scholarly journals Item Generation in the Development of an Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT): A Qualitative Study Utilizing Technology-Based Focus Groups in the United States

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 576
Author(s):  
Sunitha Zechariah ◽  
Leigh Lehman ◽  
Jennifer L. Waller ◽  
Gianluca De Leo ◽  
Judith Stallings ◽  
...  
Keyword(s):  
Focus Groups ◽  
Handgrip Strength ◽  
Subcutaneous Fat ◽  
Field Tests ◽  
The United States ◽  
Physical Exam ◽  
Face Validity ◽  
Micronutrient Deficiencies ◽  
Bedside Manner ◽  
Registered Dietitian Nutritionists

An alarming 30% to 50% prevalence rate of disease-related malnutrition among hospitalized patients compels the need for early diagnosis and treatment of malnutrition. Registered Dietitian Nutritionists (RDNs) can utilize the nutrition-focused physical examination (NFPE) as one of the nutrition assessment criteria to accurately diagnose malnutrition. Although RDNs are striving to employ NFPE in practice, a lack of experience and adequate training impedes full utilization of this technique. This results in wide skill variations requiring continuous evaluation of RDNs’ NFPE competency. However, a standardized, validated competency tool is not widely available and hence this study aims to develop a standardized, interactive nutrition-specific physical exam competency tool (INSPECT). As a first step in the development of INSPECT, a qualitative, technology-based focus group approach with 7 content and practice experts was utilized to generate appropriate tool items. A total of 70 NFPE items under 9 areas including 12 items for muscle loss, 4 items for subcutaneous fat loss, 31 items for micronutrient deficiencies, 1 item for fluid status, 2 items for handgrip strength, 5 items for initial preparation, 4 items for bedside manner, 8 items for swallowing, and 3 items for abdominal evaluation were generated. This study successfully utilized technology-based focus groups to generate appropriate NFPE items for the competency tool development. Using the items, an initial version of INSPECT has been developed, which is presently being investigated for content and face validity. The final version will undergo field tests and will be examined for reliability, validity, and item-level psychometric properties.

Demonstrating Nutrient Cost Gradients: A Brooklyn Case Study

2014 ◽  
Vol 84 (5-6) ◽  
pp. 244-251 ◽  
Author(s):  
Robert J. Karp ◽  
Gary Wong ◽  
Marguerite Orsi
Keyword(s):  
Low Income ◽  
Energy Content ◽  
Food Selection ◽  
The United States ◽  
United States Department ◽  
Micronutrient Deficiencies ◽  
Caloric Density ◽  
Low Income Families ◽  
The Cost ◽  
The Impact

Abstract. Introduction: Foods dense in micronutrients are generally more expensive than those with higher energy content. These cost-differentials may put low-income families at risk of diminished micronutrient intake. Objectives: We sought to determine differences in the cost for iron, folate, and choline in foods available for purchase in a low-income community when assessed for energy content and serving size. Methods: Sixty-nine foods listed in the menu plans provided by the United States Department of Agriculture (USDA) for low-income families were considered, in 10 domains. The cost and micronutrient content for-energy and per-serving of these foods were determined for the three micronutrients. Exact Kruskal-Wallis tests were used for comparisons of energy costs; Spearman rho tests for comparisons of micronutrient content. Ninety families were interviewed in a pediatric clinic to assess the impact of food cost on food selection. Results: Significant differences between domains were shown for energy density with both cost-for-energy (p < 0.001) and cost-per-serving (p < 0.05) comparisons. All three micronutrient contents were significantly correlated with cost-for-energy (p < 0.01). Both iron and choline contents were significantly correlated with cost-per-serving (p < 0.05). Of the 90 families, 38 (42 %) worried about food costs; 40 (44 %) had chosen foods of high caloric density in response to that fear, and 29 of 40 families experiencing both worry and making such food selection. Conclusion: Adjustments to USDA meal plans using cost-for-energy analysis showed differentials for both energy and micronutrients. These differentials were reduced using cost-per-serving analysis, but were not eliminated. A substantial proportion of low-income families are vulnerable to micronutrient deficiencies.

