scholarly journals Steps towards implementing evidence-based screening in family medicine in Ukraine: SWOT-analysis of an approach of multidimensional empowerment

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Pavlo Kolesnyk ◽  
Thomas Frese ◽  
Shlomo Vinker ◽  
Ivanna Shushman ◽  
Albina Zharkova ◽  
...  
Keyword(s):  
Swot Analysis ◽  
Screening Program ◽  
Implementation Process ◽  
Evidence Based ◽  
National Guidelines ◽  
Family Doctors ◽  
External Threats ◽  
The Family ◽  
Gate Keeping ◽  
Rapid Tests

Abstract Background The purpose of this study is to forward the implementation of an operational evidence-based state screening program of common diseases in Ukraine, where currently no state-based and evidence-based screening (EBS) exists. EBS should be performed by Family Doctors in a primary care setting and concern prevalent diseases in adults, such as: obesity (BMI), hypertension (BP measurement), diabetes (glycaemia), dyslipidemia (cholesterol/lipids), colon cancer (FOBT/colonoscopy), breast cancer (mammography), STIs (chlamydia, syphilis), HIV, HBV, HCV (i.e. serology or other rapid tests), HPV (swabs), cervical cancer (test Pap). depression (i.e., PHQ-9), and smoking (i.e., Fagerstrom). Methods Four needs-based research actions were led among citizens and healthcare professionals, based on multidimensional empowerment. Internal Strengths and Weaknesses of the ongoing implementation process were identified through these studies, whereas external Opportunities and Threats were determined by the present socio-cultural and political context. This SWOT analysis is likely to guide future state-based initiatives to accomplish EBS implementation in Ukraine. Results Internal Strengths are the bottom-up multidimensional empowerment approach, teaching of EBS and the development of an internet-based platform “Screening adviser” to assist shared decision making for person-centred EBS programs. Internal Weaknesses identified for the Family Doctors are a heterogeneous screening and the risk of decreasing motivation to screen. External Opportunities include the ongoing PHC reform, the existent WONCA and WHO support, and the existence of EBS programs in Europe. External Threats are the lack of national guidelines, not fully introduced gate keeping system, the vulnerable socio-economic situation, the war situation in the East of Ukraine and the Covid-19 pandemic. Conclusions We started EBS implementation through research actions, based on a multidimensional empowerment of citizens, HCP and in EBS pathways involved stakeholder teams, to foster a sustainable operational human resource to get involved in that new EBS pathway to implement. The presented SWOT-analysis of this ongoing implementation process allows to plan and optimize future steps towards a state based and supports EBS program in Ukraine.

scholarly journals Philosophical roots of Quaternary Prevention

2015 ◽  
Vol 10 (35) ◽  
pp. 1-8
Author(s):  
Daniel Widmer
Keyword(s):  
Practical Wisdom ◽  
Interprofessional Collaboration ◽  
Theory Of Action ◽  
Evidence Based ◽  
Family Doctors ◽  
Constructivist View ◽  
The Family ◽  
Future Challenges ◽  
Based Medicine ◽  
Quaternary Prevention

This article explores two philosophical dimensions of quaternary prevention since it represents the family doctors’ response to overmedicalization. The first dimension refers to the theory of knowledge and the second to the theory of action. Despite their interconnectedness, they are addressed separately. Firstly, in the theories of knowledge (Epistemology) we argue that the positivism of Evidence-Based Medicine (EBM), so useful to select good practices, should be balanced against critical vision of the use of EBM coupled with a constructivist view through the narrative-based medicine. Secondly, in the theory of action (Ethics) we argue that the non-maleficence principle (primum non nocere) needs to be balanced by the beneficence principle. The latter is the primary medical obligation and doctors should cultivate this practical wisdom. Finally, some aspects of P4’s future challenges are discussed such as health inequalities, interprofessional collaboration, responsibility, managerialism, and the integrative medicine, where a philosophical position should be considered.

