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Goldthorpe J, Kilbee L, Pretty I, Cotterill S, Hart J, Peters S. Supporting post-pandemic recovery: a qualitative study of the capabilities, opportunities and motivations to deliver oral health behaviour change messages to parents of young children in community settings. BMC Oral Health 2024; 24:580. [PMID: 38762726 PMCID: PMC11102627 DOI: 10.1186/s12903-024-04344-0] [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: 01/16/2023] [Accepted: 05/07/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic exacerbated vulnerabilities and inequalities in children's oral health, and treatment activity virtually ceased during periods of lockdown. Primary care dentistry is still in the post-pandemic recovery phase, and it may be some years before normal service is resumed in NHS dentistry. However, opportunities to support the dental workforce through offering some preventative care in outreach settings may exist. This has the additional benefit of potentially reaching children who do not routinely see a dentist. The aim of this research was therefore to explore views around upskilling practitioners working in early years educational and care settings to support families of pre-school aged children to adopt and maintain preventative oral health behaviours. METHODS Using the Capability, Opportunity and Motivation model of behaviour (COM-B) to structure our data collection and analysis, we conducted semi-structured interviews with 16 practitioners (dental and non-dental) and analysed the data using deductive framework analysis. RESULTS The data were a good fit with the COM-B model, and further themes were developed within each construct, representing insights from the data. CONCLUSION Early years practitioners can reach vulnerable children who are not usually brought to see a dentist, and have the capability, opportunity and motivation to support the oral health behaviours of families of children in their care. Further research is needed to identify training needs (oral health and behaviour change knowledge and skills), acceptability to parents, and supporting dental practice teams to work in partnership with early years settings.
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Affiliation(s)
- Joanna Goldthorpe
- Manchester Centre for Health Psychology, Division of Health Research, University of Manchester, Manchester, UK
| | - Lauren Kilbee
- Manchester Centre for Health Psychology, Division of Health Research, University of Manchester, Manchester, UK
| | - Iain Pretty
- Division of Medical Sciences, Colgate Palmolive University of Manchester Dental Health Unit, Manchester, UK
| | - Sarah Cotterill
- Centre for Biostatistics, School of Health Sciences, University of Manchester, Manchester, UK
| | - Jo Hart
- Division of Medical Education, School of Medical Sciences, University of Manchester, Manchester, UK
| | - Sarah Peters
- Manchester Centre for Health Psychology, Division of Health Research, University of Manchester, Manchester, UK.
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Herb CC, Custer L, Blemker S, Saliba S, Hart J, Hertel J. Gait kinematics and kinetics in patients with chronic ankle instability and healthy controls: A statistical parametric mapping analysis. Foot (Edinb) 2024; 59:102089. [PMID: 38593519 DOI: 10.1016/j.foot.2024.102089] [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] [Received: 03/02/2023] [Revised: 04/27/2023] [Accepted: 03/10/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Chronic ankle instability (CAI) is associated with changes in gait biomechanics which may be related to chronic dysfunction. Traditional statistical models may be limited in their ability to assess the complex 3D movement of the lower extremity during gait. Multivariate analysis of the lower extremity kinematics may reveal unique biomechanical differences associated with CAI. RESEARCH QUESTION Do patients with CAI differ from healthy controls in their lower extremity biomechanics and GRF when comparing 3D biomechanics? METHODS Thirty-nine young, active adults participated in this study. Data was collected using a 3D motion analysis system while patients walked and jogged. Statistical parametric mapping (SPM) was used to explore 3D GRF, kinematics and kinetics of the of the lower extremity of CAI and healthy patients. RESULTS During walking, patients with CAI had greater inversion from 68-100% of gait cycle (p < 0.001, mean difference=3.2°). During jogging, patients with CAI had greater inversion from 20-92% (p < 0.001, mean difference=4.6°). Greater plantar flexion moments were found from 65-71% (p = 0.05, mean difference=347.4Nm/kg) and greater eversion moments were found from 95-100% (p = 0.03, mean difference=74.6Nm/kg) in the CAI group. No differences in GRF were found. SIGNIFICANCE Greater inversion may present a potentially injurious position. A faulty position of the rearfoot may require greater muscle function in order to correct the position of the joint resulting in greater eversion moments at the ankle. However, this kinetic change does not appear to correct the ankle position.
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Affiliation(s)
- C C Herb
- Northern Kentucky University, School of Kinesiology, Counseling and Rehabilitative Science, Highland Heights, KY, USA.
| | - L Custer
- Towson University, Department of Kinesiology, Towson, MD, USA
| | - S Blemker
- University of Virginia, School of Engineering and Applied Science, Charlottesville, VA, USA
| | - S Saliba
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hart
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hertel
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
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Testard C, Shergold C, Acevedo-Ithier A, Hart J, Bernau A, Negron-Del Valle JE, Phillips D, Watowich MM, Sanguinetti-Scheck JI, Montague MJ, Snyder-Mackler N, Higham JP, Platt ML, Brent L. Natural disaster alters the adaptive benefits of sociality in a primate. bioRxiv 2024:2023.07.17.549328. [PMID: 37503170 PMCID: PMC10370068 DOI: 10.1101/2023.07.17.549328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Weather-related disasters can radically alter ecosystems. When disaster-driven ecological damage persists, the selective pressures exerted on individuals can change, eventually leading to phenotypic adjustments. For group-living animals, social relationships are believed to help individuals cope with environmental challenges and may be a critical mechanism enabling adaptation to ecosystems degraded by disasters. Yet, whether natural disasters alter selective pressures on patterns of social interactions and whether group-living animals can, as a result, adaptively change their social relationships remains untested. Here, we leveraged unique data collected on rhesus macaques from 5 years before to 5 years after a category 4 hurricane, leading to persistent deforestation which exacerbated monkeys' exposure to intense heat. In response, macaques increased tolerance for and decreased aggression toward other monkeys, facilitating access to scarce shade critical for thermoregulation. Social tolerance predicted individual survival for 5 years after the hurricane, but not before it, revealing a clear shift in the adaptive function of social relationships in this population. We demonstrate that an extreme climatic event altered selection on sociality and triggered substantial and persistent changes in the social structure of a primate species. Our findings unveil the function and adaptive flexibility of social relationships in degraded ecosystems and identify natural disasters as potential evolutionary drivers of sociality. One-Sentence Summary Testard et al. show that a natural disaster altered selection on sociality in group-living primates triggering persistent changes in their social structure.
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Sirota M, Habersaat KB, Betsch C, Bonga DL, Borek A, Buckel A, Butler R, Byrne-Davis L, Caudell M, Charani E, Geiger M, Gross M, Hart J, Kostopoulou O, Krockow EM, Likki T, Lo Fo Wong D, Santana AP, Sievert EDC, Theodoropoulou A, Thorpe A, Wanat M, Böhm R. We must harness the power of social and behavioural science against the growing pandemic of antimicrobial resistance. Nat Hum Behav 2024; 8:11-13. [PMID: 37985918 DOI: 10.1038/s41562-023-01762-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Affiliation(s)
- Miroslav Sirota
- Department of Psychology, University of Essex, Colchester, UK.
| | | | - Cornelia Betsch
- Health Communication, Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Implementation Research, Bernhard Nocht Institute for Tropical Medicine Hamburg, Hamburg, Germany
| | - Daniela Lejla Bonga
- Behavioural and Experimental Economics Team, Ministry of Health, Bratislava, Slovakia
| | - Aleksandra Borek
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Anica Buckel
- Food and Agriculture Organisation of the United Nations, Nairobi, Kenya
| | - Robb Butler
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Lucie Byrne-Davis
- Division of Medical Education, University of Manchester, Manchester, UK
| | - Mark Caudell
- Food and Agriculture Organisation of the United Nations, Nairobi, Kenya
| | - Esmita Charani
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Mattis Geiger
- Health Communication, Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Implementation Research, Bernhard Nocht Institute for Tropical Medicine Hamburg, Hamburg, Germany
| | - Marina Gross
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Jo Hart
- Division of Medical Education, University of Manchester, Manchester, UK
| | - Olga Kostopoulou
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Eva M Krockow
- School of Psychology and Vision Sciences, University of Leicester, Leicester, UK
| | - Tiina Likki
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Danilo Lo Fo Wong
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Ana P Santana
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth D C Sievert
- Health Communication, Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Implementation Research, Bernhard Nocht Institute for Tropical Medicine Hamburg, Hamburg, Germany
| | | | - Alistair Thorpe
- Department of Applied Health Research, University College London, London, UK
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Marta Wanat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Robert Böhm
- Faculty of Psychology, University of Vienna, Vienna, Austria
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Center for Social Data Science (SODAS), University of Copenhagen, Copenhagen, Denmark
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Turner R, Byrne-Davis L, Michael P, Coupe N, Holtom C, Smith C, Hart J. Experiences of implementing the 'Making Every Contact Count' initiative into a UK integrated care system: an interview study. J Public Health (Oxf) 2023; 45:894-903. [PMID: 37717953 PMCID: PMC10689001 DOI: 10.1093/pubmed/fdad173] [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: 02/06/2023] [Revised: 07/20/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND The 'Making Every Contact Count' (MECC) approach is in line with the current National Health Service (NHS) strategy to improve and prevent health conditions in England. Despite its importance and value for preventative healthcare, implementation of MECC varies. The aim of this study was to explore the barriers and facilitators of implementing MECC and MECC training into an integrated care system (ICS). METHODS Remote semi-structured interviews were conducted with staff across an ICS in the North West of England who were involved in implementing and delivering MECC across the region. Data were analysed initially using an inductive thematic analysis approach and then interpreted using the 'Capability, Opportunity, Motivation = Behaviour' (COM-B) model of behaviour change. RESULTS We interviewed nine stakeholders and identified three superordinate themes: (1) macro-level barriers and facilitators, e.g. funding; (2) organizational level barriers and facilitators, e.g. time and resource; and (3) individual-level barriers/facilitators for both MECC trainers and MECC agents. CONCLUSIONS MECC has potential to meet the needs of the public's health, but barriers to its implementation exist. MECC must be successfully embedded into organizations and regions in which it is implemented, which relies on further development of an appropriate infrastructure including sustainable funding and a shift in culture to value preventative healthcare.
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Affiliation(s)
- Rebecca Turner
- Division of Psychology and Mental Health, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester M13 9PL, UK
| | - Lucie Byrne-Davis
- Division of Medical Education, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester M13 9PLG, UK
| | - Panayiotis Michael
- Division of Medical Education, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester M13 9PLG, UK
| | - Nia Coupe
- Division of Psychology and Mental Health, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester M13 9PL, UK
| | - Caroline Holtom
- Public Health North West, NHS England, North West, London L3 4BL, UK
| | - Cheryl Smith
- Public Health, Lancashire County Council, Lancashire L39 2DF, UK
| | - Jo Hart
- Division of Medical Education, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester M13 9PLG, UK
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Turner RR, Epuru Reddy S, Byrne-Davis LMT, Bull ER, Hart J. An interview study to explore applied psychologists' experiences of implementing health psychology in global health partnerships: The Change Exchange. Br J Health Psychol 2023; 28:1076-1096. [PMID: 37169735 DOI: 10.1111/bjhp.12669] [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: 04/04/2022] [Accepted: 04/27/2023] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Health partnerships in global health aim to build capacity by strengthening training and education. Health psychology has an important role to play, as traditionally health partnerships focus upon increasing capability such as increasing knowledge but do not tackle opportunity and motivation. The Change Exchange recruits applied psychologist volunteers to utilize health psychology in global health partnerships, which is a novel approach. This study aimed to understand the experiences of applied psychologist volunteers working in health partnerships and how such interventions were implemented. METHODS Semi-structured interviews were carried out. Interviews were analysed using inductive thematic analysis to explore the translation and implementation of health psychology in health partnerships. A deductive approach was then taken using the higher level constructs of the Normalization Process Theory to inform and interpret the themes into recommendations. RESULTS Fifteen applied psychologists, all of whom were from the UK and had volunteered in health partnerships between the UK and low- to middle-income countries participated. Key themes and sub-themes were identified: (1) The challenges of the application of behavioural science within the health partnerships, (2) Building relationships within the health partnership, (3) Exploring the communal and individual effort carried out within the health partnership and (4) Reflecting on the work carried out within the health partnership. DISCUSSION Barriers exist in regards to the implementation of health psychology in health partnerships but capacity building is possible. Recommendations suggest, future work should establish clear roles for applied psychologists in health partnerships and critical evaluation of current psychological models, methods and measures for use outside of Western, Educated, Industrialized, Rich and Democratic societies.
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Affiliation(s)
- Rebecca R Turner
- Division of Medical Education, School of Medical Sciences, University of Manchester, Manchester, UK
| | - Shreya Epuru Reddy
- Division of Medical Education, School of Medical Sciences, University of Manchester, Manchester, UK
| | - Lucie M T Byrne-Davis
- Division of Medical Education, School of Medical Sciences, University of Manchester, Manchester, UK
| | - Eleanor R Bull
- Division of Medical Education, School of Medical Sciences, University of Manchester, Manchester, UK
| | - Jo Hart
- Division of Medical Education, School of Medical Sciences, University of Manchester, Manchester, UK
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Meade O, O'Brien M, Noone C, Lawless A, McSharry J, Deely H, Hart J, Hayes CB, Keyworth C, Lavoie K, McGowan O, Murphy AW, Murphy PJ, O'Reilly O, Byrne M. Exploring barriers and enablers to the delivery of Making Every Contact Count brief behavioural interventions in Ireland: A cross-sectional survey study. Br J Health Psychol 2023; 28:753-772. [PMID: 36843183 DOI: 10.1111/bjhp.12652] [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: 07/19/2022] [Accepted: 01/24/2023] [Indexed: 02/28/2023]
Abstract
OBJECTIVES The public health impact of the Irish Making Every Contact Count (MECC) brief intervention programme is dependent on delivery by health care professionals. We aimed to identify enablers and modifiable barriers to MECC intervention delivery to optimize MECC implementation. DESIGN Online cross-sectional survey design. METHODS Health care professionals (n = 4050) who completed MECC eLearning were invited to complete an online survey based on the Theoretical Domains Framework (TDF). Multiple regression analysis identified predictors of MECC delivery (logistic regression to predict delivery or not; linear regression to predict frequency of delivery). Data were visualized using Confidence Interval-Based Estimates of Relevance (CIBER). RESULTS Seventy-nine per cent of participants (n = 283/357) had delivered a MECC intervention. In the multiple logistic regression (Nagelkerke's R2 = .34), the significant enablers of intervention delivery were 'professional role' (OR = 1.86 [1.10, 3.15]) and 'intentions/goals' (OR = 4.75 [1.97, 11.45]); significant barriers included 'optimistic beliefs about consequences' (OR = .41 [.18, .94]) and 'negative emotions' (OR = .50 [.32, .77]). In the multiple linear regression (R2 = .29), the significant enablers of frequency of MECC delivery were 'intentions/goals' (b = 10.16, p = .02) and professional role (b = 6.72, p = .03); the significant barriers were 'negative emotions' (b = -4.74, p = .04) and 'barriers to prioritisation' (b = -5.00, p = .01). CIBER analyses suggested six predictive domains with substantial room for improvement: 'intentions and goals', 'barriers to prioritisation', 'environmental resources', 'beliefs about capabilities', 'negative emotions' and 'skills'. CONCLUSION Implementation interventions to enhance MECC delivery should target intentions and goals, beliefs about capabilities, negative emotions, environmental resources, skills and barriers to prioritization.
