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Robles R, Infante S, Feria M, Arango I, Tirado E, Rodríguez-Delgado A, Miranda E, Fresán A, Becerra C, Escamilla R, Madrigal de León EA. Remote crisis intervention and suicide risk management in COVID-19 frontline healthcare workers. Front Psychol 2023; 14:1253179. [PMID: 38022932 PMCID: PMC10645097 DOI: 10.3389/fpsyg.2023.1253179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Despite the propagation of virtual mental health services for vulnerable groups during COVID-19 pandemic, the implementation and evaluation of remote evidence-based practices (EBP) to manage them in low- and middle-income countries remains scarce. In the current study, we describe and evaluate the implementation process and clinical impact of brief, remote, manualized EBP for crisis intervention and suicide risk management among healthcare workers attending patients with COVID-19 (COVID-19-HCWs) in Mexico. Methods The implementation process comprised community engagement of volunteer mental health specialists, creation of new clinical teams with different disciplines and skills, intervention systematization through manuals and education through 4-h remote training as main strategies. Mexican COVID-19-HCWs who had used a free 24-h helpline rated their pre- and post-intervention emotional distress. Therapists recorded patients' pre-intervention diagnosis, severity, and suicide risk, the techniques used in each case, and their post-treatment perception of COVID-19-HCWs' improvement at the end of the intervention. Results All techniques included in the intervention manual were employed at least in one case (n = 51). At the beginning of the intervention, 65.9% of the COVID-19-HCWs were considered moderately ill or worse according to Clinical Global Impression-Severity (CGI-S) scores, whereas at the end, 79.4% of them were perceived as much or very much improved according to CGI-Improvement scores (CGI-I), and their emotional distress had been significantly reduced (p < 0.001). Discussion This prospective study provides evidence that implementation of remote EBP is feasible and useful to reduce emotional distress and suicide risk among COVID-19-HCWs from a middle-income country. However, this study was limited by lack of a control group, improvement ratings provided by therapists and non-anonymous satisfaction ratings.
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Affiliation(s)
- Rebeca Robles
- Global Mental Health Research Center, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Sara Infante
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Miriam Feria
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Iván Arango
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Elsa Tirado
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Andrés Rodríguez-Delgado
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Edgar Miranda
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Ana Fresán
- Laboratory of Clinical Epidemiology, Subdirectorate of Clinical Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Claudia Becerra
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Raul Escamilla
- Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
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Robles R, Ascencio L, Díaz D, Ruiz S, Gálvez L, Sánchez M, Espinoza F, Hernández-Posadas A, Fresán A, Vega H, Morales-Chainé S. Implementation Science of Telepsychotherapy for Anxiety, Depression, and Somatization in Health Care Workers Dealing with COVID-19. Telemed J E Health 2022; 29:751-760. [PMID: 36126309 DOI: 10.1089/tmj.2022.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Cognitive behavioral therapy (CBT) has proven to be effective in treating affective and somatic symptoms, which are among the leading mental health problems of health care workers (HCWs) dealing with COVID-19 (HCW-COVID-19). However, efforts to develop and evaluate the strategies required to promote its implementation in clinical practice are still scarce, particularly in low- and middle-income countries. Objective: To describe and evaluate the implementation process and clinical impact of a brief, remote, manualized CBT-based intervention for moderate anxiety, depressive, and somatic symptoms among Mexican HCW-COVID-19 ≥18 years old. Methods: The implementation process comprises community engagement, intervention systematization and education, leadership engagement, and team-based coaching as main strategies. A total of 26 participants completed self-report measures of symptoms before and after treatment, and a subsample of 21 answered a final questionnaire on the acceptability of the intervention. Therapists registered the techniques used in each case, regardless of whether they were part of the intervention manual. Results: The number of sessions was 4.6 (2.43). The most frequently employed techniques were those included in the intervention manual, especially identifying and modifying maladaptive thoughts, used to treat 70% of HCW-COVID-19. Supplementary techniques were implemented to enhance treatment or meet HCW-COVID-19s special needs (such as workplace issues, insomnia, COVID-19 status, and bereavement). The intervention had a significant effect (delta Cohen's coefficients ≥1), and the majority of HCW-COVID-19 were "totally satisfied" with its contents and considered it "not complex" (95.2% and 76.1%, respectively). Conclusions: Telepsychotherapy for anxiety, depression, and somatization in HCW coping with health emergencies in middle-income countries is a feasible, clinically valuable, and acceptable form of treatment.
