scholarly journals A Universal Early Parenting Education Intervention in Community-Based Primary Care Settings: Development and Installation Challenges

2018 ◽  
Vol 8 (4) ◽  
pp. 178 ◽  
Author(s):  
Grainne Hickey ◽  
Sinead McGilloway ◽  
Yvonne Leckey ◽  
Ann Stokes
Keyword(s):  
Primary Care ◽  
Best Practice ◽  
Service Providers ◽  
Practice Change ◽  
Parenting Education ◽  
Local Context ◽  
Programme Implementation ◽  
Community Based ◽  
Early Parenting ◽  
The Impact

Prevention and early intervention programmes, which aim to educate and support parents and young children in the earliest stages of the family lifecycle, have become an increasingly popular policy strategy for tackling intergenerational disadvantage and developmental inequality. Evidence-based, joined-up services are recommended as best practice for achieving optimal outcomes for parents and their children; however, there are persistent challenges to the development, adoption and installation of these kinds of initiatives in community-based primary health care settings. In this paper, we present a description of the design and installation of a multi-stakeholder early parenting education and intervention service model called the Parent and Infant (PIN) programme. This new programme is delivered collaboratively on a universal, area-wide basis through routine primary care services and combines standardised parent-training with other group-based supports designed to educate parents, strengthen parenting skills and wellbeing and enhance developmental outcomes in children aged 0–2 years. The programme design was informed by local needs analysis and piloting to establish an in-depth understanding of the local context. The findings demonstrate that a hospitable environment is central to establishing interagency parenting education and supports. Partnership, relationship-building and strategic leadership are vital to building commitment and buy-in for this kind of innovation and programme implementation. A graduated approach to implementation which provides training/education and coaching as well as organisational and administrative supports for practice change, are also important in creating an environment conducive to collaboration. Further research into the impact, implementation and cost-effectiveness of the PIN programme will help to build an understanding of what works for parents and infants, as well as identifying lessons for the development and implementation of other similar complex prevention and intervention programmes elsewhere. This kind of research coupled with the establishment of effective partnerships involving service providers, parents, researchers and policy makers, is necessary to meeting the challenge of improving family education and enhancing the capacity of family services to help promote positive outcomes for children.

The impact of participant pathways on the effectiveness of a community-based physical activity intervention grounded in motivational interviewing

2020 ◽  
Author(s):  
Matthew Wade ◽  
Nicola Brown ◽  
James Steele ◽  
Steven Mann ◽  
Bernadette Dancy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Motivational Interviewing ◽  
Social Action ◽  
Multilevel Models ◽  
Physical Activity Intervention ◽  
Mental Wellbeing ◽  
Community Based ◽  
The Impact ◽  
Time Point

Background: Brief advice is recommended to increase physical activity (PA) within primary care. This study assessed change in PA levels and mental wellbeing after a motivational interviewing (MI) community-based PA intervention and the impact of signposting [SP] and Social Action [SA] (i.e. weekly group support) pathways. Methods: Participants (n=2084) took part in a community-based, primary care PA programme using MI techniques. Self-reported PA and mental wellbeing data were collected at baseline (following an initial 30-minute MI appointment), 12-weeks, six-months, and 12-months. Participants were assigned based upon the surgery they attended to the SP or SA pathway. Multilevel models were used to derive point estimates and 95%CIs for outcomes at each time point and change scores. Results: Participants increased PA and mental wellbeing at each follow-up time point through both participant pathways and with little difference between pathways. Retention was similar between pathways at 12-weeks, but the SP pathway retained more participants at six-months and 12-months. Conclusions: Both pathways produced similar improvements in PA and mental wellbeing, suggesting the effectiveness of MI based PA interventions. However, due to lower resources required yet similar effects, SP pathways are recommended over SA to support PA in primary care settings.

scholarly journals Promoting cross-jurisdictional primary health care research: developing a set of common indicators across 12 community-based primary health care teams in Canada

2018 ◽  
Vol 20 ◽  
Author(s):  
Sabrina T. Wong ◽  
Julia M. Langton ◽  
Alan Katz ◽  
Martin Fortin ◽  
Marshall Godwin ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Working Group ◽  
Scale Up ◽  
Data Sources ◽  
Knowledge Generation ◽  
Community Based ◽  
Primary Health ◽  
The Impact

