Clinician-Reported Barriers to Group Visit Implementation.

BACKGROUND: Group visits have been shown to improve disease-oriented outcomes and satisfaction, yet many clinicians have not incorporated them into practice. We aimed to identify clinician-reported barriers that preclude clinicians from implementing group visits. METHODS: Primary care physicians from one practice-based research network were surveyed regarding their experience with and barriers to group visits. The survey, developed for this study, was mailed to 246 clinicians. RESULTS: Of 107 respondents (44% response rate), those in practice <10 years were significantly more likely to have had group visit experience than those with >10 years of experience. For those without prior group visit experience, training was named as the top barrier to incorporating group visits. Those with group visit experience named staffing concerns and recruitment as the top barriers to group visit implementation. CONCLUSIONS: Primary care clinicians without prior group visit experience were less likely to endorse group visits. Addressing the modifiable barriers may enhance the incorporation of group visits into practice.

Formal production features of infant and toddler DVDs.

OBJECTIVE: To describe how DVDs designed for very young children are constructed, focusing on the formal production features used to present the program content. DESIGN: Descriptive study of the concentrations of perceptually salient, nonsalient, and reflective formal features. PARTICIPANTS: Fifty-nine DVDs designed for children younger than 3 years. Main Exposure The presence and absence of specific formal features. OUTCOME MEASURES: Concentrations of reflective (singing, rhyming, camera zooms, and moderate character action), perceptually salient (rapid pacing, fast action, camera cuts, sound effects, character vocalizations, and visual special effects), and nonsalient (low-action sequences, narration, and dialogue by men, women, or children) formal features. RESULTS: Programs were composed of high concentrations of perceptually salient features, such as rapid pace and camera cuts, which are difficult even for older children to understand. Reflective features, which provide opportunities to rehearse content, were relatively rare. Character action was typically nonsalient. The DVDs used speech only 24% of the time and failed to selectively use speakers, such as choosing a child over an adult for dialogue and narration, which garners slightly older children's visual attention. CONCLUSIONS: Producers who claim that their programs are educational should pay more attention to how they transmit content. Most programs directed at infants and toddlers rely on perceptually salient features like rapid pacing and camera cuts, which may elicit attention and interest but are most likely very difficult for a young audience to understand.