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Affiliation(s)
- Oonagh Meade
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Maria O'Brien
- Office of the Chief Clinical Officer, Health Services Executive, Cork, Ireland
| | - Chris Noone
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Agatha Lawless
- Making Every Contact Count, Health & Wellbeing, Strategy & Research, Health Services Executive, Waterford, Ireland
| | - Jenny McSharry
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Helen Deely
- Strategy & Research, Healthcare Strategy, Health Service Exectutive, Dublin, Ireland
| | - Jo Hart
- University of Manchester, Manchester, UK
| | - Catherine B Hayes
- Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Dublin, Ireland
| | | | - Kim Lavoie
- University of Quebec at Montreal (UQAM) & Montréal Behavioural Medicine Centre, CIUSSS-NIM, Montréal, Canada
| | - Orla McGowan
- Health Service Executive Health and Wellbeing, Dublin, Ireland
| | - Andrew W Murphy
- Health Research Board Primary Care Clinical Trials Network Ireland, University of Galway, Galway, Ireland
| | - Patrick J Murphy
- Health Research Board Primary Care Clinical Trials Network Ireland, Discipline of General Practice, University of Galway, Galway, Ireland
| | - Orlaith O'Reilly
- Office of the Chief Clinical Officer, Health Services Executive, Kilkenny, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
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Hawkins R, Michael P, Byrne-Davis L, Bull E, Skone-James R, Hart J. The behaviours identified and the behaviour change techniques planned in health partnerships for antimicrobial stewardship. Appl Psychol Health Well Being 2023; 15:983-998. [PMID: 36433921 DOI: 10.1111/aphw.12421] [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: 06/13/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022]
Abstract
Antimicrobial stewardship (AMS) interventions promote optimised use of antimicrobials by healthcare professionals. In 2019-2020, the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) supported 12 global health partnerships in low- and middle-income countries to co-develop education and training interventions to improve AMS practices amongst hospital staff. This study aimed to describe six of the CwPAMS health partnerships' target behaviours and behaviour change techniques (BCTs) within their planned AMS interventions. Content analysis extracted behaviours and BCTs from partnership materials. Techniques used by partnerships with (n = 2) and without (n = 4) an embedded behavioural scientist were compared, to understand their added value. Nineteen AMS related behaviours for hospital staff were targeted; most commonly hand hygiene and antibiotic prescribing behaviours. Twenty-three BCTs were coded, with instructing participants on how to perform the behaviours the most prominent across all, including partnerships with a behavioural scientist. Intervention materials did not always report the context of the intervention being delivered, including who was delivering it and the target. Behaviours for change were also often not specified. Partnerships varied in reporting their content and specific behaviours, impacting replicability of their interventions, and limiting knowledge exchange. An AMS behaviour change intervention resource is recommended to support clear specification of prospective AMS interventions.
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Affiliation(s)
- Rachel Hawkins
- Faculty of Biology, Medicine and Health, Manchester, The University of Manchester, Manchester, UK
| | - Panayiotis Michael
- Faculty of Biology, Medicine and Health, Manchester, The University of Manchester, Manchester, UK
| | - Lucie Byrne-Davis
- Faculty of Biology, Medicine and Health, Manchester, The University of Manchester, Manchester, UK
| | - Eleanor Bull
- Faculty of Biology, Medicine and Health, Manchester, The University of Manchester, Manchester, UK
| | | | - Jo Hart
- Faculty of Biology, Medicine and Health, Manchester, The University of Manchester, Manchester, UK
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Turner R, Hart J, Ashiru-Oredope D, Atkins L, Eades C, Felton T, Howlett E, Rice S, Shallcross L, Lorencatto F, Byrne-Davis L. A qualitative interview study applying the COM-B model to explore how hospital-based trainers implement antimicrobial stewardship education and training in UK hospital-based care. BMC Health Serv Res 2023; 23:770. [PMID: 37468860 DOI: 10.1186/s12913-023-09559-5] [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: 02/01/2023] [Accepted: 05/16/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is a major global health threat caused by the inappropriate use of antimicrobials in healthcare and other settings. Antimicrobial stewardship (AMS) is a broad multi-component health services intervention that promotes and monitors the judicious use of antimicrobials to preserve their future effectiveness. A main component of AMS is education and training (E&T). However, there are often discrepancies in how such interventions are implemented and delivered in hospital-based care. The aim of this study was to explore the factors influencing the implementation of AMS E&T in UK hospitals. METHODS Semi-structured interviews were carried out with AMS E&T trainers in UK hospitals. The interview schedule was developed using the Capability, Opportunity, Motivation = Behaviour (COM-B) model. Participants were identified via professional networks and social media. Interviews were analysed using inductive thematic analysis, followed by deductive analysis using the COM-B model as a framework. RESULTS A total of 34 participants (26 antimicrobial pharmacists, 3 nurses, 1 advanced clinical practitioner, 2 infectious disease consultants, 1 microbiologist and 1 clinical scientist). responsible for designing, implementing and evaluating AMS E&T in UK hospitals (five from Northern Ireland, four from Wales, two from Scotland and 23 from England) took part in virtual interviews. Key themes were: (1) The organisational context, including system-level barriers to AMS included competing organisational targets (Reflective motivation and physical opportunity) and the impact of the COVID-19 pandemic on activity (Physical opportunity); (2) Healthcare professionals' roles and the wider multi-disciplinary team, such that AMS roles were defined and addressed poorly in E&T (Social opportunity); and (3) The individual perception of the need for AMS E&T in hospital-based care, manifest in a perceived lack of conviction of the wider threat of AMR and the resulting need for AMS E&T (Reflective motivation). CONCLUSION This study has identified factors influencing implementation of AMS E&T in UK hospitals and further identified where implemented, AMS E&T did not address real-world challenges. Current AMS E&T needs to be optimised to elicit practice change, with recommendations including training and engaging the wider work-force and drawing upon theoretically-informed intervention development frameworks to inform AMS E&T to better target AMS behaviour change.
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Affiliation(s)
- Rebecca Turner
- Division of Psychology and Mental Health, Faculty of Biology, Medicine & Health, the University of Manchester, Manchester, UK.
| | - Jo Hart
- Division of Medical Education, Faculty of Biology, Medicine & Health, the University of Manchester, Manchester, UK
| | | | - Lou Atkins
- Centre for Behaviour Change, University College London, London, UK
| | - Christopher Eades
- Department of Infectious Diseases, Manchester University NHS Foundation Trust, Manchester, UK
| | - Tim Felton
- Department of Critical Care Medicine, Wythenshawe Hospital, Manchester University NHS Foundation, Manchester, UK
| | - Emily Howlett
- Vocal, Manchester University NHS Foundation Trust, Manchester, UK
| | - Stephen Rice
- Population Health Sciences Institute, Faculty of Medical Sciences, the University of Newcastle Upon, Tyne, UK
| | - Laura Shallcross
- Institute of Health Informatics, University College London, London, UK
| | | | - Lucie Byrne-Davis
- Division of Medical Education, Faculty of Biology, Medicine & Health, the University of Manchester, Manchester, UK
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Chater AM, Brook-Rowland P, Tolani F, Christopher E, Hart J, Byrne-Davis LMT, Moffat A, Shorter GW, Epton T, Kamal A, O’Connor DB, Whittaker E, Lewis LJM, McBride E, Swanson V, Arden MA. Understanding a constellation of eight COVID-19 disease prevention behaviours using the COM-B model and the theoretical domains framework: a qualitative study using the behaviour change wheel. Front Public Health 2023; 11:1130875. [PMID: 37475767 PMCID: PMC10355219 DOI: 10.3389/fpubh.2023.1130875] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/30/2023] [Indexed: 07/22/2023] Open
Abstract
Background The use of behavioural science and behaviour change within local authorities and public health has supported healthful change; as evidenced by its importance and contribution to reducing harm during the COVID-19 pandemic. It can provide valuable information to enable the creation of evidence-based intervention strategies, co-created with the people they are aimed at, in an effective and efficient manner. Aim This study aimed to use the COM-B model to understand the Capability, Opportunity and Motivation of performing a constellation of eight COVID-19 disease prevention behaviours related to the slogans of 'Hands, Face, Space, Fresh Air'; 'Find, Isolate, Test, (FIT), and Vaccinate' in those employed in workplaces identified as high risk for transmission of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) to support intervention development. Methods This qualitative study recruited twenty-three participants (16 female, 7 male), who were interviewed from three environments (schools, care homes, warehouses) across three local authorities. Semi-structured interviews were analysed using thematic analysis. Findings Ten core themes were identified inductively; (1) knowledge and skills, (2) regulating the behaviour, (3) willingness to act, (4) necessity and concerns, (5) emotional impact, (6) conducive environment, (7) societal influence, (8) no longer united against COVID-19, (9) credible leadership, and (10) inconsistent adherence to COVID-19 prevention behaviours. Themes were then deductively mapped to the COM-B model of behaviour change and the theoretical domains framework and a logic model using the behaviour change wheel (BCW) was produced to inform intervention design. Conclusion This study offers a novel approach to analysis that has included eight behaviours within a single thematic analysis and COM-B diagnosis. This will enable local authorities to direct limited resources to overarching priorities. Of key importance, was the need for supportive and credible leadership, alongside developing interventions collaboratively with the target audience. COVID-19 has had an emotional toll on those interviewed, however, promoting the value of disease prevention behaviours, over and above their costs, can facilitate behaviour. Developing knowledge and skills, through education, training, marketing and modelling can further facilitate behaviour. This supports guidance produced by the British Psychological Society COVID-19 behavioural science and disease prevention taskforce.
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Affiliation(s)
- Angel M. Chater
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom
- Centre for Behaviour Change, University College London, London, United Kingdom
| | - Phoebe Brook-Rowland
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom
| | - Foyeke Tolani
- Bedford Borough, Central Bedfordshire and Milton Keynes Councils’ Shared Public Health Services, Bedford, United Kingdom
| | - Emily Christopher
- Bedford Borough, Central Bedfordshire and Milton Keynes Councils’ Shared Public Health Services, Bedford, United Kingdom
| | - Jo Hart
- School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | | | - Abby Moffat
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom
| | - Gillian W. Shorter
- Drug and Alcohol Research Network, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom
| | - Atiya Kamal
- School of Social Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Daryl B. O’Connor
- Laboratory for Stress and Health Research, University of Leeds, Leeds, United Kingdom
| | - Eleanor Whittaker
- North Yorkshire County Council, Northallerton, North Yorkshire, United Kingdom
| | - Lesley J. M. Lewis
- Behavioural Science Unit, Public Health, Somerset County Council, Taunton, United Kingdom
| | - Emily McBride
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Vivien Swanson
- Psychology Division, University of Stirling, Stirling, United Kingdom
| | - Madelynne A. Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, United Kingdom
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11
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Gifford A, Philemon R, Halbert J, Hothersall EJ, Inglis R, Hart J, Byrne-Davis L, Thirsk J, Gifford H, Howells R, Weetch S, Prentice K, Jackson A, Kirkpatrick M. A narrative review of course evaluation methods for continuing professional development: The case of paediatric and neonatal acute-care in-service courses in low and lower-middle income countries: BEME Guide No. 76. Med Teach 2023; 45:685-697. [PMID: 36369858 DOI: 10.1080/0142159x.2022.2137010] [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] [Indexed: 06/15/2023]
Abstract
BACKGROUND Training a skilled healthcare workforce is an essential part in reaching the United Nations Sustainable Development Goal to end preventable deaths in children and neonates. The greatest burden of mortality lies in low and lower-middle income countries (LLMIC). Short term, in-service courses have been implemented in many LLMIC to improve the quality of care delivered, but the evaluation methods of these courses are inconsistent. METHOD Studies describing evaluations of course and outcome measures were included if the course lasted seven days or less with postgraduate participants, included paediatric or neonatal acute or emergency training and was based in a LLMIC. This narrative review provides a detailed description of evaluation methods of course content, delivery and outcome measures based on 'Context, Input, Process and Product' (CIPP) and Kirkpatrick models. RESULTS 5265 titles were screened with 93 articles included after full-text review and quality assessment. Evaluation methods are described: context, input, process, participant satisfaction, change in learning, behaviour, health system infrastructure and patient outcomes. CONCLUSIONS Outcomes, including mortality and morbidity, are rightly considered the fundamental aim of acute-care courses in LLMIC. Course evaluation can be difficult, especially with low resources, but this review outlines what can be done to guide future course organisers in providing well-conducted courses with consistent outcome measures for maximum sustainable impact.
