Ethical publishing in 'Indigenous' contexts.

Ethical publishing practices are vital to tobacco control research practice, particularly research involving Indigenous (Indigenous peoples: For the purposes of this Special Communication, we use the term Indigenous people(s) to include self-identified individuals and communities who frequently have historical continuity with precolonial/presettler societies; are strongly linked to the land on which they or their societies reside; and often maintain their own distinct language(s), belief and social-political systems, economies and sciences. The authors humbly acknowledge, respect and value that Indigenous peoples are diverse and constitute many nations, cultures and language groups. Many Indigenous peoples also exist as governments in treaty relations with settler-colonial societies, and all Indigenous peoples have inherent rights under international law. The language and terminology used should reflect the local context(s) and could include, but are not limited to, terms such as Aboriginal, Bagumani, Cherokee, First Peoples, First Nations, Inuit, Iwaidja, Kungarakan, Lakota, Maori, Mѐtis, American Indian, Navajo, Wagadagam, Wiradjuri, Yurok, etc) people. These practices can minimise, correct and address biases that tend to privilege Euro-Western perspectives. Ethical publishing practices can minimise and address harms, such as appropriation and misuse of knowledges; strengthen mechanisms of accountability to Indigenous peoples and communities; ensure that tobacco control research is beneficial and meaningful to Indigenous peoples and communities; and support Indigenous agency, sovereignty and self-determination. To ensure ethical practice in tobacco control, the research methodology and methods must incorporate tangible mechanisms to include and engage those Indigenous peoples that the research concerns, affects and impacts.Tobacco Control is currently missing an ethical research and evaluation publishing protocol to help uphold ethical practice. The supporters of this Special Communication call on Tobacco Control to adopt publication practice that explicitly upholds ethical research and evaluation practices, particularly in Indigenous contexts. We encourage researchers, editors, peer reviewers, funding bodies and those publishing in Tobacco Control to reflect on their conduct and decision-making when working, developing and undertaking research and evaluation of relevance to Indigenous peoples.Tobacco Control and other publishers, funding bodies, institutions and research teams have a fundamental role in ensuring that the right peoples are doing the right work in the right way. We call for Tobacco Control to recognise, value and support ethical principles, processes and practices that underpin high-quality, culturally safe and priority-driven research, evaluation and science that will move us to a future that is commercial tobacco and nicotine free.

Engaging participants with research findings: A rights-informed approach.

BACKGROUND: Sharing research findings with participants is recognized as an ethical imperative for the research community. However, most discourse on this topic in mainstream public health takes a paternalistic approach, with researchers retaining the power to choose if, when, and how research findings are shared. METHODS: Fieldwork took place from August 2018 to January 2019 and again from August 2019 to December 2019 among two communities in the south Indian state of Kerala. We integrated participant engagement with study findings into the research protocol, using various collaborative strategies identified during the design stage, forming partnerships with participants and determining appropriate forms of dissemination for different participant groups during fieldwork. RESULTS: Findings from previous research projects undertaken with these communities by other researchers had not been shared with them. This was interpreted by the communities as researchers not being interested in making a difference to their situation. In the current study, building reciprocal relationships that minimized power disparities, and providing outputs in tailored formats that promoted active engagement were key factors that enabled participants to engage with results. This engagement added value by enabling us to co-develop study recommendations. This process also enabled the community to have ownership of the results and use them to advocate for health system change to improve access to health care. CONCLUSION: Research should be transformative for participating communities. Participants have a right to know the results of the research they participate in since their knowledge provides the research data which can in turn promote community change. Operationalising this requires researchers to build partnerships with participants and their communities from the outset. The role of participants must be reimagined, and adequate resources should be built into the research process. This is both socially responsible and ethical, but also improves the impact and legitimacy of research for the participants and the communities that they represent. PATIENT OR PUBLIC CONTRIBUTION: Participants of our research contributed to the design of various aspects of the engagement processes including the venue, the formats used for engagement, interpretation of the findings and recommendations from our research.

Using the Behaviour Change Wheel and modified Delphi method to identify behavioural change techniques for improving adherence to smoking cessation medications.

