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Objectives: The role of a coach in enhancing athletes' performance and achieving success is well-documented across numerous studies. However, the strategies employed by Chinese coaches in developing world champion gymnasts remain under explored. Methods: This research involved a single case study focusing on a coach from the Chinese National Men's Gymnastics Team, credited with nurturing eight world champion gymnasts. Results: The inductive content analysis leads to that 6 subthemes, "international perspective and collaborative ability," "ability to control and regulate training loads," "identifying athletes' needs and transforming them into motivation," "goal setting aligned with athletes' abilities," "adopting authoritative democratic coaching style," and "establishing hierarchical-style friendship", and 3 themes, "training management and planning," "motivation and goal setting," and "interpersonal communication" are manifested. An overarching theme "the successful experience of gymnastics world champion coach," is derived from the analysis. Conclusion: This research bridges the gap between theoretical knowledge and practical application, offering valuable insights into the successful experiences of gymnastics world champion coaches. The findings have the potential to influence coaching methodologies globally, fostering the development of resilient, motivated, and high-performing athletes. Future research should focus on sport-specific studies, longitudinal analyses, and cross-cultural comparisons to further advance the field of sports coaching and validate the effectiveness of these innovative coaching strategies.
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Prenatal alcohol exposure and fetal alcohol spectrum disorders (FASDs) remain critical public health issues. Alcohol use in pregnancy is a leading preventable cause of birth defects, developmental disabilities, and learning disabilities. Alcohol screening and brief intervention (SBI) is effective at reducing excessive alcohol use. However, this clinical preventive service remains critically underutilized in primary care. In 2014, the Centers for Disease Control and Prevention called for the creation of FASD Champion programs to promote clinician education about FASDs. Six professional health organizations and groups providing reproductive and child health services set out to create FASD Champion programs. The American College of Obstetricians and Gynecologists FASDs Prevention Program was created to focus on reducing alcohol-exposed pregnancies. The American Academy of Pediatrics' Champion program maintains the goal of improving health outcomes for children with FASDs by improving pediatricians' diagnostic capacity. The American Academy of Family Physicians has prioritized training family physician champions to improve the delivery of alcohol SBI among adult patients. The University of Alaska Anchorage has partnered with the National Association of Nurse Practitioners in Women's Health, the American College of Nurse-Midwives, and the Association of Women's Health, Obstetric, and Neonatal Nurses to assure advanced practice registered nurses and midwives have the knowledge and skills to prevent alcohol-exposed pregnancies and FASDs. The American Association of Medical Assistants has prioritized expanding the knowledge and skills of medical assistants related to promoting alcohol-free pregnancies. Finally, the Champions program at the University of Texas at Austin was established to train health social workers in alcohol SBI. Through the advocacy, education, and mission of these 6 health sectors in collaboration with national organizations and educational institutions, the evidence-based approach of alcohol SBI is being disseminated throughout the United States to reduce the harmful effects of prenatal alcohol exposure.
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OBJECTIVE: To understand the motivations of champions who worked to bring about system and practice change that supported routine screening for intimate partner violence (IPV) in two rural emergency departments (EDs). INTRODUCTION: Practice changes are required to achieve routine and effective identification and response to IPV. Nurses play a significant role in affecting such practice change. This paper identifies the motivations of champions in the ED setting who successfully brought about such change. SETTING: The EDs of two Level 5 tertiary hospitals within a rural Local Health District (LHD) of New South Wales, Australia. PARTICIPANTS: Twenty-three individuals who identified as champions and worked to introduce routine IPV screening in two rural hospital EDs. DESIGN: Qualitative longitudinal semi-structured interviews employing a process of constant comparison and an interpretive framework to analyse data thematically. Interviews were carried out between June and August 2017 and again between July and August 2019. RESULTS: Over the period of the study, routine screening was established, and screening rates steadily increased from a low baseline to a significantly higher rate. Three aspects of champion motivation emerged from the analysis: formation of an identity as a champion, making a difference to a significant social justice issue and providing quality and community-relevant care. CONCLUSIONS: This study is the first study to report on champions and their motivation as they supported IPV practice change in the ED. The findings highlight the capacity for innovation in rural health services, with important implications for other settings looking to translate similar programs. Understanding motivating factors may assist in improved utilisation and support for champions. This is vital if champions are to bring about required practice change within their service and ensure the needs of individuals experiencing IPV are effectively met.
