scholarly journals Scaling up pediatric nurse specialist education in Ghana – a longitudinal, mixed methods evaluation

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Roxana Salehi ◽  
Augustine Asamoah ◽  
Stephanie de Young ◽  
Hannah Acquah ◽  
Nikhil Agarwal ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Training Program ◽  
Clinical Skills ◽  
Scaling Up ◽  
Nurse Training ◽  
Program Outcomes ◽  
Pediatric Nursing ◽  
Pediatric Nurse

Abstract Background Inadequate health human resources is a key challenge to advancing child survival in Ghana. Nurses are an essential human resource to target because they represent the largest portion of the health workforce. Building on lessons learned from our pilot pediatric nurse training project and World Health Organization guidelines for transforming and scaling up health professional education, this project aimed to; train 500 pediatric nurse specialists through a one-year training program; develop and integrate a critical mass of pediatric nursing faculty and establish a national standardized pediatric nursing curriculum. This study aimed to evaluate the effectiveness of a national pediatric nurse training program in Ghana at the end of 4 years, including eight cohorts with 330 graduates. Methods This was a mixed-method evaluation with surveys, focus groups and a pre-test/post-test design. Before and after surveys were used to measure knowledge and confidence at baseline and graduation. Objective Structured Clinical Examinations (OSCE) were used to measure clinical skills at baseline, graduation, and 14 months follow-up. At the end of every module, surveys were used to measure students’ satisfaction. Focus groups at graduation qualitatively measured program outcomes. Repeat focus groups and surveys at 14 months after graduation captured the graduates’ career progress, experiences reintegrating into the health system and long-term program outcomes. Results Overall, the graduates completed the program with significantly increased knowledge, confidence, and clinical skills. They also had increased job satisfaction and were able to apply what they learned to their jobs, including leadership skills and gender-sensitive care. Data from 14-month follow-up OSCEs showed that all graduates remained competent in communication, physical assessment, and emergency care, although some obtained a lower mark compared to their performance at graduation. This finding is linked with the observation that the amount of mentorship, support from leadership and equipment that the graduates accessed from their respective facilities varied. Conclusions Mixed-methods evaluations demonstrated significant increases in knowledge confidence and skills by completing the program and maintenance of skills more than 1 year after graduation. Findings have implications for those working on the design, implementation, and evaluation of nursing education interventions in low- and middle-income countries.

scholarly journals InFORM: Improving care for people who Frequently call 999: co-production of guidance through an Observational study using Routine linked data and Mixed methods

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Ashrafunessa Khanom ◽  
Adrian Edwards ◽  
Bethan Edwards ◽  
Heather Hughes ◽  
Ann John ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health Outcomes ◽  
Focus Groups ◽  
Linked Data ◽  
Third Sector ◽  
Care Providers ◽  
Complex Needs ◽  
Data Matching ◽  
Future Evaluation

BackgroundPeople who frequently call the 999 ambulance service present an operational challenge to providers and their needs are inadequately met by current service provision. Aim of researchTo understand patterns and health outcomes of frequent calling and to work with stakeholders to co-produce guidance for formal testing in a future evaluation. MethodsThis mixed methods study will include a scoping review of national and international literature followed by an epidemiological study of callers at the all Wales level exploring health outcomes through anonymised linked data. We will also explore the views of patients using qualitative Bio-photographic interview method with a follow up interview at six months and use focus groups with care providers from across primary and emergency care and the third sector. We will use generalised linear model to analyse quantitative data and qualitative data will be analysed thematically. ResultsFindings will include follow up of eligible patients; successful data matching and data linkage; retrieval of outcomes within 12 months. Outcomes will include: adverse events, deaths, emergency admissions; 999 attendances. Qualitative results will include Bio-photographic interviews with completed scrap books and interviews based on the books (n=34). Care provider focus groups (n= 22). Output Co-produced guidance developed with stakeholders. ConclusionHigh users of the 999-ambulance represent a significant policy challenge to emergency ambulance services and often present with complex needs. This study will inform on the characteristics of callers and how to address their care supported with a co-produced guidance for care providers.

scholarly journals Development and Pilot Testing of Text Messages to Reduce Sugar-Sweetened Beverage Intake in Rural Caregivers and Adolescents: A Mixed-Methods Study (Preprint)

2019 ◽  
Author(s):  
Maryam Yuhas ◽  
Kathleen Joyce Porter ◽  
Donna-Jean Brock ◽  
Annie Loyd ◽  
Brittany Alexandra McCormick ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Pilot Trial ◽  
Text Message ◽  
Text Messages ◽  
Utilization Rate ◽  
Rural Caregivers ◽  
Message Development ◽  
Caregiver Behaviors