BACKGROUND: Medication adherence is a crucial component of the pharmacological treatment of smoking. Previous interventions targeted to improve adherence to smoking cessation medications (SCMs) were designed using pragmatic approaches. This study aims to develop a comprehensive intervention strategy to improve adherence to SCMs using the Behaviour Change Wheel (BCW) and a modified Delphi method. METHODS: Recommendations for the design of intervention strategies were based on the BCW guide and six studies conducted by the research team. Factors related to healthcare providers and consumers (person making a quit attempt) that showed associations with adherence were mapped into the Capability, Opportunity, Motivation, Behaviour (COM-B) model, and corresponding intervention functions and policy categories. Interventions were then represented using the Behaviour Change Technique Taxonomy. Finally, a modified Delphi study using 17 experts was conducted to evaluate the nominated strategies using the Acceptability, Practicability, Effectiveness, Affordability, Side-effects, and Equity (APEASE) criteria. RESULTS: Following a stepped approach, an adherence support wheel was designed to guide implementation strategies and programmes. Thirteen intervention strategies were selected. The selected interventions include providing detailed instructions on how to use SCMs; establishing realistic expectations from SCMs; and providing training for healthcare providers regarding comprehensive smoking cessation care with specifics on the provision of adherence support. CONCLUSION: The BCW guide and a modified Delphi were applied successfully to design interventions tailored to improve adherence to SCMs. Improving adherence to SCMs requires a comprehensive intervention approach involving various stakeholders. Future research is needed to assess the effectiveness of the nominated intervention strategies.

"Everything is provided free, but they are still hesitant to access healthcare services": why does the indigenous community in Attapadi, Kerala continue to experience poor access to healthcare?

BACKGROUND: Inequity in access to healthcare services is a constant concern. While advances in healthcare have progressed in the last several decades, thereby significantly improving the prevention and treatment of disease, these benefits have not been shared equally. Excluded communities such as Indigenous communities typically face a lack of access to healthcare services that others do not. This study seeks to understand why the indigenous communities in Attapadi continue to experience poor access to healthcare in spite of both financial protection and adequate coverage of health services. METHODS: Ethnographic fieldwork was carried out among the various stakeholders living in Attapadi. A total of 47 in-depth interviews and 6 focus group discussions were conducted amongst the indigenous community, the healthcare providers and key informants. The data was coded utilising a reflexive and inductive approach leading to the development of the key categories and themes. RESULTS: The health system provided a comprehensive financial protection package in addition to a host of healthcare facilities for the indigenous communities to avail services. In spite of this, they resisted attempts by the health system to improve their access. The failure to provide culturally respectful care, the discrimination of the community at healthcare facilities, the centralisation of the delivery of services as well as the lack of power on the part of the indigenous community to negotiate with the health system for services that were less disruptive for their lives were identified as the barriers to improving healthcare access. The existing power differentials between the community and the health system stakeholders also ensured that meaningful involvement of the community in the local health system did not occur. CONCLUSION: Improving access to health care for indigenous communities would require UHC interventions to be culturally safe, locally relevant and promote active involvement of the community at all stages of the intervention. Continuing structural power imbalances that affect access to resources and prevent meaningful involvement of indigenous communities also need to be addressed.

Family-based childhood obesity interventions in the UK: a systematic review of published studies.

Family-based programmes that emphasise lifestyle and behaviour change using psychological principles have been shown to be effective in targeting childhood obesity. While there is some evidence that evaluates UK family-based obesity interventions at a local level, no review to date has addressed this nationally. This review presents the available evidence from UK family-based childhood obesity interventions. Ten articles that met the inclusion criteria were included for review. The majority of programmes reviewed lasted 12 weeks, with only three studies providing follow-up data at 12 months or longer. Change in adiposity may be a short-term benefit of participation in a child weight management programme, but there is insufficient robust evidence to indicate that this benefit is long lasting and many studies were methodologically weak with limited internal validity. There is insufficient evidence to suggest how the inclusion of parents and the wider family may impact on the effectiveness of UK community based weight management programme for children and young people.

The reach, transferability, and impact of the Evidence-Based Practice Questionnaire: a methodological and narrative literature review.

