Evaluation of systems reform in public hospitals, Victoria, Australia, to improve access to antenatal care for women of refugee background: An interrupted time series design

IntroductionPregnancy and early parenthood are key opportunities for interaction with health services and connecting to other families at the same life stage. Public antenatal care should be accessible to all, however barriers persist for families from refugee communities to access, navigate and optimise healthcare during pregnancy. Group Pregnancy Care is an innovative model of care codesigned with a community from a refugee background and other key stakeholders in Melbourne, Australia. Group Pregnancy Care aims to provide a culturally safe and supportive environment for women to participate in antenatal care in a language they understand, to improve health literacy and promote social connections and inclusion. This paper outlines Froup Pregnancy Care and provides details of the evaluation framework.Methods and analysisThe evaluation uses community-based participatory research methods to engage stakeholders in codesign of evaluation methods. The study is being conducted across multiple sites and involves multiple phases, use of quantitative and qualitative methods, and an interrupted time series design. Process and cost-effectiveness measures will be incorporated into quality improvement cycles. Evaluation measures will be developed using codesign and participatory principles informed by community and stakeholder engagement and will be piloted prior to implementation.Ethics and disseminationEthics approvals have been provided by all six relevant authorities. Study findings will be shared with communities and stakeholders via agreed pathways including community forums, partnership meetings, conferences, policy and practice briefs and journal articles. Dissemination activities will be developed using codesign and participatory principles.

Download Full-text

Can the effects of the mobilization of vulnerable elders in Ontario (MOVE ON) implementation be replicated in new settings: an interrupted time series design

BMC Geriatrics ◽

10.1186/s12877-019-1124-0 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Julia E. Moore ◽

◽

Barbara Liu ◽

Sobia Khan ◽

Charmalee Harris ◽

...

Keyword(s):

Time Series ◽

Interrupted Time Series ◽

Series Design ◽

Time Series Design ◽

Interrupted Time Series Design

Download Full-text

Interrupted Time Series Design

Encyclopedia of Statistics in Behavioral Science ◽

10.1002/0470013192.bsa312 ◽

2005 ◽

Cited By ~ 1

Author(s):

John Ferron ◽

Gianna Rendina-Gobioff

Keyword(s):

Time Series ◽

Interrupted Time Series ◽

Series Design ◽

Time Series Design ◽

Interrupted Time Series Design

Download Full-text

Testing the Validity of the Single Interrupted Time Series Design

10.3386/w26080 ◽

2019 ◽

Cited By ~ 1

Author(s):

Katherine Baicker ◽

Theodore Svoronos

Keyword(s):

Time Series ◽

Interrupted Time Series ◽

Series Design ◽

Time Series Design ◽

Interrupted Time Series Design

Download Full-text

Scaling-up implementation in community hospitals: a multisite interrupted time series design of the Mobilization of Vulnerable Elders (MOVE) program in Alberta

BMC Geriatrics ◽

10.1186/s12877-019-1311-z ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Jayna Holroyd-Leduc ◽

◽

Charmalee Harris ◽

Jemila S. Hamid ◽

Joycelyne E. Ewusie ◽

...

Keyword(s):

Time Series ◽

Length Of Stay ◽

Interrupted Time Series ◽

Hospitalized Patients ◽

Intervention Period ◽

Community Hospitals ◽

Series Design ◽

Time Series Design ◽

The Impact ◽

Interrupted Time Series Design

Abstract Background As the population ages, older hospitalized patients are at increased risk for hospital-acquired morbidity. The Mobilization of Vulnerable Elders (MOVE) program is an evidence-informed early mobilization intervention that was previously evaluated in Ontario, Canada. The program was effective at improving mobilization rates and decreasing length of stay in academic hospitals. The aim of this study was to scale-up the program and conduct a replication study evaluating the impact of the evidence-informed mobilization intervention on various units in community hospitals within a different Canadian province. Methods The MOVE program was tailored to the local context at four community hospitals in Alberta, Canada. The study population was patients aged 65 years and older who were admitted to medicine, surgery, rehabilitation and intensive care units between July 2015 and July 2016. The primary outcome was patient mobilization measured by conducting visual audits twice a week, three times a day. The secondary outcomes included hospital length of stay obtained from hospital administrative data, and perceptions of the intervention assessed through a qualitative assessment. Using an interrupted time series design, the intervention was evaluated over three time periods (pre-intervention, during, and post-intervention). Results A total of 3601 patients [mean age 80.1 years (SD = 8.4 years)] were included in the overall analysis. There was a significant increase in mobilization at the end of the intervention period compared to pre-intervention, with 6% more patients out of bed (95% confidence interval (CI) 1, 11; p-value = 0.0173). A decreasing trend in median length of stay was observed, where patients on average stayed an estimated 3.59 fewer days (95%CI -15.06, 7.88) during the intervention compared to pre-intervention period. Conclusions MOVE is a low-cost, effective and adaptable intervention that improves mobilization in older hospitalized patients. This intervention has been replicated and scaled up across various units and hospital settings.

Download Full-text