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Shegog R, Savas LS, Frost EL, Thormaehlen LC, Teague T, Steffy J, Healy CM, Shay LA, Preston S, Vernon SW. Adaptation and Formative Evaluation of Online Decision Support to Implement Evidence-Based Strategies to Increase HPV Vaccination Rates in Pediatric Clinics. Vaccines (Basel) 2023; 11:1270. [PMID: 37515085 PMCID: PMC10383429 DOI: 10.3390/vaccines11071270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Human papilloma virus (HPV) vaccination rates remain below national goals in the United States despite the availability of evidence-based strategies to increase rates. The Adolescent Vaccination Program (AVP) is a multi-component intervention demonstrated to increase HPV vaccination rates in pediatric clinics through the implementation of six evidence-based strategies. The purpose of this study, conducted in Houston, Texas, from 2019-2021, was to adapt the AVP into an online decision support implementation tool for standalone use and to evaluate its feasibility for use in community clinics. Phase 1 (Adaptation) comprised clinic interviews (n = 23), literature review, Adolescent Vaccination Program Implementation Tool (AVP-IT) design documentation, and AVP-IT development. Phase 2 (Evaluation) comprised usability testing with healthcare providers (HCPs) (n = 5) and feasibility testing in community-based clinics (n = 2). AVP-IT decision support provides an Action Plan with tailored guidance on implementing six evidence-based strategies (immunization champions, assessment and feedback, continuing education, provider prompts, parent reminders, and parent education). HCPs rated the AVP-IT as acceptable, credible, easy, helpful, impactful, and appealing (≥80% agreement). They rated AVP-IT supported implementation as easier and more effective compared to usual practice (p ≤ 0.05). The clinic-based AVP-IT uses facilitated strategy implementation by 3-month follow-up. The AVP-IT promises accessible, utilitarian, and scalable decision support on strategies to increase HPV vaccination rates in pediatric clinic settings. Further feasibility and efficacy testing is indicated.
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Affiliation(s)
- Ross Shegog
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - Lara S Savas
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - Erica L Frost
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - Laura C Thormaehlen
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - Travis Teague
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - Jack Steffy
- Department of Anthropology, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Catherine Mary Healy
- Department of Pediatrics, Infectious Diseases Section, Baylor College of Medicine, Houston, TX 77030, USA
| | - Laura Aubree Shay
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - Sharice Preston
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - Sally W Vernon
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
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Markham CM, Rushing SC, Manthei J, Singer M, Jessen C, Gorman G, Peskin MF, Hernandez BF, Sacca L, Evans GS, Luna-Meza C, Merritt Z, Shegog R. The Healthy Native Youth Implementation Toolbox: Using Implementation Mapping to adapt an online decision support system to promote culturally-relevant sexual health education for American Indian and Alaska Native youth. Front Public Health 2022; 10:889924. [PMID: 36388328 PMCID: PMC9659648 DOI: 10.3389/fpubh.2022.889924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/03/2022] [Indexed: 01/21/2023] Open
Abstract
Background American Indian and Alaska Native (AI/AN) youth experience serious disparities in sexual and reproductive health, including the highest teen birth rate among racial/ethnic groups, and disproportionate rates of sexually transmitted infections (STI), including HIV. A growing number of evidence-based programs (EBPs) that integrate the strengths and cultural teachings of Native communities exist. Yet, multiple factors, including lack of trained personnel, limited resources, and geographic isolation, may hinder their adoption and implementation. Innovative implementation strategies that facilitate the adoption and implementation of sexual health EBPs in Native communities may help reduce these disparities. Methods We applied Implementation Mapping, a systematic planning framework that utilizes theory, empirical evidence, and community input, to adapt a theory-based, online decision support system, iCHAMPSS (CHoosing And Maintaining Effective Programs for Sex Education in Schools), to support underlying dissemination and implementation processes unique to Native communities. We used an iterative design process, incorporating input from Native practitioners and academicians, to ensure that the adapted decision support system reflects cultural identification, community values, and experiences. Results Grounded in diffusion of innovations, organizational stage theory, and social cognitive theory, the Healthy Native Youth Implementation Toolbox supports Native practitioners through five phases (Gather, Choose, Prepare, Implement, and Grow) to adopt, implement, and maintain a culturally-relevant, age-appropriate sexual health EBP. The Toolbox provides tools, ready-to-use templates, and guidance to plan, implement, and grow a culturally-relevant adolescent health program with their Tribe or community. Hosted within the Healthy Native Youth website (www.healthynativeyouth.org), the Toolbox comprises: (1) a curriculum portal with access to 15 culturally-relevant, age-appropriate evidence-based health promotion programs for AI/AN youth; (2) a "resource library" comprising 20+ support tools, templates, and links to external resources, and (3) "stories from the field" comprising testimonials from experienced Native educators, who have implemented sexual health programs. Conclusion There is a continued need to design, test, and evaluate D&I strategies that are relevant to Native communities. The Healthy Native Youth Implementation Toolbox contributes to the dissemination and implementation of evidence-based, culturally-relevant sexual health education programs in diverse Native communities. Implementation Mapping provided a systematic approach to guide the adaptation process and integrate community voice with the ultimate goal of enhancing sexual health equity among AI/AN youth.