ASD Into Adulthood

2020 ◽  
pp. 99-114
Author(s):  
Alison B. Bourdeau
Keyword(s):  
Sex Education ◽  
Family System ◽  
Implementation Process ◽  
Family Therapist ◽  
Evidence Based ◽  
Behavioral Challenges ◽  
Target Behavior ◽  
The Family ◽  
Adults With Asd

The purpose of this chapter is to provide a case study highlighting where lack of explicit sex education for people with ASD poses challenges into adulthood. The case study of represents ecologically valid challenges for adults with ASD and supports that takes into account the family system. Provided is a description of the setting, including the context of the environment that impacts the target behavior through the lens of a family therapist. A review of evidence-based interventions to address behavioral challenges is provided in conjunction with the implementation process and individuals involved.

RETROSPECTIVE ANALYSIS OF THE MEDICAL DOCUMENTATION OF PATIENTS WHO APPLIED TO THE AMBULATORY OF GENERAL PRACTICE - FAMILY MEDICINE

2019 ◽  
Vol 72 (5) ◽  
pp. 938-941
Author(s):  
Оlexander Ye. Kononov ◽  
Liliana V. Klymenko ◽  
Ganna V. Batsiura ◽  
Larysa F. Matiukha ◽  
Olha V. Protsiuk ◽  
...  
Keyword(s):  
Family Medicine ◽  
Middle Ages ◽  
Risk Groups ◽  
Medical Documentation ◽  
Aged Patients ◽  
Family Doctors ◽  
Functional Changes ◽  
Medicine Clinic ◽  
Leading Role ◽  
The Family

Introduction: In today’s realities of health care reform in Ukraine family doctors play a leading role. The aim of our work was to analyze the medical cards of patients who applied for medical care to the family medicine clinic. Materials and methods: It was analyzed outpatient medical cards of 87 patients who applied to the family medicine clinic in the Khotov village, Kyiv region. The study included people aged 18 to 60 years, which corresponded to the groups of young and middle ages according to the WHO classification. Review: Our findings indicate the prevalence of functional changes among young people: somatoform dysfunction of the autonomic nervous system - 9 (37,5%) and the development of organic manifestations at middle-aged patients: arterial hypertension - 32 (62,7%) and coronary artery disease - 17 (33,3%). Conclusions: This study is important for determining the risk groups, early diagnosis and prevention of diseases.

Evidence-based eHealth interventions for caregivers of people with dementia (Myinlife and Partner in Balance): Evaluation of implementations in municipality contexts (Preprint)

2020 ◽  
Author(s):  
Hannah Liane Christie ◽  
Lizzy Mitzy Maria Boots ◽  
Huibert Johannes Tange ◽  
Frans Rochus Josef Verhey ◽  
Marjolein Elizabeth de Vugt
Keyword(s):  
Self Efficacy ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Successful Implementation ◽  
Evidence Based ◽  
Multiple Sources ◽  
Target Groups ◽  
Face To Face ◽  
People With Dementia ◽  
Implementation Context

BACKGROUND Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context to implement these interventions, due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in eight municipalities in the Euregion Meuse-Rhine. OBJECTIVE This study’s objectives were to (1.) evaluate this implementation and (2.) investigate determinants of successful implementation. METHODS This study collected eHealth usage data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials, based on the Measurement Instrument for Determinants of Implementation (MIDI). This data from multiple sources and perspectives was integrated and analysed to form a total picture of the municipality implementation process. RESULTS The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, three municipalities planned to continue the implementation of Partner in Balance, while none planned to continue the implementation of Myinlife. The two Partner in Balance municipalities that did not consider the implementation to be successful, viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and the target groups. Successful implementations were linked to implementer self-efficacy CONCLUSIONS The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols, as part of standard implementation materials for municipalities and organisations implementing Myinlife and Partner in Balance.

scholarly journals Achieving a Sustainable Development Process by Deployment of Solar PV Power in ASEAN: A SWOT Analysis

Processes ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 630
Author(s):  
Hengtian Wang ◽  
Xiaolong Yang ◽  
Qihe Lou ◽  
Xinxin Xu
Keyword(s):  
Sustainable Development ◽  
Development Process ◽  
Swot Analysis ◽  
Primary Energy ◽  
Solar Pv ◽  
Proper Actions ◽  
External Threats ◽  
Process Deployment ◽  
Asean Countries ◽  
Primary Energy Supply

