scholarly journals Using the behavior change wheel to identify barriers to and potential solutions for primary care clinical guideline use in four provinces in South Africa

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Tamara Kredo ◽  
Sara Cooper ◽  
Amber Abrams ◽  
Jocelyn Muller ◽  
Jimmy Volmink ◽  
...  
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Behavior Change ◽  
Clinical Guideline ◽  
Behavior Change Wheel

scholarly journals Influencers on deprescribing practice of primary healthcare providers in Nova Scotia: An examination using behavior change frameworks

2020 ◽  
Vol 4 ◽  
pp. 239920262092250
Author(s):  
Natalie Kennie-Kaulbach ◽  
Rachel Cormier ◽  
Olga Kits ◽  
Emily Reeve ◽  
Anne Marie Whelan ◽  
...  
Keyword(s):  
Primary Care ◽  
Nova Scotia ◽  
Behavior Change ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
System Level ◽  
Care Providers ◽  
Behavior Change Wheel ◽  
Primary Healthcare Providers

Background: Deprescribing is a complex process requiring consideration of behavior change theory to improve implementation and uptake. Aim: The aim of this study was to describe the knowledge, attitudes, beliefs, and behaviors that influence deprescribing for primary healthcare providers (family physicians, nurse practitioners (NPs), and pharmacists) within Nova Scotia using the Theoretical Domains Framework version 2 (TDF(v2)) and the Behavior Change Wheel. Methods: Interviews and focus groups were completed with primary care providers (physicians, NPs, and pharmacists) in Nova Scotia, Canada. Coding was completed using the TDF(v2) to identify the key influencers. Subdomain themes were also identified for the main TDF(v2) domains and results were then linked to the Behavior Change Wheel—Capability, Opportunity, and Motivation components. Results: Participants identified key influencers for deprescribing including areas related to Opportunity, within TDF(v2) domain Social Influences, such as patients and other healthcare providers, as well as Physical barriers (TDF(v2) domain Environmental Context and Resources), such as lack of time and reimbursement. Conclusion: Our results suggest that a systematic approach to deprescribing in primary care should be supported by opportunities for patient and healthcare provider collaborations, as well as practice and system level enhancements to support sustainability of deprescribing practices.

scholarly journals The Kidney Score Platform for Patient and Clinician Awareness, Communication, and Management of Kidney Disease: Protocol for a Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Delphine S Tuot ◽  
Susan T Crowley ◽  
Lois A Katz ◽  
Joseph Leung ◽  
Delly K Alcantara-Cadillo ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Behavior Change ◽  
Practice Guidelines ◽  
Risk Calculator ◽  
National Kidney Foundation ◽  
Primary Care Settings ◽  
Behavior Change Wheel

BACKGROUND Patient awareness, clinician detection, and management of chronic kidney disease remain suboptimal, despite clinical practice guidelines and diverse education programs. OBJECTIVE This protocol describes a study to develop and investigate the impact of the National Kidney Foundation Kidney Score Platform on chronic kidney disease awareness, communication, and management, by leveraging the Behavior Change Wheel, an implementation science framework that helps identify behavioral intervention targets and functions that address barriers to behavior change. METHODS We interviewed 20 patients with chronic kidney disease and 11 clinicians to identify patient and clinician behaviors suitable for intervention and barriers to behavior change (eg, limited awareness of chronic kidney disease clinical practice guidelines within primary care settings, limited data analytics to highlight chronic kidney disease care gaps, asymptomatic nature of chronic kidney disease in conjunction with patient reliance on primary care clinicians to determine risk and order kidney testing). Leveraging the Behavior Change Wheel, the Kidney Score Platform was developed with a patient-facing online Risk Calculator and a clinician-facing Clinical Practice Toolkit. The Risk Calculator utilizes risk predictive analytics to provide interactive health information tailored to an individual’s chronic kidney disease risk and health status. The Clinical Practice Toolkit assists clinicians in discussing chronic kidney disease with individuals at risk for and with kidney disease and in managing their patient population with chronic kidney disease. The Kidney Score Platform will be tested in 2 Veterans Affairs primary health care settings using a pre–post study design. Outcomes will include changes in patient self-efficacy for chronic kidney disease management (primary outcome), quality of communication with clinicians about chronic kidney disease, and practitioners’ knowledge of chronic kidney disease guidelines. Process outcomes will identify usability and adoption of different elements of the Kidney Score Platform using qualitative and quantitative methods. RESULTS As of September 2020, usability studies are underway with veterans and clinicians to refine the patient-facing components of the Kidney Score Platform before study initiation. Results and subsequent changes to the Kidney Score Platform will be published at a later date. The study is expected to be completed by December 2021. CONCLUSIONS Results of this study will be used to inform integration of the Kidney Score Platform within primary care settings so that it can serve as a central component of the National Kidney Foundation public awareness campaign to educate, engage, and empower individuals at risk for and living with chronic kidney disease. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/22024

