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Izquierdo-Tort S, Alatorre A, Arroyo-Gerala P, Shapiro-Garza E, Naime J, Dupras J. Exploring local perceptions and drivers of engagement in biodiversity monitoring among participants in payments for ecosystem services schemes in southeastern Mexico. Conserv Biol 2024:e14282. [PMID: 38660922 DOI: 10.1111/cobi.14282] [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: 01/31/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 04/26/2024]
Abstract
Payments for ecosystem services (PES) are widely applied incentive-based instruments with diverse objectives that increasingly include biodiversity conservation. Yet, there is a gap in understanding of how to best assess and monitor programs' biodiversity outcomes. We examined perceptions and drivers of engagement related to biodiversity monitoring through surveys among current PES participants in 7 communities in Mexico's Selva Lacandona. We conducted workshops among survey participants that included training and field deployment of tools used to monitor biodiversity and land cover, including visual transects, camera traps, acoustic recorders, and forest cover satellite images. We conducted pre- and postworkshop surveys in each community to evaluate changes in respondents' perceptions following exposure to biodiversity monitoring training and related field activities. We also reviewed existing research on participatory environmental management and monitoring approaches. One quarter of current PES participants in the study area participated in our surveys and workshops. The majority stated interest in engaging in diverse activities related to the procedural aspects of biodiversity monitoring (e.g., planning, field data collection, results dissemination) and acknowledged multiple benefits of introducing biodiversity monitoring into PES (e.g., knowledge and capacity building, improved natural resource management, and greater support for conservation). Household economic reliance on PES was positively associated with willingness to engage in monitoring. Technical expertise, time, and monetary constraints were deterrents. Respondents were most interested in monitoring mammals, birds, and plants and using visual transects, camera traps, and forest cover satellite images. Exposure to monitoring enhanced subsequent interest in monitoring by providing respondents with new insights from their communities related to deforestation and species' abundance and diversity. Respondents identified key strengths and weaknesses of applying different monitoring tools, which suggests that deploying multiple tools simultaneously can increase local engagement and produce complementary findings and data. Overall, our findings support the relevance and usefulness of incorporating participatory biodiversity monitoring into PES.
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Affiliation(s)
- Santiago Izquierdo-Tort
- Instituto de Investigaciones Económicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Andrea Alatorre
- Département Des Sciences Naturelles, Université du Québec en Outaouais, Ripon, Quebec, Canada
- Institute of Development Policy, University of Antwerp, Antwerpen, Belgium
| | | | | | - Julia Naime
- Center for International Forestry Research, Bogor, Indonesia
| | - Jérôme Dupras
- Institut des Sciences de la Forêt tempérée, Université du Québec en Outaouais, Université du Québec en Outaouais, Ripon, Quebec, Canada
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Landström C, Sarmiento E, Whatmore SJ. Stakeholder engagement does not guarantee impact: A co-productionist perspective on model-based drought research. Soc Stud Sci 2024; 54:210-230. [PMID: 37753924 PMCID: PMC10981195 DOI: 10.1177/03063127231199220] [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: 09/28/2023]
Abstract
Stakeholder engagement has become a watchword for environmental scientists to assert the societal relevance of their projects to funding agencies. In water research based on computer simulation modelling, stakeholder engagement has attracted interest as a means to overcome low uptake of new tools for water management. An increasingly accepted view is that more and better stakeholder involvement in research projects will lead to increased adoption of the modelling tools created by scientists in water management. However, we cast doubt on this view by drawing attention to how the freedom of stakeholder organizations to adopt new scientific modelling tools in their regular practices is circumscribed by the societal context. We use a modified concept of co-production in an analysis of a case of scientific research on drought in the UK to show how relationships between actors in the drought governance space influence the uptake of scientific modelling tools. The analysis suggests an explanation of why stakeholder engagement with one scientific project led to one output (data) getting adopted by stakeholders while another output (modelling tools) attracted no discernible interest. Our main objective is to improve the understanding of the limitations to stakeholder engagement as a means of increasing societal uptake of scientific research outputs.
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Affiliation(s)
- Catharina Landström
- Chalmers University of Technology, Gothenburg, Sweden
- University of Oxford, Oxford, UK
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Kosa SD, Coelho M, Friedman-Burley J, Lebel N, Kelly CE, Macdonald S, Du Mont J. Bridging Gaps in Collaboration Between Community Organizations and Hospital-Based Violence Treatment Centers Serving Transgender Sexual Assault Survivors. J Interpers Violence 2024; 39:1811-1829. [PMID: 37970834 DOI: 10.1177/08862605231211922] [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: 11/19/2023]
Abstract
Community and healthcare organizations have not historically collaborated effectively, leaving gaps in the continuum of care for survivors of sexual assault. These gaps are particularly acutely felt by transgender (trans) survivors, who experience additional barriers to care and face higher rates of sexual assault. To bridge these gaps and enhance the provision of comprehensive support for trans people, we developed an intersectoral network of trans-positive community and hospital-based organizations in Ontario, Canada. As part of a baseline evaluation of the network, we conducted a social network analysis to determine the extent and nature of collaboration between members within and across these two sectors. Using a validated social network analysis tool (PARTNER survey), data were collected from June 22 to July 22, 2021. The extent of collaboration was examined by relationship type: intrasectoral (same sector) and intersectoral (different sectors). The nature of collaboration was examined using relational scores (value: power, level of involvement, potential resource contribution; trust: reliability, mission congruence, openness to discussion). Fifty-four community organizations (65.9% of 82 invited) and 24 hospital-based violence treatment centers (64.9% of 37 invited) responded. The majority of collaborations were within, rather than across, the two sectors: of all 378 collaborations described, 70.9% (n = 268) were intrasectoral collaborations and 29.1% (n = 110) were intersectoral collaborations. Intersectoral relationships were characterized by lower scores for level of involvement, trust, reliability, and mission congruence than intrasectoral relationships, but higher scores for power. These findings were shared in a virtual consultation session of key stakeholders, in which some participants expressed "surprise" and concern for the lack of collaboration and character of relationships across sectors. Recommendations to increase intersectoral collaboration, which included intersectoral program planning and service design and supporting increased opportunities for intersectoral training and knowledge exchange, are presented.
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Affiliation(s)
- Sarah Daisy Kosa
- Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, ON, Canada
| | - Madelaine Coelho
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Joseph Friedman-Burley
- Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, ON, Canada
| | - Nicholas Lebel
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Carolyn Emma Kelly
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Sheila Macdonald
- Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, ON, Canada
| | - Janice Du Mont
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, ON, Canada
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Russo S, Caruso R, Conte G, Magon A, Vangone I, Bascape' B, Maga G, Pasek M, Arrigoni C. Development of a Core Outcome Set for Family and Community Nursing: Protocol for a Delphi Study. JMIR Res Protoc 2024; 13:e51084. [PMID: 38551623 PMCID: PMC11015374 DOI: 10.2196/51084] [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: 07/20/2023] [Revised: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Family and community nurses (FCNs) play a crucial role in delivering primary care to patients within their homes and communities. A key aspect of their role involves various health interventions, which are influenced by their unique competencies, such as health promotion, advanced clinical knowledge, and strong interpersonal skills. However, it is essential to understand which specific health outcomes these interventions impact to better understand the relationship between FCNs' skills and the health results. OBJECTIVE This study aims to outline the steps we will take to develop a set of core outcomes. These outcomes will be particularly sensitive to the health interventions carried out by FCNs, providing a clearer picture of their practice's impact. METHODS A Delphi survey will be used for this research, conducted from January to December 2024. The process will involve 5 steps and input from 3 stakeholder categories. These stakeholders will help identify a preliminary list of outcomes that will form the basis of our core outcome set (COS). RESULTS This guideline will be beneficial for a wide range of stakeholders involved in COS development, including COS developers, trialists, systematic reviewers, journal editors, policy makers, and patient groups. As of January 2024, we have successfully completed the first stage of the study, with the stakeholder group approving the reported outcomes and assigning participant lists for each stakeholder group. CONCLUSIONS This study will provide a roadmap for identifying the key health outcomes influenced by the interventions of FCNs. The multistakeholder, multiphase approach will ensure a comprehensive and inclusive process. Ultimately, the findings will enhance our understanding of FCNs' impact on health outcomes, leading to more effective primary care strategies and policies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/51084.
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Affiliation(s)
- Sara Russo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosario Caruso
- Health Professions Researchand Development Unit, Istituto di Ricerca e cura a carattere scientifico Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Gianluca Conte
- Health Professions Researchand Development Unit, Istituto di Ricerca e cura a carattere scientifico Policlinico San Donato, San Donato Milanese, Italy
| | - Arianna Magon
- Health Professions Researchand Development Unit, Istituto di Ricerca e cura a carattere scientifico Policlinico San Donato, San Donato Milanese, Italy
| | - Ida Vangone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Nursing Degree Course University of Pavia, Istituto Maugeri Istituto di Ricovero e Cura a Carattere Scientifico, Pavia, Italy
| | - Barbara Bascape'
- Nursing Degree Course University of Pavia, Istituti Clinici di Pavia e Vigevano, Pavia, Italy
| | - Giulia Maga
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Malgorzata Pasek
- Department of Nursing, Faculty of Health, University of Applied Sciences in Tarnów, Tarnów, Poland
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
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Vita A, Barlati S, Porcellana M, Sala E, Lisoni J, Brogonzoli L, Percudani ME, Iardino R. The patient journey project in Italian mental health services: results from a co-designed survey on clinical interventions and current barriers to improve the care of people living with schizophrenia. Front Psychiatry 2024; 15:1382326. [PMID: 38606407 PMCID: PMC11007707 DOI: 10.3389/fpsyt.2024.1382326] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/04/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction The Patient Journey Project aimed to analyze the scenario among Italian Mental Health Services (MHS) to understand the clinical interventions that are properly implemented and the ones deserving further implementation to design an effective treatment plan for patients living with schizophrenia (PLWS). Methods The 60-items survey was co-designed with all the stakeholders (clinicians, expert patients and caregivers) involved in the Patient Journey and focused on three phases of schizophrenia course: early detection and management, acute phase management, long-term management/continuity of care. Respondents were Heads of the Mental Health Departments and Addiction Services (MHDAS) or facilities directors throughout Italian MHS. For each statement, respondents expressed the consensus on the importance and the degree of implementation in clinical practice. Results Considering the importance of the statement, strong consensus was reached for most of the statements. Good levels of implementation were found on 2/17 statements of early detection and management, on 3/16 statements for acute phase management and on 1/27 statements of long-term management/continuity of care. Poor levels of implementation were found on 1/17 statements of early detection and management, none of acute phase management, and 4/27 statements for long-term management/continuity of care. Moderate levels of implementation were found on 14/17 statements for early detection and management, on 13/16 statements of acute phase management, and on 22/27 statements of long-term management/continuity of care. Thus, among Italian MHDAS, most interventions for PLWS were moderately implemented in clinical practice. Discussion Italian MHS have to provide new strategies and structural actions to overcome these current limitations and barriers to effectively improve the journey of PLWS. The areas that deserve most implementation include interventions during the early stage (especially the continuity of care between Child and Adolescent Mental Health Services and Adult Mental Health Services), the evidence-based psychosocial interventions during the chronic stages of the disorder, and the continuity of care after acute hospitalization.
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Affiliation(s)
- Antonio Vita
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Stefano Barlati
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Matteo Porcellana
- Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Italy
| | - Elisa Sala
- Department of Political and Social Sciences, University of Pavia, Pavia, Italy
| | - Jacopo Lisoni
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
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Powell PA. Incorporating public and wider stakeholder views in the design of health state valuation studies in adults and young people: an undervalued resource? Expert Rev Pharmacoecon Outcomes Res 2024:1-4. [PMID: 38517687 DOI: 10.1080/14737167.2024.2334349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/20/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Philip A Powell
- Sheffield Centre for Health and Related Research, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
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Ingold H, Gomez GB, Stuckler D, Vassall A, Gafos M. "Going into the black box": a policy analysis of how the World Health Organization uses evidence to inform guideline recommendations. Front Public Health 2024; 12:1292475. [PMID: 38584925 PMCID: PMC10995388 DOI: 10.3389/fpubh.2024.1292475] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/29/2024] [Indexed: 04/09/2024] Open
Abstract
Background The World Health Organization (WHO) plays a crucial role in producing global guidelines. In response to previous criticism, WHO has made efforts to enhance the process of guideline development, aiming for greater systematicity and transparency. However, it remains unclear whether these changes have effectively addressed these earlier critiques. This paper examines the policy process employed by WHO to inform guideline recommendations, using the update of the WHO Consolidated HIV Testing Services (HTS) Guidelines as a case study. Methods We observed guideline development meetings and conducted semi-structured interviews with key participants involved in the WHO guideline-making process. The interviews were recorded, transcribed, and analysed thematically. The data were deductively coded and analysed in line with the main themes from a published conceptual framework for context-based evidence-based decision making: introduction, interpretation, and application of evidence. Results The HTS guideline update was characterized by an inclusive and transparent process, involving a wide range of stakeholders. However, it was noted that not all stakeholders could participate equally due to gaps in training and preparation, particularly regarding the complexity of the Grading Recommendations Assessment Development Evaluation (GRADE) framework. We also found that WHO does not set priorities for which or how many guidelines should be produced each year and does not systematically evaluate the implementation of their recommendations. Our interviews revealed disconnects in the evidence synthesis process, starting from the development of systematic review protocols. While GRADE prioritizes evidence from RCTs, the Guideline Development Group (GDG) heavily emphasized "other" GRADE domains for which little or no evidence was available from the systematic reviews. As a result, expert judgements and opinions played a role in making recommendations. Finally, the role of donors and their presence as observers during GDG meetings was not clearly defined. Conclusion We found a need for a different approach to evidence synthesis due to the diverse range of global guidelines produced by WHO. Ideally, the evidence synthesis should be broad enough to capture evidence from different types of studies for all domains in the GRADE framework. Greater structure is required in formulating GDGs and clarifying the role of donors through the process.
