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Khoza TL, Sibiya MN, Mshunqane N. Factors Predisposing Emergency Medical Technicians to Workplace Violence: A Cross Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241233452. [PMID: 38491932 PMCID: PMC10944587 DOI: 10.1177/00469580241233452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/04/2023] [Accepted: 01/31/2024] [Indexed: 03/18/2024]
Abstract
Emergency medical technicians (EMT) are at high risk of workplace violence as they often care for patients in uncontrolled and often hostile emergency settings. Gauteng Province, the most populous province in South Africa, caters for 75% of the total population which is dependant on state funded health care. Public sector EMTs' have been robbed with aggravated circumstances, assaulted with intent to do grievous bodily harm, raped and even murdered whilst on duty. Despite this, comprehensive studies investigating the factors that predispose public sector EMTs' to workplace violence in Gauteng Province are lacking. Thus, the aim of this study was to investigate the factors that predispose public service EMTs' to workplace violence in Gauteng Province. Data were collected using questionnaires. A total of 413 questionnaires were returned by community members of Gauteng who met the inclusion criteria. Descriptive statistics and binomial tests were used to analyze data. The results of this study revealed that workplace violence toward public service EMTs' in Gauteng is attributed to the high rates of crime, the widening gap of inequality, economic deprivation of basic rights to previously disadvantaged communities by government, vulnerability of EMTs' when responding to the ill and injured within low- and middle-income communities and a lack of consequence for disorderly behavior within the communities. An understanding of the community factors that predispose EMTs' to workplace violence may improve the understanding of the phenomenon of workplace violence and developing prevention programs within the communities.
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Makhado TG, Lebese RT, Maputle MS. Incorporation of Epilepsy into Life Skills Education: Perceptions of Primary School Learners in Mpumalanga and Limpopo Province—A Qualitative Exploratory Study. CHILDREN 2023; 10:children10030569. [PMID: 36980128 PMCID: PMC10047888 DOI: 10.3390/children10030569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023]
Abstract
Providing education on epilepsy is crucial, as this helps individuals to acquire the necessary knowledge and skills to effectively manage seizures while also reducing the stigma and misconceptions surrounding the condition. The aim of this research was to examine how learners perceive the integration of epilepsy education into life skills training. A descriptive-exploratory design was utilized for the study. The research took place in the provinces of Limpopo and Mpumalanga, located in South Africa, where primary schools in chosen rural communities were selected for the research. Six focus group discussions were conducted with learners aged 9 to 14 years in grades 4 to 7. Each group was comprised of six learners, resulting in a total of 36 individuals who satisfied the inclusion criteria. Data were collected from August to November 2022. Semi-structured interviews were utilized to collect data until saturation was reached. The collected data were analyzed with the assistance of ATLAS.ti. The study’s results underscore the significance of incorporating epilepsy education into life skills curricula at the primary school level, as revealed by two prominent themes that emerged: first, the reasons provided by students for the integration of epilepsy education into life skills training, and second, the preferred teaching methodologies for epilepsy education within the life skills curriculum as identified by learners. Trustworthiness and ethical consideration were ensured. It is recommended that guidelines for epilepsy life skills should be developed to enhance the wellbeing and academic performance of learners with epilepsy in primary schools in Mpumalanga and Limpopo provinces.
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Affiliation(s)
- Thendo Gertie Makhado
- Department of Advance Nursing Sciences, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
- Correspondence:
| | - Rachel Tsakani Lebese
- Research Office, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
| | - Maria Sonto Maputle
- Department of Advance Nursing Sciences, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
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Mantula F, Chamisa JA, Nunu WN, Nyanhongo PS. Women's Perspectives on Cultural Sensitivity of Midwives During Intrapartum Care at a Maternity Ward in a National Referral Hospital in Zimbabwe. SAGE Open Nurs 2023; 9:23779608231160476. [PMID: 36875792 PMCID: PMC9974627 DOI: 10.1177/23779608231160476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/12/2023] [Indexed: 03/07/2023] Open
Abstract
Introduction Midwives attend intrapartum women of diverse ethnic backgrounds who each bring their cultural beliefs into the labor and delivery rooms. The International Confederation of Midwives has recommended providing culturally appropriate maternity care in its quest to increase skilled birth attendance and subsequently improve maternal and newborn health. Objective This study aimed to examine midwives' cultural sensitivity during intrapartum care from women's perspectives, and how this relates to women's satisfaction with maternity care services. Methods A qualitative phenomenological design was employed. Two focus group discussions were conducted with 16 women who had delivered in the labor ward of the selected national referral maternity unit. An interpretive phenomenological approach was used to analyze the data. Results This study revealed ineffective midwife-woman collaboration that excludes the incorporation of women's cultural beliefs in the design of maternity care plans. Emotional, physical, and informational support in the care provided to women during labor and childbirth was found to be incompetent. This suggests that midwives are not sensitive to cultural norms and do not provide woman-centered intrapartum care. Conclusion Various factors implying midwives' lack of cultural sensitivity in their provision of intrapartum care were identified. Resultantly, women's expectations of labor are not met and this could negatively affect future maternity care-seeking behaviors. This study's findings provide policy makers, midwifery program managers and implementers with better insights for developing targeted interventions to improve cultural sensitivity for the delivery of respectful maternity care. Identifying factors that affect the implementation of culture-sensitive care by midwives could guide the adjustments required in midwifery education and practice.
