Medical Students' Readiness for Prescription Communication Skills Training: A Needs Assessment Study.

Background and objectives The quality of doctor-patient communication plays a crucial role in determining positive medical outcomes. Medical educators may be able to develop effective programs to orient the students toward learning communication skills with the aid of assessment of the attitude of medical students toward such learning. Recently, the National Medical Commission's updated syllabus strongly emphasized on the value of training in prescription communication skills (PCS), in pharmacology. Our study utilizes the Communication Skills Attitude Scale (CSAS) to explore medical students' attitudes toward learning PCS in a private medical college, aiming to address the dearth of data in the Indian context. Methodology This cross-sectional study assessed the attitudes of 131 second-year medical students at Adichunchanagiri Institute of Medical Sciences toward PCS training. Validated, 26-item CSAS was used to measure their attitudes which include 13 items of Positive Attitude Scale (PAS) and 13 items of Negative Attitude Scale (NAS), and data analysis was conducted using independent t-tests to explore potential associations based on socio-demographic factors. Results The study scale showed an acceptable internal consistency of 0.71 (Cronbach's alpha) with 0.92 and 0.76 for PAS and NAS, respectively. The overall mean PAS score and NAS score were 54.2±6.9 and 34.7±6.3, respectively, indicating that the majority of students recognized the significance of communication skills for their future medical practice. Male students had significantly lower PAS scores (52.1±7.4) compared to female students (55±6.6) (p=0.02). Students with a rural background had significantly higher PAS scores (56.2±6.1) (p=0.01) compared to those with an urban background (53.2±9.8). No significant association was seen with demographic parameters like schooling background, presence of doctors in the family, and mother tongue they spoke. Conclusion The study revealed that second-year medical students had a strong inclination toward learning PCS. Therefore, greater emphasis should be placed on providing adequate training in PCS to the students to ensure effective doctor-patient interactions.

Cross-cultural adaptation and validation of the 2021 Louisiana Needs Assessment Questionnaire for Arabic-speaking people living with HIV.

BACKGROUND: Despite the global decline in HIV infections and mortality worldwide, the HIV epidemic is still growing in the MENA region. In the region, People Living with HIV (PLWH) are facing many challenges related to cultural values, norms, and provided services which create significant obstacles to HIV prevention and control efforts. This study aimed to translate, culturally adapt, and validate the "2021 Louisiana Needs Assessment Questionnaire" for use among Egyptians and Arabic-speaking population. METHODS: Arabic translation and cultural adaptation of the questionnaire passed through five stages. The questionnaire was translated forward and backward then an expert committee reviewed the translated version. Another expert committee reviewed the developed version after modification to assess the content validity using the Content Validity Index (CVI). The last step included a cognitive interview of a convenient sample of 50 adult PLWH in five consecutive rounds to assess subjects' understanding of questions and response items and their meanings. RESULTS: Modifications were carried out all through the translation and adaptation process of the questionnaire including used words, nomenclature of services, adding or omitting response items, and ordering of questions and response items. The synthesized Arabic-adapted questionnaire has adequate content validity and all questions are clearly understood by the studied subjects. The calculated Content Validity Index of all questionnaire items ranged from 0.82 to 1. CONCLUSION: The developed culturally adapted questionnaire has adequate content validity/semantic appropriateness. It can be used to assess the needs of PLWH in the MENA region with minor adaptations to fit each country. It can also be used to follow the outcome and impact of implemented programs and services. Further research is recommended to assess its psychometric properties.

Understanding non-pharmacological palliative care for people with serious COPD: the individual and organizational perspective.

