Diffusion of an effective tobacco prevention program. Part II: Evaluation of the adoption phase.

PubMed

Parcel, G S; O'Hara-Tompkins, N M; Harrist, R B; Basen-Engquist, K M; McCormick, L K; Gottlieb, N H; Eriksen, M P

1995-09-01

This paper presents the results of theory-based intervention strategies to increase the adoption of a tobacco prevention program. The adoption intervention followed a series of dissemination intervention strategies targeted at 128 school districts in Texas. Informed by Social Cognitive Theory, the intervention provided opportunities for districts to learn about and model themselves after 'successful' school districts that had adopted the program, and to see the potential for social reinforcement through the knowledge that the program had the potential to have an important influence on students' lives. The proportion of districts in the Intervention condition that adopted the program was significantly greater than in the Comparison condition (P < 0.001). Stepwise logistic regression indicated that the variables most closely related to adoption among intervention districts were teacher attitudes toward the innovation and organizational considerations of administrators. Recommendations for the development of effective strategies for the diffusion of innovations are presented.

Modelling innovation performance of European regions using multi-output neural networks

PubMed Central

Henriques, Roberto

2017-01-01

Regional innovation performance is an important indicator for decision-making regarding the implementation of policies intended to support innovation. However, patterns in regional innovation structures are becoming increasingly diverse, complex and nonlinear. To address these issues, this study aims to develop a model based on a multi-output neural network. Both intra- and inter-regional determinants of innovation performance are empirically investigated using data from the 4th and 5th Community Innovation Surveys of NUTS 2 (Nomenclature of Territorial Units for Statistics) regions. The results suggest that specific innovation strategies must be developed based on the current state of input attributes in the region. Thus, it is possible to develop appropriate strategies and targeted interventions to improve regional innovation performance. We demonstrate that support of entrepreneurship is an effective instrument of innovation policy. We also provide empirical support that both business and government R&D activity have a sigmoidal effect, implying that the most effective R&D support should be directed to regions with below-average and average R&D activity. We further show that the multi-output neural network outperforms traditional statistical and machine learning regression models. In general, therefore, it seems that the proposed model can effectively reflect both the multiple-output nature of innovation performance and the interdependency of the output attributes. PMID:28968449

Modelling innovation performance of European regions using multi-output neural networks.

PubMed

Hajek, Petr; Henriques, Roberto

2017-01-01

Regional innovation performance is an important indicator for decision-making regarding the implementation of policies intended to support innovation. However, patterns in regional innovation structures are becoming increasingly diverse, complex and nonlinear. To address these issues, this study aims to develop a model based on a multi-output neural network. Both intra- and inter-regional determinants of innovation performance are empirically investigated using data from the 4th and 5th Community Innovation Surveys of NUTS 2 (Nomenclature of Territorial Units for Statistics) regions. The results suggest that specific innovation strategies must be developed based on the current state of input attributes in the region. Thus, it is possible to develop appropriate strategies and targeted interventions to improve regional innovation performance. We demonstrate that support of entrepreneurship is an effective instrument of innovation policy. We also provide empirical support that both business and government R&D activity have a sigmoidal effect, implying that the most effective R&D support should be directed to regions with below-average and average R&D activity. We further show that the multi-output neural network outperforms traditional statistical and machine learning regression models. In general, therefore, it seems that the proposed model can effectively reflect both the multiple-output nature of innovation performance and the interdependency of the output attributes.

Short Term Intervention Model for Enhancing Divergent Thinking among School Aged Children

ERIC Educational Resources Information Center

Doron, Eyal

2016-01-01

Creative ability can be developed and improved through intervention and training. This study presents a unique and innovative intervention program for enhancing creative thinking among children, focusing on divergent thinking skills. The program was designed as a short-term (10 weeks) training and conducted with 150 school students ranging in age…

Positioning the arts for intervention design research in the human services.

PubMed

Moxley, David P; Calligan, Holly Feen

2015-12-01

The arts have been integral to the human experience fostering innovation in social arrangements, strengthening group cohesion, and merging esthetics with the utilitarian properties of technology. For intervention design research in the human services the arts can harness innovation and creativity in meeting human needs and addressing social issues. Given their capacities to stimulate expression of first person experience through interpretative strategies, the arts can equip people and groups, including researchers, with opportunities to express primary experiential knowledge through creative means, portray useful ways of meeting human needs, educate others about the social issues people experience, and formulate intervention strategies or even models to address the causes and consequences of those issues. In this paper, the authors discuss how the arts can inform and deepen human service intervention design and development and, as a result, advance innovation in the human services. They offer a rationale supporting the inclusion of the arts in the design of human service interventions, examine the contributions of the arts to the formulation of intervention concept and developmental research to further improve interventions, and consider how the arts can advance the reflexivity of intervention designers. The authors draw implications for how researchers can position the arts in the nine steps of intervention design and development the authors offer in this paper. Copyright © 2015 Elsevier Ltd. All rights reserved.

Implementing a web-based home monitoring system within an academic health care network: barriers and facilitators to innovation diffusion.

PubMed

Pelletier, Alexandra C; Jethwani, Kamal; Bello, Heather; Kvedar, Joseph; Grant, Richard W

2011-01-01

The practice of outpatient type 2 diabetes management is gradually moving from the traditional visit-based, fee-for-service model to a new, health information communication technology (ICT)-supported model that can enable non-visit-based diabetes care. To date, adoption of innovative health ICT tools for diabetes management has been slowed by numerous barriers, such as capital investment costs, lack of reliable reimbursement mechanisms, design defects that have made some systems time-consuming and inefficient to use, and the need to integrate new ICT tools into a system not primarily designed for their use. Effective implementation of innovative diabetes health ICT interventions must address local practice heterogeneity and the interaction of this heterogeneity with clinical care delivery. The Center for Connected Health at Partners Healthcare has implemented a new ICT intervention, Diabetes Connect (DC), a Web-based glucose home monitoring and clinical messaging system. Using the framework of the diffusion of innovation theory, we review the implementation and examine lessons learned as we continue to deploy DC across the health care network. © 2010 Diabetes Technology Society.

Implementation of a "Learner-Driven" Curriculum: An Screening, Brief Intervention, and Referral to Treatment (SBIRT) Interdisciplinary Primary Care Model

ERIC Educational Resources Information Center

Stanton, Marina R.; Atherton, W. Leigh; Toriello, Paul J.; Hodgson, Jennifer L.

2012-01-01

Although screening, brief intervention, and referral to treatment (SBIRT) has been a popular model to address potential substance abuse issues in primary care, there is a need for innovative approaches for training providers and staff on SBIRT protocols. An interdisciplinary approach to SBIRT training, named ICARE, was implemented at 3 different…

Mental Health Intervention Teams: A Collaborative Model to Promote Positive Behavioral Support for Youth with Emotional or Behavioral Disorders

ERIC Educational Resources Information Center

Lambros, Katina M.; Culver, Shirley K.; Angulo, Aidee; Hosmer, Pamela

2007-01-01

This paper describes an innovative intervention model for promoting mental health and positive social adjustment for youth with emotional or behavioral disorders (EBD) in San Diego. More specifically, it highlights a unique partnership between several program divisions within the San Diego Unified School District (SDUSD), namely, the Mental Health…

Innovations in non-communicable diseases management in ASEAN: a case series.

PubMed

Lim, Jeremy; Chan, Melissa M H; Alsagoff, Fatimah Z; Ha, Duc

2014-01-01

Non-communicable diseases (NCDs) are reaching epidemic proportions worldwide and present an unprecedented challenge to economic and social development globally. In Southeast Asia, the challenges are exacerbated by vastly differing levels of health systems development and funding availability. In addressing the burden of NCDs, ASEAN nations need to fundamentally re-examine how health care services are structured and delivered and discover new models as undiscerning application of models from other geographies with different cultures and resources will be problematic. We sought to examine cases of innovation and identify critical success factors in NCD management in ASEAN. A qualitative design, focusing on in-depth interviews and site visits to explore the meanings and perceptions of participants regarding innovations in NCD against the backdrop of the overall context of delivering health care within the country's context was adopted. In total 12 case studies in six ASEAN countries were analysed. Primary interventions accounted for five of the total cases, whereas secondary interventions comprised four, and tertiary interventions three. Five core themes contributing to successful innovation for NCD management were identified. They include: 1) encourage better outcomes through leadership and support, 2) strengthen inter-disciplinary partnership, 3) community ownership is key, 4) recognise the needs of the people and what appeals to them, and 5) raise awareness through capacity building and increasing health literacy. Innovation is vital in enabling ASEAN nations to successfully address the growing crisis of NCDs. More of the same or wholesale transfers of developed world models will be ineffective and lead to financially unsustainable programmes or programmes lacking appropriate human capital. The case studies have demonstrated the transformative impact of innovation and identified key factors in successful implementation. Beyond pilot success, the bigger challenge is scaling up. Medical technologies are crucial but insufficient; passionate and engaged leaders and communities enabled by enlightened policy makers and funding agencies matter more.

Innovations in non-communicable diseases management in ASEAN: a case series

PubMed Central

Lim, Jeremy; Chan, Melissa M. H.; Alsagoff, Fatimah Z.; Ha, Duc

2014-01-01

Background Non-communicable diseases (NCDs) are reaching epidemic proportions worldwide and present an unprecedented challenge to economic and social development globally. In Southeast Asia, the challenges are exacerbated by vastly differing levels of health systems development and funding availability. In addressing the burden of NCDs, ASEAN nations need to fundamentally re-examine how health care services are structured and delivered and discover new models as undiscerning application of models from other geographies with different cultures and resources will be problematic. Objective We sought to examine cases of innovation and identify critical success factors in NCD management in ASEAN. Design A qualitative design, focusing on in-depth interviews and site visits to explore the meanings and perceptions of participants regarding innovations in NCD against the backdrop of the overall context of delivering health care within the country's context was adopted. Results In total 12 case studies in six ASEAN countries were analysed. Primary interventions accounted for five of the total cases, whereas secondary interventions comprised four, and tertiary interventions three. Five core themes contributing to successful innovation for NCD management were identified. They include: 1) encourage better outcomes through leadership and support, 2) strengthen inter-disciplinary partnership, 3) community ownership is key, 4) recognise the needs of the people and what appeals to them, and 5) raise awareness through capacity building and increasing health literacy. Conclusions Innovation is vital in enabling ASEAN nations to successfully address the growing crisis of NCDs. More of the same or wholesale transfers of developed world models will be ineffective and lead to financially unsustainable programmes or programmes lacking appropriate human capital. The case studies have demonstrated the transformative impact of innovation and identified key factors in successful implementation. Beyond pilot success, the bigger challenge is scaling up. Medical technologies are crucial but insufficient; passionate and engaged leaders and communities enabled by enlightened policy makers and funding agencies matter more. PMID:25249061

Mainstreaming implementation science into immunization systems in the decade of vaccines: a programmatic imperative for the African Region.

PubMed

Adamu, Abdu A; Adamu, Aishatu L; Dahiru, Abdulkarim I; Uthman, Olalekan A; Wiysonge, Charles S

2018-05-17

Several innovations that can improve immunization systems already exist. Some interventions target service consumers within communities to raise awareness, build trust, improve understanding, remind caregivers, reward service users, and improve communication. Other interventions target health facilities to improve access and quality of vaccination services among others. Despite available empirical evidence, there is a delay in translating innovations into routine practice by immunization programmes. Drawing on an existing implementation science framework, we propose an interactive, and multi-perspective model to improve uptake and utilization of available immunization-related innovations in the African region. It is important to stress that our framework is by no means prescriptive. The key intention is to advocate for the entire immunization system to be viewed as an interconnected system of stakeholders, so as to foster better interaction, and proactive transfer of evidence-based innovation into policy and practice.

Assessing and changing organizational social contexts for effective mental health services.

PubMed

Glisson, Charles; Williams, Nathaniel J

2015-03-18

Culture and climate are critical dimensions of a mental health service organization's social context that affect the quality and outcomes of the services it provides and the implementation of innovations such as evidence-based treatments (EBTs). We describe a measure of culture and climate labeled Organizational Social Context (OSC), which has been associated with innovation, service quality, and outcomes in national samples and randomized controlled trials (RCTs) of mental health and social service organizations. The article also describes an empirically supported organizational intervention model labeled Availability, Responsiveness, and Continuity (ARC), which has improved organizational social context, innovation, and effectiveness in five RCTs. Finally, the article outlines a research agenda for developing more efficient and scalable organizational strategies to improve mental health services by identifying the mechanisms that link organizational interventions and social context to individual-level service provider intentions and behaviors associated with innovation and effectiveness.

Mujeres en accion: design and baseline data.

PubMed

Keller, Colleen; Fleury, Julie; Perez, Adriana; Belyea, Michael; Castro, Felipe G

2011-10-01

The majority of programs designed to promote physical activity in older Hispanic women includes few innovative theory-based interventions that address cultural relevant strategies. The purpose of this report is to describe the design and baseline data for Mujeres en Accion, a physical activity intervention to increase regular physical activity, and cardiovascular health outcomes among older Hispanic women. Mujeres en Accion [Women in Action for Health], a 12 month randomized controlled trial to evaluate the effectiveness of a social support physical activity intervention in midlife and older Hispanic women. This study tests an innovative intervention, Mujeres en Accion, and includes the use of a theory-driven approach to intervention, explores social support as a theoretical mediating variable, use of a Promotora model and a Community Advisory group to incorporate cultural and social approaches and resources, and use of objective measures of physical activity in Hispanic women.

Mujeres en Accion: Design and Baseline Data

PubMed Central

Fleury, Julie; Perez, Adriana; Belyea, Michael; Castro, Felipe G.

2015-01-01

The majority of programs designed to promote physical activity in older Hispanic women includes few innovative theory-based interventions that address cultural relevant strategies. The purpose of this report is to describe the design and baseline data for Mujeres en Accion, a physical activity intervention to increase regular physical activity, and cardiovascular health outcomes among older Hispanic women. Mujeres en Accion [Women in Action for Health], a 12 month randomized controlled trial to evaluate the effectiveness of a social support physical activity intervention in midlife and older Hispanic women. This study tests an innovative intervention, Mujeres en Accion, and includes the use of a theory-driven approach to intervention, explores social support as a theoretical mediating variable, use of a Promotora model and a Community Advisory group to incorporate cultural and social approaches and resources, and use of objective measures of physical activity in Hispanic women. PMID:21298400

Implementing Mobile Learning Curricula in Schools: A Programme of Research from Innovation to Scaling

ERIC Educational Resources Information Center

Looi, Chee-Kit; Wong, Lung-Hsiang

2014-01-01

Many countries, regions and education districts in the world have experimented with models of one-device-per-student as an enabler of new or effective pedagogies supported by mobile technologies. Researchers have also designed innovations or interventions for possible adoption by schools or for informal learning. Of critical interest to the…

BioBridge Professional Development: Bringing Innovative Science into the Classroom

ERIC Educational Resources Information Center

Babendure, Jeremy; Thompson, Loren; Peterman, Karen; Teiper, Leanne; Gastil, Heather; Liwanag, Heather; Glenn-Lee, Shelley

2011-01-01

The BioBridge Professional Development model was created to bring current and relevant science into the high school classroom. The purpose of this intervention was to connect teachers with relevant science and to create innovative, hands-on activities that engage students, with the goal of increasing student interest in STEM careers. To this end,…

A process model of technology innovation in governmental agencies: Insights from NASA’s science directorate

NASA Astrophysics Data System (ADS)

Szajnfarber, Zoe; Weigel, Annalisa L.

2013-03-01

This paper investigates the process through which new technical concepts are matured in the NASA innovation ecosystem. We propose an "epoch-shock" conceptualization as an alternative mental model to the traditional stage-gate view. The epoch-shock model is developed inductively, based on detailed empirical observations of the process, and validated, to the extent possible, through expert review. The paper concludes by illustrating how the new epoch-shock conceptualization could provide a useful basis for rethinking feasible interventions to improve innovation management in the space agency context. Where the more traditional stage-gate model leads to an emphasis on centralized flow control, the epoch-shock model acknowledges the decentralized, probabilistic nature of key interactions and highlights which aspects may be influenced.

IMPACT: An Early Intervention Demonstration Project. Abbreviated Version.

ERIC Educational Resources Information Center

Ungerleider, Steven; Caudill, Barry D.

Project IMPACT is based on an innovative prevention/community intervention model designed to stem the use of drugs and alcohol in an Oregon school district. A total of 74 teachers, administrators, and community leaders participated in a training session which included didactic and experiential sessions informing participants about the nature and…

Awareness, Solidarity, and Action: An Educational Model

ERIC Educational Resources Information Center

Reichenbach, Michael R.

2016-01-01

How Extension fosters social change and innovation can be improved through the use of theory-based educational models. Educational models can serve as foundations for the conceptual designs of educational interventions. I describe, using examples from my own work, one such model: the awareness, solidarity, and action model. This three-part model…

Integration of Treatment Innovation Planning and Implementation: Strategic Process Models and Organizational Challenges

PubMed Central

Lehman, Wayne E. K.; Simpson, D. Dwayne; Knight, Danica K.; Flynn, Patrick M.

2015-01-01

Sustained and effective use of evidence-based practices in substance abuse treatment services faces both clinical and contextual challenges. Implementation approaches are reviewed that rely on variations of plan-do-study-act (PDSA) cycles, but most emphasize conceptual identification of core components for system change strategies. A 2-phase procedural approach is therefore presented based on the integration of TCU models and related resources for improving treatment process and program change. Phase 1 focuses on the dynamics of clinical services, including stages of client recovery (cross-linked with targeted assessments and interventions), as the foundations for identifying and planning appropriate innovations to improve efficiency and effectiveness. Phase 2 shifts to the operational and organizational dynamics involved in implementing and sustaining innovations (including the stages of training, adoption, implementation, and practice). A comprehensive system of TCU assessments and interventions for client and program-level needs and functioning are summarized as well, with descriptions and guidelines for applications in practical settings. PMID:21443294

Using Innovative Technical Solutions as an Intervention for at Risk Students: A Meta-Cognitive Statistical Analysis to Determine the Impact of Ninth Grade Freshman Academies, Centers, and Center Models upon Minority Student Retention and Achievement

ERIC Educational Resources Information Center

Osler, James Edward; Waden, Carl

2012-01-01

This paper provides an active discourse on the use of innovative solutions to conduct an in-depth investigation on the success and viability of 9th Grade Freshman Academies, Centers, and Center Models to aid in the retention of at risk students. These types of academic programs provide an active solution for the retention and projected completion…

Preventive Intervention for Anxious Preschoolers and Their Parents: Strengthening Early Emotional Development

ERIC Educational Resources Information Center

Fox, Jeremy K.; Warner, Carrie Masia; Lerner, Amy B.; Ludwig, Kristy; Ryan, Julie L.; Colognori, Daniela; Lucas, Christopher P.; Brotman, Laurie Miller

2012-01-01

The high prevalence and early onset of anxiety disorders have inspired innovative prevention efforts targeting young at-risk children. With parent-child prevention models showing success for older children and adolescents, the goal of this study was to evaluate a parent-child indicated preventive intervention for preschoolers with mild to moderate…

Development of a cervical cancer educational program for Chinese women using intervention mapping.

PubMed

Hou, Su-I; Fernandez, Maria E; Parcel, Guy S

2004-01-01

This article describes the development of a program to increase Pap screening behavior among women in Taiwan. Intervention mapping, an innovative process of intervention design, guided the development of this program. The development process included a needs assessment identifying factors influencing Pap screening behavior relevant to Chinese women. The program used methods such as information transmission, modeling, persuasion, and facilitation. Strategies included direct mail communication, role-model stories and testimonials, and a telephone-counseling component. The delineation of specific plans for implementation and evaluation are also described.

Implementation of a "County-Township-Village" Allied HIV Prevention and Control Intervention in Rural China.

PubMed

Yu, Jun; Zhang, Yi; Jiang, Junjun; Lu, Qinglin; Liang, Bingyu; Liu, Deping; Fang, Keyong; Huang, Jiegang; He, Yang; Ning, Chuanyi; Liao, Yanyan; Lai, Jingzhen; Wei, Wudi; Qin, Fengxiang; Ye, Li; Geng, Wenkui; Liang, Hao

2017-09-01

In China, rural areas are a weak link of HIV/AIDS prevention and control. From September 2011, an innovative "county-township-village" allied intervention was implemented in Longzhou County, Guangxi, which assigned the tasks of HIV/AIDS prevention and control to the county Centers for Disease Control and Prevention (CDC), township hospitals, and village clinics, respectively, instead of traditional intervention in which the county CDC undertook the entire work. A 6-year consecutive cross-sectional survey, including 3-year traditional intervention (2009-2011) and 3-year innovative intervention (2012-2014), was conducted to evaluate the effects of the new intervention. Compared to traditional intervention, the innovative intervention achieved positive effects in decreasing risky behaviors. Among female sex workers, condom use rate in the last month increased from 72.06% to 96.82% (p < 0.01). Among drug users, having commercial sex rate in the last year reduced from 17.20% to 5.94% and condom use rate increased from 14.06% to 76.09% (p < 0.01). The risk ratio of HIV infection during innovative intervention was 0.631 (95% confidence interval 0.549-0.726) compared with traditional one. Cost-effectiveness analysis indicates that innovative intervention restores each disability-adjusted life year costing an average of $124.26. Taken together, Longzhou's innovative intervention has achieved good effects on HIV/AIDS prevention and control and provides a good reference for rural China.

The ARC organizational and community intervention strategy for implementing evidence-based children's mental health treatments.

PubMed

Glisson, Charles; Schoenwald, Sonja K

2005-12-01

This paper reviews the implications of organizational and community intervention research for the implementation of effective mental health treatments in usual community practice settings. The paper describes an organizational and community intervention model named ARC for Availability, Responsiveness and Continuity, that was designed to support the improvement of social and mental health services for children. The ARC model incorporates intervention components from organizational development, interorganizational domain development, the diffusion of innovation, and technology transfer that target social, strategic, and technological factors in effective children's services. This paper also describes a current NIMH-funded study that is using the ARC intervention model to support the implementation of an evidence-based treatment, Multisystemic Therapy (MST), for delinquent youth in extremely rural, impoverished communities in the Appalachian Mountains of East Tennessee.

Future directions in physical activity intervention research: expanding our focus to sedentary behaviors, technology, and dissemination.

PubMed

Lewis, Beth A; Napolitano, Melissa A; Buman, Matthew P; Williams, David M; Nigg, Claudio R

2017-02-01

Despite the increased health risks of a sedentary lifestyle, only 49 % of American adults participate in physical activity (PA) at the recommended levels. In an effort to move the PA field forward, we briefly review three emerging areas of PA intervention research. First, new intervention research has focused on not only increasing PA but also on decreasing sedentary behavior. Researchers should utilize randomized controlled trials, common terminology, investigate which behaviors should replace sedentary behaviors, evaluate long-term outcomes, and focus across the lifespan. Second, technology has contributed to an increase in sedentary behavior but has also led to innovative PA interventions. PA technology research should focus on large randomized trials with evidence-based components, explore social networking and innovative apps, improve PA monitoring, consider the lifespan, and be grounded in theory. Finally, in an effort to maximize public health impact, dissemination efforts should address the RE-AIM model, health disparities, and intervention costs.

Future directions in physical activity intervention research: expanding our focus to sedentary behaviors, technology, and dissemination

PubMed Central

Napolitano, Melissa A.; Buman, Matthew P.; Williams, David M.; Nigg, Claudio R.

2016-01-01

Despite the increased health risks of a sedentary lifestyle, only 49 % of American adults participate in physical activity (PA) at the recommended levels. In an effort to move the PA field forward, we briefly review three emerging areas of PA intervention research. First, new intervention research has focused on not only increasing PA but also on decreasing sedentary behavior. Researchers should utilize randomized controlled trials, common terminology, investigate which behaviors should replace sedentary behaviors, evaluate long-term outcomes, and focus across the lifespan. Second, technology has contributed to an increase in sedentary behavior but has also led to innovative PA interventions. PA technology research should focus on large randomized trials with evidence-based components, explore social networking and innovative apps, improve PA monitoring, consider the lifespan, and be grounded in theory. Finally, in an effort to maximize public health impact, dissemination efforts should address the RE-AIM model, health disparities, and intervention costs. PMID:27722907

Engaged for Change: A Community-Engaged Process for Developing Interventions to Reduce Health Disparities.

PubMed

Rhodes, Scott D; Mann-Jackson, Lilli; Alonzo, Jorge; Simán, Florence M; Vissman, Aaron T; Nall, Jennifer; Abraham, Claire; Aronson, Robert E; Tanner, Amanda E

2017-12-01

The science underlying the development of individual, community, system, and policy interventions designed to reduce health disparities has lagged behind other innovations. Few models, theoretical frameworks, or processes exist to guide intervention development. Our community-engaged research partnership has been developing, implementing, and evaluating efficacious interventions to reduce HIV disparities for over 15 years. Based on our intervention research experiences, we propose a novel 13-step process designed to demystify and guide intervention development. Our intervention development process includes steps such as establishing an intervention team to manage the details of intervention development; assessing community needs, priorities, and assets; generating intervention priorities; evaluating and incorporating theory; developing a conceptual or logic model; crafting activities; honing materials; administering a pilot, noting its process, and gathering feedback from all those involved; and editing the intervention based on what was learned. Here, we outline and describe each of these 13 steps.

Innovative Interdisciplinary Training in and Delivery of Evidence-Based Geriatric Services: Creating a Bridge with Social Work and Physical Therapy

ERIC Educational Resources Information Center

Rowan, Noell L.; Gillette, Patricia D.; Faul, Anna C.; Yankeelov, Pamela A.; Borders, Kevin W.; Deck, Stacy; Nicholas, Lori D.; Wiegand, Mark

2009-01-01

With focus on interdisciplinary education models, social work and physical therapy faculty from two proximate universities partnered to create an evidence-based geriatric assessment and brief intervention research, training, and service project for community-dwelling older adults. Assessment tools and interventions were selected from the…

Leadership, Knowledge Sharing, and Creativity: The Key Factors in Nurses' Innovative Behaviors.

PubMed

Kim, Sung-Jin; Park, Myonghwa

2015-12-01

This study identified the factors that affect the innovative behaviors of nurses at general hospitals based on their individual and organizational characteristics. The predictors of innovative nursing behaviors, such as self-leadership, individual knowledge sharing, creative self-efficacy, organizational knowledge sharing, and innovative organizational cultures, should be explored at individual and organizational level. This study administered a cross-sectional survey to 347 registered nurses working at 6 general hospitals (with >300 beds) in central South Korea. Data were collected using a self-report questionnaire and analyzed using structural equation modeling. Self-leadership, creative self-efficacy, and individual knowledge sharing directly affected individual innovative behaviors. Organizational knowledge sharing indirectly affected individual innovative behaviors, and this effect was mediated by an innovative organizational culture. This study contributes to the knowledge base regarding the effective management of individuals and organizations through innovative behavior; furthermore, it provides future directions for nursing interventions.

Cognitive computing and eScience in health and life science research: artificial intelligence and obesity intervention programs.

PubMed

Marshall, Thomas; Champagne-Langabeer, Tiffiany; Castelli, Darla; Hoelscher, Deanna

2017-12-01

To present research models based on artificial intelligence and discuss the concept of cognitive computing and eScience as disruptive factors in health and life science research methodologies. The paper identifies big data as a catalyst to innovation and the development of artificial intelligence, presents a framework for computer-supported human problem solving and describes a transformation of research support models. This framework includes traditional computer support; federated cognition using machine learning and cognitive agents to augment human intelligence; and a semi-autonomous/autonomous cognitive model, based on deep machine learning, which supports eScience. The paper provides a forward view of the impact of artificial intelligence on our human-computer support and research methods in health and life science research. By augmenting or amplifying human task performance with artificial intelligence, cognitive computing and eScience research models are discussed as novel and innovative systems for developing more effective adaptive obesity intervention programs.

An Alternative Methodological Approach for Cost-Effectiveness Analysis and Decision Making in Genomic Medicine.

PubMed

Fragoulakis, Vasilios; Mitropoulou, Christina; van Schaik, Ron H; Maniadakis, Nikolaos; Patrinos, George P

2016-05-01

Genomic Medicine aims to improve therapeutic interventions and diagnostics, the quality of life of patients, but also to rationalize healthcare costs. To reach this goal, careful assessment and identification of evidence gaps for public health genomics priorities are required so that a more efficient healthcare environment is created. Here, we propose a public health genomics-driven approach to adjust the classical healthcare decision making process with an alternative methodological approach of cost-effectiveness analysis, which is particularly helpful for genomic medicine interventions. By combining classical cost-effectiveness analysis with budget constraints, social preferences, and patient ethics, we demonstrate the application of this model, the Genome Economics Model (GEM), based on a previously reported genome-guided intervention from a developing country environment. The model and the attendant rationale provide a practical guide by which all major healthcare stakeholders could ensure the sustainability of funding for genome-guided interventions, their adoption and coverage by health insurance funds, and prioritization of Genomic Medicine research, development, and innovation, given the restriction of budgets, particularly in developing countries and low-income healthcare settings in developed countries. The implications of the GEM for the policy makers interested in Genomic Medicine and new health technology and innovation assessment are also discussed.

Prevention through Design Adoption Readiness Model (PtD ARM): An integrated conceptual model.

PubMed

Weidman, Justin; Dickerson, Deborah E; Koebel, Charles T

2015-01-01

Prevention through Design (PtD), eliminating hazards at the design-stage of tools and systems, is the optimal method of mitigating occupational health and safety risks. A recent National Institute of Safety and Health initiative has established a goal to increase adoption of PtD innovation in industry. The construction industry has traditionally lagged behind other sectors in the adoption of innovation, in general; and of safety and health prevention innovation, in particular. Therefore, as a first step toward improving adoption trends in this sector, a conceptual model was developed to describe the parameters and causal relationships that influence and predict construction stakeholder "adoption readiness" for PtD technology innovation. This model was built upon three well-established theoretical frameworks: the Health Belief Model, the Diffusion of Innovation Model, and the Technology Acceptance Model. Earp and Ennett's model development methodology was employed to build a depiction of the key constructs and directionality and magnitude of relationships among them. Key constructs were identified from the literature associated with the three theoretical frameworks, with special emphasis given to studies related to construction or OHS technology adoption. A conceptual model is presented. Recommendations for future research are described and include confirmatory structural equation modeling of model parameters and relationships, additional descriptive investigation of barriers to adoption in some trade sectors, and design and evaluation of an intervention strategy.

Integration of treatment innovation planning and implementation: strategic process models and organizational challenges.

PubMed

Lehman, Wayne E K; Simpson, D Dwayne; Knight, Danica K; Flynn, Patrick M

2011-06-01

Sustained and effective use of evidence-based practices in substance abuse treatment services faces both clinical and contextual challenges. Implementation approaches are reviewed that rely on variations of plan-do-study-act (PDSA) cycles, but most emphasize conceptual identification of core components for system change strategies. A two-phase procedural approach is therefore presented based on the integration of Texas Christian University (TCU) models and related resources for improving treatment process and program change. Phase 1 focuses on the dynamics of clinical services, including stages of client recovery (cross-linked with targeted assessments and interventions), as the foundations for identifying and planning appropriate innovations to improve efficiency and effectiveness. Phase 2 shifts to the operational and organizational dynamics involved in implementing and sustaining innovations (including the stages of training, adoption, implementation, and practice). A comprehensive system of TCU assessments and interventions for client and program-level needs and functioning are summarized as well, with descriptions and guidelines for applications in practical settings. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Exploring the diffusion of tweets designed to raise the road safety agenda in Saudi Arabia.

PubMed

Albalawi, Yousef A; Sixsmith, Jane

2017-12-01

This study demonstrates the importance of understanding the diffusion process in social media such as Twitter as an example of the relationship between new media platforms and health promotion interventions. Evidence-informed tweets were developed, pilot tested and distributed to all followers of the Ministry of Health's Twitter account with the aim of influencing the agenda on road safety in Saudi Arabia. The dissemination pattern and influence of this health communication was assessed. We collected 70 tweets into two groups (29 intervention tweets and 41 additional supported tweets) extracted from the Tweetreach data set and then analysed them using Microsoft Excel and SPSS. Using the concept of innovation/imitation as defined in the Bass Model, we classified retweeting by direct followers as innovation and retweeting by users who were not followers as imitation. In the study, we identify an informative indicator of successful diffusion and propose a novel procedure to measure innovation/imitation coefficients ( p and q). We also provided a statistical procedure for evaluating tweet adoption by innovators (influentials) and imitators. In addition, we also assessed the use of message design tools for new media messages. The resulting information can be used to improve public health and health promotion interventions at the levels of planning, design, implementation and evaluation.

A Crisis Mental Health Intervention Service: An Innovative Model for Working Intensively with Young People on the Edge of Care

ERIC Educational Resources Information Center

Witkon, Yael

2012-01-01

This paper describes the setting up and the first year of running of an innovative outreach service for adolescents on the edge of care that aimed at redressing family breakdown and preventing placements in the care system. It was a collaborative endeavour between social services and a child and adolescent mental health provision to facilitate the…

Disruptive Innovations for Designing and Diffusing Evidence-based Interventions

PubMed Central

Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chorpita, Bruce F.

2013-01-01

The numbers of evidence-based interventions (EBIs) have been growing exponentially, both therapeutic and prevention programs. Yet, EBIs have not been broadly adopted in the United States. In order for our EBI science to significantly reduce disease burden, we need to critically re-examine our scientific conventions and norms. Innovation may be spurred by re-examining the biomedical model for validating EBIs and the compartmentalization of EBIs as disease-specific, institutionally-based, counseling programs. The model of Disruptive Innovations suggests that we re-engineer EBIs based on their most robust features in order to reach more people in less time and at lower cost. Four new research agendas will be required to support disruptive innovations in EBI science: synthesize common elements across EBIs; experiment with new delivery formats (e.g., consumer controlled, self-directed, brief, paraprofessional, coaching, and technology and media strategies); adopt market strategies to promote and diffuse EBI science, knowledge, and products; and adopt continuous quality improvement as a research paradigm for systematically improving EBIs, based on ongoing data and feedback. EBI science can have more impact if it can better leverage what we know from existing EBIs in order to inspire, engage, inform, and support families and children to adopt and sustain healthy daily routines and lifestyles. PMID:22545596

Disruptive innovations for designing and diffusing evidence-based interventions.

PubMed

Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chorpita, Bruce F

2012-09-01

Evidence-based therapeutic and preventive intervention programs (EBIs) have been growing exponentially. Yet EBIs have not been broadly adopted in the United States. In order for our EBI science to significantly reduce disease burden, we need to critically reexamine our scientific conventions and norms. Innovation may be spurred by reexamining the traditional biomedical model for validating, implementing, and diffusing EBI products and science. The model of disruptive innovations suggests that we reengineer EBIs on the basis of their most robust features in order to serve more people in less time and at lower cost. A disruptive innovation provides a simpler and less expensive alternative that meets the essential needs for the majority of consumers and is more accessible, scalable, replicable, and sustainable. Examples of disruptive innovations from other fields include minute clinics embedded in retail chain drug stores, $2 generic eyeglasses, automated teller machines, and telemedicine. Four new research approaches will be required to support disruptive innovations in EBI science: synthesize common elements across EBIs; experiment with new delivery formats (e.g., consumer controlled, self-directed, brief, paraprofessional, coaching, and technology and media strategies); adopt market strategies to promote and diffuse EBI science, knowledge, and products; and adopt continuous quality improvement as a research paradigm for systematically improving EBIs, based on ongoing monitoring data and feedback. EBI science can have more impact if it can better leverage what we know from existing EBIs in order to inspire, engage, inform, and support families and children to adopt and sustain healthy daily routines and lifestyles. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

HIP HOP for HIV Awareness: Using Hip Hop Culture to Promote Community-Level HIV Prevention

ERIC Educational Resources Information Center

Hill, Mandy J.; Hallmark, Camden J.; McNeese, Marlene; Blue, Nike; Ross, Michael W.

2014-01-01

The goal of this paper was to determine the effectiveness of the HIP HOP for HIV Awareness intervention, an innovative model utilising an exchange of an HIV test for a hip hop concert ticket, in a metropolitan city among African American youth and young adults. A subset of intervention participants participated in standardised testing, sex…

Human Factors in Patient Safety as an Innovation

PubMed Central

Carayon, Pascale

2010-01-01

The use of Human Factors and Ergonomics (HFE) tools, methods, concepts and theories has been advocated by many experts and organizations to improve patient safety. To facilitate and support the spread of HFE knowledge and skills in health care and patient safety, we propose to conceptualize HFE as innovations whose diffusion, dissemination, implementation and sustainability need to be understood and specified. Using Greenhalgh et al. (2004) model of innovation, we identified various factors that can either hinder or facilitate the spread of HFE innovations in healthcare organizations. Barriers include lack of systems thinking, complexity of HFE innovations and lack of understanding about the benefits of HFE innovations. Positive impact of HFE interventions on task performance and the presence of local champions can facilitate the adoption, implementation and sustainability of HFE innovations. This analysis concludes with a series of recommendations for HFE professionals, researchers and educators. PMID:20106468

Road Map For Diffusion Of Innovation In Health Care.

PubMed

Balas, E Andrew; Chapman, Wendy W

2018-02-01

New scientific knowledge and innovation are often slow to disseminate. In other cases, providers rush into adopting what appears to be a clinically relevant innovation, based on a single clinical trial. In reality, adopting innovations without appropriate translation and repeated testing of practical application is problematic. In this article we provide examples of clinical innovations (for example, tight glucose control in critically ill patients) that were adopted inappropriately and that caused what we term a malfunction. To address the issue of malfunctions, we review various examples and suggest frameworks for the diffusion of knowledge leading to the adoption of useful innovations. The resulting model is termed an integrated road map for coordinating knowledge transformation and innovation adoption. We make recommendations for the targeted development of practice change procedures, practice change assessment, structured descriptions of tested interventions, intelligent knowledge management technologies, and policy support for knowledge transformation, including further standardization to facilitate sharing among institutions.

Motivation-based intervention to promote colonoscopy screening: An integration of a fear management model and motivational interviewing

PubMed Central

Pengchit, Watcharaporn; Walters, Scott T.; Simmons, Rebecca G.; Kohlmann, Wendy; Burt, Randall W.; Schwartz, Marc D.; Kinney, Anita Y.

2011-01-01

Colorectal cancer (CRC) screening rates have been low despite effectiveness of screening in reducing CRC mortality. This article outlines the theoretical background and development of an innovative, telephone-based risk communication designed to promote screening among individuals at increased risk for familial CRC. This ongoing intervention integrates the Extended Parallel Process Model of fear management and the motivational interviewing counselling style. Tailoring and implementation intentions are incorporated. The primary outcome is self-reported colonoscopy within nine months following intervention. If proven effective, the remote intervention could be broadly disseminated to individuals at increased familial CRC risk, especially those in geographically underserved areas. PMID:21464114

Innovation Adoption as Facilitated by a Change-Oriented Workplace

PubMed Central

Becan, Jennifer Edwards; Knight, Danica K.; Flynn, Patrick M.

2011-01-01

One of the unique contributions of the current study is a glimpse into the process by which counselors decide to try new innovations in their clinical work. Data were collected from 421 counseling staff from 71 outpatient treatment programs in 4 US regions. Using hierarchical linear modeling, results reveal that the propensity to adopt workshop-based interventions is facilitated by two important mechanisms (1) an innovative organization with creative leadership and (2) change-oriented staff attributes (i.e., seeking professional growth, efficacy, adaptability, and influence on others). Innovative leaders and a climate receptive to change also bolster the development of these change-oriented attributes. One implication of these findings is the cascading effect of leaders’ support of innovative thinking and action resulting in employees strengthening their own adaptive skills and carrying this innovative thinking into individual adoption. PMID:22154030

Adoption of a High-Impact Innovation in a Homogeneous Population.

PubMed

Weiss, Curtis H; Poncela-Casasnovas, Julia; Glaser, Joshua I; Pah, Adam R; Persell, Stephen D; Baker, David W; Wunderink, Richard G; Nunes Amaral, Luís A

2014-10-15

Adoption of innovations, whether new ideas, technologies, or products, is crucially important to knowledge societies. The landmark studies of adoption dealt with innovations having great societal impact (such as antibiotics or hybrid crops) but where determining the utility of the innovation was straightforward (such as fewer side effects or greater yield). Recent large-scale studies of adoption were conducted within heterogeneous populations and focused on products with little societal impact. Here, we focus on a case with great practical significance: adoption by small groups of highly trained individuals of innovations with large societal impact but for which it is impractical to determine the true utility of the innovation. Specifically, we study experimentally the adoption by critical care physicians of a diagnostic assay that complements current protocols for the diagnosis of life-threatening bacterial infections and for which a physician cannot estimate the true accuracy of the assay based on personal experience. We show through computational modeling of the experiment that infection-spreading models-which have been formalized as generalized contagion processes-are not consistent with the experimental data, while a model inspired by opinion models is able to reproduce the empirical data. Our modeling approach enables us to investigate the efficacy of different intervention schemes on the rate and robustness of innovation adoption in the real world. While our study is focused on critical care physicians, our findings have implications for other settings in education, research, and business, where small groups of highly qualified peers make decisions about the adoption of innovations whose utility is difficult if not impossible to gauge.

Catalyzing Innovation in Social Work Practice

ERIC Educational Resources Information Center

Traube, Dorian E.; Begun, Stephanie; Okpych, Nathanael; Choy-Brown, Mimi

2017-01-01

Social innovation is defined by novelty and improvement. This definition requires social work practice to be more effective or efficient than preexisting alternatives. Practice innovation is accomplished by leveraging technical, social, and economic factors to generate novel interventions, diffusion or adoption of the interventions into broader…

A Service Delivery Model for Children with DCD Based on Principles of Best Practice.

PubMed

Camden, Chantal; Léger, France; Morel, Julie; Missiuna, Cheryl

2015-01-01

In this perspective article, we propose the Apollo model as an example of an innovative interdisciplinary, community-based service delivery model for children with Developmental Coordination Disorder (DCD) characterized by the use of graduated levels of intensity and evidence-based interventions that focus on function and participation. We describe the context that led to the creation of the Apollo model, describe the approach to service delivery and the services offered. The Apollo model has 5 components: first contact, service delivery coordination, community-, group-, and individual-interventions. This model guided the development of a streamlined set of services offered to children with DCD, including early-intake to share educational information with families, community interventions, inter-disciplinary and occupational therapy groups, and individual interventions. Following implementation of the Apollo model, wait-times decreased and the number of children receiving services increased, without compromising service quality. Lessons learned are shared to facilitate development of other practice models to support children with DCD.

HIV/AIDS interventions in an aging U.S. population.

PubMed

Jacobson, Stephanie A

2011-05-01

According to the Centers for Disease Control and Prevention (CDC), 25 percent of people living with HIV in the United States in 2006 were age 50 and older. HIV prevention for people over 50 is an important health concern, especially as the U.S. population grows older. Scholarly research has identified the need for HIV/AIDS interventions in the population of people over age 50, but few interventions have been established. The ecological perspective, which integrates intrapersonal, interpersonal, organizational, community, and policy factors, was used to review the current interventions and propose possible new HIV/AIDS prevention efforts for older adults. Intrapersonal interventions are often based on the health belief model. The precaution adoption process model was explored as an alternative intrapersonal theory for modeling prevention efforts. Community interventions using diffusion of innovations theory are fully explored, and new interventions are proposed as an option for preventing HIV/AIDS in older adults. An agenda for future research and interventions is proposed. Social workers will be at the forefront of the effort to prevent HIV/AIDS in older adults. They must accept this responsibility, propose interventions, and evaluate their effectiveness.

Determinants of practice nurses' intention to implement a new smoking cessation intervention: the importance of attitude and innovation characteristics.

PubMed

Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

2013-12-01

To identify determinants of practice nurses' intention to implement a new smoking cessation intervention and to investigate the independent value of attitude and Rogers' innovation characteristics. While effective smoking cessation interventions exist, implementation is often suboptimal. No previous studies have disentangled the independent value of beliefs towards implementation and innovation characteristics in explaining implementation. A cross-sectional descriptive study. In 2010, 56 of 91 general practice nurses who participated in an intervention effectiveness trial completed an online questionnaire concerning demographics, patient population characteristics, attitude, innovation characteristics, self-efficacy, perceived social influence and intention to implement the intervention in the future. Recruitment success during the trial was defined as the number of patients participating. To detect differences between intending and non-intending practice nurses, independent sample t-tests and Chi-squared tests were conducted. Correlation coefficients were calculated to identify associations between potential determinants of intention. To identify significant determinants logistic hierarchical regression analyses were conducted. Innovation characteristics and attitude were both significantly associated with practice nurses' intention to implement. While recruitment success showed a significant positive association with intention, perceived patient support was only a significant determinant when including innovation characteristics or attitude. To increase new interventions' implementation rates, it is most important to convince health professionals of its beneficial characteristics, to generate a positive attitude towards the intervention, to aid practice nurses in recruiting smoking patients and to increase perceived patient support. © 2013 John Wiley & Sons Ltd.

Adoption of a High-Impact Innovation in a Homogeneous Population

NASA Astrophysics Data System (ADS)

Weiss, Curtis H.; Poncela-Casasnovas, Julia; Glaser, Joshua I.; Pah, Adam R.; Persell, Stephen D.; Baker, David W.; Wunderink, Richard G.; Nunes Amaral, Luís A.

2014-10-01

Adoption of innovations, whether new ideas, technologies, or products, is crucially important to knowledge societies. The landmark studies of adoption dealt with innovations having great societal impact (such as antibiotics or hybrid crops) but where determining the utility of the innovation was straightforward (such as fewer side effects or greater yield). Recent large-scale studies of adoption were conducted within heterogeneous populations and focused on products with little societal impact. Here, we focus on a case with great practical significance: adoption by small groups of highly trained individuals of innovations with large societal impact but for which it is impractical to determine the true utility of the innovation. Specifically, we study experimentally the adoption by critical care physicians of a diagnostic assay that complements current protocols for the diagnosis of life-threatening bacterial infections and for which a physician cannot estimate the true accuracy of the assay based on personal experience. We show through computational modeling of the experiment that infection-spreading models—which have been formalized as generalized contagion processes—are not consistent with the experimental data, while a model inspired by opinion models is able to reproduce the empirical data. Our modeling approach enables us to investigate the efficacy of different intervention schemes on the rate and robustness of innovation adoption in the real world. While our study is focused on critical care physicians, our findings have implications for other settings in education, research, and business, where small groups of highly qualified peers make decisions about the adoption of innovations whose utility is difficult if not impossible to gauge.

Technological Innovations and Intervention Practices for Children with Cochlear Implants.

ERIC Educational Resources Information Center

Ertmer, David J.

2002-01-01

This epilogue to a forum on children with hearing impairments who have cochlear implants discusses innovation in implant technology and considers intervention issues. Key factors influencing outcomes are discussed, including educational programming, amount and length of communication intervention, and the targeting of both developmental and…

A structural model of treatment program and individual counselor leadership in innovation transfer.

PubMed

Joe, George W; Becan, Jennifer E; Knight, Danica K; Flynn, Patrick M

2017-03-23

A number of program-level and counselor-level factors are known to impact the adoption of treatment innovations. While program leadership is considered a primary factor, the importance of leadership among clinical staff to innovation transfer is less known. Objectives included explore (1) the influence of two leadership roles, program director and individual counselor, on recent training activity and (2) the relationship of counselor attributes on training endorsement. The sample included 301 clinical staff in 49 treatment programs. A structural equation model was evaluated for key hypothesized relationships between exogenous and endogenous variables related to the two leadership roles. The importance of organizational leadership, climate, and counselor attributes (particularly counseling innovation interest and influence) to recent training activity was supported. In a subset of 68 counselors who attended a developer-led training on a new intervention, it was found that training endorsement was higher among those with high innovation interest and influence. The findings suggest that each leadership level impacts the organization in different ways, yet both can promote or impede technology transfer.

Transforming the Classroom With Tablet Technology.

PubMed

Sargent, Lana; Miles, Elizabeth

Identifying the most effective models for integrating new technology into the classroom and understanding its effects on educational outcomes are essential for nurse educators. This article describes an educational intervention with tablet technology (iPads) using an innovative case-based learning model in a nursing program. Students reported positive learning outcomes when using the tablet technology for learning course content.

Understanding and Facilitating Career Development of People of Appalachian Culture: An Integrated Approach

ERIC Educational Resources Information Center

Tang, Mei; Russ, Kathryn

2007-01-01

The literature on career development for people of Appalachian culture is sparse. This article reviews cultural values of Appalachians and proposes an innovative career intervention model to best serve people of this culture. The model integrates the concepts of the social cognitive career development approach (R. W. Lent, S. D. Brown, & G.…

Innovative Technology-Based Interventions for Autism Spectrum Disorders: A Meta-Analysis

ERIC Educational Resources Information Center

Grynszpan, Ouriel; Weiss, Patrice L.; Perez-Diaz, Fernando; Gal, Eynat

2014-01-01

This article reports the results of a meta-analysis of technology-based intervention studies for children with autism spectrum disorders. We conducted a systematic review of research that used a pre-post design to assess innovative technology interventions, including computer programs, virtual reality, and robotics. The selected studies provided…

Intent to sustain use of a mental health innovation by school providers: What matters most?

PubMed Central

Livet, Melanie; Yannayon, Mary; Kocher, Kelly; McMillen, Janey

2017-01-01

Despite innovations being routinely introduced in schools to support the mental health of students, few are successfully maintained over time. This study explores the role of innovation characteristics, individual attitudes and skills, and organizational factors in school providers’ decisions to continue use of Centervention, a technology-based tool that supports implementation of evidence-based mental health interventions (EBIs). Data were collected from 44 providers through online surveys following use of Centervention over a one-year period. When considered with individual and organizational factors, experience with Centervention (usability, usefulness, and satisfaction) was found to be the most influential predictor of intent to sustain use. Results reinforce the importance of (1) differentiating between factors that predict initial adoption vs. those that enable sustainability and (2) tailoring sustainability decision models to the nature of the innovation. They also support the need to incorporate strategies to enhance provider experience during implementation of an innovation. PMID:29403540

Applying the Kirkpatrick Model: Evaluating an "Interaction for Learning Framework" Curriculum Intervention

ERIC Educational Resources Information Center

Paull, Megan; Whitsed, Craig; Girardi, Antonia

2016-01-01

Global perspectives and interpersonal and intercultural communication competencies are viewed as a priority within higher education. For management educators, globalisation, student mobility and widening pathways present numerous challenges, but afford opportunities for curriculum innovation. The "Interaction for Learning Framework"…

Identification of innovation in public health.

PubMed

Fung, Matthew; Simpson, Sue; Packer, Claire

2011-03-01

The National Horizon Scanning Centre provides national policy-makers in England with forewarning about emerging and new health technologies. This includes public health interventions (PHIs) but identification of these interventions is not always easy. The aim of this study was to explore the meaning and define innovation in public health. We used a quasi-Delphi method with questionnaire 1 sent to 106 public health and horizon scanning professionals and decision-makers in June 2008. Questionnaire 2 was developed based on answers to questionnaire 1 and sent to all respondents. A definition of innovative PHIs was developed: 'Innovative PHIs are generally new and different to established interventions. They should be equitable, applicable to all in a population, cost-effective and may address health determinants in the non-health sector of society. A good evidence base is ideal, but sometimes it may be necessary to consider PHIs lacking evidence'. Sources suggested for identifying innovative PHIs were similar to those used for other types of health technologies. Our findings should help early awareness and alert systems distinguish innovative from non-innovative PHIs, although its application in practice needs trialling.

Evolution and revolution: gauging the impact of technological and technical innovation on Olympic performance.

PubMed

Balmer, Nigel; Pleasence, Pascoe; Nevill, Alan

2012-01-01

A number of studies have pointed to a plateauing of athletic performance, with the suggestion that further improvements will need to be driven by revolutions in technology or technique. In the present study, we examine post-war men's Olympic performance in jumping events (pole vault, long jump, high jump, triple jump) to determine whether performance has indeed plateaued and to present techniques, derived from models of human growth, for assessing the impact of technological and technical innovation over time (logistic and double logistic models of growth). Significantly, two of the events involve well-documented changes in technology (pole material in pole vault) or technique (the Fosbury Flop in high jump), while the other two do not. We find that in all four cases, performance appears to have plateaued and that no further "general" improvement should be expected. In the case of high jump, the double logistic model provides a convenient method for modelling and quantifying a performance intervention (in this case the Fosbury Flop). However, some shortcomings are revealed for pole vault, where evolutionary post-war improvements and innovation (fibre glass poles) were concurrent, preventing their separate identification in the model. In all four events, it is argued that further general growth in performance will indeed need to rely predominantly on technological or technical innovation.

Innovation in sexually transmitted disease and HIV prevention: internet and mobile phone delivery vehicles for global diffusion.

PubMed

Swendeman, Dallas; Rotheram-Borus, Mary Jane

2010-03-01

Efficacious behavioral interventions and practices have not been universally accepted, adopted, or diffused by policy makers, administrators, providers, advocates, or consumers. Biomedical innovations for sexually transmitted disease (STD) and HIV prevention have been embraced but their effectiveness is hindered by behavioral factors. Behavioral interventions are required to support providers and consumers for adoption and diffusion of biomedical innovations, protocol adherence, and sustained prevention for other STDs. Information and communication technology such as the Internet and mobile phones can deliver behavioral components for STD/HIV prevention and care to more people at less cost. Recent innovations in STD/HIV prevention with information and communication technology-mediated behavioral supports include STD/HIV testing and partner interventions, behavioral interventions, self-management, and provider care. Computer-based and Internet-based behavioral STD/HIV interventions have demonstrated efficacy comparable to face-to-face interventions. Mobile phone STD/HIV interventions using text-messaging are being broadly utilized but more work is needed to demonstrate efficacy. Electronic health records and care management systems can improve care, but interventions are needed to support adoption. Information and communication technology is rapidly diffusing globally. Over the next 5-10 years smart-phones will be broadly disseminated, connecting billions of people to the Internet and enabling lower cost, highly engaging, and ubiquitous STD/HIV prevention and treatment support interventions.

A computational future for preventing HIV in minority communities: how advanced technology can improve implementation of effective programs.

PubMed

Brown, C Hendricks; Mohr, David C; Gallo, Carlos G; Mader, Christopher; Palinkas, Lawrence; Wingood, Gina; Prado, Guillermo; Kellam, Sheppard G; Pantin, Hilda; Poduska, Jeanne; Gibbons, Robert; McManus, John; Ogihara, Mitsunori; Valente, Thomas; Wulczyn, Fred; Czaja, Sara; Sutcliffe, Geoff; Villamar, Juan; Jacobs, Christopher

2013-06-01

African Americans and Hispanics in the United States have much higher rates of HIV than non-minorities. There is now strong evidence that a range of behavioral interventions are efficacious in reducing sexual risk behavior in these populations. Although a handful of these programs are just beginning to be disseminated widely, we still have not implemented effective programs to a level that would reduce the population incidence of HIV for minorities. We proposed that innovative approaches involving computational technologies be explored for their use in both developing new interventions and in supporting wide-scale implementation of effective behavioral interventions. Mobile technologies have a place in both of these activities. First, mobile technologies can be used in sensing contexts and interacting to the unique preferences and needs of individuals at times where intervention to reduce risk would be most impactful. Second, mobile technologies can be used to improve the delivery of interventions by facilitators and their agencies. Systems science methods including social network analysis, agent-based models, computational linguistics, intelligent data analysis, and systems and software engineering all have strategic roles that can bring about advances in HIV prevention in minority communities. Using an existing mobile technology for depression and 3 effective HIV prevention programs, we illustrated how 8 areas in the intervention/implementation process can use innovative computational approaches to advance intervention adoption, fidelity, and sustainability.

A Transitional Model for the Introduction of Technology.

ERIC Educational Resources Information Center

Terrell, Steven R.; And Others

There are many reasons for teachers' resistance to innovation in the classroom through computer use. This resistance can be categorized into one of several broad-based themes: resistance to organizational change; resistance to outside intervention; time management problems; lack of support from the administration; teachers' perceptions; or…

Improving Care for Depression & Suicide Risk in Adolescents: Innovative Strategies for Bringing Treatments to Community Settings

PubMed Central

Asarnow, Joan Rosenbaum; Miranda, Jeanne

2015-01-01

This article reviews the literature on interventions and services for depression and suicide prevention among adolescents, with the goals of placing this science within the context of current changing health care environments and highlighting innovative models for improving health and mental health. We examine the: challenges and opportunities offered by new initiatives and legislation designed to transform the U.S. health and mental healthcare systems; summarize knowledge regarding the treatment of depression and suicidality/self-harm in adolescents; and describe innovative models for partnering with health systems and communities. This review demonstrates that treatment models and service delivery strategies are currently available for increasing evidence-based care, particularly for depression, and concludes with recommendations for future research and quality improvement initiatives aimed at inspiring additional efforts to put science to work, bridge science and community practice, and develop strategies for partnering with communities to improve care, mental health, and well-being among adolescents. PMID:24437432

A stepped-care model of post-disaster child and adolescent mental health service provision.

PubMed

McDermott, Brett M; Cobham, Vanessa E

2014-01-01

From a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions. To critique existing child and adolescent mental health services (CAMHS) models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model. A narrative review of traditional CAMHS is presented. Important elements of a disaster response - individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach. Difficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy. In this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach.

A procedural model for planning and evaluating behavioral interventions.

PubMed

Hyner, G C

2005-01-01

A model for planning, implementing and evaluating health behavior change strategies is proposed. Variables are presented which can be used in the model or serve as examples for how the model is utilized once a theory of health behavior is adopted. Examples of three innovative strategies designed to influence behavior change are presented so that the proposed model can be modified for use following comprehensive screening and baseline measurements. Three measurement priorities: clients, methods and agency are subjected to three phases of assessment: goals, implementation and effects. Lifestyles account for the majority of variability in quality-of-life and premature morbidity and mortality. Interventions designed to influence healthy behavior changes must be driven by theory and carefully planned and evaluated. The proposed model is offered as a useful tool for the behavior change strategist.

77 FR 21565 - Statement of Organization, Functions and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... promote early identification of people living with HIV, linking them to care and retaining them in care... Program) including, Planning and Capacity Development programs (Part C), HIV Early Intervention Services... strategies and innovative models for the development and provision of HIV primary care services; (3...

Training Injury Control Practitioners: The Indian Health Service Model.

ERIC Educational Resources Information Center

Smith, Richard J., III; Dellapenna, Alan J., Jr.; Berger, Lawrence R.

2000-01-01

Describes an innovative training program for injury prevention specialists developed by the Indian Health Service (IHS), noting its applicability to other community-based settings. Examines injuries and American Indians; designing the IHS program; IHS training courses; examples of community-based interventions organized by people who had completed…

Legal and Regulatory Barriers to Reverse Innovation.

PubMed

Rowthorn, Virginia; Plum, Alexander J; Zervos, John

Reverse innovation, or the importation of new, affordable, and efficacious models to high-income countries from the developing world, has emerged as a way to improve the health care system in the United States. Reverse innovation has been identified as a key emerging trend in global health systems in part because low-resourced settings are particularly good laboratories for low-cost/high-impact innovations that are developed out of necessity. A difficult question receiving scant attention is that of legal and regulatory barriers. The objective of this paper is to understand and elucidate the legal barriers faced by innovators bringing health interventions to the United States. Semistructured qualitative interviews were conducted with 9 key informants who have directly participated in the introduction of global health care approaches to the United States health system. A purposive sampling scheme was employed to identify participants. Phone interviews were conducted over one week in July 2016 with each participant and lasted an average of 35 minutes each. Purely legal barriers included questions surrounding tort liability, standard of care, and concerns around patient-administered self-care. Regulatory burdens included issues of international medical licensure, reimbursement, and task shifting and scope of work challenges among nonprofessionals (e.g. community health workers). Finally, perceived (i.e. not realized or experienced) legal and regulatory barriers to innovative modalities served as disincentives to bringing products or services developed outside of the United States to the United States market. Conflicting interests within the health care system, safety concerns, and little value placed on low-cost interventions inhibit innovation. Legal and regulatory barriers rank among, and contribute to, an anti-innovation atmosphere in healthcare for domestic and reverse innovators alike. Reverse innovation should be fostered through the thoughtful development of legal and regulatory standards that encourage the introduction and scalable adoption of successful health care innovations developed outside of the US, particularly innovations that support public health goals and do not have the benefit of a large corporate sponsor to facilitate introduction to the market. Copyright © 2016 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Breaking the Bank: Three Financing Models for Addressing the Drug Innovation Cost Crisis.

PubMed

Kleinke, J D; McGee, Nancy

2015-05-01

The introduction of innovative specialty pharmaceuticals with high prices has renewed efforts by public and private healthcare payers to constrain their utilization, increase patient cost-sharing, and compel government intervention on pricing. These efforts, although rational for individual payers, have the potential to undermine the public health impact and overall economic value of these innovations for society. The emerging archetypal example is the outcry over the cost of sofosbuvir, a drug proved to cure hepatitis C infection at a cost of $84,000 per person for a course of treatment (or $1000 per tablet). This represents a radical medical breakthrough for public health, with great promise for the long-term costs associated with this disease, but with major short-term cost implications for the budgets of healthcare payers. To propose potential financing models to provide a workable and lasting solution that directly addresses the misalignment of incentives between healthcare payers confronted with the high upfront costs of innovative specialty drugs and the rest of the US healthcare system, and to articulate these in the context of the historic struggle over paying for innovation. We describe 3 innovative financing models to manage expensive specialty drugs that will significantly reduce the direct, immediate cost burden of these drugs to public and private healthcare payers. The 3 financing models include high-cost drug mortgages, high-cost drugs reinsurance, and high-cost drug patient rebates. These models have been proved successful in other areas and should be adopted into healthcare to mitigate the high-cost of specialty drugs. We discuss the distribution of this burden over time and across the healthcare system, and we match the financial burden of medical innovations to the healthcare stakeholders who capture their overall value. All 3 models work within or replicate the current healthcare marketplace mechanisms for distributing immediate high-cost events across multiple at-risk stakeholders, and/or encouraging active participation by patients as consumers. The adoption of these 3 models for the financing of high-cost drugs would ameliorate decades-long economic conflict in the healthcare system over the value of, and financial responsibility for, drug innovation.

Breaking the Bank: Three Financing Models for Addressing the Drug Innovation Cost Crisis

PubMed Central

Kleinke, J.D.; McGee, Nancy

2015-01-01

Background The introduction of innovative specialty pharmaceuticals with high prices has renewed efforts by public and private healthcare payers to constrain their utilization, increase patient cost-sharing, and compel government intervention on pricing. These efforts, although rational for individual payers, have the potential to undermine the public health impact and overall economic value of these innovations for society. The emerging archetypal example is the outcry over the cost of sofosbuvir, a drug proved to cure hepatitis C infection at a cost of $84,000 per person for a course of treatment (or $1000 per tablet). This represents a radical medical breakthrough for public health, with great promise for the long-term costs associated with this disease, but with major short-term cost implications for the budgets of healthcare payers. Objectives To propose potential financing models to provide a workable and lasting solution that directly addresses the misalignment of incentives between healthcare payers confronted with the high upfront costs of innovative specialty drugs and the rest of the US healthcare system, and to articulate these in the context of the historic struggle over paying for innovation. Discussion We describe 3 innovative financing models to manage expensive specialty drugs that will significantly reduce the direct, immediate cost burden of these drugs to public and private healthcare payers. The 3 financing models include high-cost drug mortgages, high-cost drugs reinsurance, and high-cost drug patient rebates. These models have been proved successful in other areas and should be adopted into healthcare to mitigate the high-cost of specialty drugs. We discuss the distribution of this burden over time and across the healthcare system, and we match the financial burden of medical innovations to the healthcare stakeholders who capture their overall value. All 3 models work within or replicate the current healthcare marketplace mechanisms for distributing immediate high-cost events across multiple at-risk stakeholders, and/or encouraging active participation by patients as consumers. Conclusion The adoption of these 3 models for the financing of high-cost drugs would ameliorate decades-long economic conflict in the healthcare system over the value of, and financial responsibility for, drug innovation. PMID:26085900

Implementation of Parent Child Interaction Therapy Within Foster Care: An Attempt to Translate an Evidence-Based Program Within a Local Child Welfare Agency

PubMed Central

Topitzes, James; Mersky, Joshua P.; McNeil, Cheryl B.

2014-01-01

This paper describes an innovative adaptation of an evidence-based intervention – Parent Child Interaction Therapy or PCIT – to foster parent training services. The authors faced multiple problems that commonly plague translational child welfare research as they developed, implemented and tested their model. The paper discusses how the authors addressed these problems when: 1) specifying the child welfare context in which the intervention model was implemented and tested, choosing an intervention model that responded to child welfare service needs, and tailoring the model for a child welfare context; 2) securing external funding and initiating sustainability plans for model uptake; and 3) forging a university-community partnership to overcome logistical and ethical obstacles. Concluding with a summary of promising preliminary study results, a description of future plans to replicate and spread the model, and a distillation of project lessons, the paper suggests that child welfare translational research with PCIT is very promising. PMID:25729340

Project INTEGRATE: An integrative study of brief alcohol interventions for college students.

PubMed

Mun, Eun-Young; de la Torre, Jimmy; Atkins, David C; White, Helene R; Ray, Anne E; Kim, Su-Young; Jiao, Yang; Clarke, Nickeisha; Huo, Yan; Larimer, Mary E; Huh, David

2015-03-01

This article provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more treatment conditions. This yielded a sample of 12,630 participants (42% men; 58% first-year or incoming students). The majority of the sample identified as White (74%), with 12% Asian, 7% Hispanic, 2% Black, and 5% other/mixed ethnic groups. Participants were assessed 2 or more times from baseline up to 12 months, with varying assessment schedules across studies. This article describes how we combined individual participant-level data from multiple studies, and discusses the steps taken to develop commensurate measures across studies via harmonization and newly developed Markov chain Monte Carlo (MCMC) algorithms for 2-parameter logistic item response theory models and a generalized partial credit model. This innovative approach has intriguing promises, but significant barriers exist. To lower the barriers, there is a need to increase overlap in measures and timing of follow-up assessments across studies, better define treatment and control groups, and improve transparency and documentation in future single intervention studies. (c) 2015 APA, all rights reserved).

