Improving long-lasting insecticidal nets use in Kayange community of north-western Burundi: a pilot study exploring the use of quality improvement methodologies in low-resource community settings

Quality improvement (QI) approaches have demonstrated a lot of promise in improving clinical care processes, both in high-resource and low-resource settings. However, most examples of QI initiatives in healthcare in low-income countries are clinic-based. The objective of this study was to demonstrate feasibility of applying QI methods in low-resource community settings by applying them to the problem of correct utilisation of long-lasting insecticidal nets (LLINs) in a rural community in Burundi. Correct utilisation of LLINs had been shown to be a cost-effective approach to malaria prevention. In Burundi, LLINs utilisation is low. The Model for Improvement, a well-known QI approach, was used to increase LLINs utilisation in a rural community in Burundi. In the baseline, LLINs ownership and weekly utilisation together with factors affecting LLINs non-use were documented for a period of 4 weeks before intervention. Improvement ideas were collaboratively developed by a quality improvement team (QIT) and tested using Plan-Do-Study-Act (PDSA) cycles. The first PDSA cycle consisted of the demonstration of how to mount LLINs, the second was an implementation of reminders done by household ‘watchdogs’, the third cycle consisted of conducting two community reminders every week and the last cycle was a combination of the last two PDSA cycles. The intervention lasted 4 weeks and data were collected weekly. LLINs utilisation was calculated each week and plotted on a run chart to demonstrate improvement trends. LLINs utilisation data were collected for another 3 weeks postintervention. Of 96 households, 83 (87%) households owned at least one LLIN. After intervention, the number of LLINs used increased from 32% to 75% (134% increase) and the number of persons (general population) sleeping under LLINs from 35% to 73% (108% increase). The number of children under 5 years sleeping under LLINs increased from 31% to 76% (145% increase) and the number of pregnant women who slept under LLINs from 43% to 73% (69% increase). Also, the averages of the number of nights in each week that the general population slept under LLINs increased from 2.13 to 5.11 (140% increase), children under 5 years from 1.68 to 4.78 (184% increase) and pregnant women from 1.56 to 4.47 (186% increase). Each of the 4 PDSA cycles led to a significant increase in outcome indicators and the trends appear to persist even after the implementation was complete. While it is impossible to draw generalisable conclusions from a small pilot study, QI approaches appear to be feasible to implement in low-resource community setting and have promise in producing results. More research at larger scale should be encouraged to validate our initial findings.

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PO 7167 IMPROVING USE OF LONG-LASTING INSECTICIDAL NETS IN KAYANGE COMMUNITY OF NORTH-WESTERN BURUNDI: A QUALITY IMPROVEMENT STUDY

BMJ Global Health ◽

10.1136/bmjgh-2019-edc.49 ◽

2019 ◽

Vol 4 (Suppl 3) ◽

pp. A20.1-A20

Author(s):

Desire Habonimana ◽

Gabriel Ndayisaba ◽

Gideon Nimako

Keyword(s):

Quality Improvement ◽

General Population ◽

Pregnant Women ◽

Cost Effective ◽

Universal Coverage ◽

Malaria Prevention ◽

Quality Improvement Intervention ◽

Long Lasting Insecticidal Nets ◽

North Western ◽

Children Under 5

BackgroundThe use of long-lasting insecticidal nets (LLINs) for malaria prevention is a cost-effective intervention. WHO recommends universal coverage and use of LLINs. In lower- and middle-income countries, LLINs are provided free of charge but are either not used or misused. Our study sought to improve LLIN use in Kayange community of north-western Burundi by using a model for improvement (MFI).MethodsA one-group, pre/post-test study was conducted. LLIN weekly use was assessed for four weeks before intervention and for another four weeks after intervention. The study was conducted in 96 households. The intervention consisted of testing four different weekly small change actions by using the MFI.ResultsOf the 96 households, 83 households (87%) owned at least one LLIN. However, only 40 households (42%) owned at least one LLIN for every two people. After intervention, the number of LLINs used increased from 32 to 75 per cent (134% increase) and the number of persons (general population) sleeping under LLIN from 35 to 73 per cent (108% increase). The number of children under 5 years old sleeping under LLIN increased from 31 to 76 per cent (145% increase) and the number of pregnant women who slept under LLIN from 43 to 73 per cent (69% increase). Also, the averages of the number of nights in each week that the general population slept under LLIN increased from 2.13 to 5.11 (140% increase), children under 5 years old slept under LLIN from 1.68 to 4.78 (184% increase) and pregnant women slept under LLIN from 1.56 to 4.47 (186% increase).ConclusionOur intervention led to significant increase in all outcome indicators. This increase is the result of a combination of an enabling context and an effective implementation of an evidence-based quality improvement intervention. Small tests of change at the community level have the potential for achieving improved outcomes.

