1
|
Breton M, Gaboury I, Beaulieu C, Deville-Stoetzel N, Martin E. Ten years later: A portrait of the implementation of the advanced access model in Quebec. Healthc Manage Forum 2023; 36:317-321. [PMID: 37326497 PMCID: PMC10446410 DOI: 10.1177/08404704231181676] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Since 2012, implementation of the advanced access model in primary care has been highly recommended across Canada to improve timely access. We present a portrait of the implementation of the advanced access model 10 years after its large-scale implementation across the province of Quebec. In total, 127 clinics participated in the study, with 999 family physicians and 107 nurse practitioners responding to the survey. Results show that opening schedules for appointments over a period of 2 to 4 weeks has largely been implemented. However, reserving consultation time for urgent or semi-urgent conditions was implemented by less than half and planning supply and demand for 20% or more of the upcoming year by fewer than one fifth of respondents. More strategies need to be put in place to react to imbalances when they occur. We demonstrate that strategies based on individual practice change are more often implemented than those requiring changes at the clinic.
Collapse
|
2
|
Tibbels NJ, Dosso A, Kra KW, Gbeke KD, Coffi G, Ngoran AR, Niamke JL, Nana M, Benié W, Hendrickson ZM, Naugle DA. "In our culture, if you quarantine someone, you stigmatize them": Qualitative insights on barriers to observing COVID-19 prevention behaviors in Côte d'Ivoire. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000489. [PMID: 36962697 PMCID: PMC10022382 DOI: 10.1371/journal.pgph.0000489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/13/2022] [Indexed: 11/19/2022]
Abstract
While vaccines are now authorized for use against the SARS-CoV2 virus, they remain inaccessible for much of the world and widespread hesitancy persists. Ending the COVID-19 pandemic depends on continued prevention behaviors such as mask wearing, distancing, hand hygiene, and limiting large gatherings. Research in low- and middle-income countries has focused on the prevalence of adherence and demographic determinants, but there is a need for a nuanced understanding of why people do or do not practice a given prevention behavior. The Breakthrough ACTION project led by Johns Hopkins Center for Communication Programs conducted a qualitative study in November 2020 in Côte d'Ivoire to explore people's experience with and perceptions of the COVID-19 pandemic. We conducted 24 focus group discussions and 29 in-depth interviews with members of the general population and health providers. This analysis explores barriers and facilitators to seven recommended prevention behaviors with a particular focus on response efficacy, self-efficacy, and social norms. We found these constructs to be salient for participants who generally felt that the behaviors were useful for preventing COVID-19 but were difficult to practice for a variety of reasons. The perception that COVID-19 prevention behaviors were anti-social emerged as a key theme. Behavior change interventions must reframe the recommended behaviors as pro-social, while making them very easy to practice by removing social and structural barriers such as the expense or inaccessibility of masks and hand sanitizer.
Collapse
Affiliation(s)
- Natalie Jean Tibbels
- Center for Communication Programs, Health, Behavior & Society Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Abdul Dosso
- Center for Communication Programs-Côte d'Ivoire, Johns Hopkins Bloomberg School of Public Health, Abidjan, Côte d'Ivoire
| | - Kouamé Walter Kra
- Department of Sociology, Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | | | - Gervais Coffi
- Department of Sociology, Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - Alex Romeo Ngoran
- Department of Sociology, Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - Jean Louis Niamke
- Department of Sociology, Université de Cocody, Abidjan, Côte d'Ivoire
| | - Marjorie Nana
- Center for Communication Programs, Health, Behavior & Society Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - William Benié
- Center for Communication Programs-Côte d'Ivoire, Johns Hopkins Bloomberg School of Public Health, Abidjan, Côte d'Ivoire
| | - Zoé Mistrale Hendrickson
- Center for Communication Programs, Health, Behavior & Society Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Danielle Amani Naugle
- Center for Communication Programs, Health, Behavior & Society Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| |
Collapse
|
3
|
Nguyen QA, Hens L, Nguyen N, MacAlister C, Lebel L. Explaining Intentions by Vietnamese Schoolchildren to Adopt Pro-Environmental Behaviors in Response to Climate Change Using Theories of Persuasive Communication. ENVIRONMENTAL MANAGEMENT 2020; 66:845-857. [PMID: 32686001 DOI: 10.1007/s00267-020-01334-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
Climate change adaptation capacity remains low among vulnerable communities in developing countries such as Vietnam. Vector-borne diseases as dengue fever are increasing as a result of changing weather patterns. This study aims to examine the impact of key psychological variables in the Theory of Reasoned Action, the Theory of Planned Behavior, an Extended Parallel Process Model and the Social Cognitive Theory on the intention of schoolchildren to engage in climate change adaptation behavior-in this study, practices which would help reduce the risks of contracting dengue fever. It also seeks to identify the most salient predictors of the behavioral intention across these theories. Data were obtained from 796 Vietnamese schoolchildren who completed questionnaires measuring constructs of the four theories. Multivariate data analysis demonstrated that self-efficacy and severity appeared to be significant and consistent predictors of the individual's intention to reduce dengue fever. The results provide practical suggestions for the use of the theorical constructs tested in climate change communication campaigns in Vietnam and insights generally on pro-environmental behavior change.