BACKGROUND High consumption of sugar-sweetened beverages (SSB) poses significant health concerns, particularly for rural adults and adolescents. Developing innovative strategies that target caregivers as the agents of change could be a promising way to improve both caregiver and adolescent health. Sending text messages through mobile phones has been cited as an effective way to improve behavioral outcomes, although little research has been conducted in rural areas, particularly focusing on SSB intake. OBJECTIVE Targeting rural caregivers, the objectives of this two phase study were to: 1) understand caregivers’ perceptions and language preferences for SSB-related text messages to inform and refine message development and delivery, and 2) evaluate the acceptability of text messages for SSB behavior change, and examine short-term effects on SSB behaviors. METHODS A convergent mixed-methods design was used to systematically develop and pilot test text messages with caregivers in Southwest Virginia. In phase one, five focus groups that included a card-sorting activity were conducted to explore advantages/disadvantages, language preferences (i.e., tone of voice, audience, phrase preferences), and perceived use of text messages. In phase two, caregivers participated in a 5-week text message pilot trial that included weekly educational and personalized strategy messages and SSB assessments at baseline and follow-up. Before the focus groups and after completing the pilot trial, caregivers also completed a pre-post survey that assessed SSB intake, SSB home availability, and caregiver SSB-related practices. Caregivers also completed individual follow-up telephone interviews following the pilot trial. RESULTS In phase one, caregivers (n=33) reported that text messages were convenient, accessible, and easy to read. Additionally, caregivers preferred messages with empathetic and authoritative tones of voice that provided useful strategies and stayed away from using absolute words (e.g., always, never). In the phase two pilot trial (n=30), 87% of caregivers completed baseline and 77% completed follow-up assessment suggesting a high utilization rate. Other ways caregivers reported benefiting from the text messages included sharing messages with family members, friends, and coworkers (80%), making mental notes (57%), and looking back at messages as reminders (50%). Caregivers reported significant improvements in home environment, parenting practices, and rulemaking around SSB (all P <0.05). Also, the frequency of SSB intake among caregivers and adolescents significantly decreased (P <0.01). CONCLUSIONS Spending time in the formative phases of text message development helped to understand the unique perspectives and language preferences of the target population. This study also found that delivering an intervention through text messages has the potential to improve caregiver behaviors and reduce SSB intake in rural caregivers and adolescents. Findings from this study were used to develop a larger bank of text messages, which will be used in a future study testing the effectiveness of a text message intervention targeting SSB-related caregiver behaviors.

scholarly journals Development and Pilot Testing of Text Messages to Help Reduce Sugar-Sweetened Beverage Intake Among Rural Caregivers and Adolescents: Mixed Methods Study

10.2196/14785 ◽  
2019 ◽  
Vol 7 (7) ◽  
pp. e14785
Author(s):  
Maryam Yuhas ◽  
Kathleen J Porter ◽  
Donna-Jean P Brock ◽  
Annie Loyd ◽  
Brittany A McCormick ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Phase 1 ◽  
Pilot Trial ◽  
Text Message ◽  
Text Messages ◽  
Phase 2 ◽  
Rural Caregivers ◽  
Caregiver Behaviors

Background A high consumption of sugar-sweetened beverages (SSBs) poses significant health concerns, particularly for rural adults and adolescents. A manner in which the health of both caregivers and adolescents can be improved is by developing innovative strategies that target caregivers as the agents of change. Sending text messages through mobile phones has been cited as an effective way to improve behavioral outcomes, although little research has been conducted in rural areas, particularly focusing on SSB intake. Objective By targeting rural caregivers, this 2-phase study aimed to (1) understand caregivers’ perceptions and language preferences for SSB-related text messages to inform and refine message development and delivery and (2) evaluate the acceptability of text messages for SSB intake behavior change and examine short-term effects on SSB intake behavior. Methods A convergent mixed methods design was used to systematically develop and pilot-test text messages with caregivers in Southwest Virginia. In phase 1, 5 focus groups that included a card-sorting activity were conducted to explore advantages/disadvantages, language preferences (ie, tone of voice, audience, and phrase preferences), and perceived use of text messages. In phase 2, caregivers participated in a 5-week text message pilot trial that included weekly educational and personalized strategy messages and SSB intake assessments at baseline and follow-up. Before the focus groups and after completing the pilot trial, caregivers also completed a pre-post survey that assessed SSB intake, SSB home availability, and caregivers’ SSB-related practices. Caregivers also completed individual follow-up telephone interviews following the pilot trial. Results In phase 1, caregivers (N=33) reported that text messages were convenient, accessible, and easy to read. In addition, they preferred messages with empathetic and authoritative tones that provided useful strategies and stayed away from using absolute words (eg, always and never). In the phase 2 pilot trial (N=30), 87% of caregivers completed baseline and 77% completed follow-up assessment, suggesting a high utilization rate. Other ways in which caregivers reported benefiting from the text messages included sharing messages with family members and friends (80%), making mental notes (57%), and looking back at messages as reminders (50%). Caregivers reported significant improvements in home environment, parenting practices, and rulemaking around SSB (P=.003, P=.02, and P=.04, respectively). In addition, the frequency of SSB intake among caregivers and adolescents significantly decreased (P=.003 and P=.005, respectively). Conclusions Spending time in the formative phases of text message development helped understand the unique perspectives and language preferences of the target population. Furthermore, delivering an intervention through text messages has the potential to improve caregiver behaviors and reduce SSB intake among rural caregivers and adolescents. Findings from this study were used to develop a larger bank of text messages, which would be used in a future study, testing the effectiveness of a text message intervention targeting SSB intake–related caregiver behaviors.

