Translating Evidence-Based Interventions Into Practice

2011 ◽  
Vol 12 (6_suppl_1) ◽  
pp. 9S-19S ◽  
Author(s):  
Meera Viswanathan ◽  
Linda Lux ◽  
Kathleen N. Lohr ◽  
Tammeka Swinson Evans ◽  
Lucia Rojas Smith ◽  
...  
Keyword(s):  
Health Care Providers ◽  
System Integration ◽  
Pediatric Asthma ◽  
Evidence Based ◽  
Extensive Literature ◽  
Care Providers ◽  
Planning Period ◽  
Community Based ◽  
Asthma Morbidity ◽  
Effective Interventions

Pediatric asthma is a multifactorial disease, requiring complex, interrelated interventions addressing children, families, schools, and communities. The Merck Childhood Asthma Network, Inc. (MCAN) is a nonprofit organization that provides support to translate evidence-based interventions from research to practice. MCAN developed the rationale and vision for the program through a phased approach, including an extensive literature review, stakeholder engagement, and evaluation of funding gaps. The analysis pointed to the need to identify pediatric asthma interventions implemented in urban U.S. settings that have demonstrated efficacy and materials for replication and to translate the interventions into wider practice. In addition to this overall MCAN objective, specific goals included service and system integration through linkages among health care providers, schools, community-based organizations, patients, parents, and other caregivers. MCAN selected sites based on demonstrated ability to implement effective interventions and to address multiple contexts of pediatric asthma prevention and management. Selected MCAN program sites were mature institutions or organizations with significant infrastructure, existing funding, and the ability to provide services without requiring a lengthy planning period. Program sites were located in communities with high asthma morbidity and intended to integrate new elements into existing programs to create comprehensive care approaches.

Developing an Evidence-Based Clinical Decision-Support System to Enhance Prosthetic Prescription

2021 ◽  
Vol 10 (1) ◽  
pp. 121-125
Author(s):  
Pratima Saravanan ◽  
Jessica Menold
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Support System ◽  
Gait Analysis ◽  
Support System ◽  
Patient Specific ◽  
Evidence Based ◽  
Extensive Literature ◽  
Analysis Tool ◽  
Care Providers

With the rapid increase in the global amputee population, there is a clear need to assist amputee care providers with their decision-making during the prosthetic prescription process. To achieve this, an evidence-based decision support system that encompasses existing literature, current decision-making strategies employed by amputee care providers and patient-specific factors is proposed. Based on an extensive literature review combined with natural language processing and expert survey, the factors influencing the current decision-making of amputee care providers in prosthetic prescription were identified. Following that, the decision-making strategies employed by expert and novice prosthetists were captured and analyzed. Finally, a fundamental understanding of the effect gait analysis has on the decision-making strategies of prosthetists was studied. Findings from this work lay the foundation for developing a real-time decision support system integrated with a portable gait analysis tool to enhance prescription processes. This is critical in the low-income countries where there is a scarcity of amputee care providers and resources for an appropriate prescription.

scholarly journals “What is the actual goal of the pathway?”: examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anh Ly ◽  
Roger Zemek ◽  
Bruce Wright ◽  
Jennifer Zwicker ◽  
Kathryn Schneider ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Clinical Pathways ◽  
Theoretical Domains Framework ◽  
Local Context ◽  
Emergency Department Physician ◽  
Evidence Based ◽  
Care Providers ◽  
Structured Interviews ◽  
Pediatric Concussion

Abstract Background Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion. Methods Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation. Results The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes. Conclusion Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.

scholarly journals Issues Associated With the Management and Governance of Sensor Data and Information to Assist Aging in Place: Focus Group Study With Health Care Professionals (Preprint)

2020 ◽  
Author(s):  
Inga Hunter ◽  
Phoebe Elers ◽  
Caroline Lockhart ◽  
Hans Guesgen ◽  
Amardeep Singh ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Information Needs ◽  
Sensor Data ◽  
Care Providers ◽  
Community Based ◽  
Age In Place