AbstractAimTo describe the process by which the 12 community-based primary health care (CBPHC) research teams worked together and fostered cross-jurisdictional collaboration, including collection of common indicators with the goal of using the same measures and data sources.BackgroundA pan-Canadian mechanism for common measurement of the impact of primary care innovations across Canada is lacking. The Canadian Institutes for Health Research and its partners funded 12 teams to conduct research and collaborate on development of a set of commonly collected indicators.MethodsA working group representing the 12 teams was established. They undertook an iterative process to consider existing primary care indicators identified from the literature and by stakeholders. Indicators were agreed upon with the intention of addressing three objectives across the 12 teams: (1) describing the impact of improving access to CBPHC; (2) examining the impact of alternative models of chronic disease prevention and management in CBPHC; and (3) describing the structures and context that influence the implementation, delivery, cost, and potential for scale-up of CBPHC innovations.FindingsNineteen common indicators within the core dimensions of primary care were identified: access, comprehensiveness, coordination, effectiveness, and equity. We also agreed to collect data on health care costs and utilization within each team. Data sources include surveys, health administrative data, interviews, focus groups, and case studies. Collaboration across these teams sets the foundation for a unique opportunity for new knowledge generation, over and above any knowledge developed by any one team. Keys to success are each team’s willingness to engage and commitment to working across teams, funding to support this collaboration, and distributed leadership across the working group. Reaching consensus on collection of common indicators is challenging but achievable.

Measuring impact of telephone triage in Acute Medicine

2017 ◽  
Vol 16 (3) ◽  
pp. 104-106
Author(s):  
Huma Asmat ◽  
◽  
Shah Khalid Shinwari ◽  
Timothy Cooksley ◽  
Roger Duckitt ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Emergency Departments ◽  
Local Context ◽  
Telephone Triage ◽  
Time Data ◽  
Acute Medicine ◽  
The Impact ◽  
First Time

The Society for Acute Medicine’s Benchmarking Audit (SAMBA) was undertaken for the 5th time in June 2016. For the first time, data on telephone triage calls prior to admission to Acute Medical Units were collected: 1238 patients were referred from Emergency Departments, 925 from General Practitioners (GPs), 52 from clinics and 147 from other sources. Calls from Emergency Departments rarely resulted in admission avoidance. Calls from Primary Care resulted in avoidance of an admission in 115 (12%) patients; the percentage of avoided admissions was highest if the call was taken by a Consultant. Consultant triage might result in admission avoidance but the impact of local context on the effectiveness is not clear.

The role of a remote knowledge broker from an academic setting using an adaptive approach to implement evidence-based practice in primary care settings: A case study of integrating mood management interventions for treatment seeking tobacco users.

2020 ◽  
Author(s):  
Nadia Minian ◽  
Sheleza Ahad ◽  
Laurie Zawertailo ◽  
Arun Ravindran ◽  
Claire de Oliveira ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthcare Providers ◽  
Family Health ◽  
Practice Change ◽  
Knowledge Broker ◽  
Local Context ◽  
Knowledge Brokering ◽  
Mood Management ◽  
Management Interventions

Abstract Background: Knowledge brokering is an emerging knowledge translation strategy used within healthcare to bridge the gap between evidence and practice. Reported studies indicate that the day-to-day role of a knowledge broker often involves in-person communication with frontline workers and decision makers. However, travelling to primary care sites can be cost- and resource-intensive and thus not feasible. In this paper, we describe the role and experience of a remote knowledge broker (rKB) working in an academic health sciences centre, delivering tailored one-on-one support to end-users using phone and email communications. Methods: A rKB was hired to support (n = 62) English-speaking Family Health Teams (FHTs) across Ontario with implementing mood management interventions as part of an existing smoking cessation program, the Smoking Treatment for Ontario Patients (STOP) program. We describe the eight categories of tasks performed by the rKB over a 12-month period, as well as their experience communicating via technology to develop relationships with healthcare providers (HCPs). Results: Sixty-one of the 62 FHTs (n = 73 HCPs) were provided rKB services. The total number of successful phone and email communications with the rKB ranged from 3-98 interactions over 12 months. Common barriers to implementation reported by FHTs were associated with the Inner and Outer Setting domains of the Consolidated Framework for Implementation Research (CFIR) and included lack of time, resources, and patient engagement. Conclusions: The role of the rKB involved building relationships with HCPs, identifying and helping to problem solve barriers, and building capacity in the field. Similar to traditional knowledge brokering, this analysis shows that developing a meaningful relationship between a remotely situated KB and HCPs could take anywhere between 1-6 months. Using implementation frameworks such as CFIR can help the rKB identify barriers and be ready to address them. In addition, hiring a rKB with previous engagements and knowledge of the local context may facilitate clinical practice change. Our future work will evaluate the cost-effectiveness of rKBs to inform its potential to be scaled up.