Collapse
Affiliation(s)
- Quynh Anh Nguyen
- National Institute for Science and Technology Policy and Strategy Study (NISTAPSS), 38 Ngo Quyen, Hanoi, Vietnam.
| | - Luc Hens
- Department of Human Ecology, Universidade of Nova De Lisboa, Campus de Campolide, 1099-085, Lisboa, Portugal
| | - Ninh Nguyen
- Department of Economics, Finance and Marketing, La Trobe Business School, La Trobe University, Plenty Road, Bundoora, VIC, 3086, Australia.
- Business Sustainability Research Group, Thuongmai University, 79 Ho Tung Mau Road, Hanoi, 100000, Vietnam.
| | - Charlotte MacAlister
- International Development Research Centre (IDRC), 150 Kent Street, Ottawa, ON, Canada
| | - Louis Lebel
- Unit for Social and Environmental Research (USER), School of Public Policy, Chiang Mai University, 239 Huay Kaew Road, Muang District, Chiang Mai, 50200, Thailand
| |
Collapse
|
4
|
Termeh Zonouzy V, Niknami S, Ghofranipour F, Montazeri A. An educational intervention based on the extended parallel process model to improve attitude, behavioral intention, and early breast cancer diagnosis: a randomized trial. Int J Womens Health 2019; 11:1-10. [PMID: 30588127 PMCID: PMC6302829 DOI: 10.2147/ijwh.s182146] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Breast cancer is an important public health problem worldwide. This study aimed to assess the effectiveness of an educational intervention based on fear appeals using the extended parallel process model (EPPM) to improve attitudes, intention, and early breast cancer diagnosis in Iranian women. METHODS This was a cluster-randomized trial conducted in Tehran, Iran. A sample of women 40 years old and above was recruited and assigned either to intervention group or to control group. The intervention group received two pamphlets containing fear appeals specially designed for this study using the EPPM. The control group received nothing. The primary outcomes were changes in attitude, behavioral intention, and early breast cancer diagnosis. Participants responded to a questionnaire before intervention and at 3 months follow-up assessments. Independent t-tests and paired t-tests were used for comparison. RESULT In all, 600 women were entered into the study (277 in the intervention group and 323 in the control group). Of these, 162 were lost to follow-up assessment. Thus, the analysis was restricted to those for whom both baseline and follow-up information was available (n=438). The mean age of participants was 53.2 (SD=9.45) years, and the mean year education of participants was 9.4 (SD=4.12) years. There were no significant differences between two groups regarding demographic variables. However, comparing outcome variables (attitude, intention, and early breast cancer diagnosis) at baseline and follow-up assessments, we found that the intervention group showed significant improvements in attitude and intention (P=0.01 and P=0.001, respectively), but no significant improvement was observed for early breast cancer diagnosis (P=0.78). The control group did not show any changes. CONCLUSION The findings showed that fear appeals could not influence early breast cancer diagnosis among women. However, significant changes were observed for attitude and behavioral intention.
