scholarly journals Feasibility and Effect of Adding a Concurrent Parental Component to a School-Base Wellness Program Using Two Modes of Mobile-Based Technology – Mixed Methods Evaluation of RCT

2021 ◽  
Author(s):  
Moria Golan ◽  
Shakked Benifla ◽  
Aviv Samo ◽  
Noa Alon ◽  
Maya Mozeikov
Keyword(s):  
Mixed Methods ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Feasibility Studies ◽  
Smartphone Application ◽  
Self Report ◽  
Structured Interviews ◽  
Post Intervention ◽  
Staff Members ◽  
Small Effect Size

Abstract Background: This study assessed the feasibility and effect of two mobile modes (WhatsApp vs. a specially designed app) in their delivery of updates and assignments to parents.Methods: Two three-armed, randomized, controlled feasibility studies were conducted. Participants were randomly allocated to the control arm, youth-only arm, or youth & parental component arm. In the parental component, parents received updates and were requested to complete shared assignments with their children. In the first year, the assignments were sent through WhatsApp and in the following year via the specially designed smartphone application. Students and parents filled out questionnaires at three measure points: pre and post intervention and at three months follow-up. Mixed-methods assessments were performed using semi-structured interviews with parents and school staff members, as well as a computerized self-report questionnaire.Results: The addition of the concurrent parental component via WhatsApp was associated with superior improvement in self-esteem and identification of advertisement strategies, compared with the youth-only program. However, adolescents in the youth-only program delivered via the specially designed application demonstrated superior improvement compared to those in the youth & parental component arm.Conclusions: Although the addition of the concurrent parenting component was praised by the actively participating parents, overall, this intervention was not statistically superior to the youth-only arm. Only a few variables demonstrated statistically significant improvement, usually with a small effect size. The use of WhatsApp had higher feasibility and uptake than the use of the specially designed application. Under the chosen structure and population, it seems that the program did not have the intended impact. Parents who expressed specific resistance may have negatively affected their children, causing them to be less engaged. A cost-benefit analysis of programs with parental components as well as the development of strategies to enhance parent-school partnership are warranted.Trial registrations: NCT04129892 (1.11.2017) and NCT03540277 (26.4.2018)

scholarly journals Controlling tsetse flies and ticks using insecticide treatment of cattle in Tororo district Uganda: cost benefit analysis 

2021 ◽  
Author(s):  
Walter O. Okelo ◽  
Ewan T. MacLeod ◽  
Dennis Muhanguzi ◽  
Susan C. Welburn
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Economic Benefits ◽  
Tsetse Flies ◽  
Cattle Population ◽  
Benefit Analysis ◽  
Structured Interviews ◽  
Post Intervention ◽  
Incremental Benefit ◽  
Benefit Cost

Abstract BackgroundThe endemic vector-borne diseases transmitted by tsetse and ticks impose heavy burdens on Africa’s livestock. Cattle offers the possibility of mitigating these losses at a cost affordable to livestock keepers, by applying deltamethrin just to the belly, legs and ears of cattle. Although studies have quantified the impacts of individual diseases on livestock productivity, little is known about the dual economic benefits of controlling both tsetse and ticks, nor about the number of cattle who need to be treated to confer these benefits. Alongside an epidemiological study in south-east Uganda, a farm level assessment was done to investigate the benefits and costs of spraying different proportions of the village cattle population using this restricted application protocol. MethodsA study comprising 1,902 semi-structured interviews was undertaken over a period of 18 months. Financial data on household income from and expenditure on cattle was collected and cost benefit analysis done, pre and post intervention and for different spraying regimes. The total cost of the intervention was obtained from the epidemiological study’s implementation costs and from expenses incurred by participating farmers enabling examination of benefit-cost ratios and incremental benefit-cost ratios for each treatment regime. ResultsThe benefit-cost analysis of spraying 25%, 50% and 75% of the cattle population yielded average benefit-cost ratios of 1.55, 3.85, 4.51 and 4.46. The incremental benefit-cost ratios from spraying each additional 25% of the cattle population were 11.38, 3.89 and 0.79 respectively, showing a very high return on investment for spraying 50% of the population, with returns reducing thereafter. ConclusionComparing the gross margins per bovine, the study found that increasing the proportion of cattle sprayed yielded increasing benefits to farmers, but that these benefits were subject to diminishing returns. From a practical viewpoint this study recommends spraying only draft cattle to control trypanosomiasis and tick-borne diseases in this area as they make 38.62% of the cattle population, approaching the 50% threshold. In areas with a lower proportion of draft males, farmers could be advised to also include cows.