The Development of an Online Tobacco Tracker Tool to Crowdsource Campus Environmental Reports for Smoke and Tobacco Free College Policies: A Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Sabrina F. Loureiro ◽  
Kim M. Pulvers ◽  
Melissa M. Gosdin ◽  
Keavagh R. Clift ◽  
Myra J. Rice ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Positive Reinforcement ◽  
The United States ◽  
College Campuses ◽  
Policy Enforcement ◽  
Sequential Mixed Methods ◽  
Effective Policy ◽  
Online Tracking ◽  
One Year

BACKGROUND College campuses in the United States have begun implementing Smoke and Tobacco-Free policies to discourage the use of tobacco. Smoke and Tobacco-Free policies, however, are contingent upon effective policy enforcement. OBJECTIVE To develop an empirically-derived online tracking tool (Tracker) for crowdsourcing campus environmental reports of tobacco use and waste to support smoke and tobacco-free college policies. METHODS An exploratory sequential mixed methods approach was utilized to inform the development and evaluation of the Tracker. In October 2018, three focus groups across two California universities were conducted and themes were analyzed, guiding Tracker development. After one year of implementation, users were asked in April 2020 to complete a survey about their experience. RESULTS In the focus groups, two major themes emerged: barriers and facilitators to tool utilization. Further Tracker development was guided by focus group input to address these barriers (e.g. information, policing, and logistical concerns) and facilitators (e.g. environmental motivators, positive reinforcement). Amongst 1,163 Tracker reports, those who completed the user survey (n=316) reported the top motivations to using the tool were having a cleaner environment (79%) and health concerns (69%). CONCLUSIONS Environmental concerns, a motivator which emerged in focus groups, shaped the Tracker’s development and was cited by the majority of users surveyed as a top motivator for utilization.

scholarly journals Translation, Cross-Cultural Adaptation, and Validation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) into the Malay Language

2019 ◽  
Vol 16 (11) ◽  
pp. 2054 ◽  
Author(s):  
Ahmad Badruridzwanullah Zun ◽  
Mohd Ismail Ibrahim ◽  
Ariffin Marzuki Mokhtar ◽  
Ahmad Sukari Halim ◽  
Wan Nor Arifin Wan Mansor
Keyword(s):  
Healthcare Providers ◽  
The United States ◽  
Patient Perceptions ◽  
Face Validity ◽  
System Quality ◽  
Validity Index ◽  
Hospital Consumer Assessment ◽  
Discharged Patients ◽  
Consumer Assessment ◽  
Face Validation

Background: Patient feedback is an important tool in assessing health system quality. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was developed in 2006 as a standardized instrument to assess patient perceptions in the United States of America. This study aimed to translate and validate the HCAHPS questionnaire into the Malay language in order to assess patient perceptions of health services in Malaysia. Methods: The original HCAPHS in English was translated into Malay based on the established guideline. The content validation involved an expert panel of 10 members, including patients. The face validation pilot testing of the HCAHPS-Malay version was conducted among 10 discharged patients. The exploratory factor analysis (EFA) used principal axis factor, and varimax rotation was established based on a cross-sectional study conducted among 200 discharged patients from Hospital Universiti Sains Malaysia (Hospital USM). Results: The overall content validity index was 0.87, and the universal face validity index was 0.82. From the EFA, the factor loading value ranged from 0.652 to 0.961 within nine domains. The internal consistency reliability with Cronbach’s alpha was 0.844. Conclusion: The HCAHPS-Malay is a reliable and valid tool to determine patients’ perception of healthcare services among inpatients in Hospital USM based on the content and face validation result together with a good construct validity and excellent absolute reliability. Further testing on HCAHPS-Malay version in other settings in Malaysia needs to be done for cross-validation.

scholarly journals Behavior of a Wild-Type and Two Mutant Strains of Colletotrichum gloeosporioides f. sp. aeschynomene on Northern Jointvetch in the Field

Plant Disease ◽  
1998 ◽  
Vol 82 (4) ◽  
pp. 374-379 ◽  
Author(s):  
Y. Luo ◽  
D. O. TeBeest
Keyword(s):  
Population Density ◽  
Wild Type Strain ◽  
Colletotrichum Gloeosporioides ◽  
Biological Control Agent ◽  
Field Tests ◽  
The United States ◽  
Control Agent ◽  
Sampling Time ◽  
Wild Type ◽  
Mutant Strains

The fungus Colletotrichum gloeosporioides f. sp. aeschynomene causes an anthracnose on Aeschynomene virginica and has been used as a biological control agent to control this weed in the United States. The population dynamics of a wild-type strain (3-1-3) and two mutant strains of 3-1-3 of C. gloeosporioides f. sp. aeschynomene, a benomyl-resistant strain (B21) and nitrate-nonutilizing strain (Nit A), were studied in field tests on northern jointvetch in 1994 and 1995 to determine how the strains interacted on infected plants under field conditions. Plants were co-inoculated with strains 3-1-3 and B21, strains 3-1-3 and Nit A, and strains 3-1-3, B21, and Nit A at equal and unequal initial proportions. Plants were grown and maintained under flooded conditions in small wading pools. In co-inoculation of plants with 3-1-3 and B21 from equal initial proportions, the population of 3-1-3 increased slightly until it reached a proportion of 60 to 70%, whereas the population density of B21 reached 30 to 40% at the end of growing season. From unequal initial proportions, the population density of B21 decreased from 90 to about 50%, whereas the 3-1-3 increased from 10 to 50%. The population density of 3-1-3 increased from an equal initial proportion and was significantly greater than that of Nit A on every sampling time. From unequal initial proportions, the population density of 3-1-3 increased from 10 to 90%, whereas that of Nit A declined. In co-inoculation of plants with the three strains, the population density of 3-1-3 was significantly greater than those of the mutant strains at every sampling time. The proportions of mutant strains within the total population of C. gloeosporioides f. sp. aeschynomene on plants varied according to the test conditions and the number and types of strains co-inoculated.

