Abstract 16831: Identifying Barriers to Hypertension Care: Development and Validation of a Behavioral Assessment Tool for Optimizing Linkage and Retention to Hypertension Care in Kenya (LARK Hypertension Study)

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Alexandra Douglas ◽  
Jackson Rotich ◽  
Peninah Kiptoo ◽  
Kennedy K Lagat ◽  
Kennedy Mutai ◽  
...  

Introduction: Hypertension is the leading risk factor for global mortality. Hypertension treatment rates are low, partly due to inadequate linkage and retention to care. The LARK Study evaluates the use of community health workers (CHWs), equipped with a behavioral assessment and a tailored behavioral change strategy, to improve linkage and retention to hypertension care in Kenya. Here we describe the development and validation of the assessment tool used by CHWs to identify patients’ barriers to care, facilitating behavioral change communication. Methods: We derived behavioral assessment items from prior research on barriers to hypertension care in Kenya. Patients, CHWs, and clinicians scored each item for clarity and representativeness, and provided qualitative feedback during focus groups. A content validity index (CVI), representing inter-rater agreement of scores, was calculated for each item. Multivariable linear mixed-effects models were used to compare CVIs and level of modification (none, minor, major, or deleted) by participant category. Results: We tested 70 items in 9 focus groups. Mean CVIs were greater than 0.9 in all study groups (Table). Multivariable adjustment revealed that patients and CHWs had significantly higher CVIs than clinicians. Despite this, qualitative feedback from patients and CHWsled to higher item modification rates. 37 items were retained in the linkage assessment and 57 items in the retention assessment. Conclusions: The mean CVI was greater than 0.9 in all study populations, indicating excellent inter-rater agreement of the overall clarity and representativeness of assessment items. However, CVI alone could not account for modifications suggested during qualitative discussions. A combination of quantitative and qualitative methods yielded the most informative evaluation of assessment items. These findings may be relevant to the validation of similar assessment tools in other low-resource settings.

2019 ◽  
Vol 35 (S1) ◽  
pp. 31-32
Author(s):  
Elisa Puigdomenech Puig ◽  
Elisa Poses Ferrer ◽  
Lina Masana ◽  
Mireia Espallargues

IntroductionDue to the specific characteristics and challenges of mobile health (mHealth) technologies there is a need to have assessment tools based on their particularities to be used by health technology assessment (HTA) agencies and evaluation experts. In the development of a comprehensive and practical evaluation tool for the evaluation of mHealth solutions we aimed to include the views and opinions of key stakeholders: health professionals, developers, hospital managers, HTA agencies, patients and general public.MethodsFocus groups and an online modification of the Delphi technique are being used to discuss and agree on domains and criteria to be included in the mHealth assessment tool. Domains and criteria used for health apps evaluation were drawn from a literature review on the topic. The initial list includes 95 criteria grouped into the following domains: purpose of the app, privacy and security, clinical effectiveness, content of the intervention, user experience and usability, interoperability, expenses, impact on the organization, and legal and ethical aspects. Data coming from focus groups is currently being analyzed from a thematic and content analysis perspective.ResultsFocus groups with professionals have showed that the most important domains to be considered when evaluating health apps are those related with security, user experience, and clinical effectiveness. Some criteria were considered to be mandatory (mainly regarding safety issues), on which a first step assessment should indicate whether the app ‘pass or fails’ for the subsequent throughout assessment. Focus groups with patients will provide insight on critical aspects related to the choice, use and adherence to a health app.ConclusionsInsights from main stakeholders on the design of the tool for mHealth assessment are relevant and complementary between them. Next steps include (i) the agreement of criteria by using an online modification of the Delphi Technique and (ii) piloting of the tool.


