scholarly journals Smoker profiles and their influence on smokers’ intention to use a digital decision aid aimed at the uptake of evidence-based smoking cessation tools: An explorative study

2020 ◽  
Vol 6 ◽  
pp. 205520762098024
Author(s):  
Thomas Gültzow ◽  
Eline Suzanne Smit ◽  
Raesita Hudales ◽  
Carmen D Dirksen ◽  
Ciska Hoving
Keyword(s):  
Decision Making ◽  
Smoking Cessation ◽  
Decision Aid ◽  
Hierarchical Cluster ◽  
Evidence Based ◽  
Intention To Use ◽  
Cognitive Variables ◽  
Cross Sectional ◽  
Cluster Membership ◽  
Mediation Analyses

Objectives Evidence-based smoking cessation support tools (EBSTs) can double the quitting chances, but uptake among smokers is low. A digital decision aid (DA) could help smokers choose an EBST in concordance with their values and preferences, but it is unclear which type of smokers are interested in a digital DA. We hypothesized that smokers’ general decision-making style (GDMS) could be used to identify early adopters. This study therefore aimed to identify smoker profiles based on smokers’ GDMS and investigate these profiles’ association with intention to use a digital DA. Design A cross-sectional dataset (N = 200 smokers intending to quit) was used to perform a hierarchical cluster analysis based on smokers’ GDMS scores. Methods Clusters were compared on demographic and socio-cognitive variables. Mediation analyses were conducted to see if the relationship between cluster membership and intention was mediated through socio-cognitive variables (e.g., attitude). Results Two clusters were identified; “ Avoidant Regretters ” (n = 134) were more avoidant, more regretful and tended to depend more on others in their decision making, while “ Intuitive Non-regretters ” (n = 66) were more spontaneous and intuitive in their decision making. Cluster membership was significantly related to intention to use a DA, with “ Avoidant Regretters ” being more interested. Yet, this association ceased to be significant when corrected for socio-cognitive variables (e.g., attitude). This indicates that cluster membership affected intention via socio-cognitive variables. Conclusions The GDMS can be used to identify smokers who are interested in a digital DA early on. As such, the GDMS can be used to tailor recruitment and DA content.

Women's decision-making about mode of birth after a previous caesarean section

2020 ◽  
Vol 28 (2) ◽  
pp. 104-113
Author(s):  
Simona Fumagalli ◽  
Elisabetta Colciago ◽  
Laura Antolini ◽  
Sofia Perego ◽  
Micaela Fiorasi ◽  
...  
Keyword(s):  
Decision Making ◽  
Cross Sectional Study ◽  
Vaginal Birth ◽  
Evidence Based ◽  
Sectional Study ◽  
Cross Sectional ◽  
Midwifery Care ◽  
Previous Birth ◽  
Mode Of Birth ◽  
Vaginal Birth After Caesarean

Background Evidence on the safety and appropriateness of vaginal birth after caesarean (VBAC) appears clear, but knowledge about women's choice towards this mode of birth is limited. Aims To identify variables related to women's decision-making about whether to try for VBAC. Method and findings Cross-sectional study was conducted. Feelings of body failure towards the previous birth and the desire to have a vaginal birth were associated with maternal choice of VBAC. Women who perceived a repeated section as being dangerous for them opted for a VBAC (p=0.030). Opinion of women with the same experience and information found online were implicated into maternal decision-making. Conclusion This is the first Italian study to confirm that maternal choice is complex and involves many factors. Midwives and obstetricians should strive to provide an evidence-based midwifery care, in order to offer a VBAC as a safe birth option.

scholarly journals EVIDENCE-BASED MEDICINE IN THE TIMES OF COVID-19: A CROSS-SECTIONAL SURVEY TO UNDERSTAND THE INDIAN PERSPECTIVE

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Karan B. Bhanushali ◽  
Nikita Gupta ◽  
Vinayak Mishra ◽  
Heena Asnani
Keyword(s):  
Decision Making ◽  
Clinical Experience ◽  
Evidence Based Medicine ◽  
Online Survey ◽  
Medical Literature ◽  
Evidence Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
Based Medicine