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Affiliation(s)
| | - Rune Philemon
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Jay Halbert
- Department of Paediatrics, University College Hospital, London, England
| | | | - Rebecca Inglis
- Intensive Care Medicine, University of Oxford, Oxford, England
| | - Jo Hart
- Division of Medical Education, University of Manchester, Manchester, England
| | | | - Joanna Thirsk
- University Hospital Southampton NHS Foundation Trust, Southampton, England
| | | | - Rachel Howells
- Royal Devon and Exeter NHS Foundation Trust, Exeter, England
| | - Shona Weetch
- Clinical Development, NHS Greater Glasgow and Clyde, Glasgow, Scotland
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12
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Gordon SF, Lam J, Vasquez JT, Cercone R, Tenneti N, Hart J, Chisholm M, Heland M, Hoq M, Kaufman J, Danchin M. A tailored COVID-19 vaccination pathway for children 5-11 years in Victoria, Australia. Vaccine 2023; 41:3436-3445. [PMID: 37120401 PMCID: PMC10106821 DOI: 10.1016/j.vaccine.2023.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Procedural anxiety was anticipated in children 5-11 years during the COVID-19 vaccine rollout in Victoria, Australia, as children in this age group receive few routine vaccines. Therefore, the Victorian state government designed a tailored, child-friendly vaccine program. This study aimed to assess parental satisfaction with elements of the bespoke vaccination pathway. METHODS The Victorian government and state-run vaccination hubs in Victoria facilitated an online immunisation plan to help parents identify their child's support needs, and utilised experienced paediatric staff and additional supports for children with severe needle distress and/or disability. All parents/guardians of children 5-11 years who received a COVID-19 vaccine in a vaccination hub were sent a 16-item feedback survey via text message. RESULTS Between 9 February and 31 May 2022 there were 9203 responses; 865 children (9.4%) had a first language other than English, 499 (5.4%) had a disability or special needs, and 142 (1.5%) were Aboriginal or Torres Strait Islander. Most parents (94.4%; 8687/9203) rated their satisfaction with the program as very good or excellent. The immunisation plan was used by 13.5% (1244/9203) of respondents, with usage more common for Aboriginal or Torres Strait Islander children (26.1%; 23/88) or families with a first language other than English (23.5%; 42/179). The child-friendly staff (88.5%, 255/288) and themed environment (66.3%, 191/288) were the most valued measures for vaccination. Additional support measures were required by 1.6% (150/9203) of children in the general population and 7.9%, (17/261) of children with a disability and/or special needs. CONCLUSION A tailored COVID-19 vaccination program for children 5-11 years, with additional support for children with severe needle distress and/or disability, had high parental satisfaction. This model could be utilised for COVID-19 vaccination in pre-school children and for routine childhood vaccination programs to provide optimal support to children and their families.
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Affiliation(s)
- S F Gordon
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
| | - J Lam
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J T Vasquez
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - R Cercone
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - N Tenneti
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J Hart
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Chisholm
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Heland
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - J Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - M Danchin
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia; Department of General Medicine, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia
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13
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Dharni N, Byrne-Davis LMT, Sanga E, Hart J, Shrestha AB, Gurung T, Shrestha RR, Vaidya PR, Hossain A, Lilaonitkul M, Snell D, Barrett-Chapman A, Walker I, Bull ER. Using behavioural science to explore impact and implementation of obstetric anaesthesia training in Tanzania, Nepal and Bangladesh: a qualitative evaluation study with obstetric anaesthesia providers. Psychol Health 2023:1-15. [PMID: 36622305 DOI: 10.1080/08870446.2022.2160472] [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: 07/14/2022] [Revised: 10/14/2022] [Accepted: 12/15/2022] [Indexed: 01/10/2023]
Abstract
Objective: High quality obstetric anaesthetic care is integral to reducing preventable maternal deaths in Low-and-Middle-Income-Countries (LMICs). We applied behavioural science to evaluate SAFE Obstetrics, a 3-day Continuing Professional Development (CPD) course, on physician and non-physician anaesthetists' practice behaviours across 3 LMICs.Methods: Seven anaesthetist Fellows from Bangladesh, Nepal and Tanzania were trained in qualitative methods and behavioural science. Structured interviews were undertaken by Fellows and two UK behavioural scientists with course participants. Interviews were based on the Theoretical Domains Framework: a comprehensive framework of influences on behaviour change. Interviews were recorded, transcribed and analysed using content and thematic analysis.Results: 78 physician and non-physician anaesthetists participated (n = 26 Bangladesh, n = 24 Nepal and n = 28 Tanzania). Participants reported positive improvements in patient-centered working, safety, teamwork and confidence. Across countries, we found similar barriers and facilitators: environmental resources, a strong professional identity and positive social influences were key facilitators of change.Conclusion: This multi-country theory-based evaluation highlighted the impact of SAFE Obstetrics on participants' clinical practice. A supportive work environment was crucial for implementing learning following training; CPD courses in LMICs must furnish participants with skills and equipment to address training implementation challenges. Building local behavioural science capacity can strengthen LMIC health intervention evaluations.
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Affiliation(s)
- Nimarta Dharni
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Lucie M T Byrne-Davis
- Faculty of Biology Medicine and Health, Division of Medical Education, University of Manchester, Manchester, UK
| | - Evans Sanga
- Department of Anaesthesia, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Jo Hart
- Faculty of Biology Medicine and Health, Division of Medical Education, University of Manchester, Manchester, UK
| | - Amir Babu Shrestha
- Department of Anaesthesia, Paropakar Maternity and Women's Hospital, Kathmandu, Nepal
| | - Tara Gurung
- Department of Anaesthesia, Paropakar Maternity and Women's Hospital, Kathmandu, Nepal
| | - Ravi R Shrestha
- Department of Anaesthesia, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Pradip R Vaidya
- Department of Anaesthesia, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Amir Hossain
- Department of Anaesthesia, Shaheed Tajuddin Ahmad Medical College, Gazipur, Bangladesh
| | - Maytinee Lilaonitkul
- Department of Anaesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA
| | - David Snell
- Department of Anaesthesia, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | | | | | - Eleanor R Bull
- Faculty of Biology Medicine and Health, Division of Medical Education, University of Manchester, Manchester, UK
- Department of Anaesthesia, Manchester University NHS Foundation Trust, Manchester, UK
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Hart J, Okoro U, Mohr N, Ahmed A. 84 Bystander CPR Rates for Out-of-Hospital Cardiac Arrest Higher in Rural Areas Versus Urban Areas. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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15
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Sneddon J, Thompson W, Kpobi LNA, Ade DA, Sefah IA, Afriyie D, Goldthorpe J, Turner R, Nawaz S, Wilson S, Hart J, Byrne-Davis L. Exploring the Use of Antibiotics for Dental Patients in a Middle-Income Country: Interviews with Clinicians in Two Ghanaian Hospitals. Antibiotics (Basel) 2022; 11:antibiotics11081081. [PMID: 36009950 PMCID: PMC9404843 DOI: 10.3390/antibiotics11081081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Antimicrobial resistance is a global problem driven by the overuse of antibiotics. Dentists are responsible for about 10% of antibiotics usage across healthcare worldwide. Factors influencing dental antibiotic prescribing are numerous, with some differences in low- and middle-income countries compared with high-income countries. This study aimed to explore the antibiotic prescribing behaviour and knowledge of teams treating dental patients in two Ghanaian hospitals. Methods: Qualitative interviews were undertaken with dentists, pharmacists, and other healthcare team members at two hospitals in urban and rural locations. Thematic and behaviour analyses using the Actor, Action, Context, Target, Time framework were undertaken. Results: Knowledge about ‘antimicrobial resistance and antibiotic stewardship’ and ‘people and places’ were identified themes. Influences on dental prescribing decisions related to the organisational context (such as the hierarchical influence of colleagues and availability of specific antibiotics in the hospital setting), clinical issues (such as therapeutic versus prophylactic indications and availability of sterile dental instruments), and patient issues such as hygiene in the home environment, delays in seeking professional help, ability to access antibiotics in the community without a prescription and patient’s ability to pay for the complete prescription. Conclusions: This work provides new evidence on behavioural factors influencing dental antibiotic prescribing, including resource constraints which affect the availability of certain antibiotics and diagnostic tests. Further research is required to fully understand their influence and inform the development of new approaches to optimising antibiotic use by dentists in Ghana and potentially other low- and middle-income countries.
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Affiliation(s)
- Jacqueline Sneddon
- Healthcare Improvement Scotland, Glasgow G1 2NP, UK
- British Society for Antimicrobial Chemotherapy, Birmingham B1 3NJ, UK
- Correspondence:
| | - Wendy Thompson
- Division of Dentistry, University of Manchester, Manchester M13 9PL, UK
| | - Lily N. A. Kpobi
- Regional Institute for Population Studies, University of Ghana, Legon, Accra P.O. Box LG25, Ghana
| | - Diana Abena Ade
- Regional Institute for Population Studies, University of Ghana, Legon, Accra P.O. Box LG25, Ghana
| | - Israel Abebrese Sefah
- Pharmacy Practice Department, School of Pharmacy, University of Health and Allied Sciences, Ho P.O. Box PMB31, Ghana
- Keta Municipal Hospital, Keta-Dzelukope P.O. Box WT82, Ghana
| | | | - Joanna Goldthorpe
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
| | - Rebecca Turner
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
| | - Saher Nawaz
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
| | - Shona Wilson
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
| | - Jo Hart
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
| | - Lucie Byrne-Davis
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
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16
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Chisholm A, Coupe N, Ujhelyi Gomez K, Hart J, Peters S. Exploring primary school years interactions around child weight: A qualitative meta-synthesis of school staff, parent, and child views and experiences. Obes Rev 2022; 23:e13451. [PMID: 35398951 PMCID: PMC9539573 DOI: 10.1111/obr.13451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/17/2021] [Accepted: 07/17/2021] [Indexed: 11/30/2022]
Abstract
Interactions about children's weight and weight-related behaviors occur from an early stage in school settings between various stakeholders and are often intended to facilitate weight-related behavioral change in children and/or families. This meta-synthesis (PROSPERO - CRD42019133231) aimed to investigate stakeholder reported experiences and challenges of these encounters. Studies were eligible if they included school stakeholders (teaching or nonteaching staff, parents, caregivers, or children), explored communication topics related to child obesity (weight, diet or activity), were conducted within an early school setting (primary school stage or international equivalent), and used qualitative methods. Database searches conducted March-July 2019 (updated November 2020) identified 40 studies (2324 participants) from seven countries. Included studies were assessed for quality using the Critical Appraisal Skills Programme. Using inductive thematic analysis, we identified four core themes across this database: (1) "conversation characteristics and consequences," (2) "missing components," (3) "avoiding stigma," and (4) "school responsibilities." Overall, stakeholders recognized that schools are well-positioned to provide positive influential messages about childhood obesity and reported that discussions on this topic do occur in early school settings but that stakeholders find them difficult, complex, and lack the necessary skills to deliver the nonjudgmental, consistent, and tailored support that they desire.
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Affiliation(s)
- Anna Chisholm
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Nia Coupe
- Department of Psychology, University of Liverpool, Liverpool, UK
| | | | - Jo Hart
- Division of Medical Education, University of Manchester, Manchester, UK
| | - Sarah Peters
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
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17
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Conley M, Schaffert J, Cullum CM, Hart J, Didehbani N. A-10 Influence of Different Normative Reference Standards among Cognitively Normal Former NFL Players. Arch Clin Neuropsychol 2022. [DOI: 10.1093/arclin/acac32.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose: Demographic adjustments (e.g., age, sex, race/ethnicity) to neuropsychological tests can assist clinical interpretation and avoid false-positive diagnoses of cognitive impairment. The issue of “race” as a criterion for normative adjustment has been highlighted in recent cases among former NFL players. We examined the impact of different normative reference comparisons on neuropsychological scores among cognitively normal Black and White NFL retirees. Methods: Cognitively normal Black (n = 20) and White (n = 20) retirees were age- and education-matched. Measures of attention (Digit Span), processing speed (Coding, TMTA), memory (ROCFT, CVLT), language (FAS, Animals, BNT), and executive function (TMTB) were examined. Independent samples t-tests (using p < 0.01) were conducted between raw and normative scores of Black and White retirees that adjusted for 1) age/education (Mitrushina); 2) age/education/sex (NACC); and 3) age/education/sex/race (Heaton, MOANS/MOAANS). An additional ANCOVA evaluated group differences controlling for baseline estimated IQ. Results: Raw scores differed between groups on TMTB, Coding, and BNT. Mitrushina normative data showed differences on TMTB (p = 0.007) and BNT (p < 0.001). NACC normative data showed differences on the BNT (p < 0.001). ANCOVA (controlling for IQ) of raw scores between groups differed on the BNT (p = 0.002). Heaton and MOANS/MOAANS normative scores did not reveal differences between groups on any test. Conclusions: As expected, the use of different neuropsychological norms influences findings across different sociodemographic groups to various degrees, depending on the test. The underlying contributors to group differences using “race” as a proxy need to be disentangled and understood. Cautious use of demographically-adjusted norms as interpretive guidelines is warranted until these factors are identified.
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18
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Epton T, Ghio D, Ballard LM, Allen SF, Kassianos AP, Hewitt R, Swainston K, Fynn WI, Rowland V, Westbrook J, Jenkinson E, Morrow A, McGeechan GJ, Stanescu S, Yousuf AA, Sharma N, Begum S, Karasouli E, Scanlan D, Shorter GW, Arden MA, Armitage CJ, O'Connor DB, Kamal A, McBride E, Swanson V, Hart J, Byrne-Davis L, Chater A, Drury J. Interventions to promote physical distancing behaviour during infectious disease pandemics or epidemics: A systematic review. Soc Sci Med 2022; 303:114946. [PMID: 35605431 PMCID: PMC8957361 DOI: 10.1016/j.socscimed.2022.114946] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Physical distancing, defined as keeping 1-2m apart when co-located, can prevent cases of droplet or aerosol transmitted infectious diseases such as SARS-CoV2. During the COVID-19 pandemic, distancing was a recommendation or a requirement in many countries. This systematic review aimed to determine which interventions and behavior change techniques (BCTs) are effective in promoting adherence to distancing and through which potential mechanisms of action (MOAs). METHODS Six databases were searched. The review included studies that were (a) conducted on humans, (b) reported physical distancing interventions, (c) included any comparator (e.g., pre-intervention versus post-intervention; randomized controlled trial), and (d) reported actual distancing or predictors of distancing behavior. Risk of bias was assessed using the Mixed Methods Appraisal Tool. BCTs and potential MoAs were identified in each intervention. RESULTS Six articles (with seven studies and 19 comparisons) indicated that distancing interventions could successfully change MoAs and behavior. Successful BCTs (MoAs) included feedback on behavior (e.g., motivation); information about health consequences, salience of health consequences (e.g., beliefs about consequences), demonstration (e.g., beliefs about capabilities), and restructuring the physical environment (e.g., environmental context and resources). The most promising interventions were proximity buzzers, directional systems, and posters with loss-framed messages that demonstrated the behaviors. CONCLUSIONS The evidence indicates several BCTs and potential MoAs that should be targeted in interventions and highlights gaps that should be the focus of future research.
