Evaluating Implementation of the Behavioral Recovery Outreach (BRO) Team: One Year of Implementation

We present evaluation results after one year of implementation by nine BRO Teams. Monthly checklists documented consistent composition across teams: a psychologist, social worker and nurse. Social workers were recognized as having a critical role in implementation, serving as a referral source and liaison between the CLC, Veteran/family, and community facility. Early implementation focused on team and program development with barriers including unprotected time for Team members. In the first year, the nine teams enrolled 70 Veterans, discharging 86% to community facilities. Characteristics of the Veterans suggest Teams are reaching the complex Veteran targeted by the model. Barriers to successful discharge include community facility inexperience/training and confidence to manage complex residents. COVID emerged as the leading barrier to outreach to internal and external partners and providing transitional support to the Veteran after discharge. We discuss the impact of these preliminary findings on future implementation and dissemination of the model.

Support From the Top: Diverse Leadership Partners for Sustained STAR-VA Implementation

The STAR-VA program was an initiative out of what is now called the VA Office of Mental Health and Suicide Prevention, partnering with the national Offices of Geriatrics and Extended Care and Nursing Services. Ongoing collaboration with these national, as well as regional and medical-center-level leaders, has been critical for informing program implementation and dissemination strategies. We will discuss several key partnered strategies, including (1) linking STAR-VA to national CLC systematic quality improvement efforts; (2) engaging national inter-office program leaders in decisions about outreach to and inclusion of facilities in STAR-VA training and implementation; (3) training local STAR-VA champions on strategies for engaging local leadership support; (4) briefing leaders across the system with program updates; and (5) using national VA data to inform STAR-VA sustained implementation. Discussion will address challenges and opportunities for engaging leadership stakeholders in facilitating sustained implementation of evidence-based programs.

Polish Nurses’ Attitude to e-Health Solutions and Self-Assessment of Their IT Competence

In many countries, the implementation and dissemination of e-services for healthcare systems are important aspects of projects and strategies, as they contribute to significantly improving the access to such a system. The aim of the study is to analyze nurses’ opinions on the application of the e-health solutions at work and the self-assessment of their IT competence. A linear stepwise regression allowed for the visualization of independent variables significantly influencing considerably the level of IT competency. Reduced IT competency was found in the group of nurses who rated the impact of the Internet and the new technologies as lower on the health care and general lives of modern people (β = 0.203; p < 0.0001), recommended e-health solutions to a lesser extent (β = 0.175; p < 0.0001), rated e-health solutions lower in relation to the patient (β = 0.149; p < 0.0001), and were older in age (β = 0.095; p = 0.0032). IT competence has become an indispensable requirement for nurses in fulfilling their professional roles. The quality of using new technologies in the work of nurses depends on their IT competence.

Pediatric hypertension screening and recognition in primary care clinics in Canada

Objectives Screening for hypertension in children is recommended by pediatric consensus guidelines. However, current practice is unknown. We evaluated rates of blood pressure assessment and hypertension recognition in primary care. Methods This retrospective cohort study evaluated electronic medical record data from the Canadian Primary Care Sentinel Surveillance Network between 2011 and 2017. Children aged 3 to &lt;18 years with at least one clinical encounter were included. Screening, follow-up, and hypertension recognition rates were evaluated. Descriptive statistics and multivariate logistical regression were used to determine patient and provider characteristics associated with increased screening and recognition of pediatric hypertension. Results Among 378,002 children, blood pressure was documented in 33.3% of all encounters, increasing from 26.7% in 2011 to 36.2% in 2017; P=0.007. Blood pressure was documented in 76.0% of well child visits. Follow-up visits occurred within 6 months for 26.4% of children with elevated blood pressure, 57.1% of children with hypertension, and within 1 month for 7.2% of children with hypertension. Patient factors associated with increased blood pressure screening include being overweight (OR 2.15, CI 2.09 to 2.22), having diabetes (OR 1.69, CI 1.37 to 2.08), chronic kidney disease (OR 7.51, CI 6.54 to 8.62), increased social deprivation (OR 1.10, CI 1.09 to 1.11), and urban residence (OR 1.27, CI 1.15 to 1.4). Overall prevalence of hypertension was 1.9% (n=715) and of those, 5.6% (n=40) had recognized hypertension. Factors associated with increased recognition include male sex, overweight, and hyperlipidemia. Conclusions Rates of hypertension screening and recognition are low in primary care settings in Canada, suggesting pediatric hypertension should be a priority for implementation and dissemination of interventions.

