Using Community-Based Participatory Research to Conduct a Collaborative Needs Assessment of Mental Health Service Users: Identifying Research Questions and Building Academic-Community Trust

Attempts to meaningfully engage people with serious mental illnesses (SMI) as allies in conducting research have often failed because researchers tend to decide on the research topic without including community members. Academic researchers can avoid this pitfall by collaborating with community members to conduct a needs assessment to identify relevant research topics and build trust. Here, we report on the results of a psychosocial needs assessment for adult mental health service users in Massachusetts conducted by an academic-peer research team. The project was initiated as part of an academic mental health center's efforts to conduct community-based participatory research (CBPR) with a group of people with SMI. People with SMI were hired and trained to co-lead research projects and the development of the listening group guide, and they conducted 18 listening groups with 159 adults with mental health conditions. The data were transcribed, and rapid analysis employing qualitative and matrix classification methods was used to identify service need themes. Six themes emerged from qualitative analysis: reduce community and provider stigma, improve access to services, focus on the whole person, include peers in recovery care, have respectful and understanding clinicians, and recruit diverse staff. The policy and practice implications of these findings include creating a stronger culture of innovation within provider organizations, developing specific plans for improving recruitment and retention of peer workers and a multicultural workforce, enhancing training and supervision in cultural humility, communicating respectfully with clients, and including peers in quality improvement activities.

Psychosocial Care Needs, Personality Styles, and Coping Strategies of Mourners in a Rural Municipality in Spain: An Observational Study

Grieving is a natural, self-limiting process of adaptation to a new reality following a significant loss, either real or perceived, with a wide range of manifestations that have an impact on the health of the grieving individual. This study aims to analyse the relationships between interpersonal styles, coping strategies, and psychosocial care needs in a sample of mourners in a rural municipality. Initial hypothesis: there are associations between types of grief and psychosocial needs, as well as between types of grief and interpersonal styles or coping strategies. An observational, descriptive, analytical, cross-sectional study was carried out with a sample of 123 people. Female participants represented 64.2% of all participants. The mean age was 42.7 (±13.2) years, and 86.2% of participants reported continuing to suffer from the loss, with a 10.5% prevalence of maladaptive grieving. Regarding the associations identified between coping strategies and the interpersonal characteristics of the mourners, we found that those with the best coping scores described themselves as self-confident, boastful, jovial, forceful, gentle-hearted, self-assured, outgoing, and/or neighbourly. By contrast, mourners who obtained poorer coping scores self-identified as shy, unsparkling, timid, unsociable, unbold, and/or bashful. This provides a clinical profile linked to maladaptive grieving in which emotional, self-perception, and social problems are prevalent.

Great Plains American Indians' Perspectives on Patient and Family Needs Throughout the Cancer Journey

PURPOSE

To explore the perspectives on patient and family needs during cancer treatment and survivorship of American Indian (AI) cancer survivors, caregivers, Tribal leaders, and healers.

PARTICIPANTS & SETTING

36 AI cancer survivors from three reservations in the Great Plains region.

METHODOLOGIC APPROACH

A community-based participatory research design was employed. Postcolonial Indigenous research techniques of talking circles and semistructured interviews were used to gather qualitative data. Data were analyzed using content analysis to identify themes.

FINDINGS

The overarching theme of accompaniment was identified. The following themes were intertwined with this theme: (a) the need for home health care, with the subthemes of family support and symptom management; and (b) patient and family education.

IMPLICATIONS FOR NURSING

To provide high-quality cancer care to AI patients in their home communities, oncology clinicians should collaborate with local care providers, relevant organizations, and the Indian Health Service to identify and develop essential services. Future efforts must emphasize culturally responsive interventions in which Tribal community health workers serve as navigators to accompany patients and families during treatment and in survivorship.