The Association of Southeast Asian Nations (ASEAN) has experienced rapid social and economic development in the past decades, while energy shortage, environmental pollution, and climate change are the factors that prevent a sustainable development process. Deployment of solar photovoltaic (PV) power is one of the effective alternatives to overcome the above barriers and assist ASEAN to achieve the aspirational target of 23% renewable energy (RE) in the total primary energy supply (TPES). In this study, SWOT analysis is adopted to analyze the internal strengths and weaknesses and the external threats and opportunities tightly related to the development of solar PV power in ASEAN countries. Through the SWOT analysis, great potential for the development of solar PV power in ASEAN is found. As long as appropriate policies are implemented and proper actions are taken, huge space for deployment of solar PV power can be expected. Based on the SWOT analysis, countermeasures that emphasize further deployment of solar PV power in ASEAN countries are put forward. The tactics include arousing people’s awareness of a sustainable development process, government issue coherence and stable incentive policies, fostering a solar PV industry chain and master key technology, and seek opportunities via an international cooperation.

University Educational-Practical Centres of the primary medical care – a step to the improvement of the family doctors training

2014 ◽  
Vol 18 (4 (72)) ◽  
Author(s):  
L. P. Sydorchuk ◽  
S. V. Biletskyi ◽  
O. A. Petrynych ◽  
S. I. Ivashchuk ◽  
T. V. Kazantseva ◽  
...  
Keyword(s):  
Medical Care ◽  
Teaching Process ◽  
Primary Medical Care ◽  
Family Doctors ◽  
The Family ◽  
The University ◽  
Medical University

The information about the University Educational-Practical Centres of the primary medical care of Bukovinian State Medical University and the peculiarities of the teaching process in present conditions is given.

Implementation of the Comprehensive Operating Room Ergonomics Program for Surgeons Through an OT Approach: A Feasibility Study

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512515314p1-7512515314p1
Author(s):  
Pamela Hess ◽  
Penelope Moyers Cleveland
Keyword(s):  
Operating Room ◽  
Feasibility Study ◽  
Mixed Methods Research ◽  
Implementation Process ◽  
Evidence Based ◽  
Health And Wellness ◽  
Design And Implementation ◽  
The Core ◽  
Core Program ◽  
Primary Author

Abstract Date Presented 04/22/21 The Comprehensive Operating Room Ergonomics (CORE) program was developed to address the physical and environmental demands among surgeons. This feasibility study examined the design and implementation process of an evidence-based OT ergonomics intervention using a mixed-methods research design. The CORE program supports the American Occupational Therapy Association’s Vision 2025 of promoting population health and wellness, especially among surgeons who are essential to our health care system. Primary Author and Speaker: Pamela Hess Additional Authors and Speakers: Elena Donoso Brown

scholarly journals Facilitators and Barriers in Cross-Country Transport of Evidence-based Preventive Interventions: a Case Study Using the Family Check-Up

2018 ◽  
Vol 22 (1) ◽  
pp. 73-83 ◽  
Author(s):  
Anne M. Mauricio ◽  
◽  
Jenna Rudo-Stern ◽  
Thomas J. Dishion ◽  
Daniel S. Shaw ◽  
...  
Keyword(s):  
Evidence Based ◽  
Preventive Interventions ◽  
The Family ◽  
Facilitators And Barriers ◽  
Cross Country

scholarly journals The Value Equation: Three complementary propositions for reconciling fidelity and adaptation in evidence-based practice implementation

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ulrica von Thiele Schwarz ◽  
Gregory A. Aarons ◽  
Henna Hasson
Keyword(s):  
Patient Outcomes ◽  
Theoretical Approach ◽  
Internal Validity ◽  
Implementation Strategies ◽  
Implementation Process ◽  
Evidence Based ◽  
A Value ◽  
The One ◽  
Practice Implementation ◽  
Fidelity And Adaptation

