Facilitators, barriers and lessons learnt from the first state-wide naloxone distribution conducted in West Virginia

BackgroundOverdose education and naloxone distribution programmes are known to reduce opioid-related deaths. A state-wide naloxone distribution effort of 8250 rescue kits was undertaken by government, community and university partners in West Virginia in 2016–2017. The purpose of this study was to discern the barriers, facilitators and lesson learnt from implementing this endeavour in a rural state with the highest opioid overdose fatality rate in the US.MethodsStructured interviews (n=26) were conducted among both internal and external stakeholders. Those who participated were >18 years of age and were the lead representative from agencies that either received naloxone (ie, external stakeholders) or helped implement the distribution (ie, internal stakeholders). The interviews followed standardised scripts and lasted approximately 40 min. Sessions were audio-recorded and transcribed. Qualitative content analysis was performed by two researchers to determine themes surrounding facilitators or barriers to programme implementation.ResultsThe primary facilitators reported by stakeholders included collaborative partnerships, ease of participating in the programme, being established in prevention efforts, demand for naloxone and the need for personal protection from overdose. The primary barriers identified by stakeholders included bureaucracy/policy/procedures of their organisation or agency, stigma, logistical or planning issues, problems with reporting, lack of communication post distribution and sustainability. Numerous lessons were learnt.ConclusionsBased on the implementation of the programme in 87 organisations, including law enforcement and fire departments, the impact of facilitators outweighed that of barriers. These findings may inform others planning to conduct a similar, large-scale project.

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Public libraries digital services and sustainability issues

The Bottom Line Managing Library Finances ◽

10.1108/bl-12-2014-0034 ◽

2015 ◽

Vol 28 (1/2) ◽

pp. 34-43 ◽

Cited By ~ 5

Author(s):

Katarina Michnik

Keyword(s):

Public Libraries ◽

Qualitative Content Analysis ◽

Public Library ◽

Structured Interviews ◽

Content Type ◽

The Sustainable Development ◽

Digital Services ◽

Local Politicians ◽

Physical Spaces ◽

The Impact

Purpose – The purpose of this paper is to study how Swedish local politicians perceive the impact of public library digital services on public libraries and to discuss how this can affect the sustainable development of public libraries. Design/methodology/approach – Empirical data were collected through semi-structured interviews with local politicians from 19 different Swedish municipalities. Data were treated to qualitative content analysis and discussed based on the concept of sustainable organization. Findings – According to local politicians, public library digital services may affect public libraries through changes to libraries’ physical spaces, librarians’ tasks and competencies and libraries’ economic situations. Based on these findings, public library digital services can both strengthen and weaken public library sustainability through, for example, increased access and expenditures, the latter of which may threaten public library sustainability. Research limitations/implications – Interviews did not focus specifically on the politicians’ views on public library digital services but dealt generally with their views on public libraries. To identify reasons for variations in views on this topic, follow-up interviews should be done. Data on views from public library managers would also be of use to determine the degree to which they are shared with local politicians. Originality/value – When sustainability and public libraries are discussed, the focus is generally on the library’s contribution to a sustainable society. Here, the focus is instead on the sustainability of the public library itself.

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20 Adolescent and caregiver perspectives on living with a limb fracture: A qualitative study

Paediatrics & Child Health ◽

10.1093/pch/pxab061.014 ◽

2021 ◽

Vol 26 (Supplement_1) ◽

pp. e12-e13

Author(s):

Manisha Bharadia ◽

Stevi Golden-Plotnik ◽

Michael van Manen ◽

Mithra Sivakumar ◽

Amy Drendel ◽

...

Keyword(s):

