scholarly journals Peer advocacy and access to healthcare for people who are homeless in London, UK: a mixed method impact, economic and process evaluation protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050717
Author(s):  
Sujit D Rathod ◽  
Andrew Guise ◽  
PJ Annand ◽  
Paniz Hosseini ◽  
Elizabeth Williamson ◽  
...  
Keyword(s):  
Lived Experience ◽  
Ethics Committee ◽  
Access To Healthcare ◽  
London School ◽  
Journal Articles ◽  
Mixed Methods Evaluation ◽  
Evaluation Protocol ◽  
Study Progress ◽  
Conference Presentations ◽  
Study Designs

IntroductionPeople who are homeless experience higher morbidity and mortality than the general population. These outcomes are exacerbated by inequitable access to healthcare. Emerging evidence suggests a role for peer advocates—that is, trained volunteers with lived experience—to support people who are homeless to access healthcare.Methods and analysisWe plan to conduct a mixed methods evaluation to assess the effects (qualitative, cohort and economic studies); processes and contexts (qualitative study); fidelity; and acceptability and reach (process study) of Peer Advocacy on people who are homeless and on peers themselves in London, UK. People with lived experience of homelessness are partners in the design, execution, analysis and dissemination of the evaluation.Ethics and disseminationEthics approval for all study designs has been granted by the National Health Service London—Dulwich Research Ethics Committee (UK) and the London School of Hygiene and Tropical Medicine’s Ethics Committee (UK). We plan to disseminate study progress and outputs via a website, conference presentations, community meetings and peer-reviewed journal articles.

scholarly journals Notifications to Improve Engagement With an Alcohol Reduction App: Protocol for a Micro-Randomized Trial

10.2196/18690 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e18690 ◽  
Author(s):  
Lauren Bell ◽  
Claire Garnett ◽  
Tianchen Qian ◽  
Olga Perski ◽  
Henry W W Potts ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Behavior Change ◽  
Randomized Trial ◽  
Research Ethics ◽  
Adult Population ◽  
Ethics Committee ◽  
Perceived Usefulness ◽  
Self Report ◽  
London School ◽  
Research Ethics Committee

Background Drink Less is a behavior change app that aims to help users in the general adult population reduce hazardous and harmful alcohol consumption. The app includes a daily push notification, delivered at 11 am, asking users to “Please complete your mood and drinking diaries.” Previous analysis of Drink Less engagement data suggests the current notification strongly influences how users engage with the app in the subsequent hour. To exploit a potential increase of vulnerability of excess drinking and opportunity to engage with the app in the evenings, we changed the delivery time from 11 am to 8 pm. We now aim to further optimise the content and sequence of notifications, testing 30 new evidence-informed notifications targeting the user’s perceived usefulness of the app. Objective The primary objective is to assess whether sending a notification at 8 pm increases behavioral engagement (opening the app) in the subsequent hour. Secondary objectives include comparing the effect of the new bank of messages with the standard message and effect moderation over time. We also aim to more generally understand the role notifications have on the overall duration, depth, and frequency of engagement with Drink Less over the first 30 days after download. Methods This is a protocol for a micro-randomized trial with two additional parallel arms. Inclusion criteria are Drink Less users who (1) consent to participate in the trial; (2) self-report a baseline Alcohol Use Disorders Identification Test score of 8 or above; (3) reside in the United Kingdom; (4) age ≥18 years and; (5) report interest in drinking less alcohol. In the micro-randomized trial, participants will be randomized daily at 8 pm to receive no notification, a notification with text from the new message bank, or the standard message. The primary outcome is the time-varying, binary outcome of “Did the user open the app in the hour from 8 pm to 9 pm?”. The primary analysis will estimate the marginal relative risk for the notifications using an estimator developed for micro-randomized trials with binary outcomes. Participants randomized to the parallel arms will receive no notifications (Secondary Arm A), or the standard notification delivered daily at 11 am (Secondary Arm B) over 30 days, allowing the comparison of overall engagement between different notification delivery strategies. Results Approval was granted by the University College of London’s Departmental Research Ethics Committee (CEHP/2016/556) on October 11, 2019, and The London School of Hygiene and Tropical Medicine Interventions Research Ethics Committee (17929) on November 27, 2019. Recruitment began on January 2, 2020, and is ongoing. Conclusions Understanding how push notifications may impact engagement with a behavior change app can lead to further improvements in engagement, and ultimately help users reduce their alcohol consumption. This understanding may also be generalizable to other apps that target a variety of behavior changes. International Registered Report Identifier (IRRID) DERR1-10.2196/18690