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Affiliation(s)
- Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, UK,Corresponding author. Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Daniela Ghio
- Manchester Centre for Health Psychology, University of Manchester, UK
| | | | - Sarah F. Allen
- School of Social Sciences, Humanities and Law, Teesside University, UK
| | | | | | - Katherine Swainston
- Psychology, Centre for Applied Psychological Science, Teesside University, UK
| | | | | | | | - Elizabeth Jenkinson
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | | | | | - Sabina Stanescu
- School of Psychology, University of Southampton, Southampton, UK
| | | | - Nisha Sharma
- Department of Clinical Health Psychology, Royal National Orthopaedic Hospital, UK
| | - Suhana Begum
- Department of Psychology, City University of London, UK,Surrey County Council, UK
| | | | - Daniel Scanlan
- Research and Communication, Education Support, London, N5 1EW, UK
| | - Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, Queen's University Belfast, UK
| | - Madelynne A. Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, UK
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, UK,Manchester University NHS Foundation Trust, University of Manchester, UK,Manchester Academic Health Science Centre, University of Manchester, UK,NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK
| | | | - Atiya Kamal
- Department of Psychology, Birmingham City University, UK
| | - Emily McBride
- Department of Behavioural Science and Health, University College London, UK
| | | | - Jo Hart
- Manchester Centre for Health Psychology, University of Manchester, UK,Division of Medical Education, University of Manchester, UK
| | - Lucie Byrne-Davis
- Manchester Centre for Health Psychology, University of Manchester, UK,Division of Medical Education, University of Manchester, UK
| | | | - John Drury
- School of Psychology, University of Sussex, UK
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19
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Meade O, O'Brien M, Mc Sharry J, Lawless A, Coughlan S, Hart J, Hayes C, Keyworth C, Lavoie KL, Murphy AW, Murphy P, Noone C, O'Reilly O, Byrne M. Enhancing the implementation of the Making Every Contact Count brief behavioural intervention programme in Ireland: protocol for the Making MECC Work research programme. HRB Open Res 2022; 5:6. [PMID: 35224443 PMCID: PMC8847722 DOI: 10.12688/hrbopenres.13481.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Brief behavioural interventions offered by healthcare professionals to target health behavioural risk factors (e.g. physical activity, diet, smoking and drug and alcohol use) can positively impact patient health outcomes. The Irish Health Service Executive (HSE) Making Every Contact Count (MECC) Programme supports healthcare professionals to offer patients brief opportunistic behavioural interventions during routine consultations. The potential for MECC to impact public health depends on its uptake and implementation. Aim: This protocol outlines the ‘Making MECC Work’ research programme, a HSE/Health Behaviour Change Research Group collaboration to develop an implementation strategy to optimise uptake of MECC in Ireland. The programme will answer three research questions: (1) What determines delivery of MECC brief interventions by healthcare professionals at individual and organisational levels? (2) What are patient attitudes towards, and experiences of, receiving MECC interventions from healthcare professionals? (3) What evidence-informed implementation strategy options can be consensually developed with key stakeholders to optimise MECC implementation? Methods: In Work Package 1, we will examine determinants of MECC delivery by healthcare professionals using a multi-methods approach, including: (WP1.1) a national survey of healthcare professionals who have participated in MECC eLearning training and (WP1.2) a qualitative interview study with relevant healthcare professionals and HSE staff. In Work Package 2, we will examine patient attitudes towards, and experiences of, MECC using qualitative interviews. Work Package 3 will combine findings from Work Packages 1 and 2 using the Behaviour Change Wheel to identify and develop testable implementation strategy options (WP 3.1). Strategies will be refined and prioritised using a key stakeholder consensus process to develop a collaborative implementation blueprint to optimise and scale-up MECC (WP3.2). Discussion: Research programme outputs are expected to positively support the integration of MECC brief behaviour change interventions into the Irish healthcare system and inform the scale-up of behaviour change interventions internationally.
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Affiliation(s)
- Oonagh Meade
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, H91 EV56, Ireland
| | - Maria O'Brien
- National Heart Programme, Integrated Care Programme for Chronic Disease, Clinical Design and Innovation, Office of the Chief Clinical Officer, Health Services Executive, Áras Sláinte, Wilton Road, Cork, T12 XRR0, Ireland
| | - Jenny Mc Sharry
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, H91 EV56, Ireland
| | - Agatha Lawless
- Health & Wellbeing, Strategy and Research, Healthcare Strategy, c/o Health Promotion and Improvement Office, Health Service Executive, Waterford, X91 T256, Ireland
| | - Sandra Coughlan
- Strategic Planning and Transformation, Health Service Executive, Cork, T12 WP62, Ireland
| | - Jo Hart
- School of Medical Sciences, University of Manchester, Manchester, M13 9PT, UK
| | - Catherine Hayes
- Public Health and Primary Care, School of Medicine, Trinity College Dubin, Dublin, D02 R590, Ireland
| | - Chris Keyworth
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Kim L Lavoie
- Montréal Behavioural Medicine Centre, CIUSSS-NIM, Hôpital Sacré-Cœur de Montréal, Montréal, Quebec, QC H4J 1C5, Canada
- Department of Psychology, University of Quebec at Montréal, Montréal, Quebec, QC H2L 2C4, Canada
| | - Andrew W Murphy
- Health Research Board Primary Care Clinical Trials Network Ireland, School of Medicine, NUI Galway, Galway, Ireland
| | - Patrick Murphy
- Health Research Board Primary Care Clinical Trials Network Ireland, School of Medicine, NUI Galway, Galway, Ireland
| | - Chris Noone
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, H91 EV56, Ireland
| | - Orlaith O'Reilly
- Health and Wellbeing Division, HSE South East, Public Health Department, Health Service Executive, Kilkenny, Ireland
| | | | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, H91 EV56, Ireland
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Doherty S, Knight JG, Backhouse T, Tran TST, Paterson R, Stahl F, Alharbi HY, Chamberlain TW, Bourne RA, Stones R, Griffiths A, White JP, Aslam Z, Hardare C, Daly H, Hart J, Temperton RH, O'Shea JN, Rees NH. Highly efficient and selective aqueous phase hydrogenation of aryl ketones, aldehydes, furfural and levulinic acid and its ethyl ester catalyzed by phosphine oxide-decorated polymer immobilized ionic liquid-stabilized ruthenium nanoparticles. Catal Sci Technol 2022. [DOI: 10.1039/d2cy00205a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Phosphine oxide-decorated polymer immobilized ionic liquid stabilized RuNPs catalyse the hydrogenation of aryl ketones with remarkable selectivity for the CO bond, complete hydrogenation to the cyclohexylalcohol and hydrogenation of levulinic acid to γ-valerolactone.
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Affiliation(s)
- S. Doherty
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - J. G. Knight
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - T. Backhouse
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - T. S. T. Tran
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - R. Paterson
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - F. Stahl
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - H. Y. Alharbi
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - T. W. Chamberlain
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - R. A. Bourne
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - R. Stones
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - A. Griffiths
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - J. P. White
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - Z. Aslam
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - C. Hardare
- School of Chemical Engineering and Analytical Sciences, The University of Manchester, The Mill, Sackville Street Campus, Manchester, M13 9PL, UK
| | - H. Daly
- School of Chemical Engineering and Analytical Sciences, The University of Manchester, The Mill, Sackville Street Campus, Manchester, M13 9PL, UK
| | - J. Hart
- School of Physics & Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - R. H. Temperton
- School of Physics & Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - J. N. O'Shea
- School of Physics & Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - N. H. Rees
- Inorganic Chemistry Laboratory, University of Oxford, South Parks Road, Oxford OX1 3QR, UK
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Ghio D, Lawes-Wickwar S, Tang MY, Epton T, Howlett N, Jenkinson E, Stanescu S, Westbrook J, Kassianos AP, Watson D, Sutherland L, Stanulewicz N, Guest E, Scanlan D, Carr N, Chater A, Hotham S, Thorneloe R, Armitage CJ, Arden M, Hart J, Byrne-Davis L, Keyworth C. What influences people's responses to public health messages for managing risks and preventing infectious diseases? A rapid systematic review of the evidence and recommendations. BMJ Open 2021; 11:e048750. [PMID: 34764167 PMCID: PMC8587350 DOI: 10.1136/bmjopen-2021-048750] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Individual behaviour changes, such as hand hygiene and physical distancing, are required on a population scale to reduce transmission of infectious diseases such as COVID-19. However, little is known about effective methods of communicating risk reducing information, and how populations might respond. OBJECTIVE To synthesise evidence relating to what (1) characterises effective public health messages for managing risk and preventing infectious disease and (2) influences people's responses to messages. DESIGN A rapid systematic review was conducted. Protocol is published on Prospero CRD42020188704. DATA SOURCES Electronic databases were searched: Ovid Medline, Ovid PsycINFO and Healthevidence.org, and grey literature (PsyarXiv, OSF Preprints) up to May 2020. STUDY SELECTION All study designs that (1) evaluated public health messaging interventions targeted at adults and (2) concerned a communicable disease spread via primary route of transmission of respiratory and/or touch were included. Outcomes included preventative behaviours, perceptions/awareness and intentions. Non-English language papers were excluded. SYNTHESIS Due to high heterogeneity studies were synthesised narratively focusing on determinants of intentions in the absence of measured adherence/preventative behaviours. Themes were developed independently by two researchers and discussed within team to reach consensus. Recommendations were translated from narrative synthesis to provide evidence-based methods in providing effective messaging. RESULTS Sixty-eight eligible papers were identified. Characteristics of effective messaging include delivery by credible sources, community engagement, increasing awareness/knowledge, mapping to stage of epidemic/pandemic. To influence intent effectively, public health messages need to be acceptable, increase understanding/perceptions of health threat and perceived susceptibility. DISCUSSION There are four key recommendations: (1) engage communities in development of messaging, (2) address uncertainty immediately and with transparency, (3) focus on unifying messages from sources and (4) frame messages aimed at increasing understanding, social responsibility and personal control. Embedding principles of behavioural science into public health messaging is an important step towards more effective health-risk communication during epidemics/pandemics.
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Affiliation(s)
- Daniela Ghio
- Department of Psychology, Faculty of Health and Society, University of Salford, Manchester, UK
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Sadie Lawes-Wickwar
- Department of Primary Care and Population Health, University College London, London, UK
| | - Mei Yee Tang
- Behavioural Science Policy Research Unit, Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Neil Howlett
- Department of Psychology, Sports, and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK
| | - Elizabeth Jenkinson
- Department of Health and Social Sciences, University of West England, Bristol, UK
| | - Sabina Stanescu
- School of Psychology, University of Southampton, Southampton, UK
| | | | - Angelos P Kassianos
- Department of Applied Health Research, University College London, London, UK
| | - Daniella Watson
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lisa Sutherland
- Behavioural Insight for Public Affairs, Ipsos Mori, Edinburgh & London, UK
| | - Natalia Stanulewicz
- Faculty of Health and Life Sciences, School of Applied Social Sciences, De Montfort University, Leicester, UK
| | - Ella Guest
- Centre for Appearance Research,Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Daniel Scanlan
- Department of Communication, Policy, and Research, Education Support, London, UK
| | - Natalie Carr
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
- Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Angel Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedfordshire, UK
| | - Sarah Hotham
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Rachael Thorneloe
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester; and NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Madelynne Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
| | - Jo Hart
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Lucie Byrne-Davis
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Christopher Keyworth
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
- School of Psychology, University of Leeds, Leeds, UK
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22
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Drummond C, Drummond M, Fennell M, Hart J, Kamaludin M, Keith C, Lange B, Paparella L, Ramos J, Wallen M, Williams H. The relationship between cardiorespiratory fitness and chronic pelvic pain in women with endometriosis: a preliminary cross-sectional analysis. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Chater AM, Shorter GW, Swanson V, Kamal A, Epton T, Arden MA, Hart J, Byrne-Davis LMT, Drury J, Whittaker E, Lewis LJM, McBride E, Chadwick P, O’Connor DB, Armitage CJ. Template for Rapid Iterative Consensus of Experts (TRICE). Int J Environ Res Public Health 2021; 18:10255. [PMID: 34639553 PMCID: PMC8508030 DOI: 10.3390/ijerph181910255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Public health emergencies require rapid responses from experts. Differing viewpoints are common in science, however, "mixed messaging" of varied perspectives can undermine credibility of experts; reduce trust in guidance; and act as a barrier to changing public health behaviours. Collation of a unified voice for effective knowledge creation and translation can be challenging. This work aimed to create a method for rapid psychologically-informed expert guidance during the COVID-19 response. METHOD TRICE (Template for Rapid Iterative Consensus of Experts) brings structure, peer-review and consensus to the rapid generation of expert advice. It was developed and trialled with 15 core members of the British Psychological Society COVID-19 Behavioural Science and Disease Prevention Taskforce. RESULTS Using TRICE; we have produced 18 peer-reviewed COVID-19 guidance documents; based on rapid systematic reviews; co-created by experts in behavioural science and public health; taking 4-156 days to produce; with approximately 18 experts and a median of 7 drafts per output. We provide worked-examples and key considerations; including a shared ethos and theoretical/methodological framework; in this case; the Behaviour Change Wheel and COM-B. CONCLUSION TRICE extends existing consensus methodologies and has supported public health collaboration; co-creation of guidance and translation of behavioural science to practice through explicit processes in generating expert advice for public health emergencies.