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Affiliation(s)
- Rebeca Robles
- Global Mental Health Research Center, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Leticia Ascencio
- Palliative Care Unit, National Cancer Institute, Mexico City, Mexico
| | - Dulce Díaz
- Global Mental Health Research Center, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Susan Ruiz
- Globality Studies Seminar, Medicine Faculty, National Autonomous University of Mexico, Mexico City, Mexico
| | - Lizette Gálvez
- Palliative Care Unit, National Cancer Institute, Mexico City, Mexico
| | - Magaly Sánchez
- Psycho-Onclology and Palliative Care Unit, Morelos Children's Hospital, Mexico City, Mexico
| | - Fátima Espinoza
- Coordination of Training Centers and Psychological Services, Psychology Faculty, National Autonomous University of Mexico, Mexico City, Mexico
| | - Alejandro Hernández-Posadas
- Coordination of Training Centers and Psychological Services, Psychology Faculty, National Autonomous University of Mexico, Mexico City, Mexico
| | - Ana Fresán
- Subdirectorate of Clinical Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Hamid Vega
- Global Mental Health Research Center, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Silvia Morales-Chainé
- Coordination of Training Centers and Psychological Services, Psychology Faculty, National Autonomous University of Mexico, Mexico City, Mexico
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Laird Y, Manner J, Baldwin L, Hunter R, McAteer J, Rodgers S, Williamson C, Jepson R. Stakeholders' experiences of the public health research process: time to change the system? Health Res Policy Syst 2020; 18:83. [PMID: 32682426 PMCID: PMC7368787 DOI: 10.1186/s12961-020-00599-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 07/03/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The importance of engaging stakeholders in the research process is well recognised. Whilst engagement is important, guidelines and practices vary for how stakeholders should be involved in research and how to facilitate effective collaborative relationships. METHODS This study aimed to explore the perspectives and experiences of stakeholders involved in the policy and practice area of outdoor space and non-communicable disease prevention. Stakeholders interviewed included academics, practitioners, policy-makers, knowledge brokers and a funder. RESULTS The findings suggest that stakeholders had positive experiences when engaged meaningfully in the research process, where research projects were carefully planned and managed with attention to context and culture, and where the research team was effective, respectful and communicative. These factors help to facilitate the translation of research into policy and practice. However, multiple challenges of collaborative research were identified which related to structural and systemic challenges, building and maintaining relationships, use and collection of data and information, cultural perceptions of research and research generation, and getting evidence into action. Participants felt that changing the funding system, exploring more collaborative research methodologies, improved research translation, and more effective collaborative relationships at all stages of the research process could address some of these challenges. CONCLUSIONS The findings highlight that, whilst stakeholder engagement in research was considered important, structural, cultural and individual practices impacted how this worked in practice. Identifying and testing solutions to address these challenges could improve synergies between research, policy, and practice and lead to the production of impactful research that reduces wastage of public funding, improves implementation of findings and ultimately improves public health outcomes.
