scholarly journals State Tobacco Control Program Implementation Strategies for Smoke-Free Multiunit Housing

2016 ◽  
Vol 17 (6) ◽  
pp. 836-844 ◽  
Author(s):  
Nicole M. Kuiper ◽  
LaTisha L. Marshall ◽  
S. Rene Lavinghouze ◽  
Brian A. King
Keyword(s):  
Program Implementation ◽  
Information Needs ◽  
Technical Assistance ◽  
Local Level ◽  
Implementation Strategies ◽  
State Level ◽  
Control Program ◽  
Time Frame ◽  
Use Of Resources ◽  
Multiunit Housing

Multiunit housing residents are at risk of secondhand smoke exposure from adjoining units and common areas. We developed this case study to document state-level strategies undertaken to address this risk. We explored program documents to identify facilitators, barriers, and outcomes. Three states (Montana, Michigan, and Nebraska) provided detailed information on multiunit housing efforts in the study time frame. We conducted a qualitative analysis using inductive coding to develop themes. Several facilitators relating to existing infrastructure included traditional and nontraditional partnerships, leadership and champions, collecting and using data, efficient use of resources, and strategic plans. We also report external catalysts, barriers, and outcomes. Significant state leadership and effort were required to provide local-level technical assistance to engage traditional and nontraditional partners. Information needs were identified and varied by stakeholder type (i.e., health vs. housing). States recommend starting with public housing authorities, so they can become resources for affordable and subsidized housing. These lessons and resources can be used to inform smoke-free multiunit housing initiatives in other states and localities.

scholarly journals “Part of getting to where we are is because we have been open to change” integrating community health workers on care teams at ten Ryan White HIV/AIDS program recipient sites

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linda Sprague Martinez ◽  
Melissa Davoust ◽  
Serena Rajabiun ◽  
Allyson Baughman ◽  
Sara S. Bachman ◽  
...  
Keyword(s):  
Program Implementation ◽  
Technical Assistance ◽  
Health Workers ◽  
Implementation Strategies ◽  
Hiv Care ◽  
Organizational Policies ◽  
Ryan White ◽  
Aids Program ◽  
Group Interviews ◽  
Hiv Aids

Abstract Background Community Health Workers (CHWs) have long been integrated in the delivery of HIV care in middle- and low-income countries. However, less is known about CHW integration into HIV care teams in the United States (US). To date, US-based CHW integration studies have studies explored integration in the context of primary care and patient-centered medical homes. There is a need for research related to strategies that promote the successful integration of CHWs into HIV care delivery systems. In 2016, the Health Resources and Services Administration HIV/AIDS Bureau launched a three-year initiative to provide training, technical assistance and evaluation for Ryan White HIV/AIDS Program (RWHAP) recipient sites to integrate CHWs into their multidisciplinary care teams, and in turn strengthen their capacity to reach communities of color and reduce HIV inequities. Methods Ten RWHAP sites were selected from across eight states. The multi-site program evaluation included a process evaluation guided by RE-AIM to understand how the organizations integrated CHWs into their care teams. Site team members participated in group interviews to walk-the-process during early implementation and following the program period. Directed content analysis was employed to examine program implementation. Codes developed using implementation strategies outlined in the Expert Recommendations for Implementing Change project were applied to group interviews (n = 20). Findings Implementation strategies most frequently described by sites were associated with organizational-level adaptations in order to integrate the CHW into the HIV care team. These included revising, defining, and differentiating professional roles and changing organizational policies. Strategies used for implementation, such as network weaving, supervision, and promoting adaptability, were second most commonly cited strategies, followed by training and Technical Assistance strategies. Conclusions Wrapped up in the implementation experience of the sites there were some underlying issues that pose challenges for healthcare organizations. Organizational policies and the ability to adapt proved significant in facilitating CHW program implementation. The integration of the CHWs in the delivery of HIV care requires clearly distinguishing their role from the roles of other members of the healthcare delivery team.