scholarly journals The candidate perspective of the clinical competency test (CCT) of the MICGP examination: a mixed-methods study

BJGP Open ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. bjgpopen18X101605 ◽  
Author(s):  
Tony Foley ◽  
Kathleen McLoughlin ◽  
Elaine K Walsh ◽  
Paul Leggett ◽  
Muríosa O'Reilly ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
General Practitioners ◽  
Clinical Skills ◽  
Mixed Methods Study ◽  
Clinical Competency ◽  
Online Questionnaire ◽  
Clinical Skills Assessment ◽  
Time Restrictions ◽  
Study Results

BackgroundThe clinical competency test (CCT) was introduced by the Irish College of General Practitioners (ICGP) in 2015. Similar to the clinical skills assessment (CSA) of the Membership of the Royal College of General Practitioners exam (MRCGP), the CCT is a modified objective structured clinical examination (OSCE).AimThe aim of this study was to evaluate the MICGP CCT from the candidates' perspective, to gain an insight into their views of its fairness, relevance, and acceptability.Design & settingThis mixed-methods study was conducted with GP registrars in Ireland.MethodThe study was conducted in two phases. Firstly, focus groups were conducted with participants who had previously undertaken the CCT to explore their experience of the CCT. Secondly, findings from the focus groups informed the development of an online questionnaire, which was sent to all GP registrars who completed the CCT in the 2017 summer sitting.ResultsTwo focus groups were held with a total of nine participants. Following this, the online questionnaire was emailed to 134 registrars. Of these, 83 registrars completed the questionnaire in full. Registrars reported that the CCT is a fair exam and is relevant to daily general practice. They considered the exam to be a comprehensive assessment that has a positive educational impact. However, they were challenged by time restrictions, and found it financially and emotionally stressful.ConclusionThis is the first study to evaluate the candidate’s perspective of an exiting GP membership exam in the UK or Ireland. The CCT is well-regarded by registrars. The study results will help to inform the future development of the CCT exam.

Understanding Diabetes-Related Distress Characteristics and Psychosocial Support Preferences of Urban African American Adults Living With Type 2 Diabetes: A Mixed-Methods Study

2018 ◽  
Vol 44 (2) ◽  
pp. 144-157 ◽  
Author(s):  
Sula Hood ◽  
Amy Irby-Shasanmi ◽  
Mary de Groot ◽  
Elissabeth Martin ◽  
Andrew S. LaJoie
Keyword(s):  
Type 2 Diabetes ◽  
African American ◽  
Mixed Methods ◽  
Focus Groups ◽  
Psychosocial Support ◽  
Phase 1 ◽  
Culturally Appropriate ◽  
African American Adults

Purpose The purpose of this study is to understand diabetes-related distress (DRD) characteristics and identify psychosocial support preferences of urban African American adults living with type 2 diabetes (T2DM). Methods A 2-phase, mixed-methods sequential explanatory study design was used to gather data. In phase 1, a purposive sample of participants (N = 155) was recruited and asked to complete a written survey. The Diabetes Distress Scale (DDS17) was used to assess DRD, including subscales—emotional burden (EB), regimen distress (RD), interpersonal distress (ID), and physician distress (PD). In phase 2, a subset of phase 1 participants (N = 23) volunteered to attend 1 of 4 gender-stratified follow-up focus groups to contextualize the quantitative survey results. Results Survey findings indicate that on average, participants had moderate levels of DRD (aggregate), RD, and EB but had low ID and PD. During follow-up focus groups, participants described RD and EB as their primary distress types and emphasized that clinicians should prioritize the mental health aspects of T2DM similarly to its physical aspects. Participants expressed a desire for culturally appropriate peer support groups as a psychosocial support resource for distress coping and specifically requested the development of gender-stratified groups and groups for young adults. Conclusions Results support the need to screen for and address diabetes-related distress among African American patients with T2DM. Findings also inform the development of culturally appropriate psychosocial support resources to facilitate diabetes-related distress coping.