Disrupting the Systems: Opportunities to Enhance Methodological Approaches to Address Socio-Structural Determinants of HIV and End the Epidemic Through Effective Community Engagement

A world without HIV is only possible by addressing the socio-structural determinants of health. Our understanding of socio-structural determinants is constantly changing, and parallel changes must occur with the methodologies used to explain the drivers of the HIV epidemic. We argue for the need to engage communities in the planning, implementation, and dissemination of research on the socio-structural determinants of HIV. Community engagement should cross-cut various types of research including rigorous measurement development of socio-structural determinants and novel analytic techniques to model their role in the trajectory of the epidemic and the impact of interventions. Considering the role of place, we recommend collaboration between scientists and communities in the interpretation of results from studies that map HIV-related behaviors and movement. As we collectively delve into historically oppressive systems with colonial antecedents, we must be ready to challenge these systems and replace them with collaborative models. The success of research-driven HIV policy and programming will best be evaluated with methodologies derived from the insights of the very individuals that these policies and programs aim to serve.

Practice What We Preach: Beginning a Journey to Embrace Patient-Centered Outcomes Research

Background: Patient-centered outcomes research seeks to answer patient-centered questions. The process includes varied locations and individuals throughout the care continuum to address individual differences and constraints in implementation and dissemination. Problem: This paper intends to answer this question: do academic nurses practice what they preach by assisting patient-centered outcomes research and researchers through their engagement with patients, caregivers, and other community stakeholder partners in nursing research? Approach: This paper provides an overview of how academic nurses in a single institution (the University of Texas Medical Branch at Galveston School of Nursing) began to embrace patient-centered outcomes research. Conclusion: Whether academic nurses are practicing what they preach in terms of patient-centered outcomes research remains uncertain. More examples from academia are required to make that determination. Academic nurses worldwide have embarked on a steep learning curve to embrace patient-centered outcomes research. This journey will require patience and a systematic strategy.

Is it my job? Leaders' family-supportive role perceptions

PurposeDespite a burgeoning literature on family-supportive supervisor behaviors (FSSB), it is unclear whether supervisors view these behaviors as in-role or discretionary. We proposed a new cognitive motivational construct, FSSB role perceptions (FSSB-RP; that is the extent to which supervisors perceive FSSB as an expected part of their job) and evaluated it as a mediator of the relationship between supervisors' own work–family experiences and FSSB.Design/methodology/approachWe used an online survey of 245 US based supervisors.FindingsWe find that FSSB role perceptions is a unique but related construct to FSSB, and that approximately half of our sample of 245 supervisors either do not believe that FSSB is a part of their job or are unsure as to whether it is. Path analyses revealed that supervisors' own experiences of work–family conflict and enrichment are related to engaging in FSSB through role perceptions, especially when a reward system is in place that values FSSB.Practical implicationsThese results may influence the design, implementation and dissemination of leader family-supportive training programs.Originality/valueThe factors that drive supervisors to engage in FSSB are relatively unknown, yet this study suggests the novel construct of FSSB role perceptions and supervisors' own work–family experiences are important factors.

Ethical Issues in the Design and Conduct of Community-Based Intervention Studies

This chapter examines the scientific, methodological, and practical foundations of community-based intervention research that bear on ethical concerns. It begins with a description of community-based intervention research, including intervention strategies, study designs, and data collection methods. Given the major role of partnerships in community-based research, it also analyzes ethical issues along a continuum of community-engaged research and discusses the establishment, implementation and dissemination phases of community engaged research. The chapter covers considerations for working with vulnerable or disadvantaged communities, as well as considerations for ethical issues in a global context. It discusses traditional ethical principles in research and briefly reviews professional codes of ethics with implications for community-based intervention research.

Pragmatic patient engagement in designing pragmatic oncology clinical trials

Oncology trials are the cornerstone of effective and safe therapeutic discoveries. However, there is increasing demand for pragmatism and patient engagement in the design, implementation and dissemination of oncology trials. Many researchers are uncertain about making trials more practical and even less knowledgeable about how to meaningfully engage patients without compromising scientific rigor to meet regulatory requirements. The present work provides practical guidance for addressing both pragmaticism and meaningful patient engagement. Applying evidence-based approaches like PRECIS-2-tool and the 10-Step Engagement Framework offer practical guidance to make future trials in oncology truly pragmatic and patient-centered. Consequently, such patient-centered trials have improved participation, faster recruitment and greater retention, and uptake of innovative technologies in community-based care.

LEGAL REGULATION OF SCIENCE PARKS ACTIVITIES IN UKRAINE

The article is devoted to topical issues of legal regulation of science parks in Ukraine and the world. The study examined the essence of the concept of science park and the genesis of the development of legislation on the activities of science parks. The peculiarities of the types of science parks have been studied. The issue of regulating the activities of the science park as a subject of legal relations is detailed. The general tendencies of the international legal regulation of activity of science parks are defined. The author came to the conclusion that science parks have proven their effectiveness and efficiency in the development, implementation and dissemination of modern innovative technologies, have played a significant role in raising the level of science in Ukraine, as well as in training highly qualified scientists. However, starting in the mid-2000s, almost all indicators of technology parks began to decline sharply. The main reason lies in the state's non-compliance with the law and its constant change, the termination of state support in the form of benefits and reduction of the tax burden, blocking of innovative projects and the actual lack of budget funding for science.