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Rice KL, Ottley P, Bing M, McMonigle M, Miller GF. Costs of Implementing Teen Dating Violence and Youth Violence Prevention Strategies: Evidence From 5 CDC-Funded Local Health Departments. Public Health Rep 2024; 139:351-359. [PMID: 37846099 PMCID: PMC11037232 DOI: 10.1177/00333549231201615] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVES In 2016, the Centers for Disease Control and Prevention supported 5 local health departments (LHDs) to implement teen dating violence and youth violence primary prevention strategies across multiple levels of the social-ecological model and build capacity for the expansion of such prevention efforts at the local level. The objective of this study was to estimate the total cost of implementing primary prevention strategies for all LHDs across 3 years of program implementation. METHODS We used a microcosting analytic approach to identify resources and compute costs for all prevention strategies implemented by LHDs. We computed the total program cost, total and average cost per strategy by social-ecological model level, and average cost of implementation per participant served by the program. All costs were inflated via the monthly Consumer Price Index and reported in August 2020 dollars. RESULTS For 3 years of program implementation, the total estimated cost of implementing teen dating violence and youth violence primary prevention strategies was >$7.1 million across all 5 LHDs. The largest shares of program-related costs were program staff (55.9%-57.0%) and contracts (22.4%-25.5%). Among prevention strategies, the largest share of total costs was for strategies implemented at the community level of the social-ecological model (42.8%). CONCLUSIONS The findings from this analysis provide a first look at the total costs of implementing comprehensive teen dating violence and youth violence primary prevention strategies and serve as a foundation for investments in local violence prevention funding for young people.
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Affiliation(s)
- Ketra L. Rice
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Phyllis Ottley
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Melissa Bing
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Megan McMonigle
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gabrielle F. Miller
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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2
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Buckley PR, Combs KM, Drewelow KM, Hubler BL, Lain MA. Validity Evidence for an Observational Fidelity Measure to Inform Scale-Up of Evidence-Based Interventions. Eval Rev 2024:193841X241248864. [PMID: 38687041 DOI: 10.1177/0193841x241248864] [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] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
As evidence-based interventions are scaled, fidelity of implementation, and thus effectiveness, often wanes. Validated fidelity measures can improve researchers' ability to attribute outcomes to the intervention and help practitioners feel more confident in implementing the intervention as intended. We aim to provide a model for the validation of fidelity observation protocols to guide future research studying evidence-based interventions scaled-up under real-world conditions. We describe a process to build evidence of validity for items within the Session Review Form, an observational tool measuring fidelity to interactive drug prevention programs such as the Botvin LifeSkills Training program. Following Kane's (2006) assumptions framework requiring that validity evidence be built across four areas (scoring, generalizability, extrapolation, and decision), confirmatory factor analysis supported the hypothesized two-factor structure measuring quality of delivery (seven items assessing how well the material is implemented) and participant responsiveness (three items evaluating how well the intervention is received), and measurement invariance tests suggested the structure held across grade level and schools serving different student populations. These findings provide some evidence supporting the extrapolation assumption, though additional research is warranted since a more complete overall depiction of the validity argument is needed to evaluate fidelity measures.
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Affiliation(s)
- Pamela R Buckley
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, USA
| | - Katie Massey Combs
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, USA
| | - Karen M Drewelow
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, USA
| | - Brittany L Hubler
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, USA
| | - Marion Amanda Lain
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, USA
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3
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Mittra ES, Wong RKS, Winters C, Brown A, Murley S, Kennecke H. Establishing a robust radioligand therapy program: A practical approach for North American centers. Cancer Med 2024; 13:e6780. [PMID: 38214130 PMCID: PMC10905220 DOI: 10.1002/cam4.6780] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 11/08/2023] [Accepted: 11/21/2023] [Indexed: 01/13/2024] Open
Abstract
Radioligand therapy (RLT) is a targeted approach to treating cancer that has been shown to be safe and effective in a variety of disease states, including gastroenteropancreatic neuroendocrine tumors, lymphoma, and most recently, advanced prostate cancer. In the United States, patient access to this therapy is currently variable. Implementation of new RLT programs and expansion of existing programs are needed to broaden patient access to and standardize the delivery of RLT, especially as new therapies are introduced into clinical practice. Drawing from experience in establishing RLT programs in different settings, we have developed practical recommendations for building and implementing a robust RLT program. In this review, we present our recommendations for minimal requirements and optimal requirements, as well as system considerations, and special issues associated with implementing an RLT program in North American centers.
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Affiliation(s)
- Erik S. Mittra
- Department of Diagnostic RadiologyOregon Health & Science UniversityPortlandOregonUSA
| | - Rebecca K. S. Wong
- Department of Radiation Oncology, Princess Margaret Cancer CentreUniversity of TorontoTorontoOntarioCanada
| | - Celeste Winters
- Department of Diagnostic RadiologyOregon Health & Science UniversityPortlandOregonUSA
| | - Adam Brown
- Department of Diagnostic RadiologyOregon Health & Science UniversityPortlandOregonUSA
| | - Shondra Murley
- Department of Nuclear MedicineWest Tennessee HealthcareJacksonTennesseeUSA
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4
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Ong CY, Lai J, Lee DWC, Lee JMH. Bridging Hospital and Nursing Home: Collaboration for Smoother Transitions and Reduced Hospitalizations. J Am Med Dir Assoc 2024:104924. [PMID: 38310943 DOI: 10.1016/j.jamda.2023.12.012] [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: 10/31/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 02/06/2024]
Abstract
The exigencies of managing acutely ill residents within nursing homes have led to an increase in ambulance conveyances to the emergency department. This is further compounded by a shortage of adequately trained nursing staff and on-site physicians available around the clock. An acute regional hospital, strategically located in the epicenter of nursing home facilities in Singapore, encountered this challenge on its inception in 2018 within the northeast region. In response, the institution initiated a collaboration, EAGLEcareACT (Enhancing Advance Care Planning, Geriatrics, and End-of-Life Care Acute Care Team), aimed at rectifying the prevailing care disparities between neighboring nursing homes and the hospital. Within the EAGLEcareACT, a systematic and comprehensive approach was undertaken to engage diverse nursing homes, delineate precise needs, and establish mutually shared objectives. This encompassed the provisioning of monitoring of patients treated for acute medical conditions, structured training programs for nursing staff and aids in advance care planning. Teleconsultations with EAGLEcareACT team obviate the immediate necessity for conveyance to the emergency department.
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Affiliation(s)
- Chong Yau Ong
- Department of Transitional Care Community Medicine, Sengkang General Hospital, Singapore.
| | - Jieru Lai
- Department of Transitional Care Community Medicine, Sengkang General Hospital, Singapore
| | | | - Jean Mui Hua Lee
- Department of Transitional Care Community Medicine, Sengkang General Hospital, Singapore
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5
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Hellem A, Whitfield C, Mansour M, Curran Y, Dinh M, Warden K, Skolarus LE. Determinants of Bluetooth-Enabled Self-Measured Blood Pressure Monitoring in Federally Qualified Health Centers. J Prim Care Community Health 2024; 15:21501319241229921. [PMID: 38400549 PMCID: PMC10894531 DOI: 10.1177/21501319241229921] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND In 2021, the Health Resources and Services Administration (HRSA) launched the National Hypertension Control Initiative (HTN Initiative) with the goal to enhance HTN control through Bluetooth-enabled self-measured blood pressure (BT-SMBP) monitoring and use this data to inform clinical decisions in Federally Qualified Health Centers (FQHCs) with a large proportion of their population with uncontrolled blood pressure (BP). We sought to understand the experience of Michigan-based FQHCs in implementing the HTN initiative. METHODS Staff from three Michigan-based FQHCs were invited to participate in semi-structured interviews from September to November 2022. Interviews were conducted in-person and were based on the Tailored Implementation in Chronic Diseases framework. Content analysis was performed by three coders. RESULTS Ten staff participated in interviews (FQHC 1: n = 6, FQHC 2: n = 1, FQHC 3: n = 3). The FQHCs differed in their stage of implementation and their approach. FQHC 1 created a large-scale, community health worker driven program, FQHC 2 created a small-scale, short term, BP device loan program, and FQHC 3 created a primarily outsourced, large-scale program through a contracted partner. Positive staff attitudes and outcome expectations, previous experience with SMBP grants, supportive clinic leadership, social support, and free BP cuff resources were identified as facilitators to implementation. Patients' high social needs, SMBP-related Technology, and insufficient workforce and staff capacity were identified as barriers. CONCLUSION BT-SMBP among FQHC patients is promising but challenges in integrating SMBP data into clinic workflow, workforce capacity to support the high social needs of participants, and to assist in reacting to the more frequent BP data remain to be overcome.
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Affiliation(s)
- Abby Hellem
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Candace Whitfield
- Department of Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Maria Mansour
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Yvonne Curran
- Davee Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Mackenzie Dinh
- Department of Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - Lesli E Skolarus
- Davee Department of Neurology, Northwestern University, Chicago, IL, USA
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6
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Mattheus D, Loos JR, Vogeler A. The Development and Implementation of a School-Based Dental Sealant Program for Hawaii Public Schools. J Sch Health 2024; 94:87-95. [PMID: 37857279 DOI: 10.1111/josh.13401] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND School-based dental sealant programs are noted to increase sealant uptake among children, especially those from low-income families and those living in rural and underserved areas. However, nationally school-based dental sealant programs are substantially underutilized. This paper describes a partnership approach to a school-based dental sealant program for Title 1 public schools in Hawaii. METHODS The Hawaii Keiki: Healthy and Ready to Learn program partnered with the Hawaii Dental Service to develop and implement an interprofessional, school-based sealant program (SBSP). This article describes the development of key factors, such as partnerships, an interprofessional team, team roles, policies, and marketing tools to optimize program success. RESULTS The SBSP has completed over 3 academic years of implementation in Hawaii public schools. In its initial year (school year [SY] 2019-2020), which presented challenges due to the COVID-19 pandemic, it served 6 schools (106 students screened) on 1 island. It expanded to 14 schools on 1 island (193 students screened) in its second year (SY 2020-2021), 28 schools on 3 islands (653 students screened) in its third year (SY 2021-2022), and during the Fall of the fourth year, the program reached 50 schools on 3 islands (1821 students screened) and is projected to reach over 70 schools by the end of SY 2022-2023. CONCLUSION Taking advantage of strategic partnerships and key interprofessional team members, a school-based dental sealant program can help to improve the oral health of children in public schools by helping to decrease barriers to care.
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Affiliation(s)
- Deborah Mattheus
- Hawaii Keiki: Healthy & Ready to Learn, Professor, Nancy Atmospera-Walch School of Nursing (NAWSON), University of Hawaii at Manoa (UHM), HI. Honolulu, Honolulu, HI; NAWSON, UHM
| | | | - Azeema Vogeler
- Hawaii Keiki: Healthy & Ready to Learn, Nancy Atmospera-Walch School of Nursing (NAWSON), University of Hawaii at Manoa (UHM), HI. Honolulu, Honolulu, HI; NAWSON, UHM
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7
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Parks CA, Mitchell E, Byker Shanks C, Budd Nugent N, Reynolds M, Sun K, Zhang N, Yaroch AL. Which Program Implementation Factors Lead to more Fruit and Vegetable Purchases? An Exploratory Analysis of Nutrition Incentive Programs across the United States. Curr Dev Nutr 2023; 7:102040. [PMID: 38130331 PMCID: PMC10733675 DOI: 10.1016/j.cdnut.2023.102040] [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: 07/28/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 12/23/2023] Open
Abstract
Background Nutrition incentive (NI) programs help low-income households better afford fruits and vegetables (FVs) by providing incentives to spend on FVs (e.g., spend $10 to receive an additional $10 for FVs). NI programs are heterogeneous in programmatic implementation and operate in food retail outlets, including brick-and-mortar and farm-direct sites. Objective This study aimed to explore NI program implementation factors and the amount of incentives redeemed. Methods A total of 28 NI projects across the United States including 487 brick-and-mortar and 1078 farm-direct sites reported data between 2020 and 2021. Descriptive statistics and linear regression analyses (outcome: incentives redeemed) were applied. Results Traditional brick-and-mortar stores had 0.48 times the incentives redeemed compared with small brick-and-mortar stores. At brick-and-mortar sites, automatic discounts had 3.47 times the incentives redeemed compared with physical discounts; and auxiliary services and marketing led to greater redemption. Farm-direct sites using multilingual and direct promotional marketing had greater incentives redeemed. Conclusions To our knowledge, this is the first national study to focus on NI program implementation across sites nationwide. Factors identified can help inform future programming and research.
