scholarly journals Barriers to implementing motivational interviewing in addiction treatment: A nominal group technique process evaluation

2021 ◽  
Vol 2 ◽  
pp. 263348952110184
Author(s):  
Melissa R Hatch ◽  
Kristine Carandang ◽  
Joanna C Moullin ◽  
Mark G Ehrhart ◽  
Gregory A Aarons

Background: The successful implementation of evidence-based practices (EBPs) in real-world settings requires an adaptive approach and ongoing process evaluation and tailoring. Although conducting a needs assessment during the preparation phase of implementation is beneficial, it is challenging to predict all barriers to EBP implementation that may arise over the course of implementation and sustainment. This article describes a process evaluation that identified emergent and persistent barriers that impacted the implementation of an EBP across multiple behavioral health organizations and clinics. Methods: This study was conducted during the first cohort of a cluster randomized controlled trial testing the effectiveness of the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI) in substance use disorder treatment agencies and clinics. We used a modified nominal group technique (NGT) in which clinic leaders identified barriers faced during the implementation process. Barriers were categorized, then ranked and rated according to leaders’ perceptions of each barrier’s influence on implementation. The barriers were then contextualized through individual qualitative interviews. Results: Fifteen barriers were identified, grouped into staff-level barriers, management-level barriers, and implementation program barriers. Time and resistance to MI were rated as the most influential staff-level barriers. Among management-level barriers, time was also rated highest, followed by turnover and external contractual constraints. The most influential implementation barrier was client apprehension of recording for fidelity assessment and feedback. Individual interviews supported these findings and provided suggested adaptations for future implementation efforts. Conclusion: EBP implementation is an ongoing process whereby implementation strategies must be proactively and strategically tailored to address emergent barriers. This research described a process evaluation that was used to identify 15 emergent and/or persistent barriers related to staff, management, and the implementation program. Using implementation strategies that can be tailored and/or adapted to such emergent barriers is critical to implementation effectiveness. Plain Language Summary Unforeseen barriers often arise during the course of implementation. Conducting evaluations during implementation allows for tailoring the implementation strategy. As part of a larger study using the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI), we collected data from the first cohort of LOCI clinic leaders to identify barriers to MI implementation that persisted despite advanced planning and to understand unanticipated barriers that arose during implementation. Leaders identified 15 barriers faced during the implementation process that fell into three categories: staff-level barriers, management-level barriers, and implementation program barriers. The leaders ranked time as the most influential barrier at both the staff and management levels. Staff apprehension, resistance to MI implementation, and staff turnover were also of significant concern to leaders. Future implementation efforts may benefit from conducting a similar process evaluation during the implementation phase.

Foods ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 1102
Author(s):  
Purificación García-Segovia ◽  
Mª Jesús Pagán-Moreno ◽  
Amparo Tárrega ◽  
Javier Martínez-Monzó

Sandwiches are the most common “casual-food” consumed by all age groups in Spain. Due to the importance of visual appearance to promote unplanned or impulse buying, foodservice and hospitality companies focus on improving the visual impression of their food menus to create an expectation that satisfies both sensory and hedonic consumer experiences. To provide a list of attributes about the visual appearance of sandwiches, 25 students were recruited from a university and were invited to participate in two nominal group technique (NGT) sessions. To understand whether a sandwiches’ appearance can influence the expectation of consumers, 259 participants completed an online survey specially designed from the results of the NGT sessions. Data were analyzed using conjoint, internal preference mapping and cluster analysis; the interaction effect by gender was also studied. The conjoint results indicate that visual perception about the filling (vegetal or pork based) plays the most key role overall in consumer expectation. When consumers choose vegetables as the filling, the consumers’ perceived sandwiches as healthier, but the pork filling was perceived as more attractive and satiating. Interaction effect by gender was observed in filling when females perceived pork filling as less healthy than vegetable. By acceptance, consumers were segmented into three groups. The first cluster (n = 80) selected the pork filling. The smaller group (cluster 3, n = 36) prioritized the vegetal filling, and the most numerous cluster 2 (n = 140) liked sandwiches with multigrain bread. These results may help companies to build tailor-made marketing strategies to satisfy consumer segments.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Leigh M. Vanderloo ◽  
Shelley M. Vanderhout ◽  
Erika Tavares ◽  
Jonathon Maguire ◽  
Sharon Straus ◽  
...  