BACKGROUND Smart home and telemonitoring technologies have often been suggested to assist health care workers in supporting older people to age in place. However, there is limited research examining diverse information needs of different groups of health care workers and their access to appropriate information technologies. OBJECTIVE The aim of this study was to investigate the issues associated with using technologies that connect older people to their health care providers to support aging in place and enhance older people’s health and well-being. METHODS Seven focus group discussions were conducted comprising 44 health care professionals who provided clinic-based or in-home services to community-dwelling older people. Participants were asked about their information needs and how technology could help them support older people to age in place. The recordings of the sessions were transcribed and thematically analyzed. RESULTS The perspectives varied between the respondents who worked in primary care clinics and those who worked in community-based services. Three overarching themes were identified. The first theme was “access to technology and systems,” which examined the different levels of technology in use and the problems that various groups of health care professionals had in accessing information about their patients. Primary care professionals had access to good internal information systems but they experienced poor integration with other health care providers. The community-based teams had poor access to technology. The second theme was “collecting and sharing of information,” which focused on how technology might be used to provide them with more information about their patients. Primary care teams were interested in telemonitoring for specific clinical indicators but they wanted the information to be preprocessed. Community-based teams were more concerned about gaining information on the patients’ social environment. The third theme was that all respondents identified similar “barriers to uptake”: cost and funding issues, usability of systems by older people, and information security and privacy concerns. CONCLUSIONS The participants perceived the potential benefits of technologies, but they were concerned that the information they received should be preprocessed and integrated with current information systems and tailored to the older people’s unique and changing situations. Several management and governance issues were identified, which needed to be resolved to enable the widespread integration of these technologies into the health care system. The disconnected nature of the current information architecture means that there is no clear way for sensor data from telemonitoring and smart home devices to be integrated with other patient information. Furthermore, cost, privacy, security, and usability barriers also need to be resolved. This study highlights the importance and the complexity of management and governance of systems to collect and disseminate such information. Further research into the requirements of all stakeholder groups and how the information can be processed and disseminated is required.

scholarly journals A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Providers ◽  
Low Income ◽  
Access To Health Care ◽  
Social Determinant ◽  
Evidence Based ◽  
Patient Portal ◽  
Care Providers ◽  
Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

scholarly journals Faktor-Faktor yang Mempengaruhi Self-care Behavior pada Klien dengan Hipertensi di Komunitas

2020 ◽  
Vol 11 ◽  
pp. 37
Author(s):  
Wimar Anugrah Romadhon ◽  
Bernadetta Germia Aridamayanti ◽  
Anggi Hanafiah Syanif ◽  
Gevi Melliya Sari
Keyword(s):  
Health Care Providers ◽  
Self Efficacy ◽  
Self Care ◽  
Google Scholar ◽  
Evidence Based ◽  
Care Providers ◽  
Inclusion Criteria ◽  
Salt Diet ◽  
Low Salt ◽  
Care Behavior

Background: self-care behavior is an important thing that needs to be considered by clients with hypertension which consists of several components, namely the use of drugs, low-salt diet, physical activity, smoking, weight management and alcohol consumption. Purpose: to show the factors that influence self-care behavior in clients with hypertension. Method: the database used to identify suitable articles obtained from Scopus, ProQuest and Google Scholar, limited to the last 5 years of publication from 2014 to 2019, English, and fulltext articles. The literature review used the keyword "Self-care behavior, Hypertension". In searching articles used "AND". Only 12 articles met the inclusion criteria. This review was from 12 of these articles. Results: self-care behavior in hypertensive clients were influenced by several factors, namely family support, self-efficacy, knowledge, and spirituality. Conclusion: factors related to self-care behavior and pathways can help health care providers develop and design evidence-based interventions for clients with hypertension. Recommendation: Community nurses understand the factors that influence self-care behavior in hypertensive clients in the community so they are able to provide appropriate nursing care. Keywords: factors of self-care behavior; hypertension; community ABSTRAK Latar belakang: self-care behavior merupakan hal penting yang perlu diperhatikan oleh klien dengan hipertensi yang terdiri dari beberapa komponen yaitu penggunaan obat-obatan, diet rendah garam, aktifitas fisik, merokok, manajemen berat badan dan konsumsi alkohol. Tujuan: untuk melihat adanya faktor-faktor yang mempengaruhi self-care behavior pada klien dengan hipertensi. Metode: database digunakan untuk mengidentifikasi artikel yang sesuai diperoleh dari Scopus, ProQuest dan Google Scholar terbatas untuk publikasi 5 tahun terakhir dari 2014 hingga 2019, bahasa inggris, dan fulltex article. Tinjauan literatur menggunakan kata kunci “factors of self-care behavior, Hypertension”. Dalam pencarian artikel menggunakan "AND". Hanya 12 artikel yang memenuhi kriteria inklusi. Ulasan ini berasal dari 12 artikel tersebut. Hasil: self-care behavior pada klien hipertensi dipengaruhi oleh beberapa faktor yaitu dukungan keluarga, self-efficacy, faktor personal, dan spiritualitas. Simpulan: faktor-faktor yang terkait dengan self-care behavior dan jalurnya dapat membantu penyedia layanan kesehatan mengembangkan dan mendesain intervensi bebasis bukti pada klien dengan hipertensi. Saran: Perawat komunitas memahami faktor-faktor yang mempengaruhi self-care behavior pada klien hipertensi di komunitas sehingga mampu memberikan asuhan keperawatan yang tepat. Kata kunci: factors of self-care behavior; hypertension; community

