Lay involvement in the analysis of qualitative data in health services research: a descriptive study.

PubMed

Garfield, S; Jheeta, S; Husson, F; Jacklin, A; Bischler, A; Norton, C; Franklin, B D

2016-01-01

There is a consensus that patients and the public should be involved in research in a meaningful way. However, to date, lay people have been mostly involved in developing research ideas and commenting on patient information.We previously published a paper describing our experience with lay partners conducting observations in a study of how patients in hospital are involved with their medicines. In a later part of the same study, lay partners were also involved in analysing interviews that a researcher had conducted with patients, carers and healthcare professionals about patient and carer involvement with medicines in hospital. We therefore wanted to build on our previous paper and report on our experiences with lay partners helping to conduct data analysis. We therefore interviewed the lay members and researchers involved in the analysis to find out their views.Both lay members and researchers reported that lay partners added value to the study by bringing their own perspectives and identifying further areas for the researcher to look for in the interviews. In this way researchers and lay partners were able to work together to produce a richer analysis than would have been possible from either alone. Background It is recognised that involving lay people in research in a meaningful rather than tokenistic way is both important and challenging. In this paper, we contribute to this debate by describing our experiences of lay involvement in data analysis. Methods We conducted semi-structured interviews with the lay partners and researchers involved in qualitative data analysis in a wider study of inpatient involvement in medication safety. The interviews were transcribed verbatim and coded using open thematic analysis. Results We interviewed three lay partners and the three researchers involved. These interviews demonstrated that the lay members added value to the analysis by bringing their own perspectives; these were systematically integrated into the analysis by the lead researcher to create a synergistic output. Some challenges arose, including difficulties in recruiting a diverse range of members of the public to carry out the role; however there were generally fewer challenges in data analysis than there had been with our previous experience of lay partners' involvement in data collection. Conclusions Lay members can add value to health services research by being involved in qualitative data analysis.

Adaptation of a Lay Health Advisor Model as a Recruitment and Retention Strategy in a Clinical Trial of College Student Smokers

PubMed Central

Varvel, Shiloh Jordan; Cronk, Nikole J.; Harris, Kari Jo; Scott, Anne B.

2011-01-01

This study describes and provides results from a process evaluation of a lay health advisor (LHA) model to enhance participation in a clinical trial of the effectiveness of motivational interviewing on smoking cessation in college fraternity and sorority members. The implementation of the model had two phases: (a) the selection and training of LHAs as liaisons between research staff and participants and (b) LHAs’ roles in recruitment and retention. Perceptions of the LHA model were explored using survey questionnaires. Trial participants (N = 118) and LHAs (N = 8) were generally satisfied with the model and identified LHAs as helpful to participation. Seventy-four percent of chapter members were screened and 73% of participants received three of the four motivational interviewing sessions. These results indicate the LHA model was well received and met the needs of the research project. PMID:19116416

LEAP: A randomized-controlled trial of a lay-educator inpatient asthma education program.

PubMed

Rice, Jessica L; Matlack, Kristen M; Simmons, Marsha D; Steinfeld, Jonathan; Laws, Margaret A; Dovey, Mark E; Cohen, Robyn T

2015-06-29

To evaluate the impact of LEAP, a volunteer-based, inpatient asthma education program for families of inner-city children with asthma. 711 children ages 2-17 years admitted with status asthmaticus were randomized to receive usual care or usual care plus a supplemental education intervention. Both groups completed a baseline interview. Trained volunteer lay educators conducted individualized bedside education with the intervention group. Primary outcome was attendance at a post-hospitalization follow-up visit 7-10 days after discharge. Secondary outcomes included parent-reported asthma management behaviors, symptoms, and self-efficacy scores from a one month follow-up interview. Post-hospitalization asthma clinic attendance was poor (38%), with no difference between groups. Families randomized to the intervention group were more likely to report use of a controller (OR 2.4, 95% CI 1.3-4.2, p<0.01) and a valved-holding chamber (OR 2.9, 95% CI 1.1-7.4, p=0.03), and were more likely to have an asthma action plan at follow up (OR 2.0, 95% CI 1.3-3.0, p<0.01). Asthma self-efficacy scores were significantly improved among those who received the intervention (p=0.04). Inpatient asthma education by trained lay volunteers was associated with improved asthma management behaviors. This novel volunteer-based program could have widespread implications as a sustainable model for asthma education. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Task shifting in maternal and newborn care: a non-inferiority study examining delegation of antenatal counseling to lay nurse aides supported by job aids in Benin.

PubMed

Jennings, Larissa; Yebadokpo, André Sourou; Affo, Jean; Agbogbe, Marthe; Tankoano, Aguima

2011-01-06

Shifting the role of counseling to less skilled workers may improve efficiency and coverage of health services, but evidence is needed on the impact of substitution on quality of care. This research explored the influence of delegating maternal and newborn counseling responsibilities to clinic-based lay nurse aides on the quality of counseling provided as part of a task shifting initiative to expand their role. Nurse-midwives and lay nurse aides in seven public maternities were trained to use job aids to improve counseling in maternal and newborn care. Quality of counseling and maternal knowledge were assessed using direct observation of antenatal consultations and patient exit interviews. Both provider types were interviewed to examine perceptions regarding the task shift. To compare provider performance levels, non-inferiority analyses were conducted where non-inferiority was demonstrated if the lower confidence limit of the performance difference did not exceed a margin of 10 percentage points. Mean percent of recommended messages provided by lay nurse aides was non-inferior to counseling by nurse-midwives in adjusted analyses for birth preparedness (β = -0.0, 95% CI: -9.0, 9.1), danger sign recognition (β = 4.7, 95% CI: -5.1, 14.6), and clean delivery (β = 1.4, 95% CI: -9.4, 12.3). Lay nurse aides demonstrated superior performance for communication on general prenatal care (β = 15.7, 95% CI: 7.0, 24.4), although non-inferiority was not achieved for newborn care counseling (β = -7.3, 95% CI: -23.1, 8.4). The proportion of women with correct knowledge was significantly higher among those counseled by lay nurse aides as compared to nurse-midwives in general prenatal care (β = 23.8, 95% CI: 15.7, 32.0), birth preparedness (β = 12.7, 95% CI: 5.2, 20.1), and danger sign recognition (β = 8.6, 95% CI: 3.3, 13.9). Both cadres had positive opinions regarding task shifting, although several preferred 'task sharing' over full delegation. Lay nurse aides can provide effective antenatal counseling in maternal and newborn care in facility-based settings, provided they receive adequate training and support. Efforts are needed to improve management of human resources to ensure that effective mechanisms for regulating and financing task shifting are sustained.

Task shifting in maternal and newborn care: a non-inferiority study examining delegation of antenatal counseling to lay nurse aides supported by job aids in Benin

PubMed Central

2011-01-01

Background Shifting the role of counseling to less skilled workers may improve efficiency and coverage of health services, but evidence is needed on the impact of substitution on quality of care. This research explored the influence of delegating maternal and newborn counseling responsibilities to clinic-based lay nurse aides on the quality of counseling provided as part of a task shifting initiative to expand their role. Methods Nurse-midwives and lay nurse aides in seven public maternities were trained to use job aids to improve counseling in maternal and newborn care. Quality of counseling and maternal knowledge were assessed using direct observation of antenatal consultations and patient exit interviews. Both provider types were interviewed to examine perceptions regarding the task shift. To compare provider performance levels, non-inferiority analyses were conducted where non-inferiority was demonstrated if the lower confidence limit of the performance difference did not exceed a margin of 10 percentage points. Results Mean percent of recommended messages provided by lay nurse aides was non-inferior to counseling by nurse-midwives in adjusted analyses for birth preparedness (β = -0.0, 95% CI: -9.0, 9.1), danger sign recognition (β = 4.7, 95% CI: -5.1, 14.6), and clean delivery (β = 1.4, 95% CI: -9.4, 12.3). Lay nurse aides demonstrated superior performance for communication on general prenatal care (β = 15.7, 95% CI: 7.0, 24.4), although non-inferiority was not achieved for newborn care counseling (β = -7.3, 95% CI: -23.1, 8.4). The proportion of women with correct knowledge was significantly higher among those counseled by lay nurse aides as compared to nurse-midwives in general prenatal care (β = 23.8, 95% CI: 15.7, 32.0), birth preparedness (β = 12.7, 95% CI: 5.2, 20.1), and danger sign recognition (β = 8.6, 95% CI: 3.3, 13.9). Both cadres had positive opinions regarding task shifting, although several preferred 'task sharing' over full delegation. Conclusions Lay nurse aides can provide effective antenatal counseling in maternal and newborn care in facility-based settings, provided they receive adequate training and support. Efforts are needed to improve management of human resources to ensure that effective mechanisms for regulating and financing task shifting are sustained. PMID:21211045

Strength training in community settings: impact of lay leaders on program access and sustainability for rural older adults.

PubMed

Washburn, Lisa T; Cornell, Carol E; Phillips, Martha; Felix, Holly; Traywick, LaVona

2014-09-01

The effect of volunteer lay leaders on availability and sustainability of strength-training programs for older adults has not been well explored. We describe implementation of the StrongWomen strength training program by the Arkansas Cooperative Extension Service, and report on the relationship between delivery approach (agent-led, lay-led, or combination of agent- and lay-led) and program access and sustainability. All state Extension agents (n = 66) were surveyed on program implementation, continuance, and use of lay leaders. Program records were used to identify the number of trained lay leaders. Regression models were used to examine the relationship between delivery approach and group availability. Counties using lay leaders had twice as many groups as counties using only agents. There was a significant, positive relationship between the number of lay leaders and the number of groups. Counties using lay leaders were 8.3 times more likely to have continuing groups compared with counties not using lay leaders. Program continuance was significantly and positively associated with lay leader use. Lay delivery expanded access to strength training programs and increased the likelihood that programs would continue. This approach can be used to increase access to and sustainability of strength training programs, particularly in resource-constrained areas.

Cross-cultural perspectives on physician and lay models of the common cold.

PubMed

Baer, Roberta D; Weller, Susan C; de Alba García, Javier García; Rocha, Ana L Salcedo

2008-06-01

We compare physicians and laypeople within and across cultures, focusing on similarities and differences across samples, to determine whether cultural differences or lay-professional differences have a greater effect on explanatory models of the common cold. Data on explanatory models for the common cold were collected from physicians and laypeople in South Texas and Guadalajara, Mexico. Structured interview materials were developed on the basis of open-ended interviews with samples of lay informants at each locale. A structured questionnaire was used to collect information from each sample on causes, symptoms, and treatments for the common cold. Consensus analysis was used to estimate the cultural beliefs for each sample. Instead of systematic differences between samples based on nationality or level of professional training, all four samples largely shared a single-explanatory model of the common cold, with some differences on subthemes, such as the role of hot and cold forces in the etiology of the common cold. An evaluation of our findings indicates that, although there has been conjecture about whether cultural or lay-professional differences are of greater importance in understanding variation in explanatory models of disease and illness, systematic data collected on community and professional beliefs indicate that such differences may be a function of the specific illness. Further generalizations about lay-professional differences need to be based on detailed data for a variety of illnesses, to discern patterns that may be present. Finally, a systematic approach indicates that agreement across individual explanatory models is sufficient to allow for a community-level explanatory model of the common cold.

AED use in businesses, public facilities and homes by minimally trained first responders.

PubMed

Jorgenson, Dawn B; Skarr, Teresa; Russell, James K; Snyder, David E; Uhrbrock, Karen

2003-11-01

Automated external defibrillators (AEDs) have become increasingly available outside of the Emergency Medical Systems (EMS) community to treat sudden cardiac arrest (SCA). We sought to study the use of AEDs in the home, businesses and other public settings by minimally trained first responders. The frequency of AED use, type of training offered to first responders, and outcomes of AED use were investigated. In addition, minimally trained responders were asked if they had encountered any safety problems associated with the AED. We conducted a telephone survey of businesses and public facilities (2683) and homes (145) owning at least one AED for at least 12 months. Use was defined as an AED taken to a medical emergency thought to be a SCA, regardless of whether the AED was applied to the patient or identified a shockable rhythm. Of owners that participated in the survey, 13% (209/1581) of businesses and 5% (4/73) of homes had responded with the AED to a suspected cardiac arrest. Ninety-five percent of the businesses/public facilities offered training that specifically covered AED use. The rate of use for the AEDs was highest in residential buildings, public places, malls and recreational facilities with an overall usage rate of 11.6% per year. In-depth interviews were conducted with lay responders who had used the AED in a suspected cardiac arrest. In the four cases where the AED was used solely by a lay responder, all four patients survived to hospital admission and two were known to be discharged from the hospital. There were no reports of injury or harm. This survey demonstrates that AEDs purchased by businesses and homes were frequently taken to suspected cardiac arrests. Lay responders were able to successfully use the AEDs in emergency situations. Further, there were no reports of harm or injury to the operators, bystanders or patients from lay responder use of the AEDs.

Lay Health Trainers Supporting Self-Management amongst Those with Low Heath Literacy and Diabetes: Lessons from a Mixed Methods Pilot, Feasibility Study.

PubMed

Bartlam, Bernadette; Rathod, Trishna; Rowlands, Gillian; Protheroe, Joanne

2016-01-01

This article reports a mixed methods process evaluation of a pilot feasibility randomised controlled trial comparing a Lay Health Trainer (LHT) intervention and usual care for those with poorly controlled Type 2 Diabetes Melitus (T2DM). Set in a deprived area in the UK, this research explores patient and health care practitioner (HCP) views on whether a structured interview between a patient and a Lay Health Trainer (LHT), for the purpose of developing a tailored self-management plan for patients, is acceptable and likely to change health behaviours. In doing so, it considers the implications for a future, randomised controlled trial (RCT). Participants were patients, LHTs delivering the intervention, service managers, and practice nurses recruiting patients to the study. Patients were purposively sampled on their responses to a baseline survey, and semistructured interviews were conducted within an exploratory thematic analysis framework. Findings indicate that the intervention is acceptable to patients and HCPs. However, LHTs found it challenging to work with older patients with long-term and/or complex conditions. In order to address this, given an ageing population and concomitant increases in those with such health needs, LHT training should develop skills working with these populations. The design of any future RCT intervention should take account of this.

Epidemiology of pathological gambling in Edmonton.

PubMed

Bland, R C; Newman, S C; Orn, H; Stebelsky, G

1993-03-01

Thirty lifetime pathological gamblers (DSM-III, no exclusion criteria) were identified when 7,214 randomly selected household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule. The lifelong prevalence of pathological gambling was 0.42% (ratio of males to females 3:1). The peak age of onset was 25 to 29 years. Gamblers had high rates of comorbidity with other psychiatric disorders. They were likely to have made suicide attempts (13.3%), to have been convicted of offences (26.7%), to be spouse and child abusers (23.3% and 16.7% respectively) and to have spent long periods unemployed (40%). In addition, 80% had trouble at home or work because of gambling, and 60% borrowed or stole to gamble.

Study Guide for Carpet Laying [and Instructor's Key]. A Resource Guide for Industrial Cooperative Training Programs. V&TECC Curriculum Guide.

ERIC Educational Resources Information Center

Duenk, Lester G.; And Others

This study guide was prepared to aid industrial cooperative training coordinators in the technical training phase of the carpet laying training program. The guide begins with a section related to carpet laying career guidance. Specific topics in the section include status of the occupation, working conditions, salary, qualifications, and future…

Types of Lay Health Influencers in Tobacco Cessation: A Qualitative Study

PubMed Central

Yuan, Nicole P.; Wind, Steven; Nichter, Mimi; Nichter, Mark; Castañeda, Heide; Carruth, Lauren; Muramoto, Myra L.

2014-01-01

Objective To identify types of health influencers in tobacco cessation based on the frequency and characteristics of brief intervention activities. Methods Longitudinal qualitative interviews were completed with 28 individuals post-training. Results Four individuals were categorized as Rarely Active, 5 as Active with Family and Friends, 9 as Active in the Workplace, and 10 as Proactive in Multiple Settings. Unique motivators, intervention behaviors, and barriers were documented. Some individuals displayed high levels of self-efficacy necessary for expanding the reach of community-based interventions. Conclusion Training programs need to address the impact of contextual factors on initiating and sustaining intervention activities. PMID:20524890

Co-producing public involvement training with members of the public and research organisations in the East Midlands: creating, delivering and evaluating the lay assessor training programme.

PubMed

Horobin, Adele; Brown, George; Higton, Fred; Vanhegan, Stevie; Wragg, Andrew; Wray, Paula; Walker, Dawn-Marie

2017-01-01

Members of the public share their views with researchers to improve health and social care research. Lay assessing is one way of doing this. This is where people, drawing upon personal and general life experience, comment on material, such as grant applications and patient information, to highlight strengths and weaknesses and to suggest improvements. This paper reports on setting up a training programme for lay assessors. Meetings were held between interested public and staff from research organisations. People discussed what lay assessing is, why they want to do it, skills and support needed and if training was wanted. They were invited to form a group to develop the training together. Training was delivered in the East Midlands. People who attended gave their thoughts about it by completing questionnaires and joining a feedback event. The group developed the structure of the training programme together and it oversaw the development of the training content by individual members. People who attended training reported feeling more confident about lay assessing. This was particularly so for those who had not done lay assessing before. They indicated how valuable it was to talk with others at the training. Our findings support the National Institute for Health Research recommendations for improving learning and development for public involvement in research. This project has created a solid base for local research organisations to work together in public involvement training. Lay assessor training is now part of a wider programme of shared resources called the Sharebank. Background Involving members of the public in research can improve its quality and incorporate the needs and views of patients. One method for doing this is lay assessing, where members of the public are consulted to improve research materials. This paper documents the establishment of a pilot training programme for lay assessors. It describes a way of working that embodies a regional, cross-organisational approach to co-producing training with members of the public. Methods Open meetings, led by AH, were held for existing and aspiring lay assessors to define lay assessing, motivations for doing it, skills required, associated learning and development needs, and to gauge interest for training. Those who attended meetings, including members of the public and staff, were invited to form a working group to co-produce the training programme. Training was delivered in modules at two centres in the East Midlands and evaluated through participant feedback at the end of each module and at an evaluation event. Feedback was through a mix of Likert scale scoring, open text and verbal responses. Results Discussions from the open meetings informed the development of the training by the working group. Led by AH, the working group, as a whole, co-produced the structure and format of the training and oversaw training content development by individuals within the group. Training was well-received by participants. Feedback through Likert scoring ( n  = 14) indicated higher feelings of confidence in knowledge of relevant subject matter and in fulfilling the lay assessor role, particularly amongst those who had not done lay assessing before. Opportunities that the training afforded for interaction between participants - sharing of varied experiences and knowledge - and a 'learn by doing' approach was of particular value, as indicated by 10 responses to open-ended questions. Conclusions This project has created a solid foundation for collaboration between research organisations in the East Midlands in devising and delivering training in public involvement together. Our evaluation provides evidence in support of National Institute for Health Research (NIHR) recommendations on principles for learning and development for public involvement in research.

Lay Health Trainers Supporting Self-Management amongst Those with Low Heath Literacy and Diabetes: Lessons from a Mixed Methods Pilot, Feasibility Study

PubMed Central

Rathod, Trishna; Rowlands, Gillian

2016-01-01

This article reports a mixed methods process evaluation of a pilot feasibility randomised controlled trial comparing a Lay Health Trainer (LHT) intervention and usual care for those with poorly controlled Type 2 Diabetes Melitus (T2DM). Set in a deprived area in the UK, this research explores patient and health care practitioner (HCP) views on whether a structured interview between a patient and a Lay Health Trainer (LHT), for the purpose of developing a tailored self-management plan for patients, is acceptable and likely to change health behaviours. In doing so, it considers the implications for a future, randomised controlled trial (RCT). Participants were patients, LHTs delivering the intervention, service managers, and practice nurses recruiting patients to the study. Patients were purposively sampled on their responses to a baseline survey, and semistructured interviews were conducted within an exploratory thematic analysis framework. Findings indicate that the intervention is acceptable to patients and HCPs. However, LHTs found it challenging to work with older patients with long-term and/or complex conditions. In order to address this, given an ageing population and concomitant increases in those with such health needs, LHT training should develop skills working with these populations. The design of any future RCT intervention should take account of this. PMID:27840834

A SHARED study-the benefits and costs of setting up a health research study involving lay co-researchers and how we overcame the challenges.

PubMed

Mockford, Carole; Murray, Matt; Seers, Kate; Oyebode, Jan; Grant, Richard; Boex, Sue; Staniszewska, Sophie; Diment, Yvonne; Leach, Jim; Sharma, Uma; Clarke, Rosemary; Suleman, Rashida

2016-01-01

In the United Kingdom (UK), official bodies such as the Department of Health and research funders such as the National Institute for Health Research support and encourage lay involvement in all stages of research studies. The SHARED study has had substantial patient and public involvement (PPI) from developing the idea to dissemination. The aim of the study has been to develop recommendations led by service users for health and social care professionals to use at hospital discharge and in care planning for people living with memory loss and their carers. This article is about how the study started and the benefits, costs and challenges we encountered as the lead and lay co-researchers. Once we were successful with the grant application, we had to recruit and train the lay co-researchers and obtain various approvals before we could start the project. We had various support from funders, the Research Ethics Committee, lay members of Alzheimer's Society and from the lay co-researchers. However, we encountered some challenges with paying the lay co-researchers and with getting the approval for the co-researchers to interview staff on NHS premises. The challenges were overcome eventually but some aspects of the study changed because of this. We suggest that some changes could be made to the research system which would lead to greater inclusion of the lay co-researchers in research studies and would make the process more straightforward for the research team. Background Involving patients and the public in all stages of research has been the focus of the SHARED study. Patient and public involvement (PPI) is an important strategic priority for the Department of Health and funders such as the National Institute for Health Research. The aim of this paper is to describe the benefits, challenges and costs involved in setting up the research study with lay members as part of the research team. The study focused on developing service user-led recommendations for people with memory loss and their carers, on discharge from acute hospital to the community. Methods This began with a discussion of an initial research idea with a lay group of carers and people living with dementia. Once funded, approval was sought from the Research Ethics Committee and NHS Trusts to conduct the research including the active involvement of lay co-researchers. Finally, to recruit, train and pay lay co-researchers in their role. Results The benefits of PPI have included developing ideas which are important to people living with memory loss; support for PPI received from the funders and research ethics committee, high levels of interest from volunteer groups, and lasting enthusiasm from many of the co-researchers. Organisational challenges were met in the requirement for research passports and with payment methods for the co-researchers. Training was beneficial but incurred extra costs for repeated training days. Discussion Overall the benefits outweighed the challenges which were overcome to varying degrees. The lay co-researchers gained membership of a study group and a beneficial partnership developed with the third sector. The biggest challenge was in overcoming the differences in approach to lay co-researchers between NHS Trusts. Organisational culture has been slow to incorporate PPI and this has not yet been fully addressed. It has the potential to delay the start of projects, affect recruitment time, incur extra research costs and disadvantage PPI. Conclusion Buy-in to service user involvement in research studies could be improved by clarifying the requirements for NHS Trust approval and by simplifying the system for financial reimbursement to lay co-researchers. This would improve inclusivity and provide a smoother process for the research team and the co-researchers.

Training lay-people to use automatic external defibrillators: are all of their needs being met?

PubMed

Harrison-Paul, Russell; Timmons, Stephen; van Schalkwyk, Wilna Dirkse

2006-10-01

We explored the experiences of lay people who have been trained to use automatic external defibrillators. The research questions were: (1) How can training courses help prepare people for dealing with real life situations? (2) Who is ultimately responsible for providing critical incident debriefing and how should this be organised? (3) What is the best process for providing feedback to those who have used an AED? Fifty-three semi-structured, qualitative interviews were conducted, some with those who had been trained and others with trainers. Locations included airports, railway stations, private companies and first responder schemes. Geographically, we covered Nottinghamshire, Lincolnshire, Yorkshire, Staffordshire, Essex and the West Midlands in the UK. Our analysis of the data indicates that most people believe scenarios based within their place of work were most useful in preparing for 'real life'. Many people had not received critical incident debriefing after using an AED. There were a variety of systems in place to provide support after an incident, many of which were informal. Training scenarios should be conducted outside the classroom. There should be more focus on critical incident debriefing during training and a clear identification of who should provide support after an incident. Other issues which were of interest included: (1) people's views on do not attempt resuscitation (DNAR); (2) perceived boundaries of responsibility when using an AED; (3) when is someone no longer 'qualified' to use an AED?

Sustaining the future of HIV counselling to reach 90-90-90: a regional country analysis.

PubMed

Bemelmans, Marielle; Baert, Saar; Negussie, Eyerusalem; Bygrave, Helen; Biot, Marc; Jamet, Christine; Ellman, Tom; Banda, Amanda; van den Akker, Thomas; Ford, Nathan

2016-01-01

Counselling services are recommended by the World Health Organization and have been partially adopted by national HIV guidelines. In settings with a high HIV burden, patient education and counselling is often performed by lay workers, mainly supported with international funding. There are few examples where ministries of health have been able to absorb lay counsellors into their health systems or otherwise sustain their work. We document the role of lay cadres involved in HIV testing and counselling and adherence support and discuss approaches to sustainability. We focused on a purposive sample of eight sub-Saharan African countries where Médecins Sans Frontières supports HIV programmes: Guinea, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Zambia and Zimbabwe. We reviewed both published and grey literature, including national policies and donor proposals, and interviewed key informants, including relevant government staff, donors and non-governmental organizations. Lay counsellors play a critical role in scaling up HIV services and addressing gaps in the HIV testing and treatment cascade by providing HIV testing and counselling and adherence support at both the facility and community levels. Countries have taken various steps in recognizing lay counsellors, including harmonizing training, job descriptions and support structures. However, formal integration of this cadre into national health systems is limited, as lay counsellors are usually not included in national strategies or budgeting. The current trend of reduced donor support for lay counsellors, combined with lack of national prioritization, threatens the sustainability of this cadre and thereby quality HIV service delivery.

The Lay Sister in Educational History and Memory.

ERIC Educational Resources Information Center

Jack, Christine Trimingham

2000-01-01

Focuses on the construction of lay sisters in a religious order and school setting using a poststructuralist orientation. Explains that in the study documents were examined and interviews were conducted with ex-students, choir nuns, and a lay sister at a small Catholic girls-preparatory boarding school. Explores the narrative of one lay sister.…

A critique of the design, implementation, and delivery of a culturally-tailored self-management education intervention: a qualitative evaluation.

PubMed

Sidhu, Manbinder S; Gale, Nicola K; Gill, Paramjit; Marshall, Tom; Jolly, Kate

2015-02-07

Self-management education is at the forefront of addressing the increasing prevalence of chronic diseases. For those at greatest risk, such as minority-ethnic and/or socio-economically deprived groups, self-management education can be culturally-tailored to encourage behavioural change. Yet, the application of culturally appropriate material and expertise within health promotion services continues to be debated. We critique the design, implementation, and delivery of a culturally-tailored self-management intervention, with particular focus on the experiences of lay educators. A mixed methods qualitative evaluation was undertaken to understand self-management service provision to culturally diverse communities (i.e. how components such as lay workers, group-based design, and culturally-appropriate educational material are intended to encourage behavioural change). We interviewed lay educators delivering the Chronic Disease Educator programme along with attendees, whilst observing workshops. Data were thematically analysed using a content-based constant comparison approach through a number of interpretative analytical stages. Lay educators felt part of the local community, relating to attendees from different races and ethnicities. However, lay educators faced challenges when addressing health beliefs and changing lifestyle practices. Culturally-tailored components aided communication, with educator's cultural awareness leading to close relationships with attendees, while the group-based design facilitated discussions of the emotional impact of illness. Lay educators bring with them a number of nuanced skills and knowledge when delivering self-management education. The development and training required for this role is inhibited by financial constraints at policy-level. The interpretation of being from the 'community' links with the identity and status of the lay role, overlapping notions of race, ethnicity, and language.

Should trained lay providers perform HIV testing? A systematic review to inform World Health Organization guidelines.

PubMed

Kennedy, C E; Yeh, P T; Johnson, C; Baggaley, R

2017-12-01

New strategies for HIV testing services (HTS) are needed to achieve UN 90-90-90 targets, including diagnosis of 90% of people living with HIV. Task-sharing HTS to trained lay providers may alleviate health worker shortages and better reach target groups. We conducted a systematic review of studies evaluating HTS by lay providers using rapid diagnostic tests (RDTs). Peer-reviewed articles were included if they compared HTS using RDTs performed by trained lay providers to HTS by health professionals, or to no intervention. We also reviewed data on end-users' values and preferences around lay providers preforming HTS. Searching was conducted through 10 online databases, reviewing reference lists, and contacting experts. Screening and data abstraction were conducted in duplicate using systematic methods. Of 6113 unique citations identified, 5 studies were included in the effectiveness review and 6 in the values and preferences review. One US-based randomized trial found patients' uptake of HTS doubled with lay providers (57% vs. 27%, percent difference: 30, 95% confidence interval: 27-32, p < 0.001). In Malawi, a pre/post study showed increases in HTS sites and tests after delegation to lay providers. Studies from Cambodia, Malawi, and South Africa comparing testing quality between lay providers and laboratory staff found little discordance and high sensitivity and specificity (≥98%). Values and preferences studies generally found support for lay providers conducting HTS, particularly in non-hypothetical scenarios. Based on evidence supporting using trained lay providers, a WHO expert panel recommended lay providers be allowed to conduct HTS using HIV RDTs. Uptake of this recommendation could expand HIV testing to more people globally.

Current patterns of prehospital trauma care in Kampala, Uganda and the feasibility of a lay-first-responder training program.

PubMed

Jayaraman, Sudha; Mabweijano, Jacqueline R; Lipnick, Michael S; Caldwell, Nolan; Miyamoto, Justin; Wangoda, Robert; Mijumbi, Cephas; Hsia, Renee; Dicker, Rochelle; Ozgediz, Doruk

2009-12-01

Uganda currently has no organized prehospital emergency system. We sought to measure the current burden of injury seen by lay people in Kampala, Uganda and to determine the feasibility of a lay first-responder training program. We conducted a cross-sectional survey of current prehospital care providers in Kampala: police officers, minibus taxi drivers, and Local Council officials, and collected data on types and frequencies of emergencies witnessed, barriers to aid provision, history of training, and current availability of first-aid supplies. A context-appropriate course on basic first-aid for trauma was designed and implemented. We measured changes in trainees' fund of knowledge before and after training. A total of 309 lay people participated in the study, and during the previous 6 months saw 18 traumatic emergencies each; 39% saw an injury-related death. The most common injury mechanisms were road crashes, assault, and burns. In these cases, 90% of trainees provided some aid, most commonly lifting (82%) or transport (76%). Fifty-two percent of trainees had previous first-aid training, 44% had some access to equipment, and 32% had ever purchased a first-aid kit. Before training, participants answered 45% of test questions correctly (mean %) and this increased to 86% after training (p < 0.0001). Lay people witness many emergencies and deaths in Kampala, Uganda and provide much needed care but are ill-prepared to do so. A context-appropriate prehospital trauma care course can be developed and improve lay people's knowledge of basic trauma care. The effectiveness of such a training program needs to be evaluated prospectively.

Culturally Competent Training Program: A Key to Training Lay Health Advisors for Promoting Breast Cancer Screening

ERIC Educational Resources Information Center

Yu, Mei-yu; Song, Lixin; Seetoo, Amy; Cai, Cuijuan; Smith, Gary; Oakley, Deborah

2007-01-01

The lay health advisor (LHA) training program for breast cancer screening was conducted among Chinese-English bilingual trainees residing in Southeast Michigan. Guided by Bandura's Social Learning Theory, the development of the training curriculum followed the health communication process recommended by the National Cancer Institute. Data analysis…

Pride in Parenting Training Program: A Curriculum for Training Lay Home Visitors.

ERIC Educational Resources Information Center

Jarrett, Marian H.; Katz, Kathy S.; Sharps, Phyllis; Schneider, Susan; Diamond, Linda T.

1998-01-01

Describes the Pride in Parenting Training Curriculum developed by an interdisciplinary team to reduce infant mortality in minority populations. The program has been used to train lay home visitors to deliver a home-visiting curriculum focused on effective use of health-care services and improved infant development. (Author/CR)

Disability, employment and work performance among people with ICD-10 anxiety disorders.

PubMed

Waghorn, Geoff; Chant, David; White, Paul; Whiteford, Harvey

2005-01-01

To ascertain at a population level, patterns of disability, labour force participation, employment and work performance among people with ICD-10 anxiety disorders in comparison to people without disability or long-term health conditions. A secondary analysis was conducted of a probability sample of 42 664 individuals collected in an Australian Bureau of Statistics (ABS) national survey in 1998. Trained lay interviewers using ICD-10 computer-assisted interviews identified household residents with anxiety disorders. Anxiety disorders were associated with: reduced labour force participation, degraded employment trajectories and impaired work performance compared to people without disabilities or long-term health conditions. People with anxiety disorders may need more effective treatments and assistance with completing education and training, joining and rejoining the workforce, developing career pathways, remaining in the workforce and sustaining work performance. A whole-of-government approach appears needed to reduce the burden of disease and increase community labour resources. Implications for clinicians, vocational professionals and policy makers are discussed.

The acceptability, feasibility and impact of a lay health counsellor delivered health promoting schools programme in India: a case study evaluation

PubMed Central

2012-01-01

Background Studies in resource-limited settings have shown that there are constraints to the use of teachers, peers or health professionals to deliver school health promotion interventions. School health programmes delivered by trained lay health counsellors could offer a cost-effective alternative. This paper presents a case study of a multi-component school health promotion intervention in India that was delivered by lay school health counsellors, who possessed neither formal educational nor health provider qualifications. Methods The intervention was based on the WHO’s Health Promoting Schools framework, and included health screening camps; an anonymous letter box for student questions and complaints; classroom-based life skills training; and, individual psycho-social and academic counselling for students. The intervention was delivered by a lay school health counsellor who had attained a minimum of a high school education. The counsellor was trained over four weeks and received structured supervision from health professionals working for the implementing NGO. The evaluation design was a mixed methods case study. Quantitative process indicators were collected to assess the extent to which the programme was delivered as planned (feasibility), the uptake of services (acceptability), and the number of students who received corrective health treatment (evidence of impact). Semi-structured interviews were conducted over two years with 108 stakeholders, and were analysed to identify barriers and facilitators for the programme (feasibility), evaluate acceptability, and gather evidence of positive or negative effects of the programme. Results Feasibility was established by the high reported coverage of all the targeted activities by the school health counsellor. Acceptability was indicated by a growing number of submissions to the students’ anonymous letter-box; more students self-referring for counselling services over time; and, the perceived need for the programme, as expressed by principals, parents and students. A minority of teachers complained that there was inadequate information sharing about the programme and mentioned reservations about the capacities of the lay health counsellor. Preliminary evidence of the positive effects of the programme included the correction of vision problems detected in health screening camps, and qualitative evidence of changes in health-related knowledge and behaviour of students. Conclusion A task-shifting approach of delegating school health promotion activities to lay school health counsellors rather than education or health professionals shows promise of effectiveness as a scalable model for promoting the health and well being of school based adolescents in resource constrained settings. PMID:22630607

The acceptability, feasibility and impact of a lay health counsellor delivered health promoting schools programme in India: a case study evaluation.

PubMed

Rajaraman, Divya; Travasso, Sandra; Chatterjee, Achira; Bhat, Bhargav; Andrew, Gracy; Parab, Suraj; Patel, Vikram

2012-05-25

Studies in resource-limited settings have shown that there are constraints to the use of teachers, peers or health professionals to deliver school health promotion interventions. School health programmes delivered by trained lay health counsellors could offer a cost-effective alternative. This paper presents a case study of a multi-component school health promotion intervention in India that was delivered by lay school health counsellors, who possessed neither formal educational nor health provider qualifications. The intervention was based on the WHO's Health Promoting Schools framework, and included health screening camps; an anonymous letter box for student questions and complaints; classroom-based life skills training; and, individual psycho-social and academic counselling for students. The intervention was delivered by a lay school health counsellor who had attained a minimum of a high school education. The counsellor was trained over four weeks and received structured supervision from health professionals working for the implementing NGO. The evaluation design was a mixed methods case study. Quantitative process indicators were collected to assess the extent to which the programme was delivered as planned (feasibility), the uptake of services (acceptability), and the number of students who received corrective health treatment (evidence of impact). Semi-structured interviews were conducted over two years with 108 stakeholders, and were analysed to identify barriers and facilitators for the programme (feasibility), evaluate acceptability, and gather evidence of positive or negative effects of the programme. Feasibility was established by the high reported coverage of all the targeted activities by the school health counsellor. Acceptability was indicated by a growing number of submissions to the students' anonymous letter-box; more students self-referring for counselling services over time; and, the perceived need for the programme, as expressed by principals, parents and students. A minority of teachers complained that there was inadequate information sharing about the programme and mentioned reservations about the capacities of the lay health counsellor. Preliminary evidence of the positive effects of the programme included the correction of vision problems detected in health screening camps, and qualitative evidence of changes in health-related knowledge and behaviour of students. A task-shifting approach of delegating school health promotion activities to lay school health counsellors rather than education or health professionals shows promise of effectiveness as a scalable model for promoting the health and well being of school based adolescents in resource constrained settings.

Insiders and incomers: how lay public health workers' knowledge might improve public health practice.

PubMed

Yoeli, Heather; Cattan, Mima

2017-11-01

Since 2005, health trainers and other lay public health workers (LPHWs) have been increasingly active in the UK. Although elsewhere in the world LPHWs are expected to come from the communities within which they work and know that their knowledge is valued, neither is the case for LPHWs in the UK. This study sought to discover the lay knowledge of health trainers and other LPHWs, aiming to ascertain how this knowledge might more effectively be utilised within UK public health services. This paper describes a participatory and ethnographic case study research project undertaken on an anonymised urban estate in North East England. Findings were generated by a range of means including by participant observation and semi-structured interviews. Seven LPHWs took part, as did 32 other community members. This study found that the lay health knowledge of an individual UK LPHW is determined primarily by his or her position within, or in relation to, the community within which he or she works. Insider LPHWs possess an embodied knowledge and incomer LPHWs possess an experiential knowledge which, although different from one another, are essentially interpersonal in nature. Lay health knowledge can take different forms, and different LPHWs can provide different forms of lay health knowledge. Public health structures and services in the UK should make better use of all forms of LPHW knowledge, and should seek from LPHWs training on how to engage the most 'hard-to-reach' or 'difficult-to-engage' groups. Services recruiting LPHWs should decide whether they are seeking embodied insider LPHW knowledge, experiential incomer LPHW knowledge or a mixture of both. © 2017 John Wiley & Sons Ltd.

Managing uncertainty in advanced liver disease: a qualitative, multiperspective, serial interview study.

PubMed

Kimbell, Barbara; Boyd, Kirsty; Kendall, Marilyn; Iredale, John; Murray, Scott A

2015-11-19

To understand the experiences and support needs of people with advanced liver disease and those of their lay and professional carers to inform improvements in the supportive and palliative care of this rapidly growing but currently neglected patient group. Multiperspective, serial interviews. We conducted up to three qualitative in-depth interviews with each patient and lay carer over 12 months and single interviews with case-linked healthcare professionals. Data were analysed using grounded theory techniques. Patients with advanced liver disease of diverse aetiologies recruited from an inpatient hepatology ward, and their lay carers and case-linked healthcare professionals nominated by the patients. Primary and secondary care in South-East Scotland. 37 participants (15 patients, 11 lay and 11 professional carers) completed 51 individual and 13 joint patient-carer interviews. Nine patients died during the study. Uncertainty dominated experiences throughout the course of the illness, across patients' considerable physical, psychological, social and existential needs and affected patients, lay carers and professionals. This related to the nature of the condition, the unpredictability of physical deterioration and prognosis, poor communication and information-sharing, and complexities of care. The pervasive uncertainty also shaped patients' and lay carers' strategies for coping and impeded care planning. While patients' acute medical care was usually well coordinated, their ongoing care lacked structure and focus. Living, dying and caring in advanced liver disease is dominated by pervasive, enduring and universally shared uncertainty. In the face of high levels of multidimensional patient distress, professionals must acknowledge this uncertainty in constructive ways that value its contribution to the person's coping approach. Pervasive uncertainty makes anticipatory care planning in advanced liver disease challenging, but planning 'just in case' is vital to ensure that patients receive timely and appropriate supportive and palliative care alongside effective management of this unpredictable illness. 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/

Making a structured psychiatric diagnostic interview faithful to the nomenclature.

PubMed

Robins, Lee N; Cottler, Linda B

2004-10-15

Psychiatric diagnostic interviews to be used in epidemiologic studies by lay interviewers have, since the 1970s, attempted to operationalize existing psychiatric nomenclatures. How to maximize the chances that they do so successfully has not previously been spelled out. In this article, the authors discuss strategies for each of the seven steps involved in writing, updating, or modifying a diagnostic interview and its supporting materials: 1) writing questions that match the nomenclature's criteria, 2) checking that respondents will be willing and able to answer the questions, 3) choosing a format acceptable to interviewers that maximizes accurate answering and recording of answers, 4) constructing a data entry and cleaning program that highlights errors to be corrected, 5) creating a diagnostic scoring program that matches the nomenclature's algorithms, 6) developing an interviewer training program that maximizes reliability, and 7) computerizing the interview. For each step, the authors discuss how to identify errors, correct them, and validate the revisions. Although operationalization will never be perfect because of ambiguities in the nomenclature, specifying methods for minimizing divergence from the nomenclature is timely as users modify existing interviews and look forward to updating interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the International Classification of Diseases, Eleventh Revision.

Effects of training to implement new tools and working methods to reduce knee load in floor layers.

PubMed

Jensen, Lilli Kirkeskov; Friche, Claus

2007-09-01

The purpose was to measure the effect of a participatory ergonomics implementation strategy consisting of information, education, and facilitation on the use of new tools and working methods in the floor laying trade. Floor layers (n=292) were trained in using new working methods. The effects were evaluated by using questionnaires, interviews, and assessments of quality and productivity. Following the training, 43% had used the new working methods weekly/daily compared to 11% before. There was a reduction in the degree of self-reported pain in the knees among the floor layers using the new working methods weekly or daily compared to those using them never or occasionally. The musculoskeletal complaints did not increase from any other region and the quality and the productivity of the work were not decreased. This indicates that within a 3-months perspective the implementation strategy succeeded.

Training and deployment of lay refugee/internally displaced persons to provide basic health services in camps: a systematic review.

PubMed

Ehiri, John E; Gunn, Jayleen K L; Center, Katherine E; Li, Ying; Rouhani, Mae; Ezeanolue, Echezona E

2014-01-01

Training of lay refugees/internally displaced persons (IDPs) and deploying them to provide basic health services to other women, children, and families in camps is perceived to be associated with public health benefits. However, there is limited evidence to support this hypothesis. To assess the effects of interventions to train and deploy lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. PubMed, Science and Social Science Citation Indices, PsycINFO, EMBASE, POPLINE, CINAHL, and reference lists of relevant articles were searched (from inception to June 30, 2014) with the aim of identifying studies that reported the effects of interventions that trained and deployed lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles. Discrepancies were resolved by repeated review, discussion, and consensus. Study quality assessment was undertaken using standard protocols. Ten studies (five cross-sectional, four pre-post, and one post-test only) conducted in Africa (Guinea and Tanzania), Central America (Belize), and Asia (Myanmar) were included. The studies demonstrated some positive impact on population health associated with training and deployment of trained lay refugees/IDPs as health workers in camps. Reported effects included increased service coverage, increased knowledge about disease symptoms and prevention, increased adoption of improved treatment seeking and protective behaviors, increased uptake of services, and improved access to reproductive health information. One study, which assessed the effect of peer refugee health education on sexual and reproductive health, did not demonstrate a marked reduction in unintended pregnancies among refugee/IDP women. Although available evidence suggests a positive impact of training and deployment of lay refugees/IDPs as health workers in camps, existing body of evidence is weak, and calls for a re-examination of current practices. Interventions that promote training and deployment of lay refugees/IDPs as health workers in camps should include strong evaluation components in order to facilitate assessment of effects on population health.

Training and deployment of lay refugee/internally displaced persons to provide basic health services in camps: a systematic review

PubMed Central

Ehiri, John E.; Gunn, Jayleen K.L.; Center, Katherine E.; Li, Ying; Rouhani, Mae; Ezeanolue, Echezona E.

2014-01-01

Background Training of lay refugees/internally displaced persons (IDPs) and deploying them to provide basic health services to other women, children, and families in camps is perceived to be associated with public health benefits. However, there is limited evidence to support this hypothesis. Objectives To assess the effects of interventions to train and deploy lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Methods PubMed, Science and Social Science Citation Indices, PsycINFO, EMBASE, POPLINE, CINAHL, and reference lists of relevant articles were searched (from inception to June 30, 2014) with the aim of identifying studies that reported the effects of interventions that trained and deployed lay refugees and/or IDPs for the provision of basic health service to other women, children, and families in camps. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles. Discrepancies were resolved by repeated review, discussion, and consensus. Study quality assessment was undertaken using standard protocols. Results Ten studies (five cross-sectional, four pre-post, and one post-test only) conducted in Africa (Guinea and Tanzania), Central America (Belize), and Asia (Myanmar) were included. The studies demonstrated some positive impact on population health associated with training and deployment of trained lay refugees/IDPs as health workers in camps. Reported effects included increased service coverage, increased knowledge about disease symptoms and prevention, increased adoption of improved treatment seeking and protective behaviors, increased uptake of services, and improved access to reproductive health information. One study, which assessed the effect of peer refugee health education on sexual and reproductive health, did not demonstrate a marked reduction in unintended pregnancies among refugee/IDP women. Conclusion Although available evidence suggests a positive impact of training and deployment of lay refugees/IDPs as health workers in camps, existing body of evidence is weak, and calls for a re-examination of current practices. Interventions that promote training and deployment of lay refugees/IDPs as health workers in camps should include strong evaluation components in order to facilitate assessment of effects on population health. PMID:25280734

Types of lay health influencers in tobacco cessation: a qualitative study.

PubMed

Yuan, Nicole P; Wind, Steven; Nichter, Mimi; Nichter, Mark; Castañeda, Heide; Carruth, Lauren; Muramoto, Myra

2010-01-01

To identify types of health influencers in tobacco cessation based on the frequency and characteristics of brief intervention activities. Longitudinal qualitative interviews were completed with 28 individuals posttraining. Four individuals were categorized as Rarely Active, 5 as Active With Family and Friends, 9 as Active in the Workplace, and 10 as Proactive in Multiple Settings. Unique motivators, intervention behaviors, and barriers were documented. Some individuals displayed high levels of self-efficacy necessary for expanding the reach of community-based interventions. Training programs need to address the impact of contextual factors on initiating and sustaining intervention activities.

Training Community Clergy in Serious Illness: Balancing Faith and Medicine.

PubMed

Koss, Sarah E; Weissman, Ross; Chow, Vinca; Smith, Patrick T; Slack, Bethany; Voytenko, Vitaliy; Balboni, Tracy A; Balboni, Michael J

2018-06-06

Community-based clergy are highly engaged in helping seriously ill patients address spiritual concerns at the end of life (EOL). While they desire EOL training, no data exist in guiding how to conceptualize a clergy-training program. The objective of this study was used to identify best practices in an EOL training program for community clergy. As part of the National Clergy Project on End-of-Life Care, the project conducted key informant interviews and focus groups with active clergy in five US states (California, Illinois, Massachusetts, New York, and Texas). A diverse purposive sample of 35 active clergy representing pre-identified racial, educational, theological, and denominational categories hypothesized to be associated with more intensive utilization of medical care at the EOL. We assessed suggested curriculum structure and content for clergy EOL training through interviews and focus groups for the purpose of qualitative analysis. Thematic analysis identified key themes around curriculum structure, curriculum content, and issues of tension. Curriculum structure included ideas for targeting clergy as well as lay congregational leaders and found that clergy were open to combining resources from both religious and health-based institutions. Curriculum content included clergy desires for educational topics such as increasing their medical literacy and reviewing pastoral counseling approaches. Finally, clergy identified challenging barriers to EOL training needing to be openly discussed, including difficulties in collaborating with medical teams, surrounding issues of trust, the role of miracles, and caution of prognostication. Future EOL training is desired and needed for community-based clergy. In partnering together, religious-medical training programs should consider curricula sensitive toward structure, desired content, and perceived clergy tensions.

The National Comorbidity Survey Adolescent Supplement (NCS-A): I. Background and Measures

PubMed Central

Merikangas, Kathleen R.; Avenevoli, Shelli; Costello, E. Jane; Koretz, Doreen; Kessler, Ronald C.

2009-01-01

Objective This paper presents an overview of the background and measures used in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A). Methods The NCS-A is a national psychiatric epidemiological survey of adolescents ages 13–17. Results The NCS-A was designed to provide the first nationally representative estimates of the prevalence, correlates and patterns of service use for DSM-V mental disorders among US adolescents and to lay the groundwork for follow-up studies of risk-protective factors, consequences, and early expressions of adult mental disorders. The core NCS-A diagnostic interview, the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI), is a fully-structured research diagnostic interview designed for use by trained lay interviewers. A multi-construct, multi-method, multi-informant battery was also included to assess risk and protective factors and barriers to service use. Design limitations due to the NCS-A evolving as a supplement to an ongoing survey of mental disorders of US adults include restricted age range of youth, cross-sectional assessment, and lack of full parental/surrogate informant reports on youth mental disorders and correlates. Conclusions Despite these limitations, the NCS-A contains unparalleled information that can be used to generate national estimates of prevalence and correlates of adolescent mental disorders, risk and protective factors, patterns of service use, and barriers to receiving treatment for these disorders. The retrospective NCS-A data on the development of psychopathology can additionally complement data from longitudinal studies based on more geographically restricted samples and serve as a useful baseline for future prospective studies of the onset and progression of mental disorders in adulthood. PMID:19242382

Dissemination of CPR video self-instruction materials to secondary trainees: results from a hospital-based CPR education trial

PubMed Central

Ikeda, Daniel J.; Buckler, David G.; Li, Jiaqi; Agarwal, Amit K.; Di Taranti, Laura J.; Kurtz, James; dos Reis, Ryan; Leary, Marion; Abella, Benjamin S.; Blewer, Audrey L.

2016-01-01

Background Cardiopulmonary resuscitation (CPR) video self-instruction (VSI) materials have been promoted as a scalable approach to increase the prevalence of CPR skills among the lay public, in part due to the opportunity for secondary training (i.e., sharing of training materials). However, the motivations for, and barriers to, disseminating VSI materials to secondary trainees is poorly understood. Methods This work represents an ancillary investigation of a prospective hospital-based CPR education trial in which family members of cardiac patients were trained using VSI. Mixed-methods surveys were administered to primary trainees six months after initial enrollment. Surveys were designed to capture motivations for, and barriers to, sharing VSI materials, the number of secondary trainees with whom materials were shared, and the settings, timing, and recipients of trainings. Results Between 07/2012–05/2015, 653 study participants completed a six-month follow-up interview. Of those, 345 reported sharing VSI materials with 1455 secondary trainees. Materials were shared most commonly with family members. In a logistic regression analysis, participants in the oldest quartile (age > 63 years) were less likely to share materials compared to those in the youngest quartile (age ≤ 44 years, OR 0.58, CI 0.37–0.90, p=0.02). Among the 308 participants who did not share their materials, time constraints was the most commonly cited barrier for not sharing. Conclusions VSI materials represent a strategy for secondary dissemination of CPR training, yet older individuals have a lower likelihood of sharing relative to younger individuals. Further work is warranted to remedy perceived barriers to CPR dissemination among the lay public using VSI approaches. PMID:26776900

Training Lay Interventionists to Support Tobacco Cessation among Teachers in India.

PubMed

Aghi, Mira; Nagler, Eve; Lando, Harry; Pednekar, Mangesh; Gupta, Prakash; Sorensen, Glorian

2016-01-01

Despite the rapidly increasing burden of tobacco-related morbidity and mortality in low- and middle-income countries, tobacco control initiatives - especially cessation - receive little emphasis. This is true despite low-cost methods that have potential for widespread dissemination. The purpose of this paper is to provide a case study example of how lay interventionists may be trained and supported to facilitate tobacco use cessation, based on the successful Tobacco Free Teachers-Tobacco Free Society program (TFT-TFS) implemented in Bihar, India. This school-based program included multiple components, with lay interventionists having a crucial role. The lay interventionists included health educators and lead teachers, both of whom were selected based on formative research, underwent extensive training and received continuing support. We emphasized encouraging and supporting teachers to quit tobacco use and engaging both tobacco users and nonusers to create a supportive environment for cessation. We also stressed that neither the health educators nor lead teachers were being trained as counselors or as cessation experts. We focused on the importance of respecting teachers as individuals and identifying locally relevant methods of cessation. Although we cannot isolate the precise contribution of the lay interventionists to the successful TFT-TFS intervention, the abstinence findings in favor of the intervention at follow up are highly encouraging. Teachers have been neglected as lay interventionists for tobacco cessation despite the fact that they tend to be highly respected and credible. The approach used for TFT-TFS could be disseminable in multiple low- and middle-income country contexts through train-the-trainer programs targeted to teachers.

Home visiting programs for HIV-affected families: a comparison of service quality between volunteer-driven and paraprofessional models.

PubMed

Kidman, Rachel; Nice, Johanna; Taylor, Tory; Thurman, Tonya R

2014-10-02

Home visiting is a popular component of programs for HIV-affected children in sub-Saharan Africa, but its implementation varies widely. While some home visitors are lay volunteers, other programs invest in more highly trained paraprofessional staff. This paper describes a study investigating whether additional investment in paraprofessional staffing translated into higher quality service delivery in one program context. Beneficiary children and caregivers at sites in KwaZulu-Natal, South Africa were interviewed after 2 years of program enrollment and asked to report about their experiences with home visiting. Analysis focused on intervention exposure, including visit intensity, duration and the kinds of emotional, informational and tangible support provided. Few beneficiaries reported receiving home visits in program models primarily driven by lay volunteers; when visits did occur, they were shorter and more infrequent. Paraprofessional-driven programs not only provided significantly more home visits, but also provided greater interaction with the child, communication on a larger variety of topics, and more tangible support to caregivers. These results suggest that programs that invest in compensation and extensive training for home visitors are better able to serve and retain beneficiaries, and they support a move toward establishing a professional workforce of home visitors to support vulnerable children and families in South Africa.

INTERFACING INFANT MENTAL HEALTH KNOWLEDGE SYSTEMS: REFLECTIONS ON THE NARRATIVES OF LAY HOME VISITORS' EXPERIENCES OF LEARNING AND APPLYING RELATIONAL CONCEPTS OF DEVELOPMENT IN A SOUTH AFRICAN INTERVENTION PROGRAM.

PubMed

Baradon, Tessa; Bain, Katherine

2016-07-01

The question of interfacing research and clinically generated knowledge in the field of infant mental health (IMH) with local cultural knowledge and belief systems has provoked extended discussion in recent years. This article explores convergences and divergences between current research-based, relational IMH mental health models and "community" knowledge held by a group of South African lay home visitors from a socioeconomically deprived township. These women were trained in a psychoanalytic and attachment-informed infant mental health program that promotes a relational model of infant development. They provide an intervention that supports high risk mother-infant relationships in the same locality. A two-tiered approach was taken to the analysis of the home visitor interviews and focused on the home visitors' constructed narratives of infant development posttraining as well as the personal impact of the training and work on the home visitors themselves. The study found that psychoanalytic and attachment-informed thinking about development makes sense to those operating within the local South African cultural context, but that the accommodation of this knowledge is a complex and challenging process. © 2016 Michigan Association for Infant Mental Health.

"They Just Seem to Live Their Lives in Their Own Little World": Lay Perceptions of Autism

ERIC Educational Resources Information Center

Huws, J. C.; Jones, R. S. P.

2010-01-01

The prevalence of autism spectrum disorders is believed to be higher than that of other conditions, such as Down syndrome or diabetes, yet few studies have explored the ideas lay people have about autism. Semi-structured interviews were used to explore how 10 lay people with no knowledge or experience of autism conceptualised autism.…

The Art and Skill of Delivering Culturally Responsive TF-CBT in Tanzania and Kenya

PubMed Central

Kava, Christine M.; Akiba, Christopher F.; Lucid, Leah; Dorsey, Shannon

2016-01-01

Objective This study explored the facilitators, barriers, and strategies used to deliver a child mental health evidence-based treatment (EBT), trauma-focused cognitive behavioral therapy (TF-CBT), in a culturally responsive manner. In low- and middle-income countries most individuals with mental health problems do not receive treatment due to a shortage of mental health professionals. One approach to addressing this problem is task-sharing, in which lay counselors are trained to deliver mental health treatment. Combining this approach with a focus on EBT provides a strategy for bridging the mental health treatment gap. However, little is known how about western-developed EBTs are delivered in a culturally responsive manner. Method Semistructured qualitative interviews were conducted with 12 TF-CBT lay counselors involved in a large randomized controlled trial of TF-CBT in Kenya and Tanzania. An inductive approach was used to analyze the data. Results Lay counselors described the importance of being responsive to TF-CBT participants’ customs, beliefs, and socioeconomic conditions and highlighted the value of TF-CBT for their community. They also discussed the importance of partnering with other organizations to address unmet socioeconomic needs. Conclusion The findings from this study provide support for the acceptability and appropriateness of TF-CBT as a treatment approach for improving child mental health. Having a better understanding of the strategies used by lay counselors to ensure that treatment is relevant to the cultural and socioeconomic context of participants can help to inform the implementation of future EBTs. PMID:27414470

"Please. Don't. Die.": A Grounded Theory Study of Bystander Cardiopulmonary Resuscitation.

PubMed

Mausz, Justin; Snobelen, Paul; Tavares, Walter

2018-02-01

Bystander cardiopulmonary resuscitation (CPR) is an important determinant of survival from out-of-hospital cardiac arrest (OHCA), yet rates of bystander CPR are highly variable. In an effort to promote bystander CPR, the procedure has been streamlined, and ultrashort teaching modalities have been introduced. CPR has been increasingly reconceptualized as simple, safe, and easy to perform; however, current methods of CPR instruction may not adequately prepare lay rescuers for the various logistical, conceptual, and emotional challenges of resuscitating a victim of cardiac arrest. We adopted a constructivist grounded theory methodology to qualitatively explore bystander CPR and invited lay rescuers who had recently (ie, within 1 week) intervened in an OHCA to participate in semistructured interviews and focus groups. We used constant comparative analysis until theoretical saturation to derive a midrange explanatory theory of bystander CPR. We constructed a 3-stage theoretical model describing a common experiential process for lay rescuer intervention in OHCA: Being called to act is disturbing, causing panic, shock, and disbelief that must ultimately be overcome. Taking action to save the victim is complicated by several misconceptions about cardiac arrest, where victims are mistakenly believed to be choking, and agonal respirations are misinterpreted to mean the victim is alive. Making sense of the experience is challenging, at least in the short term, where lay rescuers have to contend with self-doubt, unanswered questions, and uncomfortable emotional reactions to a traumatic event. Our study suggests that current CPR training programs may not adequately prepare lay rescuers for the reality of an OHCA and identifies several key knowledge gaps that should be addressed. The long-term psychological consequences of bystander intervention in OHCA remain poorly understood and warrant further study. © 2018 American Heart Association, Inc.

Training Tribal Lay Advocates at Sitting Bull College

ERIC Educational Resources Information Center

Shelley, W. L.

2015-01-01

Students in Sitting Bull College's lay advocate program develop a well-rounded understanding of the law, enabling them to represent defendants in tribal courts. The program offers legal training for its students--and illustrates how American Indian nations can broaden legal representation for Native defendants in tribal courts. It is one of only…

Science and Me: A Student-Driven Science Outreach Program for Lay Adult Audiences

ERIC Educational Resources Information Center

Alexander, Hannah; Waldron, Anna M.; Abell, Sandra K.

2011-01-01

The increasing need for communicating science to the public suggests that future scientists and science educators should be educated in science outreach and trained to communicate with lay audiences. We present a recently developed novel graduate course, which trains students in outreach efforts aimed to increase the public's understanding of…

Barriers to community case management of malaria in Saraya, Senegal: training, and supply-chains.

PubMed

Blanas, Demetri A; Ndiaye, Youssoupha; Nichols, Kim; Jensen, Andrew; Siddiqui, Ammar; Hennig, Nils

2013-03-14

Health workers in sub-Saharan Africa can now diagnose and treat malaria in the field, using rapid diagnostic tests and artemisinin-based combination therapy in areas without microscopy and widespread resistance to previously effective drugs. This study evaluates communities' perceptions of a new community case management of malaria programme in the district of Saraya, south-eastern Senegal, the effectiveness of lay health worker trainings, and the availability of rapid diagnostic tests and artemisinin-based combination therapy in the field. The study employed qualitative and quantitative methods including focus groups with villagers, and pre- and post-training questionnaires with lay health workers. Communities approved of the community case management programme, but expressed concern about other general barriers to care, particularly transportation challenges. Most lay health workers acquired important skills, but a sizeable minority did not understand the rapid diagnostic test algorithm and were not able to correctly prescribe arteminisin-based combination therapy soon after the training. Further, few women lay health workers participated in the programme. Finally, the study identified stock-outs of rapid tests and anti-malaria medication products in over half of the programme sites two months after the start of the programme, thought due to a regional shortage. This study identified barriers to implementation of the community case management of malaria programme in Saraya that include lay health worker training, low numbers of women participants, and generalized stock-outs. These barriers warrant investigation into possible solutions of relevance to community case management generally.

The politics of midwifery education and training in New South Wales during the last decades of the 19th Century.

PubMed

Purcal, Nita K

2008-03-01

This paper focuses on the introduction and development of midwifery education and training in Sydney during the last decades of the 19th century. The aim of the training, it is argued, was to displace the lay midwives by trained midwifery nurses who would work under medical control. The lay midwives were one of the largest occupational groups among women and two-thirds of births in NSW were being delivered by them in the late 19th century. It was a period of professionalisation of medicine and medical men laid claim to midwifery as a legitimate sphere of their practice and saw it as the gateway for establishing a family practice. The lay midwife stood in the way of their claim. The training programs were established purportedly to control maternal mortality. From the beginning in 1887 medical men were in control of midwifery nurse training. In addition to training at the Benevolent Society Asylum, three more women's hospitals were established in the 1890s in Sydney making it possible to train a stream of midwifery nurses. The midwifery nurses were charged exorbitant fees for their training; the fees contributed substantially towards running the new hospitals that delivered birth services to the poor and destitute women mostly in their homes. The midwifery nurses worked hard in miserable conditions under the guise of clinical experience required for training. When a critical mass of poorly trained midwifery nurses were in the offing, a Bill was introduced into the Parliament in 1895, restricting registration to midwifery nurses and this would have eliminated the lay midwife if passed. It took more than two decades to get a Registration Bill passed in the NSW Parliament.