BACKGROUND: Since the 1990s, evidence-based practice (EBP) has been increasingly emphasized in nursing, but its implementation is still sometimes met with confusion and resistance. Therefore, identifying factors affecting its implementation is crucial. The Evidence-Based Practice Questionnaire (EBPQ) was published in 2006, addressing a need for a robust measure of nurses' practice of, attitudes toward, and knowledge of EBP. The growing body of professionals using the questionnaire means that a review of its reach, transferability, and impact is timely. AIMS: The aims of this review were threefold: (a) identify the situations in which the EBPQ has been used in both published and unpublished research internationally (Reach); (b) collate the psychometric properties of the EBPQ from the research reviewed (Transferability); and (c) discuss the study's findings to shed new light on issues facing professionals in implementing EBP, and possible future directions for research (Impact). METHODS: Literature searches on studies reported between 2006 and July 2012 inclusive were conducted using the terms "Evidence-Based Practice Questionnaire" and "EBPQ." Green, Johnson and Adams's guidelines for completing narrative literature reviews and Terwee et al.'s framework for reporting questionnaires' psychometric properties were adopted to ensure rigor. FINDINGS: Twenty-seven studies were reviewed in which the EBPQ had been translated into five different languages and used with a variety of professional groups. The questionnaire demonstrated convergent and discriminant validity and good internal reliability. Research adopting the questionnaire identified a range of variables related to EBP implementation, including qualification route and job role. LINKING EVIDENCE TO ACTION: Assessment of organizational culture and workforce training needs prior to developing educational interventions is crucial. The EBPQ has the potential to provide further understanding of these and other issues faced by professionals when implementing EBP.

Increasing children's lunchtime consumption of fruit and vegetables: an evaluation of the Food Dudes programme.

OBJECTIVES: Although previous research has shown that the Food Dudes programme increases children's fruit and vegetable consumption at school, there has been limited evaluation of the extent to which changes are maintained in the long term. Furthermore, despite knowledge that the nutritional content of home-supplied meals is lower than that of school-supplied meals, little consideration has been given to the programme's impact on meals provided from home. The present study therefore assessed the long-term effectiveness of the Food Dudes programme for both school- and home-supplied lunches. DESIGN: Two cohorts of children participated, one receiving the Food Dudes intervention and a matched control group who did not receive any intervention. Consumption of fruit and vegetables was assessed pre-intervention, then at 3 and 12 months post-intervention. Consumption was measured across five consecutive days in each school using weighed intake (school-provided meals) and digital photography (home-provided meals). SETTING: Fifteen primary schools, six intervention (n 1282) and seven control schools (n 1151). SUBJECTS: Participants were children aged 4-11 years. RESULTS: A significant increase in the consumption of fruit and vegetables was found at 3 months for children in the intervention schools, but only for those eating school-supplied lunches. However, increases were not maintained at 12 months. CONCLUSIONS: The Food Dudes programme has a limited effect in producing even short-term changes in children's fruit and vegetable consumption at lunchtime. Further development work is required to ensure the short- and long-term effectiveness of interventions promoting fruit and vegetable consumption in children such as the Food Dudes programme.

Experiences of outreach workers in promoting smoking cessation to Bangladeshi and Pakistani men: longitudinal qualitative evaluation.