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Affiliation(s)
- Fennie Mantula
- Department of Nursing and Midwifery, Faculty of Medicine, National University of Science and Technology, Ascot, Bulawayo, Zimbabwe
| | - Judith Audrey Chamisa
- Department of Nursing and Midwifery, Faculty of Medicine, National University of Science and Technology, Ascot, Bulawayo, Zimbabwe
| | - Wilfred Njabulo Nunu
- Department of Environmental Health, Faculty of Environmental Science, National University of Science and Technology, Ascot, Bulawayo, Zimbabwe
| | - Prisca Sophia Nyanhongo
- Department of Nursing and Midwifery, Faculty of Medicine, National University of Science and Technology, Ascot, Bulawayo, Zimbabwe
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Lister HE, Mostert K, Botha T, van der Linde S, van Wyk E, Rocher SA, Laing R, Wu L, Müller S, des Tombe A, Kganyago T, Zwane N, Mphogo B, Maric F. South African Healthcare Professionals' Knowledge, Attitudes, and Practices Regarding Environmental Sustainability in Healthcare: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10121. [PMID: 36011760 PMCID: PMC9408692 DOI: 10.3390/ijerph191610121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
Climate change, biodiversity loss and large-scale environmental degradation are widely recognized as the biggest health threats of the 21st century, with the African continent already amongst the most severely affected and vulnerable to their further progression. The healthcare system's contribution to climate change and environmental degradation requires healthcare professionals to address environmental issues urgently. However, the foundation for context-relevant interventions across research, practice, and education is not readily available. Therefore, we conducted a convergent mixed-methods study to investigate South African healthcare professionals' knowledge, attitudes, practices, and barriers to environmental sustainability. Healthcare professionals participated in a cross-sectional questionnaire (n = 100) and in-depth semi-structured focus group discussions (n = 18). Data were analyzed using descriptive statistics and thematic analysis, respectively, and integrated to provide holistic findings. Our results confirm overwhelmingly positive attitudes and a high degree of interest in education, implementation, and taking on more corresponding responsibility, but a lack of substantial knowledge of the subject matter, and only tentative implementation of practices. Identified barriers include a lack of knowledge, resources, and policies. Further research, education, and policy development on overcoming these barriers is required. This will facilitate harnessing the extant enthusiasm and advance environmental sustainability in South Africa's healthcare practice.
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Affiliation(s)
- Helga E. Lister
- Department of Occupational Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Karien Mostert
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Tanita Botha
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Simoné van der Linde
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Elaine van Wyk
- Department of Occupational Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Su-Ané Rocher
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Richelle Laing
- Department of Occupational Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Lucy Wu
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Selma Müller
- Department of Occupational Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Alexander des Tombe
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Tebogo Kganyago
- Department of Occupational Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Nonhlanhla Zwane
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Boitumelo Mphogo
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Filip Maric
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9020 Tromsø, Norway
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Shaw AR, Perales-Puchalt J, Moore T, Weatherspoon P, Robinson M, Hill CV, Vidoni ED. Recruitment of Older African Americans in Alzheimer's Disease Clinical Trials Using a Community Education Approach. J Prev Alzheimers Dis 2022; 9:672-678. [PMID: 36281671 PMCID: PMC9514712 DOI: 10.14283/jpad.2022.82] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/31/2022] [Indexed: 11/11/2022]
Abstract
Alzheimer's disease and related dementias (ADRD) is two times more prevalent among compared to non-Hispanic Whites. Despite the higher prevalence of ADRD among older African Americans, recent estimates suggest research enrollment by those who identify as African American remains limited. The purpose of the study is to 1) explore how a culturally tailored community education program impacts clinical trial interest and enrollment in ADRD research studies and to 2) identify how applicable the African American community perceived the culturally tailored curriculum. Using a community-engaged research approach, we collaborated with predominately African American serving community-based organizations to support content development and delivery of Aging with Grace (AWG), a culturally tailored ADRD educational curriculum. A total of five AWG presentations were given to 66 attendees. Most attendees (67%) expressed interest in participating in clinical trials after attending AWG. Enrollment increased within an observational study (84%) and lifestyle prevention clinical trials (52%) from 2018 to 2019. Attendees (32%) also perceived an increase in ADRD knowledge from attending AWG and 89.1% believed more African Americans should participate in research. Our work demonstrates the effectiveness of a culturally tailored community education program to enhance knowledge, clinical trial interest, and recruitment into observational studies and lifestyle ADRD clinical trials among older African Americans. Education programs developed in partnership with the community can serve as bridge to research participation for underrepresented minorities in clinical research. Future studies should assess long-term retention of knowledge and research readiness.
