Perspectives on the Initial Adoption of Multitiered Systems of Support for Behavior

2021 ◽  
pp. 109830072110243
Author(s):  
Blair P. Lloyd ◽  
Erik W. Carter ◽  
Brooke C. Shuster ◽  
Tara L. Axelroth ◽  
A. Dia Davis ◽  
...  
Keyword(s):  
Student Behavior ◽  
Technical Assistance ◽  
Evidence Based ◽  
Staff Support ◽  
Team Members ◽  
High Expectations ◽  
Building Administrators ◽  
The Impact ◽  
School Team ◽  
Systems Of Support

Although the number of schools implementing multitiered systems of support for behavior (MTSS-B) continues to grow, most schools have still not adopted these evidence-based frameworks. We examined the views of educators ( N = 561) at the outset of adopting MTSS-B in their schools or districts. Our survey addressed the (a) reasons schools and districts decided to adopt MTSS-B, (b) challenges they anticipated with respect to implementation, and (c) expected outcomes of MTSS-B. We also compared views across three groups of stakeholders: local school team members, building administrators, and district representatives. Although most participants reported multiple motivations for adopting MTSS-B, concerns about student behavior and the need for staff support in this area were among the primary reasons. Anticipated challenges varied by group, with district representatives affirming those challenges most strongly. Responses also suggest these stakeholders have high expectations regarding the impact of MTSS-B in their school or district. We discuss implications for technical assistance providers related to supporting a more widespread adoption of MTSS-B.

scholarly journals Optima TB: A tool to help optimally allocate tuberculosis spending

2021 ◽  
Vol 17 (9) ◽  
pp. e1009255
Author(s):  
Lara Goscé ◽  
Gerard J. Abou Jaoude ◽  
David J. Kedziora ◽  
Clemens Benedikt ◽  
Azfar Hussain ◽  
...  
Keyword(s):  
Priority Setting ◽  
Disease Transmission ◽  
Technical Assistance ◽  
Transmission Model ◽  
People Living With Hiv ◽  
Evidence Based ◽  
Middle Income ◽  
Substantial Impact ◽  
Local Stakeholders ◽  
The Impact

Approximately 85% of tuberculosis (TB) related deaths occur in low- and middle-income countries where health resources are scarce. Effective priority setting is required to maximise the impact of limited budgets. The Optima TB tool has been developed to support analytical capacity and inform evidence-based priority setting processes for TB health benefits package design. This paper outlines the Optima TB framework and how it was applied in Belarus, an upper-middle income country in Eastern Europe with a relatively high burden of TB. Optima TB is a population-based disease transmission model, with programmatic cost functions and an optimisation algorithm. Modelled populations include age-differentiated general populations and higher-risk populations such as people living with HIV. Populations and prospective interventions are defined in consultation with local stakeholders. In partnership with the latter, demographic, epidemiological, programmatic, as well as cost and spending data for these populations and interventions are then collated. An optimisation analysis of TB spending was conducted in Belarus, using program objectives and constraints defined in collaboration with local stakeholders, which included experts, decision makers, funders and organisations involved in service delivery, support and technical assistance. These analyses show that it is possible to improve health impact by redistributing current TB spending in Belarus. Specifically, shifting funding from inpatient- to outpatient-focused care models, and from mass screening to active case finding strategies, could reduce TB prevalence and mortality by up to 45% and 50%, respectively, by 2035. In addition, an optimised allocation of TB spending could lead to a reduction in drug-resistant TB infections by 40% over this period. This would support progress towards national TB targets without additional financial resources. The case study in Belarus demonstrates how reallocations of spending across existing and new interventions could have a substantial impact on TB outcomes. This highlights the potential for Optima TB and similar modelling tools to support evidence-based priority setting.

scholarly journals Evaluating the impact of clinical librarians on clinical questions during inpatient rounds

2018 ◽  
Vol 106 (2) ◽  
Author(s):  
Riley Brian ◽  
Nicola Orlov ◽  
Debra Werner ◽  
Shannon K. Martin ◽  
Vineet M. Arora ◽  
...  
Keyword(s):  
Evidence Based Medicine ◽  
Effective Means ◽  
Median Number ◽  
Evidence Based ◽  
Test Quality ◽  
Team Members ◽  
Fresno Test ◽  
Attending Rounds ◽  
Based Medicine ◽  
The Impact