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Affiliation(s)
| | - Elise Mitchell
- Gretchen Swanson Center for Nutrition, Omaha, NE United States
| | | | | | - Megan Reynolds
- Gretchen Swanson Center for Nutrition, Omaha, NE United States
| | - Kiki Sun
- Division of Biostatistics & Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Nanhua Zhang
- Division of Biostatistics & Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Amy L Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, NE United States
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Roderick E, Ricaurte D, Croteau A, Gates J, Bass S, Jain AK, Keating J. The Implementation of a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) Program at a Level 1 New England Trauma Center: Feasibility and Early Outcomes. Am Surg 2023; 89:5474-5479. [PMID: 36757849 DOI: 10.1177/00031348231156759] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVES We evaluated the feasibility of implementing a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) program at our urban level 1 trauma center and evaluated early outcomes. DESIGN A multidisciplinary committee including physicians (trauma surgery, emergency medicine, vascular surgery, and interventional radiology) and nurses created clinical practice guidelines for the placement of REBOA at our institution. All trauma surgeons and critical care board certified emergency medicine physicians were trained in placement and nurses received management training. A formal review process was implemented to identify areas for improvement. Finally, we instituted refresher training to maintain REBOA competency. Trauma patients with noncompressible torso hemorrhage from blunt or penetrating injuries who were partial or nonresponders to blood product resuscitation were included. Pregnant patients, children, or patients with significant hemothorax or suspected aortic or cardiac injury were excluded. RESULTS Over seven months, eight catheters were successfully placed, all on the first attempt, including six in Zone 3 and two in Zone 1. All Zone 3 catheters were placed for pelvic fracture-related bleeding which were subsequently embolized. The Zone 1 catheters were placed immediately preoperatively for intraabdominal bleeding. Upon committee review, one critique was made regarding zone selection. One patient developed an arteriovenous fistula after placement which resolved without intervention. There were no other complications and all patients survived to discharge. CONCLUSIONS An REBOA program is feasible and safe following a comprehensive multidisciplinary effort. The efforts described here can be utilized by similar trauma programs for adaptation of this endovascular approach to bleeding control.
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Affiliation(s)
| | - Daniel Ricaurte
- Department of Trauma and Critical Care, Hartford Hospital, CT, USA
| | - Alfred Croteau
- Department of Trauma and Critical Care, Hartford Hospital, CT, USA
| | - Jonathan Gates
- Department of Trauma and Critical Care, Hartford Hospital, CT, USA
| | - Stacy Bass
- Department of Interventional Radiology, Hartford Hospital, CT, USA
| | - A K Jain
- Department of Vascular Surgery, Hartford Hospital, CT, USA
| | - Jane Keating
- Department of Trauma and Critical Care, Hartford Hospital, CT, USA
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Bradley C, Smith L, Youens K, White BAA, Couchman G. Formalizing the curbside: digitally enhancing access to specialty care. Proc AMIA Symp 2023; 36:716-720. [PMID: 37829223 PMCID: PMC10566420 DOI: 10.1080/08998280.2023.2240364] [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: 03/31/2023] [Accepted: 07/17/2023] [Indexed: 10/14/2023] Open
Abstract
Asynchronous medical care has increased in utilization, patient interest, and industry demand. While E-consults have been discussed extensively in the literature, there are rare examples of a multispecialty implementation within a large health system. Here, we describe our experience in implementing an internal E-consult program for asynchronous, nonurgent communication between ambulatory specialists and primary care providers in our large multispecialty regional health system. To ensure adoption of the program, patient, specialist, and primary care physician concerns were systematically addressed. The program commenced in February 2022 with three high referral rate specialties: cardiology, orthopedics, and dermatology. In the 12 months after implementation, 2243 total E-consults were ordered among 505 ordering providers. Dermatology received the most consultations, and we have expanded to 19 specialties and subspecialties available in the program in the first year. Our E-consult implementation experienced substantial growth in a short time period, demonstrating the viability of E-consult utilization for increasing asynchronous access to ambulatory specialists' expertise in a large healthcare system.
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Affiliation(s)
- Camille Bradley
- Baylor Scott and White Health Family Medicine Lakewood, Dallas, Texas, USA
| | - LaPortia Smith
- Department of Internal Medicine, Baylor Scott and White Medical Center Round Rock, Round Rock, Texas, USA
| | - Kenneth Youens
- Department of Pathology and Laboratory Medicine, Baylor Scott and White Medical Center Temple, Temple, Texas, USA
| | - Bobbie Ann Adair White
- Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, USA
| | - Glen Couchman
- Department of Family Medicine, Baylor Scott and White Medical Center Temple, Temple, Texas, USA
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Dsouza N, Monteiro S, Mihinjac M, Cuellar S, Bell R, Moore B, Moses S, Johnson W, Ziebarth E. "Creating communities that care:" reflections from community leaders on Livability Academy, a neighborhood quality-of-life training program in Philadelphia. Cities Health 2023; 7:964-972. [PMID: 38234465 PMCID: PMC10794020 DOI: 10.1080/23748834.2023.2228962] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/20/2023] [Indexed: 01/19/2024]
Abstract
"What does livability mean to us? Creating communities that care." This reflective praxis think-piece was a collective effort by graduates of the Livability Academy program, a community leadership program hosted in eastern North Philadelphia. Program participants worked in teams to implement programs to improve neighborhood quality of life, as those involved in implementing Livability Academy collaborated to strengthen the bottom-up, asset-based, network-driven model. Our reflections on successes and areas for improvement can strengthen future cohorts of Livability Academy and keep us connected to continue making our neighborhoods more livable.
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Affiliation(s)
- Nishita Dsouza
- Social Intervention Group, Columbia School of Social Work
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11
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Morales SI, Vicente G, LaMonaca K, Rios J, Cunningham SD, Higginbottom J, Mathios E, Werlin S, Cramer J, Santilli A, O'Connor Duffany K. The Implementation of a Nutrition Intervention in Food Pantries: The Spirit of SWAP. Health Promot Pract 2023; 24:80S-91S. [PMID: 36999497 DOI: 10.1177/15248399221112454] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Background. Food insecurity, affecting approximately 10% of the U.S. population, with up to 40% or higher in some communities, is associated with higher rates of chronic conditions and inversely associated with diet quality. Nutrition interventions implemented at food pantries are an effective strategy to increase healthy food choices and improve health outcomes for people experiencing food and nutrition insecurity. Supporting Wellness at Pantries (SWAP), a stoplight nutrition ranking system, can facilitate healthy food procurement and distribution at pantries. Purpose. Guided by the RE-AIM Framework, this study assesses the implementation and outcomes of SWAP as nutritional guidance and institutional policy intervention, to increase procurement and distribution of healthy foods in pantries. Method. Mixed-methods evaluation included observations, process forms, and in-depth interviews. Food inventory assessments were conducted at baseline and 2-year follow-up. Results. Two large pantries in New Haven, Connecticut, collectively reaching more than 12,200 individuals yearly, implemented SWAP in 2019. Implementation was consistent prepandemic at both pantries. Due to COVID-mandated distribution changes, pantries adapted SWAP implementation during the pandemic while still maintaining the "spirit of SWAP." One pantry increased the percentage of Green foods offered. Challenges to healthy food distribution are considered. Discussion. This study has implications for policy, systems, and environmental changes. It shows the potential for SWAP adoption at pantries, which can serve as a guide for continued healthy food procurement and advocacy. Maintaining the "spirit of SWAP" shows promising results for food pantries looking to implement nutrition interventions when standard practice may not be possible.
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Affiliation(s)
- Sofia I Morales
- Yale School of Public Health, New Haven, CT, USA
- Community Alliance for Research and Engagement, New Haven, CT, USA
| | - Genesis Vicente
- Community Alliance for Research and Engagement, New Haven, CT, USA
- Southern Connecticut State University, New Haven, CT, USA
| | - Katherine LaMonaca
- Yale School of Public Health, New Haven, CT, USA
- Community Alliance for Research and Engagement, New Haven, CT, USA
| | - Jasmine Rios
- Yale School of Public Health, New Haven, CT, USA
- Community Alliance for Research and Engagement, New Haven, CT, USA
| | | | - Jackson Higginbottom
- Yale School of Public Health, New Haven, CT, USA
- Community Alliance for Research and Engagement, New Haven, CT, USA
| | - Erin Mathios
- Yale School of Public Health, New Haven, CT, USA
- Community Alliance for Research and Engagement, New Haven, CT, USA
| | - Steve Werlin
- The Downtown Evening Soup Kitchen, New Haven, CT, USA
| | | | - Alycia Santilli
- Community Alliance for Research and Engagement, New Haven, CT, USA
- Southern Connecticut State University, New Haven, CT, USA
| | - Kathleen O'Connor Duffany
- Yale School of Public Health, New Haven, CT, USA
- Community Alliance for Research and Engagement, New Haven, CT, USA
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12
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Wilker OG, Stevens ER, Gold HT, Haber Y, Slover JD, Sherman SE. Implementation of a relapse prevention program among smokers undergoing arthroplasty: lessons learned. ANZ J Surg 2023; 93:1001-1007. [PMID: 36852876 DOI: 10.1111/ans.18354] [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: 08/03/2022] [Revised: 01/27/2023] [Accepted: 02/15/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Surgery is a potent motivator to help people quit smoking to reduce the risk of complications. Many patients who smoke receive tobacco cessation counseling prior to surgery and are able to quit, but do not receive the same resources after surgery and often resume smoking. METHODS We present a case study describing the recruitment process, study components, and lessons learned from StayQuit, a comprehensive relapse prevention program designed to prevent relapse after arthroplasty. Lessons learned were examined post hoc to determine challenges related to program implementation, using existing study procedures and information collected. RESULTS While a comprehensive postoperative relapse prevention program may be beneficial to patients, implementation of StayQuit is unlikely to be feasible under current circumstances. The primary challenges to successful implementation of StayQuit focused on themes of lack of engagement in the preoperative Orthopedic Surgery Quit Smoking Program (OSQSP) and an environment unfavorable to in-person enrollment on the day of surgery. CONCLUSIONS Postoperative relapse prevention programs may be beneficial for patients who quit smoking prior to elective surgery. To help guide implementation, it is important to consider surgeon behavior, the collaboration of clinical and non-clinical teams, and best practices for study enrollment in surgical settings.