TOPIC IMPORTANCE: This narrative review emphasizes the growing interest in palliative care for people with serious lung diseases, such as COPD. It reflects upon recent publications from the American Thoracic Society (ATS), the World Health Organization (WHO) and European Respiratory Society (ERS) with a focus on non-pharmacological palliative care for people with COPD, from both the healthcare professional and the organizational perspective. REVIEW FINDINGS: The concept of palliative care has changed over time and is now seen as applicable throughout the whole disease trajectory according to need, in conjunction with any disease-modifying therapies. Palliative care should pay attention to the needs of the person with COPD as well as the informal caregiver. Timely integration of palliative care with disease-modifying treatment requires assessment of needs at the individual level as well as organizational changes. High-quality communication, including advance care planning is a cornerstone of palliative care. SUMMARY: Therefore, services should be based on the understanding that palliative care is not just specific standardized actions and treatments, but a holistic approach that includes compassionate communication and treatment and care addressing the patient, informal and formal caregivers. Living with and dying from COPD is much more than objective measurements. It is the sum of relationships with others and the experience of living in the best possible harmony with one's own values and hopes despite having a serious illness.

Testing and refining an approach to identifying health and social care needs in probation.

We piloted an approach to identifying the health and social care needs of people on probation using a survey consisting of validated screening tools and key additional questions. We share findings from our analysis of the sample data, showing that there is a high complexity of needs in this population, with 65.4% of participants reporting at least one unmet need. We also explore the acceptability of this approach to identifying needs being used in routine probation practice and make recommendations about how identification and recording of needs could be approached and further researched in the future.

Development of an evaluation list for older adult community-based rehabilitation needs through a Delphi method.

Older adults' functional and intrinsic abilities may decline with increasing age. The positive effects of comprehensive community-based rehabilitation services to maintain physical, mental, and social function are essential. Nevertheless, few tools are available to assess the community-based rehabilitation needs of older adults. Therefore, we aimed to construct a list for the comprehensive evaluation of community-based rehabilitation needs of older adults. The International Classification of Functioning, Disability, and Health (ICF) was used to construct a first draft of the assessment list. From September to November 2023, 18 experts from five provinces and nine tertiary hospitals and institutions of higher education in China participated in this Delphi study. The older adult community-based rehabilitation needs evaluation list included six dimensions and 29 items. The weights of the six dimensions, from high to low, included mental function rehabilitation need (0.30), body function rehabilitation need (0.24), social participation need (0.18), individual activity rehabilitation need (0.14), environmental rehabilitation need (0.09) and rehabilitation information need (0.05). Using the Delphi method, an assessment list of older adult community-based rehabilitation needs based on ICF was developed. Future work should evaluate the list's reliability and validity and its application in managing community-based rehabilitation for older adults.

Internal Medicine Residents' Confidence and Preferences in Hospital Medicine Competencies: A Multi-Site Study.

BACKGROUND: Hospital medicine (HM) is an important career option for internal medicine (IM) residency graduates. Limited data exist regarding preferences and educational gaps in HM competencies among IM residents. OBJECTIVE: To assess resident confidence and desire for additional instruction in HM competencies across a broad spectrum of residents. DESIGN: A multi-center survey-based assessment of IM resident confidence and desire for additional instruction in published HM competencies. PARTICIPANTS: PGY-1 through PGY-4 residents from eight US IM residency programs, including academic medical center (AMC) and community-based programs (CBPs). MAIN MEASURES: Resident confidence and desire for more teaching in HM competency domains including procedures, point-of-care ultrasound (POCUS), system-level competencies, clinical skills, patient-level competencies, palliative care, and care transitions. KEY RESULTS: We received survey responses from 272 of 594 (46%) residents. More than half of respondents envisioned a future HM position. Results demonstrated lower than expected confidence for all HM competencies surveyed. Confidence was lowest (30-36% confident) for procedures, POCUS, and system-level competencies, and highest (65-78%) in care transitions, patient-level competencies, and palliative care. Desire for more instruction was highest in the same competency domains rated with the lowest confidence. Junior residents (PGY-1 and PGY-2) reported significantly lower confidence levels than senior residents (PGY-3 and PGY-4) across all domains except patient-level competencies. Junior residents expressed a significantly higher desire than senior residents for more teaching in all domains. There were no significant differences in confidence or desire for more instruction between trainees who envision a future HM position versus those who do not. Residents from AMCs expressed significantly higher confidence than those from CBPs in POCUS, clinical skill, patient-level, palliative care, and care transitions, while residents from CBPs reported significantly higher confidence in procedures. CONCLUSIONS: Our data can inform targeted inpatient competencies and educational curricula for IM residents in the USA.