AbstractEvidence generated from partnering with parents to design and conduct research together may be used to refine, adjust, and modify future research approaches. This study aimed to describe the initial approaches to parent engagement in the design of the PARENT trial as well as understand parent perspectives on the acceptability and relevance of the PARENT trial and potential barriers and facilitators to participation.Parents participating in the TARGet Kids! cohort were invited to participate in a focus group, called the PARENT panel, to co-design the PARENT trial. This focus group was conducted to capture diverse individual and collective parents’ experiences. Overall methodological approaches for the PARENT panel were informed by the CIHR Strategy for Patient Oriented Research (SPOR) guiding principles (mutual respect, co-building, inclusiveness, and support) for patient engagement in research, and facilitated through the Knowledge Translation Program in the Li Ka Shing Knowledge Institute at Unity Health Toronto. Using a Nominal Group Technique, the PARENT panel provided feedback on the feasibility, relevance, and acceptability of the proposed intervention. Findings from this work will be used to further refine, adjust, and modify the next iteration of the PARENT trial, which will also serve as an opportunity to discuss the efforts made by researchers to incorporate parent suggestions and what additional steps are required for improved patient engagement.


1970 ◽  
Vol 8 (1) ◽  
pp. 20-30
Author(s):  
R Sogarwal ◽  
D Bachani

Introduction: During the fi rst 2 years of the fi ve year plan of India’s National AIDS Control Programme Phase-III (NACP-III; 2007-12), various interactive consultative workshops were organized in collaboration with development partners with the objective of identifying priority areas for operational research and further development of research protocols adopting mentorship approach. Methodology: This article is an attempt to present the Nominal Group Technique (NGT) which was used to identify a set of fundable and practically feasible research priorities under NACP-III specifi cally focusing on Prevention of Parent to Child Transmission (PPTCT) and Pediatric HIV Care in India. The activity was undertaken with support of UNICEF in the year 2010. A total of 110 persons participated in the consultation clustering into 37, 36 and 37 members in Group A, B and C, respectively. The participants refl ected the mix of policy makers / decision makers (8), programme managers (12), implementers (36), subject experts / researchers (28), other stakeholders (16). Results: A total of nine highest priority research questions were identifi ed by all the groups in the assigned themes. The value of Kendall’s W coeffi cient of concordance was 0.68, which shows signifi cant agreement among raters on priority research questions (chi-square=16.35; p=0.03). Conclusion: Based on our experience, we can conclude that NGT was found to be an important tool for setting research priorities that is more democratic and transparent than the traditional methods. By applying various stages of the group sessions, participants can experience the rethinking process with reference information to enhance their judgment. The results of our experience may help programme managers / policy makers to plan similar and more improved method in other element of NACP as well as other health programmes. DOI: http://dx.doi.org/10.3126/saarctb.v8i1.5888 SAARCTB 2011; 8(1): 20-30


2010 ◽  
Vol 13 (2) ◽  
pp. 47-56 ◽  
Author(s):  
Matthew G. Kenney ◽  
Art Weinstein

Although it is well established in the academic literature that entrepreneurs share common traits, there has been limited research dedicated to evaluating psychographic profiles of the self-employed. Using the Nominal Group Technique, the authors gleaned insight from a panel of experts in an effort to segment the self-employed based on personality traits and the benefits they receive from an entrepreneurial career. The findings show that self-employed individuals can be classified into four distinct segments: Exemplars, Generals, Moms and Dads, and Altruists. Each group derives different benefits from self-employment. Understanding these benefits can greatly assist entrepreneurship educators and marketers of small business oriented products and services.


Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Eithne Heffernan ◽  
Dylan Keegan ◽  
Jenny Mc Sharry ◽  
Tomas Barry ◽  
Andrew Murphy ◽  
...  

