scholarly journals Feasibility, usability and acceptability of paediatric lung ultrasound among healthcare providers and caregivers for the diagnosis of childhood pneumonia in resource-constrained settings: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042547
Author(s):  
Atif Riaz ◽  
Olga Cambaco ◽  
Laura Elizabeth Ellington ◽  
Jennifer L Lenahan ◽  
Khatia Munguambe ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Low Income ◽  
Lung Ultrasound ◽  
New Technology ◽  
Healthcare Providers ◽  
Ease Of Use ◽  
Local Context ◽  
Future Research ◽  
Successful Implementation ◽  
Pneumonia Diagnosis

ObjectivesPaediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.DesignProspective qualitative study using semistructured interviewsSettingTwo referral hospitals in Mozambique and PakistanParticipantsA total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.ResultsHCPs highlighted themes of limited resource availability for the feasibility of LUS implementation, including perceived high cost of equipment, maintenance demands, time constraints and limited trained staff. HCPs emphasised the importance of policymaker support and caregiver acceptance for long-term success. HCP perspectives of usability highlighted ease of use and integration into existing workflow. HCPs and caregivers had positive attitudes towards LUS with few exceptions. Both HCPs and caregivers emphasised the potential for rapid, improved diagnosis of paediatric respiratory conditions using LUS.ConclusionsThis was the first study to evaluate HCP and caregiver perspectives of paediatric LUS through qualitative analysis. Critical components impacting feasibility, usability and acceptability of LUS for paediatric pneumonia diagnosis in LMIC were identified for initial deployment. Future research should explore LUS sustainability, with a particular focus on quality control, device maintenance and functionality and adoption of the new technology within the health system. This study highlights the need to engage both users and recipients of new technology early in order to adapt future interventions to the local context for successful implementation.Trial registration numberNCT03187067.

scholarly journals Community health worker models in South Africa: a qualitative study on policy implementation of the 2018/19 revised framework

2020 ◽  
Author(s):  
Joshua P Murphy ◽  
Aneesa Moolla ◽  
Sharon Kgowedi ◽  
Constance Mongwenyana ◽  
Sithabile Mngadi ◽  
...  
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Policy Implementation ◽  
Community Health ◽  
Resource Constraints ◽  
Health Workers ◽  
Healthcare Providers ◽  
Successful Implementation ◽  
Programme Implementation ◽  
Healthcare Facilities

Abstract South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South Africa’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning. We conducted a qualitative study among a sample of Department of Health Managers at the National, Provincial and District level, healthcare providers, implementing partners [including non-governmental organizations (NGOs) who worked with CHWs] and CHWs themselves. Data were collected between April 2018 and December 2018. We conducted 65 in-depth interviews (IDIs) with healthcare providers, managers and experts familiar with CHW work and nine focus group discussions (FGDs) with 101 CHWs. We present (i) current models of CHW policy implementation across South Africa, (ii) facilitators, (iii) barriers to CHW programme implementation and (iv) respondents’ recommendations on how the CHW programme can be improved. We chronicled the differences in NGO involvement, the common facilitators of purpose and passion in the CHWs’ work and the multitude of barriers and resource limitations CHWs must work under. We found that models of implementation vary greatly and that adaptability is an important aspect of successful implementation under resource constraints. Our findings largely aligned to existing research but included an evaluation of districts/provinces that had not previously been explored together. CHWs continue to promote health and link their communities to healthcare facilities, in spite of lack of permanent employment, limited resources, such as uniforms, and low wages.

Gamified Self

2016 ◽  
pp. 304-327
Author(s):  
Rachelle DiGregorio ◽  
Harsha Gangadharbatla
Keyword(s):  
Technology Acceptance ◽  
Online Survey ◽  
Personal Information ◽  
New Technology ◽  
Ease Of Use ◽  
Future Research ◽  
Research Directions ◽  
Future Research Directions ◽  
Self Knowledge ◽  
Over Time

