Implementing the Med Wise Program in rural Alberta: A feasibility study to support seniors.
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ABSTRACT:
SUBMITTER: Aref HAT
PROVIDER: S-EPMC8020275 | biostudies-literature | 2021 Mar-Apr
REPOSITORIES: biostudies-literature
Publications
Implementing the Med Wise Program in rural Alberta: A feasibility study to support seniors.
Aref Heba A T HAT Kolewaski Linda L Whitfield Kyle Y KY Sadowski Cheryl A CA Guirguis Lisa M LM
Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC 20210215 2
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Project description:BackgroundWhen experiencing mental distress, many university students seek support from their peers. In schools and mental health services, formalised peer support interventions have demonstrated some success but implementation challenges have been reported. This study aimed to assess the feasibility, acceptability and safety of a novel manualized peer support intervention and associated data collection processes.MethodsA longitudinal mixed methods study was conducted following the pilot of a peer support intervention at a large London university between June 2021 and May 2022. The study utilised data routinely recorded on all students who booked a peer support session, focus groups with nine peer workers and five staff members implementing the intervention, pre-post intervention surveys with 13 students and qualitative interviews with 10 of those students.Results169 bookings were made during the pilot, of which 130 (77%) were attended, with November the peak month. Staff and peer workers described strong motivation and commitment to implement the intervention, noting that the peer support model and peer worker role addressed previously unmet needs at the university. However, students described implementation problems relating to the coherence of the intervention and the burden of participation. While students mostly described acceptable experiences, there were examples where acceptability was lower. No adverse events were reported during the pilot.ConclusionThe training and supervision of peer workers, and the provision of one-to-one peer support to students was found to be feasible, mostly acceptable, and safe. However, sustained implementation difficulties were observed. These pose challenges to the scalability of peer support in universities. We make recommendations to improve implementation of peer support including improving reach, greater clarity about the intervention, and fuller involvement of students throughout.
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Project description:BackgroundObesity is a major public health crisis in Latino youth. Mounting evidence implicates stress in the development and maintenance of obesity. This study examined the feasibility and acceptability of having community health workers, i.e., promotoras, deliver Adaptando Dieta y Acción Para Todos (ADAPT)+, a family-based health promotion program integrating mindfulness strategies for stress reduction to underserved Latino families in rural communities.MethodsIn an ORBIT model Phase IIb longitudinal quasi-cluster feasibility study, promotoras delivered the 6-session ADAPT+ intervention and 1-session Enhanced Usual Care (EUC) in rural Florida. Feasibility was assessed via sample size and recruitment, randomization by community, data collection completion, and intervention fidelity. Acceptability was assessed via participant retention and program satisfaction. Effect sizes of differences in parent stress and mindful eating between conditions at baseline, end of treatment, and 3-month follow-up were calculated.ResultsFeasibility and acceptability were demonstrated. The recruitment target was 99% met (n = 95 recruited). Randomization was limited to site level due to coronavirus disease 2019-related challenges. Data collection procedures were feasible (100% completion). Retention was 86% at post-assessment and 82.6% at 3-month follow-up. All sessions were completed (100% fidelity). Mean program satisfaction was 3.91/4.00. ADAPT+ parents reported lower stress (difference = -3.04, medium-to-large effect, d = .70) and more mindful eating (difference = 2.00, medium effect, d = .44) than EUC parents at 3-month follow-up.ConclusionStudy implementation and intervention delivery to rural Latino families using promotoras were feasible and acceptable. Promising findings regarding parent stress and mindful eating support a larger (ORBIT Phase III) efficacy trial.Clinical trial registrationThis trial was registered with ClinicalTrials.gov under identifier NCT04800432.
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Project description:BACKGROUND: Multisource feedback (MSF) is emerging as a central assessment method for several medical education competencies. Planning and resource requirements for a successful implementation can be significant. Our goal is to examine barriers and challenges to a successful multisite MSF implementation, and identify the benefits of MSF as perceived by participants. METHODS: We analyzed the 2007-2008 field trial implementation of the Assessment of Professional Behaviors, an MSF program of the National Board of Medical Examiners, conducted with 8 residency and fellowship programs at 4 institutions. We use a multimethod analysis that draws on quantitative process indicators and qualitative participant experience data. Process indicators include program attrition, completion of implementation milestones, number of participants at each site, number of MSF surveys assigned and completed, and adherence to an experimental rater training protocol. Qualitative data include communications with each program and semistructured interviews conducted with key field trial staff to elicit their experiences with implementation. RESULTS: Several implementation challenges are identified, including communication gaps and difficulty scheduling implementation and training workshops. Participant interviews indicate several program changes that should enhance feasibility, including increasing communication and streamlining the training process. CONCLUSIONS: Multisource feedback is a complex educational intervention that has the potential to provide users with a better understanding of performance expectations in the graduate medical education environment. Standardization of the implementation processes and tools should reduce the burden on program administrators and participants. Further study is warranted to broaden our understanding of the resource requirements for a successful MSF implementation and to show how outcomes change as MSF gains broader acceptance.