Introduction: During the COVID-19 pandemic, there is a tremendous amount of literature published regularly. In a country like India, historically, where there is a paternalistic approach to practicing medicine, there is a lot of hindrance to evidence-based medicine (EBM). Doctors have always weighed one's clinical experience superior over any other form of decision-making. This system of practice has made decision-making difficult for the physicians during this pandemic as COVID-19 is a reasonably new disease entity and the physicians lack enough 'prior experience' dealing with such a situation. Our survey tries to address the common barriers to evidence-based medical practices especially during the COVID-19 pandemic in India. We also try to explore the various source of information used by the doctors. Methods: It is a descriptive cross-sectional survey. The questions were provided in multiple-choice question format. An online survey comprising of 10 questions entitled “Hurdles faced by physicians to assimilate evidence-based guidelines on COVID-19” was made using Google Forms (Google Inc, California, US) and circulated through email to medical practitioners in the Ghatkopar (Mumbai, India) Medical Association's register from 17th June 2020 to 1st September 2020. Results: Our survey collected 213 responses, out of which 80.3% (n=171) of doctors were involved in care, counseling, or management of COVID-19 patients. The most opted primary sources for evidence-based information during this pandemic were teachings of/discussions with medical colleagues (71.4%, n=152), followed by online webinars (59.6%, n= 127) and social media (41.8%, n=89). When questioned about the main obstacles faced by them to obtain evidence-based information, the responses were as follows: Overload of medical literature (53.5%, n=114), limited access to quality resources (40.8%, n=87), unfamiliarity with the bio-statistics analysis (39%, n= 83), difficulty in locating relevant medical literature (38%, n=81), unfamiliarity with the research methodology (37.1%, n=79), lack of time (30%, n=64).  Our respondents' perspective concerning EBM attributes: 57.3% (n=122) think evidence-based practice takes their clinical experience into account. 93.4% (n=199) of them have shown an interest in broadening their skills. There was no significant difference between doctors' attitudes with less than 10 years and more than 10 years of experience (chi-square value = 0.857, p = 0.65). Conclusion: Our survey results highlight the balance maintained between evidence-based medicine and experience-based medicine by Indian physicians. They identify the importance of EBM while acknowledging its shortcomings. They realize the significance of developing their repertoire to understand, appraise, and practice EBM. Keywords: EBM, COVID-19

scholarly journals Commitment Levels of Health Care Providers in Using the District Health Information System and the Associated Factors for Decision Making in Resource-Limited Settings: Cross-sectional Survey Study

10.2196/23951 ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. e23951
Author(s):  
Shuma G Kanfe ◽  
Berhanu F Endehabtu ◽  
Mohammedjud H Ahmed ◽  
Nebyu D Mengestie ◽  
Binyam Tilahun
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Providers ◽  
Data Use ◽  
Health Information System ◽  
Evidence Based ◽  
Care Providers ◽  
District Health ◽  
Cross Sectional ◽  
Evidence Based Decision Making

Background Changing the culture of information use, which is one of the transformation agendas of the Ministry of Health of Ethiopia, cannot become real unless health care providers are committed to using locally collected data for evidence-based decision making. The commitment of health care providers has paramount influence on district health information system 2 (DHIS2) data utilization for decision making. Evidence is limited on health care providers’ level of commitment to using DHIS2 data in Ethiopia. Therefore, this study aims to fill this evidence gap. Objective This study aimed to assess the levels of commitment of health care providers and the factors influencing their commitment levels in using DHIS2 data for decision making at public health care facilities in the Ilu Aba Bora zone of the Oromia national regional state, Ethiopia in 2020. Methods The cross-sectional quantitative study supplemented by qualitative methods was conducted from February 26, 2020 to April 17, 2020. A total of 264 participants were approached. SPSS version 20 software was used for data entry and analysis. Descriptive and analytical statistics, including bivariable and multivariable analyses, were performed. Thematic analysis was conducted for the qualitative data. Results Of the 264 respondents, 121 (45.8%, 95% CI 40.0%-52.8%) respondents showed high commitment levels to use DHIS2 data. The variables associated with the level of commitment to use DHIS2 data were found to be provision of feedback for DHIS2 data use (adjusted odds ratio [AOR] 1.85, 95% CI 1.02-3.33), regular supervision and managerial support (AOR 2.84, 95% CI 1.50-5.37), information use culture (AOR 1.92, 95% CI 1.03-3.59), motivation to use DHIS2 data (AOR 1.80, 95% CI 1.00-3.25), health needs (AOR 3.96, 95% CI 2.11-7.41), and competency in DHIS2 tasks (AOR 2.41, 95% CI 1.27-4.55). Conclusions In general, less than half of the study participants showed high commitment levels to use DHIS2 data for decision making in health care. Providing regular supportive supervision and feedback and increasing the motivation and competency of the health care providers in performing DHIS2 data tasks will help in promoting their levels of commitment that can result in the cultural transformation of data use for evidence-based decision making in health care.

