A Mixed Method Investigation of Parent Perspectives on Behavioral Services in Primary Care

2020 ◽  
Author(s):  
Andrew Riley ◽  
Bethany L. Walker ◽  
Krishnapriya Ramanujam ◽  
Wendy M. Gaultney ◽  
Deborah J. Cohen
Keyword(s):  
Primary Care ◽  
Mixed Method ◽  
Behavioral Interventions ◽  
Parental Participation ◽  
Parent Perspectives ◽  
Delivery Methods ◽  
Behavioral Services

Primary care is a key setting for the delivery of parent-focused behavioral interventions. Various methods of intervention show promising efficacy, but fail to engage adequate parental participation. The objective of this study was to understand factors underlying parents’ attitudes towards the content, sources, and delivery methods of behavioral guidance in primary care.

A Mixed-Method Investigation of Parent Perspectives on Early Childhood Behavioral Services in Primary Care

2021 ◽  
Author(s):  
Andrew R. Riley ◽  
Bethany L. Walker ◽  
Krishnapriya Ramanujam ◽  
Wendy M. Gaultney ◽  
Deborah J. Cohen
Keyword(s):  
Primary Care ◽  
Early Childhood ◽  
Mixed Method ◽  
Parent Perspectives ◽  
Behavioral Services

scholarly journals Effects of Behavioral Interventions on Inappropriate Antibiotic Prescribing in Primary Care 12 Months After Stopping Interventions

JAMA ◽  
2017 ◽  
Vol 318 (14) ◽  
pp. 1391 ◽  
Author(s):  
Jeffrey A. Linder ◽  
Daniella Meeker ◽  
Craig R. Fox ◽  
Mark W. Friedberg ◽  
Stephen D. Persell ◽  
...  
Keyword(s):  
Primary Care ◽  
Behavioral Interventions ◽  
Antibiotic Prescribing

AAP Developmental and Behavioral Pediatrics

2010 ◽  
Author(s):  
Keyword(s):  
Primary Care ◽  
Behavioral Problems ◽  
Behavioral Interventions ◽  
Autism Spectrum ◽  
Social And Emotional Development ◽  
Social And Emotional ◽  
Medical Evaluation ◽  
Behavioral Pediatrics ◽  
Spectrum Disorders ◽  
Speech And Language Development

Developed by leading experts in developmental and behavioral pediatrics, the all-new AAP Developmental and Behavioral Pediatrics gives one place to turn for expert recommendations to deliver, coordinate, and/or monitor quality developmental/behavioral care within the medical home. The one resource with all the essentials for pediatric primary care providers. Evaluation and care initiation: Interviewing and counseling, Surveillance and screening, Psychoeducational testing, Neurodevelopmental assessment and medical evaluation. Development and disorders: Motor and cognitive development, Speech and language development and disorders, Social and emotional development, Autism spectrum disorders, Learning disabilities. Management solutions: Psychological interventions, Behavioral interventions, Psychopharmacologic management, Complementary and alternative medicine approaches. Contents: Introduction - Child Development: The Basic Science of Pediatrics, Nature, Nurture and Their Interactions in Child Development and Behavior, Interviewing and Counseling Children and Families, Basics of Child Behavior and Primary Care Management of Common Behavioral Problems, Early Intervention, Developmental and Behavioral Surveillance and Screening Within the Medical Home, Neurodevelopmental Assessment and Medical Evaluation, Developmental and Behavioral Diagnoses: The Spectrum and Continuum of Developmental Disabilities and Behavioral Disorders, Motor Development, Cognitive Development, Speech and Language Development and Disorders, Social and Emotional Development, Autism Spectrum Disorders, Psychoeducational Testing, Learning Disabilities, Attention-Deficit/Hyperactivity Disorder, Disruptive Behavior Disorders, Anxiety and Mood Disorders, Evidence-based Psychological and Behavioral Interventions, Principles of Psychopharmacologic Management, Complementary and Alternative Medicine in Developmental and Behavioral Pediatrics, Sensory Impairments: Hearing and Vision, Social and Community Services, Transition to Adult Medical Care, Billing and Coding for Developmental and Behavioral Problems in Outpatient Primary Care.