Objective: The investigation sought to determine the effects of a clinical librarian (CL) on inpatient team clinical questioning quality and quantity, learner self-reported literature searching skills, and use of evidence-based medicine (EBM).Methods: Clinical questioning was observed over 50 days of inpatient pediatric and internal medicine attending rounds. A CL was present for 25 days and absent for 25 days. Questioning was compared between groups. Question quality was assessed by a blinded evaluator, who used a rubric adapted from the Fresno Test of Competence in Evidence-Based Medicine. Team members were surveyed to assess perceived impacts of the CL on rounds.Results: Rounds with a CL (CLR) were associated with significantly increased median number of questions asked (5 questions CLR vs. 3 NCLR; p<0.01) and answered (3 CLR vs. 2 NCLR; p<0.01) compared to rounds without a CL (NCLR). CLR were also associated with increased mean time spent asking (1.39 minutes CLR vs. 0.52 NCLR; p<0.01) and answering (2.15 minutes CLR vs. 1.05 NCLR; p=0.02) questions. Rounding time per patient was not significantly different between CLR and NCLR. Questions during CLR were 2 times higher in adapted Fresno Test quality than during NCLR (p<0.01). Select participants described how the CL’s presence improved their EBM skills and care decisions.Conclusions: Inpatient CLR were associated with more and improved clinical questioning and subjectively perceived to improve clinicians’ EBM skills. CLs may directly affect patient care; further study is required to assess this. CLs on inpatient rounds may be an effective means for clinicians to learn and use EBM skills.

scholarly journals Protocol for a hybrid type 3 cluster randomized trial of a technical assistance system supporting coalitions and evidence-based drug prevention programs

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Louis D. Brown ◽  
Sarah M. Chilenski ◽  
Rebecca Wells ◽  
Eric C. Jones ◽  
Janet A. Welsh ◽  
...  
Keyword(s):  
Substance Use ◽  
Technical Assistance ◽  
Drug Prevention ◽  
Interactive Systems ◽  
Evidence Based ◽  
Interactive Systems Framework ◽  
Ebp Implementation ◽  
Prevention Support System ◽  
Systems Framework ◽  
The Impact

Abstract Background Over 5000 community anti-drug coalitions operating in the USA serve as a cornerstone of federal drug prevention. These coalitions, however, have demonstrated effectiveness in preventing substance use only when they use technical assistance (TA) and implement evidence-based programs (EBPs). The absence of TA and EBP implementation by coalitions is a key research-to-practice gap. The Coalition Check-Up TA system is designed to fill this gap by supporting community coalition implementation of EBPs. Existing TA models for evidence-based coalition approaches are resource intensive and coalition model specific. The Coalition Check-Up is a lower cost strategy that works with a variety of types of coalitions to support sustainable implementation of EBPs. This study protocol describes a hybrid type 3 effectiveness-implementation trial applying Wandersman’s Interactive Systems Framework to test the effects of the Coalition Check-Up on coalition EBP implementation capacity and outcomes. The Interactive Systems Framework outlines how the prevention support system—especially TA—bolsters EBP dissemination and implementation. Methods Using a cluster randomized controlled design, this trial will test the overall effectiveness of the Coalition Check-Up, including how it contributes to EBP implementation and prevention of youth substance use. The first aim is to estimate the impact of the Coalition Check-Up on coalitions’ capacity to do their work. We will recruit 68 anti-drug coalitions for random assignment to the Coalition Check-Up or “TA as usual” condition. We will evaluate whether the Coalition Check-Up improves coalition capacity using measures of coalition member responses about team processes, coalition network composition, and collaborative structure. Our second aim is to estimate the impact of the Coalition Check-Up on implementation of EBPs, and our third aim is to estimate the impact of the Coalition Check-Up on youth substance use. Discussion This project will clarify how the Coalition Check-Up, a scalable approach to TA due to its low cost, affects coalition capacity to support EBP implementation. Analyses also provide insight into causal pathways from the prevention support system to the prevention delivery system outlined by the Interactive Systems Framework. Results will build the evidence-base for how to support community coalitions’ sustainable implementation of evidence-based prevention programs and policies. Trial registration Clinicaltrials.gov registration number NCT04592120. Registered on October 19, 2020.

scholarly journals The Development of a Community-based COVID-19 Public Health Intervention in Rural Ghana

2021 ◽  
Author(s):  
Shadrack Osei Frimpong ◽  
Moro Seidu ◽  
Sam Kris Hilton ◽  
Yusuf Ransome ◽  
Elijah Paintsil ◽  
...  
Keyword(s):  
Public Health ◽  
Rural Communities ◽  
Technical Assistance ◽  
Public Health Intervention ◽  
Academic Community ◽  
Evidence Based ◽  
Community Based ◽  
Parihs Framework ◽  
Community Team ◽  
The Impact