BACKGROUND: Despite having high smoking rates, there have been few tailored cessation programmes for male Bangladeshi and Pakistani smokers in the UK. We report on a qualitative evaluation of a community-based, outreach worker delivered, intervention that aimed to increase uptake of NHS smoking cessation services and tailor services to meet the needs of Bangladeshi and Pakistani men. METHODS: This was a longitudinal, qualitative study, nested within a phase II cluster randomised controlled trial of a complex intervention. We explored the perspectives and experiences of five outreach workers, two stop smoking service managers and a specialist stop smoking advisor. Data were collected through focus group discussions, weekly diaries, observations of management meetings, shadowing of outreach workers, and one-to-one interviews with outreach workers and their managers. Analysis was undertaken using a modified Framework approach. RESULTS: Outreach workers promoted cessation services by word of mouth on the streets, in health service premises, in local businesses and at a wide range of community events. They emphasised the reasons for cessation, especially health effects, financial implications, and the impact of smoking on the family. Many smokers agreed to be referred to cessation services, but few attended, this in part being explained by concerns about the relative inflexibility of existing service provision. Although outreach workers successfully expanded service reach, they faced the challenges of perceived lack of awareness of the health risks associated with smoking in older smokers and apathy in younger smokers. These were compounded by perceptions of "lip service" being given to their role by community organisations and tensions both amongst the outreach workers and with the wider management team. CONCLUSIONS: Outreach workers expanded reach of the service through taking it to diverse locations of relevance to Pakistani and Bangladeshi communities. The optimum method of outreach to retain and treat Bangladeshi and Pakistani smokers effectively in cessation programmes needs further development.

Development of a parent version of the Manchester-Minneapolis quality of life survey for use by parents and carers of UK children: MMQL-UK (PF).

BACKGROUND: Although it is now widely endorsed that children should as far as possible rate their own health related quality of life (HRQL), there are situations where proxy information on child HRQL may be useful, especially where a child is too ill or young to provide their own HRQL assessment. There is limited availability of generic HRQL scales that have a parallel child and parent version and that are reliable, valid, brief, comprehensible and suitable for use in UK populations. The aims of this study were therefore to develop and validate a parent version of the anglicised Manchester-Minneapolis Quality of Life child form (MMQL-UK (CF)) and to determine the level of association between the child and parent versions of this form. METHODS: This study was undertaken concurrently with the anglicisation and validation of the MMQL, a measure of HRQL developed for use with children in North America. At that time, no parent version existed, so the MMQL form for children (MMQL-UK (CF)) was used as the basis for the development of the MMQL-UK parent form (PF). The sample included a control group of healthy children and their parents and five exemplar groups; children diagnosed with asthma, diabetes or inflammatory bowel disease and their parents, children in remission from cancer and their parents and children in public care and their carers. Consistency of the MMQL-UK (PF) components were assessed by calculating Cronbach's alpha. Validation of the parent questionnaire was undertaken by comparing MMQL-UK (PF) component scores with comparable components on the proxy PedsQLtrade mark quality of life scales, comparing MMQL-UK (PF) component scores between parents of healthy and chronic disease children and by comparison of component scores from children and their parents or carers. Reproducibility and responsiveness were assessed by retesting parents by follow-up questionnaires. RESULTS: A total of 874 children (completing MMQL-UK (CF)) and 572 parents or carers (completing MMQL-UK (PF)) took part in the study. The internal consistency of all the MMQL-UK (PF) components exceeding the accepted criterion of 0.70 and the construct validity was good with moderate correlations being evident between comparable components of the MMQL-UK (PF) and the proxy PedsQLtrade mark. Discriminant validity was demonstrated with significant differences being identified between parents of healthy children and those with chronic conditions. Intra-class correlations exceeded 0.65 for all MMQL-UK (PF) components demonstrating good reproducibility. Weak to moderate levels of responsiveness were demonstrated for all but social functioning. The MMQL-UK (PF) showed moderate parent-child correlation with the MMQL-UK (CF) for all components. The best correlations were seen for those components measuring the same construct (Pearson's r ranged from 0.31 to 0.61, p < 0.01 for equivalent components). CONCLUSION: The MMQL-UK (PF) showed moderate to good correlations with the MMQL-UK (CF) component scores. The MMQL-UK (PF) will be of use when comparing child and parent/carer perception of the impact of a child's condition on their HRQL or where the child is too ill or young to provide their own report.

Vulnerable, single and living in poverty: Women's challenges to accessing food in the Australian Capital Territory.