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Affiliation(s)
- Heather Ingold
- Department of Global Health and Development, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Unitaid, Global Health Campus, Geneva, Switzerland
| | - Gabriela B. Gomez
- Department of Global Health and Development, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - David Stuckler
- Department of Social Sciences and Politics, Bocconi University, Milan, Italy
| | - Anna Vassall
- Department of Global Health and Development, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mitzy Gafos
- Department of Global Health and Development, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Bente BE, Van Dongen A, Verdaasdonk R, van Gemert-Pijnen L. eHealth implementation in Europe: a scoping review on legal, ethical, financial, and technological aspects. Front Digit Health 2024; 6:1332707. [PMID: 38524249 PMCID: PMC10957613 DOI: 10.3389/fdgth.2024.1332707] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/12/2024] [Indexed: 03/26/2024] Open
Abstract
Background The evolution of eHealth development has shifted from standalone tools to comprehensive digital health environments, fostering data exchange among diverse stakeholders and systems. Nevertheless, existing research and implementation frameworks have primarily emphasized technological and organizational aspects of eHealth implementation, overlooking the intricate legal, ethical, and financial considerations. It is essential to discover what legal, ethical, financial, and technological challenges should be considered to ensure successful and sustainable implementation of eHealth. Objective This review aims to provide insights into barriers and facilitators of legal, ethical, financial, and technological aspects for successful implementation of complex eHealth technologies, which impacts multiple levels and multiple stakeholders. Methods A scoping review was conducted by querying PubMed, Scopus, Web of Science, and ACM Digital Library (2018-2023) for studies describing the implementation process of eHealth technologies that facilitate data exchange. Studies solely reporting clinical outcomes or conducted outside Europe were excluded. Two independent reviewers selected the studies. A conceptual framework was constructed through axial and inductive coding, extracting data from literature on legal, ethical, financial, and technological aspects of eHealth implementation. This framework guided systematic extraction and interpretation. Results The search resulted in 7.308 studies that were screened for eligibility, of which 35 (0.48%) were included. Legal barriers revolve around data confidentiality and security, necessitating clear regulatory guidelines. Ethical barriers span consent, responsibility, liability, and validation complexities, necessitating robust frameworks. Financial barriers stem from inadequate funding, requiring (commercial) partnerships and business models. Technological issues include interoperability, integration, and malfunctioning, necessitating strategies for enhancing data reliability, improving accessibility, and aligning eHealth technology with existing systems for smoother integration. Conclusions This research highlights the multifaceted nature of eHealth implementation, encompassing legal, ethical, financial, and technological considerations. Collaborative stakeholder engagement is paramount for effective decision-making and aligns with the transition from standalone eHealth tools to integrated digital health environments. Identifying suitable stakeholders and recognizing their stakes and values enriches implementation strategies with expertise and guidance across all aspects. Future research should explore the timing of these considerations and practical solutions for regulatory compliance, funding, navigation of responsibility and liability, and business models for reimbursement strategies.
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Affiliation(s)
- Britt E. Bente
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, University of Twente, Esnchede, Netherlands
| | - Anne Van Dongen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, University of Twente, Esnchede, Netherlands
| | - Ruud Verdaasdonk
- Section of Health, Technology and Implementation, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Lisette van Gemert-Pijnen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, University of Twente, Esnchede, Netherlands
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He T, Cui W, Feng Y, Li X, Yu G. Digital health integration for noncommunicable diseases: Comprehensive process mapping for full-life-cycle management. J Evid Based Med 2024; 17:26-36. [PMID: 38361398 DOI: 10.1111/jebm.12583] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/05/2024] [Indexed: 02/17/2024]
Abstract
AIM To create a systematic digital health process mapping framework for full-life-cycle noncommunicable disease management grounded in key stakeholder engagement. METHODS A triphasic, qualitative methodology was employed to construct a process mapping framework for digital noncommunicable disease management in Shanghai, China. The first phase involved desk research to examine current guidance and practices. In the second phase, pivotal stakeholders participated in focus group discussions to identify prevalent digital touchpoints across lifetime noncommunicable disease management. In the final phase, the Delphi technique was used to refine the framework based on expert insights and obtain consensus. RESULTS We identified 60 digital touchpoints across five essential stages of full-life-cycle noncommunicable disease management. Most experts acknowledged the rationality and feasibility of these touchpoints. CONCLUSIONS This study led to the creation of a comprehensive digital health process mapping framework that encompasses the entire life cycle of noncommunicable disease management. The insights gained emphasize the importance of a systemic strategic, person-centered approach over a fragmented, purely technocentric approach. We recommend that healthcare professionals use this framework as a linchpin for efficient disease management and seamless technology incorporation in clinical practice.
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Affiliation(s)
- Tianrui He
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenbin Cui
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuxuan Feng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xingyi Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guangjun Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wilkinson A, Thabethe S, Salzwedel J, Slack C. The "3 Ps" of EmPowerment, Partnership and Protection - Stakeholder Perceptions of Beneficial Outcomes of Engagement in HIV Prevention Trials. J Empir Res Hum Res Ethics 2024; 19:37-47. [PMID: 38105464 PMCID: PMC10958749 DOI: 10.1177/15562646231221259] [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: 04/14/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
Background: Stakeholder engagement is increasingly recognized as a key component of ethical research in leading ethics guidelines. Ethics commentators have also argued that engagement has several beneficial outcomes for the field. Aim: This paper reports on the beneficial outcomes of stakeholder engagement in HIV prevention trials as perceived by stakeholders in the field. Method: We conducted 28 interviews between 2019 and 2021 with interviewees from various stakeholder groups in 12 countries and used thematic analysis to analyze the transcripts. Findings: We found three major themes - namely emPowerment where engagement is perceived to empower stakeholders, Partnerships where engagement is perceived to build equitable relationships and Protections where engagement is perceived to strengthen protections for participants and community stakeholders and to improve science. Conclusions: These findings map closely onto beneficial outcomes envisaged by ethics guidelines, however, the relationship between outcomes seen as beneficial deserves further exploration.
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Affiliation(s)
- Abigail Wilkinson
- HIV AIDS Vaccines Ethics Group (HAVEG), School of Applied Human Sciences, College of Humanities, University of KwaZulu-Natal, South Africa
| | - Siyabonga Thabethe
- HIV AIDS Vaccines Ethics Group (HAVEG), School of Applied Human Sciences, College of Humanities, University of KwaZulu-Natal, South Africa
| | | | - Catherine Slack
- HIV AIDS Vaccines Ethics Group (HAVEG), School of Applied Human Sciences, College of Humanities, University of KwaZulu-Natal, South Africa
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Musie MR, Mulaudzi FM, Anokwuru R, Sepeng NV. An Inclusive Framework for Collaboration between Midwives and Traditional Birth Attendants and Optimising Maternal and Child Healthcare in Restricted Rural Communities in South Africa: Policy Considerations. Healthcare (Basel) 2024; 12:363. [PMID: 38338248 PMCID: PMC10855344 DOI: 10.3390/healthcare12030363] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/12/2024] Open
Abstract
Collaboration between midwives and traditional birth attendants for maternal and child healthcare is a challenge in rural South African communities due to the absence of a guiding framework. To address this, this study sought to develop and validate an inclusive framework informed by the Donabedian structure-process-outcome (SPO) framework for collaboration between these healthcare professionals. METHOD Key stakeholders were invited to participate in a co-creation workshop to develop the framework. Twenty (20) participants were purposively sampled based on their maternal and child healthcare expertise. A consensus design using the nominal group technique was followed. RESULTS Participants identified the components needed in the framework, encompassing (i) objectives, (ii) structures, (iii) processes, and (iv) outcomes. CONCLUSION This paper will contribute to the development of an inclusive healthcare framework, providing insights for stakeholders, policymakers, and practitioners seeking to improve maternal and child healthcare outcomes in resource-constrained, rural settings. Ultimately, the proposed framework will create a sustainable and culturally sensitive model that optimises the strengths of midwives and TBAs and fosters improved healthcare delivery to rural South African communities.
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Affiliation(s)
- Maurine Rofhiwa Musie
- Department of Nursing Sciences, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa (N.V.S.)
| | - Fhumulani Mavis Mulaudzi
- Department of Nursing Sciences, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa (N.V.S.)
| | - Rafiat Anokwuru
- Department of Maternal and Child Health, llishan School of Nursing, Babcock University Remo, Ilishan-Remo 121003, Nigeria;
| | - Nombulelo Veronica Sepeng
- Department of Nursing Sciences, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa (N.V.S.)
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Bomhof CHC, Smids J, Sybesma S, Schermer M, Bunnik EM. Ethics of access to newly approved expensive medical treatments: multi-stakeholder dialogues in a publicly funded healthcare system. Front Pharmacol 2024; 14:1265029. [PMID: 38352693 PMCID: PMC10863042 DOI: 10.3389/fphar.2023.1265029] [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: 07/21/2023] [Accepted: 12/29/2023] [Indexed: 02/16/2024] Open
Abstract
Background: Due to rising healthcare expenditures, countries with publicly funded healthcare systems face challenges when providing newly approved expensive anti-cancer treatments to all eligible patients. In the Netherlands in 2015, the so-called Coverage Lock (CL), was introduced to help safeguard the sustainability of the healthcare system. Since then, newly approved treatments are no longer automatically reimbursed. Previous work has shown that as policies for access to CL treatments are lacking, patient access to non-reimbursed treatments is limited and variable, which raises ethical issues. The ethics of access were discussed in a series of multi-stakeholder dialogues in the Netherlands. Methods: Three dialogues were held in early 2023 and included physicians, health insurers, hospital executives, policymakers, patients, citizens, and representatives of pharmaceutical companies, patient and professional organizations. In advance, participants had received an 'argument scheme' featuring three models: 1) access based on third-party payment (e.g., by pharmaceutical companies, health insurers or hospitals) 2) access based on out-of-pocket payments by patients 3) no access to CL treatments. During the dialogues, participants were asked to discuss the merits of the ethical arguments for and against these models together, and ultimately to weigh them. The discussions were audio-taped, transcribed, coded, and thematically analyzed. Results: Generally, most stakeholders were in favour of allowing access-at least when treatments are clearly beneficial-to treatments in the CL. When discussing third-party payment, stakeholders favoured payment by pharmaceutical companies over payment by health insurers or hospitals, not wanting to usurp collective funds while cost-effectiveness assessments are still pending. Largely, stakeholders were not in favour of out-of-pocket payments, emphasizing solidarity and equal access as important pillars of the Dutch healthcare system. Recurrent themes included the conflict between individual and collective interests, shifting attitudes, withholding access as a means to put pressure on the system, and the importance of transparency about access to CL-treatments. Conclusion: Policies for access to non-reimbursed treatments should address stakeholders' concerns regarding transparency, equal access and solidarity, and loss of potential health benefits for patients. Multi-stakeholder dialogues are an important tool to help inform policy-making on access to newly approved (too) expensive treatments in countries facing challenges to the sustainability of healthcare systems.
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Affiliation(s)
- Charlotte H. C. Bomhof
- Department of Medical Ethics, Philosophy and History of Medicine, Erasmus MC, Rotterdam, Netherlands
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Langner J, Langston K, Mrachek A, Faitak B, Martin P, Cueto A, Clampitt JL, Long CR, Bartow A, Bodey S, McElfish PA. Creating Healthy Environments for Schools: A Comprehensive Approach to Improving Nutrition in Arkansas Public Schools. J Sch Health 2024. [PMID: 38267004 DOI: 10.1111/josh.13437] [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: 08/18/2023] [Revised: 12/12/2023] [Accepted: 01/04/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Nutrition plays a vital role in children's physical and emotional health. More than half of school age children's calories are provided in the school food environment, making school interventions an opportunity to address child nutrition. METHODS The Creating Health Environments for Schools (CHEFS) program is designed to leverage local resources to create customized solutions that improve the nutritional content of school food and encourage children to choose healthier food. There are 8 components: (1) customizing nutrition plans, (2) modifying/replacing menu items, (3) helping procure healthier food, (4) providing equipment grants, (5) training cafeteria staff, (6) implementing environmental changes and nudges, (7) engaging students and parents, and (8) supporting sustainability. Supporting child nutrition directors is key to facilitating cooperation with schools. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Menu modifications and procurement are interrelated and depend on successfully collaborating with corporate, independent, and local food services organizations. Limited school budgets require low or no-cost solutions and staff training. Student and parent engagement are critical to facilitate culturally-appropriate solutions that increase awareness of healthy food. CONCLUSIONS Every school district has particular resources and constraints. CHEFs engaged stakeholders to design customized solutions and encourage healthier nutrition for school children.
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Affiliation(s)
- Jonathan Langner
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR, 72762
| | - Krista Langston
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR, 72762
| | - Ally Mrachek
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR, 72762
| | - Bonnie Faitak
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR, 72762
| | - Pamela Martin
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR, 72762
| | - Alexa Cueto
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR, 72762
| | - Jennifer L Clampitt
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR, 72762
| | | | | | | | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, 72762
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Dicko B, Kodio S, Samoura H, Traoré F, Sykes N, Drabo M, Thizy D, Coche I, Robinson B, Sanogo K, Yagouré B, Diop S, Coulibaly MB. Stakeholder engagement in the development of genetically modified mosquitoes for malaria control in West Africa: lessons learned from 10 years of Target Malaria's work in Mali. Front Bioeng Biotechnol 2024; 11:1286694. [PMID: 38249804 PMCID: PMC10797414 DOI: 10.3389/fbioe.2023.1286694] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/05/2023] [Indexed: 01/23/2024] Open
Abstract
From 2012 to 2023, the Malaria Research and Training Center (MRTC), based out of the University of Sciences, Techniques and Technologies of Bamako (USTTB), was part of the Target Malaria research consortium working towards developing novel gene drive-based tools for controlling populations of malaria vector mosquitoes. As part of this work, Target Malaria Mali has undertaken a range of in-depth engagement activities with the communities where their research is conducted and with other stakeholders nationally. These activities were meant to ensure that the project's activities took place with the agreement of those communities, and that those communities were able to play a role in shaping the project's approach to ensure that its eventual outcomes were in line with their needs and concerns. This paper aims to conduct a critical assessment of those 10 years of stakeholder engagement in order to identify good practices which can inform future engagement work on gene drive research in West Africa. It sets out a range of approaches and practices that enabled the Target Malaria Mali team to engage a variety of stakeholders, to share information, collect feedback, and determine community agreement, in a manner that was inclusive, effective, and culturally appropriate. These can be useful tools for those working on gene drive research and other area-wide vector control methods in West African contexts to ensure that their research is aligned with the interests of the communities who are intended to be its ultimate beneficiaries, and to allow those communities to play a meaningful role in the research process.