Project INTEGRATE: An Integrative Study of Brief Alcohol Interventions for College Students

PubMed Central

Mun, Eun-Young; de la Torre, Jimmy; Atkins, David C.; White, Helene R.; Ray, Anne E.; Kim, Su-Young; Jiao, Yang; Clarke, Nickeisha; Huo, Yan; Larimer, Mary E.; Huh, David

2014-01-01

This paper provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more treatment conditions. This yielded a sample of 12,630 participants (42% men; 58% first-year or incoming students). The majority of the sample identified as White (74%), with 12% Asian, 7% Hispanic, 2% Black, and 5% other/mixed ethnic groups. Participants were assessed two or more times from baseline up to 12 months, with varying assessment schedules across studies. This paper describes how we combined individual participant-level data from multiple studies, and discusses the steps taken to develop commensurate measures across studies via harmonization and newly developed Markov chain Monte Carlo algorithms for two-parameter logistic item response theory models and a generalized partial credit model. This innovative approach has intriguing promises, but significant barriers exist. To lower the barriers, there is a need to increase overlap in measures and timing of follow-up assessments across studies, better define treatment and control groups, and improve transparency and documentation in future single, intervention studies. PMID:25546144

Democratizing Implementation and Innovation in Mental Health Care.

PubMed

Saxe, Glenn; Acri, Mary

2017-03-01

Improvements in the quality of mental health care in the United States depend on the successful implementation of evidence-based treatments (EBT's) in typical settings of care. Unfortunately, there is little evidence that EBT's are used in ways that would approximate their established fidelity standards in such settings. This article describes an approach to more successful implementation of EBT's via a collaborative process between intervention developers and intervention users (e.g. providers, administrators, consumers) called Lead-user Innovation. Lead-user Innovation democratizes the implementation process by integrating the expertise of lead-users in the delivery, adaptation, innovation and evaluation of EBT's.

The Oregon Model of Behavior Family Therapy: From Intervention Design to Promoting Large-Scale System Change

PubMed Central

Dishion, Thomas; Forgatch, Marion; Chamberlain, Patricia; Pelham, William E.

2017-01-01

This paper reviews the evolution of the Oregon model of family behavior therapy over the past four decades. Inspired by basic research on family interaction and innovation in behavior change theory, a set of intervention strategies were developed that were effective for reducing multiple forms of problem behavior in children (e.g., Patterson, Chamberlain, & Reid, 1982). Over the ensuing decades, the behavior family therapy principles were applied and adapted to promote children’s adjustment to address family formation and adaptation (Family Check-Up model), family disruption and maladaptation (Parent Management Training–Oregon model), and family attenuation and dissolution (Treatment Foster Care–Oregon model). We provide a brief overview of each intervention model and summarize randomized trials of intervention effectiveness. We review evidence on the viability of effective implementation, as well as barriers and solutions to adopting these evidence-based practices. We conclude by proposing an integrated family support system for the three models applied to the goal of reducing the prevalence of severe problem behavior, addiction, and mental problems for children and families, as well as reducing the need for costly and largely ineffective residential placements. PMID:27993335

The Cross-Level Mediating Effect of Psychological Capital on the Organizational Innovation Climate-Employee Innovative Behavior Relationship

ERIC Educational Resources Information Center

Hsu, Michael L. A.; Chen, Forrence Hsinhung

2017-01-01

Organizational innovation climates have been found to be effective predictors of employee creativity and organizational innovation. As such, climate assessments provide a basis for useful organizational interventions in enhancing creativity and innovation. Researchers now call for better articulation of the motivational mechanisms that link social…

Implementation of a documentation model comprising nursing terminologies--theoretical and methodological issues.

PubMed

von Krogh, Gunn; Nåden, Dagfinn

2008-04-01

To describe and discuss theoretical and methodological issues of implementation of a nursing services documentation model comprising NANDA nursing diagnoses, Nursing Intervention Classification and Nursing Outcome Classification terminologies. The model is developed for electronic patient record and was implemented in a psychiatric hospital on an organizational level and on five test wards in 2001-2005. The theory of Rogers guided the process of innovation, whereas the implementation procedure of McCloskey and Bulecheck combined with adult learning principals guided the test site implementation. The test wards managed in different degrees to adopt the model. Two wards succeeded fully, including a ward with high percentage of staff with interdisciplinary background. Better planning regarding the impact of the organization's innovative aptitude, the innovation strategies and the use of differentiated methods regarding the clinician's individual premises for learning nursing terminologies might have enhanced the adoption to the model. To better understand the nature of barriers and the importance of careful planning regarding the implementation of electronic patient record elements in nursing care services, focusing on nursing terminologies. Further to indicate how a theory and specific procedure can be used to guide the process of implementation throughout the different levels of management.

Quackery or quality: the ethicolegal basis for a legislative framework for medical innovation.

PubMed

Samanta, Jo; Samanta, Ash

2015-06-01

Innovative therapy is a matter of recent public interest, particularly following Lord Saatchi's Medical Innovation Bill. The purpose of the Bill is to encourage responsible innovation in medical treatment. We argue for the need to achieve a balance between the risks of medical innovation and patient safety considerations. We make the case for statutory regulation of medical innovation on the basis of responsible innovation, choice and patient-centred care. At the heart of regulation of medical innovation is care delivered by a process which is accountable, transparent and allows full consideration of all relevant matters. This paper proposes a two-stage test (to assess applicability of medical innovation as well as suitability for the choice of intervention to be undertaken). It is suggested that this model would provide safeguards for patients as well as define limits for doctors in the context of innovative therapy. Implementation and application of such therapy must be underpinned by due process and governance oversight, which could be provided through context-specific professional peer review. A combination of these ethicolegal principles would permit responsible medical innovation and maximise benefit in terms of therapy and patient-centred care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

An Innovative School-Based Intervention to Promote Healthy Lifestyles

ERIC Educational Resources Information Center

Piana, Natalia; Ranucci, Claudia; Buratta, Livia; Foglia, Elena; Fabi, Marta; Novelli, Francesca; Casucci, Simone; Reginato, Elisa; Pippi, Roberto; Aiello, Cristina; Leonardi, Alessia; Romani, Giannermete; De Feo, Pierpaolo; Mazzeschi, Claudia

2017-01-01

Objective: To describe an innovative school-based intervention to promote healthy lifestyles. To evaluate its effects on children's food habits and to highlight the key components which contribute most to the beneficial effects obtained from children's, teachers' and parents' perspectives. Design: An educational tool to improve personal awareness,…

Promotion of Early School Readiness Using Pediatric Primary Care as an Innovative Platform

ERIC Educational Resources Information Center

Mendelsohn, Alan L.; Cates, Carolyn Brockmeyer; Weisleder, Adriana; Berkule, Samantha B.; Dreyer, Benard P.

2013-01-01

Pediatric health care represents an innovative platform for implementation of low-cost, population-wide, preventive interventions to improve school readiness. This article describes the Video Interaction Project, a targeted intervention in the pediatric primary care setting designed to enhance parenting skills and boost school readiness. The…

Innovation and Integrity in Intervention Research: Conceptual Issues, Methodology, and Knowledge Translation.

PubMed

Malti, Tina; Beelmann, Andreas; Noam, Gil G; Sommer, Simon

2018-04-01

In this article, we introduce the special issue entitled Innovation and Integrity in Intervention Science. Its focus is on essential problems and prospects for intervention research examining two related topics, i.e., methodological issues and research integrity, and challenges in the transfer of research knowledge into practice and policy. The main aims are to identify how to advance methodology in order to improve research quality, examine scientific integrity in the field of intervention science, and discuss future steps to enhance the transfer of knowledge about evidence-based intervention principles into sustained practice, routine activities, and policy decisions. Themes of the special issue are twofold. The first includes questions about research methodology in intervention science, both in terms of research design and methods, as well as data analyses and the reporting of findings. Second, the issue tackles questions surrounding the types of knowledge translation frameworks that might be beneficial to mobilize the transfer of research-based knowledge into practice and public policies. The issue argues that innovations in methodology and thoughtful approaches to knowledge translation can enable transparency, quality, and sustainability of intervention research.

To Be or Not to Be in Thrall to the March of Smart Products

PubMed Central

Van den Hende, Ellis A.

2016-01-01

ABSTRACT This article explores how perceived disempowerment impacts the intention to adopt smart autonomous products. Empirically, the paper builds on three studies to show this impact. Study 1 explores the relevance of the perceived disempowerment in respect of smart autonomous products. Study 2 manipulates autonomy of smart products and finds that perceived disempowerment mediates the link between smart products’ autonomy and adoption intention. Study 3 indicates that an intervention design―that is, a product design that allows consumers to intervene in the actions of an autonomous smart product―can reduce their perceived disempowerment in respect of autonomous smart products. Further, Study 3 reveals that personal innovativeness moderates the role that an intervention design plays in product adoption: an intervention design shows a positive effect on adoption intention for individuals with low personal innovativeness, but for those with high personal innovativeness no effect of an intervention design is present on adoption intention. The authors suggest that managers consider consumers’ perceived disempowerment when designing autonomous smart products, because (1) perceived disempowerment reduces adoption and (2) when targeted at consumers with low personal innovativeness, an intervention design reduces their perceived disempowerment. PMID:27980356

Sex Is Like Jelly Beans: Educating Students on the Risks of Oral Sex

ERIC Educational Resources Information Center

Moore, Erin; Harris, Terrance

2014-01-01

This study provides a description of an innovative workshop that educated college students about the risks of unprotected sexual behavior, particularly oral sex, and methods of risk reduction using a metaphor of "sharing and eating jelly beans." Intervention development was guided by the Information-Motivation-Behavioral Skills model.…

Rural Special Education Quarterly, Volume 5, Nos. 1-4, Spring-Fall 1984, Winter 1985.

ERIC Educational Resources Information Center

Rural Special Education Quarterly, 1985

1985-01-01

Four newsletter issues examine aspects of rural special education. Issue number one considers the generic problems or solutions in rural special education leadership, the need for innovative preservice preparation for rural educators, preservice training for Native American professionals and paraprofessionals, a model for rural early intervention,…

Strong Start Wraparound: Addressing the Complex Needs of Mothers in Early Recovery

ERIC Educational Resources Information Center

Teel, M. Kay

2014-01-01

The Strong Start Study tested an innovative, High-Fidelity Wraparound intervention with families in early recovery from substance use. The Strong Start Wraparound model addressed the complex needs of pregnant and parenting women who were in early recovery to increase the protective factors of parental resilience, social connections, concrete…

RTI Success: Proven Tools and Strategies for Schools and Classrooms

ERIC Educational Resources Information Center

Whitten, Elizabeth; Esteves, Kelli J.; Woodrow, Alice

2009-01-01

What is Response to Intervention (RTI) and how can it benefit your school? Find out in "RTI Success", an all-in-one resource that provides information on this innovative model as well as step-by-step administrator guidelines and practical teacher tools for implementation. Despite ongoing federal initiatives meant to increase the profile…

Integrative Care for Adolescents with Dual Diagnosis: Considering Trauma and Attachment within an Innovative Model for Clinical Practice

ERIC Educational Resources Information Center

Gardiner, Emily; Iarocci, Grace; Moretti, Marlene

2017-01-01

Adolescents with intellectual disability are at significant risk for developing concomitant mental health and behavior problems. Youth who experience "dual diagnosis" face great challenges, and require interventions that will promote their autonomy, self-determination, and adaptive functioning. In this article, we devote attention to…

ProvenCare: Geisinger's Model for Care Transformation through Innovative Clinical Initiatives and Value Creation.

PubMed

2009-04-01

Geisinger's system of care can be seen as a microcosm of the national delivery of healthcare, with implications for decision makers in other health plans. In this interview, Dr Ronald A. Paulus focuses on Geisinger's unique approach to patient care. In its core, this approach represents a system of quality and value initiatives based on 3 major programs-Proven Health Navigation (medical home); the ProvenCare model; and transitions of care. The goal of such an approach is to optimize disease management by using a rational reimbursement paradigm for appropriate interventions, providing innovative incentives, and engaging patients in their own care as part of any intervention. Dr Paulus explains the reasons why, unlike Geisinger, other stakeholders, including payers, providers, patients, and employers, have no intrinsic reasons to be concerned with quality and value initiatives. In addition, he says, an electronic infrastructure that could be modified as management paradigms evolve is a necessary tool to ensure the healthcare delivery system's ability to adapt to new clinical realities quickly to ensure the continuation of delivering best value for all stakeholders.

Education, empowerment and community based structural reinforcement: An HIV prevention response to mass incarceration and removal✩

PubMed Central

Draine, Jeffrey; McTighe, Laura; Bourgois, Philippe

2011-01-01

In the context of US urban jails, incarceration is often seen as an opportune intervention point for prevention interventions in public health. For the detained individual, it is an opportunity to reflect on individual choices and the potential for changes in one's life course. For population focused public health professionals, jail detention facilities represent a concentration of health risks, and an opportunity to have an impact on a significant portion of those at risk for HIV and other health concerns. This paper presents an innovative education and empowerment model that bridges across jail walls, beginning on the inside, and continuing on the outside of jail where individuals continue to be challenged and supported toward positive health and social choices. The intervention also seeks to foment community activism in the communities to which jail detainees return, thus aiming to have a structural impact. This paper examines both the intervention model and the challenges of examining the effectiveness claims for the intervention at multiple levels. PMID:21794919

Contingency management in the 21st century: technological innovations to promote smoking cessation.

PubMed

Dallery, Jesse; Raiff, Bethany R

2011-01-01

Information technology represents an excellent medium to deliver contingencies of reinforcement to change behavior. Recently, we have linked the Internet with a science-based, behavioral treatment for cigarette smoking: abstinence reinforcement therapy. Under abstinence reinforcement interventions, incentives are provided for objective evidence of abstinence. Several studies suggest that the intervention is effective in initiating abstinence. The intervention addresses limitations (access, cost, sustainability, and dissemination potential) inherent in traditional abstinence reinforcement delivery models. It can also be applied to vulnerable, at-risk populations, and to other behavior to promote health. Information technologies offer unprecedented and rapidly expanding opportunities to facilitate behavior change.

A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery.

PubMed

Prochaska, Judith J; Delucchi, Kevin; Hall, Sharon M

2004-12-01

This meta-analysis examined outcomes of smoking cessation interventions evaluated in 19 randomized controlled trials with individuals in current addictions treatment or recovery. Smoking and substance use outcomes at posttreatment and long-term follow-up (> or = 6 months) were summarized with random effects models. Intervention effects for smoking cessation were significant at posttreatment and comparable for participants in addictions treatment and recovery; however, intervention effects for smoking cessation were nonsignificant at long-term follow-up. Smoking cessation interventions provided during addictions treatment were associated with a 25% increased likelihood of long-term abstinence from alcohol and illicit drugs. Short-term smoking cessation effects look promising, but innovative strategies are needed for long-term cessation. Contrary to previous concerns, smoking cessation interventions during addictions treatment appeared to enhance rather than compromise long-term sobriety. Copyright 2004 APA.

Needs-Based Innovation in Interventional Radiology: The Biodesign Process.

PubMed

Steinberger, Jonathan D; Denend, Lyn; Azagury, Dan E; Brinton, Todd J; Makower, Josh; Yock, Paul G

2017-06-01

There are many possible mechanisms for innovation and bringing new technology into the marketplace. The Stanford Biodesign innovation process is based in a deep understanding of clinical unmet needs as the basis for focused ideation and development. By identifying and vetting a compelling unmet need, the aspiring innovator can "derisk" a project and maximize chances for successful development in an increasingly challenging regulatory and economic environment. As a specialty founded by tinkerers, with a history of disruptive innovation that has yielded countless new ways of delivering care with minimal invasiveness, lower morbidity, and lower cost, interventional radiologists are uniquely well positioned to identify unmet needs and develop novel solutions free of dogmatic convention. Copyright © 2017 Elsevier Inc. All rights reserved.

Balancing cognitive diversity and mutual understanding in multidisciplinary teams.

PubMed

Mitchell, Rebecca; Boyle, Brendan; O'Brien, Rachael; Malik, Ashish; Tian, Karen; Parker, Vicki; Giles, Michelle; Joyce, Pauline; Chiang, Vico

Interprofessional health care teams are increasingly utilized in health care organizations. Although there is support for their capacity to solve complex problems, there is also evidence that such teams are not always successful. In an effort to understand the capacity of interprofessional teams to innovate successfully, we investigate the role of cognitive diversity to establish whether and how knowledge differences lead to innovation. The aim of this study was to construct and investigate a model of team innovation predicted by cognitive diversity. In addition to investigating the direct impact of cognitive diversity in interprofessional health care teams, we develop a model incorporating mediated and moderated effects. In this study, we explore the role of debate as a mediating factor capable of explaining the impact of cognitive diversity on innovation. We further propose that the link between cognitive diversity and innovation through debate is contingent upon trans-specialist knowledge, knowledge shared by health care professionals, spanning specialist divides and enabling mutual understanding. The hypotheses were investigated using a cross-sectional, correlational design. Survey data received from 75 interprofessional teams employed in an acute care setting, representing a 36% response rate, were used to investigate our model. Analysis supports a significant relationship between cognitive diversity and debate, which is stronger when teams rate highly for trans-specialist knowledge. Results also support a positive relationship between debate and innovation and our full moderated mediated pathway. A range of strategies are indicated by our results to increase innovation in interprofessional teams. In particular, interventions such as interprofessional education and training, which have been shown to facilitate the development of shared language and meaning, are recommended by our findings.

Applying a structured innovation process to interventional radiology: a single-center experience.

PubMed

Sista, Akhilesh K; Hwang, Gloria L; Hovsepian, David M; Sze, Daniel Y; Kuo, William T; Kothary, Nishita; Louie, John D; Yamada, Kei; Hong, Richard; Dhanani, Riaz; Brinton, Todd J; Krummel, Thomas M; Makower, Joshua; Yock, Paul G; Hofmann, Lawrence V

2012-04-01

To determine the feasibility and efficacy of applying an established innovation process to an active academic interventional radiology (IR) practice. The Stanford Biodesign Medical Technology Innovation Process was used as the innovation template. Over a 4-month period, seven IR faculty and four IR fellow physicians recorded observations. These observations were converted into need statements. One particular need relating to gastrostomy tubes was diligently screened and was the subject of a single formal brainstorming session. Investigators collected 82 observations, 34 by faculty and 48 by fellows. The categories that generated the most observations were enteral feeding (n = 9, 11%), biopsy (n = 8, 10%), chest tubes (n = 6, 7%), chemoembolization and radioembolization (n = 6, 7%), and biliary interventions (n = 5, 6%). The output from the screening on the gastrostomy tube need was a specification sheet that served as a guidance document for the subsequent brainstorming session. The brainstorming session produced 10 concepts under three separate categories. This formalized innovation process generated numerous observations and ultimately 10 concepts to potentially to solve a significant clinical need, suggesting that a structured process can help guide an IR practice interested in medical innovation. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

Desarrollo de una intervención grupal para la prevención del VIH en parejas heterosexuales.

PubMed

Pérez-Jiménez, David; Escabí Montalvo, Aracelis; Del Carmen Cabrera Aponte, María

2010-01-01

HIV preventive efforts with heterosexual couples are almost nonexistent. We designed a group intervention based on the Information-Motivation-Behavioral Skills model with the aim of increasing male condom use and promoting the practice of mutual masturbation as a safer sex alternative. We carried out a pilot study with four couples to evaluate the feasibility of the intervention and the aspects of content and format that needed to be modified. Findings reflect that participants were very satisfied with the intervention and they found it entertaining and innovative. They were very comfortable with its format, as well as with the activities. The findings confirm the feasibility of this intervention and the need to direct preventive efforts to this population.

Introducing Technology for Thriving in Residential Long-Term Care.

PubMed

Østensen, Elisabeth; Gjevjon, Edith Roth; Øderud, Tone; Moen, Anne

2017-01-01

To present an emerging innovative care model that supports participation and thriving by older adults in residential care, by introduction to new technology and mobilizing volunteer services. Qualitative, exploratory study, introducing tablet computers to 15 older adults in two municipalities. The intervention encompassed weekly workshops over the course of 1 year with volunteer adolescents as personal tutors. Observations of workshops, interviews with nurses, and repeated semistructured interviews with older adult participants eliciting their perspective on use, experiences, perceived usefulness, and overall evaluation of the intervention. A model of four components is suggested to support participation and thriving by older adults in residential care: (a) simplified tools: iPad-technology relatively easy to use; (b) person-centered process: one-to-one tutoring following each individual's own pace; (c) young volunteers to teach technology, establishing an intergenerational arena; and (d) being mindful of driving forces that encourage use and learning. We found that all kinds of use and all levels of mastery generated a sense of pride that supported thriving and enjoyment. These findings support the use of new technology and use of volunteer services for sustaining thriving in older adults. The person-centered approach stimulates use of the tablet, and participants showed enjoyment, more social participation, and reported subjective experiences of thriving. Innovative models of care that prevent (or postpone) functional decline and support thriving in older adults are highly sought after in health care. A model that systematically involves volunteer services comes with potentials to alleviate nurses' workload, and then the intervention is seen as a manageable and low-cost initiative in residential care. © 2016 Sigma Theta Tau International.

Reinventing the Reel: An Innovative Approach to Resident Skill-Building in Motivational Interviewing for Brief Intervention

ERIC Educational Resources Information Center

Cole, Bonnie; Clark, Denice Crowe; Seale, J. Paul; Shellenberger, Sylvia; Lyme, Alan; Johnson, J. Aaron; Chhabria, Aruna

2012-01-01

To enhance the skills of primary care residents in addressing substance misuse, residency screening, brief intervention, and referral to treatment (SBIRT) programs increasingly offer motivational interviewing (MI) training, but seldom include feedback and coaching. This innovative 2-round "Virginia Reel" approach, supplementing 3 hours of basic MI…

Bridging the Research-to-Practice Gap in Autism Intervention: An Application of Diffusion of Innovation Theory

PubMed Central

Mandell, David S.

2011-01-01

There is growing evidence that efficacious interventions for autism are rarely adopted or successfully implemented in public mental health and education systems. We propose applying diffusion of innovation theory to further our understanding of why this is the case. We pose a practical set of questions that administrators face as they decide about the use of interventions. Using literature from autism intervention and dissemination science, we describe reasons why efficacious interventions for autism are rarely adopted, implemented, and maintained in community settings, all revolving around the perceived fit between the intervention and the needs and capacities of the setting. Finally, we suggest strategies for intervention development that may increase the probability that these interventions will be used in real-world settings. PMID:20717714

MobileODT: a case study of a novel approach to an mHealth-based model of sustainable impact

PubMed Central

Mink, Jonah

2016-01-01

A persistent challenge facing global health actors is ensuring that time-bound interventions are ultimately adopted and integrated into local health systems for long term health system strengthening and capacity building. This level of sustainability is rarely achieved with current models of global health intervention that rely on continuous injection of resources or persistent external presence on the ground. Presented here is a case study of a flipped approach to creating capacity and adoption through an engagement strategy centered around an innovative mHealth device and connected service. Through an impact-oriented business model, this mHealth solution engages stakeholders in a cohesive and interdependent network by appealing to the pain points for each actor throughout the health system. This particular intervention centers around the MobileODT, Inc. Enhanced Visual Assessment (EVA) System for enhanced visualization. While focused on challenges to cervical cancer screening and treatment services, the lessons learned are offered as a model for lateral translation into adjacent health condition verticals. PMID:28293590

Preventing disease through opportunistic, rapid engagement by primary care teams using behaviour change counselling (PRE-EMPT): protocol for a general practice-based cluster randomised trial.

PubMed

Spanou, Clio; Simpson, Sharon A; Hood, Kerry; Edwards, Adrian; Cohen, David; Rollnick, Stephen; Carter, Ben; McCambridge, Jim; Moore, Laurence; Randell, Elizabeth; Pickles, Timothy; Smith, Christine; Lane, Claire; Wood, Fiona; Thornton, Hazel; Butler, Chris C

2010-09-21

Smoking, excessive alcohol consumption, lack of exercise and an unhealthy diet are the key modifiable factors contributing to premature morbidity and mortality in the developed world. Brief interventions in health care consultations can be effective in changing single health behaviours. General Practice holds considerable potential for primary prevention through modifying patients' multiple risk behaviours, but feasible, acceptable and effective interventions are poorly developed, and uptake by practitioners is low. Through a process of theoretical development, modeling and exploratory trials, we have developed an intervention called Behaviour Change Counselling (BCC) derived from Motivational Interviewing (MI). This paper describes the protocol for an evaluation of a training intervention (the Talking Lifestyles Programme) which will enable practitioners to routinely use BCC during consultations for the above four risk behaviours. This cluster randomised controlled efficacy trial (RCT) will evaluate the outcomes and costs of this training intervention for General Practitioners (GPs) and nurses. Training methods will include: a practice-based seminar, online self-directed learning, and reflecting on video recorded and simulated consultations. The intervention will be evaluated in 29 practices in Wales, UK; two clinicians will take part (one GP and one nurse) from each practice. In intervention practices both clinicians will receive training. The aim is to recruit 2000 patients into the study with an expected 30% drop out. The primary outcome will be the proportion of patients making changes in one or more of the four behaviours at three months. Results will be compared for patients seeing clinicians trained in BCC with patients seeing non-BCC trained clinicians. Economic and process evaluations will also be conducted. Opportunistic engagement by health professionals potentially represents a cost effective medical intervention. This study integrates an existing, innovative intervention method with an innovative training model to enable clinicians to routinely use BCC, providing them with new tools to encourage and support people to make healthier choices. This trial will evaluate effectiveness in primary care and determine costs of the intervention.

Preventing disease through opportunistic, rapid engagement by primary care teams using behaviour change counselling (PRE-EMPT): protocol for a general practice-based cluster randomised trial

PubMed Central

2010-01-01

Background Smoking, excessive alcohol consumption, lack of exercise and an unhealthy diet are the key modifiable factors contributing to premature morbidity and mortality in the developed world. Brief interventions in health care consultations can be effective in changing single health behaviours. General Practice holds considerable potential for primary prevention through modifying patients' multiple risk behaviours, but feasible, acceptable and effective interventions are poorly developed, and uptake by practitioners is low. Through a process of theoretical development, modeling and exploratory trials, we have developed an intervention called Behaviour Change Counselling (BCC) derived from Motivational Interviewing (MI). This paper describes the protocol for an evaluation of a training intervention (the Talking Lifestyles Programme) which will enable practitioners to routinely use BCC during consultations for the above four risk behaviours. Methods/Design This cluster randomised controlled efficacy trial (RCT) will evaluate the outcomes and costs of this training intervention for General Practitioners (GPs) and nurses. Training methods will include: a practice-based seminar, online self-directed learning, and reflecting on video recorded and simulated consultations. The intervention will be evaluated in 29 practices in Wales, UK; two clinicians will take part (one GP and one nurse) from each practice. In intervention practices both clinicians will receive training. The aim is to recruit 2000 patients into the study with an expected 30% drop out. The primary outcome will be the proportion of patients making changes in one or more of the four behaviours at three months. Results will be compared for patients seeing clinicians trained in BCC with patients seeing non-BCC trained clinicians. Economic and process evaluations will also be conducted. Discussion Opportunistic engagement by health professionals potentially represents a cost effective medical intervention. This study integrates an existing, innovative intervention method with an innovative training model to enable clinicians to routinely use BCC, providing them with new tools to encourage and support people to make healthier choices. This trial will evaluate effectiveness in primary care and determine costs of the intervention. Trial Registration ISRCTN22495456 PMID:20858273

Mississippi Communities for Healthy Living: Implementing a nutrition intervention effectiveness study in a rural health disparate region.

PubMed

Connell, Carol L; Thomson, Jessica L; Huye, Holly F; Landry, Alicia S; Crook, LaShaundrea B; Yadrick, Kathy

2015-05-01

Intervention research in rural, health disparate communities presents unique challenges for study design, implementation, and evaluation. Challenges include 1) culturally appropriate intervention components, 2) participant recruitment and retention, 3) treatment cross-contamination, 4) intervention delivery and data collection, and 5) potential measurement reactivity. The purposes of this paper are to 1) detail the methods of the MCHL study and 2) report baseline demographic characteristics of study participants. The secondary aim is to determine if study participants were engaging in behavior changes after enrollment and prior to intervention initiation. MCHL was developed using the RE-AIM planning and evaluation framework (reach, effectiveness, adoption, implementation, maintenance). Intervention components were based on Roger's diffusion of innovation attributes that promote adoption of a new innovation as well as on the psychosocial constructs of social support, self-efficacy and decisional balance. Rolling enrollment data collection was used to acquire sufficient sample size and a second data collection just prior to intervention implementation assessed measurement reactivity effects. Participant outcomes included diet quality, blood pressure, weight status, and quality of life. Cluster stratified assignment to one of two treatment arms was utilized to minimize cross contamination. Generalized linear models were used to compare enrollment measures between the two treatment arms while mixed model linear regression was used to test for changes in diet quality outcomes from enrollment to pre-intervention baseline. There were no significant differences in participant demographic, anthropometric or clinical measures between the two treatment arms at enrollment. With the exception of total vegetables, none of the diet quality indicators were significantly different between enrollment and baseline timepoints. Conducting nutrition intervention research in a rural health disparate region requires flexibility in adapting the recruitment, retention, and data collection procedures while maintaining a high level of scientific rigor. Negligible research participation effects, such as measurement reactivity, were noted in this population. However, further research is needed to identify methods to successfully recruit and retain Caucasian females to participate in community-based nutrition interventions in this region. Copyright © 2015 Elsevier Inc. All rights reserved.

Getting Clearer About Surgical Innovation: A New Definition and a New Tool to Support Responsible Practice.

PubMed

Hutchison, Katrina; Rogers, Wendy; Eyers, Anthony; Lotz, Mianna

2015-12-01

This article presents an original definition of surgical innovation and a practical tool for identifying planned innovations. These will support the responsible introduction of surgical innovations. Frameworks developed for the safer introduction of surgical innovations rely upon identifying cases of innovation; oversight cannot occur unless innovations are identified. However, there is no consensus among surgeons about which interventions they consider innovative; existing definitions are vague and impractical. Using conceptual analysis, this article synthesizes findings from relevant literature, and from qualitative research with surgeons, to develop an original definition of surgical innovation and a tool for prospectively identifying planned surgical innovations. The tool has been developed in light of feedback from health care professionals, surgeons, and policy makers. This definition of innovation distinguishes between variations, introduction of established interventions, and innovations in surgical techniques or use of devices. It can be applied easily and consistently, is sensitive to the key features of innovation (newness and degree of change), is prospective, and focuses on features relevant to safety and evaluation. The accompanying tool is deliberately broad so that appropriate supports may, if necessary, be provided each time that a surgeon does something "new." The definition presented in this article overcomes a number of practical challenges. The definition and tool will be of value in supporting responsible surgical innovation, in particular, through the prospective identification of planned innovations.

Seeking to Engage "Hard-to-Reach" Families: Towards a Transferable Model of Intervention

ERIC Educational Resources Information Center

Evangelou, Maria; Coxon, Kate; Sylva, Kathy; Smith, Sally; Chan, Lydia L. S.

2013-01-01

This paper describes an exploratory evaluation of the Peers Early Education Partnership "Room to Play", an innovative and experimental "drop-in" service seeking to attract and engage "hard-to-reach" families in one of the most deprived areas of a Midlands city. Located in a shop unit of a busy community shopping…

Multilevel Dynamic Systems Affecting Introduction of HIV/STI Prevention Innovations among Chinese Women in Sex Work Establishments

ERIC Educational Resources Information Center

Weeks, Margaret R.; Li, Jianghong; Liao, Susu; Zhang, Qingning; Dunn, Jennifer; Wang, Yanhong; Jiang, Jingmei

2013-01-01

Social and public health scientists are increasingly interested in applying system dynamics theory to improve understanding and to harness the forces of change within complex, multilevel systems that affect community intervention implementation, effects, and sustainability. Building a system dynamics model based on ethnographic case study has the…

Influences on children's dietary behavior, and innovative attempts to change it.

PubMed

Baranowski, Tom; Diep, Cassandra; Baranowski, Janice

2013-01-01

Fruit and vegetable (FV) intake may protect against several chronic diseases, and the preferences and habits in relation to FV intake appear to form in early childhood. Child FV intake reflects many influences from multiple levels (e.g. internal to the child, family, school, and neighborhood). We have documented influences at each of these levels, but more definitive research in longitudinal samples remains to be conducted. Even though validated comprehensive models of influences on child FV intake in longitudinal studies are not available to guide intervention design for children of different ages, there has been an urgency to initiate chronic disease prevention interventions to mitigate the substantial health consequences. Effective interventions use known behavior change procedures to change the influences on FV intake enough to change the behavior, but few such interventions have demonstrated effectiveness at meaningful levels. Innovative methods need to be explored. Videogames for Health offer a medium that is attractive to children and shows promising results, especially for dietary behavior change. Exciting additional research is needed to clarify possible bidirectional influences between the environmental and individual influences on child intake with possible age-related differences in influence and in the optimal design of video games for dietary change. Copyright © 2013 S. Karger AG, Basel.

Exploring the Acceptability of Innovative Technology: A Pilot Study Using LENA with Parents of Young Deaf Children in the UK

ERIC Educational Resources Information Center

Allen, Sarah; Crawford, Paul; Mulla, Imran

2017-01-01

Early intervention is widely recommended for children at risk of difficulties with speech, language and communication. Evidence for effective practice remains limited due in part to inherent difficulties in defining complex interventions and measuring change. The innovative Language Environment Analysis (LENA) system has exciting potential for…

Factors Associated with Tweens' Intentions to Sustain Participation in an Innovative Community-Based Physical Activity Intervention

ERIC Educational Resources Information Center

DeBate, Rita D.; McDermott, Robert J.; Baldwin, Julie A.; Bryant, Carol A.; Courtney, Anita H.; Hogeboom, David L.; Nickelson, Jen; Phiilips, Leah M.; Alfonso, Moya L.

2009-01-01

Background: Participation in free-time play, including individual and group activities, is important during youth as patterns of physical activity established then persist into adulthood. The VERB Summer Scorecard (VSS) intervention is an innovative physical activity promotion initiative that offers tweens (8-13 year-olds) opportunities to be…

Second-Year Results of an Obesity Prevention Program at The Dow Chemical Company

PubMed Central

Roemer, Enid C.; Pei, Xiaofei; Short, Meghan E.; Tabrizi, Maryam J.; Wilson, Mark G.; DeJoy, David M.; Craun, Beth A.; Tully, Karen J.; White, John M.; Baase, Catherine M.

2010-01-01

Objective Evaluate innovative, evidence-based approaches to organizational/supportive environmental interventions aimed at reducing the prevalence of obesity among Dow employees after two years of implementation. Methods A quasi-experimental study design compared outcomes for two levels of intervention intensity to a control group. Propensity scores were used to weight baseline differences between intervention and control subjects. Difference-in-differences methods and multi-level modeling were used to control for individual and site-level confounders. Results Intervention participants maintained their weight and BMI while control participants gained 1.3 pounds and increased their BMI values by 0.2 over two years. Significant differences in blood pressure and cholesterol values were observed when comparing intervention employees to controls. At higher intensity sites, improvements were more pronounced. Conclusions Environmental interventions at the workplace can support weight management and risk reduction after two years. PMID:20190646

The impact of integrated prevention and treatment on child malnutrition and health: the PROMIS project, a randomized control trial in Burkina Faso and Mali.

PubMed

Huybregts, Lieven; Becquey, Elodie; Zongrone, Amanda; Le Port, Agnes; Khassanova, Regina; Coulibaly, Lazare; Leroy, Jef L; Rawat, Rahul; Ruel, Marie T

2017-03-09

Evidence suggests that both preventive and curative nutrition interventions are needed to tackle child acute malnutrition (AM) in developing countries. In addition to reducing the incidence of AM, providing preventive interventions may also help increase attendance (and coverage) of AM screening, a major constraint in the community-based management of child acute malnutrition (CMAM) model. There is a paucity of evidence-based strategies to deliver integrated preventive and curative interventions effectively and affordably at scale. The aim of the Innovative Approaches for the Prevention of Childhood Malnutrition (PROMIS) study is to assess the feasibility, quality of implementation, effectiveness and cost-effectiveness of an integrated child malnutrition prevention and treatment intervention package implemented through a community-based platform in Mali and a facility-based platform in Burkina Faso. The PROMIS intervention entails a comprehensive preventive package offered on a monthly basis to caregivers of children, while children are screened for acute malnutrition (AM). The package consists of behavior change communication on essential nutrition and hygiene actions, and monthly preventive doses of small quantity lipid-based nutrient supplements (SQ-LNS) for children aged 6 to 23.9 months. Positive AM cases are referred to treatment services offered by first-line health services according to the CMAM model. The PROMIS intervention will be evaluated using a mixed methods approach. The impact study encompasses two types of study design: i) repeated cross-sectional surveys conducted at baseline and at endline after 24 months of program implementation and ii) a longitudinal study with a monthly follow-up for 18 months. Primary study impact measures include the incidence and endpoint prevalence of AM, AM screening coverage and treatment compliance. A process evaluation will assess the feasibility and quality of implementation of the intervention guided by country specific program impact pathways (PIPs). Cost-effectiveness analysis will assess the economic feasibility of the intervention. The PROMIS study assesses the effectiveness of an innovative model to integrate prevention and treatment interventions for greater and more sustainable impacts on the incidence and prevalence of AM using a rigorous, theory-based randomized control trial approach. This type of programmatic research is urgently needed to help program implementers, policy makers, and investors prioritize, select and scale-up the best program models to prevent and treat AM and achieve the World Health Assembly goal of reducing childhood wasting to less than 5% globally by the year 2025. Clinicaltrials.gov NCT02323815 (registered on December 18, 2014) and NCT02245152 (registered on September 16, 2014).

Knowledge translation interventions to sustain direct care provider behaviour change in long-term care: A process evaluation.

PubMed

Slaughter, Susan E; Bampton, Erin; Erin, Daniel F; Ickert, Carla; Wagg, Adrian S; Allyson Jones, C; Schalm, Corinne; Estabrooks, Carole A

2018-02-01

Process evaluation can be used to understand the factors influencing the impact of knowledge translation (KT) interventions. The aim of this mixed methods process evaluation was to evaluate the processes and perceived outcomes of eight KT interventions that were used with healthcare aides (HCAs) to introduce a mobility innovation into their daily care practices. The study examined the perceived effectiveness of various KT interventions in sustaining daily performance of the sit-to-stand mobility innovation by HCAs with residents in long-term care. In-person interviews were conducted with four leaders across three long-term care facilities. Seven focus groups with 27 HCAs were conducted across the three facilities. All participants were asked to rank the eight interventions involved in the trial according to their perceived effectiveness and, for the leaders, their perceived ease of implementation. Focus group and interview questions asked participants to discuss the relative merits of each KT intervention. Two research assistants coded all of the transcripts independently using content analysis. Both HCAs and their leaders perceived reminders, followed by discussion groups, to be the most effective KT interventions to sustain practice change. Healthcare aide champions were deemed least effective by both leaders and HCAs. Leaders identified both the focus group discussion and audit and feedback posters in the study as the most difficult to implement. Participants valued interventions that were strategically visible, helped to clarify misconceptions about the new care innovation, supported teamwork, and made visible the resident benefits of the care innovation. Logistical issues, such as staff scheduling and workload, influenced the perceived feasibility of the various KT interventions. Understanding how care staff in long-term care settings perceive KT interventions can inform the choice of future use of these interventions to move research evidence into practice. © 2017 John Wiley & Sons, Ltd.

Factors associated with staff development processes and the creation of innovative science courses in higher education

NASA Astrophysics Data System (ADS)

Hodges, Jeanelle Bland

1999-11-01

The purpose of the study was to determine factors associated with staff development processes and the creation of innovative science courses by higher education faculty who have participated in a model staff development project. The staff development program was designed for college faculty interested in creating interdisciplinary, constructivist-based science, mathematics, or engineering courses designed for non-majors. The program includes workshops on incorporating constructivist pedagogy, alternative assessment, and technology into interdisciplinary courses. Staff development interventions used in the program include grant opportunities, distribution of resource materials, and peer mentoring. University teams attending the workshops are comprised of faculty from the sciences, mathematics, or engineering, as well as education, and administration. A purposeful and convenient sample of three university teams were subjects for this qualitative study. Each team had attended a NASA Opportunities for Visionary Academics (NOVA) workshop, received funding for course development, and offered innovative courses. Five questions were addressed in this study: (a) What methods were used by faculty teams in planning the courses? (b) What changes occurred in existing science courses? (c) What factors affected the team collaboration process? (d) What personal characteristics of faculty members were important in successful course development? and (e) What barriers existed for faculty in the course development process? Data was collected at each site through individual faculty interviews (N = 11), student focus group interviews (N = 15), and classroom observations. Secondary data included original funding proposals. The NOVA staff development model incorporated effective K--12 interventions with higher education interventions. Analysis of data revealed that there were four factors of staff development processes that were most beneficial. First, the team collaborative processes were crucial in successful course development. Second, the use of instructional grants to fund course development gave credibility to the faculty involved in course development. Third, the faculty members taking the lead in creating teams actively sought out faculty members in the sciences who had previous experience teaching at the K--12 level or in informal education. In addition, college environments were found to have an impact on the success of the innovative course development projects.

Advancing Novel HIV Prevention Intervention Research with MSM—Meeting Report

PubMed Central

Grossman, Cynthia I.; Forsyth, Andrew; Purcell, David W.; Allison, Susannah; Toledo, Carlos; Gordon, Christopher M.

2011-01-01

HIV continues to exact an enormous toll on society and to disproportionately affect gay and bisexual men and other men who have sex with men (MSM). Innovative prevention interventions are needed to reverse this trend. In August 2009, the U.S. National Institute of Mental Health and the Centers for Disease Control and Prevention convened a meeting of scientists, community representatives, advocates, and federal partners to discuss innovative prevention-intervention science. The meeting was structured to maximize discussion of (1) healthy sex interventions, (2) community and structural interventions, (3) integrated biomedical and behavioral interventions, and (4) interventions to improve uptake of HIV testing. Presentations and discussion focused on research gaps in designing risk-reducing and sexual health-promoting interventions for MSM, including interventions to address mental health, substance use, disclosure, and stigma. This article summarizes the meeting proceedings, highlights key points, and outlines future directions. PMID:21800742

Developing a Dissemination Model to Improve Intervention Reach among West Virginia Youth Smokers

PubMed Central

Horn, Kimberly; Jarrett, Traci; Anesetti-Rothermel, Andrew; O’Hara Tompkins, Nancy; Dino, Geri

2014-01-01

The not-on-tobacco program is an evidence-based teen smoking cessation program adopted by the American Lung Association (ALA). Although widely disseminated nationally via ALA Master Trainers, in recent years, adoption and implementation of the N-O-T program in West Virginia (WV) has slowed. WV, unfortunately, has one of the highest smoking rates in the US. Although it is a goal of public health science, dissemination of evidence-based interventions is woefully understudied. The present manuscript reviews a theoretical model of dissemination of the not-on-tobacco program in WV. Based on social marketing, diffusion of innovations, and social cognitive theories, the nine-phase model incorporates elements of infrastructure development, accountability, training, delivery, incentives, and communication. The model components as well as preliminary lessons learned from initial implementation are discussed. PMID:25136547

Multilevel dynamic systems affecting introduction of HIV/STI prevention innovations among Chinese women in sex work establishments.

PubMed

Weeks, Margaret R; Li, Jianghong; Liao, Susu; Zhang, Qingning; Dunn, Jennifer; Wang, Yanhong; Jiang, Jingmei

2013-10-01

Social and public health scientists are increasingly interested in applying system dynamics theory to improve understanding and to harness the forces of change within complex, multilevel systems that affect community intervention implementation, effects, and sustainability. Building a system dynamics model based on ethnographic case study has the advantage of using empirically documented contextual factors and processes of change in a real-world and real-time setting that can then be tested in the same and other settings. System dynamics modeling offers great promise for addressing persistent problems like HIV and other sexually transmitted epidemics, particularly in complex rapidly developing countries such as China. We generated a system dynamics model of a multilevel intervention we conducted to promote female condoms for HIV/sexually transmitted infection (STI) prevention among Chinese women in sex work establishments. The model reflects factors and forces affecting the study's intervention, implementation, and effects. To build this conceptual model, we drew on our experiences and findings from this intensive, longitudinal mixed-ethnographic and quantitative four-town comparative case study (2007-2012) of the sex work establishments, the intervention conducted in them, and factors likely to explain variation in process and outcomes in the four towns. Multiple feedback loops in the sex work establishments, women's social networks, and the health organization responsible for implementing HIV/STI interventions in each town and at the town level directly or indirectly influenced the female condom intervention. We present the conceptual system dynamics model and discuss how further testing in this and other settings can inform future community interventions to reduce HIV and STIs.

Multilevel Dynamic Systems Affecting Introduction of HIV/STI Prevention Innovations among Chinese Women in Sex-work Establishments

PubMed Central

Weeks, Margaret R.; Li, Jianghong; Liao, Susu; Zhang, Qingning; Dunn, Jennifer; Wang, Yanhong; Jiang, Jingmei

2015-01-01

Social and public health scientists are increasingly interested in applying system dynamics theory to improve understanding and to harness the forces of change within complex, multilevel systems that affect community intervention implementation, effects, and sustainability. Building a system dynamics model based on ethnographic case study has the advantage of using empirically documented contextual factors and processes of change in a real world and real time setting that can then be tested in the same and other settings. System dynamics modeling offers great promise for addressing persistent problems like HIV and other sexually transmitted epidemics, particularly in complex rapidly developing countries like China. We generated a system dynamics model of a multilevel intervention we conducted to promote female condoms (FC) for HIV/STI prevention among Chinese women in sex-work establishments. The model reflects factors and forces affecting the study’s intervention implementation and effects. To build this conceptual model, we drew on our experiences and findings from this intensive, longitudinal mixed ethnographic and quantitative four-town comparative case study (2007–2012) of the sex-work establishments, the intervention conducted in them, and factors likely to explain variation in process and outcomes in the four towns. Multiple feedback loops in the sex-work establishments, women’s social networks, and the health organization responsible for implementing HIV/STI interventions in each town and at the town level directly or indirectly influenced the FC intervention. We present the conceptual system dynamics model and discuss how further testing in this and other settings can inform future community interventions to reduce HIV and STIs. PMID:24084394

Desarrollo de una intervención grupal para la prevención del VIH en parejas heterosexuales1

PubMed Central

Pérez-Jiménez, David; Escabí Montalvo, Aracelis; del Carmen Cabrera Aponte, María

2012-01-01

HIV preventive efforts with heterosexual couples are almost nonexistent. We designed a group intervention based on the Information-Motivation-Behavioral Skills model with the aim of increasing male condom use and promoting the practice of mutual masturbation as a safer sex alternative. We carried out a pilot study with four couples to evaluate the feasibility of the intervention and the aspects of content and format that needed to be modified. Findings reflect that participants were very satisfied with the intervention and they found it entertaining and innovative. They were very comfortable with its format, as well as with the activities. The findings confirm the feasibility of this intervention and the need to direct preventive efforts to this population. PMID:23847716

In-home monitoring of persons with dementia: ethical guidelines for technology research and development.

PubMed

Mahoney, Diane F; Purtilo, Ruth B; Webbe, Frank M; Alwan, Majd; Bharucha, Ashok J; Adlam, Tim D; Jimison, Holly B; Turner, Beverly; Becker, S Ann

2007-07-01

Innovative technologies are rapidly emerging that offer caregivers the support and means to assist older adults with cognitive impairment to continue living "at home." Technology research and development efforts applied to older adults with dementia invoke special grant review and institutional review board concerns, to ensure not only safe but also ethically appropriate interventions. Evidence is emerging, however, that tensions are growing between innovators and reviewers. Reviewers with antitechnology biases are in a position to stifle needed innovation. Technology developers who fail to understand the clinical and caregiving aspects of dementia may design applications that are not in alignment with users' capabilities. To bridge this divide, we offer an analysis of the ethical issues surrounding home monitoring, a model framework, and ethical guidelines for technology research and development for persons with Alzheimer's disease and their caregivers.

Global Health Innovation Technology Models.

PubMed

Harding, Kimberly

2016-01-01

Chronic technology and business process disparities between High Income, Low Middle Income and Low Income (HIC, LMIC, LIC) research collaborators directly prevent the growth of sustainable Global Health innovation for infectious and rare diseases. There is a need for an Open Source-Open Science Architecture Framework to bridge this divide. We are proposing such a framework for consideration by the Global Health community, by utilizing a hybrid approach of integrating agnostic Open Source technology and healthcare interoperability standards and Total Quality Management principles. We will validate this architecture framework through our programme called Project Orchid. Project Orchid is a conceptual Clinical Intelligence Exchange and Virtual Innovation platform utilizing this approach to support clinical innovation efforts for multi-national collaboration that can be locally sustainable for LIC and LMIC research cohorts. The goal is to enable LIC and LMIC research organizations to accelerate their clinical trial process maturity in the field of drug discovery, population health innovation initiatives and public domain knowledge networks. When sponsored, this concept will be tested by 12 confirmed clinical research and public health organizations in six countries. The potential impact of this platform is reduced drug discovery and public health innovation lag time and improved clinical trial interventions, due to reliable clinical intelligence and bio-surveillance across all phases of the clinical innovation process.

Global Health Innovation Technology Models

PubMed Central

Harding, Kimberly

2016-01-01

Chronic technology and business process disparities between High Income, Low Middle Income and Low Income (HIC, LMIC, LIC) research collaborators directly prevent the growth of sustainable Global Health innovation for infectious and rare diseases. There is a need for an Open Source-Open Science Architecture Framework to bridge this divide. We are proposing such a framework for consideration by the Global Health community, by utilizing a hybrid approach of integrating agnostic Open Source technology and healthcare interoperability standards and Total Quality Management principles. We will validate this architecture framework through our programme called Project Orchid. Project Orchid is a conceptual Clinical Intelligence Exchange and Virtual Innovation platform utilizing this approach to support clinical innovation efforts for multi-national collaboration that can be locally sustainable for LIC and LMIC research cohorts. The goal is to enable LIC and LMIC research organizations to accelerate their clinical trial process maturity in the field of drug discovery, population health innovation initiatives and public domain knowledge networks. When sponsored, this concept will be tested by 12 confirmed clinical research and public health organizations in six countries. The potential impact of this platform is reduced drug discovery and public health innovation lag time and improved clinical trial interventions, due to reliable clinical intelligence and bio-surveillance across all phases of the clinical innovation process.

STEM Learning Opportunities Providing Equity (SLOPE): An Investing in Innovation (i3) Grant. Final Evaluation Report

ERIC Educational Resources Information Center

Gallagher, Carole; Huang, Kevin; Van Matre, Joseph

2015-01-01

This five-year evaluation examined the effectiveness of a promising middle-school mathematics intervention funded through an Investing in Innovation (i3) development grant. Evaluation objectives were to: (1) study the impact of an intervention aimed at increasing the academic achievement of students in Algebra I--a gate-keeping course--as measured…

Chaos or transformation? Managing innovation.

PubMed

Manion, J

1993-05-01

Nurse innovation is the key to transformation of the healthcare organization and the healthcare system. This article offers the nurse executive and the leadership team a way to assess innovative tendencies of their department or organization and determine where strengths and trouble spots exist. The author discusses a five-phase innovation management process with suggested interventions for each phase.

Examination of Food Choice Motives: The Influence of an Innovative, Interdisciplinary Learning Community Related to Environmental Sustainability

ERIC Educational Resources Information Center

Billingsley, Kelly J.

2014-01-01

What and how much an individual eats largely defines his/her health. The most used dietary intervention models target individuals' concern for personal health, thereby undermining the interdisciplinary trajectory of the nutrition field. The purpose of this study was to compare the food choice motives of students enrolled in an interdisciplinary…

Enacting Key Skills-Based Curricula in Secondary Education: Lessons from a Technology-Mediated, Group-Based Learning Initiative

ERIC Educational Resources Information Center

Johnston, Keith; Conneely, Claire; Murchan, Damian; Tangney, Brendan

2015-01-01

Bridge21 is an innovative approach to learning for secondary education that was originally conceptualised as part of a social outreach intervention in the authors' third-level institution whereby participants attended workshops at a dedicated learning space on campus focusing on a particular model of technology-mediated group-based learning. This…

Applying an alternative mathematics pedagogy for students with weak mathematics: meta-analysis of alternative pedagogies

NASA Astrophysics Data System (ADS)

Lake, Warren; Wallin, Margie; Woolcott, Geoff; Boyd, Wendy; Foster, Alan; Markopoulos, Christos; Boyd, William

2017-02-01

Student mathematics performance and the need for work-ready graduates to be mathematics-competent is a core issue for many universities. While both student and teacher are responsible for learning outcomes, there is a need to explicitly acknowledge the weak mathematics foundation of many university students. A systematic literature review was undertaken of identified innovations and/or interventions that may lead to improvement in student outcomes for university mathematics-based units of study. The review revealed the importance of understanding the foundations of student performance in higher education mathematics learning, especially in first year. Pre-university mathematics skills were identified as significant in student retention and mathematics success at university, and a specific focus on student pre-university mathematics skill level was found to be more effective in providing help, rather than simply focusing on a particular at-risk group. Diagnostics tools were found to be important in identifying (1) student background and (2) appropriate intervention. The studies highlighted the importance of appropriate and validated interventions in mathematics teaching and learning, and the need to improve the learning model for mathematics-based subjects, communication and technology innovations.

Towards a systems approach for chronic diseases, based on health state modeling

PubMed Central

Rebhan, Michael

2017-01-01

Rising pressure from chronic diseases means that we need to learn how to deal with challenges at a different level, including the use of systems approaches that better connect across fragments, such as disciplines, stakeholders, institutions, and technologies. By learning from progress in leading areas of health innovation (including oncology and AIDS), as well as complementary indications (Alzheimer’s disease), I try to extract the most enabling innovation paradigms, and discuss their extension to additional areas of application within a systems approach. To facilitate such work, a Precision, P4 or Systems Medicine platform is proposed, which is centered on the representation of health states that enable the definition of time in the vision to provide the right intervention for the right patient at the right time and dose. Modeling of such health states should allow iterative optimization, as longitudinal human data accumulate. This platform is designed to facilitate the discovery of links between opportunities related to a) the modernization of diagnosis, including the increased use of omics profiling, b) patient-centric approaches enabled by technology convergence, including digital health and connected devices, c) increasing understanding of the pathobiological, clinical and health economic aspects of disease progression stages, d) design of new interventions, including therapies as well as preventive measures, including sequential intervention approaches. Probabilistic Markov models of health states, e.g. those used for health economic analysis, are discussed as a simple starting point for the platform. A path towards extension into other indications, data types and uses is discussed, with a focus on regenerative medicine and relevant pathobiology. PMID:28529704

The Mental Health, Substance Use, and Delinquency among Truant Youths in a Brief Intervention Project: A Longitudinal Study

PubMed Central

Dembo, Richard; Briones-Robinson, Rhissa; Barrett, Kimberly; Winters, Ken C.; Schmeidler, James; Ungaro, Rocio; Karas, Lora M.; Belenko, Steven; Gulledge, Laura

2011-01-01

The relationship between substance use, mental health disorders, and delinquency among youth is well documented. What has received far less attention from researchers is the relationship between these issues among truant youth, in spite of studies that document truants are a population at-risk for negative outcomes. The present study bridges this gap by (1) examining psychosocial functioning and delinquency among truants, and (2) assessing the efficacy of a Brief Intervention (BI) in reducing delinquent behavior over time. To meet these objectives, data were collected from 183 truant youth enrolled in an ongoing NIDA-funded BI project. Informed by a developmental damage perspective, a structural equation model was formulated and estimated. Interim results provide overall support for the model, and suggest the BI may be a promising, innovative intervention for truant youth. Service delivery implications and directions for future analyses are discussed. PMID:23914129

Innovations in medical care and mortality trends from four circulatory diseases between 1970 and 2005.

PubMed

Hoffmann, Rasmus; Plug, Iris; McKee, Martin; Khoshaba, Bernadette; Westerling, Ragnar; Looman, Caspar; Rey, Gregoire; Jougla, Eric; Luis Alfonso, Jose; Lang, Katrin; Pärna, Kersti; Mackenbach, Johan P

2013-10-01

Governments have identified innovation in pharmaceuticals and medical technology as a priority for health policy. Although the contribution of medical care to health has been studied extensively in clinical settings, much less is known about its contribution to population health. We examine how innovations in the management of four circulatory disorders have influenced trends in cause-specific mortality at the population level. Based on literature reviews, we selected six medical innovations with proven effectiveness against hypertension, ischaemic heart disease, heart failure and cerebrovascular disease. We combined data on the timing of these innovations and cause-specific mortality trends (1970-2005) from seven European countries. We sought to identify associations between the introduction of innovations and favourable changes in mortality, using Joinpoint-models based on linear spline regression. For both ischaemic heart disease and cerebrovascular disease, the timing of medical innovations was associated with improved mortality in four out of five countries and five out of seven countries, respectively, depending on the innovation. This suggests that innovation has impacted positively on mortality at the population level. For hypertension and heart failure, such associations could not be identified. Although improvements in cause-specific mortality coincide with the introduction of some innovations, this is not invariably true. This is likely to reflect the incremental effects of many interventions, the time taken for them to be adopted fully and the presence of contemporaneous changes in disease incidence. Research on the impact of medical innovations on population health is limited by unreliable data on their introduction.

DISCOVERING FRUGAL INNOVATIONS THROUGH DELIVERING EARLY CHILDHOOD HOME-VISITING INTERVENTIONS IN LOW-RESOURCE TRIBAL COMMUNITIES.

PubMed

Barlow, Allison; McDaniel, Judy A; Marfani, Farha; Lowe, Anne; Keplinger, Cassie; Beltangady, Moushumi; Goklish, Novalene

2018-05-01

Early childhood home-visiting has been shown to yield the greatest impact for the lowest income, highest disparity families. Yet, poor communities generally experience fractured systems of care, a paucity of providers, and limited resources to deliver intensive home-visiting models to families who stand to benefit most. This article explores lessons emerging from the recent Tribal Maternal and Infant Early Childhood Home Visiting (MIECHV) legislation supporting delivery of home-visiting interventions in low-income, hard-to-reach American Indian and Alaska Native communities. We draw experience from four diverse tribal communities that participated in the Tribal MIECHV Program and overcame socioeconomic, geographic, and structural challenges that called for both early childhood home-visiting services and increased the difficulty of delivery. Key innovations are described, including unique community engagement, recruitment and retention strategies, expanded case management roles of home visitors to overcome fragmented care systems, contextual demands for employing paraprofessional home visitors, and practical advances toward streamlined evaluation approaches. We draw on the concept of "frugal innovation" to explain how the experience of Tribal MIECHV participation has led to more efficient, effective, and culturally informed early childhood home-visiting service delivery, with lessons for future dissemination to underserved communities in the United States and abroad. © 2018 Michigan Association for Infant Mental Health.

Developing a Questionnaire to Measure Perceived Attributes of eHealth Innovations

ERIC Educational Resources Information Center

Atkinson, Nancy L.

2007-01-01

Objectives: To design a valid and reliable questionnaire to assess perceived attributes of technology-based health education innovations. Methods: College students in 12 personal health courses reviewed a prototype eHealth intervention using a 30-item instrument based upon diffusion theory's perceived attributes of an innovation. Results:…

Organizational Factors Associated with the Use of Contingency Management in Publicly Funded Substance Abuse Treatment Centers

PubMed Central

Bride, Brian E.; Abraham, Amanda J.; Roman, Paul M.

2010-01-01

A promising area within technology transfer studies is the identification of organizational factors that influence the adoption of treatment innovations. While studies have identified organizational factors associated with the adoption of pharmacological innovations, few studies have examined organizational factors in the adoption of psychosocial innovations, among which contingency management (CM) is a significant practice. Using data from a sample (n = 318) drawn from the population of publicly funded treatment centers in the U.S., this study modeled organizational factors falling in the domains of structural characteristics, workforce variables, values and norms, and patient characteristics associated with the use of CM. Organizations were more likely to use CM if they: embrace a supportive therapeutic approach, are research-friendly, offer only outpatient levels of care, or serve drug-court patients. Implications for studying the diffusion and implementation of evidence-based psychosocial interventions are discussed. PMID:20850259

Interdisciplinary Postdoctoral Training in Global Health Through a Novel Joint Project for Trainees from Diverse Disciplines: Benefits, Risks, and Observations.

PubMed

Oberhelman, Richard A; Huaynate, Cynthia Anticona; Correa, Malena; Malpartida, Holger Mayta; Pajuelo, Monica; Paz-Soldan, Valerie A; Gilman, Robert H; Zimic, Mirko; Murphy, Laura; Belizan, Jose

2017-03-01

Postdoctoral training programs are usually highly individualized arrangements between trainees and a limited number of senior mentors in their field, an approach that contrasts with current trends in public health education that promote interdisciplinary training to spur innovation. Herein, we describe an alternative model for postdoctoral training for a group of fellows from distinct disciplines. Fellows work with mentors from diverse fields to create a joint research project or a group of complementary projects, with the goal of developing a new device, intervention, or innovation to address a global health problem. The perceived benefits, challenges, and limitations of this team approach to interdisciplinary postdoctoral training are presented.

The Environment and Directed Technical Change†

PubMed Central

Acemoglu, Daron; Aghion, Philippe; Bursztyn, Leonardo

2015-01-01

This paper introduces endogenous and directed technical change in a growth model with environmental constraints. The final good is produced from “dirty” and “clean” inputs. We show that: (i) when inputs are sufficiently substitutable, sustainable growth can be achieved with temporary taxes/subsidies that redirect innovation toward clean inputs; (ii) optimal policy involves both “carbon taxes” and research subsidies, avoiding excessive use of carbon taxes; (iii) delay in intervention is costly, as it later necessitates a longer transition phase with slow growth; and (iv) use of an exhaustible resource in dirty input production helps the switch to clean innovation under laissez-faire. (JEL O33, O44, Q30, Q54, Q56, Q58) PMID:26719595

The Environment and Directed Technical Change.

PubMed

Acemoglu, Daron; Aghion, Philippe; Bursztyn, Leonardo; Hemous, David

2012-02-01

This paper introduces endogenous and directed technical change in a growth model with environmental constraints. The final good is produced from "dirty" and "clean" inputs. We show that: (i) when inputs are sufficiently substitutable, sustainable growth can be achieved with temporary taxes/subsidies that redirect innovation toward clean inputs; (ii) optimal policy involves both "carbon taxes" and research subsidies, avoiding excessive use of carbon taxes; (iii) delay in intervention is costly, as it later necessitates a longer transition phase with slow growth; and (iv) use of an exhaustible resource in dirty input production helps the switch to clean innovation under laissez-faire. (JEL O33, O44, Q30, Q54, Q56, Q58).

Technology Innovations to Improve Biomass Cookstoves to Meet Tier 4 Standards

DOE Office of Scientific and Technical Information (OSTI.GOV)

Still, Dean K; Hatfield, Micheal S

Technology Innovations to Improve Biomass Cookstoves to Meet Tier 4 Standards. Protecting public health has become a major motivation for investigating how improved cook stoves might function as a viable intervention. Currently, the great majority of cookstoves for sale in the developing world were not designed for this purpose but instead success was based on criteria such as reduced fuel use, affordability, and ease of use. With DOE funding Aprovecho Research Center spent three years creating stoves using an iterative development and modeling approach resulting in four stoves that in lab tests met the World Health Organization (2014) intermediate ratemore » vented targets for PM2.5 and for CO.« less

Skills for a Low-Carbon Europe: The Role of VET in a Sustainable Energy Scenario. Synthesis Report. Research Paper No 34

ERIC Educational Resources Information Center

Ranieri, Antonio, Ed.

2013-01-01

This report provides an analysis of the labour market impacts of EU policy interventions designed to support the transition to a job-rich, low-carbon economy. The approach taken is innovative as it combines quantitative (econometric modelling) and qualitative (case study) methods to investigate the expected impact of sustainable energy policies on…

R-IDEAL: A Framework for Systematic Clinical Evaluation of Technical Innovations in Radiation Oncology.

PubMed

Verkooijen, Helena M; Kerkmeijer, Linda G W; Fuller, Clifton D; Huddart, Robbert; Faivre-Finn, Corinne; Verheij, Marcel; Mook, Stella; Sahgal, Arjun; Hall, Emma; Schultz, Chris

2017-01-01

The pace of innovation in radiation oncology is high and the window of opportunity for evaluation narrow. Financial incentives, industry pressure, and patients' demand for high-tech treatments have led to widespread implementation of innovations before, or even without, robust evidence of improved outcomes has been generated. The standard phase I-IV framework for drug evaluation is not the most efficient and desirable framework for assessment of technological innovations. In order to provide a standard assessment methodology for clinical evaluation of innovations in radiotherapy, we adapted the surgical IDEAL framework to fit the radiation oncology setting. Like surgery, clinical evaluation of innovations in radiation oncology is complicated by continuous technical development, team and operator dependence, and differences in quality control. Contrary to surgery, radiotherapy innovations may be used in various ways, e.g., at different tumor sites and with different aims, such as radiation volume reduction and dose escalation. Also, the effect of radiation treatment can be modeled, allowing better prediction of potential benefits and improved patient selection. Key distinctive features of R-IDEAL include the important role of predicate and modeling studies (Stage 0), randomization at an early stage in the development of the technology, and long-term follow-up for late toxicity. We implemented R-IDEAL for clinical evaluation of a recent innovation in radiation oncology, the MRI-guided linear accelerator (MR-Linac). MR-Linac combines a radiotherapy linear accelerator with a 1.5-T MRI, aiming for improved targeting, dose escalation, and margin reduction, and is expected to increase the use of hypofractionation, improve tumor control, leading to higher cure rates and less toxicity. An international consortium, with participants from seven large cancer institutes from Europe and North America, has adopted the R-IDEAL framework to work toward coordinated, evidence-based introduction of the MR-Linac. R-IDEAL holds the promise for timely, evidence-based introduction of radiotherapy innovations with proven superior effectiveness, while preventing unnecessary exposure of patients to potentially harmful interventions.