Is the Far West Mental Health Integration Project Making a Difference? The General Practitioner Perspective

2005 ◽  
Vol 11 (3) ◽  
pp. 32 ◽  
Author(s):  
David Perkins ◽  
David Lyle
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Care Providers ◽  
Care Staff ◽  
Care Providers ◽  
Community Based ◽  
Mental Health Integration ◽  
Integration Project ◽  
The Impact

This paper reports on the evaluation of an Australian Government and NSW State funded Mental Health Integration Project in remote far western NSW. The project was part of the Mental Health Integration Program, developed from the Second National Mental Health Plan. The project implemented a model of community-based mental health services and used innovative financing arrangements to allow the provision of community-based specialist mental health teams to remote communities and to recruit visiting psychiatrists to support the local primary care providers. The evaluation strategy included a survey of general practitioners (GPs) in the Upper Western Sector and Broken Hill, designed to investigate their level and type of contact with psychiatrists and community-based specialist mental health care teams, their perceptions about the impact of the new services, and their interest in further professional development in mental health care.The project has shown that visiting specialists can be deployed in a primary care setting with a focus on meeting the needs of local GPs, primary health care staff and their patients.

scholarly journals Effectiveness of a community-based intervention to improve nutrition in young children in Senegal: a difference in difference analysis

2009 ◽  
Vol 12 (5) ◽  
pp. 667-673 ◽  
Author(s):  
Harold Alderman ◽  
Biram Ndiaye ◽  
Sebastian Linnemayr ◽  
Abdoulaye Ka ◽  
Claudia Rokx ◽  
...  
Keyword(s):  
Rural Areas ◽  
Large Scale ◽  
Service Providers ◽  
Growth Promotion ◽  
Difference In Difference ◽  
Health Seeking ◽  
Community Based ◽  
Regional Trends ◽  
Community Growth ◽  
The Impact

AbstractThere are few studies of community growth promotion as a means of addressing malnutrition that are based on longitudinal analysis of large-scale programmes with adequate controls to construct a counterfactual. The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006. The project, designed to extend nutrition and growth promotion intervention into rural areas through non-governmental organisation service providers, significantly lowered the risk of a child having a weight more than 2 sd below international norms. The odds ratio of being underweight for children in programme villages after introduction of the intervention was 0·83 (95% CI 0·686, 1·000), after controlling for regional trends and village and household characteristics. Most measured aspects of health care and health seeking behaviour improved in the treatment relative to the control.

scholarly journals The impacts of and outcomes from telehealth delivered in prisons: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251840
Author(s):  
Esther Jie Tian ◽  
Sooraj Venugopalan ◽  
Saravana Kumar ◽  
Matthew Beard
Keyword(s):  
Systematic Review ◽  
Best Practice ◽  
Selection Process ◽  
Implementation Process ◽  
Healthcare Services ◽  
Evidence Base ◽  
Conventional Care ◽  
Local Context ◽  
Successful Implementation ◽  
The Impact

