scholarly journals Operational Challenges that May Affect Implementation of Evidence-Based Interventions at Mobile Produce Markets

2021 ◽  
Author(s):  
Christina Kasprzak ◽  
Anne Lally ◽  
Julia J. Schoonover ◽  
Deanna Gallicchio ◽  
Lindsey Haynes-Maslow ◽  
...  
Keyword(s):  
Organizational Factors ◽  
Evidence Based ◽  
Community Partnership ◽  
Community Partners ◽  
Outer Setting ◽  
Key Informant ◽  
Innovative Solutions ◽  
Inner Setting ◽  
Published Research ◽  
Mobile Market

Abstract Introduction: Mobile produce markets are becoming an increasingly prevalent, accepted, and effective strategy for improving fruit and vegetable (F&V) access and consumption across underserved and lower-income communities. However, there is limited published research on mobile market operations. The goal of this research is to identify the challenges mobile markets face and ways to potentially mitigate those challenges. We will also discuss implications of our findings on implementation of evidence-based interventions for mobile produce markets. Methods: We conducted 21 semi-structured key informant (KI) interviews to assess common practices of mobile market organizations that had been operating for 2 + years. We asked KIs about their organizational structure, operations, procurement and logistics, evaluation efforts, marketing and community engagement, success and challenges. All interviews were recorded, transcribed, and analyzed by two independent coders using ATLAS.ti 8.0 qualitative software. A secondary qualitative analysis identified subthemes related to common challenges and remedial practices. An inductive coding process was applied to match identified challenges to the appropriate Consolidated Framework for Implementation Research (CFIR). Results: The leading challenges cited by KIs correspond to the CFIR domains of inner setting (e.g., funding and resources), outer setting (e.g., navigating regulations), and process (e.g. engaging community partnership). Practices that may mitigate challenges include maximizing ancillary services, adopting innovative volunteer and staffing structures, and formalizing agreements with community partners. Conclusion: Common and persistent challenges ought to be addressed to ensure and enhance the positive public health impacts of mobile produce markets. Contextual factors, particularly organizational factors, that impact implementation should also be considered when implementing an evidence-based-intervention at a mobile market. Further research is needed to determine which innovative solutions are the most effective in mitigating challenges, improving implementation, and enhancing sustainability of mobile markets.

scholarly journals Operational Challenges That May Affect Implementation of Evidence-based Interventions at Mobile Produce Markets

2021 ◽  
Author(s):  
Christina Kasprzak ◽  
Anne Lally ◽  
Julia Schoonover ◽  
Deanna Gallicchio ◽  
Lindsey Haynes-Maslow ◽  
...  
Keyword(s):  
Organizational Factors ◽  
Evidence Based ◽  
Community Partnership ◽  
Lower Income ◽  
Outer Setting ◽  
Key Informant ◽  
Innovative Solutions ◽  
Inner Setting ◽  
Published Research ◽  
Mobile Market

Abstract Introduction: Mobile produce markets are becoming an increasingly prevalent, accepted, and effective strategy for improving fruit and vegetable (F&V) access and consumption across underserved and lower-income communities. However, there is limited published research on mobile market operations. The goal of this research is to identify the challenges mobile markets face and ways to potentially mitigate those challenges. We will also discuss implications of our findings on implementation of evidence-based interventions for mobile produce markets.Methods: We conducted 21 semi-structured key informant (KI) interviews to assess common practices of mobile market organizations that had been operating for 2 + years. We asked KIs about their organizational structure, operations, procurement and logistics, evaluation efforts, marketing and community engagement, success and challenges. All interviews were recorded, transcribed, and analyzed by two independent coders using ATLAS.ti 8.0 qualitative software. A secondary qualitative analysis identified subthemes related to common challenges and remedial practices. An inductive coding process was applied to match identified challenges to the appropriate Consolidated Framework for Implementation Research (CFIR).Results: The leading challenges cited by KIs correspond to the CFIR domains of inner setting (e.g., funding and resources), outer setting (e.g., navigating regulations), and process (e.g. engaging community partnership). Practices that may mitigate challenges include maximizing ancillary services, adopting innovative volunteer and staffing structures, and formalizing agreements with community partners.Conclusion: Common and persistent challenges ought to be addressed to ensure and enhance the positive public health impacts of mobile produce markets. Contextual factors, particularly organizational factors, that impact implementation should also be considered when implementing an evidence-based-intervention at a mobile market. Further research is needed to determine which innovative solutions are the most effective in mitigating challenges, improving implementation, and enhancing sustainability of mobile markets.

