scholarly journals Participant perspectives of a telehealth trial investigating the use of telephone and text message support in obesity management: a qualitative evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emily Lewis ◽  
Peter Hassmén ◽  
Kate L. Pumpa
Keyword(s):  
Text Message ◽  
Qualitative Evaluation ◽  
Management Program ◽  
Obesity Management ◽  
Community Based ◽  
Quantitative Evidence ◽  
Intervention Adherence ◽  
Telephone Calls ◽  
Participant Perspectives ◽  
High Degree

AbstractBackground: Quantitative evidence suggests that interventions involving telephone calls and text message are feasible and effective for improving lifestyle intervention adherence and clinical outcomes among adults with obesity. The aim of this article is to provide qualitative insight into the perspectives and experiences of participants who completed a telehealth trial exploring the use of telephone and text support as adjunctive tools to support a community-based obesity management program. Methods: Focus groups were conducted in order to evaluate program acceptability and overall participant perceptions of the clinical trial. Thematic content analysis was used to analyse the data, aided by the development of a thematic network. Results: The telehealth trial was well received. Participants found the telephone and text message support highly beneficial, providing encouragement, motivation and accountability via a simple and convenient mode of communication. Conclusions: These findings suggest a high degree of promise for the incorporation of telephone and text support in obesity management.

scholarly journals The Importance of Perceived Relevance: A Qualitative Evaluation of Patient’s Perceptions of Value and Impact Following a Low-Intensity Group-Based Pain Management Program

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 46
Author(s):  
Joshua W. Pate ◽  
Elizabeth Tran ◽  
Seema Radhakrishnan ◽  
Andrew M. Leaver
Keyword(s):  
Pain Management ◽  
Qualitative Evaluation ◽  
Management Program ◽  
Structured Interviews ◽  
Patient Beliefs ◽  
Pain Management Program ◽  
Westmead Hospital ◽  
Group A ◽  
Perceived Relevance ◽  
Beliefs And Attitudes

Background and objectives: Limited evidence exists exploring perceptions of which aspects of a pain management program are perceived as valuable and impactful. The aim of this study was to explore patient beliefs about which aspects of a pain management program were valued and/or had perceived impact. Materials and Methods: One-on-one structured interviews were conducted with 11 adults three months after their completion of the Spark Pain Program at Westmead Hospital, Sydney, Australia. Concepts in the transcripts were inductively identified and explored, utilizing thematic analysis to better understand their relevance to the study aim. Results: Four themes emerged: (1) “The program overall was positive, but…”; (2) “I valued my improved knowledge and understanding of pain, but…”; (3) “I valued the stretching/relaxation/pacing/activity monitoring”; and (4) “I valued being part of a supportive and understanding group”. Participants reported that they liked being treated as an individual within the group. A lack of perceived personal relevance of key messages was identified in some participants; it appears that patients in pain programs must determine that changes in knowledge, beliefs, and attitudes are personally relevant in order for the changes to have a significant impact on them. Conclusions: This study provides new insights into aspects of a pain management program that were perceived as valuable and impactful, areas that “missed the mark”, and hypotheses to guide the implementation of service delivery and program redesign.

scholarly journals Economic burden of childhood diarrhea in Burundi

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Fulgence Niyibitegeka ◽  
Arthorn Riewpaiboon ◽  
Sitaporn Youngkong ◽  
Montarat Thavorncharoensap
Keyword(s):  
Economic Burden ◽  
Cost Model ◽  
Primary Treatment ◽  
Management Program ◽  
Community Based ◽  
Factors Affecting ◽  
Hospitalization Costs ◽  
Illness Study ◽  
The Cost ◽  
Substantial Economic Burden