Individualized cancer follow-up supported by electronic Patient-Reported Outcomes: Development and evaluation (Preprint)

2020 ◽  
Author(s):  
Sissel Ravn ◽  
Henriette Vind Thaysen ◽  
Lene Seibaek ◽  
Victor Jilbert Verwaal ◽  
Lene Hjerrild Iversen
Keyword(s):  
Ct Scan ◽  
Advanced Cancer ◽  
Patient Reported Outcomes ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Structured Interviews ◽  
European Organization ◽  
Individualized Care ◽  
Patient Reported

BACKGROUND Cancer survivors experience unmet needs during follow-up. Besides recurrence, a follow-up includes detection of late side effects, rehabilitation, palliation and individualized care. OBJECTIVE We aimed to describe the development and evaluate the feasibility of an intervention providing individualized cancer follow-up supported by electronic patient-reported outcomes (e-PRO). METHODS The study was carried out as an interventional study at a Surgical and a Gynecological Department offering complex cancer surgery and follow-up for advanced cancer. The e-PRO screened for a priori defined clinical important symptoms and needs providing individualized follow-up. We included following questionnaires in the e-PRO; the general European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC validated for colorectal and ovarian cancer patients. To support individualization, we included three prioritized issues of the patient’s preference in each e-PRO. The response-algorithm was aggregated based on the severity of the patient’s response. To ensure the sensitivity of the e-PRO, we performed semi-structured interviews with five patients. All clinicians (surgeons and gynecologists) performing the consultations reviewed the e-PRO. The evaluation was divided in two, 1)The feasibility was assessed by a)Patients’ response rate of the e-PRO, b)Number of follow-up visits documenting the use of e-PRO and c)Patients’ prioritized issues prior to the consultation(‘yes’ / ‘no’), and after the follow-up 2)Patients assessment of a)The need and purpose of the follow-up visit and b)the support provided during the follow-up visit. RESULTS In total, 187 patients were included in the study, of which 73%(n=136/187) patients responded to the e-PRO and were subjected to an individualized follow-up. The e-PRO was documented as applied in 79% of the follow-up visits. In total, 23% of the prioritized issues did not include a response. Stratified by time since surgery, significantly more patients did not fill out a prioritized issue had a follow-up >6 months since surgery. In total, 72 % follow-up visits were evaluated to be necessary in order to discuss the outcome of the CT scan, symptoms, and/or prioritized issues. Contrary, 19% of the follow-up visits were evaluated to be necessary only to discuss the result of the CT scan. A range from 19.3–56.3% of patients assessed the follow-up visit to provide support with respect to physical (42% of patients), mental (56%), sexual (19%) or dietary (27%) issues. Further, a range from 34–60% of the patients reported that they did not need support regarding physical (43% of patients), mental (34%), sexual (63%) or dietary (57%) issues. CONCLUSIONS An individualized follow-up based on e-PRO is feasible, and support most patients surgically treated for advanced cancer. However, results indicate that follow-up based on e-PRO may not be beneficial for all patients and circumstances. A thorough cost-benefit analysis may be warranted before implementation in routine clinic.

scholarly journals Health-related quality of life among 13–14 year old adolescents with overweight - a mixed methods approach

2019 ◽  
Author(s):  
Turid Kristin Bigum Sundar ◽  
Kirsti Riiser ◽  
Milada Småstuen ◽  
Randi Opheim ◽  
Knut Løndal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Well Being ◽  
Reference Population ◽  
Health Related Quality ◽  
Structured Interviews ◽  
Post Intervention ◽  
Related Quality ◽  
Health Related