Gamified self has many dimensions, one of which is self-tracking. It is an activity in which a person collects and reflects on their personal information over time. Digital tools such as pedometers, GPS-enabled mobile applications, and number-crunching websites increasingly facilitate this practice. The collection of personal information is now a commonplace activity as a result of connected devices and the Internet. Tracking is integrated into so many digital services and devices; it is more or less unavoidable. Self-tracking engages with new technology to put the power of self-improvement and self-knowledge into people's own hands by bringing game dynamics to non-game contexts. The purpose of this chapter's research is to move towards a better understanding of how self-tracking can (and will) grow in the consumer market. An online survey was conducted and results indicate that perceptions of ease of use and enjoyment of tracking tools are less influential to technology acceptance than perceptions of usefulness. Implications and future research directions are presented.

scholarly journals Unraveling PBF effects beyond impact evaluation: results from a qualitative study in Cameroon

2018 ◽  
Vol 3 (2) ◽  
pp. e000693 ◽  
Author(s):  
Manuela De Allegri ◽  
Maria Paola Bertone ◽  
Shannon McMahon ◽  
Idrissou Mounpe Chare ◽  
Paul Jacob Robyn
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Low Income ◽  
Impact Evaluation ◽  
Healthcare Providers ◽  
Analytical Techniques ◽  
Demand Side ◽  
Middle Income ◽  
Implementation Processes ◽  
Heterogeneous Effects

IntroductionPerformance-based financing (PBF) has acquired increased prominence as a means of reforming health system purchasing structures in low-income and middle-income countries. A number of impact evaluations have noted that PBF often produces mixed and heterogeneous effects. Still, little systematic effort has been channelled towards understanding what causes such heterogeneity, including looking more closely at implementation processes.MethodsOur qualitative study aimed at closing this gap in knowledge by attempting to unpack the mixed and heterogeneous effects detected by the PBF impact evaluation in Cameroon to inform further implementation as the country scales up the PBF approach. We collected data at all levels of the health system (national, district, facility) and at the community level, using a mixture of in-depth interviews and focus group discussions. We combined deductive and inductive analytical techniques and applied analyst triangulation.ResultsOur findings indicate that heterogeneity in effects across facilities could be explained by pre-existing infrastructural weaknesses coupled with rigid administrative processes and implementation challenges, while heterogeneity across indicators could be explained by providers’ practices, privileging services where demand-side barriers were less substantive.ConclusionIn light of the country’s commitment to scaling up PBF, it follows that substantial efforts (particularly entrusting facilities with more financial autonomy) should be made to overcome infrastructural and demand-side barriers and to smooth implementation processes, thus, enabling healthcare providers to use PBF resources and management models to a fuller potential.

scholarly journals Healthcare Professionals’ Acceptance of Digital Cognitive Rehabilitation

2020 ◽  
Vol 11 ◽  
Author(s):  
Ineke J. M. van der Ham ◽  
Rosalie van der Vaart ◽  
Anouk Miedema ◽  
Johanna M. A. Visser-Meily ◽  
Milan N. A. van der Kuil
Keyword(s):  
Technology Acceptance ◽  
Cognitive Rehabilitation ◽  
Healthcare Providers ◽  
Subjective Norm ◽  
Ease Of Use ◽  
Perceived Usefulness ◽  
Successful Implementation ◽  
Perceived Ease Of Use ◽  
Technological Advances ◽  
And Gender

With technological possibilities in healthcare steadily increasing, more tools for digital cognitive rehabilitation become available. Acceptance of such technological advances is crucial for successful implementation. Therefore, we examined technology acceptance specifically for this form of rehabilitation in a sample of healthcare providers involved in cognitive rehabilitation. An adjusted version of the Technology Acceptance Model (TAM) questionnaire was used, including the subscales for perceived usefulness, perceived ease of use, subjective norm (toward use), and intention to use, which all contribute to actual use of a specific technology. Results indicate a generally favorable attitude toward the use of digital cognitive rehabilitation and positive responses toward the TAM constructs. Only for subjective norm, a neutral mean response was found, indicating that this could pose a potential obstacle toward implementation. Potential differences between subgroups of different age, gender, and professional background were assessed. Age and gender did not affect the attitude toward digital cognitive rehabilitation. Occupational therapists showed lower scores than healthcare psychologists and physiatrists with regard to perceived usefulness, possibly linked to a difference in operational and managerial tasks. The findings of his study stimulate further implementation of digital cognitive rehabilitation, where the role of subjective norms should be specifically considered.