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Affiliation(s)
- Yvonne Laird
- Sydney School of Public Health, Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Sydney, Australia.
| | - Jillian Manner
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Louise Baldwin
- School of Public Health and Social Work, Queensland University of Technology (QUT), Institute of Health and Biomedical Innovation, Brisbane, Australia
| | - Ruth Hunter
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - John McAteer
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Sarah Rodgers
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
| | - Chloë Williamson
- Physical Activity for Health Research Centre, Institute of Sport, Physical Education and Health Sciences, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, United Kingdom
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
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de Moissac D, Bowen S, Botting I, Graham ID, MacLeod M, Harlos K, Songok CM, Bohémier M. Evidence of commitment to research partnerships? Results of two web reviews. Health Res Policy Syst 2019; 17:73. [PMID: 31362791 PMCID: PMC6668137 DOI: 10.1186/s12961-019-0475-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partnerships between academic researchers and health system leadership are often promoted by health research funding agencies as an important strategy in helping ensure that funded research is relevant and the results used. While potential benefits of such partnerships have been identified, there is limited guidance in the scientific literature for either healthcare organisations or researchers on how to select, build and manage effective research partnerships. Our main research objective was to explore the health system perspective on partnerships with researchers with a focus on issues related to the design and organisation of the health system and services. Two structured web reviews were conducted as one component of this larger study. METHODS Two separate structured web reviews were conducted using structured data extraction tools. The first review focused on sites of health research bodies and those providing information on health system management and knowledge translation (n = 38) to identify what guidance to support partnerships might be available on websites commonly accessed by health leaders and researchers. The second reviewed sites from all health 'regions' in Canada (n = 64) to determine what criteria and standards were currently used in guiding decisions to engage in research partnerships; phone follow-up ensured all relevant information was collected. RESULTS Absence of guidance on partnerships between research institutions and health system leaders was found. In the first review, absence of guidance on research partnerships and knowledge coproduction was striking and in contrast with coverage of other forms of collaboration such as patient/community engagement. In the second review, little evidence of criteria and standards regarding research partnerships was found. Difficulties in finding appropriate contact information for those responsible for research and obtaining a response were commonly experienced. CONCLUSION Guidance related to health system partnerships with academic researchers is lacking on websites that should promote and support such collaborations. Health region websites provide little evidence of partnership criteria and often do not make contact information to research leaders within health systems readily available; this may hinder partnership development between health systems and academia.
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Affiliation(s)
- Danielle de Moissac
- Faculty of Sciences, Université de Saint-Boniface, 200 ave de la Cathédrale, Winnipeg, MB, R2H 0H7, Canada.
| | - Sarah Bowen
- Applied Research and Evaluation Consultant, 322 Al Bennett Rd. RR3, Centreville, NS B0P 1J0, Canada
| | - Ingrid Botting
- Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, 434-650 Main St, Winnipeg, Manitoba, R3B1E2, Canada
| | - Ian D Graham
- School of Epidemiology, Public Health and Preventive Medicine, School of Nursing, University of Ottawa, 451 Smyth, Ottawa, ON, K1H 8M5, Canada.,Centre for Practice-Changing Research, The Ottawa Hospital Research Institute, 501 Smyth Road, Box 241, Ottawa, Ontario, K1H 8L6, Canada
| | - Martha MacLeod
- School of Nursing, School of Health Sciences, UNBC Health Research Institute, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Karen Harlos
- Department of Business and Administration, Workplace Bullying and Mistreatment Partnership for Prevention (SSHRC), University of Winnipeg, 515 Portage Ave, Winnipeg, MB, R3B 2E9, Canada
| | - Charity Maritim Songok
- Max Rady College of Medicine, University of Manitoba, Room S113 - 750 Bannatyne Avenue, Winnipeg, MB, R3E 0W3, Canada
| | - Monique Bohémier
- Université de Saint-Boniface, 200 de la Cathédrale Avenue, Winnipeg, Manitoba, R2H 0H7, Canada
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Pinto RM, Spector AY, Rahman R. Nurturing Practitioner-Researcher Partnerships to Improve Adoption and Delivery of Research-Based Social and Public Health Services Worldwide. Int J Environ Res Public Health 2019; 16:E862. [PMID: 30857292 DOI: 10.3390/ijerph16050862] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/21/2019] [Accepted: 03/05/2019] [Indexed: 12/15/2022]
Abstract
