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1.
Gut ; 69(2): 311-316, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31040168

RESUMO

OBJECTIVE: The impact of a screening programme on colorectal cancer (CRC) incidence in its target population depends on several variables, including coverage with invitations, participation rate, positivity rate of the screening test, compliance with an invitation to second-level assessment and endoscopists' sensitivity. We propose a synthetic indicator that may account for all the variables influencing the potential impact of a screening programme on CRC incidence. DESIGN: We defined the 'rate of advanced adenoma on the target population' (AA-TAP) as the rate of patients who received a diagnosis of advanced adenoma within a screening programme, divided by the programme target population. We computed the AA-TAP for the CRC Italian screening programmes (biennial faecal immunochemical test, target population 50-69 year olds) using the data of the Italian National Survey from 2003 to 2016, overall and by region, and assessed the association between AA-TAP and CRC incidence fitting a linear regression between the trend of regional CRC incidence rates in 50-74 year old subjects and the cumulative AA-TAP. RESULTS: In 2016, the AA-TAP at a national level was 105×100 000, whereas significant differences were observed between the northern and central regions (respectively 126 and 149×100 000) and the South and Islands (36×100 000). The cumulative AA-TAP from 2004 to 2012 was significantly correlated with the difference between CRC incidence rates in 2013-2014 and those in 2003-2004 (p=0.009). CONCLUSION: The AA-TAP summarises into a single indicator the potential impact of a screening programme in reducing CRC incidence rates.


Assuntos
Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Adenoma/diagnóstico , Adenoma/epidemiologia , Idoso , Colonoscopia , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Incidência , Itália/epidemiologia , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Sangue Oculto , Cooperação do Paciente/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/métodos
2.
Br J Anaesth ; 124(2): 206-213, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31839255

RESUMO

BACKGROUND: Short educational programmes are important in building global anaesthesia workforce capacity. The Vital Anaesthesia Simulation Training (VAST) course is a 3-day immersive simulation-based programme concentrating on core clinical challenges and non-technical skills required by anaesthesia providers in low-resource settings. METHODS: This mixed methods study prospectively evaluated the impact of VAST in Rwanda. Anaesthetists' Non-Technical Skills (ANTS) scores were quantitatively assessed for 30 course participants at three time points (pre-, post-, and 4 months after VAST). Qualitative data were gathered during focus groups (4 months after VAST) to learn of participants' experiences implementing new knowledge into clinical practice. RESULTS: The ANTS total scores improved from pre- (11.0 [2.3]) (mean [standard deviation]) to post-test (14.0 [1.6]), and improvements were maintained at retention (14.2 [1.7]). A similar pattern was observed when data were analysed using the four ANTS categories (all P<0.001). The key theme that emerged during focus group discussions was that the use of cognitive aids and clinical algorithms, repeated and reinforced across simulated scenarios, encouraged a systematic approach to patient care. The participants attributed the systematic approach to improving their problem-solving skills and confidence, particularly during emergencies. They found value in well-functioning teams and shared decision-making. After VAST, the participants described empowerment to advocate for better patient care and system improvement. CONCLUSIONS: VAST offers a simulation-based training to anaesthesia providers working in low-resource settings. Skills retention and self-reported application of learning into the workplace reflect the scope of impact of this training.


Assuntos
Anestesiologia/educação , Competência Clínica/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/métodos , Treinamento por Simulação/métodos , Anestesistas , Países em Desenvolvimento , Seguimentos , Humanos , Estudos Prospectivos , Ruanda
3.
Rev Chilena Infectol ; 36(5): 565-575, 2019 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-31859797

RESUMO

BACKGROUND: Antimicrobial resistance (AMR) is a global threat to public health. Antibiotic stewardship programs (AMSP) promote the proper use of antimicrobials, improve clinical and economic outcomes, and helps containing the AMR. AIM: To evaluate the diagnostic phase of the AMS programs and early implementation of AMS at three high complexity hospitals that belong to the social security system in Peru. METHODS: A quasi-experimental multicenter study was implemented. The construction of the AMSP, microbiological baselines, antimicrobial consumption and consensus on AMS activities were evaluated at the diagnosis and early implementation periods of the AMSP. RESULTS: Following implementation, hospitals doubled their score of resources and processes available for the AMS program from 6.75 to 13.75. The prevalence of extended spectrum beta-lactamase producing enterobacteria was 50-60% while Pseudomonas aeruginosa averaged 69% resistance to carbapenems. The defined daily dose (DDD) of ceftriaxone was 13.63, vancomycin 7.35 and meropenem 6.73 in average. Hospitals A and C decreased the use of antimicrobials (30-50%). DISCUSSION: The implementation of the AMSP in the three hospitals was achieved through diverse strategies designed by multidisciplinary teams, which in addition to its articulation, reduce the consumption of broad spectrum antimicrobials at an early stage.


