scholarly journals Promoting HIV, HBV and HCV screening among migrants with a language barrier: Protocol for the development and evaluation of an electronic application (Apidé) (Preprint)

2020 ◽  
Author(s):  
Frédérique Thonon ◽  
Saleh Fahmi ◽  
Olivia Rousset-Torrente ◽  
Pascal Bessonneau ◽  
James W Griffith ◽  
...  
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Evaluation Study ◽  
Language Barrier ◽  
Screening Tests ◽  
Health Providers ◽  
Missed Opportunities ◽  
System Usability Scale

BACKGROUND Late diagnoses of HIV, Hepatitis B and Hepatitis C are important public health problems that affect the population at large and migrants in particular. Missed opportunities of HIV and hepatitis’ screening are numerous, with language differences being a significant barrier to testing. Several studies have shown that migrants who do not speak the language of the health provider are less likely to get tested, due to health providers’ reluctance to offer a test and to migrants’ reluctance to accept testing. OBJECTIVE The aim of our study is to develop a multilingual electronic tool (app) that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier, and to evaluate its acceptability and impact in terms of public health. METHODS The study will go through three stages: 1) concept development, 2) app development, and 3) app evaluation. A qualitative study has been undertaken to explore language barriers during healthcare encounters and their effect on communication, specifically when a screening test is offered. In parallel, a systematic review of the literature was conducted in order to have a comprehensive overlook of electronic tools designed to help healthcare providers communicate with migrants with a language barrier. In order to generate a list of items to be translated for inclusion in the app, we will conduct a focus group and Delphi survey. The development of the application will include translation and voice recording of items. The electronic development will also include three steps of testing with users. The acceptability of the application will be evaluated in a survey with the System Usability Scale. The evaluation of the application’s efficacy will consist of a stepped-wedge randomized controlled trial. The study will be carried out in 16 centers that treat migrants and offer them screening tests for infectious diseases. The primary outcome measured is the percentage of screening tests realized. The secondary outcomes are rate of screening proposal by health professionals, acceptance rate by migrants, number of positive cases using this app, and frequency of use of the app. RESULTS The app evaluation study has received a 3-year grant from Agence Nationale de la Recherche contre le SIDA et les hépatites virales (ANRS) and from Office Français de l’Immigration et Intégration (OFII). At the time of publication of this protocol, the initial qualitative study and systematic literature review have been completed. CONCLUSIONS This study will develop an app that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier, and measure its acceptability and effectiveness in terms of public health. When completed, this application could be distributed to numerous workers carrying out screening with migrant populations in various healthcare settings. CLINICALTRIAL

scholarly journals Perceptions of Treatment Burden Among Elders With Diabetes and Comorbid Alzheimer’s Disease and Related Dementias

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 276-276
Author(s):  
Victoria Vaughan Dickson ◽  
Halia Melnyk ◽  
Rosie Ferris ◽  
Joshua Chodosh ◽  
Caroline Blaum
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Qualitative Study ◽  
Financial Burden ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Patient Treatment ◽  
Treatment Burden ◽  
Treatment Plans

Abstract Background: An estimated 25% of older adults with diabetes (DM) may have co-occurring Alzheimer’s Disease and Related Dementias (ADRD), complicated by multiple treatment plans and providers. Assessing treatment burden has been limited to patients’ perspectives; little is known about caregiver perceptions of treatment burden despite their important role in personal care and treatment adherence. The purpose of this qualitative study was to describe caregiver perceptions of treatment burden for older adults with DM-ADRD. Methods: This qualitative study was conducted in the formative phase of “Enhanced Quality in Primary care for Elders with DM-ADRD (EQUIPED-ADRD) a pragmatic randomized controlled trial in a large, diverse healthcare system. A diverse sample of caregivers (n=15) of patients enrolled in the RCT participated in interviews about their caregiver role and perceptions of treatment burden of DM-ADRD clinical management. Qualitative data were analyzed using content analysis and themes about treatment burden were compared to domains on the Treatment Burden Questionnaire (TBQ). Results: Caregivers reported high levels of burden related to treatment plans for patients with DM-ADRD. Themes related to complexity and burden of medication management, monitoring (e.g., blood pressure, glucose monitoring), dietary and physical activity regimens, navigating healthcare providers and financial burden were reported. Caregivers also described high levels of emotional burden that was associated with patient’s cognitive decline and family functioning stress. Conclusions: Interventions to reduce treatment burden for patients and caregiver should include activating social/nursing services, respite care and care coordination that may support caregivers especially as patient treatment increases in complexity over time.