scholarly journals Issues Associated With the Management and Governance of Sensor Data and Information to Assist Aging in Place: Focus Group Study With Health Care Professionals

10.2196/24157 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e24157
Author(s):  
Inga Hunter ◽  
Phoebe Elers ◽  
Caroline Lockhart ◽  
Hans Guesgen ◽  
Amardeep Singh ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Information Needs ◽  
Sensor Data ◽  
Care Providers ◽  
Community Based ◽  
Age In Place

Background Smart home and telemonitoring technologies have often been suggested to assist health care workers in supporting older people to age in place. However, there is limited research examining diverse information needs of different groups of health care workers and their access to appropriate information technologies. Objective The aim of this study was to investigate the issues associated with using technologies that connect older people to their health care providers to support aging in place and enhance older people’s health and well-being. Methods Seven focus group discussions were conducted comprising 44 health care professionals who provided clinic-based or in-home services to community-dwelling older people. Participants were asked about their information needs and how technology could help them support older people to age in place. The recordings of the sessions were transcribed and thematically analyzed. Results The perspectives varied between the respondents who worked in primary care clinics and those who worked in community-based services. Three overarching themes were identified. The first theme was “access to technology and systems,” which examined the different levels of technology in use and the problems that various groups of health care professionals had in accessing information about their patients. Primary care professionals had access to good internal information systems but they experienced poor integration with other health care providers. The community-based teams had poor access to technology. The second theme was “collecting and sharing of information,” which focused on how technology might be used to provide them with more information about their patients. Primary care teams were interested in telemonitoring for specific clinical indicators but they wanted the information to be preprocessed. Community-based teams were more concerned about gaining information on the patients’ social environment. The third theme was that all respondents identified similar “barriers to uptake”: cost and funding issues, usability of systems by older people, and information security and privacy concerns. Conclusions The participants perceived the potential benefits of technologies, but they were concerned that the information they received should be preprocessed and integrated with current information systems and tailored to the older people’s unique and changing situations. Several management and governance issues were identified, which needed to be resolved to enable the widespread integration of these technologies into the health care system. The disconnected nature of the current information architecture means that there is no clear way for sensor data from telemonitoring and smart home devices to be integrated with other patient information. Furthermore, cost, privacy, security, and usability barriers also need to be resolved. This study highlights the importance and the complexity of management and governance of systems to collect and disseminate such information. Further research into the requirements of all stakeholder groups and how the information can be processed and disseminated is required.

scholarly journals Understanding How to Support Family Caregivers of Seniors with Complex Needs

2017 ◽  
Vol 20 (2) ◽  
pp. 75-84 ◽  
Author(s):  
Lesley Charles ◽  
Suzette Brémault-Phillips ◽  
Jasneet Parmar ◽  
Melissa Johnson ◽  
Lori-Ann Sacrey
Keyword(s):  
Health Care ◽  
Family Caregivers ◽  
Health Care Providers ◽  
Research Priorities ◽  
Care Providers ◽  
Community Based ◽  
Caregiver Support ◽  
Complex Needs ◽  
Participant Engagement