Research-based practices—psychosocial, behavioral, and public health interventions—have been demonstrated to be effective and often cost-saving treatments, but they can take up to two decades to reach practitioners within the health and human services workforce worldwide. Practitioners often rely on anecdotal evidence and their “practice wisdom” rather than on research, and may thus unintentionally provide less effective or ineffective services. Worldwide, community engagement in research is recommended, particularly in low-resource contexts. However, practitioner involvement has not been adequately explored in its own right as an innovative community-engaged practice that requires a tailored approach. The involvement of practitioners in research has been shown to improve their use of research-based interventions, and thus the quality of care and client outcomes. Nevertheless, the literature is lacking specificity about when and how (that is, using which tasks and procedures) to nurture and develop practitioner–researcher partnerships. This paper offers theoretical and empirical evidence on practitioner–researcher partnerships as an innovation with potential to enhance each phase of the research cycle and improve services, using data from the United States, Brazil, and Spain. Recommendations for partnership development and sustainability are offered, and a case is made for involving practitioners in research in order to advance social justice by amplifying the local relevance of research, increasing the likelihood of dissemination to community settings, and securing the sustainability of research-based interventions in practice settings.
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Abstract
In 2012, the Centers for Disease Control and Prevention (CDC) began to de-emphasize and de-implement multiple evidence-based HIV prevention practices that had been around for 20 years, thus changing the scope of implementation across the globe. The authors provide evidence how existing interventions (e.g., CDC HIV interventions) may influence implementation of interventions that came after the program was discontinued. De-implementation is an ecological event that influences, and is influenced by, many parts of a system, for instance, implementation of one type of intervention may influence the implementation of other interventions (biomedical and/or behavioral) after a long-running program is discontinued. Researchers and policy makers ought to consider how de-implementation of behavioral interventions is influenced by biomedical interventions mass-produced by companies with lobbying power. The scientific study of de-implementation will be inadequate without consideration of the political climate that surrounds de-implementation of certain types of interventions and the promotion of more-profitable ones.
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Affiliation(s)
- Rogério M. Pinto
- School of Social WorkUniversity of Michigan‐Ann ArborAnn ArborMIUSA
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7
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Pinto RM, Witte SS, Wall MM, Filippone PL. Recruiting and retaining service agencies and public health providers in longitudinal studies: Implications for community-engaged implementation research. Method Innov 2018; 11. [PMID: 30009043 DOI: 10.1177/2059799118770996] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This article addresses a lack of attention in the implementation science literature regarding how to overcome recruitment and retention challenges in longitudinal studies involving large samples of service agencies and health service providers ("providers"). Herein, we provide a case-illustration of procedures that improved recruitment and retention in a longitudinal, mixed-method study-Project Interprofessional Collaboration Implementation-funded by the US National Institute of Mental Health. Project Interprofessional Collaboration Implementation included counselors, program workers, educators, and supervisors. We present a research-engagement model to overcome barriers that included developing a low-burden study, social gatherings to engage stakeholders, protocols to recruit agencies and providers, comprehensive record-keeping, research procedures as incentives to participation, a plan to retain hard-to-reach participants, and strategies for modifying incentives over time. Using our model, we retained 36 agencies over the life of the project. Between baseline (N = 379) and 12-month follow-up (N = 285), we retained 75% of the sample and between the 12- (N = 285) and 24-month follow-ups (N = 256), we retained 90%. For qualitative interviews (between baseline and 12-month follow-up and between 12- and 24-month follow-ups), we retained 100% of the sample (N = 20). We provide a summary of frequency of contacts required to initiate data collection and time required for data collection. The model responded to environmental changes in policy and priorities that would not have been achievable without the expertise of community partners. To recruit and retain large samples longitudinally, researchers must strategically engage community partners. The strategies imbedded in our model can be performed with moderate levels of effort and human resources. Creating opportunities for research partners to participate in all phases of the research cycle is recommended, which can help build research capacity for future research.