Assuntos
Anti-Infecciosos/administração & dosagem , Gestão de Antimicrobianos/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Resistência Microbiana a Medicamentos , Implementação de Plano de Saúde , Hospitais/estatística & dados numéricos , Humanos , Ensaios Clínicos Controlados não Aleatórios como Assunto , Peru , Previdência Social , Fatores de Tempo
5.
BMC Health Serv Res ; 19(1): 694, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615525

RESUMO

BACKGROUND: Group-based Diabetes Prevention Programs (DPP), aligned with recommendations from the Centers for Disease Control and Prevention, promote clinically significant weight loss and reduce cardio-metabolic risks. Studies have examined implementation of the DPP in community settings, but less is known about its integration in healthcare systems. In 2010, a group-based DPP known as the Group Lifestyle Balance (GLB) was implemented within a large healthcare delivery system in Northern California, across three geographically distinct regional administration divisions of the organization within 12 state counties, with varying underlying socio-demographics. The regional divisions implemented the program independently, allowing for natural variation in its real-world integration. We leveraged this natural experiment to qualitatively assess the implementation of a DPP in this healthcare system and, especially, its fidelity to the original GLB curriculum and potential heterogeneity in implementation across clinics and regional divisions. METHODS: Using purposive sampling, we conducted semi-structured interviews with DPP lifestyle coaches. Data were analyzed using mixed-method techniques, guided by an implementation outcomes framework consisting of eight constructs: acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. RESULTS: We conducted 33 interviews at 20 clinics across the three regional administrative divisions. Consistencies in implementation of the program were found across regions in terms of satisfaction with the evidence base (acceptability), referral methods (adoption), eligibility criteria (fidelity), and strategies to increase retention and effectiveness (sustainability). Heterogeneity in implementation across regions were found in all categories, including: the number and frequency of sessions (fidelity); program branding (adoption); lifestyle coach training (adoption), and patient-facing cost (cost). Lifestyle coaches expressed differing attitudes about curriculum content (acceptability) and suitability of educational level (appropriateness). While difficulties with recruitment were common across regions (feasibility), strategies used to address these challenges differed (sustainability). CONCLUSIONS: Variation exists in the implementation of the DPP within a large multi-site healthcare system, revealing a dynamic and important tension between retaining fidelity to the original program and tailoring the program to meet the local needs. Moreover, certain challenges across sites may represent opportunities for considering alternative implementation to anticipate these barriers. Further research is needed to explore how differences in implementation domains impact program effectiveness.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Promoção da Saúde/métodos , California , Aconselhamento , Assistência à Saúde/organização & administração , Feminino , Educação em Saúde/métodos , Pessoal de Saúde , Estilo de Vida Saudável , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Projetos de Pesquisa , Perda de Peso
6.
Lancet Psychiatry ; 6(11): 915-925, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31601530