Storytelling: How We Learn

2019 ◽  
pp. 141-142
Keyword(s):  
Journal Articles ◽  
Effect Change ◽  
Quality Research ◽  
Conference Presentations ◽  
Research Questions ◽  
New Research

The best conference presentations tell a story with an interesting introduction, details in the middle, and a conclusion that leads to new research, questions or answers about practice, and perhaps further research on the topic. So, too, do journal articles, and this publication is dependent on the rigors of quality research to tell stories about our patients and their experiences and make suggestions on how we can effect change.

scholarly journals Mixed methods evaluation of a hospital group model using an embedded research approach: study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027086
Author(s):  
Cecilia Vindrola-Padros ◽  
Estela Capelas Barbosa ◽  
Angus I G Ramsay ◽  
Simon Turner ◽  
Stephen Morris ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Study Protocol ◽  
Cost Savings ◽  
Ethics Committee ◽  
Research Approach ◽  
Group Model ◽  
Potential Cost ◽  
Mixed Methods Evaluation ◽  
The Impact ◽  
Hospital Group

IntroductionHospital group models represent an organisational form that aims to bring together multiple provider organisations with a central headquarters and unified leadership responsible for locally managed operating units, standardised systems and a value-set shared across the group. These models seek to improve outcomes by reducing unwarranted variations in care provision and reducing costs through economies of scale. There is limited evidence on the impact and processes of implementing these models, so this study aims to evaluate one case study of a hospital group model.Methods and analysisWe will conduct a formative, mixed-methods evaluation using an embedded research approach to analyse the implementation of the model and its impact on outcomes and costs. We will carry out a multisited ethnography to analyse the programme theory for model design and implementation, the barriers and facilitators in the implementation; and wider contextual issues that influence implementation using semi-structured interviews (n=80), non-participant observations (n=80 hours), ‘shadowing’ (n=20 hours) and documentary analysis. We will also carry out an economic evaluation composed of a cost-consequence analysis and a return on investment analysis to evaluate the costs of creating and running the model and balance these against the potential cost-savings.Ethics and disseminationThe study protocol was reviewed by the local R&D Office and University College London Ethics Committee and classified as a service evaluation, not requiring approval by a research ethics committee. We will follow guidelines for informed consent, confidentiality and information governance, and address issues of critical distance prevalent in embedded research. Findings will be shared at regular time points to inform the implementation of the model. The evaluation will also generate: an evaluation framework to evaluate future changes; recommendations for meaningful baseline data and measuring improvement; identification of implementation costs and potential cost-savings; and lessons for the National Health Service on implementing these models.

scholarly journals Accuracy and consequences of usingtrial-of-antibioticsfor TB diagnosis (ACT-TB study): protocol for a randomised controlled clinical trial

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033999
Author(s):  
Titus Henry Divala ◽  
Katherine L Fielding ◽  
Derek J Sloan ◽  
Neil French ◽  
Marriott Nliwasa ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Mycobacterium Tuberculosis ◽  
Research Ethics ◽  
Primary Outcome ◽  
Standard Of Care ◽  
Ethics Committee ◽  
Absolute Difference ◽  
Controlled Clinical Trial ◽  
London School ◽  
Randomised Controlled

