scholarly journals Adaptations and modifications to a co-designed intervention and its clinical implementation: a qualitative study in Denmark

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeanette Wassar Kirk ◽  
Per Nilsen ◽  
Ove Andersen ◽  
Nina Thórný Stefánsdóttir ◽  
Birk Grønfeldt ◽  
...  
Keyword(s):  
Design Process ◽  
Evidence Based ◽  
Mixed Result ◽  
Medical Patients ◽  
Clinical Implementation ◽  
Structured Interviews ◽  
Implementation Plan ◽  
Different Types ◽  
Impact Framework ◽  
And Control

Abstract Background There is a long-standing debate in implementation research on whether adaptations to evidence-based interventions (EBIs) are desirable in health care. If an intervention is adapted and not delivered as conceived and planned, it is said to have low fidelity. The WALK-Cph project was developed based on the assumption that involving stakeholders in co-design processes would facilitate the fidelity of an intervention to increase the mobility of acutely admitted older medical patients and its implementation in two hospitals in Denmark. The purpose of this study is to describe and analyse adaptations and modifications that were made to the co-designed WALK-Cph intervention and its implementation. Methods This study used a qualitative design. An ethnographic field study was performed using participant observations, workshops and semi-structured interviews. Data were analysed twice using the Framework Method. The first analysis was based on the frameworks from Stirman, Moore and Proctor. The second analysis, a retrospective modifications analysis, was based on the Adaptation-Impact Framework. Results Many different types of adaptations and modifications were made to the WALK-Cph intervention and its implementation plan. Most of the modifications were made on the contents of the intervention. In total, 44 adaptations and modifications were made, of which 21 were planned (adaptations) and 23 were made haphazardly (modifications). Most of the content and context adaptations and modifications made on the intervention had a mixed result regarding enhanced fidelity. The retrospective modifications analysis showed that modifications were ongoing and both situationally and contextually shaped. Conclusions Although an extensive co-design process was carried out to facilitate the fidelity of the WALK-Cph intervention, this study showed that many adaptations and modifications were still made to both the intervention and its implementation plan. It could indicate that the co-design process had a small effect or that adaptations and modifications are ongoing and both situationally and contextually shaped, which challenge the assumption and the desire to be able to plan and control changes.

An Analysis on the Implementation of the Evidence-based PCOS Lifestyle Guideline: Recommendations from Women with PCOS

2021 ◽  
Vol 39 (03/04) ◽  
pp. 153-160
Author(s):  
Siew Lim ◽  
Breanna Wright ◽  
Melissa Savaglio ◽  
Denise Goodwin ◽  
Stephanie Pirotta ◽  
...  
Keyword(s):  
Peer Support ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Evidence Based ◽  
Structured Interviews ◽  
Ovary Syndrome ◽  
Implementation Plan ◽  
Lifestyle Management ◽  
Evidence Based Guideline ◽  
Recurrent Theme

AbstractPolycystic ovary syndrome (PCOS) is the most common endocrinological disorder affecting women of reproductive age, affecting 8–13% in this group. Women with PCOS are more likely to have excess BMI, which in turn exacerbates the symptoms of PCOS in these women. The latest evidence-based guideline recommends lifestyle management as the first-line treatment for PCOS. However, the implementation of this recommendation through health services faces a significant challenge. As part of the mapping of the implementation plan for lifestyle management in PCOS, citizen panels and semi-structured interviews were conducted to capture the voices of consumers. Women with PCOS expressed the need for multidisciplinary, integrated care as a recurrent theme. Other important considerations included health professionals who listen and are open to learning about PCOS, the empowerment of women to self-manage PCOS and the provision of peer support. Women with PCOS also expressed the key recommendation of focusing on practical skills when providing lifestyle advice. Within that, both individual and group lifestyle sessions were valued for privacy and peer support respectively and delivery by a dietitian is preferred. These recommendations by women with PCOS should be considered when developing the implementation plan for the PCOS lifestyle guideline.

