scholarly journals Mixed-methods Economic Evaluation of the Implementation of Tobacco Treatment Programs in National Cancer Institute-designated Cancer Centers

2021 ◽  
Author(s):  
Ramzi G. Salloum ◽  
Heather D'Angelo ◽  
Ryan Theis ◽  
Betsy Rolland ◽  
Sarah Hohl ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Operating Costs ◽  
System Level ◽  
Treatment Programs ◽  
Cancer Centers ◽  
Additional Information ◽  
Tobacco Treatment ◽  
Wide Range ◽  
Implementation Costs ◽  
Program Components

Abstract Background: The Cancer Center Cessation Initiative (C3I) was launched in 2017 as a part of the NCI Cancer Moonshot program to assist NCI-designated cancer centers in developing tobacco treatment programs for oncology patients. Participating centers have implemented varied evidence-based programs that fit their institutional resources and needs, offering a wide range of services including in-person and telephone-based counseling, point of care, interactive voice response systems, referral to the quitline, text- and web-based services, and medications.Methods: We used a mixed methods comparative case study design to evaluate system-level implementation costs across 15 C3I-funded cancer centers that reported for at least one six-month period between July 2018 and June 2020. We analyzed operating costs by resource category (e.g., personnel, medications) concurrently with transcripts from semi-structured key-informant interviews conducted during site visits. Personnel salary costs were estimated using Bureau of Labor Statistics wage data adjusted for area and occupation, and non-wage benefits. Qualitative findings provided additional information on intangible resources and contextual factors related to implementation costs.Results: Total monthly operating costs across funded centers ranged from $6,453 to $20,751. The largest operating cost category was personnel ($4,122-$19,794), with the highest personnel costs attributable to the provision of in-person program services. Monthly cost ranges for other categories were: medications ($17-$573), materials ($6-$435), training ($96-$516), technology ($171-$2,759), and equipment ($10-$620). Cost-per-participant ranged from $70 to $3,500 (median, $537) and cost-per-quit ranged from $330 to $9,799 (median, $2,699) with sites offering different combinations of program components, ranging from individually-delivered in-person counseling only to one program that offered all components. Site interviews provided context for understanding variations in program components and their cost implications.Conclusions: Among most centers that have progressed in tobacco treatment program implementation, cost-per-quit was modest relative to other prevention interventions. Although select centers have achieved similar average costs by offering program components of various levels of intensity, they have varied widely in program reach and effectiveness. Evaluating implementation costs of such programs alongside reach and effectiveness is necessary to provide decision makers in oncology settings with the important additional information needed to optimize resource allocation when establishing tobacco treatment programs.

scholarly journals Mixed-methods economic evaluation of the implementation of tobacco treatment programs in National Cancer Institute-designated cancer centers

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Ramzi G. Salloum ◽  
Heather D’Angelo ◽  
Ryan P. Theis ◽  
Betsy Rolland ◽  
Sarah Hohl ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Operating Costs ◽  
System Level ◽  
Treatment Programs ◽  
Cancer Centers ◽  
Additional Information ◽  
Tobacco Treatment ◽  
Wide Range ◽  
Implementation Costs ◽  
Program Components

Abstract Background The Cancer Center Cessation Initiative (C3I) was launched in 2017 as a part of the NCI Cancer Moonshot program to assist NCI-designated cancer centers in developing tobacco treatment programs for oncology patients. Participating centers have implemented varied evidence-based programs that fit their institutional resources and needs, offering a wide range of services including in-person and telephone-based counseling, point of care, interactive voice response systems, referral to the quitline, text- and web-based services, and medications. Methods We used a mixed methods comparative case study design to evaluate system-level implementation costs across 15 C3I-funded cancer centers that reported for at least one 6-month period between July 2018 and June 2020. We analyzed operating costs by resource category (e.g., personnel, medications) concurrently with transcripts from semi-structured key-informant interviews conducted during site visits. Personnel salary costs were estimated using Bureau of Labor Statistics wage data adjusted for area and occupation, and non-wage benefits. Qualitative findings provided additional information on intangible resources and contextual factors related to implementation costs. Results Median total monthly operating costs across funded centers were $11,045 (range: $5129–$20,751). The largest median operating cost category was personnel ($10,307; range: $4122–$19,794), with the highest personnel costs attributable to the provision of in-person program services. Monthly (non-zero) cost ranges for other categories were medications ($17–$573), materials ($6–$435), training ($96–$516), technology ($171–$2759), and equipment ($10–$620). Median cost-per-participant was $466 (range: $70–$2093) and cost-per-quit was $2688 (range: $330–$9628), with sites offering different combinations of program components, ranging from individually-delivered in-person counseling only to one program that offered all components. Site interviews provided context for understanding variations in program components and their cost implications. Conclusions Among most centers that have progressed in tobacco treatment program implementation, cost-per-quit was modest relative to other prevention interventions. Although select centers have achieved similar average costs by offering program components of various levels of intensity, they have varied widely in program reach and effectiveness. Evaluating implementation costs of such programs alongside reach and effectiveness is necessary to provide decision makers in oncology settings with the important additional information needed to optimize resource allocation when establishing tobacco treatment programs.