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Background: During the COVID-19 pandemic, public health teams tried several approaches to circulate accurate health information and engage with community members to understand what they need from public health services. Two such approaches were community champions and community participatory action research (CPAR). This study evaluates two champion programmes and a CPAR programme in terms of what worked, for whom, and in what contexts, including the funding and resourcing associated with implementation. Methods: Between June 2022 and June 2023, a realist evaluation of three distinct case studies (COVID-19 champions, Vaccine Champions, and CPAR programmes) in the city of Southampton in England was conducted in three stages: development of initial programme theories and collection of additional contextual information, including funding and resources associated with delivering each programme; initial programme theory testing; synthesis of final programme theories. Data was collected primarily through semi-structured interviews (n = 29) across programme and training leads, voluntary services, community organisations, volunteers, and local community members, and one focus group with local community members (n = 8). Results: The City Council used £642 k from two funding awards to deliver the programmes: COVID-19 Champions £41 k; Vaccine Champions £485 k; and CPAR programmes £115 k. Twenty-eight initial programme theories were generated, which were "tested" to support, refine, or refute context-mechanism-outcome relationships, resulting finally in a set of 22 programme theories across the three programmes. Six demi-regularities were generated, each featuring in multiple programme theories, and providing data on how and why these programmes can work, and in which contexts: (1) building trust through community connections; (2) fostering relationships and collaboration; (3) provision of training and resources; (4) local community knowledge and expertise; (5) community representation and leadership; (6) appropriate communication and information sharing. Conclusion: This study provides new knowledge and understanding of the factors affecting the implementation of community champion and CPAR approaches during public health emergencies. These findings suggest that representation and involvement of community members, establishing and building on trust, adequate training and resources, and clear communication from trusted community members and organisations are catalysts for meaningful engagement with communities.Evaluation registration: Research Registry identifier: researchregistry8094.
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COVID-19 , Investigación Participativa Basada en la Comunidad , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Inglaterra , Pandemias/prevención & control , SARS-CoV-2 , Evaluación de Programas y Proyectos de Salud , Salud Pública , Grupos FocalesRESUMEN
Objectives: Breast cancer is the leading cause of female cancer mortality in Armenia. The government is considering covering breast cancer screening, but prevailing attitudes towards it are unknown. This cross-sectional study assessed Armenian women's awareness and perceptions of breast cancer screening. Methods: We administered a validated telephone survey to women ages 35-65 registered in Yerevan's polyclinic system between 2019-2021, assessing sociodemographic characteristics, breast cancer exposure and screening attitudes, using an adapted Champion's Health Belief Model Scale (CHBMS). We analyzed the association, unadjusted and adjusted, between sociodemographic characteristics, screening exposure, and CHBMS scores. Results: 170 women completed surveys. Most (82.9%) were aware of screening, 48.5% knew someone with breast cancer, but only 42.5% had undergone screening, predominantly without their physician's recommendation (63.2%). Despite elevated awareness, 76.2% had never discussed screening with their provider. Barriers included cost and mistreatment concerns. Education consistently predicted prior screening and most CHBMS scores. Conclusion: Armenian women are highly exposed to breast cancer, but knowledge and prior screening primarily emanate from non-physician sources. Results highlighted the influence of education, patient-provider relationships, and healthcare costs, underscoring the importance of multi-level interventions.
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Neoplasias de la Mama , Detección Precoz del Cáncer , Conocimientos, Actitudes y Práctica en Salud , Humanos , Femenino , Neoplasias de la Mama/diagnóstico , Armenia , Persona de Mediana Edad , Adulto , Estudios Transversales , Detección Precoz del Cáncer/psicología , Anciano , Encuestas y Cuestionarios , Factores SocioeconómicosRESUMEN
BACKGROUND: Vaccine champions are common in primary care, but little is known about which champions are effective. METHODS: In 2022, we surveyed 2,144 US primary care professionals (PCPs) who reported working with vaccine champions. Respondents rated the champion with whom they worked most closely on their effectiveness at improving vaccination rates. RESULTS: About half (49 %) of PCPs perceived their closest champion as highly effective. PCPs perceived advanced practice providers and nursing staff as highly effective somewhat more often than physicians (52 % and 58 % vs 43 %, p <.001). Other correlates of perceived effectiveness included being a formally appointed versus informal champion, working extremely versus less closely with PCPs, and using a high (4-5) versus low (0-1) number of implementation strategies to improve vaccination rates (all p <.001). CONCLUSIONS: Results suggest vaccine champions may benefit from having formal roles and opportunities to work closely with colleagues to improve vaccination rates using multiple strategies.