Social Dynamics ◽

Qualitative Content Analysis ◽

Functional Limitations ◽

Pediatric Emergency ◽

Family Impact ◽

Structured Interviews ◽

Discharge Instructions ◽

Caregiver Support ◽

Fracture Function ◽

The Impact

Abstract Primary Subject area Emergency Medicine - Paediatric Background Fractures occur in up to half of children by age 16 years. After initial emergency care for a fracture, function is universally impaired in children, and impacts extend to the immediate family. Knowledge of expected functional limitations is key to providing proper discharge instructions and anticipatory guidance to families. Objectives Our study objectives were to understand: 1) how adolescents (12-17 years) describe the functional impact of fractures on their lives; 2) how adolescents’ reports of their experiences compare to those of their caregivers; and 3) the impact of the fracture on the family unit. Design/Methods We conducted individual, semi-structured interviews from June 2019 to November 2020 with adolescents and their caregivers, 7-14 days following their initial visit to a pediatric emergency department. We utilized qualitative content analysis methodology. Recruitment proceeded until thematic saturation was achieved. Coding and analysis were concurrent with recruitment and interviews. A secondary coder reviewed 40% of the transcripts, and the coding team met regularly to discuss the coding framework and key themes. The interview script was modified in an iterative process, to reflect emerging themes. Results We completed a total of 29 interviews. The most commonly affected functions were: a) showering and hygiene (which required the most caregiver support); b) sleep variability (due to pain and cast-related discomfort); and c) exclusion from sports/activities. Many adolescents experienced disruptions to social activities and gatherings. Adolescents valued independence and often chose to take more time to complete a task to preserve this, regardless of inconvenience. Both adolescents and caregivers reported feelings of frustration as a result of day-to-day impacts imposed by the injury. Generally, caregivers’ perspectives were in keeping with the experiences that adolescents described for themselves. Notable family impacts included what we described as ‘sibling burden’ or conflicts that arose when a sibling had to take on extra chores/tasks. Conclusion These themes highlight an opportunity to better tailor discharge instructions for adolescents with fractures. Key messages include: 1) expect pain and impaired sleep, especially in the first few days; 2) allow extra time to complete tasks independently, especially for grooming and hygiene; 3) consider family impact, especially sibling burden; 4) prepare for changes in activities and social dynamics; and 5) frustration is normal, for both adolescents and caregivers. Future work can focus on developing a novel, family-informed tool to assess functional outcomes following injury.

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The Impact of Mobile Phone Uses in the Developing World

International Journal of Information Communication Technologies and Human Development ◽

10.4018/ijicthd.2017040102 ◽

2017 ◽

Vol 9 (2) ◽

pp. 20-48 ◽

Cited By ~ 1

Author(s):

Sylvain K. Cibangu ◽

Mark Hepworth ◽

Donna Champion

Keyword(s):

Information And Communication Technologies ◽

Mobile Phones ◽

Large Scale ◽

Communication Technologies ◽

Structured Interviews ◽

Top Down ◽

Information And Communication ◽

The Subject ◽

The Impact

In recent years, the rise of information and communication technologies (ICTs) contrasted with the dire living conditions of the world's poorest has been the subject of debate among industry and academia. However, despite the amount of writings produced on mobile phones, Western bias is surprisingly unbridledly prevailing alongside the fêted dissemination of mobile phones. Expansive literature tends to present the rapid adoption of mobile phones among rural individuals, with little to no indication of how local values and voices are respected or promoted. We undertook semi-structured interviews with 16 rural chiefs to inquire into ways in which mobile phones enabled socio-economic development in the rural Congo. Rather than using quantitative, large-scale, or top-down data, we sought to give voice to chiefs themselves about the role of mobile phones. We found that Western bias dominates the literature and deployment of mobile phones more than usually acknowledged. We suggested some paths forward, while bringing the African communal Utu or Ubuntu culture to the center stage.

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P076: Assessment of a newly integrated and standardized approach for pediatric concussions aimed to improve the concussion recovery process

CJEM ◽

10.1017/cem.2020.282 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S91-S92

Author(s):

J. St.Onge ◽

E. Karreman ◽

M. McCarron ◽

L. Harasen ◽

C. Ames

Keyword(s):