IntroductionOver 40% of global tuberculosis case notifications are diagnosed clinically without mycobacteriological confirmation. Standard diagnostic algorithms include ‘trial-of-antibiotics’—empirical antibiotic treatment given to mycobacteriology-negative individuals to treat infectious causes of symptoms other than tuberculosis, as a ‘rule-out’ diagnostic test for tuberculosis. Potentially 26.5 million such antibiotic courses/year are prescribed globally for the 5.3 million/year mycobacteriology-negative patients, making trial-of-antibiotics the most common tuberculosis diagnostic, and a global-scale risk for antimicrobial resistance (AMR). Our systematic review found no randomised controlled trial (RCT) to support use of trial-of-antibiotic. The RCT aims to determine the diagnostic and clinical value and AMR consequences of trial-of-antibiotics.Methods and analysisA three-arm, open-label, RCT randomising (1:1:1) Malawian adults (≥18 years) seeking primary care for cough into: (a) azithromycin 500 mg one time per day for 3 days or (b) amoxicillin 1 g three times per day for 5 days or (c) standard-of-care (no immediate antibiotic). We will perform mycobacteriology tests (microscopy, Xpert MTB/RIF (Mycobacterium tuberculosis/rifampicin) andMycobacterium tuberculosisculture) at baseline. We will use audiocomputer-assisted self-interview to assess clinical improvement at day 8. First primary outcome will be proportion of patients reporting day 8 improvement out of those with negative mycobacteriology (specificity). Second primary outcome will be day 29 incidence of a composite endpoint of either death or hospitalisation or missed tuberculosis diagnosis. To determine AMR impact we compare proportion of resistant nasopharyngealStreptococcus pneumoniaeisolates on day 29. 400 mycobacteriology-negative participants/arm will be required to detect a ≥10% absolute difference in diagnostic specificity with 80% power. We will estimate measures of effect by comparing outcomes in antibiotic arms (combined and individually) to standard-of-care.Ethics and disseminationThe study has been reviewed and approved by Malawi College of Medicine Research and Ethics Committee, London School of Hygiene & Tropical Medicine (LSHTM) Research Ethics Committee and Regional Committee for Health and Research Ethics – Norway, and Malawi Pharmacy, Medicines and Poisons Board. We will present abstracts at relevant conferences, and prepare a manuscript for publication in a peer-reviewed journal.Trial registration numberThe clinical trial is registered with ClinicalTrials.gov,NCT03545373

scholarly journals A situation analysis of competences of research ethics committee members regarding review of research protocols with complex and emerging study designs in Uganda

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Provia Ainembabazi ◽  
Barbara Castelnuovo ◽  
Stephen Okoboi ◽  
Walter Joseph Arinaitwe ◽  
Rosalind Parkes-Ratanshi ◽  
...  
Keyword(s):  
Research Ethics ◽  
Study Design ◽  
Ethics Committee ◽  
Training Data ◽  
Ethical Review ◽  
Infection Model ◽  
Research Ethics Committee ◽  
Research Protocols ◽  
Study Designs

Abstract Background Over the past two decades, Uganda has experienced a significant increase in clinical research driven by both academia and industry. This has been combined with a broader spectrum of research proposals, with respect to methodologies and types of intervention that need evaluation by Research Ethics Committees (RECs) with associated increased requirement for expertise. We assessed the competencies of REC members regarding review of research protocols with complex and emerging research study designs. The aim was to guide development of a training curriculum to improve the quality of scientific and ethical review. Methods This was a cross-sectional study design, with quantitative data collection methods. Research Ethics Committee members completed a structured pre-coded questionnaire on current competence with complex and emerging study design. REC members were asked to outline a list of additional topics for which they needed training. Data from coded questions were entered into Epidata Version 3.1 and then exported to STATA Version14.1 for analysis. Descriptive analysis was performed and findings are presented using percentages and frequencies. Results We enrolled 55 REC members from 6 RECs who have a total of 97 members. The majority of whom were males (56.4%, n = 31/55). The level of competence for review of selected study design was lowest for Controlled Human Infection Model (10.9%, n = 6) and reverse pharmacology design (10.9%, n = 6), and highest for cluster randomized study design (52.7%, n = 29) and implementation science research (52.7%, n = 29). Conclusion Competence for review of research protocols with complex and emerging study design was low among participating REC members. We recommend prioritising training of REC members on complex and emerging study designs to enhance quality of research protocol review.