scholarly journals Challenges in co-designing an intervention to increase mobility in older patients: a qualitative study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jeanette Kirk ◽  
Thomas Bandholm ◽  
Ove Andersen ◽  
Rasmus Skov Husted ◽  
Tine Tjørnhøj-Thomsen ◽  
...  
Keyword(s):  
Design Process ◽  
Contextual Knowledge ◽  
Medical Patients ◽  
Physical Effort ◽  
Content Type ◽  
Health Care Intervention ◽  
Types Of Knowledge ◽  
Different Types ◽  
Time Required ◽  
Practical Implications

PurposeThe aim of this study is to explore and discuss key challenges associated with having stakeholders take part in co-designing a health care intervention to increase mobility in older medical patients admitted to two medical departments at two hospitals in Denmark.Design/methodology/approachThe study used a qualitative design to investigate the challenges of co-designing an intervention in five workshops involving health professionals, patients and relatives. “Challenges” are understood as “situations of being faced with something that needs great mental or physical effort in order to be done successfully and therefore tests a person's ability” (Cambridge Dictionary). Thematic content analysis was conducted with a background in the analytical question: “What key challenges arise in the material in relation to the co-design process?”.FindingsTwo key challenges were identified: engagement and facilitation. These consisted of five sub-themes: recruiting patients and relatives, involving physicians, adjusting to a new researcher role, utilizing contextual knowledge and handling ethical dilemmas.Research limitations/implicationsThe population of patients and relatives participating in the workshops was small, which likely affected the co-design process.Practical implicationsResearchers who want to use co-design must be prepared for the extra time required and the need for skills concerning engagement, communication, facilitation, negotiation and resolution of conflict. Time is also required for ethical discussions and considerations concerning different types of knowledge creation.Originality/valueEngaging stakeholders in co-design processes is increasingly encouraged. This study documents the key challenges in such processes and reports practical implications.

Information work of hospital librarians: Making the invisible visible

2021 ◽  
pp. 096100062110632
Author(s):  
Fredrik Hanell ◽  
Sara Ahlryd
Keyword(s):  
Information Seeking ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Practices ◽  
Structured Interviews ◽  
Building Relationships ◽  
Different Types ◽  
Field Notes ◽  
Information Work ◽  
Work Done

The aim of this paper is to explore and to make visible how the information work of hospital librarians is enacted in key practices where services of the hospital library are employed to support evidence-based practice. The empirical material was produced at three hospital libraries in three different regions in Sweden between January and March 2020. A practice-oriented approach using the theoretical lens information work is employed to analyze nine semi-structured interviews with hospital librarians and hospital library managers, together with field notes from observations of interactions between hospital librarians and healthcare practitioners. The analysis investigates the conditions for information work performed by hospital librarians as they participate in three key practices: clinical practices, information seeking practices, and HTA-practices. The results of the analysis are related to four categories of invisible information work, and the nature of the information work done to counter different types of invisibilities within the key practices is discussed. The findings suggest that a substantial amount of the information work of hospital librarians is invisible to clinicians. At the same time, considerable efforts are made by hospital librarians to counter different types of invisibility, for example through building relationships with healthcare staff and to develop and make specialized competencies visible. In particular, the importance assigned to evidence-based practice in healthcare allows for the librarians to be regarded by clinicians as legitimate partners with clearly defined competencies in specific situations.

Knowledge and Awareness of Dengue Fever

2018 ◽  
pp. 219-222
Author(s):  
Y. Arockia Suganthi ◽  
Chitra K. ◽  
J. Magelin Mary
Keyword(s):  
Dengue Fever ◽  
Prevention And Control ◽  
Control Measures ◽  
Infection Transmission ◽  
Standard Guideline ◽  
The World ◽  
Different Types ◽  
Prevention And Control Measures ◽  
Dengue Prevention ◽  
And Control

Dengue fever is a painful mosquito-borne infection caused by different types of virus in various localities of the world. There is no particular medicine or vaccine to treat person suffering from dengue fever. Dengue viruses are transmitted by the bite of female Aedes (Ae) mosquitoes. Dengue fever viruses are mainly transmitted by Aedes which can be active in tropical or subtropical climates. Aedes Aegypti is the key step to avoid infection transmission to save millions of people in all over the world. This paper provides a standard guideline in the planning of dengue prevention and control measures. At the same time gives the priorities including clinical management and hospitalized dengue patients have to address essentially.