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Affiliation(s)
- Olivia G Wilker
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Elizabeth R Stevens
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Heather T Gold
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA.,Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Yaa Haber
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - James D Slover
- Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Scott E Sherman
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA.,Department of Medicine, VA New York Harbor Healthcare System, New York, New York, USA
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13
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Hughes AS, Gutierrez A, Flint J, Franz B. Availability of Evidence-Based Diabetes Programs in U.S. Children's Hospitals. J Prim Care Community Health 2023; 14:21501319231189952. [PMID: 37522592 PMCID: PMC10392184 DOI: 10.1177/21501319231189952] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023] Open
Abstract
Diabetes affects Americans across the lifespan requiring individual and community-level interventions for prevention and management. Nonprofit hospitals are required to address community health needs under current tax law. The study objective was to assess what strategies children's hospitals implemented in prevention and care of diabetes and determine how many hospitals used evidence-based strategies. We identified the most recent Children's Hospital Needs Assessments and implementation strategies for each hospital. Data were thematically coded. Twenty-nine of the 233 U.S. children's hospitals addressed diabetes in their community benefit investments. Of the 130 hospital programs, 48 (37%) aligned with the DSMES framework. Programs focused on prevention (32%), healthy eating (18%), education (15%), physical activity (12%), quality improvement (11%), and self-management (5%). Most children's hospital interventions (85%) did not state a focus on reducing health disparities and none addressed problem solving or diabetes technology. Minimal hospitals are using evidence-based programming for diabetes management and are not targeting health disparities which undercuts their efforts. Hospitals are not adopting structural evidence-based approaches, missing key opportunities to implement strategies shown to reduce diabetes prevalence and lower A1c. This study suggests that children's hospitals need improvement in their diabetes programming to better serve their communities.
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Affiliation(s)
- Allyson S. Hughes
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Angela Gutierrez
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Julia Flint
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Berkeley Franz
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
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14
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Smith LE, Gosselin V, Collins P, Frohlich KL. A Tale of Two Cities: Unpacking the Success and Failure of School Street Interventions in Two Canadian Cities. Int J Environ Res Public Health 2022; 19:11555. [PMID: 36141827 PMCID: PMC9517135 DOI: 10.3390/ijerph191811555] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
One innovative strategy to support child-friendly cities is street-based interventions that provide safe, vehicle-free spaces for children to play and move about freely. School streets are one such innovation involving closing streets around elementary schools to vehicular traffic to improve children's safety as they come and go from school while providing opportunities for children to play and socialize on the street. Launching these initiatives in communities dominated by automobiles is enormously challenging and little is known about why these interventions are successfully launched in some places but not others. As part of a larger research project called Levelling the Playing Fields, two School Street initiatives were planned for the 2021-2022 school year; one initiative was successfully launched in Kingston, ON, while the second initiative failed to launch in Montreal, QC. Using a critical realist evaluation methodology, this paper documents the contextual elements and key mechanisms that enabled and constrained the launch of these School Streets in these cities, through document analysis and key informant interviews. Our results suggest that municipal and school support for the initiative are both imperative to establishing legitimacy and collaborative governance, both of which were necessary for a successful launch.
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Affiliation(s)
- Laura E. Smith
- Department of Geography and Planning, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Veronique Gosselin
- École de Santé Publique (ESPUM), Centre de Recherche en Santé Pulique (CReSP), Université de Montréal, Montreal, QC H3N 1X9, Canada
| | - Patricia Collins
- Department of Geography and Planning, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Katherine L. Frohlich
- École de Santé Publique (ESPUM), Centre de Recherche en Santé Pulique (CReSP), Université de Montréal, Montreal, QC H3N 1X9, Canada
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15
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Frye WS, Gardner L, Campbell JM, Katzenstein JM. Implementation of telehealth during COVID-19: Implications for
providing behavioral health services to pediatric patients. J Child Health Care 2022; 26:172-184. [PMID: 33779352 PMCID: PMC9194499 DOI: 10.1177/13674935211007329] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The coronavirus pandemic and in-person contact restrictions necessitated rapid implementation of telehealth, specifically videoconferencing, to provide essential care to patients. This study surveyed 25 pediatric behavioral health providers at a single center during their first month of utilizing telehealth during coronavirus disease 2019 (COVID-19). Twenty-one participants completed a pre-questionnaire distributed prior to telehealth service delivery, and 23 providers completed a post-questionnaire approximately three weeks later. Results indicate the majority of behavioral health providers had no experience providing telehealth services prior to COVID-19. The majority of participating behavioral health providers utilized telehealth to provide pediatric patient care within the first month of access to telehealth. Participants' confidence in their ability to provide telehealth services significantly increased within the first month of implementation, regardless of previous training in telehealth. This study identified differences between anticipated and actual barriers to treatment, with technological issues identified as the largest actual barrier to service delivery. Participants indicated a preference for in-person service delivery, which they reported allows for better rapport-building, behavioral observations, reduced technological barriers, and fewer distractions. However, most participants reported they intend to continue utilizing telehealth for certain types of behavioral health services (e.g., diagnostic interviews and outpatient therapy) after the pandemic has subsided.
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Affiliation(s)
- William S Frye
- Department of Psychology, Johns Hopkins All Children’s
Hospital, Saint Petersburg, FL, USA,William S Frye, Department of Psychology,
Johns Hopkins All Children’s Hospital, 880 6th St S, Saint Petersburg, Florida
33701-4634, USA.
| | - Lauren Gardner
- Department of Psychology, Johns Hopkins All Children’s
Hospital, Saint Petersburg, FL, USA
| | | | - Jennifer M Katzenstein
- Department of Psychology, Johns Hopkins All Children’s
Hospital, Saint Petersburg, FL, USA
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16
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Sacca L, Markham C, Hernandez B, Shegog R, Peskin M, Craig Rushing S, Warren H, Tsosie M. The Impact of COVID-19 on the Delivery of Educational Programs in Native American Communities: Qualitative Study. JMIR Form Res 2022; 6:e32325. [PMID: 35348464 PMCID: PMC9004623 DOI: 10.2196/32325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 07/22/2021] [Revised: 03/02/2022] [Accepted: 03/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background Despite the availability of culturally responsive sexual health educational programs for American Indian and Alaska Native (AI/AN) youth, barriers to their uptake and utilization persist in tribal communities. These challenges were exacerbated by the COVID-19 pandemic, which required flexible program delivery using both in-person and virtual classrooms. Objective This exploratory study provides a preliminary understanding of the extent to which pre-existing challenges impact the delivery of culturally responsive sexual health education programs in Native communities and to what extent they were exacerbated by the COVID-19 pandemic. It also highlights the challenges faced by adolescent health advocates when adapting culturally responsive health curricula to online platforms. Finally, this study discloses major socioeconomic, health, and mental challenges experienced by AI/AN youth during the pandemic. Methods An exploratory, descriptive, qualitative design approach was adopted to carry out 5 individual and 1 collective in-depth key informant interviews. A total of 8 Native and non-Native sexual health educators served as key informants and shared their personal experiences with the delivery of sexual health education programs for youth during the COVID-19 pandemic. The interviews were conducted virtually from October to November 2020 using Zoom to reach participants dispersed across different regions of the United States. We followed the consolidated criteria for reporting qualitative research (COREQ) as a reference for the study methodology. We also used the Braun and Clarke framework (2006) to conduct a thematic analysis. Results Experts’ opinions were structured according to 5 main themes: (1) competing community priorities during COVID-19; (2) moving to web-based programming: skills, training, support; (3) recruiting youth; and (4) challenges for implementation in a household environment; and (5) recommendations to overcome implementation challenges. These themes are complementary, connected, and should be considered holistically for the development, dissemination, and implementation of online sexual health programs for AI/AN youth, specifically during the COVID-19 pandemic. The results raised the following points for discussion: (1) Building partnerships with schools and community organizations facilitates program adaptation and implementation, (2) there is a need to adopt a holistic approach when addressing youth sexual health in AI/AN communities, (3) a systematic and culturally responsive adaptation approach ensures effective virtual program delivery, and (4) community and youth engagement is essential for the success of virtual sexual health programs. Conclusions Findings can provide recommendations on actions to be taken by sexual health educators and guidelines to follow to ensure cultural sensitivity, effective adaptation, and successful implementation when setting out to advocate for online sexual health programs for AI/AN youth.
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Affiliation(s)
- Lea Sacca
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Christine Markham
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Belinda Hernandez
- Center for Health Promotion and Prevention Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Ross Shegog
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Melissa Peskin
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | | | - Hannah Warren
- Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Monique Tsosie
- Inter Tribal Council of Arizona, Phoenix, AZ, United States
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17
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Broderick PC, Schussler DL. Exploring Fidelity in School-Based Mindfulness Programs. Glob Adv Health Med 2022; 10:21649561211067996. [PMID: 34993009 PMCID: PMC8725028 DOI: 10.1177/21649561211067996] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/02/2021] [Indexed: 11/15/2022] Open
Abstract
A small but growing body of research on school-based mindfulness programs (SBMPs) has demonstrated benefits for students' cognitive and affective functioning and overall wellbeing. Yet, lack of fidelity in SBMP implementation may diminish these programs' purported benefits. This commentary presents 4 current challenges that need to be addressed so that questions of whether and how mindfulness improves student functioning can be clarified and implementation of programs can be strengthened and sustained. These challenges include coming to consensus on the definition and intention of mindfulness training, balancing adherence with flexibility in SBMP delivery, determining the role SBMP teachers' mindfulness experience plays in program fidelity, and delineating distinctive features of mindful pedagogy. Some suggestions for addressing each of these challenges are provided.
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Affiliation(s)
- Patricia C Broderick
- Edna Bennett Pierce Prevention Center, The Pennsylvania State University, University Park, PS, USA
| | - Deborah L Schussler
- Edna Bennett Pierce Prevention Center, The Pennsylvania State University, University Park, PS, USA
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18
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Banandur PS, Gururaj G, Garady L, Arelingaiah M, Jyoti MK. Yuva spandana - A youth mental health promotion model in India - Design, methods and progress. Indian J Public Health 2022; 65:380-383. [PMID: 34975082 DOI: 10.4103/ijph.ijph_257_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/04/2022] Open
Abstract
A unique youth mental health promotion program called Yuva Spandana is implemented and functional across all districts within Karnataka. Trained guidance providers named Yuva Parivarthakas (YPs) and Yuva Samalochakas (YS) provide support to youth having issues at Yuva Spandana Kendras (YSKs). We highlight the process of development of the program "Yuva Spandana" into a sustainable community-based youth mental health promotion model addressing youth issues across Karnataka and describe the profile of beneficiaries attending YSKs in Karnataka between 2017 and 2019. Yuva Spandana has evolved over time and got established in local-self-governments and communities.