scholarly journals The Kidney Score Platform for Patient and Clinician Awareness, Communication, and Management of Kidney Disease: Protocol for a Mixed Methods Study

10.2196/22024 ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. e22024
Author(s):  
Delphine S Tuot ◽  
Susan T Crowley ◽  
Lois A Katz ◽  
Joseph Leung ◽  
Delly K Alcantara-Cadillo ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Behavior Change ◽  
Practice Guidelines ◽  
Risk Calculator ◽  
National Kidney Foundation ◽  
Primary Care Settings ◽  
Behavior Change Wheel

Background Patient awareness, clinician detection, and management of chronic kidney disease remain suboptimal, despite clinical practice guidelines and diverse education programs. Objective This protocol describes a study to develop and investigate the impact of the National Kidney Foundation Kidney Score Platform on chronic kidney disease awareness, communication, and management, by leveraging the Behavior Change Wheel, an implementation science framework that helps identify behavioral intervention targets and functions that address barriers to behavior change. Methods We interviewed 20 patients with chronic kidney disease and 11 clinicians to identify patient and clinician behaviors suitable for intervention and barriers to behavior change (eg, limited awareness of chronic kidney disease clinical practice guidelines within primary care settings, limited data analytics to highlight chronic kidney disease care gaps, asymptomatic nature of chronic kidney disease in conjunction with patient reliance on primary care clinicians to determine risk and order kidney testing). Leveraging the Behavior Change Wheel, the Kidney Score Platform was developed with a patient-facing online Risk Calculator and a clinician-facing Clinical Practice Toolkit. The Risk Calculator utilizes risk predictive analytics to provide interactive health information tailored to an individual’s chronic kidney disease risk and health status. The Clinical Practice Toolkit assists clinicians in discussing chronic kidney disease with individuals at risk for and with kidney disease and in managing their patient population with chronic kidney disease. The Kidney Score Platform will be tested in 2 Veterans Affairs primary health care settings using a pre–post study design. Outcomes will include changes in patient self-efficacy for chronic kidney disease management (primary outcome), quality of communication with clinicians about chronic kidney disease, and practitioners’ knowledge of chronic kidney disease guidelines. Process outcomes will identify usability and adoption of different elements of the Kidney Score Platform using qualitative and quantitative methods. Results As of September 2020, usability studies are underway with veterans and clinicians to refine the patient-facing components of the Kidney Score Platform before study initiation. Results and subsequent changes to the Kidney Score Platform will be published at a later date. The study is expected to be completed by December 2021. Conclusions Results of this study will be used to inform integration of the Kidney Score Platform within primary care settings so that it can serve as a central component of the National Kidney Foundation public awareness campaign to educate, engage, and empower individuals at risk for and living with chronic kidney disease. International Registered Report Identifier (IRRID) PRR1-10.2196/22024

A Scoping Review of Behavior Change Interventions to Decrease Health Care Disparities for Patients With Disabilities in a Primary Care Setting: Can Social Marketing Play a Role?