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Affiliation(s)
- A R Shaw
- Eric Vidoni, PhD, 4350 Shawnee Mission Parkway, Fairway, KS, 66205, USA, Phone: 913-588-5312; Fax: 913-945-5035,
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Pu D, Bonnici R, Shorr R, Haines T. Digital storytelling to facilitate consumer engagement in healthcare research. Health Promot J Austr 2021; 33:758-767. [PMID: 34923697 DOI: 10.1002/hpja.565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/25/2021] [Accepted: 12/13/2021] [Indexed: 11/11/2022] Open
Abstract
ISSUES ADDRESSED Consumer engagement in healthcare research presents with challenges, one of which is ensuring that the consumers have comprehended the often complex concepts in scientific research. This study aimed to compare how well older adult consumers understood video-based versus written and verbal description approaches to provision of information. METHODS Twenty adults in the community aged 60 years and older were recruited for this study; half were randomised to receive the information via a digital story, and the other half received the same information from a written brief. Both mediums were presented via video teleconferencing. An interviewer was present to ask questions and address queries. RESULTS Participants who viewed the digital story requested for clarifications less frequently compared to those who received the written brief. Difficulty in understanding the information rose with complexity, but providing concrete examples aided comprehension of the information. CONCLUSIONS Complex concepts benefit from the provision of concrete examples to facilitate understanding. Video-based approaches to provision of information are acceptable forms of participant engagement in research and require less human resources to successfully convey key information and facilitate understanding of the information. Research procedures that employ large amounts of data collection and/or asynchronous methods should consider the use of video-based approaches, such as digital stories, to increase cost-effectiveness.
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Affiliation(s)
- Dai Pu
- National Centre for Healthy Ageing and School of Primary and Allied Healthcare, Monash University Peninsula Campus, Frankston, Victoria, Australia
| | - Rachel Bonnici
- National Centre for Healthy Ageing and School of Primary and Allied Healthcare, Monash University Peninsula Campus, Frankston, Victoria, Australia
| | - Ronald Shorr
- Geriatric Research Education and Clinical Center, Malcolm Randall Veterans Affairs Medical Center, Gainesville, Florida, USA.,Department of Epidemiology, University of Florida, Gainesville, Florida, USA
| | - Terry Haines
- National Centre for Healthy Ageing and School of Primary and Allied Healthcare, Monash University Peninsula Campus, Frankston, Victoria, Australia
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Stringer B, Lowton K, James N, Nyang'wa BT. Capturing patient-reported and quality of life outcomes with use of shorter regimens for drug-resistant tuberculosis: mixed-methods substudy protocol, TB PRACTECAL-PRO. BMJ Open 2021; 11:e043954. [PMID: 34489263 PMCID: PMC8422308 DOI: 10.1136/bmjopen-2020-043954] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/21/2020] [Accepted: 04/21/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION People living with multidrug-resistant tuberculosis currently have few options for effective treatment and cure. Regimens that are available are toxic, may involve injections and take up to 2 years to complete treatment, with success rates as low as 50%. The TB-PRACTECAL trial is evaluating shorter, more tolerable regimens of oral drugs; we detail the substudy within this trial, PRACTECAL-PRO, which aims to evaluate patient experiences and perspectives on treatment, to understand outcomes more fully. METHODS AND ANALYSIS We are conducting a mixed-methods evaluation within both investigational and standard of care arms within the TB-PRACTECAL trial, using sequential quality of life (QoL) surveys and in-depth interviews. Data collection involves the Short Form 12 (SF-12) and St George's Respiratory Questionnaire (SGRQ), collected at up to four fixed timepoints, from baseline, to up to 12 months later. Healthy volunteers will be surveyed to establish locally relevant controls. We will also purposively sample participants for qualitative data collection and analysis, to provide rich explanation of QoL scores. The study will be implemented in all six TB-PRACTECAL study sites in Uzbekistan, South Africa and Belarus. QoL surveys will be scored and analysed according to SF-12 and SGRQ developers' manuals. Differences between scores at baseline and later timepoints will be evaluated as well as graphical exploration of group score trajectories of investigational and standard of care arms. ETHICS AND DISSEMINATION Ethics approval was obtained from the Médecins Sans Frontières Ethics Review Board. Local ethics approval has been obtained in Uzbekistan, Belarus and South Africa. Results of the substudy will be shared with local health authorities, the WHO and submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT03942354; Pre-results.