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Affiliation(s)
- Pradeep S Banandur
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Lavanya Garady
- Ramaiah International Centre for Public Health Innovations, Bengaluru, Karnataka, India
| | - Mutharaju Arelingaiah
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - M K Jyoti
- Department of Management Studies, CMR Institute of Management Studies, Bengaluru, Karnataka, India
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19
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Kodish SR, Farhikhtah A, Mlambo T, Hambayi MN, Jones V, Aburto NJ. Leveraging the Scaling Up Nutrition Movement to Operationalize Stunting Prevention Activities: Implementation Lessons From Rural Malawi. Food Nutr Bull 2021; 43:104-120. [PMID: 34747237 DOI: 10.1177/03795721211046140] [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: 11/16/2022]
Abstract
BACKGROUND The rural district of Ntchisi is in the central region of Malawi. Among children aged 6 to 23 months, the stunting prevalence is 40% to 50%. To address this high prevalence, the World Food Programme, with cooperating partners, supported the Government of Malawi to implement an integrated stunting prevention program entitled The Right Foods at the Right Time from 2013 to 2018. OBJECTIVE To provide implementation lessons learned from systematic documentation of how the Scaling Up Nutrition (SUN) movement, combined with other international and national initiatives and policies, was translated into tailored programming. METHODS During program conception, early design, and implementation, this descriptive study systematically documented the process of translating SUN principles and government policies into an operational stunting prevention program in rural Malawi. RESULTS We identified 8 factors that contributed to successful translation of policy into program activities: (1) well-structured National SUN framework, (2) reliable coordination platforms and district ownership, (3) systematic and evidence-informed program design, (4) multiple forms of data used to inform program planning, (5) multisectoral implementation approaches to stunting prevention, (6) innovation in technology to improve overall program efficiency, (7) systematic collaboration among diverse stakeholders, and (8) strong public health nutrition capacity of program team members. CONCLUSIONS Lessons from this nutrition program in Ntchisi, Malawi, provide one case illustrating how the SUN movement, government policies, and global evidence base can be operationalized into tailored programming for improving nutrition.
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Affiliation(s)
- Stephen R Kodish
- United Nations World Food Programme Headquarters, Rome, Italy.,The Pennsylvania State University, University Park, PA, USA
| | - Arghanoon Farhikhtah
- United Nations World Food Programme Headquarters, Rome, Italy.,Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Trust Mlambo
- United Nations World Food Programme, Lilongwe, Malawi
| | | | - Vanessa Jones
- United Nations World Food Programme Headquarters, Rome, Italy
| | - Nancy J Aburto
- United Nations World Food Programme Headquarters, Rome, Italy.,Food and Agriculture Organization of the United Nations, Rome, Italy
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20
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Hill TG, Langley JE, Kervin EK, Pesut B, Duggleby W, Warner G. An Integrative Review on the Feasibility and Acceptability of Delivering an Online Training and Mentoring Module to Volunteers Working in Community Organizations. Front Digit Health 2021; 3:688982. [PMID: 34723241 PMCID: PMC8551809 DOI: 10.3389/fdgth.2021.688982] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Volunteer programs that support older persons can assist them in accessing healthcare in an efficient and effective manner. Community-based initiatives that train volunteers to support patients with advancing illness is an important advance for public health. As part of implementing an effective community-based volunteer-based program, volunteers need to be sufficiently trained. Online training could be an effective and safe way to provide education for volunteers in both initial training and/or continuing education throughout their involvement as a volunteer. Method: We conducted an integrative review that synthesized literature on online training programs for volunteers who support older adults. The review included both a search of existing research literature in six databases, and an online search of online training programs currently being delivered in Canada. The purpose of this review was to examine the feasibility and acceptability of community-based organizations adopting an online training format for their volunteers. Results: The database search identified 13,626 records, these went through abstract and full text screen resulting in a final 15 records. This was supplemented by 2 records identified from hand searching the references, for a total of 17 articles. In addition to identifying Volunteers Roles and Responsibilities; Elements of Training; and Evaluation of Feasibility and Acceptability; a thematic analysis of the 17 records identified the categories: (1) Feasibility Promoting Factors; (2) Barriers to Feasibility; (3) Acceptability Promoting Factors; and (4) Barriers to Acceptability. Six programs were also identified in the online search of online training programs. These programs informed our understanding of delivery of existing online volunteer training programs. Discussion: Findings suggested that feasibility and acceptability of online training were promoted by (a) topic relevant training for volunteers; (b) high engagement of volunteers to prevent attrition; (c) mentorship or leadership component. Challenges to online training included a high workload; time elapsed between training and its application; and client attitude toward volunteers. Future research on online volunteer training should consider how online delivery can be most effectively paced to support volunteers in completing training and the technical skills needed to complete the training and whether teaching these skills can be integrated into programs.
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Affiliation(s)
- Taylor G Hill
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Jodi E Langley
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Emily K Kervin
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Barbara Pesut
- Nursing, University of British Columbia, Okanagan, BC, Canada
| | | | - Grace Warner
- School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada
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21
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Dsouza JP, Van den Broucke S, Pattanshetty S, Dhoore W. Cervical cancer screening status and implementation challenges: Report from selected states of India. Int J Health Plann Manage 2021; 37:824-838. [PMID: 34716616 DOI: 10.1002/hpm.3353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/31/2020] [Revised: 07/28/2021] [Accepted: 10/04/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Cervical cancer contributes to 6%-29% of the cancers in India. Although the Government of India in 2010 integrated cancer screening within the National Programme for the prevention of Non-communicable Diseases, only 22% of women aged 15-45 years had undergone examination of the cervix by 2016. This prompts the question regarding the organisation of the program's implementation and service delivery and regarding challenges that may explain poor screening uptake. METHODS Semi-structured interviews were held with program managers and implementers in seven districts of three selected States of India. The data analysis looked at program content, the organisation of screening delivery, and the challenges to the implementation of the program, considering six theoretically derived dimensions of public health capacity: leadership and governance, organisational structure, financial resources, workforce, partnerships, and knowledge development. RESULTS Participants perceive the existing capacities across the six domains as insufficient to implement the CCS program nationwide. A context specific implementation, a better coordination between the program and district health facilities, timely remuneration, better maintenance of data and a strong monitoring system are possible solutions to remove health system related barriers. CONCLUSION The study provides evidence on the practical challenges and provides recommendations for strengthening the capacities of the health system.
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Affiliation(s)
- Jyoshma Preema Dsouza
- Psychological Sciences Research Institute (IPSY), School of Public Health, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Stephan Van den Broucke
- Psychological Sciences Research Institute (IPSY), Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Sanjay Pattanshetty
- School of Public Health, Manipal Academy of Higher Education, Manipal University, Manipal, India
| | - William Dhoore
- School of Public Health, Université Catholique de Louvain, Woluwe, Brussels, Belgium
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22
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Spencer R, Drew AL, Horn JP. Program staff perspectives on implementing youth-initiated mentoring with systems-involved youth. J Community Psychol 2021; 49:2781-2794. [PMID: 33465272 DOI: 10.1002/jcop.22514] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/22/2020] [Accepted: 12/28/2020] [Indexed: 06/12/2023]
Abstract
Youth-initiated mentoring (YIM) is an approach to mentor recruitment that represents a significant departure from how formal mentoring typically has been conceptualized and carried out, most notably by having youth identify their own mentors. Despite enthusiasm for YIM, implementation can require significant shifts in program practices. Given the limited resources with which most mentoring programs have to work, it is important to discern staff investment in YIM and what it takes for programs to implement this approach. This study explored YIM implementation at the organizational level through interviews with mentoring program staff (n = 11) and addressed motivations of mentoring program staff to implement YIM, how their programs implemented this approach, and their perceptions of the facilitators and barriers to successful YIM implementation.
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Affiliation(s)
- Renée Spencer
- School of Social Work, Boston University, Boston, Massachusetts, USA
| | - Alison L Drew
- School of Social Work, Boston University, Boston, Massachusetts, USA
| | - John P Horn
- Department of Social Work, California State University, East Bay, Hayward, California, USA
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23
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Kim G, Patel B, Mehta TS, Du L, Mehta RJ, Phillips J. Contrast-enhanced Mammography: A Guide to Setting Up a New Clinical Program. J Breast Imaging 2021; 3:369-376. [PMID: 38424777 DOI: 10.1093/jbi/wbab027] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 11/02/2020] [Indexed: 03/02/2024]
Abstract
Contrast-enhanced mammography (CEM) is gaining rapid traction following the U.S. Food and Drug Administration approval for diagnostic indications. Contrast-enhanced mammography is an alternative form of mammography that uses a dual-energy technique for image acquisition after the intravenous administration of iodinated contrast material. The resulting exam includes a dual set of images, one that appears similar to a routine 2D mammogram and one that highlights areas of contrast uptake. Studies have shown improved sensitivity compared to mammography and similar performance to contrast-enhanced breast MRI. As radiology groups incorporate CEM into clinical practice they must first select the indications for which CEM will be used. Many practices initially use CEM as an MRI alternative or in cases recommended for biopsy. Practices should then define the CEM clinical workflow and patient selection to include ordering, scheduling, contrast safety screening, and managing imaging on the day of the exam. The main equipment requirements for performing CEM include CEM-capable mammography equipment, a power injector for contrast administration, and imaging-viewing capability. The main staffing requirements include personnel to place the intravenous line, perform the CEM exam, and interpret the CEM. To safely and appropriately perform CEM, staff must be trained in their respective roles and to manage potential contrast-related events. Lastly, informing referring colleagues and patients of CEM through marketing campaigns is helpful for successful implementation.
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Affiliation(s)
- Geunwon Kim
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| | - Bhavika Patel
- Mayo Clinic Hospital, Department of Radiology, Phoenix, AZ, USA
| | - Tejas S Mehta
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| | - Linda Du
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| | - Rashmi J Mehta
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
| | - Jordana Phillips
- Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA
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24
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Kim S, Yoo S, Cho SI, Jung H, Yang Y. Experiences of the First Year Implementation of a Nationwide School-Based Smoking Prevention Program in Korea. Int J Environ Res Public Health 2021; 18:3291. [PMID: 33810138 PMCID: PMC8005052 DOI: 10.3390/ijerph18063291] [Citation(s) in RCA: 3] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 11/17/2022]
Abstract
Encouraged by the Framework Convention on Tobacco Control, Korea has implemented a nationwide School-based Smoking Prevention Program (SSPP) to reduce the prevalence of youth smoking. This qualitative study explored the school contexts of launching the SSPP in Seoul, Korea. Five focus groups were studied with 29 lead teachers in charge of the SSPP. Thematic analysis reveals three key findings. First, while infrastructure was insufficiently prepared due to the abrupt implementation, lead teachers agreed on the purpose of the SSPP. However, they perceived the program as myopic in only targeting smoking students and spending the mandatory budgets as a burdensome task. Second, the SSPP increased experience-based activities, influenced smoking family members, and created a smoke-free school environment. Third, to ensure more effective implementation, school principals should support inducing staff engagement. The teachers also maintained that the SSPP must be institutionalized as part of regular curricula with standardized books. For a more meaningful impact, the SSPP needs instructors and counselors to support smoking cessation programs that reflect school contexts. The teachers urged tobacco prevention measures at community, policy, and society levels. This study provides insights into a nationwide approach to initiating school-based smoking prevention program to achieve a tobacco-free generation.
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Affiliation(s)
- Sookyung Kim
- College of Nursing, Yonsei University, Seoul 03722, Korea;
| | - Seunghyun Yoo
- Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul 08826, Korea;
| | - Sung-il Cho
- Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul 08826, Korea;
| | - Hanna Jung
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea; (H.J.); (Y.Y.)
| | - Yeaseul Yang
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea; (H.J.); (Y.Y.)