Abstract BackgroundOverweight and obesity are public concerns with risk of adverse health outcomes. Health-related quality of life (HRQoL) is lower in adolescents than children in general. An increase in body mass index (BMI) is associated with a decrease in HRQoL. The purpose of this study was to measure and explore the HRQoL among adolescents with overweight or obesity who had participated in an intervention study with the aim of increasing PA, reducing BMI and promoting HRQoL.Methods Mixed methods, with a convergent design, were used to investigate how different methodological approaches could expand our understanding of the adolescents’ HRQoL. Quantitative post-intervention data on HRQoL were collected among the 84 intervention participants, aged 13–14 years, using the KIDSCREEN 52 questionnaire. The data were compared with a Norwegian reference population of 244 individuals, and analysed using a non-parametric Mann-Whitney test. Qualitative semi-structured interviews were conducted with 21 adolescents from the intervention. A directed approach to content analysis was adopted, using the ten sub-scales from KIDSCREEN 52.ResultsHRQoL in the intervention sample was significantly reduced on the sub-scale of physical well-being compared to the reference population. The reference population scored significantly lower than the intervention sample on the sub-scale of parent relation and home life. No significant differences were found on the other sub-scales. The qualitative data supported the quantitative findings on the sub-scale of physical well-being, but showed that perceptions of fitness, energy level or health could vary. Regarding parent relations, the interviewees extended this to include relationships to other family members as equally important. Most of the interviewees expressed a negative view of their bodies, but not their clothing or accessories. This may explain why no statistically significant differences were found on these aspects in the results from the KIDSCREEN questionnaire. ConclusionThe use of the KIDSCREEN 52 instrument gave important indications about the adolescents’ HRQoL. Combining methods enabled a comprehensive approach to research on HRQoL, indicating better ways of providing help. More research using the benefits of mixed methods approaches is needed to further elucidate these findings.

scholarly journals Are the benefits of lean rapid process improvement workshops in healthcare worth the investment?

2020 ◽  
Vol 9 (2) ◽  
pp. 1
Author(s):  
James G. Chan ◽  
Jalil Safaei ◽  
Thomas Rotter
Keyword(s):  
Process Improvement ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Interrupted Time Series ◽  
Conclusive Evidence ◽  
Post Intervention ◽  
Process Measures ◽  
Rapid Process ◽  
Lean Tools ◽  
And Control

Background: Many organizations have adopted Lean tools to improve healthcare, but few studies adequately evaluate the effectiveness of Lean tools, such as Rapid Process Improvement Workshops (RPIWs).Objective: To evaluate the effectiveness of RPIWs conducted in surgical services at two hospital sites from economic and statistical perspectives.Methods: Retrospective data over three years from the two interventions sites were used for a cost-benefit analysis in the form of Return on Investment (ROI). The Interrupted Time Series (ITS) method was used to analyze the trends of selected process measures such as surgical volumes, overtime, and sick time hours during intervention and post-intervention periods at the two sites. Also, comparable data from two control sites were used to statistically compare the trends of some of the process measures between the intervention and control sites.Results: The cumulative effects of the six RPIWs performed at each site were examined. The results did not produce any evidence to indicate that the outcomes justify the investments. The ITS analysis revealed no indication of systematic and sustained change in the pattern of process measures at the intervention sites as a result of RPIWs. Nor did they provide significant or conclusive evidence when comparing the process measures between the intervention and control sites.Conclusions: This study identifies some of the difficulties of empirically calculating the ROI of RPIWs, and provides evidence that any realized benefits due to RPIWs implemented in two hospitals were not worth the investment. Such a result may lead us to challenge any unfounded claims of high monetary benefits from Lean tools or similar quality improvement initiatives.