The Development of an Online Tobacco Tracker Tool to Crowdsource Campus Environmental Reports for Smoke and Tobacco Free College Policies: A Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Sabrina F. Loureiro ◽  
Kim M. Pulvers ◽  
Melissa M. Gosdin ◽  
Keavagh R. Clift ◽  
Myra J. Rice ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Positive Reinforcement ◽  
The United States ◽  
College Campuses ◽  
Policy Enforcement ◽  
Sequential Mixed Methods ◽  
Effective Policy ◽  
Online Tracking ◽  
One Year

BACKGROUND College campuses in the United States have begun implementing Smoke and Tobacco-Free policies to discourage the use of tobacco. Smoke and Tobacco-Free policies, however, are contingent upon effective policy enforcement. OBJECTIVE To develop an empirically-derived online tracking tool (Tracker) for crowdsourcing campus environmental reports of tobacco use and waste to support smoke and tobacco-free college policies. METHODS An exploratory sequential mixed methods approach was utilized to inform the development and evaluation of the Tracker. In October 2018, three focus groups across two California universities were conducted and themes were analyzed, guiding Tracker development. After one year of implementation, users were asked in April 2020 to complete a survey about their experience. RESULTS In the focus groups, two major themes emerged: barriers and facilitators to tool utilization. Further Tracker development was guided by focus group input to address these barriers (e.g. information, policing, and logistical concerns) and facilitators (e.g. environmental motivators, positive reinforcement). Amongst 1,163 Tracker reports, those who completed the user survey (n=316) reported the top motivations to using the tool were having a cleaner environment (79%) and health concerns (69%). CONCLUSIONS Environmental concerns, a motivator which emerged in focus groups, shaped the Tracker’s development and was cited by the majority of users surveyed as a top motivator for utilization.

scholarly journals A theoretically informed, mixed-methods study of pharmacists’ aspirations and readiness to implement pharmacist prescribing

2021 ◽  
Author(s):  
Derek Stewart ◽  
Abdulrouf Pallivalapila ◽  
Binny Thomas ◽  
Yolande Hanssens ◽  
Wessam El Kassem ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Tertiary Care ◽  
Pharmacy Practice ◽  
Principal Component ◽  
Management Support ◽  
Pharmacist Prescribing ◽  
Facilitators And Barriers ◽  
Physician Resistance ◽  
Inner Setting

AbstractBackground Studies have highlighted advancing clinical pharmacy practice in Qatar. Objective To explore pharmacists’ aspirations and readiness to implement pharmacist prescribing. Setting Hamad Medical Corporation (HMC), the main provider of secondary and tertiary care. Method A sequential explanatory mixed-methods design. Questionnaire items were derived from the Consolidated Framework of Implementation Research (CFIR), in domains of: awareness/support; readiness; implementation; and facilitators and barriers. Following piloting, all pharmacists (n = 554) were invited to participate. Questionnaire data were analysed using descriptive and inferential statistics with principal component analysis of attitudinal items. Focus groups were recorded, transcribed and analysed using the Framework Approach. Main outcome measure Aspirations and readiness to implement pharmacist prescribing. Results The response rate was 62.8% (n = 348), with respondents highly supportive of implementation in Qatar (median 4, scale 0–5, extremely supportive). The majority (64.9%, n = 226) considered themselves ready, particularly those more senior (p < 0.05) and classifying themselves innovative (p < 0.01). Outpatient (72.9%, n = 221 agreeing) and inpatient (71.1%, n = 218 agreeing) HMC settings were those perceived as being most ready. PCA identified 2 components, with ‘personal attributes’ being more positive than ‘prescribing support’. Facilitators were access to records, organizational/management support and the practice environment, with physician resistance and scope of practice as barriers. Focus groups provided explanation, with themes in CFIR domains of innovation characteristics, characteristics of individuals and the inner setting. Conclusion HMC pharmacists largely aspire, and consider themselves ready, to be prescribers with inpatient and outpatient settings most ready. CFIR domains and constructs identified as facilitators and barriers should be focus for implementation.

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