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Personal de Salud , Atención Primaria de Salud , Vacunación , Humanos , Atención Primaria de Salud/estadística & datos numéricos , Encuestas y Cuestionarios , Vacunación/estadística & datos numéricos , Masculino , Personal de Salud/estadística & datos numéricos , Femenino , Adulto , Persona de Mediana Edad , Estados Unidos , Actitud del Personal de Salud , Vacunas/administración & dosificaciónRESUMEN
Background: Person-centered care is considered beneficial for persons with dementia. Objective: To evaluate the impact of a person-centered knowledge translation intervention on the quality of healthcare and outcomes for persons with dementia. Methods: Over nine months, sub-acute hospital nursing, allied health, and medical staff (nâ=â90) participated in online and/or face-to-face person-centered education and were supported by senior nursing, allied health, and medical staff champions (nâ=â8) to implement person-centered healthcare. The quality of healthcare service, ward climate and care delivery were evaluated pre/post study intervention. In the week following hospital admission (Time 1) and week of discharge (Time 3), agitation incidence (co-primary outcome) was assessed in participants with dementia (nâ=â80). Participant delirium (co-primary outcome), accidents/injuries, psychotropic medicines, length of stay, readmission and discharge destination (secondary outcomes) were compared with a retrospective group (nâ=â77) matched on demographics, cognition and function in activities of daily living. Results: Improvements occurred post-intervention in service quality by 17.5% (pâ=â0.369, phiâ=â0.08), ward climate by 18.1% (pâ=â0.291, phiâ=â0.08), and care quality by 50% (pâ=â0.000, phiâ=â0.37). Participant agitation did not change from Time 1 to Time 3 (pâ=â0.223). Relative to the retrospective group, significant reductions occurred in participant delirium (pâ=â0.000, phiâ=â0.73), incidents/injuries (pâ=â0.000, phiâ=â0.99), psychotropic medicine use (pâ=â0.030, phiâ=â0.09), and hospital readmissions within 30 days (pâ=â0.002, phiâ=â0.25), but not in discharge to home (pâ=â0.171). Conclusions: When person-centered healthcare knowledge is translated through staff education and practice support, persons with dementia can experience improved healthcare services and clinical outcomes, while healthcare services can benefit through reductions in unplanned service use.
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Delirio , Demencia , Humanos , Demencia/terapia , Actividades Cotidianas , Estudios Retrospectivos , Hospitales , Calidad de la Atención de Salud , Delirio/epidemiología , Delirio/terapia , Atención Dirigida al PacienteRESUMEN
Building a successful veterinary team is foundational and a driving force to having an all-around accomplished veterinary practice, one that provides quality customer service and medical care while being financially healthy and creating an environment for team members to thrive and be happy, highly productive employees. This article focuses on new and innovative approaches to cultivating a practice personality and culture that is employee centered. This article provides a road map to assist in implementing and achieving the next big steps needed to have an employee-focused business. Taking care of employees, unlike ever before, is desperately needed in veterinary practices.
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Medicina Veterinaria , Medicina Veterinaria/organización & administraciónRESUMEN
The COVID-19 pandemic allowed for widespread implementation of telehealth as a delivery method for occupational therapy (OT) services. The purpose of this study was to investigate the perceptions of novice telehealth OT practitioners regarding telehealth as a delivery method for OT services. Quantitative data was collected through a modified version of the Telehealth Usability Questionnaire and analyzed via descriptive statistics. Qualitative data was collected by open-ended questions and analyzed via thematic analysis. OT practitioners' responses revealed four major themes: logistics of telehealth practice, role of client champions, capacity of the OT practitioner, and styles and approaches. The study revealed that OT sessions delivered via telehealth increased access to clients and continuity of services. Client champion engagement, effective coaching strategies, and practitioner flexibility supported the success of OT telehealth sessions.