The Use of Evidence-Based Management in Nursing Management

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Edris Hasanpoor ◽  
Yibeltal Siraneh Belete ◽  
Ali Janati ◽  
Sakineh Hajebrahimi ◽  
Elaheh Haghgoshayie
Keyword(s):  
Decision Making ◽  
Social Development ◽  
Research Evidence ◽  
Evidence Based ◽  
Nursing Management ◽  
Professional Expertise ◽  
Cross Sectional ◽  
North West ◽  
Nursing Managers ◽  
Development Plans

Evidence-based management (EBM) has been developed as a management framework for improving the quality of decisions. To use that, we need to identify the sources of evidence and to assess the utilisation of evidence in EBM. Therefore, the purpose of this study was to assess the utilisation of evidences and to identify predominantly used sources in EBM among nursing managers in Tabriz, north-west Iran. A facility-based descriptive cross-sectional study design was used in Tabriz hospitals. Out of 276 nursing managers eligible for the study from the Tabriz hospitals (n = 20), 205 nursing managers completed and returned the self-administered questionnaire, which indicated a response rate of 74.27 per cent. The questionnaire components included scientific and research evidence (four sources), facts and information from the hospitals (four sources), political-social development plans (three sources), the managers’ professional expertise (three sources), ethical-moral evidence (three sources), and values and expectations of all stakeholders (three sources). The results showed that the average use of scientific and research evidence (58.41 ± 13.23) was less than other sources of evidence. The average use of values and expectations of all stakeholders’ political-social development plans was (67.15 ± 14.78), managers’ professional expertise (70.47 ± 12.49), and ethical-moral evidence (68.91 ± 11.62). In addition, hospital ownership and the participants’ gender influence the use of facts and information of hospital and managers’ professional expertise. The findings showed that nursing managers were more customer- and expertise-oriented in the decision-making process. From the study findings we recommend utilisation of all the sources of evidence for decision-making in a full evidence-based nursing management process.

Development of a New Encounter Decision Aid for Smoking Cessation (Preprint)

2021 ◽  
Author(s):  
Herul Holland Da Sa Neto ◽  
Ines Habfast-Robertson ◽  
Christina Hempel-Bruder ◽  
Marie-Anne Durand ◽  
Isabelle Jacot-Sadowski ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Smoking Cessation ◽  
Shared Decision Making ◽  
General Practitioners ◽  
Decision Aid ◽  
Tobacco Cessation ◽  
Decision Aids ◽  
Therapeutic Education ◽  
Shared Decision