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Affiliation(s)
- Angel M. Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford MK41 9EA, UK
- Centre for Behavioural Medicine, University College London, BMA House, Tavistock Square, London WC1H 9JP, UK
| | - Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen’s University Belfast, Northern Ireland BT7 1NN, UK;
| | - Vivien Swanson
- Psychology Division, University of Stirling, Stirling FK9 4LA, UK;
- NHS Education for Scotland, 2 Central Quay, 89, Hydepark Street, Glasgow G3 8BW, UK
| | - Atiya Kamal
- School of Social Sciences, Department of Psychology, Birmingham City University, Birmingham B4 7BD, UK;
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester M13 9PT, UK; (T.E.); (C.J.A.)
| | - Madelynne A. Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield S10 2BQ, UK;
| | - Jo Hart
- School of Medical Sciences, University of Manchester, Stopford Building, Manchester M13 9PT, UK; (J.H.); (L.M.T.B.-D.)
| | - Lucie M. T. Byrne-Davis
- School of Medical Sciences, University of Manchester, Stopford Building, Manchester M13 9PT, UK; (J.H.); (L.M.T.B.-D.)
| | - John Drury
- School of Psychology, University of Sussex, Falmer BN1 9QN, UK;
| | - Ellie Whittaker
- North Yorkshire County Council, County Hall, Northallerton, North Yorkshire DL7 8DD, UK;
| | - Lesley J. M. Lewis
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, UK;
| | - Emily McBride
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London WC1E 6BT, UK;
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK;
| | - Daryl B. O’Connor
- Laboratory for Stress and Health Research, University of Leeds, Leeds LS2 9JT, UK;
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester M13 9PT, UK; (T.E.); (C.J.A.)
- Manchester University NHS Foundation Trust and NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester M13 9PL, UK
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24
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Neipp MC, Martínez-González MC, Chisholm A, Peters S, Hart J. Translation and application of an obesity behavior change technique training in a Spanish nursing undergraduate setting. An Sist Sanit Navar 2021; 44:51-59. [PMID: 33853227 DOI: 10.23938/assn.0938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The TEnT PEGS framework is a behavior change communication toolkit which has been shown to be useful in increasing health professional trainees' skills and knowledge about obesity-related behavior change techniques. There is no version of the behavioral change intervention toolkit in Spanish. Therefore, the objectives of this study were 1) to translate the TEnT PEGS framework into Spanish and apply it to a Spanish nursing student population; 2) To analyze whether training with the Spanish toolkit (DEPREMIO) had a positive impact on students' skills in encouraging obesi-ty-related behavioral change. METHODS First year nursing students (n=95) attended two face-to-face (2 hours per session) obesity management training sessions. A specifically designed pre-post test was carried out. Data were collected using an ad-hoc questionnaire of fourteen items, ten of them evaluated the student's knowledge and attitude about behavior change techniques, and four evaluated the student's perception of their skills in developing different strategies. RESULTS Training significantly increased most students' knowledge and attitudes with a 0.05 level of significance and effect sizes were between 0.36 and 0.77. It also increased students' skills, although not to any significant extent. CONCLUSION The DEPREMIO toolkit helped nursing students to acquire more knowledge, attitudes and skills in obesity management. It therefore seems that this adaptation is an acceptable and feasible training tool for the Spanish nursing student population.
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Affiliation(s)
- M C Neipp
- Department of Health Psychology. University Miguel Hernández. Elche. Spain.
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25
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Joseph S, Hart J, Chisholm A, Robinson S, Goldthorpe J, Peters S. A feasibility and acceptability study of an e-training intervention to facilitate health behaviour change conversations in dental care settings. Br Dent J 2021:10.1038/s41415-021-2722-8. [PMID: 33707733 DOI: 10.1038/s41415-021-2722-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 07/13/2020] [Indexed: 11/09/2022]
Abstract
Introduction Health behaviours result in oral health problems. Behaviour change techniques, informed by behaviour science, are rarely utilised by dental care professionals (DCPs) within routine care.Aim To develop a theory-informed intervention to support DCPs' behaviour change conversations and evaluate its feasibility and acceptability.Intervention A behaviour change toolkit (Toothpicks) comprising 33 behaviour change techniques relevant to dentistry, delivered within an interactive online course.Design Development and mixed-methods evaluation of the intervention.Materials and methods Participants' motivation to discuss behaviour change with patients was measured before and after training using a validated questionnaire. Acceptability was assessed through semi-structured interviews.Results DCPs' (N = 32) motivation increased significantly post-training. Participants found the training acceptable and reported subsequently implementing techniques into their practice. Potential barriers preventing implementation to clinical practice include perceived lack of opportunities to effect change within the constraints of the clinical context.Conclusions Acceptable theory-informed training that is acceptable and accessible can be developed that increases DCPs' motivation to discuss behaviour change with patients. Further research is necessary to establish the longer-term impact of brief behaviour change training on DCPs' clinical practice and patient health behaviours.
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Affiliation(s)
- Sophia Joseph
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Jo Hart
- School of Medical Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Anna Chisholm
- Department of Psychological Sciences, University of Liverpool, Brownlow Hill, Liverpool, L69 7ZX, UK
| | - Sarah Robinson
- School of Medical Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Joanna Goldthorpe
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Sarah Peters
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
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26
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Presseau J, Byrne-Davis LMT, Hotham S, Lorencatto F, Potthoff S, Atkinson L, Bull ER, Dima AL, van Dongen A, French D, Hankonen N, Hart J, Ten Hoor GA, Hudson K, Kwasnicka D, van Lieshout S, McSharry J, Olander EK, Powell R, Toomey E, Byrne M. Enhancing the translation of health behaviour change research into practice: a selective conceptual review of the synergy between implementation science and health psychology. Health Psychol Rev 2021; 16:22-49. [PMID: 33446062 DOI: 10.1080/17437199.2020.1866638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Indexed: 12/11/2022]
Abstract
Health psychology is at the forefront of developing and disseminating evidence, theories, and methods that have improved the understanding of health behaviour change. However, current dissemination approaches may be insufficient for promoting broader application and impact of this evidence to benefit the health of patients and the public. Nevertheless, behaviour change theory/methods typically directed towards health behaviours are now used in implementation science to understand and support behaviour change in individuals at different health system levels whose own behaviour impacts delivering evidence-based health behaviour change interventions. Despite contributing to implementation science, health psychology is perhaps doing less to draw from it. A redoubled focus on implementation science in health psychology could provide novel prospects for enhancing the impact of health behaviour change evidence. We report a Health Psychology Review-specific review-of-reviews of trials of health behaviour change interventions published from inception to April 2020. We identified 34 reviews and assessed whether implementation readiness of behaviour change interventions was discussed. We then narratively review how implementation science has integrated theory/methods from health psychology and related discipline. Finally, we demonstrate how greater synergy between implementation science and health psychology could promote greater follow-through on advances made in the science of health behaviour change.
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Affiliation(s)
- Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,School of Psychology, University of Ottawa, Ottawa, Canada
| | | | - Sarah Hotham
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | | | - Sebastian Potthoff
- Department of Social Work, Education, and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Lou Atkinson
- School of Psychology, Aston University, Birmingham, UK
| | - Eleanor R Bull
- Research Centre for Health, Psychology and Communities, Manchester Metropolitan University, Manchester, UK
| | - Alexandra L Dima
- Health Services and Performance Research, University Claude Bernard Lyon 1, Lyon, France
| | | | - David French
- School of Health Sciences & Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Nelli Hankonen
- Social Psychology, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Jo Hart
- Division of Medical Education, University of Manchester, Manchester, UK
| | - Gill A Ten Hoor
- Dept of Work & Social Psychology, Maastricht University, Maastricht, The Netherlands.,Dept of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health, Houston, TX, USA
| | - Kristian Hudson
- Centre for Aging and Rehabilitation, Bradford Institute for Health Research, Bradford, UK
| | - Dominika Kwasnicka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Sanne van Lieshout
- Team Advies & Onderzoek, Municipal Health Service (GGD) Kennemerland, Haarlem, the Netherlands
| | - Jennifer McSharry
- Health Behaviour Change Research Group, National University of Ireland, Galway, Ireland
| | - Ellinor K Olander
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, United Kingdom
| | - Rachael Powell
- School of Health Sciences & Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Elaine Toomey
- Health Behaviour Change Research Group, National University of Ireland, Galway, Ireland.,School of Allied Health, University of Limerick, Limerick, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, National University of Ireland, Galway, Ireland
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Lawes-Wickwar S, Ghio D, Tang MY, Keyworth C, Stanescu S, Westbrook J, Jenkinson E, Kassianos AP, Scanlan D, Garnett N, Laidlaw L, Howlett N, Carr N, Stanulewicz N, Guest E, Watson D, Sutherland L, Byrne-Davis L, Chater A, Hart J, Armitage CJ, Shorter GW, Swanson V, Epton T. A Rapid Systematic Review of Public Responses to Health Messages Encouraging Vaccination against Infectious Diseases in a Pandemic or Epidemic. Vaccines (Basel) 2021; 9:72. [PMID: 33498395 PMCID: PMC7909419 DOI: 10.3390/vaccines9020072] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 01/08/2023] Open
Abstract
Public health teams need to understand how the public responds to vaccination messages in a pandemic or epidemic to inform successful campaigns encouraging the uptake of new vaccines as they become available. A rapid systematic review was performed by searching PsycINFO, MEDLINE, healthevidence.org, OSF Preprints and PsyArXiv Preprints in May 2020 for studies including at least one health message promoting vaccine uptake of airborne-, droplet- and fomite-spread viruses. Included studies were assessed for quality using the Mixed Methods Appraisal Tool (MMAT) or the Assessment of Multiple Systematic Reviews (AMSTAR), and for patient and public involvement (PPI) in the research. Thirty-five articles were included. Most reported messages for seasonal influenza (n = 11; 31%) or H1N1 (n = 11; 31%). Evidence from moderate to high quality studies for improving vaccine uptake included providing information about virus risks and vaccination safety, as well as addressing vaccine misunderstandings, offering vaccination reminders, including vaccination clinic details, and delivering mixed media campaigns across hospitals or communities. Behavioural influences (beliefs and intentions) were improved when: shorter, risk-reducing or relative risk framing messages were used; the benefits of vaccination to society were emphasised; and beliefs about capability and concerns among target populations (e.g., vaccine safety) were addressed. Clear, credible, messages in a language target groups can understand were associated with higher acceptability. Two studies (6%) described PPI in the research process. Future campaigns should consider the beliefs and information needs of target populations in their design, including ensuring that vaccine eligibility and availability is clear, and messages are accessible. More high quality research is needed to demonstrate the effects of messaging interventions on actual vaccine uptake.
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Affiliation(s)
- Sadie Lawes-Wickwar
- Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
| | - Daniela Ghio
- Department of Psychology, Faculty of Health and Society, University of Salford, Manchester M6 6PU, UK;
| | - Mei Yee Tang
- Behavioural Science Policy Research Unit, Population Health Sciences, Newcastle University, Newcastle upon Tyne NE2 4AX, UK;
| | - Chris Keyworth
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
| | - Sabina Stanescu
- School of Psychology, University of Southampton, Southampton SO17 1BJ, UK;
| | | | - Elizabeth Jenkinson
- Department of Health and Social Sciences, University of West England, Bristol BS16 1QY, UK; (E.J.); (N.G.); (E.G.)
| | - Angelos P. Kassianos
- Department of Applied Health Research, University College London, London WC1E 6BT, UK;
| | - Daniel Scanlan
- Department of Communication, Policy, and Research, Education Support, London N5 1EW, UK;
| | - Natalie Garnett
- Department of Health and Social Sciences, University of West England, Bristol BS16 1QY, UK; (E.J.); (N.G.); (E.G.)
| | - Lynn Laidlaw
- Public Contributor, Health Psychology Exchange Patient and Public Involvement (PPI) Group, UK;
| | - Neil Howlett
- Department of Psychology, Sports, and Geography, School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hertfordshire AL10 9AB, UK;
| | - Natalie Carr
- Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Manchester M15 6BH, UK;
| | - Natalia Stanulewicz
- Faculty of Health and Life Sciences, School of Applied Social Sciences, De Montfort University, Leicester LE1 9BH, UK;
| | - Ella Guest
- Department of Health and Social Sciences, University of West England, Bristol BS16 1QY, UK; (E.J.); (N.G.); (E.G.)
| | - Daniella Watson
- Global Health Research Institute, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
| | | | - Lucie Byrne-Davis
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
- Division of Medical Education, University of Manchester, Manchester M13 9PT, UK
| | - Angel Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, Bedfordshire MK41 9EA, UK;
| | - Jo Hart
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
- Division of Medical Education, University of Manchester, Manchester M13 9PT, UK
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
- Manchester Academic Health Science Centre, Health Innovation Manchester, Manchester M13 9NQ, UK
| | - Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, Queen’s University Belfast, Belfast BT7 1NN, UK;
| | - Vivien Swanson
- Department of Psychology, University of Stirling, Stirling FK9 4LA, UK;
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
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Hart J, Cox CL, Kuhn I, Fritz Z. Communicating diagnostic uncertainty in the acute and emergency medical setting: A systematic review and ethical analysis of the empirical literature. Acute Med 2021; 20:204-218. [PMID: 34679138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND diagnostic uncertainty is ubiquitous. Its communication to patients requires further investigation. AIMS To determine: 1) What is known about how and why diagnostic uncertainty is communicated in acute care; 2) evidence of the effects of (not) communicating diagnostic uncertainty in the acute setting; 3) associated ethical issues. METHODS systematic review of Medline, Web of Science and SCOPUS for (acute or emergency care) AND (diagnostic uncertainty) AND (ethics OR behaviours). Critical interpretive synthesis and ethical analysis were conducted. RESULTS AND CONCLUSION Nine studies (primarily surveys and interviews) were identified. Doctors are not trained in communicating diagnostic uncertainty and perceive it to have negative effects on patients; however not communicating diagnostic uncertainty can disempower patients, resulting in delayed/missed diagnoses or inappropriate use of resource.
