scholarly journals The Embodied Nature of Horse Human Communication: A Feasibility Study of an Equine Assisted Intervention; Benefits for Horses and Humans

2021 ◽  
Author(s):  
Ann Hemingway
Keyword(s):  
Public Health ◽  
Social Workers ◽  
Feasibility Study ◽  
Feasibility Studies ◽  
Specific Intervention ◽  
Human Communication ◽  
Learner Analysis ◽  
Before And After ◽  
Equine Assisted ◽  
Existing Data

This chapter presents the findings from a feasibility study of an equine assisted intervention (EAI) which is currently referred over 160 people with mental health and behavioural problems each year. Performing a feasibility study may be indicated when, there are few previously published studies or existing data using a specific intervention technique. The framework used for this feasibility study has been designed to underpin public health feasibility studies and outlines eight areas of focus which will be addressed here: Acceptability, demand, implementation, practicality, adaptation, integration, expansion and limited efficacy testing. The efficacy testing includes results from before and after measures completed by referrers of individuals to the course with n=336 participants (normally social workers or teachers). Overall scores for the eight outcomes measured showed statistically significant improvement for 293 of the participants two months after completing the course. The eight outcomes measured were calmness, assertiveness, empathy, communication, confidence as a learner, analysis and planning, taking responsibility and focus and perseverance.

Evaluation of a New Field Epidemiology Training Program Intermediate Course to Strengthen Public Health Workforce Capacity in Tanzania

2021 ◽  
pp. 003335492097466
Author(s):  
Kate Wilson ◽  
Amir Juya ◽  
Ahmed Abade ◽  
Senga Sembuche ◽  
Devotha Leonard ◽  
...  
Keyword(s):  
Public Health ◽  
Training Program ◽  
Health Workforce ◽  
Outcome Evaluation ◽  
Exit Interviews ◽  
Field Epidemiology ◽  
Health Threats ◽  
Before And After ◽  
Workforce Capacity ◽  
Field Epidemiology Training Program

Objectives Sub-Saharan Africa faces a shortage of skilled epidemiologists to prevent, detect, and respond to health threats. Tanzania has implemented one of the first Centers for Disease Control and Prevention Field Epidemiology Training Program (FETP) Intermediate courses in Africa. This course aims to strengthen health workforce capacity in surveillance system assessment, outbreak investigation, and evaluation, prioritizing HIV control. We conducted an outcome evaluation of this new course. Methods We used a pre/post evaluation design using data from 4 cohorts of trainees who took the FETP Intermediate course from 2017 to 2020. We conducted knowledge assessments before and after each cohort and combined those results. Outcomes included knowledge and self-rated competency and trends in integrated disease surveillance and response (IDSR) data. We collected data through tests, field assignments, exit interviews, and data audits. We compared the mean change in pre-/posttest scores using linear regression and 95% CIs. We used content analysis to summarize exit interviews. Results Fifty-three FETP trainees from 10 regions enrolled in the FETP Intermediate course, and 52 (99.0%) completed the course. We found substantial increases in mean knowledge (44.0 to 68.0 points) and self-rated competency (4.14 to 4.43) scores before and after the course. Trainees evaluated 52 surveillance systems and 52 district HIV care programs, and 39 (75.0%) trainees participated in outbreak investigations. From before to after cohort 1, timeliness and completeness of IDSR reports increased from 4.2% to 52.1% and from 27.4% to 76.5%, respectively. Course strengths were quality of instruction, individualized mentoring, and practical skills gained. Challenges were mentor availability, limited time for data analysis practice, and balancing work and field assignments. Conclusions The Tanzania FETP Intermediate course substantially improved trainee knowledge and helped to improve local data quality and reporting. This course is a promising model to strengthen subnational capacity to prevent, detect, and respond to public health threats in Africa.