American Indian Behavioral Health Treatment Preferences as Perceived by Urban Indian Health Program Providers

2021 ◽  
pp. 104973232110578
Author(s):  
Andrew Pomerville ◽  
Anna Kawennison Fetter ◽  
Joseph P. Gone
Keyword(s):  
Focus Groups ◽  
American Indian ◽  
Behavioral Health ◽  
Cultural Values ◽  
The United States ◽  
Treatment Preferences ◽  
Health Staff ◽  
Indian Health ◽  
Urban Indian ◽  
Therapy Room

Behavioral health services specifically targeted for ethnoracial clients are typically tailored to the specific needs and preferences of these populations; however, little research has been done with American Indian clients specifically. To better understand how clinicians handle provision of treatment to this population, we interviewed 28 behavioral health staff at six Urban Indian Health Programs in the United States and conducted focus groups with 23 staff at five such programs. Thematic analysis of transcripts from these interviews and focus groups suggests that these staff attempt to blend and tailor empirically supported treatments with American Indian cultural values and practices where possible. Simultaneously, staff try to honor the client’s specific preferences and needs and to encourage clients to seek cultural practices and connection outside of the therapy room. In so doing staff members were acutely aware of the limitations of the evidence base and the lack of research with American Indian clients.

Abstract TP365: Design of a Mobile-friendly Website to Reduce Stroke Caregiver Burden: a Focus Group Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Michelle R Caunca ◽  
Maria V Diaz ◽  
Andres De Leon-Benedetti ◽  
Gregory Hartley ◽  
Sara J Czaja ◽  
...  
Keyword(s):  
Focus Groups ◽  
Caregiver Burden ◽  
Short Form ◽  
The United States ◽  
Internet Technology ◽  
User Centered Design ◽  
Focus Group Study ◽  
Caregiver Support ◽  
Behavioral Issues ◽  
Burden Scale

Background: Stroke is a leading cause of disability in the United States. Family members often have to assume the role of informal caregiver. Despite an abundance of resources, caregiver burden continues to be a major issue, leading to negative outcomes such as depression. Objective: To characterize the needs of stroke caregivers in order to inform the design of a mobile-friendly website intervention. We hypothesized that a website intervention, designed using a user-centered design approach, will help equip caregivers for the caregiving role and reduce associated caregiver burden. Methods: Focus groups with caregivers of stroke patients were conducted in English (N=3) and Spanish (N=4) to gather data on major obstacles experienced by caregivers. Participants were also asked about the challenging aspects of caregiving and their use of mobile devices. Results: Of seven total caregivers (86% Hispanic, 100% female, mean [SD] age=60 [9] years), 86% were smartphone users. The median (interquartile range) score on the short form Zarit Burden scale was 18 (12-20), indicating elevated caregiver burden in our sample. Across all participants, 100% cited lack of training as a major challenge, 86% cited financial difficulties and dealing with patient cognitive issues, 71% reported physical and emotional challenges, 43% participants cited time constraints and patient behavioral issues, and 29% reported problems with patient communication and acceptance of their situation. Using these findings, we designed a Stroke Caregiver Support System prototype by collecting existing resources from publically available sources based on the issues identified by our focus groups. Website usability testing was conducted to gather feedback caregivers and further refine our intervention. Conclusions: We plan a small pilot test of this intervention in our community to measure its usability and gather more feedback on acceptability and usefulness of the intervention. Given the prevalence of mobile and internet technology, we believe that a mobile-friendly website may be a practical and easily accessible tool for caregivers as they navigate their new roles.

scholarly journals Rural Michigan Farmers’ Health Concerns and Experiences: A Focus Group Study

2021 ◽  
Vol 12 ◽  
pp. 215013272110535
Author(s):  
Nathan Wright ◽  
Marylee Scherdt ◽  
Michelle L. Aebersold ◽  
Marjorie C. McCullagh ◽  
Barbara R. Medvec ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Health Care System ◽  
Health Care Services ◽  
Well Being ◽  
The United States ◽  
Full Time ◽  
Rural Residents ◽  
Care Services ◽  
Care System