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Affiliation(s)
- J Hart
- MB BChir, MA (Cantab), North Middlesex University Hospital NHS Trust, The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
| | - C L Cox
- MB BChir, MA (Cantab), The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
| | - I Kuhn
- MA, MSc, The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
| | - Z Fritz
- MBBS, MA (Cantab), PhD, The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
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Arden MA, Byrne-Davis L, Chater A, Hart J, McBride E, Chilcot J. The vital role of health psychology in the response to COVID-19. Br J Health Psychol 2020; 25:831-838. [PMID: 33108046 DOI: 10.1111/bjhp.12484] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Madelynne A Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, UK
| | | | - Angel Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, UK
| | - Jo Hart
- Division of Medical Education, University of Manchester, UK
| | - Emily McBride
- Institute of Epidemiology and Health Care, University College London, UK
| | - Joseph Chilcot
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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Niculescu AB, Le-Niculescu H, Roseberry K, Wang S, Hart J, Kaur A, Robertson H, Jones T, Strasburger A, Williams A, Kurian SM, Lamb B, Shekhar A, Lahiri DK, Saykin AJ. Blood biomarkers for memory: toward early detection of risk for Alzheimer disease, pharmacogenomics, and repurposed drugs. Mol Psychiatry 2020; 25:1651-1672. [PMID: 31792364 PMCID: PMC7387316 DOI: 10.1038/s41380-019-0602-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/25/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022]
Abstract
Short-term memory dysfunction is a key early feature of Alzheimer's disease (AD). Psychiatric patients may be at higher risk for memory dysfunction and subsequent AD due to the negative effects of stress and depression on the brain. We carried out longitudinal within-subject studies in male and female psychiatric patients to discover blood gene expression biomarkers that track short term memory as measured by the retention measure in the Hopkins Verbal Learning Test. These biomarkers were subsequently prioritized with a convergent functional genomics approach using previous evidence in the field implicating them in AD. The top candidate biomarkers were then tested in an independent cohort for ability to predict state short-term memory, and trait future positive neuropsychological testing for cognitive impairment. The best overall evidence was for a series of new, as well as some previously known genes, which are now newly shown to have functional evidence in humans as blood biomarkers: RAB7A, NPC2, TGFB1, GAP43, ARSB, PER1, GUSB, and MAPT. Additional top blood biomarkers include GSK3B, PTGS2, APOE, BACE1, PSEN1, and TREM2, well known genes implicated in AD by previous brain and genetic studies, in humans and animal models, which serve as reassuring de facto positive controls for our whole-genome gene expression discovery approach. Biological pathway analyses implicate LXR/RXR activation, neuroinflammation, atherosclerosis signaling, and amyloid processing. Co-directionality of expression data provide new mechanistic insights that are consistent with a compensatory/scarring scenario for brain pathological changes. A majority of top biomarkers also have evidence for involvement in other psychiatric disorders, particularly stress, providing a molecular basis for clinical co-morbidity and for stress as an early precipitant/risk factor. Some of them are modulated by existing drugs, such as antidepressants, lithium and omega-3 fatty acids. Other drug and nutraceutical leads were identified through bioinformatic drug repurposing analyses (such as pioglitazone, levonorgestrel, salsolidine, ginkgolide A, and icariin). Our work contributes to the overall pathophysiological understanding of memory disorders and AD. It also opens new avenues for precision medicine- diagnostics (assement of risk) as well as early treatment (pharmacogenomically informed, personalized, and preventive).
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Affiliation(s)
- A B Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.
- Indianapolis VA Medical Center, Indianapolis, IN, USA.
| | - H Le-Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - K Roseberry
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - S Wang
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Indianapolis VA Medical Center, Indianapolis, IN, USA
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - J Hart
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Kaur
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - H Robertson
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - T Jones
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - A Strasburger
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - A Williams
- Indianapolis VA Medical Center, Indianapolis, IN, USA
- Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
| | - S M Kurian
- Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
| | - B Lamb
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Shekhar
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - D K Lahiri
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A J Saykin
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
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Schaffet J, Didehbani N, LoBue C, Hart J, Cullum CM. A-37 Neuropsychological Functioning In Cognitively Normal And Impaired Aging NFL Retirees. Arch Clin Neuropsychol 2020. [DOI: 10.1093/arclin/acaa036.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
Identify differences in neuropsychological (NP) functioning between older (≥ 50) National Football League (NFL) retirees and age-matched controls, and examine whether differences correlate to head-injury exposure.
Method
NFL retirees were diagnosed with normal cognition (n = 20), mild cognitive impairment (n = 19), or dementia (n = 5) using Jak and Bondi (2009) criteria and clinical consensus. Retirees were age-matched to either healthy controls (n = 18) or clinical controls with MCI (n = 21) or dementia (n = 5). MANCOVAs and partial correlations covarying for age and education compared retiree’s NP performances to controls, and examined whether differences in NP measures were correlated with number of concussions, or games and years played in the NFL.
Results
Cognitively normal (CN) retirees displayed lower processing speed, naming, and verbal memory (p’s < .05) than CN controls. Impaired retirees displayed worse processing speed and naming than impaired controls, but better verbal memory (p’s < .05). Only lower verbal memory performance in CN retirees significantly correlated with number of games (r = −.60) and years played (r = −.54).
Conclusions
Aging CN and impaired retirees performed worse on single measures of processing speed and naming, but their performances did not correlate to head-injury exposure. Verbal memory performance varied between CN (worse than controls) and impaired retirees (better than controls). Overall, results suggest some aging NFL players may be at risk for reduced verbal memory, but this relationship could diminish following onset of MCI. No clear dose-response relationship was observed between head-injury exposure and NP functioning. Future studies should examine longitudinal trajectories of NP performances in larger samples to elucidate these findings.
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Lilaonitkul M, Mishra S, Pritchard N, Andhoga J, Olang' P, Kibet EB, Walker IA, Hart J, Byrne-Davis L. Mixed methods analysis of factors influencing change in clinical behaviours of non-physician anaesthetists in Kenya following obstetric anaesthesia training. Anaesthesia 2020; 75:1331-1339. [PMID: 32436211 DOI: 10.1111/anae.15091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 11/30/2022]
Abstract
Maternal mortality rates in low-middle income countries remain high, with sub-Saharan Africa accounting for two-thirds of global maternal deaths. Inadequate staff training is one of the main contributors to anaesthesia-related deaths and the Association of Anaesthetists developed the Safe Anaesthesia from Education course in collaboration with the World Federation of Societies of Anaesthesiologists to address this training gap. We aimed to evaluate the impact of this course among Kenyan participants. Mixed methodologies and secondary analyses of anonymised data were used to study translation of learning into practice. In total, 103 participants from 66 facilities who attended courses between 2016 and 2017 were analysed. Ninety (87%) participants who were followed up completed knowledge tests. Baseline median (IQR [range]) knowledge test score was 41 (37-43 [21-46]). There was a significant improvement in median (IQR [range]) knowledge test score immediately post-course (43 (41-45 [33-48]); p < 0.001) which was sustained at 3-6 month follow-up (43 (41-45 [32-50]); p < 0.001 compared with baseline). Eighty-four of the 103 participants were observed in their workplace and capability, opportunity and motivation-behaviour framework was used to study the barriers and facilitators to practice change. Psychological capability and reflective motivation were the main factors enabling positive behaviour change such as team communication and pre-operative assessment, whereas physical and social opportunity accounted for the main barriers to behaviours such as performing the surgical safety checklist. Our study demonstrates that the Safe Anaesthesia from Education obstetric course is relevant in the low-resource setting and may lead to knowledge translation in clinical practice.
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Affiliation(s)
- M Lilaonitkul
- Department of Anesthesia and Peri-operative Care, University of California San Francisco, San Francisco, CA, USA
| | - S Mishra
- Department of Internal Medicine, Lincoln Medicine Center, New York, NY, USA
| | - N Pritchard
- Department of Anaesthesia, St George's University Hospitals NHS Foundation Trust, London, UK
| | - J Andhoga
- Department of Anaesthesia, Jomo Kenyatta University of Agriculture and Technology, Kiambu, Kenya
| | - P Olang'
- Department of Anaesthesia, University of Nairobi, Nairobi, Kenya
| | - E B Kibet
- Department of Anaesthesia, Kenyatta National Hospital, Nairobi, Kenya
| | - I A Walker
- University College London Institute of Child Health, London, UK
| | - J Hart
- Division of Medical Education, University of Manchester, Manchester, UK
| | - L Byrne-Davis
- Division of Medical Education, University of Manchester, UK
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Chisholm A, Byrne-Davis L, Peters S, Beenstock J, Gilman S, Hart J. Online behaviour change technique training to support healthcare staff 'Make Every Contact Count'. BMC Health Serv Res 2020; 20:390. [PMID: 32380982 PMCID: PMC7206818 DOI: 10.1186/s12913-020-05264-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 04/28/2020] [Indexed: 12/02/2022] Open
Abstract
Background National Health Service (NHS) staff support service users to change health-related behaviours such as smoking, alcohol consumption, diet and physical activity. It can be challenging to discuss behaviour changes with service users hence training is needed to equip staff with up-to-date, evidence-based behaviour change skills. In order to identify how training may help to improve health professional skills in this area, this study evaluated change in professionals’ behavioural determinants following an online behaviour change skills module as part of Making Every Contact Count (MECC) training. Methods This evaluation comprised a within-subject design in which staff from one Northwest England NHS Trust completed a 9-item survey immediately before and after training. This prospective survey identified behavioural determinants regarding adhering to MECC recommendations to hold health conversations with service users and provided written comments about their training experiences. Individuals working within the Trust in clinical or non-clinical roles were eligible to take part and were invited to contribute to the evaluation upon uptake of their usual NHS staff online training programmes. Results Of participants completing the evaluation (n=206), 12 professional cadres accessed the module, most being female (91%), nurses/midwives (43%), working in children and family services (48%), aged 22 - 62 years. Eight behavioural determinants increased significantly following training, with effect sizes ranging from sizes ranging from 0.27 to 0.51; ‘identity’ did not change. Content analysis of written feedback (n=256) indicates that training enhanced staff behaviour change skills, modelled a productive and specific method of adopting a patient-led approach to behaviour change conversations, and identified that staff may require further support with embedding skills in practice. Conclusions Behaviour change science can be translated into useful learning for NHS staff. Online training can engage staff in learning about behaviour change skills and increase their behavioural determinants to adopt these skills in practice.
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Affiliation(s)
- Anna Chisholm
- Department of Psychological Sciences, University of Liverpool, Liverpool, L69 7ZA, UK.
| | - Lucie Byrne-Davis
- Division of Medical Education, University of Manchester, Manchester, M13 9PT, UK
| | - Sarah Peters
- Division of Psychology & Mental Health, University of Manchester, Manchester, M13 9PL, UK
| | - Jane Beenstock
- Lancashire Care NHS Foundation Trust, Preston, PR5 6AW, UK.,Health Research, Lancaster University, Lancaster, LA1 4YW, UK
| | - Suzanne Gilman
- Lancashire Care NHS Foundation Trust, Preston, PR5 6AW, UK
| | - Jo Hart
- Division of Medical Education, University of Manchester, Manchester, M13 9PT, UK
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Abstract
Health professional Continuing Professional Development (CPD) courses often aim to change practice; understanding which training techniques drive behavior change can help educators facilitate this. The 93-item Behaviour Change Technique Taxonomy (BCTT) describes behavior change techniques (BCTs) used in behavior change interventions but was not designed for understanding CPD; it is necessary to explore how best to use the BCTT in this context. This study aimed to explore the BCTs used by CPD course educators to change healthcare practice and to develop and pilot an e-tool, based on the BCTT, to enable course designers and educators to understand which BCTs are in their training. This understanding could lead to enhanced CPD and an experimental approach to assessing the benefits of including a variety of BCTs in CPD. Two psychologists, trained in using the BCTT, observed three postgraduate medical CPD courses. In Phase 1, the BCTT was used to code 26 hours of observations. An e-tool including observed BCTs was developed and used to code 35 hours of observations in Phase 2. Feedback was collected through short discussions with educators from each course. The tool was further refined in Phase 3. Thirty-seven BCTs were identified in Phase 1, a further four in Phase 2, and a further two in Phase 3. The final e-tool comprised 43 BCTs with examples of their use based on course observations to aid identification, since educators fed back that they would value an uncomplicated tool with practice-related examples. A coding tool to understand the active ingredients in health professional CPD could enable educators to maximize the impact of CPD on practice. Further work should explore whether educators themselves are able to use the tool to code their training interventions.
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Affiliation(s)
- Emma Pearson
- Department of Applied Health and Social Care, Edge Hill University, Ormskirk, Lancashire, UK
| | - Lucie Byrne-Davis
- Division of Medical Education, University of Manchester, Manchester, UK
| | - Eleanor Bull
- Division of Medical Education, University of Manchester, Manchester, UK
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Jo Hart
- Division of Medical Education, University of Manchester, Manchester, UK
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Herb CC, Blemker S, Saliba S, Hart J, Hertel J. Chronic ankle instability patients exhibit higher variability in lower extremity joint-coupling variability during drop vertical jumps. J Biomech 2020; 99:109479. [PMID: 31744598 DOI: 10.1016/j.jbiomech.2019.109479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/27/2019] [Accepted: 10/30/2019] [Indexed: 12/26/2022]
Abstract
Chronic ankle instability (CAI) has been associated with biomechanical alterations during landing tasks. While joint coupling differences have been reported during gait in patients with CAI, there is no known research assessing joint coupling during a drop-vertical jumping (DVJ). Joint coupling variability measure may provide information on the sensorimotor health of these patients. The purpose of this study was to compare lower extremity joint coupling variability during a DVJ between patients with CAI and controls. Twenty-eight young, active individuals (CAI:n = 14, Control:n = 14) participated in the study. A 3D motion capture system was used to collect kinematics during 15 drop-vertical jump trials. A vector coding analysis was used to assess the variability in the following joint couples: knee sagittal-ankle frontal, knee sagittal-ankle sagittal, hip frontal-ankle frontal, and hip frontal-ankle sagittal. The CAI group had higher joint coupling variability in hip frontal-ankle sagittal, knee sagittal-ankle frontal and knee sagittal-ankle sagittal planes both prior to and following ground contact during the drop vertical jumps. These changes indicate potential adaptations to the constraint of CAI and the task of the DVJ. Higher variability may reflect an attempt by the subjects to explore alternate movement strategies or reflect poor sensorimotor control strategies. Clinicians should consider the challenges of DVJ during rehabilitation as they create a unique task constraint.