Purpose of the StudyThe purpose of this study was to describe the experiences and challenges of supporting family caregivers of seniors with complex needs and to outline support strategies and research priorities aimed at supporting them.Design and MethodsA CIHR-funded, two-day conference entitled “Supporting Family Caregivers of Seniors: Improving Care and Caregiver Outcomes” was held. An integrated knowledge translation approach guided this planning conference. Day 1 included presentations of research evidence, followed by participant engagement Qualitative data was collected regarding facilitators, barriers/gaps, and recommendations for the provisionof caregiver supports. Day 2 focused on determination of research priorities.ResultsIdentified facilitators to the provision of caregiver support included accessibility of health-care and community-based resources, availability of well-intended health-care providers, and recognition of caregivers by the system. Barriers/gaps related to challenges with communication, access to information, knowledge of what is needed, system navigation, access to financial resources, and current policies. Recommendations regarding caregiver services and research revolved around assisting caregivers to self-identify and seek support, formalizing caregiver supports, centralizing resources, making system navigation available, and preparing the next generation for caregiving.Implication A better understanding of the needs of family caregivers and ways to support them is critical to seniors’ health services redesign.

scholarly journals “Breaking the Silence” to Improve Cancer Survivorship Care for First Nations Peoples

2018 ◽  
Vol 17 (1) ◽  
pp. 160940691877413
Author(s):  
Wendy Gifford ◽  
Roanne Thomas ◽  
Gwen Barton ◽  
Viviane Grandpierre ◽  
Ian D. Graham
Keyword(s):  
Health Care ◽  
First Nations ◽  
Cancer Survivorship ◽  
Health Care Providers ◽  
Large Scale ◽  
Care Delivery ◽  
Survivorship Care ◽  
Care Providers ◽  
Community Based ◽  
Knowledge To Action

There is a significant knowledge-to-action gap in cancer survivorship care for First Nations (FN) communities. To date, many approaches to survivorship have not been culturally responsive or community-based. This study is using an Indigenous knowledge translation (KT) approach to mobilize community-based knowledge about cancer survivorship into health-care programs. Our team includes health-care providers and cancer survivors from an FN community in Canada and an urban hospital that delivers Cancer Care Ontario’s Aboriginal Cancer Program. Together, we will study the knowledge-to-action process to inform future KT research with Indigenous peoples for improving health-care delivery and outcomes. The study will be conducted in settings where research relations and partnerships have been established through our parent study, The National Picture Project. The inclusion of community liaisons and the continued engagement of participants from our parent study will foster inclusiveness and far-reaching messaging. Knowledge about unique cancer survivorship needs co-created with FN people in the parent study will be mobilized to improve cancer follow-up care and to enhance quality of life. Findings will be used to plan a large-scale implementation study across Canada.

Understanding health consumer value: service marketing perspective

2018 ◽  
Vol 7 (1) ◽  
pp. 2-21 ◽  
Author(s):  
Shahidul Islam
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Service Marketing ◽  
Equation Modeling ◽  
Extensive Literature ◽  
Service Orientation ◽  
Care Providers ◽  
Content Type ◽  
Hospital Choice ◽  
Health Consumers

Purpose The purpose of this paper is to clarify and explain patient-centered health choices, facilitating health-care providers’ service orientation. Design/methodology/approach Extensive literature review has been done to extract seven constructs (five dimensions of SERVQUAL, perceived service cost (PSC), and reference) and their underlying 28 items to be quantified. A survey of 201 health consumers was conducted to rate those variables and their constructs. Descriptive statistics and structural equation modeling are utilized to delineate and explicate factors. Findings The confirmatory factor analysis demonstrated that responsiveness has the highest predictive power in explaining hospital choice intention. However, PSC, the only construct, is not statistically significant. The models are considered to have satisfactory reliability, validity, and acceptable fit. Research limitations/implications Since the study was administered in Comilla city, the generalizations should be exploited carefully. Future studies can be carried out on the behavioral patterns of patients and attitudes of health-care providers with respect to the discussed factors and variables. Practical implications The result highlights patients’ service expectations that can be carefully and creatively applied in the service marketing program, improving doctors’ and nurses’ service orientation, developing physical evidence, and managing references to communicate service value to patients. Originality/value What health consumers emphasize and how they incorporate service quality dimensions into hospital choice intention has stayed almost unexplored in the existing literature in Bangladesh. This study provides valuable insights into the meaning of patients’ choices, which will help practitioners and researchers to formulate marketing strategies that improve health-care outcomes and are acceptable to patients.

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