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Affiliation(s)
| | - Karen Lowton
- Department of Sociology, University of Sussex, Brighton, UK
| | - Nicola James
- Manson Unit, Médecins Sans Frontières, London, UK
| | - Bern-Thomas Nyang'wa
- Manson Unit, Médecins Sans Frontières, London, UK
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
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Moving Together: Understanding Parent Perceptions Related to Physical Activity and Motor Skill Development in Preschool Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179196. [PMID: 34501785 PMCID: PMC8431392 DOI: 10.3390/ijerph18179196] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/22/2021] [Accepted: 08/27/2021] [Indexed: 11/19/2022]
Abstract
Background: Establishing physical activity (PA) and motor behaviors in early childhood are important for developing healthy activity behaviors. Parents play a central role in shaping young children’s PA and fundamental motor skills (FMS). This qualitative study explored parents’ attributes, values, perceptions, and practices related to PA and FMS. Methods: Thirty-one parents (26 mothers) of preschool-aged children participated in semi-structured in-person interviews. Interviews were audio-recorded, transcribed verbatim, coded and analyzed using an iterative approach. Results: Four themes related to PA and FMS emerged: (1) parent attributes; (2) parent–child interactions; (3) parent perception of children’s attributes; and (4) parenting practices. Although most parents enjoyed playing with their child, some did not realize the importance of engaging in PA with their child and even believed that FMS are naturally developed. Parents indicated that children’s temperament may influence their preference for practicing motor skills. Conclusions: Social support and positive parenting practices, including encouragement, monitoring, logistical support, co-participation, and facilitation, are important for the development of PA and FMS. The findings add emphasis to the importance of parents’ role in the development of young children’s PA and FMS, and they inform future strategies aiming to promote young children’s activity behaviors.
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Hajjaj SSH, Karim NKA. Adoption of Robotics in the TV & Film Industry: The IoT-enabled Robotic Camera Dolly. 2021 30TH IEEE INTERNATIONAL CONFERENCE ON ROBOT & HUMAN INTERACTIVE COMMUNICATION (RO-MAN) 2021. [DOI: 10.1109/ro-man50785.2021.9515414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
- Sami Salama Hussen Hajjaj
- Universiti Tenaga Nasional (The National Energy University),Centre for Advanced Mechatronics and Robotics (CaMaRo), Institute of Informatics and Computing in Energy (IICE),Malaysia
| | - Nur Kareelawati Abd Karim
- Universiti Sains Islam Malaysia (USIM),Muslims in Creative Media Industries (MiCMI), Faculty of Leadership and Management,Malaysia
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Bazirete O, Nzayirambaho M, Umubyeyi A, Uwimana MC, Evans M. Influencing factors for prevention of postpartum hemorrhage and early detection of childbearing women at risk in Northern Province of Rwanda: beneficiary and health worker perspectives. BMC Pregnancy Childbirth 2020; 20:678. [PMID: 33167935 PMCID: PMC7654175 DOI: 10.1186/s12884-020-03389-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reduction of maternal mortality and morbidity is a major global health priority. However, much remains unknown regarding factors associated with postpartum hemorrhage (PPH) among childbearing women in the Rwandan context. The aim of this study is to explore the influencing factors for prevention of PPH and early detection of childbearing women at risk as perceived by beneficiaries and health workers in the Northern Province of Rwanda. METHODS A qualitative descriptive exploratory study was drawn from a larger sequential exploratory-mixed methods study. Semi-structured interviews were conducted with 11 women who experienced PPH within the 6 months prior to interview. In addition, focus group discussions were conducted with: women's partners or close relatives (2 focus groups), community health workers (CHWs) in charge of maternal health (2 focus groups) and health care providers (3 focus groups). A socio ecological model was used to develop interview guides describing factors related to early detection and prevention of PPH in consideration of individual attributes, interpersonal, family and peer influences, intermediary determinants of health and structural determinants. The research protocol was approved by the University of Rwanda, College of Medicine and Health Sciences Institutional Ethics Review Board. RESULTS We generated four interrelated themes: (1) Meaning of PPH: beliefs, knowledge and understanding of PPH: (2) Organizational factors; (3) Caring and family involvement and (4) Perceived risk factors and barriers to PPH prevention. The findings from this study indicate that PPH was poorly understood by women and their partners. Family members and CHWs feel that their role for the prevention of PPH is to get the woman to the health facility on time. The main factors associated with PPH as described by participants were multiparty and retained placenta. Low socioeconomic status and delays to access health care were identified as the main barriers for the prevention of PPH. CONCLUSIONS Addressing the identified factors could enhance early prevention of PPH among childbearing women. Placing emphasis on developing strategies for early detection of women at higher risk of developing PPH, continuous professional development of health care providers, developing educational materials for CHWs and family members could improve the prevention of PPH. Involvement of all levels of the health system was recommended for a proactive prevention of PPH. Further quantitative research, using case control design is warranted to develop a screening tool for early detection of PPH risk factors for a proactive prevention.
