Suicide Prevention Takes a Nation: Collaborative Approaches to Universalize Suicide Prevention.

Suicide is a complex public health issue impacting many children and adolescents-and their families-each year, and it requires a complex public health solution. Local, state, and national collaboratives that leverage evidence-based strategies, foster community engagement, and prioritize equity are necessary to holistically address this issue. Here, the authors discuss the necessary steps for fostering inclusive community partnerships and outline the rationale for partnering with schools, youth groups, faith organizations, parent-teacher organizations, clinical settings, and professional organizations, as well as collaborating with the juvenile justice and child welfare systems and working together to foster suicide prevention policy.

Strengthening Support for Community Mental Health Programs Through Partnership and Collective Impact.

Effective partnerships can profoundly impact outcomes for youth with behavioral health concerns. Partnerships occur at multiple levels - at the individual, organizational, state, and national levels. The Systems of Care (SOC) framework helps to conceptualize and articulate the skills necessary for forming partnerships in youth's mental health. This article explores values in the SOC framework and makes the case that the framework can help develop a "road map" to develop the skills needed to achieve successful partnerships. Impediments to effective partnerships are also discussed. Several case examples are given to illustrate the principles and impediments to partnership formation.

Interprofessional Collaboration amongst Healthcare Workers of a Tertiary Hospital in North-Eastern Nigeria.

BACKGROUND: Interprofessional collaboration in healthcare is important to optimise healthcare delivery. However, relatively few studies have been conducted on the topic in Nigeria, especially in the North. OBJECTIVE: The objective of this study was to determine the levels of interprofessional collaboration, enablers and barriers amongst healthcare workers. MATERIALS AND METHODS: Data were collected using a five-domain modified Assessment of Interprofessional Team Collaboration Scale questionnaire, with a Likert scale of 1-5. The ideal mean score was ≤2 for the barriers domain and ≥4 for the other domains. Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 23. RESULTS: Two hundred and sixty-six participants responded to the questionnaire. Male and female respondents were 131 (49.2%) each. Half of the respondents were 31 to 40 years old. One hundred and thirty-six (51.1%) of the respondents were nurses, and 48 (18.0%) were doctors. The modal working experience was 6-11 years (41.4%), and 117 (44.0%) respondents had at least a bachelor's degree. The mean scores for the domains were 4.1032 for partnership, 3.2383 for cooperation, 3.6309 for coordination, 4.2844 for enablers and 3.7902 for barriers. CONCLUSION: There was adequate level of partnership and enablers amongst the healthcare workers but insufficient cooperation and coordination and high level of barriers. Staff training on cooperation, coordination and identified barriers is necessary to improve interprofessional collaboration in the hospital.

How Should Clinicians Navigate Interprofessional Tension in Their Roles as Antimicrobial Stewards?

Pharmacists and physicians play key roles in antimicrobial stewardship. This commentary on a case describes these health professionals' need to collaborate to optimize therapeutic use of antimicrobials in clinical settings. Prescription preauthorization is one antimicrobial stewardship strategy that can meet with some physicians' frustration and generate conflict between pharmacists and prescribing physicians, particularly when pharmacists make alternative treatment recommendations. This commentary considers interprofessional tension concerning prescription preauthorization and suggests strategies for navigating such conflict.

Using Photovoice to Stimulate Reflection and Collaboration in Health Professions Students Through an Interprofessional Education Activity.

OBJECTIVE: Today's healthcare system requires interprofessional collaborative practice (IPCP) to improve health outcomes. IPCP often begins with interprofessional education (IPE), which should stimulate meaningful idea exchange. This study's purpose was to assess the impact of a photovoice-based IPE experience on the attitudes and beliefs of students in two health professions programs. METHODS: Forty-two Doctor of Physical Therapy students and 13 Radiation Therapy students created photovoice slides representing the most significant "thing" in their professional education. Students discussed their slides in small groups followed by a large-group discussion. A pretest-posttest survey containing researcher-generated questions and the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R2) and a post-activity evaluation were administered. RESULTS: Forty-two students completed the pretest survey; 35 completed the posttest survey. A statistically significant difference was found between pretest (M=4.07, SD=0.91) and posttest (M=4.45, SD=0.70) SPICE-R2 total scores, t(928)=7.22, p<0.001. Statistically significant differences were found for all SPICE-R2 factor scores. Thematic analysis revealed three themes: 1) students learned about the other profession, 2) the IPE experience was meaningful, and 3) the IPE experience could be improved. CONCLUSIONS: The photovoice IPE experience stimulated student reflection, interprofessional collaboration, and new perceptions about the other health profession. Future studies should focus on similar activities offered earlier in the education program.

Individual and team profiling to support theory of mind in artificial social intelligence.

