A Formative Evaluation of Two FASD Prevention Communication Strategies.

AIMS: To evaluate the feasibility, acceptability and effectiveness of placing FASD prevention messages in the women's restrooms of establishments serving alcohol in Alaska and the Yukon, regions with high rates of FASD. METHODS: Our team placed an FASD educational poster, and posters affixed to a pregnancy test dispenser, in women's restrooms of bars and restaurants. We compared drinking behaviors and knowledge and beliefs about FASD among participants at baseline and at follow-up. RESULTS: Respondents consisted of 2132 women who completed a baseline survey and 1182 women who completed both a baseline and a follow-up survey. Women in both groups showed improvement in knowledge of FASD; the dispenser group scored higher than participants in the poster group on the FASD Health Belief questions at both baseline and follow-up. Forty-three women learned they were pregnant from our pregnancy tests and alcohol consumption among pregnant women was lower at follow-up than at baseline. CONCLUSIONS: FASD prevention messages, particularly paired with pregnancy test dispensers, in the women's restrooms of establishments that serve alcohol can effectively promote informed alcohol consumption decisions among women who are, or may become, pregnant. SHORT SUMMARY: In this FASD prevention feasibility study, we found that FASD prevention messages, particularly paired with pregnancy test dispensers, placed in the women's restrooms of establishments that serve alcohol can effectively promote informed alcohol consumption decisions among women who are, or may become, pregnant.

General medical care external hospitalizations for patients in Texas state mental health hospitals.

We explored the characteristics of general medical hospital admissions for patients in state mental health hospitals. Data were extracted from a statewide database of all hospital discharges for 5 years identified as general medical hospital admissions that occurred during the stay of patients at state mental health hospitals. Across the 9 mental health hospitals in the state system, rates of admission to general medical hospitals varied significantly from 0.7% to 3.7%. On average, of the 1.9% of all state mental health inpatients who had a general hospital admission, 25% occurred within 4 days of admission to the mental hospital. The average general hospitalization lasted 5.7 days. The reported total charge for all stays was $34 million. Dehydration (15%), hypertension (10%), and diabetes (10%) were the most frequent diagnoses. Thirteen percent of diagnoses met preventable hospitalization criteria. Given the variability among hospitals in admission rates and the number of preventable conditions, improvements in patient care and health as well as reduced admissions to general medical hospitals may be possible.

Detecting dissonance in clinical and research workflow for translational psychiatric registries.

BACKGROUND: The interplay between the workflow for clinical tasks and research data collection is often overlooked, ultimately making it ineffective. QUESTIONS/PURPOSES: To the best of our knowledge, no previous studies have developed standards that allow for the comparison of workflow models derived from clinical and research tasks toward the improvement of data collection processes. METHODS: In this study we used the term dissonance for the occurrences where there was a discord between clinical and research workflows. We developed workflow models for a translational research study in psychiatry and the clinic where its data collection was carried out. After identifying points of dissonance between clinical and research models we derived a corresponding classification system that ultimately enabled us to re-engineer the data collection workflow. We considered (1) the number of patients approached for enrollment and (2) the number of patients enrolled in the study as indicators of efficiency in research workflow. We also recorded the number of dissonances before and after the workflow modification. RESULTS: We identified 22 episodes of dissonance across 6 dissonance categories: actor, communication, information, artifact, time, and space. We were able to eliminate 18 episodes of dissonance and increase the number of patients approached and enrolled in research study trough workflow modification. CONCLUSION: The classification developed in this study is useful for guiding the identification of dissonances and reveal modifications required to align the workflow of data collection and the clinical setting. The methodology described in this study can be used by researchers to standardize data collection process.