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Affiliation(s)
- Bakara Dicko
- Malaria Research and Training Center at the University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Souleymane Kodio
- Malaria Research and Training Center at the University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Hatouma Samoura
- Malaria Research and Training Center at the University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Fatoumata Traoré
- Malaria Research and Training Center at the University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Naima Sykes
- Imperial College London, London, United Kingdom
| | | | | | | | | | - Kadiatou Sanogo
- Malaria Research and Training Center at the University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Bilkissou Yagouré
- Malaria Research and Training Center at the University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Samba Diop
- Malaria Research and Training Center at the University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mamadou B. Coulibaly
- Malaria Research and Training Center at the University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
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15
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Cromer SJ, Steiner B, York C, Mastrorilli J, Lake GA, Leibowitz S, Simmons L, Steppel-Reznik J, Low G, Fischer MA, Patorno E, Wexler DJ. Successful implementation of a stakeholder engagement program for pharmacoepidemiologic research. Pharmacoepidemiol Drug Saf 2024; 33:e5727. [PMID: 37985010 PMCID: PMC10841974 DOI: 10.1002/pds.5727] [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: 05/16/2023] [Revised: 10/06/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE Rigorously conducted pharmacoepidemiologic research requires methodologically complex study designs and analysis yet evaluates problems of high importance to patients and clinicians. Despite this, participation in and mechanisms for stakeholder engagement in pharmacoepidemiologic research are not well-described. Here, we describe our approach and lessons learned from engaging stakeholders, of varying familiarity with research methods, in a rigorous multi-year pharmacoepidemiologic research program evaluating the comparative effectiveness of diabetes medications. METHODS We recruited 5 patient and 4 clinician stakeholders; each was compensated for their time. Stakeholders received initial formal training in observational research and pharmacoepidemiologic methods sufficient to enable contribution to the research project. After onboarding, stakeholder engagement meetings were held virtually, in the evening, 2-3 times annually. Each was approximately 90 min and focused on 1-2 specific questions about the project, with preparatory materials sent in advance. RESULTS Stakeholder meeting attendance was high (89%-100%), and all stakeholders engaged with the research project, both during and between meetings. Stakeholders reported positive experiences with meetings, satisfaction, and interest in the research project and its findings, and dedication to the success of the project's goals. They affirmed the value of receiving materials to review in advance and the effectiveness of a virtual platform. Their contributions included prioritizing and suggesting research questions, optimizing written evidence briefs for a lay audience, and guidance on broader topics such as research audience and methods of dissemination. CONCLUSIONS Stakeholder engagement in pharmacoepidemiologic research using complex study designs and analysis is feasible, acceptable, and positively impacts the research project.
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Affiliation(s)
- Sara J. Cromer
- Harvard Medical School, Boston, MA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | | | - Cassie York
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Julianna Mastrorilli
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | | | | | - Leigh Simmons
- Harvard Medical School, Boston, MA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA
| | | | - Greg Low
- Massachusetts General Hospital, Boston, MA
| | - Michael A. Fischer
- Section of General Internal Medicine, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Elisabetta Patorno
- Harvard Medical School, Boston, MA
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Deborah J. Wexler
- Harvard Medical School, Boston, MA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
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16
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Berbakov ME, Hoffins EL, Stone JA, Gilson AM, Chladek JS, Watterson TL, Lehnbom EC, Moon J, Holden RJ, Jacobson N, Shiyanbola OO, Welch LL, Walker KD, Gollhardt JD, Chui MA. Adapting a community pharmacy intervention to improve medication safety. J Am Pharm Assoc (2003) 2024; 64:159-168. [PMID: 37940099 PMCID: PMC10872665 DOI: 10.1016/j.japh.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Community pharmacies are an ideal location to address challenges of over-the-counter medication safety, yet many successful interventions are only tested in a few pharmacies without expansion, creating unrealized opportunities to improve patient care on a larger scale. Scaling up to numerous pharmacies can be challenging because each community pharmacy has unique needs and layouts and requires individualized adaptation. OBJECTIVES This paper reports techniques for (a) adapting a community pharmacy intervention to fit the unique physical layout and patient needs of health system pharmacy sites without increasing staff workload, (b) identifying strategies to gather feedback on adaptations from stakeholders, and (c) developing materials to share with pharmacy champions for them to independently implement and sustain the intervention in their organization. PRACTICE DESCRIPTION The study team collaborated with Aurora Pharmacy, Inc to develop an intervention designed to increase awareness of safe over-the-counter medication use for older adults. PRACTICE INNOVATION Senior Safe, a community pharmacy-based intervention, was designed, implemented, and tested using the Exploration, Preparation, Implementation, and Sustainment implementation framework. EVALUATION METHODS Senior Safe was adapted through pilot testing and a randomized control trial. Feedback was collected from key stakeholders, including pharmacy staff, older adults, and a research advisory group. RESULTS A finalized version of Senior Safe, as well as an implementation package, was provided to Aurora Pharmacy to integrate into all 63 sites. CONCLUSION This multiphase study illustrated that refining an intervention is possible and welcomed by pharmacy staff, but it requires time, resources, and funds to create an impactful, sustainable community pharmacy intervention.
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17
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Welch LC, Brewer SK, Schleyer T, Daudelin D, Paranal R, Hunt JD, Dozier AM, Perry A, Cabrera AB, Gatto CL. Learning health system benefits: Development and initial validation of a framework. Learn Health Syst 2024; 8:e10380. [PMID: 38249854 PMCID: PMC10797574 DOI: 10.1002/lrh2.10380] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/14/2023] [Accepted: 06/22/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Implementation of research findings in clinical practice often is not realized or only partially achieved, and if so, with a significant delay. Learning health systems (LHSs) hold promise to overcome this problem by embedding clinical research and evidence-based best practices into care delivery, enabling innovation and continuous improvement. Implementing an LHS is a complex process that requires participation and resources of a wide range of stakeholders, including healthcare leaders, clinical providers, patients and families, payers, and researchers. Engaging these stakeholders requires communicating clear, tangible value propositions. Existing models identify broad categories of benefits but do not explicate the full range of benefits or ways they can manifest in different organizations. Methods To develop such a framework, a working group with representatives from six Clinical and Translational Science Award (CTSA) hubs reviewed existing literature on LHS characteristics, models, and goals; solicited expert input; and applied the framework to their local LHS experiences. Results The Framework of LHS Benefits includes six categories of benefits (quality, safety, equity, patient satisfaction, reputation, and value) relevant for a range of stakeholders and defines key concepts within each benefit. Applying the framework to five LHS case examples indicated preliminary face validity across varied LHS approaches and revealed three dimensions in which the framework is relevant: defining goals of individual LHS projects, facilitating collaboration based on shared values, and establishing guiding tenets of an LHS program or mission. Conclusion The framework can be used to communicate the value of an LHS to different stakeholders across varied contexts and purposes, and to identify future organizational priorities. Further validation will contribute to the framework's evolution and support its potential to inform the development of tools to evaluate LHS impact.
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Affiliation(s)
- Lisa C. Welch
- Tufts Clinical and Translational Science InstituteTufts UniversityBostonMassachusettsUSA
| | - Sarah K. Brewer
- Tufts Clinical and Translational Science InstituteTufts UniversityBostonMassachusettsUSA
| | - Titus Schleyer
- Center for Biomedical InformaticsRegenstrief InstituteIndianapolisIndianaUSA
- Indiana Clinical and Translational Sciences InstituteIndiana UniversityIndianapolisIndianaUSA
| | - Denise Daudelin
- Tufts Clinical and Translational Science InstituteTufts UniversityBostonMassachusettsUSA
| | - Rechelle Paranal
- South Carolina Clinical and Translational Research Institute, Medical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Joe D. Hunt
- Indiana Clinical and Translational Sciences InstituteIndiana UniversityIndianapolisIndianaUSA
| | - Ann M. Dozier
- University of Rochester Clinical and Translational Science Institute, University of RochesterRochesterNew YorkUSA
| | - Anna Perry
- Wake Forest Clinical and Translational Science Institute, Wake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Alyssa B. Cabrera
- Tufts Clinical and Translational Science InstituteTufts UniversityBostonMassachusettsUSA
| | - Cheryl L. Gatto
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical CenterNashvilleTennesseeUSA
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Jones H, Chadwell A, Dyson M. Evidencing the effectiveness of upper limb prostheses: a multi-stakeholder perspective on study requirements. Front Health Serv 2023; 3:1213752. [PMID: 38188614 PMCID: PMC10768005 DOI: 10.3389/frhs.2023.1213752] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024]
Abstract
The provision of upper limb prosthetic devices through the National Health Services (NHS) within the United Kingdom is driven by national policies. NHS England have recently published a new policy to provide multi-grip myoelectric hands. The policy highlighted that there was limited evidence to support its deployment and it will be reviewed should new information arise. The clear identification of the evidence gap provides an opportunity for the academic research community to conduct studies that will inform future iterations of this and other upper limb prosthetic related policies. This paper presents a summary of findings and recommendations based on two multi-stakeholder workshops held in June 2022 and July 2022, which explored the design requirements for policy-driven research studies. The workshops involved people from a broad range of stakeholder groups: policy, academia, NHS clinical and management, industry, and a person with upper limb absence. The workshop discussions focused on the research questions that NHS England identified in the policy evidence review: (1) Clinical Effectiveness; (2) Cost Effectiveness; (3) Safety; and (4) Patient Subgroups. The recommendations based on stakeholder discussions included the need to gather qualitative and quantitative research evidence, use goal-based outcome measures, and conduct longitudinal studies. Future research studies also need to address the complexities of conducting national and international policy-driven research, such as clinical resource capacity and participant involvement.
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Affiliation(s)
- Hannah Jones
- Intelligent Sensing Laboratory, School of Engineering, Newcastle University, Newcastle upon Tyne, United Kingdom
- Edinburgh Neuroprosthetics Laboratory, School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Alix Chadwell
- Intelligent Sensing Laboratory, School of Engineering, Newcastle University, Newcastle upon Tyne, United Kingdom
- Centre for Human Movement and Rehabilitation, University of Salford, Manchester, United Kingdom
| | - Matthew Dyson
- Intelligent Sensing Laboratory, School of Engineering, Newcastle University, Newcastle upon Tyne, United Kingdom
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Sharpe LM, Harwell MC, Phifer C, Gardner G, Newcomer-Johnson T. The final ecosystem goods and services Voltron: the power of tools together. Front Ecol Environ 2023; 11:1-16. [PMID: 38516293 PMCID: PMC10953789 DOI: 10.3389/fevo.2023.1290662] [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] [Indexed: 03/23/2024]
Abstract
Environmental decision-making benefits from considering ecosystem services to ensure that aspects of the environment that people rely upon are fully evaluated. By focusing consideration of ecosystem services on final ecosystem goods and services (FEGS), the aspects of the environment directly enjoyed, used, or consumed by humans, these analyses can be more streamlined and effective. The U.S. Environmental Protection Agency has developed a set of tools to facilitate this consideration. The central feature of FEGS is that ecosystems are viewed through the diverse ways people directly benefit from them. The National Ecosystem Services Classification System (NESCS) Plus provides a framework for describing and identifying FEGS consistently. The standardization made available by NESCS Plus allows other tools and databases to interact using the NESCS Plus architecture and taxonomy, providing diverse insights for decision makers. Here, we examine the synergy of using the following four tools together: (1) the FEGS Scoping Tool; (2) the FEGS Metrics Report; (3) the EnviroAtlas; and (4) the EcoService Models Library. The FEGS Scoping Tool helps users determine what ecosystem services are relevant to a decision by harnessing FEGS understanding to enable communities to identify the relative importance of beneficiaries relevant to a decision and biophysical aspects of the environment of direct relevance to those beneficiaries. The FEGS Metrics Report can guide which metrics to monitor or model to represent those priority services. The EnviroAtlas, a powerful tool containing geospatial data and other resources related to ecosystem services, chemical and non-chemical stressors, and human health, and the EcoService Models Library, a database of ecosystem models, are two tools that support users in mapping and modeling endpoints relevant to priority services. While each of these tools is valuable on its own, together, they provide a powerful approach to easily incorporate and operationalize ecosystem services efforts into different parts of decision-making processes across different types of decisions. We illustrate how these integrated tools can be used together with a hypothetical example of a complex environmental management case study and the combined benefit of using the FEGS tools together.
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Affiliation(s)
- Leah M. Sharpe
- Gulf Ecosystem Measurement and Modeling Division, Office of Research and Development, United States Environmental Protection Agency, Gulf Breeze, FL, United States
| | - Matthew C. Harwell
- Pacific Ecological Systems Division, Office of Research and Development, United States Environmental Protection Agency, Newport, OR, United States
| | - Colin Phifer
- Science Department, Lane Community College, Eugene, OR, United States
| | - George Gardner
- Performance Risk and Social Sciences Office, Social Science and Performance Division, Office of the Chief Financial Officer, National Oceanic and Atmospheric Administration, Silver Spring, MD, United States
| | - Tammy Newcomer-Johnson
- Watershed and Ecosystem Characterization Division, Office of Research and Development, U.S. Environmental Protection Agency, Cincinnati, OH, United States
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20
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Perrow BL, Schneider H. Mistrust in government and National Health Insurance: A qualitative study of solo private practitioners in Cape Town. S Afr Fam Pract (2004) 2023; 65:e1-e8. [PMID: 38112017 PMCID: PMC10730450 DOI: 10.4102/safp.v65i1.5768] [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: 05/07/2023] [Revised: 07/17/2023] [Accepted: 07/22/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The participation of independent private general practitioners (GPs) is of fundamental importance to the successful implementation of key elements of the proposed National Health Insurance (NHI) reform, notably the contracting units for primary health care (CUPS). This study explored knowledge and perceptions of the NHI reforms of private GPs following the tabling of the NHI Bill in parliament in 2019. METHODS An explorative qualitative research methodology was adopted. Using a semi-structured guide, nine solo private GPs, purposefully selected to represent the range of practices in the southern peninsula of Cape Town were interviewed in depth by B.L.P. over the period from January 2021 to March 2022. RESULTS The GPs indicated support for the values of greater equity outlined in the NHI proposals. However, they had little engagement on or knowledge of their potential future roles in NHI. Concerns over financial viability and design were underpinned by an overall mistrust in the public sector to implement and manage NHI. CONCLUSION The study concurs with previous research that private GPs are broadly in support of the principles of, and are potential allies, in advancing NHI. General practitioners need a platform to share their concerns and contribute as co-designers of NHI reforms. In the interim, steps to increase collaboration between private and public sectors at local and provincial level through, for example, referral processes may help to build the trust that is necessary between the sectors.Contribution: This study foregrounds the role of trust relationships in advancing NHI.
