Promoting Women’s Participation in Maternity Care in Lebanon

2015 ◽  
Vol 5 (3) ◽  
pp. 166-176 ◽  
Author(s):  
Tamar Kabakian-Khasholian ◽  
Rawan Shayboub ◽  
Mona Kanaan ◽  
Ziyad Mahfoud ◽  
Faysal El Kak
Keyword(s):  
Best Practices ◽  
Communication Skills ◽  
Health Care Providers ◽  
Maternity Care ◽  
Controlled Trial ◽  
Effective Communication ◽  
Evidence Based ◽  
Care Providers ◽  
Cluster Randomized ◽  
Evidence Based Care

This study examined the effect of providing evidence-based information to women and enabling them to use effective communication skills on requesting changes in maternity care. A cluster randomized controlled trial was conducted where pregnant women, from 65 private obstetric clinics, were recruited from 2 regions in Lebanon. The intervention consisted of 2 prenatal sessions on evidence-based care and effective communication skills. Women in the intervention arm were more likely to request not to have an enema (odds ratio [OR] = 5.57; confidence interval [CI] = 2.44–12.71), to request keeping their infants for prolonged time in their room (OR= 2.1; CI = 1.43–3.09), and to actually being able to keep their infants in their rooms for longer periods (OR= 2.39; CI = 1.13–5.04), compared to women in the control arm. Knowledge on best practices was significantly improved. Informing women about best practices and enhancing communication skills with providers of care can facilitate change in the provision of health services. More consideration needs to be given to the commitment of health care providers and senior staff within hospitals to ensure the scaling up of such interventions.

scholarly journals Conquering hypertension in Vietnam—solutions at grassroots level: study protocol of a cluster randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Duc A. Ha ◽  
Oanh T. Tran ◽  
Hoa L. Nguyen ◽  
Germán Chiriboga ◽  
Robert J. Goldberg ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Controlled Trial ◽  
Clinical Care ◽  
Intervention Group ◽  
Practice Change ◽  
Control Measures ◽  
Care Providers ◽  
Effective Prevention ◽  
Multi Media ◽  
Cluster Randomized

Abstract Background Vietnam has been experiencing an epidemiologic transition to that of a lower-middle income country with an increasing prevalence of non-communicable diseases. The key risk factors for cardiovascular disease (CVD) are either on the rise or at alarming levels in Vietnam, particularly hypertension (HTN). Inasmuch, the burden of CVD will continue to increase in the Vietnamese population unless effective prevention and control measures are put in place. The objectives of the proposed project are to evaluate the implementation and effectiveness of two multi-faceted community and clinic-based strategies on the control of elevated blood pressure (BP) among adults in Vietnam via a cluster randomized trial design. Methods Sixteen communities will be randomized to either an intervention (8 communities) or a comparison group (8 communities). Eligible and consenting adult study participants with HTN (n = 680) will be assigned to intervention/comparison status based on the community in which they reside. Both comparison and intervention groups will receive a multi-level intervention modeled after the Vietnam National Hypertension Program including education and practice change modules for health care providers, accessible reading materials for patients, and a multi-media community awareness program. In addition, the intervention group only will receive three carefully selected enhancements integrated into routine clinical care: (1) expanded community health worker services, (2) home BP self-monitoring, and (3) a “storytelling intervention,” which consists of interactive, literacy-appropriate, and culturally sensitive multi-media storytelling modules for motivating behavior change through the power of patients speaking in their own voices. The storytelling intervention will be delivered by DVDs with serial installments at baseline and at 3, 6, and 9 months after trial enrollment. Changes in BP will be assessed in both groups at several follow-up time points. Implementation outcomes will be assessed as well. Discussion Results from this full-scale trial will provide health policymakers with practical evidence on how to combat a key risk factor for CVD using a feasible, sustainable, and cost-effective intervention that could be used as a national program for controlling HTN in Vietnam. Trial registration ClinicalTrials.gov NCT03590691. Registered on July 17, 2018. Protocol version: 6. Date: August 15, 2019.

scholarly journals Evidence-based care in high- and low-risk groups following whiplash injury: a multi-centre inception cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Alexandra Griffin ◽  
Jagnoor Jagnoor ◽  
Mohit Arora ◽  
Ian D. Cameron ◽  
Annette Kifley ◽  
...  
Keyword(s):  
Therapeutic Relationship ◽  
Health Care Providers ◽  
Neck Disability Index ◽  
Risk Groups ◽  
Risk Identification ◽  
Baseline Risk ◽  
Evidence Based ◽  
Care Providers ◽  
Post Injury ◽  
Evidence Based Care