scholarly journals “We understand our community”: implementation of the Healthy Eating Healthy Aging program among community-based organizations

2020 ◽  
Author(s):  
Judy Leong ◽  
Sou Hyun Jang ◽  
Sonia K Bishop ◽  
Emily V R Brown ◽  
Eun Jeong Lee ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Healthy Eating ◽  
Healthy Aging ◽  
Successful Implementation ◽  
Evidence Based ◽  
Semistructured Interview ◽  
Community Based ◽  
Community Based Organizations ◽  
Outer Setting ◽  
Inner Setting

Abstract Cardiovascular disease is the second leading cause of death in the USA among Asian Americans and Pacific Islanders (AAPIs) over the age of 65. Healthy Eating Healthy Aging (HEHA), an evidence-based heart health program, can provide culturally appropriate nutrition education to decrease the risk of cardiovascular disease. Community-based organizations (CBOs) are optimal settings to implement community-based programs. However, there is inadequate research on how evidence-based interventions like HEHA are implemented in CBOs. This study examined processes that facilitated the implementation of HEHA among CBOs serving older AAPIs. Twelve representatives from CBOs that implemented the HEHA program were recruited to participate in a semistructured interview. All the participants were CBO directors or senior managers. A semistructured interview guide was created and informed by the Consolidated Framework for Implementation Research (CFIR) to capture how HEHA played into the five domains of CFIR: (a) intervention characteristics, (b) outer setting, (c) inner setting, (d) characteristics of the individuals, and (e) process. Data analysis captured themes under the CFIR domains. All five CFIR domains emerged from the interviews. Under intervention characteristics, three constructs emerged as facilitating the implementation of HEHA: (a) the participant’s beliefs around the quality of the HEHA program and its ability to promote healthy eating, (b) HEHA’s adaptability to different AAPI subgroups, and (c) perceptions of how successfully HEHA was bundled and assembled. Under outer setting, the participants described the community’s need for healthy eating programs and how the HEHA program meets that need. Four constructs emerged under inner setting: (a) the CBO’s structural characteristics and social standing in the community; (b) resources dedicated to the implementation and ongoing operations, including funding, training, education, physical space, and time; (c) the culture of the CBO; and (d) the participant’s commitment and involvement in marketing, promotion, and implementation of HEHA. Under characteristics of individuals, participants’ described their desire to learn the content of HEHA and deliver them successfully. Under process, participants described strategies to engage relevant individuals to facilitate HEHA implementation. The interviews with CBO representatives provided insights into CFIR domain constructs that facilitated the implementation of HEHA. CBOs are key settings for community health education. Understanding processes that lead to the successful implementation of evidence-based interventions among CBOs is critical for accelerating the dissemination and implementation of best practices.

Research Consumerism 101: Evaluating External Evidence of Treatment Effectiveness

2008 ◽  
Vol 17 (2) ◽  
pp. 43-49
Author(s):  
James L. Coyle
Keyword(s):  
Treatment Effectiveness ◽  
Code Of Ethics ◽  
Oropharyngeal Dysphagia ◽  
Clinical Importance ◽  
Professional Services ◽  
Adverse Outcomes ◽  
Professional Judgment ◽  
Evidence Based ◽  
Intervention Selection ◽  
Published Research

Abstract The modern clinician is a research consumer. Rehabilitation of oropharyngeal impairments, and prevention of the adverse outcomes of dysphagia, requires the clinician to select interventions for which evidence of a reasonable likelihood of a successful, important outcome exists. The purpose of this paper is to provide strategies for evaluation of published research regarding treatment of oropharyngeal dysphagia. This article utilizes tutorial and examples to inform and educate practitioners in methods of appraising published research. It provides and encourages the use of methods of efficiently evaluating the validity and clinical importance of published research. Additionally, it discusses the importance of the ethical obligation we, as practitioners, have to use evidence-based treatment selection methods and measurement of patient performance during therapy. The reader is provided with tactics for evaluating treatment studies to establish a study's validity and, thereby, objectively select interventions. The importance of avoiding subjective or unsubstantiated claims and using objective methods of generating empirical clinical evidence is emphasized. The ability to evaluate the quality of research provides clinicians with objective intervention selection as an important, essential component of evidence-based clinical practice. ASHA Code of Ethics (2003): Principle I, Rule F: “Individuals shall fully inform the persons they serve of the nature and possible effects of services rendered and products dispensed…” (p. 2) Principle I, Rule G: “Individuals shall evaluate the effectiveness of services rendered and of products dispensed and shall provide services or dispense products only when benefit can reasonably be expected.” (p. 2) Principle IV, Rule G: “Individuals shall not provide professional services without exercising independent professional judgment, regardless of referral source or prescription.” (p. 4)

