scholarly journals Importance of “Process Evaluation” in Audiological Rehabilitation: Examples from Studies on Hearing Impairment

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Vinaya Manchaiah ◽  
Berth Danermark ◽  
Jerker Rönnberg ◽  
Thomas Lunner
Keyword(s):  
Hearing Impairment ◽  
Process Evaluation ◽  
Outcome Measures ◽  
Relevant Literature ◽  
Temporal Dimension ◽  
Patient Journey ◽  
Process Of Change ◽  
People With Disability ◽  
Methodological Aspects ◽  
Disability Research

The main focus of this paper is to discuss the importance of “evaluating the process of change” (i.e., process evaluation) in people with disability by studying their lived experiences. Detailed discussion is made about “why and how to investigate the process of change in people with disability?” and some specific examples are provided from studies on patient journey of persons with hearing impairment (PHI) and their communication partners (CPs). In addition, methodological aspects in process evaluation are discussed in relation to various metatheoretical perspectives. The discussion has been supplemented with relevant literature. The healthcare practice and disability research in general are dominated by the use of outcome measures. Even though the values of outcome measures are not questioned, there seems to be a little focus on understanding the process of change over time in relation to health and disability. We suggest that the process evaluation has an additional temporal dimension and has applications in both clinical practice and research in relation to health and disability.

scholarly journals Implementing person-centred outcome measures (PCOMs) into routine palliative care: A protocol for a mixed-methods process evaluation of The RESOLVE PCOM Implementation Strategy

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e051904
Author(s):  
Andy Bradshaw ◽  
Martina Santarelli ◽  
Assem M Khamis ◽  
Kathryn Sartain ◽  
Miriam Johnson ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Process Evaluation ◽  
Outcome Measures ◽  
Implementation Strategy ◽  
Public Involvement ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Care Practice ◽  
Ethical Approval

IntroductionPerson-centred outcome measures improve quality of care and patient outcomes but are used inconsistently in palliative care practice. To address this implementation gap, we developed the ‘RESOLVE Implementation Strategy’. This protocol describes a process evaluation to explore mechanisms through which this strategy does, or does not, support the implementation of outcome measures in routine palliative care practice.Methods and analysisMultistrand, mixed-methods process evaluation. Strand one will collect routine outcomes data (palliative Phase of Illness, Integrated Palliative care Outcomes Scale, Australia-modified Karnofsky Performance Status) to map the changes in use of outcome measures over 12 months (July 2021–July 2022). Strand two will collect survey data over the same 12-month period to explore how professionals’ understandings of, skills in using and ability to build organisational practices around, outcome measures change over time. Strand three will collect interview data to understand the mechanisms underpinning/affecting our implementation strategy. Thematic framework analysis and descriptive statistics will be used to analyse qualitative and quantitative data, respectively.Ethics and disseminationFor strand one, ethical approval has been obtained (Cambridge REC, REF: 20/EE/0188). For strands two and three, ethical approval has been obtained from Hull York Medical School ethics committee (2105). Tailored feedback of study findings will be provided to participating sites. Abstracts and papers will be submitted to national/international conferences and peer-reviewed journals. Lay and policy briefings and newsletters will be shared through patient and public involvement and project networks, plus via the project website.

scholarly journals Building communities of trust: Challenges for disability

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Alexander M. Phiri
Keyword(s):  
Human Rights ◽  
Civil Society ◽  
International Research ◽  
Research Agenda ◽  
Research Programme ◽  
Development Research ◽  
Research Partnerships ◽  
People With Disability ◽  
The Disabled ◽  
Disability Research

This article asks questions about power and partnership in disability research in Africa. Research has been located too much in one type of organisation or another and not sufficiently in the interaction between a range of legitimate stakeholders. Across Africa and Europe, and government and civil society dialogues, the African development research agenda must be owned by Africans. Fully inclusive national and international research partnerships are crucial, but they must be driven from Africa. European constructions of and interventions concerning people with disability have often been inhumane, seeking to eliminate them from society. African cultures have also stigmatised people with disability. I call for a new African-driven research agenda that promotes the human rights of people with disability, and has people with disability not only participating in this research, but directing it. The Southern African Federation of the Disabled (SAFOD) Research Programme (SRP) is breaking new ground in this regard by allowing ‘the researched’ to become ‘the researcher’.