Abstract Background Studies aimed at improving the provision of evidence-based care (EBC) for the management of acute whiplash injuries have been largely successful. However, whether EBC is broadly provided and whether delivery of EBC varies based on risk of non-recovery, is uncertain. Receiving EBC should improve recovery, though this relationship has yet to be established. Further, mitigating the effect of EBC is the relationship with the practitioner, a phenomenon poorly understood in WAD. This study aimed to determine the proportion of individuals with whiplash, at differing baseline risk levels, receiving EBC. This study also aimed to determine whether receiving EBC and the therapeutic relationship were associated with recovery at 3 months post injury. Methods Participants with acute whiplash were recruited from public hospital emergency departments, private physiotherapy practices, and State Insurance Regulatory Authority (SIRA) databases. Participants completed questionnaires at baseline (demographics, risk of non-recovery) and 3-months (treatment received, risk identification, therapeutic relationship) post injury. Primary health care providers (HCPs) treating these participants also completed questionnaires at 3-months. Recovery was defined as neck disability index ≤4/50 and global perceived effect of ≥4/5. Results Two-hundred and twenty-eight people with acute whiplash, and 53 primary care practitioners were recruited. The majority of the cohort reported receiving EBC, with correct application of the Canadian C-spine rule (74%), and provision of active treatments (e.g. 89% receiving advice) high. Non-recommended (passive) treatments were also received by a large proportion of the cohort (e.g. 50% receiving massage). The therapeutic relationship was associated with higher odds of recovery, which was potentially clinically significant (OR 1.34, 95% CI 1.18–1.62). EBC was not significantly associated with recovery. Conclusions Guideline-based knowledge and practice has largely been retained from previous implementation strategies. However, recommendations for routine risk identification and tailored management, and reduction in the provision of passive treatment have not. The therapeutic relationship was identified as one of several important predictors of recovery, suggesting that clinicians must develop rapport and understanding with their patients to improve the likelihood of recovery.

Evidence-based training in treatment treatments: The case of pediatric psychopharmacology

2011 ◽  
Vol 26 (S2) ◽  
pp. 2048-2048
Author(s):  
P.S. Jensen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Controlled Trial ◽  
Evidence Based ◽  
Care Providers ◽  
Clinical Practices ◽  
High Quality ◽  
Health Care Practitioners ◽  
Evidence Based Treatments

IntroductionDespite major research advances in pediatric psychopharmacology and psychotherapy over the last 20 years, the lack of well-trained specialists has posed almost insurmountable barriers to many children and families from receiving high-quality, evidence-based assessment and treatments. The REACH Institute, an international non-profit organization dedicated to disseminating evidence-based treatments, has developed portable, effective methods to train primary care and specialty health providers in pediatric psychopharmacology and psychotherapies.ObjectivesTo develop effective, scientifically-proven methods for teaching and disseminating evidence-based treatments.AimsTo develop, disseminate, and evaluate high quality approaches for teaching primary care and specialty mental health practitioners in pediatric psychopharmacology.MethodsUsing novel approaches grounded in scientific behavioral change technologies, over 700 health care providers have been trained in evidence-based pediatric psychopharmacology in sites across multiple countries, including the US, Canada, and Norway. All trainings are rigorously evaluated for changes in health care practitioners' behaviors and clinical practices, including within an NIH-funded randomized controlled trial (RCT).ResultsTrainings have been very well-received across multiple countries, requiring only minor adaptations. These trainings have been effective in yielding changes in health care practitioners abilities and actual clinical practices, enabling more children to access appropriate pediatric psychopharmacology.ConclusionsEffective and disseminable methods for changing health care practitioners behaviors in applying pediatric psychopharmacology treatments are possible, and can be adapted to different countries, languages, and cultural contexts.

scholarly journals Conquering Hypertension in Vietnam- Solutions at Grassroots Level: Study Protocol of a Cluster Randomized Controlled Trial

2020 ◽  
Author(s):  
Duc Ha ◽  
Oanh Tran ◽  
Hoa Nguyen ◽  
Robert Goldberg ◽  
German Chiriboga ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Controlled Trial ◽  
Clinical Care ◽  
Intervention Group ◽  
Practice Change ◽  
Control Measures ◽  
Care Providers ◽  
Epidemiologic Transition ◽  
Effective Prevention ◽  
Cluster Randomized