Abstract Background In 2016, diarrhea killed around 7 children aged under 5 years per 1000 live births in Burundi. The objective of this study was to estimate the economic burden associated with diarrhea in Burundi and to examine factors affecting the cost to provide economic evidence useful for the policymaking about clinical management of diarrhea. Methods The study was designed as a prospective cost-of-illness study using an incidence-based approach from the societal perspective. The study included patients aged under 5 years with acute non-bloody diarrhea who visited Buyenzi health center and Prince Regent Charles hospital from November to December 2019. Data were collected through interviews with patients’ caregivers and review of patients’ medical and financial records. Multiple linear regression was performed to identify factors affecting cost, and a cost model was used to generate predictions of various clinical and care management costs. All costs were converted into international dollars for the year 2019. Results One hundred thirty-eight patients with an average age of 14.45 months were included in this study. Twenty-one percent of the total patients included were admitted. The average total cost per episode of diarrhea was Int$109.01. Outpatient visit and hospitalization costs per episode of diarrhea were Int$59.87 and Int$292, respectively. The costs were significantly affected by the health facility type, patient type, health insurance scheme, complications with dehydration, and duration of the episode before consultation. Our model indicates that the prevention of one case of dehydration results in savings of Int$16.81, accounting for approximately 11 times of the primary treatment cost of one case of diarrhea in the community-based management program for diarrhea in Burundi. Conclusion Diarrhea is associated with a substantial economic burden to society. Evidence from this study provides useful information to support health interventions aimed at prevention of diarrhea and dehydration related to diarrhea in Burundi. Appropriate and timely care provided to patients with diarrhea in their communities and primary health centers can significantly reduce the economic burden of diarrhea. Implementing a health policy to provide inexpensive treatment to prevent dehydration can save significant amount of health expenditure.

Evaluation of Clinical Competence: The Gap Between Expectation and Performance

PEDIATRICS ◽  
1996 ◽  
Vol 97 (2) ◽  
pp. 179-184
Author(s):  
Bahman Joorabchi ◽  
Jeffrey M. Devries
Keyword(s):  
Descriptive Analysis ◽  
Data Gathering ◽  
Community Based ◽  
Resident Performance ◽  
Faculty Expectations ◽  
Clinical Evaluations ◽  
Pediatric Residency ◽  
Objective Structured Clinical Examinations ◽  
And Performance ◽  
High Degree

Objective. To evaluate a 3-year experience with the Objective Structured Clinical Examinations (OSCEs) and to compare faculty expectations with resident performance. Design. Descriptive analysis of measures of resident performance. Setting. Community-based pediatric residency program in Michigan. Participants. One hundred twenty-six pediatric residents at all levels of training. Methods. The three examinations consisted of 36 to 42 5-minute stations, testing skills in physical examination, history, counseling, telephone management, and test interpretation. A committee of faculty and chief residents predetermined minimum pass levels for each resident level. Results were compared with other indices of resident performance. Results. There was evidence for content, construct, and concurrent validity, as well as a high degree of reliability. However, 40% to 96% of residents scored below the minimum pass levels for their levels. In each examination, third-year residents had the highest failure rates, yet they scored well on the American Board of Pediatrics in-training examination and on their monthly clinical evaluations. Furthermore, for residents at all levels, the scores reflecting application of data were significantly lower than those assessing data gathering. Conclusions. The gaps between expectations and performance, and between data gathering and application, have important implications for institutional educational philosophy, suggesting a shift toward more clinically oriented and learner-directed strategies in the design of instructional and evaluation methods.

scholarly journals Increasing the uptake of cervical screening at cornerstone medical practice

2021 ◽  
Vol 10 (3) ◽  
pp. e001126
Author(s):  
Adeola Oyegbite ◽  
Jessica Roberts ◽  
Joanna Bircher
Keyword(s):  
Statistical Significance ◽  
Cervical Screening ◽  
Text Message ◽  
Text Messages ◽  
Similar Response ◽  
Practice List ◽  
North West ◽  
Screening Uptake ◽  
Information Leaflets ◽  
Telephone Calls

BackgroundNationally, cervical screening uptake is suboptimal, even though research shows that the programme is highly effective at preventing cervical cancer.Local problemCornerstone is a small practice located in Salford in the North West of England. Historically, screening uptake here has been lower than average. There were 656 eligible women on our practice list and 177 of them were unscreened at the start of the project. The largest group of non-white British or Irish people on our list (13) spoke Polish as their first language.MethodsWe used quality improvement methods: the model for improvement, a driver diagram and Plan, Do, Study, Act cycles. Specifically, we targeted 177 women who were previously non-responders, as well as keeping up the regular screening service. We managed to contact 120 women during the project.InterventionsWe tested different methods of inviting women to attend cervical screening: telephone calls, text messages and letters. Later, a video link was also included in the text invitation. Information leaflets about the tests were added to letters. The letter was also translated into Polish.ResultsUptake improved and the aim was reached. Telephone calls from the nurse increased uptake but took time away from other work, so was not a sustainable change for our practice. A letter stating evidence basis for the test, and a letter translated into Polish showed limited improvement. Sending letters with information leaflets and text messages with video links achieved similar response rates with no statistical significance when we analysed the data. Offering extended hours and flexible appointment times showed very positive results.ConclusionsThe text message with a video attached was adopted as an effective method for targeting persistent non-responders.The project in its second year is being scaled up across the Primary Care Network.

