacists (n = 554) were invited to participate. Questionnaire data were analysed using descriptive and inferential statistics with principal component analysis of attitudinal items. Focus groups were recorded, transcribed and analysed using the Framework Approach. Main outcome measure Aspirations and readiness to implement pharmacist prescribing. Results The response rate was 62.8% (n = 348), with respondents highly supportive of implementation in Qatar (median 4, scale 0–5, extremely supportive). The majority (64.9%, n = 226) considered themselves ready, particularly those more senior (p < 0.05) and classifying themselves innovative (p < 0.01). Outpatient (72.9%, n = 221 agreeing) and inpatient (71.1%, n = 218 agreeing) HMC settings were those perceived as being most ready. PCA identified 2 components, with ‘personal attributes’ being more positive than ‘prescribing support’. Facilitators were access to records, organizational/management support and the practice environment, with physician resistance and scope of practice as barriers. Focus groups provided explanation, with themes in CFIR domains of innovation characteristics, characteristics of individuals and the inner setting. Conclusion HMC pharmacists largely aspire, and consider themselves ready, to be prescribers with inpatient and outpatient settings most ready. CFIR domains and constructs identified as facilitators and barriers should be focus for implementation.

scholarly journals An intervention to decrease burnout and increase retention of early career nurses: a mixed methods study of acceptability and feasibility

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Judy Brook ◽  
Leanne M. Aitken ◽  
Julie-Ann MacLaren ◽  
Debra Salmon
Keyword(s):  
Mixed Methods ◽  
Nursing Students ◽  
Focus Groups ◽  
Academic Staff ◽  
Skills Training ◽  
Early Career ◽  
Mixed Methods Study ◽  
Healthcare Organisation ◽  
Structured Interviews ◽  
Over Time

Abstract Aims To understand the experiences of nursing students and academic staff of an intervention to decrease burnout and increase retention of early career nurses, in order to identify acceptability and feasibility in a single centre. Background Internationally, retention of nurses is a persistent challenge but there is a dearth of knowledge about the perspectives of stakeholders regarding the acceptability and feasibility of interventions to resolve the issue. This study reports an intervention comprising of mindfulness, psychological skills training and cognitive realignment to prepare participants for early careers as nurses. Methods This is an explanatory sequential mixed methods study, conducted by a UK university and healthcare organisation. Participants were final year pre-registration nursing students (n = 74) and academics (n = 7) involved in the implementation of the intervention. Pre and post measures of acceptability were taken using a questionnaire adapted from the Theoretical Framework of Acceptability. Wilcoxon Signed Ranks test was used to assess change in acceptability over time. Qualitative data from semi-structured interviews, focus groups and field notes were thematically analysed, adhering to COREQ guidelines. Data were collected February to December 2019. Results One hundred and five questionnaires, 12 interviews with students and 2 focus groups engaging 7 academic staff were completed. The intervention was perceived as generally acceptable with significant positive increases in acceptability scores over time. Student nurses perceived the intervention equipped them with skills and experience that offered enduring personal benefit. Challenges related to the practice environment and academic assessment pressures. Reported benefits align with known protective factors against burnout and leaving the profession. Conclusion Planning is needed to embed the intervention into curricula and maximise relationships with placement partners. Evaluating acceptability and feasibility offers new knowledge about the value of the intervention for increasing retention and decreasing burnout for early career nurses. Wider implementation is both feasible and recommended by participants.

scholarly journals Web-based early intervention for children with motor difficulties aged 3–8 years old using multimodal rehabilitation (WECARE): protocol of a patient-centred pragmatic randomised trial of paediatric telerehabilitation to support families

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e046561
Author(s):  
Chantal Camden ◽  
Jill G Zwicker ◽  
Melanie Morin ◽  
Tibor Schuster ◽  
Melanie Couture ◽  
...  
Keyword(s):  
Early Intervention ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Parental Knowledge ◽  
Performance Measure ◽  
Performance Goals ◽  
Web Based ◽  
Study Results ◽  
Motor Difficulties ◽  
Randomised Controlled