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25
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Souadka A, Essangri H, Majbar MA, Benkabbou A, Boutayeb S, Amrani L, Ghannam A, El Ahmadi B, Belkhadir ZH, Mohsine R, Souadka A, Elias D. Mid-Term Audit of a National Peritoneal Surface Malignancy Program Implementation in a Low Middle Income Country: The Moroccan Experience. Cancers (Basel) 2021; 13:cancers13051088. [PMID: 33802609 PMCID: PMC7962020 DOI: 10.3390/cancers13051088] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/30/2020] [Revised: 12/27/2020] [Accepted: 12/30/2020] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Complete cytoreductive surgery (CRS) is the backbone of peritoneal surface malignancies (PSM) management and a major prognostic factor to better survival outcomes. Implementing a PSM program is a steep and complex process, particularly in low-middle income countries (LMIC), where limited resources are an additional challenge to overcome. In this study, we present the results of a mid-term audit of the implementation of a PSM program in Morocco. The latter was successfully and safely launched according to predicted initiation, transition and consolidation periods and allowed the significant improvement of short term surgical and oncological outcomes and completeness of cytoreduction procedures. Abstract Implementing a multimodal management of peritoneal surface malignancies is a steep and complex process, especially as complete cytoreductive surgery (CRS) is the backbone and the major prognostic factor for hyperthermic intraperitoneal chemotherapy (HIPEC) procedures. The implementation of such a program is a challenging process, particularly in low-middle income (LMIC) countries where ressource restrictions may represent a major hurdle to HIPEC appliances acquisition. Herein is the first audit of the implementation of a national peritoneal malignancy program in a north African country. The audit process was performed according to the three implementation steps, namely initiation (“1”:2005–2008), transition (“2”:2009–2013) and consolidation (“3”:2014–2017). We included all consecutive CRS without HIPEC performed with curative intent for ovarian, gastric, colorectal and pseudomyxoma peritonei type of malignancies with an Eastern Cooperative Oncology Group (ECOG) performance Status ≤ 2. Target outcomes for incomplete cytoreduction (ICRS), serious complications ≥ 3b according to the Clavien-Dindo scoring, and early oncologic failure (EOF; disease progression within 2 years of treatment) were compared between the three phases. Independent risk factors correlated to these three outcomes were calculated using a logistic regression model.198 CRS procedures were completed with 49, 60 and 89 cases performed in the three phases, respectively. Overall, patients were comparable except for ECOG and ASA scores which were more severe in the third phase. The comparison of ICRS, serious complications and EOF rates showed a significant reduction between the three phases with (34%, 18% and 4% p = <0.001), (30.6%, 20% and 11.2%, p = 0.019) and (38.8%, 23.3% and 12.4% p = 0.002) respectively. Undergoing CRS in phase 3 on the other hand was a predictive factor of better short term surgical and oncological outcomes and completeness of cytoreduction, while ECOG performance status and spleno-pancreatectomy were also predictive factors of serious complications.
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Affiliation(s)
- Amine Souadka
- Surgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat 10100, Morocco; (H.E.); (M.A.M.); (A.B.); (L.A.); (R.M.); (A.S.)
- Correspondence:
| | - Hajar Essangri
- Surgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat 10100, Morocco; (H.E.); (M.A.M.); (A.B.); (L.A.); (R.M.); (A.S.)
| | - Mohammed Anass Majbar
- Surgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat 10100, Morocco; (H.E.); (M.A.M.); (A.B.); (L.A.); (R.M.); (A.S.)
| | - Amine Benkabbou
- Surgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat 10100, Morocco; (H.E.); (M.A.M.); (A.B.); (L.A.); (R.M.); (A.S.)
| | - Saber Boutayeb
- Medical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat 10100, Morocco;
| | - Laila Amrani
- Surgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat 10100, Morocco; (H.E.); (M.A.M.); (A.B.); (L.A.); (R.M.); (A.S.)
| | - Abdelilah Ghannam
- Intensive Care Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat 10100, Morocco; (A.G.); (B.E.A.); (Z.H.B.)
| | - Brahim El Ahmadi
- Intensive Care Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat 10100, Morocco; (A.G.); (B.E.A.); (Z.H.B.)
| | - Zakaria Houssaïn Belkhadir
- Intensive Care Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat 10100, Morocco; (A.G.); (B.E.A.); (Z.H.B.)
| | - Raouf Mohsine
- Surgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat 10100, Morocco; (H.E.); (M.A.M.); (A.B.); (L.A.); (R.M.); (A.S.)
| | - Abdelilah Souadka
- Surgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat 10100, Morocco; (H.E.); (M.A.M.); (A.B.); (L.A.); (R.M.); (A.S.)
| | - Dominique Elias
- Department of Surgical Oncology, Gustave Roussy, Cancer Campus, 114 Rue Edouard Vaillant, 94805 Villejuif, France;
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Gadais T, Caron T, Ayoub MB, Karelis A, Nadeau L. The Role of the Teacher in the Implementation of a School-Based Intervention on the Physical Activity Practice of Children. Int J Environ Res Public Health 2020; 17:ijerph17197344. [PMID: 33050038 PMCID: PMC7579276 DOI: 10.3390/ijerph17197344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 12/12/2022]
Abstract
Medium- or long-term intervention strategies for physical activity practice (PAP) need to be more effective in terms of their implementation by practitioners. The aim of this study was to evaluate the role of a teacher to implement the Team Pentathlon (TP) in order to improve the PAP in primary children. TP is a health education program made to improve PAP of children through individual and collective achievements. In this study, 203 children (age: 10–13 years) in grades 5 and 6 (intervention group (IG) N = 104, control group (CG) N = 99) were guided to increase their PAP during an eight-week period by five elementary school teachers (physical education or classroom) who had received four training sessions. Levels of PAP (self-reported) were compared between groups (IG/CG), sex, socioeconomic status of the schools and between teachers: baseline and during TP. Several teachers noted significant increases in PAP in the IG for both boys and girls (p ≤ 0.05 or p < 0.01), whereas others found only small improvements in PAP. One teacher even observed higher PAP in the CG. Training session records revealed that the teacher himself, how the TP is implemented, and proper resources were the three elements that explained the successful implementation of the TP program. The implementation of the TP significantly increased the PAP in primary children. Training sessions helped teachers to implement the TP program but personal engagement, motivation, respecting protocol, and an adequate environment are also necessary in improving the PAP of children.
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Affiliation(s)
- Tegwen Gadais
- Department of Physical Activity Sciences, University of Quebec in Montreal, Montreal, QC H3C 3P8, Canada; (M.-B.A.); (A.K.)
- Correspondence: ; Tel.: +1-514-987-3000 (ext. 3704)
| | - Theo Caron
- Faculté des Sports et de l’EP, Université d’Artois, 62800 Liévin, France;
| | - Marie-Belle Ayoub
- Department of Physical Activity Sciences, University of Quebec in Montreal, Montreal, QC H3C 3P8, Canada; (M.-B.A.); (A.K.)
| | - Antony Karelis
- Department of Physical Activity Sciences, University of Quebec in Montreal, Montreal, QC H3C 3P8, Canada; (M.-B.A.); (A.K.)
| | - Luc Nadeau
- Department of Physical Education, Laval University, Quebec City, QC G1V 0A6, Canada;
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Abstract
Rabies in Asia and Africa contributes to over 99% of human rabies deaths that occur in the world today. The vast majority or 60% of these deaths are in Asia. Practically, more than four billion people in Asia or about 60% of the world’s population are at risk of getting rabies where an estimated 96% of documented human cases are from an infected dog bite. Canine-mediated rabies is one of the few communicable diseases that can possibly be eliminated by currently available vaccines and tools for veterinary and public health interventions. With a more comprehensive and integrated approach, it is expected that dog rabies will be eliminated in target areas, and there will be an eventual decline and disappearance of human rabies cases. The burden of rabies is primarily on human health but the disease control has to be focused on the animal source. The ultimate goal of a truly regional disease program is to control and eliminate dog-mediated rabies and protect and maintain rabies-free areas in Asia. Current regional efforts aim to strengthen the intercountry coordination, and technical and institutional capacities to manage dog rabies elimination programs. The regional and national implementation efforts provide strategic direction and cooperation to ensure successful implementation of rabies control measures and eventual elimination. The focus areas include human rabies prevention through pre- and postexposure prophylaxis, mass dog vaccination, surveillance and epidemiology, laboratory diagnostic capability, public awareness and risk communication, legislation, dog population management, and establishment and protection of rabies-free zones/areas. Existing mechanisms for implementation, when applied, give emphasis on One Health collaborations.
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Waller AW, Dominguez-Uscanga A, Lopez Barrera E, Andrade JE, Andrade JM. Stakeholder's Perceptions of Mexico's Federal Corn Flour Fortification Program: A Qualitative Study. Nutrients 2020; 12:nu12020433. [PMID: 32046253 PMCID: PMC7071339 DOI: 10.3390/nu12020433] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/18/2020] [Accepted: 02/06/2020] [Indexed: 11/16/2022] Open
Abstract
Background: In Mexico, the fortification of corn and wheat flours with iron, zinc, and folic acid and the restoration of B-vitamins is a mandatory program. However, the monitoring and evaluation (M&E) of this fortification process is not well understood. Thus, the purpose of the study was to understand the M&E of the food fortification program in Mexico, with an emphasis on technology research and development. Methods: Open-ended exploratory interviews were conducted with food technology representatives (n = 9), food science academic faculty (n = 1), president of a private tortilla-making federation (n = 1), and representatives of the federal monitoring agency (n = 2). Interviews were transcribed and themes were identified using the content analysis methodology. Inter-rater reliability was assessed by calculating an intraclass correlation coefficient (ICC) between the raters (n = 3). Results: A total of 49 codes were identified that resulted in three overarching themes, manufacturing/processing, monitoring logistics, and nutrition. Overall, there is a need for more robust internal and external M&E with Mexico’s fortification program to improve the manufacturing/processing of fortifying the tortillas, the monitoring of this fortification program, and the impact the fortified tortillas have on the nutritional status of the Mexican population. The overall ICC was 0.87. Conclusions: The present study can be used to gain insight into Mexico’s fortification program and to inform food fortification policymakers of best practices.
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Affiliation(s)
- Anna W. Waller
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; (A.W.W.); (A.D.-U.); (E.L.B.); (J.E.A.)
| | - Astrid Dominguez-Uscanga
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; (A.W.W.); (A.D.-U.); (E.L.B.); (J.E.A.)
| | - Emely Lopez Barrera
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; (A.W.W.); (A.D.-U.); (E.L.B.); (J.E.A.)
| | - Juan E. Andrade
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; (A.W.W.); (A.D.-U.); (E.L.B.); (J.E.A.)
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, 572 Newell Dr., Urbana, IL 61801, USA
| | - Jeanette M. Andrade
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA
- Correspondence: ; Tel.: +1-352-294-3975
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Buckley PR, Fagan AA, Pampel FC, Hill KG. Making Evidence-Based Interventions Relevant for Users: A Comparison of Requirements for Dissemination Readiness Across Program Registries. Eval Rev 2020; 44:51-83. [PMID: 32588654 PMCID: PMC8022079 DOI: 10.1177/0193841x20933776] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This study compares prevention program registries in current use on their level of support for users seeking to implement evidence-based programs. Despite the importance of registries as intermediaries between researchers and the public, and although previous studies have examined how registries define their standards for methodological soundness and evidence of efficacy, little research has focused on the degree to which registries consider programs' dissemination readiness. The result is that registry users are uncertain whether listed programs and their necessary support materials are even available for implementation. This study evaluates 11 publicly and privately funded prevention registries that review the evidence base of programs seeking to improve child health and prosocial outcomes on the degree to which they use dissemination readiness as an evidentiary criterion for rating programs, and the extent and type of information they provide about dissemination readiness to support real-world implementation. The results show wide variability, with few having standards about dissemination readiness or making evidence-based information about interventions easily accessible to users. Findings indicate the need for registries to (1) do more to assess dissemination readiness before including programs on their website and (2) offer more complete information on dissemination readiness and implementation support to users.