Establishing and evaluating the key functions of an interactive systems framework using an assets-getting to outcomes intervention.

PubMed

Chinman, Matthew; Acosta, Joie; Ebener, Patricia; Q Burkhart; Clifford, Michael; Corsello, Maryann; Duffey, Tim; Hunter, Sarah; Jones, Margaret; Lahti, Michel; Malone, Patrick S; Paddock, Susan; Phillips, Andrea; Savell, Susan; Scales, Peter C; Tellett-Royce, Nancy

2012-12-01

Community practitioners can face difficulty in achieving outcomes demonstrated by prevention science. Building a community practitioner's prevention capacity-the knowledge and skills needed to conduct critical prevention practices-could improve the quality of prevention and its outcomes. The purpose of this article is to: (1) describe how an intervention called Assets-Getting To Outcomes (AGTO) was used to establish the key functions of the ISF and present early lessons learned from that intervention's first 6 months and (2) examine whether there is an empirical relationship between practitioner capacity at the individual level and the performance of prevention at the program level-a relationship predicted by the ISF but untested. The article describes an operationalization of the ISF in the context of a five-year randomized controlled efficacy trial that combines two complementary models designed to build capacity: Getting To Outcomes (GTO) and Developmental Assets. The trial compares programs and individual practitioners from six community-based coalitions using AGTO with programs and practitioners from six similar coalitions that are not. In this article, we primarily focus on what the ISF calls innovation specific capacity and discuss how the combined AGTO innovation structures and uses feedback about its capacity-building activities, which can serve as a model for implementing the ISF. Focus group discussions used to gather lessons learned from the first 6 months of the AGTO intervention suggest that while the ISF may have been conceptualized as three distinct systems, in practice they are less distinct. Findings from the baseline wave of data collection of individual capacity and program performance suggest that practitioner capacity predicts, in part, performance of prevention programs. Empirically linking practitioner capacity and performance of prevention provides empirical support for both the ISF and AGTO.

Incredible Years parenting interventions: current effectiveness research and future directions.

PubMed

Gardner, Frances; Leijten, Patty

2017-06-01

The Incredible Years parenting intervention is a social learning theory-based programme for reducing children's conduct problems. Dozens of randomized trials, many by independent investigators, find consistent effects of Incredible Years on children's conduct problems across multiple countries and settings. However, in common with other interventions, these average effects hide much variability in the responses of individual children and families. Innovative moderator research is needed to enhance scientific understanding of why individual children and parents respond differently to intervention. Additionally, research is needed to test whether there are ways to make Incredible Years more effective and accessible for families and service providers, especially in low resource settings, by developing innovative delivery systems using new media, and by systematically testing for essential components of parenting interventions. Copyright © 2017. Published by Elsevier Ltd.

Facilitating evaluations of innovative, competence-based assessments: creating understanding and involving multiple stakeholders.

PubMed

Gulikers, Judith T M; Baartman, Liesbeth K J; Biemans, Harm J A

2010-05-01

Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers' lack of understanding of new, competence-based assessments as well as the lack of key stakeholders' involvement, hamper effective and efficient self-evaluations by teachers of innovative, competence-based assessments (CBAs). While evaluating two CBAs in Agricultural Vocational Education and Training institutions, two interventions in the evaluation process aimed to tackle these problems were examined: (1) starting with explicating the CBA in the teacher team using a concrete explication format and (2) qualitatively involving key stakeholders (i.e., teachers, students and employers) in the evaluation of the CBA through mixed-group interviews. Quantitative and qualitative analysis, as well as stakeholders' perceptions are used to find indications for the added value of these interventions for evaluation and further improvement of the CBAs. Results show that external facilitation is needed to make both interventions work. However, under this condition, explicating the CBA led to more complete, concrete and shared understandings of the actual CBA among teachers and mixed-groups interviews resulted in more concrete and elaborate evaluations of the CBAs' quality and more ideas for improvement. Both interventions can facilitate building up elaborate, more valid and concrete arguments for CBA quality in self-evaluations, certainly in the case of evaluating innovative assessments. Lessons learned will provide guidelines for incorporating the interventions into other evaluations of innovative programs. Copyright 2009 Elsevier Ltd. All rights reserved.

Innovation Attributes, Policy Intervention, and the Diffusion of Computer Applications Among Local Governments

ERIC Educational Resources Information Center

Perry, James L.; Kraemer, Kenneth L.

1978-01-01

Argues that innovation attributes, together with policies associated with the diffusion on an innovation, account for significant differences in diffusion patterns. An empirical analysis of this thesis focuses on the diffusion of computer applications software in local government. Available from Elsevier Scientific Publishing Co., Box 211,…

Toward Dynamic Adaptation of Psychological Interventions for Child and Adolescent Development and Mental Health.

PubMed

Malti, Tina; Noam, Gil G; Beelmann, Andreas; Sommer, Simon

2016-01-01

Children's and adolescents' mental health needs emphasize the necessity of a new era of translational research to enhance development and yield better lives for children, families, and communities. Developmental, clinical, and translational research serves as a powerful tool for managing the inevitable complexities in pursuit of these goals. This article proposes key ideas that will strengthen current evidence-based intervention practices by creating stronger links between research, practice, and complex systems contexts, with the potential of extending applicability, replicability, and impact. As exemplified in some of the articles throughout this special issue, new research and innovative implementation models will likely contribute to better ways of assessing and dynamically adapting structure and intervention practice within mental health systems. We contend that future models for effective interventions with children and adolescents will involve increased attention to (a) the connection of research on the developmental needs of children and adolescents to practice models; (b) consideration of informed contextual and cultural adaptation in implementation; and (c) a rational model of evidence-based planning, using a dynamic, inclusive approach with high support for adaptation, flexibility, and implementation fidelity. We discuss future directions for translational research for researchers, practitioners, and administrators in the field to continue and transform these ideas and their illustrations.

Potential for reduction of burden and local elimination of malaria by reducing Plasmodium falciparum malaria transmission: a mathematical modelling study

PubMed Central

Griffin, Jamie T; Bhatt, Samir; Sinka, Marianne E; Gething, Peter W; Lynch, Michael; Patouillard, Edith; Shutes, Erin; Newman, Robert D; Alonso, Pedro; Cibulskis, Richard E; Ghani, Azra C

2016-01-01

Summary Background Rapid declines in malaria prevalence, cases, and deaths have been achieved globally during the past 15 years because of improved access to first-line treatment and vector control. We aimed to assess the intervention coverage needed to achieve further gains over the next 15 years. Methods We used a mathematical model of the transmission of Plasmodium falciparum malaria to explore the potential effect on case incidence and malaria mortality rates from 2015 to 2030 of five different intervention scenarios: remaining at the intervention coverage levels of 2011–13 (Sustain), for which coverage comprises vector control and access to treatment; two scenarios of increased coverage to 80% (Accelerate 1) and 90% (Accelerate 2), with a switch from quinine to injectable artesunate for management of severe disease and seasonal malaria chemoprevention where recommended for both Accelerate scenarios, and rectal artesunate for pre-referral treatment at the community level added to Accelerate 2; a near-term innovation scenario (Innovate), which included longer-lasting insecticidal nets and expansion of seasonal malaria chemoprevention; and a reduction in coverage to 2006–08 levels (Reverse). We did the model simulations at the first administrative level (ie, state or province) for the 80 countries with sustained stable malaria transmission in 2010, accounting for variations in baseline endemicity, seasonality in transmission, vector species, and existing intervention coverage. To calculate the cases and deaths averted, we compared the total number of each under the five scenarios between 2015 and 2030 with the predicted number in 2015, accounting for population growth. Findings With an increase to 80% coverage, we predicted a reduction in case incidence of 21% (95% credible intervals [CrI] 19–29) and a reduction in mortality rates of 40% (27–61) by 2030 compared with 2015 levels. Acceleration to 90% coverage and expansion of treatment at the community level was predicted to reduce case incidence by 59% (Crl 56–64) and mortality rates by 74% (67–82); with additional near-term innovation, incidence was predicted to decline by 74% (70–77) and mortality rates by 81% (76–87). These scenarios were predicted to lead to local elimination in 13 countries under the Accelerate 1 scenario, 20 under Accelerate 2, and 22 under Innovate by 2030, reducing the proportion of the population living in at-risk areas by 36% if elimination is defined at the first administrative unit. However, failing to maintain coverage levels of 2011–13 is predicted to raise case incidence by 76% (Crl 71–80) and mortality rates by 46% (39–51) by 2020. Interpretation Our findings show that decreases in malaria transmission and burden can be accelerated over the next 15 years if the coverage of key interventions is increased. Funding UK Medical Research Council, UK Department for International Development, the Bill & Melinda Gates Foundation, the Swiss Development Agency, and the US Agency for International Development. PMID:26809816

Physical activity interventions using mass media, print media, and information technology.

PubMed

Marcus, B H; Owen, N; Forsyth, L H; Cavill, N A; Fridinger, F

1998-11-01

Media-based physical activity interventions include a variety of print, graphic, audiovisual, and broadcast media programs intended to influence behavior change. New information technology allows print to be delivered in personalized, interactive formats that may enhance efficacy. Media-based interventions have been shaped by conceptual models from health education, Social Cognitive Theory, the Transtheoretical Model, and Social Marketing frameworks. We reviewed 28 studies of media-based interventions of which seven were mass media campaigns at the state or national level and the remaining 21 were delivered through health care, the workplace, or in the community. Recall of mass-media messages generally was high, but mass-media campaigns had very little impact on physical activity behavior. Interventions using print and/or telephone were effective in changing behavior in the short term. Studies in which there were more contacts and interventions tailored to the target audience were most effective. A key issue for research on media-based physical activity interventions is reaching socially disadvantaged groups for whom access, particularly to new forms of communication technology, may be limited. There is a clear need for controlled trials comparing different forms and intensities of media-based physical activity interventions. Controlled studies of personalized print, interactive computer-mediated programs, and web-based formats for program delivery also are needed. The integration of media-based methods into public and private sector service delivery has much potential for innovation.

Increasing Capacity for Innovation in Bureaucratic Primary Care Organizations: A Whole System Participatory Action Research Project

PubMed Central

Thomas, Paul; McDonnell, Juliet; McCulloch, Janette; While, Alison; Bosanquet, Nick; Ferlie, Ewan

2005-01-01

PURPOSE We wanted to identify what organizational features support innovation in Primary Care Groups (PCGs). METHODS Our study used a whole system participatory action research model. Four research teams provided complementary insights. Four case study PCGs were analyzed. Two had an intervention to help local facilitators reflect on their work. Data included 70 key informant interviews, observations of clinical governance interventions and committee meetings, analysis of written materials, surveys and telephone interviews of London Primary Care Organizations, interviews with 20 nurses, and interviews with 6 finance directors. A broad range of stakeholders reviewed data at annual conferences and formed conclusions about trustworthy principles. Sequential research phases were refocused in the light of these conclusions and in response to the changing political context. RESULTS Five features were associated with increased organizational capacity for innovation: (1) clear structures and a vision for corporate and clinical governance; (2) multiple opportunities for people to reflect and learn at all levels of the organization, and connections between these “learning spaces”; (3) both clinicians and managers in leadership roles that encourage participation; (4) the right timing for an initiative and its adaptation to the local context; and (5) external facilitation that provides opportunities for people to make sense of their experiences. Low morale was commonly attributed to 3 features: (1) overwhelming pace of reform, (2) inadequate staff experience and supportive infrastructure, and (3) financial deficits. CONCLUSIONS These features together may support innovation in other primary care bureaucracies. The research methodology enabled people from different backgrounds to make sense of diverse research insights. PMID:16046563

Increasing capacity for innovation in bureaucratic primary care organizations: a whole system participatory action research project.

PubMed

Thomas, Paul; McDonnell, Juliet; McCulloch, Janette; While, Alison; Bosanquet, Nick; Ferlie, Ewan

2005-01-01

We wanted to identify what organizational features support innovation in Primary Care Groups (PCGs). Our study used a whole system participatory action research model. Four research teams provided complementary insights. Four case study PCGs were analyzed. Two had an intervention to help local facilitators reflect on their work. Data included 70 key informant interviews, observations of clinical governance interventions and committee meetings, analysis of written materials, surveys and telephone interviews of London Primary Care Organizations, interviews with 20 nurses, and interviews with 6 finance directors. A broad range of stakeholders reviewed data at annual conferences and formed conclusions about trustworthy principles. Sequential research phases were refocused in the light of these conclusions and in response to the changing political context. Five features were associated with increased organizational capacity for innovation: (1) clear structures and a vision for corporate and clinical governance; (2) multiple opportunities for people to reflect and learn at all levels of the organization, and connections between these "learning spaces"; (3) both clinicians and managers in leadership roles that encourage participation; (4) the right timing for an initiative and its adaptation to the local context; and (5) external facilitation that provides opportunities for people to make sense of their experiences. Low morale was commonly attributed to 3 features: (1) overwhelming pace of reform, (2) inadequate staff experience and supportive infrastructure, and (3) financial deficits. These features together may support innovation in other primary care bureaucracies. The research methodology enabled people from different backgrounds to make sense of diverse research insights.

Dietary factors and cancers of breast, endometrium, and ovary: strategies for modifying fat intake in African American women.

PubMed

Hargreaves, M K; Buchowski, M S; Hardy, R E; Rossi, S R; Rossi, J S

1997-06-01

Modification of dietary fat and fiber could help prevent cancers of the breast, endometrium, and ovary that are prevalent in African-American women. Dietary intervention programs aimed at reducing fat intake have had mixed results in this population. The transtheoretic model is proposed for achieving dietary change. Strategies for changing health behaviors in African-American women include heightening sensitivity to cultural values among health educators and the use of multiple strategies to reinforce messages. To stimulate healthier eating, it is important to incorporate the distinct habitual eating patterns into innovative intervention methods, using effective behavioral change methods.

The Impact of an Innovative Mindfulness-Based Stress Reduction Program on the Health and Well-Being of Nurses Employed in a Corporate Setting

PubMed Central

Bazarko, Dawn; Cate, Rebecca A.; Azocar, Francisca; Kreitzer, Mary Jo

2013-01-01

This study implemented an innovative new model of delivering a Mindfulness-Based Stress Reduction (MBSR) program that replaces six of the eight traditional in-person sessions with group telephonic sessions (tMBSR) and measured the program's impact on the health and well-being of nurses employed within a large health care organization. As part of a nonrandomized pre–post intervention study, 36 nurses completed measures of health, stress, burnout, self-compassion, serenity, and empathy at three points in time. Between baseline (Time 1) and the end of the 8-week tMBSR intervention (Time 2), participants showed improvement in general health, t(37) = 2.8, p < .01, decreased stress, t(37) = 6.8, p < .001, decreased work burnout, t(37) = 4.0, p < .001, and improvement in several other areas. Improvements were sustained 4 months later (Time 3), and individuals who continued their MBSR practice after the program demonstrated better outcomes than those that did not. Findings suggest that the tMBSR program can be a low cost, feasible, and scalable intervention that shows positive impact on health and well-being, and could allow MBSR to be delivered to employees who are otherwise unable to access traditional, on-site programs. PMID:23667348

Re-thinking Innovation in Organizations in the Industry 4.0 Scenario: New Challenges in a Primary Prevention Perspective.

PubMed

Palazzeschi, Letizia; Bucci, Ornella; Di Fabio, Annamaria

2018-01-01

In organizations, innovation is considered a relevant aspect of success and long-term survival. Organizations recognize that innovation contributes to creating competitive advantages in a more competitive, challenging and changing labor market. The present contribution addresses innovation in organizations in the scenario of Industry 4.0, including technological innovation and psychological innovation. Innovation is a core concept in this framework to face the challenge of globalized and fluid labor market in the 21st century. Reviewing the definition of innovation, the article focuses on innovative work behaviors and the relative measures. This perspective article also suggests new directions in a primary prevention perspective for future research and intervention relative to innovation and innovative work behaviors in the organizational context.

Re-thinking Innovation in Organizations in the Industry 4.0 Scenario: New Challenges in a Primary Prevention Perspective

PubMed Central

Palazzeschi, Letizia; Bucci, Ornella; Di Fabio, Annamaria

2018-01-01

In organizations, innovation is considered a relevant aspect of success and long-term survival. Organizations recognize that innovation contributes to creating competitive advantages in a more competitive, challenging and changing labor market. The present contribution addresses innovation in organizations in the scenario of Industry 4.0, including technological innovation and psychological innovation. Innovation is a core concept in this framework to face the challenge of globalized and fluid labor market in the 21st century. Reviewing the definition of innovation, the article focuses on innovative work behaviors and the relative measures. This perspective article also suggests new directions in a primary prevention perspective for future research and intervention relative to innovation and innovative work behaviors in the organizational context. PMID:29445349

An Innovate Robotic Endoscope Guidance System for Transnasal Sinus and Skull Base Surgery: Proof of Concept.

PubMed

Friedrich, D T; Sommer, F; Scheithauer, M O; Greve, J; Hoffmann, T K; Schuler, P J

2017-12-01

Objective  Advanced transnasal sinus and skull base surgery remains a challenging discipline for head and neck surgeons. Restricted access and space for instrumentation can impede advanced interventions. Thus, we present the combination of an innovative robotic endoscope guidance system and a specific endoscope with adjustable viewing angle to facilitate transnasal surgery in a human cadaver model. Materials and Methods  The applicability of the robotic endoscope guidance system with custom foot pedal controller was tested for advanced transnasal surgery on a fresh frozen human cadaver head. Visualization was enabled using a commercially available endoscope with adjustable viewing angle (15-90 degrees). Results  Visualization and instrumentation of all paranasal sinuses, including the anterior and middle skull base, were feasible with the presented setup. Controlling the robotic endoscope guidance system was effectively precise, and the adjustable endoscope lens extended the view in the surgical field without the common change of fixed viewing angle endoscopes. Conclusion  The combination of a robotic endoscope guidance system and an advanced endoscope with adjustable viewing angle enables bimanual surgery in transnasal interventions of the paranasal sinuses and the anterior skull base in a human cadaver model. The adjustable lens allows for the abandonment of fixed-angle endoscopes, saving time and resources, without reducing the quality of imaging.

Better Movers and Thinkers (BMT): An Exploratory Study of an Innovative Approach to Physical Education

PubMed Central

Dalziell, Andrew; Boyle, James; Mutrie, Nanette

2015-01-01

Recent research has confirmed a positive relationship between levels of physical activity and academic achievement. Some of these studies have been informed by neurological models of Executive Functioning (EF). There is a general consensus within the literature that the three core EF skills are; working memory, inhibitory control and cognitive flexibility. The development of these core EF skills has been linked with learning and academic achievement and is an essential component in the delivery of PE using a new and innovative approach called ‘Better Movers and Thinkers (BMT).’ A mixed methods design was used to investigate the effectiveness and feasibility of a 16-week intervention programme using BMT where 46 children were tested on two separate occasions for coordination and balance control, academic skills, working memory and non-verbal reasoning skills. One school acted as the control condition (21 students, aged 9 – 10 years) and another school acted as the intervention condition (25 students, aged 9 – 10 years). Quantitative data revealed an effect between pre and post-test conditions in the areas of phonological skills (p = .042), segmentation skills (p = .014) and working memory (p = .040) in favour of the intervention condition. Further analysis identified a gender-interaction with male students in the intervention condition making significant gains in phonological skills (p = .005) segmentation skills (p = .014) and spelling (p = .007) compared to boys in the control condition. Analysis of qualitative data from a sample of students from the intervention condition and their class teacher indicated good acceptability of BMT as an alternative approach to PE. PMID:27247688

Share2Quit: Web-Based Peer-Driven Referrals for Smoking Cessation

PubMed Central

2013-01-01

Background Smoking is the number one preventable cause of death in the United States. Effective Web-assisted tobacco interventions are often underutilized and require new and innovative engagement approaches. Web-based peer-driven chain referrals successfully used outside health care have the potential for increasing the reach of Internet interventions. Objective The objective of our study was to describe the protocol for the development and testing of proactive Web-based chain-referral tools for increasing the access to Decide2Quit.org, a Web-assisted tobacco intervention system. Methods We will build and refine proactive chain-referral tools, including email and Facebook referrals. In addition, we will implement respondent-driven sampling (RDS), a controlled chain-referral sampling technique designed to remove inherent biases in chain referrals and obtain a representative sample. We will begin our chain referrals with an initial recruitment of former and current smokers as seeds (initial participants) who will be trained to refer current smokers from their social network using the developed tools. In turn, these newly referred smokers will also be provided the tools to refer other smokers from their social networks. We will model predictors of referral success using sample weights from the RDS to estimate the success of the system in the targeted population. Results This protocol describes the evaluation of proactive Web-based chain-referral tools, which can be used in tobacco interventions to increase the access to hard-to-reach populations, for promoting smoking cessation. Conclusions Share2Quit represents an innovative advancement by capitalizing on naturally occurring technology trends to recruit smokers to Web-assisted tobacco interventions. PMID:24067329

Building a bonfire that remains stoked: sustainment of a contingency management intervention developed through collaborative design.

PubMed

Hartzler, Bryan

2015-08-06

Community dissemination of empirically-supported behavior therapies is fostered by collaborative design, a joint process pooling expertise of purveyors and treatment personnel to contextualize a therapy for sustainable use. The adaptability of contingency management renders it an exemplary therapy to model this collaborative design process. At conclusion of an implementation/effectiveness hybrid trial conducted at an opiate treatment program, a group elicitation interview was conducted with the setting's five managerial staff to cull qualitative impressions of a collaboratively-designed contingency management intervention after 90 days of provisional implementation in the setting. Two independent raters reviewed the audio-recording and conducted a phenomenological narrative analysis, extracting themes and selecting excerpts to correspond with innovation attributes (i.e., relative advantage, compatibility, complexity, trialability, observability) of a well-known implementation science framework. This qualitative analysis suggested the intervention was regarded as: (1) cost-effective and clinically useful relative to prior practices, (2) a strong fit with existing service structure and staffing resources, (3) procedurally uncomplicated, with staff consistently implementing it as intended, (4) providing site-specific data to sufficiently inform decisions about its sustainment, and (5) offering palpable benefits to staff-patient interactions. The current work complements prior reports of positive implementation outcomes and intervention effectiveness for the parent trial, mapping qualitative managerial accounts of this contingency management intervention to a set of attributes thought to influence the speed and effectiveness with which an innovative practice is disseminated. Findings support the incorporation of collaborative design processes in future efforts to transport contingency management to the addiction treatment community.

Affect and the "Really Real": The Politics of HIV/AIDS Framing in South African Theater.

PubMed

Ruthven, Jessica S

2017-01-01

Funding in South Africa privileges HIV prevention campaigns underpinned by individual behavior change goals, despite over two decades of intervention but little reduction in national HIV prevalence. In response, civil society has begun calling for innovative interventions and ways of speaking about the epidemic. Employing framing theory, I analyze differences in how HIV/AIDS is characterized in public media and interrogate the knowledge politics underpinning a group of artists' emerging attention to the nexus of affect, intersubjectivity, and epidemics within performance. I suggest this focus challenges but also complements dominant HIV intervention models by destabilizing common content, relations of power, and hierarchies of knowledge that shape normative health discourse and practice. Simultaneously, such performances reveal deep disparities between the neoliberal principles undergirding most global public health ideology, South Africa's current political economy of HIV intervention, and the dynamic concerns of its HIV-affected constituents.

Imagining roles for epigenetics in health promotion research.

PubMed

McBride, Colleen M; Koehly, Laura M

2017-04-01

Discoveries from the Human Genome Project have invigorated discussions of epigenetic effects-modifiable chemical processes that influence DNA's ability to give instructions to turn gene expression on or off-on health outcomes. We suggest three domains in which new understandings of epigenetics could inform innovations in health promotion research: (1) increase the motivational potency of health communications (e.g., explaining individual differences in health outcomes to interrupt optimistic biases about health exposures); (2) illuminate new approaches to targeted and tailored health promotion interventions (e.g., relapse prevention targeted to epigenetic responses to intervention participation); and (3) inform more sensitive measures of intervention impact, (e.g., replace or augment self-reported adherence). We suggest a three-step process for using epigenetics in health promotion research that emphasizes integrating epigenetic mechanisms into conceptual model development that then informs selection of intervention approaches and outcomes. Lastly, we pose examples of relevant scientific questions worth exploring.

User-driven health care: answering multidimensional information needs in individual patients utilizing post-EBM approaches: an operational model.

PubMed

Biswas, Rakesh; Maniam, Jayanthy; Lee, Edwin Wen Huo; Gopal, Premalatha; Umakanth, Shashikiran; Dahiya, Sumit; Ahmed, Sayeed

2008-10-01

The hypothesis in the conceptual model was that a user-driven innovation in presently available information and communication technology infrastructure would be able to meet patient and health professional users information needs and help them attain better health outcomes. An operational model was created to plan a trial on a sample diabetic population utilizing a randomized control trial design, assigning one randomly selected group of diabetics to receive electronic information intervention and analyse if it would improve their health outcomes in comparison with a matched diabetic population who would only receive regular medical intervention. Diabetes was chosen for this particular trial, as it is a major chronic illness in Malaysia as elsewhere in the world. It is in essence a position paper for how the study concept should be organized to stimulate wider discussion prior to beginning the study.

Clinical innovation for promoting family care in paediatric intensive care: demonstration, role modelling and reflective practice.

PubMed

Tomlinson, Patricia S; Thomlinson, Elizabeth; Peden-McAlpine, Cynthia; Kirschbaum, Mark

2002-04-01

To explore family caregiving problems in paediatric crisis care and methods that could be applied to move the abstraction of family care to development of specific family interventions. Family centred care has been accepted as the ideal philosophy for holistic health care of children, but methods for its implementation are not well established. In paediatric health crises, family care requires special sensitivity to family needs and a type of complex nursing care for which many practitioners are not sufficiently prepared. Developing family sensitive models of intervention and finding a strategy for transfer of this knowledge to clinical practice is an important challenge facing family nursing today. Social learning theory provides a rich background to explore these issues. Specific techniques of role modelling and reflective practice are suggested as effective approaches to teach family sensitive care in clinical settings where families are part of the care environment.

Smartphone application for multi-phasic interventional trials in psychiatry: Technical design of a smart server.

PubMed

Zhang, Melvyn W B; Ho, Roger C M

2017-01-01

Smartphones and their accompanying applications are currently widely utilized in various healthcare interventions. Prior to the deployment of these tools for healthcare intervention, typically, proof of concept feasibility studies, as well as randomized trials are conducted to determine that these tools are efficacious prior to their actual implementation. In the field of psychiatry, most of the current interventions seek to compare smartphone based intervention against conventional care. There remains a paucity of research evaluating different forms of interventions using a single smartphone application. In the field of nutrition, there has been recent pioneering research demonstrating how a multi-phasic randomized controlled trial could be conducted using a single smartphone application. Despite the innovativeness of the previous smartphone conceptualization, there remains a paucity of technical information underlying the conceptualization that would support a multi-phasic interventional trial. It is thus the aim of the current technical note to share insights into an innovative server design that would enable the delivery of multi-phasic trials.

From computer-assisted intervention research to clinical impact: The need for a holistic approach.

PubMed

Ourselin, Sébastien; Emberton, Mark; Vercauteren, Tom

2016-10-01

The early days of the field of medical image computing (MIC) and computer-assisted intervention (CAI), when publishing a strong self-contained methodological algorithm was enough to produce impact, are over. As a community, we now have substantial responsibility to translate our scientific progresses into improved patient care. In the field of computer-assisted interventions, the emphasis is also shifting from the mere use of well-known established imaging modalities and position trackers to the design and combination of innovative sensing, elaborate computational models and fine-grained clinical workflow analysis to create devices with unprecedented capabilities. The barriers to translating such devices in the complex and understandably heavily regulated surgical and interventional environment can seem daunting. Whether we leave the translation task mostly to our industrial partners or welcome, as researchers, an important share of it is up to us. We argue that embracing the complexity of surgical and interventional sciences is mandatory to the evolution of the field. Being able to do so requires large-scale infrastructure and a critical mass of expertise that very few research centres have. In this paper, we emphasise the need for a holistic approach to computer-assisted interventions where clinical, scientific, engineering and regulatory expertise are combined as a means of moving towards clinical impact. To ensure that the breadth of infrastructure and expertise required for translational computer-assisted intervention research does not lead to a situation where the field advances only thanks to a handful of exceptionally large research centres, we also advocate that solutions need to be designed to lower the barriers to entry. Inspired by fields such as particle physics and astronomy, we claim that centralised very large innovation centres with state of the art technology and health technology assessment capabilities backed by core support staff and open interoperability standards need to be accessible to the wider computer-assisted intervention research community. Copyright © 2016. Published by Elsevier B.V.

A Model for Occupational Safety and Health Intervention Diffusion to Small Businesses

PubMed Central

Sinclair, Raymond C.; Cunningham, Thomas R.; Schulte, Paul A.

2015-01-01

Background Smaller businesses differ from their larger counterparts in having higher rates of occupational injuries and illnesses and fewer resources for preventing those losses. Intervention models developed outside the United States have addressed the resource deficiency issue by incorporating intermediary organizations such as trade associations. Methods This paper extends previous models by using exchange theory and by borrowing from the diffusion of innovations model. It emphasizes that occupational safety and health (OSH) organizations must understand as much about intermediary organizations as they do about small businesses. OSH organizations (“initiators”) must understand how to position interventions and information to intermediaries as added value to their relationships with small businesses. Examples from experiences in two midwestern states are used to illustrate relationships and types of analyses implied by the extended model. Results The study found that intermediary organizations were highly attuned to providing smaller businesses with what they want, including OSH services. The study also found that there are opinion leader organizations and individual champions within intermediaries who are key to decisions and actions about OSH programming. Conclusions The model places more responsibility on both initiators and intermediaries to develop and market interventions that will be valued in the competitive small business environment where the resources required to adopt each new business activity could always be used in other ways. The model is a candidate for empirical validation, and it offers some encouragement that the issue of sustainable OSH assistance to small businesses might be addressed. PMID:24115112

Interdisciplinary Postdoctoral Training in Global Health through a Novel Joint Project for Trainees from Diverse Disciplines: Benefits, Risks, and Observations

PubMed Central

Oberhelman, Richard A.; Huaynate, Cynthia Anticona; Correa, Malena; Malpartida, Holger Mayta; Pajuelo, Monica; Paz-Soldan, Valerie A.; Gilman, Robert H.; Zimic, Mirko; Murphy, Laura; Belizan, Jose

2017-01-01

Postdoctoral training programs are usually highly individualized arrangements between trainees and a limited number of senior mentors in their field, an approach that contrasts with current trends in public health education that promote interdisciplinary training to spur innovation. Herein, we describe an alternative model for postdoctoral training for a group of fellows from distinct disciplines. Fellows work with mentors from diverse fields to create a joint research project or a group of complementary projects, with the goal of developing a new device, intervention, or innovation to address a global health problem. The perceived benefits, challenges, and limitations of this team approach to interdisciplinary postdoctoral training are presented. PMID:27821694

Digital Therapeutics: An Integral Component of Digital Innovation in Drug Development.

PubMed

Sverdlov, Oleksandr; van Dam, Joris; Hannesdottir, Kristin; Thornton-Wells, Tricia

2018-07-01

Digital therapeutics represent a new treatment modality in which digital systems such as smartphone apps are used as regulatory-approved, prescribed therapeutic interventions to treat medical conditions. In this article we provide a critical overview of the rationale for investing in such novel modalities, including the unmet medical needs addressed by digital therapeutics and the potential for reducing current costs of medical care. We also discuss emerging pathways to regulatory approval and how innovative business models are enabling further growth in the development of digital therapeutics. We conclude by providing some recent examples of digital therapeutics that have gained regulatory approval and highlight opportunities for the near future. © 2018 American Society for Clinical Pharmacology and Therapeutics.

[Strengthening innovation in clinical research methodology of acupuncture and moxibustion to promote internationalization process of acupuncture-moxibustion].

PubMed

Wang, Long; Zou, Wei; Chi, Qing-bin

2009-06-01

In order to explore the problems and countermeasure in the methodology of acupuncture and moxibustion clinical researches at present, clinical research literatures about acupuncture and moxibustion (Acup-Mox) published in recent years in our country were reviewed. For the urgent need of the current internationalization of Acup-Mox, the authors proposed the model of clinical research on Acup-Mox, which should strictly stick to the international standard and fully embody traditional Chinese medicine characteristics in the intervention measures of acupuncture. It is indicated that innovation of the methodology about clinical researches of Acup-Mox has great significance in improving the quality of clinical research on Acup-Mox in our country and promoting internationalization of Acup-Mox.

A novel, bottom-up approach to promote evidence-based HIV prevention for people who inject drugs in Ukraine: protocol for the MICT (‘Bridge’) HIV prevention exchange project

PubMed Central

2014-01-01

Background Ukraine has one of the most severe HIV epidemics in Eastern Europe, with an estimated 1.6% of the adult population living with the virus. Injection drug use accounts for 36% of new HIV cases. Nongovernmental organizations in Ukraine have little experience with effective, theory-based behavioral risk reduction interventions necessary to reduce the scope of the HIV epidemic among Ukrainians who inject drugs. This study seeks to promote the use of evidence-based HIV prevention strategies among Ukrainian organizations working with drug users. Methods/design This study combines qualitative and quantitative methods to explore a model of HIV prevention intervention development and implementation that disseminates common factors of effective behavioral risk reduction interventions and enables service providers to develop programs that reflect their specific organizational contexts. Eight agencies, located in regions of Ukraine with the highest HIV and drug use rates and selected to represent key organizational context criteria (e.g., agency size, target population, experience with HIV prevention), will be taught common factors as the basis for intervention development. We will use qualitative methods, including interviews and observations, to document the process of intervention development and implementation at each agency. Using risk assessments with intervention participants, we will also assess intervention effectiveness. The primary outcome analyses will determine the extent to which agencies develop and implement an intervention for drug users that incorporates common factors of effective behavioral interventions. Effectiveness analyses will be conducted, and effect size of each intervention will be compared to that of published HIV prevention interventions for drug users with demonstrated effectiveness. This study will explore the role of organizational context on intervention development and implementation, including resource allocation decisions, problem-solving around intervention development, and barriers and facilitators to inclusion of common factors and delivery of a high quality intervention. Discussion This innovative approach to HIV prevention science dissemination and intervention development draws on providers’ ability to quickly develop innovative programs and reach populations in greatest need of services. It has the potential to enhance providers’ ability to use HIV prevention science to develop sustainable interventions in response to a rapidly changing epidemic. PMID:24491185

Environmental Interventions for Obesity and Chronic Disease Prevention.

PubMed

Gittelsohn, Joel; Trude, Angela

2015-01-01

Innovative approaches are needed to impact obesity and other diet-related chronic diseases, including tested interventions at the environmental and policy levels. We have conducted multi-level community trials in low-income minority settings in the United States and other countries that test interventions to improve the food environment, support policy, and reduce the risk for developing obesity and other diet-related chronic diseases. All studies have examined change from pre- to post-study, comparing an intervention with a comparison group. Our results have shown consistent positive effects of these trials on consumer psychosocial factors, food purchasing, food preparation and diet, and, in some instances, obesity. We have recently implemented a systems science model to support programs and policies to improve urban food environments. Environmental interventions are a promising approach for addressing the global obesity epidemic due to their wide reach. Further work is needed to disseminate, expand and sustain these initiatives through policy at the city, state and federal levels.

Gait and balance in the aging population: Fall prevention using innovation and technology.

PubMed

Khanuja, Kavisha; Joki, Jaclyn; Bachmann, Gloria; Cuccurullo, Sara

2018-04-01

On a global basis, adults 65 years of age and older experience falls more frequently than younger individuals, and these often result in severe injuries as well as increased healthcare costs. Gait and balance disorders in this population are among the most common causes of falls and negatively influence quality of life and survivorship. Although falls are a major public health problem and guidelines/recommendations are available to physicians, many are fully aware of different assessments, tools, and resources available for intervention. Given the risk for potentially devastating outcomes if severe injuries occur secondary to a fall, fall prevention strategies in clinical offices is a timely consideration in today's health care landscape. This paper presents a three-tier model, comprising assessment, prevention, and intervention, to highlight methods, proactive programs, and innovative tools and technology that have been developed for fall prevention. Awareness of these resources will enhance the clinician's ability to accurately assess balance and gait, which can improve physical function, and decrease the risk of falls for both average-risk and high-risk older adults. Copyright © 2018 Elsevier B.V. All rights reserved.

It’s Your Game…Keep It Real: Can innovative public health prevention research thrive within a comparative effectiveness research framework?

PubMed Central

Shegog, Ross; Markham, Christine M.; Peskin, Melissa F.; Johnson, Kimberly; Cuccaro, Paula; Tortolero, Susan R.

2013-01-01

The federal comparative effectiveness research (CER) initiative is designed to evaluate best practices in health care settings where they can be disseminated for immediate benefit to patients. The CER strategic framework comprises four categories (research, human and scientific capital, data infrastructure, and dissemination) with three crosscutting themes (conditions, patient populations, and types of intervention). The challenge for the field of public health has been accommodating the CER framework within prevention research. Applying a medicine-based, research-to-practice CER approach to public health prevention research has raised concerns regarding definitions of acceptable evidence (an evidence challenge), effective intervention dissemination within heterogeneous communities (a dissemination and implementation challenge), and rewards for best practice at the cost of other promising but high-risk approaches (an innovation challenge). Herein, a dynamic operationalization of the CER framework is described that is compatible with the development, evaluation, and dissemination of innovative public health prevention interventions. An effective HIV, STI, and pregnancy prevention program, It’s Your Game…Keep It Real, provides a case study of this application, providing support that the CER framework can compatibly coexist with innovative, community-based public health prevention research. PMID:23344633

It's Your Game…Keep It Real: can innovative public health prevention research thrive within a comparative effectiveness research framework?

PubMed

Shegog, Ross; Markham, Christine M; Peskin, Melissa F; Johnson, Kimberly; Cuccaro, Paula; Tortolero, Susan R

2013-04-01

The federal comparative effectiveness research (CER) initiative is designed to evaluate best practices in health care settings where they can be disseminated for immediate benefit to patients. The CER strategic framework comprises four categories (research, human and scientific capital, data infrastructure, and dissemination) with three crosscutting themes (conditions, patient populations, and types of intervention). The challenge for the field of public health has been accommodating the CER framework within prevention research. Applying a medicine-based, research-to-practice CER approach to public health prevention research has raised concerns regarding definitions of acceptable evidence (an evidence challenge), effective intervention dissemination within heterogeneous communities (a dissemination and implementation challenge), and rewards for best practice at the cost of other promising but high-risk approaches (an innovation challenge). Herein, a dynamic operationalization of the CER framework is described that is compatible with the development, evaluation, and dissemination of innovative public health prevention interventions. An effective HIV, STI, and pregnancy prevention program, It's Your Game…Keep It Real, provides a case study of this application, providing support that the CER framework can compatibly coexist with innovative, community-based public health prevention research.

Developing a theoretical framework for complex community-based interventions.

PubMed

Angeles, Ricardo N; Dolovich, Lisa; Kaczorowski, Janusz; Thabane, Lehana

2014-01-01

Applying existing theories to research, in the form of a theoretical framework, is necessary to advance knowledge from what is already known toward the next steps to be taken. This article proposes a guide on how to develop a theoretical framework for complex community-based interventions using the Cardiovascular Health Awareness Program as an example. Developing a theoretical framework starts with identifying the intervention's essential elements. Subsequent steps include the following: (a) identifying and defining the different variables (independent, dependent, mediating/intervening, moderating, and control); (b) postulating mechanisms how the independent variables will lead to the dependent variables; (c) identifying existing theoretical models supporting the theoretical framework under development; (d) scripting the theoretical framework into a figure or sets of statements as a series of hypotheses, if/then logic statements, or a visual model; (e) content and face validation of the theoretical framework; and (f) revising the theoretical framework. In our example, we combined the "diffusion of innovation theory" and the "health belief model" to develop our framework. Using the Cardiovascular Health Awareness Program as the model, we demonstrated a stepwise process of developing a theoretical framework. The challenges encountered are described, and an overview of the strategies employed to overcome these challenges is presented.

Model for Service Delivery for Developmental Disorders in Low-Income Countries.

PubMed

Hamdani, Syed Usman; Minhas, Fareed Aslam; Iqbal, Zafar; Rahman, Atif

2015-12-01

As in many low-income countries, the treatment gap for developmental disorders in rural Pakistan is near 100%. We integrated social, technological, and business innovations to develop and pilot a potentially sustainable service for children with developmental disorders in 1 rural area. Families with developmental disorders were identified through a mobile phone-based interactive voice response system, and organized into "Family Networks." "Champion" family volunteers were trained in evidence-based interventions. An Avatar-assisted Cascade Training and information system was developed to assist with training, implementation, monitoring, and supervision. In a population of ∼30,000, we successfully established 1 self-sustaining Family Network consisting of 10 trained champion family volunteers working under supervision of specialists, providing intervention to 70 families of children with developmental disorders. Each champion was responsible for training and providing ongoing support to 5 to 7 families from his or her village, and the families supported each other in management of their children. A pre-post evaluation of the program indicated that there was significant improvement in disability and socioemotional difficulties in the child, reduction in stigmatizing experiences, and greater family empowerment to seek services and community resources for the child. There was no change in caregivers' well-being. To replicate this service more widely, a social franchise model has been developed whereby the integrated intervention will be "boxed" up and passed on to others to replicate with appropriate support. Such integrated social, technological, and business innovations have the potential to be applied to other areas of health in low-income countries. Copyright © 2015 by the American Academy of Pediatrics.

The past, present, and future of urgent matters: lessons learned from a decade of emergency department flow improvement.

PubMed

McClelland, Mark Stephen; Lazar, Danielle; Sears, Vickie; Wilson, Marcia; Siegel, Bruce; Pines, Jesse M

2011-12-01

Over the past decade, emergency departments (ED) have encountered major challenges due to increased crowding and a greater public focus on quality measurement and quality improvement. Responding to these challenges, many EDs have worked to improve their processes and develop new and innovative models of care delivery. Urgent Matters has contributed to ED quality and patient flow improvement by working with hospitals throughout the United States. Recognizing that EDs across the country are struggling with many of the same issues, Urgent Matters-a program funded by the Robert Wood Johnson Foundation (RWJF)-has sought to identify, develop, and disseminate innovative approaches, interventions, and models to improve ED flow and quality. Using a variety of techniques, such as learning networks (collaboratives), national conferences, e-newsletters, webinars, best practices toolkits, and social media, Urgent Matters has served as a thought leader and innovator in ED quality improvement initiatives. The Urgent Matters Seven Success Factors were drawn from the early work done by program participants and propose practical guidelines for implementing and sustaining ED improvement activities. This article chronicles the history, activities, lessons learned, and future of the Urgent Matters program. © 2011 by the Society for Academic Emergency Medicine.

A Technological Innovation to Reduce Prescribing Errors Based on Implementation Intentions: The Acceptability and Feasibility of MyPrescribe.

PubMed

Keyworth, Chris; Hart, Jo; Thoong, Hong; Ferguson, Jane; Tully, Mary

2017-08-01

Although prescribing of medication in hospitals is rarely an error-free process, prescribers receive little feedback on their mistakes and ways to change future practices. Audit and feedback interventions may be an effective approach to modifying the clinical practice of health professionals, but these may pose logistical challenges when used in hospitals. Moreover, such interventions are often labor intensive. Consequently, there is a need to develop effective and innovative interventions to overcome these challenges and to improve the delivery of feedback on prescribing. Implementation intentions, which have been shown to be effective in changing behavior, link critical situations with an appropriate response; however, these have rarely been used in the context of improving prescribing practices. Semistructured qualitative interviews were conducted to evaluate the acceptability and feasibility of providing feedback on prescribing errors via MyPrescribe, a mobile-compatible website informed by implementation intentions. Data relating to 200 prescribing errors made by 52 junior doctors were collected by 11 hospital pharmacists. These errors were populated into MyPrescribe, where prescribers were able to construct their own personalized action plans. Qualitative interviews with a subsample of 15 junior doctors were used to explore issues regarding feasibility and acceptability of MyPrescribe and their experiences of using implementation intentions to construct prescribing action plans. Framework analysis was used to identify prominent themes, with findings mapped to the behavioral components of the COM-B model (capability, opportunity, motivation, and behavior) to inform the development of future interventions. MyPrescribe was perceived to be effective in providing opportunities for critical reflection on prescribing errors and to complement existing training (such as junior doctors' e-portfolio). The participants were able to provide examples of how they would use "If-Then" plans for patient management. Technology, as opposed to other methods of learning (eg, traditional "paper based" learning), was seen as a positive advancement for continued learning. MyPrescribe was perceived as an acceptable and feasible learning tool for changing prescribing practices, with participants suggesting that it would make an important addition to medical prescribers' training in reflective practice. MyPrescribe is a novel theory-based technological innovation that provides the platform for doctors to create personalized implementation intentions. Applying the COM-B model allows for a more detailed understanding of the perceived mechanisms behind prescribing practices and the ways in which interventions aimed at changing professional practice can be implemented. ©Chris Keyworth, Jo Hart, Hong Thoong, Jane Ferguson, Mary Tully. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 01.08.2017.

A Technological Innovation to Reduce Prescribing Errors Based on Implementation Intentions: The Acceptability and Feasibility of MyPrescribe

PubMed Central

Hart, Jo; Thoong, Hong; Ferguson, Jane; Tully, Mary

2017-01-01

Background Although prescribing of medication in hospitals is rarely an error-free process, prescribers receive little feedback on their mistakes and ways to change future practices. Audit and feedback interventions may be an effective approach to modifying the clinical practice of health professionals, but these may pose logistical challenges when used in hospitals. Moreover, such interventions are often labor intensive. Consequently, there is a need to develop effective and innovative interventions to overcome these challenges and to improve the delivery of feedback on prescribing. Implementation intentions, which have been shown to be effective in changing behavior, link critical situations with an appropriate response; however, these have rarely been used in the context of improving prescribing practices. Objective Semistructured qualitative interviews were conducted to evaluate the acceptability and feasibility of providing feedback on prescribing errors via MyPrescribe, a mobile-compatible website informed by implementation intentions. Methods Data relating to 200 prescribing errors made by 52 junior doctors were collected by 11 hospital pharmacists. These errors were populated into MyPrescribe, where prescribers were able to construct their own personalized action plans. Qualitative interviews with a subsample of 15 junior doctors were used to explore issues regarding feasibility and acceptability of MyPrescribe and their experiences of using implementation intentions to construct prescribing action plans. Framework analysis was used to identify prominent themes, with findings mapped to the behavioral components of the COM-B model (capability, opportunity, motivation, and behavior) to inform the development of future interventions. Results MyPrescribe was perceived to be effective in providing opportunities for critical reflection on prescribing errors and to complement existing training (such as junior doctors’ e-portfolio). The participants were able to provide examples of how they would use “If-Then” plans for patient management. Technology, as opposed to other methods of learning (eg, traditional “paper based” learning), was seen as a positive advancement for continued learning. Conclusions MyPrescribe was perceived as an acceptable and feasible learning tool for changing prescribing practices, with participants suggesting that it would make an important addition to medical prescribers’ training in reflective practice. MyPrescribe is a novel theory-based technological innovation that provides the platform for doctors to create personalized implementation intentions. Applying the COM-B model allows for a more detailed understanding of the perceived mechanisms behind prescribing practices and the ways in which interventions aimed at changing professional practice can be implemented. PMID:28765104

Innovating patient care delivery: DSRIP's interrupted time series analysis paradigm.

PubMed

Shenoy, Amrita G; Begley, Charles E; Revere, Lee; Linder, Stephen H; Daiger, Stephen P

2017-12-08

Adoption of Medicaid Section 1115 waiver is one of the many ways of innovating healthcare delivery system. The Delivery System Reform Incentive Payment (DSRIP) pool, one of the two funding pools of the waiver has four categories viz. infrastructure development, program innovation and redesign, quality improvement reporting and lastly, bringing about population health improvement. A metric of the fourth category, preventable hospitalization (PH) rate was analyzed in the context of eight conditions for two time periods, pre-reporting years (2010-2012) and post-reporting years (2013-2015) for two hospital cohorts, DSRIP participating and non-participating hospitals. The study explains how DSRIP impacted Preventable Hospitalization (PH) rates of eight conditions for both hospital cohorts within two time periods. Eight PH rates were regressed as the dependent variable with time, intervention and post-DSRIP Intervention as independent variables. PH rates of eight conditions were then consolidated into one rate for regressing with the above independent variables to evaluate overall impact of DSRIP. An interrupted time series regression was performed after accounting for auto-correlation, stationarity and seasonality in the dataset. In the individual regression model, PH rates showed statistically significant coefficients for seven out of eight conditions in DSRIP participating hospitals. In the combined regression model, the coefficient of the PH rate showed a statistically significant decrease with negative p-values for regression coefficients in DSRIP participating hospitals compared to positive/increased p-values for regression coefficients in DSRIP non-participating hospitals. Several macro- and micro-level factors may have likely contributed DSRIP hospitals outperforming DSRIP non-participating hospitals. Healthcare organization/provider collaboration, support from healthcare professionals, DSRIP's design, state reimbursement and coordination in care delivery methods may have led to likely success of DSRIP. IV, a retrospective cohort study based on longitudinal data. Copyright © 2017 Elsevier Inc. All rights reserved.

Implementing Response to Intervention: Use of Innovation Configuration Maps within a Multiple-Case Study Analysis

ERIC Educational Resources Information Center

Fernando, Sheara

2010-01-01

The success of an implementation effort depends on the ability for a system to utilize the innovation effectively; the effective usage of an innovation can be determined by monitoring for program integrity and fidelity, and assessing the degree to which the program implementation matches the intended plan (Fixsen, Blase, Horner, & Sugai 2007). The…

Sociology of Low Expectations: Recalibration as Innovation Work in Biomedicine.

PubMed

Gardner, John; Samuel, Gabrielle; Williams, Clare

2015-11-01

Social scientists have drawn attention to the role of hype and optimistic visions of the future in providing momentum to biomedical innovation projects by encouraging innovation alliances. In this article, we show how less optimistic, uncertain, and modest visions of the future can also provide innovation projects with momentum. Scholars have highlighted the need for clinicians to carefully manage the expectations of their prospective patients. Using the example of a pioneering clinical team providing deep brain stimulation to children and young people with movement disorders, we show how clinicians confront this requirement by drawing on their professional knowledge and clinical expertise to construct visions of the future with their prospective patients; visions which are personalized, modest, and tainted with uncertainty. We refer to this vision-constructing work as recalibration, and we argue that recalibration enables clinicians to manage the tension between the highly optimistic and hyped visions of the future that surround novel biomedical interventions, and the exigencies of delivering those interventions in a clinical setting. Drawing on work from science and technology studies, we suggest that recalibration enrolls patients in an innovation alliance by creating a shared understanding of how the "effectiveness" of an innovation shall be judged.

Developing, delivering and evaluating primary mental health care: the co-production of a new complex intervention.

PubMed

Reeve, Joanne; Cooper, Lucy; Harrington, Sean; Rosbottom, Peter; Watkins, Jane

2016-09-06

Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention. The project was a collaboration between a local mental health charity, an academic unit, and GP practices. The aim was to translate the charity's model of care into practice-based evidence describing delivery and impact. Normalisation Process Theory (NPT) was used to support the implementation of the new model of primary mental health care into six GP practices. An integrated process evaluation evaluated the process and impact of care. Implementation quickly stalled as we identified problems with the described model of care when applied in a changing and variable primary care context. The team therefore switched to using the NPT framework to support the systematic identification and modification of the components of the complex intervention: including the core components that made it distinct (the consultation approach) and the variable components (organisational issues) that made it work in practice. The extra work significantly reduced the time available for outcome evaluation. However findings demonstrated moderately successful implementation of the model and a suggestion of hypothesised changes in outcomes. The BounceBack project demonstrates the development of a complex intervention from practice. It highlights the use of Normalisation Process Theory to support development, and not just implementation, of a complex intervention; and describes the use of the research process in the generation of practice-based evidence. Implications for future translational complex intervention research supporting practice change through scholarship are discussed.

Cultural Adaptations: Conceptual, Ethical, Contextual, and Methodological Issues for Working with Ethnocultural and Majority-World Populations.

PubMed

Bernal, Guillermo; Adames, Cristina

2017-08-01

Mayor advancements have been achieved in research on the cultural adaptation of prevention and treatment interventions that are conducted with diverse ethnocultural groups. This commentary addresses conceptual, ethical, contextual, and methodological issues related to cultural adaptations. The articles in this special issue represent a major contribution to the study of cultural adaptations in prevention science. We frame our analysis of fidelity to core intervention components using a conceptual approach that examines (a) the propositional model (theory of change), (b) the procedural model (theory of action, methods), and (c) the philosophical assumptions that undergird these models. Regarding ethics, we caution against imposing the norms, values, and world views of the Western dominant society onto vulnerable populations such as ethnocultural groups. Given that the assumption of universality in behavioral science has been questioned, and as randomized clinical trials (RCTs) seldom examine the ecological validity of evidence-based interventions and treatments (EBI/T), imposing such interventions onto ethnocultural groups is problematic since these interventions contain values, norms, beliefs, and worldviews that may be contrary to those held by many ethnocultural groups. Regarding methods, several innovative designs are discussed that serve as alternatives to the RCT and represent an important contribution to prevention science. Also, we discuss guidelines for conducting cultural adaptations. Finally, the articles in this special issue make a major contribution to the growing field of cultural adaptation of preventive interventions with ethnocultural groups and majority-world populations.

Earlybird in South Staffordshire: Reflections on an Innovative Model of Interagency Working to Deliver an Intervention for Families of Preschool Children with Autistic Spectrum Disorder

ERIC Educational Resources Information Center

Halpin, Julia; Pitt, Sally; Dodd, Emma

2011-01-01

In this article three education and health services professionals, Julia Halpin, Sally Pitt and Emma Dodd, describe and reflect upon the way in which a small group of professionals from health and education services worked in collaboration to meet the need to inform and empower parents of preschool children with a diagnosis of autistic spectrum…

The nurse's role in preventing cervical cancer: A cultural framework

PubMed Central

Johnson-Mallard, Versie; Thomas, Tami L.; Kostas-Polston, Elizabeth A.; Barta, Michelle; Lengacher, Cecile A.; Rivers, Desiree

2013-01-01

This article proposes an innovative, theoretically-driven intervention to reduce risk from human papillomavirus (HPV). This lessening of HPV risk would lead to a reduction in the rate of cervical cancer. Aims of this article are to introduce a culturally appropriate model (PEN-3) that may facilitate vaccine uptake among vulnerable populations and to ascertain whether culturally appropriate health education delivered by nurses could be included in vaccine education programs. PMID:25343003

Development of a web-based tool for the assessment of health and economic outcomes of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA).

PubMed

Boehler, Christian E H; de Graaf, Gimon; Steuten, Lotte; Yang, Yaling; Abadie, Fabienne

2015-01-01

The European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) is a European Commission led policy initiative to address the challenges of demographic change in Europe. For monitoring the health and economic impact of the social and technological innovations carried out by more than 500 stakeholder's groups ('commitments') participating in the EIP on AHA, a generic and flexible web-based monitoring and assessment tool is currently being developed. This paper describes the approach for developing and implementing this web-based tool, its main characteristics and capability to provide specific outcomes that are of value to the developers of an intervention, as well as a series of case studies planned before wider rollout. The tool builds up from a variety of surrogate endpoints commonly used across the diverse set of EIP on AHA commitments in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs) as well as health and social care utilisation. A highly adaptable Markov model with initially three mutually exclusive health states ('baseline health', 'deteriorated health' and 'death') provides the basis for the tool which draws from an extensive database of epidemiological, economic and effectiveness data; and also allows further customisation through remote data entry enabling more accurate and context specific estimation of intervention impact. Both probabilistic sensitivity analysis and deterministic scenario analysis allow assessing the impact of parameter uncertainty on intervention outcomes. A set of case studies, ranging from the pre-market assessment of early healthcare technologies to the retrospective analysis of established care pathways, will be carried out before public rollout, which is envisaged end 2015. Monitoring the activities carried out within the EIP on AHA requires an approach that is both flexible and consistent in the way health and economic impact is estimated across interventions and commitments. The added value for users of the MAFEIP-tool is its ability to provide an early assessment of the likelihood that interventions in their current design will achieve the anticipated impact, and also to identify what drives interventions' effectiveness or efficiency to guide further design, development or evaluation.

Development of a web-based tool for the assessment of health and economic outcomes of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA)

PubMed Central

2015-01-01

Background The European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) is a European Commission led policy initiative to address the challenges of demographic change in Europe. For monitoring the health and economic impact of the social and technological innovations carried out by more than 500 stakeholder's groups ('commitments') participating in the EIP on AHA, a generic and flexible web-based monitoring and assessment tool is currently being developed. Aim This paper describes the approach for developing and implementing this web-based tool, its main characteristics and capability to provide specific outcomes that are of value to the developers of an intervention, as well as a series of case studies planned before wider rollout. Methods The tool builds up from a variety of surrogate endpoints commonly used across the diverse set of EIP on AHA commitments in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs) as well as health and social care utilisation. A highly adaptable Markov model with initially three mutually exclusive health states ('baseline health', 'deteriorated health' and 'death') provides the basis for the tool which draws from an extensive database of epidemiological, economic and effectiveness data; and also allows further customisation through remote data entry enabling more accurate and context specific estimation of intervention impact. Both probabilistic sensitivity analysis and deterministic scenario analysis allow assessing the impact of parameter uncertainty on intervention outcomes. A set of case studies, ranging from the pre-market assessment of early healthcare technologies to the retrospective analysis of established care pathways, will be carried out before public rollout, which is envisaged end 2015. Conclusion Monitoring the activities carried out within the EIP on AHA requires an approach that is both flexible and consistent in the way health and economic impact is estimated across interventions and commitments. The added value for users of the MAFEIP-tool is its ability to provide an early assessment of the likelihood that interventions in their current design will achieve the anticipated impact, and also to identify what drives interventions' effectiveness or efficiency to guide further design, development or evaluation. PMID:26391559

Evolution of diffusion and dissemination theory.

PubMed

Dearing, James W

2008-01-01

The article provides a review and considers how the diffusion of innovations Research paradigm has changed, and offers suggestions for the further development of this theory of social change. Main emphases of diffusion Research studies are compared over time, with special attention to applications of diffusion theory-based concepts as types of dissemination science. A considerable degree of paradigmatic evolution is observed. The classical diffusion model focused on adopter innovativeness, individuals as the locus of decision, communication channels, and adoption as the primary outcome measures in post hoc observational study designs. The diffusion systems in question were centralized, with fidelity of implementation often assumed. Current dissemination Research and practice is better characterized by tests of interventions that operationalize one or more diffusion theory-based concepts and concepts from other change approaches, involve complex organizations as the units of adoption, and focus on implementation issues. Foment characterizes dissemination and implementation Research, Reflecting both its interdisciplinary Roots and the imperative of spreading evidence-based innovations as a basis for a new paradigm of translational studies of dissemination science.

Multi-criteria decision analysis as an innovative approach to managing zoonoses: results from a study on Lyme disease in Canada

PubMed Central

2013-01-01

Background Zoonoses are a growing international threat interacting at the human-animal-environment interface and call for transdisciplinary and multi-sectoral approaches in order to achieve effective disease management. The recent emergence of Lyme disease in Quebec, Canada is a good example of a complex health issue for which the public health sector must find protective interventions. Traditional preventive and control interventions can have important environmental, social and economic impacts and as a result, decision-making requires a systems approach capable of integrating these multiple aspects of interventions. This paper presents the results from a study of a multi-criteria decision analysis (MCDA) approach for the management of Lyme disease in Quebec, Canada. MCDA methods allow a comparison of interventions or alternatives based on multiple criteria. Methods MCDA models were developed to assess various prevention and control decision criteria pertinent to a comprehensive management of Lyme disease: a first model was developed for surveillance interventions and a second was developed for control interventions. Multi-criteria analyses were conducted under two epidemiological scenarios: a disease emergence scenario and an epidemic scenario. Results In general, we observed a good level of agreement between stakeholders. For the surveillance model, the three preferred interventions were: active surveillance of vectors by flagging or dragging, active surveillance of vectors by trapping of small rodents and passive surveillance of vectors of human origin. For the control interventions model, basic preventive communications, human vaccination and small scale landscaping were the three preferred interventions. Scenarios were found to only have a small effect on the group ranking of interventions in the control model. Conclusions MCDA was used to structure key decision criteria and capture the complexity of Lyme disease management. This facilitated the identification of gaps in the scientific literature and enabled a clear identification of complementary interventions that could be used to improve the relevance and acceptability of proposed prevention and control strategy. Overall, MCDA presents itself as an interesting systematic approach for public health planning and zoonoses management with a “One Health” perspective. PMID:24079303

Multi-criteria decision analysis as an innovative approach to managing zoonoses: results from a study on Lyme disease in Canada.

PubMed

Aenishaenslin, Cécile; Hongoh, Valérie; Cissé, Hassane Djibrilla; Hoen, Anne Gatewood; Samoura, Karim; Michel, Pascal; Waaub, Jean-Philippe; Bélanger, Denise

2013-09-30

Zoonoses are a growing international threat interacting at the human-animal-environment interface and call for transdisciplinary and multi-sectoral approaches in order to achieve effective disease management. The recent emergence of Lyme disease in Quebec, Canada is a good example of a complex health issue for which the public health sector must find protective interventions. Traditional preventive and control interventions can have important environmental, social and economic impacts and as a result, decision-making requires a systems approach capable of integrating these multiple aspects of interventions. This paper presents the results from a study of a multi-criteria decision analysis (MCDA) approach for the management of Lyme disease in Quebec, Canada. MCDA methods allow a comparison of interventions or alternatives based on multiple criteria. MCDA models were developed to assess various prevention and control decision criteria pertinent to a comprehensive management of Lyme disease: a first model was developed for surveillance interventions and a second was developed for control interventions. Multi-criteria analyses were conducted under two epidemiological scenarios: a disease emergence scenario and an epidemic scenario. In general, we observed a good level of agreement between stakeholders. For the surveillance model, the three preferred interventions were: active surveillance of vectors by flagging or dragging, active surveillance of vectors by trapping of small rodents and passive surveillance of vectors of human origin. For the control interventions model, basic preventive communications, human vaccination and small scale landscaping were the three preferred interventions. Scenarios were found to only have a small effect on the group ranking of interventions in the control model. MCDA was used to structure key decision criteria and capture the complexity of Lyme disease management. This facilitated the identification of gaps in the scientific literature and enabled a clear identification of complementary interventions that could be used to improve the relevance and acceptability of proposed prevention and control strategy. Overall, MCDA presents itself as an interesting systematic approach for public health planning and zoonoses management with a "One Health" perspective.

Toward Sustainable Anticipatory Governance: Analyzing and Assessing Nanotechnology Innovation Processes

NASA Astrophysics Data System (ADS)

Foley, Rider Williams

Cities around the globe struggle with socio-economic disparities, resource inefficiency, environmental contamination, and quality-of-life challenges. Technological innovation, as one prominent approach to problem solving, promises to address these challenges; yet, introducing new technologies, such as nanotechnology, into society and cities has often resulted in negative consequences. Recent research has conceptually linked anticipatory governance and sustainability science: to understand the role of technology in complex problems our societies face; to anticipate negative consequences of technological innovation; and to promote long-term oriented and responsible governance of technologies. This dissertation advances this link conceptually and empirically, focusing on nanotechnology and urban sustainability challenges. The guiding question for this dissertation research is: How can nanotechnology be innovated and governed in responsible ways and with sustainable outcomes? The dissertation: analyzes the nanotechnology innovation process from an actor- and activities-oriented perspective (Chapter 2); assesses this innovation process from a comprehensive perspective on sustainable governance (Chapter 3); constructs a small set of future scenarios to consider future implications of different nanotechnology governance models (Chapter 4); and appraises the amenability of sustainability problems to nanotechnological interventions (Chapter 5). The four studies are based on data collected through literature review, document analysis, participant observation, interviews, workshops, and walking audits, as part of process analysis, scenario construction, and technology assessment. Research was conducted in collaboration with representatives from industry, government agencies, and civic organizations. The empirical parts of the four studies focus on Metropolitan Phoenix. Findings suggest that: predefined mandates and economic goals dominate the nanotechnology innovation process; normative responsibilities identified by risk governance, sustainability-oriented governance, and anticipatory governance are infrequently considered in the nanotechnology innovation process; different governance models will have major impacts on the role and effects of nanotechnology in cities in the future; and nanotechnologies, currently, do not effectively address the root causes of urban sustainability challenges and require complementary solution approaches. This dissertation contributes to the concepts of anticipatory governance and sustainability science on how to constructively guide nanotechnological innovation in order to harvest its positive potential and safeguard against negative consequences.

The Transgender Women of Color Initiative: Implementing and Evaluating Innovative Interventions to Enhance Engagement and Retention in HIV Care.