Information Technology Process Improvement Decision-Making

2012 ◽  
Vol 3 (2) ◽  
pp. 18-35
Author(s):  
Sandy A. Lamp ◽  
Kathleen M. Hargiss ◽  
Caroline Howard
Keyword(s):  
Decision Making ◽  
Process Improvement ◽  
Cost Benefit Analysis ◽  
Investment Decision ◽  
Cost Benefit ◽  
Final Decision ◽  
Insurance Company ◽  
Senior Leadership ◽  
Structured Interviews ◽  
Process Managers

This article is derived from a qualitative multicase study with two settings that explored the way decisions are made in two IT organizations regarding process improvement initiatives by using face-to-face semi-structured interviews with 20 IT process owners and managers. The two participating organizations are a healthcare insurance company and a manufacturer of electronic interconnects. The study sought to uncover (a) how IT process improvements are prioritized and how approvals are attained, (b) how senior leadership is involved in decision making, (c) how security and risk are considered, (d) if and how formal process improvement methodologies are used, (e) if and how estimated and actual cost benefit analysis are conducted associated with decisions, and (f) how alignment with organizational goals is attained. The topic of IT governance was narrowed to explore the perspective of IT process owners and process managers, and their approaches and methodologies used with IT process improvement initiatives. The study found that pre-decision stages take place in IT investment decision making, and that process owners and process managers, participants other than senior leadership, and executive level decision makers are involved in these pre-decision stages and may be involved in the final decision stages.

scholarly journals Implementing the Aseptic Non Touch Technique (ANTT®) clinical practice framework for aseptic technique: a pragmatic evaluation using a mixed methods approach in two London hospitals

2017 ◽  
Vol 19 (1) ◽  
pp. 6-15 ◽  
Author(s):  
Simon Clare ◽  
Stephen Rowley
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Infection Prevention ◽  
Self Report ◽  
Healthcare Associated Infection ◽  
Structured Interviews ◽  
Aseptic Technique ◽  
Mixed Methods Approach ◽  
Practice Framework ◽  
Mean Compliance

Background: Aseptic technique is an important infection prevention competency for protecting patients from healthcare-associated infection (HAI). Healthcare providers using the Aseptic Non Touch Technique (ANTT®) aseptic technique have demonstrated reduced variability and improved compliance with aseptic technique. Objectives: The primary aim of this study is to determine whether standardizing aseptic technique for invasive IV procedures, using the ANTT® - Clinical Practice Framework (CPF), increases staff compliance with the infection prevention actions designed to achieve a safe and effective aseptic technique, and whether this is sustainable over time. Methods: A pragmatic evaluation using a mixed-methods approach consisting of an observational audit of practice, a self-report survey and structured interviews with key stakeholders. Compliance with aseptic technique before and after the implementation of ANTT® was measured by observation of 49 registered healthcare professionals. Results: Mean compliance with competencies was 94%; each component of practice was improved over baseline: hand hygiene = 63% ( P ≤ 0.001); glove use = 14% ( P ≤ 0.037); Key-Part protection = 54% ( P ≤ 0.001); a non-touch technique = 45% ( P ≤ 0.001); Key-Part cleaning = 82% ( P ≤ 0.001); and aseptic field management = 80% ( P ≤ 0.001). Conclusions: Results show implementation of ANTT® improved compliance with the prerequisite steps for safe and effective aseptic technique as defined by the ANTT®-CPF. Improvements in compliance were sustained over four years.

An evaluation of the skills group component of DBT-A for parent/guardians: a mixed methods study

2020 ◽  
pp. 1-9
Author(s):  
Daniel Flynn ◽  
Conall Gillespie ◽  
Mary Joyce ◽  
Ailbhe Spillane
Keyword(s):  
Mixed Methods ◽  
Family Relationships ◽  
Parental Stress ◽  
Self Report ◽  
Subjective Burden ◽  
Behaviour Therapy ◽  
Post Intervention ◽  
Comparison Groups ◽  
National Public Health ◽  
Skills Group

