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Oosterbaan-Lodder SCM, Kors J, Visser CLF, Kvist BM, Kusurkar RA, Scheele F. Twelve tips for designing, implementing and sustaining interprofessional training units on hospital wards. Med Teach 2024; 46:323-329. [PMID: 37688778 DOI: 10.1080/0142159x.2023.2252591] [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: 09/11/2023]
Abstract
Dedicated Interprofessional Training Units (ITUs) in hospital wards are one way to prepare healthcare students for Interprofessional patient-centered care. Based on theoretical foundations, research, and our lived experiences of successes as well as failures, we propose 12 tips on how to prepare, implement, and sustain a dedicated ITU, combining the Grol & Wensing model for planning change with the Self-determination Theory of motivation. Start with a steering group, with a dedicated project leader, to translate awareness of the need for an ITU into wider awareness and motivation among stakeholders, with the ITU being a solution to authentic problems. Create shared ownership by jointly formulating feasible educational goals and starting with a pilot to provide opportunities for change. Motivate all stakeholders by stimulating their autonomy, interprofessional competence as well as relatedness to each other, in line with the Self-determination Theory. Confirm the value of the ITU at all stages and embed the ITU in the organizational strategy.
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Affiliation(s)
| | - Joyce Kors
- Research in Education, Amsterdam UMC location Vrije Universiteit, Amsterdam, the Netherlands
- Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University, Amsterdam, the Netherlands
| | - Cora L F Visser
- AVAG, Amsterdam Public Health Research Institute, Midwifery Science, Amsterdam UMC location Vrije Universiteit, Amstel Academie, Amsterdam, The Netherlands
| | | | - Rashmi A Kusurkar
- Research in Education, Amsterdam UMC location Vrije Universiteit, Amsterdam, the Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University, Amsterdam, the Netherlands
- Quality of Care, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Fedde Scheele
- Teaching Hospital Department, OLVG Hospital, Amsterdam, The Netherlands
- Research in Education, Amsterdam UMC location Vrije Universiteit, Amsterdam, the Netherlands
- Athena Institute, Vrije Universiteit, Amsterdam, The Netherlands
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Sharma M, Awan A, Kapukotuwa S. Mini review: possible role of the multi-theory model of health behavior change in designing substance use prevention and treatment interventions. Front Public Health 2024; 12:1298614. [PMID: 38496384 PMCID: PMC10940529 DOI: 10.3389/fpubh.2024.1298614] [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: 12/26/2023] [Accepted: 02/20/2024] [Indexed: 03/19/2024] Open
Abstract
Many behavior change theories have evolved over time. Originally, the first conceptions prioritized interventions based on information, such as raising awareness and transferring knowledge. Second-generation theories prioritize the development of skills and the promotion of awareness. The emergence of evidence-based techniques in the 1990s gave rise to third-generation theories such as the Theory of Planned Behavior and Social Cognitive Theory. Presently, fourth-generation trends amalgamate various components from multiple theories to implement accurate treatments, employing technology and emphasizing targeted behavior change. This paper aims to do a concise evaluation of the multi-theory model (MTM) of health behavior change interventions in the context of planning substance use prevention and treatment. The current area of intervention programs aimed at preventing and treating substance use may benefit from MTM, an innovative fourth-generation behavior change model. Tobacco, alcohol, and other drugs have all been the subjects of experimental, cross-sectional, and qualitative research. We have presented that additional research is required to compare MTM with knowledge-based therapies or interventions grounded in other theories. A gold standard would be the randomized controlled trials and behavioral change interventions particularly useful for this purpose. In addition, research evaluating the interventions' efficacy must be carefully planned and executed.