Tailored interventions to support the implementation of the German national guideline on screening, diagnosis and treatment of alcohol-related disorders: a project protocol

2019 ◽  
Vol 65 (6) ◽  
pp. 373-381 ◽  
Author(s):  
Bernd Schulte ◽  
Christina Lindemann ◽  
Angela Buchholz ◽  
Anke Rosahl ◽  
Martin Härter ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Guideline Implementation ◽  
Implementation Strategies ◽  
Organizational Factors ◽  
Diagnosis And Treatment ◽  
Primary Data ◽  
Routine Practice ◽  
Evidence Based ◽  
Advisory Boards ◽  
Prevention And Treatment

Abstract. Background: The German Guideline on Screening, Diagnosis and Treatment of Alcohol Use Disorders aims to increase the uptake of evidence-based interventions for the early identification, diagnosis, prevention and treatment of alcohol-related disorders in relevant healthcare settings. To date, dissemination has not been accompanied by a guideline implementation strategy. The aim of this study is to develop tailored guideline implementation strategies and to field-test these in relevant medical and psycho-social settings in the city of Bremen, Germany. Methods: The study will conduct an impact and needs assessment of healthcare provision for alcohol use orders in Bremen, drawing on a range of secondary and primary data to: evaluate existing healthcare services; model the potential impact of improved care on public health outcomes; and identify potential barriers and facilitators to implementing evidence-based guidelines. Community advisory boards will be established for the selection of single-component or multi-faceted guideline implementation strategies. The tailoring approach considers guideline, provider and organizational factors shaping implementation. In field tests quality outcome indicators of the delivery of evidence-based interventions will be evaluated accompanied by a process evaluation to examine patient, provider and organizational factors. Outlook: This project will support the translation of guideline recommendations for the identification, prevention and treatment of AUD in routine practice and therefore contributes to the reduction of alcohol-related burden in Germany. The project is running since October 2017 and will provide its main outcomes by end of 2020. Project results will be published in scientific journals and presented at national and international conferences.

Será que estamos precisando de uma lava jato científica?

2019 ◽  
Vol 18 (1) ◽  
pp. 1
Author(s):  
Antonio Marcos Andrade
Keyword(s):  
Health Care ◽  
Medical Journal ◽  
British Medical Journal ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Plos Medicine ◽  
De Se ◽  
Research Findings ◽  
Based Medicine ◽  
Published Research

Em 2005, o grego John Loannidis, professor da Universidade de Stanford, publicou um artigo na PLOS Medicine intitulado “Why most published research findings are false” [1]. Ele que é dos pioneiros da chamada “meta-ciência”, disciplina que analisa o trabalho de outros cientistas, avaliou se estão respeitando as regras fundamentais que definem a boa ciência. Esse trabalho foi visto com muito espanto e indignação por parte dos pesquisadores na época, pois colocava em xeque a credibilidade da ciência.Para muitos cientistas, isso acontece porque a forma de se produzir conhecimento ficou diferente, ao ponto que seria quase irreconhecível para os grandes gênios dos séculos passados. Antigamente, se analisavam os dados em estado bruto, os autores iam às academias reproduzir suas experiências diante de todos, mas agora isso se perdeu porque os estudos são baseados em seis milhões de folhas de dados. Outra questão importante que garantia a confiabilidade dos achados era que os cientistas, independentemente de suas titulações e da relevância de suas descobertas anteriores, tinham que demonstrar seus novos achados diante de seus pares que, por sua vez, as replicavam em seus laboratórios antes de dar credibilidade à nova descoberta. Contudo, na atualidade, essas garantias veem sendo esquecidas e com isso colocando em xeque a validade de muitos estudos na área de saúde.Preocupados com a baixa qualidade dos trabalhos atuais, um grupo de pesquisadores se reuniram em 2017 e construíram um documento manifesto que acabou de ser publicado no British Medical Journal “Evidence Based Medicine Manifesto for Better Health Care” [2]. O Documento é uma iniciativa para a melhoria da qualidade das evidências em saúde. Nele se discute as possíveis causas da pouca confiabilidade científica e são apresentadas algumas alternativas para a correção do atual cenário. Segundo seus autores, os problemas estão presentes nas diferentes fases da pesquisa:Fases da elaboração dos objetivos - Objetivos inúteis. Muito do que é produzido não tem impacto científico nem clínico. Isso porque os pesquisadores estão mais interessados em produzir um número grande de artigos do que gerar conhecimento. Quase 85% dos trabalhos não geram nenhum benefício direto a humanidade.Fase do delineamento do estudo - Estudos com amostras subdimensionados, que não previnem erros aleatórios. Métodos que não previnem erros sistemáticos (viés na escolha das amostras, falta de randomização correta, viés de confusão, desfechos muito abertos). Em torno de 35% dos pesquisadores assumem terem construídos seus métodos de maneira enviesada.Fase de análise dos dados - Trinta e cinco por cento dos pesquisadores assumem práticas inadequadas no momento de análise dos dados. Muitos assumem que durante esse processo realizam várias análises simultaneamente, e as que apresentam significância estatística são transformadas em objetivos no trabalho. As revistas também têm sua parcela de culpa nesse processo já que os trabalhos com resultados positivos são mais aceitos (2x mais) que trabalhos com resultados negativos.Fase de revisão do trabalho - Muitos revisores de saúde não foram treinados para reconhecer potenciais erros sistemáticos e aleatórios nos trabalhos.Em suma é necessário que pesquisadores e revistas científicas pensem nisso. Só assim, teremos evidências de maior qualidade, estimativas estatísticas adequadas, pensamento crítico e analítico desenvolvido e prevenção dos mais comuns vieses cognitivos do pensamento.