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Affiliation(s)
- Bridget L Perrow
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town.
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Jessani NS, Delobelle P, Balugaba BE, Mpando TL, Ayele FM, Ntawuyirushintege S, Rohwer A. Integrated Knowledge Translation for Non-Communicable Diseases: Stories from Sub-Saharan Africa. Ann Glob Health 2023; 89:87. [PMID: 38077262 PMCID: PMC10705024 DOI: 10.5334/aogh.4228] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/11/2023] [Indexed: 12/18/2023] Open
Abstract
Integrated Knowledge Translation (IKT) is a key strategy for contextualising, tailoring, and communicating research for policy and practice. In this viewpoint, we provide examples of how partners from five countries in sub-Saharan Africa used IKT to advance interventions for curbing non-communicable diseases in their contexts and how these strategies were magnified during the COVID-19 pandemic in some cases. The stories highlight the importance of deliberate and reinforced capacity building, authentic relationship enhancement, adaptable and user-informed stakeholder engagement, and agile multi-sectoral involvement.
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Affiliation(s)
| | - Peter Delobelle
- Chronic Disease Initiative for Africa, University of Cape Town, South Africa
- Department of Public Health, Vrije Universiteit Brussel, Belgium
| | - Bonny Enock Balugaba
- Department of Disease control and Environmental Health, Makerere University School of Public Health, Uganda
| | | | - Firaol Mesfin Ayele
- Non-communicable Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Seleman Ntawuyirushintege
- School of Global and Public Health. Kamuzu University of Health Sciences, Malawi
- School of Public Health of the University of Rwanda
| | - Anke Rohwer
- Centre for Evidence-Based Health Care, Stellenbosch University, South Africa
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22
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Vella S, Bolling C, Verhagen E, Moore IS. 'After they see what you have, they contact you': a qualitative study of national team football players', coaches' and clinicians' experiences in engaging with a context-specific injury surveillance system. SCI MED FOOTBALL 2023:1-12. [PMID: 38054439 DOI: 10.1080/24733938.2023.2290077] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Sports injury surveillance systems aid injury prevention, but their development without considering end-users' perspectives has led to low adherence and honesty in self-reporting by players, compromising their effectiveness. Context-specific injury surveillance systems have been proposed to address these challenges, but there is a limited understanding of stakeholders' perceptions and experiences in using them. OBJECTIVE Following the implementation of a context-specific injury surveillance system with 100% player adherence over 60 weeks, the study aimed to investigate Under-21 Maltese national football team players', coaches' and clinicians' experiences of how and why they engaged with the system. METHOD Seventeen semi-structured interviews with Under-21 Maltese male national football team players (n = 12), their coaches (n = 3) and clinicians (n = 2) were conducted. Data were analysed using reflexive thematic analysis. RESULTS Participants highlighted questionnaire-related factors that motivated engagement with the context-specific injury surveillance system (theme 1) and factors influencing further engagement with the system based on stakeholders' actions (theme 2). Perceived outcomes experienced as a result of engaging with the injury surveillance system (theme 3), in turn, motivated players to continue reporting and engaging with the system. CONCLUSION To encourage players' sustained reporting, injury-related information collected from well-designed questionnaires should serve to stimulate communication and teamwork among stakeholders, to prevent injuries and enhance performance.
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Affiliation(s)
- Sandro Vella
- Malta Football Association, Millenium Stand, National Stadium, Ta' Qali, Malta
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Van, The Netherlands
| | - Caroline Bolling
- Malta Football Association, Millenium Stand, National Stadium, Ta' Qali, Malta
| | - Evert Verhagen
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Van, The Netherlands
| | - Isabel Sarah Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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23
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Almansa X, Starostka R, Raskin L, Zeeman G, De Los Reyes F, Waechter J, Yeh D, Radu T. Anaerobic Digestion as a Core Technology in Addressing the Global Sanitation Crisis: Challenges and Opportunities. Environ Sci Technol 2023; 57:19078-19087. [PMID: 37956995 PMCID: PMC10702437 DOI: 10.1021/acs.est.3c05291] [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: 07/06/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/21/2023]
Abstract
Successfully addressing the complex global sanitation problem is a massive undertaking. Anaerobic digestion (AD), coupled with post-treatment, has been identified as a promising technology to contribute to meeting this goal. It offers multiple benefits to the end users, such as the potential inactivation of pathogenic microorganisms in waste and the recovery of resources, including renewable energy and nutrients. This feature article provides an overview of the most frequently applied AD systems for decentralized communities and low- and lower-middle-income countries with an emphasis on sanitation, including technologies for which pathogen inactivation was considered during the design. Challenges to AD use are then identified, such as experience, economics, knowledge/training of personnel and users, and stakeholder analysis. Finally, accelerators for AD implementation are noted, such as the inclusion of field studies in academic journals, analysis of emerging contaminants, the use of sanitation toolboxes and life cycle assessment in design, incorporation of artificial intelligence in monitoring, and expansion of undergraduate and graduate curricula focused on Water, Sanitation, and Hygiene (WASH).
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Affiliation(s)
| | - Renata Starostka
- Department
of Civil and Environmental Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Lutgarde Raskin
- Department
of Civil and Environmental Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Grietje Zeeman
- Wageningen
University & Research, Wageningen, 6708PB, The Netherlands
| | - Francis De Los Reyes
- Department
of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, North Carolina 27695-7908, United
States
| | | | - Daniel Yeh
- Department
of Civil and Environmental Engineering, University of South Florida, Florida 33620, United States
| | - Tanja Radu
- School
of Architecture, Building and Civil Engineering, Loughborough University, Loughborough LE11 3TU, United
Kingdom
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24
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Moen M, Doede M, Schweitzer A. Engaging Stakeholder Advisors Around Health-Related Social Needs Research, Policy, and Practice Priorities. Popul Health Manag 2023; 26:359-364. [PMID: 37738396 DOI: 10.1089/pop.2023.0177] [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: 09/24/2023] Open
Abstract
As health care systems invest significant resources to address social needs associated with poor health such as food, financial, and housing insecurity, many eligible patients are still not obtaining the resources they need. The recently initiated PURPLE Project (Promoting Understanding in Social Needs Research Projects by Listening and Engaging) engages stakeholder advisors to help address 2 challenges: (1) many patients do not accept offered assistance, and (2) of patients who accept assistance, less than half have their needs addressed. This article presents the team's engagement with local advisors, garnering real-life insights from patients with social needs, staff and leadership in public health, health care, and community service organizations. The team shares these organizations' priorities and recommendations and how these can be applied to these major challenges. This article can assist others in the social care arena who seeks to involve local partners as advisors to improve practices and policies in addressing social needs.
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Affiliation(s)
- Marik Moen
- University of Maryland Baltimore School of Nursing, Baltimore, Maryland, USA
| | - Megan Doede
- University of Maryland Baltimore School of Nursing, Baltimore, Maryland, USA
| | - Alexandra Schweitzer
- Social Enterprise Initiative, Harvard Business School, Boston, Massachusetts, USA
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25
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Shaw DR, Asmus AB, Schroeder J, Ervin DE. Changing the paradigm for pesticide resistance management. Pest Manag Sci 2023; 79:4726-4730. [PMID: 37560892 DOI: 10.1002/ps.7709] [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: 02/14/2023] [Revised: 07/25/2023] [Accepted: 08/10/2023] [Indexed: 08/11/2023]
Abstract
Collaborative action on the part of all stakeholders in pest management is essential to effectively address the challenges of pesticide resistance. The US Environmental Protection Agency (EPA), through its Pesticide Program Dialogue Committee, recently posted a report on pesticide resistance management and the role the Agency can play in these efforts. In this Perspective, we commend the Agency for acknowledging these needs, and encourage implementation of the recommendations. We urge all stakeholders to follow the example set by the EPA to engage openly, listen to other stakeholders, and determine their role as part of the broader community that is needed to address the challenges of resistance. Our contention is that pesticide resistance will continue to escalate until all stakeholders evaluate their roles in resistance management and work together as a community to influence effective management. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Affiliation(s)
- David R Shaw
- Office of the Provost and Executive Vice President, Mississippi State University, Starkville, MS, USA
| | | | - Jill Schroeder
- Department of Entomology, Plant Pathology, and Weed Science, New Mexico State University, Las Cruces, NM, USA
| | - David E Ervin
- Departments of Environmental Management and Economics, Portland State University, Portland, OR, USA
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26
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Dukhanin V, Wolff JL, Salmi L, Harcourt K, Wachenheim D, Byock I, Gonzales MJ, Niehus D, Parshley M, Reay C, Epstein S, Mohile S, Farrell TW, Supiano MA, Jajodia A, DesRoches CM. Co-Designing an Initiative to Increase Shared Access to Older Adults' Patient Portals: Stakeholder Engagement. J Med Internet Res 2023; 25:e46146. [PMID: 37991827 PMCID: PMC10701652 DOI: 10.2196/46146] [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: 02/02/2023] [Revised: 05/02/2023] [Accepted: 07/22/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND The patient portal is a widely available secure digital platform offered by care delivery organizations that enables patients to communicate electronically with clinicians and manage their care. Many organizations allow patients to authorize family members or friends-"care partners"-to share access to patient portal accounts, thus enabling care partners to receive their own identity credentials. Shared access facilitates trilateral information exchange among patients, clinicians, and care partners; however, uptake and awareness of this functionality are limited. OBJECTIVE We partnered with 3 health care organizations to co-design an initiative that aimed to increase shared access registration and use and that can be implemented using existing patient portals. METHODS In 2020, we undertook a rigorous selection process to identify 3 geographically diverse health care organizations that had engaged medical informatics teams and clinical champions within service delivery lines caring for older adults. We prioritized selecting organizations that serve racially and socioeconomically diverse populations and possess sophisticated reporting capabilities, a stable patient portal platform, a sufficient volume of older adult patients, and active patient and family advisory councils. Along with patients and care partners, clinicians, staff, and other stakeholders, the study team co-designed an initiative to increase the uptake of shared access guided by either an iterative, human-centered design process or rapid assessment procedures of stakeholders' inputs. RESULTS Between February 2020 and April 2022, 73 stakeholder engagements were conducted with patients and care partners, clinicians and clinic staff, medical informatics teams, marketing and communications staff, and administrators, as well as with funders and thought leaders. We collected insights regarding (1) barriers to awareness, registration, and use of shared access; (2) features of consumer-facing educational materials to address identified barriers; (3) features of clinician- and staff-facing materials to address identified barriers; and (4) approaches to fit the initiative into current workflows. Using these inputs iteratively via a human-centered design process, we produced brochures and posters, co-designed organization-specific web pages detailing shared access registration processes, and developed clinician and staff talking points about shared access and staff tip sheets that outline shared access registration steps. Educational materials emphasized the slogan "People remember less than half of what their doctors say," which was selected from 9 candidate alternatives as resonating best with the full range of the initiative's stakeholders. The materials were accompanied by implementation toolkits specifying and reinforcing workflows involving both in-person and telehealth visits. CONCLUSIONS Meaningful and authentic stakeholder engagement allowed our deliberate, iterative, and human-centered co-design aimed at increasing the use of shared access. Our initiative has been launched as a part of a 12-month demonstration that will include quantitative and qualitative analysis of registration and use of shared access. Educational materials are publicly available at Coalition for Care Partners.
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Affiliation(s)
- Vadim Dukhanin
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jennifer L Wolff
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Liz Salmi
- OpenNotes, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Kendall Harcourt
- OpenNotes, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Deborah Wachenheim
- OpenNotes, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Ira Byock
- The Institute for Human Caring at Providence, Gardena, CA, United States
| | - Matthew J Gonzales
- The Institute for Human Caring at Providence, Gardena, CA, United States
| | - Doug Niehus
- Providence Medical Group, Portland, OR, United States
| | | | - Caroline Reay
- Providence Medical Group, Portland, OR, United States
| | - Sara Epstein
- The Institute for Human Caring at Providence, Gardena, CA, United States
| | - Supriya Mohile
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
| | - Timothy W Farrell
- Division of Geriatrics, Spencer Fox Eccles School of Medicine and the Center on Aging, University of Utah, Salt Lake City, UT, United States
- Salt Lake City Geriatric Research, Education, and Clinical Center, Veterans Affairs, Salt Lake City, UT, United States
| | - Mark A Supiano
- Division of Geriatrics, Spencer Fox Eccles School of Medicine and the Center on Aging, University of Utah, Salt Lake City, UT, United States
| | - Anushka Jajodia
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Catherine M DesRoches
- OpenNotes, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
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27
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Hamer MK, Sobczak C, Whittington L, Bowyer RL, Koren R, Begay JA, Lum HD, Ginde AA, Wynia MK, Kwan BM. Real-world data to evaluate effects of a multi-level dissemination strategy on access, outcomes, and equity of monoclonal antibodies for COVID-19. J Clin Transl Sci 2023; 7:e258. [PMID: 38229899 PMCID: PMC10789982 DOI: 10.1017/cts.2023.679] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 09/18/2023] [Accepted: 11/03/2023] [Indexed: 01/18/2024] Open
Abstract
Introduction Multi-level dissemination strategies are needed to increase equitable access to effective treatment for high-risk outpatients with COVID-19, particularly among patients from disproportionately affected communities. Yet assessing population-level impact of such strategies can be challenging. Methods In collaboration with key contributors in Colorado, we conducted a retrospective cohort study to evaluate a multi-level dissemination strategy for neutralizing monoclonal antibody (mAb) treatment. Real-world data included county-level, de-identified output from a statewide mAb referral registry linked with publicly available epidemiological data. Outcomes included weekly number of mAb referrals, unique referring clinicians, and COVID-19 hospitalization rates. We assessed weekly changes in outcomes after dissemination strategies launched in July 2021. Results Overall, mAb referrals increased from a weekly average of 3.0 to 15.5, with an increase of 1.3 to 42.1 additional referrals per county in each post-period week (p < .05). Number of referring clinicians increased from a weekly average of 2.2 to 9.7, with an additional 1.5 to 22.2 unique referring clinicians observed per county per week beginning 5 weeks post-launch (p < .001). Larger effects were observed in communities specifically prioritized by the dissemination strategies. There were no observed differences in COVID-19 hospitalization rates between counties with and without mAb treatment sites. Conclusion Real-world data can be used to estimate population impact of multi-level dissemination strategies. The launch of these strategies corresponded with increases in mAb referrals, but no apparent population-level effects on hospitalization outcomes. Strengths of this analytic approach include pragmatism and efficiency, whereas limitations include inability to control for other contemporaneous trends.
