Developing a Consensus for Adolescent and Young Adult mHealth HIV Prevention Interventions in the United States: Delphi Method (Preprint)

BACKGROUND Engaging adolescents and young adults (AYA) who are at elevated risk for HIV acquisition or who are living with HIV in healthcare has posed a major challenge in HIV prevention and care efforts. Mobile health (mHealth) interventions are a popular and accessible strategy to support AYA engagement despite barriers to care present along the HIV care continuum. Even with progress in the field of mHealth research, expert recommendations for the process of designing, evaluating, and implementing HIV-related mHealth interventions are underdeveloped. OBJECTIVE The aim of this study was to compile expert recommendations on the development, evaluation, and implementation of AYA-focused HIV prevention and care mHealth interventions. METHODS Experts from adolescent mHealth HIV research networks and investigators of recently funded HIV mHealth projects and programs were identified and invited to complete a series of electronic surveys related to the design, implementation, and evaluation of HIV-related mHealth interventions. A modified Delphi method was used to ask experts to score 35 survey items on a 4-point Likert scale from not important to very important and encouraged experts to leave additional comments in text boxes. Responses were reviewed by the researchers, a team of four HIV mHealth intervention experts. The average importance ratings from survey responses were calculated and then categorized as retained (high importance), flagged (mid-level importance), or dropped (no/low importance). Additionally, thematic analysis of expert comments helped modify survey items for the next survey round. An evaluation of the level of agreement among experts on the most important items followed each round until consensus was reached. RESULTS Of the 35 invited experts, 23 completed the first survey representing a variety of roles within a research team. Following two rounds of Delphi surveys, experts scored 86% of the 30 survey items included in round two as important to very important. The final consensus items included 24 recommendations related to the mHealth intervention design process (n=15), evaluation (n=2), and implementation (n=7). The three survey items with the highest average scores focused on the design process, specifically, (1) creating a diverse team including researchers, app software developers, youth representation, (2) the importance of AYA-focused content, and the (3) value of an iterative process. Additionally, experts highlighted the importance of establishing the best ways to collect data and the types of data for collection during the evaluation process as well as constructing a plan for participant technology disruption when implementing an mHealth intervention. CONCLUSIONS The modified Delphi method was a useful tool to convene experts to determine recommendations for AYA-focused HIV prevention and care mHealth interventions. These recommendations can inform future mHealth interventions. To ensure acceptability, feasibility, and efficacy of these AYA HIV prevention interventions, the focus must be on specific needs of AYA by including representation of AYA in the process, including consistent and relevant content, ensuring appropriate data is collected, and considering technology and health accessibility barriers.

Alternatives to funding scientific research from the viewpoint of Academic Experts at Yemeni University: بدائل تمويل البحث العلمي من وجهة نظر الخبراء الأكاديميين في الجامعات اليمنية

The current research aimed to identify alternatives to funding scientific research from the point of view of academic experts in Yemeni universities, And the modified Delphi method were used, with the participation of a sample of academic experts in Yemeni universities, In the first round, consisted (34) male and female experts, and in the second round (30) male and female experts, They were chosen in a purposive manner, the questionnaire was used as a research tool, which included (37) items distributed over two axes. The research had several results, the most important of which were: All research axes were given a high degree of importance. The axis of obstacles to funding alternatives for scientific research obtained a high degree, As for the alternatives to funding scientific research, they all got a high degree of importance, The field of other financing alternatives ranked first, the field of self-financing alternatives ranked second, and in the third and last place comes the alternatives to government funding, The research recommended several recommendations, including: Paying attention to scientific research Increasing the share of scientific research from country budget.

Exploration of constructing the catering quality indices of university canteens in China from the viewpoint of food safety

PurposeThis study used the literature review and the modified Delphi method to evaluate the importance of the catering quality indices of university canteens in China. In order to compile the catering quality indices of university canteens in China as reference for the subsequent improvement of Chinese canteens.Design/methodology/approachThis study first analysed literature data to establish the preliminary quality indices and used the modified Delphi method for measurement. After three rounds of Delphi analysis by 35 experts, the results of the catering quality indices of university canteens in China are summarised.FindingsThe research results show that university canteen catering quality issues are divided into six dimensions, including catering safety management, employee hygiene management, catering service, food quality, environmental atmosphere and corporate social responsibility. Catering safety management is the most important index, followed by employee hygiene management.Originality/valueThe research results can be used as suggestions for follow-up improvements in the quality of university canteens in China and a basis of reference for amendments to relevant national or local laws and regulations. The food prices, food quality and whether food hygiene and safety standards are met by university canteens are all related to the health and vital interests of the teachers and students, as well as the stability of the university. Therefore, the government should increase supervision in these aspects to avoid decline in the quality of meals due to low profits and enforce strict requirements for food safety.