Objectives: Previous research indicates that dialectical behaviour therapy for adolescents (DBT-A) is effective in treating emotionally dysregulated adolescents with self-harm and/or suicidal ideation. As part of the DBT-A programme, parents attend the weekly skills group with their child. However, few studies have evaluated parental outcomes in DBT-A. This multi-site study aims to explore the outcomes and experiences of parents who participated in a 16-week DBT-A programme in Ireland. Methods: This study was conducted in community-based child and adolescent mental health services (CAMHS) in the national public health system in Ireland. Participants were parent/guardians of adolescents attending a DBT-A programme in their local CAMHS. Participants attended the group skills component of the DBT-A programme. This study utilised a mixed methods approach where both quantitative and qualitative data were collected from participants. Self-report measures of burden, grief and parental stress were completed at pre-intervention, post-intervention and 16-week follow-up. Qualitative written feedback was obtained at post-intervention. The data were analysed using multi-level linear mixed-effects models and content analysis. Results: One hundred participants (76% female) took part in this study. Significant decreases were reported for objective burden, subjective burden, grief and parental stress from pre- to post-intervention (p < 0.01). Participants reported that the skills component of DBT-A was useful in meeting their own needs and the needs of their child. Discussion: DBT-A shows promise for parents as well as their adolescent child. Future studies should evaluate changes to family relationships following completion of the programme and also include controlled comparison groups.

scholarly journals Adoption of Technology Upgrading by Rural Smallholders in the Nepalese Coffee Sector

2015 ◽  
Vol 2 (2) ◽  
pp. 1 ◽  
Author(s):  
Rishi Ram Kattel
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Global Market ◽  
Small Scale ◽  
Structured Interviews ◽  
Adoption Of Technology ◽  
Access To Credit ◽  
Wet Processing ◽  
Coffee Cultivation ◽  
Technology Upgrading

The ecological settings in the Himalayan hills provide a unique opportunity to the resource-poor farmers in Nepal to sell their organically produced coffee as specialty coffee in the global market. However, there is little research about the cultivation methods and adoption of profitable technological upgrading in coffee cultivation in the country. Against such a back drop, this paper seeks to explore the factors that influence the small-scale coffee farmers’ decision to adopt technological upgrading such as wet processing in the farming process. Semi-structured interviews as well as focus group discussions were conducted in selected coffee-growing rural regions of Nepal. The cost-benefit analysis of different modes of coffee processing shows that the adoption of wet processing has a large potential of increasing the profit margins of farmers. Results from an adoption model identify education, book keeping on coffee activities, training, and access to credit and household location as the key determining factors for the adoption of technology upgrading.

scholarly journals A Cost and Cost-Benefit Analysis of the Stand More AT Work (SMArT Work) Intervention

2020 ◽  
Vol 17 (4) ◽  
pp. 1214 ◽  
Author(s):  
Fehmidah Munir ◽  
Paul Miller ◽  
Stuart J.H. Biddle ◽  
Melanie J. Davies ◽  
David W. Dunstan ◽  
...  
Keyword(s):  
Cost Benefit Analysis ◽  
Work Productivity ◽  
Cost Benefit ◽  
Self Report ◽  
Sitting Time ◽  
Control Group ◽  
Supporting Evidence ◽  
Benefit Analysis ◽  
Usual Practice ◽  
Intervention Cost

This study conducted a cost and cost-benefit analysis of the Stand More AT (SMArT) Work workplace intervention, designed to reduce sitting time. The study was a cluster two-armed randomised controlled trial involving 37 office clusters (146 desk-based workers) in a National Health Service Trust. The intervention group received a height-adjustable workstation with supporting behaviour change strategies. The control group continued with usual practice. Self-report absenteeism, presenteeism and work productivity were assessed at baseline, 3, 6 and 12 months; and organisational sickness absence records 12 months prior to, and 12 months of the intervention. Mean per employee costs associated with SMArT Work were calculated. Absenteeism, presenteeism and work productivity were estimated, and employer-recorded absence data and employee wage-banding were used to provide a human-capital-based estimate of costs to the organisation. The return-on-investment (ROI) and incremental cost-efficacy ratios (ICER) were calculated. Intervention cost was £692.40 per employee. Cost-benefit estimates show a net saving of £1770.32 (95%CI £-354.40, £3895.04) per employee as a result of productivity increase. There were no significant differences in absence data compared to the control group. SMArT Work provides supporting evidence for policy-makers and employers on the cost benefits of reducing sitting time at work.

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