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Affiliation(s)
- Mika K. Hamer
- Center for Bioethics and Humanities, University of Colorado
Anschutz Medical Campus, Aurora, CO,
USA
| | - Chelsea Sobczak
- Department of Family Medicine, University of Colorado
Anschutz Medical Campus, Aurora, CO,
USA
| | | | | | - Ramona Koren
- Patient Partner/Community Affiliate, University of Colorado
Anschutz Medical Campus, Aurora, CO,
USA
| | - Joel A. Begay
- Johns Hopkins Center for Indigenous Health, Department of International
Health, Johns Hopkins Bloomberg School of Public Health,
Baltimore, MD, USA
| | - Hillary D. Lum
- Division of Geriatric Medicine, Department of Medicine,
University of Colorado School of Medicine, Aurora,
CO, USA
| | - Adit A. Ginde
- Department of Emergency Medicine, University of Colorado
School of Medicine, Aurora, CO,
USA
- Colorado Clinical & Translational Sciences Institute,
University of Colorado Anschutz Medical Campus,
Aurora, CO, USA
| | - Matthew K. Wynia
- Center for Bioethics and Humanities, University of Colorado
Anschutz Medical Campus, Aurora, CO,
USA
- Colorado Clinical & Translational Sciences Institute,
University of Colorado Anschutz Medical Campus,
Aurora, CO, USA
- Division of General Internal Medicine, University of Colorado
School of Medicine, Aurora, CO,
USA
| | - Bethany M. Kwan
- Department of Family Medicine, University of Colorado
Anschutz Medical Campus, Aurora, CO,
USA
- Department of Emergency Medicine, University of Colorado
School of Medicine, Aurora, CO,
USA
- Colorado Clinical & Translational Sciences Institute,
University of Colorado Anschutz Medical Campus,
Aurora, CO, USA
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28
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Castle N, Kunwar S, Khanal L, Oot L, Elkes K, Shrestha S, Joshi A, Rai P, Bhattarai S, Karmacharya BM. Using the Journey to Health and Immunization (JTHI) Framework to Engage Stakeholders in Identifying Behavioral and Social Drivers of Routine Immunization in Nepal. Vaccines (Basel) 2023; 11:1709. [PMID: 38006041 PMCID: PMC10675610 DOI: 10.3390/vaccines11111709] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
Although the Government of Nepal has achieved high and sustained childhood vaccination coverage, reaching under-immunized and zero-dose children requires different approaches. Behavioral science offers promise in better understanding the drivers of vaccination and development of more effective programs; however, the application of behavioral science to immunization programs in Nepal is nascent. Through the Behavioral Science Immunization Network, JSI, UNICEF Nepal, and Dhulikhel Hospital-Kathmandu University School of Medical Sciences established a Behavioral Science Center to engage a diverse group of stakeholders in increasing the capacity of practitioners to use behavioral science in immunization programming. As a result of the engagement during formative research, government stakeholders requested and applied tools from behavioral science to solve different immunization challenges. Of particular value was the use of the Journey to Health and Immunization framework, which helped stakeholders identify behavioral and social drivers of zero-dose communities in Kathmandu. Our experience in Nepal demonstrates that there is strong demand for approaches and tools from behavioral science to use in relation to immunization and that this type of engagement model is effective for generating demand for and strengthening capacity to use behavioral science approaches.
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Affiliation(s)
- Nicole Castle
- JSI Research & Training Institute, Inc., 2733 Crystal Drive, 4th Floor, Arlington, VA 22202, USA; (L.O.); (K.E.)
| | - Surakshya Kunwar
- Department of Public Health, Dhulikhel Hospital-Kathmandu University School of Medical Sciences, Dhulikhel 45200, Nepal; (A.J.); (P.R.); (B.M.K.)
| | | | - Lisa Oot
- JSI Research & Training Institute, Inc., 2733 Crystal Drive, 4th Floor, Arlington, VA 22202, USA; (L.O.); (K.E.)
| | - Katharine Elkes
- JSI Research & Training Institute, Inc., 2733 Crystal Drive, 4th Floor, Arlington, VA 22202, USA; (L.O.); (K.E.)
| | - Swechhya Shrestha
- UNICEF Nepal, UN House, Pulchowk, Kathmandu P.O. Box 1187, Nepal; (S.S.); (S.B.)
| | - Anjali Joshi
- Department of Public Health, Dhulikhel Hospital-Kathmandu University School of Medical Sciences, Dhulikhel 45200, Nepal; (A.J.); (P.R.); (B.M.K.)
| | - Prasanna Rai
- Department of Public Health, Dhulikhel Hospital-Kathmandu University School of Medical Sciences, Dhulikhel 45200, Nepal; (A.J.); (P.R.); (B.M.K.)
| | - Sanju Bhattarai
- UNICEF Nepal, UN House, Pulchowk, Kathmandu P.O. Box 1187, Nepal; (S.S.); (S.B.)
| | - Biraj Man Karmacharya
- Department of Public Health, Dhulikhel Hospital-Kathmandu University School of Medical Sciences, Dhulikhel 45200, Nepal; (A.J.); (P.R.); (B.M.K.)
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Goel S, Nawani S. Debunking Claims and Prioritizing Public Health: India's Bold Stand against Tobacco Imagery on OTT Platforms. Indian J Community Med 2023; 48:811-813. [PMID: 38249688 PMCID: PMC10795876 DOI: 10.4103/ijcm.ijcm_400_23] [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: 06/17/2023] [Accepted: 08/14/2023] [Indexed: 01/23/2024] Open
Abstract
India has taken a ground-breaking step in public health by mandating anti-tobacco warnings and disclaimers on over-the-top (OTT) platforms. Concerns over the prevalence of tobacco imagery in media, including OTT platforms, prompted this decision due to its role in normalizing and glamorizing smoking, particularly among the youth. The Indian government aims to comprehensively address this issue and protect public health. This article reviews recent news articles on the developments in the 2023 amendments to Cigarette and other tobacco products act COTPA 2004 and relevant studies on the ill effects of tobacco imagery to form the viewpoint. To effectively implement the new order, clear guidelines, and standards need to be established. Additionally, comprehensive awareness and education campaigns should be launched, while strict monitoring and enforcement mechanisms must be implemented. Supporting research initiatives should evaluate the impact of the warnings, and multiple stakeholders should be involved in the decision-making process. India's commitment to protecting public health and curbing tobacco advertisements on OTT platforms necessitates clear guidelines, awareness campaigns, monitoring and enforcement mechanisms, research initiatives, and stakeholder engagement. This government order aligns with international public health frameworks and can serve as a precedent for other countries. By implementing these measures, we can counter the normalization and glamorization of tobacco use and create a healthier future.
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Affiliation(s)
- Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
- The School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Ireland
- Faculty of Human and Health Sciences, Swansea University, United Kingdom
| | - Srishti Nawani
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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30
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Harding S, Williams L, Smith N, Soomro DES, Allawi S, Singh K, Chowdhury M, Deogan V, Staples A, Leung N, Srivastava S, Adamali H, Barratt SL. Animal-derived medicinal products: community representatives' views of their use. Future Healthc J 2023; 10:291-295. [PMID: 38162195 PMCID: PMC10753222 DOI: 10.7861/fhj.2023-0005] [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: 01/03/2024]
Abstract
In the UK, there are a variety of religious or cultural beliefs and preferences that guide people in a range of lifestyle decisions. This qualitative study aimed to better understand the views of the public around prescribing animal-derived products, in particular low-molecular-weight heparin (LMWH), from a potential patient perspective. A series of quality improvement focus groups with stakeholders were undertaken to understand perceptions and to evaluate and inform an established treatment pathway. Stakeholders discussed finding out about the porcine nature of LMWH asking 'Why don't they tell us?', suggesting that they 'shouldn't have to give out clues' about their personal preferences. Participants' thoughts about 'how' information be provided, by 'whom' and 'when' were gained. The stakeholders indicated that current practice is unacceptable for patients. They require greater knowledge and transparency regarding product components and recommend that healthcare professionals provide more dialogue and choice to patients.
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Affiliation(s)
- Sam Harding
- Research and Innovation North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - Leonie Williams
- QSIT Team Ground Floor, Beaufort House, Southmead Hospital, NHS North Bristol Trust, Bristol, UK
| | | | | | | | - Katie Singh
- Reset & Recovery Office, Southmead Hospital, Bristol, UK
| | - Monira Chowdhury
- diversity and inclusion, HR Division, Southmead Hospital, Bristol, UK
| | - Vardeep Deogan
- Clinical Governance Division, Southmead Hospital, Bristol, UK
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31
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Elliott KC, Werkheiser I. A Framework for Transparency in Precision Livestock Farming. Animals (Basel) 2023; 13:3358. [PMID: 37958113 PMCID: PMC10648797 DOI: 10.3390/ani13213358] [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: 09/27/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
As precision livestock farming (PLF) technologies emerge, it is important to consider their social and ethical dimensions. Reviews of PLF have highlighted the importance of considering ethical issues related to privacy, security, and welfare. However, little attention has been paid to ethical issues related to transparency regarding these technologies. This paper proposes a framework for developing responsible transparency in the context of PLF. It examines the kinds of information that could be ethically important to disclose about these technologies, the different audiences that might care about this information, the challenges involved in achieving transparency for these audiences, and some promising strategies for addressing these challenges. For example, with respect to the information to be disclosed, efforts to foster transparency could focus on: (1) information about the goals and priorities of those developing PLF systems; (2) details about how the systems operate; (3) information about implicit values that could be embedded in the systems; and/or (4) characteristics of the machine learning algorithms often incorporated into these systems. In many cases, this information is likely to be difficult to obtain or communicate meaningfully to relevant audiences (e.g., farmers, consumers, industry, and/or regulators). Some of the potential steps for addressing these challenges include fostering collaborations between the developers and users of PLF systems, developing techniques for identifying and disclosing important forms of information, and pursuing forms of PLF that can be responsibly employed with less transparency. Given the complexity of transparency and its ethical and practical importance, a framework for developing and evaluating transparency will be an important element of ongoing PLF research.
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Affiliation(s)
- Kevin C. Elliott
- Lyman Briggs College, Department of Fisheries and Wildlife, and Department of Philosophy, Michigan State University, East Lansing, MI 48825, USA
| | - Ian Werkheiser
- Department of Philosophy, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA
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32
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Wilpert NM, Tonduti D, Vaia Y, Krude H, Sarret C, Schuelke M. Establishing Patient-Centered Outcomes for MCT8 Deficiency: Stakeholder Engagement and Systematic Literature Review. Neuropsychiatr Dis Treat 2023; 19:2195-2216. [PMID: 37881807 PMCID: PMC10595182 DOI: 10.2147/ndt.s379703] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/07/2023] [Indexed: 10/27/2023] Open
Abstract
Introduction The SCL16A2 gene encodes the thyroid hormone (TH) transporter MCT8. Pathogenic variants result in a reduced TH uptake into the CNS despite high serum T3 concentrations. Patients suffer from severe neurodevelopmental delay and require multidisciplinary care. Since a first compassionate use study in 2008, the development of therapies has recently gained momentum. Treatment strategies range from symptom-based approaches, supplementation with TH or TH-analogs, to gene therapy. All these studies have mainly used surrogate endpoints and clinical outcomes. However, the EMA and FDA strongly encourage researchers to involve patients and their advocacy groups in the design of clinical trials. This should strengthen the patients' perspective and identify clinical endpoints that are clinically relevant to their daily life. Methods We involved patient families to define patient-relevant outcomes for MCT8 deficiency. In close collaboration with patient families, we designed a questionnaire asking for their five most preferred therapeutic goals, which, if achieved at least, make a difference in their lives. In addition, we performed a systematic review according to Cochrane recommendations of the published treatment trials. Results We obtained results from 15 families with completed questionnaires from 14 mothers and 8 fathers. Improvement in development, especially in gross motor skills, was most important to the parents. 59% wished for head control and 50% for sitting ability. Another 36% wished for weight gain, 32% for improvement of expressive language skills, and 18% for a reduction of dystonia/spasticity, less dysphagia, and reflux. Paraclinical aspects were least important (5-9%). In a treatment trial (n=46) and compassionate use cases (n=83), the results were mainly inconclusive, partly due to a lack of predefined patient-centered clinical endpoints. Discussion We recommend that future trials should define a relevant improvement in "development" and/or other patient-relevant outcomes compared to natural history as treatment goals.
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Affiliation(s)
- Nina-Maria Wilpert
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Department of Pediatric Neurology, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health (BIH), Center for Chronically Sick Children, Berlin, Germany
| | - Davide Tonduti
- Unit of Pediatric Neurology, C.O.A.L.A. (Center for Diagnosis and Treatment of Leukodystrophies), V. Buzzi Children’s Hospital, Università Degli Studi Di Milano, Milan, Italy
| | - Ylenia Vaia
- Unit of Pediatric Neurology, C.O.A.L.A. (Center for Diagnosis and Treatment of Leukodystrophies), V. Buzzi Children’s Hospital, Università Degli Studi Di Milano, Milan, Italy
| | - Heiko Krude
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Experimental Pediatric Endocrinology, Berlin, Germany
| | - Catherine Sarret
- Centre de Compétence des Leucodystrophies et Leucoencéphalopathies de Cause Rare, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Markus Schuelke
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Department of Pediatric Neurology, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health (BIH), Center for Chronically Sick Children, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), NeuroCure Clinical Research Center, Berlin, Germany
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33
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Elliott SA, Scott SD, Wright KS, Hartling L. Establishing priorities in child health: Giving parents and youth a voice. J Child Health Care 2023:13674935231205041. [PMID: 37842797 DOI: 10.1177/13674935231205041] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Parents and youth across Alberta were engaged to identify specific research questions that are a priority to them. Two lists, containing 27 topics were developed with local parent and youth advisory groups, and sent to participants via online questionnaires. Topics were rated from one (least important) to five (most important) and ranked in order of priority. Initial questionnaires were completed by 263 (46%) parents and 308 (54%) youth. Parents rated five topics (behaviour, learning, and developmental disorders; mental health; food, environment and lifestyle; quality of health care; and vaccines) and youth rated four topics (brain and nerve health; mental health; quality of health care; and vaccines) as a high priority. Research questions stemming from 4 parent (12 [5%]) and 6 youth (21 [7%]) focus group discussions were then ranked in a second questionnaire, completed by 43 (43%) parents and 56 (56%) youth. Parents' highest ranked research question was 'What is the effect of screen time on cognition and neurodevelopment for children and adolescents?', while the highest ranked question from youth was 'What are the early signs of anxiety and depression and when should an individual seek help?'. These topics highlight areas that are important to parents and youth where funding, research, and knowledge mobilization efforts should be directed.