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Affiliation(s)
- Oliva Bazirete
- College of Medicine and Health Sciences, University of Rwanda, 3286 Kigali, Rwanda
| | - Manassé Nzayirambaho
- College of Medicine and Health Sciences, University of Rwanda, 3286 Kigali, Rwanda
| | - Aline Umubyeyi
- College of Medicine and Health Sciences, University of Rwanda, 3286 Kigali, Rwanda
| | | | - Marilyn Evans
- University of Western Ontario, Arthur Labatt Family School of Nursing, 1151 Richmond St, London, ON N6A 3K7 Canada
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Okoyo Opiyo R, Nyawade SA, McCaul M, Nyasulu PS, Lango DB, Were AJO, Nabakwe EC, Bukania ZN, Olenja JM. Perceptions on Adherence to Dietary Prescriptions for Adults with Chronic Kidney Disease on Hemodialysis: A Qualitative Study. Diseases 2020; 8:diseases8030029. [PMID: 32781501 PMCID: PMC7565887 DOI: 10.3390/diseases8030029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 11/16/2022] Open
Abstract
Diet is one of the modifiable lifestyle factors in management of kidney disease. We explored perceptions on adherence to dietary prescriptions for adults with chronic kidney disease on hemodialysis. This was a qualitative descriptive study. Participants were purposively selected at renal clinics/dialysis units at national referral hospitals in Kenya. Data were collected using in-depth interviews, note-taking and voice-recording. The data were managed and analyzed thematically in NVIV0-12 computer software. Study participants were 52 patients and 40 family caregivers (42 males and 50 females) aged 20 to 69 years. Six sub-themes emerged in this study: “perceived health benefits”; “ease in implementing prescribed diets”; “cost of prescribed renal diets”; “nutrition information and messages”; “transition to new diets” and “fear of complications/severity of disease”. Both patients and caregivers acknowledged the health benefits of adherence to diet prescriptions. However, there are mixed messages to the patients and caregivers who have challenges with management and acceptability of the prescriptions. Most of them make un-informed dietary decisions that lead to consumption of unhealthy foods with negative outcomes such as metabolic waste accumulation in the patients’ bodies negating the effects of dialysis and undermining the efforts of healthcare system in management of patients with chronic kidney disease.
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Affiliation(s)
- Rose Okoyo Opiyo
- Disease Prevention, Control and Health Promotion Unit, School of Public Health, College of Health Sciences, University of Nairobi, P.O. Box 19676-KNH, Nairobi 00202, Kenya;
- East African Kidney Institute, College of Health Sciences, University of Nairobi, P.O. Box 19676-KNH, Nairobi 00202, Kenya;
- Correspondence: ; Tel.: +254-722-473-122
| | - Susan Akoth Nyawade
- Community Health Sciences Unit, School of Public Health, College of Health Sciences, University of Nairobi, P.O. Box 19676-KNH, Nairobi 00202, Kenya; (S.A.N.); (J.M.O.)
| | - Michael McCaul
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Parow, Cape Town 7505, South Africa; (M.M.); (P.S.N.)
| | - Peter Suwirakwenda Nyasulu
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Parow, Cape Town 7505, South Africa; (M.M.); (P.S.N.)
| | - Daniel Bolo Lango
- Disease Prevention, Control and Health Promotion Unit, School of Public Health, College of Health Sciences, University of Nairobi, P.O. Box 19676-KNH, Nairobi 00202, Kenya;
| | - Anthony Jude Omolo Were
- East African Kidney Institute, College of Health Sciences, University of Nairobi, P.O. Box 19676-KNH, Nairobi 00202, Kenya;
- Department of Internal Medicine, College of Health Sciences, University of Nairobi, P.O. Box 19676-KNH, Nairobi 00202, Kenya
| | - Esther Clyde Nabakwe
- Department of Child Health and Pediatrics Moi University, P.O. Box 4606, Eldoret 30100, Kenya;
| | - Zipporah Nekesa Bukania
- Centre for Public Health Research—Kenya Medical Research Institute, P.O. Box 20752, Nairobi 00202, Kenya;
| | - Joyce Muhenge Olenja
- Community Health Sciences Unit, School of Public Health, College of Health Sciences, University of Nairobi, P.O. Box 19676-KNH, Nairobi 00202, Kenya; (S.A.N.); (J.M.O.)