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Affiliation(s)
- Rogério M Pinto
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Susan S Witte
- School of Social Work, Columbia University, New York, NY, USA
| | - Melanie M Wall
- Department of Biostatistics, Mailman School of Public Health and Director of Mental Health Data Science in the Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute
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Crooks CV, Exner-Cortens D, Siebold W, Moore K, Grassgreen L, Owen P, Rausch A, Rosier M. The role of relationships in collaborative partnership success: Lessons from the Alaska Fourth R project. Eval Program Plann 2018; 67:97-104. [PMID: 29289925 DOI: 10.1016/j.evalprogplan.2017.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 12/07/2017] [Accepted: 12/19/2017] [Indexed: 05/14/2023]
Abstract
Collaborative partnerships are critical to achieving health equity. As such, it is important to understand what contributes to the success of such partnerships. This paper describes the Alaska Fourth R collaborative, a multisectoral group of agencies (including education, health and human services, the violence against women sector, the governor's council on domestic violence, and an external evaluator) that successfully planned, implemented and evaluated a multi-focus health education program statewide. The purpose of this paper was to explore the ways in which seven pre-identified factors contributed to the successful achievement of the collaborative's goals. This project was grounded in community-based research principles, and collectively, the group chose to use Roussos and Fawcett's (2000) seven-factor model as the basis for the project. Using this model as a guide, semi-structured interviews were conducted with five leaders from the key organizations in the collaborative. In interviews, stakeholders described how each of the seven factors functioned in the Alaska collaborative to contribute to project success, with a particular focus on the critical role of relationships. Three specific relationship facets emerged as cross-cutting themes: flexibility, transparency, and prioritization. In sum, taking the time to build deep and authentic relationships, and then developing a shared vision and mission within the context of relationships that are flexible, transparent and prioritized, provided a strong foundation for future success in this collaborative.
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Affiliation(s)
- Claire V Crooks
- Centre for School Mental Health, Western University, 1137 Western Road, London, ON N6G 1G7, Canada.
| | - Deinera Exner-Cortens
- Faculty of Social Work, University of Calgary, 2500 University Drive NW, PF3222, Calgary, AB T2N 1N4, Canada
| | - Wendi Siebold
- Strategic Prevention Solutions, 1752 NW Market Street #402, Seattle, WA 98107, United States
| | - Kami Moore
- SouthEast Alaska Regional Health Consortium, 3100 Channel Drive, Suite 300, Juneau, AK 99801, United States
| | - Lori Grassgreen
- Association of Alaska School Boards, 1111 W 9th St., Juneau, AK 99801, United States
| | - Patricia Owen
- Alaska Dept. of Ed. and Early Development, 801 West 10th St., Suite 200, Juneau, AK 99801, United States
| | - Ann Rausch
- State of Alaska Department of Public Safety, Council on Domestic Violence and Sexual Assault, 450 Whittier Street, Room 105, Juneau, AK 99801, United States
| | - Mollie Rosier
- Division of Public Health Section of Women's, Children's and Family Health, 3601C Street, Suite 322, Anchorage, AK 99503, United States
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Stolp S, Bottorff JL, Seaton CL, Jones-Bricker M, Oliffe JL, Johnson ST, Errey S, Medhurst K, Lamont S. Measurement and evaluation practices of factors that contribute to effective health promotion collaboration functioning: A scoping review. Eval Program Plann 2017; 61:38-44. [PMID: 27915114 DOI: 10.1016/j.evalprogplan.2016.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 11/14/2016] [Accepted: 11/21/2016] [Indexed: 06/06/2023]
Abstract
The purpose of this scoping review was to identify promising factors that underpin effective health promotion collaborations, measurement approaches, and evaluation practices. Measurement approaches and evaluation practices employed in 14 English-language articles published between January 2001 and October 2015 were considered. Data extraction included research design, health focus of the collaboration, factors being evaluated, how factors were conceptualized and measured, and outcome measures. Studies were methodologically diverse employing either quantitative methods (n=9), mixed methods (n=4), or qualitative methods (n=1). In total, these 14 studies examined 113 factors, 88 of which were only measured once. Leadership was the most commonly studied factor but was conceptualized differently across studies. Six factors were significantly associated with outcome measures across studies; leadership (n=3), gender (n=2), trust (n=2), length of the collaboration (n=2), budget (n=2) and changes in organizational model (n=2). Since factors were often conceptualized differently, drawing conclusions about their impact on collaborative functioning remains difficult. The use of reliable and validated tools would strengthen evaluation of health promotion collaborations and would support and enhance the effectiveness of collaboration.