Funding models and expenditures with primary healthcare in Salvador, Bahia, Brazil metropolitan area

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Vivas ◽  
M Duarte ◽  
A Pitta ◽  
B Christovam
Keyword(s):  
Public Health ◽  
Metropolitan Area ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Ministry Of Health ◽  
Healthcare Budget ◽  
Health Budget ◽  
The Public ◽  
Before And After ◽  
The Government

Abstract Background The government investments in quality primary healthcare are the basis to strengthening the health systems and monitoring the public expenditure in this area is a way to assess the effectiveness and efficiency of the public health policies. The Brazil Ministry of Health changed, in 2017, the method of onlending federal resources to states and cities seeking to make the public funds management more flexible. This change, however, suppressed mandatory investments in primary healthcare. This research aims to determine the difference of expenditures on primary healthcare in Salvador, Bahia, Brazil metropolitan area before and after this funding reform, seeking to verify how it can impact the quality of primary healthcare services and programs. Methods This is an ecological time-series study that used data obtained in the Brazil Ministry of Health budget reports. The median and interquartile range of expenditures on primary healthcare (set as the percentage of total public health budget applied in primary care services and programs) of the 13 cities in the Salvador metropolitan area were compared two years before and after the reform. Results The median of expenditures on primary healthcare in Salvador metropolitan area was 25.5% (13,9% - 32,2%) of total public health budget before and 24.8% (20.8% - 30.0%) of total public health budget after the reform (-0.7% difference). Seven cities decreased the expenditures on primary healthcare after the reform, ranging from 1.2% to 10.8% reduction in the primary healthcare budget in five years. Conclusions Expenditures on primary healthcare in Salvador metropolitan area decreased after the 2017 funding reform. Seven of 13 cities reduced the government investments on primary healthcare services and programs in this scenario. Although the overall difference was -0.7%, the budget cuts ranged from 1.2% to 10.8% in the analyzed period and sample. More studies should assess these events in wide areas and with long time ranges. Key messages Public health funding models can impact the primary healthcare settings regardless of the health policy. Reforms in the funding models should consider the possible benefits before implementation. Funding models and methods that require mandatory investments in primary healthcare may be considered over more flexible ones.

scholarly journals Changes of Walking Activity During the First Cycle Phases of COVID-19 Pandemic: A Case Study of Seoul, Korea

2021 ◽  
pp. 193758672110265
Author(s):  
Youngjun Park ◽  
Haekwon Chung ◽  
Sohyun Park
Keyword(s):  
Public Health ◽  
Physical Inactivity ◽  
Voluntary Participation ◽  
Walking Activity ◽  
Significant Difference ◽  
Before And After ◽  
Acceleration And Deceleration ◽  
Preliminary Study ◽  
The Government

Aim: This study explores the changes in regular walking activities during the phases of the pandemic. Background: With the spread of COVID-19 transmission, people are refraining from going out, reducing their physical activity. In South Korea, COVID-19 broke out in the 4th week of 2020 and experienced the first cycle phases of the pandemic, such as outbreak, widespread, and decline. In response to the pandemic, the government encouraged voluntary participation in social distancing campaigns, and people reduced their outside activities. Methods: This article examines the decrease and increase of the Prevalence of Regular Walking (≥30 min of moderate walking a day, on ≥5 days a week) by the COVID-19 phases. This study is based on weekly walking data for 15 weeks in 2020, via the smartphone healthcare app, which is managed by 25 public health offices of the Seoul government. Results: According to the findings, the level of prevalence of regular walking (PRW) has a significant difference before and after the outbreak, and every interval of the four-stage COVID-19 phases, that is, pre-pandemic, initiation, acceleration, and deceleration. The level of PRW sharply decreased during initiation and acceleration intervals. In the deceleration interval of COVID-19, the PRW kept increasing, but it has not yet reached the same level as the previous year when the COVID-19 did not exist. Conclusions: As a preliminary study, this study explains empirically how COVID-19 changed PRW in Seoul. It would be helpful to enhance our understanding of the changes in physical inactivity in the pandemic period.

scholarly journals An innovative approach to improve the detection and treatment of risk factors in poor urban settings: a feasibility study in Argentina

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Poggio Rosana ◽  
Goodarz Danaei ◽  
Laura Gutierrez ◽  
Ana Cavallo ◽  
María Victoria Lopez ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Primary Care ◽  
Community Health ◽  
Community Health Workers ◽  
Feasibility Study ◽  
Health Workers ◽  
Health Coverage ◽  
Cvd Risk Factors ◽  
Cvd Risk