Addressing Hispanic Veterans that Live in Rural Area's Needs to Improve Suicide Prevention Efforts.

Despite the alarming recent increase in suicide rates among Hispanic Veterans, suicide among this population remains relatively understudied and little is known about their needs and how to prevent suicide in this population. A mixed methods approach was utilized to conduct a needs assessment of community suicide prevention services and resources available to Hispanic Veterans living in rural areas in the Veterans Health Administration's Veterans Integrated Services Network (VISN) 8. Five themes related to the suicide prevention's needs and gaps in services were identified: (1) lack of adequate information; (2) disruptions in social support network; (3) limited or lack of access to services; (4) risky behaviors; and (5) natural disasters. Understanding the unique needs of Hispanic Veterans in rural communities and the gaps in services in these areas can help in the development of tailored suicide prevention efforts and potentially mitigate suicide disparities.

A Community-Informed Maternal and Infant Health Needs Assessment in Alabama.

BACKGROUND: Maternal mortality is a global clinical and public health crisis. Researchers and leading organizations have highlighted the need for local partnerships to implement evidence-based strategies to mitigate poor outcomes. Alabama has the third highest maternal mortality rate in the nation. Research on the complexity of maternity mortality is strengthening, but poor outcomes in Alabama persist and there is limited data highlighting the perspectives of those on the frontlines of providing and receiving care. PURPOSE: We conducted a qualitative, statewide, community-informed, maternal and infant health research assessment with physicians, providers, professionals, and birthing persons to identify challenges and solutions to addressing the states' poor perinatal health outcomes.   METHODS: Data were collected using a four-phase, research design that included semi-structured interviews, focus groups, one state-wide data sharing event, and five regional data sharing events. Data were collected between January 2020 and October 2021. The data were analyzed using consensus coding and thematic analysis. MAIN FINDINGS: Fifty-nine (N = 59) individuals participated. Three themes emerged: 1) "They were making me feel so overlooked.": A disconnect between perinatal healthcare services and patient needs; 2) "That shouldn't be something you have to ask for": Limitations to providing respectful perinatal healthcare; and 3) "If they work together, they can have all the tools they need.": Building a case for collaborative care. CONCLUSIONS: Participants advocated for a collaborative perinatal healthcare model that focuses on the provision of respectful, quality perinatal healthcare. Our approach can be applied across contexts and used to support the effective implementation contextually relevant maternity care practices.

Food Safety Research and Extension Needs for the U.S. Low-Moisture Food Industry.

Historically, low-moisture foods were considered to have minimal microbial risks. However, they have been linked to many high-profile multistate outbreaks and recalls in recent years, drawing research and extension attention to low-moisture food safety. Limited studies have assessed the food safety research and extension needs for the low-moisture food industry. The objectives of this needs assessment were to explore the food safety culture and education needs, identify the food safety challenges and data gaps, and understand the barriers to adopting food-safety-enhancing technologies in the U.S. low-moisture food industry. This needs assessment was composed of two studies. In Study 1, food safety experts from the low-moisture food industry upper management participated in online interviews and a debriefing discussion session. In Study 2, an online anonymous survey was disseminated to a different group of experts with experience in the low-moisture food industry. The qualitative data were analyzed using deductive and inductive coding approaches, while the quantitative data were analyzed via descriptive analysis. Twenty-five experts participated in the studies (Study 1: n = 12; Study 2: n = 13). Common commodities that participants had worked with included nuts and seeds, spices, flour, and dried fruits and vegetables. A food safety culture conceptual framework was adapted, which included three main components: infrastructure conditions (foundation), individual's food safety knowledge, attitudes, and risk perceptions; and organizational conditions (supporting pillars). Major barriers to establishing a positive food safety culture were identified to be limited resources, difficulties in risk communication, and difficulties in behavioral change. For continual improvement in food safety performance, two major themes of food safety challenges and data gaps were identified: cleaning, sanitation, and hygienic design; and pathogen reduction. Participants perceived the main barriers discouraging the low-moisture food industry from adopting food-safety-enhancing technologies were: (1) budgetary priorities, (2) operation constraints, (3) technology validation, (4) consumer acceptance, and (5) maintaining desired product characteristics such as quality and sensory functionality. The findings of this needs assessment provide guidance for the food industry, academia, and government agencies about the direction of future research and the development of targeted extension programs that might help improve food safety in the low-moisture food industry.