Abstract Background Vietnam has been experiencing an epidemiologic transition to that of a lower-middle income country with an increasing prevalence of non-communicable diseases. The key risk factors for cardiovascular disease (CVD) are either on the rise or at alarming levels in Vietnam, particularly hypertension (HTN). Inasmuch, the burden of CVD will continue to increase in the Vietnamese population unless effective prevention and control measures are put in place. The objectives of the proposed project are to evaluate the implementation and effectiveness of two multi-faceted community and clinic-based strategies on the control of elevated blood pressure (BP) among adults in Vietnam via a cluster-randomized trial design. MethodsSixteen communities will be randomized to either an intervention (8 communities) or comparison group (8 communities). Eligible and consenting adult study participants with HTN (n = 680) will be assigned to intervention/comparison status based on the community in which they reside. Both comparison and intervention groups will receive a multi-level intervention modeled after the Vietnam National Hypertension Program including education and practice change modules for health care providers, accessible reading materials for patients, and a multi-media community awareness program. In addition, the intervention group only will receive three carefully selected enhancements integrated into routine clinical care: (1) expanded community health worker services; (2) home BP self-monitoring; and (3) a “storytelling intervention”, which consists of interactive, literacy-appropriate, and culturally sensitive multimedia storytelling modules for motivating behavior change through the power of patients speaking in their own voices. The storytelling intervention will be delivered by DVDs with serial installments at baseline and at 3, 6, and 9 months after trial enrollment. Changes in BP will be assessed in both groups at several follow-up time points. Implementation outcomes will be assessed as well.DiscussionResults from this full-scale trial will provide health policy makers with practical evidence on how to combat a key risk factor for CVD using a feasible, sustainable, and cost-effective intervention that could be used as a national program for controlling HTN in Vietnam.Trial registration: ClinicalTrials.gov. Registration number: https://clinicaltrials.gov/ct2/show/NCT03590691 (registration date July 17, 2018).Protocol version: 6. Date: 08/15/2019

scholarly journals Effectiveness of a nutrition education and counselling training package on antenatal care: a cluster randomized controlled trial in Addis Ababa

2020 ◽  
Vol 35 (Supplement_1) ◽  
pp. i65-i75
Author(s):  
Afrah Mohammedsanni Omer ◽  
Demewoz Haile ◽  
Bilal Shikur ◽  
Erlyn Rachelle Macarayan ◽  
Seifu Hagos
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Nutrition Education ◽  
Health Care Providers ◽  
Addis Ababa ◽  
Controlled Trial ◽  
Care Providers ◽  
Training Package ◽  
Health Centres ◽  
Cluster Randomized

Abstract The World Health Organization (WHO) recommends the need for a strong nutrition training package for practitioners, including antenatal care (ANC) providers. Without such a training package, ANC visits remain a missed opportunity to address nutritional problems among pregnant women. This study evaluated the effectiveness of an in-service nutrition education and counselling package on the providers’ counselling skills during ANC visits. A cluster randomized controlled trial was conducted in Addis Ababa, Ethiopia. All health-care providers working in ANC units across 20 health centres participated in this study. Health centres were allocated to intervention and control arms using a matched-pair randomization technique. An in-service nutrition education and counselling package, including training for ANC providers, supportive supervision and provision of modules, pamphlets and job aids, was provided for health centres assigned to the intervention arm. Observation checklists were used to assess the counselling skills of health-care providers. We used mixed-effect linear regression to evaluate the impact of the intervention. Significantly more health-care providers in the intervention arm informed pregnant women about the need to have one additional meal (Difference in proportion [DP] 49.17% vs −0.84%; DID 50.0%), about minimum required dietary diversity (DP 72.5% vs −2.5%; DID 75.0%) and about gestational weight gain (DP 68.33% vs −8.33%; DID 76.6%). Furthermore, providers improved in identifying key difficulties that pregnant women face (DP 28.34% vs −2.5%; DID 30.8%), and in recommending simple achievable actions on nutrition during pregnancy (DP 20.8% vs −10.9%; DID 31.6%). The intervention did not have statistically significant effects on how providers informed women about early initiation of breastfeeding (DP 6.67% vs 9.17%; DID −2.5%). The comprehensive in-service nutrition education and counselling package improved how ANC providers engaged with pregnant women and delivered nutrition messages during ANC consultations. This trial was registered in the Pan African Clinical Trial (PACTR registry, PACTR20170900 2477373; Date issued 21 September 2017).

Writing a Simulation Scenario: A Step-By-Step Guide

2016 ◽  
Vol 27 (1) ◽  
pp. 62-70 ◽  
Author(s):  
Deborah Bambini
Keyword(s):  
Best Practices ◽  
Health Care Providers ◽  
Nursing Faculty ◽  
Clinical Settings ◽  
Evidence Based ◽  
Care Providers ◽  
Clinical Area ◽  
Step Process ◽  
Academic Settings ◽  
Simulation Scenario

Simulation is becoming a widely used method of helping nurses learn and maintain competency in the clinical area for both staff educators in clinical settings and nursing faculty in academic settings. Designing an effective simulation experience requires thoughtful planning, knowledge of educational principles, and knowledge of best practices in both simulation and clinical practice. An evidence-based strategy for writing a simulation scenario for nurses and other health care providers in any setting is described. A step-by-step process is outlined that incorporates best practices. Examples and suggestions are provided to help readers create quality simulation experiences.