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Implementation of an Integrated Community-Based Dental Care System for Low Income Children: Initial Findings (Preprint)

10.2196/preprints.11178 ◽

2018 ◽

Author(s):

Joana Cunha-Cruz ◽

Colleen E. Huebner ◽

Sharity Ludwig ◽

Douglas A. Conrad ◽

Jeanne Dysert ◽

...

Keyword(s):

Quality Improvement ◽

Pregnant Women ◽

Low Income ◽

Dental Care ◽

First Year ◽

Dental Hygienists ◽

Community Settings ◽

Community Based ◽

Low Income Children ◽

Dental Clinics

BACKGROUND To improve access to care and reduce disparities in oral health of low-income children and pregnant women, this quality improvement program used expanded practice dental hygienists, provided an evidence-based risk assessment and dental caries management protocol-based care in community settings, and paid personnel based on performance. A health information technology system was implemented integrating community-based practice, case management, and clinic records. OBJECTIVE Our objective was to describe the first year of implementation of the program including the processes, services provided, and factors that helped and hindered these implementation efforts. METHODS The mobile integrated community-based delivery system (PREDICT) was implemented as a quality improvement project within a large Dental Care Organization (DCO) that includes fixed dental clinics and contracted practices. The program is being tested in a randomized controlled trial. The target populations were Medicaid-eligible children and pregnant women in 7 rural counties in Oregon State USA. Data were collected from staff and community surveys, interviews, and administrative and dental health records. RESULTS Baseline assessments indicated patient satisfaction with care and staff readiness to implement changes were high. In PREDICT counties 9 expanded practice dental hygienists provided 37,369 services - an average of 4,152 services per EPDH in 198 community sites. Utilization ranged from 33-63% of eligible children and 30-42% of women, respectively, by county. For patients with ≥1 visits, 42% received a needs assessment, 88% preventive services and 26% restorative or endodontic services. By dental care need levels, 34% were low, 30% moderate, 32% high and 4% were not assigned to a group. Among moderate-need group, 51% received 1 silver diamine fluoride application and 19% two applications. Within the high-need group referred to dental clinics, 11% had urgent needs, 56% non-urgent needs, and the remaining 33% had non-urgent needs that could be treated in community settings. About 51% of the high-need group referred to dental clinics received services. CONCLUSIONS Initial findings confirm the strong emphasis of the program on access and use of preventive services, and the varying degrees of program reach in different counties. Implementation challenges in communities at different stages of collaboration between the dental care, school, and other community organizations limited the achievement of the audacious goals of the program in its first year. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT02312921

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Quality Improvement Pilot Study of the Living Your Best Weight Program: A Health at Every Size Approach

Canadian Journal of Dietetic Practice and Research ◽

10.3148/cjdpr-2019-032 ◽

2020 ◽

Vol 81 (2) ◽

pp. 91-93

Author(s):

Anna Angelinas ◽

Roseann Nasser ◽

Amanda Geradts ◽

Justine Herle ◽

Kristen Schott ◽

...