Strategy and Control of Antimicrobial Therapy Program Implementation at the B.V. Petrovsky National Research Center of Surgery

2020 ◽  
Vol 65 (9-10) ◽  
pp. 44-50
Author(s):  
M. A. Chukina ◽  
N. V. Vistovskaya ◽  
M. V. Lukina ◽  
M. V. Zhuravleva
Keyword(s):  
Drug Resistance ◽  
Program Implementation ◽  
Local Level ◽  
Resistance Index ◽  
Surgical Site Infections ◽  
Infectious Complications ◽  
Research Center ◽  
Case Histories ◽  
Medical Organization ◽  
Therapy Program

The introduction of local programs for the rational use of antibiotics in a multidisciplinary hospital is aimed at reducing the level of antibiotic resistance and the frequency of healthcare associated infections (HAI). The aim of the study was to analyze the frequency of infectious complications caused by pathogens with multidrug resistance and the level of resistance at the B.V. Petrovsky National Research Center of Surgery based on the implementation of the SCAT program. Material and methods. A retrospective analysis of the SCAT program implementation results on the basis of the B.V. Petrovsky National Research Center of Surgery was carried out. 1850 case histories of the surgical profile for 2018 were analyzed (male —1095, average age 56.2±14.9 years; female — 755, average age 53.7±11.9 years) and 1502 case histories for the January–October period for 2019 (male — 1114, average age 58.3±12.1 years, and female — 388, average age 55.4±12.6 years). Results. The incidence of HAI in 2018 and 2019 was 354 and 159 cases, respectively. Of these, the incidence of nosocomial pneumonia (NP) was 64 cases (61.5%) and 40 cases (38.5%); skin and soft tissue infection (SSTI) — 93 cases (57.4%) and 69 cases (42.6%); surgical site infections (SSI) — 69 cases (82.1%) and 15 cases (17.9%) in 2018 and 2019, respectively. The drug resistance index (DRI) for the most clinically significant strains of the causative agents of HAI was: Klebsiella pneumoniae — 0.14, Acinetobacter baumannii — 0.22, Klebsiella spp. — 0.11, Enterobacter cloacae — 0.15, Enterococcus faecalis — 0.18, Enterococcus faecium — 0.21. Conclusion. The proposed measures for the implementation of the SCAT program at the level of a medical organization reduce the incidence of HAI and the local level of the drug resistance index.

scholarly journals Strategies to Integrate Genomic Medicine into Clinical Care: Evidence from the IGNITE Network

2021 ◽  
Vol 11 (7) ◽  
pp. 647
Author(s):  
Nina R. Sperber ◽  
Olivia M. Dong ◽  
Megan C. Roberts ◽  
Paul Dexter ◽  
Amanda R. Elsey ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Program Implementation ◽  
Clinical Care ◽  
Genomic Medicine ◽  
Implementation Strategies ◽  
Clinical Decision ◽  
Implementing Change ◽  
Implementation Outcomes ◽  
Planning Framework

The complexity of genomic medicine can be streamlined by implementing some form of clinical decision support (CDS) to guide clinicians in how to use and interpret personalized data; however, it is not yet clear which strategies are best suited for this purpose. In this study, we used implementation science to identify common strategies for applying provider-based CDS interventions across six genomic medicine clinical research projects funded by an NIH consortium. Each project’s strategies were elicited via a structured survey derived from a typology of implementation strategies, the Expert Recommendations for Implementing Change (ERIC), and follow-up interviews guided by both implementation strategy reporting criteria and a planning framework, RE-AIM, to obtain more detail about implementation strategies and desired outcomes. We found that, on average, the three pharmacogenomics implementation projects used more strategies than the disease-focused projects. Overall, projects had four implementation strategies in common; however, operationalization of each differed in accordance with each study’s implementation outcomes. These four common strategies may be important for precision medicine program implementation, and pharmacogenomics may require more integration into clinical care. Understanding how and why these strategies were successfully employed could be useful for others implementing genomic or precision medicine programs in different contexts.

scholarly journals Effect of PEMF on Muscle Oxygenation during Cycling: A Single-Blind Controlled Pilot Study

2021 ◽  
Vol 11 (8) ◽  
pp. 3624
Author(s):  
Aurelio Trofè ◽  
Milena Raffi ◽  
David Muehsam ◽  
Andrea Meoni ◽  
Francesco Campa ◽  
...  
Keyword(s):  
Blood Lactate ◽  
Slow Component ◽  
Local Level ◽  
Lactate Concentration ◽  
Oxygenation Index ◽  
State Level ◽  
Acute Effect ◽  
Primary Component ◽  
Muscle Oxygenation ◽  
Oxygen Kinetics