PubMed

Rebchook, Gregory; Keatley, JoAnne; Contreras, Robert; Perloff, Judy; Molano, Luis Freddy; Reback, Cathy J; Ducheny, Kelly; Nemoto, Tooru; Lin, Royce; Birnbaum, Jeffrey; Woods, Tiffany; Xavier, Jessica

2017-02-01

To improve health outcomes among transgender women of color living with HIV, the Health Resources and Services Administration's Special Programs of National Significance program funded the Enhancing Engagement and Retention in Quality HIV Care for Transgender Women of Color Initiative in 2012. Nine demonstration projects in four US urban areas implemented innovative, theory-based interventions specifically targeting transgender women of color in their jurisdictions. An evaluation and technical assistance center was funded to evaluate the outcomes of the access to care interventions, and these findings will yield best practices and lessons learned to improve the care and treatment of transgender women of color living with HIV infection.

New arrows in the quiver for targeting care management: high-risk versus high-opportunity case identification.

PubMed

Bernstein, Richard H

2007-01-01

"Care management" purposefully obscures the distinctions between disease and case management and stresses their common features: action in the present to prevent adverse future outcomes and costs. It includes identifying a high-need population by referrals, screening, or data analysis, assessing those likely to benefit from interventions, intervening, evaluating the intervention, and adjusting interventions when needed. High-risk individuals can be identified using at least 9 techniques, from referrals and questionnaires to retrospective claims analysis and predictive models. Other than referrals, software based on the risk-adjustment methodology that we have adapted can incorporate all these methodologies. Because the risk adjustment employs extensive case mix and severity adjustment, it provides care managers with 3 innovative ways to identify not only high-risk individuals but also high-opportunity cases.

[Food and nutrition education in school: a literature review].

PubMed

Ramos, Flavia Pascoal; Santos, Ligia Amparo da Silva; Reis, Amélia Borba Costa

2013-11-01

Food and nutrition education is viewed as a key strategy for promoting healthy eating habits, and the school is an appropriate space for developing these activities. The objective of this study was to describe and analyze the scientific literature on intervention studies on food and nutrition education in Brazilian schools. A literature review was conducted, selecting articles published from 2000 to 2011. Despite the topic's current importance, there were few articles, and most were published after 2009. The main results showed improvement in the children's nutritional knowledge and food choices. However, most studies that performed anthropometric measurements failed to show changes in nutritional status. In addition, the studies chose designs based on epidemiological intervention studies, indicating the need for interventions based on innovative health education methodologies and research models that are consistent with the study's objects.

A PRECEDE-PROCEED based educational intervention in quality of life of women-headed households in Iran.

PubMed

Solhi, Mahnaz; Shabani Hamedan, Marziyeh; Salehi, Masoud

2016-01-01

Background: Women-headed households are more exposed to social damages than other women. Such condition remarkably influences the women's health-related life quality. The present study is aimed to investigate the effect of an educational intervention in quality of life of women-headed households under protection of Tehran Welfare Organization, in 2015. Methods: In this quasi-experimental study with control group, 180 women-headed households participated. Sampling method was random allocation. Data collection tools were Life Quality standard questionnaire (WHOQOL-BREF) and a researcher-made questionnaire about structures of ecological and educational diagnosis phase of PRECEDE-PROCEED model. Validity and reliability of the questionnaire approved in a primary study. Based on the results obtained from the primary study, the intervention was performed in the case group only. Participants were followed one and three months after intervention. Data were analyzed through SPSS v. 15 software using descriptive and analytical tests. Results: Before intervention no significant difference was observed among the mean scores of life quality, behavioral factors, and knowledge, enabling, and reinforcing factors in the two groups. But, one month and three months after intervention a significant difference was observed between the mean scores of these variables (in five instances p<0.001). Conclusion: Intervention through the PRECEDE-PROCEED model improved the women-headed households' quality of life. The innovation of this study is using such intervention on quality of life in women-headed households for the first time.

Handling of hazardous drugs - Effect of an innovative teaching session for nursing students.

PubMed

Zimmer, Janine; Hartl, Stefanie; Standfuß, Katrin; Möhn, Till; Bertsche, Astrid; Frontini, Roberto; Neininger, Martina P; Bertsche, Thilo

2017-02-01

Imparting knowledge and practical skills in hazardous drug handling in nursing students' education is essential to prevent hazardous exposure and to preserve nurses' health. This study aimed at comparing routine nursing education with an additional innovative teaching session. A prospective controlled study in nursing students was conducted in two study periods: (i) a status-quo period (routine education on handling hazardous drugs) followed by (ii) an intervention period (additional innovative teaching session on handling hazardous drugs). Nursing students at a vocational school were invited to participate voluntarily. In both study periods (i) and (ii), the following factors were analysed: (a) knowledge of hazardous drug handling by questionnaire, (b) practical skills in hazardous drug handling (e.g. cleaning) by a simulated handling scenario, (c) contamination with drug residuals on the work surface by fluorescent imaging. Fifty-three nursing students were enrolled. (a) Median knowledge improved from status-quo (39% right answers) to intervention (65%, p<0.001), (b) practical skills improved from status-quo (53% of all participants cleaned the work surface) to intervention (92%, p<0.001). (c) Median number of particles/m 2 decreased from status-quo to intervention (932/97, p<0.001). Compared with routine education, knowledge and practical skills in hazardous drug handling were significantly improved after an innovative teaching session. Additionally, the amount of residuals on the work surface decreased. This indicates a lower risk for hazardous drug exposure. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mental health care system optimization from a health-economics perspective: where to sow and where to reap?

PubMed

Lokkerbol, Joran; Weehuizen, Rifka; Mavranezouli, Ifigeneia; Mihalopoulos, Cathrine; Smit, Filip

2014-06-01

Health care expenditure (as % of GDP) has been rising in all OECD countries over the last decades. Now, in the context of the economic downturn, there is an even more pressing need to better guarantee the sustainability of health care systems. This requires that policy makers are informed about optimal allocation of budgets. We take the Dutch mental health system in the primary care setting as an example of new ways to approach optimal allocation. To demonstrate how health economic modelling can help in identifying opportunities to improve the Dutch mental health care system for patients presenting at their GP with symptoms of anxiety, stress, symptoms of depression, alcohol abuse/dependence, anxiety disorder or depressive disorder such that changes in the health care system have the biggest leverage in terms of improved cost-effectiveness. Investigating such scenarios may serve as a starting point for setting an agenda for innovative and sustainable health care policies. A health economic simulation model was used to synthesize clinical and economic evidence. The model was populated with data from GPs' national register on the diagnosis, treatment, referral and prescription of their patients in the year 2009. A series of `what-if' analyses was conducted to see what parameters (uptake, adherence, effectiveness and the costs of the interventions) are associated with the most substantial impact on the cost-effectiveness of the health care system overall. In terms of improving the overall cost-effectiveness of the primary mental health care system, substantial benefits could be derived from increasing uptake of psycho-education by GPs for patients presenting with stress and when low cost interventions are made available that help to increase the patients' compliance with pharmaceutical interventions, particularly in patients presenting with symptoms of anxiety. In terms of intervention costs, decreasing the costs of antidepressants is expected to yield the biggest impact on the cost-effectiveness of the primary mental health care system as a whole. These "target group -- intervention" combinations are the most appealing candidates for system innovation from a cost-effectiveness point of view, but need to be carefully aligned with other considerations such as equity, acceptability, appropriateness, feasibility and strength of evidence. The study has some strengths and limitations. Cost-effectiveness analysis is performed using a health economic model that is based on registration data from a sample of GPs, but assumptions had to be made on how these data could be extrapolated to all GPs. Parameters on compliance rates were obtained from a focus group or were based on mere assumptions, while the clinical effectiveness of interventions were taken from meta-analyses or randomised trials. Effectiveness is expressed in terms of years lived with disability (YLD) averted; indirect benefits such as reduction of lost productivity or lesser pressure on informal caregivers are not taken into account. Whenever assumptions had to be made, we opted for conservative estimates that are unlikely to have resulted in an overly optimistic portrayal of the cost-effectiveness ratios. The model can be used to guide health care system innovation, by identifying those parameters where changes in the uptake, compliance, effectiveness and costs of interventions have the largest impact on the cost-effectiveness of a mental health care system overall. In this sense, the model could assist policy makers during the first stage of decision making on where to make improvements in the health care system, or assist the process of guideline development. However, the improvement candidates need to be assessed during a second-stage 'normative filter', to address considerations other than cost-effectiveness.

Moving beyond the treatment package approach to developing behavioral interventions: addressing questions that arose during an application of the Multiphase Optimization Strategy (MOST).

PubMed

Wyrick, David L; Rulison, Kelly L; Fearnow-Kenney, Melodie; Milroy, Jeffrey J; Collins, Linda M

2014-09-01

Given current pressures to increase the public health contributions of behavioral interventions, intervention scientists may wish to consider moving beyond the classical treatment package approach that focuses primarily on achieving statistical significance. They may wish also to focus on goals directly related to optimizing public health impact. The Multiphase Optimization Strategy (MOST) is an innovative methodological framework that draws on engineering principles to achieve more potent behavioral interventions. MOST is increasingly being adopted by intervention scientists seeking a systematic framework to engineer an optimized intervention. As with any innovation, there are challenges that arise with early adoption. This article describes the solutions to several critical questions that we addressed during the first-ever iterative application of MOST. Specifically, we describe how we have applied MOST to optimize an online program (myPlaybook) for the prevention of substance use among college student-athletes. Our application of MOST can serve as a blueprint for other intervention scientists who wish to design optimized behavioral interventions. We believe using MOST is feasible and has the potential to dramatically improve program effectiveness thereby advancing the public health impact of behavioral interventions.

Using Regression Discontinuity to Test the Impact of a Tier 2 Reading Intervention in First Grade

ERIC Educational Resources Information Center

Baker, Scott K.; Smolkowski, Keith; Chaparro, Erin A.; Smith, Jean L. M.; Fien, Hank

2015-01-01

Multitiered systems of reading instruction and intervention, including response to intervention, are widely used in early reading by schools to provide more intense services to students who need them. Research using randomized controlled trials has compared innovative Tier 2 interventions to business-as-usual Tier 2 approaches and established a…

Increasing the public health impact of evidence-based interventions in behavioral medicine: new approaches and future directions.

PubMed

Buscemi, Joanna; Janke, E Amy; Kugler, Kari C; Duffecy, Jenna; Mielenz, Thelma J; St George, Sara M; Sheinfeld Gorin, Sherri N

2017-02-01

The dissemination and implementation of evidence-based behavioral medicine interventions into real world practice has been limited. The purpose of this paper is to discuss specific limitations of current behavioral medicine research within the context of the RE-AIM framework, and potential opportunities to increase public health impact by applying novel intervention designs and data collection approaches. The MOST framework has recently emerged as an alternative approach to development and evaluation that aims to optimize multicomponent behavioral and bio-behavioral interventions. SMART designs, imbedded within the MOST framework, are an approach to optimize adaptive interventions. In addition to innovative design strategies, novel data collection approaches that have the potential to improve the public-health dissemination include mHealth approaches and considering environment as a potential data source. Finally, becoming involved in advocacy via policy related work may help to improve the impact of evidence-based behavioral interventions. Innovative methods, if increasingly implemented, may have the ability to increase the public health impact of evidence-based behavioral interventions to prevent disease.

Innovative technology-based interventions for autism spectrum disorders: a meta-analysis.

PubMed

Grynszpan, Ouriel; Weiss, Patrice L Tamar; Perez-Diaz, Fernando; Gal, Eynat

2014-05-01

This article reports the results of a meta-analysis of technology-based intervention studies for children with autism spectrum disorders. We conducted a systematic review of research that used a pre-post design to assess innovative technology interventions, including computer programs, virtual reality, and robotics. The selected studies provided interventions via a desktop computer, interactive DVD, shared active surface, and virtual reality. None employed robotics. The results provide evidence for the overall effectiveness of technology-based training. The overall mean effect size for posttests of controlled studies of children with autism spectrum disorders who received technology-based interventions was significantly different from zero and approached the medium magnitude, d = 0.47 (confidence interval: 0.08-0.86). The influence of age and IQ was not significant. Differences in training procedures are discussed in the light of the negative correlation that was found between the intervention durations and the studies' effect sizes. The results of this meta-analysis provide support for the continuing development, evaluation, and clinical usage of technology-based intervention for individuals with autism spectrum disorders.

Activating multi-ethnic youth for smoking prevention: design, baseline findings, and implementation of project SPLASH.

PubMed

Glanz, Karen; Lunde, Kevin B; Leakey, Tricia; Maddock, Jay; Koga, Karin; Yamauchi, Jessica; Maskarinec, Gertraud; Shigaki, Dorothy

2007-01-01

Achieving significant reductions in tobacco use by youth is an important challenge. There is a pressing need to develop and evaluate innovative strategies that stimulate youth involvement and are effective in multi-ethnic populations. This article describes an innovative tobacco prevention trial, and reports baseline characteristics of participants and findings about implementation of the curriculum. The aim of Project SPLASH is to evaluate the impact of a school-based smoking prevention intervention that emphasizes active involvement of middle school students, on rates of smoking initiation and regular smoking in a multi-ethnic cohort of youth in Hawaii. Project SPLASH is a group randomized trial that compares a 2-year innovative intervention with a social influence prevention program, in 20 public schools in Hawaii. The main outcome is mean 30-day smoking prevalence rates. The response rate was 78.4%. Approximately 1 in 4 students had tried smoking and 30-day smoking prevalence at baseline was 8%. Intervention and control groups were comparable in terms of tobacco use, gender, ethnicity, behavioral, environmental, and psychosocial characteristics. Differences in ethnic identification, socio-economic status, acculturation, and involvement in prevention activities may be due to chance. The intervention was well implemented by teachers across both the intervention and control school classes. For this study, 20 schools in Hawaii with close to 4000 participating students were recruited. Student smoking behavior and curriculum implementation were comparable by group status. The intervention study has the potential to elucidate how youth respond to an intervention with student involvement that incorporates cognitive and social action components.

Potential for reduction of burden and local elimination of malaria by reducing Plasmodium falciparum malaria transmission: a mathematical modelling study.

PubMed

Griffin, Jamie T; Bhatt, Samir; Sinka, Marianne E; Gething, Peter W; Lynch, Michael; Patouillard, Edith; Shutes, Erin; Newman, Robert D; Alonso, Pedro; Cibulskis, Richard E; Ghani, Azra C

2016-04-01

Rapid declines in malaria prevalence, cases, and deaths have been achieved globally during the past 15 years because of improved access to first-line treatment and vector control. We aimed to assess the intervention coverage needed to achieve further gains over the next 15 years. We used a mathematical model of the transmission of Plasmodium falciparum malaria to explore the potential effect on case incidence and malaria mortality rates from 2015 to 2030 of five different intervention scenarios: remaining at the intervention coverage levels of 2011-13 (Sustain), for which coverage comprises vector control and access to treatment; two scenarios of increased coverage to 80% (Accelerate 1) and 90% (Accelerate 2), with a switch from quinine to injectable artesunate for management of severe disease and seasonal malaria chemoprevention where recommended for both Accelerate scenarios, and rectal artesunate for pre-referral treatment at the community level added to Accelerate 2; a near-term innovation scenario (Innovate), which included longer-lasting insecticidal nets and expansion of seasonal malaria chemoprevention; and a reduction in coverage to 2006-08 levels (Reverse). We did the model simulations at the first administrative level (ie, state or province) for the 80 countries with sustained stable malaria transmission in 2010, accounting for variations in baseline endemicity, seasonality in transmission, vector species, and existing intervention coverage. To calculate the cases and deaths averted, we compared the total number of each under the five scenarios between 2015 and 2030 with the predicted number in 2015, accounting for population growth. With an increase to 80% coverage, we predicted a reduction in case incidence of 21% (95% credible intervals [CrI] 19-29) and a reduction in mortality rates of 40% (27-61) by 2030 compared with 2015 levels. Acceleration to 90% coverage and expansion of treatment at the community level was predicted to reduce case incidence by 59% (Crl 56-64) and mortality rates by 74% (67-82); with additional near-term innovation, incidence was predicted to decline by 74% (70-77) and mortality rates by 81% (76-87). These scenarios were predicted to lead to local elimination in 13 countries under the Accelerate 1 scenario, 20 under Accelerate 2, and 22 under Innovate by 2030, reducing the proportion of the population living in at-risk areas by 36% if elimination is defined at the first administrative unit. However, failing to maintain coverage levels of 2011-13 is predicted to raise case incidence by 76% (Crl 71-80) and mortality rates by 46% (39-51) by 2020. Our findings show that decreases in malaria transmission and burden can be accelerated over the next 15 years if the coverage of key interventions is increased. UK Medical Research Council, UK Department for International Development, the Bill & Melinda Gates Foundation, the Swiss Development Agency, and the US Agency for International Development. Copyright © Griffin et al. Open Access article distributed under the terms of CC BY. 2015. World Health Organization; licensee Elsevier. This is an Open Access article published without any waiver of WHO's privileges and immunities under international law, convention, or agreement. This article should not be reproduced for use in association with the promotion of commercial products, services, or any legal entity. There should be no suggestion that WHO endorses any specific organisation or products. The use of the WHO logo is not permitted. This notice should be preserved along with the Article's original URL.

Society for Cardiovascular Angiography and Interventions

MedlinePlus

... SCAI This Week eBrief President's Pages Press Contacts Social Media Help ... in invasive/interventional cardiology, a commitment to the highest levels of clinical care, innovation, publications, and teaching, and who have dedicated their ...

Assessing the population health impact of market interventions to improve access to antiretroviral treatment

PubMed Central

Bärnighausen, Till; Kyle, Margaret; Salomon, Joshua A; Waning, Brenda

2012-01-01

Despite extraordinary global progress in increasing coverage of antiretroviral treatment (ART), the majority of people needing ART currently are not receiving treatment. Both the number of people needing ART and the average ART price per patient-year are expected to increase in coming years, which will dramatically raise funding needs for ART. Several international organizations are using interventions in ART markets to decrease ART price or to improve ART quality, delivery and innovation, with the ultimate goal of improving population health. These organizations need to select those market interventions that are most likely to substantially affect population health outcomes (ex ante assessment) and to evaluate whether implemented interventions have improved health outcomes (ex post assessment). We develop a framework to structure ex ante and ex post assessment of the population health impact of market interventions, which is transmitted through effects in markets and health systems. Ex ante assessment should include evaluation of the safety and efficacy of the ART products whose markets will be affected by the intervention; theoretical consideration of the mechanisms through which the intervention will affect population health; and predictive modelling to estimate the potential population health impact of the intervention. For ex post assessment, analysts need to consider which outcomes to estimate empirically and which to model based on empirical findings and understanding of the economic and biological mechanisms along the causal pathway from market intervention to population health. We discuss methods for ex post assessment and analyse assessment issues (unintended intervention effects, interaction effects between different interventions, and assessment impartiality and cost). We offer seven recommendations for ex ante and ex post assessment of population health impact of market interventions. PMID:21914713

NASA Johnson Space Center SBIR STTR Program Technology Innovations

NASA Technical Reports Server (NTRS)

Krishen, Kumar

2007-01-01

The Small Business Innovation Research (SBIR) Program increases opportunities for small businesses to participate in research and development (R&D), increases employment, and improves U.S. competitiveness. Specifically the program stimulates U.S. technological innovation by using small businesses to meet federal R&D needs, increasing private-sector commercialization of innovations derived from federal R&D, and fostering and encouraging the participation of socially disadvantaged businesses. In 2000, the Small Business Technology Transfer (STTR) Program extended and strengthened the SBIR Program, increasing its emphasis on pursuing commercial applications by awarding contracts to small business concerns for cooperative R&D with a nonprofit research institution. Modeled after the SBIR Program, STTR is nevertheless a separately funded activity. Technologies that have resulted from the Johnson Space Center SBIR STTR Program include: a device for regenerating iodinated resin beds; laser-assisted in-situ keratomileusis or LASIK; a miniature physiological monitoring device capable of collecting and analyzing a multitude of real-time signals to transmit medical data from remote locations to medical centers for diagnosis and intervention; a new thermal management system for fibers and fabrics giving rise to new line of garments and thermal-enhancing environments; and a highly electropositive material that attracts and retains electronegative particles in water.

System of Indicators in the Innovation Management: Business Intelligence Applied to Tourism

NASA Astrophysics Data System (ADS)

Lozada, Dayana; Araque, Francisco; Castillo, Jose Manuel; Salguero, Alberto; Delgado, Cecilia; Noda, Marcia; Hernández, Gilberto

The work presents an approach to study mechanisms that allows managers the Innovation Management (IM) measurements. It is assumed, as main motivation, the analysis of patterns for the design of an integral system of indicators. A methodology that integrates the thought process, focusing on the Business Intelligence and the Balance Scorecard will be presented. A group of indexes based on the multidimensionality of IM in organizations of the sector of tourism is proposed. To approach this quality it is necessary to contextualize, in the conditions of sectoral operation, the theories, models and systems used in our approach. It has been used intervention methods like experts' criteria, consensus search techniques by means of surveys, consultation of documents, and statistical methods such as analysis of the main components.

Achieving Developmental Synchrony in Young Children With Hearing Loss

PubMed Central

Mellon, Nancy K.; Ouellette, Meredith; Greer, Tracy; Gates-Ulanet, Patricia

2009-01-01

Children with hearing loss, with early and appropriate amplification and intervention, demonstrate gains in speech, language, and literacy skills. Despite these improvements many children continue to exhibit disturbances in cognitive, behavioral, and emotional control, self-regulation, and aspects of executive function. Given the complexity of developmental learning, educational settings should provide services that foster the growth of skills across multiple dimensions. Transdisciplinary intervention services that target the domains of language, communication, psychosocial functioning, motor, and cognitive development can promote academic and social success. Educational programs must provide children with access to the full range of basic skills necessary for academic and social achievement. In addition to an integrated curriculum that nurtures speech, language, and literacy development, innovations in the areas of auditory perception, social emotional learning, motor development, and vestibular function can enhance student outcomes. Through ongoing evaluation and modification, clearly articulated curricular approaches can serve as a model for early intervention and special education programs. The purpose of this article is to propose an intervention model that combines best practices from a variety of disciplines that affect developmental outcomes for young children with hearing loss, along with specific strategies and approaches that may help to promote optimal development across domains. Access to typically developing peers who model age-appropriate skills in language and behavior, small class sizes, a co-teaching model, and a social constructivist perspective of teaching and learning, are among the key elements of the model. PMID:20150187

Challenges and Innovations in a Community-Based Participatory Randomized Controlled Trial

ERIC Educational Resources Information Center

Goodkind, Jessica R.; Amer, Suha; Christian, Charlisa; Hess, Julia Meredith; Bybee, Deborah; Isakson, Brian L.; Baca, Brandon; Ndayisenga, Martin; Greene, R. Neil; Shantzek, Cece

2017-01-01

Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants' intervention experiences, and their…

Empirically Based Play Interventions for Children

ERIC Educational Resources Information Center

Reddy, Linda A., Ed.; Files-Hall, Tara M., Ed.; Schaefer, Charles E., Ed.

2005-01-01

"Empirically Based Play Interventions for Children" is a compilation of innovative, well-designed play interventions, presented for the first time in one text. Play therapy is the oldest and most popular form of child therapy in clinical practice and is widely considered by practitioners to be uniquely responsive to children's developmental needs.…

Exploring the Gaps in Practical Ethical Guidance for Animal Welfare Considerations of Field Interventions and Innovations Targeting Dogs and Cats.

PubMed

Tasker, Louisa; Getty, Susan F; Briggs, Joyce R; Benka, Valerie A W

2018-01-27

Domestic dogs ( Canis lupus familiaris ) and cats ( Felis silvestris catus ) are common species targeted by nongovernmental or intergovernmental organizations, veterinarians and government agencies worldwide, for field interventions (e.g., population management, rabies vaccination programs) or innovations (e.g., development of technologies or pharmaceuticals to improve animal welfare). We have a moral responsibility to ensure that the conduct of this work is humane for dogs or cats, and to consider the human communities in which the animals live. Ethical review is widely accepted as being integral to responsible practice, and it is fundamental to good science that underpins innovation. Despite the necessity of field interventions or innovations to advance the welfare of individuals or populations of animals, we found a lack of specific guidance and review processes to help navigate ethical dilemmas surrounding the conduct of such work. This can be detrimental to the wellbeing of animals and their human communities. Here we identify the gaps in existing ethical frameworks (specifically application of Reduction and Refinement principles, challenges of obtaining meaningful informed consent with variations in the quality of human-animal relationships, and limited resources regarding considerations of local stakeholders), and outline the need for additional tools to promote ethical conduct in the field.

Theories, models and frameworks used in capacity building interventions relevant to public health: a systematic review.

PubMed

Bergeron, Kim; Abdi, Samiya; DeCorby, Kara; Mensah, Gloria; Rempel, Benjamin; Manson, Heather

2017-11-28

There is limited research on capacity building interventions that include theoretical foundations. The purpose of this systematic review is to identify underlying theories, models and frameworks used to support capacity building interventions relevant to public health practice. The aim is to inform and improve capacity building practices and services offered by public health organizations. Four search strategies were used: 1) electronic database searching; 2) reference lists of included papers; 3) key informant consultation; and 4) grey literature searching. Inclusion and exclusion criteria are outlined with included papers focusing on capacity building, learning plans, professional development plans in combination with tools, resources, processes, procedures, steps, model, framework, guideline, described in a public health or healthcare setting, or non-government, government, or community organizations as they relate to healthcare, and explicitly or implicitly mention a theory, model and/or framework that grounds the type of capacity building approach developed. Quality assessment were performed on all included articles. Data analysis included a process for synthesizing, analyzing and presenting descriptive summaries, categorizing theoretical foundations according to which theory, model and/or framework was used and whether or not the theory, model or framework was implied or explicitly identified. Nineteen articles were included in this review. A total of 28 theories, models and frameworks were identified. Of this number, two theories (Diffusion of Innovations and Transformational Learning), two models (Ecological and Interactive Systems Framework for Dissemination and Implementation) and one framework (Bloom's Taxonomy of Learning) were identified as the most frequently cited. This review identifies specific theories, models and frameworks to support capacity building interventions relevant to public health organizations. It provides public health practitioners with a menu of potentially usable theories, models and frameworks to support capacity building efforts. The findings also support the need for the use of theories, models or frameworks to be intentional, explicitly identified, referenced and for it to be clearly outlined how they were applied to the capacity building intervention.

Creating a new investment pool for innovative health systems research.

PubMed

Laba, Tracey-Lea; Patel, Anushka; Jan, Stephen

2017-05-01

Recent trends in health research funding towards 'safe bets' is discouraging investment into the development of health systems interventions and choking off a vital area of policy-relevant research. This paper argues that to encourage investment into innovative and perceivably riskier health systems research, researchers need to create more attractive business cases by exploring alternative approaches to the design and evaluation of health system interventions. At the same time, the creation of dedicated funding opportunities to support this work, as well as for relevant early career researchers, is needed.

PERSPECTIVE ON OPPORTUNITIES FOR RESEARCH AND INTERVENTIONS PROVIDED BY COMMUNITY BASED HEALTH INFORMATION SYSTEM ILLUSTRATED BY THE POTENTIAL USE OF MOTIVATIONAL INTERVIEWING INTERVENTION.

PubMed

Gisore, P; Were, F; Ayuku, D; Kaseje, D

2012-05-01

With the growth of Community-Based Health Information (CBHIS) for decision making and service provision in the low income settings, innovative models of addressing Maternal and Newborn Health (MNH) morbidity and mortality are necessary. World Health Organization (WHO) estimates that five hundred thousand mothers and about three million newborns die each year in middle and low income countries. To stimulate interest in utilisation CBHIS for research and interventions, with an illustration of potential using on Motivational Interviewing intervention. Literature searched electronically, discussion with behavioural experts, health system researchers, and maternal and Newborn Health (MNH) experts, and book reviews. Broad selection criteria including all current literature relevantsubjects including CBHIS, behaviour change methods and Community MNH. A checklist for relevance was used to identify the relevant behaviour change intervention to use in the illustration. A method that met the criteria was identified, and based on a discussion with behavioural experts, the decision to use it the illustration was reached. Motivational Interviewing Intervention (MII) should be considered for implementation and study on near-term Pregnant women in a setting where these mothers can be identified and a targeted intervention instituted.

Family Crisis Intervention in War Contexts: A Case Study of a Traumatised Palestinian Family

ERIC Educational Resources Information Center

Veronese, Guido; Said, Mahmud S.; Castiglioni, Marco

2014-01-01

The aim of this study was to analyse the phases of an innovative in vivo exposure intervention in which all family members were present at the scene of a traumatic incident. Clinical practice has borne out the efficacy of family intervention and its benefits for traumatised individuals and family groups. The intervention discussed here was…

A tool for exploring the dynamics of innovative interventions for public health: the critical event card.

PubMed

Figueiro, Ana Claudia; de Araújo Oliveira, Sydia Rosana; Hartz, Zulmira; Couturier, Yves; Bernier, Jocelyne; do Socorro Machado Freire, Maria; Samico, Isabella; Medina, Maria Guadalupe; de Sa, Ronice Franco; Potvin, Louise

2017-03-01

Public health interventions are increasingly represented as complex systems. Research tools for capturing the dynamic of interventions processes, however, are practically non-existent. This paper describes the development and proof of concept process of an analytical tool, the critical event card (CEC), which supports the representation and analysis of complex interventions' evolution, based on critical events. Drawing on the actor-network theory (ANT), we developed and field-tested the tool using three innovative health interventions in northeastern Brazil. Interventions were aimed to promote health equity through intersectoral approaches; were engaged in participatory evaluation and linked to professional training programs. The CEC developing involve practitioners and researchers from projects. Proof of concept was based on document analysis, face-to-face interviews and focus groups. Analytical categories from CEC allow identifying and describing critical events as milestones in the evolution of complex interventions. Categories are (1) event description; (2) actants (human and non-human) involved; (3) interactions between actants; (4) mediations performed; (5) actions performed; (6) inscriptions produced; and (7) consequences for interventions. The CEC provides a tool to analyze and represent intersectoral internvetions' complex and dynamic evolution.

Coaching of physicians by RNs to improve diabetes care.

PubMed

Frederick, Mary L; Johnson, Pamela Jo; Duffee, Janelle; McCarthy, Bruce D

2013-01-01

The purpose of this study is to describe preliminary results of an innovative quality improvement intervention focused on improving physician practice patterns in diabetes care via Coaching Physicians by RN certified diabetes educators (CDEs), a program called "CPR for Diabetes Care." METHODS The program identified primary care physicians with optimal diabetes control rates below the system aggregate (n = 195). Physicians with the lowest rates (n = 74) were targeted for comprehensive intervention. All other low-performing physicians practicing in the same clinic system (n = 121) comprised the comparison group. Data were obtained from electronic diabetes registries for 2007 and 2008. Each physician had a set of measures from 2 points in time. Measures included optimal diabetes scores and the 5 component measures of the optimal diabetes care bundle (A1C <7, low-density lipoprotein cholesterol <100, blood pressure <130/80, aspirin use if older than 40, and no tobacco use). T tests and difference-in-difference models were used to examine changes over time. Optimal diabetes scores increased 11.7 points (from 14.7% to 26.4%) for intervention physicians and 4.0 points (from 29.7% to 32.9%) for comparison physicians. The improvement was greater for the intervention group. The greatest component improvements were in control of blood pressure and cholesterol. CONCLUSIONS Coaching low-performing physicians dramatically improved the proportion of diabetes patients with optimal diabetes control. The CPR for Diabetes Care program represents an innovative and effective way to address the long-standing problem of disseminating and sustaining quality improvement efforts by focusing on low-performing physicians.

Equipping community pharmacy workers as agents for health behaviour change: developing and testing a theory-based smoking cessation intervention.

PubMed

Steed, Liz; Sohanpal, Ratna; James, Wai-Yee; Rivas, Carol; Jumbe, Sandra; Chater, Angel; Todd, Adam; Edwards, Elizabeth; Macneil, Virginia; Macfarlane, Fraser; Greenhalgh, Trisha; Griffiths, Chris; Eldridge, Sandra; Taylor, Stephanie; Walton, Robert

2017-08-11

To develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates. Following the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention. Phase I : We used information from qualitative studies in pharmacies, systematic literature reviews and the Capability, Opportunity, Motivation-Behaviour framework to inform design of the initial version of the intervention. Phase II : We then tested the acceptability of this intervention with smoking cessation advisers and assessed fidelity using actors who visited pharmacies posing as smokers, in a pilot study. Phase III : We reviewed the content and associated theory underpinning our intervention, taking account of the results of the earlier studies and a realist analysis of published literature. We then confirmed a logic model describing the intended operation of the intervention and used this model to refine the intervention and associated materials. Eight community pharmacies in three inner east London boroughs. 12 Stop Smoking Advisers. Two, 150 min, skills-based training sessions focused on communication and behaviour change skills with between session practice. The pilot study confirmed acceptability of the intervention and showed preliminary evidence of benefit; however, organisational barriers tended to limit effective operation. The pilot data and realist review pointed to additional use of Diffusion of Innovations Theory to seat the intervention in the wider organisational context. We have developed and refined an intervention to promote smoking cessation services in community pharmacies, which we now plan to evaluate in a randomised controlled trial. UKCRN ID 18446, Pilot. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

An innovation in curriculum content and delivery of cancer education within undergraduate nurse training in the UK. What impact does this have on the knowledge, attitudes and confidence in delivering cancer care?

PubMed

Edwards, Deborah; Anstey, Sally; Kelly, Daniel; Hopkinson, Jane

2016-04-01

This was an evaluation of an innovation in curriculum content and delivery within undergraduate nursing education in the UK. Its purpose was to investigate the effect on knowledge, attitudes and confidence in delivering cancer care. The study design was a pre-test post-test survey design with a comparison group. Participants were two cohorts of undergraduate nursing students (n(intervention) = 84, n(comparison) = 91). The intervention cohort were exposed to a new 3.5 day programme of cancer education, coproduced with patients, carers and health professionals, which focused on cancer as a life changing long-term condition. The comparison cohort had been exposed to a 2 day programme produced by a lecturer. Following exposure to the new model for the delivery of undergraduate nurse cancer education, the intervention cohort demonstrated good overall knowledge of the impact of cancer, more positive attitudes towards cancer treatment and more confidence in their ability to deliver cancer care. Attitudes were more positive and confidence in ability to support cancer patients at all stages of the cancer journey were greater than in the comparison group. Insights gained into the cancer patient and carer perspectives were highly valued. This study has found that a new model for the delivery of cancer education focusing on survivorship and delivered in partnership with patients, carers and clinicians, may improve knowledge, attitudes and confidence in the delivery of cancer care. Further work is now needed, using a more robust experimental design, to investigate the generalisability of the results to other education programs. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Establishing and Evaluating the Key Functions of an Interactive Systems Framework Using an Assets-Getting to Outcomes Intervention

PubMed Central

Chinman, Matthew; Acosta, Joie; Ebener, Patricia; Burkhart, Q; Clifford, Michael; Corsello, Maryann; Duffey, Tim; Hunter, Sarah; Jones, Margaret; Lahti, Michel; Malone, Patrick S.; Paddock, Susan; Phillips, Andrea; Savell, Susan; Scales, Peter C.; Tellett-Royce, Nancy

2012-01-01

Community practitioners can face difficulty in achieving outcomes demonstrated by prevention science. Building a community practitioner’s prevention capacity—the knowledge and skills needed to conduct critical prevention practices—could improve the quality of prevention and its outcomes. The purpose of this article is to: (1) describe how an intervention called Assets-Getting To Outcomes (AGTO) was used to establish the key functions of the ISF and present early lessons learned from that intervention’s first 6 months and (2) examine whether there is an empirical relationship between practitioner capacity at the individual level and the performance of prevention at the program level—a relationship predicted by the ISF but untested. The article describes an operationalization of the ISF in the context of a five-year randomized controlled efficacy trial that combines two complementary models designed to build capacity: Getting To Outcomes (GTO) and Developmental Assets. The trial compares programs and individual practitioners from six community-based coalitions using AGTO with programs and practitionersfrom six similar coalitions that are not. In this article, we primarily focus on what the ISF calls innovation specific capacity and discuss how the combined AGTO innovation structures and uses feedback about its capacity-building activities, which can serve as a model for implementing the ISF. Focus group discussions used to gather lessons learned from the first 6 months of the AGTO intervention suggest that while the ISF may have been conceptualized as three distinct systems, in practice they are less distinct. Findings from the baseline wave of data collection of individual capacity and program performance suggest that practitioner capacity predicts, in part, performance of prevention programs. Empirically linking practitioner capacity and performance of prevention provides empirical support for both the ISF and AGTO. PMID:22446975

Cardiac 3D Printing and its Future Directions.

PubMed

Vukicevic, Marija; Mosadegh, Bobak; Min, James K; Little, Stephen H

2017-02-01

Three-dimensional (3D) printing is at the crossroads of printer and materials engineering, noninvasive diagnostic imaging, computer-aided design, and structural heart intervention. Cardiovascular applications of this technology development include the use of patient-specific 3D models for medical teaching, exploration of valve and vessel function, surgical and catheter-based procedural planning, and early work in designing and refining the latest innovations in percutaneous structural devices. In this review, we discuss the methods and materials being used for 3D printing today. We discuss the basic principles of clinical image segmentation, including coregistration of multiple imaging datasets to create an anatomic model of interest. With applications in congenital heart disease, coronary artery disease, and surgical and catheter-based structural disease, 3D printing is a new tool that is challenging how we image, plan, and carry out cardiovascular interventions. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

An Integrated Framework For The Prevention And Treatment Of Obesity And Its Related Chronic Diseases.

PubMed

Dietz, William H; Solomon, Loel S; Pronk, Nico; Ziegenhorn, Sarah K; Standish, Marion; Longjohn, Matt M; Fukuzawa, David D; Eneli, Ihuoma U; Loy, Lisel; Muth, Natalie D; Sanchez, Eduardo J; Bogard, Jenny; Bradley, Don W

2015-09-01

Improved patient experience, population health, and reduced cost of care for patients with obesity and other chronic diseases will not be achieved by clinical interventions alone. We offer here a new iteration of the Chronic Care Model that integrates clinical and community systems to address chronic diseases. Obesity contributes substantially to cardiovascular disease, type 2 diabetes mellitus, and cancer. Dietary and physical activity interventions will prevent, mitigate, and treat obesity and its related diseases. Challenges with the implementation of this model include provider training, the need to provide incentives for health systems to move beyond clinical care to link with community systems, and addressing the multiple elements necessary for integration within clinical care and with social systems. The Affordable Care Act, with its emphasis on prevention and new systems for care delivery, provides support for innovative strategies such as those proposed here. Project HOPE—The People-to-People Health Foundation, Inc.

Music, health, and well-being: a review.

PubMed

MacDonald, Raymond A R

2013-08-07

The relationship between arts participation and health is currently very topical. Motivated by a desire to investigate innovative, non-invasive, and economically viable interventions that embrace contemporary definitions of health, practitioners and researchers across the world have been developing and researching arts inventions. One of the key drivers in this vigorous research milieu is the growth of qualitative research within health care contexts and researchers interested in exploring the potential benefits of musical participation have fully embraced the advances that have taken place in health-related qualitative research. The following article presents a number of different types of qualitative research projects focused on exploring the process and outcomes of music interventions. It also presents a new conceptual model for music, health and well-being. This new model develops on a previous version of MacDonald, Kreutz, and Mitchell (2012b) by incorporating new elements and contextualization and providing detailed experimental examples to support the various components.

Music, health, and well-being: A review

PubMed Central

2013-01-01

The relationship between arts participation and health is currently very topical. Motivated by a desire to investigate innovative, non-invasive, and economically viable interventions that embrace contemporary definitions of health, practitioners and researchers across the world have been developing and researching arts inventions. One of the key drivers in this vigorous research milieu is the growth of qualitative research within health care contexts and researchers interested in exploring the potential benefits of musical participation have fully embraced the advances that have taken place in health-related qualitative research. The following article presents a number of different types of qualitative research projects focused on exploring the process and outcomes of music interventions. It also presents a new conceptual model for music, health and well-being. This new model develops on a previous version of MacDonald, Kreutz, and Mitchell (2012b) by incorporating new elements and contextualization and providing detailed experimental examples to support the various components. PMID:23930991

Cardiac 3D Printing and Its Future Directions

PubMed Central

Vukicevic, Marija; Mosadegh, Bobak; Min, James K.; Little, Stephen H.

2017-01-01

3D printing is at the crossroads of printer and materials engineering; non-invasive diagnostic imaging; computer aided design (CAD); and structural heart intervention. Cardiovascular applications of this technology development include the use of patient-specific 3D models for medical teaching, exploration of valve and vessel function, surgical and catheter-based procedural planning, and early work in designing and refining the latest innovations in percutaneous structural devices. In this review we discuss the methods and materials being used for 3D printing today. We discuss the basic principles of clinical image segmentation including co-registration of multiple imaging datasets to create an anatomic model of interest. With applications in congenital heart disease, coronary artery disease, and in surgical and catheter-based structural disease – 3D printing is a new tool that is challenging how we image, plan, and carry out cardiovascular interventions. PMID:28183437

Understanding a successful obesity prevention initiative in children under 5 from a systems perspective.

PubMed

Owen, Brynle; Brown, Andrew D; Kuhlberg, Jill; Millar, Lynne; Nichols, Melanie; Economos, Christina; Allender, Steven

2018-01-01

Systems thinking represents an innovative and logical approach to understanding complexity in community-based obesity prevention interventions. We report on an approach to apply systems thinking to understand the complexity of a successful obesity prevention intervention in early childhood (children aged up to 5 years) conducted in a regional city in Victoria, Australia. A causal loop diagram (CLD) was developed to represent system elements related to a successful childhood obesity prevention intervention in early childhood. Key stakeholder interviews (n = 16) were examined retrospectively to generate purposive text data, create microstructures, and form a CLD. A CLD representing key stakeholder perceptions of a successful intervention comprised six key feedback loops explaining changes in project implementation over time. The loops described the dynamics of collaboration, network formation, community awareness, human resources, project clarity, and innovation. The CLD developed provides a replicable means to capture, evaluate and disseminate a description of the dynamic elements of a successful obesity prevention intervention in early childhood.

Masivukeni: Development of a Multimedia Based Antiretroviral Therapy Adherence Intervention for Counselors and Patients in South Africa

PubMed Central

Remien, Robert H; Mellins, Claude A.; Robbins, Reuben N.; Kelsey, Ryan; Rowe, Jessica; Warne, Patricia; Chowdhury, Jenifar; Lalkhen, Nuruneesa; Hoppe, Lara; Abrams, Elaine J.; El-Bassel, Nabila; Witte, Susan; Stein, Dan J.

2013-01-01

Effective medical treatment for HIV/AIDS requires patients’ optimal adherence to antiretroviral therapy (ART). In resource-constrained settings, lack of adequate standardized counseling for patients on ART remains a significant barrier to adherence. Masivukeni (“Lets Wake Up” in Xhosa) is an innovative multimedia-based intervention designed to help people living with HIV in resource-limited settings achieve and maintain high levels of ART adherence. Adapted from a couples-based intervention tested in the United States (US), Masivukeni was developed through community-based participatory research with US and South African partners and informed by Ewart’s Social Action Theory. Innovative computer-based multimedia strategies were used to translate a labor- and training-intensive intervention into one that could be readily and widely used by lay counselors with relatively little training with low-literacy patients. In this paper, we describe the foundations of this new intervention, the process of its development, and the evidence of its high acceptability and feasibility. PMID:23468079

Participant selection for preventive Regenerative Medicine trials: ethical challenges of selecting individuals at risk.

PubMed

Niemansburg, Sophie L; Habets, Michelle G J L; Dhert, Wouter J A; van Delden, Johannes J M; Bredenoord, Annelien L

2015-11-01

The innovative field of Regenerative Medicine (RM) is expected to extend the possibilities of prevention or early treatment in healthcare. Increasingly, clinical trials will be developed for people at risk of disease to investigate these RM interventions. These individuals at risk are characterised by their susceptibility for developing clinically manifest disease in future due to the existence of degenerative abnormalities. So far, there has been little debate about the ethical appropriateness of including such individuals at risk in clinical trials. We discuss three main challenges of selecting this participant model for testing RM interventions: the challenge of achieving a proportional risk-benefit balance; complexities in the trial design in terms of follow-up and sample size; and the difficulty of obtaining informed consent due to the many uncertainties. We conclude that selecting the model is not ethically justifiable for first-in-man trials with RM interventions due to the high risks and uncertainties. However, the model can be ethically appropriate for testing the efficacy of RM interventions under the following conditions: interventions should be low risk; the degenerative abnormalities (and other risk factors) should be strongly related with disease within a short time frame; robust preclinical evidence of efficacy needs to be present; and the informed consent procedure should contain extra safeguards with regard to communication on uncertainties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Description of the EUROBIS Program: A Combination of an Epode Community-Based and a Clinical Care Intervention to Improve the Lifestyles of Children and Adolescents with Overweight or Obesity

PubMed Central

Mazzeschi, Claudia; Pazzagli, Chiara; Laghezza, Loredana; Battistini, Dalila; Reginato, Elisa; Perrone, Chiara; Ranucci, Claudia; Fatone, Cristina; Pippi, Roberto; Giaimo, Maria Donata; Verrotti, Alberto; De Giorgi, Giovanni; De Feo, Pierpaolo

2014-01-01

The present paper describes the Epode Umbria Region Obesity Prevention Study (EUROBIS) and aims to implement the C.U.R.I.A.MO. model through the EPODE methodology. The main goal of the EUROBIS is to change the pendency of slope of the actual trend towards the increase in the yearly rates of childhood overweight and obesity in Umbria and to improve healthy lifestyles of children and their parents. The project is the first EPODE program to be performed in Italy. The aims of the Italian EUROBIS study are: (1) a community-based intervention program (CBP) carrying out activities in all primary schools of the Umbria Region and family settings as first step, to reverse the current obesity trend on a long-term basis, and (2) a clinical care program for childhood and adolescent by C.U.R.I.A.MO. model. C.U.R.I.A.MO. model is a multidisciplinary approach to improve three key aspects of healthy lifestyles: nutrition, exercise, and psychological aspects with the strategy of a family-based approach. The community-based intervention and clinical trial provide an innovative valuable model to address the childhood obesity prevention and treatment in Italy. PMID:25162015

Comprehensive home-based care coordination for vulnerable elders with dementia: Maximizing Independence at Home-Plus-Study protocol.

PubMed

Samus, Quincy M; Davis, Karen; Willink, Amber; Black, Betty S; Reuland, Melissa; Leoutsakos, Jeannie; Roth, David L; Wolff, Jennifer; Gitlin, Laura N; Lyketsos, Constantine G; Johnston, Deirdre

2017-12-01

Despite availability of effective care strategies for dementia, most health care systems are not yet organized or equipped to provide comprehensive family-centered dementia care management. Maximizing Independence at Home-Plus is a promising new model of dementia care coordination being tested in the U.S. through a Health Care Innovation Award funded by the Centers for Medicare and Medicaid Services that may serve as a model to address these delivery gaps, improve outcomes, and lower costs. This report provides an overview of the Health Care Innovation Award aims, study design, and methodology. This is a prospective, quasi-experimental intervention study of 342 community-living Medicare-Medicaid dual eligibles and Medicare-only beneficiaries with dementia in Maryland. Primary analyses will assess the impact of Maximizing Independence at Home-Plus on risk of nursing home long-term care placement, hospitalization, and health care expenditures (Medicare, Medicaid) at 12, 18 (primary end point), and 24 months, compared to a propensity-matched comparison group. The goals of the Maximizing Independence at Home-Plus model are to improve care coordination, ability to remain at home, and life quality for participants and caregivers, while reducing total costs of care for this vulnerable population. This Health Care Innovation Award project will provide timely information on the impact of Maximizing Independence at Home-Plus care coordination model on a variety of outcomes including effects on Medicaid and Medicare expenditures and service utilization. Participant characteristic data, cost savings, and program delivery costs will be analyzed to develop a risk-adjusted payment model to encourage sustainability and facilitate spread.

The effectiveness of a training method using self-modeling webcam photos for reducing musculoskeletal risk among office workers using computers.

PubMed

Taieb-Maimon, Meirav; Cwikel, Julie; Shapira, Bracha; Orenstein, Ido

2012-03-01

An intervention study was conducted to examine the effectiveness of an innovative self-modeling photo-training method for reducing musculoskeletal risk among office workers using computers. Sixty workers were randomly assigned to either: 1) a control group; 2) an office training group that received personal, ergonomic training and workstation adjustments or 3) a photo-training group that received both office training and an automatic frequent-feedback system that displayed on the computer screen a photo of the worker's current sitting posture together with the correct posture photo taken earlier during office training. Musculoskeletal risk was evaluated using the Rapid Upper Limb Assessment (RULA) method before, during and after the six weeks intervention. Both training methods provided effective short-term posture improvement; however, sustained improvement was only attained with the photo-training method. Both interventions had a greater effect on older workers and on workers suffering more musculoskeletal pain. The photo-training method had a greater positive effect on women than on men. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

The Marriage Checkup: Increasing Access to Marital Health Care

PubMed Central

Morrill, Melinda

2016-01-01

Despite the ongoing prevalence of marital distress, very few couples seek therapy. Researchers and clinicians have increasingly been calling for innovative interventions that can reach a larger number of untreated couples. Based on a motivational marital health model, the Marriage Checkup (MC) was designed to attract couples who are unlikely to seek traditional tertiary therapy. The objective of the MC is to promote marital health for as broad of a population of couples as possible, much like regular physical health checkups. This first paper from the largest MC study to date examines whether the MC engaged previously unreached couples who might benefit from intervention. Interview and survey data suggested that the MC attracted couples across the distress continuum and was perceived by couples as more accessible than traditional therapy. Notably, the MC attracted a substantial number of couples who had not previously participated in marital interventions. The motivational health checkup model appeared to encourage a broad range of couples who might not have otherwise sought relationship services to deliberately take care of their marital health. Clinical implications are discussed. PMID:22145720

A technology selection framework for supporting delivery of patient-oriented health interventions in developing countries

PubMed Central

Chan, Connie V.; Kaufman, David R.

2009-01-01

Health information technologies (HIT) have great potential to advance health care globally. In particular, HIT can provide innovative approaches and methodologies to overcome the range of access and resource barriers specific to developing countries. However, there is a paucity of models and empirical evidence informing the technology selection process in these settings. We propose a framework for selecting patient-oriented technologies in developing countries. The selection guidance process is structured by a set of filters that impose particular constraints and serve to narrow the space of possible decisions. The framework consists of three levels of factors: 1) situational factors, 2) the technology and its relationship with health interventions and with target patients, and 3) empirical evidence. We demonstrate the utility of the framework in the context of mobile phones for behavioral health interventions to reduce risk factors for cardiovascular disease. This framework can be applied to health interventions across health domains to explore how and whether available technologies can support delivery of the associated types of interventions and with the target populations. PMID:19796709

Mitigating the Effects of Family Poverty on Early Child Development through Parenting Interventions in Primary Care.

PubMed

Cates, Carolyn Brockmeyer; Weisleder, Adriana; Mendelsohn, Alan L

2016-04-01

Poverty related disparities in early child development and school readiness are a major public health crisis, the prevention of which has emerged in recent years as a national priority. Interventions targeting parenting and the quality of the early home language environment are at the forefront of efforts to address these disparities. In this article we discuss the innovative use of the pediatric primary care platform as part of a comprehensive public health strategy to prevent adverse child development outcomes through the promotion of parenting. Models of interventions in the pediatric primary care setting are discussed with evidence of effectiveness reviewed. Taken together, a review of this significant body of work shows the tremendous potential to deliver evidence-based preventive interventions to families at risk for poverty related disparities in child development and school readiness at the time of pediatric primary care visits. We also addresss considerations related to scaling and maximizing the effect of pediatric primary care parenting interventions and provide key policy recommendations. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Innovative approach to teaching communication skills to nursing students.

PubMed

Zavertnik, Jean Ellen; Huff, Tanya A; Munro, Cindy L

2010-02-01

This study assessed the effectiveness of a learner-centered simulation intervention designed to improve the communication skills of preprofessional sophomore nursing students. An innovative teaching strategy in which communication skills are taught to nursing students by using trained actors who served as standardized family members in a clinical learning laboratory setting was evaluated using a two-group posttest design. In addition to current standard education, the intervention group received a formal training session presenting a framework for communication and a 60-minute practice session with the standardized family members. Four domains of communication-introduction, gathering of information, imparting information, and clarifying goals and expectations-were evaluated in the control and intervention groups in individual testing sessions with a standardized family member. The intervention group performed better than the control group in all four tested domains related to communication skills, and the difference was statistically significant in the domain of gathering information (p = 0.0257). Copyright 2010, SLACK Incorporated.

Culturally adapting a physical activity intervention for Somali women: the need for theory and innovation to promote equity.

PubMed

Murray, Kate E; Ermias, Azieb; Lung, Amber; Mohamed, Amina Sheik; Ellis, B Heidi; Linke, Sarah; Kerr, Jacqueline; Bowen, Deborah J; Marcus, Bess H

2017-03-01

There is pressing need for innovation in clinical research to more effectively recruit, engage, retain, and promote health among diverse populations overburdened by health disparities. The purpose of this study is to provide a detailed illustration of the cultural adaptation of an evidence-based intervention to bolster translational research with currently underserved communities. The cultural adaptation heuristic framework described by Barrera and colleagues is applied to the adaptation of a physical activity evidence-based intervention with adult Somali women. Widespread changes were required to ensure program feasibility and acceptability, including the reduction of assessment protocols and changes discordant with current trends in physical activity research. The cultural adaptation of evidence-based interventions offers an important mechanism for reducing health disparities. Improved reporting standards, assessment of features relevant to underserved communities, and greater funding requirements to ensure better representation are needed to promote more widespread access for all people.

Use of a screening tool and primary health care gerontology nurse specialist for high-needs older people.

PubMed

King, Anna; Boyd, Michal; Dagley, Lynelle

2017-02-01

To describe implementation of an innovative gerontology nurse specialist role within one primary health organisation in Auckland, New Zealand. Quantitative outcomes of the screening tool as well as the nurse specialist assessment will be presented. The intervention involved use of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify high-needs older people with subsequent comprehensive geriatric assessment (CGA) performed by the gerontology nurse specialist. A total 384 of the 416 BRIGHTs were completed (92% response rate) and 15% of these were identified as high risk (n = 57). The BRIGHTs for high-risk older people revealed the highest scoring question was 'needing help with housework' (26%). The most frequent intervention by the gerontology nurse specialist was education (30%). The primary health care gerontology nurse specialist model delivers a proactive case finding and specialist gerontology intervention for older people at high risk of functional or health decline.

Statewide Implementation of an Evidence-Based Trauma Intervention in Schools

ERIC Educational Resources Information Center

Hoover, Sharon A.; Sapere, Heather; Lang, Jason M.; Nadeem, Erum; Dean, Kristin L.; Vona, Pamela

2018-01-01

The goal of the current article is to describe the implementation and outcomes of an innovative statewide dissemination approach of the evidence-based trauma intervention "Cognitive Behavioral Intervention for Trauma in Schools (CBITS)". In the context of a 2-year statewide learning collaborative effort, 73 CBITS groups led by 20…

Rapid-Response Parenting Intervention in Diagnostic Centers as a Patient-Centered Innovation for Autism Spectrum Disorders

ERIC Educational Resources Information Center

McMillin, Stephen Edward; Bultas, Margaret W.; Wilmott, Jennifer; Grafeman, Sarah; Zand, Debra H.

2015-01-01

Parents of children newly diagnosed with autism spectrum disorders are a high-need population for whom skills-based parenting interventions likely help. Diagnostic centers are compelling locations to deliver parenting interventions because families are served in an accessible location and at a time they receive overwhelming treatment…

A Tale of Two Countries: Innovation and Collaboration Aimed at Changing the Culture of Medicine in Uruguay.

PubMed

Dapueto, Juan J; Viera, Mercedes; Samenow, Charles; Swiggart, William H; Steiger, Jeffrey

2018-05-11

This is a case study of a program to address professionalism at the Universidad de la República in Uruguay. We describe a five-year ongoing international collaboration. Relevant characteristics of the context, the program components, activities, and results were analyzed. The expected outcomes were to introduce standards of professional practices in the curricula of medical students and residents and the implementation of a program that might lead to a significant change in the culture of medicine in the University. Traditional didactics, interactive theater, and professional development workshops, issues such as teamwork and communication, professional behavior, and the culture of medicine, and physician wellness were addressed. A total of 359 faculty members, general practitioners, stakeholders, and other healthcare professionals (nurses, psychologists, social workers) participated in the intervention. The process led to specific achievements including new content in the curricula, the use of educational innovations to address issues of professionalism, a growing institutional culture of accountability, and the establishment of new rules and regulations. The strategies and interventions followed in the case of Uruguay can serve as a model to other developing countries to promote physician professionalism, wellness, and joy.

Using propensity scores in difference-in-differences models to estimate the effects of a policy change

PubMed Central

Stuart, Elizabeth A.; Huskamp, Haiden A.; Duckworth, Kenneth; Simmons, Jeffrey; Song, Zirui; Chernew, Michael; Barry, Colleen L.

2014-01-01

Difference-in-difference (DD) methods are a common strategy for evaluating the effects of policies or programs that are instituted at a particular point in time, such as the implementation of a new law. The DD method compares changes over time in a group unaffected by the policy intervention to the changes over time in a group affected by the policy intervention, and attributes the “difference-in-differences” to the effect of the policy. DD methods provide unbiased effect estimates if the trend over time would have been the same between the intervention and comparison groups in the absence of the intervention. However, a concern with DD models is that the program and intervention groups may differ in ways that would affect their trends over time, or their compositions may change over time. Propensity score methods are commonly used to handle this type of confounding in other non-experimental studies, but the particular considerations when using them in the context of a DD model have not been well investigated. In this paper, we describe the use of propensity scores in conjunction with DD models, in particular investigating a propensity score weighting strategy that weights the four groups (defined by time and intervention status) to be balanced on a set of characteristics. We discuss the conceptual issues associated with this approach, including the need for caution when selecting variables to include in the propensity score model, particularly given the multiple time point nature of the analysis. We illustrate the ideas and method with an application estimating the effects of a new payment and delivery system innovation (an accountable care organization model called the “Alternative Quality Contract” (AQC) implemented by Blue Cross Blue Shield of Massachusetts) on health plan enrollee out-of-pocket mental health service expenditures. We find no evidence that the AQC affected out-of-pocket mental health service expenditures of enrollees. PMID:25530705

Strategies used by community-based organizations to evaluate their locally developed HIV prevention interventions: Lessons learned from the CDC's innovative interventions project.

PubMed

Painter, Thomas M; Ngalame, Paulyne M; Lucas, Basil; Lauby, Jennifer L; Herbst, Jeffrey H

2010-10-01

Community-based organizations (CBOs) play an important role in health promotion efforts and the delivery of HIV prevention interventions for at-risk minority populations. CBOs may also develop their own interventions but often lack the capacity or funds to rigorously evaluate them. The Innovative Interventions project of the Centers for Disease Control and Prevention (CDC) funded three CBOs to rigorously evaluate the efficacy of interventions they had developed and were delivering to Black women, Black men who have sex with men (MSM), and adolescent males in juvenile justice settings, respectively. The evaluation results have been reported elsewhere. This article describes operational issues that the CBOs identified as being particularly salient to their evaluations and the strategies they developed to address the issues and successfully complete their evaluations. These issues included the development of organizational capacity to conduct a rigorous outcome evaluation, difficulties with recruitment and retention of evaluation participants, and the use of process monitoring data to improve intervention delivery. The strategies described in this article can be used by CBOs when evaluating their locally developed HIV prevention interventions and may be of interest to funding agencies and researchers that collaborate with CBOs to evaluate their interventions.

[Social and organizational innovation to tackle the challenge of integrated care of the chronically ill].

PubMed

Nuño-Solinís, Roberto

2014-01-01

The increase in life expectancy, coupled with other factors, has led to an increase in the prevalence of chronic diseases and multiple morbidity. This has led to the need to develop new health and social care models, which will allow managing these efficiently and in a sustainable manner. In particular, there seems to be consensus on the need to move towards integrated, patient-centered, and more proactive care. Thus, in recent years, chronic care models have been developed at international, national and regional level, as well as introducing strategies to tackle the challenge of chronic illness. However, the implementation of actions facilitating the change towards this new model of care does not seem to be an easy task. This paper presents some of the strategic lines and initiatives carried out by the Department of Health of the Basque Government. These actions can be described within a social and organizational innovation framework, as a means for effective implementation of interventions and strategies that shape the model required for the improved care of chronic illnesses within a universal and tax-funded health system. Copyright © 2013 Elsevier España, S.L. All rights reserved.

An Integrative, Multilevel, and Transdisciplinary Research Approach to Challenges of Work, Family, and Health

PubMed Central

Bray, Jeremy W.; Kelly, Erin L.; Hammer, Leslie B.; Almeida, David M.; Dearing, James W.; King, Rosalind B.; Buxton, Orfeu M.

2013-01-01

Recognizing a need for rigorous, experimental research to support the efforts of workplaces and policymakers in improving the health and wellbeing of employees and their families, the National Institutes of Health and the Centers for Disease Control and Prevention formed the Work, Family & Health Network (WFHN). The WFHN is implementing an innovative multisite study with a rigorous experimental design (adaptive randomization, control groups), comprehensive multilevel measures, a novel and theoretically based intervention targeting the psychosocial work environment, and translational activities. This paper describes challenges and benefits of designing a multilevel and transdisciplinary research network that includes an effectiveness study to assess intervention effects on employees, families, and managers; a daily diary study to examine effects on family functioning and daily stress; a process study to understand intervention implementation; and translational research to understand and inform diffusion of innovation. Challenges were both conceptual and logistical, spanning all aspects of study design and implementation. In dealing with these challenges, however, the WFHN developed innovative, transdisciplinary, multi-method approaches to conducting workplace research that will benefit both the research and business communities. PMID:24618878

Proceedings from the Digital Innovation in Mental Health Conference, London, 2017

PubMed Central

Inkster, Becky

2018-01-01

Aims and Scope: The conference aims were two-fold: (1) to explore how digital technology is implemented into personalized and/or group mental health interventions and (2) to promote digital equality through developing culturally sensitive ways of bringing technological innovation to disadvantaged groups. A broad scope of perspectives were welcomed and encouraged, from lived experience, academic, clinical, media, the arts, policy-making, tech innovation, and other perspectives. PMID:29623001

Innovation in microbiome-based strategies for promoting metabolic health.

PubMed

Romaní-Pérez, Marina; Agusti, Ana; Sanz, Yolanda

2017-11-01

Update on the development of microbiome-based interventions and dietary supplements to combat obesity and related comorbidities, which are leading causes of global mortality. The role of intestinal dysbiosis, partly resulting from unhealthy diets, in the development of obesity and metabolic disorders, is well documented by recent translational research. Human experimental trials with whole-faecal transplants are ongoing, and their results will be crucial as proof of concept that interventions intended to modulate the microbiome composition and function could be alternatives for the management of obesity and related comorbidities. Potential next-generation probiotic bacteria (Akkermansia, Bacteroides spp., Eubacterium halli) and microbiota-derived molecules (e.g. membrane proteins, short-chain fatty acids) are being evaluated in preclinical and clinical trials to promote the development of innovative dietary supplements. The fact that live or inactivated bacteria and their products can regulate pathways that increase energy expenditure, and reduce energy intake, and absorption and systemic inflammation make them attractive research targets from a nutritional and clinical perspective. Understanding which are the beneficial bacteria and their bioactive products is helping us to envisage innovative microbiome-based dietary interventions to tackle obesity. Advances will likely result from future refinements of these strategies according to the individual's microbiome configuration and its particular response to interventions, thereby progressing towards personalized nutrition.

Systematic, theoretically-grounded development and feasibility testing of an innovative, preventive web-based game for children exposed to acute trauma

PubMed Central

Marsac, Meghan L.; Winston, Flaura K.; Hildenbrand, Aimee K.; Kohser, Kristen L.; March, Sonja; Kenardy, Justin; Kassam-Adams, Nancy

2015-01-01

Background Millions of children are affected by acute medical events annually, creating need for resources to promote recovery. While web-based interventions promise wide reach and low cost for users, development can be time- and cost-intensive. A systematic approach to intervention development can help to minimize costs and increase likelihood of effectiveness. Using a systematic approach, our team integrated evidence on the etiology of traumatic stress, an explicit program theory, and a user-centered design process to intervention development. Objective To describe evidence and the program theory model applied to the Coping Coach intervention and present pilot data evaluating intervention feasibility and acceptability. Method Informed by empirical evidence on traumatic stress prevention, an overarching program theory model was articulated to delineate pathways from a) specific intervention content to b) program targets and proximal outcomes to c) key longer-term health outcomes. Systematic user-testing with children ages 8–12 (N = 42) exposed to an acute medical event and their parents was conducted throughout intervention development. Results Functionality challenges in early prototypes necessitated revisions. Child engagement was positive throughout revisions to the Coping Coach intervention. Final pilot-testing demonstrated promising feasibility and high user-engagement and satisfaction. Conclusion Applying a systematic approach to the development of Coping Coach led to the creation of a functional intervention that is accepted by children and parents. Development of new e-health interventions may benefit from a similar approach. Future research should evaluate the efficacy of Coping Coach in achieving targeted outcomes of reduced trauma symptoms and improved health-related quality of life. PMID:25844276

Artificial Intelligence-Assisted Online Social Therapy for Youth Mental Health

PubMed Central

D'Alfonso, Simon; Santesteban-Echarri, Olga; Rice, Simon; Wadley, Greg; Lederman, Reeva; Miles, Christopher; Gleeson, John; Alvarez-Jimenez, Mario

2017-01-01

Introduction: Benefits from mental health early interventions may not be sustained over time, and longer-term intervention programs may be required to maintain early clinical gains. However, due to the high intensity of face-to-face early intervention treatments, this may not be feasible. Adjunctive internet-based interventions specifically designed for youth may provide a cost-effective and engaging alternative to prevent loss of intervention benefits. However, until now online interventions have relied on human moderators to deliver therapeutic content. More sophisticated models responsive to user data are critical to inform tailored online therapy. Thus, integration of user experience with a sophisticated and cutting-edge technology to deliver content is necessary to redefine online interventions in youth mental health. This paper discusses the development of the moderated online social therapy (MOST) web application, which provides an interactive social media-based platform for recovery in mental health. We provide an overview of the system's main features and discus our current work regarding the incorporation of advanced computational and artificial intelligence methods to enhance user engagement and improve the discovery and delivery of therapy content. Methods: Our case study is the ongoing Horyzons site (5-year randomized controlled trial for youth recovering from early psychosis), which is powered by MOST. We outline the motivation underlying the project and the web application's foundational features and interface. We discuss system innovations, including the incorporation of pertinent usage patterns as well as identifying certain limitations of the system. This leads to our current motivations and focus on using computational and artificial intelligence methods to enhance user engagement, and to further improve the system with novel mechanisms for the delivery of therapy content to users. In particular, we cover our usage of natural language analysis and chatbot technologies as strategies to tailor interventions and scale up the system. Conclusions: To date, the innovative MOST system has demonstrated viability in a series of clinical research trials. Given the data-driven opportunities afforded by the software system, observed usage patterns, and the aim to deploy it on a greater scale, an important next step in its evolution is the incorporation of advanced and automated content delivery mechanisms. PMID:28626431

Artificial Intelligence-Assisted Online Social Therapy for Youth Mental Health.