Introduction: Community First Response (CFR) is an important intervention for out-of-hospital cardiac arrest (OHCA) in many countries. CFR entails the mobilization of volunteers by the Emergency Medical Services (EMS) to respond to OHCAs in their vicinity. These volunteers include lay-people and professionals (e.g. physicians, fire-fighters). CFR can increase rates of cardiopulmonary resuscitation (CPR) or defibrillation performed prior to EMS arrival. However, its impact on additional outcomes (e.g. survival, cognitive function) requires further study. This research aimed to identify the most important CFR data to collect and analyze, as well as the most important uses of CFR data. Methods: This study used the Nominal Group Technique: a structured consensus process where key stakeholders develop a set of prioritized recommendations. There were 16 participants, including CFR volunteers, an OHCA survivor, researchers, clinicians, EMS personnel, and policy-makers. They completed an online survey to generate lists of the most important (1) CFR data to collect and analyze and (2) uses of CFR data. They then attended a virtual meeting where they discussed the survey results in groups before voting for their top ten priorities from each list. They also identified barriers to CFR data collection. Results: The top ten CFR data to collect and analyze included volunteer response time, interventions performed by volunteers, time of emergency, time of CPR initiation, individuals who performed CPR, and the mental and physical effects of being a volunteer. The top ten uses of CFR data included providing feedback to volunteers, increasing bystander participation in resuscitation, improving volunteer training, measuring CFR effectiveness, and encouraging inter-operability with the EMS. Barriers to data collection included time constraints, prioritization of patient care, and limited training. Conclusions: This study established priorities for the collection, analysis, and use of CFR data in consultation with key stakeholders. These findings have important implications for both CFR research and practice. In particular, they can be used to improve the efficiency, consistency, and utility of CFR data collection and to build evidence for this intervention.


2021 ◽  
Vol 15 (2) ◽  
pp. 103-113
Author(s):  
Zafirah Ab. Muin ◽  
Maimunah Sapri ◽  
Ibrahim Sipan ◽  
Hariati Abdullah Hashim

The mosque has been a focal point of Islam since its inception, serving as a place of worship, a centre of education, economic pursuits, communal services, and spirituality. However, due to a variety of causes, the scope of mosque functions has been constrained as the world has developed rapidly. In summary, congregational capacity and facilities relating to hygiene, safety, and space utilisation are among the problems being closely examined in Malaysia. Based on the problems, the subject of mosque management's competencies that need to be improved in order to become more professional arises. Reviews of literature suggested that facilities management (FM) approach has the potential to be incorporated in the management of mosque. The purpose of this study is to examine the implementation of FM process in mosque in supporting the achievement of mosque’s functions. A quantitative approach was adopted in this study. The implementation of FM process from 12 state mosques in Peninsular Malaysia were investigated using questionnaire survey which distributed among the mosque management that manage mosque facilities. Descriptive statistics were used to analyse the questionnaire survey data with Statistical Package for the Social Sciences (SPSS) software. Results from the questionnaire survey revealed that, 50 per cent of the mosque has implemented most of the FM process model elements whereas other mosque still need further improvement to ensure the standards of FM process model is achieved. The results indicated that there is potential for improvement in mosque that possesses low position in implementing elements of FM process model that includes FM formulation strategy, requirement analysis of services, FM solutions development, FM solutions implementation and monitoring service provision. The finding could assist the top management level of the mosque in strategising the implementation action plan of mosque facilities management.


2018 ◽  
Vol 46 (7) ◽  
pp. 721-726 ◽  
Author(s):  
Sindhu R. Johnson ◽  
Dinesh Khanna ◽  
David Daikh ◽  
Ricard Cervera ◽  
Nathalie Costedoat-Chalumeau ◽  
...  

Objective.Given the complexity and heterogeneity of systemic lupus erythematosus (SLE), high-performing classification criteria are critical to advancing research and clinical care. A collaborative effort by the European League Against Rheumatism and the American College of Rheumatology was undertaken to generate candidate criteria, and then to reduce them to a smaller set. The objective of the current study was to select a set of criteria that maximizes the likelihood of accurate classification of SLE, particularly early disease.Methods.An independent panel of international SLE experts and the SLE classification criteria steering committee (conducting SLE research in Canada, Mexico, United States, Austria, Germany, Greece, France, Italy, and Spain) ranked 43 candidate criteria. A consensus meeting using nominal group technique (NGT) was conducted to reduce the list of criteria for consideration.Results.The expert panel NGT exercise reduced the candidate criteria for SLE classification from 43 to 21. The panel distinguished potential “entry criteria,” which would be required for classification, from potential “additive criteria.” Potential entry criteria were antinuclear antibody (ANA) ≥ 1:80 (HEp-2 immunofluorescence), and low C3 and/or low C4. The use of low complement as an entry criterion was considered potentially useful in cases with negative ANA. Potential additive criteria included lupus nephritis by renal biopsy, autoantibodies, cytopenias, acute and chronic cutaneous lupus, alopecia, arthritis, serositis, oral mucosal lesions, central nervous system manifestations, and fever.Conclusion.The NGT exercise resulted in 21 candidate SLE classification criteria. The next phases of SLE classification criteria development will require refinement of criteria definitions, evaluation of the ability to cluster criteria into domains, and evaluation of weighting of criteria.


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