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Affiliation(s)
- Christine M. Markham
- Center for Health Promotion and Prevention Research, University of Texas Health Science Center Houston, Houston, TX, United States
| | | | - Jane Manthei
- Northwest Portland Area Indian Health Board, Portland, OR, United States
| | - Michelle Singer
- Northwest Portland Area Indian Health Board, Portland, OR, United States
| | - Cornelia Jessen
- Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Gwenda Gorman
- Inter Tribal Council of Arizona, Inc., Phoenix, AZ, United States
| | - Melissa F. Peskin
- Center for Health Promotion and Prevention Research, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Belinda F. Hernandez
- Center for Health Promotion and Prevention Research, University of Texas Health Science Center Houston, San Antonio, TX, United States
| | - Lea Sacca
- College of Medicine, Florida International University, Miami, FL, United States
| | - Gabrielle S. Evans
- Center for Health Promotion and Prevention Research, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Claudia Luna-Meza
- Center for Health Promotion and Prevention Research, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Zoe Merritt
- Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Ross Shegog
- Center for Health Promotion and Prevention Research, University of Texas Health Science Center Houston, Houston, TX, United States
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Wilkins NJ, Rasberry C, Liddon N, Szucs LE, Johns M, Leonard S, Goss SJ, Oglesby H. Addressing HIV/Sexually Transmitted Diseases and Pregnancy Prevention Through Schools: An Approach for Strengthening Education, Health Services, and School Environments That Promote Adolescent Sexual Health and Well-Being. J Adolesc Health 2022; 70:540-549. [PMID: 35305791 PMCID: PMC9260911 DOI: 10.1016/j.jadohealth.2021.05.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/18/2020] [Accepted: 05/04/2021] [Indexed: 10/18/2022]
Abstract
Adolescents' health behaviors and experiences contribute to many outcomes, including risks for HIV, other sexually transmitted diseases, and unintended pregnancy. Public health interventions and approaches addressing risk behaviors or experiences in adolescence have the potential for wide-reaching impacts on sexual health and other related outcomes across the lifespan, and schools are a critical venue for such interventions. This paper describes a school-based program model developed by the Centers for Disease Control and Prevention's Division of Adolescent and School Health for preventing HIV/sexually transmitted diseases, unintended pregnancy, and related health risk behaviors and experiences among middle and high school students. This includes a summary of the theoretical and evidence base that inform the model, and a description of the model's activities, organized into three key strategies (sexual health education, sexual health services, and safe and supportive environments) and across three cross-cutting domains (strengthening staff capacity, increasing student access to programs and services, and engaging parent and community partners). The paper also outlines implications for adolescent health professionals and organizations working across schools, clinics, and communities, to address and promote adolescent sexual health and well-being.
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Affiliation(s)
- Natalie J. Wilkins
- Division of Adolescent and School Health National Center for HIV/AIDS, Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road, MS US8-1 Atlanta, GA 30329,b Corresponding author: , 770-488-1392
| | - Catherine Rasberry
- Division of Adolescent and School Health National Center for HIV/AIDS, Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road, MS US8-1 Atlanta, GA 30329
| | - Nicole Liddon
- Division of Adolescent and School Health National Center for HIV/AIDS, Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road, MS US8-1 Atlanta, GA 30329
| | - Leigh E. Szucs
- Division of Adolescent and School Health National Center for HIV/AIDS, Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road, MS US8-1 Atlanta, GA 30329
| | - Michelle Johns
- Division of Adolescent and School Health National Center for HIV/AIDS, Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road, MS US8-1 Atlanta, GA 30329
| | - Sandra Leonard
- Division of Adolescent and School Health National Center for HIV/AIDS, Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road, MS US8-1 Atlanta, GA 30329
| | - Sally J. Goss
- Division of Adolescent and School Health National Center for HIV/AIDS, Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road, MS US8-1 Atlanta, GA 30329
| | - Heather Oglesby
- Division of Adolescent and School Health National Center for HIV/AIDS, Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road, MS US8-1 Atlanta, GA 30329
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Szeszulski J, Walker T, Robertson M, Cuccaro P, Fernandez ME. School Staff's Perspectives on the Adoption of Elementary-School Physical Activity Approaches: A Qualitative Study. AMERICAN JOURNAL OF HEALTH EDUCATION 2020; 51:395-405. [PMID: 33763162 DOI: 10.1080/19325037.2020.1822241] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background There is a need to understand how schools adopt physical activity approaches (curricula, programs and practices), but few studies report on this process. Purpose To obtain elementary school staff's perspectives regarding how their schools are currently adopting physical activity approaches. Methods We recruited 15 participants from four job types in an urban Texas school district to participate in semi-structured interviews. We coded and analyzed interviews using directed content analysis and iterative categorization. Results We identified four themes pertaining to how the district, schools, and teachers contribute to the adoption of approaches. Themes included: (1) Staff identify new approaches through numerous channels; (2) Adoption occurs at multiple organizational levels; (3) District staff fulfilled a supporting role in the adoption process; and (4) School staff's perceptions of approach characteristics influence adoption. Discussion We found that schools adopt physical activity approaches at both the district- and school-level. Additionally, multiple stakeholders played a role in the adoption process and those roles varied across approaches. Translation to Health Education Practice Time, money, space, staff, competing priorities, limited information, the school's mission, and the benefits an approach provides to children are factors that researches and practitioners should consider when starting a new physical activity approach.