scholarly journals Mixed-methods Economic Evaluation of the Implementation of Tobacco Treatment Programs in National Cancer Institute-designated Cancer Centers

2021 ◽  
Author(s):  
Ramzi G. Salloum ◽  
Heather D'Angelo ◽  
Ryan Theis ◽  
Betsy Rolland ◽  
Sarah Hohl ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Operating Costs ◽  
System Level ◽  
Treatment Programs ◽  
Cancer Centers ◽  
Additional Information ◽  
Tobacco Treatment ◽  
Wide Range ◽  
Implementation Costs ◽  
Program Components

Abstract Background: The Cancer Center Cessation Initiative (C3I) was launched in 2017 as a part of the NCI Cancer Moonshot program to assist NCI-designated cancer centers in developing tobacco treatment programs for oncology patients. Participating centers have implemented varied evidence-based programs that fit their institutional resources and needs, offering a wide range of services including in-person and telephone-based counseling, point of care, interactive voice response systems, referral to the quitline, text- and web-based services, and medications.Methods: We used a mixed methods comparative case study design to evaluate system-level implementation costs across 15 C3I-funded cancer centers that reported for at least one six-month period between July 2018 and June 2020. We analyzed operating costs by resource category (e.g., personnel, medications) concurrently with transcripts from semi-structured key-informant interviews conducted during site visits. Personnel salary costs were estimated using Bureau of Labor Statistics wage data adjusted for area and occupation, and non-wage benefits. Qualitative findings provided additional information on intangible resources and contextual factors related to implementation costs.Results: Total monthly operating costs across funded centers ranged from $6,453 to $20,751. The largest operating cost category was personnel ($4,122-$19,794), with the highest personnel costs attributable to the provision of in-person program services. Monthly cost ranges for other categories were: medications ($17-$573), materials ($6-$435), training ($96-$516), technology ($171-$2,759), and equipment ($10-$620). Cost-per-participant ranged from $70 to $3,500 (median, $537) and cost-per-quit ranged from $330 to $9,799 (median, $2,699) with sites offering different combinations of program components, ranging from individually-delivered in-person counseling only to one program that offered all components. Site interviews provided context for understanding variations in program components and their cost implications.Conclusions: Among most centers that have progressed in tobacco treatment program implementation, cost-per-quit was modest relative to other prevention interventions. Although select centers have achieved similar average costs by offering program components of various levels of intensity, they have varied widely in program reach and effectiveness. Evaluating implementation costs of such programs alongside reach and effectiveness is necessary to provide decision makers in oncology settings with the important additional information needed to optimize resource allocation when establishing tobacco treatment programs.

scholarly journals Tobacco Treatment Programs at National Cancer Institute-designated Cancer Centers

2019 ◽  
Vol 42 (4) ◽  
pp. 407-410 ◽  
Author(s):  
Andrew T. Day ◽  
Liyang Tang ◽  
Maher Karam-Hage ◽  
Carole Fakhry
Keyword(s):  
National Cancer Institute ◽  
Treatment Programs ◽  
Cancer Centers ◽  
Tobacco Treatment

scholarly journals Establishing Cross-Systems Collaborations for Implementation: Protocol for a Longitudinal Mixed Methods Study

2020 ◽  
Author(s):  
Alicia C. Bunger ◽  
Emmeline Chuang ◽  
Amanda Girth ◽  
Kathryn E. Lancaster ◽  
Fawn Gadel ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Child Welfare ◽  
Rural Communities ◽  
Service Delivery ◽  
Controlled Trial ◽  
Mixed Methods Study ◽  
System Level ◽  
Wide Range ◽  
Collaborative Strategies ◽  
Cross System