The Impact of Weighting Methods and Behavioral Attitudes on the Weighting Process in Decision-Making

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Anastasia Tzioutziou ◽  
Yiannis Xenidis
Keyword(s):  
Decision Making ◽  
Relevant Literature ◽  
Weighting Method ◽  
Behavioral Traits ◽  
Complex Process ◽  
Original Survey ◽  
Methodological Aspects ◽  
The Impact ◽  
Behavioral Attitudes ◽  
Weighting Methods

Abstract The determination of weights in decision-making problems can be deduced as a complex process of preference formation. Preferences are expressions of behavioral attitudes and are affected by external circumstances, such as risk and ambiguity. The objective of this research is to examine the impact of both the human factor and the weighting methods on the weighting process in decision-making problems. Based on relevant literature a new methodology is proposed and applied to identify with the use of a psychometric function the behavioral attitudes of decision-making analysts against risk and ambiguity. Furthermore, the examination of process-related features such as the weighting method, the weighting scale and the weighting problem's presentation provides additional knowledge on the understanding of the weighting process in decision-making problems. Thus, an original survey is designed, aiming at: (a) the identification of the respondents' attitudinal preferences based on multiple personality tests and (b) the elicitation of weight assignments through the use of different weighting tasks and subtasks. The findings reveal that the weightings and their consistency are significantly affected by the elicitation method, the nature of the weighting scale and the problem's framing. It is also interesting that the decision analysts' behavioral traits, in association with the problem's methodological aspects, affect the weight assignments, thus providing evidence for the potential to predict weightings in the decision-making process.

scholarly journals Process and outcome measures used in acceptance and commitment therapy research, with adults with acquired neurological conditions: a systematic review

2021 ◽  
Author(s):  
Hannah Foote ◽  
Audrey Bowen ◽  
Sarah Cotterill ◽  
Geoff Hill ◽  
Matilde Pieri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Acceptance And Commitment Therapy ◽  
Anxiety And Depression ◽  
Core Outcome ◽  
Process Of Change ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Health Related ◽  
Neurological Conditions

Background: Acceptance and Commitment Therapy (ACT) interventions may promote wellbeing in neurological populations, but there is a lack of evidence to inform measure selection in research. Purpose: To identify and classify the measures used in ACT with adults with acquired neurological conditions.Methods: PRISMA guided systematic review. MEDLINE, PsycInfo and CINAHL databases searched (27/05/2020) with forward and backward searching. All study types included. Extraction of ACT process-of-change and health-related outcome measures. Outcomes coded using the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy.Results: 204 papers screened. 34 studies included. Conditions included multiple sclerosis (n=17), traumatic brain injury (n=9) and stroke (n=8). 25 process-of-change measures extracted. Psychological flexibility was the most common process measured (AAQ-II most commonly used, n=14 studies). 76 health-related outcome measures extracted. Measures exploring quality of life, health status, anxiety and depression occurred most frequently. The Hospital Anxiety and Depression Scale was the most commonly used measure (n=8 studies). Conclusions: Future studies should follow reporting guidelines and consider the consistent use of measures to support synthesis of results. This could be achieved through the development of a Core Outcome Set – a standardised set of measures to be used across trials of ACT with adults with neurological conditions.

scholarly journals Basic Measures of Prosody in Spontaneous Speech of Children With Early and Late Cochlear Implantation

2018 ◽  
Vol 61 (12) ◽  
pp. 3075-3094 ◽  
Author(s):  
Daan J. van de Velde ◽  
Johan H. M. Frijns ◽  
Mieke Beers ◽  
Vincent J. van Heuven ◽  
Claartje C. Levelt ◽  
...  
Keyword(s):  
Speech Production ◽  
Cochlear Implants ◽  
Fundamental Frequency ◽  
Outcome Measures ◽  
Cochlear Implantation ◽  
Spontaneous Speech ◽  
Spectral Measures ◽  
Temporal Dimension ◽  
Temporal Measures ◽  
Over Time

