scholarly journals A Web-Based Alcohol Risk Communication Tool: Development and Pretesting Study

10.2196/13224 ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. e13224
Author(s):  
Bridget Kool ◽  
Rosie Dobson ◽  
Sarah Sharpe ◽  
Gayl Humphrey ◽  
Robyn Whittaker ◽  
...  
Keyword(s):  
Primary Care ◽  
Focus Groups ◽  
Risk Communication ◽  
Health Professionals ◽  
Health Concern ◽  
Communication Tool ◽  
Web Based ◽  
Key Informants ◽  
Alcohol Risk ◽  
Doctors And Nurses

Background Alcohol use is a major public health concern associated with an increased risk of morbidity and mortality. Health professionals in primary care commonly see patients with a range of alcohol-related risks and problems, providing an ideal opportunity for screening and brief intervention (BI). Objective This study aimed to develop a prototype for a Web-based tool for use by primary care health professionals (eg, doctors and nurses) to communicate alcohol harm risk to their patients and to engage with them regarding ways this risk could be reduced. Methods Following conceptualization and development of prototype wireframes, formative work and pretesting were undertaken. For the formative work, focus groups and key informant interviews were conducted with potential end users of the risk communication tool, including health professionals and consumers. The focus groups and interviews explored perceptions of alcohol risk communication and obtained feedback on the initial prototype. For pretesting, participants (primary care doctors and nurses) completed a Web-based survey followed by a period of pretesting before completion of a follow-up survey. The study was designed to gain feedback on the tool’s performance in real-world settings as well as its relevance, ease of use, and any suggested refinements. Results In the formative work stage, 11 key informants and 7 consumers participated in either focus groups or individual interviews. Participants were very positive about the prototype and believed that it would be useful and acceptable in practice. Key informants identified that the key point of difference with the tool was that it provided all the pieces in 1 place (ie, assessment, interpretation, and resources to support change). Participants provided feedback on how the tool could be improved, and these suggestions were incorporated into the prototype where possible. In the pretesting stage, 7 people (5 doctors and 2 primary care nurses) completed the pretesting. Participants reported that the tool provided a useful framework for an intervention, that it would be acceptable to patients, that it was easy to use, that they would be likely to use it in practice, and that there were no technical issues. Conclusions The alcohol risk communication tool was found to be acceptable and has the potential to increase the confidence of health professionals in assessing risk and providing BI.

scholarly journals A Web-Based Alcohol Risk Communication Tool: Development and Pretesting Study (Preprint)

2018 ◽  
Author(s):  
Bridget Kool ◽  
Rosie Dobson ◽  
Sarah Sharpe ◽  
Gayl Humphrey ◽  
Robyn Whittaker ◽  
...  
Keyword(s):  
Primary Care ◽  
Focus Groups ◽  
Risk Communication ◽  
Health Professionals ◽  
Health Concern ◽  
Communication Tool ◽  
Web Based ◽  
Key Informants ◽  
Alcohol Risk ◽  
Doctors And Nurses

BACKGROUND Alcohol use is a major public health concern associated with an increased risk of morbidity and mortality. Health professionals in primary care commonly see patients with a range of alcohol-related risks and problems, providing an ideal opportunity for screening and brief intervention (BI). OBJECTIVE This study aimed to develop a prototype for a Web-based tool for use by primary care health professionals (eg, doctors and nurses) to communicate alcohol harm risk to their patients and to engage with them regarding ways this risk could be reduced. METHODS Following conceptualization and development of prototype wireframes, formative work and pretesting were undertaken. For the formative work, focus groups and key informant interviews were conducted with potential end users of the risk communication tool, including health professionals and consumers. The focus groups and interviews explored perceptions of alcohol risk communication and obtained feedback on the initial prototype. For pretesting, participants (primary care doctors and nurses) completed a Web-based survey followed by a period of pretesting before completion of a follow-up survey. The study was designed to gain feedback on the tool’s performance in real-world settings as well as its relevance, ease of use, and any suggested refinements. RESULTS In the formative work stage, 11 key informants and 7 consumers participated in either focus groups or individual interviews. Participants were very positive about the prototype and believed that it would be useful and acceptable in practice. Key informants identified that the key point of difference with the tool was that it provided <italic>all the pieces</italic> in 1 place (ie, assessment, interpretation, and resources to support change). Participants provided feedback on how the tool could be improved, and these suggestions were incorporated into the prototype where possible. In the pretesting stage, 7 people (5 doctors and 2 primary care nurses) completed the pretesting. Participants reported that the tool provided a useful framework for an intervention, that it would be acceptable to patients, that it was easy to use, that they would be likely to use it in practice, and that there were no technical issues. CONCLUSIONS The alcohol risk communication tool was found to be acceptable and has the potential to increase the confidence of health professionals in assessing risk and providing BI.