scholarly journals Barriers and Facilitators to Modern Contraception Among Married Women in Conflict Affected Town of Mogadishu, Somalia

2021 ◽  
Author(s):  
Abdi Gele ◽  
Mary Shrestha ◽  
Fathia Khalif ◽  
Samera Qureshi
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Ecological Model ◽  
Maternal Mortality Ratio ◽  
Married Women ◽  
Barriers And Facilitators ◽  
Health Providers ◽  
Modern Contraception ◽  
Contraception Use ◽  
Somali Women

Abstract Background - With a maternal mortality ratio of 692 per 100,000 live births and modern contraception prevalence of 1%, understanding factors hindering Somali women from using modern contraception is key to developing and implementing locally adopted public health responses. The purpose of this qualitative study is to explore barriers and facilitators to the use of modern contraception among married women in Mogadishu. Methods - We conducted a qualitative study using semi-structured, in-depth interviews with 21 married women aged >18 years, living in different neighborhoods in Mogadishu between July—December 2018. We recruited the participants using a convenience sampling method. We used thematic analysis and adapted ecological model as a framework for the synthesis.Results – The findings show that systemic, individual and socio-cultural barriers hinder women’s ability to access modern contraception. Barriers identified by this study include: Health communication messages and contraceptive information provided by health providers, prevalent religious fallacies among women and fear of permanent infertility upon modern contraception. Conclusion - Training health providers in the principles of modern contraception, in addition to the medical ethics that govern their responsibility to provide correct and relevant information to their patients, is vital for increasing modern contraception use among Somali women. The findings of this study may be used for designing public health interventions that promote acceptance and the use of modern contraception among both women and men in Somalia.

scholarly journals TEST (Trial of Eczema allergy Screening Tests): protocol for feasibility randomised controlled trial of allergy tests in children with eczema, including economic scoping and nested qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028428 ◽  
Author(s):  
Matthew J Ridd ◽  
Louisa Edwards ◽  
Miriam Santer ◽  
Joanne R Chalmers ◽  
Lisa Waddell ◽  
...  
Keyword(s):  
Food Allergy ◽  
Randomised Controlled Trial ◽  
Qualitative Study ◽  
Controlled Trial ◽  
Screening Tests ◽  
Dietary Management ◽  
Allergy Testing ◽  
Dietary Restrictions ◽  
Feasibility Randomised Controlled Trial ◽  
Randomised Controlled

BackgroundEarly onset eczema is associated with food allergy, and allergic reactions to foods can cause acute exacerbations of eczema. Parents often pursue dietary restrictions as a way of managing eczema and seek allergy testing for their children to guide dietary management. However, it is unclear whether test-guided dietary management improves eczema symptoms, and whether the practice causes harm through reduced use of conventional eczema treatment or unnecessary dietary restrictions. The aim of the Trial of Eczema allergy Screening Tests Study is to determine the feasibility of conducting a trial comparing food allergy testing and dietary advice versus usual care, for the management of eczema in children.Methods and analysisDesign: A single centre, two-group, individually randomised, feasibility randomised controlled trial (RCT) with economic scoping and a nested qualitative study. Setting: General Practioner (GP) surgeries in the west of England. Participants: children aged over 3 months and less than 5 years with mild to severe eczema. Interventions: allergy testing (structured allergy history and skin prick tests) or usual care. Sample size and outcome measures: we aim to recruit 80 participants and follow them up using 4-weekly questionnaires for 24 weeks. Nested qualitative study: We will conduct ~20 interviews with parents of participating children, 5–8 interviews with parents who decline or withdraw from the trial and ~10 interviews with participating GPs. Economic scoping: We will gather data on key costs and outcomes to assess the feasibility of carrying out a cost-effectiveness analysis in a future definitive trial.Ethics and disseminationThe study has been reviewed by the Health Research Authority and given a favourable opinion by the NHS REC (West Midlands – South Birmingham Research Ethics Committee, Reference Number 18/WM/0124). Findings will be submitted for presentation at conferences and written up for publication in peer-reviewed journals, which may include mixed-method triangulation and integration of the quantitative and qualitative findings.Trial registrationISRCTN15397185; Pre-results.