Abstract Background The effective management of cardiovascular (CVD) prevention among the population with exclusive public health coverage in Argentina is low since less than 30% of the individuals with predicted 10-year CVD risk ≥10% attend a clinical visit for CVD risk factors control in the primary care clinics (PCCs). Methods We conducted a non-controlled feasibility study using a mixed methods approach to evaluate acceptability, adoption and fidelity of a multi-component intervention implemented in the public healthcare system. The eligibility criteria were having exclusive public health coverage, age ≥ 40 years, residence in the PCC’s catchment area and 10-year CVD risk ≥10%. The multi-component intervention addressed (1) system barriers through task shifting among the PCC’s staff, protected medical appointments slots and a new CVD form and (2) Provider barriers through training for primary care physicians and CHW and individual barriers through a home-based intervention delivered by community health workers (CHWs). Results A total of 185 participants were included in the study. Of the total number of eligible participants, 82.2% attended at least one clinical visit for risk factor control. Physicians intensified drug treatment in 77% of participants with BP ≥140/90 mmHg and 79.5% of participants with diabetes, increased the proportion of participants treated according to GCP from 21 to 32.6% in hypertensive participants, 7.4 to 33.3% in high CVD risk and 1.4 to 8.7% in very high CVD risk groups. Mean systolic and diastolic blood pressure were lower at the end of follow up (156.9 to 145.4 mmHg and 92.9 to 88.9 mmHg, respectively) and control of hypertension (BP < 140/90 mmHg) increased from 20.3 to 35.5%. Conclusion The proposed CHWs-led intervention was feasible and well accepted to improve the detection and treatment of risk factors in the poor population with exclusive public health coverage and with moderate or high CVD risk at the primary care setting in Argentina. Task sharing activities with CHWs did not only stimulate teamwork among PCC staff, but it also improved quality of care. This study showed that community health workers could have a more active role in the detection and clinical management of CVD risk factors in low-income communities.

scholarly journals Role of feasibility and pilot studies in randomised controlled trials: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e022233 ◽  
Author(s):  
Amanda Jane Blatch-Jones ◽  
Wei Pek ◽  
Emma Kirkpatrick ◽  
Martin Ashton-Key
Keyword(s):  
Feasibility Study ◽  
Randomised Controlled Trials ◽  
Feasibility Studies ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group 2 ◽  
Randomised Controlled ◽  
Pilot Feasibility Study ◽  
Group 1

ObjectivesTo assess the value of pilot and feasibility studies to randomised controlled trials (RCTs) funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme. To explore the methodological components of pilot/feasibility studies and how they inform full RCTs.Study designCross-sectional study.SettingBoth groups included NIHR HTA programme funded studies in the period 1 January 2010–31 December 2014 (decision date). Group 1: stand-alone pilot/feasibility studies published in the HTA Journal or accepted for publication. Group 2: all funded RCT applications funded by the HTA programme, including reference to an internal and/or external pilot/feasibility study. The methodological components were assessed using an adapted framework from a previous study.Main outcome measuresThe proportion of stand-alone pilot and feasibility studies which recommended proceeding to full trial and what study elements were assessed. The proportion of ‘HTA funded’ trials which used internal and external pilot and feasibility studies to inform the design of the trial.ResultsGroup 1 identified 15 stand-alone pilot/feasibility studies. Study elements most commonly assessed weretesting recruitment(100% in both groups),feasibility(83%, 100%) andsuggestions for further study/investigation(83%, 100%). Group 2 identified 161 ‘HTA funded’ applications: 59 cited an external pilot/feasibility study wheretesting recruitment(50%, 73%) andfeasibility(42%, 73%) were the most commonly reported study elements: 92 reported an internal pilot/feasibility study wheretesting recruitment(93%, 100%) andfeasibility(44%, 92%) were the most common study elements reported.Conclusions‘HTA funded’ research which includes pilot and feasibility studies assesses a variety of study elements. Pilot and feasibility studies serve an important role when determining the most appropriate trial design. However, how they are reported and in what context requires caution when interpreting the findings and delivering a definitive trial.