RESUMO

BACKGROUND: Housing First is increasingly implemented for homeless adults with mental illness in large urban centres, but little is known about its long-term effectiveness. The At Home/Chez Soi randomised controlled trial done in five cities in Canada showed that Housing First improved housing stability and other select health outcomes. We extended the At Home/Chez Soi trial at the Toronto site to evaluate the long-term effects of the Housing First intervention on housing and health outcomes of homeless adults with mental illness over 6 years. METHODS: The At Home/Chez Soi Toronto study was a randomised, controlled trial done in Toronto (ON, Canada). Here, we present the results of an extension study done at the same site. Participants were homeless adults (aged ≥18 years) with a serious mental disorder with or without co-occurring substance use disorder. In phase 1, participants were stratified by level of need for mental health support services (high vs moderate), and randomly assigned (1:1) using adaptive randomisation procedures to Housing First with assertive community treatment (HF-ACT), Housing First with intensive case management (HF-ICM), or to treatment as usual (TAU). Participants with moderate support needs were further stratified by ethnoracial status. Considering the nature of the Housing First intervention, study participants and study personnel were not masked to group assignment. Phase 1 participants could choose to enrol in the extension study (phase 2). The primary outcome was the rate of days stably housed per year analysed in the modified intention-to-treat population, which included all randomly assigned participants who had at least one assessment for the primary outcome. Participants contributed data to the study up to the point of their last interview. Multilevel multiple imputation was used to handle missing data. The trial was registered with ISRCTN, ISRCTN42520374. FINDINGS: Between Oct 1, 2009, and March 31, 2013, 575 individuals participated in phase 1 of the Toronto Site At Home/Chez Soi study (197 [34%] participants with high support needs and 378 [66%] with moderate support needs). Of the 378 participants with moderate support needs, 204 were randomly assigned to receive the HF intervention with ICM or with ethnoracial-specific ICM services (HF-ER-ICM; HF-ICM or HF-ER-ICM groups) and 174 were randomly assigned to TAU. Of the 197 participants with high support needs, 97 were randomly assigned to receive the HF intervention with ACT (HF-ACT treatment group) and 100 were randomly assigned to TAU group. Between Jan 1, 2014, and March 31, 2017, 414 (81%) of 575 phase 1 participants participated in the extended phase 2 study. The median duration of follow-up was 5·4 years (IQR 2·1-5·9). Among phase 2 participants, 141 had high support needs (79 participants in the HF-ACT group; 62 participants in the TAU group), and 273 had moderate support needs (160 participants in the HF-ICM or HF-ER-ICM group; 113 participants in the TAU group). 187 high support needs participants (93 participants in the HF-ACT group, 94 participants in the TAU group), and 361 moderate support needs participants (201 participants in the HF-ICM or HF-ER-ICM group, 160 participants in the TAU group) were included in the modified intention-to-treat analysis for the primary outcome. The number of days spent stably housed was significantly higher among participants in the HF-ACT and HR-ICM or HF-ER-ICM groups than participants in the TAU groups at all timepoints. For participants with moderate support needs, the rate ratio (RR) of days stably housed in the Housing First group, compared with TAU, was 2·40 (95% CI 2·03-2·83) in year 1, which decreased to 1·13 (1·01-1·26) in year 6. The RR of days stably housed for participants with high support needs, compared with TAU, was 3·02 (2·43-3·75) in year 1 and 1·42 (1·19-1·69) in year 6. In year 6, high support needs participants in the Housing First group spent 85·51% of days stably housed compared with 60·33% for the TAU group, and moderate needs participants in the Housing First group spent 88·16% of days stably housed compared with 78·22% for the TAU group. INTERPRETATION: Rent supplements and mental health support services had an enduring positive effect on housing stability for homeless adults with mental illness in a large, resource-rich urban centre, with a larger impact on individuals with high support needs than moderate support needs. FUNDING: Mental Health Commission of Canada, Ontario Ministry of Health and Long-Term Care, and the Canadian Institute of Health Research.


Assuntos
Serviços Comunitários de Saúde Mental/métodos , Pessoas em Situação de Rua/psicologia , Pessoas em Situação de Rua/estatística & dados numéricos , Transtornos Mentais/terapia , Avaliação de Programas e Projetos de Saúde/métodos , Habitação Popular/estatística & dados numéricos , Adulto , Feminino , Seguimentos , Humanos , Masculino , Transtornos Mentais/psicologia , Ontário , Tempo , População Urbana/estatística & dados numéricos
7.
Z Psychosom Med Psychother ; 65(3): 272-287, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31477000

RESUMO

Development of an evaluation system for online self-help groups by using the example of German-speaking cancer forums Objectives: This paper pursues the question how the quality of forums can be evaluated. Therefor a grading system was designed and 23 German-speaking cancer forums were evaluated by content and formal criteria Methods: Using a keyword-based internet search, 23 forums were identified. Data was gathered about: number of themes, posts and members, structure, key subjects and type of financing. Furthermore, an evaluation system was developed, with which the forums where assessed. Results: The forums were divided in forums with (n = 10) and without (n = 9) focus on a type of cancer. Four are health portals with forum-function. The quality of online cancer forums is heterogeneous, the evaluation resulted an average quality index of 2.7 for the total cancer forums Conclusion: A good information editing, moderation, data protection and transparency are important quality criteria. The evaluation of forums may help the patients, to autonomously value the quality of the presented information.