scholarly journals Conceptions of the professionals about their attributions in the Expanded Nucleus of Family Health

Psico-USF ◽  
2019 ◽  
Vol 24 (4) ◽  
pp. 661-671
Author(s):  
Meyrielle Belotti ◽  
Alexandra Iglesias ◽  
Luziane Zacché Avellar
Keyword(s):  
Primary Care ◽  
Qualitative Research ◽  
Content Analysis ◽  
Data Collection ◽  
Focus Groups ◽  
Health Professionals ◽  
Family Health ◽  
Work Processes ◽  
The Family ◽  
Specialized Care

Abstract The article aims to analyze the conceptions conferred by the health professionals that compose the Expanded Nuclei of Family Health (NASF) on their work assignments. This is a qualitative research, in which was used, for the data collection, eight focus groups, with a total of 43 participants. The data were submitted to content analysis. The results outlined the following categories: integrating NASF work with the Family Health Teams (ESF); developing specialized care; promoting intersectionality; contributing to the promotion of teamwork in Primary Care (AB) and strengthening AB. The study indicates the importance of a better understanding of the functions of the NASF, so that it does not restrict the opportunity to perform specialized care in AB. It is pointed out, the need for adjustments in the work processes of the ESF, in order to enable the shared work in the AB.

scholarly journals Feasibility, acceptability, and effectiveness of a web-based therapeutic intervention for post-traumatic stress disorder among American Indian/Alaska Native adults in primary care (Preprint)

2019 ◽  
Author(s):  
Vanessa Hiratsuka ◽  
Laurie Moore ◽  
Jaedon P Avey ◽  
Lisa G Dirks ◽  
Barbara D Beach ◽  
...  
Keyword(s):  
Primary Care ◽  
American Indian ◽  
Alaska Native ◽  
Repeated Measures ◽  
Stress Disorder ◽  
Health Concern ◽  
Web Based ◽  
Study Enrollment ◽  
Primary Care Patients

BACKGROUND Posttraumatic stress disorder (PTSD) is a major public health concern among American Indian and Alaska Native (AI/AN) populations. Primary care clinics are often the first point of contact for AI/AN people seeking health care and are feasible locations for trauma-focused interventions. OBJECTIVE Web-based therapeutic interventions (WBTI) for PTSD have the potential to reduce PTSD symptoms in AI/AN primary care patients by offering culturally tailored psychoeducation and symptom self-management tools. In this study, we investigate the feasibility and acceptability in two AI/AN serving primary care sites and effectiveness of a WBTI on trauma symptom changes in a 12-week period. METHODS A community-based participatory research process was used to refine the WBTI adaptations and content, and conduct a feasibility test of the resultant 16-guide intervention “Health is Our Tradition: Balance and Harmony after Trauma” within two AI/AN healthcare settings. AI/AN people ages 18 years and older who were not in crisis and scored positive on the primary care PTSD instrument completed baseline measures and were trained on WBTI usage. Participants were provided weekly tip via text message during the 12-week intervention. Content was devised to reinforce website use, complement website content, and remind participants about follow-up visits. At each visit, participants completed follow-up versions of all baseline measures (except demographics) including the PC-PTSD and a satisfaction/acceptability questionnaire. Electronic health records were collected for the periods extending to 12 months prior to study enrollment and 3 months following study enrollment. Changes in perceptions of acceptability/feasibility between the 6-week and 12-week follow-up were examined with paired t-tests. Analysts explored changes in symptomatology over the 12-week intervention with one-way ANOVAs for repeated measures or repeated measures logistic regression tests. To examine the effect of the intervention on service utilization, analysts compared clinic visit frequency from the health record data in the 12 months before the intervention (divided by 4 for comparison) and the 3 months after it with paired t-tests. The Wilcoxon Signed Rank Test for non-parametric data was used to test significance for non-normally distributed data. RESULTS In a sample of N=24, the WBTI was well received with no difference in use, engagement, satisfaction or technical skills needed for use by age or gender. Website usage decreased significantly over the course of the 12-week intervention period yet participants reported significant reductions in PTSD, depression, and physical symptoms related to PTSD, and problematic alcohol use over the same period of WBTI usage. CONCLUSIONS The website shows promise for integration into primary care and behavioral health settings to augment and improve access to treatment of the health consequences of trauma exposure among adult AI/AN primary care patients.

scholarly journals Expectations Among Patients and Health Professionals Regarding Web-Based Interventions for Depression in Primary Care: A Qualitative Study