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Affiliation(s)
- C C Herb
- Northern Kentucky University, School of Kinesiology, Counseling and Rehabilitation Sciences, Highland Heights, KY, USA.
| | - S Blemker
- University of Virginia, School of Engineering and Applied Science, Charlottesville, VA, USA
| | - S Saliba
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hart
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hertel
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
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Atasoy D, Kandasamy N, Hart J, Lynch J, Yang SH, Walsh D, Tolias C, Booth TC. Outcome Study of the Pipeline Embolization Device with Shield Technology in Unruptured Aneurysms (PEDSU). AJNR Am J Neuroradiol 2019; 40:2094-2101. [PMID: 31727754 DOI: 10.3174/ajnr.a6314] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 09/20/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The recently introduced Pipeline Flex Embolization Device with Shield Technology (Pipeline Shield) is the third generation of Pipeline flow-diverter devices. It has a new stent-surface modification, which reduces thrombogenicity. We aimed to evaluate clinical and radiographic (safety and efficacy) outcomes of the Pipeline Shield. MATERIALS AND METHODS The 30-day and 1-year mortality and morbidity rates and the 6- and 18-month radiographic aneurysm occlusion outcomes for procedures performed between March 2016 and January 2018 were analyzed. 3D-TOF-MRA was used for follow-up. RESULTS Forty-four attempted Pipeline Shield procedures were performed for 41 patients with 44 target aneurysms (total of 52 aneurysms treated). A total of 88.5% of devices were inserted in the anterior circulation, and 11.5%, in the posterior circulation; 49/52 (94.2%) aneurysms were saccular; and 1/52 (1.9%) was fusiform. One (1.9%) aneurysm was an iatrogenic pseudoaneurysm, and 1 (1.9%) was a dissecting aneurysm. Seventy-one percent (35/49) of the saccular aneurysms were wide-neck (neck, >4 mm), 34.6% (18/52) were large (≥10 mm), and 3.8% (2/52) were giant (≥25 mm). The mean aneurysm sac maximal diameter was 9.0 mm, and the mean neck width was 5.0 mm. The cumulative mortality and morbidity rates were 2.3% and 6.8% at 1 year, respectively. The adequate occlusion rate was 78.8% at 6 months and 90.3% at 18 months. CONCLUSIONS In this pragmatic and non-industry-sponsored study, the occlusion rates and safety outcomes were similar to those seen in previously published studies with flow-diverter devices and earlier generation Pipeline Embolization Devices.
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Affiliation(s)
- D Atasoy
- From Karadeniz Technical University (D.A.), Farabi Hospital, Trabzon, Turkey
| | - N Kandasamy
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.)
| | - J Hart
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.)
| | - J Lynch
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.)
| | - S-H Yang
- Department of Radiology (S.-H.Y.), Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Radiology (S.-H.Y.), School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - D Walsh
- Neurosurgery (D.W., C.T.), King's College Hospital National Health Service Foundation Trust, London, UK
| | - C Tolias
- Neurosurgery (D.W., C.T.), King's College Hospital National Health Service Foundation Trust, London, UK
| | - T C Booth
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.) .,School of Biomedical Engineering and Imaging Sciences (T.C.B.), King's College London, London, UK
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Smith E, Schaffert J, LoBue C, Hart J, Rossetti H, Lacritz L. Annualized Decline in Instrumental Activities of Daily Living Is Slower in Hispanics Compared to Non-Hispanics in an Alzheimer’s Disease Sample. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Research examining the course of Alzheimer’s disease (AD) in Hispanics is lacking. This study examined demographic, psychiatric, cognitive, and genetic predictors of longitudinal functional change in Hispanics and non-Hispanics with AD.
Method
Longitudinal change in instrumental activities of daily living (IADL) was examined over 10 years (M = 4.15 years) in 292 subjects (Hispanic = 67, non-Hispanic = 225). All were part of the Texas Alzheimer’s Research & Care Consortium and included those with AD (n = 217) and those with mild cognitive impairment at baseline who progressed to AD at follow-up (n = 75). Baseline comparisons were conducted between ethnic groups for demographics, Geriatric Depression Scale (GDS-30) score, Mini Mental State Examination (MMSE) score, presence of apolipoprotein ɛ4 alleles (APOE4), and annualized IADL change scores and then entered into a multiple linear regression model as predictors of annualized IADL change.
Results
The Hispanic group had significantly more females (χ2 = 5.71, p = .017), lower education [MH = 9.96(4.39), MNH = 15.26(2.70)], higher depression scores [GDS-30; MH = 9.45(5.89), MNH = 5.51(4.29)], lower MMSE scores [MH = 23.31(4.33), MNH = 24.65(3.21)], and slower annualized IADL change [MH = 1.19(1.42), MNH = 2.02(1.60)]. Regression results were significant (F = 3.66, p = .001, R2 = .08 ), with higher baseline MMSE (p = .007) and Hispanic origin (p = .010) predicting slower annualized IADL change. Demographics, APOE4 status, and depression did not significantly predict IADL change.
Conclusions
Higher cognitive functioning at baseline and Hispanic origin was associated with slower functional decline over an average 4-year period of time. Despite having lower MMSE scores at baseline, greater depression, and less education, the Hispanic group had a slower decline in IADLs compared to non-Hispanics. Further research is needed to better understand how/why Hispanic origin is associated with slower functional decline.
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Schaffert J, LoBue C, Presley C, Hynan L, Wilmoth K, Lacritz L, Hart J, Cullum CM. Predictors of Life Expectancy After an Alzheimer’s Disease Diagnosis in a National Multi-Center Autopsy-Confirmed Sample. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Life expectancy varies between 3-12 years following the diagnosis of Alzheimer’s disease (AD) and is an important clinical question for patients and families. Current literature is limited by relatively small sample sizes and a reliance on clinical diagnoses. This study sought to evaluate predictors of AD life expectancy in a large autopsy-confirmed sample.
Methods
Baseline data from individuals 50 years and older clinically and neuropathologically diagnosed with AD (N=764) were obtained from the National Alzheimer’s Coordinating Center. Life expectancy was calculated in months from AD diagnosis to death. Nineteen variables (demographic, medical/health, disease severity, and psychiatric) obtained at dementia diagnosis were examined. Variables that showed significant differences in life expectancy using t-tests and Pearson correlations (14 of 19) were then entered into a forward multiple regression.
Results
Seven predictors in the model explained 27% of the variance in life expectancy (F= 40.7, R-squared= 0.267). Lower MMSE scores (β= 0.339, p < .001), male sex (β= -0.144, p < .001), older age (β= -0.130, p < .001), non-Hispanic Caucasian race/ethnicity (β= 0.115, p < .001), greater impairment on the Functional Activities Questionnaire (β= -0.091, p=.042), abnormal neurological/physical exam (β= -0.083, p=.011), and higher Neuropsychiatric Inventory Questionnaire total scores (β= -0.079, p=.016) predicted shorter life expectancy.
Conclusions
Global cognitive impairment, sex, age, race/ethnicity, functional impairment, abnormal neurological exam findings, and psychiatric symptoms explain a significant proportion of life expectancy following an AD diagnosis. Future studies should explore the relationship between life expectancy, specific neurological abnormalities, and psychiatric symptoms. These 7 predictors could potentially be used to predict life expectancy in individuals diagnosed with AD.
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Boyd N, Sharkey E, Nabukenya M, Tumukunde J, Sipuka N, Zyambo M, Walker I, Hart J, Byrne-Davis L. The Safer Anaesthesia from Education (SAFE) ® paediatric anaesthesia course: educational impact in five countries in East and Central Africa. Anaesthesia 2019; 74:1290-1297. [PMID: 31350856 DOI: 10.1111/anae.14778] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2019] [Indexed: 11/28/2022]
Abstract
There is an urgent need to improve access to safe surgical and anaesthetic care for children living in many low- and middle-income countries. Providing quality training for healthcare workers is a key component of achieving this. The 3-day Safer Anaesthesia from Education (SAFE)® paediatric anaesthesia course was developed to address the specific skills and knowledge required in this field. We undertook a project to expand this course across five East and Central African countries (Ethiopia, Kenya, Malawi, Uganda and Zambia) and train local faculty. This study reports the outcomes from course evaluation data, exploring the impact on knowledge, skills and behaviour change in participants. Eleven courses were conducted in a 15-month period, with 381 participants attending. Fifty-nine new faculty members were trained. Knowledge scores (0-50 scale) increased significantly from mean (SD) 37.5 (4.7) pre-course to 43.2 (3.5) post-course (p < 0.0001). Skills scores (0-10 scale) increased significantly from 5.7 (2.0) pre-course to 8.0 (1.5) post-course (p < 0.0001). One hundred and twenty-six participants in Malawi, Uganda and Zambia were visited in their workplace 3-6 months later. Knowledge and skills were maintained at follow-up, with scores of 41.5 (5.0) and 8.3 (1.4), respectively (p < 0.0001 compared with pre-course scores). Content analysis from interviews with these participants highlighted positive behaviour changes in the areas of preparation, peri-operative care, resuscitation, management of the sick child, communication and teaching. This study indicates that the SAFE paediatric anaesthesia course is an effective way to deliver training, and could be used to help strengthen emergency and essential surgical care for children as a component of universal health coverage.
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Affiliation(s)
- N Boyd
- Department of Anaesthesia, Bristol Royal Hospital for Children, Bristol, UK
| | - E Sharkey
- Department of Anaesthesia, University College Hospital, London, UK
| | - M Nabukenya
- Department of Anaesthesia, Makerere University College of Health Sciences, Kampala, Uganda
| | - J Tumukunde
- Department of Anaesthesia, Makerere University College of Health Sciences, Kampala, Uganda
| | - N Sipuka
- Department of Anaesthesia and Critical Care, University Teaching Hospital, Lusaka, Zambia
| | - M Zyambo
- Department of Anaesthesia and Critical Care, University Teaching Hospital, Lusaka, Zambia
| | - I Walker
- Department of Anaesthesia, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.,Department of Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - J Hart
- Department of Education, University of Manchester, Manchester, UK
| | - L Byrne-Davis
- Department of Education, University of Manchester, Manchester, UK
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Morris K, Wagner S, Reddy Y, Salerno C, Ravichandran A, Garcia-Cortes R, Patel A, Plotner S, Hart J, Neawedde K, Walsh M, Chaudhry S. SIPAT Scores Do Not Correlate with Outcomes in Patients with Ventricular Assist Devices. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Tyler N, Chatwin J, Byrne G, Hart J, Byrne-Davis L. The benefits of international volunteering in a low-resource setting: development of a core outcome set. Hum Resour Health 2018; 16:69. [PMID: 30567549 PMCID: PMC6300912 DOI: 10.1186/s12960-018-0333-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Qualitative narrative analysis and case studies form the majority of the current peer-reviewed literature about the benefits of professional volunteering or international placements for healthcare professionals. These often describe generalised outcomes that are difficult to define or have multiple meanings (such as 'communication skills' or 'leadership') and are therefore difficult to measure. However, there is an interest from employers, professional groups and individual volunteers in generating metrics for monitoring personal and professional development of volunteers and comparing different volunteering experiences in terms of their impact on the volunteers. In this paper, we describe two studies in which we (a) consolidated qualitative research and individual accounts into a core outcome set and (b) tested the core outcome set in a large group of global health stakeholders. METHOD We conducted a systematic review and meta-synthesis of literature to extract outcomes of international placements and variables that may affect these outcomes. We presented these outcomes to 58 stakeholders in global health, employing a Delphi method to reach consensus about which were 'core' and which were likely to be developed through international volunteering. RESULTS The systematic review of 55 papers generated 133 unique outcomes and 34 potential variables. One hundred fifty-six statements were then presented to the Delphi stakeholders, of which they agreed 116 were core to a wide variety of healthcare professional practice and likely to be developed through international experiences. The core outcomes (COs) were both negative and positive and included skills, knowledge, attitudes and outcomes for healthcare organisations. CONCLUSIONS We summarised existing literature and stakeholder opinion into a core outcome set of 116 items that are core to healthcare professional practice and likely to be developed through international experiences. We identified, in the literature, a set of variables that could affect learning outcomes. The core outcome set will be used in a future study to develop a psychometric assessment tool.