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Affiliation(s)
- Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, United States
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, United States
| | - Asma Awan
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Sidath Kapukotuwa
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, United States
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Sebastian IA, Gandhi DBC, Kakarla R, Phillips A. Developing a Second Line of Physician Leaders. Stroke 2023; 54:e444-e447. [PMID: 37675610 DOI: 10.1161/strokeaha.123.040864] [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] [Indexed: 09/08/2023]
Affiliation(s)
| | - Dorcas B C Gandhi
- Department of Neurology, Christian Medical College, Ludhiana, India (D.B.C.G.)
| | - Raviteja Kakarla
- Department of Stroke and Neurointervention, Artemis Hospital, Delhi, India (R.K.)
| | - Atul Phillips
- Department of Critical Care (A.P.), St Stephen's Hospital, Delhi, India
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Sun Y, Stenson K, Mohan ML, Gupta MK, Wanner N, Asosingh K, Erzurum S, Naga Prasad SV. Hypoxia Sensing of β-Adrenergic Receptor Is Regulated by Endosomal PI3Kγ. Circ Res 2023; 132:690-703. [PMID: 36779349 PMCID: PMC10023460 DOI: 10.1161/circresaha.122.321735] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 08/08/2022] [Accepted: 01/31/2023] [Indexed: 02/14/2023]
Abstract
BACKGROUND Impaired beta-adrenergic receptor (β1 and β2AR) function following hypoxia underlies ischemic heart failure/stroke. Activation of PI3Kγ (phosphoinositide 3-kinase γ) by beta-adrenergic receptor leads to feedback regulation of the receptor by hindering beta-adrenergic receptor dephosphorylation through inhibition of PP2A (protein phosphatase 2A). However, little is known about PI3Kγ feedback mechanism in regulating hypoxia-mediated β1 and β2AR dysfunction and cardiac remodeling. METHODS Human embryonic kidney 293 cells or mouse adult cardiomyocytes and C57BL/6 (WT) or PI3Kγ knockout (KO) mice were subjected to hypoxia. Cardiac plasma membranes and endosomes were isolated and evaluated for β1 and β2AR density and function, PI3Kγ activity and β1 and β2AR-associated PP2A activity. Metabolic labeling was performed to assess β1 and β2AR phosphorylation and epinephrine/norepinephrine levels measured post-hypoxia. RESULTS Hypoxia increased β1 and β2AR phosphorylation, reduced cAMP, and led to endosomal accumulation of phosphorylated β2ARs in human embryonic kidney 293 cells and WT cardiomyocytes. Acute hypoxia in WT mice resulted in cardiac remodeling and loss of adenylyl cyclase activity associated with increased β1 and β2AR phosphorylation. This was agonist-independent as plasma and cardiac epinephrine and norepinephrine levels were unaltered. Unexpectedly, PI3Kγ activity was selectively increased in the endosomes of human embryonic kidney 293 cells and WT hearts post-hypoxia. Endosomal β1- and β2AR-associated PP2A activity was inhibited upon hypoxia in human embryonic kidney 293 cells and WT hearts showing regulation of beta-adrenergic receptors by PI3Kγ. This was accompanied with phosphorylation of endogenous inhibitor of protein phosphatase 2A whose phosphorylation by PI3Kγ inhibits PP2A. Increased β1 and β2AR-associated PP2A activity, decreased beta-adrenergic receptor phosphorylation, and normalized cardiac function was observed in PI3Kγ KO mice despite hypoxia. Compared to WT, PI3Kγ KO mice had preserved cardiac response to challenge with β1AR-selective agonist dobutamine post-hypoxia. CONCLUSIONS Agonist-independent activation of PI3Kγ underlies hypoxia sensing as its ablation leads to reduction in β1- and β2AR phosphorylation and amelioration of cardiac dysfunction.