Pediatric primary care clinicians' views on needs and challenges in caring for infants with intrauterine opioid exposure and their families

Opioid use disorder (OUD) during pregnancy has risen in the U.S. over the past two decades, resulting in a growing number of children with intrauterine opioid exposure (IOE). Limited research exists supporting best practices to optimize primary care for these children and their families, particularly mothers with OUD. Using a modified Delphi method, we surveyed pediatric primary care clinicians from a single children's health care system regarding their experiences in caring for this population. In Phase 1, open-ended survey questions inquired about needs and challenges facing these infants, their families, and clinicians and resources within primary care. After thematic analysis, the most frequent responses were presented as a Phase 2 survey for clinicians to select their top five. Percentages for the most commonly selected top five themes were tabulated. Survey response rates were 58/139 (42%) for Phase 1 and 45/137 (33%) for Phase 2. For infants with IOE and their families, respondents identified parenting knowledge and family issues related to maternal OUD as top challenges, with limited resources to address them in primary care. Clinicians identified time constraints and follow-up issues as top challenges. Future intervention in pediatric primary care could include addressing parenting education, resource gaps, and best practice recommendations in caring for children with IOE.

Use of the HESPER Web to assess perceived needs immediately after multiple disaster events in Fiji

OBJECTIVE

In January 2022, Fiji was hit by multiple natural disasters including a cyclone causing flooding, an underwater volcanic eruption and tsunami. This study aimed to investigate perceived needs among the disaster-affected people in Fiji and to evaluate the feasibility of the Humanitarian Emergency Settings Perceived Needs Scale (HESPER Web) during the early stage after multiple natural disasters.

METHODS

A cross-sectional study using a self-selected, non-representative study sample was conducted. The HESPER Web was used to collect data.

RESULTS

In all, 242 people participated. The number of perceived serious needs ranged between 2 and 14 (out of a possible 26), with a mean of 6 (SD 3). The top three most reported needs were access to toilets (60%), care for people in the community who are on their own (55%), and distress (51%). Volunteers reported fewer needs than the general public.

CONCLUSIONS

The top three needs reported were related to water and sanitation and psychosocial needs. Such needs should not be underestimated in the emergency phase after natural disasters, and may require more attention from responding actors. The HESPER Web was be considered as a usable tool for needs assessment in a sudden onset disaster.

The demands of caregivers of children with acute lymphoblastic leukaemia in different therapy stages and the exploration of possible interventions: A longitudinal investigation survey at a Tertiary Medical Institution

AIM

To describe the demands of family caregivers of children with ALL at different therapy stages and explore the possible interventions to address their care demands.

DESIGN

A longitudinal investigation study.

METHOD

A total of 157 family caregivers of children treated in the Haematological oncology ward of a tertiary medical hospital in China between March and December in 2020 were included in this study. The Comprehensive Needs of Caregivers of Cancer Patients and Families Taking Care of Children Scale was used to investigate the family caregivers of children with ALL. The family caregivers completed the questionnaire accompanied by a researcher within two weeks of each therapy stage, which included the induction, consolidation and continuation stages.

RESULTS

Family caregivers of children with ALL had many demands that varied based on the stage of therapy. Family caregivers in the induction therapy stage needed more information about their children's disease, having the highest score in information demands (35.60 ± 5.85). The family caregivers in the consolidation therapy stage needed more information on symptom management and socio-economic support, having the highest score in care and support demands (36.14 ± 5.12). The family caregivers in the continuation therapy stage (including interim and maintenance therapy stages) focused more on their own and the children's social adaptation, so they scored the highest for psychosocial demands (35.96 ± 5.69).

CONCLUSION

Family caregivers of children with ALL had different demands that varied based on the stage of therapy. Medical personnel should be aware of the primary needs of family caregivers at different therapy stages to provide early interventions and support based on their demands, ultimately improving the physical and mental condition of family caregivers and the quality of care.