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OBJECTIVE: To synthesise the evidence on the roles and outcomes of change agents in facilitating the use of powered technology systems and devices for staff end-users in residential aged care workplaces. DESIGN: Systematic review and narrative synthesis. DATA SOURCES: CINAHL, MEDLINE and EMBASE databases were searched for articles published in English between January 2010 and July 2022. REVIEW METHODS: Two of three reviewers independently screened each title and abstract, and subsequently the full texts of selected records. The Mixed Method Appraisal Tool was used to assess the quality of the included articles. RESULTS: Of 3,680 records identified, ten articles reporting nine studies were included. In all the studies, the change agent role was a minor component embedded within implementation processes. Three key change agent roles were identified: 1) providing guidance, expertise, and support with implementing a new technology; 2) delivering training to others, and 3) troubleshooting and responding to issues. The key outcome of change agent roles related to achieving project implementation milestones and higher levels of implementation of technology. Change agent processes, however, were compromised when the designated change agent role was included late in the implementation process, or was not supported, recognised, embraced, or when roles or responsibilities were unclear. The direct contribution of change agents was difficult to elucidate because the roles and outcomes of change agents were embedded in multi-faceted implementation strategies. CONCLUSIONS: The change agent can play an important role in facilitating technology implementation by providing support, training, and troubleshooting. Challenges with the change agent role included unclear role expectations and appointment late in the implementation process. Overall, there was limited evidence specific to the role and outcome of the change agent role to inform ideal approaches for their role in technology facilitation for end-users in residential aged care workplaces.
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Health systems face barriers implementing routine screening for social needs. We assessed the impact of "clinician champions" on social needs screening. Screening data were assessed at 11 pediatric primary care practices in Bronx, NY, between April 2018 and August 2021. Three intervention practices had clinician champions; 8 control practices did not. The Wald chi-square tests and Poisson regressions evaluated the relationship between screening and introduction of clinician champions. The introduction of a clinician champion was a significant predictor of screening (P < .001). Within a practice, screening after the introduction of a clinician champion was higher than before the introduction (P < .001). The rate of screening for practices with a clinician champion was 2.8 times higher per month than for practices without a clinician champion. Furthermore, practices with clinician champions had higher rates of screening during the pandemic. In summary, the presence of clinician champions increased social needs screening rates in pediatric primary care practices.
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Health literacy is an important aspect of equitable, safe, and high-quality care. For organizations implementing health literacy initiatives, using 'change champions' appears to be a promising strategy. This systematic review aimed to identify the empirical and conceptual research that exists about health literacy champions. We conducted the systematic literature search using MEDLINE, Embase, CINAHL, Scopus, and PubMed, with additional studies identified by searching references and citations of included studies and reviews of organizational health literacy. Seventeen articles were included in the final review (case studies, n = 9; qualitative research, n = 4; quasi-experimental, n = 2; opinion articles without case studies, n = 2). Using JBI critical appraisal tools, most articles had a high risk of bias. Often champions were not the focus of the article. Champions included staff across frontline, management, and executive levels. Only five studies described training for champions. Key champion activities related to either (i) increasing organizational awareness and commitment to health literacy, or (ii) influencing organizational strategic and operational planning. The most common output was ensuring that the organization's health information materials met health literacy guidelines. Articles recommended engaging multiple champions at varying levels within the organization, including the executive level. Limited funding and resources were key barriers. Two of four articles reported positive impacts of champions on implementation of health literacy initiatives. Overall, few of the articles described health literacy champions in adequate detail. More comprehensive reporting on this implementation strategy and further experimental and process evaluation research are needed to progress this area of research. This systematic review was registered with PROSPERO (CRD42022348816).