We describe an approach aimed at helping artificial intelligence develop theory of mind of their human teammates to support team interactions. We show how this can be supported through the provision of quantifiable, machine-readable, a priori information about the human team members to an agent. We first show how our profiling approach can capture individual team member characteristic profiles that can be constructed from sparse data and provided to agents to support the development of artificial theory of mind. We then show how it captures features of team composition that may influence team performance. We document this through an experiment examining factors influencing the performance of ad-hoc teams executing a complex team coordination task when paired with an artificial social intelligence (ASI) teammate. We report the relationship between the individual and team characteristics and measures related to task performance and self-reported perceptions of the ASI. The results show that individual and emergent team profiles were able to characterize features of the team that predicted behavior and explain differences in perceptions of ASI. Further, the features of these profiles may interact differently when teams work with human versus ASI advisors. Most strikingly, our analyses showed that ASI advisors had a strong positive impact on low potential teams such that they improved the performance of those teams across mission outcome measures. We discuss these findings in the context of developing intelligent technologies capable of social cognition and engage in collaborative behaviors that improve team effectiveness.

Sharpening the lens to evaluate interprofessional education and interprofessional collaboration by improving the conceptual framework: a critical discussion.

It has been difficult to demonstrate that interprofessional education (IPE) and interprofessional collaboration (IPC) have positive effects on patient care quality, cost effectiveness of patient care, and healthcare provider satisfaction. Here we propose a detailed explanation for this difficulty based on an adjusted theory about cause and effect in the field of IPE and IPC by asking: 1) What are the critical weaknesses of the causal models predominantly used which link IPE with IPC, and IPE and IPC with final outcomes? 2) What would a more precise causal model look like? 3) Can the proposed novel model help us better understand the challenges of IPE and IPC outcome evaluations? In the format of a critical theoretical discussion, based on a critical appraisal of the literature, we first reason that a monocausal, IPE-biased view on IPC and IPC outcomes does not form a sufficient foundation for proper IPE and IPC outcome evaluations; rather, interprofessional organization (IPO) has to be considered an additional necessary cause for IPC; and factors outside of IPC additional causes for final outcomes. Second, we present an adjusted model representing the "multi-stage multi-causality" of patient, healthcare provider, and system outcomes. Third, we demonstrate the model's explanatory power by employing it to deduce why misuse of the modified Kirkpatrick classification as a causal model in IPE and IPC outcome evaluations might have led to inconclusive results in the past. We conclude by applying the derived theoretical clarification to formulate recommendations for enhancing future evaluations of IPE, IPO, and IPC. Our main recommendations: 1) Focus should be placed on a comprehensive evaluation of factual IPC as the fundamental metric and 2) A step-by-step approach should be used that separates the outcome evaluation of IPE from that of IPC in the overarching quest for proving the benefits of IPE, IPO and IPC for patients, healthcare providers, and health systems. With this critical discussion we hope to enable more effective evaluations of IPE, IPO and IPC in the future.

Enhancing patient-clinician collaboration during treatment decision-making: study protocol for a community-engaged, mixed method hybrid type 1 trial of collaborative decision skills training (CDST) for veterans with psychosis.

BACKGROUND: Patient participation in treatment decision making is a pillar of recovery-oriented care and is associated with improvements in empowerment and well-being. Although demand for increased involvement in treatment decision-making is high among veterans with serious mental illness, rates of involvement are low. Collaborative decision skills training (CDST) is a recovery-oriented, skills-based intervention designed to support meaningful patient participation in treatment decision making. An open trial among veterans with psychosis supported CDST's feasibility and demonstrated preliminary indications of effectiveness. A randomized control trial (RCT) is needed to test CDST's effectiveness in comparison with an active control and further evaluate implementation feasibility. METHODS: The planned RCT is a hybrid type 1 trial, which will use mixed methods to systematically evaluate the effectiveness and implementation feasibility of CDST among veterans participating in a VA Psychosocial Rehabilitation and Recovery Center (PRRC) in Southern California. The first aim is to assess the effectiveness of CDST in comparison with the active control via the primary outcome, collaborative decision-making behavior during usual care appointments between veterans and their VA mental health clinicians, and secondary outcomes (i.e., treatment engagement, satisfaction, and outcome). The second aim is to characterize the implementation feasibility of CDST within the VA PRRC using the Practical Robust Implementation and Sustainability Model framework, including barriers and facilitators within the PRRC context to support future implementation. DISCUSSION: If CDST is found to be effective and feasible, implementation determinants gathered throughout the study can be used to ensure sustained and successful implementation at this PRRC and other PRRCs and similar settings nationally. TRIAL REGISTRATION: ClinicalTrials.gov NCT04324944. Registered on March 27, 2020. Trial registration data can be found in Appendix 1.