Life course experiences and lay diagnosis explain low-income parents' child dental decisions: a qualitative study.

PubMed

Muirhead, Vanessa; Levine, Alissa; Nicolau, Belinda; Landry, Anne; Bedos, Christophe

2013-02-01

This study aimed to better understand low-income parents' child dental care decisions through a life course approach that captured parents' experiences within the social context of poverty. We conducted 43 qualitative life history interviews with 10 parents, who were long-term social assistance recipients living in Montreal, Canada. Thematic analysis involved interview debriefing, transcript coding, theme identification and data interpretation. Our interviews identified two emergent themes: lay diagnosis and parental oral health management. Parents described a process of 'lay diagnosis' that consisted of examining their children's teeth and interpreting their children's oral signs and symptoms based on their observations. These lay diagnoses were also shaped by their own dental crises, care experiences and oral health knowledge gained across a life course of poverty and dental disadvantage. Parents' management strategies included monitoring and managing their children's oral health themselves or by seeking professional recourse. Parents' management strategies were influenced both by their lay diagnoses and their perceived ability to manage their children's oral health. Parents felt responsible for their children's dental care, empowered to manage their oral health and sometimes forgo dental visits for their children because of their own self-management life history. This original approach revealed insights that help to understand why low-income parents may underutilize free dental services. Further research should consider how dental programs can nurture parental empowerment and capitalize on parents' perceived ability to diagnose and manage their children's oral health.

Lay information mediary behavior uncovered: exploring how nonprofessionals seek health information for themselves and others online.

PubMed

Abrahamson, Jennie A; Fisher, Karen E; Turner, Anne G; Durrance, Joan C; Turner, Tammara Combs

2008-10-01

This research studied motivations for, barriers to, and effects of online health information seeking and explored lay information mediary behavior (LIMB) characteristics in the consumer health information domain. Lay information mediaries (LIMs) seek information on behalf or because of others, without necessarily being asked to do so or engaging in follow up, and have represented more than 50% of health information seekers in prior studies. A web-based survey was posted on NC Health Info (NCHI) with 211 respondents, self-identified per the information need that brought them to NCHI as 20% LIMs (n = 43), 58% direct users (n = 122), and 22% health or information providers (n = 46). Follow-up telephone interviews were performed with 10% (n = 21). Interview analysis focused on lay participants (n = 15 LIMs and direct users combined). Interviewees were reclassified post-survey as 12 LIMs and 3 direct users when studied information behavior extended beyond NCHI search. Interview data were analyzed using grounded theory approach. Surveyed LIMs were 77% female (n = 33) and searched on behalf or because of family members (81%, n = 35) and people they felt "extremely close" to (77%, n = 33). LIMs reported various information seeking barriers "sometimes" to "often." LIMs searched mostly without prompting (51%, n = 22). Interview results triangulated survey findings regarding gender, tie strength, and prompting. LIMB may be related to gender and relationship tie strength and appears more internally than externally motivated. Further LIMB research is warranted.

Layoff Time Training: A Key to Upgrading Workforce Utilization and EEOC Affirmative Action. A Case Study in the Northern California Canning Industry. R & D Monograph 61.

ERIC Educational Resources Information Center

Aller, Curtis C.; And Others

An experimental and demonstration project was conducted over a five-year period in California to test the concept of lay-off time training to enable workers to qualify for promotion and increase their earnings. The canning industry was found to be a suitable area for this type of training since it had annual lay-offs followed by assured recalls to…

Lay Consultations in Heart Failure Symptom Evaluation.

PubMed

Reeder, Katherine M; Sims, Jessica L; Ercole, Patrick M; Shetty, Shivan S; Wallendorf, Michael

2017-01-01

Lay consultations can facilitate or impede healthcare. However, little is known about how lay consultations for symptom evaluation affect treatment decision-making. The purpose of this study was to explore the role of lay consultations in symptom evaluation prior to hospitalization among patients with heart failure. Semi-structured interviews were conducted with 60 patients hospitalized for acute decompensated heart failure. Chi-square and Fisher's exact tests, along with logistic regression were used to characterize lay consultations in this sample. A large proportion of patients engaged in lay consultations for symptom evaluation and decision-making before hospitalization. Lay consultants provided attributions and advice and helped make the decision to seek medical care. Men consulted more often with their spouse than women, while women more often consulted with adult children. Findings have implications for optimizing heart failure self-management interventions, improving outcomes, and reducing hospital readmissions.

The art and skill of delivering culturally responsive trauma-focused cognitive behavioral therapy in Tanzania and Kenya.

PubMed

Woods-Jaeger, Briana A; Kava, Christine M; Akiba, Christopher F; Lucid, Leah; Dorsey, Shannon

2017-03-01

This study explored the facilitators, barriers, and strategies used to deliver a child mental health evidence-based treatment (EBT), trauma-focused cognitive behavioral therapy (TF-CBT), in a culturally responsive manner. In low- and middle-income countries most individuals with mental health problems do not receive treatment due to a shortage of mental health professionals. One approach to addressing this problem is task-sharing, in which lay counselors are trained to deliver mental health treatment. Combining this approach with a focus on EBT provides a strategy for bridging the mental health treatment gap. However, little is known about how western-developed EBTs are delivered in a culturally responsive manner. Semistructured qualitative interviews were conducted with 12 TF-CBT lay counselors involved in a large randomized controlled trial of TF-CBT in Kenya and Tanzania. An inductive approach was used to analyze the data. Lay counselors described the importance of being responsive to TF-CBT participants' customs, beliefs, and socioeconomic conditions and highlighted the value of TF-CBT for their community. They also discussed the importance of partnering with other organizations to address unmet socioeconomic needs. The findings from this study provide support for the acceptability and appropriateness of TF-CBT as a treatment approach for improving child mental health. Having a better understanding of the strategies used by lay counselors to ensure that treatment is relevant to the cultural and socioeconomic context of participants can help to inform the implementation of future EBTs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Levels of Emotional Awareness: a model for conceptualizing and measuring emotion-centered structural change.

PubMed

Subic-Wrana, Claudia; Beutel, Manfred E; Garfield, David A S; Lane, Richard D

2011-04-01

The need to establish the efficacy of psychoanalytic long-term treatments has promoted efforts to operationalize psychic structure and structural change as key elements of psychoanalytic treatments and their outcomes. Current, promising measures of structural change, however, require extensive interviews and rater training. The purpose of this paper is to present the theory and measurement of Levels of Emotional Awareness (LEA) and to illustrate its use based on clinical case vignettes. The LEA model lays out a developmental trajectory of affective processing, akin to Piaget's theory of sensory-cognitive development, from implicit to explicit processing. Unlike other current assessments of psychic structure (Scales of Psychological Capacities, Reflective Functioning, Operationalized Psychodynamic Diagnostics) requiring intensive rater and interviewer training, it is easily assessed based on a self-report performance test. The LEA model conceptualizes a basic psychological capacity, affect processing. As we will illustrate using two case vignettes, by operationalizing implicit and explicit modes of affect processing, it provides a clinical measure of emotional awareness that is highly pertinent to the ongoing psychoanalytic debate on the nature and mechanisms of structural change. Copyright © 2011 Institute of Psychoanalysis.

Psychometric Evaluation of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID).

PubMed

Duncan, Laura; Georgiades, Kathy; Wang, Li; Van Lieshout, Ryan J; MacMillan, Harriet L; Ferro, Mark A; Lipman, Ellen L; Szatmari, Peter; Bennett, Kathryn; Kata, Anna; Janus, Magdalena; Boyle, Michael H

2017-12-04

The goals of the study were to examine test-retest reliability, informant agreement and convergent and discriminant validity of nine DSM-IV-TR psychiatric disorders classified by parent and youth versions of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Using samples drawn from the general population and child mental health outpatient clinics, 283 youth aged 9 to 18 years and their parents separately completed the MINI-KID with trained lay interviewers on two occasions 7 to 14 days apart. Test-retest reliability estimates based on kappa (κ) went from 0.33 to 0.79 across disorders, samples and informants. Parent-youth agreement on disorders was low (average κ = 0.20). Confirmatory factor analysis provided evidence supporting convergent and discriminant validity. The MINI-KID disorder classifications yielded estimates of test-retest reliability and validity comparable to other standardized diagnostic interviews in both general population and clinic samples. These findings, in addition to the brevity and low administration cost, make the MINI-KID a good candidate for use in epidemiological research and clinical practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Training of Lay Health Educators to Implement an Evidence-Based Behavioral Weight Loss Intervention in Rural Senior Centers

ERIC Educational Resources Information Center

Krukowski, Rebecca A.; Lensing, Shelly; Love, ShaRhonda; Prewitt, T. Elaine; Adams, Becky; Cornell, Carol E.; Felix, Holly C.; West, Delia

2013-01-01

Purpose of the Study: Lay health educators (LHEs) offer great promise for facilitating the translation of evidence-based health promotion programs to underserved areas; yet, there is little guidance on how to train LHEs to implement these programs, particularly in the crucial area of empirically validated obesity interventions. Design and Methods:…

International Cooperation in Popular Education. A Report on the Study and Work Visit to Brazil, February to April 1986.

ERIC Educational Resources Information Center

Workers Educational Association, Sunderland (England). Northern District.

Four adult educators from the North East/Brazil Project spent three months in Brazil in 1986 on "pilot" education ventures. The areas selected for collaboration were health and safety for lay officers and induction/leadership training for women. "Methods" courses were selected as the means to train lay officers as discussion…

Task-shifting of CD4 T cell count monitoring by the touchscreen-based Muse™ Auto CD4/CD4% single-platform system for CD4 T cell numeration: Implication for decentralization in resource-constrained settings.

PubMed

Kouabosso, André; Mossoro-Kpinde, Christian Diamant; Bouassa, Ralph-Sydney Mboumba; Longo, Jean De Dieu; Mbeko Simaleko, Marcel; Grésenguet, Gérard; Bélec, Laurent

2018-04-01

The accuracy of CD4 T cell monitoring by the recently developed flow cytometry-based CD4 T cell counting Muse™ Auto CD4/CD4% Assay analyzer (EMD Millipore Corporation, Merck Life Sciences, KGaA, Darmstadt, Germany) was evaluated in trained lay providers against laboratory technicians. After 2 days of training on the Muse™ Auto CD4/CD4% analyzer, EDTA-blood samples from 6 HIV-positive and 4 HIV-negative individuals were used for CD4 T cell counting in triplicate in parallel by 12 trained lay providers as compared to 10 lab technicians. Mean number of CD4 T cells in absolute number was 829 ± 380 cells/μl by lay providers and 794 ± 409 cells/μl by technicians (P > 0.05); and in percentage 36.2 ± 14.8%CD4 by lay providers and 36.1 ± 15.0%CD4 by laboratory technician (P > 0.05). The unweighted linear regression and Passing-Bablok regression analyses on CD4 T cell results expressed in absolute count revealed moderate correlation between CD4 T cell counts obtained by lay providers and lab technicians. The mean absolute bias measured by Bland-Altman analysis between CD4 T cell/μl obtained by lay providers and lab technicians was -3.41 cells/μl. Intra-assay coefficient of variance (CV) of Muse™ Auto CD4/CD4% in absolute number was 10.1% by lay providers and 8.5% by lab technicians (P > 0.05), and in percentage 5.5% by lay providers and 4.4% by lab technicians (P > 0.05). The inter-assay CV of Muse™ Auto CD4/CD4% in absolute number was 13.4% by lay providers and 10.3% by lab technicians (P > 0.05), and in percentage 7.8% by lay providers and 6.9% by lab technicians (P > 0.05). The study demonstrates the feasibility of CD4 T cell counting using the alternative flow cytometer Muse™ Auto CD4/CD4% analyzer by trained lay providers and therefore the practical possibility of decentralization CD4 T cell counting to health community centers. Copyright © 2018. Published by Elsevier B.V.

Lay Consultations in Heart Failure Symptom Evaluation

PubMed Central

Reeder, Katherine M.; Sims, Jessica L.; Ercole, Patrick M.; Shetty, Shivan S.; Wallendorf, Michael

2017-01-01

Purpose Lay consultations can facilitate or impede healthcare. However, little is known about how lay consultations for symptom evaluation affect treatment decision-making. The purpose of this study was to explore the role of lay consultations in symptom evaluation prior to hospitalization among patients with heart failure. Methods Semi-structured interviews were conducted with 60 patients hospitalized for acute decompensated heart failure. Chi-square and Fisher’s exact tests, along with logistic regression were used to characterize lay consultations in this sample. Results A large proportion of patients engaged in lay consultations for symptom evaluation and decision-making before hospitalization. Lay consultants provided attributions and advice and helped make the decision to seek medical care. Men consulted more often with their spouse than women, while women more often consulted with adult children. Conclusions Findings have implications for optimizing heart failure self-management interventions, improving outcomes, and reducing hospital readmissions. PMID:29399657

Treatment of Posttraumatic Stress Disorder by Trained Lay Counselors in an African Refugee Settlement: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Neuner, Frank; Onyut, Patience Lamaro; Ertl, Verena; Odenwald, Michael; Schauer, Elisabeth; Elbert, Thomas

2008-01-01

Traumatic stress due to conflict and war causes major mental health problems in many resource-poor countries. The objective of this study was to examine whether trained lay counselors can carry out effective treatment of posttraumatic stress disorder (PTSD) in a refugee settlement. In a randomized controlled dissemination trial in Uganda with 277…

A qualitative interview study exploring pregnant women's and health professionals' attitudes to external cephalic version.

PubMed

Say, Rebecca; Thomson, Richard; Robson, Stephen; Exley, Catherine

2013-01-16

Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV) and how they want to give birth if the baby remains breech, either by planned caesarean section (CS) or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. We carried out semi-structured interviews with pregnant women with a breech presentation (n=11) and health professionals who manage breech presentation (n=11) recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women's attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals' attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the differences between evidence-based information about ECV and lay beliefs. To address these challenges a number of approaches will be required.

Optimizing lay counsellor services for chronic care in South Africa: a qualitative systematic review.

PubMed

Petersen, Inge; Fairall, Lara; Egbe, Catherine O; Bhana, Arvin

2014-05-01

To conduct a qualitative systematic review on the use of lay counsellors in South Africa to provide lessons on optimizing their use for psychological and behavioural change counselling for chronic long-term care in scare-resource contexts. A qualitative systematic review of the literature on lay counsellor services in South Africa. Twenty-nine studies met the inclusion criteria. Five randomized control trials and two cohort studies reported that lay counsellors can provide behaviour change counselling with good outcomes. One multi-centre cohort study provided promising evidence of improved anti-retroviral treatment adherence and one non-randomized controlled study provided promising results for counselling for depression. Six studies found low fidelity of lay counsellor-delivered interventions in routine care. Reasons for low fidelity include poor role definition, inconsistent remuneration, lack of standardized training, and poor supervision and logistical support. Within resource-constrained settings, adjunct behaviour change and psychological services provided by lay counsellors can be harnessed to promote chronic care at primary health care level. Optimizing lay counsellor services requires interventions at an organizational level that provide a clear role definition and scope of practice; in-service training and formal supervision; and sensitization of health managers to the importance and logistical requirements of counselling. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Adapting an Early Palliative Care Intervention to Family Caregivers of Persons With Advanced Cancer in the Rural Deep South: A Qualitative Formative Evaluation.

PubMed

Dionne-Odom, J Nicholas; Taylor, Richard; Rocque, Gabrielle; Chambless, Carol; Ramsey, Thomas; Azuero, Andres; Ivankova, Nataliya; Martin, Michelle Y; Bakitas, Marie A

2018-06-01

There is a scarcity of early palliative care interventions to support family caregivers of persons with advanced cancer living in the rural Southern U.S. The objective of this study was to adapt the content, format, and delivery of a six session, palliative care, telehealth intervention with monthly follow-up for rural family caregivers to enhance their own self-care and caregiving skills. Qualitative formative evaluation consisting of one-on-one, semistructured interviews with rural-dwelling persons with metastatic cancer (n = 18), their primary family caregiver (n = 20), and lay patient navigators (n = 26) were conducted to elicit feedback on a family caregiver intervention outline based on published evidence-based interventions. Transcribed interviews were analyzed using a thematic analysis approach. Coinvestigators reviewed and refined preliminary themes. Participants recommended that intervention topical content be flexible and has an adaptable format based on continuous needs assessment. Sessions should be 20 minutes long at minimum, and additional sessions should be offered if requested. Faith and spirituality is essential to address but should not be an overarching intervention theme. Content needs to be communicated in simple language. Intervention delivery via telephone is acceptable, but face-to-face contact is desired to establish relationships. Other Internet-based technologies (e.g., video-conferencing) could be helpful, but many rural dwellers may not be technology savvy or have Internet access. Most lay navigators believed they could lead the intervention with additional training, protocols for professional referral, and supervision by specialty-trained palliative care clinicians. A potentially scalable palliative care intervention is being adapted for family caregivers of rural-dwelling persons with advanced cancer and will undergo piloting in a small-scale randomized controlled trial. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Barriers and Facilitators to Adoption of a Lay-Delivered Community-Based Strength Training Program for Women in Rural Areas

ERIC Educational Resources Information Center

Washburn, Lisa T.; Cornell, Carol E.; Traywick, LaVona; Felix, Holly C.; Phillips, Martha E.

2017-01-01

Background: Limited access to fitness programs for rural older adults make lay or volunteer delivery approaches potentially desirable to extend reach. However, factors affecting adoption of such approaches are not well explored. Purpose: This study sought to identify barriers and facilitators affecting adoption of a volunteer lay delivery approach…

Reactions and coping strategies in lay rescuers who have provided CPR to out-of-hospital cardiac arrest victims: a qualitative study

PubMed Central

Mathiesen, Wenche Torunn; Bjørshol, Conrad Arnfinn; Braut, Geir Sverre; Søreide, Eldar

2016-01-01

Objective Cardiopulmonary resuscitation (CPR) provided by community citizens is of paramount importance for out-of-hospital cardiac arrest (OHCA) victims' survival. Fortunately, CPR rates by community citizens seem to be rising. However, the experience of providing CPR is rarely investigated. The aim of this study was to explore reactions and coping strategies in lay rescuers who have provided CPR to OHCA victims. Methods, participants This is a qualitative study of 20 lay rescuers who have provided CPR to 18 OHCA victims. We used a semistructured interview guide focusing on their experiences after providing CPR. Setting The study was conducted in the Stavanger region of Norway, an area with very high bystander CPR rates. Results Three themes emerged from the interview analysis: concern, uncertainty and coping strategies. Providing CPR had been emotionally challenging for all lay rescuers and, for some, had consequences in terms of family and work life. Several lay rescuers experienced persistent mental recurrences of the OHCA incident and had concerns about the outcome for the cardiac arrest victim. Unknown or fatal outcomes often caused feelings of guilt and were particularly difficult to handle. Several reported the need to be acknowledged for their CPR attempts. Health-educated lay rescuers seemed to be less affected than others. A common coping strategy was confiding in close relations, preferably the health educated. However, some required professional help to cope with the OHCA incident. Conclusions Lay rescuers experience emotional and social challenges, and some struggle to cope in life after providing CPR in OHCA incidents. Experiencing a positive patient outcome and being a health-educated lay rescuer seem to mitigate concerns. Common coping strategies are attempts to reduce uncertainty towards patient outcome and own CPR quality. Further studies are needed to determine whether an organised professional follow-up can mitigate the concerns and uncertainty of lay rescuers. PMID:27225648

Lay theories of gender identity disorder.

PubMed

Furnham, Adrian; Sen, Radhika

2013-01-01

This study examined lay theories regarding gender identity disorder (GID). Pilot interviews were completed with participants (n = 10) regarding their views on possible causes and treatments of GID. Participants (mainly young British people and students; n = 124) then completed a questionnaire that was based on the interviews and a review of the salient literature on lay theories. As hypothesized, participants believed most in biomedical causes and treatments of GID. Factor analysis (with varimax rotation) identified 4 factors in relation to causes of GID: upbringing and personal factors, pregnancy and brain abnormalities, environmental factors, and biomedical causes. Five factors that were identified in relation to the cure/treatment of GID were psychological assistance and personal factors, extreme medical and behavioral changes, alternative therapies, external factors, and medical treatments. The results indicated that participants neither agreed nor strongly disagreed about causes and cures regarding GID, but that these beliefs were logically related. Limitations, particularly of sampling, were considered.

Lay Theories of Gender Identity Disorder

PubMed Central

Sen, Radhika

2013-01-01

This study examined lay theories regarding gender identity disorder (GID). Pilot interviews were completed with participants (n = 10) regarding their views on possible causes and treatments of GID. Participants (mainly young British people and students; n = 124) then completed a questionnaire that was based on the interviews and a review of the salient literature on lay theories. As hypothesized, participants believed most in biomedical causes and treatments of GID. Factor analysis (with varimax rotation) identified 4 factors in relation to causes of GID: upbringing and personal factors, pregnancy and brain abnormalities, environmental factors, and biomedical causes. Five factors that were identified in relation to the cure/treatment of GID were psychological assistance and personal factors, extreme medical and behavioral changes, alternative therapies, external factors, and medical treatments. The results indicated that participants neither agreed nor strongly disagreed about causes and cures regarding GID, but that these beliefs were logically related. Limitations, particularly of sampling, were considered. PMID:24059967

The impact of a knowledge translation intervention employing educational outreach and a point-of-care reminder tool vs standard lay health worker training on tuberculosis treatment completion rates: study protocol for a cluster randomized controlled trial.

PubMed

Puchalski Ritchie, Lisa M; van Lettow, Monique; Makwakwa, Austine; Chan, Adrienne K; Hamid, Jemila S; Kawonga, Harry; Martiniuk, Alexandra L C; Schull, Michael J; van Schoor, Vanessa; Zwarenstein, Merrick; Barnsley, Jan; Straus, Sharon E

2016-09-07

Despite availability of effective treatment, tuberculosis (TB) remains an important cause of morbidity and mortality globally, with low- and middle-income countries most affected. In many such settings, including Malawi, the high burden of disease and severe shortage of skilled healthcare workers has led to task-shifting of outpatient TB care to lay health workers (LHWs). LHWs improve access to healthcare and some outcomes, including TB completion rates, but lack of training and supervision limit their impact. The goals of this study are to improve TB care provided by LHWs in Malawi by refining, implementing, and evaluating a knowledge translation strategy designed to address a recognized gap in LHWs' TB and job-specific knowledge and, through this, to improve patient outcomes. We are employing a mixed-methods design that includes a pragmatic cluster randomized controlled trial and a process evaluation using qualitative methods. Trial participants will include all health centers providing TB care in four districts in the South East Zone of Malawi. The intervention employs educational outreach, a point-of-care reminder tool, and a peer support network. The primary outcome is proportion of treatment successes, defined as the total of TB patients cured or completing treatment, with outcomes taken from Ministry of Health treatment records. With an alpha of 0.05, power of 0.80, a baseline treatment success of 0.80, intraclass correlation coefficient of 0.1 based on our pilot study, and an estimated 100 clusters (health centers providing TB care), a minimum of 6 patients per cluster is required to detect a clinically significant 0.10 increase in the proportion of treatment successes. Our process evaluation will include interviews with LHWs and patients, and a document analysis of LHW training logs, quarterly peer trainer meetings, and mentorship meeting notes. An estimated 10-15 LHWs and 10-15 patients will be required to reach saturation in each of 2 planned interview periods, for a total of 40-60 interview participants. This study will directly inform the efforts of knowledge users within TB care and, through extension of the approach, other areas of care provided by LHWs in Malawi and other low- and middle-income countries. ClinicalTrials.gov NCT02533089 . Registered 20 August 2015. Protocol Date/Version 29 May 2016/Version 2.

Building Blocks: Laying the Groundwork for Guided Pathways Reform in Ohio

ERIC Educational Resources Information Center

Jenkins, Davis; Lahr, Hana; Fink, John

2017-01-01

This report describes how Ohio's two-year colleges are approaching guided pathways reforms, based on on-site interviews with faculty, administrators, staff, and students at six selected community colleges and telephone interviews with representatives from all 23 Ohio community colleges. In these interviews participants were asked to describe their…

Lay health advisor activity levels: definitions from the field.

PubMed

Altpeter, M; Earp, J A; Bishop, C; Eng, E

1999-08-01

One type of lay health advisor model assumes that an effective mechanism for reaching the underserved is through informal advice-givers called natural helpers. Despite the growing use of this approach, few programs have defined what an active lay health advisor does within the natural helping process. To explore perceptions and definitions of lay health advisors' activity, we conducted semistructured, in-person interviews with four field staff who coordinate the advisors' activities in a breast cancer screening program. These staff viewed lay health advisor activity as fluctuating over the course of a year, occurring along a continuum of participation (inactive, moderately active, active, and superactive), and reflecting varying degrees of proactivity and participation in multiple activities. These results suggest an empirical process for refining the definition of an active lay health advisor, improving advisors' productivity in achieving outreach objectives, and managing and monitoring their ongoing activities.

Volunteers' experiences of becoming arthritis self-management lay leaders: "It's almost as if I've stopped aging and started to get younger!".

PubMed

Hainsworth, J; Barlow, J

2001-08-01

To determine whether undergoing training to become a lay leader and conducting an arthritis self-management course is associated with improvements in physical and psychological health status, arthritis self-efficacy, use of self-management techniques, and visits to the general practitioner. In addition, we aimed to describe the experiences of training and course delivery from the older volunteers' perspective. 21 participants completed all assessments and had a median age of 58, median disease duration of 10 years, and either osteoarthritis (n = 13) or rheumatoid arthritis (n = 8). The study was a pretest-posttest design with qualitative data collected at 3 points in time: before training, 6 weeks after training, and 6 months after training. Quantitative data were collected through self-administered postal questionnaires at baseline and 6-month followup. Six months after training, participants reported small, significant increases in arthritis self-efficacy for pain (P = 0.002), cognitive symptom management (P = 0.004), and communication with their physician (P = 0.024) and a small, significant decrease in depressed mood (P = 0.04). Qualitative data supported these findings, with participants reporting more confidence, happiness, and a changed outlook on life in general. Volunteerism was associated with altruistic behavior and with filling the vocational void caused by retirement. Findings support the value of volunteerism and training to become lay leaders in arthritis self-management programs. Volunteers reported positive changes both in themselves and in course participants. They enjoyed helping similar others and being involved in a worthwhile activity, and they valued their newly acquired status as lay leaders. Many had begun to apply their newfound knowledge about self-management to their own situation, reporting less pain and more willingness "to get on with life."

Family Maltreatment, Substance Problems, and Suicidality: Randomized Prevention Effectiveness Trial

DTIC Science & Technology

2008-02-01

IV. LAY SUMMARY & PROJECT DESCRIPTION (CONTINUING STUDY) ............................ 7 V. SUBJECT INFORMATION...assessment training evaluation at the 3 AF sites. At this time, we have no preliminary findings to report. IV. LAY SUMMARY & PROJECT DESCRIPTION

Activating lay health influencers to promote tobacco cessation.

PubMed

Muramoto, Myra L; Hall, John R; Nichter, Mark; Nichter, Mimi; Aickin, Mikel; Connolly, Tim; Matthews, Eva; Campbell, Jean Z; Lando, Harry A

2014-05-01

To evaluate the effect of tobacco cessation brief-intervention (BI) training for lay "health influencers," on knowledge, self-efficacy and the proportion of participants reporting BI delivery post-training. Randomized, community-based study comparing In-person or Web-based training, with mailed materials. In-person and Web-training groups had significant post-training cessation knowledge and self-efficacy gains. All groups increased the proportion of individuals reporting BIs at follow-up, with no significant between-group differences. Irrespective of participants' prior intervention experience, 80%-86% reported BIs within the past 90 days; 71%-79% reported >1 in the past 30. Web and In-person training significantly increase health influencer cessation knowledge and self-efficacy. With minimal prompting and materials, even persons without BI experience can be activated to encourage tobacco cessation.

A smartphone application for dispatch of lay responders to out-of-hospital cardiac arrests.

PubMed

Berglund, Ellinor; Claesson, Andreas; Nordberg, Per; Djärv, Therese; Lundgren, Peter; Folke, Fredrik; Forsberg, Sune; Riva, Gabriel; Ringh, Mattias

2018-05-01

Dispatch of lay volunteers trained in cardiopulmonary resuscitation (CPR) and equipped with automated external defibrillators (AEDs) may improve survival in cases of out-of-hospital cardiac arrest (OHCA). The aim of this study was to investigate the functionality and performance of a smartphone application for locating and alerting nearby trained laymen/women in cases of OHCA. A system using a smartphone application activated by Emergency Dispatch Centres was used to locate and alert laymen/women to nearby suspected OHCAs. Lay responders were instructed either to perform CPR or collect a nearby AED. An online survey was carried out among the responders. From February to August 2016, the system was activated in 685 cases of suspected OHCA. Among these, 224 cases were Emergency Medical Services (EMSs)-treated OHCAs (33%). EMS-witnessed cases (n = 11) and cases with missing survey data (n = 15) were excluded. In the remaining 198 OHCAs, lay responders arrived at the scene in 116 cases (58%), and prior to EMSs in 51 cases (26%). An AED was attached in 17 cases (9%) and 4 (2%) were defibrillated. Lay responders performed CPR in 54 cases (27%). Median distance to the OHCA was 560 m (IQR 332-860 m), and 1280 m (IQR 748-1776 m) via AED pick-up. The survey-answering rate was 82%. A smartphone application can be used to alert CPR-trained lay volunteers to OHCAs for CPR. Further improvements are needed to shorten the time to defibrillation before EMS arrival. Copyright © 2018 Elsevier B.V. All rights reserved.

Psychological impact on dispatched local lay rescuers performing bystander cardiopulmonary resuscitation.

PubMed

Zijlstra, Jolande A; Beesems, Stefanie G; De Haan, Rob J; Koster, Rudolph W

2015-07-01

We studied the short-term psychological impact and post-traumatic stress disorder (PTSD)-related symptoms in lay rescuers performing cardiopulmonary resuscitation (CPR) after a text message (TM)-alert for out-of-hospital-cardiac arrest, and assessed which factors contribute to a higher level of PTSD-related symptoms. The lay rescuers received a TM-alert and simultaneously an email with a link to an online questionnaire. We analyzed all questionnaires from February 2013 until October 2014 measuring the short-term psychological impact. We interviewed by telephone all first arriving lay rescuers performing bystander CPR and assessed PTSD-related symptoms with the Impact of Event Scale (IES) 4-6 weeks after the resuscitation. IES-scores 0-8 reflected no stress, 9-25 mild, 26-43 moderate, and 44-75 severe stress. A score ≥ 26 indicated PTSD symptomatology. Of all alerted lay rescuers, 6572 completed the online questionnaire. Of these, 1955 responded to the alert and 507 assisted in the resuscitation. We interviewed 203 first arriving rescuers of whom 189 completed the IES. Of these, 41% perceived no/mild short-term impact, 46% bearable impact and 13% severe impact. On the IES, 81% scored no stress and 19% scored mild stress. None scored moderate or severe stress. Using a multivariable logistic regression model we identified three factors with an independent impact on mild stress level: no automated external defibrillator connected by the lay rescuer, severe short-term impact, and no (very) positive experience. Lay rescuers alerted by text messages, do not show PTSD-related symptoms 4-6 weeks after performing bystander CPR, even if they perceive severe short-term psychological impact. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Development and evaluation of a training workshop for lay health promoters to implement a community-based intervention program in a public low rent housing estate: The Learning Families Project in Hong Kong

PubMed Central

Lai, Agnes Y.; Stewart, Sunita M.; Wan, Alice; Fok, Helen; Lai, Hebe Y. W.; Lam, Tai-hing; Chan, Sophia S.

2017-01-01

This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled “Learning Families Project”, under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees’ knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees’ reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents’ survey results before and after participating in the community activities delivered by the trainees. The trainees’ learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen’s d: 0.5–1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen’s d: 0.4–0.6). The application of planning skills to implement community activities was higher at one year (Cohen’s d: 0.4), compared with baseline. At one year, the residents’ survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical example of development and evaluation of training programs for lay personnel to be lay health promoters. Trial registration: ClinicalTrials.gov NCT02844244 PMID:28841677

Development and evaluation of a training workshop for lay health promoters to implement a community-based intervention program in a public low rent housing estate: The Learning Families Project in Hong Kong.

PubMed

Lai, Agnes Y; Stewart, Sunita M; Wan, Alice; Fok, Helen; Lai, Hebe Y W; Lam, Tai-Hing; Chan, Sophia S

2017-01-01

This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled "Learning Families Project", under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees' knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees' reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents' survey results before and after participating in the community activities delivered by the trainees. The trainees' learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen's d: 0.5-1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen's d: 0.4-0.6). The application of planning skills to implement community activities was higher at one year (Cohen's d: 0.4), compared with baseline. At one year, the residents' survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical example of development and evaluation of training programs for lay personnel to be lay health promoters. ClinicalTrials.gov NCT02844244.

Disciplinary power and the process of training informal carers on stroke units.

PubMed

Sadler, Euan; Hawkins, Rebecca; Clarke, David J; Godfrey, Mary; Dickerson, Josie; McKevitt, Christopher

2018-01-01

This article examines the process of training informal carers on stroke units using the lens of power. Care is usually assumed as a kinship obligation but the state has long had an interest in framing the carer and caring work. Training carers in healthcare settings raises questions about the power of the state and healthcare professionals as its agents to shape expectations and practices related to the caring role. Drawing on Foucault's notion of disciplinary power, we show how disciplinary forms of power exercised in interactions between healthcare professionals and carers shape the engagement and resistance of carers in the process of training. Interview and observational field note extracts are drawn from a multi-sited study of a training programme on stroke units targeting family carers of people with stroke to consider the consequences of subjecting caring to this intervention. We found that the process of training informal carers on stroke units was not simply a matter of transferring skills from professional to lay person, but entailed disciplinary forms of power intended to shape the conduct of the carer. We interrogate the extent to which a specific kind of carer is produced through such an approach, and the wider implications for the participation of carers in training in healthcare settings and the empowerment of carers. © 2017 Foundation for the Sociology of Health & Illness.

Challenges in the delivery of public HIV testing and counselling (HTC) in Douala, Cameroon: providers perspectives and implications on quality of HTC services.

PubMed

Ngangue, Patrice; Gagnon, Marie-Pierre; Bedard, Emmanuelle

2017-04-08

The Cameroon government has made HIV testing and counselling (HTC) a priority in its HIV/AIDS strategic plan. However, there is a dearth of literature on the perspectives of providers on the quality of HTC services. The aim of this study was to explore challenges in the provision of HTC services and their implications on quality of HTC services in Douala's district hospitals. Two primary data collection methods supported by the Donabedian's model of healthcare were used to explain the challenges in the provision of HTC services and their implications on quality of HTC services. This consisted of semi-structured individual interviews with 6 nurses and 16 lay counsellors and a non-participant observation of the physical environment for HTC by site. The study sites were the prevention and voluntary testing and counselling centre (PVTCC) of the six district hospitals of the city of Douala. The study reveals concerns about confidentiality and privacy during the counselling sessions due to inadequate and limited space. An absence of consent, even verbal, was reported in one PVTCC. There is no specific accredited training curriculum that leads to a formal registration as a PVTCC staff, and some lay counsellors work without training. Lay counsellors carry the burden of HIV counselling, but the majority of them work for many years without remuneration and recognition. Another quality challenge is the high workload in the district hospitals' lab, which leads to long waiting times for HIV test results, thus contributing to failure to return for results. The findings of this study highlighted some issues such as lack of adequate space and equipment for HIV testing and counselling that hinder the quality of HTC services and should challenge the health authorities of Cameroon on the need to reorganize HTC services and create a national HIV quality assurance program.

The emotional wellbeing of lay HIV counselling and testing counsellors.

PubMed

Visser, Maretha; Mabota, Princess

2015-01-01

The HIV testing, treatment and care programme of the South African public healthcare system depends on HIV counselling and testing (HCT) that is primarily delivered by lay counsellors. Lay counsellors are expected to educate clients about HIV/AIDS, advocate behaviour change, convey test results and support those infected and affected to cope with the emotional and social challenges associated with HIV/AIDS. This research focuses on the emotional wellbeing of lay HCT counsellors because this influences the quality of services they provide. A mixed methods approach was used. The emotional wellbeing, level of burnout, depression and coping style of 50 lay HCT counsellors working at the City of Tshwane clinics were assessed. Additionally, five focus group discussions were conducted. The results showed that HCT counsellors reported average emotional wellbeing, high levels of emotional exhaustion and depression. They had a sense of personal accomplishment and positive coping skills. The results revealed that they may have difficulty dealing with clients' emotional distress without adequate training and supervision. This creates a dilemma for service delivery. In the light of the important role they play in service delivery, the role of the lay HCT counsellor needs to be reconsidered. HCT should develop as a profession with specific training and supervision to develop their emotional competencies to conduct effective counselling sessions.

Lay perspectives on lay health worker roles, boundaries and participation within three UK community-based health promotion projects.

PubMed

South, J; Kinsella, K; Meah, A

2012-08-01

This paper examines lay interpretations of lay health worker roles within three UK community-based health promotion projects. It argues that understanding lay health worker roles requires critical analysis of the complex interrelationships between professionals, lay workers and the communities receiving a programme. Findings are presented that are drawn from a qualitative study of lay engagement in public health programme delivery where a key objective was to examine the perspectives of community members with the experience of receiving services delivered by lay health workers. Interviews and focus groups were conducted with 46 programme recipients from three case study projects; a breastfeeding peer support service, a walking for health scheme and a neighbourhood health project. The results show how participants interpreted the function and responsibilities of lay health workers and how those roles provided personalized support and facilitated engagement in group activities. Further insights into community participation processes are provided revealing the potential for active engagement in both formal and informal roles. The paper concludes that social relationships are core to understanding lay health worker programmes and therefore analysis needs to take account of the capacity for community members to move within a spectrum of participation defined by increasing responsibility for others.

Activating Lay Health Influencers to Promote Tobacco Cessation

PubMed Central

Muramoto, Myra L.; Hall, John R.; Nichter, Mark; Nichter, Mimi; Aickin, Mikel; Connolly, Tim; Matthews, Eva; Campbell, Jean Z.; Lando, Harry A.

2014-01-01

Objective Evaluate the effect of tobacco cessation brief-intervention (BI) training for lay “health influencers,” on knowledge, self-efficacy and the proportion of participants reporting BI delivery post-training. Methods Randomized, community-based study comparing In-person or Web-based training, with mailed materials. Results In-person and Web-training groups had significant post-training cessation knowledge and self-efficacy gains. All groups increased the proportion of individuals reporting BIs at follow-up, with no significant between-group differences. Irrespective of participants’ prior intervention experience, 80–86% reported BIs within the past 90 days; 71–79% reported ≥1 in the past 30. Conclusions Web and In-person training significantly increase health influencer cessation knowledge and self-efficacy. With minimal prompting and materials, even persons without BI experience can be activated to encourage tobacco cessation. PMID:24636035

A qualitative interview study exploring pregnant women’s and health professionals’ attitudes to external cephalic version

PubMed Central

2013-01-01

Background Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV) and how they want to give birth if the baby remains breech, either by planned caesarean section (CS) or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. Methods We carried out semi-structured interviews with pregnant women with a breech presentation (n=11) and health professionals who manage breech presentation (n=11) recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Results Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women’s attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals’ attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Conclusions Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the differences between evidence-based information about ECV and lay beliefs. To address these challenges a number of approaches will be required. PMID:23324533

Web-based versus in-person methods for training lay community health advisors to implement health promotion workshops: participant outcomes from a cluster-randomized trial.

PubMed

Holt, Cheryl L; Tagai, Erin K; Santos, Sherie Lou Zara; Scheirer, Mary Ann; Bowie, Janice; Haider, Muhiuddin; Slade, Jimmie

2018-06-28

Project HEAL (Health through Early Awareness and Learning) is an implementation trial that compared two methods of training lay peer community health advisors (CHAs)-in-person ("Traditional") versus web-based ("Technology")-to conduct a series of three evidence-based cancer educational workshops in African American churches. This analysis reports on participant outcomes from Project HEAL. Fifteen churches were randomized to the two CHA training methods and the intervention impact was examined over 24 months. This study was conducted in Prince George's County, MD, and enrolled 375 church members age 40-75. Participants reported on knowledge and screening behaviors for breast, prostate, and colorectal cancer. Overall, cancer knowledge in all areas increased during the study period (p < .001). There were significant increases in digital rectal exam (p < .05), fecal occult blood test (p < .001), and colonoscopy (p < .01) at 24 months; however, this did not differ by study group. Mammography maintenance (56% overall) was evidenced by women reporting multiple mammograms within the study period. Participants attending all three workshops were more likely to report a fecal occult blood test or colonoscopy at 24 months (p < .05) than those who attended only one. These findings suggest that lay individuals can receive web-based training to successfully implement an evidence-based health promotion intervention that results in participant-level outcomes comparable with (a) people trained using the traditional classroom method and (b) previous efficacy trials. Findings have implications for resources and use of technology to increase widespread dissemination of evidence-based health promotion interventions through training lay persons in community settings.

Is the concept of ethics misplaced in the migration of Indian trained dentists to Australia? The need for better international co-operation in dentistry.

PubMed

Balasubramanian, Madhan; Short, Stephanie D

2011-01-01

The purpose of this article is to discuss the ethics involved in the migration of Indian trained dentists to Australia. It develops from interviews of senior oral health leaders in both the countries to provide evidence that ethics in migration is diluted in practice and to suggest that migratory procedures in both the countries should be reconsidered. There is also an urgent need for more organized bilateral communication and negotiation between the concerned organizations of both the countries (dental councils, immigration departments and research centers) in order to prevent the somewhat irreversible and intensive brain drain of top quality dentists from India to Australia. We would suggest as a starting point better monitoring of the migrants' academic and social background, the nature of the educational investment in India and the nature of the stay in Australia. This new information base could possibly lay the groundwork for more restrictive policies to be introduced both in Australia and India.

Nurse led versus lay educators support for those with asthma in primary care: a costing study

PubMed Central

2012-01-01

Background Regular review and support for asthma self-management is promoted in guidelines. A randomised controlled trial suggested that unscheduled health care usage was similar when patients were offered self management support by a lay-trainer or practice nurses. Methods Following the RCT, a costing study was undertaken using the trial data to account for the cost of delivery of the service under both strategies and the resulting impact on unscheduled healthcare (measure of effectiveness) in this trial. Results One year data (n = 418) showed that 29% (61/205) of the nurse group required unscheduled healthcare (177 events) compared with 30.5% (65/213) for lay-trainers (178 events). The training costs for the lay-trainers were greater than nurses (£36 versus £18 respectively per patient, p<0.001), however, the consultation cost for lay-trainers were lower than nurses (£6 per patient versus £24, p<0.001). If the cost of unscheduled healthcare are accounted for then the costs of nurses is £161, and £135 for lay-trainers (mean difference £25, [95% CI = −£97, £149, p = 0.681]). The total costs (delivery and unscheduled healthcare) were £202 per patient for nurses versus £178 for lay-trainers, (mean difference £24, [95%CI = −£100, £147, p = 0.707]). Conclusions There were no significant differences in the cost of training and healthcare delivery between nurse and lay trainers, and no significant difference in the cost of unscheduled health care use. PMID:22958541

HIV rapid diagnostic testing by lay providers in a key population-led health service programme in Thailand.

PubMed

Wongkanya, Rapeeporn; Pankam, Tippawan; Wolf, Shauna; Pattanachaiwit, Supanit; Jantarapakde, Jureeporn; Pengnongyang, Supabhorn; Thapwong, Prasopsuk; Udomjirasirichot, Apichat; Churattanakraisri, Yutthana; Prawepray, Nanthika; Paksornsit, Apiluk; Sitthipau, Thidadaow; Petchaithong, Sarayut; Jitsakulchaidejt, Raruay; Nookhai, Somboon; Lertpiriyasuwat, Cheewanan; Ongwandee, Sumet; Phanuphak, Praphan; Phanuphak, Nittaya

2018-01-01

Introduction:  Rapid diagnostic testing (RDT) for HIV has a quick turn-around time, which increases the proportion of people testing who receive their result. HIV RDT in Thailand has traditionally been performed only by medical technologists (MTs), which is a barrier to its being scaled up. We evaluated the performance of HIV RDT conducted by trained lay providers who were members of, or worked closely with, a group of men who have sex with men (MSM) and with transgender women (TG) communities, and compared it to tests conducted by MTs. Methods:  Lay providers received a 3-day intensive training course on how to perform a finger-prick blood collection and an HIV RDT as part of the Key Population-led Health Services (KPLHS) programme among MSM and TG. All the samples were tested by lay providers using Alere Determine HIV 1/2. HIV-reactive samples were confirmed by DoubleCheckGold Ultra HIV 1&2 and SD Bioline HIV 1/2. All HIV-positive and 10% of HIV-negative samples were re-tested by MTs using Serodia HIV 1/2. Results:  Of 1680 finger-prick blood samples collected and tested using HIV RDT by lay providers in six drop-in centres in Bangkok, Chiang Mai, Chonburi and Songkhla, 252 (15%) were HIV-positive. MTs re-tested these HIV-positive samples and 143 randomly selected HIV-negative samples with 100% concordant test results. Conclusion:  Lay providers in Thailand can be trained and empowered to perform HIV RDT as they were found to achieve comparable results in sample testing with MTs. Based on the task-shifting concept, this rapid HIV testing performed by lay providers as part of the KPLHS programme has great potential to enhance HIV prevention and treatment programmes among key at-risk populations.

Reactions and coping strategies in lay rescuers who have provided CPR to out-of-hospital cardiac arrest victims: a qualitative study.

PubMed

Mathiesen, Wenche Torunn; Bjørshol, Conrad Arnfinn; Braut, Geir Sverre; Søreide, Eldar

2016-05-25

Cardiopulmonary resuscitation (CPR) provided by community citizens is of paramount importance for out-of-hospital cardiac arrest (OHCA) victims' survival. Fortunately, CPR rates by community citizens seem to be rising. However, the experience of providing CPR is rarely investigated. The aim of this study was to explore reactions and coping strategies in lay rescuers who have provided CPR to OHCA victims. This is a qualitative study of 20 lay rescuers who have provided CPR to 18 OHCA victims. We used a semistructured interview guide focusing on their experiences after providing CPR. The study was conducted in the Stavanger region of Norway, an area with very high bystander CPR rates. Three themes emerged from the interview analysis: concern, uncertainty and coping strategies. Providing CPR had been emotionally challenging for all lay rescuers and, for some, had consequences in terms of family and work life. Several lay rescuers experienced persistent mental recurrences of the OHCA incident and had concerns about the outcome for the cardiac arrest victim. Unknown or fatal outcomes often caused feelings of guilt and were particularly difficult to handle. Several reported the need to be acknowledged for their CPR attempts. Health-educated lay rescuers seemed to be less affected than others. A common coping strategy was confiding in close relations, preferably the health educated. However, some required professional help to cope with the OHCA incident. Lay rescuers experience emotional and social challenges, and some struggle to cope in life after providing CPR in OHCA incidents. Experiencing a positive patient outcome and being a health-educated lay rescuer seem to mitigate concerns. Common coping strategies are attempts to reduce uncertainty towards patient outcome and own CPR quality. Further studies are needed to determine whether an organised professional follow-up can mitigate the concerns and uncertainty of lay rescuers. 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/

Drivers of Continuing Education Learning Preferences for Veterans Affairs Women's Health Primary Care Providers.

PubMed

Zuchowski, Jessica L; Hamilton, Alison B; Washington, Donna L; Gomez, Arthur G; Veet, Laure; Cordasco, Kristina M

2017-01-01

Documented gaps in health professionals' training in women's health are a special concern for continuing education (CE). In the Veterans Affairs (VA) health care system, women veterans are a numerical minority, preferably assigned to designated women's health primary care providers (DWHPs). DWHPs need to maintain their knowledge and skills in women's health topics, in addition to general internal medicine topics. We explored drivers of VA DWHPs' learning preferences for women's health topics-ie, factors which influence greater and lesser learning interest. We conducted semistructured telephone interviews with DWHPs across six VA health care systems. Interviews were audio recorded, transcribed, and coded in ATLAS.ti. We synthesized results by grouping relevant coded sections of text to form emergent themes. Among the 31 DWHPs interviewed, reported drivers of learning interests among women's health topics were (1) high frequency of clinical incidence of particular issues; (2) perceived appropriateness of particular issues for management in primary care settings; and (3) perceived appropriateness of particular issues for partial management in primary care. Lower interest in particular women's health topics was associated with (1) perceived existing competency or recent training in an issue and (2) perceived need for specialty care management of an issue. Understanding drivers of DWHPs' CE learning priorities lays a foundation for developing CE programming that will be of interest to women's health primary care providers. Attention to drivers of learning interests may have applicability beyond women's health, suggesting a general approach for CE programming that prioritizes high-volume topics within the practice scope of target providers.

Medical dominance within research ethics committees.

PubMed

Humphreys, Stephen; Thomas, Hilary; Martin, Robyn

2014-01-01

Qualitative research is reported which explores the perceptions of members of the U.K.'s independent Phase I ethics committees (IECs) about key issues identified following a literature review. Audio-recorded interviews were conducted with ten expert and ten lay members from all IECs except the one to which the lead author was attached. Transcripts were thematically analyzed following a broadly hermeneutical approach. The findings-dealing with such matters as recruitment strategies and length of service; attitudes towards member categories, published ethics guidelines, and the adequacy of insurance; levels of training and views on achieving a recognised level of competence-have an intrinsic interest, but it is when the findings are considered collectively using Freidson's theory of professional dominance that they reveal the influence the medical profession can have in shaping ethics review.

Effects of childhood adversity on bullying and cruelty to animals in the United States: findings from a national sample.

PubMed

Vaughn, Michael G; Fu, Qiang; Beaver, Kevin M; Delisi, Matt; Perron, Brian E; Howard, Matthew O

2011-11-01

This study examined effects of type of and cumulative burden of childhood adversities on bullying and cruelty to animals in the United States. Data were derived from Waves I and II of the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of U.S. adults. Structured psychiatric interviews were completed by trained lay interviewers between 2001-2002 and 2003-2004. Although the effects of childhood adversity diminished with the inclusion of confounding variables, several adversities remained significant. For bullying, these included being made to do chores that were too difficult or dangerous, threatening to hit or throw something, pushing, shoving, slapping, or hitting, and hitting that left bruises, marks, or injuries. With respect to cruelty to animals, swearing and saying hurtful things, having a parent or other adult living within the home that went to jail or prison, and adult/other person fondling/touching in a sexual way were significant. The final models indicated that the cumulative burden of childhood adversities had strong effects on the increased likelihood of bullying behavior but not cruelty to animals.

Epidemiology of major depression in four cities in Mexico.

PubMed

Slone, Laurie B; Norris, Fran H; Murphy, Arthur D; Baker, Charlene K; Perilla, Julia L; Diaz, Dayna; Rodriguez, Francisco Gutiérrez; Gutiérrez Rodriguez, José de Jesús

2006-01-01

Analyses were conducted to estimate lifetime and current prevalence of major depressive disorder (MDD) for four representative cities of Mexico, to identify variables that influence the probability of MDD, and to further describe depression in Mexican culture. A multistage probability sampling design was used to draw a sample of 2,509 adults in four different regions of Mexico. MDD was assessed according to DSM-IV criteria by using the Composite International Diagnostic Interview collected by trained lay interviewers. The prevalence of MDD in these four cities averaged 12.8% for lifetime and 6.1% for the previous 12 months. MDD was highly comorbid with other mental disorders. Women were more likely to have lifetime MDD than were men. Being divorced, separated, or widowed (compared to married or never married) and having experienced childhood trauma were related to higher lifetime prevalence but not to current prevalence. In addition, age and education level were related to current 12-month MDD. Data on the profile of MDD in urban Mexico are provided. This research expands our understanding of MDD across cultures.

Lay Navigator Model for Impacting Cancer Health Disparities

PubMed Central

Meade, Cathy D.; Wells, Kristen J.; Arevalo, Mariana; Calcano, Ercilia R.; Rivera, Marlene; Sarmiento, Yolanda; Freeman, Harold P; Roetzheim, Richard G.

2014-01-01

This paper recounts experiences, challenges, and lessons learned when implementing a lay patient navigator program to improve cancer care among medically underserved patients who presented in a primary care clinic with a breast or colorectal cancer abnormality. The program employed five lay navigators to navigate 588 patients. Central programmatic elements were: 1) use of bilingual lay navigators with familiarity of communities they served; 2) provision of training, education and supportive activities; 3) multidisciplinary clinical oversight that factored in caseload intensity; and 4) well-developed partnerships with community clinics and social service entities. Deconstruction of health care system information was fundamental to navigation processes. We conclude that a lay model of navigation is well suited to assist patients through complex health care systems; however, a stepped care model that includes both lay and professional navigation may be optimal to help patients across the entire continuum. PMID:24683043

Lay navigator model for impacting cancer health disparities.

PubMed

Meade, Cathy D; Wells, Kristen J; Arevalo, Mariana; Calcano, Ercilia R; Rivera, Marlene; Sarmiento, Yolanda; Freeman, Harold P; Roetzheim, Richard G

2014-09-01

This paper recounts experiences, challenges, and lessons learned when implementing a lay patient navigator program to improve cancer care among medically underserved patients who presented in a primary care clinic with a breast or colorectal cancer abnormality. The program employed five lay navigators to navigate 588 patients. Central programmatic elements were the following: (1) use of bilingual lay navigators with familiarity of communities they served; (2) provision of training, education, and supportive activities; (3) multidisciplinary clinical oversight that factored in caseload intensity; and (4) well-developed partnerships with community clinics and social service entities. Deconstruction of healthcare system information was fundamental to navigation processes. We conclude that a lay model of navigation is well suited to assist patients through complex healthcare systems; however, a stepped care model that includes both lay and professional navigation may be optimal to help patients across the entire continuum.

Where There is No EMS: Lay Providers in Emergency Medical Services Care - EMS as a Public Health Priority.

PubMed

Debenham, Sierra; Fuller, Matthew; Stewart, Matthew; Price, Raymond R

2017-12-01

By 2030, road traffic accidents are projected to be the fifth leading cause of death worldwide, with 90% of these deaths occurring in low- and middle-income countries (LMICs). While high-quality, prehospital trauma care is crucial to reduce the number of trauma-related deaths, effective Emergency Medical Systems (EMS) are limited or absent in many LMICs. Although lay providers have long been recognized as the front lines of informal trauma care in countries without formal EMS, few efforts have been made to capitalize on these networks. We suggest that lay providers can become a strong foundation for nascent EMS through a four-fold approach: strengthening and expanding existing lay provider training programs; incentivizing lay providers; strengthening locally available first aid supply chains; and using technology to link lay provider networks. Debenham S , Fuller M , Stewart M , Price RR . Where there is no EMS: lay providers in Emergency Medical Services care - EMS as a public health priority. Prehosp Disaster Med. 2017;32(6):593-595.

South Asian participation in clinical trials: the views of lay people and health professionals.

PubMed

Hussain-Gambles, Mah; Atkin, Karl; Leese, Brenda

2006-07-01

There is little UK-based empirical research on South Asian participation in clinical trials. The predominantly US literature rarely engages with mainstream debates about ethnicity, diversity and difference. This study was prompted by a lack of knowledge about how South Asian people perceive trial involvement and the risks and benefits involved. Face to face interviews were conducted with 25 health professionals (consultants, GPs, nursing staff, academics, non-medically trained trial co-ordinators, LREC and MREC members) and 60 South Asian lay people (20 Indians, 20 Pakistanis and 20 Bangladeshis) who had not taken part in a trial. The study took place in the Leeds and Bradford areas of England. It was found that lay South Asian attitudes towards clinical trial participation focused on similarities rather than differences with the general UK population, suggesting that the relevance of ethnicity should be kept in perspective. There was no evidence of antipathy amongst South Asians to the concept of clinical trials, and awareness was a correlate of social class, education and younger age. Lay factors that might affect South Asian participation in clinical trials included: age; language, social class; feeling of not belonging/mistrust; culture and religion. Approachable patients (of the same gender, social class and fluent in English) tended to be 'cherry picked' to clinical trials. This practice was justified because of a lack of time, resources and inadequate support. South Asian patients might be systematically excluded from trials due to the increased cost and time associated with their inclusion, particularly in relation to the language barrier. Under-representation might also be due to passive exclusion associated with cultural stereotypes. The paper concludes by applying the theoretical framework of institutional racism as a means of making sense of policy and practice. At the same time, caution is advocated against using ethnicity as the only form of discrimination facing minority ethnic populations.

Impacting Mediators of Change for Physical Activity among Elderly Food Stamp Recipients

ERIC Educational Resources Information Center

Dye, Cheryl J.; Williams, Joel E.; Kemper, Karen A.; McGuire, Francis A.; Aybar-Damali, Begum

2012-01-01

A multidisciplinary team developed and pilot-tested a curriculum, delivered by trained lay educators, to increase self-efficacy for physical activity among elderly food stamp recipients. Curriculum development was guided by a comprehensive literature review. Process evaluation was used to revise the curriculum and to assess lay educator training…

Effect of a reminder video using a mobile phone on the retention of CPR and AED skills in lay responders.

PubMed

Ahn, Ji Yun; Cho, Gyu Chong; Shon, You Dong; Park, Seung Min; Kang, Ku Hyun

2011-12-01

Skills related to cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use by lay responders decay rapidly after training, and efforts are required to maintain competence among trainees. We examined whether repeated viewing of a reminder video on a mobile phone would be an effective means of maintaining CPR and AED skills in lay responders. In a single-blind case-control study, 75 male students received training in CPR and AED use. They were allocated either to the control or to the video-reminded group, who received a memory card containing a video clip about CPR and AED use for their mobile phone, which they were repeatedly encouraged to watch by SMS text message. CPR and AED skills were assessed in scenario format by examiners immediately and 3 months after initial training. Three months after initial training, the video-reminded group showed more accurate airway opening (P<0.001), breathing check (P<0.001), first rescue breathing (P=0.004), hand positioning (P=0.004), AED electrode positioning (P<0.001), pre-shock safety check (P<0.001), defibrillation within 90s (P=0.010), and resuming CPR after defibrillation (P<0.001) than controls. They also showed significantly higher self-assessed CPR confidence scores and increased willingness to perform bystander CPR in cardiac arrest than the controls at 3 months (P<0.001, P=0.024, respectively). Repeated viewing of a reminder video clip on a mobile phone increases retention of CPR and AED skills in lay responders. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Validation of the diagnoses of panic disorder and phobic disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) Supplement

PubMed Central

Green, Jennifer Greif; Avenevoli, Shelli; Finkelman, Matthew; Gruber, Michael J.; Kessler, Ronald C.; Merikangas, Kathleen R.; Sampson, Nancy A.; Zaslavsky, Alan M.

2012-01-01

Validity of the adolescent version of the World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent Supplement (NCS-A), a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the US. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses (AUC = .81–.94), although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes. PMID:21495110

Education and age affect skill acquisition and retention in lay rescuers after a European Resuscitation Council CPR/AED course.

PubMed

Papalexopoulou, Konstantina; Chalkias, Athanasios; Dontas, Ioannis; Pliatsika, Paraskevi; Giannakakos, Charalampos; Papapanagiotou, Panagiotis; Aggelina, Afroditi; Moumouris, Theodoros; Papadopoulos, Georgios; Xanthos, Theodoros

2014-01-01

To examine whether education and age affect skill acquisition and retention in lay rescuers after a European Resuscitation Council (ERC) CPR/AED course. Because of the importance of bystander CPR/AED skills in the setting of cardiac arrest, acquisition and retention of resuscitation skills has gained a great amount of interest. The ERC CPR/AED course format for written and practical evaluation was used. Eighty lay people were trained and evaluated at the end of the course, as well as at one, three, and six months. Retention of CPR/AED skills improved over time, recording the lowest practical scores at one month after initial training and the lowest written scores at initial training. In practical evaluation scores, when examined longitudinally, age presented a significant adverse effect and higher background education presented a non-significant positive effect. Moreover, regarding written evaluation scores, when examined longitudinally, education presented a significant positive effect while age did not significantly correlate with written scores. Education and age affected retention of CPR/AED skills in lay rescuers. Also, our results suggest that the ERC CPR/AED course format may be poorly designed to discriminate between participants with different levels of practical and written resuscitation skills and merit a thorough investigation in future studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Symptom appraisal, help seeking, and lay consultancy for symptoms of head and neck cancer.

PubMed

Queenan, J A; Gottlieb, B H; Feldman-Stewart, D; Hall, S F; Irish, J; Groome, P A

2018-01-01

Early diagnosis is important in head and neck cancer (HNC) patients to maximize the effectiveness of the treatments and minimize the debilitation associated with both the cancer and the invasive treatments of advanced disease. Many patients present with advanced disease, and there is little understanding as to why. This study investigated patients' symptom appraisal, help seeking, and lay consultancy up to the time they first went to see a health care professional (HCP). We interviewed 83 patients diagnosed with HNC. The study design was cross sectional and consisted of structured telephone interviews and a medical chart review. We gathered information on the participant's personal reactions to their symptoms, characteristics of their social network, and the feedback they received. We found that 18% of the participants thought that their symptoms were urgent enough to warrant further investigation. Participants rarely (6%) attributed their symptoms to cancer. Eighty-nine percent reported that they were unaware of the early warning signs and symptoms of HNC. Fifty-seven percent of the participants disclosed their symptoms to at least one lay consultant before seeking help from an HCP. The lay consultants were usually their spouse (77%), and the most common advice they offered was to see a doctor (76%). Lastly, 81% of the participants report that their spouse influenced their decision to see an HCP. The results of this study suggest that patients frequently believe that their symptoms were nonurgent and that their lay consultants influence their decision to seek help from an HCP. Copyright © 2017 John Wiley & Sons, Ltd.

Exploring chiropractic students' experiences of the educational environment in healthcare professional training: a qualitative study.