Collapse
Affiliation(s)
- Vahideh Termeh Zonouzy
- Department of Health Education and Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,
| | - Shamsaddin Niknami
- Department of Health Education and Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,
| | - Fazlollah Ghofranipour
- Department of Health Education and Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran,
| |
Collapse
|
5
|
Gould GS, Watt K, McEwen A, Cadet-James Y, Clough AR. Validation of risk assessment scales and predictors of intentions to quit smoking in Australian Aboriginal and Torres Strait Islander peoples: a cross-sectional survey protocol. BMJ Open 2014; 4:e004887. [PMID: 24902729 PMCID: PMC4054635 DOI: 10.1136/bmjopen-2014-004887] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Tobacco smoking is a very significant behavioural risk factor for the health of Australian Aboriginal and Torres Strait Islanders, and is embedded as a social norm. With a focus on women of childbearing age, and men of similar age, this project aims to determine how Aboriginal and Torres Strait Islander smokers assess smoking risks and how these assessments contribute to their intentions to quit. The findings from this pragmatic study should contribute to developing culturally targeted interventions. METHODS AND ANALYSIS A cross-sectional study using quantitative and qualitative data. A total of 120 Aboriginal and Torres Strait Islander community members aged 18-45 years will be recruited at community events and through an Aboriginal Community Controlled Health Service (ACCHS). Participants will be interviewed using a tablet computer or paper survey. The survey instrument uses modified risk behaviour scales, that is, the Risk Behaviour Diagnosis (RBD) scale and the Smoking Risk Assessment Target (SRAT) (adapted from the Risk Acceptance Ladder) to determine whether attitudes of Aboriginal and Torres Strait Islander smokers to health risk messages are predictors of intentions to quit smoking. The questionnaire will be assessed for face and content validity with a panel of Indigenous community members. The internal consistency of the RBD subscales and their patterns of correlation will be explored. Multivariate analyses will examine predictors of intentions to quit. This will include demographics such as age, gender, nicotine dependence, household smoking rules and perceived threat from smoking and efficacy for quitting. The two risk-assessment scales will be examined to see whether participant responses are correlated. ETHICS AND DISSEMINATION The Aboriginal Health & Medical Research Council Ethics Committee and university ethics committees approved the study. The results will be published in a peer-reviewed journal and a community report will be disseminated by the ACCHS, and at community forums. NOTE ABOUT TERMINOLOGY We use the term Aboriginal and Torres Strait Islander peoples, except where previous research has reported findings from only one group for example, Aboriginal people. Indigenous is used here to refer to Indigenous peoples in the international context, and issues, policies or systems, for example, Indigenous health, Indigenous tobacco control.
Collapse
Affiliation(s)
- Gillian Sandra Gould
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns, Queensland, Australia
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Kerrianne Watt
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia
| | - Andy McEwen
- Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
| | - Yvonne Cadet-James
- School of Indigenous Australian Studies, James Cook University, Townsville, Queensland, Australia
| | - Alan R Clough
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
| |
Collapse
|
6
|
Walters ST, Ondersma SJ, Ingersoll KS, Rodriguez M, Lerch J, Rossheim ME, Taxman FS. MAPIT: development of a web-based intervention targeting substance abuse treatment in the criminal justice system. J Subst Abuse Treat 2013; 46:60-5. [PMID: 23954392 DOI: 10.1016/j.jsat.2013.07.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 06/28/2013] [Accepted: 07/02/2013] [Indexed: 10/26/2022]
Abstract
Although drug and alcohol treatment are common requirements in the U.S. criminal justice system, only a minority of clients actually initiate treatment. This paper describes a two-session, web-based intervention to increase motivation for substance abuse treatment among clients using illicit substances. MAPIT (Motivational Assessment Program to Initiate Treatment) integrates the extended parallel process model, motivational interviewing, and social cognitive theory. The first session (completed near the start of probation) targets motivation to complete probation, to make changes in substance use (including treatment initiation), and to obtain HIV testing and care. The second session (completed approximately 30days after session 1) focuses on goal setting, coping strategies, and social support. Both sessions can generate emails or mobile texts to remind clients of their goals. MAPIT uses theory-based algorithms and a text-to-speech engine to deliver custom feedback and suggestions. In an initial test, participants indicated that the program was respectful, easy to use, and would be helpful in making changes in substance use. MAPIT is being tested in a randomized trial in two large U.S. probation agencies. MAPIT addresses the difficulties of many probation agencies to maximize client involvement in treatment, in a way that is cost effective and compatible with the existing service delivery system.