2020 ◽  
Author(s):  
Sarah Cassidy ◽  
Louise Bradley ◽  
Heather Cogger-Ward ◽  
Jacqui Rodgers

Abstract Background: Autistic people and those with high autistic traits are at high risk of experiencing suicidality. Yet, there are no suicidality assessment tools developed or validated for these groups.Methods: A widely used and validated suicidality assessment tool developed for the general population (SBQ-R), was adapted using feedback from autistic adults. The adapted tool was refined through 9 interviews, and an online survey with 251 autistic adults, to establish clarity and relevance of the items. Subsequently, 308 autistic, 113 possibly autistic, and 268 non-autistic adults completed the adapted tool online, alongside self-report measures of autistic traits (AQ), camouflaging autistic traits (CAT-Q), depression (PHQ-9), anxiety (ASA-A), thwarted belongingness and perceived burdensomeness (INQ-15), lifetime non-suicidal self-injury, and the original version of the suicidality assessment tool (SBQ-R). Analyses explored the appropriateness and measurement properties of the adapted tool between the groups.Results: There was evidence in support of content validity, structural validity, internal consistency, convergent and divergent validity, test retest validity, sensitivity and specificity (for distinguishing those with or without lifetime experience of suicide attempt), and hypothesis testing of the adapted tool (SBQ-ASC) in each group. The structure of the SBQ-ASC was equivalent between autistic and possibly autistic adults, regardless of gender, or use of visual aids to help quantify abstract rating scales.Limitations: The samples involved in the development and validation of the adapted tool were largely female, and largely diagnosed as autistic in adulthood, which is not representative of the wider autistic population. The SBQ-ASC has been developed for use in research and is not recommended to assess risk of future suicide attempts and/or self-harm.Conclusions: The SBQ-ASC is a brief self-report suicidality assessment tool, developed and validated with and for autistic adults, without co-occurring intellectual disability. The SBQ-ASC is appropriate for use in research to identify suicidal thoughts and behaviours in autistic and possibly autistic people, and model associations with risk and protective factors.


2017 ◽  
Vol 34 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Joan Esper Kuhnly ◽  
Donna J. Chapman

Background: Although lactation assessment tools are consistently used in clinical practice, there is no evidence describing registered nurses’ perspectives regarding the purpose and thought processes involved when conducting a breastfeeding assessment. Research aim: This study aimed to explore registered nurses’ perceptions on the purpose of lactation assessment tools and the thought processes involved in completing one. Methods: Seven focus groups were held from April 2015 through July 2015, in coordination with regional and international lactation and perinatal conferences. Participants included 28 hospital-based registered nurses who routinely used a lactation assessment tool to assess postpartum mothers with healthy breastfeeding newborns. Focus groups were audiotaped, transcribed verbatim, and content analyzed by two lactation researchers to identify relevant themes and subthemes. Results: The analyses identified four different purposes of breastfeeding assessment tools (Teaching and Assessing Simultaneously, Infant Safety, Standardized Practice, and “It’s Your Job!”) and four themes related to the thought processes used in completing the tool (Novice vs. Expert, Real-Time vs. Recalled Documentation, Observation or Not, and “Fudging the Score”). Conclusion: Registered nurses found lactation assessment tool completion to be an essential part of their job and that it ensured infant safety, standardized care, maternal instruction, and lactation assessment. Differences in the lactation assessment tool completion process were described, based on staff expertise, workload, hospital policies, and varying degrees of compliance with established protocols. These findings provide critical insight for the development of future breastfeeding assessment tools.


2018 ◽  
Vol 25 (2) ◽  
pp. 524-543
Author(s):  
David Morley ◽  
Thomas Van Rossum ◽  
David Richardson ◽  
Lawrence Foweather

A child’s early school years provide a crucial platform for them to develop fundamental movement skills (FMS), yet it has been acknowledged that there is a shortage of suitable FMS assessment tools for teachers to use within schools. To begin to address this shortfall, the purpose of this study was to elicit expert recommendations for the design of a FMS assessment tool for use by primary school teachers. A multi-phase research design was used, involving two scenario-guided focus groups with movement experts ( n = 8; five academics and three practitioners). Data captured in both focus groups were transcribed verbatim and thematically analysed. Three dichotomous dilemmas emerged from the data in relation to assessing children’s movement competence: (a) Why? For research purposes or to enhance teaching and learning?; (b) How? Should the assessment setting be engineered or natural?; and (c) What? Should the detail of the assessment be complex or simple and should the nature of the tasks be static or dynamic? These findings suggest that any future development of movement competence assessment protocols for use by primary school teachers needs to consider the specific purpose and context of the assessment.