PubMed

Palmgren, Per J; Laksov, Klara Bolander

2015-08-05

The educational environment has a significant impact on students' behavior, sense of well-being, and academic advancement. While various research methodologies have been used to explore the educational environment, there is a paucity of studies employing qualitative research methods. This study engages in an in-depth exploration of chiropractic students' experiences of the meaning of the educational environment. A qualitative approach was employed by interviewing 26 students in four focus group interviews at two different points in time. A conventional manifest and latent content analysis was chosen to investigate and interpret the experiences of the educational environment in an undergraduate chiropractic training institution in Sweden. The analysis resulted in five overarching themes: Personal growth; Being part of a community; A place of meaningfulness; Trust in a regulated system; and Scaffolding relationships. Early in the training, the meaning of the educational environment was experienced as part of a vocational community and the scaffolding of intra-institutional relationships. In later stages, the environment was experienced in terms of personal growth - balancing academic pressures and progress within the professional community - thus laying the foundations for autonomy and motivation. During the clinical training, the environment was experienced as where learning happens, thus creating a place of meaningfulness. Throughout the training, the formal and clinical environments were experienced as isolating, with little bridging between the two. A regulated system - conveying an operative organization with clear communication regarding what to expect - was experienced as important for an apt educational environment. We found that experiences of an educational environment are dynamic and change over time. When restructuring or evaluating curriculums, educational managers can consider the emerged themes as constituting facets relating to the educational environment, and thus possible learning conditions. Likewise, researchers can consider these aspects of the educational environment when: interpreting results from quantitative and qualitative inquiries, constructing and refining instruments, or conceptualizing and framing the educational environment phenomenon.

Masculorum concubitores: views on homosexuality among Catholics in Recife, Brazil

PubMed Central

Rios, Luís Felipe; de Aquino, Francisca Luciana; Coelho, David Handerson; Oliveira, Cinthia; de Almeida, Vagner; Parker, Richard

2011-01-01

This study focuses on Catholics' views towards homosexuality. The discussion is based on an ethnographic survey involving interviews with priests and lay leaders as well as participant observation of daily life in a working-class neighborhood in Recife, Pernambuco State, Brazil. The analysis points to persistent prejudice against homosexuality in the neighborhood and among Catholic clergy and lay leaders interviewed in the study. The priests base their assertions on the dialectics between desire/practice and chastity/reproduction. This interplay allows them to distinguish between “homosexuality,” condition of desire, and “homosexualism,” a sin of the flesh. Based on this understanding, they produce an attitude of tolerance towards homosexuals. Laypeople prove to be more intolerant and focus their assertions on the difference between the sexes as the condition for good, natural, and sanctified sexual interaction. This attitude appears to be consistent with the way the sex/gender system operates in the neighborhood, where homosexuality is evaluated in terms masculinity and femininity. In this setting, it is interesting to observe how the discourses of homosexual movements challenge lay people and destabilize their religious certainties. PMID:21822456

Trained standardized patients can train their peers to provide well-rated, cost-effective physical exam skills training to first-year medical students.

PubMed

Aamodt, Carla B; Virtue, David W; Dobbie, Alison E

2006-05-01

Teaching physical examination skills effectively, consistently, and cost-effectively is challenging. Faculty time is the most expensive resource. One solution is to train medical students using lay physical examination teaching associates. In this study, we investigated the feasibility, acceptability, and cost-effectiveness of training medical students using teaching associates trained by a lay expert instead of a clinician. We used teaching associates to instruct students about techniques of physical examination. We measured students' satisfaction with this teaching approach. We also monitored the financial cost of this approach compared to the previously used approach in which faculty physicians taught physical examination skills. Our program proved practical to accomplish and acceptable to students. Students rated the program highly, and we saved approximately $9,100, compared with our previous faculty-intensive teaching program. We believe that our program is popular with students, cost-effective, and generalizable to other institutions.

Masonry Specialist III & IV, 3-20. Military Curriculum Materials for Vocational and Technical Education.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. National Center for Research in Vocational Education.

These military-developed curriculum materials consist of a course description, plan of instruction, study guides, and workbooks for use in training masonry specialists. Covered in the course blocks are laying concrete blocks, stone, and bricks as well as plaster, stucco, and tile. Course block III, on laying concrete blocks, stone, and bricks,…

Family Caregivers as Lay Trainers: Perceptions of Learning and the Relationship between Life Experience and Learning

ERIC Educational Resources Information Center

Conceição, Simone C.O.; Johaningsmeir, Sarah; Colby, Holly; Gordon, John

2014-01-01

This article describes an initiative to train lay people, predominantly parents of children and youth with special health care needs (CYSHCN), to teach "Bridge to Independence"--a care coordination curriculum--to other family caregivers of CYSHCN. Using a model based on Kirkpatrick and Kirkpatrick's levels of evaluation, the goal…

A lay patient navigation training curriculum targeting disparities in cancer clinical trials.

PubMed

Bryant, Debbie Chatman; Williamson, Deborah; Cartmell, Kathleen; Jefferson, Melanie

2011-12-01

African-Americans experience a disproportionate share of thoracic cancer burden compared to Whites. Low socioeconomic status (SES) and race are factors in low clinical trial enrollment, accounting for the disparities between African-Americans and Whites. Less than 3% of newly diagnosed cancer patients enroll in clinical trials, and of that number, only 10% represent ethnic minorities. The value of clinical trials research is not generalizable without sufficient representation by ethnic minorities. Patient navigation, an intervention designed to ensure timely and efficient access to healthcare, may improve clinical trial enrollment among African-Americans in lung and esophageal trials by influencing a patient's perception of clinical trials. The lack of navigation programs and training may negatively influence standardization of navigation techniques. The purpose of this project was to deliver and evaluate an evidence-based navigation-training curriculum for "lay" navigators. The primary outcomes measured were confidence in the role as navigator, understanding a navigator's role, and knowledge and perception of clinical trials. The results revealed overall confidence in the role as lay navigators increased from pre-to-post test. Lessons learned included the need for preparatory classes to build the navigator's confidence, and additional training components in death and dying. A larger study is warranted to confirm the findings.

Cross-cultural differences in lay attitudes and utilisation of antibiotics in a Belgian and a Dutch city.

PubMed

Deschepper, Reginald; Vander Stichele, Robert H; Haaijer-Ruskamp, Flora M

Cultural differences are probably an important factor in the considerable variation in antibiotic use between countries. The objective of this study was to explore local cultural differences in the lay perspective on coping with URTD and using antibiotics. We interviewed 30 persons in a Dutch and a Belgian city. Twenty-one were interviewed a second time after 3 months. Between the first and second interview, they noted in a diary all URTD episodes experienced by themselves and their family members (N=69) and how they coped with them. The Dutch participants labelled most URTD episodes as "common cold" or "flu". The Flemish participants labelled most of their URTD episodes as "bronchitis" and used more antibiotics. Four categories of antibiotic users could be distinguished. Participants with a Protestant background were more sceptical about medicines than those with a Catholic background. A thorough understanding of the cultural context is necessary to design effective campaigns to promote rational antibiotic use.

Lay food and health worker involvement in community nutrition and dietetics in England: roles, responsibilities and relationship with professionals.

PubMed

Kennedy, L A; Milton, B; Bundred, P

2008-06-01

Community-based food initiatives have developed in recent years with the aim of engaging previously 'hard to reach' groups. Lay workers engaged in community nutrition activities are promoted as a cost-effective mechanism for reaching underserved groups. The main objective of the study was to explore perceptions and definitions of lay food and health worker (LFHW) helping roles within the context of National Health Service (NHS) community nutrition and dietetic services in order to define the conceptual and practical elements of this new role and examine the interface with professional roles. Interpretive qualitative inquiry; semi-structured interviews with LFHW and NHS professionals employed by community-based programmes, serving 'hard-to-reach' neighbourhoods, across England. A total sampling framework was used to capture all existing and 'fully operational' lay food initiatives in England at the commencement of fieldwork (January 2002). In total, 29 professionals and 53 LFHWs were interviewed across 15 of the 18 projects identified. Although all 15 projects shared a universal goal, to promote healthy eating, this was achieved through a limited range of approaches, characterized by a narrow, individualistic focus. Lay roles spanned three broad areas: nutrition education; health promotion; and administration and personal development. Narratives from both professionals and LFHWs indicated that the primary role for LFHWs was to encourage dietary change by translating complex messages into credible and culturally appropriate advice. This research confirms the emerging discipline involving lay helping within the NHS and community dietetics. The primary role of LFHWs in the 15 projects involved was to support existing NHS services to promote healthy eating amongst 'hard to reach' communities. The activities undertaken by LFHWs are strongly influenced by professionals and the NHS. Inherent to this is a fairly narrow interpretation of health, resulting in a limited range of practice.

Psychological first aid: a consensus-derived, empirically supported, competency-based training model.

PubMed

McCabe, O Lee; Everly, George S; Brown, Lisa M; Wendelboe, Aaron M; Abd Hamid, Nor Hashidah; Tallchief, Vicki L; Links, Jonathan M

2014-04-01

Surges in demand for professional mental health services occasioned by disasters represent a major public health challenge. To build response capacity, numerous psychological first aid (PFA) training models for professional and lay audiences have been developed that, although often concurring on broad intervention aims, have not systematically addressed pedagogical elements necessary for optimal learning or teaching. We describe a competency-based model of PFA training developed under the auspices of the Centers for Disease Control and Prevention and the Association of Schools of Public Health. We explain the approach used for developing and refining the competency set and summarize the observable knowledge, skills, and attitudes underlying the 6 core competency domains. We discuss the strategies for model dissemination, validation, and adoption in professional and lay communities.

Psychological First Aid: A Consensus-Derived, Empirically Supported, Competency-Based Training Model

PubMed Central

Everly, George S.; Brown, Lisa M.; Wendelboe, Aaron M.; Abd Hamid, Nor Hashidah; Tallchief, Vicki L.; Links, Jonathan M.

2014-01-01

Surges in demand for professional mental health services occasioned by disasters represent a major public health challenge. To build response capacity, numerous psychological first aid (PFA) training models for professional and lay audiences have been developed that, although often concurring on broad intervention aims, have not systematically addressed pedagogical elements necessary for optimal learning or teaching. We describe a competency-based model of PFA training developed under the auspices of the Centers for Disease Control and Prevention and the Association of Schools of Public Health. We explain the approach used for developing and refining the competency set and summarize the observable knowledge, skills, and attitudes underlying the 6 core competency domains. We discuss the strategies for model dissemination, validation, and adoption in professional and lay communities. PMID:23865656

Understanding the Needs of Young Women Regarding Breast Cancer Risk Assessment and Genetic Testing: Convergence and Divergence among Patient-Counselor Perceptions and the Promise of Peer Support.

PubMed

Evans, Chalanda; Hamilton, Rebekah J; Tercyak, Kenneth P; Peshkin, Beth N; Rabemananjara, Kantoniony; Isaacs, Claudine; O'Neill, Suzanne C

2016-06-28

Young women from hereditary breast and ovarian cancer (HBOC) families face a series of medical decisions regarding their cancer risk management and integrating this information into their life planning. This presents unique medical and psychosocial challenges that exist without comprehensive intervention. To help lay the groundwork for intervention, we conducted a qualitative study among young women from HBOC families (N = 12; Mean age = 22) and cancer genetic counselors (N = 12) to explicate domains most critical to caring for this population. Women and counselors were interviewed by telephone. The predominant interview themes included preventative care planning and risk management, decision making around the pros and cons of cancer risk assessment, medical management, and psychosocial stresses experienced. Young women endorsed psychosocial stress significantly more frequently than did counselors. Both groups noted the short- and long-term decision making challenges and the support and conflict engendered among familial relationships. Our results suggest young women value the support they receive from their families and their genetic counselors, but additional, external supports are needed to facilitate adaptation to HBOC risk. In feedback interviews focused on intervention planning with a subset of these young women (N = 9), they endorsed the predominant interview themes discovered as important intervention content, a structure that would balance discussion of medical information and psychosocial skill-building that could be tailored to the young women's needs, and delivery by trained peers familiar with HBOC risk.

Understanding the Needs of Young Women Regarding Breast Cancer Risk Assessment and Genetic Testing: Convergence and Divergence among Patient-Counselor Perceptions and the Promise of Peer Support

PubMed Central

Evans, Chalanda; Hamilton, Rebekah J.; Tercyak, Kenneth P.; Peshkin, Beth N.; Rabemananjara, Kantoniony; Isaacs, Claudine; O’Neill, Suzanne C.

2016-01-01

Young women from hereditary breast and ovarian cancer (HBOC) families face a series of medical decisions regarding their cancer risk management and integrating this information into their life planning. This presents unique medical and psychosocial challenges that exist without comprehensive intervention. To help lay the groundwork for intervention, we conducted a qualitative study among young women from HBOC families (N = 12; Mean age = 22) and cancer genetic counselors (N = 12) to explicate domains most critical to caring for this population. Women and counselors were interviewed by telephone. The predominant interview themes included preventative care planning and risk management, decision making around the pros and cons of cancer risk assessment, medical management, and psychosocial stresses experienced. Young women endorsed psychosocial stress significantly more frequently than did counselors. Both groups noted the short- and long-term decision making challenges and the support and conflict engendered among familial relationships. Our results suggest young women value the support they receive from their families and their genetic counselors, but additional, external supports are needed to facilitate adaptation to HBOC risk. In feedback interviews focused on intervention planning with a subset of these young women (N = 9), they endorsed the predominant interview themes discovered as important intervention content, a structure that would balance discussion of medical information and psychosocial skill-building that could be tailored to the young women’s needs, and delivery by trained peers familiar with HBOC risk. PMID:27417623

Improving communication and practical skills in working with inpatients who self-harm: a pre-test/post-test study of the effects of a training programme

PubMed Central

2014-01-01

Background Differing perspectives of self-harm may result in a struggle between patients and treatment staff. As a consequence, both sides have difficulty communicating effectively about the underlying problems and feelings surrounding self-harm. Between 2009 and 2011, a programme was developed and implemented to train mental health care staff (nurses, social workers, psychologists, psychiatrists, and occupational therapists) in how to communicate effectively with and care for patients who self-harm. An art exhibition focusing on self-harm supported the programme. Lay experts in self-harm, i.e. people who currently harm themselves, or who have harmed themselves in the past and have the skills to disseminate their knowledge and experience, played an important role throughout the programme. Methods Paired sample t-tests were conducted to measure the effects of the training programme using the Attitude Towards Deliberate Self-Harm Questionnaire, the Self-Perceived Efficacy in Dealing with Self-Harm Questionnaire, and the Patient Contact Questionnaire. Effect sizes were calculated using r. Participants evaluated the training programme with the help of a survey. The questionnaires used in the survey were analysed descriptively. Results Of the 281 persons who followed the training programme, 178 completed the questionnaires. The results show a significant increase in the total scores of the three questionnaires, with large to moderate effect sizes. Respondents were positive about the training, especially about the role of the lay expert. Conclusion A specialised training programme in how to care for patients who self-harm can result in a more positive attitude towards self-harm patients, an improved self-efficacy in caring for patients who self-harm, and a greater closeness with the patients. The deployment of lay experts is essential here. PMID:24592861

Improving communication and practical skills in working with inpatients who self-harm: a pre-test/post-test study of the effects of a training programme.

PubMed

Kool, Nienke; van Meijel, Berno; Koekkoek, Bauke; van der Bijl, Jaap; Kerkhof, Ad

2014-03-04

Differing perspectives of self-harm may result in a struggle between patients and treatment staff. As a consequence, both sides have difficulty communicating effectively about the underlying problems and feelings surrounding self-harm. Between 2009 and 2011, a programme was developed and implemented to train mental health care staff (nurses, social workers, psychologists, psychiatrists, and occupational therapists) in how to communicate effectively with and care for patients who self-harm. An art exhibition focusing on self-harm supported the programme. Lay experts in self-harm, i.e. people who currently harm themselves, or who have harmed themselves in the past and have the skills to disseminate their knowledge and experience, played an important role throughout the programme. Paired sample t-tests were conducted to measure the effects of the training programme using the Attitude Towards Deliberate Self-Harm Questionnaire, the Self-Perceived Efficacy in Dealing with Self-Harm Questionnaire, and the Patient Contact Questionnaire. Effect sizes were calculated using r. Participants evaluated the training programme with the help of a survey. The questionnaires used in the survey were analysed descriptively. Of the 281 persons who followed the training programme, 178 completed the questionnaires. The results show a significant increase in the total scores of the three questionnaires, with large to moderate effect sizes. Respondents were positive about the training, especially about the role of the lay expert. A specialised training programme in how to care for patients who self-harm can result in a more positive attitude towards self-harm patients, an improved self-efficacy in caring for patients who self-harm, and a greater closeness with the patients. The deployment of lay experts is essential here.

In search of the cancer candidate: can lay epidemiology help?

PubMed

Macdonald, Sara; Watt, Graham; Macleod, Una

2013-05-01

First published in 1991, the ideas embedded in 'Lay epidemiology and the prevention paradox' offered a novel and rational explanation for the lay public's failure to fully engage with the lifestyle messages offered by health educators. During the course of a large ethnographic study in South Wales, Davison and colleagues described the emergence of what they termed the coronary candidate. Candidacy provides a 'cultural mechanism' that facilitates the estimation of risk for coronary heart disease. The model has rarely been applied to other major illnesses. This article presents findings from a study that sought to explore the lay epidemiology model, candidacy and cancer. In a series of in-depth individual interviews, members of the lay public discussed their ideas about cancer, and what emerged was an explanatory hierarchy to account for cancer events. Yet the random and unpredictable nature of cancer was emphasised as well as a general reluctance to accept the idea of cancer candidacy. © 2012 The Authors. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Volunteer, lay tutors' experiences of the Chronic Disease Self-Management Course: being valued and adding value.

PubMed

Barlow, J H; Bancroft, G V; Turner, A P

2005-04-01

Chronic disease is a public health issue that could be addressed, in part, by increasing the ability of individuals to better manage their condition and its consequences on a day-to-day basis. One intervention designed to facilitate this is the Chronic Disease Self Management Course (CDSMC) that is delivered by volunteer, lay tutors who themselves have a chronic disease. Although there is growing evidence of course effectiveness for participants, the experiences of tutors have been neglected. This study aims to address this omission. Telephone interviews were conducted with 11 (six male) tutors: all interviews were transcribed and thematically analysed. Being a volunteer lay-tutor was perceived to be an enjoyable and valuable experience despite the challenges associated with course delivery, such as organizational demands and managing the diverse needs of mixed groups of chronic disease participants that led to a tension between disease-specific needs and the generic approach of the course. Being valued and adding value to the lives of others were key benefits of being a volunteer tutor, along with increased confidence that they were doing something positive for others. Course delivery prompted the initiation and maintenance of tutors' own self-management behaviours.

A cross-cultural study of employers' concerns about hiring people with psychotic disorder: implications for recovery.

PubMed

Tsang, Hector W H; Angell, Beth; Corrigan, Patrick W; Lee, Yueh-Ting; Shi, Kan; Lam, Chow S; Jin, Shenghua; Fung, Kevin M T

2007-09-01

Employment discrimination is considered as a major impediment to community integration for people with serious mental illness, yet little is known about how the problem manifests differently across western and non-western societies. We developed a lay model based on Chinese beliefs and values in terms of Confucianism, Taoism, Buddhism, and folk religions which may be used to explain cross-cultural variation in mental illness stigma, particularly in the arena of employment discrimination. In this study, we tested this lay approach by comparing employers' concerns about hiring people with psychotic disorder for entry-level jobs in US and China. One hundred employers (40 from Chicago, 30 from Hong Kong, and 30 from Beijing) were randomly recruited from small size firms and interviewed by certified interviewers using a semi-structured interview guide designed for this study. Content analysis was used to derive themes, which in turn were compared across the three sites using chi-square tests. Analyses reveal that employers express a range of concerns about hiring an employee with mental illness. Although some concerns were raised with equal frequency across sites, comparisons showed that, relative to US employers, Chinese employers were significantly more likely to perceive that people with mental illness would exhibit a weaker work ethic and less loyalty to the company. Comparison of themes also suggests that employers in China were more people-oriented while employers in US were more task-oriented. Cultural differences existed among employers which supported the lay theory of mental illness.

Effects of Childhood Adversity on Bullying and Cruelty to Animals in the United States: Findings From a National Sample

PubMed Central

Vaughn, Michael G.; Fu, Qiang; Beaver, Kevin M.; DeLisi, Matt; Perron, Brian E.; Howard, Matthew O.

2012-01-01

This study examined effects of type of and cumulative burden of childhood adversities on bullying and cruelty to animals in the United States. Data were derived from Waves I and II of the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of U.S. adults. Structured psychiatric interviews were completed by trained lay interviewers between 2001–2002 and 2003–2004. Although the effects of childhood adversity diminished with the inclusion of confounding variables, several adversities remained significant. For bullying, these included being made to do chores that were too difficult or dangerous, threatening to hit or throw something, pushing, shoving, slapping, or hitting, and hitting that left bruises, marks, or injuries. With respect to cruelty to animals, swearing and saying hurtful things, having a parent or other adult living within the home that went to jail or prison, and adult/other person fondling/touching in a sexual way were significant. The final models indicated that the cumulative burden of childhood adversities had strong effects on the increased likelihood of bullying behavior but not cruelty to animals. PMID:21602208

Injury perceptions of bombing survivors--interviews from the Oklahoma City bombing.

PubMed

Glenshaw, Mary T; Vernick, Jon S; Frattaroli, Shannon; Brown, Sheryll; Mallonee, Sue

2008-01-01

Bombings, including the 1995 Oklahoma City bombing, remain an important public health threat. However, there has been little investigation into the impressions of injury risk or protective factors of bombing survivors. This study analyzes Oklahoma City bombing survivors' impressions of factors that influenced their risk of injury, and validates a hazard timeline outlining phases of injury risk in a building bombing. In-depth, semi-structured interviews were conducted within a sample of Oklahoma City bombing survivors. Participants included 15 injured and uninjured survivors, who were located in three buildings surrounding the detonation site during the attack. Risk factor themes included environmental glass, debris, and entrapment. Protective factors included knowledge of egress routes, shielding behaviors to deflect debris, and survival training. Building design and health status were reported as risk and protective factors. The hazard timeline was a useful tool, but should be modified to include a lay rescue phase. The combination of a narrative approach and direct questioning is an effective method of gathering the perceptions of survivors. Investigating survivors' impressions of building bombing hazards is critical to capture injury exposures, behavior patterns, and decision-making processes during actual events, and to identify interventions that will be supported by survivors.

Thinking through every step: how people with spinal cord injuries relearn to walk.

PubMed

Jordan, Meggan M; Berkowitz, Dana; Hannold, Elizabeth; Velozo, Craig A; Behrman, Andrea L

2013-08-01

In this article we explore how people with incomplete spinal cord injury (iSCI) create meaning out of their changing bodies as they undergo a therapeutic intervention called locomotor training (LT). Therapeutic interventions like LT are used to promote the recovery of walking ability among individuals with iSCI. The chronological nature of this study--interviews at three points throughout the 12-week intervention--enhances understanding of the recovering self after spinal cord injury. Drawing on a constructivist theoretical framework, we organize data according to three narrative frames. Participants interpreted LT as (a) a physical change that was meaningful because of its social significance, (b) a coping strategy for dealing with the uncertainty of long-term recovery, and (c) a moral strategy to reconstitute the self. We offer findings that lay the conceptual groundwork for generating new knowledge about what is important to people with iSCI as they relearn how to walk.

Validation of the diagnoses of panic disorder and phobic disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) supplement.

PubMed

Green, Jennifer Greif; Avenevoli, Shelli; Finkelman, Matthew; Gruber, Michael J; Kessler, Ronald C; Merikangas, Kathleen R; Sampson, Nancy A; Zaslavsky, Alan M

2011-06-01

Validity of the adolescent version of the World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent (NCS-A) supplement, a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the United States. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses [area under the receiver operating characteristic curve (AUC) = 0.81-0.94], although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes. Copyright © 2011 John Wiley & Sons, Ltd.

Can trained lay providers perform HIV testing services? A review of national HIV testing policies.

PubMed

Flynn, David E; Johnson, Cheryl; Sands, Anita; Wong, Vincent; Figueroa, Carmen; Baggaley, Rachel

2017-01-04

Only an estimated 54% of people living with HIV are aware of their status. Despite progress scaling up HIV testing services (HTS), a testing gap remains. Delivery of HTS by lay providers may help close this testing gap, while also increasing uptake and acceptability of HIV testing among key populations and other priority groups. 50 National HIV testing policies were collated from WHO country intelligence databases, contacts and testing program websites. Data regarding lay provider use for HTS was extracted and collated. Our search had no geographical or language restrictions. This data was then compared with reported data from the Global AIDS Response Progress Reporting (GARPR) from July 2015. Forty-two percent of countries permit lay providers to perform HIV testing and 56% permit lay providers to administer pre-and post-test counseling. Comparative analysis with GARPR found that less than half (46%) of reported data from countries were consistent with their corresponding national HIV testing policy. Given the low uptake of lay provider use globally and their proven use in increasing HIV testing, countries should consider revising policies to support lay provider testing using rapid diagnostic tests.

Active Ottumwa: Adapting Evidence-Based Recommendations to Promote Physical Activity in a Micropolitan New Destination Community

PubMed Central

Baquero, Barbara; Ashida, Sato; Daniel-Ulloa, Jason; Laroche, Helena H.; Haines, Heidi; Bucklin, Rebecca; Maldonado, Adriana; Coronado Garcia, Mayra; Berto, Sandy; Sewell, Dan; Janz, Kathleen; Gates, Claudia; Parker, Edith A.

2018-01-01

Background: Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a community-wide intervention using a lay health advisor approach to increase physical activity in a micropolitan new destination community in the rural state of Iowa. Methods: The Active Ottumwa study is part of a community-academic partnership in Ottumwa, IA. Evidence-based strategies recommended by the Community Guide for Preventive Services guided study implementation and included behavioral and social, campaign and informational, and environmental and policy approaches. Evaluation methods for this study are multi-faceted and include a cross-sectional community survey, longitudinal cohort assessment, observational data, key informant interviews, and project records. Results: We are currently in our second year of intervention implementation, with 45 lay health advisors (termed physical activity leaders here) trained to carry out behavioral and social intervention approaches, including walking groups, tai chi, and yoga. We have completed a communication and informational campaign utilizing five channels. Our longitudinal cohort has been recruited, with baseline and 12-month data collection completed. Conclusions: This study will assess the effectiveness and impact of a community-wide intervention to support physical activity. PMID:29734709

Active Ottumwa: Adapting Evidence-Based Recommendations to Promote Physical Activity in a Micropolitan New Destination Community.

PubMed

Baquero, Barbara; Kava, Christine M; Ashida, Sato; Daniel-Ulloa, Jason; Laroche, Helena H; Haines, Heidi; Bucklin, Rebecca; Maldonado, Adriana; Coronado Garcia, Mayra; Berto, Sandy; Sewell, Dan; Novak, Nicole; Janz, Kathleen; Gates, Claudia; Parker, Edith A

2018-05-04

Background : Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a community-wide intervention using a lay health advisor approach to increase physical activity in a micropolitan new destination community in the rural state of Iowa. Methods : The Active Ottumwa study is part of a community-academic partnership in Ottumwa, IA. Evidence-based strategies recommended by the Community Guide for Preventive Services guided study implementation and included behavioral and social, campaign and informational, and environmental and policy approaches. Evaluation methods for this study are multi-faceted and include a cross-sectional community survey, longitudinal cohort assessment, observational data, key informant interviews, and project records. Results : We are currently in our second year of intervention implementation, with 45 lay health advisors (termed physical activity leaders here) trained to carry out behavioral and social intervention approaches, including walking groups, tai chi, and yoga. We have completed a communication and informational campaign utilizing five channels. Our longitudinal cohort has been recruited, with baseline and 12-month data collection completed. Conclusions : This study will assess the effectiveness and impact of a community-wide intervention to support physical activity.

A Long and Winding Road: Soto Zen Training in America

ERIC Educational Resources Information Center

Senauke, Hozan Alan

2006-01-01

This paper seeks to outline the broad parameters of Soto Zen Buddhist training in the North American context. Using his personal experience of training as a case study, the author argues that Zen in America is strongly oriented towards meditation and everyday practice in the world by dedicated lay people, a situation relatively rare in the history…

Nutritional intervention and physical training in malnourished frail community-dwelling elderly persons carried out by trained lay “buddies”: study protocol of a randomized controlled trial

PubMed Central

2013-01-01

Background In elderly persons frailty and malnutrition are very common and can lead to serious health hazards such as increased mortality, morbidity, dependency, institutionalization and a reduced quality of life. In Austria, the prevalence of frailty and malnutrition are increasing steadily and are becoming a challenge for our social system. Physical training and adequate nutrition may improve this situation. Methods/design In this randomized controlled trial, 80 malnourished frail community-dwelling patients (≥ 65 years) hospitalized at wards for internal medicine are recruited. Additionally, 80 lay volunteers (≥ 50 years), named buddies are recruited and subsequently trained regarding health enhancing physical activity and nutrition in four standardized training sessions. These buddies visit the malnourished frail persons at home twice a week for about one hour during an initial period of 10–12 weeks. While participants allocated to the intervention group (n = 40) receive intervention to improve their fluid intake, protein and energy intake, perform strength training and try to increase their baseline activities, the control group (n = 40) only gets home visits without any intervention. After 10–12 weeks, both, the intervention and the control group, receive the nutritional intervention and the physical training. Health, nutritional and frailty status, physical fitness, body composition and chronic inflammation of buddies and frail persons are recorded before the intervention, after 10–12 weeks, 6 and 12 months. Discussion To your knowledge this trial is the first of its kind to provide nutritional and physical activity interventions to malnourished frail community-dwelling persons by trained lay buddies, in which an improvement of the frail persons´ and the buddies’ health status is measured. This study assesses the efficacy of such an intervention and may offer new perspectives for the management of frailty and malnutrition. Trail registration ClinicalTrials.gov, NCT01991639 PMID:24369785

Who is a community health worker? - a systematic review of definitions.

PubMed

Olaniran, Abimbola; Smith, Helen; Unkels, Regine; Bar-Zeev, Sarah; van den Broek, Nynke

2017-01-01

Community health workers (CHWs) can play vital roles in increasing coverage of basic health services. However, there is a need for a systematic categorisation of CHWs that will aid common understanding among policy makers, programme planners, and researchers. To identify the common themes in the definitions and descriptions of CHWs that will aid delineation within this cadre and distinguish CHWs from other healthcare providers. A systematic review of peer-reviewed papers and grey literature. We identified 119 papers that provided definitions of CHWs in 25 countries across 7 regions. The review shows CHWs as paraprofessionals or lay individuals with an in-depth understanding of the community culture and language, have received standardised job-related training of a shorter duration than health professionals, and their primary goal is to provide culturally appropriate health services to the community. CHWs can be categorised into three groups by education and pre-service training. These are lay health workers (individuals with little or no formal education who undergo a few days to a few weeks of informal training), level 1 paraprofessionals (individuals with some form of secondary education and subsequent informal training), and level 2 paraprofessionals (individuals with some form of secondary education and subsequent formal training lasting a few months to more than a year). Lay health workers tend to provide basic health services as unpaid volunteers while level 1 paraprofessionals often receive an allowance and level 2 paraprofessionals tend to be salaried. This review provides a categorisation of CHWs that may be useful for health policy formulation, programme planning, and research.

Quality of dispatch-assisted cardiopulmonary resuscitation by lay rescuers following a standard protocol in Japan: an observational simulation study.

PubMed

Asai, Hideki; Fukushima, Hidetada; Bolstad, Francesco; Okuchi, Kazuo

2018-04-01

Bystander cardiopulmonary resuscitation (CPR) is essential for improving the outcomes of sudden cardiac arrest patients. It has been reported that dispatch-assisted CPR (DACPR) accounts for more than half of the incidence of CPR undertaken by bystanders. Its quality, however, can be suboptimal. We aimed to measure the quality of DACPR using a simulation study. We recruited laypersons at a shopping mall and measured the quality of CPR carried out in our simulation. Dispatchers provided instruction in accordance with the standard DACPR protocol in Japan. Twenty-three laypersons (13 with CPR training experience within the past 2 years and 10 with no training experience) participated in this study. The median chest compression rate and depth were 106/min and 33 mm, respectively. The median time interval from placing the 119 call to the start of chest compressions was 119 s. No significant difference was found between the groups with and without training experience. However, subjects with training experience more frequently placed their hands correctly on the manikin (84.6% versus 40.0%; P = 0.026). Twelve participants (52.2%, seven in trained and five in untrained group) interrupted chest compressions for 3-18 s, because dispatchers asked if the patient started breathing or moving. This current simulation study showed that the quality of DACPR carried out by lay rescuers can be less than optimal in terms of depth, hand placement, and minimization of pauses. Further studies are required to explore better DACPR instruction methods to help lay rescuers perform CPR with optimal quality.

Who is a community health worker? – a systematic review of definitions

PubMed Central

Olaniran, Abimbola; Smith, Helen; Unkels, Regine; Bar-Zeev, Sarah; van den Broek, Nynke

2017-01-01

ABSTRACT Background: Community health workers (CHWs) can play vital roles in increasing coverage of basic health services. However, there is a need for a systematic categorisation of CHWs that will aid common understanding among policy makers, programme planners, and researchers. Objective: To identify the common themes in the definitions and descriptions of CHWs that will aid delineation within this cadre and distinguish CHWs from other healthcare providers. Design: A systematic review of peer-reviewed papers and grey literature. Results: We identified 119 papers that provided definitions of CHWs in 25 countries across 7 regions. The review shows CHWs as paraprofessionals or lay individuals with an in-depth understanding of the community culture and language, have received standardised job-related training of a shorter duration than health professionals, and their primary goal is to provide culturally appropriate health services to the community. CHWs can be categorised into three groups by education and pre-service training. These are lay health workers (individuals with little or no formal education who undergo a few days to a few weeks of informal training), level 1 paraprofessionals (individuals with some form of secondary education and subsequent informal training), and level 2 paraprofessionals (individuals with some form of secondary education and subsequent formal training lasting a few months to more than a year). Lay health workers tend to provide basic health services as unpaid volunteers while level 1 paraprofessionals often receive an allowance and level 2 paraprofessionals tend to be salaried. Conclusions: This review provides a categorisation of CHWs that may be useful for health policy formulation, programme planning, and research. PMID:28222653

Comparison of the quality of basic life support provided by rescuers trained using the 2005 or 2010 ERC guidelines.

PubMed

Jones, Christopher M; Owen, Andrew; Thorne, Christopher J; Hulme, Jonathan

2012-08-09

Effective delivery of cardiopulmonary resuscitation (CPR) and prompt defibrillation following sudden cardiac arrest (SCA) is vital. Updated guidelines for adult basic life support (BLS) were published in 2010 by the European Resuscitation Council (ERC) in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines. We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course. We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p < 0.05), reflecting a significantly greater proportion of lay-rescuers performing chest compressions at too fast a rate when trained and assessed with the 2010 rather than 2005 guidelines (6.04% vs. 2.67%; p < 0.05). Error rates for other skills did not differ between guideline groups. The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate.

Ranking Medical Terms to Support Expansion of Lay Language Resources for Patient Comprehension of Electronic Health Record Notes: Adapted Distant Supervision Approach

PubMed Central

Jagannatha, Abhyuday N; Fodeh, Samah J; Yu, Hong

2017-01-01

Background Medical terms are a major obstacle for patients to comprehend their electronic health record (EHR) notes. Clinical natural language processing (NLP) systems that link EHR terms to lay terms or definitions allow patients to easily access helpful information when reading through their EHR notes, and have shown to improve patient EHR comprehension. However, high-quality lay language resources for EHR terms are very limited in the public domain. Because expanding and curating such a resource is a costly process, it is beneficial and even necessary to identify terms important for patient EHR comprehension first. Objective We aimed to develop an NLP system, called adapted distant supervision (ADS), to rank candidate terms mined from EHR corpora. We will give EHR terms ranked as high by ADS a higher priority for lay language annotation—that is, creating lay definitions for these terms. Methods Adapted distant supervision uses distant supervision from consumer health vocabulary and transfer learning to adapt itself to solve the problem of ranking EHR terms in the target domain. We investigated 2 state-of-the-art transfer learning algorithms (ie, feature space augmentation and supervised distant supervision) and designed 5 types of learning features, including distributed word representations learned from large EHR data for ADS. For evaluating ADS, we asked domain experts to annotate 6038 candidate terms as important or nonimportant for EHR comprehension. We then randomly divided these data into the target-domain training data (1000 examples) and the evaluation data (5038 examples). We compared ADS with 2 strong baselines, including standard supervised learning, on the evaluation data. Results The ADS system using feature space augmentation achieved the best average precision, 0.850, on the evaluation set when using 1000 target-domain training examples. The ADS system using supervised distant supervision achieved the best average precision, 0.819, on the evaluation set when using only 100 target-domain training examples. The 2 ADS systems both performed significantly better than the baseline systems (P<.001 for all measures and all conditions). Using a rich set of learning features contributed to ADS’s performance substantially. Conclusions ADS can effectively rank terms mined from EHRs. Transfer learning improved ADS’s performance even with a small number of target-domain training examples. EHR terms prioritized by ADS were used to expand a lay language resource that supports patient EHR comprehension. The top 10,000 EHR terms ranked by ADS are available upon request. PMID:29089288

Pesticide risk perceptions and the differences between farmers and extensionists: Towards a knowledge-in-context model

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

Ríos-González, Adriana, E-mail: adrianariosg@hotmail.com; The Africa and Latin America Research Groups Network; Jansen, Kees, E-mail: Kees.Jansen@wur.nl

A growing body of literature analyzes farmer perceptions of pesticide risk, but much less attention has been given to differences in risk perception between farmers and technical experts. Furthermore, inconsistencies in knowledge have too easily been explained in terms of lack of knowledge rather than exploring the underlying reasons for particular forms of thinking about pesticide risks. By doing this, the division between expert and lay knowledge has been deepened rather than transcended. Objective: This study aims to understand differences and similarities among the perceptions of pesticide risks of farmers, farm workers, and technical experts such as extensionists, by applyingmore » a social science approach towards knowledge and risk attitudes. Methods: Semi-structured interviews and field observations were conducted to smallholders, farm workers, extensionists, health professionals and scientists involved in the use and handling of pesticides. Subsequently, a survey was carried out to quantify the farmers and extensionists' acceptance or rejection of typical assertions expressed previously in the semi-structured interviews. Results: Smallholders showed to gain knowledge from their own experiences and to adapt pesticides practices, which is a potential basis for transforming notions of pesticide safety and risk reduction strategies. Though extensionists have received formal education, they sometimes develop ideas deviating from the technical perspective. The risk perception of the studied actors appeared to vary according to their role in the agricultural labor process; they varied much less than expected according to their schooling level. Conclusions: Commitment to the technical perspective is not dramatically different for extensionists on the one hand and farmers as well as farm workers on the other hand. Ideas about a supposed lack of knowledge by farmers and the need of formal training are too much driven by a deficit model of knowledge. Further research on risk perceptions of pesticides and training of rural people will benefit from the development of a knowledge-in-context model. -- Highlights: • Researching perceptions of farmers' extensionists and other professionals. • Experts as well as farmers deviate from the technical perspective. • Blaming who is responsible for pesticide problems creates expert-lay division. • Qualitative and quantitative methods, not as complementary but integrated. • Knowledge-in-context model as an alternative to the knowledge-deficit model.« less

Health Promotion in the Community: Impact of Faith-Based Lay Health Educators in Urban Neighborhoods.

PubMed

Galiatsatos, Panagis; Sundar, Siddhi; Qureshi, Adil; Ooi, Gavyn; Teague, Paula; Daniel Hale, W

2016-06-01

Promoting wellness and providing reliable health information in the community present serious challenges. Lay health educators, also known as community health workers, may offer a cost-effective solution to such challenges. This is a retrospective observational study of graduates from the Lay Health Educator Program (LHEP) at Johns Hopkins Bayview Medical Center from 2013 to 2014. Students were enrolled from the surrounding community congregations and from the hospital's accredited clinical pastoral education program. There were 50 events implemented by the lay health educators during the 2014-2015 time period, reaching a total of 2004 individuals. The mean time from date of graduation from the LHEP to implementation of their first health promotional event was 196 ± 76 days. A significant number of lay health educators implemented events within the first year after completing their training. Ongoing monitoring of their community activity and the clinical impact of their efforts should be a priority for future studies.

Building Capacity in a Rural North Carolina Community to Address Prostate Health Using a Lay Health Advisor Model

PubMed Central

Vines, Anissa I.; Hunter, Jaimie C.; White, Brandolyn S.; Richmond, Alan N.

2018-01-01

Background Prostate cancer is a critical concern for African Americans in North Carolina (NC), and innovative strategies are needed to help rural African American men maximize their prostate health. Engaging the community in research affords opportunities to build capacity for teaching and raising awareness. Approach and Strategies A community steering committee of academicians, community partners, religious leaders, and other stakeholders modified a curriculum on prostate health and screening to include interactive knowledge- and skill-building activities. This curriculum was then used to train 15 African American lay health advisors, dubbed Prostate Cancer Ambassadors, in a rural NC community. Over the 2-day training, Ambassadors achieved statistically significant improvements in knowledge of prostate health and maintained confidence in teaching. The Ambassadors, in turn, used their personal networks to share their knowledge with over 1,000 individuals in their community. Finally, the Ambassadors became researchers, implementing a prostate health survey in local churches. Discussion and Conclusions It is feasible to use community engagement models for raising awareness of prostate health in NC African American communities. Mobilizing community coalitions to develop curricula ensures that the curricula meet the communities’ needs, and training lay health advisors to deliver curricula helps secure community buy-in for the information. PMID:26232777

Social capital on poultry farms in South Sulawesi, Indonesia

NASA Astrophysics Data System (ADS)

Sri Lestari, V.; Natsir; Patrick, I. W.; Ali, H. M.; Asya, M.; Sirajuddin, S. N.

2018-05-01

Social capital plays an important role in the development of poultry farms in South Sulawesi. Poultry farms consisted of laying hen and broiler farms. Most of laying hen farms were located in Sidrap Regency, while broiler farms were located in Maros regency. The aim of this research was to know social capital on beef cattle farms in South Sulawesi. Population of this research was 120 farmers which consisted of 6o were laying hen farmers and 60 were broiler farmers. Variable of social capital was mutual trust, reciprocity, shared norms and linkage. The data were collected from observation and depth interview by using questionnaire. There were 10 questions. The answer was scored by using Likert scale ranging from 1 refer to strongly agree; 2 refer to agree; 3 refer to not sure; 4 refer to disagree and 5 refer to strongly disagree. The data were analyzed descriptively using frequency distribution. The research revealed that mutual trust and shared norms members of the group in broiler farms have higher level than that on laying hen farms, on the other hand, linkage or net working members of the group among laying hen farmers has higher level than that on broiler farms.

A qualitative study of help seeking and primary care consultation prior to suicide

PubMed Central

Owens, Christabel; Lambert, Helen; Donovan, Jenny; Lloyd, Keith R

2005-01-01

Background Many suicides may be preventable through medical intervention, but many people do not seek help from a medical practitioner prior to suicide. Little is known about how consulting decisions are made at this time. Aim To explore how distressed individuals and members of their lay networks had made decisions to seek or not to seek help from a medical practitioner in the period leading up to suicide. Design of study Qualitative analysis of psychological autopsy data. Setting One large English county. Method Semi-structured interviews with close relatives or friends of suicide victims were conducted as part of a psychological autopsy study. Sixty-six interviews were transcribed verbatim and analysed using a thematic approach. Results Relatives and friends often played a key role in determining whether or not suicidal individuals sought medical help. Half the sample had consulted in their final month and many were persuaded to do so by a relative or friend. Of those who did not consult, some were characterised as help-resisters but many others had omitted to do so because no-one around them was aware of the seriousness of their distress or considered it to be medically significant. A range of lay interventions and coping strategies was identified, including seeking non-medical help. Conclusion Greater attention needs to be given to the potential role of lay networks in managing psychological distress and preventing suicide. A balanced approach to suicide prevention is recommended that builds on lay knowledge and combines medical and non-medical strategies. PMID:16004734

'I'm Happy if I Can Help'. Public views on future medicines and gene-based therapy in Iceland.

PubMed

Traulsen, Janine M; Bjornsdóttir, Ingunn; Almarsdóttir, Anna Birna

2008-01-01

To explore lay perceptions about medicine and drug therapy (including gene-based therapy) in the present and in the future. Following almost a year of national debate, the Icelandic parliament passed the Health Sector Database (HSD) Act in 1998. No single issue has been as much debated in Iceland as this database. Despite the explosion of popular and scientific literature in the field of bioethics, there is still a paucity of research concerning 'lay' contributions to the debates. The study was designed as a qualitative study. Focus groups (FGs) were conducted followed by one-on-one interviews with the FG moderator. PARTICIPANTS were asked to comment on a future scenario consisting of predictions concerning the consequence of the Human Genome Project over the next 40 years. Forty-two persons participated in eight FGs in Iceland. The Icelandic moderator was interviewed in English after each group. The lay public was relatively optimistic with regard to the future of drugs and gene-based therapy. Reasons for this optimism can be found in a basic trust and belief in the welfare state and the health system. These results are not consistent with studies carried out in other countries where the public appears to be focused on the negative effects of genetic research and the threats to privacy. Most participants expressed concern about potential problems with regard to social and equity issues, whereas the HSD controversy, a discourse based on the rhetoric of bioethics, was at variance with the issues focused on by the lay public. (c) 2008 S. Karger AG, Basel

Protocol—the RAMESES II study: developing guidance and reporting standards for realist evaluation

PubMed Central

Greenhalgh, Trisha; Wong, Geoff; Jagosh, Justin; Greenhalgh, Joanne; Manzano, Ana; Westhorp, Gill; Pawson, Ray

2015-01-01

Introduction Realist evaluation is an increasingly popular methodology in health services research. For realist evaluations (RE) this project aims to: develop quality and reporting standards and training materials; build capacity for undertaking and critically evaluating them; produce resources and training materials for lay participants, and those seeking to involve them. Methods To achieve our aims, we will: (1) Establish management and governance infrastructure; (2) Recruit an interdisciplinary Delphi panel of 35 participants with diverse relevant experience of RE; (3) Summarise current literature and expert opinion on best practice in RE; (4) Run an online Delphi panel to generate and refine items for quality and reporting standards; (5) Capture ‘real world’ experiences and challenges of RE—for example, by providing ongoing support to realist evaluations, hosting the RAMESES JISCmail list on realist research, and feeding problems and insights from these into the deliberations of the Delphi panel; (6) Produce quality and reporting standards; (7) Collate examples of the learning and training needs of researchers, students, reviewers and lay members in relation to RE; (8) Develop, deliver and evaluate training materials for RE and deliver training workshops; and (9) Develop and evaluate information and resources for patients and other lay participants in RE (eg, draft template information sheets and model consent forms) and; (10) Disseminate training materials and other resources. Planned outputs: (1) Quality and reporting standards and training materials for RE. (2) Methodological support for RE. (3) Increase in capacity to support and evaluate RE. (4) Accessible, plain-English resources for patients and the public participating in RE. Discussion The realist evaluation is a relatively new approach to evaluation and its overall place in the is not yet fully established. As with all primary research approaches, guidance on quality assurance and uniform reporting is an important step towards improving quality and consistency. PMID:26238395

Some Contracting Controls at Mission and Installation Contracting Command, Fort Polk, Louisiana, Need Improvement

DTIC Science & Technology

2015-02-12

erosion control. Work that did not meet PWS requirements included laying pavement stones for a monument walkway and installing a glossy marble -like... property structures, roads, training areas, training facilities, and utility infrastructure. The contract period of performance consisted of a base year

A process evaluation exploring the lay counsellor experience of delivering a task shared psycho-social intervention for perinatal depression in Khayelitsha, South Africa.

PubMed

Munodawafa, Memory; Lund, Crick; Schneider, Marguerite

2017-07-01

Task sharing of psycho-social interventions for perinatal depression has been shown to be feasible, acceptable and effective in low and middle-income countries. This study conducted a process evaluation exploring the perceptions of counsellors who delivered a task shared psycho-social counselling intervention for perinatal depression in Khayelitsha, Cape Town together with independent fidelity ratings. Post intervention qualitative semi-structured interviews were conducted with six counsellors from the AFrica Focus on Intervention Research for Mental health (AFFIRM-SA) randomised controlled trial on their perceptions of delivering a task shared psycho-social intervention for perinatal depression. Themes were identified using the framework approach and were coded and analysed using Nvivo v11. These interviews were supplemented with fidelity ratings for each counsellor and supervision notes. Facilitating factors in the delivery of the intervention included intervention related factors such as: the content of the intervention, ongoing training and supervision, using a counselling manual, conducting counselling sessions in the local language (isiXhosa) and fidelity to the manual; counsellor factors included counsellors' confidence and motivation to conduct the sessions; participant factors included older age, commitment and a desire to be helped. Barriers included contextual factors such as poverty, crime and lack of space to conduct counselling sessions and participant factors such as the nature of the participant's problem, young age, and avoidance of contact with counsellors. Fidelity ratings and dropout rates varied substantially between counsellors. These findings show that a variety of intervention, counsellor, participant and contextual factors need to be considered in the delivery of task sharing counselling interventions. Careful attention needs to be paid to ongoing supervision and quality of care if lay counsellors are to deliver good quality task shared counselling interventions in under-resourced communities. Clinical Trials: NCT01977326 , registered on 24/10/2013; Pan African Clinical Trials Registry: PACTR201403000676264 , registered on 11/10/2013.

Crowdsourcing for translational research: analysis of biomarker expression using cancer microarrays

PubMed Central

Lawson, Jonathan; Robinson-Vyas, Rupesh J; McQuillan, Janette P; Paterson, Andy; Christie, Sarah; Kidza-Griffiths, Matthew; McDuffus, Leigh-Anne; Moutasim, Karwan A; Shaw, Emily C; Kiltie, Anne E; Howat, William J; Hanby, Andrew M; Thomas, Gareth J; Smittenaar, Peter

2017-01-01

Background: Academic pathology suffers from an acute and growing lack of workforce resource. This especially impacts on translational elements of clinical trials, which can require detailed analysis of thousands of tissue samples. We tested whether crowdsourcing – enlisting help from the public – is a sufficiently accurate method to score such samples. Methods: We developed a novel online interface to train and test lay participants on cancer detection and immunohistochemistry scoring in tissue microarrays. Lay participants initially performed cancer detection on lung cancer images stained for CD8, and we measured how extending a basic tutorial by annotated example images and feedback-based training affected cancer detection accuracy. We then applied this tutorial to additional cancer types and immunohistochemistry markers – bladder/ki67, lung/EGFR, and oesophageal/CD8 – to establish accuracy compared with experts. Using this optimised tutorial, we then tested lay participants' accuracy on immunohistochemistry scoring of lung/EGFR and bladder/p53 samples. Results: We observed that for cancer detection, annotated example images and feedback-based training both improved accuracy compared with a basic tutorial only. Using this optimised tutorial, we demonstrate highly accurate (>0.90 area under curve) detection of cancer in samples stained with nuclear, cytoplasmic and membrane cell markers. We also observed high Spearman correlations between lay participants and experts for immunohistochemistry scoring (0.91 (0.78, 0.96) and 0.97 (0.91, 0.99) for lung/EGFR and bladder/p53 samples, respectively). Conclusions: These results establish crowdsourcing as a promising method to screen large data sets for biomarkers in cancer pathology research across a range of cancers and immunohistochemical stains. PMID:27959886

Increasing capacity to deliver diabetes self-management education: results of the DESMOND lay educator non-randomized controlled equivalence trial.

PubMed

Carey, M E; Mandalia, P K; Daly, H; Gray, L J; Hale, R; Martin Stacey, L; Taub, N; Skinner, T C; Stone, M; Heller, S; Khunti, K; Davies, M J

2014-11-01

To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland. The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels. Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Whose voices? Patient and public involvement in clinical commissioning.

PubMed

O'Shea, Alison; Chambers, Mary; Boaz, Annette

2017-06-01

This paper aims to explore patient and public representation in a NHS clinical commissioning group and how this is experienced by staff and lay members involved. Patient and public involvement is believed to foster greater public representativeness in the development and delivery of health care services. However, there is widespread debate about what representation is or what it should be. Questions arise about the different constructions of representation and the representativeness of patients and the public in decision-making structures and processes. Ethnographic, two-phase study involving twenty-four observations across two types of clinical commissioning group meetings with patient and public involvement, fourteen follow-up interviews with NHS staff and lay members, and a focus group with five lay members. Perceptions of what constitutes legitimate representativeness varied between respondents, ranging from representing an individual patient experience to reaching large numbers of people. Consistent with previous studies, there was a lack of clarity about the role of lay members in the work of the clinical commissioning group. Unlike previous studies, it was lay members, not staff, who raised concerns about their representativeness and legitimacy. Although the clinical commissioning group provides resources to support patient and public involvement, there continues to be a lack of clarity about roles and scope for impact. Lay members are still some way from constituting a powerful voice at the table. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

[Public access defibrillation].

PubMed

Katz, Eugène; Metzger, Jacques-Thierry; Sierro, Christophe; Deac, Monica; Fishman, Daniel; Girod, Grégoire; Potin, Mathieu; Niquille, Marc; Stauffer, Jean-Christoffe; Kehtari, Réza; Sénéchaud, Christophe; Garcia, Wenceslao; Rodriguez, Maria; Fromer, Martin

2008-08-27

Placement of automated external defibrillators (AED) in public facilities and training of the lay persons in basic life support-defibrillation (BLS-D) was recommended by the American Heart Association for the treatment of out-of-hospital cardiac arrest (OHCA). Immediate use of AED result in increase of survival to hospital discharge. Many observation and much less randomized trials describe clinical efficacy of this approach. However, "negative" trials have also been published and some recent data suggest that public access defibrillation (PAD) will have a minimal impact on population survival. In this article various PAD strategies were briefly reviewed. In our opinion installation of AED in public places should be based on the long-term study of local OHCA demography and preceded by widespread BLS training of lay population.

The Structured Interview and Interviewer Training in the Admissions Process

PubMed Central

Cox, Wendy C.; White-Harris, Carla; Blalock, Susan J.

2007-01-01

Objectives To determine the extent to which the structured interview is used in the PharmD admissions process in US colleges and schools of pharmacy, and the prevalence and content of interviewer training. Methods A survey instrument consisting of 7 questions regarding interviews and interviewer training was sent to 92 colleges and schools of pharmacy in the United States that were accredited or seeking accreditation. Results Sixty survey instruments (65% response rate) were returned. The majority of the schools that responded (80%) used interviews as part of the PharmD admissions process. Of the schools that used an interview as part of the admissions process, 86% provided some type of interviewer training and 13% used a set of predefined questions in admissions interviews. Conclusions Most colleges and schools of pharmacy use some components of the structured interview in the PharmD admissions process; however, training for interviewers varies widely among colleges and schools of pharmacy. PMID:17998980

[Resuscitation - Basic Life Support in adults and application of automatic external defibrillators].

PubMed

Bohn, Andreas; Seewald, Stephan; Wnent, Jan

2016-03-01

Witnesses of a sudden cardiac arrest play a key-role in resuscitation. Lay-persons should therefore be trained to recognize that a collapsed person who is not breathing at all or breathing normally might suffer from cardiac arrest. Information of professional emergency medical staff by lay-persons and their initiation of cardio-pulmonary-resuscitation-measures are of great importance for cardiac-arrest victims. Ambulance-dispatchers have to support lay-rescuers via telephone. This support includes the localisation of the nearest Automatic External Defibrillator (AED). Presentation of agonal breathing or convulsions due to brain-hypoxia need to be recognized as potential early signs of cardiac arrest. In any case of cardiac arrest chest-compressions need to be started. There is insufficiant data to recommend "chest-compression-only"-CPR as being equally sufficient as cardio-pulmonary-resuscitation including ventilation. Rescuers trained in ventilation should therefore combine compressions and ventilations at a 30:2-ratio. Movement of the chest is being used as a sign of sufficient ventilation. High-quality chest-compressions of at least 5 cm of depth, not exceeding 6 cm, are recommended at a ratio of 100-120 chest conpressions/min. Interruption of chest-compression should be avoided. At busy public places AED should be available to enable lay-rescuers to apply early defibrillation. © Georg Thieme Verlag Stuttgart · New York.

Prevalence and correlates of fire-setting in the United States: results from the National Epidemiological Survey on Alcohol and Related Conditions.

PubMed

Vaughn, Michael G; Fu, Qiang; Delisi, Matt; Wright, John Paul; Beaver, Kevin M; Perron, Brian E; Howard, Matthew O

2010-01-01

Fire-setting is a serious and costly form of antisocial behavior. Our objective in this study was to examine the prevalence and correlates of intentional fire-setting behavior in the United States. Data were derived from a nationally representative sample of US residents 18 years and older. Structured psychiatric interviews (N = 43,093) were completed by trained lay interviewers between 2001 and 2002. Fire-setting as well as mood, anxiety, substance use, and personality disorders of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) version. The prevalence of lifetime fire-setting in the US population was 1.0%. Respondents who were men, white, 18 to 35 years old, born in the United States, and living in the western region of the United States had significantly higher rates of fire-setting than their counterparts. Fire-setting was significantly associated with a wide range of antisocial behaviors. Multivariate logistic regression analyses identified strong associations between lifetime alcohol and marijuana use disorders, conduct disorder, antisocial and obsessive-compulsive personality disorders, and family history of antisocial behavior. Intentional illicit fire-setting behavior is associated with a broad array of antisocial behaviors and psychiatric comorbidities. Given the substantial personal and social costs related to arson, prevention and treatment interventions targeting fire-setters potentially could save lives and property. 2010 Elsevier Inc. All rights reserved.

Correlates of cruelty to animals in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

PubMed

Vaughn, Michael G; Fu, Qiang; DeLisi, Matt; Beaver, Kevin M; Perron, Brian E; Terrell, Katie; Howard, Matthew O

2009-10-01

To examine the sociodemographic, behavioral, and psychiatric correlates of cruelty to animals in the US. Data were derived from a nationally representative sample of adults residing in the US Structured psychiatric interviews (N=43,093) were completed by trained lay interviewers between 2001 and 2002. Personality, substance use, mood, and anxiety disorders and cruelty to animals were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (DSM-IV) version. The lifetime prevalence of animal cruelty in US adults was 1.8%. Men, African-Americans, Native-Americans/Asians, native-born Americans, persons with lower levels of income and education and adults living the western region of the US reported comparatively high levels of cruelty to animals, whereas Hispanics reported comparatively low levels of such behavior. Cruelty to animals was significantly associated with all assessed antisocial behaviors. Adjusted analyses revealed strong associations between lifetime alcohol use disorders, conduct disorder, antisocial, obsessive-compulsive, and histrionic personality disorders, pathological gambling, family history of antisocial behavior, and cruelty to animals. Cruelty to animals is associated with elevated rates observed in young, poor, men with family histories of antisocial behavior and personal histories of conduct disorder in childhood, and antisocial, obsessive-compulsive and histrionic personality disorders, and pathological gambling in adulthood. Given these associations, and the widespread ownership of pets and animals, effective screening of children, adolescents and adults for animal cruelty and appropriate mental health interventions should be deployed.

Ranking Medical Terms to Support Expansion of Lay Language Resources for Patient Comprehension of Electronic Health Record Notes: Adapted Distant Supervision Approach.

PubMed

Chen, Jinying; Jagannatha, Abhyuday N; Fodeh, Samah J; Yu, Hong

2017-10-31

Medical terms are a major obstacle for patients to comprehend their electronic health record (EHR) notes. Clinical natural language processing (NLP) systems that link EHR terms to lay terms or definitions allow patients to easily access helpful information when reading through their EHR notes, and have shown to improve patient EHR comprehension. However, high-quality lay language resources for EHR terms are very limited in the public domain. Because expanding and curating such a resource is a costly process, it is beneficial and even necessary to identify terms important for patient EHR comprehension first. We aimed to develop an NLP system, called adapted distant supervision (ADS), to rank candidate terms mined from EHR corpora. We will give EHR terms ranked as high by ADS a higher priority for lay language annotation-that is, creating lay definitions for these terms. Adapted distant supervision uses distant supervision from consumer health vocabulary and transfer learning to adapt itself to solve the problem of ranking EHR terms in the target domain. We investigated 2 state-of-the-art transfer learning algorithms (ie, feature space augmentation and supervised distant supervision) and designed 5 types of learning features, including distributed word representations learned from large EHR data for ADS. For evaluating ADS, we asked domain experts to annotate 6038 candidate terms as important or nonimportant for EHR comprehension. We then randomly divided these data into the target-domain training data (1000 examples) and the evaluation data (5038 examples). We compared ADS with 2 strong baselines, including standard supervised learning, on the evaluation data. The ADS system using feature space augmentation achieved the best average precision, 0.850, on the evaluation set when using 1000 target-domain training examples. The ADS system using supervised distant supervision achieved the best average precision, 0.819, on the evaluation set when using only 100 target-domain training examples. The 2 ADS systems both performed significantly better than the baseline systems (P<.001 for all measures and all conditions). Using a rich set of learning features contributed to ADS's performance substantially. ADS can effectively rank terms mined from EHRs. Transfer learning improved ADS's performance even with a small number of target-domain training examples. EHR terms prioritized by ADS were used to expand a lay language resource that supports patient EHR comprehension. The top 10,000 EHR terms ranked by ADS are available upon request. ©Jinying Chen, Abhyuday N Jagannatha, Samah J Fodeh, Hong Yu. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 31.10.2017.

An innovative method to involve community health workers as partners in evaluation research.

PubMed

Peacock, Nadine; Issel, L Michele; Townsell, Stephanie J; Chapple-McGruder, Theresa; Handler, Arden

2011-12-01

We developed a process through which community outreach workers, whose role is not typically that of a trained researcher, could actively participate in collection of qualitative evaluation data. Outreach workers for a community-based intervention project received training in qualitative research methodology and certification in research ethics. They used a Voice over Internet Protocol phone-in system to provide narrative reports about challenges faced by women they encountered in their outreach activities as well as their own experiences as outreach workers. Qualitative data contributed by outreach workers provided insights not otherwise available to the evaluation team, including details about the complex lives of underserved women at risk for poor pregnancy outcomes and the challenges and rewards of the outreach worker role. Lay health workers can be a valuable asset as part of a research team. Training in research ethics and methods can be tailored to their educational level and preferences, and their insights provide important information and perspectives that may not be accessible via other data collection methods. Challenges encountered in the dual roles of researcher and lay health worker can be addressed in training.

Community-Academic Partnership to Implement a Breast and Cervical Cancer Screening Education Program in Puerto Rico.