PubMed

D'Alfonso, Simon; Santesteban-Echarri, Olga; Rice, Simon; Wadley, Greg; Lederman, Reeva; Miles, Christopher; Gleeson, John; Alvarez-Jimenez, Mario

2017-01-01

Introduction: Benefits from mental health early interventions may not be sustained over time, and longer-term intervention programs may be required to maintain early clinical gains. However, due to the high intensity of face-to-face early intervention treatments, this may not be feasible. Adjunctive internet-based interventions specifically designed for youth may provide a cost-effective and engaging alternative to prevent loss of intervention benefits. However, until now online interventions have relied on human moderators to deliver therapeutic content. More sophisticated models responsive to user data are critical to inform tailored online therapy. Thus, integration of user experience with a sophisticated and cutting-edge technology to deliver content is necessary to redefine online interventions in youth mental health. This paper discusses the development of the moderated online social therapy (MOST) web application, which provides an interactive social media-based platform for recovery in mental health. We provide an overview of the system's main features and discus our current work regarding the incorporation of advanced computational and artificial intelligence methods to enhance user engagement and improve the discovery and delivery of therapy content. Methods: Our case study is the ongoing Horyzons site (5-year randomized controlled trial for youth recovering from early psychosis), which is powered by MOST. We outline the motivation underlying the project and the web application's foundational features and interface. We discuss system innovations, including the incorporation of pertinent usage patterns as well as identifying certain limitations of the system. This leads to our current motivations and focus on using computational and artificial intelligence methods to enhance user engagement, and to further improve the system with novel mechanisms for the delivery of therapy content to users. In particular, we cover our usage of natural language analysis and chatbot technologies as strategies to tailor interventions and scale up the system. Conclusions: To date, the innovative MOST system has demonstrated viability in a series of clinical research trials. Given the data-driven opportunities afforded by the software system, observed usage patterns, and the aim to deploy it on a greater scale, an important next step in its evolution is the incorporation of advanced and automated content delivery mechanisms.

Eradicating the grey squirrel Sciurus carolinensis from urban areas: an innovative decision-making approach based on lessons learnt in Italy.

PubMed

La Morgia, Valentina; Paoloni, Daniele; Genovesi, Piero

2017-02-01

Eradication of invasive alien species supports the recovery of native biodiversity. A new European Union Regulation introduces obligations to eradicate the most harmful invasive species. However, eradications of charismatic mammals may encounter strong opposition. Considering the case study of the eastern grey squirrel (Sciurus carolinensis Gmelin, 1788) in central Italy, we developed a structured decision-making technique based on a Bayesian decision network model and explicitly considering the plurality of environmental values of invasive species management to reduce potential social conflicts. The model identified priority areas for management activities. These areas corresponded to the core of the grey squirrel range, but they also included peripheral zones, where rapid eradication is fundamental to prevent the spread of squirrels. However, when the model was expanded to integrate the attitude of citizens towards the project, the intervention strategy slightly changed. In some areas, the citizens' support was limited, and this resulted in a reduced overall utility of intervention. The suggested approach extends the scientific basis for management decisions, evaluated in terms of technical efficiency, feasibility and social impact. Here, the Bayesian decision network model analysed the potential technical and social consequences of management actions, and it responded to the need for transparency in the decision-making process, but it can easily be extended to consider further issues that are common in many mammal eradication programmes. Owing to its flexibility and comprehensiveness, it provides an innovative example of how to plan rapid eradication or control activities, as required by the new EU Regulation. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Hydrotherapy combined with Snoezelen multi-sensory therapy.

PubMed

Lavie, Efrat; Shapiro, Michele; Julius, Mona

2005-01-01

The aim of this article is to present a new and challenging model of treatment that combines two therapeutic interventions: hydrotherapy and Snoezelen or controlled multisensory stimulation. The combination of the two therapeutic approaches enhances the treatment effect by utilizing the unique characteristics of each approach. We believe that this combined model will further enhance each media to the benefit of the clients and create a new intervention approach. This article relates to a hydrotherapy swimming pool facility that has been established at the Williams Island Therapeutic Swimming and Recreation Center, Beit Issie Shapiro, Raanana in Israel, after acquiring many years of experience and gaining substantial knowledge both in the field of hydrotherapy and Snoezelen intervention. Beit Issie Shapiro is a non-profit community organization providing a range of services for children with developmental disabilities and their families. The organization provides direct services for nearly 6,000 children and adults each year. This article provides an overview of hydrotherapy and Snoezelen and presents a case study, which will demonstrate the new model of treatment and show how this new and innovative form of therapy can be used as a successful intervention. We believe it will open a path to enriching the repertoire of therapists helping people with special needs. This article is also addressed to researchers to provide ideas for further studies in this area.

Nutritional status, feeding practices and state of other related indicators at onset of a multi-model community nutrition intervention program in Mpigi District, Uganda.

PubMed

Tumwesigye, Nazarius Mbona; Tushemerirwe, Florence Basiimwa; Kajjura, Richard; Nabunya, Victoria; Naitala, Ronald Andrew; Namanda, Cissie

2016-12-01

In Uganda, malnutrition level has persistently remained high among the under-fives and this has led NGOs like World Vision, Uganda into finding innovative ways for intervention. This paper presents an assessment of nutrition status and values of related indicators at onset of a community intervention program in four sub-counties of Mpigi district in Central Uganda. This was a cross-sectional study to provide baseline information for a nutrition intervention. The study units were index children aged 6-59 months from 818 households. Face to face interviews were conducted using semi-structured questionnaires. Values of key indicators were computed and compared between designated control and intervention areas. Stunting level was 32% while wasting was 3% and underweight at 10%. Most of the index children (78%) started breastfeeding within the first hour of birth. Nearly a third of the households visited had a kitchen garden and this did not differ by intervention status. Like at regional level, nutrition status and feeding practices in the study area were poor. The values of these indicators did not significantly change by designated intervention status. Much effort was needed to realize a difference in nutrition and feeding practices in designated intervention areas.

Scaling up ART adherence clubs in the public sector health system in the Western Cape, South Africa: a study of the institutionalisation of a pilot innovation.

PubMed

MacGregor, Hayley; McKenzie, Andrew; Jacobs, Tanya; Ullauri, Angelica

2018-04-25

In 2011, a decision was made to scale up a pilot innovation involving 'adherence clubs' as a form of differentiated care for HIV positive people in the public sector antiretroviral therapy programme in the Western Cape Province of South Africa. In 2016 we were involved in the qualitative aspect of an evaluation of the adherence club model, the overall objective of which was to assess the health outcomes for patients accessing clubs through epidemiological analysis, and to conduct a health systems analysis to evaluate how the model of care performed at scale. In this paper we adopt a complex adaptive systems lens to analyse planned organisational change through intervention in a state health system. We explore the challenges associated with taking to scale a pilot that began as a relatively simple innovation by a non-governmental organisation. Our analysis reveals how a programme initially representing a simple, unitary system in terms of management and clinical governance had evolved into a complex, differentiated care system. An innovation that was assessed as an excellent idea and received political backing, worked well whilst supported on a small scale. However, as scaling up progressed, challenges have emerged at the same time as support has waned. We identified a 'tipping point' at which the system was more likely to fail, as vulnerabilities magnified and the capacity for adaptation was exceeded. Yet the study also revealed the impressive capacity that a health system can have for catalysing novel approaches. We argue that innovation in largescale, complex programmes in health systems is a continuous process that requires ongoing support and attention to new innovation as challenges emerge. Rapid scaling up is also likely to require recourse to further resources, and a culture of iterative learning to address emerging challenges and mitigate complex system errors. These are necessary steps to the future success of adherence clubs as a cornerstone of differentiated care. Further research is needed to assess the equity and quality outcomes of a differentiated care model and to ensure the inclusive distribution of the benefits to all categories of people living with HIV.

The Roles of Research Universities in Indigenous National Technological Innovation

ERIC Educational Resources Information Center

Feng, Zhuolin; Zhao, Wenhua

2008-01-01

The world is increasingly merged into a global market economy, and the government's intervention power in economy has rapidly given way to that of science and technology. For the world's major economic powers, indigenous technological innovation has become a national strategy for enhancing competitiveness. Investment in scientific and…

Engendering Situational Interest through Innovative Instruction in an Engineering Classroom: What Really Mattered?

ERIC Educational Resources Information Center

Hunsu, Nathaniel J.; Adesope, Olusola; Van Wie, Bernard J.

2017-01-01

Instructors often try out innovative interventions (INTRs) in their classrooms to promote student engagement and learning interest. While such efforts are commendable, thinking through how individual and environmental characteristics influence interest development in learners is crucial to meeting such teaching objectives. In this study, we…

Development of a Self-Management Theory-Guided Discharge Intervention for Parents of Hospitalized Children.

PubMed

Sawin, Kathleen J; Weiss, Marianne E; Johnson, Norah; Gralton, Karen; Malin, Shelly; Klingbeil, Carol; Lerret, Stacee M; Thompson, Jamie J; Zimmanck, Kim; Kaul, Molly; Schiffman, Rachel F

2017-03-01

Parents of hospitalized children, especially parents of children with complex and chronic health conditions, report not being adequately prepared for self-management of their child's care at home after discharge. No theory-based discharge intervention exists to guide pediatric nurses' preparation of parents for discharge. To develop a theory-based conversation guide to optimize nurses' preparation of parents for discharge and self-management of their child at home following hospitalization. Two frameworks and one method influenced the development of the intervention: the Individual and Family Self-Management Theory, Tanner's Model of Clinical Judgment, and the Teach-Back method. A team of nurse scientists, nursing leaders, nurse administrators, and clinical nurses developed and field tested the electronic version of a nine-domain conversation guide for use in acute care pediatric hospitals. The theory-based intervention operationalized self-management concepts, added components of nursing clinical judgment, and integrated the Teach-Back method. Development of a theory-based intervention, the translation of theoretical knowledge to clinical innovation, is an important step toward testing the effectiveness of the theory in guiding clinical practice. Clinical nurses will establish the practice relevance through future use and refinement of the intervention. © 2017 Sigma Theta Tau International.

Prescribing Activities that Engage Passive Residents. An Innovative Method

PubMed Central

Kolanowski, Ann; Buettner, Linda

2009-01-01

Individuals with dementia are often passive, which places them at risk for further cognitive and functional decline. Recreational activities have been used in research to reduce passive behaviors, but systematic reviews of these studies have found modest effect sizes for many activities. In this article, we describe the further theoretical development of an innovative method for prescribing activities that have a high likelihood of engaging nursing home residents who are passive and present examples for research application and clinical practice. This method may increase the effect size of activity interventions and encourage more widespread adoption of nonpharmacological interventions in practice. PMID:18274300

Evidence-Based Evaluation of Practice and Innovation in Physical Therapy Using the IDEAL-Physio Framework.

PubMed

Beard, David; Hamilton, David; Davies, Loretta; Cook, Jonathan; Hirst, Allison; McCulloch, Peter; Paez, Arsenio

2018-02-01

The IDEAL framework is an established method for initial and ongoing evaluations of innovation and practice for complex health care interventions. First derived for surgical sciences and embedded at a global level for evaluating surgery/surgical devices, the IDEAL framework is based on the principle that innovation and evaluation in clinical practice can, and should, evolve together in an ordered manner: from conception to development and then to validation by appropriate clinical studies and, finally, longer-term follow-up. This framework is highly suited to other complex, nonpharmacological interventions, such as physical therapist interventions. This perspective outlines the application of IDEAL to physical therapy in the new IDEAL-Physio framework. The IDEAL-Physio framework comprises 5 stages. In stage 1, the idea phase, formal data collection should begin. Stage 2a is the phase for iterative improvement and adjustment with thorough data recording. Stage 2b involves the onset of formal evaluation using systematically collected group or cohort data. Stage 3 is the phase for formal comparative assessment of treatment, usually involving randomized studies. Stage 4 involves long-term follow-up. The IDEAL-Physio framework is recommended as a method for guiding and evaluating both innovation and practice in physical therapy, with the overall goal of providing better evidence-based care. © 2017 American Physical Therapy Association.

A model for occupational safety and health intervention diffusion to small businesses.

PubMed

Sinclair, Raymond C; Cunningham, Thomas R; Schulte, Paul A

2013-12-01

Smaller businesses differ from their larger counterparts in having higher rates of occupational injuries and illnesses and fewer resources for preventing those losses. Intervention models developed outside the United States have addressed the resource deficiency issue by incorporating intermediary organizations such as trade associations. This paper extends previous models by using exchange theory and by borrowing from the diffusion of innovations model. It emphasizes that occupational safety and health (OSH) organizations must understand as much about intermediary organizations as they do about small businesses. OSH organizations ("initiators") must understand how to position interventions and information to intermediaries as added value to their relationships with small businesses. Examples from experiences in two midwestern states are used to illustrate relationships and types of analyses implied by the extended model. The study found that intermediary organizations were highly attuned to providing smaller businesses with what they want, including OSH services. The study also found that there are opinion leader organizations and individual champions within intermediaries who are key to decisions and actions about OSH programming. The model places more responsibility on both initiators and intermediaries to develop and market interventions that will be valued in the competitive small business environment where the resources required to adopt each new business activity could always be used in other ways. The model is a candidate for empirical validation, and it offers some encouragement that the issue of sustainable OSH assistance to small businesses might be addressed. Am. J. Ind. Med. 56:1442-1451, 2013. Published 2013. This article is a U.S. Government work and is in the public domain in the USA. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Learning to Lead Reading Comprehension Discussion

ERIC Educational Resources Information Center

Silver, Rita Elaine; Png, Jessie

2016-01-01

In this article, we describe and reflect on a collaborative, school-based professional development project (an "intervention") intended to encourage innovation in classroom teaching. Specifically, the intervention included a collaboration between university-based researchers/mentors and primary school teachers in Singapore who were…

'Scaling-up is a craft not a science': Catalysing scale-up of health innovations in Ethiopia, India and Nigeria.

PubMed

Spicer, Neil; Bhattacharya, Dipankar; Dimka, Ritgak; Fanta, Feleke; Mangham-Jefferies, Lindsay; Schellenberg, Joanna; Tamire-Woldemariam, Addis; Walt, Gill; Wickremasinghe, Deepthi

2014-11-01

Donors and other development partners commonly introduce innovative practices and technologies to improve health in low and middle income countries. Yet many innovations that are effective in improving health and survival are slow to be translated into policy and implemented at scale. Understanding the factors influencing scale-up is important. We conducted a qualitative study involving 150 semi-structured interviews with government, development partners, civil society organisations and externally funded implementers, professional associations and academic institutions in 2012/13 to explore scale-up of innovative interventions targeting mothers and newborns in Ethiopia, the Indian state of Uttar Pradesh and the six states of northeast Nigeria, which are settings with high burdens of maternal and neonatal mortality. Interviews were analysed using a common analytic framework developed for cross-country comparison and themes were coded using Nvivo. We found that programme implementers across the three settings require multiple steps to catalyse scale-up. Advocating for government to adopt and finance health innovations requires: designing scalable innovations; embedding scale-up in programme design and allocating time and resources; building implementer capacity to catalyse scale-up; adopting effective approaches to advocacy; presenting strong evidence to support government decision making; involving government in programme design; invoking policy champions and networks; strengthening harmonisation among external programmes; aligning innovations with health systems and priorities. Other steps include: supporting government to develop policies and programmes and strengthening health systems and staff; promoting community uptake by involving media, community leaders, mobilisation teams and role models. We conclude that scale-up has no magic bullet solution - implementers must embrace multiple activities, and require substantial support from donors and governments in doing so. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Image-guided thoracic surgery in the hybrid operation room.

PubMed

Ujiie, Hideki; Effat, Andrew; Yasufuku, Kazuhiro

2017-01-01

There has been an increase in the use of image-guided technology to facilitate minimally invasive therapy. The next generation of minimally invasive therapy is focused on advancement and translation of novel image-guided technologies in therapeutic interventions, including surgery, interventional pulmonology, radiation therapy, and interventional laser therapy. To establish the efficacy of different minimally invasive therapies, we have developed a hybrid operating room, known as the guided therapeutics operating room (GTx OR) at the Toronto General Hospital. The GTx OR is equipped with multi-modality image-guidance systems, which features a dual source-dual energy computed tomography (CT) scanner, a robotic cone-beam CT (CBCT)/fluoroscopy, high-performance endobronchial ultrasound system, endoscopic surgery system, near-infrared (NIR) fluorescence imaging system, and navigation tracking systems. The novel multimodality image-guidance systems allow physicians to quickly, and accurately image patients while they are on the operating table. This yield improved outcomes since physicians are able to use image guidance during their procedures, and carry out innovative multi-modality therapeutics. Multiple preclinical translational studies pertaining to innovative minimally invasive technology is being developed in our guided therapeutics laboratory (GTx Lab). The GTx Lab is equipped with similar technology, and multimodality image-guidance systems as the GTx OR, and acts as an appropriate platform for translation of research into human clinical trials. Through the GTx Lab, we are able to perform basic research, such as the development of image-guided technologies, preclinical model testing, as well as preclinical imaging, and then translate that research into the GTx OR. This OR allows for the utilization of new technologies in cancer therapy, including molecular imaging, and other innovative imaging modalities, and therefore enables a better quality of life for patients, both during and after the procedure. In this article, we describe capabilities of the GTx systems, and discuss the first-in-human technologies used, and evaluated in GTx OR.

[Qualitative analysis of organizational innovations in Spanish public hospitals].

PubMed

del Llano, J; Martínez-Cantarero, J F; Gol, J; Raigada, F

2002-01-01

To determine the opinion of chief executive officers (CEOs) and physicians in public hospitals concerning new managerial trends. We performed a qualitative study designed to determine the opinion of CEOs and physicians on the organizational innovations that affect more than one level of health management intervention. In-depth semi-structured interviews were conducted to identify behavior, experiences, opinions, knowledge and other personal and institutional aspects related to the study's aim. Focus groups (two study groups and one control group) were also used. Interaction between groups was used to obtain different types of information on the development of ideas, operational capacity, and the degree of consensus and disagreement on the subjects discussed. Comparison between the control and the study groups revealed that the new management trends added value in the following areas: economy of contracts, delegation, administrative decentralization, incentives, risk avoidance, process re-engineering, heath care continuity, competitiveness, leadership, information systems and client centeredness. Physicians are showing increased interest in organizational innovations while CEOs are ambivalent about their changing role and respective responsibilities. There is evidence of resistance to change. There is no single institutional model; institutional design depends on internal factors (cohesion and leadership) and external factors (environment, size and technology). The incipient development of innovations reveals the need for changes in the style and characteristics of management structure (composition, functions, responsibilities).

The Potential Role of Social Innovation Financing in Career and Technical Education

ERIC Educational Resources Information Center

Overholster, George; Klein, Steven

2015-01-01

A new class of financial tools is being developed to promote human capital investments that benefit society. Social innovation financing (SIF) entails raising private capital to support promising social interventions, with the expectation that those providing the funding will eventually be repaid. Funds are allocated based on service providers'…

Design for Scalability: A Case Study of the River City Curriculum

ERIC Educational Resources Information Center

Clarke, Jody; Dede, Chris

2009-01-01

One-size-fits-all educational innovations do not work because they ignore contextual factors that determine an intervention's efficacy in a particular local situation. This paper presents a framework on how to design educational innovations for scalability through enhancing their adaptability for effective usage in a wide variety of settings. The…

Evaluation of an Innovative Post-Arrest Diversion Program: 12-Month Recidivism Analysis

ERIC Educational Resources Information Center

Dembo, Richard; Walters, Wansley; Wareham, Jennifer; Burgos, Catherimarty; Schmeidler, James; Hoge, Robert; Underwood, Lee

2008-01-01

We report the results of an evaluation study of a diversion program, operated by the Miami-Dade County Juvenile Assessment Center in Florida. The Post-Arrest Diversion (PAD) program represents an innovative approach to treatment and intervention within the juvenile justice system that utilizes standardized psychosocial risks and needs assessment…

Smoking Cessation: Next Steps for Special Populations Research and Innovative Treatments

ERIC Educational Resources Information Center

Borrelli, Belinda

2010-01-01

Objective: The current introductory article provides the rationale for the special section on understudied smokers and innovative treatments. This article proposes a definition of "special populations" of smokers, outlines a priori criteria by which to judge whether an intervention should be adapted for these smokers, and delineates a process by…

Impact: The Magazine for Innovation and Change in Counseling. Spring, 1972.

ERIC Educational Resources Information Center

Walz, Garry, Ed.; And Others

The third issue of this publication offers, as its overriding theme, the concern with improving the quality of education through financial measures, personnel, crisis intervention, and innovation adoption. Wilbur Cohen, Dean of the University of Michigan School of Education, was interviewed concerning a variety of aspects of education. In another…

Seeing the forests and the trees—innovative approaches to exploring heterogeneity in systematic reviews of complex interventions to enhance health system decision-making: a protocol

PubMed Central

2014-01-01

Background To improve quality of care and patient outcomes, health system decision-makers need to identify and implement effective interventions. An increasing number of systematic reviews document the effects of quality improvement programs to assist decision-makers in developing new initiatives. However, limitations in the reporting of primary studies and current meta-analysis methods (including approaches for exploring heterogeneity) reduce the utility of existing syntheses for health system decision-makers. This study will explore the role of innovative meta-analysis approaches and the added value of enriched and updated data for increasing the utility of systematic reviews of complex interventions. Methods/Design We will use the dataset from our recent systematic review of 142 randomized trials of diabetes quality improvement programs to evaluate novel approaches for exploring heterogeneity. These will include exploratory methods, such as multivariate meta-regression analyses and all-subsets combinatorial meta-analysis. We will then update our systematic review to include new trials and enrich the dataset by surveying authors of all included trials. In doing so, we will explore the impact of variables not, reported in previous publications, such as details of study context, on the effectiveness of the intervention. We will use innovative analytical methods on the enriched and updated dataset to identify key success factors in the implementation of quality improvement interventions for diabetes. Decision-makers will be involved throughout to help identify and prioritize variables to be explored and to aid in the interpretation and dissemination of results. Discussion This study will inform future systematic reviews of complex interventions and describe the value of enriching and updating data for exploring heterogeneity in meta-analysis. It will also result in an updated comprehensive systematic review of diabetes quality improvement interventions that will be useful to health system decision-makers in developing interventions to improve outcomes for people with diabetes. Systematic review registration PROSPERO registration no. CRD42013005165 PMID:25115289

Adoption of innovations by specialised nurses: personal, work and organisational characteristics.

PubMed

van der Weide, Marian; Smits, Jeroen

2004-04-01

To gain insight in the factors that influence the adoption of professional information by specialised nurses, we studied the effects of individual, work and organisational characteristics on the extent to which continence nurses gained knowledge and made use of a book on nursing diagnosis and interventions for patients with urinary incontinence, which they received as a present. Subjects were all members of the Dutch Association of Continence Nurses. Data collection took place via a postal questionnaire with closed questions. In total, 109 valid questionnaires (78%) were received back. Stepwise selected ordered logit models were estimated with reading the book and knowledge and use of five selected parts of it as dependent variables and individual, work and organisational characteristics as independent variables. The most important factors found to promote reading of the book and taking knowledge of the parts of it were a personal characteristic of the nurses called "information directedness" (or eagerness to acquire professional information from other sources), the presence of an "innovative atmosphere" at the department, and "relevance" of the information for daily nursing practice. The most important factors found to promote the use of the book are (again) information directedness, working at a (relatively) small department and having experience with nursing diagnosis. Results suggest that nurses differ in the degree to which they are open to innovations and that information directedness might be a useful indicator of this characteristic. In addition, the degree of innovativeness of the atmosphere at the department and the relevance of the innovation for nursing practice are important factors influencing the success or failure of innovations in nursing practice.

Implementing a stigma reduction intervention in healthcare settings

PubMed Central

Li, Li; Lin, Chunqing; Guan, Jihui; Wu, Zunyou

2013-01-01

Introduction Globally, HIV-related stigma is prevalent in healthcare settings and is a major barrier to HIV prevention and treatment adherence. Some intervention studies have showed encouraging outcomes, but a gap continues to exist between what is known and what is actually delivered in medical settings to reduce HIV-related stigma. Methods This article describes the process of implementing a stigma reduction intervention trial that involved 1760 service providers in 40 hospitals in China. Guided by Diffusion of Innovation theory, the intervention identified and trained about 15–20% providers as popular opinion leaders (POLs) to disseminate stigma reduction messages in each intervention hospital. The intervention also engaged governmental support in the provision of universal precaution supplies to all participating hospitals in the trial. The frequency of message diffusion and reception, perceived improvement in universal precaution practices and reduction in the level of stigma in hospitals were measured at 6- and 12-month follow-up assessments. Results Within the intervention hospitals, POL providers reported more frequent discussions with their co-workers regarding universal precaution principles, equal treatment of patients, provider-patient relationships and reducing HIV-related stigma. Service providers in the intervention hospitals reported more desirable intervention outcomes than providers in the control hospitals. Our evaluation revealed that the POL model is compatible with the target population, and that the unique intervention entry point of enhancing universal precaution and occupational safety was the key to improved acceptance by service providers. The involvement of health authorities in supporting occupational safety was an important element for sustainability. Conclusions This report focuses on explaining the elements of our intervention rather than its outcomes. Lessons learned from the intervention implementation will enrich the development of future programs that integrate this or other intervention models into routine medical practice, with the aim of reducing HIV-related stigma and improving HIV testing, treatment and care in medical settings. PMID:24242261

Organizational Learning, Strategic Flexibility and Business Model Innovation: An Empirical Research Based on Logistics Enterprises

NASA Astrophysics Data System (ADS)

Bao, Yaodong; Cheng, Lin; Zhang, Jian

Using the data of 237 Jiangsu logistics firms, this paper empirically studies the relationship among organizational learning capability, business model innovation, strategic flexibility. The results show as follows; organizational learning capability has positive impacts on business model innovation performance; strategic flexibility plays mediating roles on the relationship between organizational learning capability and business model innovation; interaction among strategic flexibility, explorative learning and exploitative learning play significant roles in radical business model innovation and incremental business model innovation.

Reducing Stress Among Mothers in Drug Treatment: A Description of a Mindfulness Based Parenting Intervention.

PubMed

Short, Vanessa L; Gannon, Meghan; Weingarten, Wendy; Kaltenbach, Karol; LaNoue, Marianna; Abatemarco, Diane J

2017-06-01

Background Parenting women with substance use disorder could potentially benefit from interventions designed to decrease stress and improve overall psychosocial health. In this study we assessed whether a mindfulness based parenting (MBP) intervention could be successful in decreasing general and parenting stress in a population of women who are in treatment for substance use disorder and who have infants or young children. Methods MBP participants (N = 59) attended a two-hour session once a week for 12 weeks. Within-group differences on stress outcome measures administered prior to the beginning of the MBP intervention and following the intervention period were investigated using mixed-effects linear regression models accounting for correlations arising from the repeated-measures. Scales assessed for pre-post change included the Perceived Stress Scale-10 (PSS) and the Parenting Stress Index-Short Form (PSI). Results General stress, as measured by the PSS, decreased significantly from baseline to post-intervention. Women with the highest baseline general stress level experienced the greatest change in total stress score. A significant change also occurred across the Parental Distress PSI subscale. Conclusions Findings from this innovative interventional study suggest that the addition of MBP within treatment programs for parenting women with substance use disorder is an effective strategy for reducing stress within this at risk population.

Research on the Mode of Technology Innovation Alliance of the New Material Industry in Hunan Province

NASA Astrophysics Data System (ADS)

Wang, Fan

2018-03-01

One of the main directions of technology development in the 21st century is the development and application of new materials, and the key to the development of the new material industry lies in the industrial technology innovation. The gross scale of the new material industry in Hunan Province ranks the first array in China. Based on the present situation of Hunan’s new material industry, three modes of technology innovation alliance are put forward in this paper, namely the government-driven mode, the research-driven and the market-oriented mode. The government-driven mode is applicable to the major technology innovation fields with uncertain market prospect, high risk of innovation and government’s direct or indirect intervention;the research-driven mode is applicable to the key technology innovation fields with a high technology content; and the market-oriented mode is applicable to the general innovation fields in which enterprises have demands for technology innovation but such innovation must be achieved via cooperative research and development.

Culturally relevant model program to prevent and reduce agricultural injuries.

PubMed

Helitzer, D L; Hathorn, G; Benally, J; Ortega, C

2014-07-01

Limited research has explored pesticide injury prevention among American Indian farmers. In a five-year agricultural intervention, a university-community partnership, including the University of New Mexico School of Medicine, New Mexico State University, Shiprock Area Cooperative Extension Service, and Navajo Nation communities, used a culturally relevant model to introduce and maintain safe use of integrated pest management techniques. We applied the Diffusion of Innovations theory and community-based approaches to tailor health promotion strategies for our intervention. In a longitudinal study with repeated measures, we trained six "model farmers" to be crop management experts in pesticide safety, application, and control. Subsequently, these model farmers worked with 120 farm families randomized into two groups: intervention (Group 1) and delayed intervention (Group 2). Measurements included a walk-through analysis, test of knowledge and attitudes, and yield analysis. Both groups demonstrated improvements in pesticide storage behaviors after training. Test scores regarding safety practices improved significantly: from 57.3 to 72.4 for Group 1 and from 52.6 to 76.3 for Group 2. Group 1 maintained their knowledge and safety practices after the intervention. Attitudes about pesticides and communication of viewpoints changed across the study years. With pesticides and fertilizer, the number of corn ears increased by 56.3% and yield (kg m(-2)) of alfalfa increased by 41.2%. The study combined traditional farming practices with culturally relevant approaches and behavior change theory to affect knowledge, safety practices, attitudes, communication channels, and crop yield. Storage behaviors, use of pesticides and safety and application equipment, and safety practice knowledge changed significantly, as did attitudes about social networking, social support, and the compatibility and relative advantage of pesticides for farms.

Innovative techniques for evaluating behavioral nutrition interventions

USDA-ARS?s Scientific Manuscript database

Assessing outcomes and impact from behavioral nutrition interventions in the community has remained challenging for a variety of reasons. One main reason is the lack of methods available beyond traditional nutrition assessment tools and techniques. With current global obesity and related chronic dis...

Advancing research in regeneration and repair of the motor circuitry: non-human primate models and imaging scales as the missing links for successfully translating injectable therapeutics to the clinic.

PubMed

Tsintou, Magdalini; Dalamagkas, Kyriakos; Makris, Nikos

2016-01-01

Regeneration and repair is the ultimate goal of therapeutics in trauma of the central nervous system (CNS). Stroke and spinal cord injury (SCI) are two highly prevalent CNS disorders that remain incurable, despite numerous research studies and the clinical need for effective treatments. Neural engineering is a diverse biomedical field, that addresses these diseases using new approaches. Research in the field involves principally rodent models and biologically active, biodegradable hydrogels. Promising results have been reported in preclinical studies of CNS repair, demonstrating the great potential for the development of new treatments for the brain, spinal cord and peripheral nerve injury. Several obstacles stand in the way of clinical translation of neuroregeneration research. There seems to be a key gap in the translation of research from rodent models to human applications, namely non-human primate models, which constitute a critical bridging step. Applying injectable therapeutics and multimodal neuroimaging in stroke lesions using experimental rhesus monkey models is an avenue that a few research groups have begun to embark on. Understanding and assessing the changes that the injured brain or spinal cord undergoes after an intervention with biodegradable hydrogels in non-human primates seem to represent critical preclinical research steps. Existing innovative models in non-human primates allow us to evaluate the potential of neural engineering and injectable hydrogels. The results of these preliminary studies will pave the way for translating this research into much needed clinical therapeutic approaches. Cutting edge imaging technology using Connectome scanners represents a tremendous advancement, enabling the in vivo, detailed, high-resolution evaluation of these therapeutic interventions in experimental animals. Most importantly, they also allow quantifiable and clinically meaningful correlations with humans, increasing the translatability of these innovations to the bedside.

Development, implementation, and dissemination of the I-PASS handoff curriculum: A multisite educational intervention to improve patient handoffs.

PubMed

Starmer, Amy J; O'Toole, Jennifer K; Rosenbluth, Glenn; Calaman, Sharon; Balmer, Dorene; West, Daniel C; Bale, James F; Yu, Clifton E; Noble, Elizabeth L; Tse, Lisa L; Srivastava, Rajendu; Landrigan, Christopher P; Sectish, Theodore C; Spector, Nancy D

2014-06-01

Patient handoffs are a key source of communication failures and adverse events in hospitals. Despite Accreditation Council for Graduate Medical Education requirements for residency training programs to provide formal handoff skills training and to monitor handoffs, well-established curricula and validated skills assessment tools are lacking. Developing a handoff curriculum is challenging because of the need for standardized processes and faculty development, cultural resistance to change, and diverse institution- and unit-level factors. In this article, the authors apply a logic model to describe the process they used from June 2010 to February 2014 to develop, implement, and disseminate an innovative, comprehensive handoff curriculum in pediatric residency training programs as a fundamental component of the multicenter Initiative for Innovation in Pediatric Education-Pediatric Research in Inpatient Settings Accelerating Safe Sign-outs (I-PASS) Study. They describe resources, activities, and outputs, and report preliminary learner outcomes using data from resident and faculty evaluations of the I-PASS Handoff Curriculum: 96% of residents and 97% of faculty agreed or strongly agreed that the curriculum promoted acquisition of relevant skills for patient care activities. They also share lessons learned that could be of value to others seeking to adopt a structured handoff curriculum or to develop large-scale curricular innovations that involve redesigning firmly established processes. These lessons include the importance of approaching curricular implementation as a transformational change effort, assembling a diverse team of junior and senior faculty to provide opportunities for mentoring and professional development, and linking the educational intervention with the direct measurement of patient outcomes.

Exposure, hazard, and survival analysis of diffusion on social networks.

PubMed

Wu, Jiacheng; Crawford, Forrest W; Kim, David A; Stafford, Derek; Christakis, Nicholas A

2018-04-29

Sociologists, economists, epidemiologists, and others recognize the importance of social networks in the diffusion of ideas and behaviors through human societies. To measure the flow of information on real-world networks, researchers often conduct comprehensive sociometric mapping of social links between individuals and then follow the spread of an "innovation" from reports of adoption or change in behavior over time. The innovation is introduced to a small number of individuals who may also be encouraged to spread it to their network contacts. In conjunction with the known social network, the pattern of adoptions gives researchers insight into the spread of the innovation in the population and factors associated with successful diffusion. Researchers have used widely varying statistical tools to estimate these quantities, and there is disagreement about how to analyze diffusion on fully observed networks. Here, we describe a framework for measuring features of diffusion processes on social networks using the epidemiological concepts of exposure and competing risks. Given a realization of a diffusion process on a fully observed network, we show that classical survival regression models can be adapted to estimate the rate of diffusion, and actor/edge attributes associated with successful transmission or adoption, while accounting for the topology of the social network. We illustrate these tools by applying them to a randomized network intervention trial conducted in Honduras to estimate the rate of adoption of 2 health-related interventions-multivitamins and chlorine bleach for water purification-and determine factors associated with successful social transmission. Copyright © 2018 John Wiley & Sons, Ltd.

Innovation Attributes and Adoption Decisions: Perspectives from Leaders of a National Sample of Addiction Treatment Organizations

PubMed Central

Knudsen, Hannah K.; Roman, Paul M

2014-01-01

Drawing on diffusion theory to further knowledge about evidence-based practices (EBPs) in the treatment of substance use disorders (SUDs), this study describes the perceived importance of innovation attributes in adoption decisions within a national sample of SUD treatment organizations. Face-to-face interviews were conducted with leaders of 307 organizations. A typology differentiated organizations reporting: (1) adoption of a treatment innovation in the past year (“recent adoption”), (2) plans to adopt an innovation in the upcoming year (“planned adoption”), or (3) no actual or planned adoption (“non-adoption”). About 30.7% of organizations reported recent adoption, 20.5% indicated planned adoption, and 48.8% were non-adopters. Leaders of organizations reporting recent adoption (n = 93) or planned adoption (n = 62) rated the importance of innovation attributes, including relative advantage, compatibility, complexity, and observability, on these adoption decisions using a Likert scale that ranged from 0 to 5. Innovation attributes most strongly endorsed were consistency with the program's treatment philosophy (mean = 4.47, SD = 1.03), improvement in the program's reputation with referral sources (mean = 4.00, SD = 1.33), reputational improvement with clients and their families (mean = 3.98, SD = 1.31), and reductions in treatment dropout (mean = 3.75, SD = 1.54). Innovation characteristics reflecting organizational growth and implementation costs were less strongly endorsed. Adopters and planners were generally similar in their importance ratings. There were modest differences in importance ratings when pharmacological innovations were compared to psychosocial interventions. These findings are consistent with diffusion theory and suggest that efforts to link EBPs with client satisfaction and potential reputational benefits may enhance the diffusion of EBPs. Attention to these attributes when developing and evaluating SUD treatment interventions may enhance efforts to increase subsequent adoption. PMID:25218918

Innovation attributes and adoption decisions: perspectives from leaders of a national sample of addiction treatment organizations.

PubMed

Knudsen, Hannah K; Roman, Paul M

2015-02-01

Drawing on diffusion theory to further knowledge about evidence-based practices (EBPs) in the treatment of substance use disorders (SUDs), this study describes the perceived importance of innovation attributes in adoption decisions within a national sample of SUD treatment organizations. Face-to-face interviews were conducted with leaders of 307 organizations. A typology differentiated organizations reporting: (1) adoption of a treatment innovation in the past year ("recent adoption"), (2) plans to adopt an innovation in the upcoming year ("planned adoption"), or (3) no actual or planned adoption ("non-adoption"). About 30.7% of organizations reported recent adoption, 20.5% indicated planned adoption, and 48.8% were non-adopters. Leaders of organizations reporting recent adoption (n=93) or planned adoption (n=62) rated the importance of innovation attributes, including relative advantage, compatibility, complexity, and observability, on these adoption decisions using a Likert scale that ranged from 0 to 5. Innovation attributes most strongly endorsed were consistency with the program's treatment philosophy (mean=4.47, SD=1.03), improvement in the program's reputation with referral sources (mean=4.00, SD=1.33), reputational improvement with clients and their families (mean=3.98, SD=1.31), and reductions in treatment dropout (mean=3.75, SD=1.54). Innovation characteristics reflecting organizational growth and implementation costs were less strongly endorsed. Adopters and planners were generally similar in their importance ratings. There were modest differences in importance ratings when pharmacological innovations were compared to psychosocial interventions. These findings are consistent with diffusion theory and suggest that efforts to link EBPs with client satisfaction and potential reputational benefits may enhance the diffusion of EBPs. Attention to these attributes when developing and evaluating SUD treatment interventions may enhance efforts to increase subsequent adoption. Copyright © 2015 Elsevier Inc. All rights reserved.

Muscle mass and physical recovery in ICU: innovations for targeting of nutrition and exercise.

PubMed

Wischmeyer, Paul E; Puthucheary, Zudin; San Millán, Iñigo; Butz, Daniel; Grocott, Michael P W

2017-08-01

We have significantly improved hospital mortality from sepsis and critical illness in last 10 years; however, over this same period we have tripled the number of 'ICU survivors' going to rehabilitation. Furthermore, as up to half the deaths in the first year following ICU admission occur post-ICU discharge, it is unclear how many of these patients ever returned home or a meaningful quality of life. For those who do survive, recent data reveals many 'ICU survivors' will suffer significant functional impairment or post-ICU syndrome (PICS). Thus, new innovative metabolic and exercise interventions to address PICS are urgently needed. These should focus on optimal nutrition and lean body mass (LBM) assessment, targeted nutrition delivery, anabolic/anticatabolic strategies, and utilization of personalized exercise intervention techniques, such as utilized by elite athletes to optimize preparation and recovery from critical care. New data for novel LBM analysis technique such as computerized tomography scan and ultrasound analysis of LBM are available showing objective measures of LBM now becoming more practical for predicting metabolic reserve and effectiveness of nutrition/exercise interventions. 13C-Breath testing is a novel technique under study to predict infection earlier and predict over-feeding and under-feeding to target nutrition delivery. New technologies utilized routinely by athletes such as muscle glycogen ultrasound also show promise. Finally, the role of personalized cardiopulmonary exercise testing to target preoperative exercise optimization and post-ICU recovery are becoming reality. New innovative techniques are demonstrating promise to target recovery from PICS utilizing a combination of objective LBM and metabolic assessment, targeted nutrition interventions, personalized exercise interventions for prehabilitation and post-ICU recovery. These interventions should provide hope that we will soon begin to create more 'survivors' and fewer victim's post-ICU care.

The Development and Implementation of a Peer-Led Intervention to Prevent Smoking among Secondary School Students Using Their Established Social Networks

ERIC Educational Resources Information Center

Audrey, Suzanne; Cordall, Kathleen; Moore, Laurence; Cohen, David; Campbell, Rona

2004-01-01

Objective: To design, implement and evaluate a peer-led intervention to reduce smoking amongst secondary school students. Design: A health promotion intervention combining peer education with diffusion of innovation theory, to be rigorously evaluated by means of a cluster randomised controlled trial with concurrent process and economic…

Who Am I? A Life Story Intervention for Persons with Intellectual Disability and Psychiatric Problems

ERIC Educational Resources Information Center

Westerhof, Gerben J.; Beernink, Janny; Sools, Anneke

2016-01-01

This article describes an innovative intervention based on narrative and life review therapy that is tailored to people with intellectual disability (ID) and psychiatric problems. The current study provides a first evaluation of the intervention. A symptom checklist (SCL-90) was used in a pre- and post-follow-up design, and a qualitative…

Innovative approach to patient-centered care coordination in primary care practices.

PubMed

Clarke, Robin; Bharmal, Nazleen; Di Capua, Paul; Tseng, Chi-Hong; Mangione, Carol M; Mittman, Brian; Skootsky, Samuel A

2015-09-01

Although care coordination is an essential component of the patient-centered medical home structure, current case manager models have limited usefulness to population health because they typically serve a small group of patients defined based on disease or utilization. Our objective was to support our health system's population health by implementing and evaluating a program that embedded nonlicensed coordinators within our primary care practices to support physicians in executing care plans and communicating with patients. Matched case-control differences-in-differences. Comprehensive care coordinators (CCC) were introduced into 14 of the system's 28 practice sites in 2 waves. After a structured training program, CCCs identified, engaged, and intervened among patients within the practice in conjunction with practice primary care providers. We counted and broadly coded CCC activities that were documented in the intervention database. We examined the impact of CCC intervention on emergency department (ED) utilization at the practice level using a negative binomial multivariate regression model controlling for age, gender, and medical complexity. CCCs touched 10,500 unique patients over a 1-year period. CCC interventions included execution of care (38%), coordination of transitions (32%), self-management support/link to community resources (15%), monitor and follow-up (10%), and patient assessment (1%). The CCC intervention group had a 20% greater reduction in its prepost ED visit rate compared with the control group (P < .0001). Our CCC intervention demonstrated a significant reduction in ED visits by focusing on the centrality of the primary care provider and practice. Our model may serve as a cost-effective and scalable alternative for care coordination in primary care.

Mapping new theoretical and methodological terrain for knowledge translation: contributions from critical realism and the arts

PubMed Central

Kontos, Pia C; Poland, Blake D

2009-01-01

Background Clinical practice guidelines have been a popular tool for the improvement of health care through the implementation of evidence from systematic research. Yet, it is increasingly clear that knowledge alone is insufficient to change practice. The social, cultural, and material contexts within which practice occurs may invite or reject innovation, complement or inhibit the activities required for success, and sustain or alter adherence to entrenched practices. However, knowledge translation (KT) models are limited in providing insight about how and why contextual contingencies interact, the causal mechanisms linking structural aspects of context and individual agency, and how these mechanisms influence KT. Another limitation of KT models is the neglect of methods to engage potential adopters of the innovation in critical reflection about aspects of context that influence practice, the relevance and meaning of innovation in the context of practice, and the identification of strategies for bringing about meaningful change. Discussion This paper presents a KT model, the Critical Realism and the Arts Research Utilization Model (CRARUM), that combines critical realism and arts-based methodologies. Critical realism facilitates understanding of clinical settings by providing insight into the interrelationship between its structures and potentials, and individual action. The arts nurture empathy, and can foster reflection on the ways in which contextual factors influence and shape clinical practice, and how they may facilitate or impede change. The combination of critical realism and the arts within the CRARUM model promotes the successful embedding of interventions, and greater impact and sustainability. Conclusion CRARUM has the potential to strengthen the science of implementation research by addressing the complexities of practice settings, and engaging potential adopters to critically reflect on existing and proposed practices and strategies for sustaining change. PMID:19123945

Early interventions and lessons from Harvard Business Review.

PubMed

Chong, Siow-Ann

2007-11-01

To describe the establishment and development of an Early Psychosis Intervention Programme in Singapore that is based on a business model and with concepts drawn from the corporate world. The author who directed this programme describes the circumstances that led to this initiative, the ideas borrowed and adapted from the corporate world, and the lessons learnt in setting up this intervention programme. The modus operandi of the programme is based on the Balanced Scorecard - a model which stresses four equally important components: customers, internal processes, financial health and learning and innovation. Other complementary actions like creating a sense of urgency, forging a vision with a core ideology, empowerment of team members, creating short-term wins, anchoring the changes and finding meaning in the work are vital for the programme to thrive. This model also emphasizes the importance of accountability through the measurability of indicators. These indicators included a significant reduction in the duration of untreated psychosis, a positive change in the referral patterns with better engagement of the primary health-care sector and an improvement in the quality of care for the patients. Much can be learnt from the business world in building and maintaining a public mental health programme. Effective change also requires effective leadership, and the successful implementation of certain strategic steps.

The chronic care model and technological research and innovation: a scoping review at the crossroads.

PubMed

Gammon, Deede; Berntsen, Gro Karine Rosvold; Koricho, Absera Teshome; Sygna, Karin; Ruland, Cornelia

2015-02-06

Information and communication technologies (ICT) are key to optimizing the outcomes of the Chronic Care Model (CCM), currently acknowledged as the best synthesis of available evidence for chronic illness prevention and management. At the same time, CCM can offer a needed framework for increasing the relevance and feasibility of ICT innovation and research in health care. Little is known about how and to what extent CCM and ICT research inform each other to leverage mutual strengths. The current study examines: What characterizes work being done at the crossroads of CCM and ICT research and innovation? Our aim is identify the gaps and potential that lie between the research domains CCM and ICT, thus enabling more substantive questions and opportunities for accelerating improvements in ICT-supported chronic care. Using a scoping study approach, we developed a search strategy applied to medical and technical databases resulting in 1054 titles and abstracts that address CCM and ICT. After iteratively adapting our inclusion/exclusion criteria to balance between breadth and feasibility, 26 publications from 20 studies were found to fulfill our criteria. Following initial coding of each article according to predefined categories (eg, type of article, CCM component, ICT, health issue), a 1st level analysis was conducted resulting in a broad range of categories. These were gradually reduced by constantly comparing them for underlying commonalities and discrepancies. None of the studies included were from technical databases and interventions relied mostly on "old-fashioned" technologies. Technologies supporting "productive interactions" were often one-way (provider to patient), and it was sometimes difficult to decipher how CCM was guiding intervention design. In particular, the major focus on ICT to support providers did not appear unique to the challenges of chronic care. Challenges in facilitating CCM components through ICT included poorly designed user interfaces, digital divide issues, and lack of integration with existing infrastructure. The CCM is a highly influential guide for health care development, which recognizes the need for alignment of system tools such as ICT. Yet, there seem to be alarmingly few touch points between the subject fields of "health service development" and "ICT-innovation". Bridging these gaps needs explicit and urgent attention as the synergies between these domains have enormous potential. Policy makers and funding agencies need to facilitate the joining of forces between high-tech innovative expertise and experts in the chronic care system redesign that is required for tackling the current epidemic of long-term multiple conditions.

The Integrated Care Team Approach of the Department of Veterans Affairs (VA): Geriatric Primary Care.

PubMed

Rasin-Waters, Donna; Abel, Valerie; Kearney, Lisa K; Zeiss, Antonette

2018-05-01

Historically, integrated mental and behavioral healthcare in the Department of Veterans Affairs (VA) commenced with initiatives in geriatrics. Innovation and system-wide expansion has occurred over decades and culminated in a unified vision for training and practice in the VA medical home model: Patient Aligned Care Team or PACT approach. In one VA hospital, the integration of neuropsychological services in geriatric primary care is pivotal and increases access for patients, as well as contributing to timely and effective care on an interprofessional team. The development and innovative use of an algorithm to identify problems with cognition, health literacy, and mental and behavioral health has been pragmatic and provides useful information for collaborative treatment planning in GeriPACT, VA geriatric primary care. Use of the algorithm also assists with decision-making regarding brief versus comprehensive neuropsychological assessment in the primary care setting. The model presented here was developed by supervising neuropsychologists as part of a postdoctoral residency program in geropsychology. However, postdoctoral residency programs in neuropsychology, as well as neuropsychological clinics, can also use this model to integrate neuropsychological assessment and interventions in geriatric primary care settings.

An Interprofessional Collaborative Practice model for preparation of clinical educators.

PubMed

Scarvell, Jennie M; Stone, Judy

2010-07-01

Work-integrated learning is essential to health professional education, but faces increasing academic and industry resource pressures. The aim of this pilot "Professional Practice Project" was to develop and implement an innovative education intervention for clinical educators across several health disciplines. The project used interprofessional collaboration as its underlying philosophy, and a participatory action research methodology in four cycles: Cycle 1: Formation of an interprofessional project executive and working party from academic staff. Data collection of student insights into work integrated learning. Cycle 2: Formation of an interprofessional reference group to inform curriculum development for a series of clinical education workshops. Cycle 3: Delivery of workshops; 174 clinical educators, supervisors and preceptors attended two workshops: "Introduction to experiential learning" and " utilizing available resources for learning". Cycle 4: Seminar discussion of the Professional Practice Project at a national health-education conference. This pilot project demonstrated the advantages of using collaborative synergies to allow innovation around clinical education, free from the constraints of traditional discipline-specific education models. The planning, delivery and evaluation of clinical education workshops describe the benefits of interprofessional collaboration through enhanced creative thinking, sharing of clinical education models and a broadening of experience for both learners and facilitators.

Position of the American Dietetic Association: individual-, family-, school-, and community-based interventions for pediatric overweight.

PubMed

2006-06-01

The American Dietetic Association (ADA), recognizing that overweight is a significant problem for children and adolescents in the United States, takes the position that pediatric overweight intervention requires a combination of family-based and school-based multi-component programs that include the promotion of physical activity, parent training/modeling, behavioral counseling, and nutrition education. Furthermore, although not yet evidence-based, community-based and environmental interventions are recommended as among the most feasible ways to support healthful lifestyles for the greatest numbers of children and their families. ADA supports the commitment of resources for programs, policy development, and research for the efficacious promotion of healthful eating habits and increased physical activity in all children and adolescents, regardless of weight status. This is the first position paper of ADA to be based on a rigorous systematic evidence-based analysis of the pediatric overweight literature on intervention programs. The research showed positive effects of two specific kinds of overweight interventions: a) multicomponent, family-based programs for children between the ages of 5 and 12 years, and b) multicomponent, school-based programs for adolescents. Multicomponent programs include behavioral counseling, promotion of physical activity, parent training/modeling, dietary counseling, and nutrition education. Analysis of the literature to date points to the need for further investigation of promising strategies not yet adequately evaluated. Furthermore, this review highlights the need for research to develop effective and innovative overweight prevention programs for various sectors of the population, including those of varying ethnicities, young children, and adolescents. To support and enhance the efficacy of family- and school-based weight interventions, community-wide interventions should be undertaken; few such interventions have been conducted and even fewer evaluated.

Interventional Oncology in Hepatocellular Carcinoma: Progress Through Innovation.

PubMed

Mu, Lin; Chapiro, Julius; Stringam, Jeremiah; Geschwind, Jean-François

The clinical management of hepatocellular carcinoma has evolved greatly in the last decade mostly through recent technical innovations. In particular, the application of cutting-edge image guidance has led to minimally invasive solutions for complex clinical problems and rapid advances in the field of interventional oncology. Many image-guided therapies, such as transarterial chemoembolization and radiofrequency ablation, have meanwhile been fully integrated into interdisciplinary clinical practice, whereas others are currently being investigated. This review summarizes and evaluates the most relevant completed and ongoing clinical trials, provides a synopsis of recent innovations in the field of intraprocedural imaging and tumor response assessment, and offers an outlook on new technologies, such as radiopaque embolic materials. In addition, combination therapies consisting of locoregional therapies and systemic molecular targeted agents (e.g., sorafenib) remain of major interest to the field and are also discussed. Finally, we address the many substantial advances in immune response pathways that have been related to the systemic effects of locoregional therapies. Knowledge of these new developments is crucial as they continue to shape the future of cancer treatment, further establishing interventional oncology along with surgical, medical, and radiation oncology as the fourth pillar of cancer care.

Ways of Knowing: Integrating Research Into CAM Education and Holism Into Conventional Health Professional Education

PubMed Central

Jo Kreitzer, Mary; Sierpina, Victor; Maiers, Michele; Delagran, Louise; Baldwin, Lori; Evans, Roni; Chase, Michele

2012-01-01

Content on integrative healthcare and complementary and alternative medicine is being taught in hundreds of educational programs across the country. Nursing, medical, osteopathic, chiropractic, acupuncture, naturopathic,andotherprogramsarefindingcreative and innovative ways to include these approaches in new models of education and practice. This column spotlights such innovations in integrative healthcare and CAM education and presents readers with specific educational interventions they can adapt into new or ongoing educational efforts at their institution or programs. We invite readers to submit brief descriptions of efforts in their institutions that reflect the creativity, diversity, and interdisciplinary nature of the field. Please submit to Dr Sierpina at vssierpi@utmb.edu or Dr Kreitzer at kreit003@umn.edu. Submissions should be no more than 500 to 1500 words. Please include any Web site or other resource that is relevant, as well as contact information. PMID:18602624

Transformational learning: an immersion course on the big island of Hawaii.

PubMed

Kreitzer, Mary Jo; Sierpina, Victor S; Traub, Michael; Riff, Ken

2008-01-01

Content on integrative healthcare and complementary and alternative medicine is being taught in hundreds of educational programs across the country. Nursing, medical, osteopathic, chiropractic, acupuncture, naturopathic, and other programs are finding creative and innovative ways to include these approaches in new models of education and practice. This column spotlights such innovations in integrative healthcare and CAM education and presents readers with specific educational interventions they can adapt into new or ongoing educational efforts at their institution or programs. We invite readers to submit brief descriptions of efforts in their institutions that reflect the creativity, diversity, and interdisciplinary nature of the field. Please submit to Dr Sierpina at vssierpi@utmb.edu or Dr Kreitzer at kreit003@umn.edu. Submissions should be no more than 500 to 1,500 words. Please include any Web site or other resource that is relevant, as well as contact information.

Advances in Degradable Embolic Microspheres: A State of the Art Review

PubMed Central

Doucet, Jensen; Kiri, Lauren; O’Connell, Kathleen; Kehoe, Sharon; Lewandowski, Robert J.; Liu, David M.; Abraham, Robert J.; Boyd, Daniel

2018-01-01

Considerable efforts have been placed on the development of degradable microspheres for use in transarterial embolization indications. Using the guidance of the U.S. Food and Drug Administration (FDA) special controls document for the preclinical evaluation of vascular embolization devices, this review consolidates all relevant data pertaining to novel degradable microsphere technologies for bland embolization into a single reference. This review emphasizes intended use, chemical composition, degradative mechanisms, and pre-clinical safety, efficacy, and performance, while summarizing the key advantages and disadvantages for each degradable technology that is currently under development for transarterial embolization. This review is intended to provide an inclusive reference for clinicians that may facilitate an understanding of clinical and technical concepts related to this field of interventional radiology. For materials scientists, this review highlights innovative devices and current evaluation methodologies (i.e., preclinical models), and is designed to be instructive in the development of innovative/new technologies and evaluation methodologies. PMID:29373510

Navigating complex patients using an innovative tool: the MTM Spider Web.

PubMed

Morello, Candis M; Hirsch, Jan D; Lee, Kelly C

2013-01-01

To introduce a teaching tool that can be used to assess the complexity of medication therapy management (MTM) patients, prioritize appropriate interventions, and design patient-centered care plans for each encounter. MTM patients are complex as a result of multiple comorbidities, medications, and socioeconomic and behavioral issues. Pharmacists who provide MTM services are required to synthesize a plethora of information (medical and nonmedical), evaluate and prioritize the clinical problems, and design a comprehensive patient-centered care plan. The MTM Spider Web is a visual tool to facilitate this process. A description is provided regarding how to build the MTM Spider Web using case-based scenarios. This model can be used to teach pharmacists, health professional students, and patients. The MTM Spider Web is an innovative teaching tool that can be used to teach pharmacists and students how to assess complex patients and design a patient-centered care plan to deliver the most appropriate medication therapy.

Capturing multi-stage fuzzy uncertainties in hybrid system dynamics and agent-based models for enhancing policy implementation in health systems research.

PubMed

Liu, Shiyong; Triantis, Konstantinos P; Zhao, Li; Wang, Youfa

2018-01-01

In practical research, it was found that most people made health-related decisions not based on numerical data but on perceptions. Examples include the perceptions and their corresponding linguistic values of health risks such as, smoking, syringe sharing, eating energy-dense food, drinking sugar-sweetened beverages etc. For the sake of understanding the mechanisms that affect the implementations of health-related interventions, we employ fuzzy variables to quantify linguistic variable in healthcare modeling where we employ an integrated system dynamics and agent-based model. In a nonlinear causal-driven simulation environment driven by feedback loops, we mathematically demonstrate how interventions at an aggregate level affect the dynamics of linguistic variables that are captured by fuzzy agents and how interactions among fuzzy agents, at the same time, affect the formation of different clusters(groups) that are targeted by specific interventions. In this paper, we provide an innovative framework to capture multi-stage fuzzy uncertainties manifested among interacting heterogeneous agents (individuals) and intervention decisions that affect homogeneous agents (groups of individuals) in a hybrid model that combines an agent-based simulation model (ABM) and a system dynamics models (SDM). Having built the platform to incorporate high-dimension data in a hybrid ABM/SDM model, this paper demonstrates how one can obtain the state variable behaviors in the SDM and the corresponding values of linguistic variables in the ABM. This research provides a way to incorporate high-dimension data in a hybrid ABM/SDM model. This research not only enriches the application of fuzzy set theory by capturing the dynamics of variables associated with interacting fuzzy agents that lead to aggregate behaviors but also informs implementation research by enabling the incorporation of linguistic variables at both individual and institutional levels, which makes unstructured linguistic data meaningful and quantifiable in a simulation environment. This research can help practitioners and decision makers to gain better understanding on the dynamics and complexities of precision intervention in healthcare. It can aid the improvement of the optimal allocation of resources for targeted group (s) and the achievement of maximum utility. As this technology becomes more mature, one can design policy flight simulators by which policy/intervention designers can test a variety of assumptions when they evaluate different alternatives interventions.

Rationale and design of a randomized trial of automated hovering for post-myocardial infarction patients: The HeartStrong program.

PubMed

Troxel, Andrea B; Asch, David A; Mehta, Shivan J; Norton, Laurie; Taylor, Devon; Calderon, Tirza A; Lim, Raymond; Zhu, Jingsan; Kolansky, Daniel M; Drachman, Brian M; Volpp, Kevin G

2016-09-01

Coronary artery disease is the single leading cause of death in the United States, and medications can significantly reduce the rate of repeat cardiovascular events and treatment procedures. Adherence to these medications, however, is very low. HeartStrong is a national randomized trial offering 3 innovations. First, the intervention is built on concepts from behavioral economics that we expect to enhance its effectiveness. Second, the implementation of the trial takes advantage of new technology, including wireless pill bottles and remote feedback, to substantially automate procedures. Third, the trial's design includes an enhancement of the standard randomized clinical trial that allows rapid-cycle innovation and ongoing program enhancement. Using a system involving direct data feeds from 6 insurance partners followed by mail, telephone, and email contact, we enrolled 1,509 patients discharged from the hospital with acute myocardial infarction in a 2:1 ratio of intervention:usual care. The intervention period lasts 1 year; the primary outcome is time to first fatal or nonfatal acute vascular event or revascularization, including acute myocardial infarction, unstable angina, stroke, acute coronary syndrome admission, or death. Our randomized controlled trial of the HeartStrong program will provide an evaluation of a state-of-the-art behavioral economic intervention with a number of important pragmatic features. These include a tailored intervention responding to patient activity, streamlining of consent and implementation processes using new technologies, outcomes centrally important to patients, and the ability to implement rapid-cycle innovation. Copyright © 2016 Elsevier Inc. All rights reserved.

Closing the Gap: Principal Perspectives on an Innovative School-Based Mental Health Intervention

ERIC Educational Resources Information Center

Blackman, Kate F.; Powers, Joelle D.; Edwards, Jeffrey D.; Wegmann, Kate M.; Lechner, Ethan; Swick, Danielle C.

2016-01-01

Mental health needs among children in the United States have significant consequences for children and their families, as well as the schools that serve them. This qualitative study evaluated the second year of an innovative school-based mental health project that created a multi-system partnership between an urban school district, a public mental…

Can Education Innovations Be Sustained after the End of Donor Funding? The Case of a Reading Intervention Programme in Zambia

ERIC Educational Resources Information Center

Kombe, Charity Lengwe Meki Kombe; Herman, Chaya

2017-01-01

This article explores the sustainability of donor-supported innovations in the education sector. Accordingly, a case study was conducted of a programme (Primary Reading Programme) implemented in Zambian primary schools which was intended to improve literacy levels. The programme was initially supported by the Department for International…

Collaborating with Digital Tools and Peers in Medical Education: Cases and Simulations as Interventions in Learning

ERIC Educational Resources Information Center

Helle, Laura; Saljo, Roger

2012-01-01

Medical education has pioneered educational innovation in higher education as exemplified by the problem-based learning (PBL) movement. A multitude of reviews and meta-analyses indicate that the PBL movement has been successful in many ways. Innovations in medical education, however, are not limited to curricular reform and interactive…

Applying Diffusion of Innovation Theory to Intervention Development

ERIC Educational Resources Information Center

Dearing, James W.

2009-01-01

Few social science theories have a history of conceptual and empirical study as long as does the diffusion of innovations. The robustness of this theory derives from the many disciplines and fields of study in which diffusion has been studied, from the international richness of these studies, and from the variety of new ideas, practices, programs,…

From Innovation to Impact at Scale: Lessons Learned from a Cluster of Research-Community Partnerships

ERIC Educational Resources Information Center

Schindler, Holly S.; Fisher, Philip A.; Shonkoff, Jack P.

2017-01-01

This article presents a description of how an interdisciplinary network of academic researchers, community-based programs, parents, and state agencies have joined together to design, test, and scale a suite of innovative intervention strategies rooted in new knowledge about the biology of adversity. Through a process of cocreation, collective…

From translational research to open technology innovation systems.

PubMed

Savory, Clive; Fortune, Joyce

2015-01-01

The purpose of this paper is to question whether the emphasis placed within translational research on a linear model of innovation provides the most effective model for managing health technology innovation. Several alternative perspectives are presented that have potential to enhance the existing model of translational research. A case study is presented of innovation of a clinical decision support system. The paper concludes from the case study that an extending the triple helix model of technology transfer, to one based on a quadruple helix, present a basis for improving the performance translational research. A case study approach is used to help understand development of an innovative technology within a teaching hospital. The case is then used to develop and refine a model of the health technology innovation system. The paper concludes from the case study that existing models of translational research could be refined further through the development of a quadruple helix model of heath technology innovation that encompasses greater emphasis on user-led and open innovation perspectives. The paper presents several implications for future research based on the need to enhance the model of health technology innovation used to guide policy and practice. The quadruple helix model of innovation that is proposed can potentially guide alterations to the existing model of translational research in the healthcare sector. Several suggestions are made for how innovation activity can be better supported at both a policy and operational level. This paper presents a synthesis of the innovation literature applied to a theoretically important case of open innovation in the UK National Health Service. It draws in perspectives from other industrial sectors and applies them specifically to the management and organisation of innovation activities around health technology and the services in which they are embedded.

Care delivery for Filipino Americans using the Neuman systems model.

PubMed

Angosta, Alona D; Ceria-Ulep, Clementina D; Tse, Alice M

2014-04-01

Filipino Americans are at risk of coronary heart disease due to the presence of multiple cardiometabolic factors. Selecting a framework that addresses the factors leading to coronary heart disease is vital when providing care for this population. The Neuman systems model is a comprehensive and wholistic framework that offers an innovative method of viewing clients, their families, and the healthcare system across multiple dimensions. Using the Neuman systems model, advanced practice nurses can develop and implement interventions that will help reduce the potential cardiovascular problems of clients with multiple risk factors. The authors in this article provides insight into the cardiovascular health of Filipino Americans and has implications for nurses and other healthcare providers working with various Southeast Asian groups in the United States.