Pulsed electromagnetic fields (PEMFs) are used as non-invasive tools to enhance microcirculation and tissue oxygenation, with a modulatory influence on the microvasculature. This study aimed to measure the acute effect of PEMF on muscle oxygenation and its influence on pulmonary oxygen kinetics during exercise. Eighteen male cyclists performed, on different days, a constant-load exercise in both active (ON) and inactive (OFF) PEMF stimulations while deoxyhemoglobin and pulmonary oxygen kinetics, total oxygenation index, and blood lactate were collected. PEMF enhanced muscle oxygenation, with higher values of deoxyhemoglobin both at the primary component and at the steady-state level. Moreover, PEMF accelerated deoxyhemoglobin on-transition kinetic, with a shorter time delay, time constant, and mean response time than the OFF condition. Lactate concentration was higher during stimulation. No differences were found for total oxygenation index and pulmonary oxygen kinetics. Local application of a precise PEMF stimulation can increase the rate of the muscle O2 extraction and utilization. These changes were not accompanied by faster oxygen kinetics, reduced oxygen slow component, or reduced blood lactate level. It seems that oxygen consumption is more influenced by exercise involving large muscle mass like cycling, whereas PEMF might only act at the local level.

Building Italianità in Northern Adriatic: The case of organized migration of population from Pola/Pula

2018 ◽  
Vol 46 (6) ◽  
pp. 992-1007
Author(s):  
Miha Kosmač
Keyword(s):  
Local Level ◽  
State Level ◽  
The State ◽  
Peace Treaty ◽  
Italian Population ◽  
Top Down ◽  
Northern Adriatic ◽  
Building Process ◽  
Border Areas ◽  
Complex Activities

The article analyzes the process of buildingitalianitàin the case of migration of population from Pola/Pula that started as early as May 1945 and culminated in an organized process that officially began on 23 January 1947 and lasted until 20 March that same year. The article sheds light on the premises of that identity by analyzing complex activities of the Italian authorities who wanted to “defend Italianism” in Pola/Pula, as well as in other border areas of former Venezia Giulia. At the state level, they were mainly carried out by the Office for the Julian March/Ufficio per la Venezia Giuliaand following reorganization beginning at the end of 1946 by the Office for Border Areas/Ufficio per le Zone di Confine, and at the local level by a network of pro-Italian organizations and groups. Analysis contributes to the understanding of the top-down and bottom-upitalianitàbuilding process. On the local level, common identity was built upon the myth of thepatria, reiteration of traumatic/“wounded” memories and victim presentation of the “Italian” population, fear to be separated from thepatria, and unjust peace treaty propaganda. Simultaneously, the “Italian” population understood the Italian state as their defender.

Examining barriers and strategies for effective professional or interagency collaboration in secondary transition

2021 ◽  
pp. 1-14
Author(s):  
Elizabeth Magee ◽  
Anthony Plotner
Keyword(s):  
Independent Living ◽  
Technical Assistance ◽  
Transition Planning ◽  
Local Level ◽  
Collaborative Partnerships ◽  
Rehabilitation Professionals ◽  
High School Outcomes ◽  
Service Delivery Systems ◽  
State And Local ◽  
Participant Role

BACKGROUND: For young adults with disabilities, post-high school outcomes in employment, higher education, and independent living are markedly worse than their peers without disabilities. As a result, legislation and research aimed at supporting transitioning students has increased. Further, numerous initiatives that better support youth and families have been implemented at the state and local level. Collaboration within and across service delivery systems has been identified as a critical aspect of transition planning and supports; however, evidence-based research related to the implementation and effects of collaborative partnerships is limited. OBJECTIVE: In the current study, we identify transition professionals’ perceptions of collaborative factors that facilitate and inhibit collaboration. METHOD: This study utilizes a single-state survey research design to examine the viewpoints of transition professions, specifically educators, Vocational Rehabilitation professionals, and community supports providers. RESULTS: Variance in perceptions were found among participant role groups. Specifically, educators as a whole report that time and workload barriers affect their ability to collaborate effectively. Further, findings indicate that ensuring individual collaborative team member responsibility is perceived as an effective strategy. CONCLUSIONS: These findings may be applied to technical assistance providers when developing team-level evaluations to monitor current levels and support needs of collaborative transition planning teams.