The Role of Organizational Processes in Dissemination and Implementation Research

2017 ◽  
Author(s):  
Gregory A. Aarons ◽  
Joanna C. Moullin ◽  
Mark G. Ehrhart
Keyword(s):  
Health Care ◽  
Organizational Development ◽  
Organizational Factors ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Organizational Strategies ◽  
Evidence Based Practices ◽  
Effective Dissemination ◽  
Dissemination And Implementation Research ◽  
Ebp Implementation

Both organizational characteristics and specific organizational strategies are important for the effective dissemination and implementation of evidence-based practices (EBPs) in health and allied health care settings, as well as mental health, alcohol/drug treatment, and social service settings. One of the primary goals of this chapter is to support implementers and leaders within organizations in attending to and shaping the context in which implementation takes place in order to increase the likelihood of implementation success and long-term sustainment. The chapter summarizes some of the most critical organizational factors and strategies likely to impact successful evidence-based practice implementation. There are myriad approaches to supporting organizational development and change—this chapter focuses on issues supported by relevant scientific literatures, particularly those germane to EBP implementation in health care and related settings.

scholarly journals Catalyzing Implementation of Evidence-Based Interventions in Safety Net Settings: A Clinical–Community Partnership in South Los Angeles

2017 ◽  
Vol 18 (4) ◽  
pp. 586-597 ◽  
Author(s):  
Denise D. Payán ◽  
David C. Sloane ◽  
Jacqueline Illum ◽  
Roberto B. Vargas ◽  
Donzella Lee ◽  
...  
Keyword(s):  
Health Care ◽  
Los Angeles ◽  
Safety Net ◽  
Evidence Based ◽  
Community Partnership ◽  
South Los Angeles ◽  
Partnership Model ◽  
Clinical Community ◽  
Adoption And Implementation ◽  
Interview Guide

This study is a process evaluation of a clinical–community partnership that implemented evidence-based interventions in clinical safety net settings. Adoption and implementation of evidence-based interventions in these settings can help reduce health disparities by improving the quality of clinical preventive services in health care settings with underserved populations. A clinical–community partnership model is a possible avenue to catalyze adoption and implementation of interventions amid organizational barriers to change. Three Federally Qualified Health Centers in South Los Angeles participated in a partnership led by a local community-based organization (CBO) to implement hypertension interventions. Qualitative research methods were used to evaluate intervention selection and implementation processes between January 2014 and June 2015. Data collection tools included a key participant interview guide, health care provider interview guide, and protocol for taking meeting minutes. This case study demonstrates how a CBO acted as an external facilitator and employed a collaborative partnership model to catalyze implementation of evidence-based interventions in safety net settings. The study phases observed included initiation, planning, and implementation. Three emergent categories of organizational facilitators and barriers were identified (personnel capacity, professional development capacity, and technological capacity). Key participants and health care providers expressed a high level of satisfaction with the collaborative and the interventions, respectively. The CBO’s role as a facilitator and catalyst is a replicable model to promote intervention adoption and implementation in safety net settings. Key lessons learned are provided for researchers and practitioners interested in partnering with Federally Qualified Health Centers to implement health promotion interventions.

scholarly journals Community Partnership Interprofessional Program as Pedagogy: Process Outcomes and Faculty Impressions

