scholarly journals Application of the PRECEDE–PROCEED model in the development of evidence-informed interventions for drowning prevention: a mixed-methods study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050688
Author(s):  
Jonathan P Guevarra ◽  
Amy E Peden ◽  
Richard Charles Franklin
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Local Community ◽  
Evaluation Model ◽  
Population Data ◽  
The Philippines ◽  
Mixed Methods Study ◽  
Global Public Health ◽  
Middle Income ◽  
Drowning Prevention

IntroductionDrowning is a global public health threat, disproportionately impacting low-income and middle-income countries. In the Philippines, it is estimated that more than 5200 people die from drowning per annum. This number is likely to be higher than currently estimated with the inclusion of disaster-related and transportation-related drowning. Drowning is preventable if appropriate preventive interventions are put in place which redress known risk factors.Methods and analysisThis study uses the PRECEDE–PROCEED model (PPM), an eight-step health promotion planning and evaluation model for building and improving intervention programmes. This mixed-methods study, which can be used in any location, will be implemented in Los Baňos, Laguna, Philippines, identified as an area of concern for drowning. Using the PPM, data on drowning will be collected from death records, community observation, key informant interviews, focus group discussions and community survey. A range of analytical methods will be used to explore drowning data including univariate and χ2 analyses, analysis of variance, relative risk and calculating rates using population data. The quantitative data and themes drawn from qualitative data will be used to populate the first four phases of the PPM. Following the data collection, the remaining stages of the PPM will be designed and implemented in the barangay (village) with the highest drowning rate.Ethics and disseminationThis study has obtained ethical clearance from the University of the Philippines Manila Research Ethics Board (UPMREB 2017-425-01). Study findings will be disseminated through workshops and presentations to the local community as well as through peer-reviewed literature and conference presentations. The PPM has rarely been applied to drowning prevention and it is the aim that the study described in this protocol is expanded across other areas of the Philippines and to other countries with a high drowning burden to inform prevention efforts.

scholarly journals A model for scale up of family health innovations in low-income and middle-income settings: a mixed methods study

BMJ Open ◽  
2012 ◽  
Vol 2 (4) ◽  
pp. e000987 ◽  
Author(s):  
Elizabeth H Bradley ◽  
Leslie A Curry ◽  
Lauren A Taylor ◽  
Sarah Wood Pallas ◽  
Kristina Talbert-Slagle ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Scale Up ◽  
Family Health ◽  
Mixed Methods Study ◽  
Middle Income ◽  
Health Innovations

scholarly journals Fatal drowning in the Western Cape, South Africa: a 7-year retrospective, epidemiological study

2018 ◽  
Vol 25 (6) ◽  
pp. 529-534 ◽  
Author(s):  
Colleen Jayne Saunders ◽  
Robyn Adriaanse ◽  
Abigail Simons ◽  
Ashley van Niekerk
Keyword(s):  
South Africa ◽  
Young Adult ◽  
Low Income ◽  
Western Cape ◽  
Middle Income ◽  
Registration System ◽  
Drowning Prevention ◽  
Adult Men ◽  
Context Specific ◽  
Public Holidays

IntroductionDrowning is a neglected public health threat in low-income and middle-income countries where the greatest drowning burden is observed. There is a paucity of drowning surveillance data from low-resource settings, particularly in Africa. Understanding local epidemiological factors will enable the development of context-specific drowning prevention initiatives and the appropriate allocation of resources.AimThe primary aim of this study was to describe the epidemiology of fatal drowning in the Western Cape, South Africa.MethodThis retrospective study describes fatal drowning incidents captured in the Western Cape vital registration system between 2010 and 2016. Data were obtained from the Forensic Pathology Services of the Western Cape Government. One-way analysis of variance was performed to detect a trend in mean drowning mortality rates between 2010 and 2016. χ2 tests for independence were performed to detect differences in the distribution of variables between groups.ResultsA total of 1391 fatal drownings occurred in the Western Cape between 2010 and 2016, with an age-adjusted drowning mortality rate of 3.2 per 100 000 population. Rates were fourfold higher in men compared with women. Children, particularly young children aged 0–4 years, and young adult men between 20 and 34 years of age were identified to be at high risk of fatal drowning. Drowning occurred predominantly in large, open bodies of water with concentrations in summer and public holidays.ConclusionsThe Western Cape drowning prevention strategy should prioritise interventions to reduce drowning in children and young adult men, with a targeted focus on festive periods such as public holidays.

scholarly journals Evidence-based intrapartum practice and its associated factors at a tertiary teaching hospital in the Philippines, a descriptive mixed-methods study.

