Evaluating the national multisite implementation of dialectical behaviour therapy in a community setting: A mixed methods approach

Abstract Background: The implementation of evidence-based interventions for borderline personality disorder in community settings is important given that individuals with this diagnosis are often extensive users of both inpatient and outpatient mental health services. Although work in this area is limited, previous studies have identified facilitators and barriers to successful DBT implementation. This study seeks to expand on previous work by evaluating a coordinated implementation of DBT in community settings at a national level. The Consolidated Framework for Implementation Research (CFIR) [1] provided structural guidance for this national level coordinated implementation. Methods: A mixed methods approach was utilised to explore the national multi-site implementation of DBT from the perspective of team leaders and therapists who participated in the coordinated training and subsequent implementation of DBT. Qualitative interviews with DBT team leaders (n = 8) explored their experiences of implementing DBT in their local service and was analysed using content analysis. Quantitative surveys from DBT therapists (n = 74) examined their experience of multiple aspects of the implementation process including orienting the system, and preparations and support for implementation. Frequencies of responses were calculated. Written qualitative feedback was analysed using content analysis. Results: Five themes were identified from the interview data: team formation, implementation preparation, client selection, service level challenges and team leader role. Participants identified team size and support for the team leader as key points for consideration in DBT implementation. Key challenges encountered were the lack of system support to facilitate phone coaching and a lack of allocated time to focus on DBT. Implementation facilitators included having dedicated team members and support from management. Conclusions: The barriers and facilitators identified in this study are broadly similar to those reported in previous research. Barriers and facilitators were identified across several domains of the CFIR and are consistent with a recently published DBT implementation Framework [2]. Future research should pay particular attention to the domain of characteristics of individuals involved in DBT implementation. The results highlight the importance of a mandated service plan for the coordinated implementation of an evidence-based treatment in a public health service.Trial Registration: ClinicalTrials.gov ID: NCT03180541; Registered June 7th 2017 ‘retrospectively registered’

Download Full-text

Evaluating the national multisite implementation of dialectical behaviour therapy in a community setting: A mixed methods approach

10.21203/rs.2.14353/v2 ◽

2019 ◽

Author(s):

Daniel Flynn ◽

Mary Joyce ◽

Conall Gillespie ◽

Mary Kells ◽

Michaela Swales ◽

...

Keyword(s):

Mixed Methods ◽

National Level ◽

Team Leader ◽

Barriers And Facilitators ◽

Future Research ◽

Evidence Based ◽

Community Settings ◽

Team Leaders ◽

Implementation Framework ◽

Mixed Methods Approach

Abstract Background The implementation of evidence-based interventions for borderline personality disorder in community settings is important given that individuals with this diagnosis are often extensive users of both inpatient and outpatient mental health services. Although work in this area is limited, previous studies have identified facilitators and barriers to successful DBT implementation. This study seeks to expand on previous work by evaluating a coordinated implementation of DBT in community settings at a national level. The Consolidated Framework for Implementation Research (CFIR) [1] provided structural guidance for this national level coordinated implementation.Methods A mixed methods approach was utilised to explore the national multi-site implementation of DBT from the perspective of team leaders and therapists who participated in the coordinated training and subsequent implementation of DBT. Qualitative interviews with DBT team leaders ( n = 8) explored their experiences of implementing DBT in their local service and was analysed using content analysis. Quantitative surveys from DBT therapists ( n = 74) examined their experience of multiple aspects of the implementation process including orienting the system, and preparations and support for implementation. Frequencies of responses were calculated. Written qualitative feedback was analysed using content analysis.Results Five themes were identified from the interview data: team formation, implementation preparation, client selection, service level challenges and team leader role. Participants identified team size and support for the team leader as key points for consideration in DBT implementation. Key challenges encountered were the lack of system support to facilitate phone coaching and a lack of allocated time to focus on DBT. Implementation facilitators included having dedicated team members and support from management.Conclusions The barriers and facilitators identified in this study are broadly similar to those reported in previous research. Barriers and facilitators were identified across several domains of the CFIR and are consistent with a recently published DBT implementation Framework [2]. Future research should pay particular attention to the domain of characteristics of individuals involved in DBT implementation. The results highlight the importance of a mandated service plan for the coordinated implementation of an evidence-based treatment in a public health service.