scholarly journals Vignette research on messy and confusing problems in primary mental healthcare

2017 ◽  
Vol 13 (2) ◽  
pp. 300-313 ◽  
Author(s):  
E. H. (Dineke) Smit ◽  
J. J. L. (Jan) Derksen
Keyword(s):  
Primary Care ◽  
Mixed Method ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Complex Dynamic ◽  
Negative Feedback Loops ◽  
Norms And Values ◽  
The Family ◽  
Mixed Feelings ◽  
Working Together

The average primary care psychologist feels an ever-widening gap between objective, measurable reality as described and the complex and dynamic reality they experience. To obtain a better understanding of this complex dynamic reality, we conducted an exploratory mixed-method study of primary care psychologists. We asked our participants to write vignettes about messy and confusing problems in the complex context of mental healthcare. We then examined the data in portions, exposed the patterns in the data, and subsequently analysed all in conjunction. The 113 vignettes showed experiences of psychologists dealing not only with the patient, but also with the family of the patient and/or employers, working together with other healthcare professionals, struggling with dilemmas and having mixed feelings. However, using the Cynafin Framework, 36% of the vignettes were still rated as simple. Was it because those vignettes contained fewer words (p = .006)? Or because it is difficult to grasp complexity when cause and effect are intertwined with emotions, norms and values? In the discussion, we suggest examining a complex dynamic system in terms of both the consistency of its various elements and the dynamics of the system. We also discuss how to optimize the system’s adaptive self-organizing ability and how to challenge ourselves to invent negative feedback loops that can keep the complex system in equilibrium.

scholarly journals Experience of primary care for people with HIV: a mixed-method analysis

BJGP Open ◽  
2019 ◽  
Vol 3 (4) ◽  
pp. bjgpopen19X101665
Author(s):  
Tanvi Rai ◽  
Jane Bruton ◽  
Meaghan Kall ◽  
Richard Ma ◽  
Erica Pufall ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Mixed Method ◽  
Care Staff ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Framework Analysis ◽  
Complex Needs ◽  
Hiv Status Disclosure ◽  
Method Analysis

BackgroundAdvances in treatment have transformed HIV into a long-term condition (LTC), presenting fresh challenges for health services, HIV specialists, and GPs.AimTo explore the experience of people living with HIV (PLHIV) regarding consulting their GPs.Design & settingA mixed-method analysis using data from two sources: a nationally-representative survey of PLHIV and a qualitative study with London-based PLHIV.MethodUnivariate logistic regression was used for quantitative data and framework analysis for qualitative data.ResultsThe survey had 4422 participants; the qualitative study included 52 participants. In both studies, registration with a GP and HIV status disclosure were high. Similar to general population trends, recent GP use was associated with poor self-rated health status, comorbidities, older age, and lower socioeconomic status. Two-thirds reported a good experience with GPs; a lower proportion felt comfortable asking HIV-related questions. Actual or perceived HIV stigma were consistently associated with poor satisfaction. In the interviews, participants with additional LTCs valued sensitive and consistent support from GPs. Some anticipated, and sometimes experienced, problems relating to HIV status, as well as GPs’ limited experience and time to manage their complex needs. Sometimes they took their own initiative to facilitate coordination and communication. For PLHIV, a ‘good’ GP offered continuity and took time to know and accept them without judgment.ConclusionThe authors suggest clarification of roles and provision of relevant support to build the confidence of PLHIV in GPs and primary care staff to care for them. As the PLHIV population ages, there is a strong need to develop trusting patient–GP relationships and HIV-friendly GP practices.

scholarly journals What GPs do and what gets in their way: a mixed-methods study

2021 ◽  
pp. BJGP.2021.0357
Author(s):  
Carol Sinnott ◽  
Jordan M Moxey ◽  
Sonja Marjanovic ◽  
Brandi Leach ◽  
Lucy Hocking ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Method ◽  
Qualitative Data ◽  
Mixed Methods Study ◽  
Task Completion ◽  
Work Systems ◽  
Motion Data ◽  
Time Motion ◽  
General Practices ◽  
Operational Failures