Designing and Developing a Medical-Legal Partnership to Address Cancer Patients' Health-Harming Legal Needs.

The Georgetown University's Cancer Legal Assistance and Well-being Project launched in 2020 as a medical-legal partnership that works with health care providers at a Washington, D.C. safety-net hospital to treat the health-harming legal needs of historically and intentionally marginalized patients with cancer.

Centering relationships to place for more meaningful research and engagement.

Research has the potential to simultaneously generate new knowledge and contribute meaningful social-ecological benefits; however, research processes and outcomes can also perpetuate extractive patterns that have manifested the climate, biodiversity, and social justice crises. One approach to enhance the societal value of research processes is to strengthen relationships with places of study and the peoples of those places. Deepening relational engagement with the social-ecological context and history of a place can lead to more accurate results and improved public trust in the scientific process and is particularly important for natural scientists who work at the interface of nature and society. We provide three actionable pathways that range from individual to systemic change to enhance place-based relationships within research systems: 1) deepen reflection and communication about relationships with places and peoples; 2) strengthen collaboration among research teams and partners; and 3) transform systems of knowledge creation to foster place-based roots. Action on any of these proposed pathways, but especially action taken across all three, can build empathy and connections to place and people, strengthening the meaningful impact of research both locally and globally.

Co-production of a systematic review on decision coaching: a mixed methods case study within a review.

BACKGROUND: Co-production is a collaborative approach to prepare, plan, conduct, and apply research with those who will use or be impacted by research (knowledge users). Our team of knowledge users and researchers sought to conduct and evaluate co-production of a systematic review on decision coaching. METHODS: We conducted a mixed-methods case study within a review to describe team co-production of a systematic review. We used the Collaborative Research Framework to support an integrated knowledge translation approach to guide a team through the steps in co-production of a systematic review. The team agreed to conduct self-study as a study within a review to learn from belonging to a co-production research team. A core group that includes a patient partner developed and conducted the study within a review. Data sources were surveys and documents. The study coordinator administered surveys to determine participant preferred and actual levels of engagement, experiences, and perceptions. We included frequency counts, content, and document analysis. RESULTS: We describe co-production of a systematic review. Of 17 team members, 14 (82%) agreed to study participation and of those 12 (86%) provided data pre- and post-systematic review. Most participants identified as women (n = 9, 75.0%), researchers (n = 7, 58%), trainees (n = 4, 33%), and/or clinicians (n = 2, 17%) with two patient/caregiver partners (17%). The team self-organized study governance with an executive and Steering Committee and agreed on research co-production actions and strategies. Satisfaction for engagement in the 11 systematic review steps ranged from 75 to 92%, with one participant who did not respond to any of the questions (8%) for all. Participants reported positive experiences with team communication processes (n = 12, 100%), collaboration (n = 12, 100%), and negotiation (n = 10-12, 83-100%). Participants perceived the systematic review as co-produced (n = 12, 100%) with collaborative (n = 8, 67%) and engagement activities to characterize co-production (n = 8, 67%). Participants indicated that they would not change the co-production approach (n = 8, 66%). Five participants (42%) reported team logistics challenges and four (33%) were unaware of challenges. CONCLUSIONS: Our results indicate that it is feasible to use an integrated knowledge translation approach to conduct a systematic review. We demonstrate the importance of a relational approach to research co-production, and that it is essential to plan and actively support team engagement in the research lifecycle.

The impact of mobility costs on cooperation and welfare in spatial social dilemmas.

From over-exploitation of resources to urban pollution, sustaining well-being requires solving social dilemmas of cooperation. Often such dilemmas are studied assuming that individuals occupy fixed positions in a network or lattice. In spatial settings, however, agents can move, and such movements involve costs. Here we investigate how mobility costs impact cooperation dynamics. To this end, we study cooperation dilemmas where individuals are located in a two-dimensional space and can be of two types: cooperators-or cleaners, who pay an individual cost to have a positive impact on their neighbours-and defectors-or polluters, free-riding on others' effort to sustain a clean environment. Importantly, agents can pay a cost to move to a cleaner site. Both analytically and through agent-based simulations we find that, in general, introducing mobility costs increases pollution felt in the limit of fast movement (equivalently slow strategy revision). The effect on cooperation of increasing mobility costs is non-monotonic when mobility co-occurs with strategy revision. In such scenarios, low (yet non-zero) mobility costs minimise cooperation in low density environments; whereas high costs can promote cooperation even when a minority of agents initially defect. Finally, we find that heterogeneity in mobility cost affects the final distribution of strategies, leading to differences in who supports the burden of having a clean environment.

The Effect of Interprofessional Education on Student Readiness for Collaborative Practice.