Veterinarians' Self-Reported Needs and Attitudes on the Atlantic Canada Veterinary College and Associated Teaching Hospital in Relation to Continuing Education, Research, and Clinical Referrals

The relationship between veterinary colleges (VCs), associated veterinary teaching hospital referral centers (VTHs), and referring veterinarians (rVets) is important and complex. Despite this, there has been minimal research on rVets with respect to their regional VC and VTH. Our objectives were to evaluate rVets' attitudes and self-reported needs on their regional VC's VTH surrounding (a) continuing education, (b) collaborative research, and (c) referrals for specialty consultation and care. Participants (rVets) were invited to complete an online questionnaire (2018-2019). Respondents (n = 56) indicated multiple (24) unmet continuing education topic needs, of which dermatology and behavior were most selected. Many rVets (70%) reported an interest in collaborative research participation. Communication was frequently selected by respondents when asked what could be improved with respect to the VTH referral center process. Our work provides a benchmark attitudes and needs assessment, identifies areas for improvement, and may aid initiatives regionally, and likely externally, as adapted to other rVet-VC-VTH relationships.

Primary Palliative Care Education for Graduate Medical Trainees: Impacts and Needs

As demand for palliative care (PC) services rise, there are insufficient numbers of PC specialists to provide PC for the US population. "Primary palliative care" refers to PC services that are administered by non-specialist PC providers. Educating trainees in graduate medical education (GME) programs is 1 strategy for expanding primary palliative care, though questions remain regarding the impact of PC education for GME trainees and where additional education is needed. This study is a multicenter, cross-sectional, web-based survey study of GME trainees assessing the needs for and impacts of primary palliative care education. The survey assessed the implementation of and participants' confidence with fundamental PC skills. The survey also asked about prior exposure to PC education and for participants' beliefs regarding areas that would be particularly helpful for future education. 170 residents and fellows from diverse training backgrounds participated in the survey out of 851 potential participants (response rate 19.98%). Exposure to PC education was associated with higher confidence and increased frequency of implementation of fundamental PC skills. Of the forms of education that were assessed, clinical/experiential education was associated most often with higher confidence and higher frequency of use of PC skills. Discussing goals of care, pain management for seriously ill patients, and communicating difficult information were those skills most frequently identified as important for additional training. This study demonstrates that by improving existing PC education or increasing access to PC education for GME trainees, it may be possible to improve primary palliative care.

Developing Authentic Mentorship Through Professional Organizations

Harsh realities in pandemic fatigue, burnout, inequities, and isolation are impacting academic pharmacy. Mentoring programs, especially inter-institutional programs such as those provided within the Sections and Special Interest Groups (SIGs) of the American Association of Colleges of Pharmacy (AACP), may combat some of these issues. Unfortunately, year after year, Academy members continue to request information from these groups on mentoring, whether it be the opportunity to pair up, for advice on how to be better mentors, or for guidance on how to develop a program on mentoring for the Sections and SIGs without an existing program. The need for authentic mentoring is vital to the success and retention of faculty and staff within the Academy. Therefore, it may be appropriate to take a closer look at why, despite ongoing mentoring programs scattered within AACP Sections and SIGs, these programs are unable to fulfill the needs of participants.

Obstetric Provider Perspectives on Postpartum Patient Navigation for Low-Income Patients

BACKGROUND

Patient navigation programs have shown promise for improving health but are not widely used in obstetric care. Our objective was to understand obstetric provider perspectives on how to implement patient navigation to optimize care during the postpartum period for low-income patients.

METHOD

Focus groups were conducted with obstetric physicians, nurses, and social workers who care for low-income pregnant and postpartum patients in an academic medical center. Semistructured interview guides were developed to elicit conversations about the potential value of patient navigators, recommendations for navigator training, and how navigators could be most effective in improving postpartum care. Analysis of themes was based on the constant comparative method.

RESULTS

Twenty-six obstetric providers (six focus groups) discussed elements for a successful obstetric navigation program. Successful implementation themes included selecting navigators with appropriate interpersonal attributes, arranging navigator training, and identifying the most valuable services navigators could render. Desirable navigator attributes included persistence in patient advocacy, consistency, relatability, and a supportive manner. Training recommendations included learning the health care system, identifying where to obtain health system and community resources, and learning how be effective health educators. Suggested services were broad, ranging from traditional care coordination to specific educational and resource-driven tasks.