Assuntos
Internet , Linguagem , Neoplasias , Avaliação de Programas e Projetos de Saúde/métodos , Grupos de Autoajuda/normas , Mídias Sociais/normas , Alemanha , Humanos
8.
Tidsskr Nor Laegeforen ; 139(11)2019 Aug 20.
Artigo em Norueguês, Inglês | MEDLINE | ID: mdl-31429231

RESUMO

BACKGROUND: Students and education authorities are expressing an increasing demand for educational quality and student involvement in higher education. We present a descriptive observational study of a student-initiated system for evaluation of lectures in the medical degree programme at the University of Oslo. MATERIAL AND METHOD: Criteria-based student evaluations of 445 lectures in the first and second year of the medical degree programme were conducted in spring and autumn 2017 and spring 2018; after each lecture, three students completed a questionnaire about the lecture. The responses were sent by email to the lecturer on the same day. We performed an analysis of the evaluations, a group interview with the cohort's elected representatives, and a questionnaire survey among the lecturers who received an evaluation. RESULTS: The lecturers received generally good feedback, but the student evaluations also indicated a clear potential for improvement: 21 % of the lectures were not adapted to the volume of information, 32 % did not point out the association with the learning outcomes, 31 % failed to activate the students and 40 % did not provide a summary at the end of the lecture. The cohort's elected representatives had a positive attitude to the evaluation scheme, but requested a simpler technical solution. Almost all the lecturers welcomed the student evaluation, and more than half had used the evaluations to improve their lectures. INTERPRETATION: This quality development project shows how students, teachers, administration and management can collaborate to improve the teaching.


Assuntos
Educação de Graduação em Medicina/normas , Avaliação de Programas e Projetos de Saúde/métodos , Estudantes de Medicina/psicologia , Inquéritos e Questionários , Feedback Formativo , Humanos , Entrevistas como Assunto , Noruega , Melhoria de Qualidade
9.
J Autism Dev Disord ; 49(11): 4468-4481, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31463631

RESUMO

Despite the need for parent education and training programmes in autism spectrum disorder (ASD), there is no generally-accepted evaluation framework to select programmes for different settings. Here we generated an evaluation framework using a multi-stakeholder, implementation science approach. Purposive sampling identified ASD experts, implementation/health systems experts, and parents/carers of individuals with ASD. A consensus-building stakeholder workshop with 14 stakeholders and thematic analysis was used to generate themes and components of the framework. Main themes included 'Outcomes' (parent, child, family and community), 'Processes and Procedures' (accessibility, acceptability, psychological process, and referral pathways) and 'Implementation Landscape' (sustainability, scalability, integration and coordination, and monitoring and evaluation). We propose that the evaluation framework and Evaluation Framework Checklist generated could guide clinicians, researchers and policy-makers.


Assuntos
Transtorno do Espectro Autista/psicologia , Educação não Profissionalizante , Poder Familiar/psicologia , Avaliação de Programas e Projetos de Saúde/métodos , Participação dos Interessados/psicologia , Adulto , Criança , Feminino , Humanos , Ciência da Implementação , Masculino , Pais/educação , Pais/psicologia
10.
Afr J Prim Health Care Fam Med ; 11(1): e1-e6, 2019 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-31296013

RESUMO

BACKGROUND:  Tobacco use is an important public health issue. Morocco implemented a tobacco control programme, which has been ongoing among students at middle and secondary schools since 2010. AIM:  This study aims to compare the trend in smoking among the programme beneficiaries with the results of the initial study conducted prior to the implementation of the programme. SETTING:  This study was conducted in middle and secondary schools of the Gharb Region in Morocco between 2010 and 2015. METHODS:  Two cross-sectional studies were conducted in 2010 and 2015 in the middle and secondary schools of the Gharb Region. Multistage cluster sampling was used. The information was collected using a self-administered questionnaire. RESULTS:  In the first study in 2010, 5312 students participated, and in the second one in 2015, 4208 students participated. The level of information on smoking and its effects was higher in 2015 (94.0%) than in 2010 (92.5%). In 2010, parents, primary schools and television and radio were more involved in student information on smoking compared to 2015. The proportion of students claiming that tobacco was not a pleasure (86.3%) and that it does not calm nerves (76.5%) was significantly higher in 2015 than in 2010. The prevalence of smoking increased significantly in 2015 (2.9%) against 2010 (1.8%). CONCLUSION:  This study reports the general positive evolution in knowledge about smoking and its effects. Despite that the prevalence of smokers increased in 2015. The results suggest the need to address family influences on adolescent smoking and to investigate participation of schools in education and training students in tobacco dependence prevention.