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Affiliation(s)
- Jacob Szeszulski
- The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin St. Houston, TX, USA 77030.,The University of Texas Health Science Center at Houston School of Public Health, Austin Campus, Michael Susan Dell Center for Healthy Living, 1616 Guadalupe St Suite 6.300, Austin, TX, USA 78701
| | - Tim Walker
- The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin St. Houston, TX, USA 77030
| | - Michael Robertson
- The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin St. Houston, TX, USA 77030.,MD Anderson Cancer Center, Cancer Prevention Building, Center for Energy Balance, Department of Behavioral Science, Unit 1330, 1155 Pressler St, Houston, TX USA 77030
| | - Paula Cuccaro
- The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin St. Houston, TX, USA 77030
| | - Maria E Fernandez
- The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin St. Houston, TX, USA 77030
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Markham CM, Peskin MF, Baumler ER, Addy RC, Thiel MA, Laris BA, Baker K, Hernandez B, Shegog R, Coyle K, Emery ST. Socio-Ecological Factors Associated With Students' Perceived Impact of an Evidence-Based Sexual Health Education Curriculum. THE JOURNAL OF SCHOOL HEALTH 2020; 90:604-617. [PMID: 32510609 DOI: 10.1111/josh.12908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 10/03/2019] [Accepted: 01/31/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although schools often implement evidence-based sexual health education programs to address sexual and reproductive health disparities, multiple factors may influence program effectiveness. METHODS Using student-reported perceived impact measures as a proxy for program effectiveness, we employed a socio-ecological approach to examine student, teacher, school, and district factors associated with greater perceived impact of It's Your Game (IYG), an evidence-based middle school sexual health education program. The student sample was 58.7% female, 51.8% Hispanic, mean age 13.2 years, from 73 middle schools. We assessed students' (N = 4531) perceived impact of IYG on healthy decision-making (α = 0.75) and sexual communication (α = 0.71); satisfaction with IYG activities and teacher; and demographics. We assessed teachers' (N = 56) self-efficacy to teach IYG, perceived administrative support, implementation barriers, and demographics. School and district data were abstracted from state records. We used multilevel logistic regression to estimate associations between independent variables and student-reported perceived impact. RESULTS In final multivariate models, students' demographics (sex, β = 0.06, SE = 0.015), satisfaction with IYG (β = 0.21, SE = 0.012), and their IYG teacher (β = 0.18, SE = 0.013) (all p = .000) were significantly associated with perceived impact on healthy decision-making. Similar findings resulted for sexual communication. No other variables were significantly associated with perceived impact. CONCLUSIONS Helping schools select age-appropriate, culturally relevant programs, and facilitate supportive learning environments may enhance the perceived impact of sexual health education programs.