Abstract Background: Cross-system interventions can help integrate services across different service delivery systems but require organizations to establish strong collaborative relationships for implementation. Contingency theory suggests that the effectiveness of different collaborative strategies (i.e. specific ways organizations align operations and services) varies by context. This paper describes a study of different strategies for fostering collaboration between child welfare and substance abuse treatment agencies and the conditions under which they are effective for implementation. We also describe the development and piloting of the Collaborating Across Systems for Program Implementation (CASPI) tool—a decision-making guide intended to help researchers and organizational leaders identify and use appropriate collaborative strategies for their context. Methods/Design: This multisite longitudinal, mixed methods study, leverages a naturally occurring implementation initiative -- in up to 17 Ohio counties -- to implement Ohio START (Sobriety Treatment and Reducing Trauma). START is a child welfare model that requires strong collaboration with local substance use treatment organizations to promote integrated services. During the first two years, we will identify collaborative strategies associated with improved START implementation (penetration and fidelity) and service delivery outcomes (timeliness), given system, and organizational features. We will conduct a convergent mixed methods study drawing on worker surveys, agency documents, administrative data, formal partner agreements, and group interviews. Data will be integrated and analyzed using Qualitative Comparative Analysis (QCA). To develop the CASPI, an expert panel comprised of implementation experts, and community stakeholders will convene to synthesize our findings and develop contents (including a decision tree). During the final year of the study, we will assess the acceptability, appropriateness, and feasibility of the CASPI in a randomized vignette experiment, and a pilot-test with 3 child welfare agencies that have not yet implemented START. Discussion: Our results will lay the groundwork for a larger controlled trial that will test the CASPI’s effectiveness for supporting effective and efficient implementation of cross-system interventions like START. The CASPI is expected to help leaders and researchers select and use collaboration strategies tailored to their context and be applicable in a wide range of settings including rural communities. Our work also advances system-level implementation strategies.Trial Registration: NCT03931005, Registered April 29, 2019, https://clinicaltrials.gov/ct2/show/NCT03931005

scholarly journals Design and psychometric evaluation of epilepsy-related apathy scale (E-RAS) in adults with epilepsy: a sequential exploratory mixed methods design

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abbas Shamsalinia ◽  
Mozhgan Moradi ◽  
Reza Ebrahimi Rad ◽  
Reza Ghadimi ◽  
Mansoureh Ashghali Farahani ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Mixed Methods ◽  
Care Providers ◽  
Divergent Validity ◽  
Validity And Reliability ◽  
Mixed Methods Design ◽  
Scale Evaluation ◽  
Wide Range ◽  
Epileptic Patients ◽  
Convergent And Divergent Validity

Abstract Background Apathy in patients with epilepsy is associated with a wide range of consequences that reduce the patient’s ability to perform social functions and participate in self-care and rehabilitation programs. Therefore, apathy is one of the important diagnoses of the healthcare team in the process of caring for epileptic patients and its dimensions need to be examined and recognized. Therefore, appropriate instruments with the sociocultural milieu of each community should be provided to health care providers. The aim of the present study was to design and measure epilepsy–related apathy scale (E-RAS) in adults with epilepsy. Methods This study of sequential exploratory mixed methods design was conducted in Iran from April 2019 to December 2019. In the Item generation stage, two inductive (face-to-face and semi-structured interviews with 17 adult epileptic patients) and deductive (literature review) were used. In item reduction, integration of qualitative and literature reviews and scale evaluation were accomplished. For Scale Evaluation, face, content, construct [exploratory factor analysis (EFA) (n = 360) and confirmatory factor analysis (CFA) (n = 200)], convergent and divergent Validity and reliability (internal consistency and stability) were investigated. Results The results of EFA showed that E-RAS has four factors, namely, motivation; self-regulatory; cognition and emotional-effective. These four latent factors accounted for a total of 48.351% of the total variance in the E-RAS construct. The results of CFA showed that the 4-factor model of E-RAS has the highest fit with the data. The results of convergent and divergent validity showed that the values of composite reliability (CR) and average variance extracted (AVE) for the four factors were greater than 0.7 and 0.5, respectively, and the value of AVE for each factor was greater than CR. The Cronbach’s alpha coefficient for the whole scale was obtained 0.815. The results of the test-retest showed that there was a significant agreement between the test and retest scores (P < 0.001). Conclusion E-RAS is a multidimensional construct consisting of 24 items, and has acceptable validity and reliability for the study of epilepsy-related apathy in adult epileptic patients.