CONCLUSIONS

Obstetric providers perceive patient navigation to be a potentially beneficial resource to support low-income patients and offered recommendations for navigation implementation. These included suggestions for patient-centered navigators, with specific training and services focused on promoting care continuity and coordination.

Needs assessment survey for enhancing United States child agricultural injury prevention capacity: Brief report

The dissemination of childhood agricultural safety and health information and resources through organizations that farmers trust enhances implementation and the Socio-Ecological Model can help identify these organizations. However, to become effective partners in improving agricultural health and safety, organizations need to build capacity in child agricultural safety and health, thus, more information is needed about these organizations' current practices, needs, and capacity for leadership, policy makers, and knowledge mobilization. An online survey was administered to organization leaders with an interest in child agricultural injury prevention, chosen through agricultural health and safety organization membership lists. Invitations to participate in the online survey were mailed to 95 organization leaders with three weekly reminders, resulting in participation from 50 organization leaders (53% response rate). Respondents indicated a high level of awareness of child agricultural injuries, yet few were actively engaged in injury prevention. When asked about "needs" for building capacity in injury prevention, over half (56%) identified a need for more promotion and dissemination of safety resources and strategies, including ATV safety, no extra riders on equipment, and keeping young children out of the worksite. The only topic that more than half of the organizations (54%) identified as "needing more information" was childhood agricultural injury surveillance. This assessment yielded valuable details for identifying opportunities, priorities, and topics for future collaborations and capacity building. Findings help inform national and international planning committees' work, such as the next iteration of a US National Action Plan for Childhood Agricultural Injury Prevention, scheduled for release in 2024.

The Adolescent and Young Adult Needs Assessment & Service Bridge (NA-SB): A single-arm feasibility pilot study

PURPOSE

In this pilot study, we evaluated the feasibility of implementing the Needs Assessment & Service Bridge (NA-SB)- an intervention to address the pervasive unmet needs of adolescents and young adults (AYAs) during cancer treatment.

METHODS

We conducted a mixed methods single-arm feasibility pilot study of NA-SB at the North Carolina Basnight Cancer Hospital. Eligible participants were AYAs ages 18-39 in active cancer treatment. After receiving NA-SB, participants completed a postintervention survey assessing their perceptions of NA-SB. We interviewed participating providers to assess their implementation experiences.

RESULTS

On average, AYA participants (n = 26) rated NA-SB's feasibility as 4.5/5, its acceptability as 4.5/5, and its appropriateness as 4.4/5. 77% of participants agreed or strongly agreed that their needs were met in the study period.

CONCLUSION

This pilot study generated preliminary evidence to establish NA-SB's feasibility as well as proof of concept for the intervention as a viable approach for identifying and addressing AYAs' unmet needs.

Exploring training needs of newly graduated medical doctors to inform the undergraduate simulation-based curriculum: a national Delphi consensus study

PURPOSE

Mastering technical procedures is a key component in succeeding as a newly graduated medical doctor and is of critical importance to ensure patient safety. The efficacy of simulation-based education has been demonstrated but medical schools have different requirements for undergraduate curricula. We aimed to identify and prioritize the technical procedures needed by newly graduated medical doctors.

METHODS

We conducted a national needs assessment survey using the Delphi technique to gather consensus from key opinion leaders in the field. In the first round, a brainstorm was conducted to identify all potential technical procedures. In the second round, respondents rated the need for simulation-based training of each procedure using the Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula (CAMES-NAF). The third round was a final elimination and prioritization of the procedures.

RESULTS

In total, 107 experts from 21 specialties answered the first round: 123 unique technical procedures were suggested. Response rates were 58% and 64% in the second and the third round, respectively. In the third round, 104 procedures were eliminated based on the consensus criterion, and the remaining 19 procedures were included and prioritized. The top five procedures were: (i) insert peripheral intravenous catheter, (ii) put on personal protection equipment, (iii) perform basic airway maneuvers, (iv) perform basic life support, and (v) perform radial artery puncture.

CONCLUSION

Based on the Delphi process a final list of 19 technical procedures reached expert consensus to be included in the undergraduate curriculum for simulation-based education.