scholarly journals Conquering Hypertension in Vietnam- Solutions at Grassroots Level: Study Protocol of a Cluster Randomized Controlled Trial

2020 ◽  
Author(s):  
Duc Ha ◽  
Oanh Tran ◽  
Hoa Nguyen ◽  
Robert Goldberg ◽  
German Chiriboga ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care Providers ◽  
Controlled Trial ◽  
Clinical Care ◽  
Intervention Group ◽  
Practice Change ◽  
Control Measures ◽  
Care Providers ◽  
Effective Prevention ◽  
Cluster Randomized

Abstract BackgroundVietnam has been experiencing an epidemiologic transition to that of a low-middle income country with an increasing prevalence of non-communicable diseases. The key risk factors for cardiovascular disease (CVD) are either on the rise or at alarming levels in Vietnam, particularly hypertension (HTN). Inasmuch, the burden of CVD will continue to increase in the Vietnamese population unless effective prevention and control measures are put in place. The objectives of the proposed project are to evaluate the implementation and effectiveness of two multi-faceted community and clinic-based strategies on the control of elevated blood pressure (BP) among adults in Vietnam via a cluster-randomized trial design. MethodsSixteen communities will be randomized to either an intervention (8 communities) or comparison group (8 communities). Eligible and consenting adult study participants with HTN (n = 680) will be assigned to intervention/comparison status based on the community in which they reside. Both comparison and intervention groups will receive a multi-level intervention modeled after the Vietnam National Hypertension Program including education and practice change modules for health care providers, accessible reading materials for patients, and a multi-media community awareness program. In addition, the intervention group only will receive three carefully selected enhancements integrated into routine clinical care: (1) expanded community health worker services; (2) home blood pressure (BP) self-monitoring; and (3) a “storytelling intervention.”. which consists of interactive, literacy-appropriate, and culturally sensitive multimedia storytelling modules for motivating behavior change through the power of patients speaking in their own voice. The storytelling intervention will be delivered by DVD, with serial installments at baseline and at 3, 6, and 9 months after trial enrollment. Changes in BP will be assessed in both groups at several follow-up time points. Implementation outcomes will be assessed as well.DiscussionResults from this full-scale trial will provide health policy makers with practical evidence on how to combat a key risk factor for CVD using a feasible, sustainable, and cost-effective intervention that could be used as a national program for controlling HTN in Vietnam.Trial registration: ClinicalTrials.gov. Registration number: https://clinicaltrials.gov/ct2/show/NCT03590691 (registration date July 17, 2018).Protocol version: 6. Date: 08/15/2019

scholarly journals Ethical Considerations on Pediatric Genetic Testing Results in Electronic Health Records

2020 ◽  
Vol 11 (05) ◽  
pp. 755-763
Author(s):  
Shibani Kanungo ◽  
Jayne Barr ◽  
Parker Crutchfield ◽  
Casey Fealko ◽  
Neelkamal Soares
Keyword(s):  
Genetic Testing ◽  
Best Practices ◽  
Health Care Providers ◽  
Genetic Information ◽  
Ethical Issues ◽  
Interdisciplinary Approach ◽  
Care Providers ◽  
Ethical Considerations ◽  
Electronic Health ◽  
Genetic Results

Abstract Background Advances in technology and access to expanded genetic testing have resulted in more children and adolescents receiving genetic testing for diagnostic and prognostic purposes. With increased adoption of the electronic health record (EHR), genetic testing is increasingly resulted in the EHR. However, this leads to challenges in both storage and disclosure of genetic results, particularly when parental results are combined with child genetic results. Privacy and Ethical Considerations Accidental disclosure and erroneous documentation of genetic results can occur due to the nature of their presentation in the EHR and documentation processes by clinicians. Genetic information is both sensitive and identifying, and requires a considered approach to both timing and extent of disclosure to families and access to clinicians. Methods This article uses an interdisciplinary approach to explore ethical issues surrounding privacy, confidentiality of genetic data, and access to genetic results by health care providers and family members, and provides suggestions in a stakeholder format for best practices on this topic for clinicians and informaticians. Suggestions are made for clinicians on documenting and accessing genetic information in the EHR, and on collaborating with genetics specialists and disclosure of genetic results to families. Additional considerations for families including ethics around results of adolescents and special scenarios for blended families and foster minors are also provided. Finally, administrators and informaticians are provided best practices on both institutional processes and EHR architecture, including security and access control, with emphasis on the minimum necessary paradigm and parent/patient engagement and control of the use and disclosure of data. Conclusion The authors hope that these best practices energize specialty societies to craft practice guidelines on genetic information management in the EHR with interdisciplinary input that addresses all stakeholder needs.

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