2018 ◽  
Vol 7 (2.29) ◽  
pp. 1130
Author(s):  
Sani Abdullahi Sarki ◽  
Razali Adul-Hamid ◽  
Mahmood W.Y.W

The late payment has been the major issues facing the construction industry across the globe. Many studies have looked at this issues from management and legal perspectives. Despite its endemic effect on the construction industry, there is no any assessment tools for measuring the payment performance (late and prompt payment). This paper developed and validated a payment performance assessment tool in the context of construction industry client organization, particularly in the Nigerian construction industry. The tool was developed based on the organizational culture and payment performance attributes for the client organization. Analytical Hierarchy Process (AHP) was used to elicit pair-wise comparison and weight of each variable. This led to the development of the tool. The tool was then validated in the assessment of client’s payment performance of a case organization. The assessment tool was calibrated based on consensus benchmarking. However, the calibration ranges from 0.00-0.69 as late payment performance, 0.70-0.98 prompt payment performance and 0.99-1.00. Absolute prompt payment performance. The result shows that the payment assessment tool succeeded in measuring payment performance of a case organization with a score of 0.50 points indicating that the organization do not pay its contractors on time. Therefore, the organization is experiencing late payment. However, there is need to replication the study to revalidate the tool in another organization or country.  


2020 ◽  
pp. 104365962093812
Author(s):  
Kimberly Subasic ◽  
Rebecca Kronk ◽  
Andrea Mantione ◽  
Maria Vital

Introduction: Genetic literacy recognizes one’s ability to gather, understand, and apply genomic information to make informed health care choices and social decisions. A limited understanding of genomic literacy carries the potential for poor health outcomes. The aim of this pilot study was to determine the usefulness of an assessment tool to ascertain genetic literacy in a small Hispanic clinic population. Methodology: Mixed-method, cross-sectional pilot study requiring forward-back translation of an established questionnaire. Twenty Spanish-speaking adults were recruited through purposive and convenience sampling. Results: Forward–back translation provided a comparable questionnaire. Participants indicated information was relevant. Qualitative feedback uncovered regional differences. Quantitative results reported descriptive statistics, frequencies, and Cronbach alphas. Discussion: Findings from this study reveal the need for genetic literacy assessment tools that are attuned to the linguistic, ethnic, and cultural differences within the Hispanic population.


2019 ◽  
Vol 3 (1) ◽  
pp. 50-62
Author(s):  
Mayusef Sukmana ◽  
Roni Sianturi ◽  
Muhammad Aminuddin

Background: Diabetic ulcer is one of the complications of Diabetes mellitus. Assessment of diabetic ulcers is done as a basis in determining wound care and therapy provided so that it needs to know its characteristics.Purpose: This study was to determine the characteristics of wounds assessment tools diabetic ulcer International Best Practice Guideline (IBPG).Method: The study design was descriptive with a case study approach, the sampling technique was purposive sampling carried out in May 2019 with three respondents. The instrument used is the wound assessment tool International Best Practice Guideline which contains: sensation, callus, wound base, temperature and location.Results: Respondents 1 experienced neuroiskemic injuries. Respondent 2 suffered neuropathic injuries and Respondent 3 had ischemic injury.Conclusion: Characteristics of ulcers based on the International Best Practice Guidelines respectively, neuroiskemic, neuropathic and ischemic ulcers. Health workers are expected to apply a more detailed assessment of diabetic ulcers so that they can determine the appropriate treatment.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Sarah A. Cassidy ◽  
Louise Bradley ◽  
Heather Cogger-Ward ◽  
Jacqui Rodgers