Background: Though problems that impair task completion – known as operational failures – are an important focus of concern in primary care, they have remained little studied. Aim: To quantify the time general practitioners (GPs) spend on different activities during clinical sessions; to identify the number of operational failures they encountered; and to characterise the nature of operational failures and their impacts for GPs. Design and setting: Mixed-method triangulation study with 61 GPs in 28 NHS general practices. Method: Time-motion methods, ethnographic observations and interviews. Results: Time-motion data on 7679 GP tasks during 238 hours of practice in 61 clinical sessions suggested that operational failures were responsible for around 5.0% (confidence interval 4.5 to 5.4) of all tasks undertaken by GPs and accounted for 3.9% (3.2 to 4.5) of clinical time. However, qualitative data showed that time-motion methods, which depend on pre-programmed categories, substantially underestimated operational failures. Qualitative data also enabled further characterisation of operational failures, extending beyond those measured directly in the time-motion data (eg, interruptions, deficits in equipment/supplies and technology) to include problems linked to GPs’ coordination role and weaknesses in work systems and processes. The impacts of operational failures were highly consequential for GPs’ experiences of work. Conclusion: GPs experience frequent operational failures, disrupting patient care, impairing experiences of work, and imposing burden in an already pressurised system. Better understanding of the nature and impact of operational failures allows identification of targets for improvement and indicates the need for coordinated action to support GPs.

scholarly journals Implementing online consultations in primary care: a mixed-method evaluation extending normalisation process theory through service co-production

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019966 ◽  
Author(s):  
Michelle Farr ◽  
Jonathan Banks ◽  
Hannah B Edwards ◽  
Kate Northstone ◽  
Elly Bernard ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Method ◽  
Process Theory ◽  
Normalisation Process Theory ◽  
Free Text ◽  
Method Evaluation ◽  
Current Form ◽  
Financial Investment ◽  
Face To Face ◽  
Consultation System

ObjectivesTo examine patient and staff views, experiences and acceptability of a UK primary care online consultation system and ask how the system and its implementation may be improved.DesignMixed-method evaluation of a primary care e-consultation system.SettingPrimary care practices in South West England.MethodsQualitative interviews with 23 practice staff in six practices. Patient survey data for 756 e-consultations from 36 practices, with free-text survey comments from 512 patients, were analysed thematically. Anonymised patients’ records were abstracted for 485 e-consultations from eight practices, including consultation types and outcomes. Descriptive statistics were used to analyse quantitative data. Analysis of implementation and the usage of the e-consultation system were informed by: (1) normalisation process theory, (2) a framework that illustrates how e-consultations were co-produced and (3) patients’ and staff touchpoints.ResultsWe found different expectations between patients and staff on how to use e-consultations ‘appropriately’. While some patients used the system to try and save time for themselves and their general practitioners (GPs), some used e-consultations when they could not get a timely face-to-face appointment. Most e-consultations resulted in either follow-on phone (32%) or face-to-face appointments (38%) and GPs felt that this duplicated their workload. Patient satisfaction of the system was high, but a minority were dissatisfied with practice communication about their e-consultation.ConclusionsWhere both patients and staff interact with technology, it is in effect ‘co-implemented’. How patients used e-consultations impacted on practice staff’s experiences and appraisal of the system. Overall, the e-consultation system studied could improve access for some patients, but in its current form, it was not perceived by practices as creating sufficient efficiencies to warrant financial investment. We illustrate how this e-consultation system and its implementation can be improved, through mapping the co-production of e-consultations through touchpoints.

scholarly journals Factors influencing the implementation of cardiovascular risk scoring in primary care: a mixed-method systematic review

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Tonny B. Muthee ◽  
Derick Kimathi ◽  
Georgia C. Richards ◽  
Anthony Etyang ◽  
David Nunan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Mixed Method ◽  
Factors Influencing ◽  
Risk Scoring
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