scholarly journals Patient, Caregiver, and Physician Barriers to Home-Based Palliative Care: Findings From a Terminated Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 167-167
Author(s):  
Susan Enguidanos ◽  
Stephanie Wladkowski
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Qualitative Study ◽  
Primary Care Physicians ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Insurance Company ◽  
Care Services ◽  
Home Based ◽  
Palliative Care Services

Abstract Despite two decades of palliative care services, there remains numerous barriers to patient and caregiver use of palliative care. For many years, policymakers believed lack of funding for palliative care was the primary obstacle to accessing palliative care services. In 2017, we undertook a randomized controlled trial to test the effectiveness of a home-based palliative care (HBPC) program within accountable care organizations and in partnership with an insurance company that covered the cost of HBPC. After 20 months, we had recruited just 28 patients. This symposium will: (1) describe outcomes from various approaches undertaken to engage primary care physicians and recruit patients and their caregivers into this trial; (2) present barriers to HBPC referral identified from a qualitative study of primary care physicians; (3) present findings from a qualitative study of patient- and caregiver-identified barriers to HBPC; (4) describe physician and patient barriers to research participation; and (5) discuss implications of these findings for researchers and healthcare providers. Information presented in this symposium will inform researchers and policy makers about challenges and facilitators to recruiting patients, caregivers, and physicians to participate in research studies as well as inform healthcare practitioners of potential obstacles to increasing patient access to HBPC.

The Implementable Needs of Woman With Maternal Near Miss Experience: A Qualitative Study of Healthcare Providers

2021 ◽  
Author(s):  
Sedigheh Abdollahpour ◽  
Abbas Heydari ◽  
Hosein Ebrahimipour ◽  
Farhad Faridhoseini ◽  
Talat Khadivzadeh
Keyword(s):  
Qualitative Study ◽  
Qualitative Content Analysis ◽  
Quality Care ◽  
Healthcare Providers ◽  
Care Quality ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Health Providers ◽  
Data Saturation ◽  
Maternal Health Policy

Abstract Introduction: Maternal Near Miss (MNM) case is defined as “a woman who nearly died but survived a life-threatening and failure organ during pregnancy or childbirth complication that the challenges of this group of mothers have not been addressed. Aim: This qualitative study of healthcare providers was conducted to discover the Iranian near miss mother’s (NMM) needs. Design: conventional qualitative content analysis Methods: In this study 37 participants of key informants, health providers, NMM and their husbands were selected using purposive sampling. Semi structured in-depth interviews were conducted for data collection until data saturation was achieved. Data was analyzed using Graneheim and Lundman. MAXQDA 10 software was used for organizing data and managing the process of analysis. Results: The analysis revealed the core category of "the need for comprehensive support". Eight categories included "psychological", "fertility", "information", "improvement of the care quality care", "sociocultural", "financial", "breastfeeding" and "nutritional" needs emerged from 18 sub-categories, were formed from 2112 codes. Conclusions: Maternal health policy makers should call on health provider centers to work on program designed to support NMMs according to standard guidelines designed to assessment needs.

scholarly journals Reasons for Refusing Home-based Palliative Care: A Qualitative Study of Patients and Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 903-904
Author(s):  
Valeria Cardenas ◽  
YuJun Zhu ◽  
Anna Rahman ◽  
Susan Enguidanos
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Care Service ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Palliative Care Service ◽  
Health Condition ◽  
Insurance Company ◽  
Home Based ◽  
Palliative Care Services