Background While the delivery of healthcare services within prison systems is underpinned by different models, access to timely and optimal healthcare is often constrained by multifaceted factors. Telehealth has been used as an alternative approach to conventional care. To date, much of the focus has been on evaluation of telehealth interventions within certain geographical contexts such as rural and remote communities. Therefore, the aim of this systematic review was to synthesise the evidence base to date for the impacts of, and outcomes from, telehealth delivered in prisons. Methods This systematic review was underpinned by best practice in the conduct and reporting of systematic reviews. A systematic search was conducted to reinforce the literature selection process. The modified McMaster Critical Appraisal Tool was used to assess the methodological quality of the included studies. A narrative synthesis of the study outcomes was undertaken. Results Twenty-nine quantitative studies were included. Telehealth interventions were greatly varied in terms of types of healthcare services, implementation process and intervention parameters. Methodological concerns such as rigour in data collection and analysis, and psychometric properties of outcome measures were commonly identified. Process-related outcomes and telehealth outcomes were the two overarching categories identified. Conclusion This systematic review provides mixed evidence on the impact of, and outcomes from, telehealth in prisons. While the evidence base does highlight some positive impacts of telehealth, which at the least, is as effective as conventional care while achieving patient satisfaction, it is also important to consider the local context and drivers that may influence what, when and how telehealth services are provided. Addressing critical factors throughout the lifecycle of telehealth is equally important for successful implementation and sustainability.

Pilot action within the framework of the Mig-HealthCare project - implementation of community-based pilot studies addressing health inequalities of migrants and refugees

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Zota ◽  
P Karnaki ◽  
A Gil-Salmerón ◽  
E Riza ◽  
J Garcés-Ferrer ◽  
...  
Keyword(s):  
Service Providers ◽  
Local Population ◽  
Target Groups ◽  
Community Based ◽  
Pilot Studies ◽  
Breast And Cervical Cancer ◽  
Implementation Context ◽  
Study Population ◽  
Pilot Implementation ◽  
The Impact

Abstract In the framework of the Mig-HealthCare project, a roadmap to community-based health care was developed including a toolbox and an algorithm. The Mig-HealthCare partners piloted parts of the roadmap in 8 EU countries. Piloting included actions on health promotion issues for migrants/refugees, mental health issues, non-communicable diseases, screening for breast and cervical cancer and vaccination issues. Two recommended practices were also piloted among migrants/refugees namely the 'circle of health' and health mentors while the Greek partner tested the developed algorithm in various health settings. All pilots were evaluated using common and pilot specific indicators for (a) appropriateness: the extent to which the piloted interventions were suitable for the target groups (service providers and/or migrants/refugees) (b) effectiveness: the extent to which the pilots' objectives were achieved, or are expected to be achieved, taking into account their relative importance (c) satisfaction: the extent to which pilots meet or surpass target groups and stakeholders (refugee/migrants, service providers and local population) expectation and needs (d) sustainability: the continuation of benefits from the pilot. Sustainability in the pilot implementation context is the ability of key target groups to sustain pilot benefits. Moreover, the impact of the interventions and their results should be sustainable in time. The impact of the pilots on the study population as well as implications for community-level health services are discussed.

Engaging the Third Estate: The Transplant Growth and Management Collaborative

2009 ◽  
Vol 19 (3) ◽  
pp. 235-243 ◽  
Author(s):  
Shannon Dowell ◽  
Anthony Dawson ◽  
Virginia McBride
Keyword(s):  
Best Practice ◽  
Health Resources ◽  
The United States ◽  
Practice Change ◽  
Organ Donors ◽  
Volume Increase ◽  
High Performing ◽  
Department Of Health ◽  
The Us ◽  
The Impact

The Organ Donation and Transplantation Collaboratives that occurred within the United States from 2004 to 2008 helped contribute to a significant increase in organ donors and transplants across the country. Centers were needed to accommodate and maintain this increase in capacity to perform successful transplantations for candidates on the waiting list. The Transplant Growth and Management Collaborative was created to help fulfill this new performance level expectation. In 2007 the US Department of Health and Human Services, Health Resources and Services Administration published a best-practice report based on high-performing centers that experienced a significant increase in volume while maintaining expected, or higher than expected, outcomes. The report produced a change package that outlined common strategies, key change concepts, and actions used at the best-practice centers that could be adapted by other transplant programs by using Plan-Do-Study-Act cycles to test the impact of the changes. This change package and use of the Plan-Do-Study-Act cycles formed the foundation of the Collaborative that occurred from October 2007 through October 2008 to spread best practices to transplant programs willing to commit to making changes that could result in a 20% increase in transplant volume. More than 120 transplant centers participated at some point in the Collaborative. Although preliminary results of the Collaborative show that only a few participating programs achieved the 20% volume increase goal, many participating centers reported putting successful models in place for each of the strategies identified in the best-practice change package.

Sign in / Sign up

Export Citation Format

Share Document