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Affiliation(s)
- Sean Stolp
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, Canada.
| | - Joan L Bottorff
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, Canada; Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Cherisse L Seaton
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, Canada
| | | | - John L Oliffe
- School of Nursing, Faculty of Applied Science, University of British Columbia, Vancouver, Canada
| | - Steven T Johnson
- Centre for Nursing and Health Studies, Athabasca University, Athabasca, Alberta, Canada
| | - Sally Errey
- Prevention Programs, BC Cancer Agency, Canada
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10
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Bowen S, Botting I, Graham ID, Huebner LA. Beyond "Two Cultures": Guidance for Establishing Effective Researcher/Health System Partnerships. Int J Health Policy Manag 2017; 6:27-42. [PMID: 28005540 PMCID: PMC5193504 DOI: 10.15171/ijhpm.2016.71] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 05/31/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The current literature proposing criteria and guidelines for collaborative health system research often fails to differentiate between: (a) various types of partnerships, (b) collaborations formed for the specific purpose of developing a research proposal and those based on long-standing relationships, (c) researcher vs. decision-maker initiatives, and (d) the underlying drivers for the collaboration. METHODS Qualitative interviews were conducted with 16 decision-makers and researchers who partnered on a Canadian major peer-reviewed grant proposal in 2013. Objectives of this exploration of participants' experiences with health system research collaboration were to: (a) explore perspectives and experience with research collaboration in general; (b) identify characteristics and strategies associated with effective partnerships; and (c) provide guidance for development of effective research partnerships. Interviews were audio-recorded and transcribed: transcripts were qualitatively analyzed using a general inductive approach. RESULTS Findings suggest that the common "two cultures" approach to research/decision-maker collaboration provides an inadequate framework for understanding the complexity of research partnerships. Many commonly-identified challenges to researcher/knowledge user (KU) collaboration are experienced as manageable by experienced research teams. Additional challenges (past experience with research and researchers; issues arising from previous collaboration; and health system dynamics) may be experienced in partnerships based on existing collaborations, and interact with partnership demands of time and communication. Current research practice may discourage KUs from engaging in collaborative research, in spite of strong beliefs in its potential benefits. Practical suggestions for supporting collaborations designed to respond to real-time health system challenges were identified. CONCLUSION Participants' experience with previous research activities, factors related to the established collaboration, and interpersonal, intra- and inter-organizational dynamics may present additional challenges to research partnerships built on existing collaboration. Differences between researchers and KUs may pose no greater challenges than differences among KUs (at various levels, and representing diverse perspectives and organizations) themselves. Effective "relationship brokering" is essential for meaningful collaboration.