Abstract Background: The Promoting Action on Research Implementation in Health Services (PARIHS) framework was utilized to design an evidence-based practice, Cocoa360’s COVID Preparedness & Outbreak Prevention Plan (CoCoPOPP), for rural communities in Ghana. Through participatory academic-community team discussion, interactive dissemination, systematic review of evidence about community-based interventions during Ebola, HIV/AIDS, and Influenza outbreaks and effective engagement with local and national stakeholders, CoCoPOPP was developed to be consistent with the PARIHS framework. Methods: Applying the three core elements of the PARIHS framework (evidence, context, and facilitation), the designers developed orientation, logistic needs and planning, and social mobilization. Components of CoCoPOPP also included participant recruitment and training, communication, research, monitoring & evaluation plan, execution, technical assistance, and facilitation. Results: This intervention achieved three (3) main aims: (1) meet a pressing health need during the COVID-19 pandemic in local underserved settings, (2) ensure that the strategy is informed by high-quality evidence from similar interventions in past outbreaks, and (3) evaluate and learn from research on interventions to garner data. Beyond the impact on health outcomes and healthcare services utilization, CoCoPOPP sought to garner data for organizational use and to share insights on pandemic management and control with the Ghanaian government and the broader global health community. Conclusion: The use of evidence-based public health framework, PARIHS, renders CoCoPOPP a replicable community-based model that can be implemented in other rural communities in Ghana and other Sub-Saharan African counties with similar cultural settings.

scholarly journals THE IMPACT OF ALIVIADO DEMENTIA CARE HOSPICE EDITION TRAINING PROGRAM ON HOSPICE STAFF’S DEMENTIA SYMPTOM KNOWLEDGE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S851-S851
Author(s):  
Catherine E Schneider ◽  
Alycia A Bristol ◽  
Ariel Ford ◽  
Shih-Yin Lin ◽  
Abraham A Brody
Keyword(s):  
Psychological Symptoms ◽  
Daily Practice ◽  
Dementia Care ◽  
Interdisciplinary Teams ◽  
Practice Change ◽  
P Value ◽  
Evidence Based ◽  
Improvement Program ◽  
Team Members ◽  
The Impact

Abstract A lack of high quality dementia training for healthcare workers is a key barrier to effective care for persons with dementia (PWD), a vulnerable and increasing population across the care continuum. Hospice agencies in particular are underprepared to care for this population, although annually about 17% of hospice patients have a primary diagnosis of dementia and an additional 28% as a comorbidity. Aliviado Dementia Care-Hospice Edition is an interdisciplinary, evidence-based quality improvement program developed to assist hospice interdisciplinary teams in caring for PWD and their caregivers. Interdisciplinary hospice team members in two agencies were enrolled in online training modules, which addressed multiple areas including pain, behavioral and psychological symptoms of dementia (BPSD), and working with caregivers. They were also provided a toolkit to integrate training in daily practice. Changes in knowledge, confidence and attitudes were tested before and after training and paired t-tests were utilized to evaluate the program’s effect. Thirty-five individuals completed the program and pre/post tests. Paired t-tests showed clinically and statistically significant increases in knowledge, attitudes and confidence in five of 10 domains including depression knowledge and confidence and BPSD knowledge, confidence and interventions. The greatest increase was in using BPSD interventions (18.5% increase, p-value: 0.0002), depression confidence (15.9% increase, p-value: 0.006) and BPSD confidence (12.6% increase, p-value: 0.02). Aliviado is an evidence-based, systems-level intervention shown to improve clinical knowledge, attitudes and confidence in treating pain and BPSD in PWD. This training could be used to produce systems-level practice change for hospice interdisciplinary team members serving PWD.

The Impact of TimeSlips on Undergraduate Students in Service Learning With Older Adults

2020 ◽  
pp. 1-8
Author(s):  
Sabine Heuer
Keyword(s):  
Older Adults ◽  
Service Learning ◽  
Undergraduate Students ◽  
Attitude Scale ◽  
Evidence Based ◽  
Attitudes Toward Older Adults ◽  
Students Attitudes ◽  
Attitude Shift ◽  
The Impact ◽  
Journal Entries

Purpose Future speech-language pathologists are often unprepared in their academic training to serve the communicative and cognitive needs of older adults with dementia. While negative attitudes toward older adults are prevalent among undergraduate students, service learning has been shown to positively affect students' attitudes toward older adults. TimeSlips is an evidence-based approach that has been shown to improve health care students' attitudes toward older adults. The purpose of this study is to explore the change in attitudes in speech-language pathology students toward older adults using TimeSlips in service learning. Method Fifty-one students participated in TimeSlips service learning with older adults and completed the Dementia Attitude Scale (DAS) before and after service learning. In addition, students completed a reflection journal. The DAS data were analyzed using nonparametric statistics, and journal entries were analyzed using a qualitative analysis approach. Results The service learners exhibited a significant increase in positive attitude as indexed on the DAS. The reflective journal entries supported the positive change in attitudes. Conclusions A noticeable attitude shift was indexed in reflective journals and on the DAS. TimeSlips is an evidence-based, patient-centered approach well suited to address challenges in the preparation of Communication Sciences and Disorders students to work with the growing population of older adults.