Keyword(s):

Quality Improvement ◽

Pilot Study ◽

Response Rate ◽

Participant Satisfaction ◽

Health At Every Size ◽

Outpatient Program ◽

To Receive

Purpose: Living Your Best Weight (LYBW) is an outpatient program based on Health at Every Size (HAES) principles for adults interested in managing their weight. The purpose of this pilot study was to determine perceptions of participants and their satisfaction with the LYBW program. Methods: A survey was developed to determine participant satisfaction of the LYBW program. Fifty-six participants who completed the LYBW program from June 2017 to February 2018 were contacted via telephone and invited to participate in the study. Forty-five participants agreed to receive the survey by mail or email. Results: Thirty-four participants completed the survey for a response rate of 61%. The average age of respondents was 52 years. Seventy-nine percent of respondents agreed that the program helped them to focus on health instead of weight. Eighty-two percent agreed that the program helped them respond to internal cues of hunger and fullness, and 94% were satisfied with the program. Conclusion: Participants reported that they were satisfied with the LYBW program and perceived improvements in their health. Future programming may benefit from using a HAES-based approach with adults.

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Essential Acute Stroke Care in Low Resource Settings: a Pilot studY

Case Medical Research ◽

10.31525/ct1-nct04157231 ◽

2019 ◽

Author(s):

Keyword(s):

Pilot Study ◽

Acute Stroke ◽

Stroke Care ◽

Acute Stroke Care ◽

Low Resource Settings ◽

Low Resource

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128 Mapping of the biophysical properties of pregnant women abdomen skin: A pilot study

Journal of Investigative Dermatology ◽

10.1016/j.jid.2021.02.147 ◽

2021 ◽

Vol 141 (5) ◽

pp. S23

Author(s):

G. Boyer ◽

G. Bellemère ◽

C. de Belilovsky ◽

C. Baudouin

Keyword(s):

Pilot Study ◽

Pregnant Women ◽

Biophysical Properties

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Healthcare career intervention with youth in a predominantly Latinx rural community: a pilot study of a creative approach

International Journal for Educational and Vocational Guidance ◽

10.1007/s10775-020-09455-y ◽

2021 ◽

Author(s):

Yunkyoung Garrison ◽

Saba Rasheed Ali ◽

Ching-Lan Rosaline Lin ◽

Ji Youn Cindy Kim ◽

Sara Heshmati

Keyword(s):

Pilot Study ◽

Rural Community ◽

Career Intervention

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P.5 Association of body fluid distribution with obstructive sleep apnea in pregnant women with body mass index ⩾ 40 kg/m2: A prospective observational pilot study

International Journal of Obstetric Anesthesia ◽

10.1016/j.ijoa.2021.103003 ◽

2021 ◽

Vol 46 ◽

pp. 103003

Author(s):

J. Wicker ◽

C.V. Maxwell ◽

K. Downey ◽

M. Singh ◽

M. Balki

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Pilot Study ◽

Pregnant Women ◽

Body Mass ◽

Body Fluid ◽

Fluid Distribution ◽

Obstructive Sleep

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Teacher’s Reasons for Trust and Distrust in Scientific Evidence: Reflecting a “Smart But Evil” Stereotype?

AERA Open ◽

10.1177/23328584211028599 ◽

2021 ◽

Vol 7 ◽

pp. 233285842110285

Author(s):

Tom Rosman ◽

Samuel Merk

Keyword(s):

Pilot Study ◽

General Population ◽

Educational Research ◽

Scientific Evidence ◽

Population Sample ◽

Empirical Support ◽

Evaluation Framework ◽

General Population Sample ◽

Online Study ◽

Hypothesis Evaluation

We investigate in-service teachers’ reasons for trust and distrust in educational research compared to research in general. Building on previous research on a so-called “smart but evil” stereotype regarding educational researchers, three sets of confirmatory hypotheses were preregistered. First, we expected that teachers would emphasize expertise—as compared with benevolence and integrity—as a stronger reason for trust in educational researchers. Moreover, we expected that this pattern would not only apply to educational researchers, but that it would generalize to researchers in general. Furthermore, we hypothesized that the pattern could also be found in the general population. Following a pilot study aiming to establish the validity of our measures (German general population sample; N = 504), hypotheses were tested in an online study with N = 414 randomly sampled German in-service teachers. Using the Bayesian informative hypothesis evaluation framework, we found empirical support for five of our six preregistered hypotheses.

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