scholarly journals Patient-reported outcome measures in oncology: a qualitative study of the healthcare professional’s perspective

2021 ◽  
Author(s):  
Caitlin Graupner ◽  
S. O. Breukink ◽  
S. Mul ◽  
D. Claessens ◽  
A. H. M. Slok ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Barriers And Facilitators ◽  
Local Context ◽  
Healthcare Organisation ◽  
Successful Implementation ◽  
Oncological Care ◽  
Patient Reported

Abstract Background In the last decades, the number of cancer survivors has increased significantly due to improved treatment and better detection of recurrence. This increased survival redirects the scope from survival towards optimising functional outcomes and improving health-related quality of life (HRQol). Functional and HRQoL outcomes can be assessed with patient-reported outcome measures (PROMs). However, the use of PROMs in daily oncological care is not common. This qualitative study investigates the barriers and facilitators of PROM use in an oncological setting, from the perspective of the healthcare professionals (HCPs). Methods Individual semi-structured interviews were conducted among Dutch oncological HCPs. Barriers and facilitators of PROM implementation were identified on various levels of the healthcare system (i.e. level of the patient, individual professional, medical team, and healthcare organisation). Interviews were audio recorded and transcribed verbatim. Transcripts were manually analysed by two independent reviewers using a thematic approach. Identified barriers and facilitators were categorised into Grol and Wensing’s framework for changing healthcare practice. Results Nineteen oncological HCPs working in academic and non-academic hospitals were interviewed. Barriers for PROM implementation were lack of good IT support, lack of knowledge on how to use PROMs, lack of time to complete and interpret PROMs, and a high administrative burden. PROM implementation can be facilitated by providing clear guidance regarding PROM interpretation, evidence that PROMs can save time, and stimulating multidisciplinary teamwork. Conclusion From a HCP point of view, adequately functioning IT technology, sufficient knowledge on PROMs, and dedicated time during the consultation are essential for successful implementation of PROMs in oncological care. Additional local context-specific factors need to be thoroughly addressed.

scholarly journals Developing and evaluating a lay health worker delivered implementation intervention to decrease engagement disparities in behavioural parent training: a mixed methods study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028988 ◽  
Author(s):  
Miya Barnett ◽  
Jeanne Miranda ◽  
Maryam Kia-Keating ◽  
Lisa Saldana ◽  
John Landsverk ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Parent Training ◽  
Low Income ◽  
Local Context ◽  
Successful Implementation ◽  
Evidence Based ◽  
Implementation Intervention ◽  
Implementation Framework ◽  
Behavioural Parent Training

IntroductionBehavioural parent training (BPT) programmes are effective in preventing and treating early-onset conduct problems and child maltreatment. Unfortunately, pervasive mental health service disparities continue to limit access to and engagement in these interventions. Furthermore, challenges with parental engagement can impede the successful implementation of evidence-based practices (EBPs) in community settings that serve low-income, ethnic minority families. Lay health workers (LHWs)—individuals without formal mental health training—represent an important workforce to increase engagement, as they are members of the communities they serve. However, the mobilisation of LHWs has not been well studied as an implementation strategy to extend the reach or effectiveness of EBPs in the USA. LHW-delivered implementation interventions that specifically support the engagement of Latinx parents in evidence-based BPT programmes have the potential to improve clinical and implementation outcomes.Methods and analysisA community-partnered approach will use the Quality Implementation Framework (QIF) to tailor and implement an LHW-delivered implementation intervention that aims to promote Latinx parent engagement in BPT programmes. Steps from the QIF will guide study activities to (1) conduct a mixed methods needs assessment to fit the implementation intervention to the local context, (2) adapt LHW-delivered implementation strategies to promote parent access to and engagement in Parent-Child Interaction Therapy and (3) conduct a hybrid effectiveness-implementation pilot trial to examine the feasibility, acceptability and preliminary effectiveness of the LHW implementation intervention at increasing engagement.Ethics and disseminationStudy procedures have been approved by the Institutional Review Board at the University of California, Santa Barbara. Results will be shared with the community-advisory group, at community-based meetings for other stakeholders involved in the pilot project, and submitted for publication in peer-reviewed journals.