2014 ◽  
Vol 4 (2) ◽  
Author(s):  
Mary Ann Littleton ◽  
Ken Z. Silver ◽  
Susan L. Grover ◽  
Rachel Ward ◽  
Randy L. Byington ◽  
...  
Keyword(s):  
Health Education ◽  
Rural Health ◽  
Interprofessional Education ◽  
Health Program ◽  
Community Partnership ◽  
State University ◽  
Faculty Work ◽  
Community Partners ◽  
Traditional Health ◽  
Process Outcomes

Background: Since 1992, East Tennessee State University (ETSU) has augmented traditional health professions curricula with community-based, experiential learning through the Community Partnership Interprofessional Rural Health Program. The program was expanded in 2005 by including more interprofessional faculty, students, and community partners. Interprofessional teams of students and faculty work with community organizations to identify health needs and assets and implement health education programs or services.Methods and Findings: Course process outcomes were compiled from a survey of section reports and presentations. Faculty impressions of being involved in the course were gathered through conducting interviews with five interprofessional faculty. From 2005–2011, community partners included individuals, groups, and organizations within seven counties in Tennessee. Forty programs and services have been implemented through the program during the past seven years. Faculty reported the main reasons for being involved are their interests in interprofessional education and working in communities. Faculty also cited 12 different types of teaching strategies (pedagogical approaches) employed through the course.Conclusions: The Community Partnership Interprofessional Rural Health Program at ETSU is a testing ground for the unique combination of communitybased learning and interprofessional health education. Study findings demonstrate how the course has benefited faculty, students, and communities.

scholarly journals Incorporating Evidence in Clinical Education; Barriers and Opportunities in Allied Health

2011 ◽  
Author(s):  
Clare Delany ◽  
Andrea Bailocerkowski
Keyword(s):  
Clinical Education ◽  
Professional Education ◽  
Self Efficacy ◽  
Allied Health ◽  
Research Evidence ◽  
Hospital Setting ◽  
Organizational Factors ◽  
Data Uncertainty ◽  
Evidence Based ◽  
Clinical Educators

Clinical education is a key component of health professional education. Clinical educators, like clinicians, are increasingly expected to access and apply evidence from clinical education theories to inform their teaching methods and approaches. Purpose: This study evaluated personal and organizational factors that influenced the ability to access and apply clinical education research evidence into clinical teaching in a group of allied health practitioners at one large metropolitan hospital in Melbourne, Australia. Method: A Cross-sectional survey based on a previously published survey of clinical physiotherapists was custom-designed to examine the factors that influence evidence based practices (EBP) of a range of allied health clinicians working as clinical educators in the hospital setting. Results: The majority of respondents were aware of the importance of evidence-based practice to their work as clinical educators. However, their positive beliefs about the value of EBP were moderated by four inhibiting factors: moderate levels of self-efficacy in accessing and applying clinical education evidence; low levels of self-efficacy in interpreting research data; uncertainty with respect to who is responsible for searching, and critically appraising research evidence; and lack of time and organisational priority for such activities. Conclusions: These results highlight a combination of factors, both intrinsic (skills of the educator) and extrinsic (organisational), that impact on the effective application and integration of evidence from the literature to inform clinical education practices. They also provide directions for increasing the use of EBP for clinical educators, including creating clinical education and workplace cultures that value and promote critical appraisal of EBP in everyday clinical education practice and the need for ongoing professional development opportunities in EBP.

scholarly journals Engaging Religious Institutions to Address Racial Disparities in HIV/AIDS: A Case of Academic-Community Partnership

2014 ◽  
Vol 2 (1) ◽  
pp. 95-114 ◽  
Author(s):  
Magdalena Szaflarski ◽  
Lisa M. Vaughn ◽  
Camisha Chambers ◽  
Mamie Harris ◽  
Andrew Ruffner ◽  
...  
Keyword(s):  
African American ◽  
Black Churches ◽  
Academic Community ◽  
Faith Communities ◽  
Hiv Stigma ◽  
Community Partnership ◽  
Religious Institutions ◽  
Community Partners ◽  
Faith Leaders ◽  
Primary Strategy

African Americans face the most severe burden of HIV among all racial and ethnic groups. Direct involvement of faith leaders and faith communities is increasingly suggested as a primary strategy to reduce HIV-related disparities, and Black churches are uniquely positioned to address HIV stigma, prevention, and care in African American communities. The authors describe an academic-community partnership to engage Black churches to address HIV in a predominantly African American, urban, southern Midwest location. The opportunities, process, and challenges in forming this academic community partnership with Black churches can be used to guide future efforts toward engaging faith institutions, academia, and other community partners in the fight against HIV.

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