Abstract Background Autistic people and those with high autistic traits are at high risk of experiencing suicidality. Yet, there are no suicidality assessment tools developed or validated for these groups. Methods A widely used and validated suicidality assessment tool developed for the general population (SBQ-R), was adapted using feedback from autistic adults, to create the Suicidal Behaviours Questionnaire—Autism Spectrum Conditions (SBQ-ASC). The adapted tool was refined through nine interviews, and an online survey with 251 autistic adults, to establish clarity and relevance of the items. Subsequently, 308 autistic, 113 possibly autistic, and 268 non-autistic adults completed the adapted tool online, alongside self-report measures of autistic traits (AQ), camouflaging autistic traits (CAT-Q), depression (PHQ-9), anxiety (ASA-A), thwarted belongingness and perceived burdensomeness (INQ-15), lifetime non-suicidal self-injury, and the original version of the suicidality assessment tool (SBQ-R). Analyses explored the appropriateness and measurement properties of the adapted tool between the groups. Results There was evidence in support of content validity, structural validity, internal consistency, convergent and divergent validity, test–retest validity, sensitivity and specificity (for distinguishing those with or without lifetime experience of suicide attempt), and hypothesis testing of the adapted tool (SBQ-ASC) in each group. The structure of the SBQ-ASC was equivalent between autistic and possibly autistic adults, regardless of gender, or use of visual aids to help quantify abstract rating scales. Limitations The samples involved in the development and validation of the adapted tool were largely female, and largely diagnosed as autistic in adulthood, which limits the generalisability of results to the wider autistic population. The SBQ-ASC has been developed for use in research and is not recommended to assess risk of future suicide attempts and/or self-harm. The SBQ-ASC has been designed with and for autistic and possibly autistic adults, and is not appropriate to compare to non-autistic adults given measurement differences between these groups. Conclusions The SBQ-ASC is a brief self-report suicidality assessment tool, developed and validated with and for autistic adults, without co-occurring intellectual disability. The SBQ-ASC is appropriate for use in research to identify suicidal thoughts and behaviours in autistic and possibly autistic people, and model associations with risk and protective factors.


Author(s):  
Nicole M. Dorfan ◽  
Sheila R. Woody

This chapter describes methods and tools for assessing obsessive compulsive disorder (OCD). The chapter outlines the purposes of assessment and discusses special challenges presented by OCD, such as shame associated with socially unacceptable obsessional content. Several types of assessment tools are discussed, including structured diagnostic interviews, semistructured clinician interviews to assess OCD symptom profile and severity, self-report instruments, behavioral assessment and self-monitoring, assessment of appraisals and beliefs relevant to OCD, and functional impairment. The importance of linking assessment findings to an evidence-based treatment plan is discussed.


Homeopathy ◽  
2020 ◽  
Vol 109 (04) ◽  
pp. 191-197
Author(s):  
Chetna Deep Lamba ◽  
Vishwa Kumar Gupta ◽  
Robbert van Haselen ◽  
Lex Rutten ◽  
Nidhi Mahajan ◽  
...  

Abstract Objectives The objective of this study was to establish the reliability and content validity of the “Modified Naranjo Criteria for Homeopathy—Causal Attribution Inventory” as a tool for attributing a causal relationship between the homeopathic intervention and outcome in clinical case reports. Methods Purposive sampling was adopted for the selection of information-rich case reports using pre-defined criteria. Eligible case reports had to fulfil a minimum of nine items of the CARE Clinical Case Reporting Guideline checklist and a minimum of three of the homeopathic HOM-CASE CARE extension items. The Modified Naranjo Criteria for Homeopathy Inventory consists of 10 domains. Inter-rater agreement in the scoring of these domains was determined by calculating the percentage agreement and kappa (κ) values. A κ greater than 0.4, indicating fair agreement between raters, in conjunction with the absence of concerns regarding the face validity, was taken to indicate the validity of a given domain. Each domain was assessed by four raters for the selected case reports. Results Sixty case reports met the inclusion criteria. Inter-rater agreement/concordance per domain was “perfect” for domains 1 (100%, κ = 1.00) and 2 (100%, κ = 1.00); “almost perfect” for domain 8 (97.5%, κ = 0.86); “substantial” for domains 3 (96.7%, κ = 0.80) and 5 (91.1%, κ = 0.70); “moderate” for domains 4 (83.3%, κ = 0.60), 7 (67.8%, κ = 0.46) and 9 (99.2%, κ = 0.50); and “fair” for domain 10 (56.1%, κ = 0.38). For domains 6A (46.7%, κ = 0.03) and 6B (50.3%, κ = 0.18), there was “slight agreement” only. Thus, the validity of the Modified Naranjo Criteria for Homeopathy tool was established for each of its domains, except for the two that pertain to direction of cure (domains 6A and 6B). Conclusion The Modified Naranjo Criteria for Homeopathy—Causal Attribution Inventory was identified as a valid tool for assessing the likelihood of a causal relationship between a homeopathic intervention and clinical outcome. Improved wordings for several criteria have been proposed for the assessment tool, under the new acronym “MONARCH”. Further assessment of two MONARCH domains is required.


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