THE IMPACT OF LEADERSHIP PRACTICES TO TEAM MEMBERS’ SATISFACTION

2009 ◽  
Vol 8 (1) ◽  
Author(s):  
Chalimah .
Keyword(s):  
Conflict Resolution ◽  
Leadership Practices ◽  
Hotel Industry ◽  
Leader Behavior ◽  
Team Leader ◽  
Shop Floor ◽  
Team Members ◽  
Top Executives ◽  
Wide Range ◽  
The Impact

eamwork is becoming increasingly important to wide range of operations. It applies to all levels of the company. It is just as important for top executives as it is to middle management, supervisors and shop floor workers. Poor teamwork at any level or between levels can seriously damage organizational effectiveness. The focus of this paper was therefore to examine whether leadership practices consist of team leader behavior, conflict resolution style and openness in communication significantly influenced the team member’s satisfaction in hotel industry. Result indicates that team leader behavior and the conflict resolution style significantly influenced team member satisfaction. It was surprising that openness in communication did not affect significantly to the team members’ satisfaction.

Systematic review methodology for development: An example from microfinance

2018 ◽  
Vol 43 (1) ◽  
pp. 65-77 ◽  
Author(s):  
Carina Van Rooyen ◽  
Ruth Stewart ◽  
Thea De Wet
Keyword(s):  
Systematic Review ◽  
International Development ◽  
Health Sector ◽  
Evidence Based ◽  
Systematic Review Methodology ◽  
Development Interventions ◽  
The Us ◽  
Sub Saharan ◽  
The Impact ◽  
Evidence Based Decision Making

Big international development donors such as the UK’s Department for International Development and USAID have recently started using systematic review as a methodology to assess the effectiveness of various development interventions to help them decide what is the ‘best’ intervention to spend money on. Such an approach to evidence-based decision-making has long been practiced in the health sector in the US, UK, and elsewhere but it is relatively new in the development field. In this article we use the case of a systematic review of the impact of microfinance on the poor in sub-Saharan African to indicate how systematic review as a methodology can be used to assess the impact of specific development interventions.

33 An Evidence Based Laser Therapy Algorithm for the Treatment of Burn Scars

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S26-S27
Author(s):  
Rajiv Sood
Keyword(s):  
Laser Treatment ◽  
Laser Therapy ◽  
Co2 Laser ◽  
Statistical Significance ◽  
Evidence Based ◽  
Baseline Measurement ◽  
Burn Scar ◽  
Therapy Algorithm ◽  
Laser Treatments ◽  
The Impact

Abstract Introduction Hypertrophic scarring after burn injury can be extremely painful, cause profound itching, and affect the way patients view themselves and how the outside world perceives them. We have utilized laser therapy as a modality for scar modulation for our patients since 2013. In 2014, we initiated and completed a prospective IRB approved study to evaluate the outcome of scars treated with fractional CO2 laser therapy (FLT) utilizing objective and subjective tools. Recently, we have completed a prospective study evaluating the use of pulse dye laser (PDL) therapy and the impact on post-burn pruritis. In reviewing the outcomes from these two studies, we have developed an evidence-based laser therapy algorithm for burn scar management. Methods The FLT study entailed a series of three CO2 laser treatments minimally 4–6 weeks apart with scar measurements and POSAS form completion performed prior to each laser treatment and four weeks after the last FLT. Scar measurements that included color, pliability, and scar thickness; and completion of the POSAS form were obtained prior to each laser therapy session and four weeks after the third laser treatment. The measurements of color, pliability, and scar thickness were measured with the Colorimeter, Cutometer, and ultrasound. The PDL study utilized the 5-D Itch scale to evaluate post-burn pruritis. A baseline measurement was obtained prior to any laser treatments. Each patient underwent two PDL sessions and a 5-D itch scale was completed four to six weeks after the second PDL session. The baseline measurement was then compared to the final 5-D itch scale measurement. Results Data from the FLT study is in Table 1 and shows that there were statistically significant improvements in the Patient and Observer POSAS scores, patient rated Itch score, scar thickness, and measured skin density. Changes to patient rated scar pain, scar color, and pliability were noted but were not of statistical significance. Data from the PDL study is in Table 2 and shows a statistically significant decrease in the treated patients’ post-burn pruritis. Conclusions In reviewing the outcomes of these two studies, we have developed an algorithm based on our studies. All of our patients undergoing laser therapy receive two PDL sessions that are four to six weeks apart followed by 3 FLT sessions. The use of both PDL and FLT decreases post-burn pruritis, decreases scar thickness, decreases pain, and increases patient satisfaction as shown in our research.

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