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Alfabetización en Salud , Humanos , ActitudRESUMEN
Introduction: Breast cancer (BC) is a most common and frequently occurring malignancy of women worldwide. Breast self-examination (BSE) is important for the early detection and prevention of BC and to limit the morbidity and mortality. Young students are ideal people to understand and motivate other women to perform BSE. Objective: BSE behavior of undergraduate students was predicted using Champion's Health Belief Model Scale (CHBMS). Methods: A descriptive cross-sectional design was adopted. This study was conducted in all nine colleges of Sultan Qaboos University, , Oman. Three-hundred eighty-one female undergraduate students were selected through convenient sampling technique. The health belief towards BSE was predicted using CHBMS. Results: The mean and SD of beliefs about the benefits of performing BSE showed 10.84 and 3.2, respectively. Mean and SD of confidence in performing BSE indicated 56.24 and 10.8. Likewise, the mean and SD of barriers in performing BSE are 13.58 and 4.2. Source of information is found to be a statistically significant predictor of barrier in performing BSE at p < .05. Conclusion: If the self- confidence of women in performing BSE improves, the women will uptake BSE more frequently thereby they can be prevented from developing the adverse consequences of advanced stages of breast cancer.
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AIM: To identify the barriers, challenges, and enablers that clinical champions experience whilst implementing Intimate Partner Violence (IPV) screening within Emergency Departments (EDs). BACKGROUND: Champions support the introduction of IPV screening within EDs. This paper shares new knowledge about IPV practice change champions: barriers, challenges and enablers they experienced in their efforts. DESIGN: Between 2017-2019, semi structured qualitative interviews were conducted with 23 individuals who identified as champions, working to introduce routine IPV in two rural tertiary hospital Emergency Departments. An interpretive framework and process of constant comparison was used to thematically analyse data from transcribed interviews. RESULTS: Champions identified barriers, challenges, and enablers that they experienced. Enablers included: support for the work of champions; champion leadership and collegiality; and training for the champion role. Challenges and Barriers included: resistance to a change in the focus of practice; and workflow and workload. CONCLUSIONS AND IMPLICATIONS: Nurse champions can effectively support IPV practice change but face certain barriers, challenges and enablers. Nurse managers can use this information to support champions to undertake their role effectively in order to better meet the needs of individuals experiencing IPV.
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Violencia de Pareja , Humanos , Violencia de Pareja/prevención & control , Servicio de Urgencia en Hospital , Tamizaje MasivoRESUMEN
Nuclear proteins are major constituents and key regulators of nucleome topological organization and manipulators of nuclear events. To decipher the global connectivity of nuclear proteins and the hierarchically organized modules of their interactions, we conducted two rounds of cross-linking mass spectrometry (XL-MS) analysis, one of which followed a quantitative double chemical cross-linking mass spectrometry (in vivoqXL-MS) workflow, and identified 24,140 unique crosslinks in total from the nuclei of soybean seedlings. This in vivo quantitative interactomics enabled the identification of 5340 crosslinks that can be converted into 1297 nuclear protein-protein interactions (PPIs), 1220 (94%) of which were non-confirmative (or novel) nuclear PPIs compared with those in repositories. There were 250 and 26 novel interactors of histones and the nucleolar box C/D small nucleolar ribonucleoprotein complex, respectively. Modulomic analysis of orthologous Arabidopsis PPIs produced 27 and 24 master nuclear PPI modules (NPIMs) that contain the condensate-forming protein(s) and the intrinsically disordered region-containing proteins, respectively. These NPIMs successfully captured previously reported nuclear protein complexes and nuclear bodies in the nucleus. Surprisingly, these NPIMs were hierarchically assorted into four higher-order communities in a nucleomic graph, including genome and nucleolus communities. This combinatorial pipeline of 4C quantitative interactomics and PPI network modularization revealed 17 ethylene-specific module variants that participate in a broad range of nuclear events. The pipeline was able to capture both nuclear protein complexes and nuclear bodies, construct the topological architectures of PPI modules and module variants in the nucleome, and probably map the protein compositions of biomolecular condensates.