2020 ◽  
Author(s):  
Chisato Masuda ◽  
Shirley Kristine Ferolin ◽  
Ken Masuda ◽  
Chris Smith ◽  
Mitsuaki Matsui
Keyword(s):  
Mixed Methods ◽  
Associated Factors ◽  
Healthcare Providers ◽  
The Philippines ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Factors Associated ◽  
Second Stage ◽  
Assisted Delivery ◽  
Fundal Pressure

Abstract Background Evidenced-based practice is a key component of quality care. However, studies in the Philippines have identified gaps between evidence and actual maternity practices. This study aims to describe the practice of evidence-based intrapartum care and its associated factors, as well as exploring the perceptions of healthcare providers in a tertiary hospital in the Philippines. Methods A mixed-methods study was conducted, which consisted of direct observation of intrapartum practices during the second and third stages, as well as semi-structured interviews and focus group discussions with care providers to determine their perceptions and reasoning behind decisions to perform episiotomy or fundal pressure. Univariate and multivariate logistic regression were used to analyse the relationship between observed practices and maternal, neonatal, and environmental factors. Qualitative data were parsed and categorised to identify themes related to the decision-making process. Results A total of 170 deliveries were included. Recommended care, such as prophylactic use of oxytocin and controlled cord traction in the third stage, were applied in almost all the cases. However, harmful practices were also observed, such as intramuscular or intravenous oxytocin use in the second stage (14%) and lack of foetal heart rate monitoring (57%). Of primiparae, 92% received episiotomy and 31% of all deliveries received fundal pressure. Factors associated with the implementation of episiotomy included primipara (adjusted Odds Ratio [aOR] 62.3), duration of the second stage of more than 30 minutes (aOR 4.6), and assisted vaginal delivery (aOR 15.0). Factors associated with fundal pressure were primipara (aOR 3.0), augmentation with oxytocin (aOR 3.3), and assisted delivery (aOR 4.8). Healthcare providers believe that these practices can prevent laceration. The rate of obstetric anal sphincter injuries (OASIS) was 17%. Associated with OASIS were assisted delivery (aOR 6.0), baby weights of more than 3.5 kg (aOR 7.8), episiotomy (aOR 26.4), and fundal pressure (aOR 6.2). Conclusions Our study found that potentially harmful practices are still conducted that contribute to the occurrence of OASIS. The perception of these practices is divergent with current evidence, and empirical knowledge has more influence. To improve practices the scientific evidence and its underlying basis should be understood among providers.

Health-related quality of life in adult CHD surgical patients in a low middle-income country: a mixed-methods study

2020 ◽  
Vol 30 (8) ◽  
pp. 1126-1137
Author(s):  
Laila A. Ladak ◽  
Robyn Gallagher ◽  
Babar S. Hasan ◽  
Khadija Awais ◽  
Ahmed Abdullah ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Income Country ◽  
Surgical Patients ◽  
Health Related Quality ◽  
Middle Income ◽  
Related Quality ◽  
Health Related

AbstractBackground and objectives:This mixed-methods study aimed to assess health-related quality of life in young adults with CHD following surgery in a low middle-income country, Pakistan. Despite the knowledge that geographic, cultural and socio-economic factors may shape the way health and illness is experienced and managed and consequently determine a person’s health-related quality of life, few health-related quality of life studies are conducted in low middle-income countries. This deficit is pronounced in CHD, so there is little guidance for patient care.Methods:The study utilised concurrent, mixed methods. Adults with CHD (n = 59) completed health-related quality of life surveys (PedsQLTM 4.0 Generic Core Scale, PedsQLTM Cognitive Functioning Scale and PedsQLTM 3.0 Cardiac Module). Semi-structured interview data were collected from a nested sub-sample of 17 participants and analysed using qualitative content analysis, guided by the revised Wilson–Cleary model of health-related quality of life.Results:The lowest health-related quality of life domain was emotional with the mean score (71.61 ± 20.6), followed by physical (78.81 ± 21.18) and heart problem (79.41 ± 18.05). There was no statistical difference in general or cardiac-specific health-related quality of life between mild, moderate or complex CHD. Qualitative findings suggested low health-related quality of life arose from a reduced capacity to contribute to family life including family income and gender. A sense of reduced marriageability and fear of dependency were important socio-cultural considerations.Conclusions:CHD surgical patients in this low-income country experience poor health-related quality of life, and contributing factors differ to those reported for high-income countries. Socio-cultural understandings should underpin assessment, management and care-partnering with young adults with CHD following surgical correction.

