Learning to Implement Dialogic Reading Through Video-Based Online Training: A Preliminary Study.

PURPOSE: Dialogic reading (DR) is an evidence-based method for reading with young children that is associated with improvements in children's oral language skills. There is, however, a lack of consensus on (a) how to train educators to deliver the intervention and (b) methods for assessing implementation fidelity. We designed this study to provide preliminary data about the viability of online video modules as an initial training option within a future tiered training model. METHOD: We employed a within-subject repeated-measures group design to evaluate educators' (N = 20) implementation of DR after viewing training videos. Educators filmed themselves reading three storybooks with a child "as they would typically" to establish pretest reading behaviors. After being given access to a series of DR training videos, the educators recorded themselves reading three storybooks with the child using DR strategies as a posttest measure. RESULTS: Educators improved their use of individual strategies included in the DR instructional sequence at posttest; however, most participants did not consistently follow the entire instructional sequence as designed. Only one educator delivered the complete DR instructional sequence in > 80% of opportunities at posttest. CONCLUSION: Modifications to video training modules and additional coaching support may be warranted for many educators to achieve the level of implementation fidelity needed to improve the child's oral language skills from the intervention. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25749387.

Diagnostic accuracy of a point-of-care antigen test for SARS-CoV-2 and influenza in a primary care population (RAPTOR-C19).

OBJECTIVES: Limited evidence exists for the diagnostic performance of point-of-care tests for SARS-CoV-2 and influenza in community healthcare. We carried out a prospective diagnostic accuracy study of the LumiraDx™ SARS-CoV-2 and influenza A or B assay in primary care. METHODS: Total of 913 adults and children with symptoms of current SARS-CoV-2 infection were recruited from 18 UK primary care practices during a period when Omicron was the predominant COVID variant of concern (June 2022 to December 2022). Trained health care staff performed the index test, with diagnostic accuracy parameters estimated for SARS-CoV-2 and influenza against real-time reverse-transcription PCR (rtRT-PCR). RESULTS: 151/887 participants were SARS-CoV-2 rtRT-PCR positive, 109 positive for Influenza A, 6 for Influenza B. Index test sensitivity for SARS-CoV-2 was 80.8% (122 of the 151, 95% CI, 73.6-86.7%) and specificity 98.9% (728 of the 736, 95% CI, 97.9-99.5%). For influenza A, sensitivity was 61.5% (67 of the 109, 95% CI, 51.7-70.6%) and specificity 99.4% (771 of the 776, 95% CI, 98.5-99.8%). Sensitivity to detect SARS-CoV-2 and influenza dropped sharply at rtRT-PCR cycle thresholds (Ct) > 30. DISCUSSIONS: The LumiraDx™ SARS-CoV-2 and influenza A/B assay had moderate sensitivity for SARS-CoV-2 in symptomatic patients in primary care, with lower performance with high rtRT-PCR Ct. Negative results in this patient group cannot definitively rule out SARS-CoV-2 or influenza.

Effects of user fees on the utilization pattern of family planning services in primary care centers in St. Elizabeth

Effective family planning services are critical to reducing fertility levels and increasing life expectancy. With declining donor support and the inability of public health resources to provide for all, the introduction of user fees - a cost recovery alternative was adopted. The study was conducted on 250 women 15-39 years in St. Elizabeth. The results indicate that although 49 percent women discontinued the use of contraceptives after the introduction of user fees, a similar proportion accepted a contraceptive method. More women, however, chose low cost contraceptives. Women are willing to pay for contraceptives based on their economic status; but concern exists for the under privileged who are unable to pay for a service which is so vital to the entire population. The need exists for strategies to be employed in the assessment of women, so that the poor can access these services free of cost, and for improving cost effective use of resources. The study points to the need for structured, ongoing family planning educational programmes focused on individual needs of both sexes. Formal education and employment opportunities could also play a major role in accessing family planning services. The search for alternate methods of financing such as private sector/community involvement, to supplement user fees, may be seen as another option (AU)