Assessment of laparoscopic surgery practice, knowledge, and training goals in Liberia: A mixed-methods study among Liberian surgeons.

BACKGROUND: Laparoscopy training remains inaccessible in many low- and middle-income countries, including Liberia. We assessed the availability of laparoscopy and feasibility of implementing a laparoscopic program among Liberian surgeons and trainees. METHODS: This mixed-methods study utilized a 32-item survey and semi-structured interviews on laparoscopic experience, knowledge, desires, barriers, patient perceptions, and training opportunities among surgeons and trainees at Liberia's two main teaching hospitals in March 2023. Data analysis utilized summed knowledge and desirability scores, descriptive statistics, and qualitative content analysis. RESULTS: 31 interns, residents, and consultants participated, comprising 60% of Liberia's surgeons. Laparoscopic training (32%) and experience (16%) was low, with exposure limited to those training outside Liberia (p = 0.001). While laparoscopy knowledge varied (29% low, 55% medium, 16% high), participants expressed high interest in training (100%) and willingness to pay (52%). Interviews revealed four themes: desires for training, patient acceptability, feasibility of technology-based training, and barriers including limited equipment and expert trainers. At the time of survey, the only minimally invasive surgeries ever performed in Liberia were two diagnostic laparoscopies. CONCLUSIONS: This is the first mixed-methods study assessing laparoscopy in Liberia. Our sample, though small, comprised approximately 60% of Liberian surgeons in both rural and urban hospitals. Findings demonstrated limited experience, variable knowledge, and high desires for training, showing feasibility for laparoscopy implementation in Liberia.

The Importance of Capacity-Building in Watershed Groups: Lessons from the Hudson River Watershed, USA.

Municipalities face challenges meeting environmental protection and conservation goals due to a lack of resources, capacity, and political will. As a result, grassroots environmental organizations often emerge to help meet these challenges by filling gaps in governmental operation and structure. At the watershed scale, environmental organizations and groups are critical for effective watershed governance, often helping with collaboration as well as providing municipalities with additional support and resources. Despite the vital role environmental organizations and groups can play, they continue to face challenges such as insufficient resources, inconsistent leadership, and lack of organizational structure, thus limiting the contributions they can deliver. In this manuscript, we present case study research on watershed groups exploring their capacity to meet their mission and goals. Drawing from a needs assessment study conducted in the Hudson River watershed in 2019-2021, we found that while watershed groups are generally in need of technical resources, participation, and funding, our research suggests capacity (such as internal structure, strategic planning, and leadership) is most important for successful and sustainable groups. Therefore, we argue that support for capacity is more likely to help sustain groups and their long-term beneficial impact. To make this argument we present qualitative interview and focus group data to articulate watershed group goals, challenges, and needs, with an emphasis on capacity-related themes that emerged around expertise, leadership, structure, and planning. We then conclude with recommendations that can be applied to other watershed groups in the United States, and likely beyond.

Modeling a needs assessment approach for policymakers to investigate, understand, and reduce gun violence.