Assuntos
Fumar Cigarros/epidemiologia , Fumar Cigarros/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Avaliação de Programas e Projetos de Saúde/métodos , Adolescente , Adulto , Criança , Análise por Conglomerados , Estudos Transversais , Feminino , Humanos , Masculino , Marrocos/epidemiologia , Inquéritos e Questionários , Adulto Jovem
11.
BMC Pregnancy Childbirth ; 19(1): 253, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331285

RESUMO

BACKGROUND: During pregnancy and postnatally, women seek information from a variety of sources. The potential to incorporate educational pregnancy and parenting resources into conventional health services is underexplored. In 2014-2016, UK-based charity Best Beginnings used an embedding model to embed three of their resources - the Baby Buddy app, Baby Express magazine, and 'From Bump to Breastfeeding' DVD - into maternity and early years care pathways at three sites in the north of England. A mixed-methods evaluation comprising an impact evaluation and a process evaluation was undertaken. Here we report findings from the process evaluation that aimed to understand the embedding process, explore maternity and early years' professionals' views and use of the resources, explore women's engagement with and views of the resources, and identify barriers and facilitators to the embedding process. METHODS: We carried out semi-structured interviews with stakeholders (professionals involved in embedding) and observations of embedding activities to understand how embedding worked. Surveys of postnatal women were conducted over a two-month period both prior to, and after, the resources had been embedded, to ascertain engagement with and views of the resources. A survey of professionals was carried out post-embedding to understand how, where and when the resources were used in practice, and professionals' views. Descriptive and thematic analyses were undertaken. RESULTS: Thirty stakeholders took part in interviews. Surveys were completed by 146 professionals, and by 161 and 192 women in the pre and post-embedding phases respectively. Themes derived from analysis of qualitative data were 'Implementation of the embedding model', 'Promotion and distribution of, and engagement with, the resources', 'Fit with care pathways', and 'Perceptions of the resources'. While survey responses indicated that embedding of the resources into practice was not yet complete, those who had used the resources believed that they had helped increase knowledge, build confidence and support relationship-building. CONCLUSIONS: Incorporating supportive parenting resources into maternity and early years' care pathways requires a planned embedding approach, committed champions, and senior management support. Findings indicate largely positive views of women and professionals, and suggest the resources can be a beneficial aid for families.


Assuntos
Promoção da Saúde , Comportamento Materno/psicologia , Educação Pré-Natal , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Humanos , Comportamento de Busca de Informação , Serviços de Saúde Materna , Participação do Paciente/métodos , Gravidez , Educação Pré-Natal/métodos , Educação Pré-Natal/organização & administração , Avaliação de Programas e Projetos de Saúde/métodos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Apoio Social , Reino Unido
12.
Implement Sci ; 14(1): 73, 2019 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319857

RESUMO

BACKGROUND: Full capacity protocol (FCP) is an internationally recognized intervention designed to address emergency department (ED) crowding. Despite FCP international recognition and positive effects on hospital performance measures, many hospitals, even the most crowded ones, have not implemented FCP. We conducted this study to identify the core components of FCP, explore the key barriers and facilitators associated with the FCP implementation, and provide practical recommendations on how to overcome those barriers. METHODS: To identify the core components of FCP, we used a non-experimental approach. We conducted semi-structured interviews with key informants (e.g., division chiefs, medical directors) involved in the implementation of FCP. We used the Consolidated Framework for Implementation Research (CFIR) to guide data collection and analysis. We used a template analysis approach to determine the relevance of the CFIR constructs to implementing the FCP. We analyzed the responses to the interview questions about FCP definition and FCP key principles, compared different hospitals' FCP official documents, and consulted with the original FCP developer. We then used an adaptation framework to categorize the core components of FCP into three main groups. Finally, we summarized practical recommendations for each barrier based on information provided by the interviewees. RESULTS: A total of 32 interviews were conducted. We observed that FCP has evolved from the idea of transferring boarded patients from ED hallways to inpatient hallways to a practical hospital-wide intervention with several components and multiple levels. The key determinant of successful FCP implementation was collaboration with inpatient nursing staff, as they were often reluctant to have patients boarded in inpatient hallways. Other determinants of successful FCP implementation were reaching consensus about the criteria for activation of each FCP level and actions in each FCP level, modifying the electronic health records system, restructuring the inpatient units to have adequate staffing and resources, complying with external regulations and policies such as fire marshal guidelines, and gaining hospital leaders' support. CONCLUSIONS: The key determinant in implementing FCP is creating a supportive and cooperative hospital culture and encouraging key stakeholders, including inpatient nursing staff, to acknowledge that crowding is a hospital-wide problem that requires a hospital-wide response.