BACKGROUND Smoking cessation is an essential part of preventing and reducing risk of smoking associated morbidity and mortality. However, there is often little time to discuss smoking cessation in primary care. Encounter decision aids, short, patient-facing decision aids used during clinic visits, optimize therapeutic education and increase interaction and the therapeutic alliance. Such a decision aid for smoking cessation could potentially improve counselling and increase the use of pharmacological treatments. OBJECTIVE We aimed to develop and test an electronic encounter decision aid (DA) that facilitates physician-patient interaction and shared decision making for smoking cessation in primary care. METHODS We developed a DA (howtoquit.ch) adapted from a paper version developed by our team in 2017 following user-centered design principles. The DA is a one page interactive website presenting and comparing medications for tobacco cessation and electronic cigarettes. Each smoking cessation medication has a drop down menu that presents additional information, a video demonstration, and prescribing information for physicians. To test the DA, a questionnaire was submitted to general practitioner residents of an academic general medicine department, five general practitioners, and five experts in the field of smoking cessation. The questionnaire consisted of 4 multiple-choice and 2 free text questions assessing the usability/acceptability of the DA, the acquisition of new knowledge for practitioners, the perceived utility in supporting shared decision making and patients' choices, perceived strengths and weaknesses and if they would recommend the tool to other clinicians. RESULTS Six residents, 3 general practitioners in private practice, and 2 tobacco cessation experts completed the questionnaire (n=11), and 4 additional experts provided open-text feedback. On the 11 questionnaires, the DA was rated as practical and intuitive (mean 4.6/5) and supported shared decision making (mean 4.4/5), as comparisons were readily possible. Inclusion of explanatory videos was seen as a bonus. Several changes were suggested like grouping together similar medications and adding a landing page to briefly explain the site. Changes were implemented according to the end users comments. CONCLUSIONS The overall assessment of the DA by a group of physicians and experts was positive. The ultimate objective is to have the tool deployed and easily accessible for all to use.

scholarly journals Evidence-based decision making and promotion of physical activity among directors of local health departments

2018 ◽  
Vol 52 ◽  
pp. 90
Author(s):  
Leonardo Augusto Becker ◽  
Cassiano Ricardo Rech ◽  
Adriano Akira Ferreira Hino ◽  
Rodrigo Siqueira Reis
Keyword(s):  
Physical Activity ◽  
Decision Making ◽  
The State ◽  
Evidence Based ◽  
Local Health ◽  
Cross Sectional ◽  
Promotion Of Physical Activity ◽  
Municipal Administrators ◽  
Decision Making Model ◽  
Evidence Based Decision Making

OBJECTIVE: To describe the steps involved in evidence-based decision making for the implementation of programs aimed at the promotion of physical activity. METHODS: It is a descriptive, cross-sectional study with quali-quantitative approach, held with municipal health secretaries chosen deliberately by regional health representatives of the state of Paraná. A total of 27 secretaries participated in a telephone interview consisting of 17 open questions. Content analysis was conducted according to the categories of an evidencebased decision-making model consisting of seven steps. RESULTS: None of the participants employed every step of the evidence-based decision-making model. The steps that were most often mentioned included: evaluation of the program (33.3%), use of evidence from the literature (22.2%) and identification of the problem (22.2%). The steps that were reported the least included: quantification of the problem (14.8%), development and prioritization of actions (14.8%), development of the plan of action (14.8%) and evaluation of the community (3.7%). CONCLUSIONS: The use of evidence-based decision making in the context of the promotion of physical activity was shown to be incipient among the health secretaries of the state of Paraná. We suggest widening dissemination and training on the use of evidence-based decision making among municipal administrators to increase the effectiveness of actions for promotion of physical activity.

scholarly journals Utilisation of smoking cessation aids among South African adult smokers: findings from a national survey of 18 208 South African adults

2021 ◽  
Vol 9 (1) ◽  
pp. e000637
Author(s):  
Israel Agaku ◽  
Catherine Egbe ◽  
Olalekan Ayo-Yusuf
Keyword(s):  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
South African ◽  
Tobacco Consumption ◽  
Tobacco Product ◽  
Evidence Based ◽  
Cross Sectional ◽  
Nicotine Replacement ◽  
The Past

