scholarly journals Building implementation capacity in health care and welfare through team training—study protocol of a longitudinal mixed-methods evaluation of the building implementation capacity intervention

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Hanna Augustsson ◽  
Veronica-Aurelia Costea ◽  
Leif Eriksson ◽  
Henna Hasson ◽  
Annika Bäck ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Behavior Change ◽  
Cost Effective ◽  
Team Training ◽  
Evidence Based ◽  
Knowledge And Skills ◽  
Individual Level ◽  
Mixed Methods Evaluation ◽  
Implementation Capacity

Abstract Background To ensure the provision of high-quality safety and cost-effective health and welfare services, managers and professionals are required to introduce and ensure the routine use of clinical guidelines and other evidence-based interventions. Despite this, they often lack training and support in implementation. This project aims to investigate how a team training intervention, with the goal to build implementation capacity, influences participants’ implementation knowledge and skills, as well as how it influences implementation activities and implementation capacity within participating health and welfare organizations. Furthermore, the aim is to investigate how the organizations’ contexts influence the intervention outcomes. Methods The building implementation capacity (BIC) intervention builds on the behavior change wheel, which considers implementation as a matter of behavior change. The intervention will be provided to teams of managers and professionals working in health and welfare organizations and seeking support to implement a guideline- or evidence-based intervention. The intervention consists of a series of interactive workshops that provides the participating teams with the knowledge and skills to apply a systematic implementation model. A longitudinal mixed-methods evaluation, including interviews, surveys, and document analysis, will be applied over 24 months. The normalization process theory measure will be used to assess how the intervention influences implementation activities in practice and implementation capacity in the teams and the wider organizations. Discussion This project has an ambition to add to the knowledge concerning how to promote the uptake of research findings into health care by building implementation capacity through team training in implementation. The project’s uniqueness is that it is designed to move beyond individual-level outcomes and evaluate implementation activities and implementation capacity in participating organizations. Further, the intervention will be evaluated over 24 months to investigate long-term outcomes of implementation training.

A Mixed-Methods Evaluation of Diabetic Retinopathy Screening Supported by Provincial Health-Care Administrative Data

2021 ◽  
Vol 45 (7) ◽  
pp. S31
Author(s):  
James Bowen ◽  
Aleksandra Stanimirovic ◽  
Olivera Sutakovic ◽  
Conrad Pow ◽  
Debbie Sissmore ◽  
...  
Keyword(s):  
Health Care ◽  
Diabetic Retinopathy ◽  
Mixed Methods ◽  
Administrative Data ◽  
Diabetic Retinopathy Screening ◽  
Mixed Methods Evaluation ◽  
Retinopathy Screening

scholarly journals Building implementation capacity (BIC): a longitudinal mixed methods evaluation of a team intervention

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Rebecca Mosson ◽  
Hanna Augustsson ◽  
Annika Bäck ◽  
Mårten Åhström ◽  
Ulrica von Thiele Schwarz ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Mixed Methods Evaluation ◽  
Implementation Capacity

scholarly journals Medication Adherence, When Lifestyle Is the Medicine

2017 ◽  
Vol 11 (5) ◽  
pp. 397-403 ◽  
Author(s):  
Mark D. Faries ◽  
Alyssa Abreu
Keyword(s):  
Medication Adherence ◽  
Behavior Change ◽  
Emotional Regulation ◽  
Evidence Based ◽  
Vicarious Experience ◽  
Past Performance ◽  
Knowledge And Skills ◽  
Constructive Feedback ◽  
Coping Planning ◽  
Mastery Experience

Giving patients insight, knowledge, and skills, although important, may not alone be enough for behavior change maintenance. Rather, the health care provider (HCP) has an important role in fostering behavior change and maintenance by asking, “Why do people change?” and “What can I do to help?” This review highlights 4 evidence-based factors related to medication adherence, when lifestyle is the medicine. (1) Autonomy is the belief that one is the origin of his or her own actions, and must be supported by the HCP (eg, “My HCP listens to how I would like to do things regarding my health”). (2) Competence and confidence ensure that patients believe they can succeed. These are gained through mastery experience, vicarious experience, and through positive and constructive feedback on past performance (eg, “My HCP conveys confidence in my ability to make changes regarding my health”). (3) Coping planning is being able to formulate a plan of intention, with the awareness of barriers and emotional regulation that can inhibit patient behavior (eg, “I feel able to share my feelings with my HCP”). (4) Personal values of the patients are used to understand how and why they cope when there is a threat to these values (eg, “My HCP tries to understand how I see my health before suggesting any changes”).