Assuntos
Aglomeração , Serviço Hospitalar de Emergência/organização & administração , Política Organizacional , Avaliação de Programas e Projetos de Saúde/métodos , Melhoria de Qualidade/organização & administração , Humanos
13.
Int J Evid Based Healthc ; 17 Suppl 1: S15-S17, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31283571

RESUMO

BACKGROUND: The Spanish Best Practice Guidelines (BPG) Implementation Project is part of the Best Practice Spotlight Organizations international program, coordinated by the Registered Nurses' Association of Ontario (RNAO). AIMS: To influence the uptake of nursing BPG across healthcare organizations, to enable practice excellence and positive client outcomes. METHODS: After translating the RNAO's BPG into Spanish, the Host Organization published a formal call for proposals to select healthcare settings in Spain to implement the RNAO's BPG and evaluate the results. The approach is nursing-led and multidisciplinary; context specific; and involving a wide range of stakeholders. The implementation of BPG Toolkit guides the process: cascade training, selection of recommendations to be implemented, 3 years of planned implementation activities, monitoring of process and outcome results for patients discharged 60 days every year. The Host Organization supports healthcare settings selected. RESULTS/DISCUSSION: The first call was launched in 2012. Eight healthcare settings (11 sites), serving 1.3 million people, were selected (hospitals and primary healthcare centers). They chose 10 BPG, according to their needs. In 2015 and 2018, 16 more healthcare settings have joined the program with a total of 263 sites. And in 2019, three complete regions will join the program as a regional host. Currently, more than 3200 nurses and 40 other healthcare professionals have been trained, evidence-based protocols have been developed or updated, patient education has been promoted, and international Best Practice Spotlight Organizations indicators have been evaluated in an electronic platform. CONCLUSION: The results obtained acknowledge that the RNAO implementation method could be replicated with success internationally. The strategies based on local context have worked and we have consolidated a network that shares knowledge and strategies and promotes evidence-based culture among Spanish healthcare settings and evidence-based care to patients.


Assuntos
Enfermagem Baseada em Evidências/normas , Guias como Assunto/normas , Administração Hospitalar , Hospitais , Humanos , Educação de Pacientes como Assunto , Atenção Primária à Saúde/organização & administração , Avaliação de Programas e Projetos de Saúde/métodos , Espanha , Traduções
14.
Pediatrics ; 144(2)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31262779

RESUMO

CONTEXT: Although adolescent mental health interventions are widely implemented, little consensus exists about elements comprising successful models. OBJECTIVE: We aimed to identify effective program components of interventions to promote mental health and prevent mental disorders and risk behaviors during adolescence and to match these components across these key health outcomes to inform future multicomponent intervention development. DATA SOURCES: A total of 14 600 records were identified, and 158 studies were included. STUDY SELECTION: Studies included universally delivered psychosocial interventions administered to adolescents ages 10 to 19. We included studies published between 2000 and 2018, using PubMed, Medline, PsycINFO, Scopus, Embase, and Applied Social Sciences Index Abstracts databases. We included randomized controlled, cluster randomized controlled, factorial, and crossover trials. Outcomes included positive mental health, depressive and anxious symptomatology, violence perpetration and bullying, and alcohol and other substance use. DATA EXTRACTION: Data were extracted by 3 researchers who identified core components and relevant outcomes. Interventions were separated by modality; data were analyzed by using a robust variance estimation meta-analysis model, and we estimated a series of single-predictor meta-regression models using random effects. RESULTS: Universally delivered interventions can improve adolescent mental health and reduce risk behavior. Of 7 components with consistent signals of effectiveness, 3 had significant effects over multiple outcomes (interpersonal skills, emotional regulation, and alcohol and drug education). LIMITATIONS: Most included studies were from high-income settings, limiting the applicability of these findings to low- and middle-income countries. Our sample included only trials. CONCLUSIONS: Three program components emerged as consistently effective across different outcomes, providing a basis for developing future multioutcome intervention programs.