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Affiliation(s)
- Yu Sun
- Departments of Cardiovascular and Metabolic Sciences (Y.S., K.S., M.L.M., M.K.G., S.V., N.P.), Lerner Research Institute, Cleveland Clinic, OH
| | - Kate Stenson
- Departments of Cardiovascular and Metabolic Sciences (Y.S., K.S., M.L.M., M.K.G., S.V., N.P.), Lerner Research Institute, Cleveland Clinic, OH
| | - Maradumane L Mohan
- Departments of Cardiovascular and Metabolic Sciences (Y.S., K.S., M.L.M., M.K.G., S.V., N.P.), Lerner Research Institute, Cleveland Clinic, OH
| | - Manveen K Gupta
- Departments of Cardiovascular and Metabolic Sciences (Y.S., K.S., M.L.M., M.K.G., S.V., N.P.), Lerner Research Institute, Cleveland Clinic, OH
| | - Nick Wanner
- Inflammation and Immunity (N.W., K.A., S.E.), Lerner Research Institute, Cleveland Clinic, OH
| | - Kewal Asosingh
- Inflammation and Immunity (N.W., K.A., S.E.), Lerner Research Institute, Cleveland Clinic, OH
| | - Serpil Erzurum
- Inflammation and Immunity (N.W., K.A., S.E.), Lerner Research Institute, Cleveland Clinic, OH
| | - Sathyamangla V Naga Prasad
- Departments of Cardiovascular and Metabolic Sciences (Y.S., K.S., M.L.M., M.K.G., S.V., N.P.), Lerner Research Institute, Cleveland Clinic, OH
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Nerida TM, Sharma M, Labus B, Marquez E, Dai CL. COVID-19 Vaccine Acceptance Behavior among Hispanics/Latinxs in Nevada: A Theory-Based Analysis. Healthcare (Basel) 2023; 11. [PMID: 36900698 DOI: 10.3390/healthcare11050688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Hesitancy toward the COVID-19 vaccine has hindered its rapid uptake among the Hispanic and Latinx populations. The study aimed to use the Multi-Theory Model (MTM) for health behavior change to explain the intention of initiating and sustaining the behavior of COVID-19 vaccination among the Hispanic and Latinx populations that expressed and did not express hesitancy towards the vaccine in Nevada. Using a quantitative cross-sectional and survey-based research study design, data were collected using a 50-item questionnaire and analyzed using multiple linear regression modeling. Of 231 respondents, participatory dialogue (b = 0.113, p < 0.001; b = 0.072, p < 0.001) and behavioral confidence (b = 0.358, p < 0.001; b = 0.206, p < 0.001) displayed significant associations with the initiation of COVID-19 vaccine acceptance among vaccine-hesitant and non-vaccine-hesitant individuals. Emotional transformation (b = 0.087, p < 0.001; b = 0.177, p < 0.001) displayed a significant association with the sustenance of COVID-19 vaccine acceptance among vaccine-hesitant and non-vaccine-hesitant individuals. Results from this study provide evidence that the MTM is a useful tool in predicting COVID-19 vaccine acceptance behavior among Hispanics and Latinxs in Nevada, and it should be used in intervention designs and messaging to promote vaccine uptake.
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Sharma M, Batra K, Singh TP, Dua R, Ickes M, Batra R, Nahar VK. Explaining Screen-Time Behavior Among Preschoolers in Northern India Using Multi Theory Model: A Parental Cross-Sectional Survey. Int Q Community Health Educ 2021; 43:95-104. [PMID: 33765887 DOI: 10.1177/0272684x211006604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Screen-time (ST) is the time spent on digital media. The American Academy of Pediatrics recommends the daily ST of less than an hour for preschoolers. However, increased ST among preschoolers is becoming a public health concern. OBJECTIVE This study assessed the multi-theory model (MTM)'s applicability in explaining the ST behavior change among preschoolers through parents. METHODS A quota sample of 72 parents was drawn from Northern India. Data were analyzed using multiple regression. RESULTS Behavioral confidence (p < 0.001) and changes in the physical environment (p < 0.001) significantly predicted the initiation of reducing ST. The sustenance of limiting ST was significantly predicted by the emotional transformation (p < 0.001), practice for change (p < 0.001), and changes in the social environment (p = 0.001). CONCLUSIONS The study highlights the usability of the MTM model in designing and testing interventions for parents to limit ST among their children.
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Affiliation(s)
- Manoj Sharma
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Nevada, United States
| | - Kavita Batra
- Office of Research, School of Medicine, University of Nevada, Las Vegas, Nevada, United States
| | - Tejinder Pal Singh
- Department of Family and Preventive Medicine, Division of Public Health, School of Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Rohini Dua
- Department of Pediatric and Preventive Dentistry, National Dental College and Hospital, Dera Bassi, India
| | - Melinda Ickes
- Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, Kentucky, United States
| | - Ravi Batra
- Department of Information Technology and Testing Center of Excellence, Coforge, Atlanta, Georgia, United States
| | - Vinayak K Nahar
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
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