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Nunu WN, Makhado L, Mabunda JT, Lebese RT. Strategies to facilitate safe sexual practices in adolescents through integrated health systems in selected districts of Zimbabwe: a mixed method study protocol. Reprod Health 2020; 17:20. [PMID: 32005263 PMCID: PMC6995095 DOI: 10.1186/s12978-020-0862-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/14/2020] [Indexed: 01/08/2023] Open
Abstract
Background Zimbabwe has the highest teenage pregnancy rate in Sub Saharan Africa. Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) prevalence in adolescents that are from tribes that perform cultural initiations and subscribe to certain norms are higher than the national prevalence which is estimated at 12% (18 and 13.6% respectively) in Zimbabwe. Indigenous Health Systems (IHSs) and Modern Health Systems (MHSs) in Zimbabwe run parallel thereby introducing challenges in the management of adolescent sexual health due to conflicts. This study seeks to develop strategies that will facilitate the integration of IHSs and MHS in Mberengwa and Umguza districts. Methods This research will be conducted in two phases. The first phase would utilise a concurrent triangulation mixed methods design with both qualitative and quantitative approaches. The findings from the qualitative and quantitative approaches would be merged through a comparison of findings side by side. The second phase would focus on the development and validation of strategies that would facilitate the integration of IHSs and MHSs. The Strength, Weakness, Opportunity and Threat (SWOT) analysis would be applied on interfaced findings from phase one. The Basic Logic and the Build, Overcome, Explore and Minimise (BOEM) models would then be used to develop strategies based on the SWOT findings. The developed strategies would be validated through the application of Delphi technique and administration of checklist to selected key stakeholders through organised workshops. Discussion There have been no known studies found in the literature that explores the possibility and developed strategies of integrating IHSs and MHSs so as to promote safe sexual practices in adolescents. Most programs on sexual health have ignored the role of IHSs and MHSs in influencing safe sexual practices leading to them failing to attain desired goals. A lot of emphases has been targeted at minimising the spread of Sexually Transmitted Infections (STIs) through advocating for utilisation MHSs rather than focussing on an integrating systems that are meant to manage Adolescent Sexual Health (ASH) related issues. The study protocol was approved by the University of Venda Ethics Committee Registration (SHS/19/PH/17/2608) on the 26th of August 2019.
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Affiliation(s)
- Wilfred Njabulo Nunu
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa. .,Department of Environmental Science and Health, Faculty of Applied Sciences, National University of Science and Technology, Bulawayo, Zimbabwe.
| | - Lufuno Makhado
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Jabu Tsakani Mabunda
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa
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Owolabi MO, Gebregziabher M, Akinyemi RO, Akinyemi JO, Akpa O, Olaniyan O, Salako BL, Arulogun O, Tagge R, Uvere E, Fakunle A, Ovbiagele B. Randomized Trial of an Intervention to Improve Blood Pressure Control in Stroke Survivors. Circ Cardiovasc Qual Outcomes 2019; 12:e005904. [PMID: 31805787 PMCID: PMC7139215 DOI: 10.1161/circoutcomes.119.005904] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND We conducted the first-of-its kind randomized stroke trial in Africa to test whether a THRIVES (Tailored Hospital-based Risk reduction to Impede Vascular Events after Stroke) intervention improved blood pressure (BP) control among patients with stroke. METHODS AND RESULTS Intervention comprised a patient global risk factor control report card, personalized phone text-messaging, and educational video. Four hundred patients recruited from 4 distinct medical facilities in Nigeria, aged ≥18 years with stroke-onset within one-year, were randomized to THRIVES intervention and control group. The control group also received text messages, and both groups received modest financial incentives. The primary outcome was mean change in systolic BP (SBP) at 12 months. There were 36.5% females, 72.3% with ischemic stroke; mean age was 57.2±11.7 years; 93.5% had hypertension and mean SBP was 138.33 (23.64) mm Hg. At 12 months, there was no significant difference in SBP reduction from baseline in the THRIVES versus control group (2.32 versus 2.01 mm Hg, P=0.82). In an exploratory analysis of subjects with baseline BP >140/90 mm Hg (n=168), THRIVES showed a significant mean SBP (diastolic BP) decrease of 11.7 (7.0) mm Hg while control group showed a significant mean SBP (diastolic BP) decrease of 11.2 (7.9) mm Hg at 12 months. CONCLUSIONS THRIVES intervention did not significantly reduce SBP compared with controls. However, there was similar significant decrease in mean BP in both treatment arms in the subgroup with baseline hypertension. As text-messaging and a modest financial incentive were the common elements between both treatment arms, further research is required to establish whether these measures alone can improve BP control among stroke survivors. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01900756.