Professional Information Needs of Library Specialists in Russia

2021 ◽  
Vol 70 (1) ◽  
pp. 7-20
Author(s):  
Marina Y. Neshcheret
Keyword(s):  
Information Needs ◽  
Rapid Development ◽  
Information Service ◽  
Library Science ◽  
Information Process ◽  
Cultural Workers ◽  
Use Of Resources ◽  
The Creation ◽  
Professional Information ◽  
Comprehensive Study

The article is devoted to the comprehensive study of the professional information needs (IN) of specialists of the central libraries of the subjects of the Russian Federation. The rapid development of high technologies in the field of accumulation, transmission and processing of information, the creation of modern telecommunications systems have led to the emergence of fundamentally new opportunities for organizing the information process. This, in turn, led to the qualitative growth of IN specialists, including those employed in the field of library activities. The specific features of IN library specialists are determined by their place and role in the modern process of cultural activity, industry orientation, nature of work and specialization. During 2018—2019, the Centre for Research of Problems of the Development of Libraries in the Information Society of the Russian State Library carried out research aimed at comprehensive study of the information needs of cultural workers employed in the library sphere. At the first stage of the research, there was comprehended the existing experience of studying professional information needs in the national library science. At the second stage, using the method of questionnaire survey, information needs of library specialists were studied in order to identify the most rational forms and methods of providing them. The analysis of the survey results made it possible to identify the sources of professional information, to reveal information resources that have the greatest importance and characterize specific features of librarians’ information needs.The author concludes on the need to expand the access to full-text databases and electronic versions of periodicals for library staff. The creation of integrated information centre could help providing library professionals with professional information. Currently, the function of such a centre is performed by the National Electronic Library, which includes the professional section for library specialists. The results of the study form theoretical and methodological basis for the rational use of resources and potential of libraries in providing information to professional information needs of library specialists and determine the prospects for further research related to improving the forms and methods of information service for this category of users.

Optimising horizontal and vertical partnership connections: bringing partnerships together to create a network advantage

2009 ◽  
Vol 15 (3) ◽  
pp. 196 ◽  
Author(s):  
Carolyn Wallace
Keyword(s):  
State Government ◽  
Local Development ◽  
Local Level ◽  
National Policy ◽  
State Level ◽  
Community Partnership ◽  
Transfer Of Knowledge ◽  
Partnership Network ◽  
Local Partnerships ◽  
Network Advantage

Partnerships bring actors together to make horizontal connections between organisations. This has proven to be an effective model at the local level in Ireland. This paper explores possibilities for local partnerships to come together through a network to make vertical connections to national policy processes. It is written as a practice and innovation paper by the national coordinator of the Community Partnership Network in Ireland. A review of current practice and expectations of the Community Partnership Network indicates there has been greater success in providing support to members compared with impacts from strong vertical connections. This experience is common for a range of local actors in the community development sector in Ireland who find that there are insufficient meaningful connections between local and national institutions. This limits the opportunity for transfer of knowledge from the local level to inform national policy. Going forward, the notion of network advantage is explored as a means to make the necessary vertical connections. It is proposed that the outcomes from a network should cover the dimensions of: joint value creation, mutual capacity development and collective engagement with decision makers. There is real opportunity to apply this in Ireland as the three networks representing local development are about to merge into a single representative body for what are now local integrated development partnerships. Thinking about network advantage also provides possible application for creating stronger vertical linkages between local partnerships in Victoria, Australia and bodies at the state level, including the Victorian State Government.

scholarly journals Pengentasan Kemiskinan Berbasis Pemberdayaan Masyarakat di Kabupaten Pohuwato

2019 ◽  
Vol 11 (3) ◽  
pp. 246-270
Author(s):  
Rusni Djafar ◽  
Umar Sune
Keyword(s):  
Political System ◽  
Technical Assistance ◽  
Local Level ◽  
Development Program ◽  
Poor People ◽  
Development Programs ◽  
Poverty Eradication ◽  
The Poor ◽  
Research Show