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Affiliation(s)
- Christine M Markham
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | - Melissa F Peskin
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | | | - Robert C Addy
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | | | - B A Laris
- ETR, 100 Enterprise Way, Suite G300, Scotts Valley, CA, 95066
| | - Kimberly Baker
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | - Belinda Hernandez
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | - Ross Shegog
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | - Karin Coyle
- ETR, 100 Enterprise Way, Suite G300, Scotts Valley, CA, 95066
| | - Susan Tortolero Emery
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
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6
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Peskin MF, Coyle KK, Anderson PM, Laris BA, Glassman JR, Franks HM, Thiel MA, Potter SC, Unti T, Edwards S, Johnson-Baker K, Cuccaro PM, Diamond P, Markham CM, Shegog R, Baumler ER, Gabay EK, Emery ST. Replication of It's Your Game…Keep It Real! in Southeast Texas. J Prim Prev 2020; 40:297-323. [PMID: 31028508 DOI: 10.1007/s10935-019-00549-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Despite the recent efforts of the Office of Adolescent Health to replicate programs with demonstrated efficacy, there are still few evidence-based HIV, sexually transmitted infection (STI), and teen pregnancy prevention programs that have been replicated in "real-world" settings. To test the effectiveness of It's Your Game…Keep It Real! (IYG), an evidence-based STI and pregnancy prevention program for middle schools, the curriculum was implemented by teachers in urban and suburban middle schools in Southeast Texas from 2012 to 2015. IYG was evaluated using a group-randomized wait-list controlled effectiveness trial design in which 20 middle schools in nine urban and suburban school districts in Southeast Texas were randomized equally, using a multi-attribute randomization protocol, to either the intervention condition (received IYG) (n = 10 schools comprising 1936 eligible seventh graders) or the comparison condition (received usual care) (n = 10 schools comprising 1825 eligible seventh graders). All students were blinded to condition prior to administering the baseline survey. The analytic sample comprised 1543 students (n = 804, intervention; n = 739, comparison) who were followed from baseline (seventh grade) to the 24-month follow-up (ninth grade). Multilevel regression analyses were conducted to assess behavioral and psychosocial outcomes at follow-up. There were no significant differences in initiation of vaginal or oral sex between study conditions at follow-up. However, at 12-month follow-up, compared with students in the comparison condition, students in the intervention condition reported increased knowledge, self-efficacy, and perceived favorable norms related to HIV/STIs, condoms, and/or abstinence; decreased intentions to have sex; and increased intentions to use birth control. Knowledge outcomes were statistically significant at 24-month follow-up. This IYG effectiveness trial did not replicate the behavioral effects of the original IYG efficacy trials. However, it adds to the growing literature on the replication of evidence-based programs, and underscores the need to better understand how variations in implementation, setting, and measurement affect the behavioral impact of such programs.Clinical trial registration clinicaltrials.gov (NCT03533192).
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Affiliation(s)
- Melissa F Peskin
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA.
| | | | | | | | | | | | | | | | | | | | - Kimberly Johnson-Baker
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Paula M Cuccaro
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Pamela Diamond
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Christine M Markham
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Ross Shegog
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Elizabeth R Baumler
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Efrat K Gabay
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Susan Tortolero Emery
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
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Dugan AG, Punnett L. Dissemination and Implementation Research for Occupational Safety and Health. OCCUPATIONAL HEALTH SCIENCE 2017; 1:29-45. [PMID: 29725613 PMCID: PMC5929143 DOI: 10.1007/s41542-017-0006-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022]
Abstract
The translation of evidence-based health innovations into real-world practice is both incomplete and exceedingly slow. This represents a poor return on research investment dollars for the general public. U.S. funders of health sciences research (e.g., NIH, CDC, NIOSH) are increasingly calling for dissemination plans, and to a lesser extent for dissemination and implementation (D&I) research, which are studies that examine the effectiveness of D&I efforts and strategies and the predictors of D&I success. For example, rather than merely broadcasting information about a preventable hazard, D&I research in occupational safety and health (OSH) might examine how employers or practitioners are most likely to receive and act upon that information. We propose here that D&I research should be seen as a dedicated and necessary area of study within OSH, as a way to generate new knowledge that can bridge the research-to-practice gap. We present D&I concepts, frameworks, and examples that can increase the capacity of OSH professionals to conduct D&I research and accelerate the translation of research findings into meaningful everyday practice to improve worker safety and health.
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Affiliation(s)
- Alicia G Dugan
- Department of Medicine, UConn Health, 263 Farmington Ave, Farmington, CT 06030, USA
| | - Laura Punnett
- Department of Public Health, University of Massachusetts Lowell, One University Avenue, Lowell, MA 01854, USA
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Peskin MF, Hernandez BF, Gabay EK, Cuccaro P, Li DH, Ratliff E, Reed-Hirsch K, Rivera Y, Johnson-Baker K, Emery ST, Shegog R. Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs. Front Public Health 2017; 5:203. [PMID: 28848729 PMCID: PMC5554483 DOI: 10.3389/fpubh.2017.00203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/25/2017] [Indexed: 12/02/2022] Open
Abstract
In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs) have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance) of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular), a systematic design framework that uses theory, empirical evidence, and input from the community to develop CHoosing And Maintaining Effective Programs for Sex Education in Schools (iCHAMPSS), an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings.
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Affiliation(s)
- Melissa F Peskin
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Belinda F Hernandez
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Efrat K Gabay
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Paula Cuccaro
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Dennis H Li
- Northwestern University, Chicago, IL, United States
| | - Eric Ratliff
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | | | - Yanneth Rivera
- University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kimberly Johnson-Baker
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Susan Tortolero Emery
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
| | - Ross Shegog
- University of Texas Health Science at Houston School of Public Health, Houston, TX, United States
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