Development of Population-Based Cancer Indicators and a Measurement of Cancer Care Continuum Using a Modified Delphi Method

To identify population-based cancer indicators and construct monitoring systems for the entire lifecycle of cancer patients using a modified Delphi method. A modified Delphi method was used to identify the cancer indicators and measurement by scoping review and gray literature. The final list of cancer indicators was developed by consensus of 11 multidisciplinary experts over multiple rounds and rating scored the importance of each indicator on a 10-point scale. Frequency analysis was performed to rate with median scores ≥7 and finalized the list of indicators according to the priority. Initially, 254 indicators were identified, of which 94 were considered important and feasible. After two rounds of rating by the experts and panel discussions, 26 indicators were finalized in six domains: primary prevention (n = 7), secondary prevention (n = 11), treatment (n = 2), quality of life (n = 4), survivor management (n = 1), and end-of-life care (n = 1). The Donabedian model used for examining health services and the Institute of Medicine quality of healthcare domains were applied to the measurement system. Panel experts identified cancer indicators based on priorities with a high level of consensus, providing a scrupulous foundation for community-based monitoring of cancer patients.

Exploration of Evaluation Index for Obstetric Anesthesiologists Training in China Using Modified Delphi Method, Experiences From Pilot Project of PKUHSC

BackgroundWith the gruadual liberation of fertility policy and the increased number of pregnant women at high-risk in China, a large number of obstetric anesthesiologists (OA) with competency were urgently demanded. In order to establish a replicable and standardized training system for OA specialists, Peking University Health Science Center, one of the first ratified specialists training centers in China, initiated this explorative project. As this is a continuous improving process, the final evaluation index has not been formulated. MethodA working group was set up to devise survey instrument and the initial index draft. We initiated a nation-wide questionnaire pooling opinions of 40 experts from Youth committee of China Anesthesiology Association to construct the evaluation index based on modified Delphi method to reach a consensus. Experts’ demographic information, enthusiasm, authority, and agreement consensus were surgeyed. The final evaluation index would be constructed based on experts’ opinion.ResultsData were collected and analyzed for stability of the experts’ enthusiasm (97.5% and 87.2%, respectively), authority (0.91 ± 0.07 and 0.90 ± 0.13 for the respective two rounds), and agreement consensus (16.7% and 1.3% respectively; Kendall coefficient were 0.26 p = 0.415 and 0.147 p = 0.000, respectively). After two rounds of the survey, the evaluation standard was achieved with 2 items deleted, 5 items added, and 11 major revisions according to experts’ opinion. Revisions mainly focused on clinical practical ability (72%) and the research ability (28%).ConclusionThe final evaluation index was constructed consisting 3 categories (practice ability, non-technical skills, and teaching and research capabilities) with 5 primary and 14 secondary evaluation standards which further divided into 51 items. We hope it could be widely adopted as a standardized evaluation reference for obstetric anesthesiologists training.

Creating a Pediatric Prehospital Destination Decision Tool Using a Modified Delphi Method

Decisions for patient transport by emergency medical services (EMS) are individualized; while established guidelines help direct adult patients to specialty hospitals, no such pediatric equivalents are in wide use. When children are transported to a hospital that cannot provide definitive care, care is delayed and may cause adverse events. Therefore, we created a novel evidence-based decision tool to support EMS destination choice. A multidisciplinary expert panel (EP) of stakeholders reviewed published literature. Four facility capability levels for pediatric care were defined. Using a modified Delphi method, the EP matched specific conditions to a facility pediatric-capability level in a draft tool. The literature review and EP recommendations identified seventeen pediatric medical conditions at risk for secondary transport. In the first voting round, two were rejected, nine met consensus for a specific facility capability level, and six did not reach consensus on the destination facility level. A second round reached consensus on a facility level for the six conditions as well as revision of one previously rejected condition. In the third round, the panel selected a visual display format. Finally, the panel unanimously approved the PDTree. Using a modified Delphi technique, we developed the PDTree EMS destination decision tool by incorporating existing evidence and the expertise of a multidisciplinary panel.