OBJECTIVE: To explore challenges to food access faced by vulnerable women living in the Australian Capital Territory and surrounds. METHOD: Qualitative study comprising semi-structured interviews supplemented with quantitative demographic data. RESULTS: Forty-one women, mean age of 43 years, living in government and community housing who had an income of <$300 per week participated. A total of 78% of women had completed Year 10 or above and 93% had accessed food from at least one charitable organisation. Women requested greater and reliable access to meat, dairy and quality fruit and vegetables. Primary challenges to accessing food included: limited income, distance to food outlets, lack of nutritious, safe and healthy food, limited knowledge of services and opening hours. CONCLUSION: Access to safe, nutritious and healthy food is difficult for women living in poverty. Acknowledgement of challenges that contribute to women's food insecurity by all stakeholders is essential to address the problem and build sustainable actions and solutions. Implications for public health: Collaboration from all stakeholders within our food system is required to address current inequities to accessing reliable, nutritious and safe food and to reduce individual food insecurity.

Achieving the four dimensions of food security for resettled refugees in Australia: A systematic review.

AIM: Food security is defined by four dimensions: food availability, access, utilisation and stability. Resettled refugees face unique struggles securing these dimensions and, thus, food security when moving to a new country. This systematic review aimed to identify the challenges Australian refugees experience in achieving the four dimensions of food security. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed; the SPIDER tool was used to determine eligibility criteria. Three databases were searched using terms relating to food in/security and refugees from 2000 to 20 May 2017. RESULTS: Seven articles were retained for analysis. Studies were categorised against the four dimensions, with four studies identifying challenges against all dimensions. Challenges contributing to high levels of food insecurity in each dimension included: availability and cost of traditional foods, difficulty in accessing preferred food outlets, limited food knowledge and preparation skills and food stability due to low income and social support. CONCLUSIONS: Food insecurity adversely impacts refugee health and integration. Methodical research framed by the four dimensions of food security is imperative to address challenges to securing food security in refugee groups and assisting in the development of sustainable interventions.

Egyptian and Jordanian nurse educators' perception of barriers preventing the implementation of evidence-based practice: A cross-sectional study.

BACKGROUND: Studies discussing nurse educators' attitudes, knowledge/skills, practicing of evidence-based practice (EBP) and barriers encountered towards implementation is somewhat limited. OBJECTIVE: The study aimed to identify the attitudes, perceived knowledge/skills, and implementation of evidence-based as perceived by nurse educators, in Egyptian and Jordanian universities, and to assess factors preventing them from adopting it in nursing program. DESIGN/SETTING/RESPONDENTS/METHODS: A cross-sectional design was conducted including two groups from Egypt and Jordan. Two questionnaires: (i) The Evidence-Based Practice Questionnaire (EBPQ) and (ii) The Developing Evidence-Based Practice Questionnaire (DEBPQ) and a demographic data sheet were used. Data were analyzed using SPSS version 20 and descriptive and inferential statistics tabulated. RESULTS: Majority of the respondents (85.5%) were females, <40 years old (62.1%), and from medical-surgical nursing departments (49.2%). The mean score of EBPQ was 4.96 ±â€¯standard deviation 0.91. Frequency of practicing EBP and attitudes toward EBP scores were similar between nurse educators in both countries (p > 0.05). However, the Jordanian staff had a remarkably higher perceived knowledge/skills of EBP than their Egyptian counterparts (Mean Rank = 79.98 & 57.63 respectively, at p = 0.004). There was a statistically significant positive, moderate correlation between attitudes, knowledge/skills and frequency of practicing EBP among nurse educators in both countries. The highest correlation observed for attitudes and frequency of practicing EBP was among Jordanian staff (r = 0.707, p < 0.000). Egyptian nurse educators had significantly higher perceived barriers to finding and reviewing evidence than their Jordanian counterparts (p = 0.000). However, both groups had similar perceived barriers related to changing practice and support from colleagues. CONCLUSIONS: Egyptian and Jordanian nurse educators, equally, hold positive attitudes toward adopting EBP. However, they encounter many barriers to implement it.

To embed or not to embed? A longitudinal study exploring the impact of curriculum design on the evidence-based practice profiles of UK pre-registration nursing students.