scholarly journals Evaluation of the Balanced Menus Challenge: a healthy food and sustainability programme in hospitals in Maryland

2014 ◽  
Vol 18 (13) ◽  
pp. 2341-2349 ◽  
Author(s):  
Tarah D Ranke ◽  
C Louise Mitchell ◽  
Diane Marie St. George ◽  
Christopher R D’Adamo
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Cost Effective ◽  
Washington Dc ◽  
Previous Survey ◽  
Structured Interviews ◽  
Health Care Settings ◽  
Retrospective Assessment ◽  
Good Nutrition ◽  
National Effort

AbstractObjectiveThe Balanced Menus Challenge (BMC) is a national effort to bring the healthiest, most sustainably produced meat available into health-care settings to preserve antibiotic effectiveness and promote good nutrition. The present study evaluated the outcomes of the BMC in the Maryland/Washington, DC region.DesignThe BMC is a cost-effective programme whereby participating hospitals reduce meat purchases by 20 % of their budget, then invest the savings into purchasing sustainably produced meat. A mixed-methods retrospective assessment was conducted to assess (i) utilization of the BMC ‘implementation toolkit’ and (ii) achievement of the 20 % reduction in meat purchases. Previous survey data were reviewed and semi-structured interviews were conducted.SettingHospitals located in the Maryland/Washington, DC region, USA, that adopted the BMC.SubjectsTwelve hospitals signed the BMC in the Maryland/Washington, DC region and six were available for interview.ResultsThree hospitals in the Maryland/Washington, DC region that signed the BMC tracked their progress and two achieved a reduction in meat procurement by ≥20 %. One hospital demonstrated that the final outcome goal of switching to a local and sustainable source for meat is possible to achieve, at least for a portion of the meal budget. The three hospitals that reduced meat purchases also received and used the highest number of BMC implementation tools. There was a positive correlation between receipt and usage of implementation tools (r=0·93, P=0·005).ConclusionsThe study demonstrates that hospitals in the Maryland/Washington, DC region that sign the BMC can increase the amount of sustainably produced meat purchased and served.

scholarly journals Autonomy and automatons: managed care in the USA

1998 ◽  
Vol 22 (12) ◽  
pp. 765-768
Author(s):  
Kwame McKenzie
Keyword(s):  
Health Care ◽  
New York ◽  
Managed Care ◽  
San Francisco ◽  
Evidence Based Medicine ◽  
Cost Effective ◽  
Evidence Based ◽  
The Usa ◽  
Based Medicine

Managed care is a phrase on the lips of every US psychiatrist. Some believe that this revolution in health care has brought US doctors kicking and screaming into the age of ‘cost-effective’, ‘evidence-based medicine’ (Mechanic, 1997). But most psychiatrists I interviewed from Boston, San Francisco and New York, thought it had transformed them from autonomous professionals to automatons.

Implications for health policy, public health, health care, and research

2019 ◽  
pp. 221-246
Author(s):  
Raj S. Bhopal
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Health Care ◽  
Health Policy ◽  
High Risk ◽  
Protective Factors ◽  
Low Cost ◽  
South Asians ◽  
Cost Effective ◽  
Individual Level

Achieving internationally agreed prevention strategies is extremely difficult and doing so for South Asians, specifically, is tougher still. Most guidance is centred on individual level behaviour change. The challenge is to produce focused, low cost, effective actions, underpinned by clear, simple, and accurate explanations of the causes of the phenomenon. The key messages are that the high risk of CVD and DM2 in urbanizing South Asians is not inevitable. It is not innate or genetic. Similarly, the risks are unlikely to be acquired in utero, birth, or infancy, and programmed in a fixed way. Rather, exposure to risk factors in childhood, adolescence, and most particularly in adulthood is the key. In addition to the established causes we need to research additional factors especially those identified as novel in Chapter 9. National legislation and policy that alters environments to reduce exposure to risk factors and increase exposure to protective factors is essential.

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