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Arabidopsis , Núcleo Celular , Arabidopsis/genética , Arabidopsis/metabolismo , Espectrometría de Masas , Proteínas Nucleares/metabolismoRESUMEN
BACKGROUND: Community wellness coalitions are an important part of functioning program infrastructure and have been effective in promoting policy, systems, and environmental (PSE) change, especially when paired with technical support by a community champion or Extension staff. PSE strategies are critical to support long-lasting behavior change but can be challenging to implement. Extension is an established and equipped organization that has potential to help community overcome those challenges. The aim of this article was to identify and describe experiences of Extension staff working as community coaches. METHODS: A mixed-methods design to assess the impact of Extension staff working with Community Champions included a quantitative Extension Coaching Confidence Scorecard and an Extension Key Informant Interview. RESULTS: The total Extension Coaching Confidence score significantly increased from pre- to post-intervention (55.1 ± 35.3 vs. 81.7 ± 37.7, p = .03). Five facilitators and two barriers to wellness coalition development were identified by Extension staff. DISCUSSION: The results of this study indicate that the model of community coaching used was effective at addressing the foundational components of the Component Model of Infrastructure (CMI). However, comprehensive training for Extension staff in the CMI and technical assistance are needed in order to build capacity, achieve outcomes, and promote sustainability. IMPLICATIONS FOR PRACTICE: Individuals seeking to transition to PSE work should be provided with a foundation of specific, targeted training in the CMI and evidence-based technical assistance methods. Practitioners should recognize the essential role of community champions in PSE work. Completing the Extension Coaching Confidence Scorecard periodically can inform evolving training needs.
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Servicios de Salud Comunitaria , Políticas , HumanosRESUMEN
INTRODUCTION: Dementia Friends is a dementia awareness program that trains lay leaders (called "dementia champions") to give presentations about dementia to combat stigma in their community. OBJECTIVE: In this mixed methods study, we aimed to evaluate the impact and implementation of a pilot Dementia Friends program in Washington State to assess whether it improved attitudes towards people living with dementia. METHOD: Fifteen champions were recruited, who organized 22 Dementia Friends sessions, reaching 214 Dementia Friends participants. We collected data through interviews with champions and surveys administered to Dementia Friends participants before, immediately after, and 1-month after attending a Dementia Friends session. The survey collected demographic information and measured respondent attitudes towards people living with dementia using the Dementia Attitudes Scale. RESULTS: Quantitative analysis showed that Dementia Attitude scores improved after a Dementia Friends session; this improvement was maintained through the 1-month follow-up. In qualitative analysis of champion interviews, we identified several suggestions regarding implementation of the Dementia Friends program, which could strengthen the program and better support champions in their role, such as increasing logistical assistance during participant recruitment. CONCLUSION: Dementia Friends sessions were effective in improving participant attitudes towards people living with dementia and inspiring ongoing action towards building Dementia-Friendly communities. Champions found deep meaning in their role, but would benefit from increased support to make the volunteer role more sustainable. Our findings can inform efforts to successfully deliver Dementia Friends in other locations.
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Demencia , Amigos , Humanos , ActitudRESUMEN
How do strategic initiatives emerge? Despite rich tradition in the emergent strategy literature-focused on significant organizational change-surprisingly little insight exists on the dynamics of a new initiative's emergence. This is particularly relevant in healthcare because of the increasing pressure to implement value transformation models focused on maximizing value at the point of care. The value transformation model prioritizes the decisions of the frontline providers and thus requires their expertise and commitment for the model's implementation and success. In our case study of a dental organization, "OptiPlex," we trace the emergence of a value transformation strategic initiative from its origination at the point of care to its formalization into the organization's strategic plan. Using qualitative methods, we identify three phases in the emergence of the value transformation strategic initiative, each embodying different championing behaviors necessary for the initiative's emergence. In doing so, we explicate the nature of these behaviors and how they link up across the organizational hierarchy to drive the value transformation strategic initiative's emergence and implementation.
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Atención a la Salud , Humanos , Innovación OrganizacionalRESUMEN
The importance of champions in the implementation of evidence-based public health programs has been well established. Champions perform a range of behaviors which can have significant influence on the adoption and sustainability of interventions. This study investigates champion behaviors in parenting practitioners with the aim to provide insight into the range and extent that practitioners engage in champion behaviors and to examine predictors of practitioners' champion behaviors using structural equation modeling. Data were collected during a large international implementation survey of 1606 practitioners trained to deliver an evidence-based parenting program, the triple P-Positive Parenting Program. We developed a 13-item Champion Behaviors Scale which was administered alongside other measures of predictors of implementation outcomes. Perceived usefulness of the program was the most important facilitator of both public and personal champion behaviors. Certain desirable features of the program tended to not only be positively associated with the perceived usefulness of the program, but also had a unique impact on practitioners' personal champion behaviors. Higher positions within organizations were linked with more public champion behaviors. Although organizational support was found to be unrelated to champion behaviors in the structural model, it facilitated other predictors of champion behaviors.