Disruptive innovation in health care delivery: a framework for business-model innovation.

PubMed

Hwang, Jason; Christensen, Clayton M

2008-01-01

Disruptive innovation has brought affordability and convenience to customers in a variety of industries. However, health care remains expensive and inaccessible to many because of the lack of business-model innovation. This paper explains the theory of disruptive innovation and describes how disruptive technologies must be matched with innovative business models. The authors present a framework for categorizing and developing business models in health care, followed by a discussion of some of the reasons why disruptive innovation in health care delivery has been slow.

Circular instead of hierarchical: methodological principles for the evaluation of complex interventions

PubMed Central

Walach, Harald; Falkenberg, Torkel; Fønnebø, Vinjar; Lewith, George; Jonas, Wayne B

2006-01-01

Background The reasoning behind evaluating medical interventions is that a hierarchy of methods exists which successively produce improved and therefore more rigorous evidence based medicine upon which to make clinical decisions. At the foundation of this hierarchy are case studies, retrospective and prospective case series, followed by cohort studies with historical and concomitant non-randomized controls. Open-label randomized controlled studies (RCTs), and finally blinded, placebo-controlled RCTs, which offer most internal validity are considered the most reliable evidence. Rigorous RCTs remove bias. Evidence from RCTs forms the basis of meta-analyses and systematic reviews. This hierarchy, founded on a pharmacological model of therapy, is generalized to other interventions which may be complex and non-pharmacological (healing, acupuncture and surgery). Discussion The hierarchical model is valid for limited questions of efficacy, for instance for regulatory purposes and newly devised products and pharmacological preparations. It is inadequate for the evaluation of complex interventions such as physiotherapy, surgery and complementary and alternative medicine (CAM). This has to do with the essential tension between internal validity (rigor and the removal of bias) and external validity (generalizability). Summary Instead of an Evidence Hierarchy, we propose a Circular Model. This would imply a multiplicity of methods, using different designs, counterbalancing their individual strengths and weaknesses to arrive at pragmatic but equally rigorous evidence which would provide significant assistance in clinical and health systems innovation. Such evidence would better inform national health care technology assessment agencies and promote evidence based health reform. PMID:16796762

A Contingency Management Intervention for Adolescent Marijuana Abuse and Conduct Problems.

ERIC Educational Resources Information Center

Kamon, Jody; Budney, Alan; Stanger, Catherine

2005-01-01

Objective: To describe an innovative treatment for adolescent marijuana abuse and provide initial information about its feasibility, acceptability, and potential efficacy. Method: Provided an intervention composed of (1) a clinic-administered, abstinence-based incentive program; (2) parent-directed contingency management targeting substance use…

Effectiveness of the Mississippi communities for healthy living (MCHL) nutrition intervention

USDA-ARS?s Scientific Manuscript database

The objective of our study was to determine the effectiveness of two nutrition interventions targeting women's social/civic organizations in the Lower Mississippi Delta. Diffusion of Innovation theory and the RE-AIM structured framework for program development and evaluation guided the 6-month MCHL ...

Statistical synthesis of contextual knowledge to increase the effectiveness of theory-based behaviour change interventions.

PubMed

Hanbury, Andria; Thompson, Carl; Mannion, Russell

2011-07-01

Tailored implementation strategies targeting health professionals' adoption of evidence-based recommendations are currently being developed. Research has focused on how to select an appropriate theoretical base, how to use that theoretical base to explore the local context, and how to translate theoretical constructs associated with the key factors found to influence innovation adoption into feasible and tailored implementation strategies. The reasons why an intervention is thought not to have worked are often cited as being: inappropriate choice of theoretical base; unsystematic development of the implementation strategies; and a poor evidence base to guide the process. One area of implementation research that is commonly overlooked is how to synthesize the data collected in a local context in order to identify what factors to target with the implementation strategies. This is suggested to be a critical process in the development of a theory-based intervention. The potential of multilevel modelling techniques to synthesize data collected at different hierarchical levels, for example, individual attitudes and team level variables, is discussed. Future research is needed to explore further the potential of multilevel modelling for synthesizing contextual data in implementation studies, as well as techniques for synthesizing qualitative and quantitative data.

Family economic empowerment and mental health among AIDS-affected children living in AIDS-impacted communities: evidence from a randomised evaluation in southwestern Uganda.

PubMed

Han, Chang-Keun; Ssewamala, Fred M; Wang, Julia Shu-Huah

2013-03-01

The authors examine whether an innovative family economic empowerment intervention addresses mental health functioning of AIDS-affected children in communities heavily impacted by HIV/AIDS in Uganda. A cluster randomised controlled trial consisting of two study arms, a treatment condition (n=179) and a control condition (n=118), was used to examine the impact of the family economic empowerment intervention on children's levels of hopelessness and depression. The intervention comprised matched children savings accounts, financial management workshops and mentorship. Data were collected at baseline and 12 months post-intervention. Using multivariate analysis with several socioeconomic controls, the authors find that children in the treatment condition (receiving the intervention) report significant improvement in their mental health functioning. Specifically, the intervention reduces hopelessness and depression levels. On the other hand, children in the control condition (not receiving the intervention) report no changes on both measures. The findings indicate that children with poor mental health functioning living in communities affected by HIV/AIDS may benefit from innovative family economic empowerment interventions. As measures of mental health functioning, both hopelessness and depression have long-term negative psychosocial and developmental impacts on children. These findings have implications for public health programmes intended for long-term care and support of children living in resource poor AIDS-impacted communities.

Family Economic Empowerment and Mental Health Among AIDS-Affected Children Living in AIDS-Impacted Communities: Evidence from a Randomized Evaluation in Southwestern Uganda

PubMed Central

Han, Chang-Keun; Ssewamala, Fred M.; Wang, Julia Shu-Huah

2012-01-01

OBJECTIVE We examine whether an innovative family economic empowerment intervention addresses mental health functioning of AIDS-affected children in communities heavily impacted by HIV/AIDS in Uganda. METHODS A cluster randomized controlled trial (RCT) consisting of two study arms: a treatment condition (n=179) and a control condition (n=118) was used to examine the impact of the family economic empowerment intervention on children’s levels of hopelessness and depression. The intervention comprised of matched children savings accounts, financial management workshops, and mentorship. Data were collected at baseline and 12 months post-intervention. RESULTS Using multivariate analysis with several socio-economic controls, we find that children in the treatment condition (receiving the intervention) report significant improvement in their mental health functioning. Specifically, the intervention reduces hopelessness and depression levels. On the other hand, children in the control condition (not receiving the intervention) report no changes on both measures. CONCLUSIONS The findings indicate that children with poor mental health functioning living in communities affected by HIV/AIDS may benefit from innovative family economic empowerment interventions. As measures of mental health functioning, both hopelessness and depression have long-term negative psychosocial and developmental impacts on children. These findings have implications for public health programs intended for long-term care and support of children living in resource poor, AIDS-impacted communities. PMID:23410851

Scaling Up of an Innovative Intervention to Reduce Risk of Dengue, Chikungunya, and Zika Transmission in Uruguay in the Framework of an Intersectoral Approach with and without Community Participation

PubMed Central

Basso, César; García da Rosa, Elsa; Lairihoy, Rosario; Caffera, Ruben M.; Roche, Ingrid; González, Cristina; da Rosa, Ricardo; Gularte, Alexis; Alfonso-Sierra, Eduardo; Petzold, Max; Kroeger, Axel; Sommerfeld, Johannes

2017-01-01

Abstract. To contribute to the prevention of dengue, chikungunya, and Zika, a process of scaling up an innovative intervention to reduce Aedes aegypti habitats, was carried out in the city of Salto (Uruguay) based on a transdisciplinary analysis of the eco-bio-social determinants. The intervention in one-third of the city included the distributions of plastic bags for all households to collect all discarded water containers that were recollected by the Ministry of Health and the Municipality vector control services. The results were evaluated in 20 randomly assigned clusters of 100 households each, in the intervention and control arm. The intervention resulted in a significantly larger decrease in the number of pupae per person index (as a proxy for adult vector abundance) than the corresponding decrease in the control areas (both areas decreased by winter effects). The reduction of intervention costs (“incremental costs”) in relation to routine vector control activities was 46%. Community participation increased the collaboration with the intervention program considerably (from 48% of bags handed back out of the total of bags delivered to 59% of bags handed back). Although the costs increased by 26% compared with intervention without community participation, the acceptability of actions by residents increased from 66% to 78%. PMID:28820690

Scaling Up of an Innovative Intervention to Reduce Risk of Dengue, Chikungunya, and Zika Transmission in Uruguay in the Framework of an Intersectoral Approach with and without Community Participation.

PubMed

Basso, César; García da Rosa, Elsa; Lairihoy, Rosario; Caffera, Ruben M; Roche, Ingrid; González, Cristina; da Rosa, Ricardo; Gularte, Alexis; Alfonso-Sierra, Eduardo; Petzold, Max; Kroeger, Axel; Sommerfeld, Johannes

2017-11-01

To contribute to the prevention of dengue, chikungunya, and Zika, a process of scaling up an innovative intervention to reduce Aedes aegypti habitats, was carried out in the city of Salto (Uruguay) based on a transdisciplinary analysis of the eco-bio-social determinants. The intervention in one-third of the city included the distributions of plastic bags for all households to collect all discarded water containers that were recollected by the Ministry of Health and the Municipality vector control services. The results were evaluated in 20 randomly assigned clusters of 100 households each, in the intervention and control arm. The intervention resulted in a significantly larger decrease in the number of pupae per person index (as a proxy for adult vector abundance) than the corresponding decrease in the control areas (both areas decreased by winter effects). The reduction of intervention costs ("incremental costs") in relation to routine vector control activities was 46%. Community participation increased the collaboration with the intervention program considerably (from 48% of bags handed back out of the total of bags delivered to 59% of bags handed back). Although the costs increased by 26% compared with intervention without community participation, the acceptability of actions by residents increased from 66% to 78%.

The Development of a Physician Vitality Program: A Brief Report.

PubMed

Hernandez, Barbara Couden; Thomas, Tamara L

2015-10-01

We describe the development of an innovative program to support physician vitality. We provide the context and process of program delivery which includes a number of experimental support programs. We discuss a model for intervention and methods used to enhance physician resilience, support work-life balance, and change the culture to one that explicitly addresses the physician's biopsychosocial-spiritual needs. Recommendations are given for marriage and family therapists (MFTs) who wish to develop similar support programs for healthcare providers. Video Abstract. © 2014 American Association for Marriage and Family Therapy.

From innovation to standard practice: Developing and disseminating behavioral procedures

PubMed Central

Paine, Stan C.; Bellamy, G. Thomas

1982-01-01

This paper proposes a three-stage continuum for discussing the development and dissemination of behavioral technology. At the level of behavioral techniques, researchers need only establish a functional relationship between technologically defined intervention procedures and socially significant target behaviors. Dissemination is conducted for informational purposes only, and the purposes and details surrounding subsequent use of the technique are left to the discretion of the user. At the level of behavioral demonstration, a collection of socially acceptable intervention procedures is refined and standardized and must be shown to produce behavior changes across a number of subjects. Here dissemination is conducted, in large part, to generate support for provision of services. At the level of behavioral models, procedural descriptions must be useroriented. Additionally, model effects must be obtainable by agents not associated with their development and must compare favorably with other treatment or service alternatives. The purpose of dissemination at this level is to obtain adoptions and replications of the model. Details of development and dissemination of behavioral technology at each of these three levels are discussed. PMID:22478555

Gay and bisexual men's use of the Internet: research from the 1990s through 2013.

PubMed

Grov, Christian; Breslow, Aaron S; Newcomb, Michael E; Rosenberger, Joshua G; Bauermeister, Jose A

2014-01-01

We document the historical and cultural shifts in how gay and bisexual men have used the Internet for sexuality between the 1990s and 2013-including shifting technology as well as research methods to study gay and bisexual men online. Gay and bisexual men have rapidly taken to using the Internet for sexual purposes: for health information seeking, finding sex partners, dating, cybersex, and pornography. Men have adapted to the ever-evolving technological advances that have been made in connecting users to the Internet-from logging on via dial-up modem on a desktop computer to geo-social-sexual networking via handheld devices. In kind, researchers have adapted to the Internet to study gay and bisexual men. Studies have carefully considered the ethics, feasibility, and acceptability of using the Internet to conduct research and interventions. Much of this work has been grounded in models of disease prevention, largely as a result of the ongoing HIV/AIDS epidemic. The need to reduce HIV in this population has been a driving force to develop innovative research and Internet-based intervention methodologies. The Internet, and specifically mobile technology, is an environment gay and bisexual men are using for sexual purposes. These innovative technologies represent powerful resources for researchers to study and provide outreach.

Implementation of a school-based social and emotional learning intervention: understanding diffusion processes within complex systems.

PubMed

Evans, Rhiannon; Murphy, Simon; Scourfield, Jonathan

2015-07-01

Sporadic and inconsistent implementation remains a significant challenge for social and emotional learning (SEL) interventions. This may be partly explained by the dearth of flexible, causative models that capture the multifarious determinants of implementation practices within complex systems. This paper draws upon Rogers (2003) Diffusion of Innovations Theory to explain the adoption, implementation and discontinuance of a SEL intervention. A pragmatic, formative process evaluation was conducted in alignment with phase 1 of the UK Medical Research Council's framework for Developing and Evaluating Complex Interventions. Employing case-study methodology, qualitative data were generated with four socio-economically and academically contrasting secondary schools in Wales implementing the Student Assistance Programme. Semi-structured interviews were conducted with 15 programme stakeholders. Data suggested that variation in implementation activity could be largely attributed to four key intervention reinvention points, which contributed to the transformation of the programme as it interacted with contextual features and individual needs. These reinvention points comprise the following: intervention training, which captures the process through which adopters acquire knowledge about a programme and delivery expertise; intervention assessment, which reflects adopters' evaluation of an intervention in relation to contextual needs; intervention clarification, which comprises the cascading of knowledge through an organisation in order to secure support in delivery; and intervention responsibility, which refers to the process of assigning accountability for sustainable delivery. Taken together, these points identify opportunities to predict and intervene with potential implementation problems. Further research would benefit from exploring additional reinvention activity.

"La Comunidad Habla": Using Internet Community-Based Information Interventions to Increase Empowerment and Access to Health Care of Low Income Latino/a Immigrants

ERIC Educational Resources Information Center

Ginossar, Tamar; Nelson, Sara

2010-01-01

The innovative educational communication interventions described in this paper include the use of bi-lingual, low literacy level websites and training created by low income Latina women to increase access to health care, health information, and the internet. We focus on one grassroots intervention, aimed at increasing access to health care for…

An Examination of the Promise of the NumberShire Level 1 Gaming Intervention for Improving Student Mathematics Outcomes

ERIC Educational Resources Information Center

Fien, Hank; Doabler, Christian T.; Nelson, Nancy J.; Kosty, Derek B.; Clarke, Ben; Baker, Scott K.

2016-01-01

The purpose of this study was to test the promise of the NumberShire Level 1 Gaming Intervention (NS1) to accelerate math learning for first-grade students with or at risk for math difficulties. The NS1 intervention was developed through the Institute of Education Sciences, Small Business Innovation Research Program (Gause, Fien, Baker, &…

Design of the Bottom-up Innovation project--a participatory, primary preventive, organizational level intervention on work-related stress and well-being for workers in Dutch vocational education.

PubMed

Schelvis, Roosmarijn M C; Oude Hengel, Karen M; Wiezer, Noortje M; Blatter, Birgitte M; van Genabeek, Joost A G M; Bohlmeijer, Ernst T; van der Beek, Allard J

2013-08-15

In the educational sector job demands have intensified, while job resources remained the same. A prolonged disbalance between demands and resources contributes to lowered vitality and heightened need for recovery, eventually resulting in burnout, sickness absence and retention problems. Until now stress management interventions in education focused mostly on strengthening the individual capacity to cope with stress, instead of altering the sources of stress at work at the organizational level. These interventions have been only partly effective in influencing burnout and well-being. Therefore, the "Bottom-up Innovation" project tests a two-phased participatory, primary preventive organizational level intervention (i.e. a participatory action approach) that targets and engages all workers in the primary process of schools. It is hypothesized that participating in the project results in increased occupational self-efficacy and organizational efficacy. The central research question: is an organization focused stress management intervention based on participatory action effective in reducing the need for recovery and enhancing vitality in school employees in comparison to business as usual? The study is designed as a controlled trial with mixed methods and three measurement moments: baseline (quantitative measures), six months and 18 months (quantitative and qualitative measures). At first follow-up short term effects of taking part in the needs assessment (phase 1) will be determined. At second follow-up the long term effects of taking part in the needs assessment will be determined as well as the effects of implemented tailored workplace solutions (phase 2). A process evaluation based on quantitative and qualitative data will shed light on whether, how and why the intervention (does not) work(s). "Bottom-up Innovation" is a combined effort of the educational sector, intervention providers and researchers. Results will provide insight into (1) the relation between participating in the intervention and occupational and organizational self-efficacy, (2) how an improved balance between job demands and job resources might affect need for recovery and vitality, in the short and long term, from an organizational perspective, and (3) success and fail factors for implementation of an organizational intervention. Netherlands Trial Register NTR3284.

Harmonization of clinical laboratories in Africa: a multidisciplinary approach to identify innovative and sustainable technical solutions.

PubMed

Putoto, Giovanni; Cortese, Antonella; Pecorari, Ilaria; Musi, Roberto; Nunziata, Enrico

2015-06-01

In an effective and efficient health system, laboratory medicine should play a critical role. This is not the case in Africa, where there is a lack of demand for diagnostic exams due to mistrust of health laboratory performance. Doctors with Africa CUAMM (Collegio Universitario Aspiranti Medici Missionari) is a non-profit organization, working mainly in sub-Saharan Africa (Angola, Ethiopia, Mozambique, Sierra Leone, South Sudan, Tanzania and Uganda) to help and sustain local health systems. Doctors with Africa CUAMM has advocated the need for a harmonized model for health laboratories to assess and evaluate the performance of the facilities in which they operate. In order to develop a harmonized model for African health laboratories, previous attempts at strengthening them through standardization were taken into consideration and reviewed. A survey with four Italian clinicians experienced in the field was then performed to try and understand the actual needs of health facilities. Finally a market survey was conducted to find new technologies able to update the resulting model. Comparison of actual laboratories with the developed standard - which represents the best setting any African health laboratory could aim for - allowed shortcomings in expected services to be identified and interventions subsequently prioritized. The most appropriate equipment was proposed to perform the envisaged techniques. The suitability of appliances was evaluated in consideration of recognized international recommendations, reported experiences in the field, and the availability of innovative solutions that can be performed on site in rural areas, but require minimal sample preparation and little technical expertise. The present work has developed a new, up-to-date, harmonized model for African health laboratories. The authors suggest lists of procedures to challenge the major African health problems - HIV/AIDS, malaria, tubercolosis (TB) - at each level of pyramidal health system. This model will hopefully support the non-governmental organization (NGO) Doctors with Africa CUAMM in its activities in sub-Saharan hospitals, providing them with a guideline to programme future interventions.

The Role of Effective Partnerships in an Australian Place-Based Intervention to Reduce Race-Based Discrimination

PubMed Central

Paradies, Yin; Kelaher, Margaret Anne

2013-01-01

Localities Embracing and Accepting Diversity (LEAD) is an ongoing place-based pilot program aimed at improving health outcomes among Aboriginal and migrant communities through increased social and economic participation. Specifically, LEAD works with mainstream organizations to prevent race-based discrimination from occurring. The partnership model of LEAD was designed to create a community intervention that was evidence-based, effective, and flexible enough to respond to local contexts and needs. LEAD's complex organizational and partnership model, in combination with an innovative approach to reducing race-based discrimination, has necessitated the use of new language and communication strategies to build genuinely collaborative partnerships. Allocating sufficient time to develop strategies aligned with this new way of doing business has been critical. However, preliminary data indicate that a varied set of partners has been integral to supporting the widespread influence of the emerging LEAD findings across partner networks in a number of different sectors. PMID:24179280

Collective memory in primate conflict implied by temporal scaling collapse.

PubMed

Lee, Edward D; Daniels, Bryan C; Krakauer, David C; Flack, Jessica C

2017-09-01

In biological systems, prolonged conflict is costly, whereas contained conflict permits strategic innovation and refinement. Causes of variation in conflict size and duration are not well understood. We use a well-studied primate society model system to study how conflicts grow. We find conflict duration is a 'first to fight' growth process that scales superlinearly, with the number of possible pairwise interactions. This is in contrast with a 'first to fail' process that characterizes peaceful durations. Rescaling conflict distributions reveals a universal curve, showing that the typical time scale of correlated interactions exceeds nearly all individual fights. This temporal correlation implies collective memory across pairwise interactions beyond those assumed in standard models of contagion growth or iterated evolutionary games. By accounting for memory, we make quantitative predictions for interventions that mitigate or enhance the spread of conflict. Managing conflict involves balancing the efficient use of limited resources with an intervention strategy that allows for conflict while keeping it contained and controlled. © 2017 The Author(s).

Local Spatial Analysis and Dynamic Simulation of Childhood Obesity and Neighbourhood Walkability in a Major Canadian City.

PubMed

Shahid, Rizwan; Bertazzon, Stefania

2015-01-01

Body weight is an important indicator of current and future health and it is even more critical in children, who are tomorrow's adults. This paper analyzes the relationship between childhood obesity and neighbourhood walkability in Calgary, Canada. A multivariate analytical framework recognizes that childhood obesity is also associated with many factors, including socioeconomic status, foodscapes, and environmental factors, as well as less measurable factors, such as individual preferences, that could not be included in this analysis. In contrast with more conventional global analysis, this research employs localized analysis and assesses need-based interventions. The one-size-fit-all strategy may not effectively control obesity rates, since each neighbourhood has unique characteristics that need to be addressed individually. This paper presents an innovative framework combining local analysis with simulation modeling to analyze childhood obesity. Spatial models generally do not deal with simulation over time, making it cumbersome for health planners and policy makers to effectively design and implement interventions and to quantify their impact over time. This research fills this gap by integrating geographically weighted regression (GWR), which identifies vulnerable neighbourhoods and critical factors for childhood obesity, with simulation modeling, which evaluates the impact of the suggested interventions on the targeted neighbourhoods. Neighbourhood walkability was chosen as a potential target for localized interventions, owing to the crucial role of walking in developing a healthy lifestyle, as well as because increasing walkability is relatively more feasible and less expensive then modifying other factors, such as income. Simulation results suggest that local walkability interventions can achieve measurable declines in childhood obesity rates. The results are encouraging, as improvements are likely to compound over time. The results demonstrate that the integration of GWR and simulation modeling is effective, and the proposed framework can assist in designing local interventions to control and prevent childhood obesity.

Tracking the mutual shaping of the technical and social dimensions of solar-powered mosquito trapping systems (SMoTS) for malaria control on Rusinga Island, western Kenya.

PubMed

Oria, Prisca A; Hiscox, Alexandra; Alaii, Jane; Ayugi, Margaret; Mukabana, Wolfgang Richard; Takken, Willem; Leeuwis, Cees

2014-11-18

There has been increasing effort in recent years to incorporate user needs in technology design and re-design. This project employed a bottom-up approach that engaged end users from the outset. Bottom-up approaches have the potential to bolster novel interventions and move them towards adaptive and evidence-based strategies. The present study concerns an innovative use of solar-powered mosquito trapping systems (SMoTS) to control malaria in western Kenya. Our paper highlights the co-dependence of research associated with the development of the SMoTS technology on one hand and research for enhancing the sustainable uptake of that very same intervention within the community on the other. During the pre-intervention year, we examined the design, re-design and piloting of a novel technology to generate lessons for malaria elimination on Rusinga Island. Initial ideas about many technological necessities were evaluated and re-designed following feedback from various sources, including technical and social research as well as broader interactions with the social environment. We documented the interlocking of the multiple processes and activities that took place through process observation and document reviews. We analysed the data within the conceptual framework of system innovation by identifying mutual shaping between technical and social factors. Our findings illustrate how various project stakeholders including project staff, collaborators, donor, and community members simultaneously pursued interdependent technological transformations and social interests. In the ongoing process, we observed how partial outcomes in the technological domain influenced social events at a later phase and vice versa. Looking at malaria intervention projects employing novel technologies as niches that may evolve towards system innovation, helps to reveal interrelations between the various technical and social aspects. Revealing these interrelations requires a different role for research and different perspective on innovation where innovation is more than the technical aspects. This approach therefore requires that research is designed in a way that enables obtaining feedback from both aspects.

Innovative use of influential prenatal counseling may improve breastfeeding initiation rates among WIC participants.

PubMed

Hildebrand, Deana A; McCarthy, Pam; Tipton, Debi; Merriman, Connie; Schrank, Melody; Newport, Melinda

2014-01-01

To determine whether integrating influence strategies (reciprocation, consistency, consensus, feeling liked, authority, and scarcity) throughout Chickasaw Nation Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics (1) changed participants' perception of the WIC experience and (2) affected breastfeeding initiation rates. Two-part, quasi-experimental design. Four WIC clinics. Parents and caregivers of children birth to 3 years. Behavior change intervention based on Social Cognitive Theory using Caildini's Principles of Influence. Traditional-model groups (control) received services prior to the intervention; influence-model groups (experimental) received services after initiation of the intervention. The preliminary demonstration project surveyed 2 groups to measure changes in their perceptions of the WIC environment. Secondary data analysis measured changes in breastfeeding initiation in 2 groups of postpartum women. Frequency analysis, independent sample t tests, chi-square for independence, step-wise logistic regression. The demonstration project resulted in 5 improved influence measures (P < .02), aligning with the influence principle of "feeling liked." The model had a small effect (φ = 0.10) in distinguishing breastfeeding initiation; women in the influence model were 1.5 times more likely (95% CI, 1.19-1.86; P < .05) to initiate breastfeeding compared with women in the traditional model, controlling for parity, mother's age, and race. Consistent with Social Cognitive Theory, changing the WIC environment by integrating influence principles may positively affect women's infant feeding decisions and behaviors, specifically breastfeeding initiation rates. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Guinea pig models for translation of the developmental origins of health and disease hypothesis into the clinic.

PubMed

Morrison, Janna L; Botting, Kimberley J; Darby, Jack R T; David, Anna L; Dyson, Rebecca M; Gatford, Kathryn L; Gray, Clint; Herrera, Emilio A; Hirst, Jonathan J; Kim, Bona; Kind, Karen L; Krause, Bernardo J; Matthews, Stephen G; Palliser, Hannah K; Regnault, Timothy R H; Richardson, Bryan S; Sasaki, Aya; Thompson, Loren P; Berry, Mary J

2018-04-06

Over 30 years ago Professor David Barker first proposed the theory that events in early life could explain an individual's risk of non-communicable disease in later life: the developmental origins of health and disease (DOHaD) hypothesis. During the 1990s the validity of the DOHaD hypothesis was extensively tested in a number of human populations and the mechanisms underpinning it characterised in a range of experimental animal models. Over the past decade, researchers have sought to use this mechanistic understanding of DOHaD to develop therapeutic interventions during pregnancy and early life to improve adult health. A variety of animal models have been used to develop and evaluate interventions, each with strengths and limitations. It is becoming apparent that effective translational research requires that the animal paradigm selected mirrors the tempo of human fetal growth and development as closely as possible so that the effect of a perinatal insult and/or therapeutic intervention can be fully assessed. The guinea pig is one such animal model that over the past two decades has demonstrated itself to be a very useful platform for these important reproductive studies. This review highlights similarities in the in utero development between humans and guinea pigs, the strengths and limitations of the guinea pig as an experimental model of DOHaD and the guinea pig's potential to enhance clinical therapeutic innovation to improve human health. © 2018 The Authors. The Journal of Physiology © 2018 The Physiological Society.

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana’s Community-based Health Planning and Services (CHPS)

PubMed Central

2014-01-01

Background Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. Methods This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. Results The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a broader expertise and training of the CHOs. Conclusions Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings. PMID:24690310

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS).

PubMed

Adongo, Philip Baba; Phillips, James F; Aikins, Moses; Arhin, Doris Afua; Schmitt, Margaret; Nwameme, Adanna U; Tabong, Philip Teg-Nefaah; Binka, Fred N

2014-04-01

Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a broader expertise and training of the CHOs. Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings.

Evidence for underuse of effective medical services around the world.

PubMed

Glasziou, Paul; Straus, Sharon; Brownlee, Shannon; Trevena, Lyndal; Dans, Leonila; Guyatt, Gordon; Elshaug, Adam G; Janett, Robert; Saini, Vikas

2017-07-08

Underuse-the failure to use effective and affordable medical interventions-is common and responsible for substantial suffering, disability, and loss of life worldwide. Underuse occurs at every point along the treatment continuum, from populations lacking access to health care to inadequate supply of medical resources and labour, slow or partial uptake of innovations, and patients not accessing or declining them. The extent of underuse for different interventions varies by country, and is documented in countries of high, middle, and low-income, and across different types of health-care systems, payment models, and health services. Most research into underuse has focused on measuring solutions to the problem, with considerably less attention paid to its global prevalence or its consequences for patients and populations. Although focused effort and resources can overcome specific underuse problems, comparatively little is spent on work to better understand and overcome the barriers to improved uptake of effective interventions, and methods to make them affordable. Copyright © 2017 Elsevier Ltd. All rights reserved.

PubMed Central

CICIRIELLO, E.

2016-01-01

SUMMARY Non-uniform, late, or inappropriate care of childhood with permanent hearing impairment (PHI) predisposes many children to develop communicative- behaviour problems and impaired psychosocial adjustment that can persist in adolescence and adulthood.In March 2014, the CCM (Centro Controllo Malattie or Disease Control Centre) of the Italian Ministry of Health funded a project entitled " Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children". The project involved 5 tertiary centres with UNHS programs formally approved by the Region. The main purpose of the project is to define and launch an integrated regionally-based public health model for identification, diagnosis and intervention of childhood PHI. The first phase of the project investigated the state of art and produced recommendations for positive changes in identification, diagnosis, therapy and care of childhood PHI in Italy, taking into account diagnostic and treatment innovations, family empowerment, treatment alliance and an interdisciplinary approach. Recommendations drawn from this initial phase will represent the basis for a regional system for early intervention that is validated, integrated and shared between the five regions. PMID:27054384

CHALLENGES AND INNOVATIONS IN A COMMUNITY-BASED PARTICIPATORY RANDOMIZED CONTROLLED TRIAL

PubMed Central

Goodkind, Jessica R.; Amer, Suha; Christian, Charlisa; Hess, Julia Meredith; Bybee, Deborah; Isakson, Brian; Baca, Brandon; Ndaysenga, Martin; Greene, R. Neil; Shantzek, Cece

2016-01-01

Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants’ intervention experiences, and their feasibility and acceptability. In the current mixed methods study, academic and community partners developed and implemented an RCT to test the effectiveness of a collaboratively developed community-based advocacy, learning, and social support intervention. The goals of the intervention were to address social determinants of health and build trust and connections with other mental health services in order to reduce mental health disparities among Afghan, Great Lakes Region African and Iraqi refugee adults and engage and retain refugees in trauma-focused treatment, if needed. Two cohorts completed the intervention between 2013-2015. Ninety-three adult refugees were randomly assigned to intervention or control group and completed four research interviews (pre-, mid-, post-intervention, and follow-up). Several challenges to conducting a community-based RCT emerged, including issues related to interviewer intervention to assist participants in the control group, diffusion of intervention resources throughout the small refugee communities, and staff and community concerns about the RCT design and what evidence is meaningful to demonstrate intervention effectiveness. These findings highlight important epistemological, methodological, and ethical challenges that should be considered when conducting community-based RCTs and interpreting results from them. In addition, several innovations were developed to address these challenges, which may be useful for other community-academic partnerships engaged in RCTs. PMID:27179291

Enhancing Learning Outcomes through Evaluation of Serious Gaming: A Mixed Methods Study

ERIC Educational Resources Information Center

Douglas, Kerrie Anna

2012-01-01

This study compared the change in counseling student's self-efficacy and skill related to suicide assessment and intervention through the use of a novel intervention-oriented evaluation method, evaluation focused discussion groups, in an experimental embedded mixed methods design. An innovation counselor pedagogical tool, Suicide Risk Assessment…

Innovation Diffusion: Implications for Evaluation

ERIC Educational Resources Information Center

Ashley, Shena R.

2009-01-01

Whether looking at the spread and adoption of an intervention across a community, across multiple units, or within a single unit, an understanding of diffusion theory can help evaluators uncover patterns and impacts that might otherwise be overlooked. The theory alerts evaluators to examine why uptake of an intervention appeared different in…

Parenting, Autism Spectrum Disorders and Inner Journeys

ERIC Educational Resources Information Center

Twomey, Miriam; Shevlin, Michael

2017-01-01

The importance of Early Intervention for children with Autism has been established however little attention has been given to the role of the parent and their perspective (Griffin & Shevlin, 2011). Research on Early Intervention has proliferated and innovative research on involving parents as partners has emerged (Carpenter, 2007; Hornby,…

Development of Innovative Group Work Practice Using the Intervention Research Paradigm

ERIC Educational Resources Information Center

Comer, Edna; Meier, Andrea; Galinsky, Maeda J.

2004-01-01

Rothman and Thomas' intervention research (IR) paradigm provides an alternative, developmental research method that is appropriate for practice research, especially at the early stages. It is more flexible than conventional experimental designs, capitalizes on the availability of small samples, accommodates the dynamism and variation in practice…

Sustainability of Promising Innovations, November 1, 1998-October 31, 2002. Final Report.

ERIC Educational Resources Information Center

Vadasy, Patricia

This final report discusses the activities and outcomes of a project designed to investigate the sustainability of two federally funded intervention programs by school staff. The first, Eastlake High School Inclusion Program, implemented processes and instructional interventions designed to support the full inclusion of students with disabilities…

Academic Advising as an Intervention for College Students with ADHD

ERIC Educational Resources Information Center

D'Alessio, Kathleen A.; Banerjee, Manju

2016-01-01

An innovative approach to academic advising is being proposed as an intervention for college students with attention deficit hyperactivity disorder (ADHD). This is a student-centered developmental approach that includes specific elements of coaching, such as open-ended questioning, creating a safe space for students with challenges in…

Food Safety and Intervention Technologies Research: Cold Plasma as a Nonthermal food processing technology

USDA-ARS?s Scientific Manuscript database

Contamination of meats, seafood, poultry, eggs, and fresh and fresh-cut fruits and vegetables is an ongoing concern. The Food Safety and Intervention Technologies Research Unit develops and validates innovative approaches and new technologies that control pathogenic bacteria and viruses while preser...

Food Safety and Intervention Technologies research: cold plasma as a nonthermal food processing technology

USDA-ARS?s Scientific Manuscript database

Contamination of meats, seafood, poultry, eggs, and fresh and fresh-cut fruits and vegetables is an ongoing concern. The Food Safety and Intervention Technologies Research Unit develops and validates innovative approaches and new technologies that control pathogenic bacteria and viruses while preser...

Development and Evaluation of a Computerized Engagement Intervention for IPS Supported Employment

ERIC Educational Resources Information Center

Haslett, William R.

2013-01-01

Background: Current information technology offers the promise of innovative approaches to engagement for mental health. Specific psychosocial services may also benefit from technology-based engagement interventions. Individual Placement and Support (IPS) is an evidence-based service that helps people who have a severe mental illness to gain…

Psychology as Field Experience: Impact on Attitudes Toward Social Interventions.

ERIC Educational Resources Information Center

Snellman, Lynn A.; And Others

An innovation in the teaching of undergraduate psychology courses is the implementation of a field experience that gives students the opportunity to apply newly learned skills and knowledge in a community setting. Changes in undergraduates' attitudes toward various delinquency interventions were examined as a result of participation in a…

An Analysis of Implementation Strategies in a School-Wide Vocabulary Intervention

ERIC Educational Resources Information Center

Roskos, Katheen A.; Moe, Jennifer Randazzo; Rosemary, Catherine

2017-01-01

From an improvement research perspective, this study explores strategies used to implement a school-wide vocabulary intervention into language arts instruction at an urban elementary school. Academic language time, an innovative change in the instructional delivery system, allots time and structure for deliberate teaching of cross-disciplinary…

Family-Centered Early Intervention with Infants & Toddlers: Innovative Cross-Disciplinary Approaches.

ERIC Educational Resources Information Center

Brown, Wesley, Ed.; And Others

This multi-contributor volume addresses the challenges of providing early intervention services to infants and toddlers with disabilities, within a family-centered framework. The book provides a legislative review of the key elements of eligibility, assessment, and evaluation and then examines service coordination, curricula, special intervention…

Childhood Obesity Research Demonstration (CORD): The Cross-Site Overview and Opportunities for Interventions Addressing Obesity Community-Wide

PubMed Central

Belay, Brook; Dooyema, Carrie A.; Williams, Nancy; Blanck, Heidi M.

2015-01-01

Abstract Background: This is the first of a set of articles in this issue on the Childhood Obesity Research Demonstration (CORD) project and provides an overview of the multisite approach and community-wide interventions. Innovative multisetting, multilevel approaches that integrate primary healthcare and public health interventions to improve outcomes for children with obesity need to be evaluated. The CORD project aims to improve BMI and obesity-related behaviors among underserved 2- to 12-year-old children by utilizing these approaches. Methods: The CORD consortium, structure, model terminology and key components, and common measures were solidified in year 1 of the CORD project. Demonstration sites applied the CORD model across communities in years 2 and 3. Evaluation plans for year 4 include site-specific analyses as well as cross-site impact, process, and sustainability evaluations. Results: The CORD approach resulted in commonalities and differences in participant, intervention, comparison, and outcome elements across sites. Products are to include analytic results as well as cost assessment, lessons learned, tools, and materials. Discussion: Foreseen opportunities and challenges arise from the similarities and unique aspects across sites. Communities adapted interventions to fit their local context and build on strengths, but, in turn, this flexibility makes cross-site evaluation challenging. Conclusion: The CORD project represents an evidence-based approach that integrates primary care and public health strategies and evaluates multisetting multilevel interventions, thus adding to the limited research in this field. CORD products will be disseminated to a variety of stakeholders to aid the understanding, prevention, and management of childhood obesity. PMID:25679059

Is telephone health coaching a useful population health strategy for supporting older people with multimorbidity? An evaluation of reach, effectiveness and cost-effectiveness using a 'trial within a cohort'.

PubMed

Panagioti, Maria; Reeves, David; Meacock, Rachel; Parkinson, Beth; Lovell, Karina; Hann, Mark; Howells, Kelly; Blakemore, Amy; Riste, Lisa; Coventry, Peter; Blakeman, Thomas; Sidaway, Mark; Bower, Peter

2018-05-30

Innovative ways of delivering care are needed to improve outcomes for older people with multimorbidity. Health coaching involves 'a regular series of phone calls between patient and health professional to provide support and encouragement to promote healthy behaviours'. This intervention is promising, but evidence is insufficient to support a wider role in multimorbidity care. We evaluated health coaching in older people with multimorbidity. We used the innovative 'Trials within Cohorts' design. A cohort was recruited, and a trial was conducted using a 'patient-centred' consent model. A randomly selected group within the cohort were offered the intervention and were analysed as the intervention group whether they accepted the offer or not. The intervention sought to improve the skills of patients with multimorbidity to deal with a range of long-term conditions, through health coaching, social prescribing and low-intensity support for low mood. We recruited 4377 older people, and 1306 met the eligibility criteria (two or more long-term conditions and moderate 'patient activation'). We selected 504 for health coaching, and 41% consented. More than 80% of consenters received the defined 'dose' of 4+ sessions. In an intention-to-treat analysis, those selected for health coaching did not improve on any outcome (patient activation, quality of life, depression or self-care) compared to usual care. We examined health care utilisation using hospital administrative and self-report data. Patients selected for health coaching demonstrated lower levels of emergency care use, but an increase in the use of planned services and higher overall costs, as well as a quality-adjusted life year (QALY) gain. The incremental cost per QALY was £8049, with a 70-79% probability of being cost-effective at conventional levels of willingness to pay. Health coaching did not lead to significant benefits on the primary measures of patient-reported outcome. This is likely related to relatively low levels of uptake amongst those selected for the intervention. Demonstrating effectiveness in this design is challenging, as it estimates the effect of being selected for treatment, regardless of whether treatment is adopted. We argue that the treatment effect estimated is appropriate for health coaching, a proactive model relevant to many patients in the community, not just those seeking care. International Standard Randomised Controlled Trial Number ( ISRCTN12286422 ).

An Exploratory Descriptive Study of Registered Nurse Innovation: Implications for Levels of Adoption.

PubMed

Polster, Debra; Villines, Dana

The aims of this study were to describe registered nurses' levels of personal innovativeness and registered nurses' perceived organizational innovativeness and determine the relationship between these 2 variables. There is limited research to describe the levels of innovation of nurses within a hospital. The levels of innovation can determine the likelihood of adoption of evidence-based practices at the bedside. As change agents, clinical nurse specialists can determine successful implementation strategies tailored to nurse levels of innovation. This was a descriptive study at a midwest, urban, teaching, 408-bed Magnet hospital. Surveys were completed by 217 nurses. The participants reported high personal innovativeness ((Equation is included in full-text article.)= 32.1; SD, 6.4), and the institution was perceived as innovative, with 90.3% of scores categorized as positive innovativeness. The statistically significant correlation was in the medical-surgical unit (r = -0.52, P < .01). There is no correlation between personal innovativeness and organizational innovativeness except for medical-surgical nurses (P = .03). They are likely to perceive the organization more innovative than themselves. Determining adopter characteristics can be valuable to the clinical nurse specialist by adapting strategic interventions to advance nursing practice. Exploring levels of adoption can be an innovative strategy to transform nursing at the bedside and throughout the organization.

A randomized, home-based, childhood obesity intervention delivered by patient navigators.

PubMed

Yun, Lourdes; Boles, Richard E; Haemer, Matthew A; Knierim, Shanna; Dickinson, L Miriam; Mancinas, Heather; Hambidge, Simon J; Davidson, Arthur J

2015-05-23

Although Colorado is perceived as a healthy state, in 2010, 14.1 % of children aged 2-5 were overweight and 9.1 % were obese. Despite the high prevalence of obesity in this population, evidence to support particular strategies to treat obese preschoolers is lacking. The efficacy of home-based, childhood obesity interventions to reduce a child's body mass index is inconclusive. However, this model uniquely provides an opportunity to observe and intervene with the home food and activity environment and engage the entire family in promoting changes that fit each family's unique dynamics. Eligible participants are children aged 2-5 years who attended a well-child care visit at a Denver Health Community Health Service clinic within 12 months prior to recruitment and on that visit had a body mass index (BMI) >85th percentile-for-age. Participants are randomly recruited at study inception and allocated to the intervention in one of five defined 6-month stepped wedge engagements; the delayed intervention groups serves as control groups until the start of the intervention. The program is delivered by a patient navigator at the family' home and consists of a 16-session curriculum focused on 1) parenting styles, 2) nutrition, and 3) physical activity. At each visit, a portion of curriculum is delivered to guide parents and children in selecting one goal for behavior change in each of three work areas to work on during the following week. The primary study outcome measure is change in BMI z-score from baseline to post-intervention period. This childhood obesity study, innovative for its home-based intervention venue, provides rich data characterizing barriers and facilitators to healthy behavior change within the home. The study population is innovative as it is focused on preschool-aged, Latino children from low-income families; this population has not typically been targeted in obesity management assessments. The home-based intervention is linked to clinical care through update letters and assessment of the program's impact to the child's medical providers. Informing primary care providers about a child's accomplishments and challenges, allows the clinician to support the health weight effort when seeing families during subsequent clinical visits. ClinicalTrials.gov NCT02024360 Registered December 21, 2013.

Animal-assisted interventions as innovative tools for mental health.

PubMed

Cirulli, Francesca; Borgi, Marta; Berry, Alessandra; Francia, Nadia; Alleva, Enrico

2011-01-01

There is a growing interest for the potential health benefits of human-animal interactions. Although scientific evidence on the effects is far from being consistent, companion animals are used with a large number of human subjects, ranging from children to elderly people, who benefit most from emotional support. Based on a comprehensive review of the literature, this paper examines the potential for domesticated animals, such as dogs, for providing emotional and physical opportunities to enrich the lives of many frail subjects. In particular, we focus on innovative interventions, including the potential use of dogs to improve the life of emotionally-impaired children, such as those affected by autism spectrum disorders. Overall an ever increasing research effort is needed to search for the mechanism that lie behind the human-animal bond as well as to provide standardized methodologies for a cautious and effective use of animal-assisted interventions.

Policy experimentation and innovation as a response to complexity in China's management of health reforms.

PubMed

Husain, Lewis

2017-08-03

There are increasing criticisms of dominant models for scaling up health systems in developing countries and a recognition that approaches are needed that better take into account the complexity of health interventions. Since Reform and Opening in the late 1970s, Chinese government has managed complex, rapid and intersecting reforms across many policy areas. As with reforms in other policy areas, reform of the health system has been through a process of trial and error. There is increasing understanding of the importance of policy experimentation and innovation in many of China's reforms; this article argues that these processes have been important in rebuilding China's health system. While China's current system still has many problems, progress is being made in developing a functioning system able to ensure broad population access. The article analyses Chinese thinking on policy experimentation and innovation and their use in management of complex reforms. It argues that China's management of reform allows space for policy tailoring and innovation by sub-national governments under a broad agreement over the ends of reform, and that shared understandings of policy innovation, alongside informational infrastructures for the systemic propagation and codification of useful practices, provide a framework for managing change in complex environments and under conditions of uncertainty in which 'what works' is not knowable in advance. The article situates China's use of experimentation and innovation in management of health system reform in relation to recent literature which applies complex systems thinking to global health, and concludes that there are lessons to be learnt from China's approaches to managing complexity in development of health systems for the benefit of the poor.

The Psychology School Mental Health Initiative: An Innovative Approach to the Delivery of School-Based Intervention Services

ERIC Educational Resources Information Center

Millar, Golden M.; Lean, Debra; Sweet, Susan D.; Moraes, Sabrina C.; Nelson, Victoria

2013-01-01

Evidence suggests that schools have, by default, become the primary mental health system for students in Canada. The goal of the present study was to design, implement, and evaluate the Psychology School Mental Health Initiative (PSMHI). The PSMHI is an innovative attempt to increase the capacity of school-based psychology staff to deliver…

The Need for a Light and Spectroscopy Concept Inventory for Assessing Innovations in Introductory Astronomy Survey Courses

ERIC Educational Resources Information Center

Bardar, Erin M.; Prather, Edward E.; Brecher, Kenneth; Slater, Timothy F.

2005-01-01

In this era of dramatically increased astronomy education research efforts, there is a growing need for standardized evaluation protocols and a strategy to assess both student comprehension of fundamental concepts and the success of innovative instructional interventions. Of the many topics that could be taught in an introductory astronomy course,…

Finding disturbances in on-farm biogas production.

PubMed

Antonio, Pereira-Querol Marco; Laura, Seppänen

2012-01-01

When implementing innovations, disturbances are very likely to take place. Disturbances are undesirable because they can lead to unwanted outcomes, such as economic losses and work overload to workers. However, they can be powerful opportunities for learning and re-designing innovations. Here, we will present activity theoretical tools for analyzing disturbances in a way that they could be used as learning opportunities. We illustrate the proposed tools by analyzing a disturbance that took place during the implementation of a project of biogas production. By interpreting the disturbance process with a network of activity systems, we found that on-farm disturbances were formed as ruptures, innovations and asynchronies originated in other activity systems. This finding suggests that disturbances are outcomes of the functioning of networks, rather than simple results of failure of individuals or technical devices. The proposed tools could be used in interventions to help practitioners and ergonomists to recognize the systemic and networked nature of problems, and therefore, realize that they may require the collaboration of actors from different activities. In this sense, disturbances may be turned into opportunities for learning and developing innovations. We conclude by discussing how the method could be used in ergonomic design and intervention.

The FIDELIS initiative: innovative strategies for increased case finding.

PubMed

Hinderaker, S G; Rusen, I D; Chiang, C-Y; Yan, L; Heldal, E; Enarson, D A

2011-01-01

Low-income, high tuberculosis (TB) burden countries. To compare case finding of new smear-positive pulmonary TB patients in projects funded to apply innovative approaches. Prospective application of innovative approaches to case finding within routine services to determine the numbers of additional cases detected and the cost per additional case detected, according to the type of approach applied. Between 2003 and 2007, 51 FIDELIS projects were implemented in 18 countries; 273,239 cases were reported, of which 85,267 were additional to the number reported in the previous year. The median cost per additional case was US$103. The interventions employed were: 1) social mobilisation and information, education and communication; 2) engagement of the private sector; 3) innovative approaches for microscopy services; 4) enhanced or semi-active case finding; 5) health systems strengthening; and 6) use of incentives. None of these was significantly more likely to detect additional cases or to have a lower cost per additional case than any of the others. While there was a substantial increase in cases detected, at a moderate cost per additional case, we were unable to show that any single intervention had an advantage over the others.

Beyond the Ask and Advise: Implementation of a Computer Tablet Intervention to Enhance Provider Adherence to the 5As for Smoking Cessation.

PubMed

Kalkhoran, Sara; Appelle, Nicole A; Napoles, Anna M; Munoz, Ricardo F; Lum, Paula J; Alvarado, Nicholas; Gregorich, Steven E; Satterfield, Jason M

2016-01-01

The 5As for smoking cessation is an evidence-based intervention to aid providers in counseling patients to quit smoking. While most providers "ask" patients about their tobacco use patterns and "advise" them to quit, fewer patients report being "assessed" for their interest in quitting, and even fewer report subsequent "assistance" in a quit attempt and having follow-up "arranged". This article describes the design of an implementation study testing a computer tablet intervention to improve provider adherence to the 5As for smoking cessation. Findings will contribute to the existing literature on technology acceptance for addressing addictive behaviors, and how digital tools may facilitate the broader implementation of evidence-based behavioral counseling practices without adversely affecting clinical flow or patient care. This project develops and tests a computer-facilitated 5As (CF-5As) model that administers the 5As intervention to patients with a computer tablet, then prompts providers to reinforce next steps. During the development phase, 5As' content will be programmed onto computer tablets, alpha and beta-testing of the service delivery model will be done, and pre-intervention interview and questionnaire data will be collected from patients, providers, and clinic staff about 5As fidelity and technology adoption. During the program evaluation phase, a randomized controlled trial comparing a group who receives the CF-5As intervention to one that does not will be conducted to assess 5As fidelity. Using the technology acceptance model, a mixed methods study of contextual and human factors influencing both 5As and technology adoption will also be conducted. Technology is increasingly being used in clinical settings. A technological tool that connects patients, providers, and clinic staff to facilitate the promotion of behavioral interventions such as smoking cessation may provide an innovative platform through which to efficiently and effectively implement evidence-based practices. Copyright © 2015 Elsevier Inc. All rights reserved.

Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement.

PubMed

Sadler, Euan; Porat, Talya; Marshall, Iain; Hoang, Uy; Curcin, Vasa; Wolfe, Charles D A; McKevitt, Christopher

2017-01-01

Stroke, like many long-term conditions, tends to be managed in isolation of its associated risk factors and multimorbidity. With increasing access to clinical and research data there is the potential to combine data from a variety of sources to inform interventions to improve healthcare. A 'Learning Health System' (LHS) is an innovative model of care which transforms integrated data into knowledge to improve healthcare. The objective of this study is to develop a process of engaging stakeholders in the use of clinical and research data to co-produce potential solutions, informed by a LHS, to improve long-term care for stroke survivors with multimorbidity. We used a stakeholder engagement study design informed by co-production principles to engage stakeholders, including service users, carers, general practitioners and other health and social care professionals, service managers, commissioners of services, policy makers, third sector representatives and researchers. Over a 10 month period we used a range of methods including stakeholder group meetings, focus groups, nominal group techniques (priority setting and consensus building) and interviews. Qualitative data were recorded, transcribed and analysed thematically. 37 participants took part in the study. The concept of how data might drive intervention development was difficult to convey and understand. The engagement process led to four priority areas for needs for data and information being identified by stakeholders: 1) improving continuity of care; 2) improving management of mental health consequences; 3) better access to health and social care; and 4) targeting multiple risk factors. These priorities informed preliminary design interventions. The final choice of intervention was agreed by consensus, informed by consideration of the gap in evidence and local service provision, and availability of robust data. This shaped a co-produced decision support tool to improve secondary prevention after stroke for further development. Stakeholder engagement to identify data-driven solutions is feasible but requires resources. While a number of potential interventions were identified, the final choice rested not just on stakeholder priorities but also on data availability. Further work is required to evaluate the impact and implementation of data-driven interventions for long-term stroke survivors.

Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement

PubMed Central

Porat, Talya; Marshall, Iain; Hoang, Uy; Curcin, Vasa; Wolfe, Charles D. A.; McKevitt, Christopher

2017-01-01

Background Stroke, like many long-term conditions, tends to be managed in isolation of its associated risk factors and multimorbidity. With increasing access to clinical and research data there is the potential to combine data from a variety of sources to inform interventions to improve healthcare. A ‘Learning Health System’ (LHS) is an innovative model of care which transforms integrated data into knowledge to improve healthcare. The objective of this study is to develop a process of engaging stakeholders in the use of clinical and research data to co-produce potential solutions, informed by a LHS, to improve long-term care for stroke survivors with multimorbidity. Methods We used a stakeholder engagement study design informed by co-production principles to engage stakeholders, including service users, carers, general practitioners and other health and social care professionals, service managers, commissioners of services, policy makers, third sector representatives and researchers. Over a 10 month period we used a range of methods including stakeholder group meetings, focus groups, nominal group techniques (priority setting and consensus building) and interviews. Qualitative data were recorded, transcribed and analysed thematically. Results 37 participants took part in the study. The concept of how data might drive intervention development was difficult to convey and understand. The engagement process led to four priority areas for needs for data and information being identified by stakeholders: 1) improving continuity of care; 2) improving management of mental health consequences; 3) better access to health and social care; and 4) targeting multiple risk factors. These priorities informed preliminary design interventions. The final choice of intervention was agreed by consensus, informed by consideration of the gap in evidence and local service provision, and availability of robust data. This shaped a co-produced decision support tool to improve secondary prevention after stroke for further development. Conclusions Stakeholder engagement to identify data-driven solutions is feasible but requires resources. While a number of potential interventions were identified, the final choice rested not just on stakeholder priorities but also on data availability. Further work is required to evaluate the impact and implementation of data-driven interventions for long-term stroke survivors. PMID:28475606

Project SMART: Preliminary Results From a Test of the Efficacy of a Swedish Internet-Based HIV Risk-Reduction Intervention for Men Who Have Sex With Men.

PubMed

Schonnesson, Lena Nilsson; Bowen, Anne M; Williams, Mark L

2016-08-01

In Sweden, 57 % of HIV transmission occurs among MSM, and other sexually transmitted infections are increasing, supporting the need for innovative interventions. The Internet is a potentially useful HIV-prevention platform, but there is a lack of such programs in Sweden. The purpose of this exploratory study was to test the efficacy of the Internet-based SMART intervention to decrease HIV sexual risks in Swedish MSM. The intervention was adapted from the Wyoming Rural AIDS Prevention Project to the Swedish context, which was guided by the Information-Motivation-Behavioral (IMB) skills model and consisted of six sessions. A total of 112 men responded to a pretest questionnaire and were randomly assigned to the SMART intervention or to a waitlist group. Fifty-four men dropped out, leaving a final sample of 58 participants. Twenty-five were assigned to the SMART intervention and 33 to a waitlist group. One month post intervention, the number of casual anal sex partners significantly decreased (t = 2.19, p = .04). Compared with the waitlist group, men in the intervention group increased their HIV knowledge (β = 0.70, p = .01), their belief of condom use as an act of responsibility (β = 1.19, p = .04), their willingness to use a condom with every new partner all the time (β = 1.39, p = .03), and their confidence in using condoms in challenging situations (β = 1.65, p = .02). Condom use was not analyzed due to the small sample size. Despite the small sample, high drop-out, and short follow-up, the study provides support for the efficacy of the Internet interventions, the SMART intervention specifically, for reducing the proportion of casual anal sex partners and improving the three cognitive components of the IMB model for Swedish MSM.

Stress self-management: an intervention for women with physical disabilities.

PubMed

Hughes, Rosemary B; Robinson-Whelen, Susan; Taylor, Heather B; Hall, John W

2006-01-01

We sought to develop and evaluate the efficacy of an innovative, theory-driven, group stress self-management intervention designed to ameliorate stress and promote health among women with physical disabilities such as spinal cord injury, multiple sclerosis, and arthritis. We recruited a voluntary sample of 78 community-living women with disabilities who were randomly assigned to either the group stress management intervention or the wait-listed control group, and we used a within- and between-groups pretest/posttest design with a 3-month follow-up. Group differences in changes over time on measures of perceived stress and mental health offer support for the efficacy of the intervention. At the 3-month follow-up assessment, the intervention group also showed greater improvement on measures of pain and role limitations owing to physical health when compared the wait-listed control group. Perceived stress was supported as a mediator of the effect of the intervention on mental health. We found support for social connectedness and self-efficacy as mediators of the relation between the intervention and perceived stress; however, there was relatively weak evidence for differential change over time in those proposed mediators. This study provides the first of its kind, that is, an evaluation of the efficacy of a stress self-management intervention designed specifically for women with physical disabilities. The results are consistent with a model in which the stress management intervention enhances self-efficacy and social connectedness, which leads to reduced stress, which then contributes to improved mental health.

A school-based physical activity promotion intervention in children: rationale and study protocol for the PREVIENE Project.

PubMed

Tercedor, Pablo; Villa-González, Emilio; Ávila-García, Manuel; Díaz-Piedra, Carolina; Martínez-Baena, Alejandro; Soriano-Maldonado, Alberto; Pérez-López, Isaac José; García-Rodríguez, Inmaculada; Mandic, Sandra; Palomares-Cuadros, Juan; Segura-Jiménez, Víctor; Huertas-Delgado, Francisco Javier

2017-09-26

The lack of physical activity and increasing time spent in sedentary behaviours during childhood place importance on developing low cost, easy-toimplement school-based interventions to increase physical activity among children. The PREVIENE Project will evaluate the effectiveness of five innovative, simple, and feasible interventions (active commuting to/from school, active Physical Education lessons, active school recess, sleep health promotion, and an integrated program incorporating all 4 interventions) to improve physical activity, fitness, anthropometry, sleep health, academic achievement, and health-related quality of life in primary school children. A total of 300 children (grade 3; 8-9 years of age) from six schools in Granada (Spain) will be enrolled in one of the 8-week interventions (one intervention per school; 50 children per school) or a control group (no intervention school; 50 children). Outcomes will include physical activity (measured by accelerometry), physical fitness (assessed using the ALPHA fitness battery), and anthropometry (height, weight and waist circumference). Furthermore, they will include sleep health (measured by accelerometers, a sleep diary, and sleep health questionnaires), academic achievement (grades from the official school's records), and health-related quality of life (child and parental questionnaires). To assess the effectiveness of the different interventions on objectively measured PA and the other outcomes, the generalized linear model will be used. The PREVIENE Project will provide the information about the effectiveness and implementation of different school-based interventions for physical activity promotion in primary school children.

Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion.

PubMed

Palinkas, Lawrence A; Campbell, Mark; Saldana, Lisa

2018-01-01

Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP). Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC) as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents. Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation) were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission. Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation.

Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion

PubMed Central

Palinkas, Lawrence A.; Campbell, Mark; Saldana, Lisa

2018-01-01

Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP). Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC) as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents. Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation) were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission. Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation. PMID:29896471

[Information technologies: new partners in treating diabetes].

PubMed

Colombet, I; Chatellier, G

2001-10-15

The management of chronic diseases such as diabetes is becoming a crucial issue in developed countries. Innovative communication technologies should now be included as new partners in the health care system. These technologies can help both in managing patients and measuring quality of care. Internet-based health promotion programs may improve compliance with treatment. Decision systems are available on the Net to help patients monitoring their diet and insulin doses. The use of electronic medical record shared on Internet may help both physicians and patients to monitor on the long term the effect of interventions. It is now time to perform appropriate trials to determine, beside other interventions, the precise role of innovative communication technologies in diabetes management.

Challenges in evaluating surgical innovation.

PubMed

Ergina, Patrick L; Cook, Jonathan A; Blazeby, Jane M; Boutron, Isabelle; Clavien, Pierre-Alain; Reeves, Barnaby C; Seiler, Christoph M; Altman, Douglas G; Aronson, Jeffrey K; Barkun, Jeffrey S; Campbell, W Bruce; Cook, Jonathan A; Feldman, Liane S; Flum, David R; Glasziou, Paul; Maddern, Guy J; Marshall, John C; McCulloch, Peter; Nicholl, Jon; Strasberg, Steven M; Meakins, Jonathan L; Ashby, Deborah; Black, Nick; Bunker, John; Burton, Martin; Campbell, Marion; Chalkidou, Kalipso; Chalmers, Iain; de Leval, Marc; Deeks, Jon; Grant, Adrian; Gray, Muir; Greenhalgh, Roger; Jenicek, Milos; Kehoe, Sean; Lilford, Richard; Littlejohns, Peter; Loke, Yoon; Madhock, Rajan; McPherson, Kim; Rothwell, Peter; Summerskill, Bill; Taggart, David; Tekkis, Parris; Thompson, Matthew; Treasure, Tom; Trohler, Ulrich; Vandenbroucke, Jan

2009-09-26

Research on surgical interventions is associated with several methodological and practical challenges of which few, if any, apply only to surgery. However, surgical evaluation is especially demanding because many of these challenges coincide. In this report, the second of three on surgical innovation and evaluation, we discuss obstacles related to the study design of randomised controlled trials and non-randomised studies assessing surgical interventions. We also describe the issues related to the nature of surgical procedures-for example, their complexity, surgeon-related factors, and the range of outcomes. Although difficult, surgical evaluation is achievable and necessary. Solutions tailored to surgical research and a framework for generating evidence on which to base surgical practice are essential.

Cancer Survivorship Care: Person Centered Care in a Multidisciplinary Shared Care Model.

PubMed

Loonen, Jacqueline J; Blijlevens, Nicole Ma; Prins, Judith; Dona, Desiree Js; Den Hartogh, Jaap; Senden, Theo; van Dulmen-Den Broeder, Eline; van der Velden, Koos; Hermens, Rosella Pmg

2018-01-16

Survivors of childhood and adult-onset cancer are at lifelong risk for the development of late effects of treatment that can lead to serious morbidity and premature mortality. Regular long-term follow-up aiming for prevention, early detection and intervention of late effects can preserve or improve health. The heterogeneous and often serious character of late effects emphasizes the need for specialized cancer survivorship care clinics. Multidisciplinary cancer survivorship care requires a coordinated and well integrated health care environment for risk based screening and intervention. In addition survivors engagement and adherence to the recommendations are also important elements. We developed an innovative model for integrated care for cancer survivors, the "Personalized Cancer Survivorship Care Model", that is being used in our clinic. This model comprises 1. Personalized follow-up care according to the principles of Person Centered Care, aiming to empower survivors and to support self management, and 2. Organization according to a multidisciplinary and risk based approach. The concept of person centered care is based on three components: initiating, integrating and safeguarding the partnership with the patient. This model has been developed as a universal model of care that will work for all cancer survivors in different health care systems. It could be used for studies to improve self efficacy and the cost-effectiveness of cancer survivorship care.

A new approach to modelling schistosomiasis transmission based on stratified worm burden.

PubMed

Gurarie, D; King, C H; Wang, X

2010-11-01

Multiple factors affect schistosomiasis transmission in distributed meta-population systems including age, behaviour, and environment. The traditional approach to modelling macroparasite transmission often exploits the 'mean worm burden' (MWB) formulation for human hosts. However, typical worm distribution in humans is overdispersed, and classic models either ignore this characteristic or make ad hoc assumptions about its pattern (e.g., by assuming a negative binomial distribution). Such oversimplifications can give wrong predictions for the impact of control interventions. We propose a new modelling approach to macro-parasite transmission by stratifying human populations according to worm burden, and replacing MWB dynamics with that of 'population strata'. We developed proper calibration procedures for such multi-component systems, based on typical epidemiological and demographic field data, and implemented them using Wolfram Mathematica. Model programming and calibration proved to be straightforward. Our calibrated system provided good agreement with the individual level field data from the Msambweni region of eastern Kenya. The Stratified Worm Burden (SWB) approach offers many advantages, in that it accounts naturally for overdispersion and accommodates other important factors and measures of human infection and demographics. Future work will apply this model and methodology to evaluate innovative control intervention strategies, including expanded drug treatment programmes proposed by the World Health Organization and its partners.

Use of an innovative video feedback technique to enhance communication skills training.

PubMed

Roter, Debra L; Larson, Susan; Shinitzky, Harold; Chernoff, Robin; Serwint, Janet R; Adamo, Graceanne; Wissow, Larry

2004-02-01

Despite growing interest in medical communication by certification bodies, significant methodological and logistic challenges are evident in experiential methods of instruction. There were three study objectives: 1) to explore the acceptability of an innovative video feedback programme to residents and faculty; 2) to evaluate a brief teaching intervention comprising the video feedback innovation when linked to a one-hour didactic and role-play teaching session on paediatric residents' communication with a simulated patient; and 3) to explore the impact of resident gender on communication change. Pre/post comparison of residents' performance in videotaped interviews with simulated patients before and after the teaching intervention. Individually tailored feedback on targeted communication skills was facilitated by embedding the Roter Interaction Analysis System (RIAS) within a software platform that presents a fully coded interview with instant search and review features. 28 first year residents in a large, urban, paediatric residency programme. Communication changes following the teaching intervention were demonstrated through significant improvements in residents' performance with simulated patients pre and post teaching and feedback. Using paired t-tests, differences include: reduced verbal dominance; increased use of open-ended questions; increased use of empathy; and increased partnership building and problem solving for therapeutic regimen adherence. Female residents demonstrated greater communication change than males. The RIAS embedded CD-ROM provides a flexible structure for individually tailoring feedback of targeted communication skills that is effective in facilitating communication change as part of a very brief teaching intervention.