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Affiliation(s)
- Sarah Bowen
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Ingrid Botting
- Health Services Integration, Winnipeg Regional Health Authority, Winnipeg, MB, Canada.,Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Ian D Graham
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Lori-Anne Huebner
- eHealth Centre of Excellence, Centre for Family Medicine, Kitchener, ON, Canada
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11
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Pinto RM, Giménez S, Spector AY, Choi J, Martinez OJD, Wall M. HIV practitioners in Madrid and New York improving inclusion of underrepresented populations in research. Health Promot Int 2015; 30:695-705. [PMID: 24676278 PMCID: PMC4542922 DOI: 10.1093/heapro/dau015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Practitioners have frequent contact with populations underrepresented in scientific research--ethnic/racial groups, sexual minorities and others at risk for poor health and whose low participation in research does not reflect their representation in the general population. Practitioners aspire to partner with researchers to conduct research that benefits underrepresented groups. However, practitioners are often overlooked as a work force that can help erase inclusion disparities. We recruited (n = 282) practitioners (e.g. physicians, social workers, health educators) to examine associations between their attitudes toward research purposes, risks, benefits and confidentiality and their involvement in recruitment, interviewing and intervention facilitation. Participants worked in community-based agencies in Madrid and New York City (NYC), two large and densely populated cities. We used cross-sectional data and two-sample tests to compare attitudes toward research and practitioner involvement in recruiting, interviewing and facilitating interventions. We fit logistic regression models to assess associations between practitioner attitudes toward ethical practices and recruitment, interviewing and facilitating interventions. The likelihood of recruiting, interviewing and facilitating was more pronounced among practitioners agreeing more strongly with ethical research practices. Though Madrid practitioners reported stronger agreement with ethical research practices, NYC practitioners were more involved in recruiting, interviewing and facilitating interventions. Practitioners can be trained to improve attitudes toward ethical practices and increase inclusion of underrepresented populations in research. Funders and researchers are encouraged to offer opportunities for practitioner involvement by supporting research infrastructure development in local agencies. Practices that promise to facilitate inclusion herein may be used in other countries.
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Affiliation(s)
| | | | - Anya Y. Spector
- HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Jean Choi
- Division of Biostatistics, New York State Psychiatric Institute, New York, NY, USA
| | - Omar J. D. Martinez
- HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Melanie Wall
- Division of Biostatistics, New York State Psychiatric Institute, New York, NY, USA
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Mpofu E, Hallfors DD, Mutepfa MM, Dune TM. A Mixed Methods Mapping of Church versus Secular School Messages to Influence Sexual Decision-Making as Perceived by Zimbabwean Orphan Girl Students. J Mix Methods Res 2014; 8:363-376. [PMID: 25530739 PMCID: PMC4267058 DOI: 10.1177/1558689814539394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study examined the messages perceived by adolescent girls with orphanhood to influence their sexual decision-making. Participants were 125 students (mean age =14.7 years), 54% of whom attended church schools in a rural district of eastern Zimbabwe. We collected and analyzed data using concept mapping, a mixed method approach that enabled the construction of message clusters, with weighting for their relative importance. Messages that clustered under Biblical Teachings and Life Planning ranked highest in salience among students in both church and secular schools. Protecting Family Honor, HIV Prevention, and Social Stigma messages ranked next, respectively. Contrary to study hypotheses, the messages that orphan adolescent girls perceived to influence their sexual decisions did not vary by type of school attended.