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Project description:This paper investigates seniors' and health care professionals' (HCPs) perceptions on needed contributions and qualities of digital technology-based motivation support for seniors' physical activity (PA). Seniors and HCPs expressed their views in focus groups, which were analyzed separately by inductive content analysis. Similarities and differences in seniors' and HCPs' views were identified through thematic analysis of qualitative results from both focus groups. This article's main findings are that both seniors and HCPs believed digital technology should support and make PA more enjoyable in ways to strengthen seniors' control and well-being. However, seniors emphasized support for social interaction, while HCPs also requested support for increasing seniors' insight into PA and for facilitating their dialogue with seniors. Conclusions to be drawn are that seniors and HPCs shared overall views on digital technology's main contributions but had different perspectives on how those contributions could be obtained. This highlights the importance of the early identification of user groups and exploration of their different needs when developing new solutions. Moreover, seniors' and HCPs' perceptions included aspects relevant for personal motivation, technology acceptance, and PA behavioral change according to self-determination theory, unified theory of acceptance and use of technology, and behavioral change techniques for increasing PA.
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Project description: Not available
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Project description:BackgroundThe most common management option for hearing loss is hearing aids. In addition to devices, patients require information and support, including maintenance and troubleshooting. Mobile health (mHealth) technologies can support hearing aid management, acclimatization, and use. This study developed an mHealth acclimatization and support program for first-time hearing aid users and subsequently implemented and pilot-tested the feasibility of the program. The program was facilitated by community health workers (CHWs) in low-income communities in South Africa.ObjectiveThis study aimed to evaluate the feasibility of an mHealth acclimatization and support program supported by CHWs in low-income communities.MethodsAn application-based acclimatization and support was adapted and translated for use in low- and middle-income countries. This program was delivered in the form of 20 different voice notes accompanied by graphical illustrations via WhatsApp or 20 different SMS text messages. The program was provided to first-time hearing aid users immediately after a community-based hearing aid fitting in March 2021 in 2 low-income communities in the Western Cape, South Africa. The 20 messages were sent over a period of 45 days. Participants were contacted telephonically on days 8, 20, and 43 of the program and via open-ended paper-based questionnaires translated to isiXhosa 45 days and 6 months after the program started to obtain information on their experiences, perceptions, and accessibility of the program. Their responses were analyzed using inductive thematic analysis.ResultsA total of 19 participants fitted with hearing aids received the mHealth acclimatization and support program. Most participants (15/19, 79%) received the program via WhatsApp, with 21% (4/19) of them receiving it via SMS text message. Participants described the program as helpful, supportive, informative, sufficient, and clear at both follow-ups. A total of 14 participants reported that they were still using their hearing aids at the 6-month follow-up. Three participants indicated that not all their questions about hearing aids were answered, and 5 others had minor hearing aid issues. This included feedback (n=1), battery performance (n=1), physical fit (n=2), and issues with hearing aid accessories (n=1). However, CHWs successfully addressed all these issues. There were no notable differences in responses between the participants who received the program via WhatsApp compared with those who received it through SMS text message. Most participants receiving WhatsApp messages reported that the voice notes were easier to understand, but the graphical illustrations supplemented the voice notes well.ConclusionsAn mHealth acclimatization and support program is feasible and potentially assists hearing aid acclimatization and use for first-time users in low-income communities. Scalable mHealth support options can facilitate increased access and improve outcomes of hearing care.