Download Full-text

Evaluating the national multisite implementation of dialectical behaviour therapy in a community setting: A mixed methods approach

10.21203/rs.2.14353/v1 ◽

2019 ◽

Author(s):

Daniel Flynn ◽

Mary Joyce ◽

Conall Gillespie ◽

Mary Kells ◽

Michaela Swales ◽

...

Keyword(s):

Mixed Methods ◽

National Level ◽

Team Leader ◽

Barriers And Facilitators ◽

Future Research ◽

Evidence Based ◽

Community Settings ◽

Team Leaders ◽

Implementation Framework ◽

Mixed Methods Approach

Abstract Background The implementation of evidence-based interventions for borderline personality disorder in community settings is important given that individuals with this diagnosis are often extensive users of both inpatient and outpatient mental health services. Although work in this area is limited, previous studies have identified facilitators and barriers to successful DBT implementation. This study seeks to expand on previous work by evaluating a coordinated implementation of DBT in community settings at a national level. The Consolidated Framework for Implementation Research (CFIR) [1] provided structural guidance for this national level coordinated implementation.Methods A mixed methods approach was utilised to explore the national multi-site implementation of DBT from the perspective of team leaders and therapists who participated in the coordinated training and subsequent implementation of DBT. Qualitative interviews with DBT team leaders (n = 8) explored their experiences of implementing DBT in their local service and was analysed using content analysis. Quantitative surveys from DBT therapists (n = 74) examined their experience of multiple aspects of the implementation process including orienting the system, and preparations and support for implementation. Frequencies of responses were calculated. Written qualitative feedback was analysed using content analysis.Results Five themes were identified from the interview data: team formation, implementation preparation, client selection, service level challenges and team leader role. Participants identified team size and support for the team leader as key points for consideration in DBT implementation. Key challenges encountered were the lack of system support to facilitate phone coaching and a lack of allocated time to focus on DBT. Implementation facilitators included having dedicated team members and support from management.Conclusions The barriers and facilitators identified in this study are broadly similar to those reported in previous research. Barriers and facilitators were identified across several domains of the CFIR and are consistent with a recently published DBT implementation Framework [2]. Future research should pay particular attention to the domain of characteristics of individuals involved in DBT implementation. The results highlight the importance of a mandated service plan for the coordinated implementation of an evidence-based treatment in a public health service.Trial Registration: ClinicalTrials.gov ID: NCT03180541; Registered June 7th 2017 ‘retrospectively registered’

Download Full-text

Mixed Integrative Heuristic Approach in content analysis: a study of the image of China in Africa based on mixed-methods approach

International Journal of Social Research Methodology ◽

10.1080/13645579.2021.1987826 ◽

2021 ◽

pp. 1-14

Author(s):

Jarosław Jura ◽

Kaja Kałużyńska

Keyword(s):

Content Analysis ◽

Mixed Methods ◽

Heuristic Approach ◽

Mixed Methods Approach

Download Full-text

Who Creates Microtransactions : The Production Context of Video Game Monetization

Game Production Studies ◽

10.5117/9789463725439_ch10 ◽

2021 ◽

Author(s):

Lies van Roessel ◽

Jan Švelch

Keyword(s):

Content Analysis ◽

Mixed Methods ◽

Data Analysis ◽

Frequency Analysis ◽

Video Game ◽

Job Descriptions ◽

Structured Interviews ◽

Game Development ◽

Mixed Methods Approach ◽

Roles And Responsibilities

Despite a growing academic interest in in-game monetization, much less attention has been paid to the production context of microtransactions. With this chapter, we aim to address this gap by focusing on the roles and responsibilities related to video game monetization. We answer the titular question of this chapter using a mixed methods approach, combining semi-structured interviews, content analysis of job descriptions, and frequency analysis of in-game credits. Results suggest that monetization responsibilities are both being integrated into various existing roles, including game designers or product managers, but also spawn new dedicated roles of monetization specialists. Monetization as a game development task is closely related to data analysis and only inconsistently appears in in-game credits.

Download Full-text

Nutritional status, food choices, barriers and facilitators to healthy nutrition in pregnant women with severe mental illness: a mixed methods approach

Journal of Human Nutrition and Dietetics ◽

10.1111/jhn.12752 ◽

2020 ◽

Vol 33 (5) ◽

pp. 698-707

Author(s):

J. Frayne ◽

Y. Hauck ◽

P. Sivakumar ◽

T. Nguyen ◽

H. Liira ◽

...