Social marketing meets health literacy: Innovative improvement of health care providers' comfort with patient interaction.

PubMed

Primack, Brian A; Bui, Thuy; Fertman, Carl I

2007-09-01

It is essential to train health care providers to deliver care sensitive to the needs of diverse individuals with varying degrees of health literacy. We aimed to evaluate an innovative, theory-based, educational intervention involving social marketing and health literacy. In 2006 at a large medical school, all first-year students were exposed to the intervention. They completed pre- and post-test anonymous surveys including demographic data, covariates, and key outcome variables. Paired t-tests and multiple linear regression were used to evaluate the intervention and to determine independent associations among the key outcome variables. Post-intervention scores were significantly higher than pre-intervention scores for social marketing (3.31 versus 1.90, p<0.001), health literacy (3.41 versus 2.98, p<0.001), and comfort in brochure development (3.11 versus 2.52, p<0.001) (N=83). After controlling for demographic and covariate data, health literacy and comfort in brochure development were independent predictors of comfort interacting with diverse populations. A brief intervention involving social marketing and health literacy can improve skills that improve medical students' comfort with patients of diverse backgrounds. Health care providers can be taught educational principles and skills involved in developing effective patient education materials. These skills may improve providers' comfort with direct patient interaction.

Accelerators: Sparking Innovation and Transdisciplinary Team Science in Disparities Research

PubMed Central

Horowitz, Carol R.; Shameer, Khader; Gabrilove, Janice; Atreja, Ashish; Shepard, Peggy; Goytia, Crispin N.; Smith, Geoffrey W.; Dudley, Joel; Manning, Rachel; Bickell, Nina A.; Galvez, Maida P.

2017-01-01

Development and implementation of effective, sustainable, and scalable interventions that advance equity could be propelled by innovative and inclusive partnerships. Readied catalytic frameworks that foster communication, collaboration, a shared vision, and transformative translational research across scientific and non-scientific divides are needed to foster rapid generation of novel solutions to address and ultimately eliminate disparities. To achieve this, we transformed and expanded a community-academic board into a translational science board with members from public, academic and private sectors. Rooted in team science, diverse board experts formed topic-specific “accelerators”, tasked with collaborating to rapidly generate new ideas, questions, approaches, and projects comprising patients, advocates, clinicians, researchers, funders, public health and industry leaders. We began with four accelerators—digital health, big data, genomics and environmental health—and were rapidly able to respond to funding opportunities, transform new ideas into clinical and community programs, generate new, accessible, actionable data, and more efficiently and effectively conduct research. This innovative model has the power to maximize research quality and efficiency, improve patient care and engagement, optimize data democratization and dissemination among target populations, contribute to policy, and lead to systems changes needed to address the root causes of disparities. PMID:28241508

Accelerators: Sparking Innovation and Transdisciplinary Team Science in Disparities Research.

PubMed

Horowitz, Carol R; Shameer, Khader; Gabrilove, Janice; Atreja, Ashish; Shepard, Peggy; Goytia, Crispin N; Smith, Geoffrey W; Dudley, Joel; Manning, Rachel; Bickell, Nina A; Galvez, Maida P

2017-02-23

Development and implementation of effective, sustainable, and scalable interventions that advance equity could be propelled by innovative and inclusive partnerships. Readied catalytic frameworks that foster communication, collaboration, a shared vision, and transformative translational research across scientific and non-scientific divides are needed to foster rapid generation of novel solutions to address and ultimately eliminate disparities. To achieve this, we transformed and expanded a community-academic board into a translational science board with members from public, academic and private sectors. Rooted in team science, diverse board experts formed topic-specific "accelerators", tasked with collaborating to rapidly generate new ideas, questions, approaches, and projects comprising patients, advocates, clinicians, researchers, funders, public health and industry leaders. We began with four accelerators-digital health, big data, genomics and environmental health-and were rapidly able to respond to funding opportunities, transform new ideas into clinical and community programs, generate new, accessible, actionable data, and more efficiently and effectively conduct research. This innovative model has the power to maximize research quality and efficiency, improve patient care and engagement, optimize data democratization and dissemination among target populations, contribute to policy, and lead to systems changes needed to address the root causes of disparities.

The application of the rapid assessment and response methodology for cannabis prevention research among youth in the Netherlands.

PubMed

Dupont, Hans B; Kaplan, Charles D; Braam, Richard V; Verbraeck, Hans T; de Vries, Nanne K

2015-08-01

Drug prevention methods tailored to specific target groups have become increasingly important. There is a growing need to find ways to rapidly assess and situate target groups in their particular contexts. This need is associated with the implementation of evidence-based interventions (EBIs) for these specific target groups. This article describes the application of Rapid Assessment and Response (RAR) as a necessary first step in designing and implementing a prevention intervention plan for problematic cannabis use among "loitering" youth in the South of the Netherlands. Seven RAR studies were conducted using an innovative stepwise model in which the prevention field worker is central. The normative structure for the use of cannabis was found to vary across the neighborhoods of the RAR studies and emerged as the focal point in designing a suitable response. The RAR studies also identified the need in the prevention toolbox for a tailored, low-threshold, effective, individual brief intervention for youth problematic cannabis use. The RAR was found to provide a powerful methodology for detecting target groups and generating contextual and normative data that enable the prevention field worker to select and adapt from the spectrum of existing Evidence based Interventions (EBIs) or develop the most promising model for implementation with the specific target group. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

A workshop report on promoting HIV/AIDS understanding through a capacity building train-the-trainer educational intervention

PubMed Central

Diesel, Holly J; Nsagha, Dickson S; Sab, Clement M; Taliaferro, Donna; Rosenburg, Neal S

2011-01-01

Nursing educators are frequently confronted with challenges that bring about innovation and transition to new ways of transferring knowledge in their home environments. These challenges are magnified when approached from an international perspective. Optimal implementation of knowledge transfer incorporates choosing models that promote local initiatives in line with increasingly decentralized educational structures. These decentralized models are a means to foster ongoing participation for both educators and students in their own professional development. Innovative education stems from creativity in approaching the need with formats and activities to meet a specific challenge. This experimental study builds upon previous study by the authors which was conducted in March, 2009, based upon the qualitative open focus forum at each of the five nursing programs. Overwhelmingly, the Cameroonian nursing students expressed a keen desire to study the HIV infected pregnant woman and the feeding options of the newborn. The study team developed the train-the-trainer program which was delivered at the University of Buea in the Southwest region of Cameroon in March, 2011. TTT is particularly effective for reaching large audiences and also permits a degree of sustainability such that the Cameroonian students will be trainers for subsequent cohorts of their peers. This study continues to strengthen the collaborative endeavors between the two nursing schools; the University of Buea (UB) and Goldfarb School of Nursing (GSON) at Barnes Jewish College in Saint Louis, Missouri, USA. The final aim of the intervention was the initiation of collaborative relationships between the faculty members of the two educational organizations. PMID:22187599

Challenges and Innovations in a Community-Based Participatory Randomized Controlled Trial.

PubMed

Goodkind, Jessica R; Amer, Suha; Christian, Charlisa; Hess, Julia Meredith; Bybee, Deborah; Isakson, Brian L; Baca, Brandon; Ndayisenga, Martin; Greene, R Neil; Shantzek, Cece

2017-02-01

Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants' intervention experiences, and their feasibility and acceptability. In the current mixed-methods study, academic and community partners developed and implemented an RCT to test the effectiveness of a collaboratively developed community-based advocacy, learning, and social support intervention. The goals of the intervention were to address social determinants of health and build trust and connections with other mental health services in order to reduce mental health disparities among Afghan, Great Lakes Region African, and Iraqi refugee adults and to engage and retain refugees in trauma-focused treatment, if needed. Two cohorts completed the intervention between 2013 and 2015. Ninety-three adult refugees were randomly assigned to intervention or control group and completed four research interviews (pre-, mid-, and postintervention, and follow-up). Several challenges to conducting a community-based RCT emerged, including issues related to interviewer intervention to assist participants in the control group, diffusion of intervention resources throughout the small refugee communities, and staff and community concerns about the RCT design and what evidence is meaningful to demonstrate intervention effectiveness. These findings highlight important epistemological, methodological, and ethical challenges that should be considered when conducting community-based RCTs and interpreting results from them. In addition, several innovations were developed to address these challenges, which may be useful for other community-academic partnerships engaged in RCTs.

A two-month follow-up evaluation testing interventions to limit the emergence and spread of antimicrobial resistant bacteria among Maasai of northern Tanzania.

PubMed

Roulette, Casey J; Caudell, Mark A; Roulette, Jennifer W; Quinlan, Robert J; Quinlan, Marsha B; Subbiah, Murugan; Call, Douglas R

2017-12-15

In sub-Saharan Africa, efforts to control antimicrobial resistance (AMR) are aggravated by unregulated drug sales and use, and high connectivity between human, livestock, and wildlife populations. Our previous research indicates that Maasai agropastoralists-who have high exposure to livestock and livestock products and self-administer veterinary antibiotics-harbor antibiotic resistant Escherichia coli (E. coli). Here, we report the results of a public health intervention project among Maasai aimed at reducing selection and transmission of E. coli bacteria. Research was conducted in two Maasai communities in Northern Tanzania. Participants were provided with health knowledge and technological innovations to facilitate: 1) the prudent use of veterinary antibiotics (tape measures and dosage charts to calculate livestock weight for more accurate dosage), and, 2) the pasteurization of milk (thermometers), the latter of which was motivated by findings of high levels of resistant E. coli in Maasai milk. To determine knowledge retention and intervention adoption, we conducted a two-month follow-up evaluation in the largest of the two communities. Retention of antimicrobial knowledge was positively associated with retention of bacterial knowledge and, among men, retention of bacterial knowledge was associated with greater wealth. Bacterial and AMR knowledge were not, however, associated with self-reported use of the innovations. Among women, self-reported use of the thermometers was associated with having more children and greater retention of knowledge about the health benefits of the innovations. Whereas 70% of women used their innovations correctly, men performed only 18% of the weight-estimation steps correctly. Men's correct use was associated with schooling, such that high illiteracy rates remain an important obstacle to the dissemination and diffusion of weight-estimation materials. Our results indicate that dietary preferences for unboiled milk, concerns over child health, and a desire to improve the health of livestock are important cultural values that need to be incorporated in future AMR-prevention interventions that target Maasai populations. More generally, these findings inform future community-health interventions to limit AMR.

Evaluating the effect of innovative motivation and supervision approaches on community health worker performance and retention in Uganda and Mozambique: study protocol for a randomised controlled trial.

PubMed

Källander, Karin; Strachan, Daniel; Soremekun, Seyi; Hill, Zelee; Lingam, Raghu; Tibenderana, James; Kasteng, Frida; Vassall, Anna; Meek, Sylvia; Kirkwood, Betty

2015-04-12

If trained, equipped and utilised, community health workers (CHWs) delivering integrated community case management for sick children can potentially reduce child deaths by 60%. However, it is essential to maintain CHW motivation and performance. The inSCALE project aims to evaluate, using a cluster randomised controlled trial, the effect of interventions to increase CHW supervision and performance on the coverage of appropriate treatment for children with diarrhoea, pneumonia and malaria. Participatory methods were used to identify best practices and innovative solutions. Quantitative community based baseline surveys were conducted to allow restricted randomisation of clusters into intervention and control arms. Individual informed consent was obtained from all respondents. Following formative research and stakeholder consultations, two intervention packages were developed in Uganda and one in Mozambique. In Uganda, approximately 3,500 CHWs in 39 clusters were randomised into a mobile health (mHealth) arm, a participatory community engagement arm and a control arm. In Mozambique, 275 CHWs in 12 clusters were randomised into a mHealth arm and a control arm. The mHealth interventions encompass three components: 1) free phone communication between users; 2) data submission using phones with automated feedback, messages to supervisors for targeted supervision, and online data access for district statisticians; and 3) motivational messages. The community engagement arm in Uganda established village health clubs seeking to 1) improve the status and standing of CHWs, 2) increase demand for health services and 3) communicate that CHWs' work is important. Process evaluation was conducted after 10 months and end-line surveys will establish impact after 12 months in Uganda and 18 months in Mozambique. Main outcomes include proportion of sick children appropriately treated, CHW performance and motivation, and cost effectiveness of interventions. Study strengths include a user-centred design to the innovations, while weaknesses include the lack of a robust measurement of coverage of appropriate treatment. Evidence of cost-effective innovations that increase motivation and performance of CHWs can potentially increase sustainable coverage of iCCM at scale. (identifier NCT01972321 ) on 22 April 22 2013.

The Sydney playground project--levelling the playing field: a cluster trial of a primary school-based intervention aiming to promote manageable risk-taking in children with disability.

PubMed

Bundy, Anita C; Wyver, Shirley; Beetham, Kassia S; Ragen, Jo; Naughton, Geraldine; Tranter, Paul; Norman, Richard; Villeneuve, Michelle; Spencer, Grace; Honey, Anne; Simpson, Judith; Baur, Louise; Sterman, Julia

2015-11-14

Providing children and adults with opportunities to engage in manageable risk taking may be a stepping stone toward closing the gap in life conditions currently experienced by young people with disabilities. We aim to demonstrate the effectiveness of a simple, innovative program for 1) changing the way parents and teachers view manageable risk-taking for children with disabilities and 2) increasing the level of responsibility that children take for their own actions, as seen on the school playground. We will employ a cluster repeated measures trial with six Sydney-area primary-school-based programs for children with disabilities. The intervention comprises two arms. 1) Risk-reframing--teachers and parents will participate together in small group intervention sessions focusing on the benefits of manageable risk-taking; 2) Introduction of play materials--materials without a defined purpose and facilitative of social cooperation will be introduced to the school playground for children to use at all break times. A control period will be undertaken first for two school terms, followed by two terms of the intervention period. Outcome measures will include playground observations, The Coping Inventory, qualitative field notes, and The Tolerance of Risk in Play Scale. New national programs, such as Australia's National Disability Insurance Scheme, will place increasing demands on young people with disabilities to assume responsibility for difficult decisions regarding procuring services. Innovative approaches, commencing early in life, are required to prepare young people and their carers for this level of responsibility. This research offers innovative intervention strategies for promoting autonomy in children with disabilities and their carers. Australian and New Zealand Clinical Trials Registration Number ACTRN12614000549628 (registered 22/5/2014).

A model for 'reverse innovation' in health care.

PubMed

Depasse, Jacqueline W; Lee, Patrick T

2013-08-30

'Reverse innovation,' a principle well established in the business world, describes the flow of ideas from emerging to more developed economies. There is strong and growing interest in applying this concept to health care, yet there is currently no framework for describing the stages of reverse innovation or identifying opportunities to accelerate the development process. This paper combines the business concept of reverse innovation with diffusion of innovation theory to propose a model for reverse innovation as a way to innovate in health care. Our model includes the following steps: (1) identifying a problem common to lower- and higher-income countries; (2) innovation and spread in the low-income country (LIC); (3) crossover to the higher-income country (HIC); and (4) innovation and spread in the HIC. The crucial populations in this pathway, drawing from diffusion of innovation theory, are LIC innovators, LIC early adopters, and HIC innovators. We illustrate the model with three examples of current reverse innovations. We then propose four sets of specific actions that forward-looking policymakers, entrepreneurs, health system leaders, and researchers may take to accelerate the movement of promising solutions through the reverse innovation pipeline: (1) identify high-priority problems shared by HICs and LICs; (2) create slack for change, especially for LIC innovators, LIC early adopters, and HIC innovators; (3) create spannable social distances between LIC early adopters and HIC innovators; and (4) measure reverse innovation activity globally.

Cigarette Smoking Cessation Intervention for Buprenorphine Treatment Patients.

PubMed

Hall, Sharon M; Humfleet, Gary L; Gasper, James J; Delucchi, Kevin L; Hersh, David F; Guydish, Joseph R

2018-04-02

Patients receiving medication assisted therapy (MAT) for opioid use disorder have high cigarette smoking rates. Cigarette smoking interventions have had limited success. We evaluated an intervention to increase cigarette abstinence rates in patients receiving buprenorphine-assisted therapy. Cigarette smokers (N = 175; 78% male; 69% Caucasian; 20% Hispanic), recruited from a buprenorphine clinic were randomly assigned to either an extended innovative system intervention (E-ISI) or to Standard Treatment Control (STC). The E-ISI combined motivational intervention with extended treatment (long-term nicotine replacement therapy , varenicline, and extended cognitive behavioral therapy). STC received written information about quit-lines, medication, and resources. Assessments were held at baseline and 3, 6, 12, and 18 months. Seven-day biochemically verified point-prevalence cigarette abstinence was the primary outcome measure. Fifty-four percent of E-ISI participants entered the extended treatment intervention; E-ISI and STC differed at 3 months on abstinence status but not at months 6, 12, and 18. E-ISI participants were more likely to attempt to quit, to have a goal of complete abstinence, and to be in a more advanced stage of change than STC participants. A higher number of cigarettes smoked and the use of cannabis in the previous 30 days predicted continued smoking. The E-ISI was successful in increasing motivation to quit smoking but did not result in long-term abstinence. The failure of treatments that have been efficacious in the general population to produce abstinence in patients receiving MAT of opioid use disorder suggests that harm reduction and other innovative interventions should be explored. This study demonstrates that an intervention combining motivational interviewing with an extended treatment protocol can increase cigarette quit attempts, enhance cigarette abstinence goals, and further movement through stages of change about quitting smoking in patients receiving MAT for opioid use disorder who smoke cigarettes. The intervention did not increase abstinence rates over those observed in a standard treatment control, however. The latter finding supports those of earlier investigators who also failed to find efficacy for smoking cessation in this population and who also used interventions effective in the general population. This pattern of findings suggests that patients with opioid use disorder can be motivated to change smoking behavior, but alternative and innovative approaches to cigarette smoking treatment should be studied.

[Collaborative and stepped care for depression: Development of a model project within the Hamburg Network for Mental Health (psychenet.de)].

PubMed

Härter, Martin; Heddaeus, Daniela; Steinmann, Maya; Schreiber, Robert; Brettschneider, Christian; König, Hans-Helmut; Watzke, Birgit

2015-04-01

Depression is one of the most widespread mental disorders in Germany and causes a great suffering and involves high costs. Guidelines recommend stepped and interdisciplinary collaborative care models for the treatment of depression. Stepped and collaborative care models are described regarding their efficacy and cost-effectiveness. A current model project within the Hamburg Network for Mental Health exemplifies how guideline-based stepped diagnostics and treatment incorporating innovative low-intensity interventions are implemented by a large network of health care professionals and clinics. An accompanying evaluation using a cluster randomized controlled design assesses depressive symptom reduction and cost-effectiveness for patients treated within "Health Network Depression" ("Gesundheitsnetz Depression", a subproject of psychenet.de) compared with patients treated in routine care. Over 90 partners from inpatient and outpatient treatment have been successfully involved in recruiting over 600 patients within the stepped care model. Communication in the network was greatly facilitated by the use of an innovative online tool for the supply and reservation of treatment capacities. The participating professionals profit from the improved infrastructure and the implementation of advanced training and quality circle work. New treatment models can greatly improve the treatment of depression owing to their explicit reference to guidelines, the establishment of algorithms for diagnostics and treatment, the integration of practices and clinics, in addition to the implementation of low-intensity treatment alternatives. These models could promote the development of a disease management program for depression.

Using the social entrepreneurship approach to generate innovative and sustainable malaria diagnosis interventions in Tanzania: a case study

PubMed Central

2010-01-01

Background There have been a number of interventions to date aimed at improving malaria diagnostic accuracy in sub-Saharan Africa. Yet, limited success is often reported for a number of reasons, especially in rural settings. This paper seeks to provide a framework for applied research aimed to improve malaria diagnosis using a combination of the established methods, participatory action research and social entrepreneurship. Methods This case study introduces the idea of using the social entrepreneurship approach (SEA) to create innovative and sustainable applied health research outcomes. The following key elements define the SEA: (1) identifying a locally relevant research topic and plan, (2) recognizing the importance of international multi-disciplinary teams and the incorporation of local knowledge, (3) engaging in a process of continuous innovation, adaptation and learning, (4) remaining motivated and determined to achieve sustainable long-term research outcomes and, (5) sharing and transferring ownership of the project with the international and local partner. Evaluation The SEA approach has a strong emphasis on innovation lead by local stakeholders. In this case, innovation resulted in a unique holistic research program aimed at understanding patient, laboratory and physician influences on accurate diagnosis of malaria. An evaluation of milestones for each SEA element revealed that the success of one element is intricately related to the success of other elements. Conclusions The SEA will provide an additional framework for researchers and local stakeholders that promotes innovation and adaptability. This approach will facilitate the development of new ideas, strategies and approaches to understand how health issues, such as malaria, affect vulnerable communities. PMID:20128922

Using the social entrepreneurship approach to generate innovative and sustainable malaria diagnosis interventions in Tanzania: a case study.

PubMed

Allen, Lisa K; Hetherington, Erin; Manyama, Mange; Hatfield, Jennifer M; van Marle, Guido

2010-02-03

There have been a number of interventions to date aimed at improving malaria diagnostic accuracy in sub-Saharan Africa. Yet, limited success is often reported for a number of reasons, especially in rural settings. This paper seeks to provide a framework for applied research aimed to improve malaria diagnosis using a combination of the established methods, participatory action research and social entrepreneurship. This case study introduces the idea of using the social entrepreneurship approach (SEA) to create innovative and sustainable applied health research outcomes. The following key elements define the SEA: (1) identifying a locally relevant research topic and plan, (2) recognizing the importance of international multi-disciplinary teams and the incorporation of local knowledge, (3) engaging in a process of continuous innovation, adaptation and learning, (4) remaining motivated and determined to achieve sustainable long-term research outcomes and, (5) sharing and transferring ownership of the project with the international and local partner. The SEA approach has a strong emphasis on innovation lead by local stakeholders. In this case, innovation resulted in a unique holistic research program aimed at understanding patient, laboratory and physician influences on accurate diagnosis of malaria. An evaluation of milestones for each SEA element revealed that the success of one element is intricately related to the success of other elements. The SEA will provide an additional framework for researchers and local stakeholders that promotes innovation and adaptability. This approach will facilitate the development of new ideas, strategies and approaches to understand how health issues, such as malaria, affect vulnerable communities.

Panacea or diagnosis? Imaginaries of innovation and the 'MIT model' in three political cultures.

PubMed

Pfotenhauer, Sebastian; Jasanoff, Sheila

2017-12-01

Innovation studies continue to struggle with an apparent disconnect between innovation's supposedly universal dynamics and a sense that policy frameworks and associated instruments of innovation are often ineffectual or even harmful when transported across regions or countries. Using a cross-country comparative analysis of three implementations of the 'MIT model' of innovation in the UK, Portugal and Singapore, we show how key features in the design, implementation and performance of the model cannot be explained as mere variations on an identical solution to the same underlying problem. We draw on the concept of sociotechnical imaginaries to show how implementations of the 'same' innovation model - and with it the notion of 'innovation' itself - are co-produced with locally specific diagnoses of a societal deficiency and equally specific understandings of acceptable remedies. Our analysis thus flips the conventional notion of 'best-practice transfer' on its head: Instead of asking 'how well' an innovation model has been implemented, we analyze the differences among the three importations to reveal the idiosyncratic ways in which each country imagines the purpose of innovation. We replace the notion of innovation as a 'panacea' - a universal fix for all social woes - with that of innovation-as-diagnosis in which a particular 'cure' is 'prescribed' for a 'diagnosed' societal 'pathology,' which may in turn trigger 'reactions' within the receiving body. This approach offers new possibilities for theorizing how and where culture matters in innovation policy. It suggests that the 'successes' and 'failures' of innovation models are not a matter of how well societies are able to implement a sound, universal model, but more about how effectively they articulate their imaginaries of innovation and tailor their strategies accordingly.

Implementation of a Self-Monitoring Application to Improve On-Task Behavior: A High-School Pilot Study

ERIC Educational Resources Information Center

Wills, Howard P.; Mason, Benjamin A.

2014-01-01

Technological innovations offer promise for improving intervention implementation in secondary, inclusive classrooms. A withdrawal design was employed with two high-school students in order to assess the effectiveness of a technologically delivered, self-monitoring intervention in improving on-task behavior in a science classroom. Two students…

Maximizing Young Learners' Input: An Intervention Program

ERIC Educational Resources Information Center

Tragant, Elsa; Muñoz, Carmen; Spada, Nina

2016-01-01

This study reports on a year-long intervention based on comprehension practice of input-rich materials. It was inspired by an innovative program in Canada in which primary school francophone children learned English as a second language (ESL) through simultaneous reading and listening. In our study the participants are a class of 10- to…

Machinima Interventions: Innovative Approaches to Immersive Virtual World Curriculum Integration

ERIC Educational Resources Information Center

Middleton, Andrew John; Mather, Richard

2008-01-01

The educational value of Immersive Virtual Worlds (IVWs) seems to be in their social immersive qualities and as an accessible simulation technology. In contrast to these synchronous applications this paper discusses the use of educational machinima developed in IVW virtual film sets. It also introduces the concept of media intervention, proposing…

Increasing Access to an ASD Imitation Intervention via a Telehealth Parent Training Program

ERIC Educational Resources Information Center

Wainer, Allison L.; Ingersoll, Brooke R.

2015-01-01

Systematic research focused on developing and improving strategies for the dissemination and implementation of effective ASD services is essential. An innovative and promising area of research is the use of telehealth programs to train parents of children with ASD in intervention techniques. A hybrid telehealth program, combining self-directed…

Everyday Uncertainties: Reframing Perceptions of Risk in Outdoor Free Play

ERIC Educational Resources Information Center

Niehues, Anita Nelson; Bundy, Anita; Broom, Alex; Tranter, Paul; Ragen, Jo; Engelen, Lina

2013-01-01

This paper reports the results of risk reframing, an intervention to offer parents and educators a context for building new and complex perceptions of risk in children's outdoor free play. Our objective was to alter these adults' perceptions of risk to increase the sustainability of an innovative child-centred playground intervention. Qualitative…

The Effects of an Active Learning Intervention in Biology on College Students' Classroom Motivational Climate Perceptions, Motivation, and Achievement

ERIC Educational Resources Information Center

Corkin, Danya M.; Horn, Catherine; Pattison, Donna

2017-01-01

This study examined differences in students' classroom motivational climate perceptions and motivational beliefs between those enrolled in undergraduate Biology courses that implemented an innovative, active learning intervention and those enrolled in traditional Biology courses (control group). This study also sought to determine whether…

An Intervention Framework Designed to Develop the Collaborative Problem-Solving Skills of Primary School Students

ERIC Educational Resources Information Center

Gu, Xiaoqing; Chen, Shan; Zhu, Wenbo; Lin, Lin

2015-01-01

Considerable effort has been invested in innovative learning practices such as collaborative inquiry. Collaborative problem solving is becoming popular in school settings, but there is limited knowledge on how to develop skills crucial in collaborative problem solving in students. Based on the intervention design in social interaction of…

Creating action plans in a serious video game increases and maintains child fruit-vegetable intake: A randomized controlled trial

USDA-ARS?s Scientific Manuscript database

Child fruit and vegetable intake is below recommended levels, increasing risk for chronic disease. Interventions to influence fruit and vegetable intake among youth have had mixed effects. Innovative, theory-driven interventions are needed. Goal setting, enhanced by implementation intentions (i.e., ...

A Randomized Trial Investigating the Effect of a Brief Lifestyle Intervention on Freshman-Year Weight Gain

ERIC Educational Resources Information Center

Middleton, Kathryn R.; Perri, Michael G.

2014-01-01

Objective: The current study was a randomized controlled trial investigating the effect of an innovative, short-term lifestyle intervention on weight gain in female freshman college students. Participants: Ninety-five freshmen were recruited from a large public university in the United States. Methods: Participants completed baseline assessments…

76 FR 29249 - Medicare Program; Pioneer Accountable Care Organization Model: Request for Applications

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-20

... on the Innovation Center Web site http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated... Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services, Mail Stop S3-13-05, 7500... and Medicaid Innovation (Innovation Center). The Pioneer ACO Model is an Innovation Center initiative...

Course Management Systems and Blended Learning: An Innovative Learning Approach

ERIC Educational Resources Information Center

Chou, Amy Y.; Chou, David C.

2011-01-01

This article utilizes Rogers' innovation-decision process model (2003) and Beckman and Berry's innovation process model (2007) to create an innovative learning map that illustrates three learning methods (i.e., face-to-face learning, online learning, and blended learning) in two types of innovation (i.e., incremental innovation and radical…

Innovative Techniques for Evaluating Behavioral Nutrition Interventions1234

PubMed Central

Laugero, Kevin D; Cunningham, Brian T; Lora, Karina R; Reicks, Marla

2017-01-01

Assessing outcomes and the impact from behavioral nutrition interventions has remained challenging because of the lack of methods available beyond traditional nutrition assessment tools and techniques. With the current high global obesity and related chronic disease rates, novel methods to evaluate the impact of behavioral nutrition-based interventions are much needed. The objective of this narrative review is to describe and review the current status of knowledge as it relates to 4 different innovative methods or tools to assess behavioral nutrition interventions. Methods reviewed include 1) the assessment of stress and stress responsiveness to enhance the evaluation of nutrition interventions, 2) eye-tracking technology in nutritional interventions, 3) smartphone biosensors to assess nutrition and health-related outcomes, and 4) skin carotenoid measurements to assess fruit and vegetable intake. Specifically, the novel use of functional magnetic resonance imaging, by characterizing the brain’s responsiveness to an intervention, can help researchers develop programs with greater efficacy. Similarly, if eye-tracking technology can enable researchers to get a better sense as to how participants view materials, the materials may be better tailored to create an optimal impact. The latter 2 techniques reviewed, smartphone biosensors and methods to detect skin carotenoids, can provide the research community with portable, effective, nonbiased ways to assess dietary intake and quality and more in the field. The information gained from using these types of methodologies can improve the efficacy and assessment of behavior-based nutrition interventions. PMID:28096132

Development of an Internet-Based Obesity Prevention Program for Children

PubMed Central

Gabriele, Jeanne M.; Stewart, Tiffany M.; Sample, Alicia; Davis, Allison B.; Allen, Ray; Martin, Corby K.; Newton, Robert L.; Williamson, Donald A.

2010-01-01

Background Childhood obesity is a growing problem, particularly in rural, Louisiana school children. Traditionally, school-based obesity prevention programs have used a primary prevention approach. Finding methods to deliver secondary prevention programs to large numbers of students without singling out overweight students has been a challenge. An innovative approach to achieving this goal is through use of an Internet intervention targeted toward a student's weight status. This article describes the Louisiana (LA) Health Internet intervention, including the student Web site, the Internet counselor Web site, and the Internet counseling process. Method The LA Health Internet intervention had separate interfaces for students and Internet counselors. The main features of the student site were behavioral weight loss lessons, lesson activities, chat with an Internet counselor, and email. The Internet counselor site contained these same features, plus a student directory and various means of obtaining student information to guide counseling. Based on their baseline weight status, students received lessons and counseling that promoted either weight loss or weight maintenance. Intervention was delivered during class time, and teachers scheduled Internet counseling sessions with intervention personnel. Results The LA Health Internet intervention was initially implemented within 14 schools; 773 students were granted access to the site. From Fall 2007 to Spring 2009, 1174 hours of Internet counselor coverage was needed to implement the Internet counseling component of this intervention Conclusion The LA Health Internet intervention is an innovative and feasible method of delivering a secondary prevention program within a school setting to large numbers of students. PMID:20513340

The link between health governance models and global health innovation: an exploration of OECD nations.

PubMed

Schnarr, Karin; Snowdon, Anne; Cramm, Heidi; Cohen, Jason; Alessi, Charles

2015-01-01

While there is established research that explores individual innovations across countries or developments in a specific health area, there is less work that attempts to match national innovations to specific systems of health governance to uncover themes across nations. We used a cross-comparison design that employed content analysis of health governance models and innovation patterns in eight OECD nations (Australia, Britain, Canada, France, Germany, The Netherlands, Switzerland, and the United States). Country-level model of health governance may impact the focus of health innovation within the eight jurisdictions studied. Innovation across all governance models has targeted consumer engagement in health systems, the integration of health services across the continuum of care, access to care in the community, and financial models that drive competition. Improving our understanding of the linkage between health governance and innovation in health systems may heighten awareness of potential enablers and barriers to innovation success.

Modeling the sustainable development of innovation in transport construction based on the communication approach

NASA Astrophysics Data System (ADS)

Revunova, Svetlana; Vlasenko, Vyacheslav; Bukreev, Anatoly

2017-10-01

The article proposes the models of innovative activity development, which is driven by the formation of “points of innovation-driven growth”. The models are based on the analysis of the current state and dynamics of innovative development of construction enterprises in the transport sector and take into account a number of essential organizational and economic changes in management. The authors substantiate implementing such development models as an organizational innovation that has a communication genesis. The use of the communication approach to the formation of “points of innovation-driven growth” allowed the authors to apply the mathematical tools of the graph theory in order to activate the innovative activity of the transport industry in the region. As a result, the authors have proposed models that allow constructing an optimal mechanism for the formation of “points of innovation-driven growth”.

Navigating the challenges of digital health innovation: considerations and solutions in developing online and smartphone-application-based interventions for mental health disorders.

PubMed

Hill, Claire; Martin, Jennifer L; Thomson, Simon; Scott-Ram, Nick; Penfold, Hugh; Creswell, Cathy

2017-08-01

This article presents an analysis of challenges and considerations when developing digital mental health innovations. Recommendations include collaborative working between clinicians, researchers, industry and service users in order to successfully navigate challenges and to ensure e-therapies are engaging, acceptable, evidence based, scalable and sustainable. © The Royal College of Psychiatrists 2017.

Care Delivery for Filipino Americans Using the Neuman Systems Model

PubMed Central

Angosta, Alona D.; Ceria-Ulep, Clementina D.; Tse, Alice M.

2016-01-01

Filipino Americans are at risk of coronary heart disease due to the presence of multiple cardiometabolic factors. Selecting a framework that addresses the factors leading to coronary heart disease is vital when providing care for this population. The Neuman systems model is a comprehensive and wholistic framework that offers an innovative method of viewing clients, their families, and the healthcare system across multiple dimensions. Using the Neuman systems model, advanced practice nurses can develop and implement interventions that will help reduce the potential cardiovascular problems of clients with multiple risk factors. The authors in this article provides insight into the cardiovascular health of Filipino Americans and has implications for nurses and other healthcare providers working with various Southeast Asian groups in the United States. PMID:24740949

Evaluation of a task-based community oriented teaching model in family medicine for undergraduate medical students in Iraq.

PubMed

Al-Dabbagh, Samim A; Al-Taee, Waleed G

2005-08-22

The inclusion of family medicine in medical school curricula is essential for producing competent general practitioners. The aim of this study is to evaluate a task-based, community oriented teaching model of family medicine for undergraduate students in Iraqi medical schools. An innovative training model in family medicine was developed based upon tasks regularly performed by family physicians providing health care services at the Primary Health Care Centre (PHCC) in Mosul, Iraq. Participants were medical students enrolled in their final clinical year. Students were assigned to one of two groups. The implementation group (28 students) was exposed to the experimental model and the control group (56 students) received the standard teaching curriculum. The study took place at the Mosul College of Medicine and at the Al-Hadba PHCC in Mosul, Iraq, during the academic year 1999-2000. Pre- and post-exposure evaluations comparing the intervention group with the control group were conducted using a variety of assessment tools. The primary endpoints were improvement in knowledge of family medicine and development of essential performance skills. Results showed that the implementation group experienced a significant increase in knowledge and performance skills after exposure to the model and in comparison with the control group. Assessment of the model by participating students revealed a high degree of satisfaction with the planning, organization, and implementation of the intervention activities. Students also highly rated the relevancy of the intervention for future work. A model on PHCC training in family medicine is essential for all Iraqi medical schools. The model is to be implemented by various relevant departments until Departments of Family medicine are established.

An Alternative Approach for Supportive Supervision and Skill Measurements of Health Workers for Integrated Management of Neonatal and Childhood Illnesses Program in 10 Districts of Haryana.

PubMed

Aggarwal, Arun K; Gupta, Rakesh; Das, Dhritiman; Dhakar, Anar S; Sharma, Gourav; Anand, Himani; Kaur, Kamalpreet; Sheoran, Kiran; Dalpath, Suresh; Khatri, Jaidev; Gupta, Madhu

2018-01-01

"Integrated Management of Neonatal and Childhood Illnesses" (IMNCI) needs regular supportive supervision (SS). The aim of this study was to find suitable SS model for implementing IMNCI. This was a prospective interventional study in 10 high-focus districts of Haryana. Two methods of SS were used: (a) visit to subcenters and home visits (model 1) and (b) organization of IMNCI clinics/camps at primary health center (PHC) and community health center (CHC) (model 2). Skill scores were measured at different time points. Routine IMNCI data from study block and randomly selected control block of each district were retrieved for 4 months before and after the training and supervision. Change in percentage mean skill score difference and percentage difference in median number of children were assessed in two areas. Mean skill scores increased significantly from 2.1 (pretest) to 7.0 (posttest 1). Supportive supervisory visits sustained and improved skill scores. While model 2 of SS could positively involve health system officials, model 1 was not well received. Outcome indicator in terms of number of children assessed showed a significant improvement in intervention areas. SS in IMNCI clinics/camps at PHC/CHC level and innovative skill scoring method is a promising approach.

Cost of hospital care for older adults with heart failure: medical, pharmaceutical, and nursing costs.

PubMed

Titler, Marita G; Jensen, Gwenneth A; Dochterman, Joanne McCloskey; Xie, Xian-Jin; Kanak, Mary; Reed, David; Shever, Leah L

2008-04-01

To determine the impact of patient characteristics, clinical conditions, hospital unit characteristics, and health care interventions on hospital cost of patients with heart failure. Data for this study were part of a larger study that used electronic clinical data repositories from an 843-bed, academic medical center in the Midwest. This retrospective, exploratory study used existing administrative and clinical data from 1,435 hospitalizations of 1,075 patients 60 years of age or older. A cost model was tested using generalized estimating equations (GEE) analysis. Electronic databases used in this study were the medical record abstract, the financial data repository, the pharmacy repository; and the Nursing Information System repository. Data repositories were merged at the patient level into a relational database and housed on an SQL server. The model accounted for 88 percent of the variability in hospital costs for heart failure patients 60 years of age and older. The majority of variables that were associated with hospital cost were provider interventions. Each medical procedure increased cost by $623, each unique medication increased cost by $179, and the addition of each nursing intervention increased cost by $289. One medication and several nursing interventions were associated with lower cost. Nurse staffing below the average and residing on 2-4 units increased hospital cost. The model and data analysis techniques used here provide an innovative and useful methodology to describe and quantify significant health care processes and their impact on cost per hospitalization. The findings indicate the importance of conducting research using existing clinical data in health care.

Collaborative modeling of an implementation strategy: a case study to integrate health promotion in primary and community care.

PubMed

Grandes, Gonzalo; Sanchez, Alvaro; Cortada, Josep M; Pombo, Haizea; Martinez, Catalina; Balagué, Laura; Corrales, Mary Helen; de la Peña, Enrique; Mugica, Justo; Gorostiza, Esther

2017-12-06

Evidence-based interventions are more likely to be adopted if practitioners collaborate with researchers to develop an implementation strategy. This paper describes the steps to plan and execute a strategy, including the development of structure and supports needed for implementing proven health promotion interventions in primary and community care. Between 10 and 13 discussion and consensus sessions were performed in four highly-motivated primary health care centers involving 80% of the primary care staff and 21 community-based organizations. All four centers chose to address physical activity, diet, and smoking. They selected the 5 A's evidence-based clinical intervention to be adapted to the context of the health centers. The planned implementation strategy worked at multiple levels: bottom-up primary care organizational change, top-down support from managers, community involvement, and the development of innovative e-health information and communication tools. Shared decision making and practice facilitation were perceived as the most positive aspects of the collaborative modeling process, which took more time than expected, especially the development of the new e-health tools integrated into electronic health records. Collaborative modeling of an implementation strategy for the integration of health promotion in primary and community care was feasible in motivated centers. However, it was difficult, being hindered by the heavy workload in primary care and generating uncertainty inherent to a bottom-up decision making processes. Lessons from this experience could be useful in diverse settings and for other clinical interventions. Two companion papers report the evaluation of its feasibility and assess quantitatively and qualitatively the implementation process.

The ISB model (infrastructure, service, behaviour): a tool for waste practitioners.

PubMed

Timlett, R; Williams, I D

2011-06-01

In response to the EU Landfill Directive and the challenge of mitigating climate change, the UK government (nationally and locally) must develop strategies and policies to reduce, recycle, compost and recover waste. Best practice services that yield high recycling rates, such as alternate weekly collections, are now largely mainstream in suitable areas. However, national recycling performance is short of what is needed; policy makers must look for innovative ways to meet challenging recycling targets. Increasingly, local authorities are using behaviour change interventions to encourage the public to recycle; these tend to be based on the premise that an individuals' behaviour is predetermined by their values. In practice, this has led to a host of initiatives that attempt to change individuals' behaviour without addressing situational barriers. In this paper, we argue that that a behaviour-centric approach has limited effectiveness. Using an analysis of the literature and studies that investigated recycling participation in the city of Portsmouth, we have identified three significant clusters that can facilitate effective recycling: infrastructure, service and behaviour (ISB). We present the ISB model - a tool that can be used by waste practitioners when planning interventions to maximise recycling to better understand the situation and context for behaviour. Analysis using the ISB model suggests that current best practice, "business as usual" interventions could realistically achieve a national recycling rate of 50%. If the UK is to move towards zero waste, policy makers must look "upstream" for interventions that change the situational landscape. Copyright © 2011 Elsevier Ltd. All rights reserved.

Ability, incentives, and management feedback: organizational change to reduce pressure ulcers in a nursing home.

PubMed

Rosen, Jules; Mittal, Vikas; Degenholtz, Howard; Castle, Nick; Mulsant, Benoit H; Hulland, Shelley; Nace, David; Rubin, Fred

2006-03-01

Quality improvement (QI) processes in nursing homes are highly variable and often ineffective. This study evaluated an innovative QI process to reduce pressure ulcers (PUs) in a nursing home with a high rate of PUs. This was a 48-week, longitudinal study comparing the incidence of PUs during 12-week baseline and intervention and post-intervention periods. Not-for-profit, 136-bed nursing home in urban Western Pennsylvania. All residents and all staff at the nursing home participated in this study. The intervention consisted of 3 components: Ability enhancement, incentivization, and management feedback. To enhance ability, all staff members completed a computer-based interactive video education program on PU prevention and were mandated to use penlights to promote early detection. Incentivization included $75 for each staff member if the desired reduction in PU incidence was achieved. Management feedback provided real-time information of staff"s adherence to the mandated training. Outcome measures consisted of staff's adherence to mandated training and the incidence of new PUs during the baseline period compared to the intervention and post-intervention periods. Management responded to noncompliance with training with both rewards and stepped discipline. Adherence to protocol, as measured by training compliance, was 100%. There was a significant reduction (P < .05) in the incidence of stage 2 or worse PUs during the intervention period. During the post-intervention periods, the effect was lost. An innovative QI initiative resulted in a significant decrease in PUs in 1 facility. This intervention was not sustainable when the 3 components of the QI intervention were no longer actively maintained.

Innovation Process Design: A Change Management and Innovation Dimension Perspective

NASA Astrophysics Data System (ADS)

Peisl, Thomas; Reger, Veronika; Schmied, Juergen

The authors propose an innovative approach to the management of innovation integrating business, process, and maturity dimensions. Core element of the concept is the adaptation of ISO/IEC 15504 to the innovation process including 14 innovation drivers. Two managerial models are applied to conceptualize and visualize the respective innovation strategies, the Balanced Scorecard and a Barriers in Change Processes Model. An illustrative case study shows a practical implementation process.

Developing a Model for an Innovative Culinary Competency Curriculum and Examining Its Effects on Students' Performance

ERIC Educational Resources Information Center

Hu, Meng-Lei I-Chen Monica; Horng, Jeou-Shyan; Teng, Chih-Ching

2016-01-01

The present study designs and develops an innovative culinary competency curriculum (ICCC) model comprising seven sections: innovative culture, aesthetics, techniques, service, product, management, and creativity. The model is formulated based on culinary concept, creativity, innovation, and competency theory. The four elements of curriculum…

Non-technical skills training to enhance patient safety.

PubMed

Gordon, Morris

2013-06-01

  Patient safety is an increasingly recognised issue in health care. Systems-based and organisational methods of quality improvement, as well as education focusing on key clinical areas, are common, but there are few reports of educational interventions that focus on non-technical skills to address human factor sources of error. A flexible model for non-technical skills training for health care professionals has been designed based on the best available evidence, and with sound theoretical foundations.   Educational sessions to improve non-technical skills in health care have been described before. The descriptions lack the details to allow educators to replicate and innovate further.   A non-technical skills training course that can be delivered as either a half- or full-day intervention has been designed and delivered to a number of mixed groups of undergraduate medical students and doctors in postgraduate training. Participant satisfaction has been high and patient safety attitudes have improved post-intervention.   This non-technical skills educational intervention has been built on a sound evidence base, and is described so as to facilitate replication and dissemination. With the key themes laid out, clinical educators will be able to build interventions focused on numerous clinical issues that pay attention to human factor contributors to safety. © 2013 John Wiley & Sons Ltd.

Results of a multi-media multiple behavior obesity prevention program for adolescents.

PubMed

Mauriello, Leanne M; Ciavatta, Mary Margaret H; Paiva, Andrea L; Sherman, Karen J; Castle, Patricia H; Johnson, Janet L; Prochaska, Janice M

2010-12-01

This study reports on effectiveness trial outcomes of Health in Motion, a computer tailored multiple behavior intervention for adolescents. Using school as level of assignment, students (n=1800) from eight high schools in four states (RI, TN, MA, and NY) were stratified and randomly assigned to no treatment or a multi-media intervention for physical activity, fruit and vegetable consumption, and limited TV viewing between 2006 and 2007. Intervention effects on continuous outcomes, on movement to action and maintenance stages, and on stability within action and maintenance stages were evaluated using random effects modeling. Effects were most pronounced for fruit and vegetable consumption and for total risks across all time points and for each behavior immediately post intervention. Co-variation of behavior change occurred within the treatment group, where individuals progressing to action or maintenance for one behavior were 1.4-4.2 times more likely to make similar progress on another behavior. Health in Motion is an innovative, multiple behavior obesity prevention intervention relevant for all adolescents that relies solely on interactive technology to deliver tailored feedback. The outcomes of the effectiveness trial demonstrate both an ability to initiate behavior change across multiple energy balance behaviors simultaneously and feasibility for ease of dissemination. Copyright © 2010 The Institute For Cancer Prevention. Published by Elsevier Inc. All rights reserved.

Evaluability Assessment of an immunization improvement strategy in rural Burkina Faso: intervention theory versus reality, information need and evaluations.

PubMed

Sanou, Aboubakary; Kouyaté, Bocar; Bibeau, Gilles; Nguyen, Vinh-Kim

2011-08-01

An innovative immunization improvement strategy was proposed by the CRSN (Centre de Recherche en Santé de Nouna) to improve the low coverage rate for children aged 0-11 months in the health district of Nouna in Burkina Faso. This article reports on the Evaluability Assessment (EA) study that aimed to orient decisions for its evaluation in close relationship with the information needs of the stakeholders. Various methods were used, including document reviews, individual interviews, focus group discussions, meetings, literature reviews and site visits. A description of the intervention theory and philosophy is provided with its logic models and its reality documented. Lessons on the procedure include the importance of the position of the evaluability assessor, the value of replicating some steps of the assessment and the relationships between EA and process evaluation. The evaluability study concludes that the intervention had some evaluable components. To satisfy the stakeholders' needs, the initially planned community randomized controlled trial can be maintained and complemented with a process evaluation. There is a need to provide sufficient information on the cost of the intervention. This will inform decision makers on the possibility of replicating the intervention in other contexts. Copyright © 2010 Elsevier Ltd. All rights reserved.

A model for ‘reverse innovation’ in health care

PubMed Central

2013-01-01

‘Reverse innovation,’ a principle well established in the business world, describes the flow of ideas from emerging to more developed economies. There is strong and growing interest in applying this concept to health care, yet there is currently no framework for describing the stages of reverse innovation or identifying opportunities to accelerate the development process. This paper combines the business concept of reverse innovation with diffusion of innovation theory to propose a model for reverse innovation as a way to innovate in health care. Our model includes the following steps: (1) identifying a problem common to lower- and higher-income countries; (2) innovation and spread in the low-income country (LIC); (3) crossover to the higher-income country (HIC); and (4) innovation and spread in the HIC. The crucial populations in this pathway, drawing from diffusion of innovation theory, are LIC innovators, LIC early adopters, and HIC innovators. We illustrate the model with three examples of current reverse innovations. We then propose four sets of specific actions that forward-looking policymakers, entrepreneurs, health system leaders, and researchers may take to accelerate the movement of promising solutions through the reverse innovation pipeline: (1) identify high-priority problems shared by HICs and LICs; (2) create slack for change, especially for LIC innovators, LIC early adopters, and HIC innovators; (3) create spannable social distances between LIC early adopters and HIC innovators; and (4) measure reverse innovation activity globally. PMID:24001367

Integrating Worksite Health Protection and Health Promotion: A Conceptual Model for Intervention and Research

PubMed Central

Sorensen, Glorian; McLellan, Deborah L.; Sabbath, Erika L.; Dennerlein, Jack T.; Nagler, Eve M.; Hurtado, David A.; Pronk, Nicolaas P.; Wagner, Gregory R.

2016-01-01

There is increasing recognition of the value added by integrating traditionally separate efforts to protect and promote worker safety and health. This paper presents an innovative conceptual model to guide research on determinants of worker safety and health and to inform the design, implementation and evaluation of integrated approaches to promoting and protecting worker health. This model is rooted in multiple theories and the premise that the conditions of work are important determinants of individual safety and health outcomes and behaviors, and outcomes important to enterprises such as absence and turnover. Integrated policies, programs and practices simultaneously address multiple conditions of work, including the physical work environment and the organization of work (e.g., psychosocial factors, job tasks and demands). Findings from two recent studies conducted in Boston and Minnesota (2009–2015) illustrate the application of this model to guide social epidemiological research. This paper focuses particular attention on the relationships of the conditions of work to worker health-related behaviors, musculoskeletal symptoms, and occupational injury; and to the design of integrated interventions in response to specific settings and conditions of work of small and medium size manufacturing businesses, based on a systematic assessment of priorities, needs, and resources within an organization. This model provides an organizing framework for both research and practice by specifying the causal pathways through which work may influence health outcomes, and for designing and testing interventions to improve worker safety and health that are meaningful for workers and employers, and responsive to that setting’s conditions of work. PMID:27527576

Community Partnership to Address Snack Quality and Cost in Afterschool Programs

PubMed Central

Tilley, Falon; Turner-McGrievy, Gabrielle; Weaver, Robert Glenn; Jones, Sonya

2014-01-01

Background Policies call on afterschool programs (ASPs) to serve more nutritious snacks. A major barrier for improving snack quality is cost. This study describes the impact on snack quality and expenditures from a community-partnership between ASPs and local grocery stores. Methods Four large-scale ASPs (serving ∼500 children aged 6-12 years each day) and a single local grocery store chain participated in the study. The nutritional quality of snacks served was recorded pre-intervention (18 weeks spring/fall 2011) and post-intervention (7 weeks spring 2012) via direct observation, along with cost/child/snack/day. Results Pre-intervention snacks were low-nutrient-density salty snacks (eg, chips, 3.0 servings/week), sugar-sweetened beverages (eg, powdered-lemonade, 1.9 servings/week), and desserts (eg, cookies, 2.1servings/week), with only 0.4 servings/week of fruits and no vegetables. By post-intervention, fruits (3.5 servings/week) and vegetables (1.2 servings/week) increased, while sugar-sweetened beverages and desserts were eliminated. Snack expenditures were $0.26 versus $0.24 from pre-intervention to post-intervention. Partnership savings versus purchasing snacks at full retail cost was 24.5% or $0.25/serving versus $0.34/serving. Conclusions This innovative partnership can serve as a model in communities where ASPs seek to identify low-cost alternatives to providing nutritious snacks. PMID:25040123

Caring for Others: Internet Video-Conferencing Group Intervention for Family Caregivers of Older Adults with Neurodegenerative Disease

ERIC Educational Resources Information Center

Marziali, Elsa; Donahue, Peter

2006-01-01

Purpose: The aim of this pilot feasibility study was to evaluate the effects of an innovative, Internet-based psychosocial intervention for family caregivers of older adults with neurodegenerative disease. Design and Methods: After receiving signed informed consent from each participant, we randomly assigned 66 caregivers to an Internet-based…

Response to Intervention for Gifted Students: Implementation by Classroom Teachers in Colorado

ERIC Educational Resources Information Center

Nichols, Leslie

2012-01-01

The purpose of this study was to examine the level of implementation that preK-12 regular classroom teachers have achieved in using the educational innovation Response to Intervention (RTI) to deliver gifted education services in Colorado. The methodology used was a mixed methods approach utilizing the online Stages of Concern Questionnaire,…

The Impact of Arbitration Intervention Services on Psychosocial Functioning: A Follow-Up Study

ERIC Educational Resources Information Center

Dembo, Richard; Wareham, Jennifer; Poythress, Norman G.; Cook, Brittany; Schmeidler, James

2006-01-01

We report the impact of case management services on drug use and self-reported delinquency for youths involved in a clinical trial of the Juvenile Arbitration program. The project evaluated an innovative intervention service providing 16 weeks of intensive case management services to youths and their families. The present study examines interview…

Promoting Academic Competence and Behavioral Health in Public Schools: A Strategy of Systemic Concatenation of Empirically Based Intervention Principles

ERIC Educational Resources Information Center

Dishion, Thomas

2011-01-01

This special issue, Developing Social- Emotional and Behavioral Interventions with School Communities: Systematic and Collaborative Processes, reflects the current state of the science for improving schools to better educate children and adolescents and promote their behavioral health. The innovations described in this volume describe advancements…

Baseline Evaluation of a Participatory Mobile Health Intervention for Dengue Prevention in Sri Lanka

ERIC Educational Resources Information Center

Lwin, May O.; Vijaykumar, Santosh; Lim, Gentatsu; Fernando, Owen Noel Newton; Rathnayake, Vajira Sampath; Foo, Schubert

2016-01-01

Challenges posed by infectious disease outbreaks have led to a range of participatory mobile phone-based innovations that use the power of crowdsourcing for disease surveillance. However, the dynamics of participatory behavior by crowds in such interventions have yet to be examined. This article reports results from a baseline evaluation of one…

Reaching the Hard to Reach: A Comparison of Two Reading Interventions with Incarcerated Youth

ERIC Educational Resources Information Center

Calderone, Cynthia; Bennett, Susan V.; Homan, Susan; Dedrick, Robert F.; Chatfield, Anne

2009-01-01

The purpose of this quantitative study, funded by the Florida Department of Education (FLDOE) through Just Read, Florida!, was to investigate the use of Tune in[TM] to Reading, an innovative reading intervention, with struggling adolescent readers in the juvenile justice system. One hundred and three students who exhibited issues ranging from…

Using iKidTools™ Software Support Systems to Develop and Implement Self-Monitoring Interventions

ERIC Educational Resources Information Center

Patti, Angela L.; Miller, Kevin J.

2011-01-01

Educational teams often are faced with the task of developing and implementing Behavioral Intervention Plans (BIPs) for students who present challenging and/or disruptive behaviors. This article describes the steps used to develop and implement a self-monitoring BIP that incorporated an innovative software system, iKidTools™. An authentic case…

A novel approach to early sickness absence management: The EASY (Early Access to Support for You) way.

PubMed

Demou, Evangelia; Brown, Judith; Sanati, Kaveh; Kennedy, Mark; Murray, Keith; Macdonald, Ewan B

2015-01-01

Sickness absence (SA) is multi-causal and remains a significant problem for employees, employers and society. This makes it necessary to concurrently manage a particular disabling condition and consider the working environment and employee-employer relationship. To describe and examine the components of a novel SA management service Early Access to Support for You (EASY) and discuss their potential influence on the intervention. A new sickness absence model, starting from day one of absence, was created called EASY. EASY is planned to support both employees and managers and comprises elements already found to be associated with reduction of SA, such as maintaining regular contact; early biopsychosocial case-management; physiotherapy; mental-health counselling; work modification; phased return-to-work; and health promotion activities. During the EASY implementation period, the SA rate at a health board reversed its trend of being one of the highest rates in the Scottish National Health Service (NHS) and EASY was considered helpful by both managers and employees. This paper describes an innovative occupational health intervention to sickness absence management based on the bio-psychosocial model to provide early intervention, and discusses the pros and cons of applying cognitive behavioural principles at an early stage in sickness-absence events, in order to improve return-to-work outcomes.

Community organizing and community health: piloting an innovative approach to community engagement applied to an early intervention project in south London

PubMed Central

Bolton, Matthew; Moore, Imogen; Ferreira, Ana; Day, Crispin; Bolton, Derek

2016-01-01

Background The importance of community engagement in health is widely recognized, and key themes in UK National Institute for Health and Clinical Excellence (NICE) recommendations for enhancing community engagement are co-production and community control. This study reports an innovative approach to community engagement using the community-organizing methodology, applied in an intervention of social support to increase social capital, reduce stress and improve well-being in mothers who were pregnant and/or with infants aged 0–2 years. Methods Professional community organizers in Citizens-UK worked with local member civic institutions in south London to facilitate social support to a group of 15 new mothers. Acceptability of the programme, adherence to principles of co-production and community control, and changes in the outcomes of interest were assessed quantitatively in a quasi-experimental design. Results The programme was found to be feasible and acceptable to participating mothers, and perceived by them to involve co-production and community control. There were no detected changes in subjective well-being, but there were important reductions in distress on a standard self-report measure (GHQ-12). There were increases in social capital of a circumscribed kind associated with the project. Conclusions Community organizing provides a promising model and method of facilitating community engagement in health. PMID:25724610

A Systems Approach to Identifying and Managing Opportunities and Constraints to Delivering Innovation Policy for Agriculture: An Analysis of the Australian Cooperative Research Centres (CRC) Program

ERIC Educational Resources Information Center

Sandall, Jean; Cooksey, Ray; Wright, Vic

2011-01-01

In this paper we outline an analytical approach to identifying points in the policy process where management intervention to adjust organizational design could enhance delivery of innovation policy over time. We illustrate this approach using an example from native vegetation policy in the state of Victoria, Australia. We then use this approach to…

An Innovative Approach for Decreasing Fall Trauma Admissions from Geriatric Living Facilities: Preliminary Investigation.

PubMed

Evans, Tracy; Gross, Brian; Rittenhouse, Katelyn; Harnish, Carissa; Vellucci, Ashley; Bupp, Katherine; Horst, Michael; Miller, Jo Ann; Baier, Ron; Chandler, Roxanne; Rogers, Frederick B

2015-12-01

Geriatric living facilities have been associated with a high rate of falls. We sought to develop an innovative intervention approach targeting geriatric living facilities that would reduce geriatric fall admissions to our Level II trauma center. In 2011, a Trauma Prevention Taskforce visited 5 of 28 local geriatric living facilities to present a fall prevention protocol composed of three sections: fall education, risk factor identification, and fall prevention strategies. To determine the impact of the intervention, the trauma registry was queried for all geriatric fall admissions attributed to patients living at local geriatric living facilities. The fall admission rate (total fall admissions/total beds) of the pre-intervention period (2010-2011) was compared with that of the postintervention period (2012-2013) at the 5 intervention and 23 control facilities. A P value < 0.05 was considered statistically significant. From 2010 to 2013, there were 487 fall admissions attributed to local geriatric living facilities (intervention: 179 fall admissions; control: 308 fall admissions). The unadjusted fall rate decreased at intervention facilities from 8.9 fall admissions/bed pre-intervention to 8.1 fall admissions/bed postintervention, whereas fall admission rates increased at control sites from 5.9 to 7.7 fall admissions/bed during the same period [control/intervention odds ratio (OR), 95% confidence interval (CI) = 1.32, 1.05-1.67; period OR, 95%CI = 1.55, 1.18-2.04, P = 0.002; interaction of control/intervention group and period OR 95% CI = 0.68, 0.46-1.00, P = 0.047]. An aggressive intervention program targeting high-risk geriatric living facilities resulted in a statistically significant decrease in geriatric fall admissions to our Level II trauma center.

Can We Recognize an Innovation? Perspective from an Evolving Network Model

NASA Astrophysics Data System (ADS)

Jain, Sanjay; Krishna, Sandeep

"Innovations" are central to the evolution of societies and the evolution of life. But what constitutes an innovation? We can often agree after the event, when its consequences and impact over a long term are known, whether something was an innovation, and whether it was a "big" innovation or a "minor" one. But can we recognize an innovation "on the fly" as it appears? Successful entrepreneurs often can. Is it possible to formalize that intuition? We discuss this question in the setting of a mathematical model of evolving networks. The model exhibits self-organization , growth, stasis, and collapse of a complex system with many interacting components, reminiscent of real-world phenomena. A notion of "innovation" is formulated in terms of graph-theoretic constructs and other dynamical variables of the model. A new node in the graph gives rise to an innovation, provided it links up "appropriately" with existing nodes; in this view innovation necessarily depends upon the existing context. We show that innovations, as defined by us, play a major role in the birth, growth, and destruction of organizational structures. Furthermore, innovations can be categorized in terms of their graph-theoretic structure as they appear. Different structural classes of innovation have potentially different qualitative consequences for the future evolution of the system, some minor and some major. Possible general lessons from this specific model are briefly discussed.

Building and analyzing an innovative community-centered dengue-ecosystem management intervention in Yogyakarta, Indonesia

PubMed Central

Tana, Susilowati; Umniyati, SittiRahmah; Petzold, Max; Kroeger, Axel; Sommerfeld, Johannes

2012-01-01

Background and Objectives Dengue is an important public health problem in Yogyakarta city, Indonesia. The aim of this study was to build an innovative community-centered dengue-ecosystem management intervention in the city and to assess the process and results. Methods For describing the baseline situation, entomological surveys and household surveys were carried out in six randomly selected neighborhoods in Yogyakarta city, documents were analyzed and different stakeholders involved in dengue control and environmental management were interviewed. Then a community-centered dengue-ecosystem management intervention was built up in two of the neighborhoods (Demangan and Giwangan) whereas two neighborhoods served as controls with no intervention (Tahunan and Bener). Six months after the intervention follow up surveys (household interviews and entomological) were conducted as well as focus group discussions and key informant interviews. FIindings The intervention results included: better community knowledge, attitude and practices in dengue prevention; increased household and community participation; improved partnership including a variety of stakeholders with prospects for sustainability; vector control efforts refocused on environmental and health issues; increased community ownership of dengue vector management including broader community development activities such as solid waste management and recycling. Conclusion The community-centred approach needs a lot of effort at the beginning but has better prospects for sustainability than the vertical “top-down” approach. PMID:23318239

Social marketing meets health literacy: Innovative improvement of health care providers’ comfort with patient interaction

PubMed Central

Primack, Brian A.; Bui, Thuy; Fertman, Carl I.

2010-01-01

Objective It is essential to train health care providers to deliver care sensitive to the needs of diverse individuals with varying degrees of health literacy. We aimed to evaluate an innovative, theory-based, educational intervention involving social marketing and health literacy. Methods In 2006 at a large medical school, all first-year students were exposed to the intervention. They completed pre- and post-test anonymous surveys including demographic data, covariates, and key outcome variables. Paired t-tests and multiple linear regression were used to evaluate the intervention and to determine independent associations among the key outcome variables. Results Post-intervention scores were significantly higher than pre-intervention scores for social marketing (3.31 versus 1.90, p < 0.001), health literacy (3.41 versus 2.98, p < 0.001), and comfort in brochure development (3.11 versus 2.52, p < 0.001) (N = 83). After controlling for demographic and covariate data, health literacy and comfort in brochure development were independent predictors of comfort interacting with diverse populations. Conclusion A brief intervention involving social marketing and health literacy can improve skills that improve medical students’ comfort with patients of diverse backgrounds. Practice implications Health care providers can be taught educational principles and skills involved in developing effective patient education materials. These skills may improve providers’ comfort with direct patient interaction. PMID:17418522

From the point-of-purchase perspective: a qualitative study of the feasibility of interventions aimed at portion-size.

PubMed

Vermeer, Willemijn M; Steenhuis, Ingrid H M; Seidell, Jacob C

2009-04-01

Food portion-sizes might be a promising starting point for interventions targeting obesity. The purpose of this qualitative study was to assess how representatives of point-of-purchase settings perceived the feasibility of interventions aimed at portion-size. Semi-structured interviews were conducted with 22 representatives of various point-of-purchase settings. Constructs derived from the diffusion of innovations theory were incorporated into the interview guide. Each interview was recorded and transcribed verbatim. Data were coded and analysed with Atlas.ti 5.2 using the framework approach. According to the participants, offering a larger variety of portion-sizes had the most relative advantages, and reducing portions was the most disadvantageous. The participants also considered portion-size reduction and linear pricing of portion-sizes to be risky. Lastly, a larger variety of portion-sizes, pricing strategies and portion-size labelling were seen as the most complex interventions. In general, participants considered offering a larger variety of portion-sizes, portion-size labelling and, to a lesser extent, pricing strategies with respect to portion-sizes as most feasible to implement. Interventions aimed at portion-size were seen as innovative by most participants. Developing adequate communication strategies about portion-size interventions with both decision-makers in point-of-purchase settings and the general public is crucial for successful implementation.