Positive Impact ◽

Qualitative Content Analysis ◽

Recovery Process ◽

Return To School ◽

Structured Interviews ◽

Discharge Data ◽

Written Information ◽

Return To Learn ◽

Concussion Recovery ◽

The Impact

Introduction: Children with concussions presenting to emergency departments often receive very different recommendations for how to recover. In addition, there are no instructions for teachers to how children should return to learn and play after a concussion. Therefore, some children take too long to return to learn and play at school while others return too soon, thereby risking long-term problems because their brain injury is not fully healed. The purpose of this project is to determine the impact of a new integrated, standardized approach aimed to help a concussed child recover faster and whether the recovery experience for all involved has improved. Methods: Structured interviews were conducted with 11 parents of children treated for concussion at the Emergency Department of Pasqua Hospital in Regina, SK, four of whom received care after a change in practice whereby parents were provided with a return-to-school protocol form prior to discharge. Data were analyzed using an inductive qualitative content analysis approach using NVivo 12 software. Results: Three main categories were noted in the data: Parental response to the child's concussion, satisfaction with health services, and the communication amongst parents, physicians, and teachers. It was with regard to the last theme in particular that the impact of the return to school protocol was noted, helping to at least indirectly address the issue of the parent as the “middleman” in the communication triad. Most parents whose children received care prior to the introduction of the protocol suggested that providing written information at discharge to guide parents through the concussion recovery process would be helpful. Conclusion: Our initial results show a positive impact in regards to the process of children returning to learn and play after a concussion. Specifically, the increased communication between physician, teacher, and parent seems to benefit and improve the child's recovery process.

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The health literacy needs of women living with HIV/AIDS

Health SA Gesondheid ◽

10.4102/hsag.v20i1.916 ◽

2015 ◽

Vol 20 (1) ◽

Author(s):

Judy Thompson ◽

Yolanda Havenga ◽

Susan Naude

Keyword(s):

Health Literacy ◽

Hiv Transmission ◽

Qualitative Content Analysis ◽

Sub Saharan Africa ◽

People Living With Hiv ◽

Structured Interviews ◽

Women Living With Hiv ◽

Living With Hiv ◽

The Impact ◽

Hiv Aids

Women in Sub-Saharan Africa are disproportionately affected by the virus and constitute 60% of the total HIV/AIDS infections in this region. Current recommendations endorse the involvement of people living with HIV in the development of programmes for people living with the virus. The purpose of the study was to explore and describe the health literacy needs of women living with HIV. The research design was qualitative, explorative, descriptive and contextual. After women living with HIV/AIDS were sampled purposively, semi-structured interviews were conducted with eight women and qualitative content analysis done. The findings revealed that the women expressed a need to increase their knowledge about HIV/AIDS. The knowledge they needed ranged from basic pathophysiology about HIV/AIDS, to the impact of HIV/AIDS on their health, to an awareness of the modes of HIV transmission and methods of protecting others from being infected. Other important health literacy needs related to self-care and correct antiretroviral use. A need for psychosocial skills was also identified in order for women to build and maintain their relationships. Recommendations were made for nursing practice, education and further research, based on these findings.

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Monitoring Implementation Impact of the EU-Indonesia’s VPA on SME Livelihood

International Journal of Forestry Research ◽

10.1155/2020/4327802 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Rahmanta Setiahadi ◽

S. R. Kartika Sari ◽

Ahmad Maryudi ◽

Julia Kalmirah ◽

Liliana Baskorowati

Keyword(s):

Large Scale ◽

Social Impact ◽

Wood Products ◽

Theory Of Change ◽

Vulnerable Groups ◽

Sustainable Livelihood ◽

The European Union ◽

Structured Interviews ◽

Marginalised Groups ◽

The Impact

The Europe Union (E.U.) has agreed to grant the Forest Law Enforcement, Governance and Trade (FLEGT) license to Indonesia as the first country in the world to receive it. FLEGT VPA (Voluntary Partnership Agreement) is a bilateral agreement between the European Union (E.U.) and wood exporting countries, to improve forest governance sector and ensure that timber and wood products imported into the E.U. are produced by the laws and regulation of partner countries. The Indonesian government has obliged to implement Article 12 relating to social safeguards. Indonesia has to periodically monitor to see the extent to which the VPA has an environmental and social impact that affect the lives and welfare of vulnerable and marginalised groups. The purpose of this study is to analyse how the effect of implementation of the Sistem Verifikasi Legalitas Kayu (SVLK) as part of VPA in the small and medium forestry industry sector. Methodology survey with focus group discussions, structured interviews, and semistructured interviews to find out the response and opinion of SME’s owner and employee addressed the effect of SVLK in East Java and Central Java, Indonesia. The theory of change (ToC) was used to consider the implications of SVLK implementation on the sustainable livelihood of small and medium enterprises (SME’s). The results of this study showed that SVLK had a more significant impact on livelihoods, as follows. First, the vulnerable and marginalised groups need to be supported by stakeholders to encourage readiness in faces of SVLK impact. Second, SVLK is susceptible to the effects and at risk of losing livelihoods for women and disabled groups in a short time. This group includes vulnerable groups of aspects of adaptability and sensitivity to the effect. Third, SME’s worker groups who do not have a labour organisation are sensitive to the impact on the workplace company. This group is classified as a group that is quite vulnerable if the effect lasts long enough and on a large scale of impact.