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Affiliation(s)
- Sarah A Elliott
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Cochrane Child Health, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Kelsey S Wright
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Cochrane Child Health, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Laugaland KA, Akerjordet K, Frøiland CT, Aase I. Co-creating digital educational resources to enhance quality in student nurses' clinical education in nursing homes: Report of a co-creative process. J Adv Nurs 2023; 79:3899-3912. [PMID: 37461247 DOI: 10.1111/jan.15800] [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: 12/21/2022] [Revised: 06/28/2023] [Accepted: 07/07/2023] [Indexed: 09/14/2023]
Abstract
AIM To report a methodological, co-creative approach for developing an interactive digital educational resource to enhance the quality of student nurses' clinical education in nursing homes and to elucidate the lessons learned from this approach. DESIGN This study applied a co-design methodology that builds on participatory design principles. METHODS Co-creating the digital educational resource included multiple sequential and interactive phases inspired by the design thinking framework. Workshops were employed as the primary co-creative activity. RESULTS Seven separate homogenous or joint heterogeneous workshops were conducted with student nurses, nurse educators, registered nurse mentors and e-learning designers (n = 36) during the active stakeholder engagement phases to inform the educational content, design and functionality of the digital educational resource. These were informed by, and grounded in, learning theory and principles. CONCLUSION Co-creative approaches in nursing education are an essential avenue for further research. We still lack systematic knowledge about the impact and benefits of co-created initiatives, stakeholders' motivations, barriers, facilitators to participation and the role of context in supporting effective co-creative processes to increase the quality of nursing education. IMPACT This paper demonstrates how digital educational initiatives to enhance quality in clinical nursing education can be co-created with key stakeholders through a novel methodological approach inspired by design thinking. To date, the methodological development process of co-created educational interventions has received limited attention and compared with the content and theoretical underpinnings of such interventions, has rarely been addressed. Therefore, this paper facilitates knowledge exchange and documents vital aspects to consider when co-creating digital educational initiatives incorporating multistakeholder perspectives. This promotes a stronger academic-practice partnership to impact and enhance the quality of clinical nursing education in nursing homes. PUBLIC CONTRIBUTIONS Student nurses, nurse educators, and registered nurse mentors worked alongside researchers and e-learning designers in the co-creative process.
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Affiliation(s)
- Kristin A Laugaland
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Kristin Akerjordet
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- School of Psychology, Faculty of the Arts, Social Sciences & Humanities, University of Wollongong, Wollongong, Australia
| | - Christina T Frøiland
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Ingunn Aase
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Potthoff S, Finch T, Bührmann L, Etzelmüller A, van Genugten CR, Girling M, May CR, Perkins N, Vis C, Rapley T. Towards an Implementation- STakeholder Engagement Model (I-STEM) for improving health and social care services. Health Expect 2023; 26:1997-2012. [PMID: 37403248 PMCID: PMC10485327 DOI: 10.1111/hex.13808] [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: 03/08/2023] [Revised: 05/29/2023] [Accepted: 06/18/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The implementation science literature acknowledges a need for engagement of key stakeholders when designing, delivering and evaluating implementation work. To date, the literature reports minimal or focused stakeholder engagement, where stakeholders are engaged in either barrier identification and/or barrier prioritisation. This paper begins to answer calls from the literature for the development of tools and guidance to support comprehensive stakeholder engagement in implementation research and practice. The paper describes the systematic development of the Implementation-STakeholder Engagement Model (I-STEM) in the context of an international, large-scale empirical implementation study (ImpleMentAll) aimed at evaluating the effectiveness of a tailored implementation toolkit. The I-STEM is a sensitising tool that defines key considerations and activities for undertaking stakeholder engagement activities across an implementation process. METHODS In-depth, semistructured interviews and observations were conducted with implementers who were tailoring implementation strategies to integrate and embed internet-based cognitive behavioural therapy (iCBT) services in 12 routine mental health care organisations in nine countries in Europe and Australia. The analytical process was informed by principles of first- and third-generation Grounded Theory, including constant comparative method. RESULTS We conducted 55 interviews and observed 19 implementation-related activities (e.g., team meetings and technical support calls). The final outcome of our analysis is expressed in an initial version of the I-STEM, consisting of five interrelated concepts: engagement objectives, stakeholder mapping, engagement approaches, engagement qualities and engagement outcomes. Engagement objectives are goals that implementers plan to achieve by working with stakeholders in the implementation process. Stakeholder mapping involves identifying a range of organisations, groups or people who may be instrumental in achieving the engagement objectives. Engagement approaches define the type of work that is undertaken with stakeholders to achieve the engagement objectives. Engagement qualities define the logistics of the engagement approach. Lastly, every engagement activity may result in a range of engagement outcomes. CONCLUSION The I-STEM represents potential avenues for substantial stakeholder engagement activity across key phases of an implementation process. It provides a conceptual model for the planning, delivery, evaluation and reporting of stakeholder engagement activities. The I-STEM is nonprescriptive and highlights the importance of a flexible, iterative approach to stakeholder engagement. It is developmental and will require application and validation across a range of implementation activities. PATIENT OR PUBLIC CONTRIBUTION Patient contribution to ImpleMentAll trial was facilitated by GAMIAN-Europe at all stages-from grant development to dissemination. GAMIAN-Europe brings together a wide variety of patient representation organisations (local, regional and national) from almost all European countries. GAMIAN-Europe was involved in pilot testing the ItFits-toolkit and provided their views on the various aspects, including stakeholder engagement. Patients were also represented in the external advisory board providing support and advice on the design, conduct and interpretation of the wider project, including the development of the ItFits-toolkit. TRIAL REGISTRATION ClinicalTrials.gov NCT03652883. Retrospectively registered on 29 August 2018.
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Affiliation(s)
- Sebastian Potthoff
- Department of Social Work, Education, and Community WellbeingNorthumbria UniversityNewcastle Upon TyneUK
| | - Tracy Finch
- Department of Nursing, Midwifery and HealthNorthumbria UniversityNewcastle upon TyneUK
| | - Leah Bührmann
- Department of Social Work, Education, and Community WellbeingNorthumbria UniversityNewcastle Upon TyneUK
- Clinical, Neuro‐, & Developmental Psychology Faculty of Behavioural and Movement SciencesVU AmsterdamThe Netherlands
| | - Anne Etzelmüller
- Department Sports and Health SciencesTechnical University of MunichMunichGermany
- HelloBetter, GET.ON Institute für Online Gesundheitstrainings GmbHHamburg/BerlinGermany
| | - Claire R. van Genugten
- Clinical, Neuro‐, & Developmental Psychology Faculty of Behavioural and Movement SciencesVU AmsterdamThe Netherlands
- Amsterdam Public Health Research Institute—Mental HealthAmsterdamThe Netherlands
| | - Melissa Girling
- Department of Nursing, Midwifery and HealthNorthumbria UniversityNewcastle upon TyneUK
| | - Carl R. May
- Department of Health Services Research and PolicyLondon School of Hygiene and Tropical Medicine & NIHR North Thames ARCLondonUK
| | - Neil Perkins
- Department of Social Work, Education, and Community WellbeingNorthumbria UniversityNewcastle Upon TyneUK
| | - Christiaan Vis
- Clinical, Neuro‐, & Developmental Psychology Faculty of Behavioural and Movement SciencesVU AmsterdamThe Netherlands
- Department of Public and Occupational HealthAmsterdam Public Health Research InstituteAmsterdam UMCThe Netherlands
- Section for Research‐Based Innovation, Forhelse Research Centre for Digital Mental Health ServicesDivision of Psychiatry Haukeland University HospitalBergenNorway
| | - Tim Rapley
- Department of Social Work, Education, and Community WellbeingNorthumbria UniversityNewcastle Upon TyneUK
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Lösch L, Zuiderent-Jerak T, Kunneman F, Syurina E, Bongers M, Stein ML, Chan M, Willems W, Timen A. Capturing Emerging Experiential Knowledge for Vaccination Guidelines Through Natural Language Processing: Proof-of-Concept Study. J Med Internet Res 2023; 25:e44461. [PMID: 37610972 PMCID: PMC10503655 DOI: 10.2196/44461] [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: 11/20/2022] [Revised: 07/11/2023] [Accepted: 07/27/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Experience-based knowledge and value considerations of health professionals, citizens, and patients are essential to formulate public health and clinical guidelines that are relevant and applicable to medical practice. Conventional methods for incorporating such knowledge into guideline development often involve a limited number of representatives and are considered to be time-consuming. Including experiential knowledge can be crucial during rapid guidance production in response to a pandemic but it is difficult to accomplish. OBJECTIVE This proof-of-concept study explored the potential of artificial intelligence (AI)-based methods to capture experiential knowledge and value considerations from existing data channels to make these insights available for public health guideline development. METHODS We developed and examined AI-based methods in relation to the COVID-19 vaccination guideline development in the Netherlands. We analyzed Dutch messages shared between December 2020 and June 2021 on social media and on 2 databases from the Dutch National Institute for Public Health and the Environment (RIVM), where experiences and questions regarding COVID-19 vaccination are reported. First, natural language processing (NLP) filtering techniques and an initial supervised machine learning model were developed to identify this type of knowledge in a large data set. Subsequently, structural topic modeling was performed to discern thematic patterns related to experiences with COVID-19 vaccination. RESULTS NLP methods proved to be able to identify and analyze experience-based knowledge and value considerations in large data sets. They provide insights into a variety of experiential knowledge that is difficult to obtain otherwise for rapid guideline development. Some topics addressed by citizens, patients, and professionals can serve as direct feedback to recommendations in the guideline. For example, a topic pointed out that although travel was not considered as a reason warranting prioritization for vaccination in the national vaccination campaign, there was a considerable need for vaccines for indispensable travel, such as cross-border informal caregiving, work or study, or accessing specialized care abroad. Another example is the ambiguity regarding the definition of medical risk groups prioritized for vaccination, with many citizens not meeting the formal priority criteria while being equally at risk. Such experiential knowledge may help the early identification of problems with the guideline's application and point to frequently occurring exceptions that might initiate a revision of the guideline text. CONCLUSIONS This proof-of-concept study presents NLP methods as viable tools to access and use experience-based knowledge and value considerations, possibly contributing to robust, equitable, and applicable guidelines. They offer a way for guideline developers to gain insights into health professionals, citizens, and patients' experience-based knowledge, especially when conventional methods are difficult to implement. AI-based methods can thus broaden the evidence and knowledge base available for rapid guideline development and may therefore be considered as an important addition to the toolbox of pandemic preparedness.
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Affiliation(s)
- Lea Lösch
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Teun Zuiderent-Jerak
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Florian Kunneman
- Department of Computer Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Elena Syurina
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marloes Bongers
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Mart L Stein
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Michelle Chan
- Department of Computer Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Willemine Willems
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Aura Timen
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, Netherlands
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Garrett SB, Jones L, Montague A, Fa-Yusuf H, Harris-Taylor J, Powell B, Chan E, Zamarripa S, Hooper S, Chambers Butcher BD. Challenges and Opportunities for Clinician Implicit Bias Training: Insights from Perinatal Care Stakeholders. Health Equity 2023; 7:506-519. [PMID: 37731787 PMCID: PMC10507933 DOI: 10.1089/heq.2023.0126] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction In an attempt to address health inequities, many U.S. states have considered or enacted legislation requiring antibias or implicit bias training (IBT) for health care providers. California's "Dignity in Pregnancy and Childbirth Act" requires that hospitals and alternative birthing centers provide IBT to perinatal clinicians with the goal of improving clinical outcomes for Black women and birthing people. However, there is as yet insufficient evidence to identify what IBT approaches, if any, achieve this goal. Engaging the experiences and insights of IBT stakeholders is a foundational step in informing nascent IBT policy, curricula, and implementation. Methods We conducted a multimethod community-based participatory research study with key stakeholders of California's IBT policy to identify key challenges and recommendations for effective clinician IBT. We used focus groups, in-depth interviews, combined inductive/deductive thematic analysis, and multiple techniques to promote rigor and validity. Participants were San Francisco Bay Area-based individuals who identified as Black or African American women with a recent hospital birth (n=20), and hospital-based perinatal clinicians (n=20). Results We identified numerous actionable challenges and recommendations regarding aspects of (1) state law; (2) IBT content and format; (3) health care facility IBT implementation; (4) health care facility environment; and (5) provider commitment and behaviors. Patient and clinician insights overlapped substantially. Many respondents felt IBT would improve outcomes only in combination with other antiracism interventions. Health Equity Implications These stakeholder insights offer policy-makers, health system leaders, and curriculum developers crucial guidance for the future development and implementation of clinician antibias interventions.