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Okyere CY, Pangaribowo EH, Gerber N. Household Water Quality Testing and Information: Identifying Impacts on Health Outcomes and Sanitation- and Hygiene-Related Risk-Mitigating Behaviors. Eval Rev 2019; 43:370-395. [PMID: 31711300 DOI: 10.1177/0193841x19885204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND In 2014, a group of 512 households in multipurpose water systems and also relying on unimproved water, sanitation, and hygiene practices in the Greater Accra region of Ghana were randomly selected to participate in water quality self-testing and also receipt of information in the form of handouts on how to improve water quality. OBJECTIVES AND RESEARCH DESIGN Using a cluster-randomized controlled design, we study the health, sanitation, and hygiene behavior impacts of the household water quality testing and information experiment. SUBJECTS The study has three arms: (1) adult household members, (2) schoolgoing children, and (3) control group. MEASURES The study measures the effects on handwashing with soap, cleanliness of households, and prevalence of diarrhea and self-reported fever. We also address impacts on child health and nutrition outcomes, particularly diarrhea and anthropometric outcomes. RESULTS We show that there is high household willingness to participate in this intervention on water quality self-testing. About 7 months after households took part in the intervention, the study finds little impacts on health outcomes and on sanitation- and hygiene-related risk-mitigating behaviors, regardless of the intervention group, either schoolchildren or adult household members. Impacts (direction and extent) are rather homogeneous for most of the outcomes across treatment groups. CONCLUSIONS The study discusses the implications of the findings and also offers several explanations for the lack of transmission of impacts from the household water quality testing and information intervention on health outcomes and on sanitation and hygiene behaviors.
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Affiliation(s)
- Charles Yaw Okyere
- Department of Agricultural Economics and Agribusiness, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Center for Development Research (ZEF), University of Bonn, Germany
| | - Evita Hanie Pangaribowo
- Faculty of Geography, Department of Environmental Geography, Gadjah Mada University, Yogyakarta, Indonesia
| | - Nicolas Gerber
- Center for Development Research (ZEF), University of Bonn, Germany
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Burt KG, Lindel N, Wang J, Burgermaster M, Fera J. A Nationwide Snapshot of the Predictors of and Barriers to School Garden Success. J Nutr Educ Behav 2019; 51:1139-1149. [PMID: 31345673 DOI: 10.1016/j.jneb.2019.06.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/09/2018] [Revised: 06/04/2019] [Accepted: 06/24/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the degree and predictors of and barriers to school garden integration (termed success). DESIGN A 30-item online survey consisting of demographic, garden characteristic, and barrier questions, as well as the School Garden Integration Scale, was conducted in 266 school garden organizations (13 national, 8 regional, and 245 state or local). PARTICIPANTS A total of 414 school gardeners from 38 states and Puerto Rico. MAIN OUTCOME MEASURES School garden success using the GREEN Tool. ANALYSIS Descriptive statistics were used to determine the degree of success of school garden programs and explore barriers. Multiple regression analysis was conducted to determine independent predictors of school garden success. RESULTS The average score was 37 (range 1-53, of a possible 57 points), indicating moderate success. Operating budget (P < .001), operating time (P < .05), and planting in-ground (P < .01) had a positive significant influence on success score, whereas rural location (P < .01) and lacking community interest (P < .01) had a negative significant influence, controlling for race/ethnicity, region, total garden investment, and Community Need Index score (a proxy for socioeconomic status). CONCLUSIONS AND IMPLICATIONS Results indicate that success of school garden programs may be more difficult for the schools located in a rural area or in the absence of school or community-at-large interest. This study found that race/ethnicity of students and socioeconomic status are not related to success score, which is promising as other research indicates that successful school gardens may be especially impactful for low-income people of color. Causal research is needed to identify strategies that increase school garden success, with a focus on engaging key stakeholders (administrators, teachers, parents, the community at large, and garden coordinators).
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Affiliation(s)
- Kate G Burt
- Department of Dietetics, Food, and Nutrition, Lehman College, City University of New York, Bronx, NY.
| | - Nicole Lindel
- Program in Nutrition, Teachers College, Columbia University, New York, NY
| | - Jiayu Wang
- Program in Nutrition, Teachers College, Columbia University, New York, NY
| | - Marissa Burgermaster
- Department of Nutritional Sciences and Population Health, Dell Medical School, University of Texas at Austin, Austin, TX
| | - Joseph Fera
- Department of Mathematics and Computer Science, Lehman College, City University of New York, Bronx, NY
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Fisher MC, Villegas E, Sutter C, Musaad SM, Koester B, Fiese BH. Sprouts Growing Healthy Habits: Curriculum Development and Pilot Study. Front Public Health 2019; 7:65. [PMID: 30972317 PMCID: PMC6445962 DOI: 10.3389/fpubh.2019.00065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/21/2018] [Accepted: 03/05/2019] [Indexed: 11/13/2022] Open
Abstract
High rates of childhood obesity and the impact this has on children's health make it important to establish a healthy lifestyle during the early school years. This pilot study explored the impact of a newly developed healthy habits curriculum. The Sprouts: Growing Healthy Habits curriculum presents topics such as energy balance, healthy sleep habits, and food groups through short activities and interactive book-reading. A nonrandomized controlled experimental study design was used to assess impact. Fifty-seven children between 5 and 6 years of age participated from two elementary schools (36 from the intervention school, 21 from the control school). Knowledge was assessed pre- and post-intervention in five content areas (farm to table, bedtime routines, portion size, energy expenditure, sugar content of beverages) using card sorting, ranking, and sequence activities. Within- and between-school comparisons were conducted using differences between groups and mixed modeling approaches. Within the intervention school, significant increases in knowledge were observed for farm to table, sugar content of beverages, and bedtime routines. For the control school, there was a significant increase in knowledge of portion sizes. Considering between-schools, only change in knowledge of bedtime routines remained significant, with greater increases in the intervention school. Results seem promising given the short dosage of curriculum. Increases in knowledge of healthy habits in early childhood may help in promoting healthy behaviors and combatting the effects of obesity.
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Affiliation(s)
- Meghan C. Fisher
- Human Development and Family Studies Department, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Elizabeth Villegas
- Human Development and Family Studies Department, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Carolyn Sutter
- Family Resiliency Center, Human Development and Family Studies Department, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Salma M. Musaad
- Family Resiliency Center, Human Development and Family Studies Department, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Brenda Koester
- Family Resiliency Center, Human Development and Family Studies Department, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Barbara H. Fiese
- Family Resiliency Center, Human Development and Family Studies Department, University of Illinois at Urbana-Champaign, Urbana, IL, United States
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Strickland JR, Kinghorn AM, Evanoff BA, Dale AM. Implementation of the Healthy Workplace Participatory Program in a Retail Setting: A Feasibility Study and Framework for Evaluation. Int J Environ Res Public Health 2019; 16:E590. [PMID: 30781669 PMCID: PMC6406806 DOI: 10.3390/ijerph16040590] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/06/2019] [Accepted: 02/14/2019] [Indexed: 12/27/2022]
Abstract
Participatory methods used in Total Worker Health® programs have not been well studied, and little is known about what is needed to successfully implement these programs. We conducted a participatory health promotion program with grocery store workers using the Healthy Workplace Participatory Program (HWPP) from the Center for the Promotion of Health in the New England Workplace. We recruited a design team made up of six line-level workers and a steering committee with management and union representatives; a research team member facilitated the program. Using a formal evaluation framework, we measured program implementation including workplace context, fidelity to HWPP materials, design team and steering committee engagement, program outputs, and perceptions of the program. The HWPP was moderately successful in this setting, but required a substantial amount of worker and facilitator time. Design team members did not have the skills needed to move through the process and the steering committee did not offer adequate support to compensate for the team's shortfall. The evaluation framework provided a simple and practical method for identifying barriers to program delivery. Future studies should address these barriers to delivery and explore translation of this program to other settings.
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Affiliation(s)
- Jaime R Strickland
- Division of General Medical Sciences, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Anna M Kinghorn
- Division of General Medical Sciences, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Bradley A Evanoff
- Division of General Medical Sciences, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Ann Marie Dale
- Division of General Medical Sciences, Washington University School of Medicine, Saint Louis, MO 63110, USA.
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Abstract
Establishment of a new bioinformatics service at the Samuel J. Wood Library of Weill Cornell Medicine was successfully achieved through reference to existing programs and utilization of established success factors. Setting the vision, focusing on the essentials, designing for value, and implementing continuous improvement through feedback, helped to create a successful and integrated bioinformatics service for the medical research community.
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Abu BAZ, Oldewage-Theron W, Aryeetey RNO. Risks of excess iodine intake in Ghana: current situation, challenges, and lessons for the future. Ann N Y Acad Sci 2018; 1446:117-138. [PMID: 30489642 PMCID: PMC6618322 DOI: 10.1111/nyas.13988] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 07/30/2018] [Revised: 10/05/2018] [Accepted: 10/19/2018] [Indexed: 12/21/2022]
Abstract
In Ghana, iodine deficiency was first reported in 1994 among 33% of the population. A nationwide Universal Salt Iodization (USI) program plus other complementary interventions were subsequently implemented as a response. Our paper reviews the current risks of excess iodine status in Ghana and identifies policy and research gaps. A mixed methods review of 12 policies and institutional reports and 13 peer‐reviewed articles was complemented with consultations with 23 key informants (salt producers and distributors, food processors, regulatory agency officials, and healthcare providers) purposively sampled between May and August 2017. The findings show a strong policy environment indicated by regulations on food and salt fortification (Act 851), including the USI regulation. However, currently, only a third of Ghanaian households use adequately iodized salt. Recent evidence shows that voluntarily fortified processed foods (including condiments) supply a considerable amount of iodine to the food system. Limited biological impact data suggest possible household exposure to excessive dietary iodine (>15 parts per million). Currently, there is no systematic tracking of iodine content from fortified foods and other sources. Cross‐sectoral actions are needed to understand this situation better. Key research gap is the lack of comprehensive data on iodine content and intake from other sources in Ghana.
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Affiliation(s)
- Brenda A Z Abu
- Rochester Institute of Technology, College of Health Sciences and Technology, Wegmans School of Health and Nutrition, Rochester, New York.,Department of Nutritional Sciences, Texas Tech University, College of Human Sciences, Lubbock, Texas
| | - Wilna Oldewage-Theron
- Department of Nutritional Sciences, Texas Tech University, College of Human Sciences, Lubbock, Texas
| | - Richmond N O Aryeetey
- Department of Population, Family and Reproductive Health, University of Ghana, School of Public Health, Legon, Accra, Ghana
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Rodríguez-Ledo C, Orejudo S, Cardoso MJ, Balaguer Á, Zarza-Alzugaray J. Emotional Intelligence and Mindfulness: Relation and Enhancement in the Classroom With Adolescents. Front Psychol 2018; 9:2162. [PMID: 30473674 PMCID: PMC6237843 DOI: 10.3389/fpsyg.2018.02162] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 05/29/2018] [Accepted: 10/22/2018] [Indexed: 11/13/2022] Open
Abstract
Emotional intelligence (EI) and mindfulness are two constructs that have been separately studied, and the relation between them still remains unclear. Research in this area has not attempted to go further into how enhancing EI and mindfulness together can achieve better improvements in this ability to attend mindfully. To bridge this knowledge gap, our research goal was to study the relationship between EI and the mindfulness competence in our study sample and to assess the impact of implementing EI and a mindfulness competence developmental program (SEA) about participants’ mindfulness competence. The sample consisted of 156 students aged 11–14 years old from a Spanish public high school. One hundred and eight participants were randomly assigned to the experimental condition, and the remaining 48 were to the control condition. The instruments used to evaluate EI were the CDE-SEC, EQi-Youth Version and the General Empathy Scale. Mindfulness on the School Scope Scale was used to assess mindfulness competences. Social adaptation was evaluated by using the social abilities and adjustment questionnaire BAS3. All the instruments where answered by the participants and have been adapted to a sample of youths with such age specifications. The results showed that EI and mindfulness were related to many of the variables measured by the instruments. Showing a good mindfulness competence was particularly related to having a good general level of the EI trait, and to many of the assessed social and emotional variables. The data indicated a significant relation between the mindfulness competence and having better general empathy skills or being better socially adjusted to the school context. The data also indicated a significant effect on participants’ interior and kinesthetic mindfulness competence after implementing the SEA Program. These findings corroborate the relationship between EI and mindfulness, and the possibility of enhancing mindfulness by applying a direct intervention program in the classroom.