PubMed

Colón-López, Vivian; González, Daisy; Vélez, Camille; Fernández-Espada, Natalie; Feldman-Soler, Alana; Ayala-Escobar, Kelly; Ayala-Marín, Alelí M; Soto-Salgado, Marievelisse; Calo, William A; Pattatucci-Aragón, Angela; Rivera-Díaz, Marinilda; Fernández, María E

2017-12-01

To describe how a community-academic partnership between Taller Salud Inc., a community-based organization, and the Puerto Rico Community Cancer Control Outreach Program of the University of Puerto Rico was crucial in the adaptation and implementation of Cultivando La Salud (CLS), an evidencebased educational outreach program designed to increase breast and cervical cancer screening among Hispanic women living in Puerto Rico. This collaboration facilitated the review and adaptation of the CLS intervention to improve cultural appropriateness, relevance, and acceptability for Puerto Rican women. A total of 25 interviewers and 12 Lay Health Workers (LHWs) were recruited and trained to deliver the program. The interviewers recruited women who were non-adherent to recommended screening guidelines for both breast and cervical cancer. LHWs then provided one-on-one education using the adapted CLS materials. A total of 444 women were recruited and 48% of them were educated through this collaborative effort. Our main accomplishment was establishing the academic-community partnership to implement the CLS program. Nevertheless, in order to promote better collaborations with our community partners, it is important to carefully delineate and establish clear roles and shared responsibilities for each partner for the successful execution of research activities, taking into consideration the community's needs.

Occupational safety beliefs among Latino residential roofing workers.

PubMed

Arcury, Thomas A; Summers, Phillip; Carrillo, Lourdes; Grzywacz, Joseph G; Quandt, Sara A; Mills, Thomas H

2014-06-01

This analysis describes beliefs about work safety and personal protective equipment (PPE) among Latino roofing workers, it delineates their perceptions of work environment characteristics that affect work safety and PPE use, and it describes how they experience work injuries and the consequences of these injuries. In-depth interviews were completed with 10 current and former Latino residential roofers. Interview transcripts were subjected to systematic qualitative analysis. Participants' valued productivity over safety, and this had a negative influence on their safety behavior and reduced their PPE use. They understood that roofing was hazardous. They limited use of PPE when they felt it reduced productivity and when it was uncomfortable. Work environment characteristics that affected safety included company size, the physical demands of the job, lack of training, the need for work, general life stress, and distractions at work. An injury had to result in lost work time to be considered significant. Access to health care is limited by employers not providing Workers' compensation. Future research is needed to substantiate these descriptive results and to delineate factors that are associated with safety behavior and use of PPE. Interventions, based on a lay health educator model, are needed to improve safety in this population. Safety regulations need to be evaluated and their enforcement needs to be improved. © 2013 Wiley Periodicals, Inc.

Implementation and Impact of Patient Lay Navigator-Led Advance Care Planning Conversations.

PubMed

Rocque, Gabrielle B; Dionne-Odom, J Nicholas; Sylvia Huang, Chao-Hui; Niranjan, Soumya J; Williams, Courtney P; Jackson, Bradford E; Halilova, Karina I; Kenzik, Kelly M; Bevis, Kerri S; Wallace, Audrey S; Lisovicz, Nedra; Taylor, Richard A; Pisu, Maria; Partridge, Edward E; Butler, Thomas W; Briggs, Linda A; Kvale, Elizabeth A

2017-04-01

Advance care planning (ACP) improves alignment between patient preferences for life-sustaining treatment and care received at end of life (EOL). To evaluate implementation of lay navigator-led ACP. A convergent, parallel mixed-methods design was used to evaluate implementation of navigator-led ACP across 12 cancer centers. Data collection included 1) electronic navigation records, 2) navigator surveys (n = 45), 3) claims-based patient outcomes (n = 820), and 4) semistructured navigator interviews (n = 26). Outcomes of interest included 1) the number of ACP conversations completed, 2) navigator self-efficacy, 3) patient resource utilization, hospice use, and chemotherapy at EOL, and 4) navigator-perceived barriers and facilitators to ACP. From June 1, 2014 to December 31, 2015, 50 navigators completed Respecting Choices ® First Steps ACP Facilitator training. Navigators approached 18% of patients (1319/8704); 481 completed; 472 in process; 366 declined. Navigators were more likely to approach African American patients than Caucasian patients (20% vs. 14%, P < 0.001). Significant increases in ACP self-efficacy were observed after training. The mean score for feeling prepared to conduct ACP conversations increased from 5.6/10 to 7.5/10 (P < 0.001). In comparison with patients declining ACP participation (n = 171), decedents in their final 30 days of life who engaged in ACP (n = 437) had fewer hospitalizations (46% vs. 56%, P = 0.02). Key facilitators of successful implementation included physician buy-in, patient readiness, and prior ACP experience; barriers included space limitations, identifying the "right" time to start conversations, and personal discomfort discussing EOL. A navigator-led ACP program was feasible and may be associated with lower rates of resource utilization near EOL. Copyright © 2017 American Academy of Hospice and Palliative Medicine. All rights reserved.

Training quality job interviews with adults with developmental disabilities.

PubMed

Mozingo, D; Ackley, G B; Bailey, J S

1994-01-01

Supported work models of vocational integration have increased the employability of individuals with developmental disabilities. Interview questions most frequently used and corresponding responses considered most beneficial to job applicants were derived from an empirical analysis of the "hiring community" and served as a basis for the development of the verbal job interview skills training package evaluated in this research. Dependent measures were objective, behavioral indices of the quality of job interview responses. One-to-one training by a direct training staff, job coach, and a trained behavior analyst resulted in improved responding by all subjects as indicated in a multiple baseline design across interview questions. Improved quality in responding to questions generalized to variations in interview questions, to a novel interviewer, and in an in vivo interview situation. Finally, global measures of social validity support the value of the quality-of-response training.

Development and interrater reliability testing of a telephone interview training programme for Australian nurse interviewers.

PubMed

Ahern, Tracey; Gardner, Anne; Gardner, Glenn; Middleton, Sandy; Della, Phillip

2013-05-01

The final phase of a three phase study analysing the implementation and impact of the nurse practitioner role in Australia (the Australian Nurse Practitioner Project or AUSPRAC) was undertaken in 2009, requiring nurse telephone interviewers to gather information about health outcomes directly from patients and their treating nurse practitioners. A team of several registered nurses was recruited and trained as telephone interviewers. The aim of this paper is to report on development and evaluation of the training process for telephone interviewers. The training process involved planning the content and methods to be used in the training session; delivering the session; testing skills and understanding of interviewers post-training; collecting and analysing data to determine the degree to which the training process was successful in meeting objectives and post-training follow-up. All aspects of the training process were informed by established educational principles. Interrater reliability between interviewers was high for well-validated sections of the survey instrument resulting in 100% agreement between interviewers. Other sections with unvalidated questions showed lower agreement (between 75% and 90%). Overall the agreement between interviewers was 92%. Each interviewer was also measured against a specifically developed master script or gold standard and for this each interviewer achieved a percentage of correct answers of 94.7% or better. This equated to a Kappa value of 0.92 or better. The telephone interviewer training process was very effective and achieved high interrater reliability. We argue that the high reliability was due to the use of well validated instruments and the carefully planned programme based on established educational principles. There is limited published literature on how to successfully operationalise educational principles and tailor them for specific research studies; this report addresses this knowledge gap. Copyright © 2012 Elsevier Ltd. All rights reserved.

Developing a Business Intelligence Process for a Training Module in SharePoint 2010

NASA Technical Reports Server (NTRS)

Schmidtchen, Bryce; Solano, Wanda M.; Albasini, Colby

2015-01-01

Prior to this project, training information for the employees of the National Center for Critical Processing and Storage (NCCIPS) was stored in an array of unrelated spreadsheets and SharePoint lists that had to be manually updated. By developing a content management system through a web application platform named SharePoint, this training system is now highly automated and provides a much less intensive method of storing training data and scheduling training courses. This system was developed by using SharePoint Designer and laying out the data structure for the interaction between different lists of data about the employees. The automation of data population inside of the lists was accomplished by implementing SharePoint workflows which essentially lay out the logic for how data is connected and calculated between certain lists. The resulting training system is constructed from a combination of five lists of data with a single list acting as the user-friendly interface. This interface is populated with the courses required for each employee and includes past and future information about course requirements. The employees of NCCIPS now have the ability to view, log, and schedule their training information and courses with much more ease. This system will relieve a significant amount of manual input and serve as a powerful informational resource for the employees of NCCIPS in the future.

Mind the gap! Lay and medical perceptions of risks associated with the use of alternative treatment and conventional medicine.

PubMed

Salamonsen, Anita

2015-01-01

Studies on the widespread use of complementary and alternative medicine (CAM) demonstrate that CAM users base their treatment decisions on both subjective, experience-based knowledge and medical knowledge. The aim of this study was to explore lay and medical risk perceptions associated with CAM and conventional medicine. In this explorative qualitative study, we conducted in-depth interviews with 25 Norwegian CAM users with cancer or multiple sclerosis and 12 doctors. The interviews revealed fundamental differences in risk perceptions influencing treatment decisions and risk communication in a clinical setting. While CAM users considered conventional medicine as potentially risky and related this to experiences of severe adverse effects, CAM was perceived as natural and safe. Doctors' risk perceptions were quite the contrary, mainly because of lack of scientific evidence for CAM as a safe and beneficial treatment option. For the safety of CAM users, such divergent risk perceptions may have far-reaching consequences. CAM users should be taken seriously with their self-perception as decision-makers considering their approaches to experiences, knowledge, and science. An awareness of differing lay and medical risk perceptions associated with CAM and conventional medicine in research, doctor-patient communication, and education of patients and doctors is thus important to optimize patient safety in complex health care systems. © 2015 S. Karger GmbH, Freiburg.

Enabling and sustaining the activities of lay health influencers: lessons from a community-based tobacco cessation intervention study.

PubMed

Castañeda, Heide; Nichter, Mark; Nichter, Mimi; Muramoto, Myra

2010-07-01

The authors present findings from a community-based tobacco cessation project that trained lay health influencers to conduct brief interventions. They outline four major lessons regarding sustainability. First, participants were concerned about the impact that promoting cessation might have on social relationships. "Social risk" must be addressed during training to ensure long-term sustainability. Second, formal training provided participants with an increased sense of self-efficacy, allowed them to embrace a health influencer identity, and aided in further reducing social risk. Third, material resources functioned to mediate social tensions during health intervention conversations. A variety of resources should be made available to health influencers to accommodate type of relationship, timing, and location of the interaction. Finally, project design must be attentive to the creation of a "community of practice" among health influencers as an integral part of project sustainability. These lessons have broad implications for successful health promotion beyond tobacco cessation.

Difficulties encountered by hospitalized Syrian refugees and their expectations from nurses.

PubMed

Sevinç, S; Kılıç, S P; Ajghif, M; Öztürk, M H; Karadağ, E

2016-09-01

Treating patients with care and respecting their cultural values are key factors necessary to enhance the quality of nursing care. The objective of this study was to explore and describe the difficulties experienced by hospitalized Syrian refugees and their expectations from nurses and hospital administration. We used a descriptive qualitative research approach to engage 30 Syrian refugees undergoing treatment in internal medicine who met the study criteria. Data were collected using a descriptive questionnaire and a semi-structured interview with open-ended interview questions. Interview transcripts were analysed using an inductive coding approach. Descriptive questions were analysed and presented via number and percentage. Other data were assessed using content analysis methods. Three major themes were developed following the analysis of the interviews. We determined that the refugees who participated in the study experienced difficulties in communicating, meeting their personal needs and correctly following treatment instructions. They also had certain expectations from the hospital administration and nurses, and they felt gratitude for both nurses and the nation of Turkey. The results of this study, shared with the executive administration of the hospital, may result in new policies which will help new Syrian refugee patients and patients with similar needs to have better experience related to patient care, communications and meeting personal needs. It is important that nurses and other healthcare provider consider the difficulties and expectations of refugees regarding healthcare services and include same in the development of provider training programmes. Development of public health welfare and employment law and policies help to lay the groundwork for successful integration of refugees in new cultures and countries. © 2016 International Council of Nurses.

Teaching Motivational Interviewing Skills to Psychiatry Trainees: Findings of a National Survey.

PubMed

Abele, Misoo; Brown, Julie; Ibrahim, Hicham; Jha, Manish K

2016-02-01

The authors report on the current status of motivational interviewing education and training director attitudes about providing it to psychiatry residents. Training directors of general, child/adolescent and addiction psychiatry training programs were invited to participate in an anonymous online survey. Of the 333 training directors who were invited to participate, 66 of 168 (39.3%) general, 41 of 121 (33.9%) child/adolescent, and 19 of 44 (43.2%) addiction psychiatry training directors completed the survey. The authors found that 90.9% of general, 80.5% of child/adolescent, and 100% of addiction psychiatry training programs provided motivational interviewing education. Most programs used multiple educational opportunities; the three most common opportunities were didactics, clinical practice with formal supervision, and self-directed reading. Most training directors believed that motivational interviewing was an important skill for general psychiatrists. The authors also found that 83.3% of general, 87.8% of child/adolescent, and 94.7% of addiction psychiatry training directors reported that motivational interviewing should be taught during general psychiatry residency. Motivational interviewing skills are considered important for general psychiatrists and widely offered by training programs. Competency in motivational interviewing skills should be considered as a graduation requirement in general psychiatry training programs.

Relationship of Automatic Data Processing Training Curriculum and Methodology in the Federal Government.

ERIC Educational Resources Information Center

Office of Education (DHEW), Washington, DC.

A conference, held in Washington, D. C., in 1967 by the Association for Educational Data Systems and the U.S. Office of Education, attempted to lay the groundwork for an efficient automatic data processing training program for the Federal Government utilizing new instructional methodologies. The rapid growth of computer applications and computer…

Moral Dilemmas and Moral Rules

ERIC Educational Resources Information Center

Nichols, Shaun; Mallon, Ron

2006-01-01

Recent work shows an important asymmetry in lay intuitions about moral dilemmas. Most people think it is permissible to divert a train so that it will kill one innocent person instead of five, but most people think that it is not permissible to push a stranger in front of a train to save five innocents. We argue that recent emotion-based…

Vocational Education and Training in Cyprus. Short Description

ERIC Educational Resources Information Center

Cedefop - European Centre for the Development of Vocational Training, 2012

2012-01-01

Cyprus takes over the European Union Presidency in the second half of 2012 in a period of continuing uncertainty due to the world economic crisis. The vocational education and training (VET) system of Cyprus is playing a significant role in dealing with the immediate adverse effects of the crisis on the labour market as well as in laying the…

The role, practice and training of unregulated birth workers in Australia: A mixed methods study.

PubMed

Rigg, Elizabeth C; Schmied, Virginia; Peters, Kath; Dahlen, Hannah G

2018-05-23

In Australia, the provision of homebirth services by unregulated birthworkers (doulas, ex-registered midwives, traditional midwives and lay workers) has increased. Accessing a homebirth with a registered midwife via mainstream services is limited. Concern is growing that new legislation aimed at prohibiting unregulated birthworkers practice may result in homebirth going underground. To explore the role, practice and training of unregulated birthworkers in Australian and establish what they would do if legislation prohibited their practice. This study used a mixed methods sequential exploratory design to explore the practice, training and role of unregulated birthworkers in Australia. In phase one, four unregulated birthworkers were interviewed in-depth and the findings informed the development of a survey in phase two. This was distributed nationally through two consumer websites, social media, Facebook and email. Data from both phases were integrated. Unregulated birthworkers in Australia provide homebirth services to women with high and low-risk pregnancies when this choice is unavailable or unacceptable within mainstream services. They operate covertly to protect their practice and avoid the scrutiny of authorities. Unregulated birthworkers can be experienced and trained in childbirth care and practice, much like a midwife working within a holistic paradigm of care. Unregulated birthworkers believe they provide women with the homebirth service they want but cannot access. Mainstream service providers need to listen to consumer criticisms, as women seek answers outside the system. Change is needed to improve and align services with women's expectations of homebirth. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Fluid and Electrolyte Needs for Training, Competition, and Recovery

DTIC Science & Technology

2011-01-01

begin both training and competition in a state of fluid deficit. Analysis of samples collected from elite football ( soccer ) players before training...surprisingly, samples collected from players before a competitive game revealed that 8 of the 20 outfield players had a urine osmolality in excess of...2007) reported that basketball players attempted fewer shots and were less able to make shots linked with movement (e.g. lay-up) when dehydration had

The Tanzanian trauma patients' prehospital experience: a qualitative interview-based study

PubMed Central

Kuzma, Kristin; Lim, Andrew George; Kepha, Bernard; Nalitolela, Neema Evelyne; Reynolds, Teri A

2015-01-01

Objectives We sought to characterise the prehospital experience of Tanzanian trauma patients, and identify barriers and facilitators to implement community-based emergency medical systems (EMS). Settings Our study was conducted in the emergency department of an urban national referral hospital in Tanzania. Participants A convenience sample of 34 adult trauma patients, or surrogate family members, presenting or referred to an urban referral emergency department in Tanzania for treatment of injury, participated in the study. Interventions Participation in semistructured, iteratively developed interviews until saturation of responses was reached. Outcomes A grounded theory-based approach to qualitative analysis was used to identify recurrent themes. Results We characterised numerous deficiencies within the existing clinic-to-hospital referral network, including missed/delayed diagnoses, limited management capabilities at pre-referral facilities and interfacility transfer delays. Potential barriers to EMS implementation include patient financial limitations and lack of insurance, limited public infrastructure and resources, and the credibility of potential first aid responders. Potential facilitators of EMS include communities’ tendency to pool resources, individuals’ trust of other community members to be first aid responders, and faith in community leaders to organise EMS response. Participants expressed a strong desire to learn first aid. Conclusions The composite themes generated by the data suggest that there are myriad structural, financial, institutional and cultural barriers to the implementation of a formal prehospital system. However, our analysis also revealed potential facilitators to a first-responder system that takes advantage of close-knit local communities and the trust of recognised leaders in society. The results suggest favourable acceptability for community-based response by trained lay people. There is significant opportunity for care improvements with short trainings and low-cost supply planning. Further research looking at the effects of delay on outcomes in this population is needed. PMID:25916487

'Don't blame the middle man': an exploratory qualitative study to explore the experiences of translators breaking bad news.

PubMed

Prentice, Joanna; Nelson, Annmarie; Baillie, Jessica; Osborn, Hannah; Noble, Simon

2014-07-01

Healthcare professionals find breaking bad news difficult and upsetting. Increasing cultural diversity has led to a greater number of patients whose first language differs to that of the healthcare provider, with more patients requiring a translator to facilitate communication. Hospitals often ask non-clinical translators to facilitate breaking bad news. We sought to explore the experiences of translators within a specialist oncology centre. Following ethical and governance approvals, semi-structured interviews were undertaken with five translators recruited from the specialist oncology centre. Interviews were audiotaped and transcribed verbatim. The data were analysed thematically, with major themes and subthemes identified. Outpatient setting of a regional cancer centre. Translators serving a regional cancer centre. Qualitative data identified through thematic analysis. Major themes included the significant emotional impact of translating distressing information, the challenges of accurately conveying information in a culturally congruent format and the need for formal briefing, debriefing and support. Subthemes included feeling guilty for divulging distressing news, being the focus of patients' distress or anger, and feeling in conflict with the patient or family and issues surrounding confidentiality. Translators also felt a strong sense of advocacy for the patients and found encounters with death and dying emotionally challenging. The increasing use of translators in the care of patients with advanced cancer is increasingly resulting in lay people being subject to similar emotional pressures faced by clinical staff, yet without the necessary formal training or support mechanisms that are recommended for clinicians. This exploratory study highlights the training and support needs of non-clinical staff as identifying a unique set of communication challenges faced by translators. © The Royal Society of Medicine.

Evaluation of a training manual for the acquisition of behavioral assessment interviewing skills.

PubMed Central

Miltenberger, R G; Fuqua, R W

1985-01-01

Two procedures were used to teach behavioral assessment interviewing skills: a training manual and one-to-one instruction that included modeling, rehearsal, and feedback. Two graduate students and two advanced undergraduates were trained with each procedure. Interviewing skills were recorded in simulated assessment interviews conducted by each student across baseline and treatment conditions. Each training procedure was evaluated in a multiple baseline across students design. The results showed that both procedures were effective for training behavioral interviewing skills, with all students reaching a level of 90%-100% correct responding. Finally, a group of experts in behavior analysis rated each interviewing skill as relevant to the conduct of an assessment interview and a group of behavioral clinicians socially validated the outcomes of the two procedures. PMID:4086413

Empowering Lay-Counsellors with Technology: Masivukeni, a Standardized Multimedia Counselling Support Tool to Deliver ART Counselling.

PubMed

Gouse, H; Robbins, R N; Mellins, C A; Kingon, A; Rowe, J; Henry, M; Remien, R H; Pearson, A; Victor, F; Joska, J A

2018-05-19

Lay-counsellors in resource-limited settings convey critical HIV- and ART-information, and face challenges including limited training and variable application of counselling. This study explored lay-counsellors and Department of Health (DoH) perspectives on the utility of a multimedia adherence counselling program. Masivukeni, an mHealth application that provides scaffolding for delivering standardized ART counselling was used in a 3-year randomized control trail at two primary health care clinics in Cape Town, South Africa. In this programmatic and descriptive narrative report, we describe the application; lay-counsellors' response to open-ended questions regarding their experience with using Masivukeni; and perspectives of the City of Cape Town and Western Cape Government DoH, obtained through ongoing engagements and feedback sessions. Counsellors reported Masivukeni empowered them to provide high quality counselling. DoH indicated strong support for a future implementation study assessing feasibility for larger scale roll-out. Masivukeni has potential as a counselling tool in resource-limited settings.

Training in motivational interviewing in obstetrics: a quantitative analytical tool.

PubMed

Lindhardt, Christina L; Rubak, Sune; Mogensen, Ole; Hansen, Helle P; Lamont, Ronald F; Jørgensen, Jan S

2014-07-01

To examine whether a 3-day training course in motivational interviewing, which is an approach to helping people to change, could improve the communication skills of obstetric healthcare professionals in their interaction with obese pregnant women. Intervention study. The Region of Southern Denmark. Eleven obstetric healthcare professionals working with obese pregnant women underwent a 3-day course in motivational interviewing techniques and were assessed before and after training to measure the impact on their overall performance as well as the effect on specific behavioral techniques observed during interviews. With a few exceptions, the participants changed their behavior appropriate to the motivational interviewing technique. The participants made more interventions towards the principles of motivational interviewing (adherent and nonadherent interventions). Furthermore, the participants asked fewer closed and more open questions before training in motivational interview. In the assessment of proficiency and competency, most of the participants scored higher after the training in motivational interviewing. Training in motivational interviewing improves healthcare professionals' proficiency and competency when communicating with obese pregnant women, albeit that the effect was not universal. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Reactions of staff members and lay people to family presence during resuscitation: the effect of visible bleeding, resuscitation outcome and gender.

PubMed

Itzhaki, Michal; Bar-Tal, Yoram; Barnoy, Sivia

2012-09-01

This article is a report on a study conducted to examine the views of healthcare professionals and lay people regarding the effect of family presence during resuscitation on both the staff performing the resuscitation and the relatives who witness it. Family presence during resuscitation is controversial. Although many professional groups in different countries have recently issued position statements about the practice and have recommended new policy moves, the Israel Ministry of Health has not issued guidelines on the matter. Study design is factorial within-between subjects. Data were collected in Israel in 2008 from a convenience sample of 220 lay people and 201 healthcare staff (52 physicians and 149 nurses) using a questionnaire based on eight different resuscitation scenarios and manipulating blood involvement and resuscitations outcome. Data were analysed using one-way analysis of variance. Overall, both staff and lay people perceived family presence during resuscitation negatively. Visible bleeding and an unsuccessful outcome significantly influenced both staff's and lay people's perceptions. Female physicians and nurses reacted more negatively to family presence than did male physicians and nurses; lay men responded more negatively than lay women. Changing the current negative perceptions of family presence at resuscitation requires (a) establishing a new national policy, (b) educating healthcare staff to the benefits of the presence of close relatives and (c) training staff to support relatives who want to be present. © 2011 Blackwell Publishing Ltd.

Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

PubMed

Haider, Sandra; Grabovac, Igor; Winzer, Eva; Kapan, Ali; Schindler, Karin Emmi; Lackinger, Christian; Titze, Sylvia; Dorner, Thomas Ernst

2017-01-01

The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35) conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23) received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2) to 3.0 pg/l (min-max = 2.0-20.8), and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9) to 0.3 mg/dl (min-max = 0.1-3.0) after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45) were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest.

PubMed

Ringh, Mattias; Rosenqvist, Mårten; Hollenberg, Jacob; Jonsson, Martin; Fredman, David; Nordberg, Per; Järnbert-Pettersson, Hans; Hasselqvist-Ax, Ingela; Riva, Gabriel; Svensson, Leif

2015-06-11

Cardiopulmonary resuscitation (CPR) performed by bystanders is associated with increased survival rates among persons with out-of-hospital cardiac arrest. We investigated whether rates of bystander-initiated CPR could be increased with the use of a mobile-phone positioning system that could instantly locate mobile-phone users and dispatch lay volunteers who were trained in CPR to a patient nearby with out-of-hospital cardiac arrest. We conducted a blinded, randomized, controlled trial in Stockholm from April 2012 through December 2013. A mobile-phone positioning system that was activated when ambulance, fire, and police services were dispatched was used to locate trained volunteers who were within 500 m of patients with out-of-hospital cardiac arrest; volunteers were then dispatched to the patients (the intervention group) or not dispatched to them (the control group). The primary outcome was bystander-initiated CPR before the arrival of ambulance, fire, and police services. A total of 5989 lay volunteers who were trained in CPR were recruited initially, and overall 9828 were recruited during the study. The mobile-phone positioning system was activated in 667 out-of-hospital cardiac arrests: 46% (306 patients) in the intervention group and 54% (361 patients) in the control group. The rate of bystander-initiated CPR was 62% (188 of 305 patients) in the intervention group and 48% (172 of 360 patients) in the control group (absolute difference for intervention vs. control, 14 percentage points; 95% confidence interval, 6 to 21; P<0.001). A mobile-phone positioning system to dispatch lay volunteers who were trained in CPR was associated with significantly increased rates of bystander-initiated CPR among persons with out-of-hospital cardiac arrest. (Funded by the Swedish Heart-Lung Foundation and Stockholm County; ClinicalTrials.gov number, NCT01789554.).

Training of lay health educators to implement an evidence-based behavioral weight loss intervention in rural senior centers.

PubMed

Krukowski, Rebecca A; Lensing, Shelly; Love, Sharhonda; Prewitt, T Elaine; Adams, Becky; Cornell, Carol E; Felix, Holly C; West, Delia

2013-02-01

Lay health educators (LHEs) offer great promise for facilitating the translation of evidence-based health promotion programs to underserved areas; yet, there is little guidance on how to train LHEs to implement these programs, particularly in the crucial area of empirically validated obesity interventions. This article describes experiences in recruiting, training, and retaining 20 LHEs who delivered a 12-month evidence-based behavioral lifestyle intervention (based on the Diabetes Prevention Program) in senior centers across a rural state. A mixed method approach was used which incorporated collecting the folllowing: quantitative data on sociodemographic characteristics of LHEs; process data related to training, recruitment, intervention implementation, and retention of LHEs; and a quantitative program evaluation questionnaire, which was supplemented by a qualitative program evaluation questionnaire. Descriptive statistics were calculated for quantitative data, and qualitative data were analyzed using content analysis. The training program was well received, and the LHEs effectively recruited participants and implemented the lifestyle intervention in senior centers following a structured protocol. The methods used in this study produced excellent long-term retention of LHEs and good adherence to intervention protocol, and as such may provide a model that could be effective for others seeking to implement LHE-delivered health promotion programs.

Amigas Latinas Motivando el ALMA (ALMA): Development and Pilot Implementation of a Stress Reduction Promotora Intervention

PubMed Central

Green, Melissa A.; Perez, Georgina; Ornelas, India J.; Tran, Anh N.; Blumenthal, Connie; Lyn, Michelle; Corbie-Smith, Giselle

2014-01-01

Use of mental health care services for psychological distress is limited among Latino immigrants. In geographic areas where migration has been rapid, mental health systems possess limited capacity to provide bilingual and bicultural assistance. The development of a bilingual and bicultural workforce is a necessary yet long-term solution. More immediate strategies, however, are needed to meet the needs of immigrant Latinos. This paper describes the development of a stress-reduction focused, lay health advisor training that targets individual behavior change among Latina immigrants. The theoretical foundation, curriculum components, and pilot implementation of the training are discussed. As natural leaders, Latina promotoras disseminated learned strategies and resources within their communities. The lay health advisor model is a salient method for disseminating information regarding mental health and stress reduction among Latinas. PMID:25364312

Partners in projects: preparing for public involvement in health and social care research.

PubMed

Parkes, Jacqueline H; Pyer, Michelle; Wray, Paula; Taylor, Jane

2014-09-01

In recent years, several UK and, international funders of health and social care related research have adopted the policy of requiring explicit evidence of the 'public' voice in all aspects of project design. For many academic researchers engaged within research, evaluations or audit projects, this formal requirement to actively engage members of the public will present them with both benefits and challenges to securing knowledgeable, skilled, and confident lay representation onto project teams. This could potentially lead to the exploitation of those individuals who are available, appropriately informed, and adequately prepared for such activities. Currently, much of the preparation of patients or members of the public for research involvement tends to be aligned to specific projects; however, with the call for greater active and meaningful involvement of lay representatives in future national and international funding applications, there is clearly a growing need to 'train' sufficient numbers of confident and competent representatives to meet this growing demand. This paper describes the development of a specifically designed research awareness training programme and underpinning theoretical model, which has been specifically designed to support active and meaningful lay involvement in research, evaluations and audit projects. Developed over a four year period, the course is a culmination of learning extracted from a series of four completed research projects, which have incorporated an element of public and patient involvement (PPI) training in their overall design. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

District nurses' and registered nurses' training in and use of motivational interviewing in primary care settings.

PubMed

Östlund, Ann-Sofi; Wadensten, Barbro; Häggström, Elisabeth; Kristofferzon, Marja-Leena

2014-08-01

To examine to what extent district nurses and registered nurses have training in motivational interviewing, to what extent they use it and what prerequisites they have for using it; to compare district nurses and registered nurses, as well as to compare users and nonusers of motivational interviewing; and to examine possible relationships between use of motivational interviewing and the variables training, supervision and feedback in motivational interviewing and prerequisites for use. Motivational interviewing is an effective method for motivating patients to change their lifestyle, used increasingly in primary care. A cross-sectional survey study. A study-specific questionnaire was sent to all district nurses and registered nurses (n = 980) in primary care in three counties in Sweden, from September 2011-January 2012; 673 (69%) responded. Differences between groups as well as relationships between study variables were tested. According to self-reports, 59% of the respondents had training in motivational interviewing and 57% used it. Approximately 15% of those who reported using it had no specific training in the method. More district nurses than registered nurses had training in motivational interviewing and used it. The following factors were independently associated with the use of motivational interviewing: training in and knowledge of motivational interviewing, conditions for using it, time and absence of 'other' obstacles. Having knowledge in motivational interviewing and personal as well as workplace prerequisites for using it may promote increased use of motivational interviewing. Having the prerequisites for using motivational interviewing at the workplace is of significance to the use of motivational interviewing. In the context of primary care, district nurses seem to have better prerequisites than registered nurses for using motivational interviewing. © 2013 John Wiley & Sons Ltd.

Perceptions of health stakeholders on task shifting and motivation of community health workers in different socio demographic contexts in Kenya (nomadic, peri-urban and rural agrarian).

PubMed

Ochieng, Beverly; Akunja, Edith; Edwards, Nancy; Mombo, Diana; Marende, Leah; Kaseje, Dan C O

2014-01-01

The shortage of health professionals in low income countries is recognized as a crisis. Community health workers are part of a "task-shift" strategy to address this crisis. Task shifting in this paper refers to the delegation of tasks from health professionals to lay, trained volunteers. In Kenya, there is a debate as to whether these volunteers should be compensated, and what motivation strategies would be effective in different socio-demographic contexts, based type of tasks shifted. The purpose of this study was to find out, from stakeholders' perspectives, the type of tasks to be shifted to community health workers and the appropriate strategies to motivate and retain them. This was an analytical comparative study employing qualitative methods: key informant interviews with health policy makers, managers, and service providers, and focus group discussions with community health workers and service consumers, to explore their perspectives on tasks to be shifted and appropriate motivation strategies. The study found that there were tasks to be shifted and motivation strategies that were common to all three contexts. Common tasks were promotive, preventive, and simple curative services. Common motivation strategies were supportive supervision, means of identification, equitable allocation of resources, training, compensation, recognition, and evidence based community dialogue. The study concluded that inclusion of curative tasks for community health workers, particularly in nomadic contexts, is inevitable but raises the need for accreditation of their training and regulation of their tasks.

Heavy Duty and Industrial Alternative Fuel Applications. Forklift and Material Handling. Alternative Fuels Training.

ERIC Educational Resources Information Center

Eckert, Doug; Casto, Lori

This training manual is designed to lay the foundation for trainers and technicians by showing the steps to achieve and maintain good indoor air quality through use of cleaner-burning forklifts and materials handlers. The first part of the manual consists of nine units that provide informational material and diagrams on these topics: comparison of…

The Community College and the Homeless: A Model for the Nation. Job Training for the Homeless Demonstration Program Final Evaluation Report.

ERIC Educational Resources Information Center

Moehrlin, Cynthia D.

Established in 1981, the Alternatives Program at Elgin Community College (ECC) has provided services for displaced homemakers, single parents, welfare recipients, and homeless women, laying the groundwork for the 1988 formation of the Fox Valley Consortium for Job Training and Placement of the Homeless. Using federal funding, the Consortium offers…

Recruiting and training labor for woods work

Treesearch

Fred C. Simmons

1949-01-01

This is the second in a series of papers about the supervisory part of the logging job. It deals with recruiting and training men for logging; it stresses the need for safety. The previous paper in the series (Station Paper 18) dealt with choosing methods and equipment; other papers planned will be about job lay-out, purchase of timber, and marketing timber products....

Explanatory models of diabetes in the U.S. and Mexico: the patient-provider gap and cultural competence.

PubMed

Weller, Susan C; Baer, Roberta D; Garcia de Alba Garcia, Javier; Salcedo Rocha, Ana L

2012-09-01

Successful management of type 2 diabetes requires support and collaboration between diabetic patients, their health care providers, family and community. Using data collected in 1994-2001, we describe illness beliefs of physicians, patients, and representative samples of community members in the US and Mexico. We test whether differences in conceptualizations of diabetes are greater across national and linguistic boundaries or between physicians and lay groups. Interviews were conducted in southern Texas on the Mexican border and in Guadalajara, Mexico. Culturally appropriate interview materials were developed with a mixed-methods approach. Qualitative interviews elicited beliefs about causes, risks, symptoms, and treatments for diabetes and salient themes were incorporated into structured interviews. A cultural consensus analysis was used to verify salient themes within each of the six samples. The consistency in responses in each of the six samples indicated a shared core of beliefs that transcended individual variations. The greatest differences occurred between physician and lay samples; patient and community models were more similar to one another than to the physician models. Differences between physicians and patients may affect optimal management of diabetes, but these differences do not appear to be simply a function of differences in national culture and language, as the largest differences occurred in Mexico. This suggests that rather than cultural competence per se, formal educational levels and class differences may also play an important role in patient understanding and the gap in patient-provider understanding. Copyright © 2012 Elsevier Ltd. All rights reserved.

An Innovative Method to Involve Community Health Workers as Partners in Evaluation Research

PubMed Central

Issel, L. Michele; Townsell, Stephanie J.; Chapple-McGruder, Theresa; Handler, Arden

2011-01-01

Objectives. We developed a process through which community outreach workers, whose role is not typically that of a trained researcher, could actively participate in collection of qualitative evaluation data. Methods. Outreach workers for a community-based intervention project received training in qualitative research methodology and certification in research ethics. They used a Voice over Internet Protocol phone-in system to provide narrative reports about challenges faced by women they encountered in their outreach activities as well as their own experiences as outreach workers. Results. Qualitative data contributed by outreach workers provided insights not otherwise available to the evaluation team, including details about the complex lives of underserved women at risk for poor pregnancy outcomes and the challenges and rewards of the outreach worker role. Conclusions. Lay health workers can be a valuable asset as part of a research team. Training in research ethics and methods can be tailored to their educational level and preferences, and their insights provide important information and perspectives that may not be accessible via other data collection methods. Challenges encountered in the dual roles of researcher and lay health worker can be addressed in training. PMID:22021290

Origins of suicidality: compatibility of lay and expert beliefs - qualitative study.

PubMed

Zadravec, Tina; Grad, Onja

2013-06-01

Today there exist different views on origins of suicidal behaviour, which can influence the help-seeking behaviour and the adherence to the treatment of suicidal people. The beliefs lay people and patients have about the origins of suicidal behaviour as well as the compatibility of their beliefs with the views of the mental health personnel (general practitioners and psychiatrists) were assessed. 45 semi-structured interviews with the general population, suicide attempters, general practitioners and psychiatrists were conducted, audio typed, transcribed and a thematic analysis of the data was carried out. The results indicated the incompatibility of the views. The general population and the suicide attempters favoured psychological explanations of suicidal behaviour, whereas the general practitioners and psychiatrists promoted medical explanations. The only common theme was perception of the suicidal crisis as a crucial factor in suicidality. Lay people and experts believe that suicidal crisis is the main origin of suicidal behaviour. The awareness of this common denominator and also of the differences in opinions between lay people and experts should be kept in mind when planning and implementing prevention and treatment programmes if we wish to promote help-seeking behaviour and attain good adherence to treatment.

Consumerism, reflexivity and the medical encounter.

PubMed

Lupton, D

1997-08-01

Much emphasis has been placed recently in sociological, policy and popular discourses on changes in lay people's attitudes towards the medical profession that have been labelled by some as a move towards the embracing of "consumerism". Notions of consumerism tend to assume that lay people act as "rational" actors in the context of the medical encounter. They align with broader sociological concepts of the "reflexive self" as a product of late modernity; that is, the self who acts in a calculated manner to engage in self-improvement and who is sceptical about expert knowledges. To explore the ways that people think and feel about medicine and the medical profession, this article draws on findings from a study involving in-depth interviews with 60 lay people from a wide range of backgrounds living in Sydney. These data suggest that, in their interactions with doctors and other health care workers, lay people may pursue both the ideal-type "consumerist" and the "passive patient" subject position simultaneously or variously, depending on the context. The article concludes that late modernist notions of reflexivity as applied to issues of consumerism fail to recognize the complexity and changeable nature of the desires, emotions and needs that characterize the patient-doctor relationship.

Pastor and Lay Leader Perceptions of Barriers and Supports to HIV Ministry Maintenance in an African American Church

PubMed Central

2013-01-01

Abstract Clergy and lay leaders have a pivotal role in the development and maintenance of HIV Ministries within the African American church. However, little is known about the actual roles these men and women have, the barriers they face and the supports they have found in the development and maintenance of an HIV Ministry. The purpose of this study is to examine the role, barriers and supports clergy and lay leaders experienced in the development of a long-standing HIV ministry in an African American church. These data were gathered from a larger ethnographic study, which examined the role of religious culture in the development, implementation and maintenance of an HIV ministry. Data for this study were collected through in-depth semi-structured interviews. Results revealed that the primary role of clergy and lay leaders involved dispelling myths surrounding HIV and ensuring congregational support. The primary barrier to the development and maintenance was views regarding sexuality. The primary support was their relationships with congregants that lived with HIV and AIDS. This information can assist in developing interventions to enhance the African American church movement toward HIV ministries. PMID:22870846

Pastor and lay leader perceptions of barriers and supports to HIV ministry maintenance in an African American church.

PubMed

Stewart, Jennifer M

2014-04-01

Clergy and lay leaders have a pivotal role in the development and maintenance of HIV Ministries within the African American church. However, little is known about the actual roles these men and women have, the barriers they face and the supports they have found in the development and maintenance of an HIV Ministry. The purpose of this study is to examine the role, barriers and supports clergy and lay leaders experienced in the development of a long-standing HIV ministry in an African American church. These data were gathered from a larger ethnographic study, which examined the role of religious culture in the development, implementation and maintenance of an HIV ministry. Data for this study were collected through in-depth semi-structured interviews. Results revealed that the primary role of clergy and lay leaders involved dispelling myths surrounding HIV and ensuring congregational support. The primary barrier to the development and maintenance was views regarding sexuality. The primary support was their relationships with congregants that lived with HIV and AIDS. This information can assist in developing interventions to enhance the African American church movement toward HIV ministries.

Effects of a training in the Disability Assessment Structured Interview on the interviews of Dutch insurance physicians.

PubMed

Spanjer, Jerry; van de Mei, Sijrike; Cornelius, Bert; Brouwer, Sandra; van der Klink, Jac

2016-08-01

The Disability Assessment Structured Interview (DASI) is a semi-structured interview for assessing functional limitations of claimants in a work disability evaluation. The aim of this study is to evaluate the effect of a 3-day DASI training course on the quality of assessment interviews of insurance physicians (IPs). In a pretest-posttest study, 55 IPs employed at the Dutch National Institute for Employee Benefits Schemes completed a 3-day DASI training. Before (T0), directly after the training (T1) and after 3 months follow-up (T2), these IPs filled out questionnaires that measured knowledge, skills, attitude and self-efficacy. Furthermore, in 10 disability assessment cases interview duration, IP's satisfaction, amount of acquired information and confidence of judgement were measured. Finally, the amount of information reported was measured in three randomly selected disability assessment reports of each IP. IP's knowledge, skills and self-efficacy improved significantly after the training. The attitude of the IPs changed towards a more open attitude and structuring of the interview. Satisfaction about the interview, amount of acquired information and confidence of their judgement all increased. The DASI training improved the quality of assessment interviews of IPs. A semi-structured interview, like the DASI, can help physicians to pay more attention to activity limitations and participation in addition to medical information. Implications for Rehabilitation Experienced IPs are able to change their disability assessment interview routine after training. In determining work ability, IPs should pay more attention to claimant's activity limitations and participation in addition to medical information. A semi-structured interview as the DASI can help IPs to pay more attention to claimant's functioning. A 3-day DASI training for IPs can increase their confidence in their judgement and provides significantly more information in their assessment reports.

Task Shifting: The Use of Laypersons for Acquisition of Vital Signs Data for Clinical Decision Making in the Emergency Room Following Traumatic Injury.

PubMed

Haac, Bryce E; Gallaher, Jared R; Mabedi, Charles; Geyer, Andrew J; Charles, Anthony G

2017-12-01

In resource-limited settings, identification of successful and sustainable task-shifting interventions is important for improving care. To determine whether the training of lay people to take vital signs as trauma clerks is an effective and sustainable method to increase availability of vital signs in the initial evaluation of trauma patients. We conducted a quasi-experimental study of patients presenting with traumatic injury pre- and post-intervention. The study was conducted at Kamuzu Central Hospital, a tertiary care referral hospital, in Lilongwe, Malawi. All adult (age ≥ 18 years) trauma patients presenting to emergency department over a six-month period from January to June prior to intervention (2011), immediately post-intervention (2012), 1 year post-intervention (2013) and 2 years post-intervention (2014). Lay people were trained to take and record vital signs. The number of patients with recorded vital signs pre- and post-intervention and sustainability of the intervention as determined by time-series analysis. Availability of vital signs on initial evaluation of trauma patients increased significantly post-intervention. The percentage of patients with at least one vital sign recorded increased from 23.5 to 92.1%, and the percentage of patients with all vital signs recorded increased from 4.1 to 91.4%. Availability of Glasgow Coma Scale also increased from 40.3 to 88.6%. Increased documentation of vital signs continued at 1 year and 2 years post-intervention. However, the percentage of documented vital signs did decrease slightly after the US-trained medical student and surgeon who trained the trauma clerks were no longer available in country, except for Glasgow Coma Scale. Patients who died during emergency department evaluation were significantly less likely to have vital signs recorded. The training of lay people to collect vital signs and Glasgow Coma Scale is an effective and sustainable method of task shifting in a resource-limited setting.

Botlhoko, botlhoko! How people talk about their musculoskeletal complaints in rural Botswana: a focused ethnography

PubMed Central

Hondras, Maria; Myburgh, Corrie; Hartvigsen, Jan; Johannessen, Helle

2015-01-01

Background Conflicting interpretations about the structure and function of the body contribute to discordance in communication between healthcare professionals and lay people. Understanding musculoskeletal (MSK) complaints presents additional complexities when discussed in more than one language or in cross-cultural settings. In low- and middle-income countries (LMICs), few healthcare professionals have specialist MSK training and not all practitioners speak the primary language of patients. Objective Our goal was to understand how people in rural Botswana perceive and express MSK complaints. Design Ethnographic fieldwork for 8 months in the Botswana Central District included participant observations and interviews with 34 community members with MSK complaints. Audio-recorded interviews were typically conducted in Setswana with an interpreter, transcribed verbatim, and contextually translated into English. Abductive qualitative analysis was used as the interpretive methodology. Results Whereas initial responses about MSK troubles yielded the exclamation botlhoko, botlhoko! combined with animated non-verbal gestures and facial expressions indicating widespread body pains, in-depth interviews revealed the complexities of pain expression among respondents. MSK pains were described as ‘bursting, exploding, aching, numbness, hot, pricking, stabbing, swollen, and pain in the heart’. Language subtleties manifested during interviews, where ‘meat’ or ‘flesh’ implied soft tissue pains; waist pains were voiced yet portrayed as low back or sacroiliac pain; and ‘veins’ variously referred to structural and functional types of pain. Psychological and social stressors accompanied many accounts of MSK troubles. Conclusions Respondents offered diverse MSK symptom descriptions consistent with biopsychosocial illness models, yet few communicated complaints using the biomedical language of healthcare providers. Although research interview and transcription processes may not be practical for clinicians, working with interpreters who communicate detailed patient accounts for MSK troubles will complement patient–provider encounters. Community member perceptions of their MSK pain and associated conditions should be explored and incorporated into healthcare interventions and innovations for rural communities in LMICs. PMID:26689457

Botlhoko, botlhoko! How people talk about their musculoskeletal complaints in rural Botswana: a focused ethnography.

PubMed

Hondras, Maria; Myburgh, Corrie; Hartvigsen, Jan; Johannessen, Helle

2015-01-01

Conflicting interpretations about the structure and function of the body contribute to discordance in communication between healthcare professionals and lay people. Understanding musculoskeletal (MSK) complaints presents additional complexities when discussed in more than one language or in cross-cultural settings. In low- and middle-income countries (LMICs), few healthcare professionals have specialist MSK training and not all practitioners speak the primary language of patients. Our goal was to understand how people in rural Botswana perceive and express MSK complaints. Ethnographic fieldwork for 8 months in the Botswana Central District included participant observations and interviews with 34 community members with MSK complaints. Audio-recorded interviews were typically conducted in Setswana with an interpreter, transcribed verbatim, and contextually translated into English. Abductive qualitative analysis was used as the interpretive methodology. Whereas initial responses about MSK troubles yielded the exclamation botlhoko, botlhoko! combined with animated non-verbal gestures and facial expressions indicating widespread body pains, in-depth interviews revealed the complexities of pain expression among respondents. MSK pains were described as 'bursting, exploding, aching, numbness, hot, pricking, stabbing, swollen, and pain in the heart'. Language subtleties manifested during interviews, where 'meat' or 'flesh' implied soft tissue pains; waist pains were voiced yet portrayed as low back or sacroiliac pain; and 'veins' variously referred to structural and functional types of pain. Psychological and social stressors accompanied many accounts of MSK troubles. Respondents offered diverse MSK symptom descriptions consistent with biopsychosocial illness models, yet few communicated complaints using the biomedical language of healthcare providers. Although research interview and transcription processes may not be practical for clinicians, working with interpreters who communicate detailed patient accounts for MSK troubles will complement patient-provider encounters. Community member perceptions of their MSK pain and associated conditions should be explored and incorporated into healthcare interventions and innovations for rural communities in LMICs.

Help-seeking for psychiatric disorders.

PubMed

Bland, R C; Newman, S C; Orn, H

1997-11-01

To examine demographic and clinical determinants of seeking help for mental or emotional problems. To determine the proportion of those people with a disorder who sought help. To determine what categories of professionals are sought by those who get care. A 2-stage random sample of 3956 adult residents of Edmonton, Alberta, Canada was interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS) (73% completion rate). An average of 2.8 years later, a systematic random sample of 1964 subjects was reinterviewed (an 86% completion rate) using the DIS and a health care utilization questionnaire. After adjusting for age and sex, the reinterview sample was representative of those with and without a diagnosis at the first interview. Of the 1964 subjects, 570 (31%) met criteria for a DIS/DSM-III diagnosis in the year preceding the interview (one-year prevalence rate). These diagnoses included generalized anxiety disorder (GAD) and posttraumatic stress disorder (PTSD). For those with a diagnosis, sex, age, marital status, education, employment, and income were examined as determinants of help-seeking. Only sex (female) and age (under 45) were significant predictors. Comorbidity was highly significant: the help-seeking rate for those with one diagnosis was 20.3%; for those with more than one diagnosis, the rate was 42.8% (OR = 2.94, chi 2 = 31.4, df = 1, P < 0.001). Just over 28% of those with a diagnosis saw any health care professional, and 7.7% of those without a diagnosis sought help for a mental or emotional problem. A specific diagnosis made a difference: 46.7% of those with a major depressive episode sought help, but only 16.0% of those with alcohol abuse or dependence sought care. Major determinants of help-seeking are sex (female), age (under 45), severity of the illness, and comorbidity. A surprisingly high proportion of those with a disorder (72%) do not seek help, and over one-third of those seeking help do not have a current DIS/DSM-III disorder.

Correlates of Cruelty to Animals in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Vaughn, Michael G.; Fu, Qiang; DeLisi, Matt; Beaver, Kevin M.; Perron, Brian E.; Terrell, Katie; Howard, Matthew O.

2009-01-01

Objective To examine the sociodeomographic, behavioral, and psychiatric correlates of cruelty to animals in the U.S. Materials and Methods Data were derived from a nationally representative sample of adults residing in the U.S. Structured psychiatric interviews (N = 43,093) were completed by trained lay interviewers between 2001 and 2002. Personality, substance use, mood, and anxiety disorders and cruelty to animals were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (DSM-IV) version. Results The lifetime prevalence of animal cruelty in U.S. adults was 1.8%. Men, African-Americans, Native-Americans/Asians, native-born Americans, persons with lower levels of income and education and adults living the western region of the U.S. reported comparatively high levels of cruelty to animals, whereas Hispanics reported comparatively low levels of such behavior. Cruelty to animals was significantly associated with all assessed antisocial behaviors. Adjusted analyses revealed strong associations between lifetime alcohol use disorders, conduct disorder, antisocial, obsessive-compulsive, and histrionic personality disorders, pathological gambling, family history of antisocial behavior, and cruelty to animals. Conclusions Cruelty to animals is associated with elevated rates observed in young, poor, men with family histories of antisocial behavior and personal histories of conduct disorder in childhood, and antisocial, obsessive-compulsive and histrionic personality disorders, and pathological gambling in adulthood. Given these associations, and the widespread ownership of pets and animals, effective screening of children, adolescents and adults for animal cruelty and appropriate mental health interventions should be deployed. PMID:19467669

How lay people understand and make sense of personalized disease risk information.

PubMed

Damman, Olga C; Bogaerts, Nina M M; van den Haak, Maaike J; Timmermans, Danielle R M

2017-10-01

Disease risk calculators are increasingly web-based, but previous studies have shown that risk information often poses problems for lay users. To examine how lay people understand the result derived from an online cardiometabolic risk calculator. A qualitative study was performed, using the risk calculator in the Dutch National Prevention Program for cardiometabolic diseases. The study consisted of three parts: (i) attention: completion of the risk calculator while an eye tracker registered eye movements; (ii) recall: completion of a recall task; and (iii) interpretation: participation in a semi-structured interview. We recruited people from the target population through an advertisement in a local newspaper; 16 people participated in the study, which took place in our university laboratory. Eye-tracking data showed that participants looked most extensively at numerical risk information. Percentages were recalled well, whereas natural frequencies and verbal labels were remembered less well. Five qualitative themes were derived from the interview data: (i) numerical information does not really sink in; (ii) the verbal categorical label made no real impact on people; (iii) people relied heavily on existing knowledge and beliefs; (iv) people zoomed in on risk factors, especially family history of diseases; and (v) people often compared their situation to that of their peers. Although people paid attention to and recalled the risk information to a certain extent, they seemed to have difficulty in properly using this information for interpreting their risk. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Computer-Based Script Training for Aphasia: Emerging Themes from Post-Treatment Interviews

ERIC Educational Resources Information Center

Cherney, Leora R.; Halper, Anita S.; Kaye, Rosalind C.

2011-01-01

This study presents results of post-treatment interviews following computer-based script training for persons with chronic aphasia. Each of the 23 participants received 9 weeks of AphasiaScripts training. Post-treatment interviews were conducted with the person with aphasia and/or a significant other person. The 23 interviews yielded 584 coded…

Improving the interview skills of college students using behavioral skills training.

PubMed

Stocco, Corey S; Thompson, Rachel H; Hart, John M; Soriano, Heidi L

2017-07-01

Obtaining a job as a college graduate is partly dependent on interview performance. We used a multiple baseline design across skills to evaluate the effects of behavioral skills training with self-evaluation for five college students. Training effects were evaluated using simulated interviews as baseline and posttraining assessments. All participants acquired targeted skills, but we observed some individual differences. Participants were satisfied with training outcomes and rated the procedures as acceptable. Furthermore, ratings from university staff who provide interview training indicated that training improved performance across several skills for the majority of participants. © 2017 Society for the Experimental Analysis of Behavior.

Fostering Department Chair Instructional Leadership Capacity: Laying the Groundwork for Distributed Instructional Leadership

ERIC Educational Resources Information Center

Klar, Hans W.

2012-01-01

In this article, I provide findings from a multisite case study of three urban high schools. In each of the schools, principals endeavoured to foster the capabilities of their department chairs to enhance school-wide instructional capacity and increase student achievement. Data were gathered from interviews, participant observations and document…

Teacher and Lay Participation in Local Curriculum Change Considerations.

ERIC Educational Resources Information Center

Schaffarzick, Jon

This study examines the roles of teachers and citizens in decision-making related to curriculum planning and change. Interviews were conducted with persons involved in curriculum decision-making in 34 school districts in order to ascertain how they determined whether or not to make elementary-level curriculum changes. The rational and political…

Laying a Foundation for Artmaking in the 21st Century: A Description and Some Dilemmas

ERIC Educational Resources Information Center

Salazar, Stacey McKenna

2013-01-01

This article describes a study of teaching and learning in the first--or "foundation"--year of art college. As a multiple embedded case study informed by systems theory, the following cases are described: art colleges, foundation programs, professors, and students. The data were collected through surveys, interviews, classroom…

A "second generation" of ministry leadership.

PubMed

Giammalvo, Peter J

2005-01-01

Catholic health care leaders differ from others in the field in that "they are expected to serve as Jesus served, teach as Jesus taught, and lead as Jesus led, in order to heal as Jesus healed." The Catholic health ministry today is led largely by laypeople-what might be called the "first generation" of lay leaders. This first generation was privileged in that it was tutored by and worked alongside women and men religious. Those religious are now mostly gone from the ministry, and that first generation of lay leaders will also be retiring in the not too distant future. Leadership will then pass to a "second generation," laypeople who have not worked alongside religious. How is this new generation to learn "to heal as Jesus healed"? Catholic Health East (CHE), Newtown Square, PA, has developed a program explicitly directed at the recruitment and development of second-generation leaders. In its efforts to fill a position, the system first assembles a preferred-candidate profile, based on 15 competencies, including seven core competencies. CHE then employs a recruitment process based on behavioral event interviewing. All involved stakeholders participate in the interviews.

Philanthropic partnerships and the future of cancer research.

PubMed

Murciano-Goroff, Yonina R

2015-02-01

Complementing government and industry funding, philanthropies have made distinct contributions to altering the trajectory of cancer research, often in ways that reflect both the business training of their donors and their close ties to the lay public.

Implications of the Americans with Disabilities Act.

ERIC Educational Resources Information Center

Meservey, Lynne

1993-01-01

The Americans with Disabilities Act of 1990 (ADA) makes it unlawful to discriminate in all employee practices such as recruitment, hiring, promotion, training, benefits, pay, firing, job assignment, leave, lay-off, and all other employment-related activities. (PAM)

Intertester agreement in refractive error measurements.

PubMed

Huang, Jiayan; Maguire, Maureen G; Ciner, Elise; Kulp, Marjean T; Quinn, Graham E; Orel-Bixler, Deborah; Cyert, Lynn A; Moore, Bruce; Ying, Gui-Shuang

2013-10-01

To determine the intertester agreement of refractive error measurements between lay and nurse screeners using the Retinomax Autorefractor and the SureSight Vision Screener. Trained lay and nurse screeners measured refractive error in 1452 preschoolers (3 to 5 years old) using the Retinomax and the SureSight in a random order for screeners and instruments. Intertester agreement between lay and nurse screeners was assessed for sphere, cylinder, and spherical equivalent (SE) using the mean difference and the 95% limits of agreement. The mean intertester difference (lay minus nurse) was compared between groups defined based on the child's age, cycloplegic refractive error, and the reading's confidence number using analysis of variance. The limits of agreement were compared between groups using the Brown-Forsythe test. Intereye correlation was accounted for in all analyses. The mean intertester differences (95% limits of agreement) were -0.04 (-1.63, 1.54) diopter (D) sphere, 0.00 (-0.52, 0.51) D cylinder, and -0.04 (1.65, 1.56) D SE for the Retinomax and 0.05 (-1.48, 1.58) D sphere, 0.01 (-0.58, 0.60) D cylinder, and 0.06 (-1.45, 1.57) D SE for the SureSight. For either instrument, the mean intertester differences in sphere and SE did not differ by the child's age, cycloplegic refractive error, or the reading's confidence number. However, for both instruments, the limits of agreement were wider when eyes had significant refractive error or the reading's confidence number was below the manufacturer's recommended value. Among Head Start preschool children, trained lay and nurse screeners agree well in measuring refractive error using the Retinomax or the SureSight. Both instruments had similar intertester agreement in refractive error measurements independent of the child's age. Significant refractive error and a reading with low confidence number were associated with worse intertester agreement.

Hypnagogic and hypnopompic hallucinations: pathological phenomena?

PubMed

Ohayon, M M; Priest, R G; Caulet, M; Guilleminault, C

1996-10-01

Hypnagogic and hypnopompic hallucinations are common in narcolepsy. However, the prevalence of these phenomena in the general population is uncertain. A representative community sample of 4972 people in the UK, aged 15-100, was interviewed by telephone (79.6% of those contacted). Interviews were performed by lay interviewers using a computerised system that guided the interviewer through the interview process. Thirty-seven per cent of the sample reported experiencing hypnagogic hallucinations and 12.5% reported hypnopompic hallucinations. Both types of hallucinations were significantly more common among subjects with symptoms of insomnia, excessive daytime sleepiness or mental disorders. According to this study, the prevalence of narcolepsy in the UK is 0.04%. Hypnagogic and hypnopompic hallucinations were much more common than expected, with a prevalence that far exceeds that which can be explained by the association with narcolepsy. Hypnopompic hallucinations may be a better indicator of narcolepsy than hypnagogic hallucinations in subjects reporting excessive daytime sleepiness.

Latino sexual and gender identity minorities promoting sexual health within their social networks: Process evaluation findings from a lay health advisor intervention

PubMed Central

Sun, Christina J.; García, Manuel; Mann, Lilli; Alonzo, Jorge; Eng, Eugenia; Rhodes, Scott D.

2015-01-01

The HOLA intervention was a lay health advisor intervention designed to reduce the disproportionate HIV burden borne by Latino sexual and gender identity minorities (gay, bisexual, and other men who have sex with men, and transgender persons) living in the United States. Process evaluation data were collected for over a year of intervention implementation from 11 trained Latino male and transgender lay health advisors (Navegantes) to document the activities each Navegante conducted to promote condom use and HIV testing among his or her 8 social network members enrolled in the study. Over 13 months, the Navegantes reported conducting 1,820 activities. The most common activity was condom distribution. Navegantes had extensive reach beyond their enrolled social network members, and they engaged in health promotion activities beyond social network members enrolled in the study. There were significant differences between the types of activities conducted by Navegantes depending on who was present. Results suggest that lay health advisor interventions reach large number of at-risk community members and may benefit populations disproportionately impacted by HIV. PMID:25416309

Attitudes of the Japanese public and doctors towards use of archived information and samples without informed consent: preliminary findings based on focus group interviews.

PubMed

Asai, Atsushi; Ohnishi, Motoki; Nishigaki, Etsuyo; Sekimoto, Miho; Fukuhara, Shunichi; Fukui, Tsuguya

2002-01-09

The purpose of this study is to explore laypersons' attitudes toward the use of archived (existing) materials such as medical records and biological samples and to compare them with the attitudes of physicians who are involved in medical research. Three focus group interviews were conducted, in which seven Japanese male members of the general public, seven female members of the general public and seven physicians participated. It was revealed that the lay public expressed diverse attitudes towards the use of archived information and samples without informed consent. Protecting a subject's privacy, maintaining confidentiality, and communicating the outcomes of studies to research subjects were regarded as essential preconditions if researchers were to have access to archived information and samples used for research without the specific informed consent of the subjects who provided the material. Although participating physicians thought that some kind of prior permission from subjects was desirable, they pointed out the difficulties involved in obtaining individual informed consent in each case. The present preliminary study indicates that the lay public and medical professionals may have different attitudes towards the use of archived information and samples without specific informed consent. This hypothesis, however, is derived from our focus groups interviews, and requires validation through research using a larger sample.

Protocol and methodology of Study epidemiological mental health in Andalusia: PISMA-ep.