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Affiliation(s)
- Sarah B. Garrett
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA
| | - Linda Jones
- California Preterm Birth Initiative, University of California, San Francisco, California, USA
| | - Alexandra Montague
- UCSF-UC Law Consortium on Law, Science & Health Policy, University of California College of the Law, San Francisco, California, USA
| | - Haleemat Fa-Yusuf
- Independent Researcher and Community Advisor, San Francisco, California, USA
| | - Julie Harris-Taylor
- California Preterm Birth Initiative, University of California, San Francisco, California, USA
| | - Breezy Powell
- California Preterm Birth Initiative, University of California, San Francisco, California, USA
| | - Erica Chan
- University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Stephen Zamarripa
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA
| | - Sarah Hooper
- UCSF-UC Law Consortium on Law, Science & Health Policy, University of California College of the Law, San Francisco, California, USA
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Lemmon ME, Reeve BB. Defining Outcomes that Matter Most to Parents: Challenging and Important Work. J Pediatr 2023; 260:113567. [PMID: 37327861 PMCID: PMC10896428 DOI: 10.1016/j.jpeds.2023.113567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Monica E Lemmon
- Department of Pediatrics, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC.
| | - Bryce B Reeve
- Department of Pediatrics, Department of Population Health Sciences, Duke Cancer Institute, Duke University School of Medicine, Durham, NC
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Adeyemi O, Ajieroh V, Umunna L, Aminu F, Onabolu A. Stakeholders, Relationships, and Coordination: 2015 Baseline Study of Needed Enablers for Bridging Agriculture-Nutrition Gaps in Nigeria. Food Nutr Bull 2023; 44:S41-S51. [PMID: 36047001 DOI: 10.1177/03795721221119249] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Renewed efforts by the Nigerian government to address malnutrition have led to nutrition actions by several sectors, including the agriculture sector. However, the success of these actions depends on the characteristics of the stakeholders involved, including their relationships and coordination. OBJECTIVE This article reports a 2015 study of nutrition-sensitive agricultural stakeholders in Nigeria that assessed what the stakeholders do, where they work and how they are organized to improve nutrition. The study provides a baseline for assessing progress and measuring stakeholder and coordination changes in the Nigerian nutrition-sensitive agriculture landscape. METHODS Semi-structured interviews (n = 17) and focus group discussions (n = 2) were held with federal, state, and local government level stakeholders; reviews of stakeholder program documents were also conducted. RESULTS The study identified 7 groups of nutrition-sensitive agriculture stakeholders and several coordination challenges. Political leadership, advocacy and provision of material and human resource support by nongovernmental organizations, and donor interest and funding have been vital for mobilizing nutrition-sensitive agriculture. Still, although stakeholders frequently highlighted that nutrition was an important consideration in their interventions, nutrition goals and activities and/or indicators to measure outcomes were not regularly communicated. Also, while coordination mechanisms existed, there appeared to be minimal actual cross-sectoral partnerships because of inadequate trust, competition, and conflicts over institutional turf and mandates. CONCLUSIONS Needed enablers for improving nutrition-sensitive agriculture in Nigeria included improved stakeholder nutrition literacy, as well as enhanced stakeholder engagement facilitated by role definition, clarification, and consensus. Exploring different approaches to coordination may also be necessary.
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Affiliation(s)
- Olutayo Adeyemi
- Department of Human Nutrition and Dietetics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Victor Ajieroh
- Bill and Melinda Gates Foundation and formerly of Federal Ministry of Agriculture and Rural Development, Abuja, Nigeria
| | | | | | - Adeyinka Onabolu
- Global Alliance for Improved Nutrition, Abuja, Nigeria
- Federal Ministry of Agriculture and Rural Development, Abuja, Nigeria
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Faro EZ, Sauder KA, Norman GS, Anderson A, Vélez-Vega C, Napp D, Huddleston KC. A mixed-methods analysis to understand the implementation of a multistakeholder research consortium: Environmental influences on child health outcomes (ECHO). J Clin Transl Sci 2023; 7:e198. [PMID: 37830008 PMCID: PMC10565193 DOI: 10.1017/cts.2023.620] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction Large, transdisciplinary research consortia have increasingly been called upon to address complex and challenging health problems. The National Institutes of Health's (NIH) Environmental influences on Child Health Outcomes (ECHO) Program developed multisite collaboration strategies to promote impactful collaborative observational research on child health. Team science and implementation science offer theoretical and methodological structure to answer questions about the strategies that facilitate successful consortia. We sought to characterize the elements and conditions that influence the implementation of a complex, interdisciplinary longitudinal research program, ECHO. Methods Informed by the Practical, Robust, Implementation and Sustainability Model, our ethnographic research included semi-structured interviews with internal stakeholders and program evaluation metrics. We conducted template and matrix analysis and triangulated the qualitative and quantitative data to understand the implementation of ECHO. Results Between February and May 2022, we conducted 24 virtual interviews with representatives from ECHO components. The main cross-cutting topics that emerged from thematic analysis were collaboration and team science; communication and decision-making; data processes and harmonization; and diversity, equity, and inclusion. Both the qualitative and secondary quantitative evaluation data provided insights into the reach, adoption, implementation, and effectiveness of the program. Conclusion A large, multidisciplinary research consortium such as ECHO has produced conceptual, instrumental, capacity building, and connectivity impact for internal and external stakeholders. Facilitators included infrastructure that supported collaboration and learning, alignment of data processes, and harmonization. Opportunities for enhanced impact include multidisciplinary, multimethod communication strategies, and alignment of research priorities.
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Affiliation(s)
- Elissa Z. Faro
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Katherine A. Sauder
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO, USA
| | - Gwendolyn S. Norman
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA
| | - Amber Anderson
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Carmen Vélez-Vega
- Social Sciences Department, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - David Napp
- Practical Applications of Public Health, Durham, NC, USA
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Reno JE, Ong TC, Voong C, Morse B, Ytell K, Koren R, Kwan BM. Engaging Patients and Other Stakeholders in "Designing for Dissemination" of Record Linkage Methods and Tools. Appl Clin Inform 2023; 14:670-683. [PMID: 37276886 PMCID: PMC10446912 DOI: 10.1055/a-2105-6505] [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: 09/23/2022] [Accepted: 06/01/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Novel record linkage (RL) methods have the potential to enhance clinical informatics by integrating patient data from multiple sources-including electronic health records, insurance claims, and digital health devices-to inform patient-centered care. Engaging patients and other stakeholders in the use of RL methods in patient-centered outcomes research (PCOR) is a key step in ensuring RL methods are viewed as acceptable, appropriate, and useful. The University of Colorado Record Linkage (CURL) platform empowers the use of RL in PCOR. OBJECTIVES This study aimed to describe the process of engaging patients and other stakeholders in the design of an RL dissemination package to support the use of RL methods in PCOR. METHODS Customer discovery, value proposition design, and user experience methods were used to iteratively develop an RL dissemination package that includes animated explainer videos for patients and an RL research planning workbook for researchers. Patients and other stakeholders (researchers, data managers, and regulatory officials) were engaged in the RL dissemination package design. RESULTS Patient partners emphasized the importance of conveying how RL methods may benefit patients and the rules researchers must follow to protect the privacy and security of patient data. Other stakeholders described accuracy, flexibility, efficiency, and data security compared with other available RL solutions. Dissemination package communication products reflect the value propositions identified by key stakeholders. As prioritized by patients, the animated explainer videos emphasize the data privacy and security processes and procedures employed when performing research using RL. The RL workbook addresses researchers' and data managers' needs to iteratively design RL projects and provides accompanying resources to alleviate leadership and regulatory officials' concerns about data regulation compliance. CONCLUSION Dissemination products to promote adoption and use of CURL include materials to facilitate patient engagement in RL research and investigator step-by-step decision-making materials about the integration of RL methods in PCOR.
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Affiliation(s)
- Jenna E. Reno
- RTI International, Center for Communication and Engagement Research, Research Triangle Park, North Carolina, United States
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Toan C. Ong
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Chan Voong
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Brad Morse
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Kate Ytell
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Ramona Koren
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Bethany M. Kwan
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
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Feldner HA, Gaebler-Spira D, Awasthi V, Bjornson KK. Supportive mobility devices across the lifespan in Cerebral Palsy: a modified Delphi study to establish stakeholder research priorities. Disabil Rehabil Assist Technol 2023:1-9. [PMID: 37452575 PMCID: PMC10883137 DOI: 10.1080/17483107.2023.2233564] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE The aim of this study was to co-develop research priorities and identify meaningful research questions with a diverse group of stakeholders representing the CP community for implementation in subsequent research activities. The overarching aim of this research was to 1) Understand the mobility experiences, supported mobility device (SMD) use, and desired participation outcomes of people with cerebral palsy (CP) across the lifespan; and 2) Describe how perspectives of rehabilitation care and professional resources may influence mobility decision-making processes and outcomes. MATERIALS AND METHODS A three-round modified Delphi consensus study was conducted with a stakeholder advisory panel consisting of three adults with CP, two parents of children with CP, and four SMD providers. RESULTS The advisory panel identified 11 unique topical categories focused on SMD selection and use, stratified by age group and stakeholder role. Questions or statements within each category were ranked, and top consensus and concordance statements were retained, reviewed, and refined for use in a co-developed focus group guide. Priorities were identified in three main groupings: (1) Age/GMFCS level/Environment-related; (2) Individual with CP/Caregiver need-related; and (3) Clinician/provider partnership-related. DISCUSSION A modified Delphi process was a useful tool for stakeholders in co-developing research priorities related to SMD use across the lifespan. Drawing on the lived expertise of stakeholders is important in facilitating improved research translation in the CP community.
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Affiliation(s)
- Heather A Feldner
- Department of Rehabilitation Medicine, University of WA, Seattle, WA, USA
| | | | - Varun Awasthi
- Seattle Children's Research Institute, Seattle, WA, USA
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Rose DM, Donahoo S, McDaniel JT, Null D, McLernon M, Kruse-Diehr AJ. Perceptions of the double value coupon program in southern Illinois. Front Public Health 2023; 11:1125069. [PMID: 37483939 PMCID: PMC10359986 DOI: 10.3389/fpubh.2023.1125069] [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: 12/15/2022] [Accepted: 05/12/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Purchasing produce at farmers markets represents one method by which individuals can purchase and have access to healthful and seasonal fruits. Despite the extension of nutrition assistance programs to local farmers markets, fruit and vegetables consumption has remained below the recommended guidelines, specifically in rural geographical locations. Statement of purpose The purpose of the study was to explore the aspects of the Link Up Illinois Double Value SNAP Nutrition Incentives Program (DVCP) and its effects on food selection at rural farmers markets for individuals enrolled in nutrition assistance programs. Methods/approach The current study uses a qualitative methodology in order to uncover barriers local health departments and farmers markets face to implementing the DVCP in their communities and to discover the perspectives of low-income individuals who utilize the DVCP. This paper explores the organizational and community member perceptions of the DVCP and its administration. Semi-structured interviews and one focus group were conducted with health educators from county health departments, DVCP stakeholders, farmers market managers, local farmers, and residents who used the DVCP. A purposeful sampling method was used, intentionally selecting individuals with lived experiences of the research objective. Data were analyzed using a three-cycle coding process, then categorized into overarching themes until thematic saturation was reached. Results There were a total of 19 individuals who participated in the study. Five themes and four subthemes emerged from data analysis, including organizational capacity, exposure to the DVCP, purchasing power, DVCP advancements, and values. Conclusion/implications These findings contextualize the facilitators and barriers of multiple stakeholders when implementing nutrition assistance programs at farmers markets. Other similar "double value" programs can utilize these lessons when seeking to increase participation of underrepresented populations at local farmers markets.
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Affiliation(s)
- Dominique M. Rose
- Nationwide Children’s Hospital, Center for Injury, Research and Policy, Abigail Wexner Research Institute, Columbus, OH, United States
| | - Saran Donahoo
- School of Education, Southern Illinois University, Carbondale, IL, United States
| | - Justin T. McDaniel
- School of Education, Southern Illinois University, Carbondale, IL, United States
- School of Human Sciences, Southern Illinois University, Carbondale, IL, United States
| | - Dawn Null
- School of Education, Southern Illinois University, Carbondale, IL, United States
- School of Human Sciences, Southern Illinois University, Carbondale, IL, United States
| | - Michelle McLernon
- School of Education, Southern Illinois University, Carbondale, IL, United States
- Center for Rural Health-SMC, Southern Illinois University, Carbondale, IL, United States
| | - Aaron J. Kruse-Diehr
- Department of Family and Community Medicine, Univeristy of Kentucky College of Medicine, Lexington, KY, United States
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Moore MD, Hall AG, Wingate MS, Ford EW. Achieving Consensus Among Stakeholders Using the Nominal Group Technique: A Perinatal Quality Collaborative Approach. Qual Manag Health Care 2023; 32:161-169. [PMID: 36007140 PMCID: PMC9950289 DOI: 10.1097/qmh.0000000000000384] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Public health systems exhibiting strong connections across the workforce experience substantial population health improvements. This is especially important for improving quality and achieving value among vulnerable populations such as mothers and infants. The purpose of this research was to demonstrate how Alabama's newly formed perinatal quality collaborative (Alabama Perinatal Quality Collaborative [ALPQC]) used evidenced-based processes to achieve consensus in identifying population quality improvement (QI) initiatives. METHODS This multiphase quantitative and qualitative study engaged stakeholders (n = 44) at the ALPQC annual meeting. Maternal and neonatal focused QI project topics were identified and catalogued from active perinatal quality collaborative websites. The Delphi method and the nominal group technique (NGT) were used to prioritize topics using selected criteria ( impact , enthusiasm , alignment , and feasibility ) and stakeholder input. RESULTS Using the Delphi method, 11 of 27 identified project topics met inclusion criteria for stakeholder consideration. Employing the NGT, maternal projects received more total votes (n = 535) than neonatal projects (n = 313). Standard deviations were higher for neonatal projects (SD: feasibility = 10.9, alignment = 17.9, enthusiasm = 19.2, and impact = 22.1) than for maternal projects (SD: alignment = 5.9, enthusiasm = 7.3, impact = 7.9, and feasibility = 11.1). Hypertension in pregnancy (n = 117) and neonatal abstinence syndrome (n = 177) achieved the most votes total and for impact (n = 35 and n = 54, respectively) but variable support for feasibility . CONCLUSIONS Together, these techniques achieved valid consensus across multidisciplinary stakeholders in alignment with state public health priorities. This model can be used in other settings to integrate stakeholder input and enhance the value of a common population QI agenda.