2015 ◽  
Vol 17 (3) ◽  
pp. e67 ◽  
Author(s):  
Jesús Montero-Marín ◽  
Javier Prado-Abril ◽  
Cristina Botella ◽  
Fermin Mayoral-Cleries ◽  
Rosa Baños ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Health Professionals ◽  
Web Based

scholarly journals Identification of the multimorbidity training needs of primary care professionals: Protocol of a survey

2021 ◽  
Vol 11 ◽  
pp. 263355652110247
Author(s):  
Francisca Leiva-Fernández ◽  
Alba González-Hevilla ◽  
Juan Daniel Prados-Torres ◽  
Fuensanta Casas-Galán ◽  
Eva García-Domingo ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Professionals ◽  
Online Survey ◽  
National Health System ◽  
Training Needs ◽  
Ordinal Scale ◽  
Health Determinants ◽  
Multiple Choice Questions ◽  
Training Interventions ◽  
Doctors And Nurses

Background: Current epidemiological situation has prompted the consideration of multimorbility (MM) as a prevalent condition, influenced by age, educational level and social support, related to unfavorable social and health determinants. Primary Care (PC) has a key role in its approach but further training of professionals in MM is required. The evidence on the effectiveness of training interventions in MM is still limited. Knowing the experiences, opinions and training needs of professionals is essential to enhance training interventions. Objectives: Identify perceived training needs by PC health professionals (doctors and nurses) in MM and polypharmacy. Methods: Design: Cross-sectional study based on an online survey (anonymous-ad hoc questionnaire). Participants and recruitment: 384 doctors and nurses working in healthcare centers and out-of-hospital emergencies of the Spanish National Health System. Non-probabilistic convenience sampling via email addressed to Health Institutions, and social networks. Data: Demographic characteristics and professional profile data (close-ended and multiple-choice questions) will be collected. Open-ended questions will be used to identify training needs, difficulties and resources about MM; required skills to care patients with MM will be assessed using a 4-item ordinal scale. Analysis: Coding of data prior to analysis. Descriptive statistical analysis, participation and completion rates of the questionnaire and estimation of absolute and relative frequencies and 95% confidence intervals in close-ended questions. Content analysis with inductive methodology in open-ended questions. Ethics: Ethical approval, Online informed consent. Conclusions: The identification of training needs of health professionals who care for patients with MM will be necessary data for developing highly effective training activities.

scholarly journals A national survey exploring views and experience of health professionals about transferring patients from critical care home to die

2015 ◽  
Vol 29 (4) ◽  
pp. 363-370 ◽  
Author(s):  
Anne-Sophie E. Darlington ◽  
Tracy Long-Sutehall ◽  
Alison Richardson ◽  
Maureen A. Coombs
Keyword(s):  
Critical Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Care Home ◽  
Professional Role ◽  
National Study ◽  
Web Based ◽  
Critical Care Units ◽  
The United Kingdom ◽  
Doctors And Nurses

Background: Transferring critically ill patients home to die is poorly explored in the literature to date. This practice is rare, and there is a need to understand health care professionals’ (HCP) experience and views. Objectives: To examine (1) HCPs’ experience of transferring patients home to die from critical care, (2) HCPs’ views about transfer and (3) characteristics of patients, HCPs would hypothetically consider transferring home to die. Design: A national study developing a web-based survey, which was sent to the lead doctors and nurses in critical care units. Setting/participants: Lead doctors and senior nurses (756 individuals) working in 409 critical care units across the United Kingdom were invited to participate in the survey. Results: In total, 180 (23.8%) completed surveys were received. A total of 65 (36.1%) respondents had been actively involved in transferring patients home to die and 28 (15.5%) had been involved in discussions that did not lead to transfer. Respondents were supportive of the idea of transfer home to die (88.8%). Patients identified by respondents as unsuitable for transfer included unstable patients (61.8%), intubated and ventilated patients (68.5%) and patients receiving inotropes (65.7%). There were statistically significant differences in views between those with and without experience and between doctors and nurses. Nurses and those with experience tended to have more positive views. Conclusion: While transferring patients home to die is supported in critical care, its frequency in practice remains low. Patient stability and level of intervention are important factors in decision-making in this area. Views held about this practice are influenced by previous experience and the professional role held.

scholarly journals Development of an intervention to support the implementation of evidence-based strategies for optimising antibiotic prescribing in general practice

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Aleksandra J. Borek ◽  
Anne Campbell ◽  
Elle Dent ◽  
Michael Moore ◽  
Christopher C. Butler ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Focus Groups ◽  
Health Professionals ◽  
Skills Training ◽  
Antibiotic Use ◽  
Behavioural Intervention ◽  
Antibiotic Prescribing ◽  
Evidence Based ◽  
Think Aloud