The effect of realistic mathematics education on student achievement in 8th grades geometric objects teaching

2021 ◽  
Vol 9 (1) ◽  
pp. 20-31
Author(s):  
Hasan Huseyin Aksu ◽  
Keyword(s):  
Academic Success ◽  
Traditional Approach ◽  
T Test ◽  
Learning Activities ◽  
Control Group ◽  
Structured Interviews ◽  
Significance Level ◽  
8Th Grade ◽  
And Control ◽  
Dependent Samples

The purpose of this study is to answer if there is a reasonable difference on academical success of students who get education with traditional and RME approach question on “Teaching geometrical objects to 8th grade students” subject. Study group consists of 47 students which contains 21 experimental and 16 control group from “Ordu Anadolu İmam Hatip High School Project School” in Altinordu, Ordu. Experimental and control group have same academical success level, as the school which this study has runned is a school which accepts students with an exam only. After the experimental and control groups were created, a 25 question pre-test was performed to understand the level of knowledge of the group regarding geometrical objects. The same test was performed on the same groups 8 weeks later as retention test. To determine opinions of the students in experimental group regarding RME and related learning activities, semi-structured interviews are conducted. The data obtained from the pretest, posttest and retention tests were analyzed with t-test for independent samples and t-test for dependent samples and variance analysis for mixed measurements with 0.05 significance level. According to the results, it is seen that learning activities prepared according to RME approach are much more effective than learning activities prepared according to the traditional approach on students’ academic success.

scholarly journals Theory-based approach to developing an implementation plan to support the adoption of a patient decision aid for Down syndrome prenatal screening

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Titilayo Tatiana Agbadjé ◽  
Matthew Menear ◽  
Marie-Pierre Gagnon ◽  
France Légaré
Keyword(s):  
Prenatal Care ◽  
Knowledge Translation ◽  
Pregnant Women ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Clinical Implementation ◽  
Implementation Plan ◽  
Translation Strategies ◽  
Knowledge To Action ◽  
Knowledge Translation Strategies

Abstract Background Our team has developed a decision aid to help pregnant women and their partners make informed decisions about Down syndrome prenatal screening. However, the decision aid is not yet widely available in Quebec’s prenatal care pathways. Objective We sought to identify knowledge translation strategies and develop an implementation plan to promote the use of the decision aid in prenatal care services in Quebec, Canada. Methods Guided by the Knowledge-to-Action Framework and the Theoretical Domains Framework, we performed a synthesis of our research (11 publications) on prenatal screening in Quebec and on the decision aid. Two authors independently reviewed the 11 articles, extracted information, and mapped it onto the Knowledge-to-Action framework. Using participatory action research methods, we then recruited pregnant women, health professionals, managers of three prenatal care services, and researchers to (a) identify the different clinical pathways followed by pregnant women and (b) select knowledge translation strategies for a clinical implementation plan. Then, based on all the information gathered, the authors established a consensus on strategies to include in the plan. Results Our knowledge synthesis showed that pregnant women and their partners are not sufficiently involved in the decision-making process about prenatal screening and that there are numerous barriers and facilitators of the use of the decision aid in clinical practice (e.g., low intention to use it among health providers). Using a participatory action approach, we met with five pregnant women, three managers, and six health professionals. They informed us about three of Quebec’s prenatal care pathways and helped us identify 20 knowledge translation strategies (e.g., nurse discusses decision aid with women before they meet the doctor) to include in a clinical implementation plan. The research team reached a consensus about the clinical plan and also about broader organizational strategies, such as training healthcare providers in the use of the decision aid, monitoring its impact (e.g., measure decisional conflict) and sustaining its use (e.g., engage key stakeholders in the implementation process). Conclusion Next steps are to pilot our implementation plan while further identifying global strategies that target institutional, policy, and systemic supports for implementation.