PurposeRelative to normally hearing (NH) peers, the speech of children with cochlear implants (CIs) has been found to have deviations such as a high fundamental frequency, elevated jitter and shimmer, and inadequate intonation. However, two important dimensions of prosody (temporal and spectral) have not been systematically investigated. Given that, in general, the resolution in CI hearing is best for the temporal dimension and worst for the spectral dimension, we expected this hierarchy to be reflected in the amount of CI speech's deviation from NH speech. Deviations, however, were expected to diminish with increasing device experience.MethodOf 9 Dutch early- and late-implanted (division at 2 years of age) children and 12 hearing age-matched NH controls, spontaneous speech was recorded at 18, 24, and 30 months after implantation (CI) or birth (NH). Six spectral and temporal outcome measures were compared between groups, sessions, and genders.ResultsOn most measures, interactions of Group and/or Gender with Session were significant. For CI recipients as compared with controls, performance on temporal measures was not in general more deviant than spectral measures, although differences were found for individual measures. The late-implanted group had a tendency to be closer to the NH group than the early-implanted group. Groups converged over time.ConclusionsResults did not support the phonetic dimension hierarchy hypothesis, suggesting that the appropriateness of the production of basic prosodic measures does not depend on auditory resolution. Rather, it seems to depend on the amount of control necessary for speech production.

scholarly journals The Future of Positive Psychology and Disability

2021 ◽  
Vol 12 ◽  
Author(s):  
Michael L. Wehmeyer
Keyword(s):  
Positive Psychology ◽  
Well Being ◽  
The Past ◽  
Strength Based ◽  
Human Functioning ◽  
People With Disability ◽  
History Of ◽  
Knowledge And Practice ◽  
Disability Research

For much of the history of the application of psychology to disability, the research and clinical focus of the field was deficits-oriented: documenting what people with disability could not do, proposing theories of why they could not do these things, creating measures to assess this incapacity and incompetence, and building interventions and treatments predicated on disease and pathology. It has been only in the last few decades that conceptualizations of disability allowed for consideration of strengths and positive attributes along with the presence of disability and only in the past two decades that a positive psychology of disability has emerged. This article will briefly summarize the factors that led to the emergence of a focus on the positive psychology of disability and a strength-based approach in the field, examine the state of knowledge and practice as it pertains to the positive psychology of disability, and will examine challenges that serve as barriers to progress in this area and opportunities for advancement. Among these is examining how “optimal human functioning” can be understood in ways that includes, and not excludes, people with disability. The importance of shifting the disability research and practice focus to emphasize flourishing, well-being, and self-determination of and for people with disability will be discussed, as well as the necessity for the field of positive psychology to more aggressively reach out to include people with disability among those populations whom the field values and includes.

scholarly journals Randomised controlled trial evaluating the effectiveness and cost-effectiveness of ‘Families for Health’, a family-based childhood obesity treatment intervention delivered in a community setting for ages 6 to 11 years

2017 ◽  
Vol 21 (1) ◽  
pp. 1-180 ◽  
Author(s):  
Wendy Robertson ◽  
Joanna Fleming ◽  
Atiya Kamal ◽  
Thomas Hamborg ◽  
Kamran A Khan ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Usual Care ◽  
Process Evaluation ◽  
Outcome Measures ◽  
Controlled Trial ◽  
Cost Effective ◽  
Z Score ◽  
Clinically Significant ◽  
Family Based ◽  
Randomised Controlled