IntroductionMild motor difficulties in children are underdiagnosed despite being highly prevalent, leaving such children often underserved and at higher risk for secondary consequences such as cardiovascular disease and anxiety. Evidence suggests that early patient-oriented interventions, coaching parents and providing children with early stimulation should be provided, even in the absence of a diagnosis. Such interventions may be effectively delivered via telerehabilitation.Methods and analysisA family-centred, pragmatic randomised controlled trial will be carried out to evaluate the real-world effectiveness of a Web-based Early intervention for Children using multimodAl REhabilitation (WECARE). Families of children with motor difficulties, 3–8 years of age, living in Quebec, Canada, and receiving no public rehabilitation services (n=118) will be asked to determine up to 12 performance goals, evaluated using the Canadian Occupational Performance Measure (COPM, the primary outcome). Families will be randomised to receive either usual care or the WECARE intervention. The WECARE intervention will be delivered for 1 year via a web-based platform. Families will have access to videoconferences with an assigned rehabilitation therapist using a collaborative coaching approach, a private chat function, a forum open to all intervention arm participants and online resources pertaining to child development. Participants will be asked to re-evaluate the child’s COPM performance goals every 3 months up to 1 year post allocation. The COPM results will be analysed using a mixed Poisson regression model. Secondary outcomes include measures of the child’s functional ability, parental knowledge and skills and health-related quality of life, as well as qualitative outcomes pertaining to parental satisfaction and service delivery trajectories. Investigators and quantitative data analysts will be blinded to group allocation.Ethics and disseminationThe CIUSSS de l’Estrie—CHUS ethics committee approved this trial (2020-3429). Study results will be communicated via peer-reviewed journal publications, conference presentations and stakeholder-specific knowledge transfer activities.Trial registration numberNCT04254302.

scholarly journals LOAD-intensity and time-under-tension of exercises for men who have Achilles tendinopathy (the LOADIT trial): a randomised feasibility trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Fatmah Hasani ◽  
Terry Haines ◽  
Shannon E. Munteanu ◽  
Peter Schoch ◽  
Bill Vicenzino ◽  
...  
Keyword(s):  
Adverse Events ◽  
Randomised Trial ◽  
Exercise Adherence ◽  
Achilles Tendinopathy ◽  
Trial Registration ◽  
Feasibility Trial ◽  
Productivity Cost ◽  
Repetition Maximum ◽  
Recruitment And Retention ◽  
Load Intensity

Abstract Background One potential reason for disparate outcomes of exercise for Achilles tendinopathy is poor knowledge about whether exercise parameters (i.e. different exercise doses) influence outcome. Whether parameters that are important for tendon adaptation influence clinical outcomes in Achilles tendinopathy has not been investigated. Therefore, this research aimed to assess the feasibility of conducting a fully powered randomised trial to investigate the efficacy of different load-intensity and time-under-tension exercise parameters for Achilles tendinopathy. Methods A factorial four-arm, randomised trial. Forty-eight male participants (18–70 years old) with mid-portion Achilles tendinopathy (≥ 3 months) were recruited. Participants were randomly allocated to high (6 repetition maximum) or low intensity (18 repetition maximum) exercise, performed with either high (6 s per cycle) or low (2 s per cycle) time-under-tension. Participants performed 12-weeks of standing and seated calf raise exercises three times per week in a gym setting using a Smith machine. One session per week was supervised (via videoconference). Primary feasibility outcomes (recruitment and retention rate, exercise adherence and fidelity [i.e. time-under-tension, volume, load intensity], incidence of adverse events, health care use and productivity cost) were collected weekly. Means and standard deviations were determined for parametric data, medians and interquartile range for non-parametric continuous data, and frequency counts for discrete data. Results Total recruitment (76%) and retention (90%) rates were high. Exercise adherence ranged from 45 to 63% and fidelity ranged from 8 to 83% across the groups. Thirty-one participants reported 64 adverse events over the 3 months. Twenty-one participants (70%) reported mild events. Participants reported reduced presenteeism more than absenteeism. Conclusions A fully powered trial is feasible. The proposed trial design and interventions demonstrated acceptable recruitment and retention rates and safety profile. However, exercise fidelity and adherence to the gym-based intervention was not acceptable. Strategies to improve intervention adherence and fidelity should be considered in future trials. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12618001315202. Registered retrospectively on August 6th, 2018.

Sign in / Sign up

Export Citation Format

Share Document