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Affiliation(s)
- Mayowa O Owolabi
- Department of Medicine, University College Hospital and University of Ibadan, Nigeria and Center for Genomic and Precision Medicine, College of Medicine (M.O.O., R.O.A.), University of Ibadan, Nigeria
- Blossom Specialist Medical Center, First Center for Neurorehabilitation, Ibadan, Nigeria (M.O.O., E.U.)
| | - Mulugeta Gebregziabher
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences (M.G.), Medical University of South Carolina
| | - Rufus O Akinyemi
- Department of Medicine, University College Hospital and University of Ibadan, Nigeria and Center for Genomic and Precision Medicine, College of Medicine (M.O.O., R.O.A.), University of Ibadan, Nigeria
- Department of Medicine, Federal Medical Center, and Sacred Heart Hospital, Abeokuta, Nigeria (R.O.A.)
| | - Joshua O Akinyemi
- Department of Epidemiology and Medical Statistics (J.O.A., O. Akpa), University of Ibadan, Nigeria
| | - Onoja Akpa
- Department of Epidemiology and Medical Statistics (J.O.A., O. Akpa), University of Ibadan, Nigeria
| | | | - Babatunde L Salako
- Department of Medicine (B.L.S., E.U., A.F.), University of Ibadan, Nigeria
| | - Oyedunni Arulogun
- Department of Health Promotion and Education (O. Arulogun), University of Ibadan, Nigeria
| | - Raelle Tagge
- Department of Neurosciences (R.T.), Medical University of South Carolina
| | - Ezinne Uvere
- Department of Medicine (B.L.S., E.U., A.F.), University of Ibadan, Nigeria
- Blossom Specialist Medical Center, First Center for Neurorehabilitation, Ibadan, Nigeria (M.O.O., E.U.)
| | - Adekunle Fakunle
- Department of Medicine (B.L.S., E.U., A.F.), University of Ibadan, Nigeria
| | - Bruce Ovbiagele
- Department of Neurology, University of California, San Francisco (B.O.)
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Michaelis R, Meyer S, Reuber M, Schöne C. Development of a patient-reported outcome measure for psychotherapeutic interventions in people with seizures: A mixed methods study. Epilepsy Behav 2019; 99:106464. [PMID: 31421518 DOI: 10.1016/j.yebeh.2019.106464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 07/28/2019] [Accepted: 07/28/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Generic or even disease-specific quality of life measures are unlikely to be equally responsive to different epilepsy treatment modalities, such as pharmacotherapy, surgery, or psychotherapy. The purpose of the present study was to summarize the development of a patient-reported outcome measure (PROM) designed to be particularly sensitive to change mediated by psychotherapeutic interventions in people with seizures. METHODS The development of this instrument involved seven steps: (1) Development of a candidate item set based on the outcome of previous qualitative research, (2) initial quantitative-descriptive study yielding an assessment of content validity by clinical experts, (3) qualitative-descriptive posttherapy cognitive debriefing interviews with patients with epileptic and/or nonepileptic seizures (NES), (4) English translation, (5) elicitation of qualitative feedback from international experts, (6) assessment of internal consistency and correlation with similar previously validated generic and epilepsy-specific measures in a pilot study, and (7) final expert content validity rating. RESULTS (1) The candidate item set comprised 29 stem items; five of which were followed by a follow-up (FU) item that refers to the statement of the stem item. (2) Eight clinical experts assessed content validity. Informed by rating and experts' qualitative comments, 15 items remained unchanged, eleven underwent substantial revisions, three were excluded, and six added. (3) Cognitive debriefing interviews were conducted with 14 patients with epilepsy and/or NES. Based on the interviewees' feedback, 29 of 32 items remained unchanged, two were excluded, one reworded, and four added. (4) The forwards-backwards English translation prompted substantial revision of two items because the verbatim back translation of the corresponding English items was conceptually more convincing than the original German wording. (5) The international experts identified problems with item comprehensibility/clarity of four stem and three FU items that were subsequently reworded. Ten items were added to incorporate their qualitative feedback resulting in a total of 44 items. (6) Thirty-one patients with epilepsy participated in the pilot study. The overall internal consistency of the self-Efficacy, Assertiveness, Social support, self-awareness, and hElpful thinking in people with seizures (EASE) was very good (α = 0.92). Analysis at item-level revealed problems with inverted and self-evident items. Based on this analysis, three items were eliminated and two items were revised (one FU item was turned into a stem item) resulting in a total of 42 items. (7) The second content validity rating showed final item-content validity indices (I-CVIs) between 0.38 and 1 and an excellent mean CVI of 0.92 at scale level (S-CVI/ave). Fourteen stem items were substantially revised by incorporating the experts' qualitative feedback, three items with low I-CVIs were excluded, and one item was added. The final questionnaire consisted of 40 stem items; eight of which include at least one FU item. CONCLUSION Based on these results, the EASE is valid in terms of content, internally consistent, clear, and acceptable to patients with seizures. The measure has now been developed to the stage at which the validity and reliability as well as the psychometric properties and factorial structure of the new instrument can be assessed in larger patient groups in a prospective clinical study.