BackgroundEffective programmes to help children manage their weight are required. ‘Families for Health’ focuses on a parenting approach, designed to help parents develop their parenting skills to support lifestyle change within the family. Families for Health version 1 showed sustained reductions in mean body mass index (BMI) z-score after 2 years in a pilot project.ObjectiveThe aim was to evaluate its effectiveness and cost-effectiveness in a randomised controlled trial (RCT).DesignThe trial was a multicentre, investigator-blind RCT, with a parallel economic and process evaluation, with follow-up at 3 and 12 months. Randomisation was by family unit, using a 1 : 1 allocation by telephone registration, stratified by three sites, with a target of 120 families.SettingThree sites in the West Midlands, England, UK.ParticipantsChildren aged 6–11 years who were overweight (≥ 91st centile BMI) or obese (≥ 98th centile BMI), and their parents/carers. Recruitment was via referral or self-referral.InterventionsFamilies for Health version 2 is a 10-week, family-based community programme with parallel groups for parents and children, addressing parenting, lifestyle, social and emotional development. Usual care was the treatment for childhood obesity provided within each locality.Main outcome measuresJoint primary outcome measures were change in children’s BMI z-score and incremental cost per quality-adjusted life-year (QALY) gained at 12 months’ follow-up (QALYs were calculated using the European Quality of Life-5 Dimensions Youth version). Secondary outcome measures included changes in children’s waist circumference, percentage body fat, physical activity, fruit/vegetable consumption and quality of life. Parents’ BMI and mental well-being, family eating/activity, parent–child relationships and parenting style were also assessed. The process evaluation documented recruitment, reach, dose delivered, dose received and fidelity, using mixed methods.ResultsThe study recruited 115 families (128 children; 63 boys and 65 girls), with 56 families randomised to the Families for Health arm and 59 to the ‘usual-care’ control arm. There was 80% retention of families at 3 months (Families for Health, 46 families; usual care, 46 families) and 72% retention at 12 months (Families for Health, 44 families; usual care, 39 families). The change in BMI z-score at 12 months was not significantly different in the Families for Health arm and the usual-care arm [0.114, 95% confidence interval (CI) –0.001 to 0.229;p = 0.053]. However, within-group analysis showed that the BMI z-score was significantly reduced in the usual-care arm (–0.118, 95% CI –0.203 to –0.034;p = 0.007), but not in the Families for Health arm (–0.005, 95% CI –0.085 to 0.078;p = 0.907). There was only one significant difference between groups for secondary outcomes. The economic evaluation, taking a NHS and Personal Social Services perspective, showed that mean costs 12 months post randomisation were significantly higher for Families for Health than for usual care (£998 vs. £548;p < 0.001). The mean incremental cost-effectiveness of Families for Health was estimated at £552,175 per QALY gained. The probability that the Families for Health programme is cost-effective did not exceed 40% across a range of thresholds. The process evaluation demonstrated that the programme was implemented, as planned, to the intended population and any adjustments did not deviate widely from the handbook. Many families waited more than 3 months to receive the intervention. Facilitators’, parents’ and children’s experiences of Families for Health were largely positive and there were no adverse events. Further analysis could explore why some children show a clinically significant benefit while others have a worse outcome.ConclusionsFamilies for Health was neither effective nor cost-effective for the management of obesity in children aged 6–11 years, in comparison with usual care. Further exploration of the wide range of responses in BMI z-score in children following the Families for Health and usual-care interventions is warranted, focusing on children who had a clinically significant benefit and those who showed a worse outcome with treatment. Further research could focus on the role of parents in the prevention of obesity, rather than treatment.Trial registrationCurrent Controlled Trials ISRCTN45032201.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 1. See the NIHR Journals Library website for further project information.

scholarly journals Systematic review on the application of wearable inertial sensors to quantify everyday life motor activity in people with mobility impairments

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Fabian Marcel Rast ◽  
Rob Labruyère
Keyword(s):  
Systematic Review ◽  
Motor Activity ◽  
Everyday Life ◽  
Outcome Measures ◽  
Inertial Sensors ◽  
Body Position ◽  
Relevant Literature ◽  
Measurement Properties ◽  
Mobility Impairments ◽  
Wearable Inertial Sensors

Abstract Background Recent advances in wearable sensor technologies enable objective and long-term monitoring of motor activities in a patient’s habitual environment. People with mobility impairments require appropriate data processing algorithms that deal with their altered movement patterns and determine clinically meaningful outcome measures. Over the years, a large variety of algorithms have been published and this review provides an overview of their outcome measures, the concepts of the algorithms, the type and placement of required sensors as well as the investigated patient populations and measurement properties. Methods A systematic search was conducted in MEDLINE, EMBASE, and SCOPUS in October 2019. The search strategy was designed to identify studies that (1) involved people with mobility impairments, (2) used wearable inertial sensors, (3) provided a description of the underlying algorithm, and (4) quantified an aspect of everyday life motor activity. The two review authors independently screened the search hits for eligibility and conducted the data extraction for the narrative review. Results Ninety-five studies were included in this review. They covered a large variety of outcome measures and algorithms which can be grouped into four categories: (1) maintaining and changing a body position, (2) walking and moving, (3) moving around using a wheelchair, and (4) activities that involve the upper extremity. The validity or reproducibility of these outcomes measures was investigated in fourteen different patient populations. Most of the studies evaluated the algorithm’s accuracy to detect certain activities in unlabeled raw data. The type and placement of required sensor technologies depends on the activity and outcome measure and are thoroughly described in this review. The usability of the applied sensor setups was rarely reported. Conclusion This systematic review provides a comprehensive overview of applications of wearable inertial sensors to quantify everyday life motor activity in people with mobility impairments. It summarizes the state-of-the-art, it provides quick access to the relevant literature, and it enables the identification of gaps for the evaluation of existing and the development of new algorithms.

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