Assuntos
Comportamento do Adolescente/psicologia , Saúde Mental , Comportamento de Redução do Risco , Assunção de Riscos , Adolescente , Humanos , Avaliação de Programas e Projetos de Saúde/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos
15.
BMC Res Notes ; 12(1): 388, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31292006

RESUMO

OBJECTIVES: This study is designed to evaluate the effect of a workshop about new teaching and learning methods on the response, knowledge, and behavior of healthcare staff working a large city healthcare center. RESULTS: Kirkpatrick's program evaluation model showed that the workshop on new teaching and learning methods significantly improved the healthcare staff's satisfaction about the teaching environment of workshops, their knowledge about new teaching and learning methods and their behavior in performing workshops for teaching people. It is recommended that this teaching and learning methods workshop should be considered in educational programs for healthcare staff. Trial registration Trial registration number: IRCT20180619040150N1 approved by Iranian Registry of Clinical Trials at 2018-07-27.


Assuntos
Currículo/normas , Pessoal de Saúde/educação , Aprendizagem , Modelos Educacionais , Ensino , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde/métodos
16.
Orv Hetil ; 160(23): 914-920, 2019 Jun.
Artigo em Húngaro | MEDLINE | ID: mdl-31155881

RESUMO

Introduction: Drug-taking habit is not infrequent in the young population. There is a need of proven effective drug prevention programs. Aim: The aim of our study was to analyze the efficiency of the Hungarian Police's DADA school-drug prevention program. Method: The research program was carried out by a standard questionnaire at Apáczai Csere János Primary School in Pécs and Kodolányi János Primary School in Pécsvárad. Results: After analyzing the participating students' answers, the results showed that the rate of those, who "know everything" about drugs, increased from 27% to 37.3%, and of those, who did "not know anything", decreased from 5.6% to 1.6% (p<0.001). Regarding self-efficiency, the DADA program did not show any significant change (p = 0.364). However, less than 60% of the students agreed the statements: "I have learned a lot from the trainings" and "I received answers to several questions that I had been interested in earlier." Conclusion: We can conclude that the DADA program was successful. Regarding the chosen reactions and opinions about the program, we have to consider the sociocultural background of the participants. Orv Hetil. 2019; 160(23): 914-920.


Assuntos
Avaliação de Programas e Projetos de Saúde/métodos , Serviços de Saúde Escolar , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Humanos , Hungria , Instituições Acadêmicas , Estudantes , Inquéritos e Questionários
17.
Adv Physiol Educ ; 43(3): 259-265, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31166127

RESUMO

Pharmacy school applications have steadily declined over the past several years. Thus pharmacy schools are not only searching for effective means to increase enrollment of qualified candidates, but are also focusing on the development of programs to improve academic performance and retention of enrolled students. To address the needs of struggling first-year pharmacy students enrolled in an Integrated Biological Sciences (BSI) course, an academic performance enrichment program (APEP) was developed. The program was designed to improve academic success by engaging low-performing students with the aims of improving their time management skills, study skills, metacognition, and understanding of BSI course material. The APEP consisted of structured tutoring sessions twice per week, which were required for all students with a course grade ≤73.5% at any point during the semester. To assess program effectiveness, performance improvement on BSI exams by the APEP students were compared with that of non-APEP students in the same class and to those in the previous 3 yr. Student perceptions of the program were also evaluated via an online survey. The APEP was deemed effective in that a greater percentage of students were able to improve their exam scores and to a greater extent by attending the APEP sessions compared with non-APEP students in the same class and with low-performing students in previous years when the APEP did not exist. Furthermore, APEP students believed the program was effective in meeting its aims. In conclusion, the APEP was effective in improving academic performance of low-performing students in BSI.


