Clinical Research in the Hospital During the Pandemic: What’s Worked and Not Worked?

Under normal conditions, the hospital setting presents multiple challenges to research with persons with dementia and their care partners. This presentation describes the additional barriers posed by the COVID-19 pandemic, as well as the strategies to meet those challenges, in a cluster randomized controlled trial that examines the efficacy of a nurse-family partnership to promote functional recovery of persons with dementia. In response to research restrictions, the research team altered their plan for recruitment, implementation of the intervention, data collection, and analytic approach. This presentation describes these alterations and discusses the plan to meet the aims of the project while meeting the requirements of the Institutional Review Board, accountability to the funder, and university regulations. Modifications in staffing patterns, staff training, and procedures will also be discussed, as well as the study timeline. Finally, strategies to maintain a positive attitude and productivity within the team will be discussed.

Improving interagency service integration of the Australian Nurse Family Partnership Program for First Nations women and babies: a qualitative study

Background The Australian Nurse Family Partnership Program (ANFPP) is an evidence-based, home visiting program that offers health education, guidance, social and emotional support to first-time mothers having Aboriginal and/or Torres Strait Islander (First Nations) babies. The community-controlled sector identified the need for specialised support for first time mothers due to the inequalities in birthing and early childhood outcomes between First Nations’ and other babies in Australia. The program is based on the United States’ Nurse Family Partnership program which has improved long-term health outcomes and life trajectories for mothers and children. International implementation of the Nurse Family Partnership program has identified interagency service integration as key to program recruitment, retention, and efficacy. How the ANFPP integrates with other services in an Australian urban setting and how to improve this is not yet known. Our research explores the barriers and enablers to interagency service integration for the Australian Nurse Family Partnership Program ANFPP in an urban setting. Methods A qualitative study using individual and group interviews. Purposive and snowball sampling was used to recruit clients, staff (internal and external to the program), Elders and family members. Interviews were conducted using a culturally appropriate ‘yarning’ method with clients, families and Elders and semi-structured interview guide for staff. Interviews were audio-recorded and transcribed prior to reflexive thematic analysis. Results Seventy-six participants were interviewed: 26 clients, 47 staff and 3 Elders/family members. Three themes were identified as barriers and three as enablers. Barriers: 1) confusion around program scope, 2) duplication of care, and 3) tensions over ‘ownership’ of clients. Enablers (existing and potential): 1) knowledge and promotion of the program; 2) cultural safety; and 3) case coordination, co-location and partnership forums. Conclusion Effective service integration is essential to maximise access and acceptability of the ANFPP; we provide practical recommendations to improve service integration in this context.

Recruiting and Retaining Dyads of Hospitalized Persons with Dementia and Family Caregivers

Persons with dementia have high rates of hospitalization, and along with their caregivers commonly experience negative hospital outcomes. The recruitment and retention of acutely ill older adults with dementia and caregivers can pose a challenge to investigators and threaten the validity of findings. The challenges encountered in an ongoing cluster randomized clinical trial in dyads of hospitalized persons with dementia and family care partners are described. The trial tests the efficacy of a nurse–family partnership model that aims to improve the following: (a) the physical and cognitive recovery in hospitalized persons with dementia, and (b) caregiver preparedness and anxiety. Strategies that address challenges include careful preplanning and preparation with the hospital site, strong communication with dyads and between team members, and honoring preferences and needs related to communication.

GAMBARAN PRIMIGRAVIDA : FRAMEWORKFAMILY NURSING PARTNERSHIP

Pendahuluan.: Ibu dan anak merupakan anggota keluarga yang perlu mendapatkan prioritas dalam penyelenggaraan upaya kesehatan, karena ibu dan anak merupakan kelompok yang rentan. Ketidakmampuan ibu hamil terutama primigravida dalam beradaptasi dengan kehamilannya akan menyebabkan gangguan pada masa kehamilan. Dalam konsep Nurse Family Partnership salah satunya yaitu self efficacy mengatakan bahwa keinginan untuk tetap menjaga kesehatan dan mengetahui kondisi kesehatan dengan baik akan membantu ibu selama masa kehamilan. Tujuan: Penelitian ini bertujuan untuk mendapatkan gambaran tentang ibu Primigravida saat menjalani kehamilan sesuai dengan framework Nursing Family Partnership. Metode: Penelitian ini menggunakan metode kualitatif dengan pendekatan fenomenologi dengan jumlah 7 (tujuh) partisipan primigravida. Hasil: Pengumpulan data dengan indepth interview dan menghasilkan 3 (tiga) tema : (1) Keluhan Ibu Hamilberupa mual muntah oleh sebagian partisipan, (2) Respon psikologis selama kehamilan di masa pandemic Covid-19 yaitu sebagian partisipan mengalami kecemasan dan (3) Keuangan keluarga selama kehamilan pada masa pandemic Covid-19 yang berkurang. Diskusi: Hal yang dialami oleh Ibu Hamil tersebut perlu mendapat dukungan dari keluarga agar kondisi selama kehamilan tetap baik.; Kata Kunci:Primigravida, Family Nursing Partnership

Dissemination strategies: experience and lessons learned

The French national public health agency is building a portal of evidence-based and promising interventions. The aim of this project is to improve the effectiveness and the efficiency of public health interventions. The portal currently contains around 80 descriptive files. But this portal is only part of a system. Each decision maker or project manager interested in an intervention must be able to have access to qualified trainers, to manual and have assistance in quality assessment. It is also necessary to adapt the interventions to each local context without losing the effectiveness demonstrated in the evaluation or initial research. It is essential to document all the local adaptations in a centralized information system and to compare them with a fidelity measure or a monitoring tool. David Chambers has named this type of system an Adaptome (AJPM 2016; 51: S124-S131). Several programs, adapted from international programs (Strengthening families' program, Good behavior game, nurse family partnership), or based on French research (Tabado, ICAPS), are being deployed. The challenges and difficulties of these deployments will be discussed.