scholarly journals ‘I was really, really shocked’: A sociological exploration of the transition experiences of English Youth Academy male footballers from school to work

2021 ◽  
pp. 101269022110054
Author(s):  
Nicola Hague ◽  
Graeme Law
Keyword(s):  
Young Children ◽  
Children And Adolescents ◽  
Thematic Analysis ◽  
School To Work ◽  
Structured Interviews ◽  
Professional Career ◽  
Professional Experiences ◽  
Transitional Experiences ◽  
The World ◽  
Different Types

The world of football arguably brings together and unites people in support of their teams and countries, while inspiring young children and adolescents to dream of a professional career. Existing research in the field has sought to begin to understand what professional footballers experience on their journey through the game. However, much of this UK-based research has focused on first team players and their professional experiences, including transitions from youth team to first team and to retirement. This study, therefore, aimed to examine players during their youth academy scholarship at one English Championship club. This study focused on the transitional experiences of youth players from school to the academy and their resulting embodying of a footballer’s identity. Twelve semi-structured interviews with players aged 17–19, were conducted and then analysed by thematic analysis using figurational sociology concepts. Three different types of transition were identified. Among other reasons, early specialisation in football was a prevalent factor that partly influenced the way the players experienced their transition. The transition into the academy coincided with the transition from youth to adulthood that was arguably anything but linear as players managed the dominant sub-cultures present in the club.

Asking the Hard Questions: Psychologists’ Discomfort With Inquiring About Sexual Abuse Histories

2021 ◽  
pp. 107780122110145
Author(s):  
Belinda Nixon ◽  
Elly Quinlan
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Mental Health Professionals ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Early Career ◽  
Evidence Based ◽  
Structured Interviews ◽  
Early Career Psychologists ◽  
University Training

The literature on sexual abuse indicates low rates of inquiry by mental health professionals. This study explores early career psychologists’ experiences of inquiry into their clients’ sexual abuse histories. Twelve Australian psychologists participated in semi-structured interviews with transcripts analyzed using thematic analysis. The vast majority of participants reported that they did not routinely inquire about sexual abuse with barriers including not knowing what to do, discomfort, stigma, and fear of negative outcomes. Participants asserted that their university training in sexual abuse inquiry was inadequate. Findings emphasize the need for the development of an evidence-based framework for sexual abuse training.

scholarly journals From Evidence to Design Solution—On How to Handle Evidence in the Design Process of Sustainable, Accessible and Health-Promoting Landscapes

2021 ◽  
Vol 13 (6) ◽  
pp. 3249
Author(s):  
Marie C. Gramkow ◽  
Ulrik Sidenius ◽  
Gaochao Zhang ◽  
Ulrika K. Stigsdotter
Keyword(s):  
Design Process ◽  
Process Model ◽  
Design Solution ◽  
Design Criteria ◽  
Evidence Based ◽  
Design Program ◽  
Evidence Collection ◽  
Health Promoting ◽  
Development Goals ◽  
Programming Step

The work of landscape architects can contribute to the United Nation’s Sustainable Development Goals and the associated ‘Leave no one behind’ agenda by creating accessible and health-promoting green spaces (especially goals 3, 10 and 11). To ensure that the design of green space delivers accessibility and intended health outcomes, an evidence-based design process is recommended. This is a challenge, since many landscape architects are not trained in evidence-based design, and leading scholars have called for methods that can help landscape architects work in an evidence-based manner. This paper examines the implementation of a process model for evidence-based health design in landscape architecture. The model comprises four steps: ‘evidence collection’, ‘programming’, ‘designing’, and ‘evaluation’. The paper aims to demonstrate how the programming step can be implemented in the design of a health-promoting nature trail that is to offer people with mobility disabilities improved mental, physical and social health. We demonstrate how the programming step systematizes evidence into design criteria (evidence-based goals) and design solutions (how the design criteria are to be solved in the design). The results of the study are presented as a design ‘Program’, which we hope can serve as an example for landscape architects of how evidence can be translated into design.

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