Abstract Background There has long been debate about the balance between fidelity to evidence-based interventions (EBIs) and the need for adaptation for specific contexts or particular patients. The debate is relevant to virtually all clinical areas. This paper synthesises arguments from both fidelity and adaptation perspectives to provide a comprehensive understanding of the challenges involved, and proposes a theoretical and practical approach for how fidelity and adaptation can optimally be managed. Discussion There are convincing arguments in support of both fidelity and adaptations, representing the perspectives of intervention developers and internal validity on the one hand and users and external validity on the other. Instead of characterizing fidelity and adaptation as mutually exclusive, we propose that they may better be conceptualized as complimentary, representing two synergistic perspectives that can increase the relevance of research, and provide a practical way to approach the goal of optimizing patient outcomes. The theoretical approach proposed, the “Value Equation,” provides a method for reconciling the fidelity and adaptation debate by putting it in relation to the value (V) that is produced. The equation involves three terms: intervention (IN), context (C), and implementation strategies (IS). Fidelity and adaptation determine how these terms are balanced and, in turn, the end product – the value it produces for patients, providers, organizations, and systems. The Value Equation summarizes three central propositions: 1) The end product of implementation efforts should emphasize overall value rather than only the intervention effects, 2) implementation strategies can be construed as a method to create fit between EBIs and context, and 3) transparency is vital; not only for the intervention but for all of the four terms of the equation. Summary There are merits to arguments for both fidelity and adaptation. We propose a theoretical approach, a Value Equation, to reconciling the fidelity and adaptation debate. Although there are complexities in the equation and the propositions, we suggest that the Value Equation be used in developing and testing hypotheses that can help implementation science move toward a more granular understanding of the roles of fidelity and adaptation in the implementation process, and ultimately sustainability of practices that provide value to stakeholders.

scholarly journals Evaluation of the Implementation Process of the Mobile Health Platform ‘WelTel’ in Six Sites in East Africa and Canada Using the Modified Consolidated Framework for Implementation Research (mCFIR)

2020 ◽  
Author(s):  
Samia El Joueidi ◽  
Kevin Bardosh ◽  
Richard Musoke ◽  
Binyam Tilahun ◽  
Maryam Abo Moslim ◽  
...  
Keyword(s):  
Implementation Research ◽  
Digital Health ◽  
Descriptive Analysis ◽  
Scale Up ◽  
Implementation Process ◽  
Evidence Based ◽  
Structured Interviews ◽  
User Friendliness ◽  
Domain 3 ◽  
And Performance

Abstract Background: Health systems globally are investing in integrating secure messaging platforms for virtual care in clinical practice. Implementation science is essential for adoption, scale-up, spread and maintenance of complex evidence-based solutions in clinics with evolving priorities. In response, the mHealth Research Group modified the existing Consolidated Framework for Implementation Research (mCFIR) to evaluate implementation of virtual health tools in clinical settings. WelTel® is an evidence-based digital health platform widely deployed in various geographical and health contexts. Objectives: To identify the facilitators and barriers for implementing WelTel and to assess the application of the mCFIR tool in facilitating focus groups in different geographical and health settings. Methodology: Both qualitative and semi-quantitative approaches were employed. Six mCFIR sessions were held in three countries with 51 key stakeholders surveyed. The mCFIR tool consists of 5 Domains and 25 Constructs and was built and distributed through Qualtrics XM. “Performance ” and “Importance” scores were valued on a scale of 0 to 10 (Mean + SD). Descriptive analysis was conducted using R computing software. NVivo 12 Pro software was used to analyze mCFIR responses and to generate themes from the participants’ input. Semi-structured interviews were conducted with the focus group facilitators to understand their experience using the mCFIR tool. Results: We observed a parallel trend in the scores for Importance and Performance. Of the five Domains, Domain 4 (End-user Characteristics) and Domain 3 (Inner Settings) scored highest in Importance (8.9 + 0.5 and 8.6 + 0.6, respectively) and Performance (7.6 + 0.7 and 7.2 + 1.3, respectively) for all sites. Domain 2 (Outer Setting) scored the lowest in both Importance and Performance for all sites (7.6 + 0.4 and 5.6 + 1.8). Areas of strengths included timely diagnosis, immediate response, cost-effectiveness, user-friendliness, and simplicity. Areas for improvement included training, phone accessibility, health authority’s engagement, and literacy. Conclusion: The mCFIR tool allowed for a comprehensive understanding of the barriers and facilitators to the implementation, reach, and scale-up of digital health tools. Participants emphasized the importance of creating partnerships with external organizations and health authorities in order to achieve sustainability and scalability.Trial Registration: NCT02603536 – November 11, 2015NCT01549457 – March 9, 2012

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