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Affiliation(s)
| | - Santos Orejudo
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Maria Jesús Cardoso
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Álvaro Balaguer
- Department of Learning and Curriculum, University of Navarre, Pamplona, Spain
| | - Javier Zarza-Alzugaray
- Department of Musical and Body Expression, Complutense University of Madrid, Madrid, Spain
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Fischer-Cartlidge E, Ross M, Hernández K, Featherstone A, Haase C. Scalp Cooling: Implementation of a Program at a Multisite Organization. Clin J Oncol Nurs 2018; 22:534-541. [PMID: 30239512 DOI: 10.1188/18.cjon.534-541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 11/17/2022]
Abstract
BACKGROUND Chemotherapy-induced alopecia is a well-known side effect of some types of cancer treatments. With U.S. Food and Drug Administration clearance of two scalp cooling machines, patients with cancer now have the opportunity to minimize this hair loss. However, multiple barriers can exist for organizations when establishing a scalp cooling program. OBJECTIVES This article describes the experience of a large multisite organization that implemented a machine-based scalp cooling program. METHODS Nursing staff led an interprofessional team that addressed components of the program. As a result, eight sites within the authors' organization simultaneously began offering scalp cooling via machine using a single unified process. This approach was then successfully replicated one year later to prepare six additional sites to launch scalp cooling for other solid tumor types beyond breast cancer. FINDINGS Using a structured, collaborative, and interprofessional approach to the implementation of a scalp cooling program at the authors' institution allowed for standardization of care across sites. This approach can be replicated at other healthcare institutions.
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Boppre B, Sundt J, Salisbury EJ. The Limitations and Strengths of the Evidence-Based Practice Attitude Scale as a Measure of Correctional Employees' Attitudes: A Psychometric Evaluation. Int J Offender Ther Comp Criminol 2018; 62:3947-3964. [PMID: 29284376 DOI: 10.1177/0306624x17749450] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Evidence-based practices (EBPs) hold tremendous potential for improving the outcomes of corrections interventions. The implementation of EBPs requires support from staff at all levels of an organization; however, the study of correctional staff attitudes toward organizational change and EBPs is in its infancy. The current study examines the psychometric properties of the Evidence-Based Practice Attitude Scale (EBPAS), an instrument originally designed for mental health professionals, to measure correctional employees' readiness to implement EBPs. The results indicate mixed conclusions regarding the use of the EBPAS with correctional staff. We found that the total scale and subscales are reliable and exhibit high internal consistency. However, the results of an exploratory and confirmatory factor analysis failed to replicate the factor structure from previous research with mental health providers. The findings indicate potential drawbacks regarding the construct validity of the EBPAS for use with correctional personnel.
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Affiliation(s)
| | - Jody Sundt
- 2 Indiana University-Purdue University Indianapolis, USA
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Friedrichsdorf SJ, Bruera E. Delivering Pediatric Palliative Care: From Denial, Palliphobia, Pallilalia to Palliactive. Children (Basel) 2018; 5:E120. [PMID: 30200370 DOI: 10.3390/children5090120] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 08/28/2018] [Indexed: 11/17/2022]
Abstract
Among the over 21 million children with life-limiting conditions worldwide that would benefit annually from a pediatric palliative care (PPC) approach, more than eight million would need specialized PPC services. In the United States alone, more than 42,000 children die every year, half of them infants younger than one year. Advanced interdisciplinary pediatric palliative care for children with serious illnesses is now an expected standard of pediatric medicine. Unfortunately, in many institutions there remain significant barriers to achieving optimal care related to lack of formal education, reimbursement issues, the emotional impact of caring for a dying child, and most importantly, the lack of interdisciplinary PPC teams with sufficient staffing and funding. Data reveals the majority of distressing symptoms in children with serious illness (such as pain, dyspnea and nausea/vomiting) were not addressed during their end-of-life period, and when treated, therapy was commonly ineffective. Whenever possible, treatment should focus on continued efforts to control the underlying illness. At the same time, children and their families should have access to interdisciplinary care aimed at promoting optimal physical, psychological and spiritual wellbeing. Persistent myths and misconceptions have led to inadequate symptom control in children with life-limiting diseases. Pediatric Palliative Care advocates the provision of comfort care, pain, and symptom management concurrently with disease-directed treatments. Families no longer have to opt for one over the other. They can pursue both, and include integrative care to maximize the child's quality of life. Since most of the sickest children with serious illness are being taken care of in a hospital, every children's hospital is now expected to offer an interdisciplinary palliative care service as the standard of care. This article addresses common myths and misconceptions which may pose clinical obstacles to effective PPC delivery and discusses the four typical stages of pediatric palliative care program implementation.
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Abstract
Policy makers face dilemmas when choosing a policy, program, or practice to implement. Researchers in education, public health, and other fields have proposed a sequential approach to identifying interventions worthy of broader adoption, involving pilot, efficacy, effectiveness, and scale-up studies. In this article, we examine a scale-up of an early math intervention to the state level, using a cluster randomized controlled trial. The intervention, Pre-K Mathematics, has produced robust positive effects on children's math ability in prior pilot, efficacy, and effectiveness studies. In the current study, we ask if it remains effective at a larger scale in a heterogeneous collection of pre-K programs that plausibly represent all low-income families with a child of pre-K age who live in California. We find that Pre-K Mathematics remains effective at the state level, with positive and statistically significant effects (effect size on the Early Childhood Longitudinal Study, Birth Cohort Mathematics Assessment = .30, p < .01). In addition, we develop a framework of the dimensions of scale-up to explain why effect sizes might decrease as scale increases. Using this framework, we compare the causal estimates from the present study to those from earlier, smaller studies. Consistent with our framework, we find that effect sizes have decreased over time. We conclude with a discussion of the implications of our study for how we think about the external validity of causal relationships.
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Affiliation(s)
| | - Thomas D Cook
- 2 Northwestern University, Evanston, IL, USA
- 3 George Washington University, Washington, DC, USA
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Abstract
The purpose of this study was to determine the level of integration of school gardens and identify factors that predict integration. 211 New York City schools completed a survey that collected demographic information and utilized the School Garden Integration Scale. A mean garden integration score was calculated, and multiple regression analysis was conducted to determine independent predictors of integration and assess relationships between individual integration characteristics and budget. The average integration score was 34.1 (of 57 points) and ranged from 8 to 53. Operating budget had significant influence on integration score, controlling for all other factors ( p < .0001). Partner organizations, evaluation/feedback, planning the physical space, and characteristics of the physical space were positively and significantly related to budget. The results of this study indicate that any garden can become well integrated, as budget is a modifiable factor. When adequate funding is secured, a well-integrated garden may be established with proper planning and sound implementation.
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Affiliation(s)
| | | | - Raquel Jacquez
- 3 Teachers College, Columbia University, New York, NY, USA
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Abstract
Limited research evaluates substance use prevention and intervention strategies for cultural sensitivity, appropriateness of content, patient/provider interactions, and implementation for racial and ethnic minority populations. This study uses the Consolidated Framework for Implementation Research (CFIR) to examine a community-based evaluation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) for implementation among the Black community in a small, urban setting. Data were gathered through four separate focus groups, one for service providers ( n = 7), one for community youth leaders ( n = 8), and two for community members ( n = 10). Findings suggest that a range of multi-level service needs and underlying mechanisms of implementation should be considered when administering SBIRT within community health settings serving Black populations. This community-involved evaluation of SBIRT responds to the call for the examination of implementation in specific settings, and suggests a need for further examinations of strategies that support engagement through SBIRT and other innovations.
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Affiliation(s)
- Helena D Green
- 1 The Institute for Community Research, Hartford, Connecticut, USA
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Abstract
BACKGROUND Variations in local context bedevil the assessment of external validity: the ability to generalize about effects of treatments. For evaluation, the challenges of assessing external validity are intimately tied to the translation and spread of evidence-based interventions. This makes external validity a question for decision makers, who need to determine whether to endorse, fund, or adopt interventions that were found to be effective and how to ensure high quality once they spread. OBJECTIVE To present the rationale for using theory to assess external validity and the value of more systematic interaction of theory and practice. METHODS We review advances in external validity, program theory, practitioner expertise, and local adaptation. Examples are provided for program theory, its adaptation to diverse contexts, and generalizing to contexts that have not yet been studied. The often critical role of practitioner experience is illustrated in these examples. Work is described that the Robert Wood Johnson Foundation is supporting to study treatment variation and context more systematically. RESULTS Researchers and developers generally see a limited range of contexts in which the intervention is implemented. Individual practitioners see a different and often a wider range of contexts, albeit not a systematic sample. Organized and taken together, however, practitioner experiences can inform external validity by challenging the developers and researchers to consider a wider range of contexts. Researchers have developed a variety of ways to adapt interventions in light of such challenges. CONCLUSIONS In systematic programs of inquiry, as opposed to individual studies, the problems of context can be better addressed. Evaluators have advocated an interaction of theory and practice for many years, but the process can be made more systematic and useful. Systematic interaction can set priorities for assessment of external validity by examining the prevalence and importance of context features and treatment variations. Practitioner interaction with researchers and developers can assist in sharpening program theory, reducing uncertainty about treatment variations that are consistent or inconsistent with the theory, inductively ruling out the ones that are harmful or irrelevant, and helping set priorities for more rigorous study of context and treatment variation.
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Evans WK, Truscott R, Cameron E, Peter A, Reid R, Selby P, Smith P, Hey A. Lessons learned implementing a province-wide smoking cessation initiative in Ontario's cancer centres. ACTA ACUST UNITED AC 2017; 24:e185-e190. [PMID: 28680285 DOI: 10.3747/co.23.3506] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 11/15/2022]
Abstract
PURPOSE A large body of evidence clearly shows that cancer patients experience significant health benefits with smoking cessation. Cancer Care Ontario, the provincial agency responsible for the quality of cancer services in Ontario, has undertaken a province-wide smoking cessation initiative. The strategies used, the results achieved, and the lessons learned are the subject of the present article. METHODS Evidence related to the health benefits of smoking cessation in cancer patients was reviewed. A steering committee developed a vision statement for the initiative, created a framework for implementation, and made recommendations for the key elements of the initiative and for smoking cessation best practices. RESULTS New ambulatory cancer patients are being screened for their smoking status in each of Ontario's 14 regional cancer centres. Current or recent smokers are advised of the benefits of cessation and are directed to smoking cessation resources as appropriate. Performance metrics are captured and used to drive improvement through quarterly performance reviews and provincial rankings of the regional cancer centres. CONCLUSIONS Regional smoking cessation champions, commitment from Cancer Care Ontario senior leadership, a provincial secretariat, and guidance from smoking cessation experts have been important enablers of early success. Data capture has been difficult because of the variety of information systems in use and non-standardized administrative and clinical processes. Numerous challenges remain, including increasing physician engagement; obtaining funding for key program elements, including in-house resources to support smoking cessation; and overcoming financial barriers to access nicotine replacement therapy. Future efforts will focus on standardizing processes to the extent possible, while tailoring the approaches to the populations served and the resources available within the individual regional cancer programs.