scholarly journals Understanding how a community-based intervention for people with spinal cord injury in Bangladesh was delivered as part of a randomised controlled trial: a process evaluation

Spinal Cord ◽  
2020 ◽  
Vol 58 (11) ◽  
pp. 1166-1175
Author(s):  
Hueiming Liu ◽  
Mohammad Sohrab Hossain ◽  
Md. Shofiqul Islam ◽  
Md. Akhlasur Rahman ◽  
Punam D. Costa ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Randomised Controlled Trial ◽  
Healthcare Professionals ◽  
Controlled Trial ◽  
Home Visits ◽  
Case Managers ◽  
Community Based ◽  
Cord Injury ◽  
Telephone Calls ◽  
Randomised Controlled

Abstract Design Mixed methods study Setting Community, Bangladesh Objectives To understand how a community-based intervention for people with spinal cord injury (SCI) in Bangladesh was delivered as part of a randomised controlled trial and to gauge the perceptions of participants and healthcare professionals to the intervention. Methods A community-based intervention was administered to 204 participants as part of a large randomised controlled trial (called the CIVIC trial). Case-managers followed-up participants with regular telephone calls and home visits over the first 2 years after discharge. The following data were collected alongside the trial: (i) chart audit of telephone calls and home visits (ii) recordings of 20 telephone calls (iii) interviews with 14 Intervention participants and four healthcare professionals including three case-managers. Results Participants received the target number of telephone calls and home visits. Pressure injuries were identified as a problem during at least one telephone call by 43% of participants. Participants and case-managers valued regular telephone calls and home visits, and believed that calls and visits prevented complications and alleviated social isolation. Participants trusted case-managers and were confident in the care and advice provided. Case-managers expressed concerns that people with SCI in Bangladesh face many problems impacting on well-being and motivation stemming from poverty, limited employment opportunities, societal attitudes and inaccessible environments. Conclusion A community-based intervention involving regular telephone calls and home visits was administered as intended and was well received by the recipients of the care. Nonetheless, people with SCI in Bangladesh face economic and social problems which cannot be fully addressed by this type of intervention alone.

scholarly journals Engaging Underserved Community Members in Diabetes Self-Management: Evidence From the YMCA of Greater Richmond Diabetes Control Program

2020 ◽  
Vol 46 (2) ◽  
pp. 169-180
Author(s):  
Julie Ober Allen ◽  
Jeannie B. Concha ◽  
María José Mejía Ruiz ◽  
Ashley Rapp ◽  
Joshua Montgomery ◽  
...  
Keyword(s):  
Low Income ◽  
Control Program ◽  
Management Program ◽  
Diabetes Control ◽  
Self Management ◽  
Sampling Frame ◽  
Community Based ◽  
Accessible Information ◽  
Health Coaches ◽  
Underserved Groups

Purpose The purpose of this study was to identify factors influencing participant engagement in a community-based diabetes self-management program (DSMP), with a focus on the needs of underserved groups (eg, racial/ethnic minorities, low income). Methods Focus groups were conducted with participants (n = 22) from the YMCA of Greater Richmond’s Diabetes Control Program, who were recruited using a purposeful sampling frame to capture a range of experiences. In-depth interviews were conducted with lay health coaches (n = 3). The RADaR qualitative analysis technique was used to identify themes related to factors across the continuum of engagement. Results Fear affected program enrollment and retention in complex ways. Peers and coaches were important for social support and accountability. The length of the program (12 weeks), accessible information, practical skill building, and emphasis on making small, feasible improvements in pursuit of larger goals were identified as critical for engagement and improving diabetes self-management. Health and outside obligations were the major barriers to program attendance. Conclusions Participant and coach perspectives provide important insight into existing strengths of community-based DSMPs that can be expanded on to promote engagement as well as potential opportunities for improvement. Actionable recommendations for increasing engagement of underserved groups in community-based DSMPs are provided.

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