Objectives: Rural residents comprise approximately 15% of the United States population. They face challenges in accessing and using a health care system that is not structured to meet their unique needs. It is important to understand rural residents’ perceptions of health and experiences interacting with the health care system to identify gaps in care. Methods: Our team conducted focus groups with members of the Michigan Farm Bureau during their 2019 Annual Meeting. Topics explored included resources to manage health, barriers to virtual health care services, and desired changes to localized healthcare delivery. Surveys were used to capture demographic and internet access information. Conclusion: Analysis included data from 2 focus groups (n = 14). Participants represented a wide age range and a variety of Michigan counties. The majority were full-time farm owners with most—93% (n = 13)—reporting they had access to the internet in their homes and 86% (n = 12) reporting that their cellphones had internet capabilities. Participants identified challenges and opportunities in 4 categories: formal health care; health and well-being supports; health insurance experiences; and virtual health care. Conclusion: The findings from this study provide a useful framework for developing interventions to address the specific needs of rural farming residents. Despite the expressed challenges in access and use of health care services and resources, participants remained hopeful that innovative approaches, such as virtual health platforms, can address existing gaps in care. The study findings should inform the design and evaluation of interventions to address rural health disparities.

Steel Girder Bridge with RC Deck Retrofit From Non-Composite to Composite Behaviour

2016 ◽  
Author(s):  
Abheetha Peiris ◽  
Issam Elias Harik
Keyword(s):  
Field Tests ◽  
High Strength ◽  
The United States ◽  
Field Application ◽  
Steel Girder ◽  
Shear Connectors ◽  
Before And After ◽  
Steel Girder Bridge ◽  
Girder Bridge ◽  
Concrete Deck

In the past, a number of steel girder-reinforced concrete deck bridges on county roads in the United States have been built as non-composite. Most of these bridges currently have load postings limiting the capacity of bus and truck loads on their roadways. Recent research showed that post installed high strength bolts could be used as shear connectors in rehabilitation work to achieve partial composite design by deploying 30% to 50% of the connectors typically required for a full composite design. This paper presents details on the analysis, design, and field application of post-installed shear connectors on a non-composite concrete deck steel girder bridge in Kentucky. In order to minimize traffic disruption and construction costs, the shear connectors were inserted on the bottom side of the deck through the top flange of the steel girder. While the load rating increased by 132%, field tests conducted before and after installation of the shear connectors showed that the bridge's live load deflections were reduced by more than 27%.

Cross Cultural Perceptions on Privacy in the United States, Vietnam, Indonesia, and Taiwan

2009 ◽  
pp. 284-299 ◽  
Author(s):  
Andy Chiou
Keyword(s):  
United States ◽  
Focus Groups ◽  
The United States ◽  
Cross Cultural ◽  
Future Research ◽  
The Internet ◽  
Single System ◽  
Cultural Perceptions ◽  
Internet Privacy ◽  
Different Cultures

In this chapter, the authors will briefly discuss some cross cultural concerns regarding Internet privacy. The authors believe that due to the cross cultural nature of the Internet itself, different cultures will tend to result in different concerns regarding Internet privacy. As such, there is no single system of protecting Internet privacy that may be suitable for all cultures. The authors also utilize focus groups from various countries spanning Asia and the United States to discover the differences between cultures. Hopefully an understanding of such differences will aid in future research on Internet privacy to take a more culture sensitive approach.

The Meaning of Social Inclusion to Players With and Without Intellectual Disability in Unified Sports Teams

Inclusion ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 234-243 ◽  
Author(s):  
Roy McConkey ◽  
Cheryl Peng ◽  
Marie Merritt ◽  
Amy Shellard
Keyword(s):  
United States ◽  
Content Analysis ◽  
Intellectual Disability ◽  
Focus Groups ◽  
Social Inclusion ◽  
The United States ◽  
Community Settings ◽  
Core Concept ◽  
Sports Teams ◽  
Thematic Content Analysis

Abstract Sport can be a means for promoting social inclusion but to date, the perspectives of participants have been rarely sought. Focus groups interviews were held with 6 Special Olympic, Unified Sports teams in the United States as well as one each in Germany and India. In all, 49 athletes with intellectual disability and 39 team-mates without disability participated. From a thematic content analysis, a core concept of togetherness emerged, with five subthemes of equality, friendships, participation, connections, and assistance. Four main feelings were associated with togetherness: happy, relaxed, confident, and cared for. The players gave specific examples of how these outcomes were realised in sport and community settings. Their insights could guide future attempts to promote social inclusion in sports and the wider community.

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