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Legal complaints about midwives and the impact on the profession

Nursing Ethics ◽

10.1177/0969733016689816 ◽

2017 ◽

Vol 26 (1) ◽

pp. 148-160 ◽

Cited By ~ 4

Author(s):

Akram Peyman ◽

Nahid Dehghan Nayeri ◽

Mohammad Esmaeilpour Bandboni ◽

Zahra Behboodi Moghadam

Keyword(s):

Qualitative Content Analysis ◽

Well Being ◽

Professional Status ◽

Medical Sciences ◽

Structured Interviews ◽

Ethical Considerations ◽

Written Text ◽

Litigation Process ◽

Training Professional ◽

The Impact

Introduction: Midwives play an important role in maintaining and increasing women’s health and well-being. Training professional midwives is one of the main policies of any healthcare system. Since the number of complaints against midwives has increased recently, this study was conducted to explore the perspectives of midwives regarding patients’ complaint to authorities and their impacts on the profession of midwifery. Methods: Being conducted in 2013, this qualitative study was the first of its type in Iran. Data were collected through in-depth semi-structured interviews with 14 midwives working in different cities across the country. The participants were selected using a purposive sampling method. Interviews were transcribed verbatim and analyzed following a qualitative content analysis approach. Written text was then coded, and themes were extracted from the data. Ethical considerations: The study was conducted with midwives’ free informed consent and was approved by Ethics Committee of Tehran University of Medical Sciences. Findings: By analyzing the data, four main themes regarding the impact of complaint on midwifery profession were developed. These included the following: “dissatisfied of midwifery, professional deviation, obsession with work, and weakening of the professional status.” Conclusion: The experience of patients’ complaint to legal authorities against midwives was described, by participants, as a painful experience. Lack of midwives’ knowledge about professional rules and litigation process created many problems for them and could negatively affect their practice and the society’s attitude toward midwifery. Thus, we suggest that in order to prevent such problems, midwives and midwifery students should be educated regarding factors that have the potential to create such problems and also prevention strategies.

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Patient, parent and educator perspectives on paediatric concussion

Journal of Concussion ◽

10.1177/2059700220969535 ◽

2021 ◽

Vol 5 ◽

pp. 205970022096953

Author(s):

Anne M Grool ◽

Carol DeMatteo ◽

Nick Reed ◽

Dennis Newhook ◽

Roger Zemek

Keyword(s):

Health Care Professionals ◽

Qualitative Content Analysis ◽

Past Research ◽

Health Concern ◽

Structured Interviews ◽

Athletic Coaches ◽

School Sports ◽

Educator Perspectives ◽

Concussion Recovery ◽

The Impact

Background Past research on paediatric concussion awareness, management, impact and outcome priorities has focused on health care professionals and sports organizations, yet little is known about patient, parent and educator perspectives. Methods To address this knowledge gap, we conducted a qualitative descriptive study using semi-structured interviews with three participant groups: patient-participants including children with acute or chronic concussion; parent-participants including caregivers of children at risk for or with history of concussion; and educator-participants including teachers and athletic coaches from three Ontario secondary schools. We designed our interview guide to elicit participants’ perspectives across four domains: concussion awareness, concussion experience, support and resources, and outcome priorities. We analyzed our resultant data using a qualitative content analysis approach. Results Nine paediatric patient-participants, 17 parent-participants, and 14 educator-participants completed the study. Participants described concussion as a serious health concern and attributed greater concussion awareness to increased media attention and concussion protocol implementation within schools/sports. While most educator-participants regarded concussion protocols positively, some feared student manipulation. Parent- and educator-participants desired consistent information and resources from reliable sources. The impact of concussion ranged from a few days to prolonged absences (from school, sports, and socializing) and necessitated accommodations in both academic and sport settings. Short-term problems (e.g., decreased peer-contact) primarily troubled patient-participants, whereas long-term problems (e.g., impaired academics, psychological stress) concerned parent and educator groups. Conclusion Patients, parents and educators worry about the consequences of paediatric concussion. Initial concussion recovery in youth should focus on a timely return to academics and on minimizing social isolation by ensuring peer-contact during recovery.