scholarly journals Making Lived-Experience Research Accessible: A Design Thinking Approach to Co-Creating Knowledge Translation Resources Based on Evidence

2021 ◽  
Vol 18 (17) ◽  
pp. 9250
Author(s):  
Katherine M. Boydell ◽  
Anne Honey ◽  
Helen Glover ◽  
Katherine Gill ◽  
Barbara Tooth ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Lived Experience ◽  
Mental Health Professionals ◽  
Participatory Design ◽  
Design Thinking ◽  
Evidence Based ◽  
Journal Articles ◽  
Translation Strategy ◽  
User Friendly

Mental health lived-experience research illuminates the perspectives and experiences of people who live with mental illness. However, little is known about how useful people with lived experience of mental illness/distress might find lived-experience research, nor what the best formats are to bring it to their attention. This paper describes the STELLER study (Supporting the Translation into Everyday Life of Lived-Experience Research), which explores the translation of lived-experience research in the lives of people living with mental illness. Our aim was to use a design thinking approach to develop a range of user-friendly formats to disseminate lived-experience research. A staged design thinking approach was used to develop a translation strategy for lived-experience research. We explored empathy via consumer consultation to understand their perspectives on lived-experience research, refined the design aim, research questions and generated ideas with consumers and mental health professionals, identified the evidence based on lived experience-authored journal articles, worked with design students and peer workers to create a suite of resources and developed prototypes tailored to individual settings and clients. Participatory design thinking strategies are essential to identify the best ways to translate evidence-based lived-experience research via accessible, lay-friendly resources targeted to individuals impacted by mental illness. This study is the first to investigate the feasibility and usefulness of bringing the findings of lived-experience research to individuals impacted by mental illness/distress. It provides evidence about a potentially important source of information that can be used to facilitate their recovery.

scholarly journals Methotrexate and prednisolone study in erythema nodosum leprosum (MaPs in ENL) protocol: a double-blind randomised clinical trial

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037700
Author(s):  
Barbara de Barros ◽  
Saba M Lambert ◽  
Mahesh Shah ◽  
Vivek V Pai ◽  
Joydeepa Darlong ◽  
...  
Keyword(s):  
Research Ethics ◽  
Erythema Nodosum ◽  
Controlled Trial ◽  
Ethics Committee ◽  
Primary Objective ◽  
Ethical Review ◽  
London School ◽  
Double Blind ◽  
Research Ethics Committee ◽  
Erythema Nodosum Leprosum

IntroductionErythema nodosum leprosum (ENL) is an immunological complication of leprosy. ENL results in morbidity and disability and if it is not treated can lead to death. The current treatment consists of thalidomide or high doses of oral corticosteroids for prolonged periods. Thalidomide is not available in many leprosy endemic countries. The use of corticosteroids is associated with morbidity and mortality. Identifying treatment regimens that reduce the use of corticosteroids in ENL is essential. Methotrexate (MTX) is used to treat many inflammatory diseases and has been used successfully to treat patients with ENL not controlled by other drugs, including prednisolone and thalidomide. We present the protocol of the ‘MTX and prednisolone study in ENL’ (MaPs in ENL) a randomised controlled trial (RCT) designed to test the efficacy of MTX in the management of ENL.Methods and analysisMaPs in ENL is an international multicentre RCT, which will be conducted in leprosy referral centres in Bangladesh, Brazil, Ethiopia, India, Indonesia and Nepal. Patients diagnosed with ENL who consent to participate will be randomly allocated to receive 48 weeks of weekly oral MTX plus 20 weeks of prednisolone or 48 weeks of placebo plus 20 weeks of prednisolone. Participants will be stratified by type of ENL into those with acute ENL and those with chronic and recurrent ENL. The primary objective is to determine whether MTX reduces the requirement for additional prednisolone. Patients’ reported outcome measures will be used to assess the efficacy of MTX. Participants will be closely monitored for adverse events.Ethics and disseminationResults will be submitted for publication in peer-reviewed journals. Ethical approval was obtained from the Observational/Interventions Research Ethics Committee of the London School of Hygiene & Tropical Medicine (15762); The Leprosy Mission International Bangladesh Institutional Research Board (in process); AHRI-ALERT Ethical Review Committee, Ethiopia; Ethics Committee of the Managing Committee of the Bombay Leprosy Project; and The Leprosy Mission Trust India Ethics Committee; the Nepal Health and Research Council and Health Research Ethics Committee Dr. Soetomo, Indonesia. This study is registered at www.clinicaltrials.gov. This is the first RCT of MTX for ENL and will contribute to the evidence for the management of ENL.Trial registration numberNCT 03775460.