Collapse
Affiliation(s)
- Scott T Walters
- University of North Texas Health Science Center, School of Public Health, Fort Worth, TX 76107-2699.
| | | | | | | | | | | | | |
Collapse
|
7
|
Macdonell K, Chen X, Yan Y, Li F, Gong J, Sun H, Li X, Stanton B. A Protection Motivation Theory-Based Scale for Tobacco Research among Chinese Youth. ACTA ACUST UNITED AC 2013; 4:154. [PMID: 24478933 PMCID: PMC3903136 DOI: 10.4172/2155-6105.1000154] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Rates of tobacco use among adolescents in China and other lower and middle-income countries remain high despite notable prevention and intervention programs. One reason for this may be the lack of theory-based research in tobacco use prevention in these countries. In the current study, a culturally appropriate 21-item measurement scale for cigarette smoking was developed based on the core constructs of Protection Motivation Theory (PMT). The scale was assessed among a sample of 553 Chinese vocational high school students. Results from correlational and measurement modeling analysis indicated adequate measurement reliability for the proposed PMT scale structure. The two PMT Pathways and the seven PMT constructs were significantly correlated with adolescent intention to smoke and actual smoking behavior. This study is the first to evaluate a PMT scale for cigarette smoking among Chinese adolescents. The scale provides a potential tool for assessing social cognitive processes underlying tobacco use. This is essential for understanding smoking behavior among Chinese youth and to support more effective tobacco use prevention efforts. Additional studies are needed to assess its utility for use with Chinese youth in other settings.
Collapse
Affiliation(s)
- Karen Macdonell
- Department of Pediatrics, Wayne State University, Detroit, MI, USA
| | - Xinguang Chen
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Yaqiong Yan
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Fang Li
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Jie Gong
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Huiling Sun
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Xiaoming Li
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Bonita Stanton
- Department of Pediatrics, Wayne State University, Detroit, MI, USA
| |
Collapse
|
8
|
Weiner EA, Billamay S, Partridge JC, Martinez AM. Antenatal education for expectant mothers results in sustained improvement in knowledge of newborn care. J Perinatol 2011; 31:92-7. [PMID: 20689517 DOI: 10.1038/jp.2010.108] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Basic perinatal education to increase parental knowledge of neonatal illnesses (such as respiratory distress, sepsis, complications of prematurity) could be a feasible way to reduce high neonatal mortality rates in limited-resource nurseries. To assess the efficacy of antenatal education in increasing mothers' knowledge of basic newborn care in a limited-resource nursery, and to determine whether the knowledge is retained postpartum. STUDY DESIGN In March to April 2008, we implemented a 10-min educational program on basic neonatal care for women receiving prenatal care in a maternal child hospital in Vientiane, Laos. The educational intervention was a structured, face-to-face interactive module taught by Lao providers using pictographic and written materials about temperature control, umbilical cord care and signs of neonatal illness. We assessed knowledge before and immediately after the module using a standardized interview tool. When possible, we reassessed knowledge postpartum to determine whether they retained information after the training. RESULT We recruited 101 women (average age=26.3 years), and the majority (53%) were primigravidas. Participants were well educated by local standards; 57% of women had >8 years and 28% had >12 years of education. Women's knowledge of neonatal care increased by 10% on immediate posttest (P<0.0001), especially regarding knowledge of umbilical cord care and temperature control (normal temperature ranges, thermometer use). Maternal education (P=0.025) and previous births (P=0.037) correlated positively with higher pretest scores. Higher maternal education correlated with higher posttest scores (P=0.01); however, less-educated women increased their scores as much as did women with more education. Nulliparous women also increased their posttest scores to comparable levels in women with previous deliveries. Women retested after delivery retained the educational message, achieving similar posttest and postdelivery scores (P=0.08). CONCLUSION Brief antenatal education increases mothers' understanding of basic newborn care. Mothers retain this knowledge into the early postpartum period and during early infancy when it might help reduce morbidity and mortality. The education was efficacious for women with little education. Brief antenatal educational modules seem a feasible, sustainable means of improving mothers' knowledge of newborn care. We speculate that similar programs could improve neonatal morbidity and mortality in developing countries.
Collapse
Affiliation(s)
- E A Weiner
- Department of Pediatrics, University of California San Francisco, San Francisco, CA 94110, USA.
| | | | | | | |
Collapse
|
9
|
Weir SS, Figueroa JP, Byfield L, Hall A, Cummings S, Suchindran C. Randomized controlled trial to investigate impact of site-based safer sex programmes in Kingston, Jamaica: trial design, methods and baseline findings. Trop Med Int Health 2008; 13:801-13. [DOI: 10.1111/j.1365-3156.2008.02057.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|