Learning Outcome Measurement in Nurse Participants After Disaster Training

2016 ◽  
Vol 10 (5) ◽  
pp. 728-733
Author(s):  
Sharon L. Farra ◽  
Sherrill Smith ◽  
Marie A Bashaw
Keyword(s):  
Public Health ◽  
Homeland Security ◽  
Emergency Preparedness ◽  
Disaster Response ◽  
Outcome Measurement ◽  
Disaster Medicine ◽  
Learning Framework ◽  
Before And After ◽  
Disaster Training ◽  
National Disaster

AbstractObjectiveThe National Disaster Health Consortium is an interprofessional disaster training program. Using the Hierarchical Learning Framework of Competency Sets in Disaster Medicine and Public Health, this program educates nurses and other professionals to provide competent care and leadership within the interprofessional team. This study examined outcomes of this training.MethodsTraining consisted of a combination of online and on-site training. Learning outcomes were measured by using the Emergency Preparedness Information Questionnaire (EPIQ) pre/post training and participant performance during live functional exercises with the use of rubrics based on Homeland Security Exercise and Evaluation principles.ResultsA total of 64 participants completed the EPIQ before and after training. The mean EPIQ pre-training score of 154 and mean post-training score of 81 (reverse-scored) was found to be statistically significant by paired t-test (P<0.001). Performance was evaluated in the areas of triage, re-triage, surge response, and sheltering. Greater than 90% of the exercise criteria were either met or partially met. Participants successfully achieved overall objectives in all scenarios.ConclusionsDisaster response requires nurses and other providers to function in interprofessional teams. Educational projects, like the National Disaster Health Consortium program, offer the potential to address the need for a standardized, interprofessional disaster training curriculum to promote positive outcomes. (Disaster Med Public Health Preparedness. 2016;page 1 of 6)

scholarly journals A Five-Year Study of Influenza in Families Joint Public Health Laboratory Service/Royal College of General Practitioners Working Group

1981 ◽  
Vol 87 (2) ◽  
pp. 191-200 ◽  
Author(s):  
P. G. Mann ◽  
M. S. Pereira ◽  
J. W. G. Smith ◽  
R. J. C. Hart ◽  
W. O. Williams ◽  
...  
Keyword(s):  
Public Health ◽  
General Practitioners ◽  
Royal College ◽  
Working Group ◽  
Virus Isolation ◽  
Collaborative Study ◽  
Influenza Viruses ◽  
Public Health Laboratory ◽  
Laboratory Service ◽  
Before And After

SummaryA five year collaborative study of influenza in volunteer families from 1973–78 covered a period in which there were outbreaks every year but no major epidemics of influenza. Volunteers over the age of 15 years were bled before and after each of the five winters, and virus isolation was attempted from as many as possible when they reported episodes of illness. Children under 15 in the volunteer families were also swabbed when they were ill. Although most families experienced one or more attacks by influenza viruses, there was little transmission within families.

scholarly journals Relationship Between Hand-washing Habit and Toilet Use with Diarrhea Incidence in Children Under Five Years

2017 ◽  
Vol 5 (1) ◽  
pp. 95
Author(s):  
Nikmatur Rohmah ◽  
Fariani Syahrul
Keyword(s):  
Public Health ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Hand Washing ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Children Under Five ◽  
Under Five ◽  
Before And After

Diarrhea is still a public health problem in the world and the mostly occur in children under five years. At the moment the number of diarrhea-caused mortality was 3.8 per 1000 per year by 3.2 episodes per year in children under five years. This research aims to analyze the association between hand-washing habits and toilet use with the incidence of diarrhea in children under five years. This is an observational analytic with cross sectional study. Population of the research was a children's mother took her children to the public health center of Sekardangan Sidoarjo Subdistrict. The number of samples taken as many as 58 mother of children under five years. Data collection was done with interviews to parents of children and the observations of the toilets. Technique of data analysis using chi-square test or Fisher's exact test. On the results of the research there is a significant association the habit of hand washing (p = 0.006) and toilet use(p = 0.014) with the incidenceof diarrhea in children under five years. Conclusions of the research is the habit of hand washing and toilet use had a significant association with the incidenceof diarrhea in children under five years. Advice that can be given to the mother of a children under five years is to wash the hands before and after defecating and before preparing food for children. Keywords: diarrhea, hand washing, toilet use, observational, children under five years

scholarly journals An assets-based intervention before and after birth to improve breastfeeding initiation and continuation: the ABA feasibility RCT