Keyword(s):

Mental Illness ◽

Mixed Methods ◽

Nutritional Status ◽

Severe Mental Illness ◽

Pregnant Women ◽

Food Choices ◽

Barriers And Facilitators ◽

Mixed Methods Approach ◽

Healthy Nutrition

Download Full-text

Recommendations for Administrators’ Involvement in School-Based Health Promotion: A Scoping Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176249 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6249 ◽

Cited By ~ 1

Author(s):

Collin A. Webster ◽

Genee Glascoe ◽

Chanta Moore ◽

Brian Dauenhauer ◽

Cate A. Egan ◽

...

Keyword(s):

Health Promotion ◽

Content Analysis ◽

Mixed Methods ◽

Scoping Review ◽

School Health ◽

School Administrators ◽

Professional Group ◽

Research Articles ◽

Evidence Based ◽

School Based

School administrator involvement is recognized as a key factor in the extent to which school health promotion programs and initiatives are successfully implemented. The aims of this scoping review are to: (a) Identify existing documents that contain recommendations regarding the involvement of school administrators in school-based health promotion; (b) distill and summarize the recommendations; (c) examine differences in the recommendations by targeted professional level, professional group, health promotion content focus, and by whether the recommendations are evidence-based or opinion-based; and (d) evaluate the research informing the recommendations. We drew upon the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines to conduct the review. Our team conducted a comprehensive literature search with no date or geographic restrictions from January 2018 through April 2018 using four electronic databases: Academic Search Complete, Google Scholar, Physical Education Index, and PubMed. Eligibility criteria included any online documents, in English, that contained recommendations targeting school administrators’ (e.g., principals, assistant principals, superintendents) involvement (e.g., support, endorsement, advocacy) in school health programming (e.g., physical activity, nutrition, wellness). The search yielded a total of 1225 records, which we screened by title, then by abstract, and finally by full text, resulting in 61 records that met inclusion criteria. Data (e.g., recommendations, targeted contexts, targeted administrators) from these records were extracted for a content analysis. Included records contained 80 distinct recommendations, which we summarized into three themes (Collaboration, Advocacy, and Support) using a content analysis. Separate content analyses revealed no qualitative differences in the recommendations by professional level, professional group, or content focus, or by whether the recommendations were evidence-based or opinion-based. Twenty-one of the included records were peer-reviewed research articles. Using the Mixed Methods Appraisal Tool (MMAT), we appraised qualitative research articles the highest and mixed methods research articles the lowest. This review provides a basis for future research and professional practice aiming to increase school administrators’ involvement in school-based health promotion.

Download Full-text

Ethical misconduct by registered physiotherapists in South Africa (2007–2013): A mixed methods approach

South African Journal of Physiotherapy ◽

10.4102/sajp.v71i1.248 ◽

2015 ◽

Vol 71 (1) ◽

Cited By ~ 3

Author(s):

Willem A. Hoffmann ◽

Nico Nortjé

Keyword(s):

South Africa ◽

Content Analysis ◽

Mixed Methods ◽

Data Analysis ◽

Qualitative Content Analysis ◽

Epidemiological Data ◽

Unethical Conduct ◽

Mixed Methods Approach ◽

Ethical Misconduct ◽

Patient Consent

Background: The role of ethics in a medical context is to protect the interests of patients. Thus,it is critically important to understand the guilty verdicts related to professional standard breaches and ethics misconduct of physiotherapists.Aim: To analyse the case content and penalties of all guilty verdicts related to ethics misconduct against registered physiotherapists in South Africa.Methods: A mixed methods approach was followed consisting of epidemiological data analysis and qualitative content analysis. The data documents were formal annual lists (2007–2013) of guilty verdicts related to ethical misconduct. Quantitative data analysis focused on annual frequencies of guilty verdicts, transgression categories and the imposed penalties. Qualitative data analysis focused on content analysis of the case content for each guilty verdict.Results: Relatively few physiotherapists (0.05%) are annually found guilty of ethical misconduct. The two most frequent penalties were fines of R5000.00 and fines of R8000.00–R10 000.00. The majority of transgressions involved fraudulent conduct (70.3%), followed by performance of procedures without patient consent (10.8%). Fraudulent conduct involved issuing misleading, inaccurate or false medical statements, and false or inaccurate medical aid scheme claims.Conclusion: Unethical conduct by physiotherapists in South Africa occurs rarely. The majority of penalties imposed on sanctioned physiotherapists were monetary penalties.