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Affiliation(s)
- W K Evans
- Department of Oncology, McMaster University, Hamilton
| | - R Truscott
- Division of Prevention and Cancer Control, Cancer Care Ontario, Toronto
| | - E Cameron
- Division of Prevention and Cancer Control, Cancer Care Ontario, Toronto
| | - A Peter
- Division of Prevention and Cancer Control, Cancer Care Ontario, Toronto
| | - R Reid
- University of Ottawa Heart Institute, Ottawa
| | - P Selby
- The Centre for Addiction and Mental Health, Toronto
| | - P Smith
- Northern Ontario School of Medicine, Thunder Bay; and
| | - A Hey
- Northeast Cancer Centre, Health Sciences North, Sudbury, ON
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Anderson S, Jenner E, Lass K, Burgess S. Perspectives of HIV Clinic Staff on the Implementation of a Client Financial Incentives Program Targeting Viral Suppression. J Assoc Nurses AIDS Care 2017. [PMID: 28629800 DOI: 10.1016/j.jana.2017.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We present perspectives of health care providers and clinic staff on the implementation of a financial incentive program for clients living with HIV in three Louisiana clinics. Interviews were conducted in May-June 2015 with 27 clinic staff to assess their perspectives on implementation of the Health Models financial incentive program, which was initiated in September 2013. Many providers and staff welcomed the program, but some were concerned about sustainability and the ethics of a program that paid patients to receive care. Most said they eventually found the program to be helpful for patients and clinic operations in general, by facilitating partnerships between providers and patients, improving appointment keeping, providing opportunities for patient education, engaging patients in care, and helping patients form new prevention habits. The findings can improve understanding of staff and leadership perceptions of incentive programs and can inform planning and implementation of these programs in the future.
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Liddy C, Rowan M, Valiquette-Tessier SC, Drosinis P, Crowe L, Hogg W. Improved Delivery of Cardiovascular Care (IDOCC): Findings from Narrative Reports by Practice Facilitators. Prev Med Rep 2017; 5:214-219. [PMID: 28271017 PMCID: PMC5330620 DOI: 10.1016/j.pmedr.2016.12.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 09/07/2016] [Revised: 11/10/2016] [Accepted: 12/19/2016] [Indexed: 11/26/2022] Open
Abstract
Practice facilitation can help family physicians adopt
evidence-based guidelines. However, many practices struggle to effectively implement
practice changes that result in meaningful improvement. Building on our previous
research, we examined the barriers to and enablers of implementation perceived by
practice facilitators (PF) in helping practices to adopt the Improved Delivery of
Cardiovascular Care (IDOCC) program, which took place at 84 primary care practices in
Ottawa, Canada between April 2008 and March 2012. We conducted a qualitative analysis
of PFs’ narrative reports using a multiple case study design. We used a combined
purposeful sampling approach to identify cases that 1) reflected experiences typical
of the broader sample and 2) presented sufficient breadth of experience from each
project step and family practice model. Sampling continued until data saturation was
reached. Team members conducted a qualitative analysis of reports using an open and
axial coding style and a constant comparative approach. Barriers and enablers were
divided into five constructs: structural, organizational, provider, patient, and
innovation. Narratives from 13 practice sites were reviewed. A total of 8 barriers
and 11 enablers were consistently identified across practices. Barriers were most
commonly reported at the organizational (n = 3)
and structural level, (n = 2) while enablers were
most common at the innovation level (n = 6).
While physicians responded positively to PFs’ presence and largely supported their
recommendations for practice change, organizational and structural aspects such as
lack of time, minimal staff engagement, and provider reimbursement remained too great
for practices to successfully implement practice-level changes. Trial Registration: ClinicalTrials.gov,
NCT00574808 Eight Barriers and 11 enablers to practice facilitation
emerged across constructs. Barriers were most common at the structural (n = 3) and organizational (n = 2) levels. The majority of enablers occurred at the innovation level
(n = 6). The Chaudoir framework provided a comprehensive picture of
barriers and enablers.
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Affiliation(s)
- Clare Liddy
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Margo Rowan
- Rowan Research & Evaluation, Ottawa, Ontario, Canada
| | | | - Paul Drosinis
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Lois Crowe
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - William Hogg
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
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Jongen CS, McCalman J, Bainbridge RG. The Implementation and Evaluation of Health Promotion Services and Programs to Improve Cultural Competency: A Systematic Scoping Review. Front Public Health 2017; 5:24. [PMID: 28289677 PMCID: PMC5327788 DOI: 10.3389/fpubh.2017.00024] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/08/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Cultural competency is a multifaceted intervention approach, which needs to be implemented at various levels of health-care systems to improve quality of care for culturally and ethnically diverse populations. One level of health care where cultural competency is required is in the provision of health promotion services and programs targeted to diverse patient groups who experience health-care and health inequalities. To inform the implementation and evaluation of health promotion programs and services to improve cultural competency, research must assess both intervention strategies and intervention outcomes. METHODS This scoping review was completed as part of a larger systematic literature search conducted on evaluations of cultural competence interventions in health care in Canada, the United States, Australia, and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched. Overall, 64 studies on cultural competency interventions were found, with 22 being health promotion programs and services. A process of thematic analysis was utilized to identify key intervention strategies and outcomes reported in the literature. RESULTS The review identified three overarching strategies utilized in health promotion services and programs to improve cultural competency: community-focused strategies, culturally focused strategies, and language-focused strategies. Studies took different approaches to delivering culturally competent health interventions, with the majority incorporating multiple strategies from each overarching category. There were various intermediate health-care and health outcomes reported across the included studies. Most commonly reported were positive reports of patient satisfaction, patient/participant service access, and program/study retention rates. The health outcome results indicate positive potential of health promotion services and programs to improve cultural competency to impact cardiovascular disease and mental health outcomes. However, due to measurement and study quality issues, it is difficult to determine the extent of the impacts. DISCUSSION Examined together, these intervention strategies and outcomes provide a framework that can be used by service providers and researchers in the implementation and evaluation of health promotion services and programs to improve cultural competency. While there is evidence indicating the effectiveness of such health promotion interventions in improving intermediate and health outcomes, further attention is needed to issues of measurement and study quality.
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Affiliation(s)
- Crystal Sky Jongen
- School of Human Health and Social Sciences, Central Queensland University, Cairns, QLD, Australia
| | - Janya McCalman
- School of Human Health and Social Sciences, Central Queensland University, Cairns, QLD, Australia
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Paulsell D, Thomas J, Monahan S, Seftor NS. A Trusted Source of Information: How Systematic Reviews Can Support User Decisions About Adopting Evidence-Based Programs. Eval Rev 2017; 41:50-77. [PMID: 27590676 DOI: 10.1177/0193841x16665963] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Systematic reviews sponsored by federal departments or agencies play an increasingly important role in disseminating information about evidence-based programs and have become a trusted source of information for administrators and practitioners seeking evidence-based programs to implement. These users vary in their knowledge of evaluation methods and their ability to interpret systematic review findings. They must consider factors beyond program effectiveness when selecting an intervention, such as the relevance of the intervention to their target population, community context, and service delivery system; readiness for replication and scale-up; and the ability of their service delivery system or agency to implement the intervention. OBJECTIVE To support user decisions about adopting evidence-based practices, this article discusses current systematic review practices and alternative approaches to synthesizing and presenting findings and providing information. METHOD We reviewed the publicly available information on review methodology and findings for eight federally funded systematic reviews in the labor, education, early childhood, mental health/substance abuse, family support, and criminal justice topic areas. CONCLUSION The eight federally sponsored evidence reviews we examined all provide information that can help users to interpret findings on evidence of effectiveness and to make adoption decisions. However, they are uneven in the amount, accessibility, and consistency of information they report. For all eight reviews, there is room for improvement in supporting users' adoption decisions through more detailed, accessible, and consistent information in these areas.
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Beard M, Chuang E, Haughton J, Arredondo EM. Determinants of Implementation Effectiveness in a Physical Activity Program for Church-Going Latinas. Fam Community Health 2016; 39:225-233. [PMID: 27536927 PMCID: PMC4991556 DOI: 10.1097/fch.0000000000000122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Faith-based interventions show promise for reducing health disparities among ethnic minority populations. However, churches vary significantly in their readiness and willingness to support these programs. Semistructured interviews were conducted with priests, other church leaders, and lay health advisors in churches implementing a physical activity intervention targeting Latinas. Implementation effectiveness was operationalized as average 6-month participation rates in physical activity classes at each church. Factors facilitating implementation include church leader support and strength of parishioners' connection to the church. Accounting for these church-level factors may be critical in determining church readiness to participate in health promotion activities.
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Affiliation(s)
- Megan Beard
- Center for Community Health, Department of Pediatrics, University of California, San Diego, La Jolla (Ms Beard); Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (Dr Chuang); and Institute of Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California (Ms Haughton and Dr Arredondo)
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Charafeddine L, Badran M, Nakad P, Ammar W, Yunis K. Strategic assessment of implementation of neonatal resuscitation training at a national level. Pediatr Int 2016; 58:595-600. [PMID: 26662795 DOI: 10.1111/ped.12868] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/10/2015] [Accepted: 12/01/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Structuring and implementation of an endorsed neonatal resuscitation program (NRP) results in decreased neonatal mortality. This study evaluated the implementation of formal training using the NRP in a private sector context of a middle income country. METHODS Between 2008 and 2011, the National Collaborative Perinatal Neonatal Network (NCPNN) supported by the Ministry of Health piloted the implementation of NRP training in member hospitals throughout the country. Training of trainers (TOT) then providers (TOP) took place via workshops where a lecture was given followed by hands-on training using low-fidelity manikins. Pre- and post-workshop knowledge assessment and hands-on training evaluation were done. t-test and one-way ANOVA were used to compare mean differences in pre- and post-workshop scores and percent improvement across specialties and locations. RESULTS Of 20 TOT participants, nine (45%) conducted NRP in their hospitals. Ten TOP workshops included 256 professionals. The majority were doctors (128, 50%), followed by nurses (99, 39%) and midwives (20, 8%). Overall pre-training scores (67.25 ± 16.00%) were significantly lower than post-training scores (87.48 ± 11.89%; P = 0.000); percent improvement among all participants was 37.12 ± 41.15%; P = 0.82). Nurses and participants from the northern governorate had highest mean difference in before/after scores (21.56 ± 12.32 and 23.29 ± 6.62, respectively). Midwives had the highest percent improvement (40.44 ± 47.28). All but 25 participants (9.8%) passed the megacode at the first attempt. CONCLUSIONS Implementing NRP training is essential to increase the knowledge and skills of health-care professionals. It is sustainable with support from the Ministry and other sources. Continuing education should be mandated at the Ministry of Health level.
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Affiliation(s)
- Lama Charafeddine
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.,National Collaborative Perinatal Neonatal Network, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Badran
- National Collaborative Perinatal Neonatal Network, American University of Beirut Medical Center, Beirut, Lebanon
| | - Pascale Nakad
- National Collaborative Perinatal Neonatal Network, American University of Beirut Medical Center, Beirut, Lebanon
| | - Walid Ammar
- Ministry of Public Health of Lebanon, Beirut, Lebanon
| | - Khalid Yunis
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.,National Collaborative Perinatal Neonatal Network, American University of Beirut Medical Center, Beirut, Lebanon
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