scholarly journals Perspectives of Orthopedic Surgeons on the Clinical Use of Bioprinted Cartilage: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Àngels Salvador Verges ◽  
Luis Fernández-Luque ◽  
Meltem Yildirim ◽  
Bertran Salvador-Mata ◽  
Francesc Garcia Cuyàs
Keyword(s):  
Qualitative Study ◽  
New Technology ◽  
Successful Implementation ◽  
Clinical Use ◽  
Key Factors ◽  
Current Health ◽  
Expert Opinions ◽  
Orthopedic Surgeons ◽  
Qualitative Thematic Analysis ◽  
The Status

BACKGROUND Over the past 60 years, no technique used for treating cartilage disorders has been completely successful. Bioprinting provides a highly anticipated, novel alternative solution to this problem. However, identifying barriers to this new technology is crucial in order to overcome them when bioprinting reaches the implementation stage. This kind of research has been declared essential because clinical efficacy and safety studies alone do not always lead to successful implementation. OBJECTIVE This qualitative study aimed to explore the stance of orthopedic surgeons on the use of bioprinted cartilage grafts for cartilaginous lesions. The study sought to summarize and classify the barriers and facilitators of this technique and to identify the key factors for successful implementation of bioprinted cartilage in routine clinical practice. METHODS A qualitative thematic analysis method was used to evaluate data obtained from semistructured interviews and from focus groups. Data were collected between June 2017 and February 2018. Interviews focused on the collection of expert opinions on bioprinted cartilage. RESULTS The perceived barriers to the adoption of this technology were (1) awareness of a lack of information on the status and possibilities of this technology, (2) uncertainty regarding compliance with current health care regulations and policies, and (3) demands for clinical evidence. The facilitators were (1) lack of surgical alternatives, (2) the perception that research is the basis of the current health system, and (3) the hope of offering a better quality of life to patients. CONCLUSIONS The results of this study are preliminary in nature and cannot be generalized without a broader group of participants. However, the key factors identified provide a frame of reference to help understand the challenges of bioprinted cartilage and help facilitate the transition toward its clinical use. These findings will also provide information for use at multidisciplinary meetings in scientific societies; create bridges between researchers, orthopedic surgeons, and regulators; and open a debate on the funding of this technique and the business model that needs to be developed.

scholarly journals Perceptions and Acceptability of Digital Interventions Among Tuberculosis Patients in Cambodia: Qualitative Study of Video-Based Directly Observed Therapy (Preprint)

2019 ◽  
Author(s):  
Lila Rabinovich ◽  
James Steven Molton ◽  
Wei Tsang Ooi ◽  
Nicholas Iain Paton ◽  
Shelly Batra ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Low Income ◽  
Patient Adherence ◽  
Mobile App ◽  
Income Country ◽  
Successful Implementation ◽  
Directly Observed Therapy ◽  
Middle Income ◽  
Tuberculosis Patients ◽  
Treatment Standard

BACKGROUND Despite the development of effective drugs for treatment, tuberculosis remains one of the leading causes of death from an infectious disease worldwide. One of the greatest challenges to tuberculosis control is patient adherence to treatment. Recent research has shown that video-based directly observed therapy is a feasible and effective approach to supporting treatment adherence in high-income settings. However, few studies have explored the potential for such a solution in a low- or middle-income country setting. Globally, these countries’ rapidly rising rate of mobile penetration suggests that the potential for translation of these results may be high. OBJECTIVE We sought to examine patient perceptions related to the use of mobile health, and specifically video-based directly observed therapy, in a previously unstudied patient demographic: patients with tuberculosis in a low-income country setting (Cambodia). METHODS We conducted a cross-sectional qualitative study in urban and periurban areas in Cambodia, consisting of 6 focus groups with tuberculosis patients who were receiving treatment (standard directly observed therapy) through a nongovernmental organization. RESULTS Familiarity with mobile technology and apps was widespread in this population, and overall willingness to consider a mobile app for video-based directly observed therapy was high. However, we identified potential challenges. First, patients very much valued their frequent in-person interactions with their health care provider, which may be reduced with the video-based directly observed therapy intervention. Second, there may be technical issues to address, including how to make the app suitable for illiterate participants. CONCLUSIONS While video-based directly observed therapy is a promising technology, even in country settings where mobile penetration is reportedly almost universal, it should be introduced with caution. However, the results were generally promising and yielded important insights that not only will be translated into the further adaptation of key features of video-based directly observed therapy for tuberculosis patients in Cambodia, but also can inform the future design and successful implementation of video-based directly observed therapy interventions in low- and middle-income settings more generally.