PubMed

Cervilla, Jorge A; Ruiz, Isabel; Rodríguez-Barranco, Miguel; Rivera, Margarita; Ibáñez-Casas, Inmaculada; Molina, Esther; Valmisa, Eulalio; Carmona-Calvo, José; Moreno-Küstner, Berta; Muñoz-Negro, José Eduardo; Ching-López, Ana; Gutiérrez, Blanca

This is the general methods describing paper of a cross-sectional study that aims to detect the prevalence of major mental disorders in Andalusia (Southern Spain), and their correlates or potential risk factors, using a large representative sample of community-dwelling adults. This is a cross-sectional study. We undertook a multistage sampling using different standard stratification levels and aimed to interview 4,518 randomly selected participants living in all 8 provinces of the Andalusian region utilizing a door-knocking approach. The Spanish version of the MINI International Neuropsychiatric Interview, a valid screening instrument ascertaining ICD-10/DSM-IV compatible mental disorder diagnoses was used as our main diagnostic tool. A large battery of other instruments was used to explore global functionality, medical comorbidity, personality traits, cognitive function and exposure to psychosocial potential risk factors. A saliva sample for DNA extraction was also obtained for a sub-genetic study. The interviews were administered and completed by fully trained interviewers, despite most tools used are compatible with lay interviewer use. A total of 3,892 (70.8%) of 5,496 initially attempted households had to be substituted for equivalent ones due to either no response (37.7%) or not fulfilling the required participant quota (33%). Thence, out of 5,496 eligible participants finally approached, 4,507 (83.7%) agreed to take part in the study, completed the interview and were finally included in the study (n=4,507) and 4,286 (78%) participants also agreed and consented to provide a saliva sample for DNA study. On the other hand, 989 (16.3%) approached potential participants refused to take part in the study. This is the largest mental health epidemiological study developed in the region of Spain (Andalusia). The response rates and representativeness of the sample obtained are fairly high. The method is particularly comprehensive for this sort of studies and includes both, personality and cognitive assessments, as well as a large array of bio-psycho-social risk measures. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Building capacity in mental health interventions in low resource countries: an apprenticeship model for training local providers

PubMed Central

2011-01-01

Background Recent global mental health research suggests that mental health interventions can be adapted for use across cultures and in low resource environments. As evidence for the feasibility and effectiveness of certain specific interventions begins to accumulate, guidelines are needed for how to train, supervise, and ideally sustain mental health treatment delivery by local providers in low- and middle-income countries (LMIC). Model and case presentations This paper presents an apprenticeship model for lay counselor training and supervision in mental health treatments in LMIC, developed and used by the authors in a range of mental health intervention studies conducted over the last decade in various low-resource settings. We describe the elements of this approach, the underlying logic, and provide examples drawn from our experiences working in 12 countries, with over 100 lay counselors. Evaluation We review the challenges experienced with this model, and propose some possible solutions. Discussion We describe and discuss how this model is consistent with, and draws on, the broader dissemination and implementation (DI) literature. Conclusion In our experience, the apprenticeship model provides a useful framework for implementation of mental health interventions in LMIC. Our goal in this paper is to provide sufficient details about the apprenticeship model to guide other training efforts in mental health interventions. PMID:22099582

Remedy or cure? Lay beliefs about over-the-counter medicines for coughs and colds.

PubMed Central

Johnson, Gina; Helman, Cecil

2004-01-01

BACKGROUND: Over 500 million is spent in the United Kingdom every year on over-the-counter medicines for coughs and colds. Evidence for their pharmacological efficacy is lacking. AIM: To examine lay beliefs about over-the-counter medicines for coughs and colds. To explore whether the distinction between symptom relief and cure has the same relevance to lay people as it does to medical professionals. DESIGN OF STUDY: Small pilot study using qualitative techniques. SETTING: Variety sample of 11 patients attending the National Health Service walk-in centre, Birmingham, England. METHOD: In-depth semi-structured interviews, including pile-sorting and fictional case histories, were used to explore participants' beliefs about the effects of over-the-counter medicines on coughs and colds. RESULTS: Eight of the 11 participants believed that at least one over the-counter cough medicine (most frequently Benylin for Chesty Coughs) could shorten, or "cure", an illness. Five participants thought that the majority of the medicines that they recognised would speed recovery rather than just relieve symptoms. CONCLUSIONS: There is a common confusion in the lay person's mind between the ability of a medicine to relieve symptoms, and its ability to cure a disease or to hasten recovery. This misunderstanding may affect the demand for primary care consultations. PMID:14965387

Medication Timing Errors for Parkinson's Disease: Perspectives Held by Caregivers and People with Parkinson's in New Zealand

PubMed Central

Buetow, Stephen; Henshaw, Jenny; Bryant, Linda; O'Sullivan, Deirdre

2010-01-01

Background. Common but seldom published are Parkinson's disease (PD) medication errors involving late, extra, or missed doses. These errors can reduce medication effectiveness and the quality of life of people with PD and their caregivers. Objective. To explore lay perspectives of factors contributing to medication timing errors for PD in hospital and community settings. Design and Methods. This qualitative research purposively sampled individuals with PD, or a proxy of their choice, throughout New Zealand during 2008-2009. Data collection involved 20 semistructured, personal interviews by telephone. A general inductive analysis of the data identified core insights consistent with the study objective. Results. Five themes help to account for possible timing adherence errors by people with PD, their caregivers or professionals. The themes are the abrupt withdrawal of PD medication; wrong, vague or misread instructions; devaluation of the lay role in managing PD medications; deficits in professional knowledge and in caring behavior around PD in formal health care settings; and lay forgetfulness. Conclusions. The results add to the limited published research on medication errors in PD and help to confirm anecdotal experience internationally. They indicate opportunities for professionals and lay people to work together to reduce errors in the timing of medication for PD in hospital and community settings. PMID:20975777

Detecting Psychopathy from Thin Slices of Behavior

ERIC Educational Resources Information Center

Fowler, Katherine A.; Lilienfeld, Scott O.; Patrick, Christopher J.

2009-01-01

This study is the first to demonstrate that features of psychopathy can be reliably and validly detected by lay raters from "thin slices" (i.e., small samples) of behavior. Brief excerpts (5 s, 10 s, and 20 s) from interviews with 96 maximum-security inmates were presented in video or audio form or in both modalities combined. Forty raters used…

Building a Definition of Irritability From Academic Definitions and Lay Descriptions.

PubMed

Barata, Paula C; Holtzman, Susan; Cunningham, Shannon; O'Connor, Brian P; Stewart, Donna E

2016-04-08

The current work builds a definition of irritability from both academic definitions and lay perspectives. In Study 1, a quantitative content analysis of academic definitions resulted in eight main content categories (i.e., behaviour, emotion or affect, cognition, physiological, qualifiers, irritant, stability or endurance, and other). In Study 2, a community sample of 39 adults participated in qualitative interviews. A deductive thematic analysis resulted in two main themes. The first main theme dealt with how participants positioned irritability in relation to other negative states. The second dealt with how participants constructed irritability as both a loss of control and as an experience that should be controlled. The discussion integrates the findings of both studies and provides a concise, but comprehensive definition.

Too Many Rationales, Not Enough Reason: A Call to Examine the Goals of Including Lay Members on Institutional Review Boards.

PubMed

Solomon, Stephanie

2016-01-01

Every major U.S. commission appointed to review Institutional Review Boards (IRBs) as well as numerous reports and scholarly articles have recommended increasing the number of lay (nonscientist and unaffiliated) members on IRBs. Meanwhile, qualitative studies have shown that lay IRB members experience confusion about their roles, including ambiguity whether their roles are different from other members of the board. Without articulating the unique reasons why unaffiliated and nonscientist members are needed, IRBs have little guidance on how to recruit and train these members, and how many should be at the table. By looking back through the history of IRB regulations, policies, and commentaries we can articulate unique contributions these members can make. Only with these contributions in mind can we make arguments for how to best achieve them and make the case that increasing their numbers is necessary.

Using Micro-Analysis in Interviewer Training: "Continuers" and Interviewer Positioning

ERIC Educational Resources Information Center

Richards, Keith

2011-01-01

Despite the recent growth of interest in the interactional construction of research interviews and advances made in our understanding of the nature of such encounters, relatively little attention has been paid to the implications of this for interviewer training, with the result that advice on interviewing techniques tends to be very general.…

The Experience of Native Peer Facilitators in the Campaign Against Type 2 Diabetes

PubMed Central

Struthers, Roxanne; Hodge, Felicia Schanche; De Cora, Lorelei; Geishirt-Cantrell, Betty

2011-01-01

Context The use of peer facilitators in health-programs has great potential. One important application is prevention and control of type 2 diabetes among American Indians. Purpose To explore the experience of American Indian facilitators in a culturally appropriate intervention (Talking Circles) on 2 Northern Plains reservations. The Talking Circles offered a forum for educational dialogue on diabetes risk factors and the management of type 2 diabetes. Methods Phenomenology, a qualitative research approach, was used to answer the research question: “What did Native Talking Circle facilitators-experience?” Participants were 4 lay health workers from the intervention reservations who had been trained to present a diabetes curriculum while coordinating and guiding the group discussion. During open-ended, taped interviews, the facilitators shared their experiences conducting the Talking Circles. Analysis categorized the experiences into common themes to explain the phenomena and cultural construction of oral discussions (Talking Circles) of diabetes. Findings Themes included the concept of “a calling” to do the work, which included a self-growth process, a blending of 2 worldviews as a diabetes intervention strategy, the importance of translating educational materials in a liaison role, and commitment to tribal people and communities. Conclusions The experience of the facilitators was positive because they were knowledgeable about American Indian culture arid worldview arid were trained in both Talking Circle facilitation and type 2 diabetes. PMID:12696854

Human subjects protection training for community workers: an example from "Faith Moves Mountains".

PubMed

Hatcher, Jennifer; Schoenberg, Nancy E

2007-01-01

Despite widespread agreement on the necessity of protecting human subjects, questions regarding ethical treatment and protection of human subjects remain and are particularly vexing for community-based participatory research (CBPR). There has been a notable lack of attention paid to what type of training should be provided and how to balance "real-life" concerns with official requirements. The purpose of this article is to demonstrate how, in consultation with the Office of Research Integrity (ORI) at our institution and our community partners, we developed training that overcame concerns related to instruction of community workers on protection of human subjects. We developed a training module written in lay terms and containing only information pertinent to non-key personnel and their role in the CBPR project. We designed and piloted this material in collaboration with our community partners who work with us to recruit and train lay health advisors (LHAs) and oversee the day-to-day operations of the CBPR project. The educational module was presented to the community workers as a part of a day-long training session. The written materials were a part of a notebook of information accompanied by an oral Power Point presentation. Each of the workers was given a written test to evaluate knowledge of the content presented. The test was administered by the project director, a community member herself, and then sent to our institution for grading by personnel not involved in this project. To date, all community workers have passed the written test. The community members, research partners, and the ORI are satisfied with the scope and simplicity of the training program developed. Our team's collaborative approach to community-based human subjects training contributes to advancing a grounded, feasible, and rigorous process of protecting human subjects while implementing CBPR ideals.

Using the tenets of the problem-centered systems therapy of the family (PCSTF) to teach the McMaster Approach to family therapists.

PubMed

Archambault, Richard; Mansfield, Abigail K; Evans, Doug; Keitner, Gabor I

2014-12-01

This article describes the videoconferencing training of a group of family therapists in the McMaster Approach to evaluating and treating families. A discussion of the key tenets of the McMaster Approach lays the groundwork for how these tenets were applied to training in a residential treatment agency for adolescents. The article serves as an example of how videoconference technology can facilitate extended training, even from a distance. © 2014 Family Process Institute.

Enhancing motivational interviewing training in a family medicine clerkship.

PubMed

Kaltman, Stacey; WinklerPrins, Vincent; Serrano, Adriana; Talisman, Nicholas

2015-01-01

Despite the prevalence of unhealthy behaviors among patients in the healthcare system, traditional medical training involves little or no exposure to effective behavior change techniques such as Motivational Interviewing. An online learning community for enhanced training in Motivational Interviewing was developed for 3rd-year medical students. The website included educational materials about Motivational Interviewing as well as problematic health behaviors, a repository of exemplar videos and student videos with feedback, and a discussion board. Student participants were given the opportunity to record an encounter with a patient and to receive feedback on their use of Motivational Interviewing from a faculty member. Student volunteers in the Family Medicine Clerkship at Georgetown University School of Medicine were randomized to enhanced training, which included the online learning community, or training as usual. All student volunteers completed a questionnaire assessing self-efficacy initially and at the end of the clerkship. Students also participated in an Observed Structured Clinical Exam, which was subsequently coded by a blinded rater for behavioral counts of Motivational Interviewing techniques, key steps in Motivational Interviewing, and overall Motivational Interviewing style. Students in the enhanced training arm were rated as having significantly higher scores in Motivational Interviewing style in the Observed Structured Clinical Exam than training as usual students. A significant increase in self-efficacy from pre- to posttest in the overall sample was observed but between-group differences were not significant. Student feedback was particularly positive regarding video recorded practice sessions with patients and individualized feedback. The results of this study as well as student feedback suggest that future work should include patient practice sessions and individualized feedback in developing Motivational Interviewing curricula.

A qualitative study exploring health perceptions and factors influencing participation in health behaviors in colorectal cancer survivors.

PubMed

Hardcastle, Sarah J; Maxwell-Smith, Chloe; Zeps, Nik; Platell, Cameron; O'Connor, Moira; Hagger, Martin S

2017-02-01

The purpose of the study was to explore colorectal cancer survivors' health perceptions following cessation of active treatment for cancer and to explore the factors influencing participation in health-promoting behaviors that may help reduce cardiovascular disease risk. Face-to-face interviews were conducted with participants that had completed active treatment for cancer within the previous 2 years. Participants were colorectal cancer survivors (N = 24, men = 11, women = 13, M age = 69.38 years, SD = 4.19) recruited from a private hospital in Perth, Australia on the basis that they had existing morbidities that put them at increased risk of cardiovascular disease. Interview transcripts were analyzed using thematic analysis. Five main themes emerged: back to normal; the pleasures in life: 'is it worth it?'; beliefs about health behavior; skepticism of eating guidelines; and lack of motivation. The majority of participants felt they were in good health and had made a full recovery. Participants questioned whether it was worth changing their lifestyle given their life stage and referred to the desire to enjoy life. Lay health beliefs, skepticism of eating guidelines, and a lack of motivation were barriers to change. Interventions should target lay beliefs and skepticism in relation to health behaviors in order to reinforce the importance and value of participating in health-related behavior. Findings may inform the development of effective, patient-centered interventions that target lay health beliefs and build motivation for health behavior change. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Evidence flowers: An innovative, visual method of presenting "best evidence" summaries to health professional and lay audiences.

PubMed

Babatunde, O O; Tan, V; Jordan, J L; Dziedzic, K; Chew-Graham, C A; Jinks, C; Protheroe, J; van der Windt, D A

2018-06-01

Barriers to dissemination and engagement with evidence pose a threat to implementing evidence-based medicine. Understanding, retention, and recall can be enhanced by visual presentation of information. The aim of this exploratory research was to develop and evaluate the accessibility and acceptability of visual summaries for presenting evidence syntheses with multiple exposures or outcomes to professional and lay audiences. "Evidence flowers" were developed as a visual method of presenting data from 4 case scenarios: 2 complex evidence syntheses with multiple outcomes, Cochrane reviews, and clinical guidelines. Petals of evidence flowers were coloured according to the GRADE evidence rating system to display key findings and recommendations from the evidence summaries. Application of evidence flowers was observed during stakeholder workshops. Evaluation and feedback were conducted via questionnaires and informal interviews. Feedback from stakeholders on the evidence flowers collected from workshops, questionnaires, and interviews was encouraging and helpful for refining the design of the flowers. Comments were made on the content and design of the flowers, as well as the usability and potential for displaying different types of evidence. Evidence flowers are a novel and visually stimulating method for presenting research evidence from evidence syntheses with multiple exposures or outcomes, Cochrane reviews, and clinical guidelines. To promote access and engagement with research evidence, evidence flowers may be used in conjunction with other evidence synthesis products, such as (lay) summaries, evidence inventories, rapid reviews, and clinical guidelines. Additional research on potential adaptations and applications of the evidence flowers may further bridge the gap between research evidence and clinical practice. Copyright © 2018 John Wiley & Sons, Ltd.

Health worker perceptions of integrating mobile phones into community case management of malaria in Saraya, Senegal.

PubMed

Blanas, Demetri A; Ndiaye, Youssoupha; MacFarlane, Matthew; Manga, Isaac; Siddiqui, Ammar; Velez, Olivia; Kanter, Andrew S; Nichols, Kim; Hennig, Nils

2015-05-01

Although community case management of malaria increases access to life-saving care in isolated settings, it contends with many logistical challenges. Mobile phone health information technology may present an opportunity to address a number of these barriers. Using the wireless adaptation of the technology acceptance model, this study assessed availability, ease of use, usefulness, and job relevance of mobile phones by health workers in Saraya, Senegal. This study conducted seven key informant interviews with government health workers, and three focus groups and 76 surveys with lay health workers. Principal findings included that mobile phones are already widely available and used, and that participants valued using phones to address training, stock management, programme reporting, and transportation challenges. By documenting widespread use of mobile phones and health worker perceptions of their most useful applications, this paper provides a framework for their integration into the community case management of malaria programme in Saraya, Senegal. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Improving the Interview Skills of College Students Using Behavioral Skills Training

ERIC Educational Resources Information Center

Stocco, Corey S.; Thompson, Rachel H.; Hart, John M.; Soriano, Heidi L.

2017-01-01

Obtaining a job as a college graduate is partly dependent on interview performance. We used a multiple baseline design across skills to evaluate the effects of behavioral skills training with self-evaluation for five college students. Training effects were evaluated using simulated interviews as baseline and posttraining assessments. All…

Speech and language therapists' perspectives of therapeutic alliance construction and maintenance in aphasia rehabilitation post-stroke.

PubMed

Lawton, Michelle; Sage, Karen; Haddock, Gillian; Conroy, Paul; Serrant, Laura

2018-05-01

Therapeutic alliance refers to the interactional and relational processes operating during therapeutic interventions. It has been shown to be a strong determinant of treatment efficacy in psychotherapy, and evidence is emerging from a range of healthcare and medical disciplines to suggest that the construct of therapeutic alliance may in fact be a variable component of treatment outcome, engagement and satisfaction. Although this construct appears to be highly relevant to aphasia rehabilitation, no research to date has attempted to explore this phenomenon and thus consider its potential utility as a mechanism for change. To explore speech and language therapists' perceptions and experiences of developing and maintaining therapeutic alliances in aphasia rehabilitation post-stroke. Twenty-two, in-depth, semi-structured interviews were conducted with speech and language therapists working with people with aphasia post-stroke. Qualitative data were analysed using inductive thematic analysis. Analysis resulted in the emergence of three overarching themes: laying the groundwork; augmenting cohesion; and contextual shapers. Recognizing personhood, developing shared expectations of therapy and establishing therapeutic ownership were central to laying the groundwork for therapeutic delivery. Augmenting cohesion was perceived to be dependent on the therapists' responsiveness and ability to resolve both conflict and resistance, as part of an ongoing active process. These processes were further moulded by contextual shapers such as the patient's family, relational continuity and organizational drivers. The findings suggest that therapists used multiple, complex, relational strategies to establish and manage alliances with people with aphasia, which were reliant on a fluid interplay of verbal and non-verbal skills. The data highlight the need for further training to support therapists to forge purposive alliances. Training should develop: therapeutic reflexivity; inclusivity in goal setting, relational strategies; and motivational enhancement techniques. The conceptualization of therapeutic alliance, however, is only provisional. Further research is essential to elucidate the experiences and perceptions of alliance development for people with aphasia undergoing rehabilitation. © 2018 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

Views of new internal medicine faculty of their preparedness and competence in physician-patient communication

PubMed Central

Mueller, Paul S; Barrier, Patricia A; Call, Timothy G; Duncan, Alan K; Hurley, Daniel L; Multari, Adamarie; Rabatin, Jeffrey T; Li, James TC

2006-01-01

Background We sought to assess self-rated importance of the medical interview to clinical practice and competence in physician-patient communication among new internal medicine faculty at an academic medical center. Methods Since 2001, new internal medicine faculty at the Mayo Clinic College of Medicine (Rochester, Minnesota) have completed a survey on physician-patient communication. The survey asks the new faculty to rate their overall competence in medical interviewing, the importance of the medical interview to their practice, their confidence and adequacy of previous training in handling eight frequently encountered challenging communication scenarios, and whether they would benefit from additional communication training. Results Between 2001 and 2004, 75 general internists and internal medicine subspecialists were appointed to the faculty, and of these, 58 (77%) completed the survey. The faculty rated (on a 10-point scale) the importance of the medical interview higher than their competence in interviewing; this difference was significant (average ± SD, 9.4 ± 1.0 vs 7.7 ± 1.2, P < .001). Similar results were obtained by sex, age, specialty, years since residency or fellowship training, and perceived benefit of training. Experienced faculty rated their competence in medical interviewing and the importance of the medical interview higher than recent graduates (ie, less than one year since training). For each challenging communication scenario, the new faculty rated the adequacy of their previous training in handling the scenario relatively low. A majority (57%) said they would benefit from additional communication training. Conclusion Although new internal medicine faculty rate high the importance of the medical interview, they rate their competence and adequacy of previous training in medical interviewing relatively low, and many indicate that they would benefit from additional communication training. These results should encourage academic medical centers to make curricula in physician-patient communication available to their faculty members because many of them not only care for patients, but also teach clinical skills, including communication skills, to trainees. PMID:16729886

Motivational interviewing: experiences of primary care nurses trained in the method.

PubMed

Östlund, Ann-Sofi; Wadensten, Barbro; Kristofferzon, Marja-Leena; Häggström, Elisabeth

2015-03-01

Motivational interviewing is a person-centered counseling style used to promote behavioral change regarding a wide variety of lifestyle problems. Use of motivational interview is growing worldwide and among many different healthcare professions, including primary care nursing. The study aim was to describe motivational interview trained nurses' experiences of motivational interviewing in primary care settings. The study had a qualitative descriptive design. It was carried out in Swedish primary care settings in two county council districts, with 20 primary care nurses trained in motivational interviewing. Half of them used the method in their work, half did not. Qualitative semi-structured interviews were used. Data were analyzed using qualitative content analysis. The nurses experienced that openness to the approach and an encouraging working climate are required to overcome internal resistance and to increase use of motivational interviewing. They also experienced mutual benefit: motivational interviewing elicits and develops abilities in both nurses and patients. For the nurses using it, motivational interviewing is perceived to facilitate work with patients in need of lifestyle change. Lack of training/education, support, interest and appropriate work tasks/patients are reasons for not using motivational interviewing.

Community lay rescuer automated external defibrillation programs: key state legislative components and implementation strategies: a summary of a decade of experience for healthcare providers, policymakers, legislators, employers, and community leaders from the American Heart Association Emergency Cardiovascular Care Committee, Council on Clinical Cardiology, and Office of State Advocacy.

PubMed

Aufderheide, Tom; Hazinski, Mary Fran; Nichol, Graham; Steffens, Suzanne Smith; Buroker, Andrew; McCune, Robin; Stapleton, Edward; Nadkarni, Vinay; Potts, Jerry; Ramirez, Raymond R; Eigel, Brian; Epstein, Andrew; Sayre, Michael; Halperin, Henry; Cummins, Richard O

2006-03-07

Cardiovascular disease is a leading cause of death for adults > or =40 years of age. The American Heart Association (AHA) estimates that sudden cardiac arrest is responsible for about 250,000 out-of-hospital deaths annually in the United States. Since the early 1990s, the AHA has called for innovative approaches to reduce time to cardiopulmonary resuscitation (CPR) and defibrillation and improve survival from sudden cardiac arrest. In the mid-1990s, the AHA launched a public health initiative to promote early CPR and early use of automated external defibrillators (AEDs) by trained lay responders in community (lay rescuer) AED programs. Between 1995 and 2000, all 50 states passed laws and regulations concerning lay rescuer AED programs. In addition, the Cardiac Arrest Survival Act (CASA, Public Law 106-505) was passed and signed into federal law in 2000. The variations in state and federal legislation and regulations have complicated efforts to promote lay rescuer AED programs and in some cases have created impediments to such programs. Since 2000, most states have reexamined lay rescuer AED statutes, and many have passed legislation to remove impediments and encourage the development of lay rescuer AED programs. The purpose of this statement is to help policymakers develop new legislation or revise existing legislation to remove barriers to effective community lay rescuer AED programs. Important areas that should be considered in state legislation and regulations are highlighted, and sample legislation sections are included. Potential sources of controversy and the rationale for proposed legislative components are noted. This statement will not address legislation to support home AED programs. Such recommendations may be made after the conclusion of a large study of home AED use.

Trained lay health workers reduce common mental disorder symptoms of adults with suicidal ideation in Zimbabwe: a cohort study.

PubMed

Munetsi, Epiphany; Simms, Victoria; Dzapasi, Lloyd; Chapoterera, Georgina; Goba, Nyaradzo; Gumunyu, Tichaona; Weiss, Helen A; Verhey, Ruth; Abas, Melanie; Araya, Ricardo; Chibanda, Dixon

2018-02-08

Suicidal ideation may lead to deliberate self-harm which increases the risk of death by suicide. Globally, the main cause of deliberate self-harm is depression. The aim of this study was to explore prevalence of, and risk factors for, suicidal ideation among men and women with common mental disorder (CMD) symptoms attending public clinics in Zimbabwe, and to determine whether problem solving therapy delivered by lay health workers can reduce common mental disorder symptoms among people with suicidal ideation, using secondary analysis of a randomised controlled trial. At trial enrolment, the Shona Symptom Questionnaire (SSQ) was used to screen for CMD symptoms. In the intervention arm, participants received six problem-solving therapy sessions conducted by trained and supervised lay health workers, while those in the control arm received enhanced usual care. We used multivariate logistic regression to identify risk factors for suicidal ideation at enrolment, and cluster-level logistic regression to compare SSQ scores at endline (6 months follow-up) between trial arms, stratified by suicidal ideation at enrolment. There were 573 participants who screened positive for CMD symptoms and 75 (13.1%) reported suicidal ideation at baseline. At baseline, after adjusting for confounders, suicidal ideation was independently associated with being aged over 24, lack of household income (household income yes/no; adjusted odds ratio 0.52 (95% CI 0.29, 0.95); p = 0.03) and with having recently skipped a meal due to lack of food (adjusted odds ratio 3.06 (95% CI 1.81, 5.18); p < 0.001). Participants who reported suicidal ideation at enrolment experienced similar benefit to CMD symptoms from the Friendship Bench intervention (adjusted mean difference - 5.38, 95% CI -7.85, - 2.90; p < 0.001) compared to those who had common mental disorder symptoms but no suicidal ideation (adjusted mean difference - 4.86, 95% CI -5.68, - 4.04; p < 0.001). Problem-solving therapy delivered by trained and supervised lay health workers reduced common mental disorder symptoms among participants with suicidal thoughts who attended primary care facilities in Zimbabwe. pactr.org ldentifier: PACTR201410000876178.

Training and quality assurance with the Structured Clinical Interview for DSM-IV (SCID-I/P).

PubMed

Ventura, J; Liberman, R P; Green, M F; Shaner, A; Mintz, J

1998-06-15

Accuracy in psychiatric diagnosis is critical for evaluating the suitability of the subjects for entry into research protocols and for establishing comparability of findings across study sites. However, training programs in the use of diagnostic instruments for research projects are not well systematized. Furthermore, little information has been published on the maintenance of interrater reliability of diagnostic assessments. At the UCLA Research Center for Major Mental Illnesses, a Training and Quality Assurance Program for SCID interviewers was used to evaluate interrater reliability and diagnostic accuracy. Although clinically experienced interviewers achieved better interrater reliability and overall diagnostic accuracy than neophyte interviewers, both groups were able to achieve and maintain high levels of interrater reliability, diagnostic accuracy, and interviewer skill. At the first quality assurance check after training, there were no significant differences between experienced and neophyte interviewers in interrater reliability or diagnostic accuracy. Standardization of training and quality assurance procedures within and across research projects may make research findings from study sites more comparable.

Educating American Protestant Religious Educators

ERIC Educational Resources Information Center

Foster, Charles R.

2015-01-01

The voluntarism in Protestant theologies and practices has significantly shaped the education of lay and professional Protestant religious educators in networks of voluntary and academic training programs that through the years have emphasized the interdependence of pedagogical, religious/theological, and social science theories and practices.…

Preparing non-government organization workers to conduct health checks for people with serious mental illness in regional Australia.

PubMed

Jones, Martin; Kruger, Mellissa; Walsh, Sandra M

2016-06-01

WHAT IS KNOWN ON THE SUBJECT?: People diagnosed with schizophrenia or bipolar disorder have a life expectancy 10-15 years less than the general population. In rural and remote Australia, there is a shortage of health care professionals to provide physical health care for people living with a serious mental illness (SMI). A large proportion of the care for people living with a SMI is provided by non-government organizations (NGOs), often employing workers without formal qualifications. There has been minimal research regarding the experiences of NGO workers who have been trained to complete health checks to help people living with SMI to access primary care services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to examine the experiences of preparing NGO workers to use the health improvement profile (HIP) to support the physical health of people with SMI. It builds on previous studies that examined the use of the HIP by trained/qualified staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study highlights that NGO employees may have an important role in helping people with a SMI to address their physical health. Engaging lay workers to use the HIP increases their awareness of the importance of providing good physical health care for people with SMI. The use of a tool, such as the HIP, prepares NGO workers to support the physical health needs and enables them to describe meaningful improvements in the health of people with a SMI. Background The life expectancy of people living with a serious mental illness (SMI) is up to 10-15 years less than the general population. They experience difficulties in accessing timely and appropriate physical health care. People with SMI living in regional Australia experience additional barriers to accessing services. This is in part due to the difficulties associated with recruiting and retaining health professionals in regional Australia. Aim To explore the regional non-government organization (NGO) workforce views of using a physical health care check list - the health improvement profile (HIP) - with people with a SMI. Gain insights into the workers' experiences of using the HIP. Understand which aspects of the HIP workers perceived as being most and least helpful. Learn how the HIP and the training program could be modified to better support its application in regional Australia. Method A focus group using a semi-structured interview was conducted with seven NGO employees who had been trained to use the HIP and subsequently used the HIP in their everyday work with patients. A mental health nurse (MHN) and a Psychology graduate working for the University of South Australia Department of Rural Health conducted the focus group. Results Using thematic analysis, the focus group discussion generated four main themes: taking control; accessing services; guiding my conversation; and working with others. The overall meta-theme was that lay workers can work effectively to address physical health problems in SMI patients. Conclusion Our observations highlight the important role lay workers in regional Australia have in helping people with SMI to address their physical health needs. They have an opportunity to extend their role in parts of the world where it is difficult to recruit MHNs. © 2016 John Wiley & Sons Ltd.

Designing a community-based lay health advisor training curriculum to address cancer health disparities.

PubMed

Gwede, Clement K; Ashley, Atalie A; McGinnis, Kara; Montiel-Ishino, F Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B; Wathington, Deanna; Dash-Pitts, Lolita; Green, B Lee

2013-05-01

Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. APPROACH AND STRATEGIES: Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic-community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research.

The ISTSS/Rand guidelines on mental health training of primary healthcare providers for trauma-exposed populations in conflict-affected countries.

PubMed

Eisenman, David; Weine, Stevan; Green, Bonnie; de Jong, Joop; Rayburn, Nadine; Ventevogel, Peter; Keller, Allen; Agani, Ferid

2006-02-01

Mental health care for trauma-exposed populations in conflict-affected developing countries often is provided by primary healthcare providers (PHPs), including doctors, nurses, and lay health workers. The Task Force on International Trauma Training, through an initiative sponsored by the International Society for Traumatic Stress Studies and the RAND Corporation, has developed evidence- and consensus-based guidelines for the mental health training of PHPs in conflict-affected developing countries. This article presents the Guidelines, which provide a conceptual framework and specific principles for improving the quality of mental health training for PHPs working with trauma-exposed populations.

Advancing understanding of the sustainability of lay health advisor (LHA) programs for African-American women in community settings.

PubMed

Shelton, Rachel C; Charles, Thana-Ashley; Dunston, Sheba King; Jandorf, Lina; Erwin, Deborah O

2017-09-01

Lay health advisor (LHA) programs have made strong contributions towards the elimination of health disparities and are increasingly being implemented to promote health and prevent disease. Developed in collaboration with African-American survivors, the National Witness Project (NWP) is an evidence-based, community-led LHA program that improves cancer screening among African-American women. NWP has been successfully disseminated, replicated, and implemented nationally in over 40 sites in 22 states in diverse community settings, reaching over 15,000 women annually. We sought to advance understanding of barriers and facilitators to the long-term implementation and sustainability of LHA programs in community settings from the viewpoint of the LHAs, as well as the broader impact of the program on African-American communities and LHAs. In the context of a mixed-methods study, in-depth telephone interviews were conducted among 76 African-American LHAs at eight NWP sites at baseline and 12-18 months later, between 2010 and 2013. Qualitative data provides insight into inner and outer contextual factors (e.g., community partnerships, site leadership, funding), implementation processes (e.g., training), as well as characteristics of the intervention (e.g., perceived need and fit in African-American community) and LHAs (e.g., motivations, burnout) that are perceived to impact the continued implementation and sustainability of NWP. Factors at the contextual levels and related to motivations of LHAs are critical to the sustainability of LHA programs. We discuss how findings are used to inform (1) the development of the LHA Sustainability Framework and (2) strategies to support the continued implementation and sustainability of evidence-based LHA interventions in community settings.

Redrawing the line: An exploration of how lay people construct child neglect.

PubMed

Williams, Sasha Emma

2017-06-01

While there has been an increasing professional and political focus on the prevalence and harmfulness of child neglect, little has been done to explore what child neglect means outside child protection circles. This qualitative study explores lay constructions of child neglect by thematically analyzing focus group discussions between 46 self-defined 'lay' people in England. Participants viewed neglect as extremely damaging for children and as arising when children's physical, emotional, training and supervisory needs were unmet due to abnormal parental behavior. Children with unmet needs were positioned as deprived, unloved, uncontrolled and escaping. They were only positioned as neglected when failure to meet their needs was attributable to a lack of parental knowledge and skill (clueless parents), a lack of appropriate parental disposition (underinvested parents) or both (unsuitable parents). 'Normal' parents - those with the appropriate parental disposition, skills and knowledge - who failed to meet their children's needs were not seen as neglectful but rather as overburdened. As 'normal parenting' has fragmented in late modernity, society wide consensus on child neglect was felt by participants to have retreated to child protection definitions, alienating lay understandings. If child neglect really is 'everybody's business', then it is important that lay people are included in forging new definitions of and responses to meeting the needs of children. Copyright © 2017 Elsevier Ltd. All rights reserved.

From "New Genetics" to Everyday Knowledge: Ideas about How Genetic Diseases Are Transmitted in Two Large Brazilian Families

ERIC Educational Resources Information Center

Santos, Silvana; Bizzo, Nelio

2005-01-01

This study focuses on everyday or lay understandings of inheritance. In the northeastern Brazil, 100 individuals were interviewed in order to describe how they explain the origin of genetic disorders affecting their relatives for several generations. There were involved 60 individuals from a large consanguineous family with many members affected…

Improving Access to Care for Warfighters: Virtual Worlds Technology to Enhance Primary Care Training in Post-Traumatic Stress and Motivational Interviewing

DTIC Science & Technology

2016-10-01

creating content, then, build off the BIM (P9) 9. Keep the training relevant with current events in the medical world (zika, infectious disease , etc... training ; curriculum development; motivational interviewing Veterans present to primary care providers (PCPs) with posttraumatic stress (PTS) symptoms...can inform the training curriculum. In total, 11 interviews were conducted with primary care providers and healthcare leadership. The data was

Latino sexual and gender identity minorities promoting sexual health within their social networks: process evaluation findings from a lay health advisor intervention.

PubMed

Sun, Christina J; García, Manuel; Mann, Lilli; Alonzo, Jorge; Eng, Eugenia; Rhodes, Scott D

2015-05-01

The HOLA intervention was a lay health advisor intervention designed to reduce the disproportionate HIV burden borne by Latino sexual and gender identity minorities (gay, bisexual, and other men who have sex with men, and transgender persons) living in the United States. Process evaluation data were collected for over a year of intervention implementation from 11 trained Latino male and transgender lay health advisors (Navegantes) to document the activities each Navegante conducted to promote condom use and HIV testing among his or her eight social network members enrolled in the study. Over 13 months, the Navegantes reported conducting 1,820 activities. The most common activity was condom distribution. Navegantes had extensive reach beyond their enrolled social network members, and they engaged in health promotion activities beyond social network members enrolled in the study. There were significant differences between the types of activities conducted by Navegantes depending on who was present. Results suggest that lay health advisor interventions reach large number of at-risk community members and may benefit populations disproportionately affected by HIV. © 2014 Society for Public Health Education.

A cluster randomised controlled trial of a manualised cognitive behavioural anger management intervention delivered by supervised lay therapists to people with intellectual disabilities.

PubMed

Willner, P; Rose, J; Jahoda, A; Stenfert Kroese, B; Felce, D; MacMahon, P; Stimpson, A; Rose, N; Gillespie, D; Shead, J; Lammie, C; Woodgate, C; Townson, J K; Nuttall, J; Cohen, D; Hood, K

2013-05-01

Anger is a frequent problem for many people with intellectual disabilities, and is often expressed as verbal and/or physical aggression. Cognitive-behaviour therapy (CBT) is the treatment of choice for common mental health problems, but CBT has only recently been adapted for people with intellectual disabilities. Anger is the main psychological presentation in which controlled trials have been used to evaluate CBT interventions for people with intellectual disabilities but these do not include rigorous randomised studies. To evaluate (1) the impact of a staff-delivered manualised CBT anger management intervention on (a) reported anger among people with mild to moderate intellectual disabilities, and (b) anger coping skills, aggression, mental health, quality of life and costs of health and social care; (2) factors that influence outcome; and (3) the experience of service users, lay therapists and service managers. A cluster randomised controlled trial based on 30 day centres (15 intervention and 15 control). Intention-to-treat comparisons of outcomes used a two-level linear regression model to allow for clustering within centres with baseline outcome levels as a covariate. Comparison of cost data used non-parametric bootstrapping. Qualitative analysis used interpretative phenomenological analysis and thematic analysis. Recruited day centres had four-plus service users with problem anger who were prepared to participate, two-plus staff willing to be lay therapists, a supportive manager and facilities for group work, and no current anger interventions. A total of 212 service users with problem anger were recruited. Thirty-three were deemed ineligible (30 could not complete assessments and three withdrew before randomisation). Retention at follow-up was 81%, with 17 withdrawals in each arm. Two to four staff per centre were recruited as lay therapists. Eleven service users, nine lay therapists and eight managers were interviewed. The manualised intervention comprised 12 weekly 2-hour group sessions supplemented by 'homework'. Lay therapists received training and ongoing supervision from a clinical psychologist. Treatment fidelity, group attendance and resources used in intervention delivery were monitored. The primary outcome was the service user-rated Provocation Index (PI), a measure of response to hypothetical situations that may provoke anger. Secondary trial outcomes were the key worker-rated PI; the service user- and key worker-rated Profile of Anger Coping Skills (PACS); the service user-rated PACS imaginal provocation test (PACS-IPT), a measure of response to actual situations known to provoke anger; aggression; mental health; self-esteem; quality of life; and health and social care resource use. Assessments were administered before randomisation and at 16 weeks and 10 months after randomisation. Fourteen treatment groups were delivered, each with 12 sessions lasting an average of 114 minutes, with a mean of 4.9 service users and 2.0 lay therapists. The mean hourly cost per service user was £ 25.26. The mean hourly excess cost over treatment as usual was £ 12.34. There was no effect of intervention on the primary outcome - self-rated PI. There was a significant impact on the following secondary outcomes at the 10-month follow-up: key worker-rated PI, self-rated PACS-IPT and self- and key worker-rated PACS. Key workers and home carers reported significantly lower aggression at 16 weeks, but not at 10 months. There was no impact on mental health, self-esteem, quality of life or total cost of health and social care. Service users, key workers and service managers were uniformly positive. The intervention was effective at changing anger coping skills and staff-rated anger. Impact on self-rated anger was equivocal. With hindsight there are reasons, from an analysis of factors influencing outcomes, to think that self-rated PI was not a well-chosen primary outcome. Widespread implementation of manualised lay therapist-led but psychologist-supervised anger management CBT for people with mild to moderate intellectual disabilities is recommended.

Simulated job interview skill training for people with psychiatric disability: feasibility and tolerability of virtual reality training.

PubMed

Bell, Morris D; Weinstein, Andrea

2011-09-01

The job interview is an important step toward successful employment and often a significant challenge for people with psychiatric disability. Vocational rehabilitation specialists can benefit from a systematic approach to training job interview skills. The investigators teamed up with a company that specializes in creating simulated job interview training to create software that provides a virtual reality experience with which learners can systematically improve their job interview skills, reduce their fears, and increase their confidence about going on job interviews. The development of this software is described and results are presented from a feasibility and tolerability trial with 10 participants with psychiatric disability referred from their vocational service programs. Results indicate that this representative sample had a strongly positive response to the prototype job interview simulation. They found it easy to use, enjoyed the experience, and thought it realistic and helpful. Almost all described the interview as anxiety provoking but that the anxiety lessened as they became more skilled. They saw the benefit of its special features such as ongoing feedback from a "coach in the corner" and from being able to review a transcript of the interview. They believed that they could learn the skills being taught through these methods. Participants were enthusiastic about wanting to use the final product when it becomes available. The advantages of virtual reality technology for training important skills for rehabilitation are discussed.

A novel method of assessing quality of postgraduate psychiatry training: experiences from a large training programme

PubMed Central

2013-01-01

Background Most assessments of the quality of postgraduate training are based on anonymised questionnaires of trainees. We report a comprehensive assessment of the quality of training at a large postgraduate psychiatry training institute using non-anonymised face-to-face interviews with trainees and their trainers. Methods Two consultant psychiatrists interviewed 99 trainees and 109 trainers. Scoring of interview responses was determined by using a pre-defined criteria. Additional comments were recorded as free text. Interviews covered 13 domains, including: Clinical, teaching, research and management opportunities, clinical environment, clinical supervision, adequacy of job description, absence of bullying and job satisfaction. Multiple interview domain scores were combined, generating a ‘Combined’ score for each post. Results The interview response rate was 97% for trainers 88% for trainees. There was a significant correlation between trainee and trainer scores for the same interview domains (Pearson’s r = 0.968, p< 0.001). Overall scores were significantly higher for specialist psychiatry posts as compared to general adult psychiatry posts (Two tailed t-test, p < 0.001, 95% CI: -0.398 to −0.132), and significantly higher for liaison psychiatry as compared to other specialist psychiatry posts (t-test: p = 0.038, 95% CI: -0.3901, -0.0118). Job satisfaction scores of year 1 to year 3 core trainees showed a significant increase with increasing seniority (Linear regression coefficient = 0.273, 95% CI: 0.033 to 0.513, ANOVA p= 0.026). Conclusions This in-depth examination of the quality of training on a large psychiatry training programme successfully elicited strengths and weakness of our programme. Such an interview scheme could be easily implemented in smaller schemes and may well provide important information to allow for targeted improvement of training. Additionally, trends in quality of training and job satisfaction amongst various psychiatric specialities were identified; specifically speciality posts and liaison posts in psychiatry were revealed to be the most popular with trainees. PMID:23768083

A novel method of assessing quality of postgraduate psychiatry training: experiences from a large training programme.

PubMed

Bizrah, Mukhtar; Iacoponi, Eduardo; Parker, Elizabeth; Rymer, Janice; Iversen, Amy; Wessely, Simon

2013-06-14

Most assessments of the quality of postgraduate training are based on anonymised questionnaires of trainees. We report a comprehensive assessment of the quality of training at a large postgraduate psychiatry training institute using non-anonymised face-to-face interviews with trainees and their trainers. Two consultant psychiatrists interviewed 99 trainees and 109 trainers. Scoring of interview responses was determined by using a pre-defined criteria. Additional comments were recorded as free text. Interviews covered 13 domains, including: Clinical, teaching, research and management opportunities, clinical environment, clinical supervision, adequacy of job description, absence of bullying and job satisfaction. Multiple interview domain scores were combined, generating a 'Combined' score for each post. The interview response rate was 97% for trainers 88% for trainees. There was a significant correlation between trainee and trainer scores for the same interview domains (Pearson's r = 0.968, p< 0.001). Overall scores were significantly higher for specialist psychiatry posts as compared to general adult psychiatry posts (Two tailed t-test, p < 0.001, 95% CI: -0.398 to -0.132), and significantly higher for liaison psychiatry as compared to other specialist psychiatry posts (t-test: p = 0.038, 95% CI: -0.3901, -0.0118). Job satisfaction scores of year 1 to year 3 core trainees showed a significant increase with increasing seniority (Linear regression coefficient = 0.273, 95% CI: 0.033 to 0.513, ANOVA p= 0.026). This in-depth examination of the quality of training on a large psychiatry training programme successfully elicited strengths and weakness of our programme. Such an interview scheme could be easily implemented in smaller schemes and may well provide important information to allow for targeted improvement of training. Additionally, trends in quality of training and job satisfaction amongst various psychiatric specialities were identified; specifically speciality posts and liaison posts in psychiatry were revealed to be the most popular with trainees.

Development and evaluation of a genomics training program for community health workers in Texas.

PubMed

Chen, Lei-Shih; Zhao, Shixi; Stelzig, Donaji; Dhar, Shweta U; Eble, Tanya; Yeh, Yu-Chen; Kwok, Oi-Man

2018-01-04

PurposeGenomics services have the potential to reduce incidence and mortality of diseases by providing individualized, family health history (FHH)-based prevention strategies to clients. These services may benefit from the involvement of community health workers (CHWs) in the provision of FHH-based genomics education and services, as CHWs are frontline public health workers and lay health educators, who share similar ethnicities, languages, socioeconomic statuses, and life experiences with the communities they serve. We developed, implemented, and evaluated the FHH-based genomics training program for CHWs.MethodsThis theory- and evidence-based FHH-focused genomics curriculum was developed by an interdisciplinary team. Full-day workshops in English and Spanish were delivered to 145 Texas CHWs (91.6% were Hispanic/black). Preworkshop, postworkshop, and 3-month follow-up data were collected.ResultsCHWs significantly improved their attitudes, intention, self-efficacy, and knowledge regarding adopting FHH-based genomics into their practice after the workshops. At 3-month follow-up, these scores remained higher, and there was a significant increase in CHWs' genomics practices.ConclusionThis FHH-based genomics training successfully educated Texas CHWs, and the outcomes were promising. Dissemination of training to CHWs in and outside of Texas is needed to promote better access to and delivery of personalized genomics services for the lay and underserved communities.GENETICS in MEDICINE advance online publication, 4 January 2018; doi:10.1038/gim.2017.236.

Validation of verbal autopsy: determination of cause of deaths in Malaysia 2013.

PubMed

Ganapathy, Shubash Shander; Yi Yi, Khoo; Omar, Mohd Azahadi; Anuar, Mohamad Fuad Mohamad; Jeevananthan, Chandrika; Rao, Chalapati

2017-08-11

Mortality statistics by age, sex and cause are the foundation of basic health data required for health status assessment, epidemiological research and formation of health policy. Close to half the deaths in Malaysia occur outside a health facility, are not attended by medical personnel, and are given a lay opinion as to the cause of death, leading to poor quality of data from vital registration. Verbal autopsy (VA) is a very useful tool in diagnosing broad causes of deaths for events that occur outside health facilities. This article reports the development of the VA methods and our principal finding from a validation study. A cross sectional study on nationally representative sample deaths that occurred in Malaysia during 2013 was used. A VA questionnaire suitable for local use was developed. Trained field interviewers visited the family members of the deceased at their homes and conducted face to face interviews with the next of kin. Completed questionnaires were reviewed by trained physicians who assigned multiple and underlying causes. Reference diagnoses for validation were obtained from review of medical records (MR) available for a sample of the overall study deaths. Corresponding MR diagnosis with matched sample of the VA diagnosis were available in 2172 cases for the validation study. Sensitivity scores were good (>75%) for transport accidents and certain cancers. Moderate sensitivity (50% - 75%) was obtained for ischaemic heart disease (64%) and cerebrovascular disease (72%). The validation sample for deaths due to major causes such as ischaemic heart disease, pneumonia, breast cancer and transport accidents show low cause-specific mortality fraction (CSMF) changes. The scores obtained for the top 10 leading site-specific cancers ranged from average to good. We can conclude that VA is suitable for implementation for deaths outside the health facilities in Malaysia. This would reduce ill-defined mortality causes in vital registration data, and yield more accurate national mortality statistics.

The Tanzanian trauma patients' prehospital experience: a qualitative interview-based study.

PubMed

Kuzma, Kristin; Lim, Andrew George; Kepha, Bernard; Nalitolela, Neema Evelyne; Reynolds, Teri A

2015-04-27

We sought to characterise the prehospital experience of Tanzanian trauma patients, and identify barriers and facilitators to implement community-based emergency medical systems (EMS). Our study was conducted in the emergency department of an urban national referral hospital in Tanzania. A convenience sample of 34 adult trauma patients, or surrogate family members, presenting or referred to an urban referral emergency department in Tanzania for treatment of injury, participated in the study. Participation in semistructured, iteratively developed interviews until saturation of responses was reached. A grounded theory-based approach to qualitative analysis was used to identify recurrent themes. We characterised numerous deficiencies within the existing clinic-to-hospital referral network, including missed/delayed diagnoses, limited management capabilities at pre-referral facilities and interfacility transfer delays. Potential barriers to EMS implementation include patient financial limitations and lack of insurance, limited public infrastructure and resources, and the credibility of potential first aid responders. Potential facilitators of EMS include communities' tendency to pool resources, individuals' trust of other community members to be first aid responders, and faith in community leaders to organise EMS response. Participants expressed a strong desire to learn first aid. The composite themes generated by the data suggest that there are myriad structural, financial, institutional and cultural barriers to the implementation of a formal prehospital system. However, our analysis also revealed potential facilitators to a first-responder system that takes advantage of close-knit local communities and the trust of recognised leaders in society. The results suggest favourable acceptability for community-based response by trained lay people. There is significant opportunity for care improvements with short trainings and low-cost supply planning. Further research looking at the effects of delay on outcomes in this population is needed. 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.

Food beliefs and practices in urban poor communities in Accra: implications for health interventions.

PubMed

Boatemaa, Sandra; Badasu, Delali Margaret; de-Graft Aikins, Ama

2018-04-02

Poor communities in low and middle income countries are reported to experience a higher burden of chronic non-communicable diseases (NCDs) and nutrition-related NCDs. Interventions that build on lay perspectives of risk are recommended. The objective of this study was to examine lay understanding of healthy and unhealthy food practices, factors that influence food choices and the implications for developing population health interventions in three urban poor communities in Accra, Ghana. Thirty lay adults were recruited and interviewed in two poor urban communities in Accra. The interviews were audio-taped, transcribed and analysed thematically. The analysis was guided by the socio-ecological model which focuses on the intrapersonal, interpersonal, community, structural and policy levels of social organisation. Food was perceived as an edible natural resource, and healthy in its raw state. A food item retained its natural, healthy properties or became unhealthy depending on how it was prepared (e.g. frying vs boiling) and consumed (e.g. early or late in the day). These food beliefs reflected broader social food norms in the community and incorporated ideas aligned with standard expert dietary guidelines. Healthy cooking was perceived as the ability to select good ingredients, use appropriate cooking methods, and maintain food hygiene. Healthy eating was defined in three ways: 1) eating the right meals; 2) eating the right quantity; and 3) eating at the right time. Factors that influenced food choice included finances, physical and psychological state, significant others and community resources. The findings suggest that beliefs about healthy and unhealthy food practices are rooted in multi-level factors, including individual experience, family dynamics and community factors. The factors influencing food choices are also multilevel. The implications of the findings for the design and content of dietary and health interventions are discussed.

What do lay people want to know about the disposal of nuclear waste? A mental model approach to the design and development of an online risk communication.

PubMed

Skarlatidou, A; Cheng, T; Haklay, M

2012-09-01

Public participation requires the involvement of lay people in the decision-making processes of issues that concern them. It is currently practiced in a variety of domains, such as transport and environmental planning. Communicating risks can be a complex task, as there may be significant differences between the risk perceptions of experts and those of lay people. Among the plethora of problems that require public involvement is the site selection of a nuclear waste disposal site in the United Kingdom, which is discussed in this article. Previous ineffective attempts to locate a site provide evidence that the problem has a strong social dimension, and studies ascribe public opposition to a loss of public trust in governmental agencies and decisionmakers, and to a lack of public understanding of nuclear waste issues. Although the mental models approach has been successfully used in the effective communication of such risks as climate change, no attempt has been made to follow a prescriptive mental model approach to develop risk communication messages that inform lay people about nuclear waste disposal. After interviewing 20 lay people and 5 experts, we construct and compare their corresponding mental models to reveal any gaps and misconceptions. The mental models approach is further applied here to identify lay people's requirements regarding what they want to know about nuclear waste, and how this information should be presented so that it is easily understood. This article further describes how the mental models approach was used in the subsequent development of an online information system for the site selection of a nuclear waste repository in the United Kingdom, which is considered essential for the improvement of public understanding and the reestablishment of trust. © 2012 Society for Risk Analysis.

Science information in the media: an academic approach to improve its intrinsic quality.

PubMed

Bruno, Flavia; Vercellesi, Luisa

2002-01-01

The lay audience expresses a clear demand for scientific information, particularly when health and welfare are involved. For most people science is what they learn from the media. The need for good scientific journalism is pressing, to bridge the gap between the slow pace of science and the fast-moving and concise nature of successful mass communication. This academic postgraduate course was established by the Department of Pharmacological Sciences to train mediators to improve the quality of lay scientific dissemination. The programme focuses on teaching a method of selecting, analysing, understanding, mediating and diffusing scientific information to lay people. The course explores the theoretical and practical aspects of methods, techniques and channels of scientific communication. Case studies, practical exercises, and stages complement the theoretical curriculum. The teaching focus is on reducing the asymmetry between scientists and the public. The different backgrounds of students and the spread of topics are major challenges. Copyright 2002 Academic Press.

Managing boundaries between professional and lay nursing following the influenza pandemic, 1918-1919: insights for professional resilience today?

PubMed

Wood, Pamela J

2017-03-01

To examine lay-professional nursing boundaries, using challenges to the New Zealand nursing profession following the 1918-1919 influenza pandemic as the example. The influenza pandemic of 1918-1919 had an overwhelming international impact on communities and the nursing profession. After the pandemic, the expectation for communities to be able to nurse the sick reflects today's increasing reliance on families to care for people at home. It similarly raised questions about the profession's role and professional boundaries in relation to volunteer or lay nursing. In New Zealand, the postpandemic challenge to build community lay nursing capacity tested these boundaries. Historical research. Analysis of historical primary sources of official reports, newspaper accounts, articles in New Zealand's professional nursing journal Kai Tiaki and the memoir of Hester Maclean, the country's chief nurse. Interpretation of findings in relation to secondary sources examining similar historical tensions between professional and lay nursing, and to the more recent notion of professional resilience. Maclean guarded nursing's professional boundaries by maintaining considerable control over community instruction in nursing and by strenuously resisting the suggestion that this should be done in hospitals where professional nurses trained. This historical example shows how the nursing profession faced the perceived threat to its professional boundaries. It also shows how competing goals of building community lay nursing capacity and protecting professional boundaries can be effectively managed. In the context of a global nursing shortage, limited healthcare budgets and a consequently increasing reliance on households to provide care for family members, this historical research shows nurses today that similar issues have been faced and effectively managed in the past. © 2016 John Wiley & Sons Ltd.

Simulated Job Interview Skill Training for People with Psychiatric Disability: Feasibility and Tolerability of Virtual Reality Training

PubMed Central

Bell, Morris D.; Weinstein, Andrea

2011-01-01

The job interview is an important step toward successful employment and often a significant challenge for people with psychiatric disability. Vocational rehabilitation specialists can benefit from a systematic approach to training job interview skills. The investigators teamed up with a company that specializes in creating simulated job interview training to create software that provides a virtual reality experience with which learners can systematically improve their job interview skills, reduce their fears, and increase their confidence about going on job interviews. The development of this software is described and results are presented from a feasibility and tolerability trial with 10 participants with psychiatric disability referred from their vocational service programs. Results indicate that this representative sample had a strongly positive response to the prototype job interview simulation. They found it easy to use, enjoyed the experience, and thought it realistic and helpful. Almost all described the interview as anxiety provoking but that the anxiety lessened as they became more skilled. They saw the benefit of its special features such as ongoing feedback from a “coach in the corner” and from being able to review a transcript of the interview. They believed that they could learn the skills being taught through these methods. Participants were enthusiastic about wanting to use the final product when it becomes available. The advantages of virtual reality technology for training important skills for rehabilitation are discussed. PMID:21860052

Pass-Fail Grading: Laying the Foundation for Self-Regulated Learning

ERIC Educational Resources Information Center

White, Casey B.; Fantone, Joseph C.

2010-01-01

Traditionally, medical schools have tended to make assumptions that students will "automatically" engage in self-education effectively after graduation and subsequent training in residency and fellowships. In reality, the majority of medical graduates out in practice feel unprepared for learning on their own. Many medical schools are now adopting…

Six Workforce Development Initiatives That Are Laying the Pathway to Success

ERIC Educational Resources Information Center

Fox, Heather L.

2015-01-01

Workforce development interventions have historically been heavily driven by federal funding, much of which was designated towards short-term training programs (less than six months) and rarely involved interaction or collaboration among colleges. The resulting efforts by the colleges to improve, update, or expand their workforce development…

Some Effects of Race of Inexperienced Lay Counselors on Black Junior High School Students

ERIC Educational Resources Information Center

Heffernon, Andrew; Bruehl, Dieter

1971-01-01

Four black and four white college men without prior counseling experience were given eight hours of training in Rogerian counseling and were each assigned two groups, each group composed of three eighth grade black boys. The behavioral measure suggested greater preference for black counselors. (Author)

Multiple mini interview (MMI) for general practice training selection in Australia: interviewers' motivation.

PubMed

Burgess, Annette; Roberts, Chris; Sureshkumar, Premala; Mossman, Karyn

2018-01-25

Multiple Mini Interviews (MMIs) are being used by a growing number of postgraduate training programs and medical schools as their interview process for selection entry. The Australian General Practice and Training (AGPT) used a National Assessment Centre (NAC) approach to selection into General Practice (GP) Training, which include MMIs. Interviewing is a resource intensive process, and implementation of the MMI requires a large number of interviewers, with a number of candidates being interviewed simultaneously. In 2015, 308 interviewers participated in the MMI process - a decrease from 340 interviewers in 2014, and 310 in 2013. At the same time, the number of applicants has steadily increased, with 1930 applications received in 2013; 2254 in 2014; and 2360 in 2015. This has raised concerns regarding the increasing recruitment needs, and the need to retain interviewers for subsequent years of MMIs. In order to investigate interviewers' reasons for participating in MMIs, we utilised self-determination theory (SDT) to consider interviewers' motivation to take part in MMIs at national selection centres. In 2015, 308 interviewers were recruited from 17 Regional Training Providers (RTPs) to participate in the MMI process at one of 15 NACs. For this study, a convenience sample of NAC sites was used. Forty interviewers were interviewed (n = 40; 40/308 = 13%) from five NACs. Framework analysis was used to code and categorise data into themes. Interviewers' motivation to take part as interviewers were largely related to their sense of duty, their desire to contribute their expertise to the process, and their desire to have input into selection of GP Registrars; a sense of duty to their profession; and an opportunity to meet with colleagues and future trainees. Interviewers also highlighted factors hindering motivation, which sometimes included the large number of candidates seen in one day. Interviewers' motivation for contributing to the MMIs was largely related to their desire to contribute to their profession, and ultimately improve future patient care. Interviewers recognised the importance of interviewing, and felt their individual roles made a crucial contribution to the profession of general practice. Good administration and leadership at each NAC is needed. By gaining an understanding of interviewers' motivation, and enhancing this, engagement and retention of interviewers may be increased.

Patient participation in cancer clinical trials: A pilot test of lay navigation.

PubMed

Cartmell, Kathleen B; Bonilha, Heather S; Matson, Terri; Bryant, Debbie C; Zapka, Jane G; Bentz, Tricia A; Ford, Marvella E; Hughes-Halbert, Chanita; Simpson, Kit N; Alberg, Anthony J

2016-08-15

Clinical trials (CT) represent an important treatment option for cancer patients. Unfortunately, patients face challenges to enrolling in CTs, such as logistical barriers, poor CT understanding and complex clinical regimens. Patient navigation is a strategy that may help to improve the delivery of CT education and support services. We examined the feasibility and initial effect of one navigation strategy, use of lay navigators. A lay CT navigation intervention was evaluated in a prospective cohort study among 40 lung and esophageal cancer patients. The intervention was delivered by a trained lay navigator who viewed a 17-minute CT educational video with each patient, assessed and answered their questions about CT participation and addressed reported barriers to care and trial participation. During this 12-month pilot project, 85% (95% CI: 72%-93%) of patients eligible for a therapeutic CT consented to participate in the CT navigation intervention. Among navigated patients, CT understanding improved between pre- and post-test (means 3.54 and 4.40, respectively; p-value 0.004), and 95% (95% CI: 82%-98%) of navigated patients consented to participate in a CT. Navigated patients reported being satisfied with patient navigation services and CT participation. In this formative single-arm pilot project, initial evidence was found for the potential effect of a lay navigation intervention on CT understanding and enrollment. A randomized controlled trial is needed to examine the efficacy of the intervention for improving CT education and enrollment.

Virtual Reality Job Interview Training for Individuals with Psychiatric Disabilities

PubMed Central

Smith, Matthew J.; Ginger, Emily J.; Wright, Michael; Wright, Katherine; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D.; Fleming, Michael F.

2014-01-01

Services are available to help support existing employment for individual with psychiatric disabilities; however, there is a gap in services targeting job interview skills that can help obtain employment. We assessed the feasibility and efficacy of Virtual Reality Job Interview Training (VR-JIT) in a randomized controlled trial. Participants were randomized to VR-JIT (n=25) or treatment as usual (TAU) (n=12) groups. VR-JIT consisted of 10 hours of simulated job interviews with a virtual character and didactic online training. Participants attended 95% of lab-based training sessions and found VR-JIT easy-to-use and felt prepared for future interviews. The VR-JIT group improved their job interview role-play performance (p<0.05) and self-confidence (p<0.05) between baseline and follow-up as compared to the TAU group. VR-JIT performance scores increased over time (R-Squared=0.65). VR-JIT demonstrated initial feasibility and efficacy at improving job interview skills and self-confidence. Future research may help clarify whether this intervention is efficacious in community-based settings. PMID:25099298

Virtual reality job interview training for individuals with psychiatric disabilities.

PubMed

Smith, Matthew J; Ginger, Emily J; Wright, Michael; Wright, Katherine; Boteler Humm, Laura; Olsen, Dale; Bell, Morris D; Fleming, Michael F

2014-09-01

Services are available to help support existing employment for individuals with psychiatric disabilities; however, there is a gap in services targeting job interview skills that can help obtain employment. We assessed the feasibility and efficacy of Virtual Reality Job Interview Training (VR-JIT) in a randomized controlled trial. Participants were randomized to VR-JIT (n = 25) or treatment-as-usual (TAU) (n = 12) groups. VR-JIT consisted of 10 hours of simulated job interviews with a virtual character and didactic online training. The participants attended 95% of laboratory-based training sessions and found VR-JIT easy to use and felt prepared for future interviews. The VR-JIT group improved their job interview role-play performance (p ≤ 0.05) and self-confidence (p ≤ 0.05) between baseline and follow-up as compared with the TAU group. VR-JIT performance scores increased over time (R = 0.65). VR-JIT demonstrated initial feasibility and efficacy at improving job interview skills and self-confidence. Future research may help clarify whether this intervention is efficacious in community-based settings.