We conducted a needs assessment evaluation as part of a community effort to plan tailored responses to reduce gun violence in a midwestern town. Various data sources were used to analyze factors leading to gun violence. The results guided the creation of evidence-based response strategies. Study findings demonstrate that even in a small town, the nature and drivers of gun violence vary considerably at the micro level and thus should be examined at this level. In this paper, we present the recommendations that followed from our study, not as solutions for other jurisdictions to adopt on their face, but rather as an example of 1) the types of solutions that follow from a thorough analysis of a local problem, and 2) a plethora of potential responses by social institutions. The goal of the paper is to provide an example process for policymakers from jurisdictions of various sizes and locales of the application of a problem-oriented approach to understanding and preventing gun violence. Undertaking a comprehensive, micro-focus to analyze the gun violence problem and its drivers in a jurisdiction provides essential information to guide the formulation of tailored, evidence-based responses.

Evaluation of the integration of palliative care in a fragile setting amongst host and refugee communities: Using consecutive rapid participatory appraisals.

BACKGROUND: Palliative care is seldom integrated in healthcare in fragile, conflict affected and vulnerable settings with significant refugee populations. AIM: This study aimed to evaluate the integration of palliative care into a fragile, conflict affected and vulnerable community in Northern Uganda. DESIGN: Consecutive Rapid Participatory Appraisals were conducted to evaluate the integration of palliative care in Adjumani District. The first established a baseline and the second, 4 years later, evaluated progress. Data collection included documentary review, key informant interviews and direct observation. SETTING/PARTICIPANTS: A rural district in Uganda with equal numbers of refugees and host populations living side-by-side. 104 key informants were interviewed, and practice observed in 11 health facilities. RESULTS: At baseline, palliative care was not routinely integrated in the health system. Barriers included health system challenges, cultural beliefs, understanding and trust, mental health issues, gaps in palliative care provision, the role of the community and beliefs about illness impacted care with the village health teams being a trusted part of the health system. Following integration activities including training, mentorship and community sensitisation, the repeat rapid appraisal after 4 years showed a significant increase in palliative care delivery. New themes identified included increased provision of palliative care, the impact of training and community engagement and ownership of palliative care. CONCLUSION: Community engagement and participation, training interventions and referral pathways enabled the integration of palliative care. Rapid Participatory Appraisal provides a useful framework to evaluate activities aimed at integration of palliative care in a community.

Identifying the Health Educational Needs of Refugees: Empirical Evidence from a Delphi Study.

Refugees experience poorer health outcomes especially which can be exacerbated by or can be a result of low health literacy of refugee populations. To address poor health outcomes, health literacy, and health usage in refugee populations, it is essential to develop health educational interventions for refugees' healthcare integration. To do so, learning objectives must be identified based on refugees' health knowledge gaps. Therefore, the overall aim of this study is to identify these knowledge gaps. A modified Delphi method was employed for this study with three rounds of survey: the first to identify learning objectives, the second to prioritise learning objectives, and the third to categorise the learning objectives as not recommended, partially recommended, or highly recommended. An overarching theme of utilising the healthcare system and its various services effectively and efficiently was recognised to be an important learning objective for educational interventions to address refugees' health integration. Overall, learning objectives within the theme self-care and preventative health were ranked as most important.

Reliability of ChatGPT in automated essay scoring for dental undergraduate examinations.

