What is known about the role of external facilitators during the implementation of complex interventions in healthcare settings? A scoping review.

OBJECTIVE: To synthesise current knowledge about the role of external facilitators as an individual role during the implementation of complex interventions in healthcare settings. DESIGN: A scoping review was conducted. We reviewed original studies (between 2000 and 2023) about implementing an evidence-based complex intervention in a healthcare setting using external facilitators to support the implementation process. An information specialist used the following databases for the search strategy: MEDLINE, CINAHL, APA PsycINFO, Academic Search Complete, EMBASE (Scopus), Business Source Complete and SocINDEX. RESULTS: 36 reports were included for analysis, including 34 different complex interventions. We performed a mixed thematic analysis to synthesise the data. We identified two primary external facilitator roles: lead facilitator and process expert facilitator. Process expert external facilitators have specific responsibilities according to their role and expertise in supporting three main processes: clinical, change management and knowledge/research management. CONCLUSIONS: Future research should study processes supported by external facilitators and their relationship with facilitation strategies and implementation outcomes. Future systematic or realist reviews may also focus on outcomes and the effectiveness of external facilitation.

The "Vulnerability" Discourse in Times of Covid-19: Between Abandonment and Protection of Canadian Francophone Older Adults.

The Covid-19 pandemic has been particularly difficult for older Canadians who have experienced age discrimination. As the media can provide a powerful channel for conveying stereotypes, the current study aimed to explore how Canadian Francophone older adults and the aging process were depicted by the media during the first wave of the Covid-19 pandemic, and to examine if and how the media discourse contributed to ageist attitudes and behaviors. A content analysis of two French Canadian media op-eds and comment pieces (n = 85) published over the course of the first wave of the pandemic was conducted. Findings reveal that the aging process was mainly associated with words of decline, loss, and vulnerability. More so, older people were quasi-absent if not silent in the media discourse. Older adults were positioned as people to fight for and not as people to fight along with in the face of the pandemic. The findings from this study enhance the understanding of theories and concepts of the Theory of Social Representations and the Stereotype Content Model while outlining the importance of providing older people with a voice and a place in the shaping of public discourse around aging. Results also illustrate the transversality and influence of ageism in this linguistic minority context.

Social information processing of positive and negative hypothetical events in children with ADHD and conduct problems and controls.

OBJECTIVE: This study examined social information processing (SIP) of events with varied outcomes in children with ADHD and conduct problems (CPs; defined as oppositional defiant disorder [ODD] or conduct disorder [CD]) and controls. METHOD: Participants were 64 children (46 boys, 18 girls) aged 6 to 12, including 39 with ADHD and 25 controls. Vignettes were developed that systematically varied with regard to peer intention (ambiguous, negative, positive) and event outcome (ambiguous, negative, positive), and were used to evaluate participants' SIP abilities (cue encoding, interpretation, and response generation). RESULTS: Results showed that, after controlling for CPs, children with ADHD detected fewer positive, negative, and neutral cues; attributed more negative and less positive intent to peers; focused less on situational outcomes of vignettes; and generated fewer positive responses compared with the control group. CONCLUSION: These results indicate that children with ADHD differ from non-ADHD children, even after controlling for CPs, in how they process positive and negative social experiences.