scholarly journals ‘Maybe we can turn the tide’: an explanatory mixed-methods study to understand how knowledge brokers mobilise health evidence in low- and middle-income countries

2019 ◽  
Author(s):  
Theresa C. Norton ◽  
Daniela C. Rodriguez ◽  
Catherine Howell ◽  
Charlene Reynolds ◽  
Sara Willems
Keyword(s):  
Mixed Methods ◽  
Online Survey ◽  
Newborn Health ◽  
Mixed Methods Study ◽  
Promising Practices ◽  
Policy And Practice ◽  
Middle Income ◽  
Middle Income Countries ◽  
Knowledge Brokers ◽  
Low And Middle Income

Background: Little is known about how knowledge brokers (KBs) operate in low- and middle-income countries (LMICs) to translate evidence for health policy and practice. These intermediaries facilitate relationships between evidence producers and users to address public health issues.<br />Aims and objectives: To increase understanding, a mixed-methods study collected data from KBs who had acted on evidence from the 2015 Global Maternal Newborn Health Conference in Mexico.<br />Methods: Of the 1000 in-person participants, 252 plus 72 online participants (n=324) from 56 countries completed an online survey, and 20 participants from 15 countries were interviewed. Thematic analysis and application of knowledge translation (KT) theory explored factors influencing KB actions leading to evidence uptake. Descriptive statistics of respondent characteristics were used for cross-case comparison.Findings: Results suggest factors supporting the KB role in evidence uptake, which include active relationships with evidence users through embedded KB roles, targeted and tailored evidence communication to fit the context, user receptiveness to evidence from a similar country setting, adaptability in the KB role, and action orientation of KBs.<br />Discussion and conclusions: Initiatives to increase evidence uptake in LMICs should work to establish supportive structures for embedded KT, identify processes for ongoing cross-country learning, and strengthen KBs already showing effectiveness in their roles.<br /><br />key messages<br /><br /><ol><li>Little is known about how knowledge brokers mobilise evidence in low- and middle-income countries.</li><br /><li>A multi-country study of knowledge brokers identified promising practices for evidence uptake.</li><br /><li>Embedded brokers who adapted messaging and evidence to context in active relationships worked well.</li><br /><li>Capacity building should use KB promising practices and facilitate multi-country evidence exchange.</li></ol>

scholarly journals Stakeholders’ perspectives on the provision of vocational training for youth with disabilities in Sri Lanka: protocol for a mixed-methods study

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e056678
Author(s):  
Uvini Tharumali Colonne ◽  
Isuru Dharmarathna ◽  
Dhammika Deepani Siriwardhana ◽  
Tamara Handy ◽  
Madhushika Harshani Gamage ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Sri Lanka ◽  
Social Services ◽  
Vocational Training ◽  
Health And Safety ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Youth With Disabilities ◽  
Middle Income ◽  
Low Middle Income Countries

IntroductionThe quality and the range of vocational training (VT) courses offered to youth with disabilities (YwD) in low-middle-income countries are underexplored. This protocol describes a study designed to gather perceptions of a range of stakeholders related to the quality and relevance of VT programmes conducted by the Department of Social Services in Sri Lanka. The purpose of this study is to communicate with authorities the ways in which they can improve their services by paying close attention to the needs and recommendations of all stakeholders.Methods and analysisA parallel mixed-methods study will be conducted at eight vocational training institutes (VTIs). A survey will be conducted with five participant groups; YwD presently enrolled in VTIs (n=358) and their caregivers (n=358), YwD who completed the VT (n=45) and their caregivers (n=45) and educators at VTIs (n=47). The qualitative component includes semi-structured interviews and focus group discussions. The three groups of participants include: educators, caregivers of potential YwD for future VT (6–10 per group) and key informants from state, corporate and non-governmental sectors (a total of 20). Quantitative and qualitative data will be analysed using descriptive and inferential statistics and cross-thematic analysis, respectively.Ethics and disseminationThis study received ethical clearance from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya (Ref. No: P/15/02/2021). All data collection processes will abide by health and safety measures required by the national government. Written informed consent will be obtained from all participants. Results from this research will be disseminated, to local stakeholders and participants, via local and international conferences and publications in peer-reviewed journals.

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