BACKGROUND: The use of Evidence-Based Practice (EBP) is increasingly emphasized within healthcare. However, little research has focused on nurses' pre-registration training; particularly regarding the impact of curriculum-design on learning EBP. OBJECTIVES: This study compared the impact of embedding EBP throughout the curriculum, with modular-based teaching, on pre-registration nursing students' EBP profiles. DESIGN: A longitudinal panel study. SETTINGS AND PARTICIPANTS: A convenience sample of fifty-six pre-registration nursing students (55.4% studying an embedded EBP-curriculum and 44.6% studying a modular EBP-curriculum), were recruited from a UK University between 2011 and 2014. METHODS: Participants completed the Student Evidence-Based Practice Questionnaire (S-EBPQ) in the first, second and third year of their course. This questionnaire measures four EBP domains: frequency of use, attitude, knowledge and skills in retrieving and reviewing evidence, and knowledge and skills in applying and sharing evidence. RESULTS: Two-way mixed between-within Analyses of Variance revealed significant improvements across all domains, except attitude (which remained broadly positive across all years), for both curriculum-groups. No significant differences in this improvement were identified between the two curricula overall. However, the direction and rate of change of scores on the retrieving and applying subscales (but not frequency of use) for the two groups differed across time; specifically those on the embedded curriculum showed a dip in scores on these subscales in year 2. This appeared to be related to associated features of the course such as the timing of placements and delivery of theory. CONCLUSIONS: Taking a modular or embedded approach to EBP may have little impact on students' final EBP profiles. However, careful consideration should be given to the timing of related course features which may play a key role in students' perceptions of their knowledge and skills in its application. Further research should explore how curriculum-design might build on students' initial positive attitudes towards EBP and its use in their practice.

Knowledge and use of evidence-based practice of GPs and hospital doctors.

RATIONALE, AIMS AND OBJECTIVES: Clinical effectiveness and evidence-based practice (EBP) are the cornerstone of modern day health care. Although many studies have explored attitudes and perceived knowledge of individual professions few have compared the factors between professional groups and in particular in the medical profession. We report a study comparing the views, knowledge and practice of hospital doctors with their general practitioner (GP) counterparts in terms of EBP and clinical effectiveness. In this way it was hoped to highlight not only any differences between these groups but also the needs of these groups and suggest some ways of fulfilling these. METHODS: A postal questionnaire survey was completed by a random sample of 500 GPs and 500 hospital medics. RESULTS: There was a significant difference between the groups with the GPs rating their skill level as lower that their medical doctor counterparts. Similarly, GPs reported using EBP steps less frequently than hospital doctors. Barriers to implementing EBP differed between the groups with GPs reporting difficulty with accessing a library and making time available. CONCLUSION: A number of differences between GPs and their hospital counterparts were recorded which highlights the difference in educational and policy approach required for greater uptake of EBP.

Knowledge and use of evidence-based practice by allied health and health science professionals in the United Kingdom.

Clinical effectiveness (CE) and evidence-based practice (EBP) are the cornerstone of modern-day health care. Although many studies have explored attitudes and perceived knowledge of individual professions, few have compared these factors between professional groups, especially in the allied health professions (AHP) and health science services (HSS). We report a study comparing the knowledge and practice of 14 different professional groups from the AHP and HSS in terms of EBP and CE. The aim was to highlight any differences between the 14 professional groups along with the needs of the groups. A postal questionnaire survey was completed by a random sample of 1,000 members of AHP and HSS across the United Kingdom. There were significant differences between professional groups with, in general, professionals from the HSS groups rating their knowledge and application of CE and EBP as lower than members of the AHP. Differences were also noted between individual professional groups. For example, podiatrists, radiographers, and orthoptists reported having less knowledge of CE and EBP than physiotherapists, occupational therapists, dietitians, speech and language therapists, and psychologists. Barriers to implementing EBP were similar for all groups, with lack of both time and money cited as the main issues. A number of differences between professions were recorded that highlight the difference in educational and policy approach required for greater uptake of EBP.

Supporting completion of an online continuing professional development programme for newly qualified practitioners: A qualitative evaluation.