Faculty Development and the Emergency Medicine Educator: A National Needs Assessment

BACKGROUND

Faculty development (FD) encompasses structured programming that aims to enhance educator knowledge, skill, and behavior. No uniform framework for faculty development exists, and academic institutions vary in their faculty development programming, ability to overcome barriers, resource utilization, and achievement of consistent outcomes.

OBJECTIVE

The authors aimed to assess current FD needs among emergency medicine educators from six geographically and clinically distinct academic institutions to inform overall faculty development advancement in emergency medicine (EM).

METHODS

This cross-sectional study assessed FD needs among EM educators. A survey was developed, piloted, and distributed to faculty via each academic institution's internal e-mail listserv. Respondents were asked to rate their comfort level with and interest in several domains of FD. Respondents were also asked to identify their previous experience, satisfaction with the FD they have received, and barriers to receiving FD.

RESULTS

Across six sites, 136/471 faculty completed the survey in late 2020 (response rate of 29%): 69.1% of respondents reported being satisfied overall with the FD they have participated in, and 50.7% reported being satisfied with education FD specifically. Faculty report higher comfort levels and interest in several domains when satisfied with the education-specific FD they have received compared with those who report not being satisfied.

CONCLUSIONS

EM faculty report generally high satisfaction with the overall faculty development they have received, although only half express satisfaction with their education-related faculty development. Faculty developers in EM may incorporate these results to inform future faculty development programs and frameworks.

The capacity to implement Lean Management in the healthcare system in Poland - results of a public consultation

BACKGROUND

Lean healthcare management is an innovative approach to process management in healthcare organizations. Despite that the Lean principles have been increasingly recognized worldwide as a tool to boost organizational performance, improve the quality of care and curb waste, the Lean methodology can be difficult to implement in some countries. This study seeks to identify the facilitators of and barriers to the implementation of Lean in the healthcare system in Poland.

MATERIAL AND METHODS

A public consultation was held among 318 representatives of stakeholder groups in the healthcare system in Poland. Data was collected using validated self-administered questionnaires. Statistical analysis was performed using the IBM SPSS Statistics 25 software.

RESULTS

The study revealed that a large share of respondents believed that the awareness of the existing organizational deficiencies in work practices among stakeholders can greatly facilitate the implementation of Lean in the healthcare system in Poland (50.9%, p < 0.05). The main barriers to the deployment of Lean include lack of awareness of the Lean methodology and its benefits (76.1%, p < 0.001); insufficient institutional support (43.7%), and lack of funding for Lean solutions (32.4%).

CONCLUSIONS

Gaps in the medical curricula and education programs for healthcare professionals concerning the latest process management solutions in healthcare should be addressed in order to raise awareness of the benefits of cooperation with and the active involvement of Lean experts in applying "lean" ideas to improve the organizational performance in healthcare. It is also necessary for policy makers to be aware of the benefits of contemporary process management in healthcare and to support its implementation. Med Pr. 2023;74(1):1-8.

Honoring What We Say We Do: Developing Real-World Tools for Routine Family Caregiver Assessment and Support in Outpatient Palliative Care

Background: Family caregivers are essential to the care of patients with serious illness and supporting caregivers alongside patients is a core tenet of palliative care. While there is increasing recognition of the need to support family caregivers, there are limited resources to assess and support their needs in a systematic way in outpatient palliative care practice. Objectives: The aim of this study is to develop an approach to conducting assessments of routine needs and support of family caregivers in outpatient palliative care practice using a quality improvement framework. Setting: Seven, interdisciplinary, outpatient palliative care teams in California collaborated in this study. Measurements: Family caregivers were surveyed about levels of distress and support using a 10-point scale and asked about specific areas of need for support. Usefulness of a supportive caregiver resource was also measured on a 10-point scale, in addition to qualitative assessment of clinician satisfaction and feasibility of routine caregiver assessment and support. Results: Seven hundred thirty-six caregiver needs assessments were conducted and 44 supportive tool kits were distributed. A majority of family caregivers reported moderate or severe distress related to caregiving (score ≥4 on a 10-point scale). The most common sources of distress included emotional distress, worry caregiving was negatively impacting their own health, and planning for the future. Most caregivers reported feeling moderately or very well supported, most commonly by family, friends, and faith/spirituality. Caregivers rated the supportive tool kit an 8.4 on a 10-point usefulness scale and 92% would recommend it to others. Conclusions: We successfully developed and piloted practical clinical tools for routine family caregiver screening and support.