2020 ◽  
Vol 8 (7) ◽  
pp. 1-156
Author(s):  
Joanne L Clarke ◽  
Jenny Ingram ◽  
Debbie Johnson ◽  
Gill Thomson ◽  
Heather Trickey ◽  
...  
Keyword(s):  
Public Health ◽  
Randomised Controlled Trial ◽  
Infant Feeding ◽  
Health Research ◽  
Controlled Trial ◽  
Intervention Group ◽  
Public Health Research ◽  
Breastfeeding Initiation ◽  
Before And After ◽  
Randomised Controlled

Background The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer-support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on the positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory. Objective To investigate the feasibility of delivering the ABA infant feeding intervention in a randomised controlled trial. Design This was an individually randomised controlled feasibility trial; women were randomised in a 1 : 1 ratio to either the intervention group or the comparator (usual care) group. Setting Two separate English sites were selected because they had an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage and low rates of breastfeeding. Participants Women aged ≥ 16 years who were pregnant with their first child, irrespective of feeding intention (n = 103), were recruited by researchers in antenatal clinics. Interventions Proactive, woman-centred support, using an assets-based approach and including behaviour change techniques, was provided by an infant-feeding helper (a breastfeeding peer supporter trained in the ABA intervention) and delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks’ gestation and could continue until 5 months postnatally. Main outcome measures The main outcome measures were feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, infant-feeding helpers and maternity services; and feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow-up rates at 3 days, 8 weeks and 6 months postnatally, and outcomes for a future full trial were collected via participant questionnaires. A mixed-methods process evaluation included qualitative interviews with women, infant-feeding helpers and maternity services; infant-feeding helper logs; and audio-recordings of antenatal contacts to check intervention fidelity. Results Of the 135 eligible women approached, 103 (76.3%) agreed to participate. The study was successful in recruiting teenagers (8.7%) and women living in areas of socioeconomic disadvantage (37.3% resided in the most deprived 40% of small areas in England). Postnatal follow-up rates were 68.0%, 85.4% and 80.6% at 3 days, 8 weeks and 6 months, respectively. Feeding status at 8 weeks was obtained for 95.1% of participants. Recruitment took place from February 2017 until August 2017. It was possible to recruit and train existing peer supporters to the infant-feeding helper role. The intervention was delivered to most women with relatively high fidelity. Among the 50 women in the intervention group, 39 received antenatal visits and 40 received postnatal support. Qualitative data showed that the intervention was acceptable. There was no evidence of intervention-related harms. Limitations Birth notification delays resulted in delays in the collection of postnatal feeding status data and in the offer of postnatal support. In addition, the intervention needs to better consider all infant-feeding types and did not adequately accommodate women who delivered prematurely. Conclusion It is feasible to deliver the intervention and trial. Future work The intervention should be tested in a fully powered randomised controlled trial. Trial registration Current Controlled Trials ISRCTN14760978. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 7. See the NIHR Journals Library website for further project information.

scholarly journals Using Geographically Referenced Data on Environmental Exposures for Public Health Research: A Feasibility Study Based on the German Socio-Economic Panel Study (SOEP)

2011 ◽  
Author(s):  
Sven Voigtländer ◽  
Jan Goebel ◽  
Thomas Claßen ◽  
Michael Wurm ◽  
Ursula Berger ◽  
...  
Keyword(s):  
Public Health ◽  
Feasibility Study ◽  
Health Research ◽  
Panel Study ◽  
Environmental Exposures ◽  
Public Health Research
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