Assuntos
Desempenho Acadêmico/normas , Avaliação Educacional/normas , Avaliação de Programas e Projetos de Saúde/normas , Faculdades de Farmácia/normas , Estudantes de Farmácia , Desempenho Acadêmico/tendências , Avaliação Educacional/métodos , Humanos , Avaliação de Programas e Projetos de Saúde/métodos , Avaliação de Programas e Projetos de Saúde/tendências , Faculdades de Farmácia/tendências , Estudantes de Farmácia/psicologia , Inquéritos e Questionários
18.
Sante Publique ; Vol. 31(1): 53-60, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31210517

RESUMO

INTRODUCTION: Regular physical activity is nowadays recognized as one of the keys for ageing well. A number of interventions are therefore developed for this target group. The goal of this study was to examine the establishment and impact of a structured physical activity program for subjects aged 60 or more on a departmental scale and according to the point of view of different actors engaged. METHODS: The PAS Project (Prévention Active Senior), coordinated by a resource and expertise center, consisted of conceiving and implementing a structured physical activity program for subjects aged 60 or more. In every municipality, the program was conducted by a local sports instructor in partnership with a municipal representative. It consisted of 3 weekly sessions of physical activity (2 supervised and 1 individual) over a period of 3 months. The data was collected thanks to the tools developed for the evaluation. RESULTS: The program was conducted in 27 municipalities. A total of 586 participants enrolled in the program and 439 completed the final evaluation. This project allowed for the improvement of three main physical capacities (endurance, muscular strength, and balance) for most of the participants. At the end of the program, more than 50% of municipalities created or supported a long term physical activity offer for elderly. DISCUSSION: This study highlights the need of adapting this kind of intervention to the local context. It confirmed the interest of a combined individual and more general approach, as well as a cross-sectorial work in order to create the conditions for sustainable daily physical activity for the target group.


Assuntos
Exercício , Avaliação de Programas e Projetos de Saúde/métodos , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade
20.
BMC Public Health ; 19(1): 803, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234804

RESUMO

BACKGROUND: The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework is a useful tool for evaluating the impact of programs in community settings. RE-AIM has been applied to evaluate individual programs but seldom used to evaluate the collective impact of community-based, public health programming developed and delivered by multiple autonomous organizations. The purposes of this paper were to (a) demonstrate how RE-AIM can be operationalized and applied to evaluate the collective impact of similar autonomous programs that promote health and well-being and (b) provide preliminary data on the collective impact of Canadian spinal cord injury (SCI) peer mentorship programs on the delivery of peer mentorship services. METHODS: Criteria from all five RE-AIM dimensions were operationalized to evaluate multiple similar community-based programs. For this study, nine provincial organizations that serve people with SCI were recruited from across Canada. Organizations completed a structured self-report questionnaire and participated in a qualitative telephone interview to examine different elements of their peer mentorship program. Data were analyzed using summary statistics. RESULTS: Having multiple indicators to assess RE-AIM dimensions provided a broad evaluation of the impact of Canadian SCI peer mentorship programs. Peer mentorship programs reached 1.63% of the estimated Canadian SCI population. The majority (67%) of organizations tracked the effectiveness of peer mentorship through testimonials and reports. Setting-level adoption rates were high with 100% of organizations offering peer mentorship in community and hospital settings. On average, organizations allocated 10.4% of their operating budget and 9.8% of their staff to implement peer mentorship and 89% had maintained their programming for over 10 years. Full interpretation of the collective impact of peer mentorship programs was limited as complete data were only collected for 52% of survey questions. CONCLUSIONS: The lack of available organizational data highlights a significant challenge when using RE-AIM to evaluate the collective impact of multiple programs that promote health and well-being. Although researchers are encouraged to use RE-AIM to evaluate the collective impact of programs delivered by different organizations, documenting limitations and providing recommendations should be done to further the understanding of how best to operationalize RE-AIM in these contexts.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Implementação de Plano de Saúde/métodos , Tutoria/organização & administração , Avaliação de Programas e Projetos de Saúde/métodos , Canadá , Serviços de Saúde Comunitária/métodos , Humanos , Tutoria/métodos , Grupo Associado , Traumatismos da Medula Espinal/psicologia , Traumatismos da Medula Espinal/reabilitação , Inquéritos e Questionários
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