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Affiliation(s)
- Matthew D. Moore
- Department of Health Policy and Organization, School of Public Health, The University of Alabama at Birmingham
| | - Allyson G. Hall
- Department of Health Services Administration, School of Health Professions, The University of Alabama at Birmingham
| | - Martha S. Wingate
- Department of Health Policy and Organization, School of Public Health, The University of Alabama at Birmingham
| | - Eric W. Ford
- Department of Health Policy and Organization, School of Public Health, The University of Alabama at Birmingham
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Drobne D, Ciornii D, Hodoroaba V, Bohmer N, Novak S, Kranjc E, Kononenko V, Reuther R. Knowledge, Information, and Data Readiness Levels (KaRLs) for Risk Assessment, Communication, and Governance of Nano-, New, and Other Advanced Materials. Glob Chall 2023; 7:2200211. [PMID: 37483420 PMCID: PMC10362106 DOI: 10.1002/gch2.202200211] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/03/2023] [Indexed: 07/25/2023]
Abstract
The obvious benefits derived from the increasing use of engineered nano-, new, and advanced materials and associated products have to be weighed out by a governance process against their possible risks. Differences in risk perception (beliefs about potential harm) among stakeholders, in particular nonscientists, and low transparency of the underlying decision processes can lead to a lack of support and acceptance of nano-, new, and other advanced material enabled products. To integrate scientific outcomes with stakeholders needs, this work develops a new approach comprising a nine-level, stepwise categorization and guidance system entitled "Knowledge, Information, and Data Readiness Levels" (KaRLs), analogous to the NASA Technology Readiness Levels. The KaRL system assesses the type, extent, and usability of the available data, information, and knowledge and integrates the participation of relevant and interested stakeholders in a cocreation/codesign process to improve current risk assessment, communication, and governance. The novelty of the new system is to communicate and share all available and relevant elements on material related risks in a user/stakeholder-friendly, transparent, flexible, and holistic way and so stimulate reflection, awareness, communication, and a deeper understanding that ultimately enables the discursive process that is needed for the sustainable risk governance of new materials.
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Affiliation(s)
- Damjana Drobne
- Department of BiologyBiotechnical FacultyUniversity of LjubljanaVečna pot 111Ljubljana1000Slovenia
| | - Dmitri Ciornii
- Bundesanstalt für Materialforschung und‐Prüfung (BAM)Division 6.1 Surface Analysis and Interfacial ChemistryUnter den Eichen 8712205BerlinGermany
| | - Vasile‐Dan Hodoroaba
- Bundesanstalt für Materialforschung und‐Prüfung (BAM)Division 6.1 Surface Analysis and Interfacial ChemistryUnter den Eichen 8712205BerlinGermany
| | - Nils Bohmer
- Evonik Operations GmbHRodenbacher Chaussee 463457Hanau‐WolfgangGermany
| | - Sara Novak
- Department of BiologyBiotechnical FacultyUniversity of LjubljanaVečna pot 111Ljubljana1000Slovenia
| | - Eva Kranjc
- Department of BiologyBiotechnical FacultyUniversity of LjubljanaVečna pot 111Ljubljana1000Slovenia
| | - Veno Kononenko
- Department of BiologyBiotechnical FacultyUniversity of LjubljanaVečna pot 111Ljubljana1000Slovenia
| | - Rudolf Reuther
- Environmental AssessmentsOberes Lautenbächle 377886LaufGermany
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Milko LV, Berg JS. Age-Based Genomic Screening during Childhood: Ethical and Practical Considerations in Public Health Genomics Implementation. Int J Neonatal Screen 2023; 9:36. [PMID: 37489489 PMCID: PMC10366892 DOI: 10.3390/ijns9030036] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/07/2023] [Accepted: 06/21/2023] [Indexed: 07/26/2023] Open
Abstract
Genomic sequencing offers an unprecedented opportunity to detect inherited variants that are implicated in rare Mendelian disorders, yet there are many challenges to overcome before this technology can routinely be applied in the healthy population. The age-based genomic screening (ABGS) approach is a novel alternative to genome-scale sequencing at birth that aims to provide highly actionable genetic information to parents over the course of their child's routine health care. ABGS utilizes an established metric to identify conditions with high clinical actionability and incorporates information about the age of onset and age of intervention to determine the optimal time to screen for any given condition. Ongoing partnerships with parents and providers are instrumental to the co-creation of educational resources and strategies to address potential implementation barriers. Implementation science frameworks and informative empirical data are used to evaluate strategies to establish this unique clinical application of targeted genomic sequencing. Ultimately, a pilot project conducted in primary care pediatrics clinics will assess patient and implementation outcomes, parent and provider perspectives, and the feasibility of ABGS. A validated, stakeholder-informed, and practical ABGS program will include hundreds of conditions that are actionable during infancy and childhood, setting the stage for a longitudinal implementation that can assess clinical and health economic outcomes.
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Affiliation(s)
- Laura V Milko
- Department of Genetics, University of North Carolina at Chapel Hill, 120 Mason Farm Rd., Chapel Hill, NC 27599-7264, USA
| | - Jonathan S Berg
- Department of Genetics, University of North Carolina at Chapel Hill, 120 Mason Farm Rd., Chapel Hill, NC 27599-7264, USA
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Raman G, Vijaysimha M, Kopleff E, Dunham K, Martin G, Slutsky J, Lawrence W. Emerging healthcare interventions: Patient-Centered Outcomes Research Institute's programmatic initiative. Int J Technol Assess Health Care 2023; 39:e36. [PMID: 37336780 DOI: 10.1017/s0266462323000284] [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: 06/21/2023]
Abstract
The Patient-Centered Outcomes Research Institute (PCORI) is a nonprofit, nongovernmental organization established by the U.S. Congress to fund comparative clinical effectiveness research focusing on patient-centered outcomes through the engagement of stakeholders. Evaluation of emerging healthcare innovations is one of PCORI's five National Priorities for Health. One such initiative is PCORI's Emerging Technologies and Therapeutics Reports program, established to provide timely overviews of evidence on new drugs and other healthcare technologies. This article provides an overview of completed and ongoing Emerging Technologies and Therapeutics Reports including lessons learned to date. In addition to systematic searches, systematic selection of studies, and transparent reporting of the available evidence, informed by a select number of stakeholders (i.e., key informants), these reports focus on contextual factors shaping the diffusion of emerging technologies that are often not reported in the medical literature. This article also compares processes and methodologies of health technology assessments (HTAs) from a selected number of national and international publicly funded agencies with a goal toward potential future enhancement of PCORI's Emerging Technologies and Therapeutics Reports program. HTAs vary considerably in terms of funding, types of assessments, the role of manufacturers, stakeholder engagement, timeline to complete from the start to the finish of a draft report publication, and communication of uncertainty for informed decision making. Future Emerging Technologies and Therapeutics Reports may focus on rapid reports to support a more expedient development of evidence. Future research could explore the role of contextual factors identified in these reports on targeted evidence generation.
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Affiliation(s)
- Gowri Raman
- New Technology, Engagement, Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Meghana Vijaysimha
- Research and New Technology, Engagement, Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Emma Kopleff
- Public and Patient Engagement, Engagement, Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Kelly Dunham
- Strategic Initiatives, Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Greg Martin
- Engagement, Dissemination, and Implementation, Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Jean Slutsky
- Executive Office, Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - William Lawrence
- Office of the Deputy Executive Director for Patient-Centered Research Programs, Patient-Centered Outcomes Research Institute, Washington, DC, USA
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Abstract
A shift in the traditional technocentric view of medical device design to a human-centered one is needed to bridge existing translational gaps and improve health equity. To ensure the successful and equitable adoption of health technology innovations, engineers must think beyond the device and the direct end user and must seek a more holistic understanding of broader stakeholder needs and the intended context of use early in a design process. The objectives of this review article are (a) to provide rationale for the need to incorporate meaningful stakeholder analysis and contextual investigation in health technology development and biomedical engineering pedagogy, (b) to review existing frameworks and human- and equity-centered approaches to stakeholder engagement and contextual investigation for improved adoption of innovative technologies, and (c) to present case studyexamples of medical device design that apply these approaches to bridge the gaps between biomedical engineers and the contexts for which they are designing.
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Affiliation(s)
- Natalia M Rodriguez
- Weldon School of Biomedical Engineering, College of Engineering, Purdue University, West Lafayette, Indiana, USA;
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA
- Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Grace Burleson
- Design Science, College of Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Jacqueline C Linnes
- Weldon School of Biomedical Engineering, College of Engineering, Purdue University, West Lafayette, Indiana, USA;
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA
- Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Kathleen H Sienko
- Design Science, College of Engineering, University of Michigan, Ann Arbor, Michigan, USA
- Department of Mechanical Engineering, College of Engineering, University of Michigan, Ann Arbor, Michigan, USA
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Hendricks S, van Wyk JP, Player B, Schlebusch R. University and stakeholder partnerships to innovate in sport - the development of the South African Cricketers' Association (SACA) career transition screening tool. S Afr J Sports Med 2023; 35:v35i1a15218. [PMID: 38249770 PMCID: PMC10798606 DOI: 10.17159/2078-516x/2023/v35i1a15218] [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: 01/23/2024] Open
Abstract
In sports, the value and mutual benefit of university-stakeholder partnerships have been well-recognised. It has been argued that cricket has a unique set of challenges compared to other team sports. In 2016, the South African Cricketers' Association (SACA) and the University of Cape Town established a partnership to (i) conduct novel research on professional cricketers and (ii) ensure SACA programmes and initiatives are informed by said research and/or the currently available literature. As the demand on professional cricketers has increased, so has the interest in their career transitioning. That is, how do professional cricketers manage stressors created by changes (or non-changes) throughout their playing careers? To help identify gaps for intervention as a cricketer transitions through their professional career, the purpose of this short report is to describe how a university-stakeholder partnership developed a career transitioning screening tool for professional cricketers in South Africa.
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Affiliation(s)
- S Hendricks
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town,
South Africa
- Health through Physical Activity, Lifestyle and Sport (HPALS) Research Centre, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town,
South Africa
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds,
United Kingdom
| | - JP van Wyk
- South African Cricketers’ Association, Cape Town,
South Africa
| | - B Player
- South African Cricketers’ Association, Cape Town,
South Africa
| | - R Schlebusch
- South African Cricketers’ Association, Cape Town,
South Africa
- Sportsthink 360, Claremont, Cape Town,
South Africa
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50
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Budin‐Ljøsne I, Friedman BB, Baaré WFC, Bartrés‐Faz D, Carver RB, Drevon CA, Ebmeier KP, Fjell AM, Ghisletta P, Henson RN, Kievit R, Madsen KS, Nawijn L, Suri S, Solé‐Padullés C, Walhovd KB, Zsoldos E. Stakeholder engagement in European brain research: Experiences of the Lifebrain consortium. Health Expect 2023; 26:1318-1326. [PMID: 36989126 PMCID: PMC10154816 DOI: 10.1111/hex.13747] [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: 09/02/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Stakeholder engagement remains scarce in basic brain research. However, it can greatly improve the relevance of investigations and accelerate the translation of study findings to policy. The Lifebrain consortium investigated risk and protective factors influencing brain health using cognition, lifestyle and imaging data from European cohorts. Stakeholder activities of Lifebrain-organized in a separate work package-included organizing stakeholder events, investigating public perceptions of brain health and dissemination. Here, we describe the experiences of researchers and stakeholders regarding stakeholder engagement in the Lifebrain project. METHODS Stakeholder engagement in Lifebrain was evaluated through surveys among researchers and stakeholders and stakeholders' feedback at stakeholder events through evaluation forms. Survey data were analysed using a simple content analysis approach, and results from evaluation forms were summarized after reviewing the frequency of responses. RESULTS Consortium researchers and stakeholders experienced the engagement activities as meaningful and relevant. Researchers highlighted that it made the research and research processes more visible and contributed to new networks, optimized data collection on brain health perceptions and the production of papers and provided insights into stakeholder views. Stakeholders found research activities conducted in the stakeholder engagement work package to be within their field of interest and research results relevant to their work. Researchers identified barriers to stakeholder engagement, including lack of time, difficulties in identifying relevant stakeholders, and challenges in communicating complex scientific issues in lay language and maintaining relationships with stakeholders over time. Stakeholders identified barriers such as lack of budget, limited resources in their organization, time constraints and insufficient communication between researchers and stakeholders. CONCLUSION Stakeholder engagement in basic brain research can greatly benefit researchers and stakeholders alike. Its success is conditional on dedicated human and financial resources, clear communication, transparent mutual expectations and clear roles and responsibilities. PUBLIC CONTRIBUTION Patient organizations, research networks, policymakers and members of the general public were involved in engagement and research activities throughout the project duration.
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Affiliation(s)
| | - Barbara B. Friedman
- Department of Psychology, Center for Lifespan Changes in Brain and CognitionUniversity of OsloOsloNorway
| | - William F. C. Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital—Amager and HvidovreCopenhagenDenmark
| | - David Bartrés‐Faz
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - Rebecca B. Carver
- Department of CommunicationsNorwegian Institute of Public HealthOsloNorway
| | - Christian A. Drevon
- Vitas ASOsloNorway
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
| | - Klaus P. Ebmeier
- Department of Psychiatry, Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Warneford HospitalUniversity of OxfordOxfordUK
| | - Anders M. Fjell
- Department of Psychology, Center for Lifespan Changes in Brain and CognitionUniversity of OsloOsloNorway
| | - Paolo Ghisletta
- Methodology and Data Analysis Group, Faculty of Psychology and Educational SciencesUniversity of GenevaGenevaSwitzerland
- Faculty Council of the Faculty of PsychologyUniDistance SuisseBrigSwitzerland
- Swiss National Centre of Competence in Research LIVESUniversity of GenevaGenevaSwitzerland
| | - Richard N. Henson
- MRC Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Rogier Kievit
- MRC Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
- Cognitive Neuroscience DepartmentDonders Institute for Brain, Cognition and Behavior, Radboud University Medical CenterNijmegenThe Netherlands
| | - Kathrine S. Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital—Amager and HvidovreCopenhagenDenmark
- Radiography, Department of TechnologyUniversity College CopenhagenCopenhagenDenmark
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Sana Suri
- Department of Psychiatry, Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Warneford HospitalUniversity of OxfordOxfordUK
| | - Cristina Solé‐Padullés
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of NeurosciencesUniversity of BarcelonaBarcelonaSpain
| | - Kristine B. Walhovd
- Department of Psychology, Center for Lifespan Changes in Brain and CognitionUniversity of OsloOsloNorway
| | - Enikő Zsoldos
- Department of Psychiatry, Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Warneford HospitalUniversity of OxfordOxfordUK
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