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Affiliation(s)
- Rosa Michaelis
- Department of Neurology, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany; Integrated Curriculum for Anthroposophic Medicine (ICURAM), Witten/Herdecke University, Herdecke, Germany.
| | - Stephanie Meyer
- Department of Psychology, University of Kassel, Kassel, Germany
| | - Markus Reuber
- Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Catrin Schöne
- Hephata Klinik Schwalmstadt-Treysa, Schwalmstadt-Treysa, Germany
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Akinyemi R, Ojagbemi A, Akinyemi J, Salami A, Olopade F, Farombi T, Nweke M, Uvere E, Aridegbe M, Balogun J, Ogbole G, Jegede A, Kalaria R, Ogunniyi A, Owolabi M, Arulogun O. Gender differential in inclination to donate brain for research among Nigerians: the IBADAN Brain Bank Project. Cell Tissue Bank 2019; 20:297-306. [PMID: 31028517 DOI: 10.1007/s10561-019-09769-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/17/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Laboratory-based studies of neurological disease patterns and mechanisms are sparse in sub-Saharan Africa. However, availability of human brain tissue resource depends on willingness towards brain donation. This study evaluated the level of willingness among outpatient clinic attendees in a Nigerian teaching hospital. METHODS Under the auspices of the IBADAN Brain Bank Project, a 43-item semi-structured interviewer-administered questionnaire was designed to evaluate knowledge, attitude, and beliefs of individuals attending Neurology, Psychiatry and Geriatrics Outpatient clinics regarding willingness to donate brain for research. Association between participants characteristics and willingness towards brain donation was investigated using logistic regression models. Analysis was conducted using Stata SE version 12.0. RESULTS A total of 412 participants were interviewed. Their mean age was 46.3 (16.1) years. 229 (55.6%) were females and 92.5% had at least 6 years of formal education. Overall, 109 (26.7%) were willing to donate brains for research. In analyses adjusting for educational status, religion, ethnicity, marital status and family setting, male sex showed independent association with willingness towards brain donation OR (95% CI) 1.7 (1.08-2.69), p = 0.023. Participants suggested public engagement and education through mass media (including social media) and involvement of religious and community leaders as important interventions to improve awareness and willingness towards brain donation. CONCLUSION The survey revealed low willingness among outpatient clinic attendees to donate brain for research, although men were more inclined to donate. It is imperative to institute public engagement and educational interventions in order to improve consent for brain donation for research.
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Affiliation(s)
- Rufus Akinyemi
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria. .,Neuroscience and Ageing Research Unit, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Akin Ojagbemi
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Joshua Akinyemi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayodeji Salami
- Department of Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Funmi Olopade
- Department of Anatomy, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Temitope Farombi
- Chief Tony Anenih Geriatric Centre, University College Hospital, Ibadan, Nigeria
| | - Michael Nweke
- Department of Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ezinne Uvere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mayowa Aridegbe
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - James Balogun
- Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Godwin Ogbole
- Department of Radiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayodele Jegede
- Department of Sociology, Faculty of the Social Sciences, University of Ibadan, Ibadan, Nigeria
| | - Rajesh Kalaria
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Adesola Ogunniyi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mayowa Owolabi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oyedunni Arulogun
- Department of Health Promotion and Education, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Smith W, Turan JM, White K, Stringer KL, Helova A, Simpson T, Cockrill K. Social Norms and Stigma Regarding Unintended Pregnancy and Pregnancy Decisions: A Qualitative Study of Young Women in Alabama. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2016; 48:73-81. [PMID: 27166869 PMCID: PMC5022769 DOI: 10.1363/48e9016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 01/09/2016] [Accepted: 01/19/2016] [Indexed: 05/06/2023]
Abstract
CONTEXT Social norms and stigma may play important roles in reproductive health behavior and decision making among young women in the U.S. South, who disproportionately experience unintended pregnancies. No research has described the presence and manifestations of social norms and stigmas associated with unintended pregnancy and related decision making from the perspective of this population. METHODS Six focus groups and 12 cognitive interviews were conducted between December 2013 and July 2014 with 46 low-income women aged 19-24 living in Birmingham, Alabama; respondents were recruited from two public health department centers and a community college. Semistructured interview guides were used to facilitate discussion about social perceptions of unintended pregnancy and related pregnancy decisions. Sessions were audio-recorded, and transcripts were analyzed using a theme-based approach. RESULTS Participants described community expectations that pregnancy occur in the context of monogamous relationships, in which both partners are mature, educated and financially stable. However, respondents reported that unintended pregnancy outside of these circumstances was common, and that the community expected young women faced with unintended pregnancies to bear and raise their children. Women who chose to do so were viewed more positively than were women who chose abortion or adoption. The community generally considered these alternatives to parenting unacceptable, and participants discussed them in terms of negative labels, social judgment and nondisclosure. CONCLUSIONS Findings suggest a need to reduce stigma and create a social environment in which young women are empowered to make the best reproductive decisions for themselves.
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Affiliation(s)
- Whitney Smith
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Janet M. Turan
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Kari White
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Kristi L. Stringer
- Department of Medical Sociology, College of Arts and Sciences/Center for Outcomes and Effectiveness Research, University of Alabama at Birmingham, Birmingham, AL
| | - Anna Helova
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Tina Simpson
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
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