Coping with COVID: Developing a Rapid-cycle Frontline Quality-improvement Process to Support Employee Well-being and Drive Institutional Responsiveness in a Tertiary Care Faith-based Hospital in Rural Kenya.

The coronavirus disease 2019 (COVID-19) pandemic has demanded rapid institutional responses to meet the needs of patients and employees in the face of a serious new disease. To support the well-being of frontline staff, a series of debriefing sessions was used to drive a rapid-cycle quality-improvement process. The goals were to confidentially determine personal coping strategies used by staff, provide an opportunity for staff cross-learning, identify what staff needed most, and provide a real-time feedback loop for decision-makers to create rapid changes to support staff safety and coping. Data were collected via sticky notes on flip charts to protect confidentiality. Management reviewed the data daily. Institutional responses to problems identified during debrief sessions were tracked, visualized, addressed, and shared with staff. More than 10% of staff participated over a 2-week period. Feedback influenced institutional decisions to improve staff schedules, transportation, and COVID-19 training.

Prediction of maximal oxygen consumption using the Young Men's Christian Association-step test in Korean adults.

PURPOSE: To develop accurate and practical prediction models of maximal oxygen consumption (VO2max) using the Young Men's Christian Association (YMCA)-step test in South Korean adults. METHODS: In total, 568 adults (20-66 years) were included in this study. To develop and cross-validate prediction models of VO2max, the total sample was divided into 80% training and 20% testing using a simple random sampling method. VO2max was measured using the maximal-graded exercise treadmill test. Sex, age, 1-min recovery heart rate, body weight, and height were measured as potential predictors. Each test was conducted within a 2- to 3-day interval, ensuring sufficient rest. Preliminary prediction models were developed from training datasets, which were cross-validated using regression analyses and/or repeated-measures analysis of variance. The accuracy of prediction models was evaluated using R2, standard error of estimate (SEE), and mean difference (MD) against a criterion-measured VO2max. RESULTS: The average age and VO2max were 43.5 ± 12.9 years and 39.1 ± 7.5 ml/kg/min, respectively. For model development, three practical models with acceptable accuracy were developed (R2 = 0.56-0.61; SEE = 4.74-5.01). For model cross-validation, significant relationships between the criterion-measured and predicted VO2max were observed in all three models (R2 = 0.56-0.61; SEE = 4.62-4.88). The difference between criterion-measured and predicted VO2max was not significant in the models (MD =- 0.03 to - 0.14). CONCLUSIONS: The prediction models included 3-5 variables as significant predictors of VO2max and had acceptable accuracy in a large sample of South Korean adults. The selected models provide a simple and practical method to estimate VO2max using the YMCA-step test for South Korean adults.

Availability of family planning services and quality of counseling by faith-based organizations: a three country comparative analysis.

BACKGROUND: Faith-based organizations (FBOs) have a long history of providing health services in developing countries and are important contributors to healthcare systems. Support for the wellbeing of women, children, and families is evidenced through active participation in the field of family planning (FP). However, there is little quantitative evidence on the availability or quality of FP services by FBOs. METHODS: The descriptive analysis uses facility-level data collected through recent Service Provision Assessments in Malawi (2013-14), Kenya (2010), and Haiti (2012) to examine 11 indicators of FP service and method availability and nine indicators of comprehensive and quality counseling. The indicators include measures of FP service provision, method mix, method stock, the provision of accurate information, and the discussion of reproductive intentions, client's questions/concerns, prevention of sexually transmitted infections, and return visits, among others. Pearson's Chi-square test is used to assess the selected indicators by managing authority (FBO, public, and other private sector) to determine statistical equivalence. RESULTS: Results show that FBOs are less likely to offer FP services than other managing authorities (p < 0.05). For example, 69% of FBOs in Kenya offer FP services compared to 97% of public facilities and 83% of other private facilities. Offering long-acting or permanent methods in faith-based facilities is especially low (43% in Malawi, 29% in Kenya and 39% in Haiti). There were few statistically significant differences between the managing authorities in comprehensive and quality counseling indicators. Interestingly, Haitian FBOs often perform as well or better than public sector health facilities on counseling indicators, such as discussion of a return visit (79% of FBO providers vs. 68% of public sector providers) and discussion of client concerns/questions (52% vs. 49%, respectively). CONCLUSIONS: Results from this analysis indicate that there is room for improvement in the availability of FP services by FBOs in these countries. Quality of counseling should be improved by all managing authorities in the three countries, as indicated by low overall coverage for practices such as ensuring confidentiality (22% in Malawi, 47% in Kenya and 12% in Haiti), discussion of sexually transmitted infections (18%, 25%, 17%, respectively), and providing services to youth (53%, 27%, 32%, respectively).

An Assessment of Needs of Church Coordinators Providing Meals to a Homeless Shelter.

Charitable meal services are crucial in sustaining the homeless, but few use nutritional professionals to create a balanced diet or make adjustments for those with specific dietary needs. A needs assessment was conducted among church coordinators responsible for providing meals to clients at a multi-service shelter in Detroit, Michigan. A survey and focus group were used to assess the processes involved in planning, preparing, and providing meals, which provided critical information and insight concerning nutrition and factors influencing meal-planning. According to the survey, a majority of faith organizations responding tried to meet food group requirements every meal. A predominant theme from the focus group was the desire to satisfy clients resulting in a variety and abundance of food enabling poor choices. The provision of healthy options was constrained by efforts to ease meal preparation, desire to provide comfort foods, and having difficulties accommodating diets related to health problems.