scholarly journals Improving care quality with prison telemedicine: The effects of context and multiplicity on successful implementation and use

2019 ◽  
pp. 1357633X1986913 ◽  
Author(s):  
Chantal Edge ◽  
Georgia Black ◽  
Emma King ◽  
Julie George ◽  
Shamir Patel ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Correctional Facility ◽  
Quality Of Healthcare ◽  
Hospital Staff ◽  
Careful Consideration ◽  
Care Quality ◽  
Local Context ◽  
Successful Implementation ◽  
Medical Subject Headings ◽  
Community Healthcare

Background Prison telemedicine can improve the access, cost and quality of healthcare for prisoners, however adoption in prison systems worldwide has been variable despite these demonstrable benefits. This study examines anticipated and realised benefits, barriers and enablers for prison telemedicine, thereby providing evidence to improve the chances of successful implementation. Methods A systematic search was conducted using a combination of medical subject headings and text word searches for prisons and telemedicine. Databases searched included: PubMed, Embase, CINAHL Plus, PsycINFO, Web of Science, Scopus and International Bibliography of the Social Sciences. Articles were included if they reported information regarding the use of/advocacy for telemedicine, for people residing within a secure correctional facility. A scoping summary and subsequent thematic qualitative analysis was undertaken on articles selected for inclusion in the review, to identify issues associated with successful implementation and use. Results One thousand, eight hundred and eighty-two non-duplicate articles were returned, 225 were identified for full text review. A total of 163 articles were included in the final literature set. Important considerations for prison telemedicine implementation include: differences between anticipated and realised benefits and barriers, differing wants and needs of prison and community healthcare providers, the importance of top-down and bottom-up support and consideration of logistical and clinical compatibility. Conclusions When implemented well, patients, prison and hospital staff are generally satisfied with telemedicine. Successful implementation requires careful consideration at outset of the partners to be engaged, the local context for implementation and the potential benefits that should be communicated to encourage participation.

scholarly journals Perceptions and experiences of healthcare providers during COVID-19 pandemic in Karachi, Pakistan: an exploratory qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048984
Author(s):  
Anam Shahil Feroz ◽  
Nousheen Akber Pradhan ◽  
Zarak Hussain Ahmed ◽  
Mashal Murad Shah ◽  
Nargis Asad ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Low Income ◽  
Healthcare Workers ◽  
Early Stage ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Working Environment ◽  
Hospital Environment ◽  
Front Line ◽  
Enabling Factors

ObjectiveTo explore healthcare provider’s perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases.Design and settingWe conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique.ParticipantsKey-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers.ResultsA total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was ‘challenges faced by front-line healthcare providers working in COVID-19 wards. Healthcare workers experienced increased anxiety due to the fear of acquiring infection and transmitting it to their family members. They felt overwhelmed due to the exhaustive donning and doffing process, intense work and stigmatisation. The second theme was ‘enablers supporting healthcare providers to deal with the COVID-19 pandemic’. Front liners pointed out several enabling factors that supported hospital staff including a safe hospital environment, adequate training, a strong system of information sharing and supportive management. The third theme was ‘recommendations to support the healthcare workforce during the COVID-19 crisis’. Healthcare workers recommended measures to mitigate current challenges including providing risk allowance to front-line healthcare providers, preparing a backup health workforce, and establishing a platform to address the mental health needs of the healthcare providers.ConclusionThis study provides an initial evidence base of healthcare providers’ experiences of managing patients with COVID-19 in the early stage of the pandemic and highlights measures needed to address the encountered challenges. It offers lessons for hospitals in low-income and middle-income countries to ensure a safe working environment for front-line workers in their fight against COVID-19.

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