BACKGROUND: This study aimed to answer the research question: How reliable is ChatGPT in automated essay scoring (AES) for oral and maxillofacial surgery (OMS) examinations for dental undergraduate students compared to human assessors? METHODS: Sixty-nine undergraduate dental students participated in a closed-book examination comprising two essays at the National University of Singapore. Using pre-created assessment rubrics, three assessors independently performed manual essay scoring, while one separate assessor performed AES using ChatGPT (GPT-4). Data analyses were performed using the intraclass correlation coefficient and Cronbach's α to evaluate the reliability and inter-rater agreement of the test scores among all assessors. The mean scores of manual versus automated scoring were evaluated for similarity and correlations. RESULTS: A strong correlation was observed for Question 1 (r = 0.752-0.848, p < 0.001) and a moderate correlation was observed between AES and all manual scorers for Question 2 (r = 0.527-0.571, p < 0.001). Intraclass correlation coefficients of 0.794-0.858 indicated excellent inter-rater agreement, and Cronbach's α of 0.881-0.932 indicated high reliability. For Question 1, the mean AES scores were similar to those for manual scoring (p > 0.05), and there was a strong correlation between AES and manual scores (r = 0.829, p < 0.001). For Question 2, AES scores were significantly lower than manual scores (p < 0.001), and there was a moderate correlation between AES and manual scores (r = 0.599, p < 0.001). CONCLUSION: This study shows the potential of ChatGPT for essay marking. However, an appropriate rubric design is essential for optimal reliability. With further validation, the ChatGPT has the potential to aid students in self-assessment or large-scale marking automated processes.

Prevalence and correlates of depression, anxiety, and stress among adolescents in urban and rural areas of Mysuru, South India.

Background: Adolescence, a volatile period of growth between the ages of 10 and 19, is associated with increased vulnerability to mental health problems. Factors such as academic pressure can contribute to these challenges. Objectives: The current study aimed to evaluate the factors and prevalence of depression, anxiety, and stress among adolescents in the urban and rural areas of Mysuru district. Materials and Methods: A cross-sectional study was conducted in private high schools in both urban and rural regions. Prior permission and informed consent were obtained from participants and their legal guardians aged 18 years and older. Results: The gender distribution in urban areas was 60.2% female and 39.8% male, while in rural areas, it was 51% male and 49% female. The prevalence of depression was higher in rural (39.3%) than in urban areas (24.2%), while anxiety was more prevalent in urban (50.6%) than in rural areas (49%). Stress was also more common in rural (16.6%) than urban adolescents (14.6%). Factors significantly associated with mental health outcomes included monthly family income, parenting practices, academic pressures, and self-esteem. Key needs identified were mobile mental health applications, online counseling services, and access to school counselors. Conclusion: This study provides insights into the prevalence and correlates of common mental health issues among adolescents in this region of South India. The findings emphasize the necessity of providing mobile applications and offline counseling services to effectively support and meet the needs of adolescents in these settings.

A needs assessment for formal emergency medicine curriculum and training in Zambia.

Emergency medicine (EM) is a nascent field in Zambia. While not yet recognized as a medical specialty, there is national interest for developing more robust emergency care systems in this setting. One key element of strengthening EM in Zambia is identifying current gaps in emergency healthcare provision and opportunities for advancement in the field. This research used a modified version of the Emergency Care Assessment Tool to characterize the landscape of EM in Zambia. We collected data on the extent of EM training and teaching engagement among physicians practicing EM in Zambia. The survey assessed three aspects of core EM "signal functions" among the respondents which included; how often they performed the function, how confident they felt with the function, and how important they deemed the function to be in their practice. Finally, we asked respondents to identify barriers to performing the functions in their departments. The majority of respondents were early in their career, all below the age of 50, and participated in some form of teaching and supervision of learners, with minimal access to teaching resources to enhance their work. There was unanimous agreement with the need for formal postgraduate EM training in Zambia. The EM functions performed least often by EM physicians, and in which they felt the least confident, were high-acuity low-occurrence (HALO) procedures such as surgical airway and pericardiocentesis. The most common barrier to performing an EM function was access to supplies, equipment and medication. The second most commonly cited barrier was healthcare worker training. This research identified several critical needs for EM curricula in Zambia, specifically teaching resources for clinicians who supervise learners, directed learning on HALO procedures, and formal postgraduate training in EM based in Zambia.

Multilevel barriers to guideline implementation: a nationwide multi-professional cross-sectional study within child and adolescent psychiatry.