This study aims to explain and analyze empowerment-based poverty alleviation programs through the activities of assistance, facilitation and promotion and determinant factors of success in empowerment-based poverty eradication in Pohuwato District. This research method using qualitative approach, descriptive type to get a complete picture of problem of resource development of apparatus. The results of the research show that the assistance activities through training, consultation and technical assistance, and similar activities have not been coordinated with other supporting programs, making it difficult for the facilitator task as a program facilitator. Empowering the poor through the provision of facilities, has not been able to improve the capacity of the community. The low capacity and quality of service of government apparatus from the local level to the rural level, so that the provision of facilities does not allow the involvement of the poor. A highly centralized bureaucratic system and a highly authoritarian political system that has been practiced for more than four decades in Indonesia, brings out the weaknesses of the bureaucratic character. Promotion activities in the context of empowering the poor as an activity aimed at developing responsive services, the reality has not been effective in helping facilitate the poor to access various development programs that are beneficial to improving the welfare of the poor by earning productive employment. Activities that require synergies of cooperation between institutions / organizations (Government, Private, NGOs), difficult to realize because the dominance of egoism interests of each stakeholders in addressing every village development program. It is recommended to optimize training, consultation and technical assistance activities, as well as similar activities coordinated with support programs. Provision of adequate supporting facilities that can empower the poor on an ongoing basis, and streamline promotion to develop responsive services that enable poor people to access programs.Need to pay attention to communication factor, resources, attitude, and bureaucracy structure,so asnot tohinder the smooth implementation of poverty eradication program based on empowerment society.

scholarly journals A cluster randomized controlled trial comparing Virtual Learning Collaborative and Technical Assistance strategies to implement an early palliative care program for patients with advanced cancer and their caregivers: a study protocol

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lisa Zubkoff ◽  
Kathleen Doyle Lyons ◽  
J. Nicholas Dionne-Odom ◽  
Gregory Hagley ◽  
Maria Pisu ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Technical Assistance ◽  
Controlled Trial ◽  
Implementation Strategies ◽  
Care Program ◽  
Early Palliative Care ◽  
Randomized Controlled ◽  
Community Oncology ◽  
Cluster Randomized

Abstract Background Virtual Learning Collaboratives (VLC), learning communities focused on a common purpose, are used frequently in healthcare settings to implement best practices. Yet, there is limited research testing the effectiveness of this approach compared to other implementation strategies. This study evaluates the effectiveness of a VLC compared to Technical Assistance (TA) among community oncology practices implementing ENABLE (Educate, Nurture, Advise, Before Life Ends), an evidence-based, early palliative care telehealth, psycho-educational intervention for patients with newly diagnosed advanced cancer and their caregivers. Methods Using Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) and Proctor’s Implementation Outcomes Frameworks, this two-arm hybrid type-III cluster-randomized controlled trial (RCT) will compare two implementation strategies, VLC versus TA, among the 48 National Cancer Institute Community Oncology Research Program (NCORP) practice clusters that have not historically provided palliative care to all patients with advanced cancer. Three cohorts of practice clusters will be randomized to the study arms. Each practice cluster will recruit 15–27 patients and a family caregiver to participate in ENABLE. The primary study outcome is ENABLE uptake (patient level), i.e., the proportion of eligible patients who complete the ENABLE program (receive a palliative care assessment and complete the six ENABLE sessions over 12 weeks). The secondary outcome is overall program implementation (practice cluster level), as measured by the General Organizational Index at baseline, 6, and 12 months. Exploratory aims assess patient and caregiver mood and quality of life outcomes at baseline, 12, and 24 weeks. Practice cluster randomization will seek to keep the proportion of rural practices, practice sizes, and minority patients seen within each practice balanced across the two study arms. Discussion This study will advance the field of implementation science by evaluating VLC effectiveness, a commonly used but understudied, implementation strategy. The study will advance the field of palliative care by building the capacity and infrastructure to implement an early palliative care program in community oncology practices. Trial registration Clinicaltrials.gov. NCT04062552; Pre-results. Registered: August 20, 2019. https://clinicaltrials.gov/ct2/show/NCT04062552?term=NCT04062552&draw=2&rank=1

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