Development, Implementation, and Evaluation of a Social Work Needs Assessment Tool: An Innovative Approach When the Palliative Care Request Is Unclear

Determining the specific needs and greatest distress of a patient requires thoughtful purposeful assessment. The objective of this article is to present a palliative care needs assessment tool utilized in an inpatient palliative care service, and to discuss the process of implementation and evaluation of outcomes. The tool is specifically designed to identify palliative care needs when there is no initial clarity on the appropriate palliative care intervention. It will support practitioners in understanding the lived experience of the patient, assess readiness to discuss future planning, and offer specific language as a guide. A team of social workers evaluated 50 completed needs assessments to determine if the tool successfully identified a palliative care intervention, elicited values, and treatment preferences, and assisted in the completion and documentation of advance directives. After analysis, the four outcomes were consistently met, demonstrating that this tool has value in the hospital setting with certain referral types. These four outcomes identified are valuable in capturing where a patient currently is in their disease trajectory, while also providing a potential framework for future decision making. Recommendations for future exploration were presented along with feedback from the social work team.

A Sierra Leone 2021 Midwifery Clinical Training Needs Assessment: A Call to Action to Augment Clinical Precepting

Objective

Sierra Leone has one of the highest maternal mortality and infant mortality rates globally. We share findings from a Midwifery Clinical Training Needs Assessment, conducted in 2021 as a collaboration between the Government of Sierra Leone and Seed Global Health. The assessment identified existing needs and gaps in midwifery clinical training at health facilities in Sierra Leone from various stakeholders' perspectives.

Methods

The descriptive needs assessment utilized mixed methods, including surveys, focus group discussions (FGDs), interviews, and reviews of maternal medical records.

Results

The following showed needs and gaps in labor and delivery management; record keeping; triage processes; clinical education for students, recent graduates, and preceptors; and lack of infrastructure and resources.

Conclusion

The knowledge gained from this needs assessment can further the development of midwifery clinical training programs in Sierra Leone and other low-income countries facing similar challenges. We discuss the implication of our findings.

Using Digital Communication Technology to Improve Neonatal Care: Two-Part Explorative Needs Assessment

BACKGROUND

The birth of a premature infant and subsequent hospitalization are stressful events for parents. Therefore, accurate and easy-to-understand communication between parents and health care professionals is crucial during this period. Mobile health (mHealth) technologies have the potential to improve communication with parents at any time and place and possibly reduce their stress.

OBJECTIVE

We aimed to conduct a 2-part explorative needs assessment in which the interaction between the pediatrician and parents was examined along with their digital communication technology needs and interest in an mHealth app with the aim of improving interpersonal communication and information exchange.

METHODS

Overall, 19 consultations between parents of preterm infants and pediatricians were observed to determine which themes are discussed the most and the number of questions asked. Afterward, the parents and the pediatrician were interviewed to evaluate the process of communication and gauge their ideas about a neonatal communication mHealth app.

RESULTS

The observations revealed the following most prevalent themes: breastfeeding, criteria for discharge, medication, and parents' personal life. Interview data showed that the parents were satisfied with the communication with their pediatrician. Furthermore, both parents and pediatricians expected that a neonatal mHealth app could further improve the communication process and the hospital stay. Parents valued app features such as asking questions, growth graphs, a diary function, hospital-specific information, and medical rounds reports.

CONCLUSIONS

Both parents of hospitalized preterm infants and pediatricians expect that the hypothetical mHealth app has the potential to cater to the most prevalent themes and improve communication and information exchange. Recommendations for developing such an app and its possible features are also discussed. On the basis of these promising results, it is suggested to further develop and study the effects of the mHealth app together with all stakeholders.