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Affiliation(s)
| | | | - Ged Byrne
- Health Education England, Leeds, United Kingdom
| | - Jo Hart
- University of Manchester, Manchester, United Kingdom
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Keyworth C, Hart J, Armitage CJ, Tully MP. What maximizes the effectiveness and implementation of technology-based interventions to support healthcare professional practice? A systematic literature review. BMC Med Inform Decis Mak 2018; 18:93. [PMID: 30404638 PMCID: PMC6223001 DOI: 10.1186/s12911-018-0661-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 09/27/2018] [Indexed: 02/02/2023] Open
Abstract
Background Technological support may be crucial in optimizing healthcare professional practice and improving patient outcomes. A focus on electronic health records has left other technological supports relatively neglected. Additionally, there has been no comparison between different types of technology-based interventions, and the importance of delivery setting on the implementation of technology-based interventions to change professional practice. Consequently, there is a need to synthesise and examine intervention characteristics using a methodology suited to identifying important features of effective interventions, and the barriers and facilitators to implementation. Three aims were addressed: to identify interventions with a technological component that are successful at changing professional practice, to determine if and how such interventions are theory-based, and to examine barriers and facilitators to successful implementation. Methods A literature review informed by realist review methods was conducted involving a systematic search of studies reporting either: (1) behavior change interventions that included technology to support professional practice change; or (2) barriers and facilitators to implementation of technological interventions. Extracted data was quantitative and qualitative, and included setting, target professionals, and use of Behaviour Change Techniques (BCTs). The primary outcome was a change in professional practice. A thematic analysis was conducted on studies reporting barriers and facilitators of implementation. Results Sixty-nine studies met the inclusion criteria; 48 (27 randomized controlled trials) reported behavior change interventions and 21 reported practicalities of implementation. The most successful technological intervention was decision support providing healthcare professionals with knowledge and/or person-specific information to assist with patient management. Successful technologies were more likely to operationalise BCTs, particularly “instruction on how to perform the behavior”. Facilitators of implementation included aligning studies with organisational initiatives, ensuring senior peer endorsement, and integration into clinical workload. Barriers included organisational challenges, and design, content and technical issues of technology-based interventions. Conclusions Technological interventions must focus on providing decision support for clinical practice using recognized behavior change techniques. Interventions must consider organizational context, clinical workload, and have clearly defined benefits for improving practice and patient outcomes. Electronic supplementary material The online version of this article (10.1186/s12911-018-0661-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C Keyworth
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK.
| | - J Hart
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK.,Division of Medical Education, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9PL, UK
| | - C J Armitage
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
| | - M P Tully
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester, M13 9PL, UK
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Abstract
BACKGROUND Action plans have been shown to be important in changing behaviour. In learners, action plans have been proposed as a mechanism by which feedback leads to an increase in expertise: feedback leads to action plans, which lead to changes in learning behaviours and finally to improvement. Little is known about the extent to which students are able to make specific actions plans that relate to the feedback they are given, however. We explored whether medical students created action plans after being given feedback, the quality of those plans and whether the action plans were related to the feedback given. Action plans have been shown to be important in changing behaviour METHODS: We collected data from a communication session for Year-1 medical students on the feedback they were given and the action plans they made for improvement. RESULTS Most students (185/196, 94%) made one or more action plans, but only 31/196 (16%) made one or more action plans that were directly related to the feedback given to them. CONCLUSIONS Although educators may include action planning in education, students are not making specific enough action plans to effect change. Future work should include support for students in making better-quality action plans. …students are not making specific enough action plans to effect change.
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Affiliation(s)
- Jo Hart
- Division of Medical Education, University of Manchester, Manchester, UK
| | - Lucie Byrne-Davis
- Division of Medical Education, University of Manchester, Manchester, UK
| | - Val Wass
- School of Medicine, Keele University, Keele, UK
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Pakpoor J, Seminatore B, Graves J, Schreiner T, Waldman A, Lotze T, Belman A, Greenberg B, Weinstock-Guttman B, Aaen G, Tillema J, McDonald J, Hart J, Ness J, Harris Y, Rubin J, Candee M, Krupp L, Gorman M, Benson L, Rodriguez M, Chitnis T, Mar S, Kahn I, Rose J, Carmichael S, Roalstad S, Waltz M, Casper T, Waubant E. Dietary factors and pediatric multiple sclerosis: A case-control study. Mult Scler 2018; 24:1067-1076. [PMID: 28608728 PMCID: PMC5711616 DOI: 10.1177/1352458517713343] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 12/13/2022]
Abstract
BACKGROUND The role of diet in multiple sclerosis (MS) is largely uncharacterized, particularly as it pertains to pediatric-onset disease. OBJECTIVE To determine the association between dietary factors and MS in children. METHODS Pediatric MS patients and controls were recruited from 16 US centers (MS or clinically isolated syndrome onset before age 18, <4 years from symptom onset and at least 2 silent lesions on magnetic resonance imaging). The validated Block Kids Food Screener questionnaire was administered 2011-2016. Chi-squared test compared categorical variables, Kruskal-Wallis test compared continuous variables, and multivariable logistic regression analysis was performed. RESULTS In total, 312 cases and 456 controls were included (mean ages 15.1 and 14.4 years). In unadjusted analyses, there was no difference in intake of fats, proteins, carbohydrates, sugars, fruits, or vegetables. Dietary iron was lower in cases ( p = 0.04), and cases were more likely to consume below recommended guidelines of iron (77.2% of cases vs 62.9% of controls, p < 0.001). In multivariable analysis, iron consumption below recommended guidelines was associated with MS (odds ratio = 1.80, p < 0.01). CONCLUSION Pediatric MS cases may be less likely to consume sufficient iron compared to controls, and this warrants broader study to characterize a temporal relationship. No other significant difference in intake of most dietary factors was found.
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Affiliation(s)
- J. Pakpoor
- Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - B. Seminatore
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - J. Graves
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - T. Schreiner
- University of Colorado School of Medicine, Neurology
| | - A. Waldman
- Children’s Hospital of Philadelphia, Neurology
| | - T. Lotze
- Texas Children’s Hospital, Child Neurology
| | - A. Belman
- Stony Brook University Medical Center, Department of Neurology, Neurology
| | | | | | - G. Aaen
- Loma Linda University, Neurology
| | | | - J. McDonald
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - J. Hart
- University of California, San Francisco, Regional Pediatric MS Center, Neurology
| | - J. Ness
- University of Alabama at Birmingham, Pediatrics
| | - Y. Harris
- University of Alabama at Birmingham, Pediatrics
| | - J. Rubin
- Ann & Robert Lurie Children's Hospital of Chicago, Neurology
| | | | - L. Krupp
- Stony Brook University Medical Center, Department of Neurology, Neurology
| | - M. Gorman
- Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center
| | - L. Benson
- Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center
| | | | | | - S. Mar
- Washington University St. Louis, Neurology
| | - I. Kahn
- Children’s National Medical Center, Washington, D.C
| | - J. Rose
- University of Utah, Neurology
| | - S.L. Carmichael
- Department of Pediatrics Division of Neonatal and Developmental Medicine, Stanford University, California, USA
| | | | | | | | - E. Waubant
- Multiple Sclerosis Center, University of California, San Francisco, CA
- University of California, San Francisco, Regional Pediatric MS Center, Neurology
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Chisholm A, Ang-Chen P, Peters S, Hart J, Beenstock J. Public health practitioners’ views of the ‘Making Every Contact Count’ initiative and standards for its evaluation. J Public Health (Oxf) 2018; 41:e70-e77. [DOI: 10.1093/pubmed/fdy094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/04/2018] [Accepted: 05/10/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Chisholm
- Department of Psychological Sciences, Institute of Psychology, Health and Society University of Liverpool, L69 7ZA, UK
| | - P Ang-Chen
- Department of Psychological Sciences, Institute of Psychology, Health and Society University of Liverpool, L69 7ZA, UK
| | - S Peters
- Division of Psychology and Mental Health, University of Manchester, UK
| | - J Hart
- Division of Medical Education, University of Manchester, UK
| | - J Beenstock
- Medical Directorate, Lancashire Care NHS Foundation Trust, UK
- Faculty of Health & Medicine, Lancaster University, UK
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Hart J, Furber C, Chisholm A, Aspinall S, Lucas C, Runswick E, Mann K, Peters S. A mixed methods investigation of an online intervention to facilitate student midwives' engagement in effective conversations about weight-related behaviour change with pregnant women. Midwifery 2018; 63:52-59. [PMID: 29803013 DOI: 10.1016/j.midw.2018.05.001] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 04/04/2018] [Accepted: 05/01/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE (1) To identify whether an online training intervention could increase midwifery students' knowledge of behaviour change techniques (BCTs) and intentions to use them in practice. (2) To identify students' views and current experiences of talking to women about weight-related behaviour change. DESIGN Mixed methods study involving pre- and post-training assessments, and qualitative interviews with midwifery students. SETTING Online training course delivered at a University in the North of England, UK. PARTICIPANTS Midwifery students in the third year of their undergraduate degree during 2015-2016. INTERVENTION Online training focused on equipping students with knowledge of theoretically-informed BCTs, and the skills to use them opportunistically in existing practice settings. MEASUREMENTS Likelihood of discussing obesity with women was assessed via a 12-item, 7-point Likert scale assessing students' attitudes, subjective norms, perceived behavioural control, and intentions. A 14-item checklist was used to assess BCT knowledge whereby students selected recognised BCTs (of 7 correct, 7 false). Students' views and experiences of current practice was explored through in-depth, semi-structured one-on-one interviews with a member of the research team. FINDINGS Students' subjective norms, perceived behavioural control, and knowledge of BCTs increased post-training but intention and attitudes did not. Interviews revealed three themes accounting for students experiences and views of behaviour change practice: (1) 'How training fits with current encounters with maternal obesity in midwifery training' (2) 'TEnT PEGS prepares students for practice', and (3) 'Value of tailored training'. KEY CONCLUSIONS Online BCT training can improve the midwifery students' confidence, knowledge and beliefs that this is part of their role. They also reported finding the training helpful in better preparing them for this challenging element of their routine practice. IMPLICATIONS FOR PRACTICE Online BCT training can be used to prepare undergraduate midwifery students for practice.
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Affiliation(s)
- Jo Hart
- Division of Medical Education, University of Manchester, Oxford Rd, Manchester M13 9PT, United Kingdom.
| | - Christine Furber
- Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PT, United Kingdom.
| | - Anna Chisholm
- Department of Psychological Sciences, University of Liverpool, Liverpool L69 3BX, United Kingdom.
| | - Samantha Aspinall
- Division of Psychology and Mental Health, University of Manchester, Manchester, M13 9PT, United Kingdom.
| | - Charlotte Lucas
- Division of Psychology and Mental Health, University of Manchester, Manchester, M13 9PT, United Kingdom.
| | - Emma Runswick
- Division of Medical Education, University of Manchester, Manchester M13 9PT, United Kingdom.
| | | | - Sarah Peters
- Division of Psychology and Mental Health, University of Manchester, Manchester, M13 9PT, United Kingdom.
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Abstract
Background Research findings indicate that working as a prison officer can be highly stressful, but the aspects of work that predict their mental health status are largely unknown. Aims To examine, using elements of the demands-resources model, the extent to which work pressure and several potential resources (i.e. control, support from managers and co-workers, role clarity, effective working relationships and positive change management) predict mental health in a sample of UK prison officers. Methods The Health and Safety Executive Management Standards Indicator Tool was used to measure job demands and resources. Mental health was assessed by the General Health Questionnaire-28. The effects of demands and resources on mental health were examined via linear regression analysis with GHQ score as the outcome. Results The study sample comprised 1267 prison officers (86% male). Seventy-four per cent met 'caseness' criteria for mental health problems. Job demands, poor interpersonal relationships, role ambiguity and, to a lesser extent, low job control and poor management of change were key predictors of mental health status. Conclusions The findings of this study can help occupational health practitioners and psychologists develop structured interventions to improve well-being among prison officers.
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Affiliation(s)
- G Kinman
- Department of Psychology, University of Bedfordshire, Luton LU1 3JU, UK
| | - A J Clements
- Department of Psychology, University of Bedfordshire, Luton LU1 3JU, UK
| | - J Hart
- Department of Psychology, University of Bedfordshire, Luton LU1 3JU, UK
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Lee S, Van Ha T, Yassan L, Hart J, Ostdiek A, Zhu Y, Yi S, Scott E, Ameer G. 3:45 PM Abstract No. 317 Thermoresponsive Nanonet as a carrier for transarterial immunomodulatory chemoembolization: an experimental study for rabbit liver cancer model. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Chang MC, Souter LH, Kamel-Reid S, Rutherford M, Bedard P, Trudeau M, Hart J, Eisen A. Clinical utility of multigene profiling assays in early-stage breast cancer. ACTA ACUST UNITED AC 2017; 24:e403-e422. [PMID: 29089811 DOI: 10.3747/co.24.3595] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND This clinical practice guideline was developed to determine the level of evidence supporting the clinical utility of commercially available multigene profiling assays and to provide guidance about whether certain breast cancer patient populations in Ontario would benefit from alternative tests in addition to Oncotype dx (Genomic Health, Redwood City, CA, U.S.A.). METHODS A systematic electronic Ovid search of the medline and embase databases sought out systematic reviews and primary literature. A systematic review and practice guideline was written by a working group and was then reviewed and approved by Cancer Care Ontario's Molecular Oncology Advisory Committee. RESULTS Twenty-four studies assessing the clinical utility of Oncotype dx, Prosigna (NanoString Technologies, Seattle, WA, U.S.A.), EndoPredict (Myriad Genetics, Salt Lake City, U.S.A.), and MammaPrint (Agendia, Irvine, CA, U.S.A.) were included in the evidence base. CONCLUSIONS The clinical utility of multigene profiling assays is currently established for an appropriate subset of patients with estrogen receptor-positive, her2-negative, node-negative breast cancer for whom a decision to give chemotherapy is difficult to make. For patients with estrogen receptor-positive tumours who receive tamoxifen alone, Oncotype dx, Prosigna, and EndoPredict validly identify a low-risk population with favourable outcomes, indicating that a low-risk assay result is actionable and the decision to withhold chemotherapy is supported. Clinical evidence indicates that a high Oncotype dx recurrence score can predict for chemotherapy benefit, but a high Prosigna or EndoPredict score, although prognostic, is not, based on clinical trial evidence, directly actionable. Prosigna and EndoPredict are statistically more likely to identify a population at risk for recurrence beyond 5 years, but that information is currently not actionable because of a lack of interventional studies.
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Affiliation(s)
- M C Chang
- Department of Laboratory Medicine and Pathobiology, Mount Sinai Hospital, Toronto
| | - L H Souter
- Juravinski Hospital, Hamilton.,Department of Oncology, McMaster University, Hamilton
| | - S Kamel-Reid
- Department of Pathology, University Health Network, Toronto
| | - M Rutherford
- Department of Molecular Diagnostics, Health Sciences North, Sudbury
| | - P Bedard
- Princess Margaret Cancer Centre, Toronto
| | | | - J Hart
- Cancer Care Ontario, Toronto, ON
| | - A Eisen
- Odette Cancer Centre, Toronto; and
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Foster C, Lee A, Hart J, Alpert L, Furtado L, Xiao S, Liauw S. Long-Term Outcomes and HPV Characteristics for an Institutional Cohort of Patients With Anal Cancer Receiving Concurrent Chemotherapy and Intensity-Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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