Scientific Writing = Thinking in Words

2020 ◽  
Author(s):  
David Lindsay
Keyword(s):  
First Language ◽  
Scientific Writing ◽  
Scientific Thinking ◽  
Journal Articles ◽  
Popular Book ◽  
Grant Applications ◽  
Conference Presentations ◽  
Way Of Thinking ◽  
The Prestige ◽  
The Way

Telling people about research is just as important as doing it. But many competent researchers are wary of scientific writing, despite its importance for sharpening scientific thinking, advancing their career, obtaining funding for their work and growing the prestige of their institution. This second edition of David Lindsay’s popular book Scientific Writing = Thinking in Words presents a way of thinking about writing that builds on the way good scientists think about research. The simple principles in this book will help you to clarify the objectives of your work and present your results with impact. Fully updated throughout, with practical examples of good and bad writing, an expanded chapter on writing for non-scientists and a new chapter on writing grant applications, this book makes communicating research easier and encourages researchers to write confidently. It is an ideal reference for researchers preparing journal articles, posters, conference presentations, reviews and popular articles; for students preparing theses; and for researchers whose first language is not English.

Physician and Nurse Research in Multidisciplinary Intensive Care Units

2020 ◽  
Vol 29 (6) ◽  
pp. 450-457
Author(s):  
Kevin B. Laupland ◽  
Fiona Coyer
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Interprofessional Collaboration ◽  
Clinical Care ◽  
Journal Articles ◽  
Medical Journals ◽  
Medical Study ◽  
Nurse Research ◽  
Study Participants ◽  
Study Designs

Background Although clinical care is multidisciplinary, intensive care unit research commonly focuses on single-discipline themes. We sought to characterize intensive care unit research conducted by physicians and nurses. Methods One hundred randomly selected reports of clinical studies published in critical care medical and nursing journals were reviewed. Results Of the 100 articles reviewed, 50 were published in medical journals and 50 were published in nursing journals. Only 1 medical study (2%) used qualitative methods, compared with 9 nursing studies (18%) (P = .02). The distribution of quantitative study designs differed between medical and nursing journals (P < .001), with medical journals having a predominance of cohort studies (29 articles [58%]). Compared with medical journal articles, nursing journal articles had significantly fewer authors (median [interquartile range], 5 [3-6] vs 8 [6-10]; P < .001) and study participants (94 [51-237] vs 375 [86-4183]; P < .001) and a significantly lower proportion of male study participants (55% [26%-65%] vs 60% [51%-65%]; P = .02). Studies published in medical journals were much more likely than those published in nursing journals to exclusively involve patients as participants (47 [94%] vs 25 [50%]; P < .001). Coauthorship between physicians and nurses was evident in 14 articles (14%), with infrequent inclusion of authors from other health care disciplines. Conclusions Physician research and nurse research differ in several important aspects and tend to occur within silos. Increased interprofessional collaboration is possible and worthwhile.

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