Download Full-text

Celebrity Brand Fashion Collaborations In A Canadian Context

10.32920/ryerson.14649027 ◽

2021 ◽

Author(s):

Jacqueline Melindy

Keyword(s):

Content Analysis ◽

Mixed Methods ◽

Product Development ◽

Design Process ◽

Economic Power ◽

Fashion Industry ◽

Mixed Methods Approach ◽

Canadian Context ◽

Branded Product ◽

Key Features

Celebrity branded collections are an interesting niche segment of the fashion industry and they have yet to be examined within a Canadian context. This research identifies factors that influence celebrity brand collaborations utilizing a mixed methods approach. Content analysis of merchandise featured on four websites of Canadian celebrities identified key features of celebrity branded product assortments. Interviews with a fashion broker and celebrity fashion editor unpacked the nuances of the design process. The evidence from this study suggests that the design process is negotiated, both the celebrity and the brand play vital roles in product development. The findings derived from the content analysis established the type of garments and accessories, fabrics, colours, patterns, motifs and slogans, logos, fit, sizes, and price points that are commonly used in celebrity fashion collections. Given the huge economic power of celebrity branded collections, this research outlines important practices for designers, product developers and celebrities.

Download Full-text

A Limb Hypothermia Wearable for Chemotherapy-Induced Peripheral Neuropathy: A Mixed-Methods Approach in Medical Product Development

Frontiers in Digital Health ◽

10.3389/fdgth.2020.573234 ◽

2020 ◽

Vol 2 ◽

Author(s):

Jonathan Binder ◽

Ertu Unver ◽

Jane Clayton ◽

Patrick Burke ◽

Richard Paxman ◽

...

Keyword(s):

Mixed Methods ◽

Peripheral Neuropathy ◽

Medical Device ◽

Development Process ◽

Central Component ◽

Evidence Based ◽

Device Design ◽

Mixed Methods Approach ◽

Medical Device Design ◽

Hands And Feet

Chemotherapy-Induced Peripheral Neuropathy (CIPN) is a common dose-limiting side-effect of taxane-based chemotherapy, causing progressive and often irreversible pain/sensitivity in the hands and feet. Prevention/treatments for CIPN are not well-developed and urgently needed. Limb cryocompression during chemotherapy has demonstrated promising early data of preventing/reducing CIPN severity. Currently there are no medical devices available that are dedicated to the specific requirements of CIPN prevention. As part of our ongoing development of a dedicated CIPN-prevention limb cryocompression system, this study documents the design & development of the wearable arm wrap, a central component of the system, from initial concept to a trial-ready prototype. A collaborative and multidisciplinary approach was adopted to address the complex and high-risk nature of this SME (Small Medium Enterprise)-centered medical device design & development process. The complementary collaboration unites multidisciplinary expertise spanning the scope of the project. Alongside the clinical, academic, and design & development expertise, the integration of commercial expertise is imperative to promote the market viability, and ultimate success, of the development. As the global leading experts in scalp cooling specializing in the prevention of chemotherapy-induced alopecia, UK-based SME Paxman Coolers Ltd is optimally positioned to support the commercial and regulatory dimensions. Development and adoption of a novel mixed-methodology (HudPAX) facilitated the integration of evidence-based and user-centered techniques to optimize the design & development approach and ensure integration of all critical design inputs. Alpha prototypes were designed through evidence-based approaches, with data from existing clinical trials utilized to determine the preliminary design inputs, alongside 3D ergonomic data. Investigations utilized computer-aided design, rapid prototyping, additive manufacturing, sketch modeling, and fast ideation. User-based approaches facilitated stakeholder-feedback through expert focus groups, informing further design & development and projecting the design into the next stage, Beta prototyping, for use in large-scale efficacy trials and upscaling manufacturing. This paper demonstrates a novel mixed-methods approach, which promotes cross-sector multidisciplinary collaboration, to address the complex multi-layered challenges posed by an early-stage medical device design & development process.

Download Full-text