Skill acquisition and retention in automated external defibrillator (AED) use and CPR by lay responders: a prospective study.

PubMed

Woollard, Malcolm; Whitfeild, Richard; Smith, Anna; Colquhoun, Michael; Newcombe, Robert G; Vetteer, Norman; Chamberlain, Douglas

2004-01-01

This prospective study evaluated the acquisition and retention of skills in cardio-pulmonary resuscitation (CPR) and the use of the automated external defibrillator (AED) by lay volunteers involved in the Department of Health, England National Defibrillator Programme. One hundred and twelve trainees were tested immediately before and after and initial 4-h class; 76 were similarly reassessed at refresher training 6 months later. A standardised test scenario that required assessment of the casualty, CPR and the use of on AED was evaluated using recording manikin data and video recordings. Before training only 44% of subjects delivered a shock. Afterwards, all did so and the average delay to first shock was reduced by 57 s. All trainees placed the defibrillator electrodes in an "acceptable" position after training, but very few did so in the recommended "ideal" position. After refresher training 80% of subjects used the correct sequence for CPR and shock delivery, yet a third failed to perform adequate safety checks before all shocks. The trainees self-assessed AED competence score was 86 (scale 0-100) after the initial class and their confidence that they would act in a real emergency was rated at a similar level. Initial training improved performance of all CPR skills, although all except compression rate had deteriorated after 6 months. The proportion of subjects able to correctly perform most CPR skill was higher following refresher training that after the initial class. Although this course was judged to be effective in teaching delivery of counter-shocks, the need was identified for more emphasis on positioning of electrodes, pre-shock safety checks, airway opening, ventilation volume, checking for signs of a circulation, hand positioning, and depth and rate of chest compressions.

How do national cultures influence lay people's preferences toward doctors' style of communication? A comparison of 35 focus groups from an European cross national research.

PubMed

Rimondini, Michela; Mazzi, Maria Angela; Deveugele, Myriam; Bensing, Jozien M

2015-12-14

The evidence that inspires and fosters communication skills, teaching programmes and clinical recommendations are often based on national studies which assume, implicitly, that patients' preferences towards doctors' communication style are not significantly affected by their cultural background. The cross-cultural validity of national results has been recognized as a potential limitation on how generally applicable they are in a wider context. Using 35 country-specific focus group discussions from four European countries, the aim of the present study is to test whether or not national cultures influence lay people's preferences towards doctors' style of communication. Lay people preferences on doctor's communication style have been collected in Belgium, the Netherlands, the United Kingdom and Italy. Each centre organized between eight and nine focus groups, where participants (n = 259) were asked to comment on a video of a simulated medical interview. The discussions were audiotaped, transcribed and coded using a common framework (Guliver Coding System) that allowed for the identification of different themes. The frequency distribution of the topics discussed highlights lay people's generally positive views towards most part of doctors interventions. The regression model applied to the Guliver categories highlighted slight national differences and the existence of a cross-cultural appreciation, in particular, of five types of intervention: Doctors attitudes (both Task-Oriented and Affective/Emotional), Summarizing, Structuring and Providing solution. Lay panels valued doctors' communication style in a similar manner in the countries selected. This highlights the existence of a common background, which in the process of internationalization of heath care, might foster the implementation of cross-national teaching programmes and clinical guidelines.

Integrating motivational interviewing and narrative therapy to teach behavior change to family medicine resident physicians.

PubMed

Oshman, Lauren D; Combs, Gene N

2016-05-01

Motivational interviewing is a useful skill to address the common problem of patient ambivalence regarding behavior change by uncovering and strengthening a person's own motivation and commitment to change. The Family Medicine Milestones underline the need for clear teaching and monitoring of skills in communication and behavior change in Family Medicine postgraduate training settings. This article reports the integration of a motivational interviewing curriculum into an existing longitudinal narrative therapy-based curriculum on patient-centered communication. Observed structured clinical examination for six participants indicate that intern physicians are able to demonstrate moderate motivational interviewing skill after a brief 2-h workshop. Participant self-evaluations for 16 participants suggest a brief 2-h curriculum was helpful at increasing importance of learning motivational interviewing by participants, and that participants desire further training opportunities. A brief motivational interviewing curriculum can be integrated into existing communication training in a Family Medicine residency training program. © The Author(s) 2016.

Brief Report: Vocational Outcomes for Young Adults with Autism Spectrum Disorders at Six Months after Virtual Reality Job Interview Training

ERIC Educational Resources Information Center

Smith, Matthew J.; Fleming, Michael F.; Wright, Michael A.; Losh, Molly; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D.

2015-01-01

Young adults with high-functioning autism spectrum disorder (ASD) have low employment rates and job interviewing presents a critical barrier to employment for them. Results from a prior randomized controlled efficacy trial suggested virtual reality job interview training (VR-JIT) improved interviewing skills among trainees with ASD, but not…

Quality Interviews with Adult Students and Trainees. A Communications Course in Student Personnel and In-Service Training.

ERIC Educational Resources Information Center

Neely, Margery A.

This book has the following objectives: (1) to sharpen the skills of interviewers to increase the quality of the interview process used with diverse populations; (2) to describe the dynamics of the occupations that use a brief interview in the education and training service-producing industry; and (3) to provide measurement for statistical process…

["Kids Save Lives"-resuscitation training for schoolchildren : Systematic review].

PubMed

Schroeder, D C; Ecker, H; Wingen, S; Semeraro, F; Böttiger, B W

2017-08-01

Even in western developed countries, the probability of survival after out-of-hospital cardiac arrest (OHCA) is only 6-10%. In order to improve survival after OHCA, early initiation of cardiopulmonary resuscitation (CPR) by laypersons is essential. Introduction of CPR training in schoolchildren seems to be effective to increase lay-CPR rates. The objective of the present investigation was to elucidate educational aspects of teaching schoolchildren in CPR and to summarize campaigns related to a comprehensive establishment of lay-CPR worldwide. A literature research in PubMed was performed, the cutoff date was 27 February 2017. Overall, 192 abstracts were analyzed; 51 articles were considered relevant and included in the manuscript. An additional keyword research in Google revealed >230,000 entries, and 20 of those were included in the present manuscript. A minimum age of 12-13 years is required to achieve a comparable quality of CPR to adult basic life support (BLS). Key issues are (i) the correct detection of a cardiac arrest, (ii) a correctly performed call for help, (iii) thoracic compressions and (iv) if applicable, the initiation of adequate mouth-to-mouth ventilation. Practical training showed a significantly higher CPR quality compared to theoretical training only or to the use of instruction or online videos only. Worldwide implementation of a 2-h BLS training per year in children from the age of 12 or younger is recommended by the "Kids Save Lives"- statement since 2015. In Germany, implementation at the level of the federal states has progressed to different degrees.

Lay health worker experiences administering a multi-level combination intervention to improve PMTCT retention.

PubMed

DiCarlo, Abby; Fayorsey, Ruby; Syengo, Masila; Chege, Duncan; Sirengo, Martin; Reidy, William; Otieno, Juliana; Omoto, Jackton; Hawken, Mark P; Abrams, Elaine J

2018-01-10

The recent scale-up of prevention of mother-to-child transmission of HIV (PMTCT) services has rapidly accelerated antiretroviral therapy (ART) uptake among pregnant and postpartum women in sub-Saharan Africa. The Mother and Infant Retention for Health (MIR4Health) study evaluates the impact of a combination intervention administered by trained lay health workers to decrease attrition among HIV-positive women initiating PMTCT services and their infants through 6 months postpartum. This was a qualitative study nested within the MIR4Health trial. MIR4Health was conducted at 10 health facilities in Nyanza, Kenya from September 2013 to September 2015. The trial intervention addressed behavioral, social, and structural barriers to PMTCT retention and included: appointment reminders via text and phone calls, follow-up and tracking for missed clinic visits, PMTCT health education at home visits and during clinic visits, and retention and adherence support and counseling. All interventions were administered by lay health workers. We describe results of a nested small qualitative inquiry which conducted two focus groups to assess the experiences and perceptions of lay health workers administering the interventions. Discussions were recorded and simultaneously transcribed and translated into English. Data were analyzed using framework analysis approach. Study findings show lay health workers played a critical role supporting mothers in PMTCT services across a range of behavioral, social, and structural domains, including improved communication and contact, health education, peer support, and patient advocacy and assistance. Findings also identified barriers to the uptake and implementation of the interventions, such as concerns about privacy and stigma, and the limitations of the healthcare system including healthcare worker attitudes. Overall, study findings indicate that lay health workers found the interventions to be feasible, acceptable, and well received by clients. Lay health workers played a fundamental role in supporting mothers engaged in PMTCT services and provided valuable feedback on the implementation of PMTCT interventions. Future interventions must include strategies to ensure client privacy, decrease stigma within communities, and address the practical limitations of health systems. This study adds important insight to the growing body of research on lay health worker experiences in HIV and PMTCT care. Clinicaltrials.gov NCT01962220 .

Zinc and Vitamin Supplementation in an Under-5 Indigenous Population of Guatemala: Influence of Lay Health Promoters in Decreasing Incidence of Diarrhea.

PubMed

Grossmann, Vicki M; Turner, Barbara S; Snyder, Denise; Stewart, Robert D; Bowen, Toni; Cifuentes, Ariadna A; Cliff, Cheryl

2015-09-01

Malnutrition is an urgent problem in the developing world, especially for children under 5 years of age. The article describes the utilization of a standard of practice designed to prevent illness in a malnourished, under-5 indigenous population and reinforced by weekly basic health messages taught by lay community health promoters. The two villages were chosen for observation after administration of the standard of care among the Maya-Kíché, the most numerous Mayan group in Guatemala. The standard of practice, 20 mg of daily oral zinc, was administered for 10 days in the home and followed by daily vitamin supplementation that continued throughout the 3 months of the project. All patients received four monthly clinic visits, with one of the village groups receiving weekly health promoter visits. Data evaluated after the quality improvement project showed significant differences in adherence to the zinc regimen (χ(2) = 3.677, p ≤ .05) as well as lower rates of diarrheal illnesses (χ(2) = 5.850, p ≤ .05), with both of these improved in the health promoter group. This study suggests that the training and implementation of para-health professionals from the lay community in response to specific health care needs could be considered a best practice in developing countries. Public health professionals are key to health promoter training and direction, and their importance in the global setting cannot be understated. © The Author(s) 2014.

Motivation Coaching Training for Instructional Coaches: A Pilot Study of Motivational Interviewing Skills Training

ERIC Educational Resources Information Center

Lyons, Michael D.; Jones, Sara J.; Smith, Bradley H.; McQuillin, Samuel D.; Richardson, Georgette; Reid, Erin; McClellan, Anne

2017-01-01

In our paper we describe a newly developed teacher coaching model that provides training on motivational interviewing (MI) to improve instructional coaches' effectiveness with classroom teachers. Participants were 38 coaches who completed a three-day coaching training. At pre- and post-test, the participants completed role plays with an actor who…

Barriers and facilitators to paediatric adherence to antiretroviral therapy in rural South Africa: a multi-stakeholder perspective.

PubMed

Coetzee, Bronwyne; Kagee, Ashraf; Bland, Ruth

2015-01-01

Poor adherence to antiretroviral therapy (ART) contributes to the development of drug resistance. HIV-infected children, especially those 5 years and under, are dependent on a caregiver to adhere to ART. However, characteristics of the caregiver, child, regimen, clinic and social context affect clinic attendance and medication-taking, both of which constitute adherent behaviour. We conducted nine interviews and three focus groups to determine how doctors, nurses, counsellors, traditional healers and caregivers understood the barriers and facilitators to ART adherence among children residing in rural South Africa. The data were transcribed, translated into English from isiZulu where necessary, and coded using Atlas.ti version 7. Results were interpreted through the lens of Bronfenbrenner's Ecological Systems Theory. We found that at the micro-level, palatability of medication and large volumes of medication were problematic for young children. Characteristics of the caregiver including absent mothers, grandmothers as caregivers and denial of HIV amongst fathers were themes related to the micro-system. Language barriers and inconsistent attendance of caregivers to monthly clinic visits were factors affecting adherence in the meso-system. Adherence counselling and training were the most problematic features in the exo-system. In the macro-system, the effects of food insecurity and the controversy surrounding the use of traditional medicines were most salient. Increased supervision and regular training amongst lay adherence counsellors are needed, as well as regular monitoring of the persons attending the clinic on the child's behalf.

Designing a Community-Based Lay Health Advisor Training Curriculum to Address Cancer Health Disparities

PubMed Central

Gwede, Clement K.; Ashley, Atalie A.; McGinnis, Kara; Montiel-Ishino, F. Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B.; Wathington, Deanna; Dash-Pitts, Lolita; Green, B. Lee

2012-01-01

Introduction Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. Approach and Strategies Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic–community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Discussion and Conclusions Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research. PMID:22982709

Virtual Reality Job Interview Training in Adults with Autism Spectrum Disorder

PubMed Central

Smith, Matthew J.; Ginger, Emily; Wright, Katherine; Wright, Michael; Taylor, Julie Lounds; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D.; Fleming, Michael F.

2014-01-01

The feasibility and efficacy of Virtual Reality Job Interview Training (VR-JIT) was assessed in a single-blinded randomized controlled trial. Adults with autism spectrum disorder were randomized to VR-JIT (n=16) or treatment as usual (TAU) (n=10) groups. VR-JIT consisted of simulated job interviews with a virtual character and didactic training. Participants attended 90% of lab-based training sessions and found VR-JIT easy-to-use, enjoyable, and they felt prepared for future interviews. VR-JIT participants had greater improvement during live standardized job interview role-play performances than TAU participants (p=0.046). A similar pattern was observed for self-reported self-confidence at a trend level (p=0.060). VR-JIT simulation performance scores increased over time (R-Squared=0.83). Results indicate preliminary support for the feasibility and efficacy of VR-JIT, which can be administered using computer software or via the internet. PMID:24803366

Virtual reality job interview training in adults with autism spectrum disorder.

PubMed

Smith, Matthew J; Ginger, Emily J; Wright, Katherine; Wright, Michael A; Taylor, Julie Lounds; Humm, Laura Boteler; Olsen, Dale E; Bell, Morris D; Fleming, Michael F

2014-10-01

The feasibility and efficacy of virtual reality job interview training (VR-JIT) was assessed in a single-blinded randomized controlled trial. Adults with autism spectrum disorder were randomized to VR-JIT (n = 16) or treatment-as-usual (TAU) (n = 10) groups. VR-JIT consisted of simulated job interviews with a virtual character and didactic training. Participants attended 90 % of laboratory-based training sessions, found VR-JIT easy to use and enjoyable, and they felt prepared for future interviews. VR-JIT participants had greater improvement during live standardized job interview role-play performances than TAU participants (p = 0.046). A similar pattern was observed for self-reported self-confidence at a trend level (p = 0.060). VR-JIT simulation performance scores increased over time (R(2) = 0.83). Results indicate preliminary support for the feasibility and efficacy of VR-JIT, which can be administered using computer software or via the internet.

Training and calibration of interviewers for oral health literacy using the BREALD-30 in epidemiological studies.

PubMed

Vilella, Karina Duarte; Assunção, Luciana Reichert da Silva; Junkes, Mônica Carmem; Menezes, José Vitor Nogara Borges de; Fraiz, Fabian Calixto; Ferreira, Fernanda de Morais

2016-08-22

The objective of this study was to describe an interviewer training and calibration method to evaluate oral health literacy using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) in epidemiological studies. An experienced researcher (gold standard) conducted all training sessions. The interviewer training and calibration sessions included three different phases: theoretical training, practical training, and calibration. In the calibration phase, six interviewers (dentists) independently assessed 15 videos of individuals who had different levels of oral health literacy. Accuracy and reproducibility were evaluated using the kappa coefficient and the intraclass correlation coefficient (ICC). The percentage of agreement for each word in the instrument was also calculated. After training, the kappa values were higher than 0.911 and 0.893 for intra- and inter-rater agreement, respectively. When the results were analyzed separately for the different levels of literacy, the lowest agreement rate was found when evaluating the videos of individuals with low literacy (K = 0.871), but still within the range considered to be near-perfect agreement. The ICC values were higher than 0.990 and 0.975 for intra- and inter-rater agreement, respectively. The lowest percentage of agreement was 86.6% for the word "hipoplasia" (hypoplasia). This interviewer training and calibration method proved to be feasible and effective. Therefore, it can be used as a methodological tool in studies assessing oral health literacy using the BREALD-30.

Corporate Strategy and Industrial Training. Contract Report.

ERIC Educational Resources Information Center

Miller, Robert R.

Using a brief series of extended interviews, a study gathered information on how corporate competitive strategies affect, and are affected by, worker training requirements. It focused on training activities involving plant-level personnel and first-level supervisors. Interviews were conducted with general manufacturing executives and training…

The experience of people with lung cancer with a volunteer-based lay navigation intervention at an outpatient cancer center.

PubMed

Lorhan, Shaun; Dennis, Darcy; van der Westhuizen, Michael; Hodgson, Sally; Berrang, Tanya; Daudt, Helena

2014-08-01

To describe the experiences of patients with lung cancer with a volunteer-based lay navigation intervention. Forty patients with newly diagnosed lung cancer enrolled in a three-step navigation intervention delivered by trained volunteer lay navigators (VLNs), beginning prior to their first oncologist's appointment and ending before the start of treatment. Methodological triangulation of data was used in a mixed method study design. Cases were categorized based on the predominant needs met by the VLN: emotional, practical/informational, family, and complex. Data were analyzed using framework analysis. The provision of emotional support, information, and referrals to other services by the VLN were of particular benefit to the patient and their families. Satisfaction with the program and its timing was high; it was considered an effective means for patients to share concerns and have their needs attended to before starting treatment. This study demonstrates capacity for lay volunteers to address the multifaceted needs of lung cancer patients during their transition from primary care in the diagnosis to treatment phase. Using volunteers as navigators offers an opportunity to meet patient needs with minimal resources, increase access to services for patients, and improve the sustainability of the program. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

[Training of interviewers in the utilization of standardized questionnaires in psychiatry: studies realized with the Present State Examination (PSE)].

PubMed

Lesage, A D; Cyr, M; Toupin, J; Cormier, H; Valiquette, C

1991-01-01

Interview questionnaires offer more validity than self-administered format in exploring psychopathological or psychosocial phenomena of interest in psychiatric research. If used, special care needs to be paid to interviewers' training and ensuring that they maintain their reliability. No widespread training standards exist and each schedule may carry its own procedure. Our aims are to indicate how we trained interviewers with the French version of the Present State Examination (Wing, Cooper and Sartorius, 1974) and how we checked and kept acceptable interraters reliability during one study. We will provide data on the interraters reliability during the training and the study, as well as the test-retest reliability. These results will be used to support some guidelines when using this sort of psychiatric research questionnaires in order to ensure comparability both within the study and between studies.

The social context of hormone and silicone injection among Puerto Rican transwomen.

PubMed

Padilla, Mark B; Rodríguez-Madera, Sheilla; Ramos Pibernus, Alixida G; Varas-Díaz, Nelson; Neilands, Torsten B

2018-05-01

This paper draws on ethnographic, qualitative and survey data with transwomen in Puerto Rico to examine the social and political-economic context of lay injection with hormone and silicone - common practices within this community. We describe specific practices of hormone and silicone injection, the actors that govern them, the market for the sale and distribution of syringes and the networks of lay specialists who provide services to a population that is neglected by and largely excluded from biomedical settings. Our data derive from ethnographic observations, sociodemographic questionnaires, surveys and semi-structured interviews conducted with a diverse group of transwomen in metropolitan San Juan, Puerto Rico. Our analysis focuses on four overlapping social domains or processes that shape the practices of lay silicone and hormone injection among transwomen: (1) the circulation of gender transitioning technologies within local and global markets; (2) the tension between the social exclusion of transwomen and their resilient sub-cultural responses; (3) the cultural meanings that shape transwomen's attitudes about injection; and (4) the perceived consequences of injection. We conclude with a discussion of the kinds of intervention and policy changes that would respond to the factors that most endanger transwomen's health.

A randomized trial of a lay person-led self-management group intervention for back pain patients in primary care.

PubMed

Von Korff, M; Moore, J E; Lorig, K; Cherkin, D C; Saunders, K; González, V M; Laurent, D; Rutter, C; Comite, F

1998-12-01

Randomized, controlled trial. To evaluate a four-session self-management group intervention for patients with pain in primary care, led by trained lay persons with back pain. The intervention was designed to reduce patient worries, encourage self-care, and reduce activity limitations. Randomized trials of educational interventions suggest that activating interventions may improve back pain outcomes. Expert opinion increasingly regards effective self-management of back pain as important in achieving good outcomes. In this study, an educational intervention designed to activate patients and support effective self-management was evaluated. Six to 8 weeks after a primary care visit for back pain, patients were invited to participate in an educational program to improve back pain self-management. Those showing interest by returning a brief questionnaire became eligible for the study. Participants (n = 255) randomly were assigned to either a self-management group intervention or to a usual care control group. The effect of the intervention, relative to usual care, was assessed 3, 6, and 12 months after randomization, controlling for baseline values. The intervention consisted of a four-session group applying problem-solving techniques to back pain self-management, supplemented by educational materials (book and videos) supporting active management of back pain. The groups were led by lay persons trained to implement a fully structured group protocol. The control group received usual care, supplemented by a book on back pain care. Participants randomly assigned to the self-management groups reported significantly less worry about back pain and expressed more confidence in self-care. Roland Disability Questionnaire Scores were significantly lower among participants in the self-management groups relative to the usual care controls at 6 months (P = 0.007), and this difference was sustained at 12 months at borderline significance levels (P = 0.09). Among self-management group participants, 48% showed a 50% or greater reduction in Roland Disability Questionnaire Score at 6 months, compared with 33% among the usual care controls. Self-management groups led by trained lay persons following a structured protocol were more effective than usual care in reducing worries, producing positive attitudes toward self-care, and reducing activity limitations among patients with back pain in primary care.

Participant-Observation and Pile Sorting: Methods for Eliciting Local Understandings and Valuations of Plants as a First Step towards Informed Community Participation in Environment and Health Initiatives in Hawai'i

ERIC Educational Resources Information Center

Gollin, Lisa X.; McMillen, Heather; Wilcox, Bruce

2004-01-01

Semistructured interviews were conducted to explore local, lay perceptions and valuations of native and nonnative flora in order to better understand and anticipate community perceptions of, and potential participation in revegetation or eradication conservation efforts in multiethnic communities of Oahu, Hawai'i. The authors detail the…

Gambler Risk Perception: A Mental Model and Grounded Theory Analysis.

PubMed

Spurrier, Michael; Blaszczynski, Alexander; Rhodes, Paul

2015-09-01

Few studies have investigated how gamblers perceive risk or the role of risk perception in disordered gambling. The purpose of the current study therefore was to obtain data on lay gamblers' beliefs on these variables and their effects on decision-making, behaviour, and disordered gambling aetiology. Fifteen regular lay gamblers (non-problem/low risk, moderate risk and problem gamblers) completed a semi-structured interview following mental models and grounded theory methodologies. Gambler interview data was compared to an expert 'map' of risk-perception, to identify comparative gaps or differences associated with harmful or safe gambling. Systematic overlapping processes of data gathering and analysis were used to iteratively extend, saturate, test for exception, and verify concepts and themes emerging from the data. The preliminary findings suggested that gambler accounts supported the presence of expert conceptual constructs, and to some degree the role of risk perception in protecting against or increasing vulnerability to harm and disordered gambling. Gambler accounts of causality, meaning, motivation, and strategy were highly idiosyncratic, and often contained content inconsistent with measures of disordered gambling. Disordered gambling appears heavily influenced by relative underestimation of risk and overvaluation of gambling, based on explicit and implicit analysis, and deliberate, innate, contextual, and learned processing evaluations and biases.

Virtual reality job interview training and 6-month employment outcomes for individuals with schizophrenia seeking employment.

PubMed

Smith, Matthew J; Fleming, Michael F; Wright, Michael A; Roberts, Andrea G; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D

2015-08-01

Individuals with schizophrenia have low employment rates and the job interview presents a critical barrier for them to obtain employment. Virtual reality training has demonstrated efficacy at improving interview skills and employment outcomes among multiple clinical populations. However, the effects of this training on individuals with schizophrenia are unknown. This study evaluated the efficacy of virtual reality job interview training (VR-JIT) at improving job interview skills and employment outcomes among individuals with schizophrenia in a small randomized controlled trial (n=21 VR-JIT trainees, n=11 waitlist controls). Trainees completed up to 10h of virtual interviews using VR-JIT, while controls received services as usual. Primary outcome measures included two pre-test and two post-test video-recorded role-play interviews scored by blinded raters with expertise in human resources and self-reported interviewing self-confidence. Six-month follow-up data on employment outcomes were collected. Trainees reported that the intervention was easy-to-use, helpful, and prepared them for future interviews. Trainees demonstrated increased role-play scores between pre-test and post-test while controls did not (p=0.001). After accounting for neurocognition and months since prior employment, trainees had greater odds of receiving a job offer by 6month follow-up compared to controls (OR: 8.73, p=0.04) and more training was associated with fewer weeks until receiving a job offer (r=-0.63, p<0.001). Results suggest that VR-JIT is acceptable to trainees and may be efficacious for improving job interview skills in individuals with schizophrenia. Moreover, trainees had greater odds of receiving a job offer by 6-month follow-up. Future studies could evaluate the effectiveness of VR-JIT within community-based services. Copyright © 2015 Elsevier B.V. All rights reserved.

The training needs of health care support workers: results of a study of workers and their managers.

PubMed

Moseley, Laurence G; Davies, Moira; Evans, Linda E

2007-12-01

This study was designed to assess the training needs of health care support workers. In the past, opinions on the topic have been varied, but were rarely based on empirical evidence. The study was designed as a self-report questionnaire survey of health care support workers and their managers in six units in health and social care, using as its basis 32 descriptors from the NHS Knowledge and Skills Framework, levels 1 and 2. The achieved sample was 117, giving a 77% response rate. Thirty-five per cent of respondents thought that health care support workers were 'unable' to perform six or more of the 32 descriptors used, whilst on the criterion of being 'less than able', the figure was 64%. Support workers and their managers agreed closely (rho = 0.8) on where the difficulties lay in achieving Knowledge and Skills Framework competencies. Those difficulties lay particularly in two areas: (1) biomedical/physiological knowledge and (2) data-handling. We concluded that the numbers in need of training were substantial and the areas of need were the two identified above. The main implications for clinical practice are that (a) for those who supervise or mentor health care support workers, there should be a greater concentration on the more scientific areas of expertise and (b) a similar emphasis is needed for those who train mentors or supervisors. These implications will become more important over time as scientific knowledge about medicine and health care increases.

Fair reckoning: a qualitative investigation of responses to an economic health resource allocation survey.

PubMed

Giacomini, Mita; Hurley, Jeremiah; DeJean, Deirdre

2014-04-01

To investigate how participants in an economic resource allocation survey construct notions of fairness. Qualitative interview study guided by interpretive grounded theory methods. Qualitative interviews were conducted with volunteer university- (n=39) and community-based (n =7) economic survey participants. INTERVENTION OR MAIN VARIABLES STUDIED: We explored how participants constructed meanings to guide or explain fair survey choices, focusing on rationales, imagery and additional desired information not provided in the survey scenarios. Data were transcribed and coded into qualitative categories. Analysis iterated with data collection iterated through three waves of interviews. Participants compared the survey dilemmas to domains outside the health system. Most compared them with other micro-level, inter-personal sharing tasks. Participants raised several fairness-relevant factors beyond need or capacity to benefit. These included age, weight, poverty, access to other options and personal responsibility for illness; illness duration, curability or seriousness; life expectancy; possibilities for sharing; awareness of other's needs; and ability to explain allocations to those affected. They also articulated a fairness principle little considered by equity theories: that everybody must get something and nobody should get nothing. Lay criteria for judging fairness are myriad. Simple scenarios may be used to investigate lay commitments to abstract principles. Although principles are the focus of analysis and inference, participants may solve simplified dilemmas by imputing extraneous features to the problem or applying unanticipated principles. These possibilities should be taken into account in the design of resource allocation surveys eliciting the views of the public. © 2012 John Wiley & Sons Ltd.

Fair reckoning: a qualitative investigation of responses to an economic health resource allocation survey

PubMed Central

Giacomini, Mita; Hurley, Jeremiah; DeJean, Deirdre

2012-01-01

Abstract Objective  To investigate how participants in an economic resource allocation survey construct notions of fairness. Design  Qualitative interview study guided by interpretive grounded theory methods. Setting and participants  Qualitative interviews were conducted with volunteer university‐ (n = 39) and community‐based (n = 7) economic survey participants. Intervention or main variables studied  We explored how participants constructed meanings to guide or explain fair survey choices, focusing on rationales, imagery and additional desired information not provided in the survey scenarios. Main outcome measures  Data were transcribed and coded into qualitative categories. Analysis iterated with data collection iterated through three waves of interviews. Results  Participants compared the survey dilemmas to domains outside the health system. Most compared them with other micro‐level, inter‐personal sharing tasks. Participants raised several fairness‐relevant factors beyond need or capacity to benefit. These included age, weight, poverty, access to other options and personal responsibility for illness; illness duration, curability or seriousness; life expectancy; possibilities for sharing; awareness of other’s needs; and ability to explain allocations to those affected. They also articulated a fairness principle little considered by equity theories: that everybody must get something and nobody should get nothing. Discussion and conclusions  Lay criteria for judging fairness are myriad. Simple scenarios may be used to investigate lay commitments to abstract principles. Although principles are the focus of analysis and inference, participants may solve simplified dilemmas by imputing extraneous features to the problem or applying unanticipated principles. These possibilities should be taken into account in the design of resource allocation surveys eliciting the views of the public. PMID:22390183

Can We Get Faculty Interviewers on the Same Page? An Examination of a Structured Interview Course for Surgeons.

PubMed

Gardner, Aimee K; D'Onofrio, Brenna C; Dunkin, Brian J

Guidance on how to train faculty to conduct structured interviews and implement them into current screening processes is lacking. The goal of this study is to describe a structured interview training program designed specifically for surgeons and examine its effectiveness. Faculty involved in advanced surgical fellowship interviews completed a 20-item knowledge assessment and video-based applicant interview ratings before taking a half-day course on conducting structured interviews. The course consisted of evidence-based strategies and methods for conducting structured interviews, asking questions, and rating applicants in a highly interactive format. After the course, faculty again completed the knowledge assessment and provided ratings for 3 video-based applicant interviews. All faculty members (N = 5) responsible for selecting fellows in minimally invasive and bariatric surgery completed the training. Faculty had an average of 15.8 ± 9.12 years in practice. Average performance on the precourse knowledge assessment was 35% ± 6.12% and the group was unable to achieve acceptable agreement for applicant interview scores for any of the competencies assessed. After the course, faculty demonstrated significant improvements (p < 0.01) on the knowledge assessment, more than doubling their scores on the pretest with average scores of 80% ± 9.35%. Faculty also improved their interrater agreement of applicant competency, with 80% of the applicant interview ratings within 2 points of each other. Implementation of a half-day course designed to teach principles and skills around structured interviewing and assessment demonstrated significant improvements in both interviewing knowledge and interrater agreement. These findings support the time and resources required to develop and implement a structured interview training program for surgeons for the postgraduate admissions process. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Perceptions and experiences of nurse preceptors regarding their training courses: a mixed method study.

PubMed

Chang, Chia-Chi; Lin, Li-Min; Chen, I-Hui; Kang, Chun-Mei; Chang, Wen-Yin

2015-01-01

Although the benefits of preceptor training programs on the performance of nurse preceptors have been reported, research related to nurse preceptors' perceptions of and experiences with preceptor training courses is relatively limited. To explore nurse preceptors' perceptions of preceptor training courses and obtain information on their experiences in working as preceptors. A mixed method design was conducted. Nurse preceptors who currently work at one of eight hospitals in northern Taiwan were recruited to participate in this study. A questionnaire survey and focus group interviews were conducted. A training course perception scale was developed and generated based on the current nurse preceptor training programs offered in eight hospitals. Focus group interviews were conducted to obtain additional information on nurse preceptors' experiences in working as preceptors. The survey data were analyzed using descriptive statistics. Interview data were transcribed and analyzed using a qualitative content analysis approach. The results from the surveys of 386 nurse preceptors revealed that most courses included in the current preceptor training programs did not fulfill the learning needs of nurse preceptors and were clinically impractical. The most necessary and clinically useful course was the communication skills course, whereas the least useful course was the adult learning theory and principles course. Three themes were identified as problems based on the three focus group interviews conducted with 36 nurse preceptors: inadequate training was received before nurses were appointed as nurse preceptors, the courses were more theoretical rather than practical, and the preceptors experienced stress from multiple sources. The results revealed that the current preceptor training courses are impractical; therefore, the content of preceptor training courses must be altered to fulfill nurse preceptors' training needs. Furthermore, problems identified through the focus group interviews reinforce the survey results. Copyright © 2014 Elsevier Ltd. All rights reserved.

Question Asking in the Science Classroom: Teacher Attitudes and Practices

NASA Astrophysics Data System (ADS)

Eshach, Haim; Dor-Ziderman, Yair; Yefroimsky, Yana

2014-02-01

Despite the wide agreement among educators that classroom learning and teaching processes can gain much from student and teacher questions, their potential is not fully utilized. Adopting the view that reporting both teachers' (of varying age groups) views and actual classroom practices is necessary for obtaining a more complete view of the phenomena at hand, the present study closely examines both cognitive and affective domains of: (a) teachers' views (via interviews) concerning: (1) importance and roles of teacher and student questions, (2) teacher responses, and (3) planning and teacher training; and (b) teachers' actual practices (via classroom observations) concerning: (1) number and (2) level of teacher and student questions, as well as (3) teachers' responses to questions. The data were collected from 3 elementary, 3 middle, and 3 high school science teachers and their respective classroom students. The findings lay out a wide view of classroom questioning and teachers' responses, and relate what actually occurs in classes to teachers' stated views. Some of the study's main conclusions are that a gap exists between how science researchers and teachers view the role of teacher questions: the former highlight the cognitive domain, while the latter emphasize the affective domain.

Opportunities for strengthening provider-initiated testing and counselling for HIV in Namibia

PubMed Central

Davyduke, Tracy; Pietersen, Ismelda; Lowrance, David; Amwaama, Selma; Taegtmeyer, Miriam

2015-01-01

This short report identifies enablers and barriers to the uptake of provider-initiated testing and counselling for HIV (PITC) in Namibia and identifies key opportunities for strengthening this vital aspect of the national HIV response. We explored this through facility mapping, register reviews and qualitative methods including focus group discussions and in-depth interviews. Four health facilities (clinics and hospitals) in two regions were included in the study. We identified that PITC in Namibia was largely delivered by lay counsellors operating in designated rapid testing rooms located in health facilities and found a large number of missed opportunities for HIV testing through this model. Nurses did not see it as an integral part of their role, were not aware of HIV testing and counselling policy, felt inadequately trained and supported, and experienced staffing shortages. Institutional issues also acted as barriers to nurses performing or initiating discussions about PITC. Wider dissemination and implementation of policy, increasing privacy of consultation spaces and community sensitisation are simple measures that represent opportunities for strengthening this response and ensuring that symptomatic individuals who are unaware of their HIV status do not fall through the net. PMID:25771903

Teachers Reflect on Homophobia in the Cypriot Education System: A Qualitative Study

ERIC Educational Resources Information Center

Shoshilou, Panayiota A.; Vasiliou, Elena

2016-01-01

A review of the academic and lay literature concerning Cyprus reveals that homophobia is prevalent throughout society. This research aimed to investigate homophobia through the narratives of educators. Twenty-three teachers were randomly selected out of the pool of volunteers in a training project. Aspects of homophobia previously reported in…

Contributions to Objective Measurement and Evaluation of Trainee Competency.

ERIC Educational Resources Information Center

Moonan, William J.

The purpose of this paper is to lay a basis for and discuss the components of a system, called COMET, designed to objectively measure and evaluate the competency of trainees in military training enterprises. COMET is an acronym for "Computerized Objective Measurement and Evaluation of Trainees." These goals will be accomplished by: (a)…

Defining the Language Assessment Literacy Gap: Evidence from a Parliamentary Inquiry

ERIC Educational Resources Information Center

Pill, John; Harding, Luke

2013-01-01

This study identifies a unique context for exploring lay understandings of language testing and, by extension, for characterizing the nature of language assessment literacy among non-practitioners, stemming from data in an inquiry into the registration processes and support for overseas trained doctors by the Australian House of Representatives…

The Political Power of Professionalism: A Study of School Superintendents and City Managers.

ERIC Educational Resources Information Center

Zeigler, Harmon; And Others

A 3-year research project was conducted to compare the conflict management behavior of school superintendents and city managers, both of whom are professionally trained experts held accountable to lay legislatures. Chapter 1, "Professionalism and Responsiveness," addresses the inherent tension, in a democracy, between elected officials'…

Rural Communities Learn to Help Themselves.

ERIC Educational Resources Information Center

Kelley, Verne R.; And Others

In an effort to prove that mental health services can be lay administered, a training program was implemented in the rural areas of Cedar County (October 1972-April 1973) and Iowa County, Iowa (October 1973-May 1974). Recruited via personal or telephone contact, 20 trainees were selected who demonstrated they: were good listeners; did not impose…

Training Substance Abuse Clinicians in Motivational Interviewing Using Live Supervision via Teleconferencing

ERIC Educational Resources Information Center

Smith, Jennifer L.; Carpenter, Kenneth M.; Amrhein, Paul C.; Brooks, Adam C.; Levin, Deborah; Schreiber, Elizabeth A.; Travaglini, Laura A.; Hu, Mei-Chen; Nunes, Edward V.

2012-01-01

Objective: Training through traditional workshops is relatively ineffective for changing counseling practices. Teleconferencing supervision (TCS) was developed to provide remote, live supervision for training motivational interviewing (MI). Method: Ninety-seven drug treatment counselors completed a 2-day MI workshop and were randomized to live…

38 CFR 21.370 - Intraregional travel at government expense.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for a personal interview prior to induction into training when: (A) The school requires the interview... transportation for the veteran's dependents, or for moving personal effects. (Authority: 38 U.S.C. 111, 3104(a... report to a prospective employer-trainer for an interview prior to induction into training, when there is...

Motivational Interviewing for Incarcerated Adolescents: Effects of Depressive Symptoms on Reducing Alcohol and Marijuana Use After Release*

PubMed Central

Stein, L. A. R.; Lebeau, Rebecca; Colby, Suzanne M.; Barnett, Nancy P.; Golembeske, Charles; Monti, Peter M.

2011-01-01

Objective: Motivational interviewing to reduce alcohol and marijuana use among incarcerated adolescents was evaluated. Method: Adolescents (N = 162, 84% male; M = 17.10 years old) were randomly assigned to receive motivational interviewing or relaxation training, with follow-up assessment 3 months after release. Results: Compared with those who received relaxation training, adolescents who received motivational interviewing had lower rates of alcohol and marijuana use at follow-up, with some evidence for moderating effects of depression. At low levels of depression, adolescents who received motivational interviewing had lower rates of use. Adolescents who received relaxation training and who had high levels of depressive symptoms early in incarceration showed less use at follow-up than those low in depressive symptoms who received relaxation training. Conclusions: This brief motivational interviewing intervention during incarceration reduces alcohol and marijuana use after release. In addition, depressive symptoms early in incarceration should be considered in treating these adolescents, but more work is needed to extend follow-up period and account for the impact of depression on outcomes. PMID:21513687

Impact of Repeated Questioning on Interviewers: Learning From a Forensic Interview Training Project.

PubMed

Duron, Jacquelynn F; Cheung, Monit

2016-01-01

Forensic interviewers have a difficult job with high risk for career burnout and secondary trauma. Few studies have addressed how new forensic interviewers or trainees experience repeated questioning and multiple interviews. This study simulated the process of training new forensic interviewers through the creation of two interview videos in which social work graduate students participated as actors portraying the roles of interviewer and child. These films served as instructional aids preparing graduate social work students for professional child welfare roles while promoting research-based approaches to interviewing children about sexual abuse allegations. Qualitative data from two cohorts of student actors were collected to analyze interviewers' perspectives on repeated questioning and interviews in child sexual abuse cases. Two themes were extracted from the subjects' experiences: "It is emotionally taxing" and "Navigating the interviewer role is unexpectedly complex." Exposure to repeated questions and multiple interviews affected the performance and confidence of the interviewers.

jsc2017e136054 - On a snowy night at Red Square in Moscow, Expedition 54-55 crewmember Anton Shkaplerov of the Russian Federal Space Agency (Roscosmos) lays flowers at the Kremlin Wall where Russian space icons are interred in traditional pre-launch cerem

NASA Image and Video Library

2017-11-30

jsc2017e136054 - On a snowy night at Red Square in Moscow, Expedition 54-55 crewmember Anton Shkaplerov of the Russian Federal Space Agency (Roscosmos) lays flowers at the Kremlin Wall where Russian space icons are interred in traditional pre-launch ceremonies Nov. 30. Shkaplerov, Norishige Kanai of the Japan Aerospace Exploration Agency (JAXA) and Scott Tingle of NASA will launch from the Baikonur Cosmodrome in Kazakhstan on the Soyuz MS-07 spacecraft Dec. 17 for a five-month mission on the International Space Station...Andrey Shelepin/Gagarin Cosmonaut Training Center.

jsc2017e136060 - On a snowy night at Red Square in Moscow, Expedition 54-55 crewmember Norishige Kanai of the Japan Aerospace Exploration Agency (JAXA) lays flowers at the Kremlin Wall where Russian space icons are interred in traditional pre-launch cerem

NASA Image and Video Library

2017-11-30

jsc2017e136060 - On a snowy night at Red Square in Moscow, Expedition 54-55 crewmember Norishige Kanai of the Japan Aerospace Exploration Agency (JAXA) lays flowers at the Kremlin Wall where Russian space icons are interred in traditional pre-launch ceremonies Nov. 30. Kanai, Scott Tingle of NASA and Anton Shkaplerov of the Russian Federal Space Agency (Roscosmos) will launch from the Baikonur Cosmodrome in Kazakhstan on the Soyuz MS-07 spacecraft Dec. 17 for a five-month mission on the International Space Station...Andrey Shelepin/Gagarin Cosmonaut Training Center.

Trained student pharmacists' telephonic collection of patient medication information: Evaluation of a structured interview tool.

PubMed

Margolis, Amanda R; Martin, Beth A; Mott, David A

2016-01-01

To determine the feasibility and fidelity of student pharmacists collecting patient medication list information using a structured interview tool and the accuracy of documenting the information. The medication lists were used by a community pharmacist to provide a targeted medication therapy management (MTM) intervention. Descriptive analysis of patient medication lists collected with telephone interviews. Ten trained student pharmacists collected the medication lists. Trained student pharmacists conducted audio-recorded telephone interviews with 80 English-speaking, community-dwelling older adults using a structured interview tool to collect and document medication lists. Feasibility was measured using the number of completed interviews, the time student pharmacists took to collect the information, and pharmacist feedback. Fidelity to the interview tool was measured by assessing student pharmacists' adherence to asking all scripted questions and probes. Accuracy was measured by comparing the audio-recorded interviews to the medication list information documented in an electronic medical record. On average, it took student pharmacists 26.7 minutes to collect the medication lists. The community pharmacist said the medication lists were complete and that having the medication lists saved time and allowed him to focus on assessment, recommendations, and education during the targeted MTM session. Fidelity was high, with an overall proportion of asked scripted probes of 83.75% (95% confidence interval [CI], 80.62-86.88%). Accuracy was also high for both prescription (95.1%; 95% CI, 94.3-95.8%) and nonprescription (90.5%; 95% CI, 89.4-91.4%) medications. Trained student pharmacists were able to use an interview tool to collect and document medication lists with a high degree of fidelity and accuracy. This study suggests that student pharmacists or trained technicians may be able to collect patient medication lists to facilitate MTM sessions in the community pharmacy setting. Evaluating the sustainability of using student pharmacists or trained technicians to collect medication lists is needed. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Trained student pharmacists’ telephonic collection of patient medication information: Evaluation of a structured interview tool

PubMed Central

Margolis, Amanda R.; Martin, Beth A.; Mott, David A.

2016-01-01

Objective To determine the feasibility and fidelity of student pharmacists collecting patient medication list information using a structured interview tool and the accuracy of documenting the information. The medication lists were used by a community pharmacist to provide a targeted medication therapy management (MTM) intervention. Design Descriptive analysis of patient medication lists collected via telephone interviews. Participants 10 trained student pharmacists collected the medication lists. Intervention Trained student pharmacists conducted audio-recorded telephone interviews with 80 English-speaking community dwelling older adults using a structured interview tool to collect and document medication lists. Main outcome measures Feasibility was measured using the number of completed interviews, the time student pharmacists took to collect the information, and pharmacist feedback. Fidelity to the interview tool was measured by assessing student pharmacists’ adherence to asking all scripted questions and probes. Accuracy was measured by comparing the audio recorded interviews to the medication list information documented in an electronic medical record. Results On average it took student pharmacists 26.7 minutes to collect the medication lists. The community pharmacist said the medication lists were complete and that having the medication lists saved time and allowed him to focus on assessment, recommendations, and education during the targeted MTM session. Fidelity was high with an overall proportion of asked scripted probes of 83.75% (95%CI: 80.62–86.88%). Accuracy was also high for both prescription (95.1%, 95%CI: 94.3–95.8%) and non-prescription (90.5%, 95%CI: 89.4–91.4%) medications. Conclusion Trained student pharmacists were able to use an interview tool to collect and document medication lists with a high degree of fidelity and accuracy. This study suggests that student pharmacists or trained technicians may be able to collect patient medication lists to facilitate MTM sessions in the community pharmacy setting. Evaluating the sustainability of using student pharmacists or trained technicians to collect medication lists is needed. PMID:27000165

Cryptococcal antigen screening by lay cadres using a rapid test at the point of care: A feasibility study in rural Lesotho.

PubMed

Rick, Fernanda; Niyibizi, Aline Aurore; Shroufi, Amir; Onami, Kazumi; Steele, Sarah-Jane; Kuleile, Malehlohonolo; Muleya, Innocent; Chiller, Tom; Walker, Tiffany; Van Cutsem, Gilles

2017-01-01

Cryptococcal meningitis is one of the leading causes of death among people with HIV in Africa, primarily due to delayed presentation, poor availability and high cost of treatment. Routine cryptococcal antigen (CrAg) screening of patients with a CD4 count less than 100 cells/mm3, followed by pre-emptive therapy if positive, might reduce mortality in high prevalence settings. Using the cryptococcal antigen (CrAg) lateral flow assay (LFA), screening is possible at the point of care (POC). However, critical shortages of health staff may limit adoption. This study investigates the feasibility of lay counsellors conducting CrAg LFA screening in rural primary care clinics in Lesotho. From May 2014 to June 2015, individuals who tested positive for HIV were tested for CD4 count and those with CD4 <100 cells/mm3 were screened with CrAg LFA. All tests were performed by lay counsellors. CrAg-positive asymptomatic patients received fluconazole, while symptomatic patients were referred to hospital. Lay counsellors were trained and supervised by a laboratory technician and counsellor activity supervisor. Additionally, nurses and doctors were trained on CrAg screening and appropriate treatment. During the study period, 1,388 people were newly diagnosed with HIV, of whom 129 (9%) presented with a CD4 count <100 cells/mm3. Of these, 128 (99%) were screened with CrAg LFA and 14/128 (11%) tested positive. Twelve of the 14 (86%) were asymptomatic, and received outpatient fluconazole. All commenced ART with a median time to initiation of 15.5 days [IQR: 14-22]. Of the asymptomatic patients, nine (75%) remained asymptomatic after a median time of 5 months [IQR; 3-6] of follow up. One (8%) became co-infected with tuberculosis and died and two were transferred out. The two patients with symptomatic cryptococcal meningitis (CM) were referred to hospital, where they later died. CrAg LFA screening by lay counsellors followed by pre-emptive fluconazole treatment for asymptomatic cases, or referral to hospital for symptomatic cases, proved feasible. However, regular follow-up to ensure proper management of cryptococcal disease was needed. These early results support the wider use of CrAg LFA screening in remote primary care settings where upper cadres of healthcare staff may be in short supply.

Cryptococcal antigen screening by lay cadres using a rapid test at the point of care: A feasibility study in rural Lesotho

PubMed Central

Rick, Fernanda; Niyibizi, Aline Aurore; Shroufi, Amir; Onami, Kazumi; Steele, Sarah-Jane; Kuleile, Malehlohonolo; Muleya, Innocent; Chiller, Tom; Walker, Tiffany; Van Cutsem, Gilles

2017-01-01

Introduction Cryptococcal meningitis is one of the leading causes of death among people with HIV in Africa, primarily due to delayed presentation, poor availability and high cost of treatment. Routine cryptococcal antigen (CrAg) screening of patients with a CD4 count less than 100 cells/mm3, followed by pre-emptive therapy if positive, might reduce mortality in high prevalence settings. Using the cryptococcal antigen (CrAg) lateral flow assay (LFA), screening is possible at the point of care (POC). However, critical shortages of health staff may limit adoption. This study investigates the feasibility of lay counsellors conducting CrAg LFA screening in rural primary care clinics in Lesotho. Methods From May 2014 to June 2015, individuals who tested positive for HIV were tested for CD4 count and those with CD4 <100 cells/mm3 were screened with CrAg LFA. All tests were performed by lay counsellors. CrAg-positive asymptomatic patients received fluconazole, while symptomatic patients were referred to hospital. Lay counsellors were trained and supervised by a laboratory technician and counsellor activity supervisor. Additionally, nurses and doctors were trained on CrAg screening and appropriate treatment. Results During the study period, 1,388 people were newly diagnosed with HIV, of whom 129 (9%) presented with a CD4 count <100 cells/mm3. Of these, 128 (99%) were screened with CrAg LFA and 14/128 (11%) tested positive. Twelve of the 14 (86%) were asymptomatic, and received outpatient fluconazole. All commenced ART with a median time to initiation of 15.5 days [IQR: 14–22]. Of the asymptomatic patients, nine (75%) remained asymptomatic after a median time of 5 months [IQR; 3–6] of follow up. One (8%) became co-infected with tuberculosis and died and two were transferred out. The two patients with symptomatic cryptococcal meningitis (CM) were referred to hospital, where they later died. Conclusions CrAg LFA screening by lay counsellors followed by pre-emptive fluconazole treatment for asymptomatic cases, or referral to hospital for symptomatic cases, proved feasible. However, regular follow-up to ensure proper management of cryptococcal disease was needed. These early results support the wider use of CrAg LFA screening in remote primary care settings where upper cadres of healthcare staff may be in short supply. PMID:28877182

Use of psychotropic medications in São Paulo Metropolitan Area, Brazil: pattern of healthcare provision to general population.

PubMed

Campanha, Angela Maria; Siu, Erica Rosanna; Milhorança, Igor André; Viana, Maria Carmen; Wang, Yuan-Pang; Andrade, Laura Helena

2015-11-01

We estimate the proportion of psychotropic medication use (PMU) among adults in São Paulo Metropolitan Area, Brazil. We investigated whether socio-demographic factors, comorbidity, and disease severity influence PMU among individuals with psychiatric disorders. Data are from the São Paulo Megacity Mental Health Survey, a cross-sectional, population-based study, the Brazilian branch of the World Mental Health Survey Initiative. Trained lay interviewers face-to-face assessed psychiatric disorders and PMU through the Composite International Diagnostic Interview. Respondents were asked about use of healthcare service and prescribed medications for mental disorders in the previous year. Information on PMU was collected for 2935 adult residents in the area and among those with disorders who received treatment. Around 6% of respondents reported PMU in the past year: hypnotics or sedatives were used by 3.7% and antidepressants by 3.5%. Among individuals with 12-month disorders, only 14% reported past year PMU. Gender, age, education, income, occupational status, comorbidity, and severity were significant predictors for PMU. Among those with 12-month DSM-IV disorders who obtained treatment in healthcare settings, almost 40% received medication only. Among those treated in specialty mental health service, around 23% received combination of medication and psychotherapy. Our study has pointed out that the recent trend of access to mental healthcare in Brazil depicts unmet needs, characterized by a low prevalence of PMU among individuals with psychiatric disorders. Policies that improve appropriate access to prescribed drugs for those most in need are urgent public health priority. Copyright © 2015 John Wiley & Sons, Ltd.

The Machinery of Management: The Art of Interviewing (MM3). Workforce 2000 Partnership.

ERIC Educational Resources Information Center

Enterprise State Junior Coll., AL.

This curriculum package on effective training skills for the art of interviewing--the machinery of management for supervisors, auditors, and training instructors has been developed by the Workforce 2000 Partnership, a network of industries and educational institutions that provides training in communication, computation, and creative thinking to…

Immediacy

ERIC Educational Resources Information Center

Hurst, James C.; Rosson, Jay

1974-01-01

This concept is viewed as a core dimension of counseling and also of practice interview training, where students can be taught to eliminate distracting mannerisms. Interview training can be more meaningful if instructors' comments are prompt and constructive. (Author/PC)

Android Robot-Mediated Mock Job Interview Sessions for Young Adults with Autism Spectrum Disorder: A Pilot Study

PubMed Central

Kumazaki, Hirokazu; Warren, Zachary; Corbett, Blythe A.; Yoshikawa, Yuichiro; Matsumoto, Yoshio; Higashida, Haruhiro; Yuhi, Teruko; Ikeda, Takashi; Ishiguro, Hiroshi; Kikuchi, Mitsuru

2017-01-01

The feasibility and preliminary efficacy of an android robot-mediated mock job interview training in terms of both bolstering self-confidence and reducing biological levels of stress in comparison to a psycho-educational approach human interview was assessed in a randomized study. Young adults (ages 18–25 years) with autism spectrum disorder (ASD) were randomized to participate either in a mock job interview training with our android robot system (n = 7) or a self-paced review of materials about job-interviewing skills (n = 8). Baseline and outcome measurements of self-reported performance/efficacy and salivary cortisol were obtained after a mock job interview with a human interviewer. After training sessions, individuals with ASD participating in the android robot-mediated sessions reported marginally improved self-confidence and demonstrated significantly lower levels of salivary cortisol as compared to the control condition. These results provide preliminary support for the feasibility and efficacy of android robot-mediated learning. PMID:28955254

Android Robot-Mediated Mock Job Interview Sessions for Young Adults with Autism Spectrum Disorder: A Pilot Study.

PubMed

Kumazaki, Hirokazu; Warren, Zachary; Corbett, Blythe A; Yoshikawa, Yuichiro; Matsumoto, Yoshio; Higashida, Haruhiro; Yuhi, Teruko; Ikeda, Takashi; Ishiguro, Hiroshi; Kikuchi, Mitsuru

2017-01-01

The feasibility and preliminary efficacy of an android robot-mediated mock job interview training in terms of both bolstering self-confidence and reducing biological levels of stress in comparison to a psycho-educational approach human interview was assessed in a randomized study. Young adults (ages 18-25 years) with autism spectrum disorder (ASD) were randomized to participate either in a mock job interview training with our android robot system ( n  = 7) or a self-paced review of materials about job-interviewing skills ( n  = 8). Baseline and outcome measurements of self-reported performance/efficacy and salivary cortisol were obtained after a mock job interview with a human interviewer. After training sessions, individuals with ASD participating in the android robot-mediated sessions reported marginally improved self-confidence and demonstrated significantly lower levels of salivary cortisol as compared to the control condition. These results provide preliminary support for the feasibility and efficacy of android robot-mediated learning.

Virtual Reality Job Interview Training in Adults with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Smith, Matthew J.; Ginger, Emily J.; Wright, Katherine; Wright, Michael A.; Taylor, Julie Lounds; Humm, Laura Boteler; Olsen, Dale E.; Bell, Morris D.; Fleming, Michael F.

2014-01-01

The feasibility and efficacy of virtual reality job interview training (VR-JIT) was assessed in a single-blinded randomized controlled trial. Adults with autism spectrum disorder were randomized to VR-JIT (n = 16) or treatment-as-usual (TAU) (n = 10) groups. VR-JIT consisted of simulated job interviews with a virtual character and didactic…

The Effect of Using Trained versus Untrained Adult Respondents in Simulated Practice Interviews about Child Abuse

ERIC Educational Resources Information Center

Powell, Martine B.; Fisher, Ronald P.; Hughes-Scholes, Carolyn H.

2008-01-01

Objective: A single study tested the hypothesis that simulated practice interviews for investigative interviewers of children are more effective when the role of the child respondent is played by trained actors (i.e., postgraduate psychology students) than untrained fellow participants (i.e., child protection workers). Method: The interviewers…

Intake Interview Skills for Rehabilitation Counselors: A Typescript Manual. Advanced Facilitative Case Management Series, Training Package I.

ERIC Educational Resources Information Center

Rubin, Stanford E.; Farley, Roy C.

This guide is the case study manual for the first in a series of instructor-assisted training modules for rehabilitation counselors, supervisors, and graduate students. This typescript manual for the first module focuses on basic intake interviewing skills consisting of: (1) systematic interview programming including attracting, planning and…

Perspectives of Parents and Tutors on a Self-Management Program for Parents/Guardians of Children with Long-Term and Life-Limiting Conditions: "A Life Raft We Can Sail along with"

ERIC Educational Resources Information Center

Barlow, Julie; Swaby, Laura; Turner, Andrew

2008-01-01

The lay-led, community-based Supporting Parents Programme (SPP) aims to assist parents caring for children with long-term or life-limiting conditions through support and cognitive behavioral techniques. The value of the SPP from the perspectives of parent participants and tutors was examined in focus groups and telephone interviews. Data were…

Automating individualized coaching and authentic role-play practice for brief intervention training.

PubMed

Hayes-Roth, B; Saker, R; Amano, K

2010-01-01

Brief intervention helps to reduce alcohol abuse, but there is a need for accessible, cost-effective training of clinicians. This study evaluated STAR Workshop , a web-based training system that automates efficacious techniques for individualized coaching and authentic role-play practice. We compared STAR Workshop to a web-based, self-guided e-book and a no-treatment control, for training the Engage for Change (E4C) brief intervention protocol. Subjects were medical and nursing students. Brief written skill probes tested subjects' performance of individual protocol steps, in different clinical scenarios, at three test times: pre-training, post-training, and post-delay (two weeks). Subjects also did live phone interviews with a standardized patient, post-delay. STAR subjects performed significantly better than both other groups. They showed significantly greater improvement from pre-training probes to post-training and post-delay probes. They scored significantly higher on post-delay phone interviews. STAR Workshop appears to be an accessible, cost-effective approach for training students to use the E4C protocol for brief intervention in alcohol abuse. It may also be useful for training other clinical interviewing protocols.

How Do Clinicians Prefer Cultural Competence Training? Findings from the DSM-5 Cultural Formulation Interview Field Trial

PubMed Central

Aggarwal, Neil Krishan; Lam, Peter; Castillo, Enrico; Weiss, Mitchell G.; Diaz, Esperanza; Alarcón, Renato D.; van Dijk, Rob; Rohlof, Hans; Ndetei, David M.; Scalco, Monica; Aguilar-Gaxiola, Sergio; Bassiri, Kavoos; Deshpande, Smita; Groen, Simon; Jadhav, Sushrut; Kirmayer, Laurence J.; Paralikar, Vasudeo; Westermeyer, Joseph; Santos, Filipa; Vega-Dienstmaier, Johann; Anez, Luis; Boiler, Marit; Nicasio, Andel V.; Lewis-Fernández, Roberto

2015-01-01

Objective This study’s objective is to analyze training methods clinicians reported as most and least helpful during the DSM-5 Cultural Formulation Interview field trial, reasons why, and associations between demographic characteristics and method preferences. Method The authors used mixed methods to analyze interviews from 75 clinicians in five continents on their training preferences after a standardized training session and clinicians’ first administration of the Cultural Formulation Interview. Content analysis identified most and least helpful educational methods by reason. Bivariate and logistic regression analysis compared clinician characteristics to method preferences. Results Most frequently, clinicians named case-based behavioral simulations as “most helpful” and video as “least helpful” training methods. Bivariate and logistic regression models, first unadjusted and then clustered by country, found that each additional year of a clinician’s age was associated with a preference for behavioral simulations: OR=1.05 (95% CI: 1.01–1.10; p=0.025). Conclusions Most clinicians preferred active behavioral simulations in cultural competence training, and this effect was most pronounced among older clinicians. Effective training may be best accomplished through a combination of reviewing written guidelines, video demonstration, and behavioral simulations. Future work can examine the impact of clinician training satisfaction on patient symptoms and quality of life. PMID:26449983

Lay people's and health professionals' views about breaking bad news to children.

PubMed

Muñoz Sastre, M T; Sorum, P C; Mullet, E

2014-01-01

Bad health news is difficult to communicate, especially when parents must give bad news to their children. We had 170 lay persons, 33 nurses and six physicians in Toulouse, France, judge the appropriateness of the parents' behaviour in 64 scenarios of parents dealing with this problem. The scenarios were composed according to a four within-subject orthogonal design: child's age (4, 6, 8 or 10), severity of disease (lethal or worrisome but curable), child's concern or not about his illness and parents' decision about communicating the news (tell nothing, minimize, tell the truth or ask the physician to tell the truth). Cluster analysis revealed four clusters, labelled 'Always Tell the Truth' (33%, including a majority of doctors and nurses), 'Tell Nothing or Minimize' (16%, with an older average age), 'Tell the Truth Except in Cases of Incurable Illness' (22%) and 'Depends on Child's Characteristics' (29%). Physicians in training and in practice need to be aware that lay people--and likely parents as well--have diverse and complex opinions about when and how parents should give bad health news to their children. © 2012 John Wiley & Sons Ltd.

Viewing an ultra-brief chest compression only video improves some measures of bystander CPR performance and responsiveness at a mass gathering event.