ObjectiveTo examine the use of different cessation aids among current South African smokers who have ever tried to quit smoking.DesignCross-sectional design.SettingSouth Africa has progressively passed several policies over the past few decades to encourage smoking cessation. Data on cessation behaviours are needed to inform policymaking. We investigated utilisation of evidence-based cessation aids and e-cigarettes among current combustible smokers. Current tobacco use, past quit attempts and use of evidence-based cessation aids (counselling, nicotine replacement therapy or prescription medication) were self-reported. Data were weighted and analysed using descriptive and multivariable approaches (p<0.05).ParticipantsOnline participants were recruited from the national consumer database for News24—South Africa’s largest digital publisher. Of the 18 208 participants aged 18 years or older, there were 5657 current smokers of any combustible tobacco product (cigarettes, cigars, pipes or roll-your-own cigarettes), including 4309 who had ever attempted to quit during their lifetime.ResultsCurrent combustible tobacco smoking prevalence was 22.4% (95% CI: 21.2% to 23.5%), and 98.7% of all current smokers of any combustible tobacco were current cigarette smokers. Awareness of cessation aids was as follows among current combustible tobacco smokers: smoking cessation counselling programmes, 50.8% (95% CI: 48.1% to 53.6%); nicotine replacement therapy, 92.1% (95% CI: 90.5% to 93.6%); prescription cessation medication, 68.2% (95% CI: 65.2% to 70.6%). Awareness of cessation aids was lowest among Black Africans, men, and persons with little or no income. Of all current combustible tobacco smokers, 74.6% (95% CI: 72.2% to 76.7%) had ever attempted to quit and 42.8% (95% CI: 40.0% to 45.4%) of these quit attempters had ever used any cessation aid. Among current combustible smokers who attempted to quit in the past, ever e-cigarette users were more likely than never e-cigarette users to have ever used any cessation aid (50.6% vs 35.9%, p<0.05). Of current combustible smokers intending to quit, 66.7% (95% CI: 64.2% to 68.9%) indicated interest in using a cessation aid for future quitting. By specific aids, 24.7% (95% CI: 21.3% to 28.1%) of those planning to use any cessation aid were interested in getting help from a pharmacist, 44.6% (95% CI: 40.9% to 48.4%) from a doctor, 49.8% (95% CI: 46.0% to 53.6%) from someone who had successfully quit, 30.0% (95% CI: 26.7% to 33.4%) from a family member and 26.5% (95% CI: 23.0% to 30.0%) from web resources.ConclusionOnly two in five past quit attempters had ever used counselling/pharmacotherapy. Any putative benefits of e-cigarettes on cessation may be partly attributable to pharmacotherapy/counselling given concurrent use patterns among past quit attempters using e-cigarettes. Comprehensive tobacco control and prevention strategies can help reduce aggregate tobacco consumption.

scholarly journals Informed Decision Making on the Uptake of Evidence-Based Smoking Cessation Assistance by Individuals Motivated to Quit Smoking

2022 ◽  
Vol 3 (1) ◽  
pp. 1-30
Author(s):  
Thomas Gültzow ◽  
Eline S. Smit ◽  
Raesita Hudales ◽  
Carmen D. Dirksen ◽  
Ciska Hoving
Keyword(s):  
Decision Making ◽  
Smoking Cessation ◽  
Decision Aids ◽  
End Users ◽  
Evidence Based ◽  
Informed Decision Making ◽  
Structured Interviews ◽  
Quit Smoking ◽  
Scientific Experts ◽  
Delphi Studies

Evidence-based cessation assistance increases cessation rates. Activating preferences during decision making could improve effectiveness further. Decision aids (DAs) facilitate deciding by taking preferences into account. To develop effective DAs, potential end users' (i.e., individuals motivated to quit) needs and experts' viewpoints should be considered. Therefore, the aim of this needs assessment was: (1) To explore end users' needs and (2) to obtain consensus among smoking cessation counsellors and scientific experts to develop a self-administered DA to support end users in choosing cessation assistance. Data was gathered via two approaches: (1) twenty semi-structured interviews with potential end users and (2) two three-round Delphi studies with 61 counsellors and 44 scientific experts. Interview data and the first Delphi rounds were analysed qualitatively, the other Delphi rounds were analysed quantitatively. Potential end users acquired information in different ways, e.g., via own experiences. Important characteristics to decide between tools varied, however effectiveness and costs were commonly reported. Experts reached consensus on 38 and 40 statements, e.g., tools should be appropriate for users' addiction level. Although some trends emerged, due to the variation among stakeholders, a 'one size fits all'-approach is undesirable. This heterogeneity should be considered, e.g., by enabling users to customise the DA.

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