Abstract Background Trials show that antimicrobial stewardship (AMS) strategies, including communication skills training, point-of-care C-reactive protein testing (POC-CRPT) and delayed prescriptions, help optimise antibiotic prescribing and use in primary care. However, the use of these strategies in general practice is limited and inconsistent. We aimed to develop an intervention to enhance uptake and implementation of these strategies in primary care. Methods We drew on the Person-Based Approach to develop an implementation intervention in two stages. (1) Planning and design: We defined the problem in behavioural terms drawing on existing literature and conducting primary qualitative research (nine focus groups) in high-prescribing general practices. We identified ‘guiding principles’ with intervention objectives and key features and developed logic models representing intended mechanisms of action. (2) Developing the intervention: We created prototype intervention materials and discussed and refined these with input from 13 health professionals and 14 citizens in two sets of design workshops. We further refined the intervention materials following think-aloud interviews with 22 health professionals. Results Focus groups highlighted uncertainties about how strategies could be used. Health professionals in the workshops suggested having practice champions, brief summaries of each AMS strategy and evidence supporting the AMS strategies, and they and citizens gave examples of helpful communication strategies/phrases. Think-aloud interviews helped clarify and shorten the text and user journey of the intervention materials. The intervention comprised components to support practice-level implementation: antibiotic champions, practice meetings with slides provided, and an ‘implementation support’ website section, and components to support individual-level uptake: website sections on each AMS strategy (with evidence, instructions, links to electronic resources) and material resources (patient leaflets, POC-CRPT equipment, clinician handouts). Conclusions We used a systematic, user-focussed process of developing a behavioural intervention, illustrating how it can be used in an implementation context. This resulted in a multicomponent intervention to facilitate practice-wide implementation of evidence-based strategies which now requires implementing and evaluating. Focusing on supporting the uptake and implementation of evidence-based strategies to optimise antibiotic use in general practice is critical to further support appropriate antibiotic use and mitigate antimicrobial resistance.

scholarly journals Designing Emails Aimed at Increasing Family Physicians� Use of a Web-Based Audit and Feedback Tool to Improve Cancer Screening Rates: Cocreation Process (Preprint)

2018 ◽  
Author(s):  
Caroline A. Bravo ◽  
Diego Llovet ◽  
Holly O Witteman ◽  
Laura Desveaux ◽  
Justin Presseau ◽  
...  
Keyword(s):  
Behavior Change ◽  
Focus Groups ◽  
Health Professionals ◽  
Scientific Evidence ◽  
Primary Care Providers ◽  
Performance Data ◽  
Audit And Feedback ◽  
Web Based ◽  
User Input ◽  
The Past

BACKGROUND Providing clinical performance data to health professionals, a process known as audit and feedback, can play an important role in health system improvement. However, audit and feedback tools can only be effective if the targeted health professionals access and actively review their data. Email is used by Cancer Care Ontario, a provincial cancer agency, to promote access to a Web-based audit and feedback tool called the Screening Activity Report (SAR); however, current emails that lack behavior change content have been ineffective at encouraging log-in to the SAR. OBJECTIVE The objective of our study was to describe the process and experience of developing email content that incorporates user input and behavior change techniques (BCTs) to promote the use of the SAR among Ontario primary care providers. METHODS Our interdisciplinary research team first identified BCTs shown to be effective in other settings that could be adapted to promote use of the SAR. We then developed draft BCT-informed email content. Next, we conducted cocreation workshops with physicians who had logged in to the SAR more than once over the past year. Participants provided reactions to researcher-developed BCT-informed content and helped to develop an email that they believed would prompt their colleagues to use the SAR. Content from cocreation workshops was brought to focus groups with physicians who had not used the SAR in the past year. We analyzed notes from the cocreation workshops and focus groups to inform decisions about content. Finally, 8 emails were created to test BCT-informed content in a 2×2×2 factorial randomized experiment. RESULTS We identified 3 key tensions during the development of the email that required us to balance user input with scientific evidence, organizational policies, and our scientific objectives, which are as follows: conflict between user preference and scientific evidence, privacy constraints around personalizing unencrypted emails with performance data, and using cocreation methods in a study with the objective of developing an email that featured BCT-informed content. CONCLUSIONS Teams tasked with developing content to promote health professional engagement with audit and feedback or other quality improvement tools might consider cocreation processes for developing communications that are informed by both users and BCTs. Teams should be cautious about making decisions solely based on user reactions because what users seem to prefer is not always the same as what works. Furthermore, implementing user recommendations may not always be feasible. Teams may face challenges when using cocreation methods to develop a product with the simultaneous goal of having clearly defined variables to test in later studies. The expected role of users, evidence, and the implementation context all warrant consideration to determine whether and how cocreation methods could help to achieve design and scientific objectives.

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