A national needs assessment to identify technical procedures in plastic surgery for simulation-based training

Medical simulation is not developed and integrated into plastic surgery unlike other surgical specialties despite the procedures being complex and require practice. First step in enhancing simulation in plastic surgery is to clarify the need among peers. The objective of the study was to identify and prioritize the technical procedures that should be included in a simulation-based curriculum for residency training in plastic surgery. A panel of participants with key roles in the Danish plastic surgery specialist training program was appointed. Participation was voluntary. A national need assessment study was performed using a three-round Delphi process to collect information from the participants. In round 1, participants reported all the procedures that a newly qualified specialist in plastic surgery should be able to perform. In round 2, participants replied to a survey exploring the frequency of the procedures, the number of surgeons performing the procedure, the risk or discomfort for patients treated by an inexperienced surgeon and the feasibility of training the procedure in simulation, resulting in a preliminary ranking of procedures. In round 3, participants eliminated and reprioritized the identified procedures according to importance. Thirty-five of 37 agreed to enter the expert panel. The response rate was 97%, 86% and 86% for rounds 1, 2 and 3, respectively. Twenty-nine of 136 procedures identified in round 1 reached the final prioritized list of procedures relevant for simulation training in plastic surgery.

Considering science needs to deliver actionable science

Conservation practitioners, natural resource managers, and environmental stewards often seek out scientific contributions to inform decision-making. This body of science only becomes actionable when motivated by decision makers considering alternative courses of action. Many in the science community equate addressing stakeholder science needs with delivering actionable science. However, not all efforts to address science needs deliver actionable science, suggesting that the synonymous use of these two constructs (delivering actionable science and addressing science needs) is not trivial. This can be the case when such needs are conveyed by people who neglect decision makers responsible for articulating a priority management concern and for specifying how the anticipated scientific information will aid the decision-making process. We argue that the actors responsible for articulating these science needs and the process used to identify them are decisive factors in the ability to deliver actionable science, stressing the importance of examining the provenance and the determination of science needs. Guided by a desire to enhance communication and cross-literacy between scientists and decision makers, we identified categories of actors who may inappropriately declare science needs (e.g., applied scientists with and without regulatory affiliation, external influencers, reluctant decision makers, agents in place of decision makers, and boundary organization representatives). We also emphasize the importance of, and general approach to, undertaking needs assessments or gap analyses as a means to identify priority science needs. We conclude that basic stipulations to legitimize actionable science, such as the declaration of decisions of interest that motivate science needs and using a robust process to identify priority information gaps, are not always satisfied and require verification. To alleviate these shortcomings, we formulated practical suggestions for consideration by applied scientists, decision makers, research funding entities, and boundary organizations to help foster conditions that lead to science output being truly actionable.

Examining How Social Risk Factors Are Integrated Into Clinical Settings Using Existing Data: A Scoping Review

PURPOSE

Integrating social care into clinical care requires substantial resources. Use of existing data through a geographic information system (GIS) has the potential to support efficient and effective integration of social care into clinical settings. We conducted a scoping literature review characterizing its use in primary care settings to identify and address social risk factors.

METHODS

In December 2018, we searched 2 databases and extracted structured data for eligible articles that (1) described the use of GIS in clinical settings to identify and/or intervene on social risks, (2) were published between December 2013 and December 2018, and (3) were based in the United States. Additional studies were identified by examining references.

RESULTS

Of the 5,574 articles included for review, 18 met study eligibility criteria: 14 (78%) were descriptive studies, 3 (17%) tested an intervention, and 1 (6%) was a theoretical report. All studies used GIS to identify social risks (increase awareness); 3 studies (17%) described interventions to address social risks, primarily by identifying relevant community resources and aligning clinical services to patients' needs.

CONCLUSIONS

Most studies describe associations between GIS and population health outcomes; however, there is a paucity of literature regarding GIS use to identify and address social risk factors in clinical settings. GIS technology may assist health systems seeking to address population health outcomes through alignment and advocacy; its current application in clinical care delivery is infrequent and largely limited to referring patients to local community resources.