PubMed

Beskind, Daniel L; Stolz, Uwe; Thiede, Rebecca; Hoyer, Riley; Robertson, Whitney; Brown, Jeffrey; Ludgate, Melissa; Tiutan, Timothy; Shane, Romy; McMorrow, Deven; Pleasants, Michael; Kern, Karl B; Panchal, Ashish R

2017-09-01

CPR training at mass gathering events is an important part of health initiatives to improve cardiac arrest survival. However, it is unclear whether training lay bystanders using an ultra-brief video at a mass gathering event improves CPR quality and responsiveness. To determine if showing a chest-compression only (CCO) Ultra-Brief Video (UBV) at a mass gathering event is effective in teaching lay bystanders CCO-CPR. Prospective control trial in adults (age >18) who attended either a women's University of Arizona or a men's Phoenix Suns basketball game. Participants were evaluated using a standardized cardiac arrest scenario with Laerdal Skillreporter™ mannequins. CPR responsiveness (calling 911, time to calling 911, starting compressions within two minutes) and quality (compression rate, depth, hands-off time) were assessed for participants and data collected at Baseline and Post-intervention. Different participants were tested before and after the exposure of the UBV. Data were analyzed via the intention to treat principle using logistic regression for binary outcomes and median regression for continuous outcomes, controlling for clustering by venue. A total of 96 people were consented (Baseline=45; Post intervention=51). CPR responsiveness post intervention improved with faster time to calling 911 (s) and time to starting compressions (sec). Likewise, CPR quality improved with deeper compressions and improved hands-off time. Showing a UBV at a mass gathering sporting event is associated with improved CPR responsiveness and performance for lay bystanders. This data provides further support for the use of mass media interventions. Copyright © 2017 Elsevier B.V. All rights reserved.

Tracking Rates and History along the Transcontinental Railroad

ERIC Educational Resources Information Center

Perham, Arnold E.; Perham, Faustine L.

2015-01-01

The Transcontinental Railroad began laying track east from Sacramento, California, in 1863 and west from Omaha, Nebraska, in 1865; the two lines eventually met in Promontory Summit, Utah, in 1869. One of the train towns, Ogallala, Nebraska, consisted of only a section house and water tank alongside newly laid track. Over the next few years, train…

Medical Requirements for Ambulance Design and Equipment. Emergency Health Series.

ERIC Educational Resources Information Center

National Academy of Sciences - National Research Council, Washington, DC. Div. of Medical Sciences.

A vehicle must meet certain specific requirements to be classified as an ambulance if it is to satisfy the demands of the physician in terms of emergency care for which properly trained ambulance attendants can be held responsible. Developed by professional and lay experts for use by automotive designers and manufacturing, this publication would…

User Involvement in Designing a Survey of People Directly Employing Care and Support Workers

ERIC Educational Resources Information Center

Dixon, Josie; McNaughton-Nicholls, Carol; d'Ardenne, Joanna; Doyle-Francis, Melanie; Manthorpe, Jill

2013-01-01

User involvement in social care research has generally been the preserve of qualitative methodologies, while user involvement in quantitative research has tended to be limited by the assumed inflexibility of statistical designs and concerns that lay people may require specialist training to engage with quantitative methods. Using the example of…

Medical technology at home: safety-related items in technical documentation.

PubMed

Hilbers, Ellen S M; de Vries, Claudette G J C A; Geertsma, Robert E

2013-01-01

This study aimed to investigate the technical documentation of manufacturers on issues of safe use of their device in a home setting. Three categories of equipment were selected: infusion pumps, ventilators, and dialysis systems. Risk analyses, instructions for use, labels, and post market surveillance procedures were requested from manufacturers. Additionally, they were asked to fill out a questionnaire on collection of field experience, on incidents, and training activities. Specific risks of device operation by lay users in a home setting were incompletely addressed in the risk analyses. A substantial number of user manuals were designed for professionals, rather than for patients or lay carers. Risk analyses and user information often showed incomplete coherence. Post market surveillance was mainly based on passive collection of field experiences. Manufacturers of infusion pumps, ventilators, and dialysis systems pay insufficient attention to the specific risks of use by lay persons in home settings. It is expected that this conclusion is also applicable for other medical equipment for treatment at home. Manufacturers of medical equipment for home use should pay more attention to use errors, lay use and home-specific risks in design, risk analysis, and user information. Field experiences should be collected more actively. Coherence between risk analysis and user information should be improved. Notified bodies should address these aspects in their assessment. User manuals issued by institutions supervising a specific home therapy should be drawn up in consultation with the manufacturer.

Researching the Size and Scope of Online Usage in the Vocational Education and Training Sector.

ERIC Educational Resources Information Center

Hill, Robyn; Malone, Peter; Markham, Selby; Sharma, Renu; Sheard, Judithe; Young, Graeme

The size and scope of online usage in Australia's vocational education and training sector were examined in a four-stage study that included the numerous data collection activities, including the following: a literature review; interviews with 85 institutes; interviews with 10 training organizations and 20 organizations using online learning;…

Motivational interviewing and colorectal cancer screening: a peek from the inside out.

PubMed

Wahab, Stéphanie; Menon, Usha; Szalacha, Laura

2008-08-01

This article focuses on design, training, and delivery of motivational interview (MI) in a longitudinal randomized controlled trial intended to assess the efficacy of two separate interventions designed to increase colorectal screening when compared to a usual care, control group. One intervention was a single-session, telephone-based MI, created to increase colorectal cancer screening within primary care populations. The other was tailored health counseling. We present the rationale, design, and process discussions of the one-time motivational interviewing telephone intervention. We discuss in this paper the training and supervision of study interventionists, in order to enhance practice and research knowledge concerned with fidelity issues in motivational interview interventions. To improve motivational interviewing proficiency and effectiveness, we developed a prescribed training program adapting MI to a telephone counseling session. The three interventionists trained in MI demonstrate some MI proficiency assessed by the motivational interviewing treatment integrity scale. In the post-intervention interview, 20.5% of the MI participants reported having had a CRC screening test, and another 19.75% (n=16) had scheduled a screening test. Almost half of the participants (43%) indicated that the phone conversation helped them to overcome the reasons why they had not had a screening test. Ongoing supervision and training (post-MI workshop) are crucial to supporting MI fidelity. The trajectory of learning MI demonstrated by the interventionists is consistent with the eight stages of learning MI. The MI road map created for the interventionists has shown to be more of a distraction than a facilitator in the delivery of the telephone intervention. MI can, however, be considered a useful tool for health education and warrants further study. MI training should include consistent training and process evaluation. MI can, however, be considered a useful tool for health education and warrants further study. MI can also be adapted to diverse health promotion scenarios.

Barriers to patient-centered human immunodeficiency virus (HIV) care with African American patients who use drugs: Social construction of the typical and ideal care visit.

PubMed

Carlberg-Racich, Suzanne; Roden, Lindsey

2017-01-01

A successful patient-provider relationship ensures that patients are treated as individuals and receive appropriate care for their unique circumstances. For this to occur, the relationship needs open communication and trust. African American persons who inject drugs (PWIDs) and who smoke crack cocaine are at elevated risks of poor health outcomes and are often lost to care. In addition, providers often experience difficulty serving this population. Although some barriers are documented in the peer-reviewed literature, this study sought to provide in-depth context to the relationship and how it is constructed. Individual, semistructured interviews were conducted with human immunodeficiency virus (HIV) care providers and their patients, specifically PWIDs and persons who smoke crack cocaine, in publicly funded HIV clinics in low-resource urban communities. n = 31 patients and n = 7 providers were interviewed about their perceptions of the other and the relationship. Interview transcripts were coded and analyzed for common themes, which were used to generate a conceptual, constructionist model of the HIV care visit. Common patient themes included the tendency to describe providers in familial terms, match between their current provider and ideal provider, concern about stigma related to their use, and expression of unmet needs. Provider themes revealed less match with their ideal patient-preferring patients who were both abstinent and adherent, and expressing frustration with patient refusal to change. Thematic results were used to create a visual and conceptual model for the HIV care visit. The model demonstrates both the positive and negative perceptions that inform the visit, and the barriers that impede a more fruitful patient-provider dynamic with a shared power structure. Provider training in communication and other identified topics may begin to lay the foundation for a shift in this structure.

The impact of a lay counselor led collaborative care intervention for common mental disorders in public and private primary care: a qualitative evaluation nested in the MANAS trial in Goa, India.

PubMed

Shinde, Sachin; Andrew, Gracy; Bangash, Omer; Cohen, Alex; Kirkwood, Betty; Patel, Vikram

2013-07-01

The MANAS trial evaluated the effectiveness of a lay counselor led collaborative stepped care intervention for Common Mental Disorders (CMD) in public and private sector primary care settings in Goa, India. This paper describes the qualitative findings of the experience of the intervention and its impact on health and psychosocial outcomes. Twenty four primary care facilities (12 public and private each) were randomized to provide either collaborative stepped care (CSC) or enhanced usual care (EUC) to adults who screen positive for CMDs. Participants were sampled purposively based on two criteria: gender and, in the CSC arm, adherence with the intervention. The qualitative study component involved two semi-structured interviews with participants of both arms (N = 115); the first interview within 2 months of recruitment and the second 6-8 months after recruitment. Data were collected between September 2007 and November 2009. More participants in the CSC than EUC arm reported relief from symptoms and an improvement in social functioning and positive impact on work and activities of daily life. The CSC participants attributed their improvement both to medication received from the doctors and the strategies suggested by the lay Health Counselors (HC). However, two key differences were observed in the results for the two types of facilities. First, the CSC participants in the public sector clinics were more likely to consider the HCs to be an important component of providing care who served as a link between patient and the doctor, provided them skills on stress management and helped in adherence to medication. Second, in the private sector, doctors performed roles similar to those of the HCs and participants in both arms placed much faith in the doctor who acted as a confidante and was perceived to understand the participant's health and context intimately. Lay counselors working in a CSC model have a positive effect on symptomatic relief, social functioning and satisfaction with care in patients with CMD attending primary care clinics although the impact, compared with usual care, is greater in the public sector. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cell phone cardiopulmonary resuscitation: audio instructions when needed by lay rescuers: a randomized, controlled trial.

PubMed

Merchant, Raina M; Abella, Benjamin S; Abotsi, Edem J; Smith, Thomas M; Long, Judith A; Trudeau, Martha E; Leary, Marion; Groeneveld, Peter W; Becker, Lance B; Asch, David A

2010-06-01

Given the ubiquitous presence of cellular telephones, we seek to evaluate the extent to which prerecorded audio cardiopulmonary resuscitation (CPR) instructions delivered by a cell telephone will improve the quality of CPR provided by untrained and trained lay rescuers. We randomly assigned both previously CPR trained and untrained volunteers to perform CPR on a manikin for 3 minutes with or without audio assistance from a cell telephone programmed to provide CPR instructions. We measured CPR quality metrics-pauses (ie, no flow time), compression rate (minute), depth (millimeters), and hand placement (percentage correct)-across the 4 groups defined by being either CPR trained or untrained and receiving or not receiving cell telephone CPR instructions. There was no difference in CPR measures for participants who had or had not received previous CPR training. Participants using the cell telephone aid performed better compression rate (100/minute [95% confidence interval (CI) 97 to 103/minute] versus 44/minute [95% CI 38 to 50/minute]), compression depth (41 mm [95% CI 38 to 44 mm] versus 31 mm [95% CI 28 to 34 mm]), hand placement (97% [95% CI 94% to 100%] versus 75% [95% CI 68% to 83%] correct), and fewer pauses (74 seconds [95% CI 72 to 76 seconds] versus 89 seconds [95% CI 80 to 98 seconds]) compared with participants without the cell telephone aid. A simple audio program that can be made available for cell telephones increases the quality of bystander CPR in a manikin simulation. Copyright (c) 2009 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

What Does Successful Aging Mean? Lay Perception of Successful Aging Among Elderly Singaporeans.

PubMed

Feng, Qiushi; Straughan, Paulin Tay

2017-03-01

We explore the culturally specific meaning of successful aging in Singapore, an ethnically diverse city-state in Asia. We aim to investigate lay perceptions of successful aging among the elderly individuals in Singapore and further examine variations of these perceptions. We applied a mixed-method research design. Firstly, we conducted qualitative interviews with 49 elderly respondents, generating 12 main subjective components of successful aging. Next, we did a national survey with a sample of 1,540 local residents aged 50 to 69 years, in which respondents were asked to evaluate the importance of each subjective component of successful aging. We used the regression models and latent class analysis to analyze the correlatives of successful aging and to classify the elderly individuals by perception types. Among 12 components of successful aging, those related to self-sufficiency received the highest acknowledgment among the elderly individuals in Singapore. At least half of them simultaneously highlighted independence from family and dependence on family. Malays and Indians in Singapore valued more of the roles of spouse and children in successful aging, as compared with Chinese. The latent class analysis classified four groups of the elderly individuals according to their lay views on successful aging. As compared with the western model of successful aging, the elderly individuals in Singapore perceived successful aging with a strong focus on familism. These lay perceptions also significantly varied among these elderly individuals. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

"It's because it's cancer, not because you're a Traveller"-exploring lay understanding of cancer in English Romany Gypsy and Irish Traveller communities.

PubMed

Berlin, Jenni; Smith, David; Newton, Paul

2018-06-01

The lay understanding of cancer among English Romany Gypsies and Irish Travellers, has not been studied in depth before. Lay understandings of cancer, and illness in general, varies between different ethnic groups suggesting that procedures that work for one community may not work for another. Therefore, the measures that are in place in the UK to educate and treat people with cancer may not work for the - often hard to reach - Gypsy and Traveller communities. This study explores Gypsies and Travellers lay perceptions of cancer. In collaboration with community interviewers, 18 Gypsies and Travellers were recruited to take part in this study. Data comes from four semi-structured focus groups that were transcribed and thematically analysed using data-driven coding. A lack of trust of the wider society has contributed to some Gypsies and Travellers' health related practices as has the persistence of old customs that negatively influence their health. As a reticence towards seeking outside help often exists, information about cancer is sought from family members. When engaged with cancer services however, Gypsies and Travellers generally feel them to be non-discriminative. Health professionals need to develop a better understanding of Gypsy and Travellers' health beliefs and practices in order to successfully interact with them. Information about cancer has to be delivered in an understandable form and to places where it reaches these communities. Because of historical societal discrimination, including by some health services, engaging with Gypsies and Travellers may require considerably more time and effort. Copyright © 2018 Elsevier Ltd. All rights reserved.

Developing lay health worker policy in South Africa: a qualitative study

PubMed Central

2012-01-01

Background Over the past half decade South Africa has been developing, implementing and redeveloping its Lay Health Worker (LHW) policies. Research during this period has highlighted challenges with LHW programme implementation. These challenges have included an increased burden of care for female LHWs. The aim of this study was to explore contemporary LHW policy development processes and the extent to which issues of gender are taken up within this process. Methods The study adopted a qualitative approach to exploring policy development from the perspective of policy actors. Eleven policy actors (policy makers and policy commentators) were interviewed individually. Data from the interviews were analysed thematically. Results Considerations of LHW working conditions drove policy redevelopment. From the interviews it seems that gender as an issue never reached the policy making agenda. Although there was strong recognition that the working conditions of LHWs needed to be improved, poor working conditions were not necessarily seen as a gender concern. Our data suggests that in the process of defining the problem which the redeveloped policy had to address, gender was not included. There was no group or body who brought the issue of gender to the attention of policy developers. As such the issue of gender never entered the policy debates. These debates focused on whether it was appropriate to have LHWs, what LHW programme model should be adopted and whether or not LHWs should be incorporated into the formal health system. Conclusion LHW policy redevelopment focused on resolving issues of LHW working conditions through an active process involving many actors and strong debates. Within this process the issue of gender had no champion and never reached the LHW policy agenda. Future research may consider how to incorporate the voices of ordinary women into the policy making process. PMID:22410185

Common sense of experts: Social representations of justice amongst professionals.

PubMed

Rochira, Alessia

2014-09-01

The dialectics between different modes of knowledge is at the very core of social sciences. In particular, the theory of social representations looks at expert and lay modes as they were not peculiar of specific domains but rather as they were mutually interdependent. Based on the conceptual distinction between reified and consensual universes, this article explores the interplay between these two sources of knowledge through the analysis of the social representations of justice produced by justice professionals. In particular, the exploration of the social representations of justice amongst experts offers intriguing clues to overtake the idea that the lay understanding of justice is somehow opposed to the expert viewpoint and to accept the polyphasic understanding of this complex object. The article reports the findings of a qualitative investigation of the social representations of justice amongst professionals. The staff members of the Youth Social Services (YSS) and the Juvenile Classification Home and Residential Community (JCHRC) were interviewed, and transcriptions were content analysed. The findings indicated that professionals generate multiple theories of justice with each presenting a particular articulation of the basic interplay between expert and lay viewpoints. Most important, findings indicate that the context of everyday working practice has a significant symbolic valence that goes beyond the boundaries of the reified context of institutional justice system.

The weaker sex? Exploring lay understandings of gender differences in life expectancy: a qualitative study.

PubMed

Emslie, Carol; Hunt, Kate

2008-09-01

Despite increasing interest in gender and health, 'lay' perceptions of gender differences in mortality have been neglected. Drawing on semi-structured interview data from 45 men and women in two age cohorts (born in the early 1950s and 1970s) in the UK, we investigated lay explanations for women's longer life expectancy. Our data suggest that respondents were aware of women's increased longevity, but found this difficult to explain. While many accounts were multifactorial, socio-cultural explanations were more common, more detailed and less tentative than biological explanations. Different socio-cultural explanations (i.e. gendered social roles, 'macho' constraints on men and gender differences in health-related behaviours) were linked by the perception that life expectancy would converge as men and women's lives became more similar. Health behaviours such as going to the doctor or drinking alcohol were often located within wider structural contexts. Female respondents were more likely to focus on women's reproductive and caring roles, while male respondents were more likely to focus on how men were disadvantaged by their 'provider' role. We locate these narratives within academic debates about conceptualising gender: e.g. 'gender as structure' versus 'gender as performance', 'gender as difference' versus 'gender as diversity'.

Posthumous Reproduction (PHR) in Israel: Policy Rationales Versus Lay People's Concerns, a Preliminary Study.

PubMed

Hashiloni-Dolev, Yael

2015-12-01

Israeli policy concerning PHR has been decided upon in an expertocratic manner, leaving the voice of the public unheard. Based on 26 semi-structured in-depth interviews with 13 Jewish-Israeli young couples, this preliminary study provides the first empirical data regarding lay attitudes toward PHR in Israel. Findings suggest major dissimilarities between the policy and lay people's wishes and rationales. While policy is built on the "presumed wish" assumption, supposing all men living in a loving relationship wish to have their partner carry their child post-mortem, this was empirically unsupported. However, the findings suggest that many interviewees were willing to defer to their surviving spouse's wishes to have their post-mortem child, sometimes even against their own wish, indicating a support for presumed consent. Respecting the wishes of the dead, a dominant argument in the bioethical discussion in Israel and beyond, was mainly irrelevant to informants, whereas interviewees considered the future child's welfare, a concern overlooked by Israeli policy. Likewise, while posthumous grandparenthood is on the rise in Israel, it clearly contradicts the wishes of the majority of this study's informants. Nonetheless, existing policy is not expected to raise any opposition, due to the extreme liberalism of the participants and their support of reproductive autonomy.

Public involvement in suicide prevention: understanding and strengthening lay responses to distress.

PubMed

Owens, Christabel; Owen, Gareth; Lambert, Helen; Donovan, Jenny; Belam, Judith; Rapport, Frances; Lloyd, Keith

2009-08-23

The slogan "Suicide prevention is everyone's business" has been used in a number of campaigns worldwide in recent years, but most research into suicide prevention has focused on the role of medical professionals in identifying and managing risk. Little consideration has been given to the role that lay people can play in suicide prevention, or to the resources they need in order to do so.The majority of people who take their own lives are not under the care of specialist mental health services, and around half have not had recent contact with their general practitioner. These individuals are not known to be 'at risk' and there is little or no opportunity for clinical intervention. Family members and friends may be the only ones to know that a person is troubled or distressed, and their capacity to recognise, assess and respond to that distress is therefore vitally important. This study aims to discover what the suicidal process looks like from the point of view of relatives and friends and to gain insight into the complex and difficult judgements that people have to make when trying to support a distressed individual. The study uses qualitative methods to build up a detailed picture of 15-20 completed suicides, aged 18-34. Data are gathered by means of in-depth interviews with relatives, friends and others who knew the deceased well. In each case, as many informants as possible are sought using a purposive snowballing technique. Interviews focus on the family and social network of the deceased, the ways in which relatives and friends interpreted and responded to his/her distress, the potential for intervention that may have existed within the lay network and the knowledge, skills and other resources that would have helped members to support the distressed individual more effectively. The study will inform interventions to promote public mental health awareness and will provide a basis on which to develop community-focussed suicide prevention strategies.

Hypnosis lessons by stage magnetizers: Medical and lay hypnotists in Spain

PubMed Central

Graus, Andrea

2017-01-01

During the late nineteenth century, Spanish physicians had few chances to observe how hypnosis worked within a clinical context. However, they had abundant opportunities to watch lay hypnotizers in action during private demonstrations or on stage. Drawing on the exemplary cases of the magnetizers Alberto Santini Sgaluppi (a.k.a. Alberto Das) and Onofroff, in this paper I discuss the positive influence of stage magnetizers on medical hypnosis in Spain. I argue that, owing to the absence of medical training in hypnosis, the stage magnetizers’ demonstrations became practical hypnosis lessons for many physicians willing to learn from them instead of condemning them. I conclude that Spain might be no exception in this regard, and that further research should be undertaken into practices in other countries.

KSC-2011-1208

NASA Image and Video Library

2011-01-27

CAPE CANAVERAL, Fla. -- Flowers lay at the foot of the Space Mirror Memorial at the Kennedy Space Center Visitor Complex in Florida before a Day of Remembrance wreath laying ceremony to honor members of the NASA family who lost their lives while furthering the cause of exploration and discovery. The memorial honors 24 United States astronauts, including the crew members of space shuttles Columbia and Challenger, Apollo 1, and those who died in training and commercial airplane accidents. The memorial is a project of the Astronauts Memorial Foundation and was paid for by Florida residents who purchased special Challenger mission automobile license plates. 2011 marks the 25th anniversary of the loss of Challenger, which broke apart over the Atlantic Ocean 73 seconds into flight on Jan. 28, 1986. Photo credit: NASA/Kim Shiflett

jsc2017e136058 - On a snowy night at Red Square in Moscow, Expedition 54-55 crewmember Scott Tingle of NASA lays flowers at the Kremlin Wall where Russian space icons are interred in traditional pre-launch ceremonies Nov. 30. Tingle, Anton Shkaplerov of t

NASA Image and Video Library

2017-11-30

jsc2017e136058 - On a snowy night at Red Square in Moscow, Expedition 54-55 crewmember Scott Tingle of NASA lays flowers at the Kremlin Wall where Russian space icons are interred in traditional pre-launch ceremonies Nov. 30. Tingle, Anton Shkaplerov of the Russian Federal Space Agency (Roscosmos) and Norishige Kanai of the Japan Aerospace Exploration Agency (JAXA) will launch from the Baikonur Cosmodrome in Kazakhstan on the Soyuz MS-07 spacecraft Dec. 17 for a five-month mission on the International Space Station...Andrey Shelepin/Gagarin Cosmonaut Training Center.

Introduction for "Reiki at University Medical Center, Tucson, Arizona, a magnet hospital": Mega R. Mease is interviewed by William Lee Rand.

PubMed

Vitale, Anne

2011-01-01

There is a sustained interest in the use of Reiki among US consumers and health care providers and lay practitioners alike. As a result, hospitals and other health care institutions are incorporating Reiki into patient care services toward the promotion of caring-healing environments. Variations in hospital-based program structures with Reiki are possible and can enhance the use of Reiki into traditional care settings.

Linking Rhetorical Sensitivity with the Ability of an Athletic Training Student to Successfully Perform a Patient Medical Interview

ERIC Educational Resources Information Center

Bertoncino, Thomas K.

2010-01-01

The purpose of this study was to investigate the extent to which the self-reported rhetorical sensitivity of a sample of athletic training students is positively related to successfully performing a patient medical interview. Particularly, the study focused on if athletic training students' reported communication behaviors is related to their…

What is a good educator? A qualitative study on the perspective of individuals with coronary heart disease.

PubMed

Svavarsdóttir, Margrét H; Sigurdardottir, Arun K; Steinsbekk, Aslak

2016-12-01

Patient views are especially important in patient education, as patient involvement is essential. However, no empirical research clarifies what knowledge, skills and competencies are needed for health professionals to competently serve as a good educator according to the patients themselves. To explore what qualities patients with coronary heart disease perceive in a good educator. A qualitative research method, with semi-structured individual interviews, was used in this study. Purposeful sampling was used to recruit participants from a general hospital in Iceland and in Norway. The data were analysed using systematic text condensation. The participants included 17 patients who had been through a percutaneous coronary intervention and participated in formal patient education after discharge from hospital. The patients saw a good educator as one who they feel is trustworthy and who individualizes the education to patients' needs and context and translates general information to their personal situation in lay language. Building trust was dependent on the patients' perceiving the educator to be knowledgeable and good at connecting with the individual patient, so that the patients feel they are being treated as a whole person with equality and respect. The patients perceived the capability of building trust and tailoring the education to the individual as the most prominent characteristics of a good educator. Training skills that facilitate patients' trust, being observant of the patient and his learning needs and adjusting the patient education to individual needs and situations should be key objectives in health professionals' training in patient education. © The European Society of Cardiology 2015.

How the Public Engages With Brain Optimization

PubMed Central

O’Connor, Cliodhna

2015-01-01

In the burgeoning debate about neuroscience’s role in contemporary society, the issue of brain optimization, or the application of neuroscientific knowledge and technologies to augment neurocognitive function, has taken center stage. Previous research has characterized media discourse on brain optimization as individualistic in ethos, pressuring individuals to expend calculated effort in cultivating culturally desirable forms of selves and bodies. However, little research has investigated whether the themes that characterize media dialogue are shared by lay populations. This article considers the relationship between the representations of brain optimization that surfaced in (i) a study of British press coverage between 2000 and 2012 and (ii) interviews with forty-eight London residents. Both data sets represented the brain as a resource that could be manipulated by the individual, with optimal brain function contingent on applying self-control in one’s lifestyle choices. However, these ideas emerged more sharply in the media than in the interviews: while most interviewees were aware of brain optimization practices, few were committed to carrying them out. The two data sets diverged in several ways: the media’s intense preoccupation with optimizing children’s brains was not apparent in lay dialogue, while interviewees elaborated beliefs about the underuse of brain tissue that showed no presence in the media. This article considers these continuities and discontinuities in light of their wider cultural significance and their implications for the media–mind relationship in public engagement with neuroscience. PMID:26336326

Community recommendations on biobank governance: Results from a deliberative community engagement in California.

PubMed

Dry, Sarah M; Garrett, Sarah B; Koenig, Barbara A; Brown, Arleen F; Burgess, Michael M; Hult, Jen R; Longstaff, Holly; Wilcox, Elizabeth S; Madrigal Contreras, Sigrid Karina; Martinez, Arturo; Boyd, Elizabeth A; Dohan, Daniel

2017-01-01

United States-based biorepositories are on the cusp of substantial change in regulatory oversight at the same time that they are increasingly including samples and data from large populations, e.g. all patients in healthcare system. It is appropriate to engage stakeholders from these populations in new governance arrangements. We sought to describe community recommendations for biorepository governance and oversight using deliberative community engagement (DCE), a qualitative research method designed to elicit lay perspectives on complex technical issues. We asked for stakeholders to provide input on governance of large biorepositories at the University of California (UC), a public university. We defined state residents as stakeholders and recruited residents from two large metropolitan areas, Los Angeles (LA) and San Francisco (SF). In LA, we recruited English and Spanish speakers; in SF the DCE was conducted in English only. We recruited individuals who had completed the 2009 California Health Interview Survey and were willing to be re-contacted for future studies. Using stratified random sampling (by age, education, race/ethnicity), we contacted 162 potential deliberants of whom 53 agreed to participate and 51 completed the 4-day DCE in June (LA) and September-October (SF), 2013. Each DCE included discussion among deliberants facilitated by a trained staff and simultaneously-translated in LA. Deliberants also received a briefing book describing biorepository operations and regulation. During the final day of the DCE, deliberants voted on governance and oversight recommendations using an audience response system. This paper describes 23 recommendations (of 57 total) that address issues including: educating the public, sharing samples broadly, monitoring researcher behavior, using informative consent procedures, and involving community members in a transparent process of biobank governance. This project demonstrates the feasibility of obtaining meaningful input on biorepository governance from diverse lay stakeholders. Such input should be considered as research institutions respond to changes in biorepository regulation.

The development of a lay health worker delivered collaborative community based intervention for people with schizophrenia in India

PubMed Central

2012-01-01

Background Care for schizophrenia in low and middle income countries is predominantly facility based and led by specialists, with limited use of non-pharmacological treatments. Although community based psychosocial interventions are emphasised, there is little evidence about their acceptability and feasibility. Furthermore, the shortage of skilled manpower is a major barrier to improving access to these interventions. Our study aimed to develop a lay health worker delivered community based intervention in three sites in India. This paper describes how the intervention was developed systematically, following the MRC framework for the development of complex interventions. Methods We reviewed the lierature on the burden of schizophrenia and the treatment gap in low and middle income countries and the evidence for community based treatments, and identified intervention components. We then evaluated the acceptability and feasibility of this package of care through formative case studies with individuals with schizophrenia and their primary caregivers and piloted its delivery with 30 families. Results Based on the reviews, our intervention comprised five components (psycho-education; adherence management; rehabilitation; referral to community agencies; and health promotion) to be delivered by trained lay health workers supervised by specialists. The intervention underwent a number of changes as a result of formative and pilot work. While all the components were acceptable and most were feasible, experiences of stigma and discrimination were inadequately addressed; some participants feared that delivery of care at home would lead to illness disclosure; some participants and providers did not understand how the intervention related to usual care; some families were unwilling to participate; and there were delivery problems, for example, in meeting the targeted number of sessions. Participants found delivery by health workers acceptable, and expected them to have knowledge about the subject matter. Some had expectations regarding their demographic and personal characteristics, for example, preferring only females or those who are understanding/friendly. New components to address stigma were then added to the intervention, the collaborative nature of service provision was strengthened, a multi-level supervision system was developed, and delivery of components was made more flexible. Criteria were evolved for the selection and training of the health workers based on participants' expectations. Conclusions A multi-component community based intervention, targeting multiple outcomes, and delivered by trained lay health workers, supervised by mental health specialists, is an acceptable and feasible intervention for treating schizophrenia in India. PMID:22340662

A cluster randomized controlled trial of lay health worker support for prevention of mother to child transmission of HIV (PMTCT) in South Africa.

PubMed

Peltzer, Karl; Weiss, Stephen M; Soni, Manasi; Lee, Tae Kyoung; Rodriguez, Violeta J; Cook, Ryan; Alcaide, Maria Luisa; Setswe, Geoffrey; Jones, Deborah L

2017-12-16

We evaluate the impact of clinic-based PMTCT community support by trained lay health workers in addition to standard clinical care on PMTCT infant outcomes. In a cluster randomized controlled trial, twelve community health centers (CHCs) in Mpumalanga Province, South Africa, were randomized to have pregnant women living with HIV receive either: a standard care (SC) condition plus time-equivalent attention-control on disease prevention (SC; 6 CHCs; n  = 357), or an enhanced intervention (EI) condition of SC PMTCT plus the "Protect Your Family" intervention (EI; 6 CHCs; n  = 342). HIV-infected pregnant women in the SC attended four antenatal and two postnatal video sessions and those in the EI, four antenatal and two postnatal PMTCT plus "Protect Your Family" sessions led by trained lay health workers. Maternal PMTCT and HIV knowledge were assessed. Infant HIV status at 6 weeks postnatal was drawn from clinic PCR records; at 12 months, HIV status was assessed by study administered DNA PCR. Maternal adherence was assessed by dried blood spot at 32 weeks, and infant adherence was assessed by maternal report at 6 weeks. The impact of the EI was ascertained on primary outcomes (infant HIV status at 6 weeks and 12 months and ART adherence for mothers and infants), and secondary outcomes (HIV and PMTCT knowledge and HIV transmission related behaviours). A series of logistic regression and latent growth curve models were developed to test the impact of the intervention on study outcomes. In all, 699 women living with HIV were recruited during pregnancy (8-24 weeks), and assessments were completed at baseline, at 32 weeks pregnant (61.7%), and at 6 weeks (47.6%), 6 months (50.6%) and 12 months (59.5%) postnatally. Infants were tested for HIV at 6 weeks and 12 months, 73.5% living infants were tested at 6 weeks and 56.7% at 12 months. There were no significant differences between SC and EI on infant HIV status at 6 weeks and at 12 months, and no differences in maternal adherence at 32 weeks, reported infant adherence at 6 weeks, or PMTCT and HIV knowledge by study condition over time. The enhanced intervention administered by trained lay health workers did not have any salutary impact on HIV infant status, ART adherence, HIV and PMTCT knowledge. Trial registration clinicaltrials.gov: number NCT02085356.

[Resuscitation training for lay persons in first aid courses: Transfer of knowledge, skills and attitude].

PubMed

Breckwoldt, J; Lingemann, C; Wagner, P

2016-01-01

Bystander cardiopulmonary resuscitation (CPR) is the most effective intervention for out of hospital sudden cardiac arrest; therefore, basic life support (BLS) courses for lay persons have become well established in industrialized countries, often since decades. Despite this favorable situation bystander CPR rates still remain low in some countries (e.g. in Germany), indicating serious implementation problems. The quality of instruction in these courses could be one reason for low bystander CPR rates. We therefore analyzed official lay BLS courses in terms of the teaching quality in the domains of knowledge, skills and attitudes (according to Bloom's taxonomy). A total of 20 officially accredited lay BLS courses in Berlin, Germany, were analyzed by a participating observer, who remained blinded to the instructor and course participants until the end of the course. Courses were offered by German rescue organizations and private providers according to European Resuscitation Council (ERC) guidelines. Teaching quality was rated by a standardized checklist including 21 observable criteria of teaching quality for transfer of knowledge (n = 10), skills (n = 8) and attitudes (n = 3). In order to achieve comparability between items the results of each criterion were quantified by Likert scales ranging from +2 (very good) to -2 (very poor). The average score of all courses was +0.47 (SD ±0.46) for transfer of knowledge, +0.03 (SD ±0.61) for skills and -1.08 (SD ±0.73) for attitudes. In the domain of knowledge transfer, learning atmosphere and course structure were rated to be generally good, whilst marked deficits were found with respect to correctness of content. In the domain of skills the more positive ratings were given for teaching of single BLS elements (e.g. compressions and ventilation), in contrast to the training of BLS context, where e.g. realistic scenarios were only used by 3 out of 20 instructors. The domain of attitude transfer had the worst rating. Detailed ratings were -0.90 for "reducing fear of doing harm to the victim", -1.25 for "positive attribution of practical training" and -1.10 for "explaining course relevance from the learners' perspective". Within the observed BLS courses the teaching quality revealed significant deficits, especially for the transfer of positive attitudes to learners. Also, the use of meaningful realistic scenario teaching was very scarce. These findings can significantly contribute to low bystander CPR rates because transfer of learned content into practice may be hampered.

[Multiple mini interviews before the occupation of main training posts in paediatrics].

PubMed

Hertel, Niels Thomas; Bjerager, Mia; Boas, Malene; Boisen, Kirsten A; Børch, Klaus; Frederiksen, Marianne Sjølin; Holm, Kirsten; Grum-Nymann, Anette; Johnsen, Martin M; Whitehouse, Stine; Balslev, Thomas

2013-09-09

Interviews are mandatory in Denmark when selecting doctors for training positions. We used multiple mini interviews (MMI) at four recruitment rounds for the main training posts in paediatrics. In total, 125 candidates were evaluated and assessed by CV and MMI (4-5 stations). Reliability for individual stations in MMI assessed by Cronbach's alpha was adequate (0.63-0.92). The overall reliability assessed by G-theory was lower, suggesting that different skills were tested. The acceptability was high. Our experiences with MMI suggest good feasibility and reliability. An increasing number of stations may improve the overall reliability.

Alcohol brief interventions practice following training for multidisciplinary health and social care teams: A qualitative interview study

PubMed Central

Fitzgerald, Niamh; Molloy, Heather; MacDonald, Fiona; McCambridge, Jim

2015-01-01

Introduction and Aims Few studies of the implementation of alcohol brief interventions (ABI) have been conducted in community settings such as mental health, social work and criminal justice teams. This qualitative interview study sought to explore the impact of training on ABI delivery by staff from a variety of such teams. Design and Methods Fifteen semi-structured telephone interviews were carried out with trained practitioners and with managers to explore the use of, perceived need for and approaches to ABI delivery and recording with clients, and compatibility of ABIs with current practice. Interviews were analysed thematically using an inductive approach. Results Very few practitioners reported delivery of any ABIs following training primarily because they felt ABIs to be inappropriate for their clients. According to practitioners, this was either because they drank too much or too little to benefit. Practitioners reported a range of current activities relating to alcohol, and some felt that their knowledge and confidence were improved following training. One practitioner reported ABI delivery and was considered a training success, while expectations of ABIs did not fit with current practice including assessment procedures for the remainder. Discussion and Conclusions Identified barriers to ABI delivery included issues relating to individual practitioners, their teams, current practice and the ABI model. They are likely to be best addressed by strategic team- and setting-specific approaches to implementation, of which training is only one part. [Fitzgerald N, Molloy H, MacDonald F, McCambridge J. Alcohol brief interventions practice following training for multidisciplinary health and social care teams: A qualitative interview study. Drug Alcohol Rev 2015;34:185–93] PMID:25196713

Building capacity for Health Impact Assessment: Training outcomes from the United States

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

Schuchter, Joseph; Rutt, Candace, E-mail: awr8@cdc.gov; Satariano, William A.

2015-01-15

Background: Despite the continued growth of Health Impact Assessment (HIA) in the US, there is little research on HIA capacity-building. A comprehensive study of longer-term training outcomes may reveal opportunities for improving capacity building activities and HIA practice. Methods: We conducted in-depth interviews with HIA trainees in the United States to assess their outcomes and needs. Using a training evaluation framework, we measured outcomes across a spectrum of reaction, learning, behavior and results. Results: From 2006 to 2012, four organizations trained over 2200 people in at least 75 in-person HIA trainings in 29 states. We interviewed 48 trainees, selected bothmore » randomly and purposefully. The mean duration between training and interview was 3.4 years. Trainees reported that their training objectives were met, especially when relevant case-studies were used. They established new collaborations at the trainings and maintained them. Training appeared to catalyze more holistic thinking and practice, including a range of HIA-related activities. Many trainees disseminated what they learned and engaged in components of HIA, even without dedicated funding. Going forward, trainees need assistance with quantitative methods, project management, community engagement, framing recommendations, and evaluation. Conclusions: The research revealed opportunities for a range of HIA stakeholders to refine and coordinate training resources, apply a competency framework and leverage complimentary workforce development efforts, and sensitize and build the capacity of communities. - Highlights: • We interviewed HIA trainees in the United States to assess longer-term outcomes. • Training appeared to catalyze a range of beneficial partnerships and activities. • Trainees reported outstanding needs for specific skills and competencies. • There are various opportunities to improve training and capacity-building.« less

The Development of Educational and/or Training Computer Games for Students with Disabilities

ERIC Educational Resources Information Center

Kwon, Jungmin

2012-01-01

Computer and video games have much in common with the strategies used in special education. Free resources for game development are becoming more widely available, so lay computer users, such as teachers and other practitioners, now have the capacity to develop games using a low budget and a little self-teaching. This article provides a guideline…

Structural-Steel Lay-Out Man (any ind.) 809.381-030--Technical Report on Development of USTES Aptitude Test Battery.

ERIC Educational Resources Information Center

Manpower Administration (DOL), Washington, DC. U.S. Training and Employment Service.

The United States Training and Employment Service General Aptitude Test Battery (GATB), first published in 1947, has been included in a continuing program of research to validate the tests against success in many different occupations. The GATB consists of 12 tests which measure nine aptitudes: General Learning Ability; Verbal Aptitude; Numerical…

Discussion on informatization teaching of certain radar transmitter

NASA Astrophysics Data System (ADS)

Liang, Guanhui; Lv, Guizhou; Meng, Yafeng

2017-04-01

With the development of informatization, the traditional teaching method of certain radar transmitter is more and more difficult to meet the need of cultivating new type of high-quality military talents. This paper first analyzes the problems traditional teaching method of certain radar transmitter, and then puts forward the strategy of informatization teaching, and finally elaborates the concrete steps and contents of informatization teaching. Using the multimedia maintenance training system, information simulation training system and network courses and other informatization means, effectively improves the master degree to radar transmitter by trainees, but also lays a good foundation for repair in the next step.

Applying verbal autopsy to determine cause of death in rural Vietnam.

PubMed

Huong, Dao Lan; Minh, Hoang Van; Byass, Peter

2003-01-01

Verbal autopsy (VA) is an attractive method for ascertaining causes of death in settings where the proportion of people who die under medical care is low. VA has been widely used to determine causes of childhood and maternal deaths, but has had limited use in assessing causes in adults and across all age groups. The objective was to test the feasibility of using VA to determine causes of death for all ages in Bavi District, Vietnam, in 1999, leading to an initial analysis of the mortality pattern in this area. Trained lay field workers interviewed a close caretaker of the deceased using a combination closed/open-ended questionnaire. A total of 189 deaths were studied. Diagnoses were made by two physicians separately, with good agreement (kappa = 0.84) and then combined to reach one single underlying cause of death for each case. The leading causes of death were cardiovascular and infectious diseases (accounting for 20.6% and 17.9% of the total respectively). Drowning was very prevalent in children under 15 (seven out of nine cases of drowning were in this age group). One month seemed an acceptable minimum recall period to ensure mourning procedures were over. A combination VA questionnaire was an appropriate instrument provided it was supported by adequate training of interviewers. Two physicians were appropriate for making the diagnoses but predefined diagnostic methods for common causes should be developed to ensure more replicable results and comparisons, as well as to observe trends of mortality over time. The causes of death in this study area reflect a typical pattern for developing countries that are in epidemiological transition. No maternal deaths and a low infant mortality rate may be the result of improvements in maternal and child health in this study area. Using the VA gave more precise causes of death than those reported at death registration. Although the validity of the VA method used has not been fully assessed, it appeared to be an appropriate method for ascertaining causes of death in the study area.

Cross-Cultural Training in Motivational Interviewing

ERIC Educational Resources Information Center

Miller, William R.; Hendrickson, Stacey M. L.; Venner, Kamilla; Bisono, Ani; Daugherty, Mikyta; Yahne, Carolina E.

2008-01-01

This study evaluated the cross-cultural transportability of motivational interviewing (MI), an evidence-based addiction treatment method. Free clinical training in MI was offered in separate targeted workshops for 86 African American, Native American, and Spanish-speaking addiction treatment providers. Audiotaped pre- and posttraining clinical…

Provider and lay perspectives on intra-uterine contraception: a global review.

PubMed

Daniele, Marina A S; Cleland, John; Benova, Lenka; Ali, Moazzam

2017-09-26

Intra-uterine contraception (IUC) involves the use of an intra-uterine device (IUD), a highly effective, long-acting, reversible contraceptive method. Historically, the popularity of IUC has waxed and waned across different world regions, due to policy choices and shifts in public opinion. However, despite its advantages and cost-effectiveness for programmes, IUC's contribution to contraceptive prevalence is currently negligible in many countries. This paper presents the results of a systematic review of the global literature on provider and lay perspectives on IUC. It aims to shed light on the reasons for low use of IUC and reflect on potential opportunities for the method's promotion. A systematic search of the literature was conducted in four peer-reviewed journals and four electronic databases (MEDLINE, EMBASE, POPLINE, and Global Health). Screening resulted in the inclusion of 68 relevant publications. Most included studies were conducted in areas where IUD use is moderate or low. Findings are similar across these areas. Many providers have low or uneven levels of knowledge on IUC and limited training. Many wrongly believe that IUC entails serious side effects such as pelvic inflammatory disease (PID), and are reluctant to provide it to entire eligible categories, such as HIV-positive women. There is particular resistance to providing IUC to teenagers and nulliparae. Provider opinions may be more favourable towards the hormonal IUD. Some health-care providers choose IUC for themselves. Many members of the public have low knowledge and unfounded misconceptions about IUC, such as the fear of infertility. Some are concerned about the insertion and removal processes, and about its effect on menses. However, users of IUC are generally satisfied and report a number of benefits. Peers and providers exert a strong influence on women's attitudes. Both providers and lay people have inaccurate knowledge and misconceptions about IUC, which contribute to explaining its low use. However, many reported concerns and fears could be alleviated through correct information. Concerted efforts to train providers, combined with demand creation initiatives, could therefore boost the method's popularity. Further research is needed on provider and lay perspectives on IUDs in low- and middle-income countries.

Commentary on Stiers and colleagues' guidelines for competency development and measurement in rehabilitation psychology postdoctoral training.

PubMed

Hatcher, Robert L

2015-05-01

Comments on the article, "Guidelines for competency development and measurement in rehabilitation psychology postdoctoral training," by Stiers et al. (see record 2014-55195-001). Stiers and colleagues have provided a thorough and well-conceived set of guidelines that lay out the competencies expected for graduates of postdoctoral residencies in rehabilitation psychology, accompanied by a set of more specific, observable indicators of the residents' competence level. This work is an important aspect of the broader project of the Rehabilitation Psychology Specialty Council (APA Division 22, the American Board of Rehabilitation Psychology, the Foundation for Rehabilitation Psychology, the Academy of Rehabilitation Psychology, and the Council of Rehabilitation Psychology Postdocotral Training Programs) to develop overall guidelines for programs providing postdoctoral training in this field (Stiers et al., 2012). (c) 2015 APA, all rights reserved).

The participant's perspective: learning from an aggression management training course for nurses. Insights from a qualitative interview study.

PubMed

Heckemann, Birgit; Breimaier, Helga Elisabeth; Halfens, Ruud J G; Schols, Jos M G A; Hahn, Sabine

2016-09-01

Aggression management training for nurses is an important part of a comprehensive strategy to reduce patient and visitor aggression in healthcare. Although training is commonplace, few scientific studies examine its benefits. To explore and describe, from a nurse's perspective, the learning gained from attending aggression management training. This was a descriptive qualitative interview study. We conducted semi-structured individual interviews with seven nurses before (September/October 2012) and after they attended aggression management training (January/February 2013). Interview transcripts were content-analysed qualitatively. The study plan was reviewed by the responsible ethics committees. Participants gave written informed consent. Aggression management training did not change nurses' attitude. Coping emotionally with the management of patient and visitor aggression remained a challenge. Nurses' theoretical knowledge increased, but they did not necessarily acquire new strategies for managing patient/visitor aggression. Instead, the course refreshed or activated existing knowledge of prevention, intervention and de-escalation strategies. The training increased nurses' environmental and situational awareness for early signs of patient and visitor. They also acquired some strategies for emotional self-management. Nurses became more confident in dealing with (potentially) aggressive situations. While the training influenced nurses' individual clinical practice, learning was rarely shared within teams. Aggression management training increases skills, knowledge and confidence in dealing with patient or visitor aggression, but the emotional management remains a challenge. Future research should investigate how aggression management training courses can strengthen nurses' ability to emotionally cope with patient and visitor aggression. More knowledge is needed on how the theoretical and practical knowledge gained from the training may be disseminated more effectively within teams and thus contributed to the creation of low-conflict ward cultures. © 2016 Nordic College of Caring Science.

Interview: G. Kip Bollinger

ERIC Educational Resources Information Center

Aronin, Miriam; McDuffie, Thomas E., Jr.

2009-01-01

This article presents an interview with G. Kip Bollinger. G. Kip Bollinger currently works as a consultant for Intermediate Units, school districts, professional science societies, and science text and kit producers. He performs curriculum alignment, does assessment training, coaches science teachers, trains teachers in the use of specific…

We Want to Train Integral Technical Experts Who Can Respond to the Real Problems of the Country, Not an Intellectual Elite.

ERIC Educational Resources Information Center

Monthalane, Dunston

1978-01-01

Presents an interview with the dean of the faculty of agronomy in Maputo, Mozambique. The interview presents the dean's perspective on the training of agricultural cadres in Mozambique, and agricultural research. (HM)

Time to question diabetes self-management support for Arabic-speaking migrants: exploring a new model of care.

PubMed

Alzubaidi, H; Mc Namara, K; Browning, C

2017-03-01

The objective of this study was to explore a new model for diabetes self-management support in Arabic-speaking migrants. Two qualitative methods were used: face-to-face semi-structured individual interviews and focus groups. Interviews were audio-taped, transcribed verbatim and coded thematically. Arabic-speaking migrants with Type 2 diabetes were recruited from several primary, secondary and tertiary healthcare settings in metropolitan Melbourne, Australia. These settings were purposefully selected to obtain a diverse group of participants. Data collection continued until saturation was reached. This is the first study that involved members of Arabic-speaking communities in Australia in a formal process of consumer and public involvement to inform research design and recruitment in order to provide evidence for a new model of diabetes self-management for Arabic-speaking migrants. No self-management support was offered to Arabic-speaking migrants beyond the initial diagnosis period. Significant knowledge gaps and skills deficits in all self-management domains were evident. The provision of tailored self-management support was considered crucial. When asked about preferred structure and delivery modalities, a strong preference was reported for face-to-face storytelling interactions over telephone- or internet-based interventions. Gender-specific group education and self-management support sessions delivered by Arabic-speaking diabetes health professionals, lay peers or social workers trained in diabetes self-management were highly regarded. A patient and public involvement approach allows genuine engagement with Arabic-speaking migrants with diabetes. There is urgent need for a new model for self-management support among Arabic-speaking migrants. Findings yielded new recommendations for diabetes health professionals working with these migrant communities to support behaviour change. © 2016 Diabetes UK.

Health education to increase screening for cervical cancer among Lumbee Indian women in North Carolina.

PubMed

Dignan, M B; Michielutte, R; Wells, H B; Sharp, P; Blinson, K; Case, L D; Bell, R; Konen, J; Davis, S; McQuellon, R P

1998-12-01

Although age-adjusted mortality rates from cancer among Native-Americans are generally lower than for the US population as a whole, cervical cancer mortality rates are higher. This report presents results from a National Cancer Institute-funded health education program conducted among the Lumbee tribe in North Carolina that was designed to increase the proportion of women, age 18 and older, who receive Pap smears to screen for cervical cancer. The Solomon Four Group research design was used for this project. Participants were selected at random from the enrollment records of the Lumbee tribe and data collection was carried out during face-to-face interviews. The health education program was provided one-on-one in women's homes by a trained lay health educator and included verbal, print and videotape information. A total of 979 women were enrolled in the study, and 125 were lost to follow-up between the pre-test and post-test. Women who received the education program were found to be more likely to have knowledge of the Pap smear and to report a Pap smear in the past year at the post-test than those in the control group, regardless of whether they received the pre-test interview, P < 0.05. Women most likely to respond to the education program were also likely to have reported that they receive an annual physical examination. Women with better knowledge of the Pap smear tended to have more education, higher income and greater identification with Native-American culture than those with less knowledge. We conclude that the health education program was associated with greater knowledge about cervical cancer prevention and higher proportions of Lumbee women obtaining Pap smears in the past year.

Development of a scale to measure symptoms of anxiety and depression in the general UK population: the psychiatric symptom frequency scale.

PubMed Central

Lindelow, M; Hardy, R; Rodgers, B

1997-01-01

OBJECTIVES: The psychiatric symptom frequency (PSF) scale was developed to assess symptoms of anxiety and depression (i.e. affective symptoms) experienced over the past year in the general population. This study aimed to examine the distribution of PSF scores, internal consistency, and factor structure and to investigate relationships between total scores for this scale and other indicators of poor mental health. PARTICIPANTS: The Medical Research Council national survey of health and development, a class stratified cohort study of men and women followed up from birth in 1946, with the most recent interview at age 43 when the PSF scale was administered. MAIN RESULTS: The PSF scale showed high internal consistency between the 18 items (Cronbach's alpha = 0.88). Ratings on items of the scale reflected one predominant factor, incorporating both depression and anxiety, and two additional factors of less statistical importance, one reflecting sleep problems and the other panic and situational anxiety. Total scores were calculated by adding 18 items of the scale, and high total scores were found to be strongly associated with reports of contact with a doctor or other health professional and use of prescribed medication for "nervous or emotional trouble or depression," and with suicidal ideas. CONCLUSIONS: The PSF is a useful and valid scale for evaluating affective symptoms in the general population. It is appropriate for administration by lay interviewers with minimal training, is relatively brief, and generates few missing data. The total score is a flexible measure which can be used in continuous or binary form to suit the purposes of individual investigations, and provides discrimination at lower as well as upper levels of symptom severity. PMID:9425466

Stroke awareness in Brazil: alarming results in a community-based study.

PubMed

Pontes-Neto, Octávio Marques; Silva, Gisele Sampaio; Feitosa, Marley Ribeiro; de Figueiredo, Nathalie Lôbo; Fiorot, José Antonio; Rocha, Talitha Nery; Massaro, Ayrton Roberto; Leite, João Pereira

2008-02-01

Stroke is the leading cause of death in Brazil. This community-based study assessed lay knowledge about stroke recognition and treatment and risk factors for cerebrovascular diseases and activation of emergency medical services in Brazil. The study was conducted between July 2004 and December 2005. Subjects were selected from the urban population in transit about public places of 4 major Brazilian cities: São Paulo, Salvador, Fortaleza, and Ribeirão Preto. Trained medical students, residents, and neurologists interviewed subjects using a structured, open-ended questionnaire in Portuguese based on a case presentation of a typical patient with acute stroke at home. Eight hundred fourteen subjects were interviewed during the study period (53.9% women; mean age, 39.2 years; age range, 18 to 80 years). There were 28 different Portuguese terms to name stroke. Twenty-two percent did not recognize any warning signs of stroke. Only 34.6% of subjects answered the correct nationwide emergency telephone number in Brazil (#192). Only 51.4% of subjects would call emergency medical services for a relative with symptoms of stroke. In a multivariate analysis, individuals with higher education called emergency medical services (P=0.038, OR=1.5, 95%, CI: 1.02 to 2.2) and knew at least one risk factor for stroke (P<0.05, OR=2.0, 95% CI: 1.2 to 3.2) more often than those with lower education. Our study discloses alarming lack of knowledge about activation of emergency medical services and availability of acute stroke treatment in Brazil. These findings have implications for public health initiatives in the treatment of stroke and other cardiovascular emergencies.

A randomized control trial of continuous support in labor by a lay doula.

PubMed

Campbell, Della A; Lake, Marian F; Falk, Michele; Backstrand, Jeffrey R

2006-01-01

To compare labor outcomes in women accompanied by an additional support person (doula group) with outcomes in women who did not have this additional support person (control group). Randomized controlled trial. A women's ambulatory care center at a tertiary perinatal care hospital in New Jersey. Six hundred nulliparous women carrying a singleton pregnancy who had a low-risk pregnancy at the time of enrollment and were able to identify a female friend or family member willing to act as their lay doula. The doula group was taught traditional doula supportive techniques in two 2-hour sessions. Length of labor, type of delivery, type and timing of analgesia/anesthesia, and Apgar scores. Significantly shorter length of labor in the doula group, greater cervical dilation at the time of epidural anesthesia, and higher Apgar scores at both 1 and 5 minutes. Differences did not reach statistical significance in type of analgesia/anesthesia or cesarean delivery despite a trend toward lower cesarean delivery rates in the doula group. Providing low-income pregnant women with the option to choose a female friend who has received lay doula training and will act as doula during labor, along with other family members, shortens the labor process.

Biopsychosocial care and the physiotherapy encounter: physiotherapists' accounts of back pain consultations.

PubMed

Sanders, Tom; Foster, Nadine E; Bishop, Annette; Ong, Bie Nio

2013-02-19

The physiotherapy profession has undergone a paradigmatic shift in recent years, where a 'biopsychosocial' model of care has acquired popularity in response to mounting research evidence indicating better patient outcomes when used alongside traditional physiotherapy. However, research has not examined how this new dimension to traditional physical therapy is implemented within the therapeutic consultation. The study aimed to investigate physiotherapists' reported approaches to back pain care in the context of increasing pressure to address patients' psychosocial concerns. A secondary analysis of semi-structured qualitative interviews with 12 UK physiotherapists was conducted. Respondents were sampled from a national survey, to include a broad mix of physiotherapists. Data were analysed thematically, adopting the constant comparative methodology. The combination of traditional physical therapy with a broader biopsychosocial approach presented significant challenges. Physiotherapists responded by attempting to navigate patients' biopsychosocial problems through use of various strategies, such as setting boundaries around their clinical role and addressing lay health beliefs of patients through the provision of reassurance and lifestyle advice. As psychosocial issues, alongside biomechanical factors, command a prominent place within the back pain consultation, physiotherapists may benefit from further specific training and mentoring support in identifying specific strategies for combining the best of traditional physiotherapy approaches with greater focus on patients' beliefs, fears and social context.

Biopsychosocial care and the physiotherapy encounter: physiotherapists’ accounts of back pain consultations

PubMed Central

2013-01-01

Background The physiotherapy profession has undergone a paradigmatic shift in recent years, where a ‘biopsychosocial’ model of care has acquired popularity in response to mounting research evidence indicating better patient outcomes when used alongside traditional physiotherapy. However, research has not examined how this new dimension to traditional physical therapy is implemented within the therapeutic consultation. Methods The study aimed to investigate physiotherapists’ reported approaches to back pain care in the context of increasing pressure to address patients’ psychosocial concerns. A secondary analysis of semi-structured qualitative interviews with 12 UK physiotherapists was conducted. Respondents were sampled from a national survey, to include a broad mix of physiotherapists. Data were analysed thematically, adopting the constant comparative methodology. Results The combination of traditional physical therapy with a broader biopsychosocial approach presented significant challenges. Physiotherapists responded by attempting to navigate patients’ biopsychosocial problems through use of various strategies, such as setting boundaries around their clinical role and addressing lay health beliefs of patients through the provision of reassurance and lifestyle advice. Conclusions As psychosocial issues, alongside biomechanical factors, command a prominent place within the back pain consultation, physiotherapists may benefit from further specific training and mentoring support in identifying specific strategies for combining the best of traditional physiotherapy approaches with greater focus on patients’ beliefs, fears and social context. PMID:23421415

The effect of time on CPR and automated external defibrillator skills in the Public Access Defibrillation Trial

PubMed Central

Christenson, Jim; Nafziger, Sarah; Compton, Scott; Vijayaraghavan, Kris; Slater, Brian; Ledingham, Robert; Powell, Judy; McBurnie, Mary Ann

2009-01-01

Background The time to skill deterioration between primary training/retraining and further retraining in Cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED) for lay-persons is unclear. The Public Access Defibrillation (PAD) Trial was a multi-center randomized controlled trial evaluating survival after CPR-only vs. CPR+AED delivered by onsite non-medical volunteer responders in out-of-hospital cardiac arrest. Aims This sub-study evaluated the relationship of time between primary training/retraining and further retraining on volunteer performance during pretest AED and CPR skill evaluation. Methods Volunteers at 1260 facilities in 24 North American regions underwent training/retraining according to facility randomization, which included an initial session and a refresher session at approximately 6 months. Before the next retraining, a CPR and AED skill test was completed for 2729 volunteers. Primary outcome for the study was assessment of global competence of CPR or AED performance (adequate vs not adequate) using Chi-square tests for trends by time interval (3, 6, 9, and 12 months). Confirmatory (GEE) logistic regression analysis, adjusted for site and potential confounders. Results The proportion of volunteers judged to be competent did not diminish by interval (3,6,9,12 months) for either CPR or AED skills. After adjusting for site and potential confounders, longer intervals before to further retraining was associated with a slightly lower likelihood of performing adequate CPR but not with AED scores. Conclusions After primary training/retraining, the CPR skills of targeted lay responders deteriorate nominally but 80% remain competent up to one year. AED skills do not significantly deteriorate and 90% of volunteers remain competent up to one year. PMID:17303309

Individual differences in personality in laying hens are related to learning a colour cue association.

PubMed

de Haas, Elske N; Lee, Caroline; Hernandez, Carlos E; Naguib, Marc; Rodenburg, T Bas

2017-01-01

Personality can influence how animals perceive and learn cues. The behaviour and physiological responses animals show during stressful events is indicative of their personality. Acute induced stress prior to a cognitive test are known to affect the judgement of a stimulus, but personality of an individual could also affect learning of a specific cognitive paradigm. Here, we assessed if adult laying hens' behaviour and physiological responses, as indicators of their personality, were related to their cognitive performance. We assessed their behavioural responses to a tonic immobility test, an open field test, and a manual restraint test, and measured plasma corticosterone levels after manual restraint. After that, hens (n=20) were trained in a pre-set training schedule to associate a colour-cue with a reward. In a two-choice go-go test, hens needed to choose between a baited or non-baited food container displayed randomly on the left or right side of an arena. Success in learning was related to personality, with better performance of hens which showed a reactive personality type by a long latency to walk, struggle or vocalize during the tests. Only eight out of 20 hens reached the training criteria. The non-learners showed a strong side preference during all training days. Side preferences were strong in hens with high levels of plasma corticosterone and with a long duration of tonic immobility, indicating that fearful, stress-sensitive hens are more prone to develop side biases. Our results show that learning can be hindered by side biases, and fearful animals with a more proactive personality type are more sensitive to develop such biases. Copyright © 2016 Elsevier B.V. All rights reserved.

User involvement in clinical governance

PubMed Central

Pickard, Susan; Marshall, Martin; Rogers, Anne; Sheaff, Rod; Sibbald, Bonnie; Campbell, Stephen; Halliwell, Shirley; Roland, Martin

2002-01-01

Objectives To investigate the involvement of users in clinical governance activities within Primary Care Groups (PCGs) and Trusts (PCTs). Drawing on policy and guidance published since 1997, the paper sets out a framework for how users are involved in this agenda, evaluates practice against this standard and suggests why current practice for user involvement in clinical governance is flawed and why this reflects a flaw in the policy design as much as its implementation. Design Qualitative data comprising semi‐structured interviews, reviews of documentary evidence and relevant literature. Setting Twelve PCGs/PCTs in England purposively selected to provide variation in size, rurality and group or trust status. Participants Key stakeholders including Lay Board members (n=12), Chief Executives (CEs) (n= 12), Clinical Governance Leads (CG leads) (n= 14), Mental Health Leads (MH leads) (n= 9), Board Chairs (n=2) and one Executive Committee Lead. Results Despite an acknowledgement of an organizational commitment to lay involvement, in practice very little has occurred. The role of lay Board members in setting priorities and implementing and monitoring clinical governance remains low. Beyond Board level, involvement of users, patients of GP practices and the general public is patchy and superficial. The PCGs/PCTs continue to rely heavily on Community Health Councils (CHCs) as a conduit or substitute for user involvement; although their abolition is planned, their role to be fulfilled by new organizations called Voices, which will have an expanded remit in addition to replacing CHCs. Conclusions Clarity is required about the role of lay members in the committees and subcommittees of PCGs and PCTs. Involvement of the wider public should spring naturally from the questions under consideration, rather than be regarded as an end in itself. PMID:12199658

Exploring lay perceptions of the causes of crib-biting/windsucking behaviour in horses.

