Feasibility of a Mindfulness-Based Intervention for Caregivers of Veterans: A Pilot Study.

Purpose: This pilot study aimed to assess the feasibility of conducting an 8-week mindfulness-based intervention with caregivers of veterans and to examine the effectiveness of the intervention to improve mindfulness using the Five Facet Mindfulness Questionnaire compared with waitlist controls. Design: In this randomized controlled trial, 23 caregivers of veterans were assigned to either the intervention or waitlist group. Method: Compliance with mindfulness instruction and attendance was assessed among those in the intervention. Wilcoxon signed-rank tests compared within group pre- and post-intervention scores and Mann-Whitney U tests compared difference scores (post-pre) by group type. Effect sizes were also calculated. Compliance variables were correlated with difference scores in the intervention group only. Findings: Of the 23 participants, 11 were assigned to the intervention; 100% of participants were retained. There was significant improvement from pre- to post-intervention in four of the five facets of mindfulness (p < .05) in the intervention group. Significant between-group differences (p < .05) were also observed in two of the five facets. Effect sizes ranged from small (.44) to large (.89). No significant improvement was observed in the waitlist control group. Conclusions: A mindfulness-based intervention is feasible and acceptable to improve mindfulness in caregivers of veterans.

Barriers to the Accessibility and Continuity of Health-Care Services in People with Multiple Sclerosis: A Literature Review.

BACKGROUND: Individuals with multiple sclerosis (MS) face a range of barriers to accessing and using health-care services. The aim of this review was to identify specific barriers to accessing and using health-care services based on a continuum of the health-care delivery system. METHODS: Literature searches were conducted in the PubMed, PsycINFO, CINAHL, and Web of Science databases. The following terms were searched as subject headings, key words, or abstracts: health care, access, barriers, physical disability, and multiple sclerosis. The literature search produced 361 potentially relevant citations. After screening titles, abstracts, and citations, eight citations were selected for full-text review. RESULTS: Health-care barriers were divided into three continuous phases of receiving health care. In the before-visit phase, the most commonly identified barrier was transportation. In the during-visit phase, communication quality was the major concern. In the after-visit phase, discontinued referral was the major barrier encountered. CONCLUSIONS: There are multiple interrelated barriers to accessing and using health-care services along the health-care delivery continuum for people with MS and its associated physical disabilities, ranging from complex and long-recognized barriers that will likely require extended advocacy to create policy changes to issues that can and should be addressed through relatively minor changes in health-care delivery practices, improved care coordination, and increased provider awareness, education, and responsiveness to patients' needs.

Writing implementation research grant proposals: ten key ingredients.

BACKGROUND: All investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Applicants need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, many investigators may not feel equipped to write competitive proposals, and this concern is pronounced among early stage implementation researchers. DISCUSSION: This article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application. SUMMARY: Every investigator struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project's feasibility and likelihood of success. While no application can include a high level of detail about every ingredient, addressing the ten ingredients summarized in this article can help assure reviewers of the significance, feasibility, and impact of the proposed research.