SYSTEMC IMPLEMENTATION AND PERFORMANCE EVALUATION OF A DECOUPLED GENERAL-PURPOSE MATRIX PROCESSOR

2010 ◽  
Vol 20 (02) ◽  
pp. 103-121 ◽  
Author(s):  
MOSTAFA I. SOLIMAN ◽  
ABDULMAJID F. Al-JUNAID
Keyword(s):  
Performance Evaluation ◽  
Matrix Multiplication ◽  
General Purpose ◽  
System Level ◽  
Memory Latency ◽  
Single Chip ◽  
Wide Range ◽  
Matrix Unit ◽  
And Performance ◽  
Vector Matrix

Technological advances in IC manufacturing provide us with the capability to integrate more and more functionality into a single chip. Today's modern processors have nearly one billion transistors on a single chip. With the increasing complexity of today's system, the designs have to be modeled at a high-level of abstraction before partitioning into hardware and software components for final implementation. This paper explains in detail the implementation and performance evaluation of a matrix processor called Mat-Core with SystemC (system level modeling language). Mat-Core is a research processor aiming at exploiting the increasingly number of transistors per IC to improve the performance of a wide range of applications. It extends a general-purpose scalar processor with a matrix unit. To hide memory latency, the extended matrix unit is decoupled into two components: address generation and data computation, which communicate through data queues. Like vector architectures, the data computation unit is organized in parallel lanes. However, on parallel lanes, Mat-Core can execute matrix-scalar, matrix-vector, and matrix-matrix instructions in addition to vector-scalar and vector-vector instructions. For controlling the execution of vector/matrix instructions on the matrix core, this paper extends the well known scoreboard technique. Furthermore, the performance of Mat-Core is evaluated on vector and matrix kernels. Our results show that the performance of four lanes Mat-Core with matrix registers of size 4 × 4 or 16 elements each, queues size of 10, start up time of 6 clock cycles, and memory latency of 10 clock cycles is about 0.94, 1.3, 2.3, 1.6, 2.3, and 5.5 FLOPs per clock cycle; achieved on scalar-vector multiplication, SAXPY, Givens, rank-1 update, vector-matrix multiplication, and matrix-matrix multiplication, respectively.

Green Communication Infrastructure (GCI) Serving Different Smart City Applications

2021 ◽  
Vol 01 ◽  
Author(s):  
Qutaiba I. Ali ◽  
Issam Jafar
Keyword(s):  
Rural Areas ◽  
Smart City ◽  
Low Cost ◽  
System Level ◽  
Green Communication ◽  
Communication Infrastructure ◽  
Wide Range ◽  
The World ◽  
Self Powered ◽  
Application Fields

Aims: The aim of the Green Communication Infrastructure ‎‎(GCI) project is to understand the idea of a self ‎‎"sustainably" controlled correspondence foundation ‎fitting for smart city application fields. ‎ Background: This paper shows the endeavors to understand the idea of a ‎self "sustainably" energized communication foundation ‎fitting for smart city application fields. The recommended ‎Green Communication Infrastructure (CGI) comprises ‎different kinds of remote settled (or even versatile) hubs ‎performing diverse activities as per the application ‎requests. An imperative class of these hubs is the Wireless ‎Solar Router (WSR). Objective: The work in this venture was begun in 2009 with the aim ‎of demonstrating the essential advances that must be taken to ‎accomplish such framework and to proclaim the value of ‎embracing natural vitality assets in building mission ‎basic frameworks. Alternate destinations of this venture ‎are introducing a sensibly cost, solid, verified, and simple ‎to introduce correspondence foundation.‎ Method: The arrangement to actualize the GCI was accomplished ‎subsequent to passing two structure levels: device level and ‎system level. Result: The suggested system is highly applicable and serves a wide ‎range of smart city application fields and hence many ‎people and organizations can utilize this system. ‎ Conclusion: The presence of a reliable, secured, low cost, easy to install ‎and self-powered communication infrastructure is ‎mandatory in our nowadays. The communities in ‎developing countries or in rural areas need such a system ‎highly in order to communicate with other people in the ‎world which will affect positively their social and ‎economic situation.

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