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Affiliation(s)
- Elias Mpofu
- Faculty of Health Sciences, University of Sydney, Australia
| | | | | | - Tinashe Moira Dune
- Faculty of Health Sciences, University of Sydney, Australia
- University of New England, Australia
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13
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Witte SS, Wu E, El-Bassel N, Hunt T, Gilbert L, Medina KP, Chang M, Kelsey R, Rowe J, Remien R. Implementation of a couple-based HIV prevention program: a cluster randomized trial comparing manual versus Web-based approaches. Implement Sci 2014; 9:116. [PMID: 25208569 PMCID: PMC4172848 DOI: 10.1186/s13012-014-0116-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 08/23/2014] [Indexed: 12/03/2022] Open
Abstract
Background Despite great need, the number of HIV prevention implementation studies remains limited. The challenge for researchers, in this time of limited HIV services agency resources, is to conceptualize and test how to disseminate efficacious, practical, and sustainable prevention programs more rapidly, and to understand how to do so in the absence of additional agency resources. We tested whether training and technical assistance (TA) in a couple-based HIV prevention program using a Web-based modality would yield greater program adoption of the program compared to training and TA in the same program in a manual-based modality among facilitators who delivered the interventions at 80 agencies in New York State. Methods This study used a cluster randomized controlled design. Participants were HIV services agencies (N = 80) and up to 6 staff members at each agency (N = 253). Agencies were recruited, matched on key variables, and randomly assigned to two conditions. Staff members participated in a four-day, face-to-face training session, followed by TA calls at two and four months, and follow-up assessments at 6, 12, and 18 months post- training and TA. The primary outcomes examined number of couples with whom staff implemented the program, mean number of sessions implemented, whether staff implemented at least one session or whether staff implemented a complete intervention (all six sessions) of the program. Outcomes were measured at both the agency and participant level. Results Over 18 months following training and TA, at least one participant from 13 (33%) Web-based assigned agencies and 19 (48%) traditional agencies reported program use. Longitudinal multilevel analysis found no differences between groups on any outcomes at the agency or participant level with one exception: Web-based agencies implemented the program with 35% fewer couples compared with staff at manual-based agencies (IRR 0.35, CI, 0.13-0.94). Conclusion Greater implementation of a Web-based program may require more resources and staff exposure, especially when paired with a couple-based modality. Manual-based and traditional programs may hold some advantage or ease for implementation, particularly at a time of low economic resources. Trial registration ClinicalTrials.gov identifier: NCT01863537
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Affiliation(s)
- Susan S Witte
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Ave, New York 10027, NY, USA.
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Pinto RM, Spector AY, Yu G, Campbell ANC. Transdisciplinary collaboration and endorsement of pharmacological and psychosocial evidence-based practices by medical and psychosocial substance abuse treatment providers in the United States. Drugs (Abingdon Engl) 2013; 20:408-416. [PMID: 26778896 DOI: 10.3109/09687637.2013.783792] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS To examine the relative contribution of providers' professional affiliation (medical vs. non-medical), involvement in research, and training needs for associations with endorsement of the following evidence-based practices (EBPs): (1) pharmacological - buprenorphine treatment and (2) psychosocial - Cognitive Behavioural Therapy (CBT). METHODS Secondary analysis from a 2008 survey of a national sample (n = 571) of substance abuse treatment providers (medical, social workers, psychologists and counsellors) affiliated with the United States National Institute on Drug Abuse's National Drug Abuse Treatment Clinical Trials Network. Multivariate linear regression models to analyze cross-sectional survey data. FINDINGS Results demonstrated that medical providers and providers with previous research involvement more strongly endorsed the effectiveness of buprenorphine over CBT. Compared to medical providers, psychosocial providers more strongly endorsed CBT. There was a positive association between needing training in rapport with patients and endorsement of buprenorphine and a negative association with CBT. There was a positive association between needing training in behavioural management and needs assessment and endorsement of CBT. CONCLUSIONS Results underscore the importance of providers' involvement in research and the need for training medical and non-medical providers in practice areas that can purposely enhance their use of pharmacological and psychosocial EBPs.
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Affiliation(s)
- Rogério M Pinto
- Department of Social Work, Columbia University, New York City, NY, USA
| | - Anya Y Spector
- Department of Social Work, Columbia University, New York City, NY, USA; New York State Psychiatric Institute, HIV Center for Clinical and Behavioral Studies, New York City, NY, USA
| | - Gary Yu
- Department of Social Work, Columbia University, New York City, NY, USA
| | - Aimee N C Campbell
- New York State Psychiatric Institute, HIV Center for Clinical and Behavioral Studies, New York City, NY, USA
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