BACKGROUND: Development programmes to support newly qualified practitioners gain confidence in their first professional role often show varied levels of engagement, due to competing priorities and demands. In Scotland, the Flying Start NHS® programme uses a structured programme of online and work-based learning with associated mentoring, to support individuals through an often difficult transition to become capable, confident practitioners. Whilst the programme was generally well received, the factors leading to widely varying completion rates between professions and organisations were not well understood. AIM: The aim of this study was to identify the factors leading to successful completion of Flying Start, a transition programme for newly qualified practitioners. METHOD: A qualitative approach was adopted to gather data from two groups of participants. Semi-structured telephone interviews were conducted with strategic and management level participants (n=23), from five health boards in Scotland. Semi-structured interviews (n=22) and focus groups (n=11) were conducted with practitioners within 6months either side of completing the programme. The interviews were transcribed and analysed using framework analysis. RESULTS: Three key themes relating to successful completion emerged from the analysis: Management and Delivery; Content and Material; Participation and Completion. Factors leading to successful completion were identified at programme, organisational and individual levels. These included clear communication and signposting, up-to-date and relevant content, links with continuing professional development frameworks, effective leadership, mentor and peer support, setting clear standards for assessment, and facilitating appropriate IT access. CONCLUSIONS: A strong strategic commitment to embedding a development programme for newly qualified practitioners can ensure that the necessary support is available to encourage timely completion. The mentor's role - to provide face-to-face support - is identified as a key factor in completion and is achieved through setting attainable targets, monitoring progress, and providing motivation. However organisational structures that facilitate the mentoring relationship are also necessary.

Development of the Student Evidence-based Practice Questionnaire (S-EBPQ).

BACKGROUND: The assessment of learning and teaching of Evidence-based Practice (EBP) in nursing is an important issue, yet few tools have been developed specifically for use with student nurses. Therefore, the Evidence-based Practice Questionnaire (EBPQ), which has been successfully used to measure EBP in nurses and nurse educators, was revised to develop a Student version (S-EBPQ). OBJECTIVE: The purpose of the study was to develop a student version of the Evidence-based Practice Questionnaire (EBPQ) and test its psychometric properties with a UK undergraduate student population. DESIGN: Instrument development study. PARTICIPANTS AND METHOD: Two hundred and forty-four undergraduate nursing students from an English University were recruited over a three year period to complete the EBPQ. This data was submitted to reliability analysis based on Item Response Theory and Exploratory Factor Analysis to explore construct validity. RESULTS: Principal Component Analysis demonstrated evidence for the S-EBPQ's construct validity, and analyses comparing the subscale scores of students in their first and second years of studies identified evidence for the tool's convergent validity. Descriptive statistics, correlation coefficients and reliability estimates demonstrated evidence for the S-EBPQ's internal reliability, and item facility and discrimination. CONCLUSION: The S-EBPQ appears to be a psychometrically robust measure of EBP use, attitudes, and knowledge and skills (regarding the retrieval and evaluation of evidence, and the application and sharing of EBP). It may therefore provide an effective means of evaluating learning of EBP with undergraduate nursing students.

Measurement properties of the UK-English version of the Pediatric Quality of Life Inventory 4.0 (PedsQL) generic core scales.

BACKGROUND: Health related quality of life (HRQL) has been recognised as an important paediatric outcome measurement. One of the more promising measures to emerge in recent years is the Pediatric Quality Of Life Inventory (PedsQL), developed in the US. Advantages of the PedsQL include brevity, availability of age appropriate versions and parallel forms for child and parent. This study developed a UK-English version of PedsQL generic module and assessed its performance in a group of UK children and their parents. METHODS: PedsQL was translated to UK-English. The psychometric properties of the UK version were then tested following administration to 1399 children and 970 of their parents. The sample included healthy children, children diagnosed with asthma, diabetes or inflammatory bowel disease and children in remission from cancer. RESULTS: Psychometric properties were similar to those reported for the original PedsQL. Internal reliability exceeded 0.70 for all proxy and self-report sub-scales. Discriminant validity was established for proxy and self-report with higher HRQL being reported for healthy children than those with health problems. Sex differences were noted on the emotional functioning subscale, with females reporting lower HRQL than males. Proxy and self-report correlation was higher for children with health problems than for healthy children. CONCLUSION: The UK-English version of PedsQL performed as well as the original PedsQL and is recommended for assessment of paediatric HRQL in the UK.