2021 ◽  
Vol 27 (1) ◽  
pp. 48-63
Author(s):  
Angela Makris ◽  
Mahmooda Khaliq ◽  
Elizabeth Perkins
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavior Change ◽  
Social Marketing ◽  
Health Care Disparities ◽  
Social Model ◽  
Care Providers ◽  
Social Model Of Disability ◽  
Behavior Change Interventions ◽  
The Social

Background: One in four Americans have a disability but remain an overlooked minority population at risk for health care disparities. Adults with disabilities can be high users of primary care but often face unmet needs and poor-quality care. Providers lack training, knowledge and have biased practices and behaviors toward people with disabilities (PWD); which ultimately undermines their quality of care. Focus of the Article: The aim is to identify behavior change interventions for decreasing health care disparities for people with disabilities in a healthcare setting, determine whether those interventions used key features of social marketing and identify gaps in research and practice. Research Question: To what extent has the social marketing framework been used to improve health care for PWD by influencing the behavior of health care providers in a primary health care setting? Program Design/Approach: Scoping Review. Importance to the Social Marketing Field: Social marketing has a long and robust history in health education and public health promotion, yet limited work has been done in the disabilities sector. The social marketing framework encompasses the appropriate features to aligned with the core principles of the social model of disability, which espouses that the barriers for PWD lie within society and not within the individual. Incorporating elements of the social model of disability into the social marketing framework could foster a better understanding of the separation of impairment and disability in the healthcare sector and open a new area of research for the field. Results: Four articles were found that target primary care providers. Overall, the studies aimed to increase knowledge, mostly for clinically practices and processes, not clinical behavior change. None were designed to capture if initial knowledge gains led to changes in behavior toward PWD. Recommendations: The lack of published research provides an opportunity to investigate both the applicability and efficacy of social marketing in reducing health care disparities for PWD in a primary care setting. Integrating the social model of disability into the social marketing framework may be an avenue to inform future interventions aimed to increase health equity and inclusiveness through behavior change interventions at a systems level.

scholarly journals High Uptake of Systematic HIV Counseling and Testing and TB Symptom Screening at a Primary Care Clinic in South Africa

PLoS ONE ◽  
2014 ◽  
Vol 9 (9) ◽  
pp. e105428 ◽  
Author(s):  
Annelies Van Rie ◽  
Kate Clouse ◽  
Colleen Hanrahan ◽  
Katerina Selibas ◽  
Ian Sanne ◽  
...  
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Primary Care Clinic ◽  
High Uptake ◽  
Care Clinic ◽  
Hiv Counseling And Testing ◽  
Hiv Counseling ◽  
Symptom Screening ◽  
Counseling And Testing

scholarly journals Inconsistent Condom Use among Public Primary Care Patients with Tuberculosis in South Africa

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Gladys Matseke ◽  
Karl Peltzer ◽  
Julia Louw ◽  
Pamela Naidoo ◽  
Gugu Mchunu ◽  
...  
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Condom Use ◽  
Multivariable Analysis ◽  
High Rate ◽  
Consistent Condom ◽  
Consistent Condom Use ◽  
Inconsistent Condom ◽  
The Past ◽  
Inconsistent Condom Use

The high rate of HIV infections among tuberculosis (TB) patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR=1.66; 95% CI 1.25–2.20) or cohabitating or separated, divorced, or widowed (OR=3.67; 1.85–7.29), lower educational level (OR=0.66; 0.46–0.94), greater poverty (OR=1.60; 1.25–2.20), not having HIV status disclosed (OR=0.34; 0.25–0.48), sexual partner on antiretroviral treatment (OR=0.38; 0.23–0.60), and partner alcohol use before sex (OR=1.56; 1.30–1.90) were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.

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