Learning needs assessments in continuing professional development: A scoping review

BACKGROUND

A rigorous learning needs assessment (LNA) is a crucial initial step in the Continuing Professional Development (CPD) process. This scoping review aimed to collate, summarize, and categorize the reported LNA approaches adopted to inform healthcare professional CPD and highlight the gaps for further research.

METHOD

In August 2020, nine bibliographic databases were searched for studies conducted with any health professional grouping, reporting the utilized LNA to inform CPD activities. Two reviewers independently screened the articles for eligibility and charted the data. A descriptive analytical approach was employed to collate, summarize, and categorize the literature.

RESULTS

151 studies were included in the review; the majority adopted quantitative methods in the form of self-assessment surveys. Mixed-methods approaches were reported in only 35 studies. Descriptions of LNA development lacked detail of measures taken to enhance their rigor or robustness.

DISCUSSION

These findings do not reflect recommendations offered by the CPD literature. Further investigations are required to evaluate more recently advocated LNA approaches and add to their limited evidence-base. Similarly, the existing support afforded to CPD developers warrants further study in order to identify the necessary resource, infrastructure and expertise essential to design and deliver effective CPD programs.

Are College Students Interested in Family Health History Education? A Large Needs Assessment Survey Study

Family health history (FHH) is an essential foundation for personalized disease prevention. As the incidence of early-onset chronic diseases is increasing among college students, it is important to provide them with the education required to learn about their FHH. This study aimed to assess college students' interest in receiving FHH education, preferred topics, and desired learning methods. We invited college students to complete an online survey from a large research-intensive university. A total of 2276 college students completed the survey. Nearly half of the participants self-identified as non-Hispanic white (45.5%). Slightly more than half of the sample (53.9%) were not interested in receiving FHH education mainly due to low prioritization. Among those who expressed interest in obtaining FHH education, the three most desired learning topics were the ability to interpret FHH information (76.1%), the application of FHH in disease prevention (72.0%), and FHH information collection strategies (63.6%). Computer-based learning (51.1%) was the most preferred educational method. Moreover, females, older individuals, those who have FHH in first-degree relatives, and participants who were members of racial and ethnic groups showed greater interests in receiving FHH education (ps < 0.05). Strategies to promote college students' awareness, collection, and use of FHH are needed.

Bidirectional needs assessment of otolaryngology-head and neck surgery short-term surgical trips to Ethiopia and Kenya

Objectives

To create an otolaryngology-specific needs assessment tool for short-term global surgical trips and to describe our findings from its implementation.

Methods

Surveys 1 and 2 were developed based on a literature review and disseminated to Low-Middle Income (LMIC) hosting institutions in Kenya and Ethiopia and to High-Income surgical trip participants (HIC), respectively. Respondents were otolaryngologists identified online, through professional organizations, and by word-of-mouth, who had participated in a surgical trip of <4 weeks.

Results

HIC and LMIC respondents shared similar goals of expanding host surgical skills through education and training while building sustainable partnerships. Discrepancies were identified between LMIC desired surgical skills and supply needs and HIC current practices. Microvascular reconstruction (17.6%), advanced otologic surgery (17.6%), and FESS (14.7%) were most desired skills and high-demand equipment needs were FESS sets (89%), endoscopes (78%), and surgical drills (56%). Frequently taught techniques included advanced otologic surgery (36.6%), congenital anomaly surgery (14.6%), and FESS (14.6%) with the largest gap between LMIC-need and HIC-offerings being in microvascular reconstruction (17.6% vs. 0%). We also highlight the discrepancy in expectations of responsibility for trip logistics, research, and patient follow-up.

Conclusion

We created and implemented the first otolaryngology-specific needs assessment tool in the literature. With its implementation in Ethiopia and Kenya, we were able to identify unmet needs as well as attitudes and perceptions of LMIC and HIC participants. This tool may be adapted and utilized to assess specific needs, resources, and goals of both host and visiting teams to facilitate successful global partnerships.

Level of Evidence

Level VI.