Abstract Despite some insurance plans now paying for home-based palliative care, recent reports have suggested that coverage for palliative care may be insufficient to expanding patient access to home-based palliative care. Research has yet to explore palliative care barriers from the perspective of palliative care-eligible patients and their caregivers. To identify patients and caregivers’ perceived barriers to home-based palliative care and their recommendations for overcoming these barriers, we conducted a qualitative study using semi-structured individual interviews. Participants (patients, proxies, and their caregivers) who were eligible for a randomized controlled trial of home-based palliative care were interviewed via telephone. Our interview protocol elicited participants’ perspectives on home-based palliative care services; positive and negative aspects of the program explanation; and suggestions for improving messaging around home-based palliative care. Researchers used grounded theory to identify the themes within the transcripts. Two researchers independently coded the transcripts and then met to compare coding and reconciled discrepancies until 100% consensus was reached. Identified themes related to home-based palliative care referral barriers included reluctance to have home visits, timing, lack of palliative care knowledge, misconceptions of palliative care, and patients’ self-perceived health condition (not sick enough for palliative care). Themes related to recommendations for overcoming these barriers included preferring a palliative care referral from healthcare providers or from insurance company and clearer presentation of palliative care service. Findings reinforce the need for additional palliative care education among patients with serious illness and the importance of delivering the information from a trusted source.

Trend of Parental Refusal or Delay of Childhood Vaccinations

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Meagan Marie Daoust
Keyword(s):  
Public Health ◽  
Social Media ◽  
Healthcare System ◽  
Educational Context ◽  
Health Consequences ◽  
Missed Opportunities ◽  
The Public ◽  
Health Related ◽  
Parental Refusal

The healthcare trend of parental refusal or delay of childhood vaccinations will be investigated through a complex Cynefin Framework component in an economic and educational context, allowing patterns to emerge that suggest recommendations of change for the RN role and healthcare system. As a major contributing factor adding complexity to this trend, social media is heavily used for health related knowledge, making it is difficult to determine which information is most trustworthy. Missed opportunities for immunization can result, leading to economic and health consequences for the healthcare system and population. Through analysis of the powerful impact social media has on this evolving trend and public health, an upstream recommendation for RNs to respond with is to utilize reliable social media to the parents’ advantage within practice. The healthcare system should focus on incorporating vaccine-related education into existing programs and classes offered to parents, and implementing new vaccine classes for the public.

scholarly journals Reluctance to Accept Palliative Care and Recommendations for Improvement: Findings From Semi-Structured Interviews With Patients and Caregivers

2021 ◽  
pp. 104990912110126
Author(s):  
Valeria Cardenas ◽  
Anna Rahman ◽  
Yujun Zhu ◽  
Susan Enguidanos
Keyword(s):  
Palliative Care ◽  
Controlled Trial ◽  
Insurance Coverage ◽  
Healthcare Providers ◽  
Health Condition ◽  
Insurance Companies ◽  
Structured Interviews ◽  
Care Services ◽  
Home Based ◽  
Palliative Care Services

Background: Despite some insurance plans now paying for home-based palliative care, recent reports have suggested that insurance coverage for palliative care may be insufficient in expanding patient access to home-based palliative care. Aim: To identify patients’ and caregivers’ perceived barriers to home-based palliative care and their recommendations for overcoming these barriers. Design: We conducted a qualitative study using semi-structured individual interviews. Our interview protocol elicited participants’ perspectives on home-based palliative care services; positive and negative aspects of the palliative program explanation; and suggestions for improving messaging around home-based palliative care. Setting/Participants: Twenty-five participants (patients, proxies, and their caregivers) who were eligible for a randomized controlled trial of home-based palliative care were interviewed by telephone. Results: Themes related to home-based palliative care referral barriers included reluctance to have home visits, enrollment timing, lack of palliative care knowledge, misconceptions about palliative care, and patients’ self-perceived health condition. Themes related to recommendations for overcoming these obstacles included ensuring that palliative care referrals come from healthcare providers or insurance companies and presenting palliative care services more clearly. Conclusion: Findings reinforce the need for additional palliative care education among patients with serious illness (and their caregivers) and the importance of delivering palliative care information and referrals from trusted sources.

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