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Project description:BackgroundThe purpose of this intervention was to investigate the feasibility, acceptability, and preliminary effectiveness of an online weight loss program, EMPOWER, in rural, underserved communities.MethodsAdults with a body mass index (BMI) ≥ 25 kg/m2 living in rural counties were recruited through collaboration with University of Illinois Extension. The intervention lasted 1 year including online educations sessions, nutrition and lifestyle coaching, and diet and weight monitoring via a novel web application, MealPlot. Feasibility was measured by enrollment attainment, participant retention, online education session completion, and completion of anthropometric and dietary measures. Acceptability was measured by survey using Likert scales of satisfaction for all program components. Anthropometric measurements, 24-h dietary records, and food frequency questionnaires (FFQs) were measures of program efficacy. Additionally, two interviews were collected for program feedback.ResultsEnrollment of 16 participants was attained, however due to higher than anticipated dropout (retention 62.5%, N = 10) at 3-months, 62.5% of the education sessions were completed and 75.0% of anthropometric and dietary measures. The average satisfaction rating for the comprehensive program was 4.2/5 with lowest satisfaction being the MealPlot web application 2.7/5 (N = 11). On average a clinically significant (≥5% baseline weight) weight loss of 6.2 ± 6.0% body weight or 5.7 ± 5.3 kg and improvements to protein and fiber intake at 12 months (N = 10) were observed.ConclusionsA novel online weight loss program showed adequate to strong feasibility and acceptability and preliminary results indicating efficacy among a pilot sample of rural residents. Future studies are required to investigate means of improving retention and reducing the burden on program collaborators.
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Project description:BackgroundIn India, despite several effective interventions being implemented, pneumonia persists as a major cause of under-five mortality. We explore barriers and facilitators to implementing a childhood pneumonia management program in a North Indian district. The study aims to inform the development of effective implementation strategies for pneumonia management in resource-constrained settings.MethodsThis mixed-method study was conducted during the formative phase of an ongoing pre-post quasi-experimental implementation study. Data collection followed the Consolidated Framework for Implementation Research, encompassing surveys on implementation climate and attitudes toward evidence-based-treatment for childhood pneumonia, as well as in-depth interviews to uncover implementation barriers and facilitators with healthcare staff. Additionally, a baseline cross-sectional facility inventory survey was conducted in 26 government healthcare facilities. We present descriptive statistics from the surveys along with deductive analysis findings from qualitative interviews.ResultsSeveral barriers were observed, like deficient infrastructure and limited space, privacy concerns, inadequate examination tables, disrupted medicine supply, non-maintenance of under-five children's records, inadequate utilization of the digital portal for pneumonia case registration, lack of specific budget allocation for medicine procurement, absence of functional equipment, staff shortages, lack of training, referral linkage issues, and limited accessibility to guideline materials. The absence of incentives demotivated community healthcare workers (CHWs), while coordination issues, power dynamics, and unclear job responsibilities affected the motivation of other healthcare staff. Community reluctance to seek care from government facilities and diminishing community-level trust in CHWs posed implementation challenges. Facilitators included committed healthcare and community workers, problem-solving skills, community engagement, and untied funds from the district government. Implementation climate scores were mildly positive, yet provider attitudes towards Evidence-Based Practices Adoption were neutral.ConclusionsWe propose a multi-pronged approach including healthcare provider training, task sharing, budget reallocation promoting medication access, performance monitoring, digitalization of the record system, and community engagement to optimize program effectiveness.Trial registrationThis research was prospectively registered in the clinical trial registry CTRI202103031622 [Registered on: 01/03/2021].
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Project description:BackgroundChild maltreatment is a global issue in need of intervention. This study investigated whether SafeCare, an evidence-based behavioral parenting program to prevent child neglect and physical violence, is desired and feasible to implement in Haiti birthing centers.MethodsA total of four focus groups were conducted with 29 birthing center staff and mothers in two birthing centers in Haiti. Staff participants also completed the World Health Organization Readiness Assessment for the Prevention of Child Maltreatment written survey.ResultsFocus group findings suggest that SafeCare is a desired program by both caregivers attending the birth center and birth center staff. Findings also showed that the SafeCare curriculum needs cultural adaptations before delivery in Haitian birth centers. We also found that despite contextual challenges that pregnant mothers and birth center staff face in Haiti, birth centers continue to be a place for women to receive pre- and post-natal medical care and weekly education sessions.ConclusionsFindings support that although there are contextual challenges to a SafeCare implementation in Haiti, birthing centers are ideal and feasible locations in which to deliver SafeCare. Birth center networks may be potential settings in which to disseminate and scale evidence-based programs for improved health outcomes for mothers and children.
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