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The Impact of Restrictive Family Presence Policies in Response to COVID-19 on Family Integrated Care in the NICU: A Qualitative Study

HERD Health Environments Research & Design Journal ◽

10.1177/19375867211065178 ◽

2021 ◽

pp. 193758672110651

Author(s):

Holly McCulloch ◽

Marsha Campbell-Yeo ◽

Brianna Richardson ◽

Justine Dol ◽

Amos Hundert ◽

...

Keyword(s):

Integrated Care ◽

Neonatal Intensive Care ◽

Qualitative Content Analysis ◽

Well Being ◽

Healthcare Team ◽

Structured Interviews ◽

Family Presence ◽

Family Integrated Care ◽

The Impact ◽

Family Integrated

Objectives: To conduct a needs assessment with families and their healthcare team to understand the impact of restrictive family presence policies in the neonatal intensive care unit (NICU) in response to COVID-19. Background: In response to the COVID-19 pandemic, significant restrictive family presence policies were instituted in most NICUs globally intended to protect infants, families, and HCPs. However, knowledge on the impact of the stress of the pandemic and policies restricting family presence in the NICU on vulnerable neonates and their families remains limited. Methods: Individuals were eligible to participate if they were a caregiver of an infant requiring NICU care or a healthcare provider (HCP) in the NICU after March 1, 2020. Semi-structured interviews were conducted using a virtual communication platform, and transcripts were analyzed using inductive thematic qualitative content analysis. Results: Twenty-three participants were interviewed (12 families and 11 HCPs). Three themes emerged: (1) successes (family-integrated care, use of technology), (2) challenges (lack of standardized messaging and family engagement, impact on parental wellbeing, institutional barriers, and virtual care), and (3) moving forward (responsive and supportive leadership). Conclusions: Our findings highlight the significant impact of family restrictions on the mental well-being of families, physical closeness with parents, and empathetic stress to HCPs. Further study of potential long-term impact is warranted.

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Hostility, compassion and role reversal in West Virginia’s long opioid overdose emergency

Harm Reduction Journal ◽

10.1186/s12954-020-00416-w ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Jeff Ondocsin ◽

Sarah G. Mars ◽

Mary Howe ◽

Daniel Ciccarone

Keyword(s):

Drug Use ◽

West Virginia ◽

Harm Reduction ◽

Ethnographic Study ◽

Role Reversal ◽

Opioid Overdose ◽

Snowball Sampling ◽

Risk Environment ◽

Structured Interviews ◽

Needle And Syringe Program

Abstract Background West Virginia is a largely rural state with strong ties of kinship, mutual systems of support and charitable giving. At the same time, wealth inequalities are extreme and the state’s drug overdose fatality rate stands above all others in the USA at 51.5/100,000 in 2018, largely opioid-related. In recent years, harm reduction services have been active in the state but in 2018 Charleston’s needle and syringe program was forced to close. This paper considers the risk environment in which the state’s drug-related loss of life, and those attempting to prevent it, exist. Methods This rapid ethnographic study involved semi-structured interviews (n = 21), observation and video recordings of injection sequences (n = 5), initially recruiting people who inject heroin/fentanyl (PWIH) at the Charleston needle and syringe program. Snowball sampling led the research team to surrounding towns in southern West Virginia. Telephone interviews (n = 2) with individuals involved in service provision were also carried out. Results PWIH in southern West Virginia described an often unsupportive, at times hostile risk environment that may increase the risk of overdose fatalities. Negative experiences, including from some emergency responders, and fears of punitive legal consequences from calling these services may deter PWIH from seeking essential help. Compassion fatigue and burnout may play a part in this, along with resentment regarding high demands placed by the overdose crisis on impoverished state resources. We also found low levels of knowledge about safe injection practices among PWIH. Conclusions Hostility faced by PWIH may increase their risk of overdose fatalities, injection-related injury and the risk of HIV and hepatitis C transmission by deterring help-seeking and limiting the range of harm reduction services provided locally. Greater provision of overdose prevention education and naloxone for peer distribution could help PWIH to reverse overdoses while alleviating the burden on emergency services. Although essential for reducing mortality, measures that address drug use alone are not enough to safeguard longer-term public health. The new wave of psychostimulant-related deaths underline the urgency of addressing the deeper causes that feed high-risk patterns of drug use beyond drugs and drug use.

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