BACKGROUND: Health care reform promotes interprofessional patient-centric health care models associated with improved population health outcomes. Interprofessional education (IPE) programs are necessary to cultivate collaborative care, yet little evidence exists to support IPE pedagogy within nursing and other health science academia. METHOD: This quasiexperimental study examined differences in pre- and posttest Readiness for Interprofessional Learning Scale (RIPLS) scores following an IPE intervention. The IPE intervention consisted of a video presentation and a debriefing session after a simulated interprofessional collaborative patient care conference that introduced baccalaureate nursing and health science students to the roles and responsibilities of clinicians in team-based primary care. Pre- and postintervention RIPLS scores were analyzed. RESULTS: Pre- and postintervention RIPLS scores increased across all subscales, with distinct variation between nursing and health science student subscales. CONCLUSION: This IPE intervention had positive effects on students' readiness for interprofessional learning. Additional research is warranted to support health science pedagogy. [J Nurs Educ. 2024;63(5):304-311.].

ResearchConnect.info: An Interactive Web-Based Platform for Building Academic Collaborations.

RATIONALE AND OBJECTIVES: Radiology is a rapidly evolving field that benefits from continuous innovation and research participation among trainees. Traditional methods for involving residents in research are often inefficient and limited, usually due to the absence of a standardized approach to identifying available research projects. A centralized online platform can enhance networking and offer equal opportunities for all residents. MATERIALS AND METHODS: Research Connect is an online platform built with PHP, SQL, and JavaScript. Features include project and collaboration listing as well as advertisement of project openings to medical/undergraduate students, residents, and fellows. The automated system maintains project data and sends notifications for new research opportunities when they meet user preference criteria. Both pre- and post-launch surveys were used to assess the platform's efficacy. RESULTS: Before the introduction of Research Connect, 69% of respondents used informal conversations as their primary method of discovering research opportunities. One year after its launch, Research Connect had 141 active users, comprising 63 residents and 41 faculty members, along with 85 projects encompassing various radiology subspecialties. The platform received a median satisfaction rating of 4 on a 1-5 scale, with 54% of users successfully locating projects of interest through the platform. CONCLUSION: Research Connect addresses the need for a standardized method and centralized platform with active research projects and is designed for scalability. Feedback suggests it has increased the visibility and accessibility of radiology research, promoting greater trainee involvement and academic collaboration.

An evaluation of the psychometric properties of the Australian Collaborative Practice Assessment Tool.

OBJECTIVES: This study aimed to validate the Collaborative Practice Assessment Tool (CPAT) in the Australian setting and provide a quality instrument in terms of psychometric properties that can be used to measure interprofessional outcomes for both healthcare practitioners and students. The outcomes evaluated include the capacity to work in an interprofessional team, good interprofessional communication skills, leadership skills, ensuring clear division of tasks and roles in a team, effective conflict management, and being actively involved with patients and their families/communities in care. METHODS: The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) taxonomy and standards were used as guides for evaluating the psychometric properties of the Australian CPAT, which include evaluations regarding instrument development requirements of sample target and size, content validity, internal structure (structural validity, internal consistency reliability and measurement invariance), and hypotheses testing. CPAT Australia was developed through two stages involving pilot studies and a validation study, both of which included healthcare practitioners and students as participants. A pilot study examined content validity regarding item relevance, item comprehensibility, and instrument comprehensiveness. The validation study was carried out to assess the internal structure of CPAT Australia for aspects of structural validity, internal consistency reliabilities, and configural, metric and scalar measurement invariance. The structural validity was explored using the following three steps: exploratory, confirmatory, and multi-group factor analysis. Construct validity was evaluated to confirm direct and indirect paths of assumptions based on a previously validated model. Data collected between August 2021 and May 2022. RESULTS: The content validity evaluation confirmed that all items were relevant, understandable and comprehensive for measuring interprofessional collaborative care in Australia. Three hundred ninety-nine participants contributed to the validation study (n=152 practitioners; n=247 students). The original instrument model of 8-Factor 56-Item was improved in the Australian CPAT. Two items, Item 27 (Physicians assume the ultimate responsibility) and Item 49 (Final decision rest with the physician), were consistently rejected and therefore discarded. The internal structure of the 7-Factor 54-Item solution was confirmed as a suitable model with fit indices meeting COSMIN standards for a good model in practitioner and student cohorts. Configural, metric and scalar invariances were confirmed, indicating the invariance of the instruments when used for the practitioner and student cohorts. The construct validity evaluation indicated that 81.3% of direct and indirect assumptions were accepted, fulfilling the COSMIN requirement of >75% of proposed assumptions being accepted. CONCLUSION: The Australian CPAT with a 7-factor 54-item solution was confirmed as a quality measure for assessing interprofessional education and collaborative practice for both healthcare practitioners and students in Australia with robust psychometric properties.