The new norms of food waste at the curb: Evidence-based policy tools to address benefits and barriers.

PubMed

Geislar, Sally

2017-10-01

Cities around the world are under increasing political pressure to develop organics collection programs (OCP) to curb the flow of food waste into landfills, reduce the associated greenhouse gases, and generate compost or biogas. While OCPs tend to focus on infrastructure, they often overlook the linchpin role that household behavior change plays in the success of OCPs. The current research used a longitudinal field experiment (n=370) to test both the effectiveness of a new curbside OCP and new social innovations intended to stimulate pro-environmental changes in household behavior. The findings suggest greater participation levels occur by implementing both new supportive infrastructure (i.e., curbside carts and collection services), and innovations that target the social aspects of waste (i.e., communicating social norms of separation). The data also provide an opportunity to test new model for predicting the most efficacious behavior-change interventions based on population profiles. The results provide some support for the model; reducing barriers (i.e., curbside carts and collection) tends to help all population profiles, but norm communication increases participation more for the hypothesized profile than for other sub-groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using the multiphase optimization strategy (MOST) to optimize an HIV care continuum intervention for vulnerable populations: a study protocol.

PubMed

Gwadz, Marya Viorst; Collins, Linda M; Cleland, Charles M; Leonard, Noelle R; Wilton, Leo; Gandhi, Monica; Scott Braithwaite, R; Perlman, David C; Kutnick, Alexandra; Ritchie, Amanda S

2017-05-04

More than half of persons living with HIV (PLWH) in the United States are insufficiently engaged in HIV primary care and not taking antiretroviral therapy (ART), mainly African Americans/Blacks and Hispanics. In the proposed project, a potent and innovative research methodology, the multiphase optimization strategy (MOST), will be employed to develop a highly efficacious, efficient, scalable, and cost-effective intervention to increase engagement along the HIV care continuum. Whereas randomized controlled trials are valuable for evaluating the efficacy of multi-component interventions as a package, they are not designed to evaluate which specific components contribute to efficacy. MOST, a pioneering, engineering-inspired framework, addresses this problem through highly efficient randomized experimentation to assess the performance of individual intervention components and their interactions. We propose to use MOST to engineer an intervention to increase engagement along the HIV care continuum for African American/Black and Hispanic PLWH not well engaged in care and not taking ART. Further, the intervention will be optimized for cost-effectiveness. A similar set of multi-level factors impede both HIV care and ART initiation for African American/Black and Hispanic PLWH, primary among them individual- (e.g., substance use, distrust, fear), social- (e.g., stigma), and structural-level barriers (e.g., difficulties accessing ancillary services). Guided by a multi-level social cognitive theory, and using the motivational interviewing approach, the study will evaluate five distinct culturally based intervention components (i.e., counseling sessions, pre-adherence preparation, support groups, peer mentorship, and patient navigation), each designed to address a specific barrier to HIV care and ART initiation. These components are well-grounded in the empirical literature and were found acceptable, feasible, and promising with respect to efficacy in a preliminary study. Study aims are: 1) using a highly efficient fractional factorial experimental design, identify which of five intervention components contribute meaningfully to improvement in HIV viral suppression, and secondary outcomes of ART adherence and engagement in HIV primary care; 2) identify mediators and moderators of intervention component efficacy; and 3) using a mathematical modeling approach, build the most cost-effective and efficient intervention package from the efficacious components. A heterogeneous sample of African American/Black and Hispanic PLWH (with respect to age, substance use, and sexual minority status) will be recruited with a proven hybrid sampling method using targeted sampling in community settings and peer recruitment (N = 512). This is the first study to apply the MOST framework in the field of HIV prevention and treatment. This innovative study will produce a culturally based HIV care continuum intervention for the nation's most vulnerable PLWH, optimized for cost-effectiveness, and with exceptional levels of efficacy, efficiency, and scalability. ClinicalTrials.gov, NCT02801747 , Registered June 8, 2016.

Small Changes and Lasting Effects (SCALE) Trial: The Formation of a Weight Loss Behavioral Intervention Using EVOLVE

PubMed Central

Phillips-Caesar, Erica G.; Winston, Ginger; Peterson, Janey C.; Wansink, Brian; Devine, Carol M.; Kanna, Balavanketsh; Michelin, Walid; Wethington, Elaine; Wells, Martin; Hollenberg, James; Charlson, Mary E.

2015-01-01

Background Obesity is a major health problem that disproportionately affects Black and Hispanic adults. This paper presents the rationale and innovative design of a small change eating and physical activity intervention (SC) combined with a positive affect and self-affirmation (PA/SA) intervention versus the SC intervention alone for weight loss. Methods Using a mixed methods translational model (EVOLVE), we designed and tested a SC approach intervention in overweight and/ or obese African American and Hispanic adults. In Phase I, we explored participant’s values and beliefs about the small change approach. In Phase II, we tested and refined the intervention and then, in Phase III we conducted a RCT. Participants were randomized to the SC approach with PA/SA intervention vs. a SC approach alone for 12 months. The primary outcome was clinically significant weight loss at 12 months. Results Over 4.5 years a total of 574 participants (67 in Phase I, 102 in Phase II and 405 in Phase III) were enrolled. Phase I findings were used to create a workbook based on real life experiences about weight loss and to refine the small change eating strategies. Phase II results shaped the recruitment and retention strategy for the RCT, as well as the final intervention. The RCT results are currently under analysis. Conclusion The present study seeks to determine if a SC approach combined with a PA/SA intervention will result in greater weight loss at 12 months in Black and Hispanic adults compared to a SC approach alone. PMID:25633208

The community popular opinion leader HIV prevention programme: conceptual basis and intervention procedures.

PubMed

2007-04-01

To describe the community popular opinion leader (C-POL) intervention employed in the NIMH Collaborative HIV/STD Prevention Trial, including its theoretical, conceptual, and empirical basis, intervention procedures and methods, core elements, and how its content was culturally tailored to address the needs of varied populations. The programme is designed to identify, recruit, train, and intensively engage C-POLs of a target population to convey HIV risk reduction messages to people in their communities, with the intention of reducing high-risk behavior at a population level. Based on the diffusion of innovation theory, the intervention identified, trained, and engaged C-POL within a high-risk community population to advocate, recommend, and endorse the importance of safer behavior to other members of the same population. Nine core elements of the intervention are discussed. Data collected during rapid ethnography were used to adapt the content of the intervention for food market owners and workers in China, male patrons of wine shops and at-risk women congregating nearby in India, young people in social gathering venues in Peruvian barrios, dormitory students in Russia, and people congregating in commercial areas of growth points in Zimbabwe. The C-POL intervention model taps into community strengths, altruism, and people's desire to do something to help fight against AIDS. With few exceptions, C-POLs participated enthusiastically in the training sessions and reported having conversations in the community. Rapid ethnography can be used to tailor an intervention to diverse settings while maintaining fidelity to the core elements of the intervention.

The CHOICE pilot project: Challenges of implementing a combined peer work and shared decision-making programme in an early intervention service.

PubMed

Simmons, Magenta B; Coates, Dominiek; Batchelor, Samantha; Dimopoulos-Bick, Tara; Howe, Deborah

2017-12-12

Youth participation is central to early intervention policy and quality frameworks. There is good evidence for peer support (individuals with lived experience helping other consumers) and shared decision making (involving consumers in making decisions about their own care) in adult settings. However, youth programs are rarely tested or described in detail. This report aims to fill this gap by describing a consumer focused intervention in an early intervention service. This paper describes the development process, intervention content and implementation challenges of the Choices about Healthcare Options Informed by Client Experiences and Expectations (CHOICE) Pilot Project. This highly novel and innovative project combined both youth peer work and youth shared decision making. Eight peer workers were employed to deliver an online shared decision-making tool at a youth mental health service in New South Wales, Australia. The intervention development involved best practice principles, including international standards and elements of co-design. The implementation of the peer workforce in the service involved a number of targeted strategies designed to support this new service model. However, several implementation challenges were experienced which resulted in critical learning about how best to deliver these types of interventions. Delivering peer work and shared decision making within an early intervention service is feasible, but not without challenges. Providing adequate detail about interventions and implementation strategies fills a critical gap in the literature. Understanding optimal youth involvement strategies assists others to deliver acceptable and effective services to young people who experience mental ill health. © 2017 John Wiley & Sons Australia, Ltd.

Current Status and Future Potential of Transcatheter Interventions in Congenital Heart Disease.

PubMed

Kenny, Damien P; Hijazi, Ziyad M

2017-03-17

Percutaneous therapies for congenital heart disease have evolved rapidly in the past 3 decades. This has occurred despite limited investment from industry and support from regulatory bodies resulting in a lack of specific device development. Indeed, many devices remain off-label with a best-fit approach often required, spurning an innovative culture within the subspecialty, which had arguably laid the foundation for many of the current and evolving structural heart interventions. Challenges remain, not least encouraging device design focused on smaller infants and the inevitable consequences of somatic growth. Data collection tools are emerging but remain behind adult cardiology and cardiac surgery and leading to partial blindness as to the longer-term consequences of our interventions. Tail coating on the back of developments in other fields of adult intervention will soon fail to meet the expanding needs for more precise interventions and biological materials. Increasing collaboration with surgical colleagues will require development of dedicated equipment for hybrid interventions aimed at minimizing the longer-term consequences of scar to the heart. Therefore, great challenges remain to ensure that children and adults with congenital heart disease continue to benefit from an exponential growth in minimally invasive interventions and technology. This can only be achieved through a concerted collaborative approach from physicians, industry, academia, and regulatory bodies supporting great innovators to continue the philosophy of thinking beyond the limits that has been the foundation of our specialty for the past 50 years. © 2017 American Heart Association, Inc.

The implementation of health promotion in primary and community care: a qualitative analysis of the 'Prescribe Vida Saludable' strategy.

PubMed

Martinez, Catalina; Bacigalupe, Gonzalo; Cortada, Josep M; Grandes, Gonzalo; Sanchez, Alvaro; Pombo, Haizea; Bully, Paola

2017-02-17

The impact of lifestyle on health is undeniable and effective healthy lifestyle promotion interventions do exist. However, this is not a fundamental part of routine primary care clinical practice. We describe factors that determine changes in performance of primary health care centers involved in piloting the health promotion innovation 'Prescribe Vida Saludable' (PVS) phase II. We engaged four primary health care centers of the Basque Healthcare Service in an action research project aimed at changing preventive health practices. Prescribe Healthy Life (PVS from the Spanish "Prescribe Vida Saludable) is focused on designing, planning, implementing and evaluating innovative programs to promote multiple healthy habits, feasible to be performed in routine primary health care conditions. After 2 years of piloting, centers were categorized as having high, medium, or low implementation effectiveness. We completed qualitative inductive and deductive analysis of five focus groups with the staff of the centers. Themes generated through consensual grounded qualitative analysis were compared between centers to identify the dimensions that explain the variation in actual implementation of PVS, and retrospectively organized and assessed against the Consolidated Framework for Implementation Research (CFIR). Of the 36 CFIR constructs, 11 were directly related to the level of implementation performance: intervention source, evidence strength and quality, adaptability, design quality and packaging, tension for change, learning climate, self-efficacy, planning, champions, executing, and reflecting and evaluating, with -organizational tracking added as a new sub-construct. Additionally, another seven constructs emerged in the participants' discourse but were not related to center performance: relative advantage, complexity, patients' needs and resources, external policy and incentives, structural characteristics, available resources, and formally appointed internal implementation leaders. Our findings indicate that the success of the implementation seems to be associated with the following components: the context, the implementation process, and the collaborative modelling. Identifying barriers and enablers is useful for designing implementation strategies for health promotion in primary health care centers that are essential for innovation success. An implementation model is proposed to highlight the relationships between the CFIR constructs in the context of health promotion in primary care.

Design of the Coordinated Anxiety Learning and Management (CALM) Study: Innovations in Collaborative Care for Anxiety Disorders

PubMed Central

Sullivan, Greer; Craske, Michelle G; Sherbourne, Cathy; Edlund, Mark J; Rose, Raphael D; Golinelli, Daniela; Chavira, Denise A; Bystritsky, Alexander; Stein, Murray B; Roy-Byrne, Peter P

2007-01-01

Background: Despite a marked increase in persons seeking help for anxiety disorders, the care provided may not be evidence-based, especially when delivered by non-specialists. Since anxiety disorders are most often treated in primary care, quality improvement interventions are needed there. Research Design: A randomized controlled trial of a collaborative care effectiveness intervention for anxiety disorders. Subjects: Approximately 1040 adult primary care patients with one of four anxiety disorders (generalized anxiety disorder, panic disorder, posttraumatic stress disorder, or social anxiety disorder), recruited from four national sites. Intervention: Anxiety clinical specialists deliver education and behavioral activation to intervention patients and monitor their symptoms. Intervention patients choose cognitive behavioral therapy, anti-anxiety medications, or both, in a “stepped care” treatment that varies according to clinical need. Control patients receive usual care from their primary care clinician. CALM's innovations include the flexibility to treat any one of four anxiety disorders, co-occurring depression, and/or alcohol abuse; its use of on-site clinicians to conduct initial assessments, and its computer-assisted psychotherapy delivery. Evaluation: Anxiety symptoms, functioning, satisfaction with care, and health care utilization are assessed at 6-month intervals. Conclusion: CALM was designed for clinical effectiveness and easy dissemination in a variety of primary care settings. PMID:17888803

[Benefit assessment of operative interventions from the perspective of surgical research].

PubMed

Hüttner, F J; Ulrich, A; Mihaljevic, A L; Probst, P; Rossion, I; Diener, Markus K

2015-03-01

The benefit assessment of surgical procedures serves as the basis for the concept of evidence-based surgery. However, especially in the field of surgery, many interventions are lacking assessment in high-quality clinical trials. Therefore, a well-structured benefit assessment of surgical interventions in the future is imperative. Considering the different perspectives, e.g. of the patients, surgeons, industry or health care investors, the implications of the benefits and risks of a procedure can differ significantly. Researchers have to abide by different regulations, depending on the type of intervention being evaluated in a surgical trial. Furthermore, the benefit assessment of surgical procedures poses specific challenges, from the choice of a relevant endpoint to issues concerning the standardization of the interventions and the impact of learning curves. The IDEAL concept, which was established by a group of international experts in 2009, serves as a framework for the future development and assessment of innovations in the field of surgery. For example, the SDGC (Study Center of the German Society of Surgery) and CHIR-Net (Surgical Studies Network) indicate that such collaborations of clinicians and methodologists can lead to the creation of a qualified structure for the effective benefit assessment of surgical procedures. In the future, the aforementioned evidence gaps must be eliminated and innovations evaluated efficiently by the work of such networks.

Transradial access: lessons learned from cardiology.

PubMed

Snelling, Brian M; Sur, Samir; Shah, Sumedh Subodh; Marlow, Megan M; Cohen, Mauricio G; Peterson, Eric C

2018-05-01

Innovations in interventional cardiology historically predate those in neuro-intervention. As such, studying trends in interventional cardiology can be useful in exploring avenues to optimise neuro-interventional techniques. One such cardiology innovation has been the steady conversion of arterial puncture sites from transfemoral access (TFA) to transradial access (TRA), a paradigm shift supported by safety benefits for patients. While neuro-intervention has unique anatomical challenges, the access itself is identical. As such, examining the extensive cardiology literature on the radial approach has the potential to offer valuable lessons for the neuro-interventionalist audience who may be unfamiliar with this body of work. Therefore, we present here a report, particularly for neuro-interventionalists, regarding the best practices for TRA by reviewing the relevant cardiology literature. We focused our review on the data most relevant to our audience, namely that surrounding the access itself. By reviewing the cardiology literature on metrics such as safety profiles, cost and patient satisfaction differences between TFA and TRA, as well as examining the technical nuances of the procedure and post-procedural care, we hope to give physicians treating complex cerebrovascular disease a broader data-driven understanding of TRA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Organizational Context and Individual Adaptability in Promoting Perceived Importance and Use of Best Practices for Substance Use.

PubMed

Knight, Danica K; Joe, George W; Morse, David T; Smith, Corey; Knudsen, Hannah; Johnson, Ingrid; Wasserman, Gail A; Arrigona, Nancy; McReynolds, Larkin S; Becan, Jennifer E; Leukefeld, Carl; Wiley, Tisha R A

2018-05-18

This study examines associations among organizational context, staff attributes, perceived importance, and use of best practices among staff in community-based, juvenile justice (JJ) agencies. As part of the National Institute on Drug Abuse's Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, 492 staff from 36 JJ agencies were surveyed about the perceived importance and use of best practices within their organization in five substance use practice domains: screening, assessment, standard referral, active referral, and treatment support. Structural equation models indicated that supervisory encouragement and organizational innovation/flexibility were associated with greater individual adaptability. Adaptability (willingness to try new ideas, use new procedures, adjust quickly to change), was positively correlated with importance ratings. Importance ratings were positively associated with reported use of best practices. Organizational climates that support innovation likely affect use of practices through staff attributes and perceptions of the importance of such services.

Respecting and protecting our relationships: a community research HIV prevention program for teen fathers and mothers.

PubMed

Lesser, Janna; Verdugo, Robert L; Koniak-Griffin, Deborah; Tello, Jerry; Kappos, Barbara; Cumberland, William G

2005-08-01

This article describes a two-phase community and academic collaboration funded by the California Collaborative Research Initiative to develop and test the feasibility of an innovative HIV prevention program relevant to the needs of the population of inner-city Latino teen parenting couples and realistic for implementation in community settings. The article describes (a) the identification of special issues that needed to be addressed before formation of a productive academic-community-based organization research partnership, including integrating a dominant theoretical model used in health education with principles of practice derived from clinical experience; (b) the first phase of the project that helped to inform the development of the HIV prevention program for couples; (c) examples from the intervention pilot study (Phase 2) that illustrate both the intervention strategies and the young participants' responses to the curriculum; and (d) the feasibility of program implementation and evaluation in a community setting.

Selecting, Adapting, and Implementing Evidence-based Interventions in Rural Settings: An Analysis of 70 Community Examples.

PubMed

Smith, Tina Anderson; Adimu, Tanisa Foxworth; Martinez, Amanda Phillips; Minyard, Karen

2016-01-01

This paper explores how communities translate evidence-based and promising health practices to rural contexts. A descriptive, qualitative analysis was conducted using data from 70 grantees funded by the Federal Office of Rural Health Policy to implement evidence-based health practices in rural settings. Findings were organized using The Interactive Systems Framework for Dissemination and Implementation. Grantees broadly interpreted evidence-based and promising practices, resulting in the implementation of a patchwork of health-related interventions that fell along a spectrum of evidentiary rigor. The cohort faced common challenges translating recognized practices into rural community settings and reported making deliberate modifications to original models as a result. Opportunities for building a more robust rural health evidence base include investments to incentivize evidence-based programming in rural settings; rural-specific research and theory-building; translation of existing evidence using a rural lens; technical assistance to support rural innovation; and prioritization of evaluation locally.

Evidence of a shared purpose, critical reflection, innovation and leadership in interprofessional healthcare teams: a realist synthesis.

PubMed

Sims, Sarah; Hewitt, Gillian; Harris, Ruth

2015-05-01

Realist synthesis is a theory-driven approach for evaluating complex interventions using empirical evidence, which seeks an explanatory analysis of who a complex intervention works for, how, why, and in what circumstances. Interprofessional teamworking in healthcare is one such complex intervention, as teams are influenced by social and organizational factors, which makes them highly variable and context dependent. This article concludes a series of four articles that report on a realist synthesis of interprofessional teamworking. The synthesis identified 13 mechanisms that are reported in the literature to be the underlying processes through which interprofessional teamworking produces its effects. This article explores four of these mechanisms: a shared purpose; critical reflection; innovation; and leadership. These mechanisms together explain how a team sets and maintains its focus and direction. This article highlights that whilst many assumptions are made within the healthcare literature about how these mechanisms operate within teams, these assumptions are not always founded upon strong empirical evidence.

Using a gamified monitoring app to change adolescents' snack intake: the development of the REWARD app and evaluation design.

PubMed

Van Lippevelde, W; Vangeel, J; De Cock, N; Lachat, C; Goossens, L; Beullens, K; Vervoort, L; Braet, C; Maes, L; Eggermont, S; Deforche, B; Van Camp, J

2016-08-05

As the snacking pattern of European adolescents is of great concern, effective interventions are necessary. Till now health promotion efforts in children and adolescents have had only limited success in changing adolescents' eating patterns and anthropometrics. Therefore, the present study proposes an innovative approach to influence dietary behaviors in youth based on new insights on effective behavior change strategies and attractive intervention channels to engage adolescents. This article describes the rationale, the development, and evaluation design of the 'Snack Track School' app. The aim of the app is to improve the snacking patterns of Flemish 14- to 16-year olds. The development of the app was informed by the systematic, stepwise, iterative, and collaborative principles of the Intervention Mapping protocol. A four week mHealth intervention was developed based on the dual-system model with behavioral change strategies targeting both the reflective (i.e., active learning, advance organizers, mere exposure, goal-setting, monitoring, and feedback) and automatic processes (i.e., rewards and positive reinforcement). This intervention will be evaluated via a controlled pre-post design in Flemish schools among 1400 adolescents. When this intervention including strategies focused on both the reflective and automatic pathway proves to be effective, it will offer a new scientifically-based vision, guidelines and practical tools for public health and health promotion (i.e., incorporation of learning theories in intervention programs). NCT02622165 registrated November 15, 2015 on clinicaltrials.gov.

Chapter Innovators Guide, 2001: Models of Innovation Award Winners.

ERIC Educational Resources Information Center

National FFA Organization, Indianapolis, IN.

This document presents the activities that received Future Farmers of America's (FFA's) Model of Innovation awards in 2001. The booklet begins with an overview of the FFA National Chapter Award program and a list of the 2001 Models of Innovation Winners. The next three sections profile award-winning activities in the following areas of the three…

Revolution or evolution? An analysis of E-health innovation and impact using a hypercube model.

PubMed

Wu, Jen-Her; Huang, An-Sheng; Hisa, Tzyh-Lih; Tsai, Hsien-Tang

2006-01-01

This study utilises a hypercube innovation model to analyse the changes in both healthcare informatics and medical related delivery models based on the innovations from Tele-healthcare, electronic healthcare (E-healthcare), to mobile healthcare (M-healthcare). Further, the critical impacts of these E-health innovations on the stakeholders: healthcare customers, hospitals, healthcare complementary providers and healthcare regulators are identified. Thereafter, the critical capabilities for adopting each innovation are discussed.

Report for the Office of Scientific and Technical Information: Population Modeling of the Emergence and Development of Scientific Fields

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bettencourt, L. M. A.; Castillo-Chavez, C.; Kaiser, D.

2006-10-04

The accelerated development of digital libraries and archives, in tandem with efficient search engines and the computational ability to retrieve and parse massive amounts of information, are making it possible to quantify the time evolution of scientific literatures. These data are but one piece of the tangible recorded evidence of the processes whereby scientists create and exchange information in their journeys towards the generation of knowledge. As such, these tools provide a proxy with which to study our ability to innovate. Innovation has often been linked with prosperity and growth and, consequently, trying to understand what drives scientific innovation ismore » of extreme interest. Identifying sets of population characteristics, factors, and mechanisms that enable scientific communities to remain at the cutting edge, accelerate their growth, or increase their ability to re-organize around new themes or research topics is therefore of special significance. Yet generating a quantitative understanding of the factors that make scientific fields arise and/or become more or less productive is still in its infancy. This is precisely the type of knowledge most needed for promoting and sustaining innovation. Ideally, the efficient and strategic allocation of resources on the part of funding agencies and corporations would be driven primarily by knowledge of this type. Early steps have been taken toward such a quantitative understanding of scientific innovation. Some have focused on characterizing the broad properties of relevant time series, such as numbers of publications and authors in a given field. Others have focused on the structure and evolution of networks of coauthorship and citation. Together these types of studies provide much needed statistical analyses of the structure and evolution of scientific communities. Despite these efforts, however, crucial elements of prediction have remained elusive. Building on many of these earlier insights, we provide here a coarse-grained approach to modeling the time-evolution of scientific fields mathematically, through adaptive models of contagion. That is, our models are inspired by epidemic contact processes, but take into account the social interactions and processes whereby scientific ideas spread - social interactions gleaned from close empirical study of historical cases. Variations in model parameters can increase or hamper the speed at which a field develops. In this way, models for the spread of 'infectious' ideas can be used to identify pressure points in the process of innovation that may allow for the evaluation of possible interventions by those responsible for promoting innovation, such as funding agencies. This report is organized as follows: Section 2 introduces and discusses the population model used here to describe the dynamics behind the establishment of scientific fields. The approach is based on a succinct (coarse) description of contact processes between scientists, and is a simplified version of a general class of models developed in the course of this work. We selected this model based primarily on its ability to treat a wide range of data patterns efficiently, across several different scientific fields. We also describe our methods for estimating parameter values, our optimization techniques used to match the model to data, and our method of generating error estimates. Section 3 presents brief accounts of six case studies of scientific evolution, measured by the growth in number of active authors over time, and shows the results of fitting our model to these data, including extrapolations to the near future. Section 4 discusses these results and provides some perspectives on the values and limitations of the models used. We also discuss topics for further research which should improve our ability to predict (and perhaps influence) the course of future scientific research. Section 5 provides more detail on the broad class of epidemic models developed as part of this project.« less

E-Rehabilitation - an Internet and mobile phone based tailored intervention to enhance self-management of cardiovascular disease: study protocol for a randomized controlled trial.

PubMed

Antypas, Konstantinos; Wangberg, Silje C

2012-07-09

Cardiac rehabilitation is very important for the recovery and the secondary prevention of cardiovascular disease, and one of its main strategies is to increase the level of physical activity. Internet and mobile phone based interventions have been successfully used to help people to achieve this. One of the components that are related to the efficacy of these interventions is tailoring of content to the individual. This trial is studying the effect of a longitudinally tailored Internet and mobile phone based intervention that is based on models of health behaviour, on the level of physical activity and the adherence to the intervention, as an extension of a face-to-face cardiac rehabilitation stay. A parallel group, cluster randomized controlled trial. The study population is adult participants of a cardiac rehabilitation programme in Norway with home Internet access and mobile phone, who in monthly clusters are randomized to the control or the intervention condition. Participants have access to a website with information regarding cardiac rehabilitation, an online discussion forum and an online activity calendar. Those randomized to the intervention condition, receive in addition tailored content based on models of health behaviour, through the website and mobile text messages. The objective is to assess the effect of the intervention on maintenance of self-management behaviours after the rehabilitation stay. Main outcome is the level of physical activity one month, three months and one year after the end of the cardiac rehabilitation programme. The randomization of clusters is based on a true random number online service, and participants, investigators and outcome assessor are blinded to the condition of the clusters. The study suggests a theory-based intervention that combines models of health behaviour in an innovative way, in order to tailor the delivered content. The users have been actively involved in its design, and because of the use of Open-Source software, the intervention can easily and at low-cost be reproduced and expanded by others. Challenges are the recruitment in the elderly population and the possible underrepresentation of women in the study sample. Funding by Northern Norway Regional Health Authority. Trial registry http://www.clinicaltrials.gov: NCT01223170.

Materialism, Altruism, Environmental Values, Learning Strategies and Sustainable Claim on Purchase Intention of Energy Efficient Vehicle (EEV) - A Literature Review

NASA Astrophysics Data System (ADS)

Syakir Shukor, Muhamad; Sulaiman, Zuraidah; Chin, Thoo Ai; Zakuan, Norhayati; Merlinda Muharam, Farrah

2017-06-01

One of the toughest challenges in social marketing is behaviour intervention. Previous research have developed various models and theories to simultaneously examine behaviour changes and their effects. Due to resources scarcity and global warming, automakers have come out with an innovative idea of Energy Efficient Vehicle (EEV) which has been a great improvement in the automotive industry. This invention targets for behavioral change or behavioral adoption for consumers to adjust their preferences from conventional vehicle to EEV. High market growth in automotive industry have encouraged social marketers, policymakers, governments and academics to propose suitable intervention approach in motivating preferences toward EEV. This study will explore the causal model of Environmental Responsible Behaviour (ERB) in measuring the purchase intention of EEV in Malaysia. In specific, this study focuses on two types of EEV - hybrid car and fuel efficient car. This study will hopefully add onto the body of knowledge for value orientation that influences green behaviour. From the practical perspective, this study may provide insights in assisting the stakeholders and automotive industry players on promoting the pro-behaviour toward EEV.

Fires in refugee and displaced persons settlements: the current situation and opportunities to improve fire prevention and control

PubMed Central

Kazerooni, Yasaman; Gyedu, Adam; Burnham, Gilbert; Nwomeh, Benedict; Charles, Anthony; Mishra, Brijesh; Kuah, Solomon S; Kushner, Adam L; Stewart, Barclay T

2015-01-01

Introduction We aimed to describe the burden of fires in displaced persons settlements and identify interventions/innovations that might address gaps in current humanitarian guidelines. Methods We performed a systematic review of: i) academic and non-academic literature databases; and ii) guidelines from leading humanitarian agencies/initiatives regarding fire prevention/control. Results Of the 1,521 records retrieved, 131 reports described settlement fires in 31 hosting countries since 1990. These incidents resulted in 487 deaths, 790 burn injuries, displacement of 382,486 individuals and destruction of 50,509 shelters. There was a 25-fold increase in the rate of settlement fires from 1990 to 2015 (0.002 to 0.051 per 100,000 refugees, respectively). Only 4 of the 15 leading humanitarian agencies provided recommendations about fire prevention/control strategies. Potentially useful interventions/innovations included safer stoves (e.g. solar cookers) and fire retardant shelter materials. Conclusion The large and increasing number of fires in displaced persons settlements highlights the need to redress gaps in humanitarian fire prevention/control guidelines. The way forward includes: i) developing consensus among aid agencies regarding fire prevention/control strategies; ii) evaluating the impact of interventions/innovations on the burden of fires; and iii) engaging agencies in a broader discussion about protecting camp residents from armed groups. PMID:26818955

Fires in refugee and displaced persons settlements: The current situation and opportunities to improve fire prevention and control.

PubMed

Kazerooni, Yasaman; Gyedu, Adam; Burnham, Gilbert; Nwomeh, Benedict; Charles, Anthony; Mishra, Brijesh; Kuah, Solomon S; Kushner, Adam L; Stewart, Barclay T

2016-08-01

We aimed to describe the burden of fires in displaced persons settlements and identify interventions/innovations that might address gaps in current humanitarian guidelines. We performed a systematic review of: (i) academic and non-academic literature databases; and (ii) guidelines from leading humanitarian agencies/initiatives regarding fire prevention/control. Of the 1521 records retrieved, 131 reports described settlement fires in 31 hosting countries since 1990. These incidents resulted in 487 deaths, 790 burn injuries, displacement of 382,486 individuals and destruction of 50,509 shelters. There was a 25-fold increase in the rate of settlement fires from 1990 to 2015 (0.002-0.051 per 100,000 refugees, respectively). Only 4 of the 15 leading humanitarian agencies provided recommendations about fire prevention/control strategies. Potentially useful interventions/innovations included safer stoves (e.g. solar cookers) and fire retardant shelter materials. The large and increasing number of fires in displaced persons settlements highlights the need to redress gaps in humanitarian fire prevention/control guidelines. The way forward includes: (i) developing consensus among aid agencies regarding fire prevention/control strategies; (ii) evaluating the impact of interventions/innovations on the burden of fires; and (iii) engaging agencies in a broader discussion about protecting camp residents from armed groups. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Technology-based Interventions in Social Work Practice: A Systematic Review of Mental Health Interventions

PubMed Central

Montgomery, Katherine

2014-01-01

Despite concerns around the use of technology-based interventions, they are increasingly being employed by social workers as a direct practice methodology to address the mental health needs of vulnerable clients. Researchers have highlighted the importance of using innovative technologies within social work practice, yet little has been done to summarize the evidence and collectively assess findings. In this systematic review, we describe accounts of technology-based mental health interventions delivered by social workers over the past 10 years. Results highlight the impacts of these tools and summarize advantages and disadvantages to utilizing technologies as a method for delivering or facilitating interventions. PMID:25321935

Technology-based interventions in social work practice: a systematic review of mental health interventions.

PubMed

Ramsey, Alex T; Montgomery, Katherine

2014-10-01

Despite concerns around the use of technology-based interventions, they are increasingly being employed by social workers as a direct practice methodology to address the mental health needs of vulnerable clients. Researchers have highlighted the importance of using innovative technologies within social work practice, yet little has been done to summarize the evidence and collectively assess findings. In this systematic review, we describe accounts of technology-based mental health interventions delivered by social workers over the past 10 years. Results highlight the impacts of these tools and summarize advantages and disadvantages to utilizing technologies as a method for delivering or facilitating interventions.

Impact of surgical innovation on tissue repair in the surgical patient.

PubMed

Tevlin, R; Atashroo, D; Duscher, D; Mc Ardle, A; Gurtner, G C; Wan, D C; Longaker, M T

2015-01-01

Throughout history, surgeons have been prolific innovators, which is hardly surprising as most surgeons innovate daily, tailoring their intervention to the intrinsic uniqueness of each operation, each patient and each disease. Innovation can be defined as the application of better solutions that meet new requirements, unarticulated needs or existing market needs. In the past two decades, surgical innovation has significantly improved patient outcomes, complication rates and length of hospital stay. There is one key area that has great potential to change the face of surgical practice and which is still in its infancy: the realm of regenerative medicine and tissue engineering. A literature review was performed using PubMed; peer-reviewed publications were screened for relevance in order to identify key surgical innovations influencing regenerative medicine, with a focus on osseous, cutaneous and soft tissue reconstruction. This review describes recent advances in regenerative medicine, documenting key innovations in osseous, cutaneous and soft tissue regeneration that have brought regenerative medicine to the forefront of the surgical imagination. Surgical innovation in the emerging field of regenerative medicine has the ability to make a major impact on surgery on a daily basis. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.

A Culturally Responsive Approach to Improving Replication of a Youth Sexual Health Program.

PubMed

Mwaria, Mercy; Chen, ChiaChing; Coppola, Nanci; Maurice, Ingrid; Phifer, Mary

2016-11-01

Youth-serving agencies continually turn to evidence-based interventions that have been empirically assessed for effectiveness in influencing young people's lives, particularly those living in communities with considerable health inequities. Replicating promising evidence-based interventions requires thoughtful adaptation and modification to better fit participants' sociocultural context and to enhance their learning experiences. Due to the restrictive nature of a replication model, adaptations to the intervention curriculum must be minimized during full implementation. Implementers must find innovative ways to ensure content is relevant and engaging to participants without altering core elements of the curriculum. This article describes practical best practice strategies used in implementing a sexual health education program among socioculturally diverse youth in a northeastern city in the United States. The implementing agency applied Richard, Brown and Forde's framework for culturally responsive pedagogy as a heuristic approach to describe the application of implementation practices across three dimensions: institutional, personal, and instructional. The results not only highlight successful culturally responsive practices that enhanced the implementation process but also acknowledge areas in which such practices proved daunting to implement. © 2016 Society for Public Health Education.

Family-based risk reduction of obesity and metabolic syndrome: an overview and outcomes of the Idaho Partnership for Hispanic Health.

PubMed

Schwartz, Rachel; Powell, Linda; Keifer, Matthew

2013-01-01

Mexican American women have the highest incidence of metabolic syndrome among all U.S. demographic groups. This paper details an innovative approach to reducing the risks for metabolic syndrome among Hispanic families in rural Idaho. Compañeros en Salud (CeS) is a promotora-led wellness program and community-based participatory research project from the Idaho Partnership for Hispanic Health. As behavior change is the first line of prevention and treatment of obesity and metabolic syndrome, the program aimed to improve nutrition and physical activity behaviors as well as increase community support and infrastructure for healthy living. CeS has demonstrated substantial improvement in health outcomes, with statistically significant reductions in weight, BMI, metabolic syndrome risk, A1c, glucose, blood pressure, and cholesterol, from pre-intervention to post-intervention and/or pre-intervention to one-year follow-up. These outcomes suggest the CeS model as a promising best practice for effecting individual and family-level physiologic and behavioral outcomes for obesity prevention.

Modeling methylene chloride exposure-reduction options for home paint-stripper users.

PubMed

Riley, D M; Small, M J; Fischhoff, B

2000-01-01

Home improvement is a popular activity, but one that can also involve exposure to hazardous substances. Paint stripping is of particular concern because of the high potential exposures to methylene chloride, a solvent that is a potential human carcinogen and neurotoxicant. This article presents a general methodology for evaluating the effectiveness of behavioral interventions for reducing these risks. It doubles as a model that assesses exposure patterns, incorporating user time-activity patterns and risk-mitigation strategies. The model draws upon recent innovations in indoor air-quality modeling to estimate exposure through inhalation and dermal pathways to paint-stripper users. It is designed to use data gathered from home paint-stripper users about room characteristics, amount of stripper used, time-activity patterns and exposure-reduction strategies (e.g., increased ventilation and modification in the timing of stripper application, scraping, and breaks). Results indicate that the effectiveness of behavioral interventions depends strongly on characteristics of the room (e.g., size, number and size of doors and windows, base air-exchange rates). The greatest simple reduction in exposure is achieved by using an exhaust fan in addition to opening windows and doors. These results can help identify the most important information for product labels and other risk-communication materials.

Application of a model for the development of a mental health service delivery collaboration between police and the health service.

PubMed

Laing, Robert; Halsey, Rebecca; Donohue, David; Newman, Claire; Cashin, Andrew

2009-05-01

Changing societal trends have revealed an increased prevalence of mental illness and diminished health resources from which to offer services. This has lead to a need to develop new and more efficient police and health service models of practice. Services offered by the police department in the management of mental health crisis in the community are essential in minimising the risk of individuals with mental health problems causing harm to themselves or a member of the public. In addressing the difficulties associated with police playing an important role in the management of mental health crisis in the community, but having little training in mental health issues, this paper discusses a proposed innovation for New South Wales police in Australia through the development of a Crisis Intervention Team model.

Musical Memories: translating evidence-based gerontological nursing into a children's picture book.

PubMed

Gerdner, Linda A; Buckwalter, Kathleen C

2013-01-01

Individuals with Alzheimer's disease (AD) are often cared for within multigenerational families. More specifically, 26% of family caregivers have children younger than 18 living with them. This article describes an innovative model for translation of an evidence-based intervention into an engaging, realistic picture book that serves as a teaching tool for children and their families. The book, Musical Memories, focuses on the relationship between a granddaughter and her grandmother who has AD. The story applies basic principles of the Progressively Lowered Stress Threshold model to explain the underlying cause of grandmother's behaviors and models the evidence-based guideline "Individualized Music for Elders with Dementia" to empower the granddaughter in maintaining a relationship with her grandmother. Musical Memories is intended to serve as a valuable resource for families and the gerontological nurses who serve them. Copyright 2013, SLACK Incorporated.

Estimating Impacts on Students, Teachers, and Schools of Programs Targeted for Preschool through Transition to College--Lessons for Methodologists from the Designs of 117 Evaluations Being Conducted in the Investing in Innovation Fund (i3) Grant Program.

ERIC Educational Resources Information Center

Price, Cristofer; Wolf, Anne; Goodson, Barbara; Boulay, Beth

2015-01-01

When presenting results from rigorous, field-based evaluations of educational interventions, researchers often reveal methodological barriers they face in designing studies to assessing program effectiveness. The evaluations funded by the Investing in Innovation Fund (i3) present a timely opportunity for identifying relevant and pressing issues…

From Mosques to Classrooms: Mobilizing the Community to Enhance Case Detection of Tuberculosis

PubMed Central

Rifat, Mahfuza; Rusen, I. D.; Mahmud, Mohammad Hasan; Nayer, Israt; Islam, Akramul; Ahmed, Faruque

2008-01-01

In response to the global challenge of inadequate case detection of tuberculosis (TB), the Fund for Innovative DOTS Expansion through Local Initiatives to Stop Tuberculosis (FIDELIS) was developed in 2003 to rapidly assess and implement innovative approaches to increase the detection of new smear-positive TB cases. As previously reported, a wide range of target populations and interventions has been incorporated into successful FIDELIS projects. PMID:18633095

Managing Tensions between Evaluation and Research: Illustrative Cases of Developmental Evaluation in the Context of Research

ERIC Educational Resources Information Center

Rey, Lynda; Tremblay, Marie-Claude; Brousselle, Astrid

2014-01-01

Developmental evaluation (DE), essentially conceptualized by Patton over the past 30 years, is a promising evaluative approach intended to support social innovation and the deployment of complex interventions. Its use is often justified by the complex nature of the interventions being evaluated and the need to produce useful results in real time.…

Analysis of Social Worker and Educator's Areas of Intervention through Multimedia Concept Maps and Online Discussion Forums in Higher Education

ERIC Educational Resources Information Center

Vázquez-Cano, Esteban; López Meneses, Eloy; Sánchez-Serrano, José Luis Sarasola

2015-01-01

This diachronic study describes an innovative university experience consisting of the development of multimedia concept maps (MCM) in relation to social educators and social workers main intervention areas and an active discussion in online forums about the results obtained. These MCMs were prepared by students who attended the Information…

Developmental Phenotypes and Causal Pathways in Attention Deficit/Hyperactivity Disorder: Potential Targets for Early Intervention?

ERIC Educational Resources Information Center

Sonuga-Barke, Edmund J. S.; Halperin, Jeffrey M.

2010-01-01

Early intervention approaches have rarely been implemented for the prevention of attention deficit/hyperactivity disorder (ADHD). In this paper we explore whether such an approach may represent an important new direction for therapeutic innovation. We propose that such an approach is most likely to be of value when grounded in and informed by…

The "10 Keys" to Healthy Aging: 24-Month Follow-Up Results from an Innovative Community-Based Prevention Program

ERIC Educational Resources Information Center

Robare, Joseph F.; Bayles, Constance M.; Newman, Anne B.; Williams, Kathy; Milas, Carole; Boudreau, Robert; McTigue, Kathleen; Albert, Steven M.; Taylor, Christopher; Kuller, Lewis H.

2011-01-01

The purpose of this report was to evaluate a prevention program to reduce risk factors for common diseases among older individuals in a lower income community. This randomized community-based study enrolled older adults into a Brief Education and Counseling Intervention or a Brief Education and Counseling Intervention plus a physical activity and…

Diabetes Health Information Technology Innovation to Improve Quality of Life for Health Plan Members in Urban Safety Net

PubMed Central

Ratanawongsa, Neda; Handley, Margaret A.; Sarkar, Urmimala; Quan, Judy; Pfeifer, Kelly; Soria, Catalina; Schillinger, Dean

2014-01-01

Safety net systems need innovative diabetes self-management programs for linguistically diverse patients. A low-income government-sponsored managed care plan implemented a 27-week automated telephone self-management support (ATSM) / health coaching intervention for English, Spanish-, and Cantonese-speaking members from four publicly-funded clinics in a practice-based research network. Compared to waitlist, immediate intervention participants had greater 6-month improvements in overall diabetes self-care behaviors (standardized effect size [ES] 0.29, p<0.01) and SF-12 physical scores (ES 0.25, p=0.03); changes in patient-centered processes of care and cardiometabolic outcomes did not differ. ATSM is a strategy for improving patient-reported self-management and may also improve some outcomes. PMID:24594561

Evaluation of the Dogs, Physical Activity, and Walking (Dogs PAW) Intervention: A Randomized Controlled Trial.

PubMed

Richards, Elizabeth A; Ogata, Niwako; Cheng, Ching-Wei

2016-01-01

To facilitate physical activity (PA) adoption and maintenance, promotion of innovative population-level strategies that focus on incorporating moderate-intensity lifestyle PAs are needed. The purpose of this randomized controlled trial was to evaluate the Dogs, Physical Activity, and Walking intervention, a 3-month, social cognitive theory (SCT), e-mail-based PA intervention. In a longitudinal, repeated-measures design, 49 dog owners were randomly assigned to a control (n = 25) or intervention group (n = 24). The intervention group received e-mail messages (twice weekly for 4 weeks and weekly for 8 weeks) designed to influence SCT constructs of self-efficacy, self-regulation, outcome expectations and expectancies, and social support. At baseline and every 3 months through 1 year, participants completed self-reported questionnaires of individual, interpersonal, and PA variables. Linear mixed models were used to assess for significant differences in weekly minutes of dog walking and theoretical constructs between groups (intervention and control) across time. To test self-efficacy as a mediator of social support for dog walking, tests for mediation were conducted using the bootstrapping technique. With the exception of Month 9, participants in the intervention group accumulated significantly more weekly minutes of dog walking than the control group. On average, the intervention group accumulated 58.4 more minutes (SD = 18.1) of weekly dog walking than the control group (p < .05). Self-efficacy partially mediated the effect of social support variables on dog walking. Results indicate that a simple SCT-based e-mail intervention is effective in increasing and maintaining an increase in dog walking among dog owners at 12-month follow-up. In light of these findings, it may be advantageous to design dog walking interventions that focus on increasing self-efficacy for dog walking by fostering social support.

Stop Stroke: development of an innovative intervention to improve risk factor management after stroke.

PubMed

Redfern, Judith; Rudd, Anthony D; Wolfe, Charles D A; McKevitt, Christopher

2008-08-01

Stroke survivors are at high risk of stroke recurrence yet current strategies to reduce recurrence risk are sub-optimal. The UK Medical Research Council (MRC) have proposed a framework for developing and evaluating complex interventions, such as community management of stroke secondary prevention. The Framework outlines a five-phased approach from theory through to implementation of effective interventions. This paper reports Phases I-III of the development of a novel intervention to improve risk factor management after stroke. The pre-clinical/theoretical phase entailed reviewing the literature and undertaking quantitative and qualitative studies to identify current practices and barriers to secondary prevention. In Phase I (modelling), findings were used to design an intervention with the potential to overcome barriers to effective stroke secondary prevention management. The feasibility of delivering the intervention and its acceptability were tested in the Phase II exploratory trial involving 25 stroke survivors and their general practitioners. This led to the development of the definitive risk factor management intervention. This comprises multiple components and involves using an on-going population stroke register to target patients, carers and health care professionals with tailored secondary prevention advice. Clinical, socio-demographic and service use data collected by the stroke register are transformed to provide an individualised secondary prevention package for patients, carers and health care professionals at three time points: within 10 weeks, 3 and 6 months post-stroke. The intervention is currently being evaluated in a randomised controlled trial. Further research is needed to test generalisability to other aspects of stroke management and for other chronic diseases. The MRC Framework for complex interventions provides a structured approach to guide the development of novel interventions in public health. Implications for practice in stroke secondary prevention will emerge when the results of our randomised controlled trial are published.

Towards a Model of Technology Adoption: A Conceptual Model Proposition

NASA Astrophysics Data System (ADS)

Costello, Pat; Moreton, Rob

A conceptual model for Information Communication Technology (ICT) adoption by Small Medium Enterprises (SMEs) is proposed. The research uses several ICT adoption models as its basis with theoretical underpinning provided by the Diffusion of Innovation theory and the Technology Acceptance Model (TAM). Taking an exploratory research approach the model was investigated amongst 200 SMEs whose core business is ICT. Evidence from this study demonstrates that these SMEs face the same issues as all other industry sectors. This work points out weaknesses in SMEs environments regarding ICT adoption and suggests what they may need to do to increase the success rate of any proposed adoption. The methodology for development of the framework is described and recommendations made for improved Government-led ICT adoption initiatives. Application of the general methodology has resulted in new opportunities to embed the ethos and culture surrounding the issues into the framework of new projects developed as a result of Government intervention. A conceptual model is proposed that may lead to a deeper understanding of the issues under consideration.

The Chronic Care Model and Technological Research and Innovation: A Scoping Review at the Crossroads

PubMed Central

Berntsen, Gro Karine Rosvold; Koricho, Absera Teshome; Sygna, Karin; Ruland, Cornelia

2015-01-01

Background Information and communication technologies (ICT) are key to optimizing the outcomes of the Chronic Care Model (CCM), currently acknowledged as the best synthesis of available evidence for chronic illness prevention and management. At the same time, CCM can offer a needed framework for increasing the relevance and feasibility of ICT innovation and research in health care. Little is known about how and to what extent CCM and ICT research inform each other to leverage mutual strengths. The current study examines: What characterizes work being done at the crossroads of CCM and ICT research and innovation? Objective Our aim is identify the gaps and potential that lie between the research domains CCM and ICT, thus enabling more substantive questions and opportunities for accelerating improvements in ICT-supported chronic care. Methods Using a scoping study approach, we developed a search strategy applied to medical and technical databases resulting in 1054 titles and abstracts that address CCM and ICT. After iteratively adapting our inclusion/exclusion criteria to balance between breadth and feasibility, 26 publications from 20 studies were found to fulfill our criteria. Following initial coding of each article according to predefined categories (eg, type of article, CCM component, ICT, health issue), a 1st level analysis was conducted resulting in a broad range of categories. These were gradually reduced by constantly comparing them for underlying commonalities and discrepancies. Results None of the studies included were from technical databases and interventions relied mostly on “old-fashioned” technologies. Technologies supporting “productive interactions” were often one-way (provider to patient), and it was sometimes difficult to decipher how CCM was guiding intervention design. In particular, the major focus on ICT to support providers did not appear unique to the challenges of chronic care. Challenges in facilitating CCM components through ICT included poorly designed user interfaces, digital divide issues, and lack of integration with existing infrastructure. Conclusions The CCM is a highly influential guide for health care development, which recognizes the need for alignment of system tools such as ICT. Yet, there seem to be alarmingly few touch points between the subject fields of “health service development” and “ICT-innovation”. Bridging these gaps needs explicit and urgent attention as the synergies between these domains have enormous potential. Policy makers and funding agencies need to facilitate the joining of forces between high-tech innovative expertise and experts in the chronic care system redesign that is required for tackling the current epidemic of long-term multiple conditions. PMID:25677200

Research and exploration of product innovative design for function

NASA Astrophysics Data System (ADS)

Wang, Donglin; Wei, Zihui; Wang, Youjiang; Tan, Runhua

2009-07-01

Products innovation is under the prerequisite of realizing the new function, the realization of the new function must solve the contradiction. A new process model of new product innovative design was proposed based on Axiomatic Design (AD) Theory and Functional Structure Analysis (FSA), imbedded Principle of Solving Contradiction. In this model, employ AD Theory to guide FSA, determine the contradiction for the realization of the principle solution. To provide powerful support for innovative design tools in principle solution, Principle of Solving Contradiction in the model were imbedded, so as to boost up the innovation of principle solution. As a case study, an innovative design of button battery separator paper punching machine has been achieved with application of the proposed model.

Systematic, Multimethod Assessment of Adaptations Across Four Diverse Health Systems Interventions.

PubMed

Rabin, Borsika A; McCreight, Marina; Battaglia, Catherine; Ayele, Roman; Burke, Robert E; Hess, Paul L; Frank, Joseph W; Glasgow, Russell E

2018-01-01

Many health outcomes and implementation science studies have demonstrated the importance of tailoring evidence-based care interventions to local context to improve fit. By adapting to local culture, history, resources, characteristics, and priorities, interventions are more likely to lead to improved outcomes. However, it is unclear how best to adapt evidence-based programs and promising innovations. There are few guides or examples of how to best categorize or assess health-care adaptations, and even fewer that are brief and practical for use by non-researchers. This study describes the importance and potential of assessing adaptations before, during, and after the implementation of health systems interventions. We present a promising multilevel and multimethod approach developed and being applied across four different health systems interventions. Finally, we discuss implications and opportunities for future research. The four case studies are diverse in the conditions addressed, interventions, and implementation strategies. They include two nurse coordinator-based transition of care interventions, a data and training-driven multimodal pain management project, and a cardiovascular patient-reported outcomes project, all of which are using audit and feedback. We used the same modified adaptation framework to document changes made to the interventions and implementation strategies. To create the modified framework, we started with the adaptation and modification model developed by Stirman and colleagues and expanded it by adding concepts from the RE-AIM framework. Our assessments address the intuitive domains of Who, How, When, What, and Why to classify and organize adaptations. For each case study, we discuss how the modified framework was operationalized, the multiple methods used to collect data, results to date and approaches utilized for data analysis. These methods include a real-time tracking system and structured interviews at key times during the intervention. We provide descriptive data on the types and categories of adaptations made and discuss lessons learned. The multimethod approaches demonstrate utility across diverse health systems interventions. The modified adaptations model adequately captures adaptations across the various projects and content areas. We recommend systematic documentation of adaptations in future clinical and public health research and have made our assessment materials publicly available.

The Mediating Effect of Innovation between Total Quality Management (TQM) and Business Performance

NASA Astrophysics Data System (ADS)

Shan, Ang Wei; Fauzi Ahmad, Mohd; Hisyamudin Muhd Nor, Nik

2016-11-01

Both TQM and Innovation are the competitive key factors that intensely embedded into organizational products, service and process. In order to achieve higher business performance, organizations are needed to adopt both quality and innovation. Therefore, the main objective of this paper is to identify the relationship between TQM and business performance with a mediator's effect of Innovation. After detailed review the extensive literature, a new TQM model is presented. The proposed model integrates the TQM practices and different type of innovation attempt to develop a theoretical knowledge to help academician and manufacturer to understand the relationship that design quality in product and service and engaging innovation in the activities. To this end, the SEM-PLS (Structural Equation Modelling - Partial Least Squares Structural) is used to identify and evaluate the relationship among TQM, Innovation and business performance in establishing a new TQM model.

CNS drug development in Europe--past progress and future challenges.

PubMed

Nutt, David J; Attridge, Jim

2014-01-01

Despite enormous progress in defining, diagnosing and treating mental disorders, EU health systems face a mounting challenge in responding to 'unmet need'. Mental illnesses produce a societal burden that exceeds that for either cancers or cardiovascular conditions. Leveraging advances in science and medicine to make available new innovative medicines is a key component in responding to this challenge. The dominant paradigm has been, is and will continue to be, one of incremental progress. Better medicines for depression, anxiety and psychoses in the working age population would add great value to patients and improve labour productivity. But psychotropic medicines face exceptional challenges in demonstrating their added value, due to uncertainty in patient diagnosis, selecting treatments and ensuring adherence. Also, there are major difficulties in estimating costs. Advances in understanding brain processes, identifying biomarkers and neuro-imaging techniques promise far more effective 'diagnostic-therapeutic' treatments and improved patient outcomes in the future. Currently there are valuable incremental innovations in late development, which may well fail to recover their R&D costs, because of very low reimbursed prices. This will send a signal to innovators not to persist with product development in this area. Recently several leading companies have withdrawn from R&D in these mental disorders. This is a worrying development since building the capabilities to succeed in any disease sector takes many years and, once dismantled, they cannot easily be re-established. Three policy interventions could improve innovation incentives: Further 'push' incentives under i) and streamlining under ii) alone will not reverse the decline in investment incentives. An EU consensus, based upon an innovation model which encompasses the Research, Development and Market phases as a single cyclical process, which addresses the weak 'market pull incentives' under iii) is needed. There is a very real risk that without such an integrated approach to policy reforms, innovation in psychotropic medicines will become a 'desert' in the same way that it did for antibiotics in the 1990's. Copyright © 2013 Elsevier Inc. All rights reserved.

Firm performance model in small and medium enterprises (SMEs) based on learning orientation and innovation

NASA Astrophysics Data System (ADS)

Lestari, E. R.; Ardianti, F. L.; Rachmawati, L.

2018-03-01

This study investigated the relationship between learning orientation, innovation, and firm performance. A conceptual model and hypothesis were empirically examined using structural equation modelling. The study involved a questionnaire-based survey of owners of small and medium enterprises (SMEs) operating in Batu City, Indonesia. The results showed that both variables of learning orientation and innovation effect positively on firm performance. Additionally, learning orientation has positive effect innovation. This study has implication for SMEs aiming at increasing their firm performance based on learning orientation and innovation capability.

Applying circular economy innovation theory in business process modeling and analysis

NASA Astrophysics Data System (ADS)

Popa, V.; Popa, L.

2017-08-01

The overall aim of this paper is to develop a new conceptual framework for business process modeling and analysis using circular economy innovative theory as a source for business knowledge management. The last part of the paper presents an author’s proposed basic structure for a new business models applying circular economy innovation theories. For people working on new innovative business models in the field of the circular economy this paper provides new ideas for clustering their concepts.

Tradition meets innovation: transforming academic medical culture at the University of Pennsylvania's Perelman School of Medicine.

PubMed

Pati, Susmita; Reum, Josef; Conant, Emily; Tuton, Lucy Wolf; Scott, Patricia; Abbuhl, Stephanie; Grisso, Jeane Ann

2013-04-01

Traditional performance expectations and career advancement paths for academic physicians persist despite dramatic transformations in the academic workflow, workload, and workforce over the past 20 years. Although the academic physician's triple role as clinician, researcher, and educator has been lauded as the ideal by academic health centers, current standards of excellence for promotion and tenure are based on outdated models. These models fail to reward collaboration and center around rigid career advancement plans that do little to accommodate the changing needs of individuals and organizations. The authors describe an innovative, comprehensive, multipronged initiative at the Perelman School of Medicine at the University of Pennsylvania to initiate change in the culture of academic medicine and improve academic productivity, job satisfaction, and overall quality of life for junior faculty. As a key part of this intervention, task forces from each of the 13 participating departments/divisions met five times between September 2010 and January 2011 to produce recommendations for institutional change. The authors discuss how this initiative, using principles adopted from business transformation, generated themes and techniques that can potentially guide workforce environment innovation in academic health centers across the United States. Recommendations include embracing a promotion/tenure/evaluation system that supports and rewards tailored individual academic career plans; ensuring leadership, decision-making roles, and recognition for junior faculty; deepening administrative and team supports for junior faculty; and solidifying and rewarding mentorship for junior faculty. By doing so, academic health centers can ensure the retention and commitment of faculty throughout all stages of their careers.

Tradition Meets Innovation: Transforming Academic Medical Culture at the University of Pennsylvania’s Perelman School of Medicine

PubMed Central

Pati, Susmita; Reum, Josef; Conant, Emily; Tuton, Lucy Wolf; Scott, Patricia; Abbuhl, Stephanie; Grisso, Jeane Ann

2013-01-01

Traditional performance expectations and career advancement paths for academic physicians persist despite dramatic transformations in the academic workflow, workload, and workforce over the past twenty years. While the academic physician’s triple role as clinician, researcher, and educator has been lauded as the ideal by academic medical centers, current standards of excellence for promotion and tenure are based on outdated models. These models fail to reward collaboration and center around rigid career advancement plans that do little to accommodate the changing needs of individuals and organizations. Here, the authors describe an innovative, comprehensive, multi-pronged initiative at the Perelman School of Medicine at the University of Pennsylvania to initiate change in the culture of academic medicine and improve academic productivity, job satisfaction, and overall quality of life for junior faculty. As a key part of this intervention, task forces from each of the 13 participating departments/divisions met 5 times between September 2010 and January 2011 to produce recommendations for institutional change. The authors discuss how this initiative, using principles adopted from business transformation, generated themes and techniques that can potentially guide workforce environment innovation in academic health centers across the United States. Recommendations include embracing a promotion/tenure/evaluation system that supports and rewards tailored individual academic career plans; ensuring leadership, decision-making roles and recognition for junior faculty; deepening administrative and team supports for junior faculty; and solidifying and rewarding mentorship for junior faculty. By doing so, academic health centers can ensure the retention and commitment of faculty throughout all stages of their careers. PMID:23425986

Upgrading the Chinese Economy by Overhauling Special Economic Zones: Innovation Model Shopping or the Emergence of a Chinese Innovation Model?

ERIC Educational Resources Information Center

Gebhardt, Christiane

2013-01-01

Technology and Education, the main body for the central government's innovation policy, highlights the strengthening of the scientific--technological base and the upgrading of domestic innovative competences, and places the industrial focus on seven new strategic…

Maybe Small Is Too Small a Term: Introduction to Advancing Small Sample Prevention Science.

PubMed

Fok, Carlotta Ching Ting; Henry, David; Allen, James

2015-10-01

Prevention research addressing health disparities often involves work with small population groups experiencing such disparities. The goals of this special section are to (1) address the question of what constitutes a small sample; (2) identify some of the key research design and analytic issues that arise in prevention research with small samples; (3) develop applied, problem-oriented, and methodologically innovative solutions to these design and analytic issues; and (4) evaluate the potential role of these innovative solutions in describing phenomena, testing theory, and evaluating interventions in prevention research. Through these efforts, we hope to promote broader application of these methodological innovations. We also seek whenever possible, to explore their implications in more general problems that appear in research with small samples but concern all areas of prevention research. This special section includes two sections. The first section aims to provide input for researchers at the design phase, while the second focuses on analysis. Each article describes an innovative solution to one or more challenges posed by the analysis of small samples, with special emphasis on testing for intervention effects in prevention research. A concluding article summarizes some of their broader implications, along with conclusions regarding future directions in research with small samples in prevention science. Finally, a commentary provides the perspective of the federal agencies that sponsored the conference that gave rise to this special section.

Narrative Exposure Therapy: A Proposed Model to Address Intimate Partner Violence-Related PTSD in Parenting and Pregnant Adolescents.

PubMed

Volpe, Ellen M; Quinn, Camille R; Resch, Kathryn; Sommers, Marilyn S; Wieling, Elizabeth; Cerulli, Catherine

Pregnant and parenting adolescents experience high rates of intimate partner violence (IPV) and its sequelae posttraumatic stress disorder (PTSD) and depression. Narrative exposure therapy (NET) is an innovative intervention that has demonstrated strong preliminary evidence in improving mental health. The specific aims of this article are 3-fold: (1) provide a brief background about IPV-related PTSD and depression among pregnant and parenting adolescents; (2) describe NET's theoretical principles, its therapeutic process, and provide a review of existing evidence; and (3) discuss NET as a potential treatment to address the mental health burden among adolescents experiencing IPV-related PTSD and depression.

The keys to healthy family child care homes intervention: study design and rationale.

PubMed

Østbye, Truls; Mann, Courtney M; Vaughn, Amber E; Namenek Brouwer, Rebecca J; Benjamin Neelon, Sara E; Hales, Derek; Bangdiwala, Shrikant I; Ward, Dianne S

2015-01-01

Obesity is a major public health problem for which early preventive interventions are needed. Large numbers of young children are enrolled in some form of child care program, making these facilities influential environments in children's development. Family child care homes (FCCH) are a specific type of child care in which children are cared for within the provider's own residence. FCCHs serve approximately 1.5 million children in the U.S.; however, research to date has overlooked FCCH providers and their potential to positively influence children's health-related behaviors. Keys to Healthy Family Child Care Homes (Keys) is a cluster-randomized controlled trial testing the efficacy of an intervention designed to help providers become healthy role models, provide quality food- and physical activity-supportive FCCH environments, and implement effective business practices. The intervention is delivered through workshops, home visits, tailored coaching calls, and educational toolkits. Primary outcomes are child physical activity measured via accelerometry data and dietary intake data collected using direct observation at the FCCH. Secondary outcomes include child body mass index, provider weight-related behaviors, and observed obesogenic environmental characteristics. Keys is an innovative approach to promoting healthy eating and physical activity in young children. The intervention operates in a novel setting, targets children during a key developmental period, and addresses both provider and child behaviors to synergistically promote health. Copyright © 2014. Published by Elsevier Inc.

The Keys to Healthy Family Child Care Homes intervention: Study design and rationale

PubMed Central

Østbye, Truls; Mann, Courtney M.; Vaughn, Amber E.; Namenek Brouwer, Rebecca J.; Benjamin Neelon, Sara E.; Hales, Derek; Bangdiwala, Shrikant I.; Ward, Dianne S.

2014-01-01

Background Obesity is a major public health problem for which early preventive interventions are needed. Large numbers of young children are enrolled in some form of child care program, making these facilities influential environments in children’s development. Family child care homes (FCCH) are a specific type of child care in which children are cared for within the provider’s own residence. FCCHs serve approximately 1.5 million children in the U.S.; however, research to date has overlooked FCCH providers and their potential to positively influence children’s health-related behaviors. Methods Keys to Healthy Family Child Care Homes (Keys) is a cluster-randomized controlled trial testing the efficacy of an intervention designed to help providers become healthy role models, provide quality food- and physical activity-supportive FCCH environments, and implement effective business practices. The intervention is delivered through workshops, home visits, tailored coaching calls, and educational toolkits. Primary outcomes are child physical activity measured via accelerometry data and dietary intake data collected using direct observation at the FCCH. Secondary outcomes include child body mass index, provider weight-related behaviors, and observed obesogenic environmental characteristics. Conclusion Keys is an innovative approach to promoting healthy eating and physical activity in young children. The intervention operates in a novel setting, targets children during a key developmental period, and addresses both provider and child behaviors to synergistically promote health. PMID:25460337

Project ORE: A Friendship-Based Intervention to Prevent HIV/STI in Urban African American Adolescent Females

ERIC Educational Resources Information Center

Dolcini, M. Margaret; Harper, Gary W.; Boyer, Cherrie B.; Pollack, Lance M.

2010-01-01

There is an urgent need for continued innovation in the design of HIV/STI prevention interventions for African American females, a group at high risk for STIs and HIV. In particular, attention to social development and to culture is needed. The present study reports on a group randomized controlled trial of a friendship-based HIV/STI prevention…

Effects of a Community-Based Lifestyle Intervention on Change in Physical Activity among Economically Disadvantaged Adults with Prediabetes

ERIC Educational Resources Information Center

Hays, Laura M.; Hoen, Helena M.; Slaven, James E.; Finch, Emily A.; Marrero, David G.; Saha, Chandan; Ackermann, Ronald T.

2016-01-01

Background: Moderate weight loss and physical activity (PA) can prevent or delay type 2 diabetes however there is a need for innovative, effective programs to promote PA in high-risk individuals. Purpose: We examined the effect of a group-based adaption of the DPP lifestyle intervention implemented in partnership with the YMCA (YDPP) on changes in…