BACKGROUND: Despite efforts to promote guideline use, guideline adoption is often suboptimal due to failure to identify and address relevant barriers. Barriers vary not only between guidelines but also between settings, intended users, and targeted patients. Multi-professional guidelines are often used in child and adolescent mental health services (CAMHS), making the implementation process more difficult. Despite this, there is a lack of knowledge about which barriers to consider or if barriers vary by profession. The aim of this study was to address these gaps by examining barriers to adopting a multi-professional depression guideline in the context of a nationwide implementation study. METHODS: 440 CAMHS clinicians across Sweden (52%) completed the Barriers and Facilitators Assessment Instrument (BFAI) ahead of an implementation endeavour. BFAI is a widely used and validated measure of guideline implementation on four scales: Innovation, Provider, Context, and Patient. Barriers were calculated at scale and at item levels. ANOVA and chi-square tests were used to analyse differences by profession and effect sizes were calculated. RESULTS: Overall, clinicians were optimistic about guideline uptake, particularly about guideline characteristics and their own adoption ability. Barriers were related to the patient and the context domains, as well as to individual clinician knowledge and training. Perceptions differed across professions; psychiatrists were most, and counsellors were least positive about guideline embeddedness. CONCLUSION: This large-scale quantitative study suggests that CAMHS clinicians have an overall favourable attitude towards guideline adoption but highlights the need for adaptations to certain patient groups. Strategies to improve guideline use should primarily address these patient issues while securing proper support to the implementation. Implementation efforts, particularly those targeting staff knowledge, training, and involvement, may benefit from being tailored to different professional needs. These findings may inform implementation projects in CAMHS and future research.

Development and Psychometric Verification of a Self-Administered Scale for Family Needs in Japanese Critical Care Settings.

AIM: We developed and evaluated the statistical reliability and validity of a family needs scale directly answerable by families in critical care settings. METHODS: In this qualitative study, 39 questions were drafted to capture family needs. These questions were then administered to the families of patients in emergency care settings. Exploratory factor analyses identified several needs factors and factor structures of the questions with oblique rotation. A confirmatory factor analysis examined internal consistency and criterion-related and construct validity. RESULTS: Three factors comprising 32 items were extracted from the exploratory factor analysis: "Needs for fulfilling family roles," "Needs for appropriate treatment and care," and "Needs for respecting family ties." Cronbach's α was 0.949 for the total score and 0.927, 0.914, and 0.896 for factors A-C, respectively, with cumulative variance of 50.0%. The three factors' confirmatory factor analysis revealed a relatively good model fit. A significant correlation was found between this scale and the assessment scale for the needs of families of patients in the intensive care unit. CONCLUSIONS: A new scale assessing family needs was developed, and its reliability and validity were confirmed. The scale has acceptable psychometric properties and can be used to measure family needs in critical care settings, particularly in Japanese cultural contexts.

Assessing the Strengths and Weaknesses for Implementing a Place-Based Model of Care for Older People on the Central Coast, Australia: Results of a Pilot Project Using the Population Health Management Maturity Index (PHM-MI) Tool.

Introduction: Population health management is increasingly being used to support place-based models of care. This case study provides an account of the use of the Population Health Management - Maturity Index (PHM-MI) tool to inform the future development of a neighbourhood model of care for older people in the Central Coast region of Australia. Description: The PHM-MI tool comprises a set of six evidence-informed elements known to be important in enabling PHM in practice. As part of a joint strategic needs assessment, 17 selected stakeholders from key regional organizations were invited to undertake the PHM-MI tool survey. Three follow-up workshops were held to interpret the results and determine priority actions. Discussion: The PHM-MI scores revealed that the overall maturity of the Central Coast to successfully deliver PHM was low across all six elements, findings that were corroborated through participant workshops. Systemic fragmentations, most pertinently of funding and regulation, incentivised silo-based working. The need to formalise and strengthen regional collaborations, enable data integration, find creative ways to use existing funding streams, and promote community engagement were highlighted as core priorities. Conclusion: Using the PHM-MI tool was enabled by it being embedded within a pre-existing regional strategic process. The results were used to inform future regional priorities. The PHM-MI tool has the potential for use across regional or national contexts.