PubMed

Litva, A; Robinson, C S; Archer, D C

2010-05-01

Crib-biting/windsucking behaviour has important consequences for equine health and welfare. Lay perceptions of health and illness are of interest to medical sociologists, providing important information to medical practitioners, but have infrequently been applied in veterinary research. To demonstrate how lay epidemiology can be applied within veterinary research by exploring the lay perceptions regarding the causes of crib-biting/windsucking behaviour in horses. Informants were recruited from professional and amateur horse owners who had or had not owned/cared for a horse that exhibited crib-biting/windsucking behaviour. In-depth interviews were used to examine perceptions about the development of this behaviour within each group until a 'saturation' of themes emerged. The main themes that emerged as causes of crib-biting/windsucking behaviour were 'boredom', 'stress' and 'habit/addiction'. In the group of owners/carers who did not have direct experience of this type of behaviour, 'copying' from other horses emerged as a strong theme and they stated that they would not wish to own a crib-biting/windsucking horse. In contrast, those who had direct experience of horses demonstrating this behaviour did not believe copying was a cause based on their own observations and would not be put off purchasing or caring for another horse displaying this behaviour. Perceptions about what causes crib-biting/windsucking was influenced by whether or not informants had personal experience of horses demonstrating this behaviour. The three main themes that emerged have some justification based on current research and highlight the need for further investigation into the underlying pathophysiology of crib-biting/windsucking behaviour. Qualitative approaches to health, disease and behaviour have an important role in the medical field and are applicable to veterinary research.

Idioms of distress, ethnopsychology, and the clinical encounter in Haiti's Central Plateau.

PubMed

Keys, Hunter M; Kaiser, Bonnie N; Kohrt, Brandon A; Khoury, Nayla M; Brewster, Aimée-Rika T

2012-08-01

Haiti's 2010 earthquake mobilized mental health and psychosocial interventions from across the globe. However, failure to understand how psychological distress is communicated between lay persons and health workers in rural clinics, where most Haitians access care, has been a major limitation in providing mental health services. The goal of this study was to map idioms of distress onto Haitian ethnopsychologies in a way that promotes improved communication between lay persons and clinicians in rural Haiti. In Haiti's Central Plateau, an ethnographic study was conducted in May and June 2010, utilizing participant observation in rural clinics, 31 key informant interviews, 11 focus groups, and four case studies. Key informants included biomedical practitioners, traditional healers, community leaders, and municipal and religious figures. Deductive and inductive themes were coded using content analysis (inter-rater reliability > 0.70). Forty-four terms for psychological distress were identified. Head (tèt) or heart (kè) terms comprise 55% of all qualitative text segments coded for idioms of distress. Twenty-eight of 142 observed patient-clinician contacts involved persons presenting with tèt terms, while 29 of the 142 contacts were presentations with kè terms. Thus, 40% of chief complaints were conveyed in either head or heart terms. Interpretations of these terms differed between lay and clinical groups. Lay respondents had broad and heterogeneous interpretations, whereas clinicians focused on biomedical concepts and excluded discussion of mental health concerns. This paper outlines preliminary evidence regarding the psychosocial dimensions of tèt and kè-based idioms of distress and calls for further exploration. Holistic approaches to mental healthcare in Haiti's Central Plateau should incorporate local ethnopsychological frameworks alongside biomedical models of healthcare. Copyright © 2012 Elsevier Ltd. All rights reserved.

Eyewitness performance in cognitive and structured interviews.

PubMed

Memon, A; Wark, L; Holley, A; Bull, R; Koehnken, G

1997-09-01

This paper addresses two methodological and theoretical questions relating to the Cognitive Interview (CI), which previous research has found to increase witness recall in interviews. (1) What are the effects of the CI mnemonic techniques when communication techniques are held constant? (2) How do trained interviewers compare with untrained interviewers? In this study, witnesses (college students) viewed a short film clip of a shooting and were questioned by interviewers (research assistants) trained in conducting the CI or a Structured Interview (SI)--similar to the CI except for the "cognitive" components--or by untrained interviewers (UI). The CI and SI groups recalled significantly more correct information compared to the UI group. However they also reported more errors and confabulated details. Theoretical and practical implications of the results are discussed in terms of precisely identifying the CI facilitatory effects and consequent good practice in the forensic setting.

A little more conversation please? Qualitative study of researchers' and patients' interview accounts of training for patient and public involvement in clinical trials.

PubMed

Dudley, Louise; Gamble, Carrol; Allam, Alison; Bell, Philip; Buck, Deborah; Goodare, Heather; Hanley, Bec; Preston, Jennifer; Walker, Alison; Williamson, Paula; Young, Bridget

2015-04-27

Training in patient and public involvement (PPI) is recommended, yet little is known about what training is needed. We explored researchers' and PPI contributors' accounts of PPI activity and training to inform the design of PPI training for both parties. We used semi-structured qualitative interviews with researchers (chief investigators and trial managers) and PPI contributors, accessed through a cohort of clinical trials, which had been funded between 2006 and 2010. An analysis of transcripts of audio-recorded interviews drew on the constant comparative method. We interviewed 31 researchers and 17 PPI contributors from 28 trials. Most researchers could see some value in PPI training for researchers, although just under half had received such training themselves, and some had concerns about the purpose and evidence base for PPI training. PPI contributors were evenly split in their perceptions of whether researchers needed training in PPI. Few PPI contributors had themselves received training for their roles. Many informants across all groups felt that training PPI contributors was unnecessary because they already possessed the skills needed. Informants were also concerned that training would professionalise PPI contributors, limiting their ability to provide an authentic patient perspective. However, informants welcomed informal induction 'conversations' to help contributors understand their roles and support them in voicing their opinions. Informants believed that PPI contributors should be confident, motivated, intelligent, focussed on helping others and have relevant experience. Researchers looked for these qualities when selecting contributors, and spoke of how finding 'the right' contributor was more important than accessing 'the right' training. While informants were broadly receptive to PPI training for researchers, they expressed considerable reluctance to training PPI contributors. Providers of training will need to address these reservations. Our findings point to the importance of reconsidering how training is conceptualised, designed and promoted and of providing flexible, learning opportunities in ways that flow from researchers' and contributors' needs and preferences. We also identify some areas of training content and the need for further consideration to be given to the selection of PPI contributors and models for implementing PPI to ensure clinical trials benefit from a diversity of patient perspectives.

Project Amistad (Friendship), a Joint Venture between DHS and Family Outreach. Final Report: Innovations in Protective Services.

ERIC Educational Resources Information Center

Dennis-Small, Lucretia

Conducted by the Texas Department of Human Services (DHS), Project Amistad (Friendship) originally set out to recruit and train Black and Hispanic volunteers to conduct lay therapy sessions with Black and Hispanic families in which abuse and neglect of children had occurred. Start-up was significantly delayed due to personnel changes; as a result,…

First responder resuscitation teams in a rural Norwegian community: sustainability and self-reports of meaningfulness, stress and mastering.

PubMed

Rørtveit, Sverre; Meland, Eivind

2010-05-04

Training of lay first responder personnel situated closer to the potential victims than medical professionals is a strategy potentially capable of shortening the interval between collapse and start of cardiopulmonary resuscitation (CPR) in cases of out-of-hospital cardiac arrest. In this study we trained lay first responders personnel in basic life support (BLS) and defibrillation for cases of cardiac arrest and suspected acute myocardial infarction (AMI). Forty-two lay first responders living in remote areas or working in industries in the island community of Austevoll, Western Norway, were trained in CPR and defibrillation. We placed particular emphasis on the first responders being able to defibrillate a primary ventricular fibrillation (PVF) in patients with AMI. The trainees were organised in four teams to attend victims of AMI and cardiac arrest while awaiting the arrival of the community emergency medical services. The purpose of the study was to find out whether the teams were able to function during the five-year study project, and to examine whether lives could be saved. The first responders completed questionnaires each year on their experiences of participation. Data on the medical actions of the teams were also collected. By the end of the project all groups were functioning. The questionnaires evidenced a reasonable degree of motivation and self-evaluated competence in both types of group organisation, but in spite of this attrition effects in the first responders were considerable. The first responders were called out on 24 occasions, for a total of 17 patients. During the study period no case of PVF occurred after the arrival of the first responders, and the number of AMIs was very low, strongly deviating from what was anticipated. No lives were saved by the project. The teams were sustained for almost five years without any significant deterioration of self-reported stress or mastering, but still showed attrition effects. Evaluated as a medical project the intervention was not successful, but the small scale prevents us from drawing firm conclusions on this aspect.

First responder resuscitation teams in a rural Norwegian community: sustainability and self-reports of meaningfulness, stress and mastering

PubMed Central

2010-01-01

Background Training of lay first responder personnel situated closer to the potential victims than medical professionals is a strategy potentially capable of shortening the interval between collapse and start of cardiopulmonary resuscitation (CPR) in cases of out-of-hospital cardiac arrest. In this study we trained lay first responders personnel in basic life support (BLS) and defibrillation for cases of cardiac arrest and suspected acute myocardial infarction (AMI). Methods Forty-two lay first responders living in remote areas or working in industries in the island community of Austevoll, Western Norway, were trained in CPR and defibrillation. We placed particular emphasis on the first responders being able to defibrillate a primary ventricular fibrillation (PVF) in patients with AMI. The trainees were organised in four teams to attend victims of AMI and cardiac arrest while awaiting the arrival of the community emergency medical services. The purpose of the study was to find out whether the teams were able to function during the five-year study project, and to examine whether lives could be saved. The first responders completed questionnaires each year on their experiences of participation. Data on the medical actions of the teams were also collected. Results By the end of the project all groups were functioning. The questionnaires evidenced a reasonable degree of motivation and self-evaluated competence in both types of group organisation, but in spite of this attrition effects in the first responders were considerable. The first responders were called out on 24 occasions, for a total of 17 patients. During the study period no case of PVF occurred after the arrival of the first responders, and the number of AMIs was very low, strongly deviating from what was anticipated. No lives were saved by the project. Conclusions The teams were sustained for almost five years without any significant deterioration of self-reported stress or mastering, but still showed attrition effects. Evaluated as a medical project the intervention was not successful, but the small scale prevents us from drawing firm conclusions on this aspect. PMID:20441592

Community first responders and responder schemes in the United Kingdom: systematic scoping review.

PubMed

Phung, Viet-Hai; Trueman, Ian; Togher, Fiona; Orner, Roderick; Siriwardena, A Niroshan

2017-06-19

Community First Responder (CFR) schemes support lay people to respond to medical emergencies, working closely with ambulance services. They operate widely in the UK. There has been no previous review of UK literature on these schemes. This is the first systematic scoping review of UK literature on CFR schemes, which identifies the reasons for becoming a CFR, requirements for training and feedback and confusion between the CFR role and that of ambulance service staff. This study also reveals gaps in the evidence base for CFR schemes. We conducted a systematic scoping review of the published literature, in the English language from 2000 onwards using specific search terms in six databases. Narrative synthesis was used to analyse article content. Nine articles remained from the initial search of 15,969 articles after removing duplicates, title and abstract and then full text review. People were motivated to become CFRs through an altruistic desire to help others. They generally felt rewarded by their work but recognised that the help they provided was limited by their training compared with ambulance staff. There were concerns about the possible emotional impact on CFRs responding to incidents. CFRs felt that better feedback would enhance their learning. Ongoing training and support were viewed as essential to enable CFRs to progress. They perceived that public recognition of the CFR role was low, patients sometimes confusing them with ambulance staff. Relationships with the ambulance service were sometimes ambivalent due to confusion over roles. There was support for local autonomy of CFR schemes but with greater sharing of best practice. Most studies dated from 2005 and were descriptive rather than analytical. In the UK and Australia CFRs are usually lay volunteers equipped with basic skills for responding to medical emergencies, whereas in the US they include other emergency staff as well as lay people. Opportunities for future research include exploring experiences and perceptions of patients who have been treated by CFRs and other stakeholders, while also evaluating the effectiveness and costs of CFR schemes.

What do men who serve as lay health advisors really do?: Immigrant Latino men share their experiences as Navegantes to prevent HIV

PubMed Central

Vissman, Aaron T.; Eng, Eugenia; Aronson, Robert E.; Bloom, Fred R.; Leichliter, Jami S.; Montaño, Jaime; Rhodes, Scott D.

2018-01-01

Background HoMBReS was a lay health advisor (LHA) intervention designed to reduce sexual risk among recently-arrived, non-English-speaking Latino men who were members of a multi-county soccer league in central NC. Methods Our community-based participatory research (CBPR) partnership collected, analyzed, and interpreted qualitative life-story narratives to characterize the roles of male LHAs known as Navegantes. Results Nine Navegantes were interviewed. Their mean age was 39 years (range 26–62 years); 6 were from Mexico and 3 from El Salvador. Navegantes described the function and facilitators of serving as LHAs and identified leverage points for future HIV and STD prevention strategies. They highlighted psychosocial and sociocultural influences on HIV risk, settings for risky behavior, and personal changes from serving as Navegantes. Conclusions This study provides preliminary evidence that an LHA approach is feasible and appropriate for Latino men, and can be effective in reaching men who might otherwise be difficult to reach. PMID:19519237

Calling the Doctor: A Qualitative Study of Patient-Initiated Physician Consultation among rural older adults

PubMed Central

Grzywacz, Joseph G.; Quandt, Sara A.; Bell, Ronny A.; Chapman, Christine; Altizer, Kathryn P.; Arcury, Thomas A.

2011-01-01

Objectives Guided by Leventhal’s Self-regulatory Model and Cockerham’s theory of health lifestyles, we explore 2 questions regarding physician consultation among elderly rural adults: What symptom characteristics prompt patient-initiated physician consultation? Do participants’ accounts of responses to symptoms, including the decision to consult a physician, incorporate descriptions of change over time? Methods We analyze data from semi-structured in-depth interviews with 62 older rural adults. Results Accounts of decisions to initiate contact with physicians support prior research. Some symptoms encouraged immediate consultation; others prompted periods of monitoring and lay management. Physicians were most often contacted if changes were new, unusually severe, persisted or worsened, or failed to respond to lay treatment. Discussion We characterize participants’ responses to symptoms as bricolages to highlight their construction from available materials. Incorporating the integrating concept of bricolage and Cockerham’s emphasis on both general dispositions and symptom-specific responses represents an important extension of Leventhal’s conceptualization of illness behavior, including patient-initiated physician consultation. PMID:21311048

Calling the doctor: a qualitative study of patient-initiated physician consultation among rural older adults.

PubMed

Stoller, Eleanor Palo; Grzywacz, Joseph G; Quandt, Sara A; Bell, Ronny A; Chapman, Christine; Altizer, Kathryn P; Arcury, Thomas A

2011-08-01

Guided by Leventhal's self-regulatory model and Cockerham's theory of health lifestyles, we explore two questions regarding physician consultation among elderly rural adults: What symptom characteristics prompt patient-initiated physician consultation? Do participants' accounts of responses to symptoms, including the decision to consult a physician, incorporate descriptions of change over time? We analyze data from semistructured in-depth interviews with 62 older rural adults. Accounts of decisions to initiate contact with physicians support prior research. Some symptoms encouraged immediate consultation; others prompted periods of monitoring and lay management. Physicians were most often contacted if changes were new, unusually severe, persisted or worsened, or failed to respond to lay treatment. We characterize participants' responses to symptoms as bricolages to highlight their construction from available materials. Incorporating the integrating concept of bricolage and Cockerham's emphasis on both general dispositions and symptom-specific responses represents an important extension of Leventhal's conceptualization of illness behavior, including patient-initiated physician consultation.

Smart choices for healthy families: a pilot study for the treatment of childhood obesity in low-income families.

PubMed

Pinard, Courtney A; Hart, Michael H; Hodgkins, Yvonne; Serrano, Elena L; McFerren, Mary M; Estabrooks, Paul A

2012-08-01

This pre-post study used a mixed-methods approach to examine the impact of a family-based weight management program among a low-income population. Smart Choices for Healthy Families was developed through an integrated research-practice partnership and piloted with 26 children and parents (50% boys; mean age = 10.5 years; 54% Black) who were referred by their pediatrician. Smart Choices included six biweekly group sessions and six automated telephone-counseling calls over 3 months. Children displayed reduced body mass index z-scores (p < .05), increased lean muscle mass (p < .001), and increased quality of life (p < .0001). Follow-up interviews indicated that physicians valued the lay leaders' ability to provide lifestyle education, whereas lay leaders extended their reach to more community members. Parents wanted to become positive role models and found that the calls maintained focus on goals. Smart Choices shows promise to initiate weight management for children in low-income families.

Social support among African Americans with heart failure: is there a role for community health advisors?

PubMed

Durant, Raegan W; Brown, Qiana L; Cherrington, Andrea L; Andreae, Lynn J; Hardy, Claudia M; Scarinci, Isabel C

2013-01-01

The study had 2 objectives: (1) to gather the observations of community health advisors (CHAs) on the role of social support in the lives of African Americans; and (2) to develop a lay support intervention framework, on the basis of the existing literature and observations of CHAs, depicting how social support may address the needs of African American patients with heart failure. Qualitative data were collected in semistructured interviews among 15 CHAs working in African American communities in Birmingham, Alabama. Prominent themes included the challenge of meeting clients' overlapping health care and general life needs, the variation in social support received from family and friends, and the opportunities for CHAs to provide multiple types of social support to clients. CHAs also believed that their support activities could be implemented among populations with heart failure. The experience of CHAs with social support can inform a potential framework of a lay support intervention among African Americans with heart failure. Published by Mosby, Inc.

Specialization training in Malawi: a qualitative study on the perspectives of medical students graduating from the University of Malawi College of Medicine

PubMed Central

2014-01-01

Background There is a critical shortage of healthcare workers in sub-Saharan Africa, and Malawi has one of the lowest physician densities in the region. One of the reasons for this shortage is inadequate retention of medical school graduates, partly due to the desire for specialization training. The University of Malawi College of Medicine has developed specialty training programs, but medical school graduates continue to report a desire to leave the country for specialization training. To understand this desire, we studied medical students’ perspectives on specialization training in Malawi. Methods We conducted semi-structured interviews of medical students in the final year of their degree program. We developed an interview guide through an iterative process, and recorded and transcribed all interviews for analysis. Two independent coders coded the manuscripts and assessed inter-coder reliability, and the authors used an “editing approach” to qualitative analysis to identify and categorize themes relating to the research aim. The University of Pittsburgh Institutional Review Board and the University of Malawi College of Medicine Research and Ethics Committee approved this study and authors obtained written informed consent from all participants. Results We interviewed 21 medical students. All students reported a desire for specialization training, with 12 (57%) students interested in specialties not currently offered in Malawi. Students discussed reasons for pursuing specialization training, impressions of specialization training in Malawi, reasons for staying or leaving Malawi to pursue specialization training and recommendations to improve training. Conclusions Graduating medical students in Malawi have mixed views of specialization training in their own country and still desire to leave Malawi to pursue further training. Training institutions in sub-Saharan Africa need to understand the needs of the country’s healthcare workforce and the needs of their graduating medical students to be able to match opportunities and retain graduating students. PMID:24393278

Specialization training in Malawi: a qualitative study on the perspectives of medical students graduating from the University of Malawi College of Medicine.

PubMed

Sawatsky, Adam P; Parekh, Natasha; Muula, Adamson S; Bui, Thuy

2014-01-06

There is a critical shortage of healthcare workers in sub-Saharan Africa, and Malawi has one of the lowest physician densities in the region. One of the reasons for this shortage is inadequate retention of medical school graduates, partly due to the desire for specialization training. The University of Malawi College of Medicine has developed specialty training programs, but medical school graduates continue to report a desire to leave the country for specialization training. To understand this desire, we studied medical students' perspectives on specialization training in Malawi. We conducted semi-structured interviews of medical students in the final year of their degree program. We developed an interview guide through an iterative process, and recorded and transcribed all interviews for analysis. Two independent coders coded the manuscripts and assessed inter-coder reliability, and the authors used an "editing approach" to qualitative analysis to identify and categorize themes relating to the research aim. The University of Pittsburgh Institutional Review Board and the University of Malawi College of Medicine Research and Ethics Committee approved this study and authors obtained written informed consent from all participants. We interviewed 21 medical students. All students reported a desire for specialization training, with 12 (57%) students interested in specialties not currently offered in Malawi. Students discussed reasons for pursuing specialization training, impressions of specialization training in Malawi, reasons for staying or leaving Malawi to pursue specialization training and recommendations to improve training. Graduating medical students in Malawi have mixed views of specialization training in their own country and still desire to leave Malawi to pursue further training. Training institutions in sub-Saharan Africa need to understand the needs of the country's healthcare workforce and the needs of their graduating medical students to be able to match opportunities and retain graduating students.

Human resources and models of mental healthcare integration into primary and community care in India: Case studies of 72 programmes

PubMed Central

Maheedhariah, Meera S.; Ghani, Sarah; Raja, Anusha; Patel, Vikram

2017-01-01

Background Given the scarcity of specialist mental healthcare in India, diverse community mental healthcare models have evolved. This study explores and compares Indian models of mental healthcare delivered by primary-level workers (PHW), and health workers’ roles within these. We aim to describe current service delivery to identify feasible and acceptable models with potential for scaling up. Methods Seventy two programmes (governmental and non-governmental) across 12 states were visited. 246 PHWs, coordinators, leaders, specialists and other staff were interviewed to understand the programme structure, the model of mental health delivery and health workers’ roles. Data were analysed using framework analysis. Results Programmes were categorised using an existing framework of collaborative and non-collaborative models of primary mental healthcare. A new model was identified: the specialist community model, whereby PHWs are trained within specialist programmes to provide community support and treatment for those with severe mental disorders. Most collaborative and specialist community models used lay health workers rather than doctors. Both these models used care managers. PHWs and care managers received support often through multiple specialist and non-specialist organisations from voluntary and government sectors. Many projects still use a simple yet ineffective model of training without supervision (training and identification/referral models). Discussion and conclusion Indian models differ significantly to those in high-income countries—there are less professional PHWs used across all models. There is also intensive specialist involvement particularly in the community outreach and collaborative care models. Excessive reliance on specialists inhibits their scalability, though they may be useful in targeted interventions for severe mental disorders. We propose a revised framework of models based on our findings. The current priorities are to evaluate the comparative effectiveness, cost-effectiveness and scalability of these models in resource-limited settings both in India and in other low- and middle- income countries. PMID:28582445

Evaluation of trained volunteer doula services for disadvantaged women in five areas in England: women's experiences.

PubMed

Darwin, Zoe; Green, Josephine; McLeish, Jenny; Willmot, Helen; Spiby, Helen

2017-03-01

Disadvantaged childbearing women experience barriers to accessing health and social care services and face greater risk of adverse medical, social and emotional outcomes. Support from doulas (trained lay women) has been identified as a way to improve outcomes; however, in the UK doula support is usually paid-for privately by the individual, limiting access among disadvantaged groups. As part of an independent multi-site evaluation of a volunteer doula service, this study examined women's experiences of one-to-one support from a trained volunteer doula during pregnancy, labour and the post-natal period among women living in five low-income communities in England. A mixed methods multi-site evaluation was conducted with women (total n = 137) who received the service before December 2012, using a combination of questionnaires (n = 136), and individual or group interviews (n = 12). Topics explored with women included the timing and nature of support, its impact, the relationship with the doula and negative experiences. Most women valued volunteer support, describing positive impacts for emotional health and well-being, and their relationships with their partners. Such impacts did not depend upon the volunteer's presence during labour and birth. Indeed, only half (75/137; 54.7%) had a doula attend their birth. Many experienced volunteer support as a friendship, distinct from the relationships offered by healthcare professionals and family. This led to potential feelings of loss in these often isolated women when the relationship ended. Volunteer doula support that supplements routine maternity services is potentially beneficial for disadvantaged women in the UK even when it does not involve birth support. However, the distress experienced by some women at the conclusion of their relationship with their volunteer doula may compromise the service's impact. Greater consideration is needed for managing the ending of a one-to-one relationship with a volunteer, particularly given the likelihood of it coinciding with a period of heightened emotional vulnerability. © 2016 John Wiley & Sons Ltd.

Know your public: the importance of the EMS provider in community and media relations.

PubMed

Silvester, A

1997-10-01

In the hundreds, and even the thousands, of hours that are spent in EMS training, none of the time is dedicated to community relations and public information. You have learned how to provide a service, but not how to sell the product. We relate to stories about physicians who were unsuccessful because of a poor "bedside manner." The patient's perception of you has very little to do with your score on the final exam or the terminology used as you explain an illness. You are judged by the same rules by which store clerks, telephone operators, waitresses and all others in the field of public service are gauged everyday. You may never do great things, but you can do small things in a great way. Just calling 911 is not enough to save a life. The very idea that we can get everywhere in the nick of time to snatch victims from the jaws of death is a fallacy. You most be concerned with the training provided for the lay public as you are with your own continuing education. There is no better way to make your service more effective than to train your entire community to save lives. There are many reasons why you should know how to deal with the media. A strong relationship can be formed simply by knowing how to make their job easier. Following the golden rules for news releases and interviews help us all appear more professional. The career of an EMT is in metamorphosis. You have been accepted by the patients you served and your fellow members of the medical community. Now you must continue to evolve as practitioners; your skills must change to meet the demands of modern medicine, and your knowledge base must continue to increase as new information becomes available. The one thing that must remain the same is your total commitment to patient care.

Training Neighborhood Residents to Conduct a Survey

ERIC Educational Resources Information Center

Back, Susan Malone; Tseng, Wan-Chun; Li, Jiaqi; Wang, Yuanhua; Phan, Van Thanh; Yeter, Ibrahim Halil

2015-01-01

As a requirement for a federal neighborhood revitalization grant, the authors trained resident interviewers and coordinated the conduct of more than 1000 door-to-door interviews of a stratified random sample. The targeted area was a multiethnic, lower income neighborhood that continues to experience the effects of past segregation. Monitoring and…

What's Not Being Said? Recollections of Nondisclosure in Clinical Supervision While in Training

ERIC Educational Resources Information Center

Sweeney, Jennifer; Creaner, Mary

2014-01-01

The aim of this qualitative study was to retrospectively examine nondisclosure in individual supervision while in training. Interviews were conducted with supervisees two years post-qualification. Specific nondisclosures were examined and reasons for these nondisclosures were explored. Six in-depth semi-structured interviews were conducted and…

If Anything Can Go Wrong, Maybe It Will.

ERIC Educational Resources Information Center

Wager, Jane C.; Rayner, Gail T.

Thirty personnel involved in various stages of the Training Extension Course (TEC) design, development, and distribution process were interviewed by telephone to determine the major problems perceived within each stage of the program, which provides validated extension training wherever U.S. soldiers are stationed. Those interviewed included TEC…

The Effect of a Brief Training in Motivational Interviewing on Trainee Skill Development

ERIC Educational Resources Information Center

Young, Tabitha L.; Hagedorn, W. Bryce

2012-01-01

Motivational interviewing (MI) is an empirically based practice that provides counselors with methods for working with resistant and ambivalent clients. Whereas previous research has demonstrated the effectiveness of training current clinicians in this evidenced-based practice, no research has investigated the efficacy of teaching MI to…

Clinical communication skills learning outcomes among first year medical students are consistent irrespective of participation in an interview for admission to medical school.

PubMed

Casey, Mavourneen; Wilkinson, David; Fitzgerald, Jennifer; Eley, Diann; Connor, Jason

2014-07-01

Although contentious most medical schools interview potential students to assess personal abilities such as communication. To investigate any differences in clinical communication skills (CCS) between first year students admitted to UQ medical school with or without an admissions interview. A retrospective analysis of 1495 student assessment scores obtained after structured communication skills training (CCS) between 2007 and 2010. The average assessment score was 3.76 ([95% CI, 3.73-3.78]) and adjusting for student characteristics, showed no main effect for interview (p = 0.89). The strongest predictor of scores was gender with females achieving significantly higher scores (3.91 [95% CI, 3.54-4.28] vs. 3.76 [95% CI, 3.39-4.13]; p ≤ 0.001). Data show no differences in post-training assessment measures between students who were interviewed during selection or not. Further research about the quality and retention of communications skills after training is warranted.

"I think it is right": a qualitative exploration of the acceptability and desired future use of oral swab and finger-prick HIV self-tests by lay users in KwaZulu-Natal, South Africa.

PubMed

Knight, Lucia; Makusha, Tawanda; Lim, Jeanette; Peck, Roger; Taegtmeyer, Miriam; van Rooyen, Heidi

2017-09-18

The uptake of HIV testing has increased in sub-Saharan Africa over the past three decades. However, the proportion of people aware of their HIV status remains lower than required to change the pandemic. HIV self-testing (HIVST) may meet this gap. Assessment of readiness for and the acceptability of HIVST by lay users in South Africa is limited. This paper presents results from a formative study designed to assess the perceived usability and acceptability of HIVST among lay users using several self-test prototypes. Fifty lay users were purposively selected from rural and peri-urban KwaZulu-Natal, South Africa. Acceptability of HIVST was assessed using a simple post-test quantitative assessment tool addressing confidence, ease-of-use, intended future use and willingness to pay. In-depth qualitative interviews explored what participants felt about the HIVST and why, their willingness to recommend and how much they would pay for a test. The key finding is that there is high acceptability regardless of self-test prototype. Acceptability is framed by two domains: usability and perceived need. Perceived usability was explored through perceived ease of use, which, regardless of actual correct usage, was reported by many of the respondents. Acceptability is influenced by perceived need, expressed by many who felt that the need for the self-test to protect privacy and autonomy. Ease of access and widespread availability of the test, not at a significant cost, were also important factors. Many participants would recommend self-test use to others and also indicated that they would choose to conduct the test again if it was free while some also indicated being willing to buy a test. The positive response and readiness amongst lay users for an HIVST in this context prototype suggests that there would be a ready and willing market for HIVST. For scalability and sustainability usability, including access and availability that are here independent indications of acceptability, should be considered. So too should the desire for future use, as an additional factor pointing to acceptability. The results show high acceptability in all of these areas domains and a general interest in HIVST amongst lay users in a community in KwaZulu-Natal.

Using the Rose Angina Questionnaire cross-culturally: the importance of consulting lay people when translating epidemiological questionnaires.

PubMed

Hanna, Lisa C; Hunt, Sonja M; Bhopal, Raj S

2012-01-01

The Rose Angina Questionnaire (RAQ) is an important measure of coronary heart disease prevalence. It has been shown to perform inconsistently across some ethnic groups in Britain. This study investigates whether the best available versions of the RAQ in Punjabi and Cantonese were linguistically equivalent to the English version. Interviews were carried out with lay people from the Pakistani, Chinese and European-origin communities in Scotland to assess the versions of the RAQ used in the Newcastle Heart Project (the best available versions). For each questionnaire item, participants were asked to elaborate on their understanding of the question and the meaning of keywords or phrases. Problems were discovered with the Punjabi and Cantonese translations of the RAQ. For example, the translation for 'chest' was interpreted by some Pakistani and Chinese women to mean 'breasts'. 'Walking uphill' was translated in Chinese as 'walking the hill', without stipulation of the direction, so that some Cantonese speakers interpreted the question as pertaining to walking downhill. Many Chinese interpreted RAQ items to be referring to breathlessness rather than chest pain due to ambiguous wording. Existing versions of the RAQ are unlikely to be yielding data that are cross-culturally valid or comparable. For robust health survey research in languages other than that in which the questionnaire was developed, lay assessment of questionnaires prior to and after translation is a necessity rather than a luxury.

Interviews as Historical Evidence: A Discussion of New Standards of Documentation and Access.

ERIC Educational Resources Information Center

Ritchie, Donald A.; And Others

1991-01-01

Presents a discussion of the documentation of and access to interviews for historical research purposes. Examines problems of documentation, transcription, permission, and storage. Presents questions of property, professional ethics, and witnesses. Argues for interview guidelines, training of researchers for interviewing, and taping of interviews.…

Integrating musculoskeletal sonography into rehabilitation: Therapists’ experiences with training and implementation

PubMed Central

Gray, Julie McLaughlin; Frank, Gelya; Roll, Shawn C.

2018-01-01

Musculoskeletal sonography is rapidly extending beyond radiology; however, best practices for successful integration into new practice contexts are unknown. This study explored non-physician experiences with the processes of training and integration of musculoskeletal sonography into rehabilitation. Qualitative data were captured through multiple sources and iterative thematic analysis was used to describe two occupational therapists’ experiences. The dominant emerging theme was competency, in three domains: technical, procedural and analytical. Additionally, three practice considerations were illuminated: (1) understanding imaging within the dynamics of rehabilitation, (2) navigating nuances of interprofessional care, and (3) implications for post-professional training. Findings indicate that sonography training for rehabilitation providers requires multi-level competency development and consideration of practice complexities. These data lay a foundation on which to explore and develop best practices for incorporating sonographic imaging into the clinic as a means for engaging clients as active participants in the rehabilitation process to improve health and rehabilitation outcomes. PMID:28830315

Pharmacist supply of sildenafil: pharmacists' experiences and perceptions on training and tools for supply.

PubMed

Braund, Rhiannon; Ratnayake, Kaushalya; Tong, Katie; Song, Jackie; Chai, Stephen; Gauld, Natalie

2018-06-01

Background In 2014, New Zealand reclassified sildenafil (for erectile dysfunction) to allow supply by specially trained pharmacists under strict criteria. Objective The study aimed to determine pharmacists' experiences and perspectives on the training for, and supply of sildenafil under this model. Setting New Zealand community pharmacy. Method This qualitative study captured data with a semi-structured interview used with purposively-sampled participants. A maximum variation sample was used to select a wide range of pharmacists working in various pharmacies, including pharmacists who were trained to provide sildenafil and those not trained to supply sildenafil. Consenting pharmacists were interviewed, with interviews audio-recorded and transcribed. Analysis used a framework approach. Main outcome measures Topics explored included: satisfaction and experience of the training; suitability and usability of the screening tools; experiences of the supply process and why some pharmacists chose not to become trained. Results Thirty-five pharmacists were interviewed. Training was seen as uncomplicated and the screening tools provided confidence that key consultation areas were covered. Most consultations reportedly took 15-20 min, some up to 60 min. Pharmacists reported being comfortable with the consultations. Many men requesting supply fell outside of the parameters, resulting in medical referral. This new model of supply was seen as a positive for pharmacists and their patients. Unaccredited pharmacists reported a perceived lack of interest from men, or ability to provide the service as reasons for not seeking accreditation. Conclusion New Zealand's model of pharmacist supply of sildenafil appears workable with some areas for improvement identified.

The Senior Companion Program Plus: A culturally tailored psychoeducational training program (innovative practice).

PubMed

Fields, Noelle L; Xu, Ling; Richardson, Virginia E; Parekh, Rupal; Ivey, Dorothea; Feinhals, Gretchen; Calhoun, Melanie

2016-01-01

A purposive sample of African American Senior Companions ( N = 23) participated in a 5-day, 20-hour psychoeducational training designed to address the unique cultural needs of African American dementia caregivers. Previous studies have not utilized lay caregiver volunteers such as Senior Companions in dementia research in the United States. Pre- and post-tests were administered to determine whether African American Senior Companions increased their knowledge of Alzheimer's disease after participating in the Senior Companion Program Plus. Results from both the quantitative and qualitative data suggest that participants improved their understanding of Alzheimer's disease. Findings from the Senior Companion Program Plus pilot warrant further study for its potential as cost effective, culturally tailored training for Senior Companions who serve persons with dementia and their family caregivers.

'I think my body has become addicted to those tablets'. Chronic heart failure patients' understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda.

PubMed

Namukwaya, Elizabeth; Murray, Scott A; Downing, Julia; Leng, Mhoira; Grant, Liz

2017-01-01

Patients with heart failure in Uganda present for health care with advanced structural heart disease, have repeated hospitalizations and poorly controlled disease symptoms. The reasons for these are unclear. Literature from other settings shows that patients' understanding of their illness and their beliefs influence their health related behaviour. The study aimed to explore the beliefs of patients with heart failure, their understanding of their illness and its treatment, and how this influenced their health related behaviour to inform future health education programs, information and palliative care services. Serial qualitative in-depth interviews were conducted with Heart Failure patients who were purposively sampled and recruited in Mulago National Referral Hospital until thematic saturation was reached. In-depth interviews were conducted at three time points over the course of their illness with intervals of 3 months between interviews. A grounded theory approach was used in data analysis. The University of Edinburgh ethics committee, Mulago Hospital Research Ethics committee and the Uganda National Council of Science and Technology (Reference numbers D/GC/178; MREC 33, SS 3083 respectively) approved the research. A total of 40 face to face qualitative longitudinal interviews (36-patient alone, 4 paired-patient and family carer), were conducted with 21 patients. The findings revealed that heart failure patients were unaware of the symptoms of the illness and their definition of illness differed from that of health professionals. Patients understood their diagnosis, cause of illness, prognosis and the importance of the medicines differently from health professionals, and had insufficient information on self-care. Lay beliefs were used to explain many aspects of the illness and treatments. All these influenced where patients sought care and their adherence to treatment, self-care and follow up leading to uncontrolled disease. There is a high level of health illiteracy among heart failure patients in Uganda. Patients rely on lay beliefs to make health decisions and medical information is often miscomprehended. There is an urgent need for health education using culturally appropriate information.

‘I think my body has become addicted to those tablets’. Chronic heart failure patients’ understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda

PubMed Central

Murray, Scott A.; Downing, Julia; Leng, Mhoira; Grant, Liz

2017-01-01

Background Patients with heart failure in Uganda present for health care with advanced structural heart disease, have repeated hospitalizations and poorly controlled disease symptoms. The reasons for these are unclear. Literature from other settings shows that patients’ understanding of their illness and their beliefs influence their health related behaviour. The study aimed to explore the beliefs of patients with heart failure, their understanding of their illness and its treatment, and how this influenced their health related behaviour to inform future health education programs, information and palliative care services. Methods Serial qualitative in-depth interviews were conducted with Heart Failure patients who were purposively sampled and recruited in Mulago National Referral Hospital until thematic saturation was reached. In-depth interviews were conducted at three time points over the course of their illness with intervals of 3 months between interviews. A grounded theory approach was used in data analysis. The University of Edinburgh ethics committee, Mulago Hospital Research Ethics committee and the Uganda National Council of Science and Technology (Reference numbers D/GC/178; MREC 33, SS 3083 respectively) approved the research. Results A total of 40 face to face qualitative longitudinal interviews (36-patient alone, 4 paired-patient and family carer), were conducted with 21 patients. The findings revealed that heart failure patients were unaware of the symptoms of the illness and their definition of illness differed from that of health professionals. Patients understood their diagnosis, cause of illness, prognosis and the importance of the medicines differently from health professionals, and had insufficient information on self-care. Lay beliefs were used to explain many aspects of the illness and treatments. All these influenced where patients sought care and their adherence to treatment, self-care and follow up leading to uncontrolled disease. Conclusion There is a high level of health illiteracy among heart failure patients in Uganda. Patients rely on lay beliefs to make health decisions and medical information is often miscomprehended. There is an urgent need for health education using culturally appropriate information. PMID:28957338

Cultural Background Variables in Dance Talent Development: Findings from the UK Centres for Advanced Training

ERIC Educational Resources Information Center

Sanchez, Erin N.; Aujla, Imogen J.; Nordin-Bates, Sanna

2013-01-01

This study is a qualitative enquiry into cultural background variables--social support, values, race/ethnicity and economic means--in the process of dance talent development. Seven urban dance students in pre-vocational training, aged 15-19, participated in semi-structured interviews. Interviews were inductively analysed using QSR International…

The Effect of Simulation Training on the Performance of Nurses

ERIC Educational Resources Information Center

Taylor, Lynne

2011-01-01

In December, 2005, the Air Force Auditing Agency conducted an interview of 282 nurses and physicians stationed in Iraq. The majority of the nurses from the interview reported they were not prepared to care for critically injured soldiers. This study investigated whether a new training technology, using scenario-based simulations, could improve…

Training for International Development: A Summary of Faculty and Foreign Student Interviews.

ERIC Educational Resources Information Center

Wallace, George; And Others

To determine a basic design for training Colorado State University (CSU) faculty for assignment to international development programs, a written questionnaire and oral interview were administered to faculty with experience in international programs in Africa, the Middle East, and Latin America. A subset of 10 selected from each geographical…

Identifying Future Scientists: Predicting Persistence into Research Training

ERIC Educational Resources Information Center

McGee, Richard; Keller, Jill L.

2007-01-01

This study used semistructured interviews and grounded theory to look for characteristics among college undergraduates that predicted persistence into Ph.D. and M.D./Ph.D. training. Participants in the summer undergraduate and postbaccalaureate research programs at the Mayo Clinic College of Medicine were interviewed at the start, near the end,…

Hiring and Training Workers: Executive Summary.

ERIC Educational Resources Information Center

Bishop, John, Ed.

To determine how employers select and train employees and the implications of this behavior for schools, telephone interviews were conducted with more than 3,500 employers. These employers answered questions on the number of persons who applied for the last position for which they hired prior to August, 1981; the number of applicants interviewed;…

Using Motivational Interviewing to Meet Core Competencies in Psychiatric Resident Training

ERIC Educational Resources Information Center

Kaplan, Sebastian; Elliott, Harold

2011-01-01

Objective: The authors propose that motivational interviewing (MI), a brief intervention designed to manage ambivalence regarding complex behavior change, is well suited for integration into psychiatric residency training programs. Methods: The authors provide a brief description of MI. In addition, based on a review of the literature the authors…

Motivational Interviewing as a Supervision Strategy in Probation: A Randomized Effectiveness Trial

ERIC Educational Resources Information Center

Walters, Scott T.; Vader, Amanda M.; Nguyen, Norma; Harris, T. Robert; Eells, Jennifer

2010-01-01

Motivational interviewing (MI) has been recommended as a supervision style in probation. This project examined the effectiveness of an MI training curriculum on probation officer MI skill and subsequent probationer outcome. Twenty probation officers were randomized to receive MI training, or to a waiting list control, while an additional group of…

Workers with hand dermatitis and workplace training experiences: A qualitative perspective.

PubMed

Zack, Bethany; Arrandale, Victoria H; Holness, Dorothy Linn

2017-01-01

Workplace training may help to prevent contact dermatitis, a common work-related disease. Information on the characteristics of existing workplace training programs and worker perceptions of this training is limited. Fourteen workers with suspected occupational contact dermatitis participated in one-on-one, semi-structured interviews. An inductive thematic analysis approach was used to identify interview themes. Workers expressed a desire for hands-on training with content relevant to their job tasks, favored training from supervisors who had practical experience, and were conflicted about employer motivations for providing training. Few workers had received training on skin protection. In many cases, the training workers had received differed greatly from their desired training. Although, workers with contact dermatitis describe having received workplace training, some question its value and effectiveness. This perspective may be attributed not only to the content and methods of training but also the health and safety culture of the workplace. Am. J. Ind. Med. 60:69-76, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Assessing the effectiveness of the NICHD investigative interview protocol when interviewing French-speaking alleged victims of child sexual abuse in Quebec.

PubMed

Cyr, Mireille; Lamb, Michael E

2009-05-01

The study was designed to assess the effectiveness of the flexibly structured NICHD Investigative Interview Protocol for child sexual abuse (CSA) investigative interviews by police officers and mental health workers in Quebec. The NICHD Protocol was designed to operationalize "best practice" guidelines and to help forensic interviewers use open-ended prompts to facilitate free recall by alleged victims. A total of 83 interviews with 3- to 13-year-old alleged victims were matched with 83 interviews conducted by the same interviewers before they were trained to use the Protocol. Interviews were matched with respect to the children's ages, children-perpetrator relationships, and the types and frequency of abuse. Coders categorized each of the prompts used to elicit information about the abuse and tabulated the numbers of new forensically relevant details provided in each response. Interviewers used three times as many open-ended prompts in Protocol interviews than in non-Protocol interviews, whereas use of all other types of questions was halved, and the total number of questions asked decreased by 25%. Protocol-guided interviews yielded more details than comparison interviews. The mean number of details per prompt increased from 3 to 5 details when the Protocol was used. Even with young children, interviewers using the Protocol employed more invitations to elicit forensically relevant details. French-speaking investigators using the NICHD Protocol used open-ended prompts rather than focused questions when interviewing alleged victims. In addition, these interviewers needed fewer questions to get relevant information when using the Protocol. A French version of the NICHD Protocol is now available to police officers and social workers who investigate the alleged sexual abuse of young children in French-speaking countries. This French version allowed trained interviewers to increase the use of invitations and reduce the use of more focused and risky questions. When the number of questions was controlled, more central details and more details in total were obtained in Protocol interviews, because the average prompt elicited more detailed answers in Protocol interviews. However, learning to use the NICHD Protocol required extended training and continued feedback sessions to maintain the high quality of interviewing.

The application and interviewing process for surgical house officership.

PubMed

Rutkow, I M; Imbembo, A L; Zuidema, G D

1979-02-01

The application and interviewing procedure for surgical house officership is an important process to both the medical student and the clinical department. Up-to-date, informative, and honest appraisals of the training programs under evaluation must be obtained. A survey was undertaken to compare and contrast students' and surgical department members' perceptions of nationwide surgical residency application procedures. It is concluded from this sampling that the majority of medical students applying to university-sponsored surgical training programs and the training institutions themselves generally are satisfied with the present application and interviewing experience. Certain areas in need of reform were elucidated, and the following recommendations are offered to aid in the development of a more effective process: (1) if possible, the descriptive information brochure should be updated on a yearly basis and must be comprehensive in scope; (2) when "en masse" interviewing is conducted, it should be held on a number of dates during the year, not just one, and a limited time for "walk-in" interviews should be allowed; (3) an opportunity should be available for the spouse or fiance'(e) to accompany the applicant; (4) an interviewer should prepare for an interview by having read the applicant's file beforehand; and (5) the interviewing schedule should be arranged so that the applicant is able to meet either the department chairperson and/or program director.

Pride in Parenting: Training Curriculum for Lay Home Visitors. NIH-DC Initiative To Reduce Infant Mortality in Minority Populations.

ERIC Educational Resources Information Center

Diamond, Linda T., Ed.; Jarrett, Marion H., Ed.

The Pride in Parenting (PIP) program was developed for mothers 18 years of age or older who had little or no prenatal care and their infants from birth to one year. The major goals of the program were to promote effective use of health services by mothers and their infants and to enhance infant development. The intervention program consisted of…

Reaction to frustration in high and low feather pecking lines of laying hens from commercial or semi-natural rearing conditions.

PubMed

Rodenburg, T B; Koene, P; Spruijt, B M

2004-02-27

The effect of rearing conditions on feather pecking and reaction to frustration was studied in two lines of laying hens. From commercial rearing conditions (large group, no mother hen), seven birds from a high feather pecking line (HC birds) and eight birds from a low feather pecking line (LC birds) were used. From semi-natural rearing conditions (small group, mother hen present) seven birds from the high feather pecking line (HN birds) were used. Feather pecking behaviour of HC, LC, and HN groups was recorded for 30 min. After that, each bird was food deprived and trained to peck a key for a food reward in a Skinnerbox. After training, each bird was subjected to a frustration session in a Skinnerbox, where the feeder was covered with Perspex. Three HC birds showed severe feather pecking, compared with one HN bird and zero LC birds. Differences in reaction to frustration were found between birds from different lines, but not in birds from different rearing conditions. LC birds tended to put their head in the feeder more frequently than HC birds over all sessions. Although limited, this study indicates that rearing conditions influence feather pecking, but not reaction to frustration.

Implementing psychological first-aid training for medical reserve corps volunteers.

PubMed

Chandra, Anita; Kim, Jee; Pieters, Huibrie C; Tang, Jennifer; McCreary, Michael; Schreiber, Merritt; Wells, Kenneth

2014-02-01

We assessed the feasibility and impact on knowledge, attitudes, and reported practices of psychological first-aid (PFA) training in a sample of Medical Reserve Corps (MRC) members. Data have been limited on the uptake of PFA training in surge responders (eg, MRC) who are critical to community response. Our mixed-methods approach involved self-administered pre- and post-training surveys and within-training focus group discussions of 76 MRC members attending a PFA training and train-the-trainer workshop. Listen, protect, connect (a PFA model for lay persons) focuses on listening and understanding both verbal and nonverbal cues; protecting the individual by determining realistic ways to help while providing reassurance; and connecting the individual with resources in the community. From pre- to post-training, perceived confidence and capability in using PFA after an emergency or disaster increased from 71% to 90% (P < .01), but no significant increase was found in PFA-related knowledge. Qualitative analyses suggest that knowledge and intentions to use PFA increased with training. Brief training was feasible, and while results were modest, the PFA training resulted in greater reported confidence and perceived capability in addressing psychological distress of persons affected by public health threats. PFA training is a promising approach to improve surge responder confidence and competency in addressing postdisaster needs.

Impact of partial participation in integrated family planning training on medical knowledge, patient communication and professionalism.

PubMed

Steinauer, Jody E; Turk, Jema K; Preskill, Felisa; Devaskar, Sangita; Freedman, Lori; Landy, Uta

2014-04-01

Obstetrics and gynecology residency programs are required to provide access to abortion training, but residents can opt out of participating for religious or moral reasons. Quantitative data suggest that most residents who opt out of doing abortions participate and gain skills in other aspects of the family planning training. However, little is known about their experience and perspective. Between June 2010 and June 2011, we conducted semistructured interviews with current and former residents who opted out of some or all of the family planning training at ob-gyn residency programs affiliated with the Kenneth J. Ryan Residency Training Program in Abortion and Family Planning. Residents were either self-identified or were identified by their Ryan Program directors as having opted out of some training. The interviews were transcribed and coded using modified grounded theory. Twenty-six physicians were interviewed by telephone. Interviewees were from geographically diverse programs (35% Midwest, 31% West, 19% South/Southeast and 15% North/Northeast). We identified four dominant themes about their experience: (a) skills valued in the family planning training, (b) improved patient-centered care, (c) changes in attitudes about abortion and (d) miscommunication as a source of negative feelings. Respondents valued the ability to partially participate in the family planning training and identified specific aspects of their training which will impact future patient care. Many of the effects described in the interviews address core competencies in medical knowledge, patient care, communication and professionalism. We recommend that programs offer a spectrum of partial participation in family planning training to all residents, including residents who choose to opt out of doing some or all abortions. Learners who morally object to abortion but participate in training in family planning and abortion, up to their level of comfort, gain clinical and professional skills. We recommend that trainers should offer a range of participation levels to maximize the educational opportunities for these learners. Copyright © 2014 Elsevier Inc. All rights reserved.

KSC-2011-1209

NASA Image and Video Library

2011-01-27

CAPE CANAVERAL, Fla. -- Flowers lay at the foot of the Space Mirror Memorial at the Kennedy Space Center Visitor Complex in Florida before a Day of Remembrance wreath laying ceremony to honor members of the NASA family who lost their lives while furthering the cause of exploration and discovery. The floral arrangement is dedicated to the Apollo 1 crew members Virgil "Gus" Grissom, Roger B. Chaffee and Edward H. White II. The memorial honors 24 United States astronauts, including the crew members of space shuttles Columbia and Challenger, Apollo 1, and those who died in training and commercial airplane accidents. The memorial is a project of the Astronauts Memorial Foundation and was paid for by Florida residents who purchased special Challenger mission automobile license plates. 2011 marks the 25th anniversary of the loss of Challenger, which broke apart over the Atlantic Ocean 73 seconds into flight on Jan. 28, 1986. Photo credit: NASA/Kim Shiflett

jsc2017e136055 - On a snowy night at Red Square in Moscow, Expedition 54-55 backup crewmember Jeanette Epps of NASA lays flowers at the Kremlin Wall where Russian space icons are interred in traditional pre-launch ceremonies Nov. 30. Looking on are backup

NASA Image and Video Library

2017-11-30

jsc2017e136055 - On a snowy night at Red Square in Moscow, Expedition 54-55 backup crewmember Jeanette Epps of NASA lays flowers at the Kremlin Wall where Russian space icons are interred in traditional pre-launch ceremonies Nov. 30. Looking on are backup crewmembers Sergey Prokopyev of the Russian Federal Space Agency (Roscosmos, left) and Alexander Gerst of the European Space Agency. They are backups to Anton Shkaplerov of Roscosmos, Scott Tingle of NASA and Norishige Kanai of the Japan Aerospace Exploration Agency (JAXA), who will launch from the Baikonur Cosmodrome in Kazakhstan on the Soyuz MS-07 spacecraft Dec. 17 for a five-month mission on the International Space Station...Andrey Shelepin/Gagarin Cosmonaut Training Center.

Leading the rebirth of the rural obstetrician.

PubMed

Campbell, Alison M; Brown, James; Simon, David R; Young, Sari; Kinsman, Leigh

2014-12-11

To understand the factors influencing the decisions of rural general practitioners and GP registrars to practise obstetrics, and to understand the impact on these decisions of an innovative obstetric training and support program in the Gippsland region of Victoria. Qualitative approach using semistructured interviews conducted in July and August 2013 and inductive content analysis. Participants were identified from training records over the previous 5 years for the Gippsland GP obstetric training and support program. Two questions were posed during interviews: What challenges face rural GPs in practising obstetrics? What impact has the Gippsland GP obstetric program had on GP obstetric career decisions? Of 60 people invited to participate, 22 agreed. Interviews ranged in duration from 40 to 90 minutes. The major themes that emerged on the challenges facing rural GPs in practising obstetrics were isolation, work-life balance and safety. The major themes that emerged on the impact of the Gippsland GP obstetric program were professional support, structured training and effective leadership. Rural GP obstetricians are challenged by isolation, the impact of their job on work-life balance, and safety. The support, training and leadership offered by the Gippsland expanded obstetric training program helped doctors to deal with these challenges. The Gippsland model of training offers a template for GP obstetric procedural training programs for other rural settings.

Mechanism of Action for Obtaining Job Offers With Virtual Reality Job Interview Training.

PubMed

Smith, Matthew J; Smith, Justin D; Fleming, Michael F; Jordan, Neil; Brown, C Hendricks; Humm, Laura; Olsen, Dale; Bell, Morris D

2017-07-01

Four randomized controlled trials revealed that virtual-reality job interview training (VR-JIT) improved interviewing skills and the odds of obtaining a job offer among trainees with severe mental illness or autism spectrum disorder. This study assessed whether postintervention interviewing skills mediated the relationship between completion of virtual interviews and receiving job offers by six-month follow-up. VR-JIT trainees (N=79) completed pre- and posttest mock interviews and a brief survey approximately six months later to assess whether they received a job offer. As hypothesized, analyses indicated that the number of completed virtual interviews predicted greater posttest interviewing skills (β=.20, 95% posterior credible interval [PCI]=.08-.33), which in turn predicted trainees' obtaining a job offer (β=.28, 95% PCI=.01-.53). VR-JIT may provide a mechanism of action that helps trainees with various psychiatric diagnoses obtain job offers in the community. Future research can evaluate the community-based effectiveness of this novel intervention.

Learning to Detect Deception from Evasive Answers and Inconsistencies across Repeated Interviews: A Study with Lay Respondents and Police Officers

PubMed Central

Masip, Jaume; Martínez, Carmen; Blandón-Gitlin, Iris; Sánchez, Nuria; Herrero, Carmen; Ibabe, Izaskun

2018-01-01

Previous research has shown that inconsistencies across repeated interviews do not indicate deception because liars deliberately tend to repeat the same story. However, when a strategic interview approach that makes it difficult for liars to use the repeat strategy is used, both consistency and evasive answers differ significantly between truth tellers and liars, and statistical software (binary logistic regression analyses) can reach high classification rates (Masip et al., 2016b). Yet, if the interview procedure is to be used in applied settings the decision process will be made by humans, not statistical software. To address this issue, in the current study, 475 college students (Experiment 1) and 142 police officers (Experiment 2) were instructed to code and use consistency, evasive answers, or a combination or both before judging the veracity of Masip et al.'s (2016b) interview transcripts. Accuracy rates were high (60% to over 90%). Evasive answers yielded higher rates than consistency, and the combination of both these cues produced the highest accuracy rates in identifying both truthful and deceptive statements. Uninstructed participants performed fairly well (around 75% accuracy), apparently because they spontaneously used consistency and evasive answers. The pattern of results was the same among students, all officers, and veteran officers only, and shows that inconsistencies between interviews and evasive answers reveal deception when a strategic interview approach that hinders the repeat strategy is used. PMID:29354078

Training Select-in Interviewers for Astronaut Selection: A Program Evaluation

NASA Technical Reports Server (NTRS)

Hysong, S.; Galarza, L.; Holland, A.; Billica, Roger (Technical Monitor)

2000-01-01

Psychological factors critical to the success of short and long-duration missions have been identified in previous research; however, evaluation for such critical factors in astronaut applicants leaves much room for human interpretation. Thus, an evaluator training session was designed to standardize the interpretation of critical factors, as well as the structure of the select-in interview across evaluators. The purpose of this evaluative study was to determine the effectiveness of the evaluator training sessions and their potential impact on evaluator ratings.

Instrument Display Visual Angles for Conventional Aircraft and the MQ-9 Ground Control Station

NASA Technical Reports Server (NTRS)

Bendrick, Gregg A.; Kamine, Tovy Haber

2008-01-01

Aircraft instrument panels should be designed such that primary displays are in optimal viewing location to minimize pilot perception and response time. Human Factors engineers define three zones (i.e. "cones") of visual location: 1) "Easy Eye Movement" (foveal vision); 2) "Maximum Eye Movement" (peripheral vision with saccades), and 3) "Head Movement" (head movement required). Instrument display visual angles were measured to determine how well conventional aircraft (T-34, T-38, F- 15B, F-16XL, F/A-18A, U-2D, ER-2, King Air, G-III, B-52H, DC-10, B747-SCA) and the MQ-9 ground control station (GCS) complied with these standards, and how they compared with each other. Methods: Selected instrument parameters included: attitude, pitch, bank, power, airspeed, altitude, vertical speed, heading, turn rate, slip/skid, AOA, flight path, latitude, longitude, course, bearing, range and time. Vertical and horizontal visual angles for each component were measured from the pilot s eye position in each system. Results: The vertical visual angles of displays in conventional aircraft lay within the cone of "Easy Eye Movement" for all but three of the parameters measured, and almost all of the horizontal visual angles fell within this range. All conventional vertical and horizontal visual angles lay within the cone of "Maximum Eye Movement". However, most instrument vertical visual angles of the MQ-9 GCS lay outside the cone of "Easy Eye Movement", though all were within the cone of "Maximum Eye Movement". All the horizontal visual angles for the MQ-9 GCS were within the cone of "Easy Eye Movement". Discussion: Most instrument displays in conventional aircraft lay within the cone of "Easy Eye Movement", though mission-critical instruments sometimes displaced less important instruments outside this area. Many of the MQ-9 GCS systems lay outside this area. Specific training for MQ-9 pilots may be needed to avoid increased response time and potential error during flight.

Effect of First Aid Education on First Aid Knowledge and Skills of Commercial Drivers in South West Nigeria.

PubMed

Olumide, Adesola O; Asuzu, Michael C; Kale, Oladele O

2015-12-01

Prompt prehospital care is essential for improving outcomes of road crash victims; however, this service is sub-optimal in developing countries because Emergency Medical Services (EMS) are not readily available. Training of lay responders in first aid has been suggested as a means of filling this gap in settings with inadequate EMS. This study was conducted to determine the effect of first aid training on the first aid knowledge and skills of commercial drivers. A before-and-after study was conducted among 128 commercial drivers (62 intervention and 66 controls) selected by multi-stage sampling. Drivers' first aid knowledge and skills were assessed at baseline, immediate, and three months post-intervention. The intervention involved a 2-day training session in first aid. Repeated measures ANOVA was used to test for differences in respondents' pre- and post-intervention scores over the three assessment points. Mean first aid knowledge scores for intervention drivers were 48.9% (SD=12.0), 57.8% (SD=11.2), and 59.2% (SD=9.0) at baseline, immediate, and three months post-intervention. Corresponding scores for the controls were 48.3% (SD=12.8), 39.2% (SD=15.3), and 46.8% (SD=15.3). Mean first aid skill scores for intervention drivers were 17.5% (SD=3.8), 80.7% (SD=8.3), and 72.3% (SD=16.8). Scores for control drivers were 16.5% (SD=4.5), 16.3% (SD=4.7), and 20.4% (SD=9.1), respectively. Repeated measures ANOVA showed significant differences in first aid knowledge and skills scores over the three phases. Independent t-test revealed significant differences in scores between the intervention and control groups post-intervention. The training led to significant improvement in first aid knowledge and skills of intervention drivers. This confirms that lay responders can be trained in provision of first aid. The slight drop in skills scores, which occurred three months post-intervention, highlights the need for periodic refresher trainings to be conducted for the drivers in order to maintain the knowledge and skills acquired.

"Old Dogs" and New Skills: How Clinician Characteristics Relate to Motivational Interviewing Skills before, during, and after Training

ERIC Educational Resources Information Center

Carpenter, Kenneth M.; Cheng, Wendy Y.; Smith, Jennifer L.; Brooks, Adam C.; Amrhein, Paul C.; Wain, R. Morgan; Nunes, Edward V.

2012-01-01

Objective: The relationships between the occupational, educational, and verbal-cognitive characteristics of health care professionals and their motivational interviewing (MI) skills before, during, and after training were investigated. Method: Fifty-eight community-based addiction clinicians (M = 42.1 years, SD = 10.0; 66% Female) were assessed…

The Role of Cultural Context in Continuing Vocational Training: A Study on Auto Repairmen in Turkey

ERIC Educational Resources Information Center

Akbas, Oktay

2011-01-01

This study analysed how auto repairmen working in micro-enterprises undertake continuing vocational training in relation to cultural context. The study was conducted in Kirikkale, a city in central Anatolia in Turkey. To this end, the descriptive research technique of structured interview was used. Interviews with 33 auto repairmen were recorded…

Views of School Administrators Related to In-Service Training Activities

ERIC Educational Resources Information Center

Güngör, Semra Kiranli; Yildirim, Yusuf

2016-01-01

The aim of this research is to specify the views of school administrators related to in-service training activities. In this research, semi-structured interview method, one of the qualitative research methods, has been used. Content analysis has been used in order to analyze the interview data and themes and sub-themes have been constituted. The…

Effectiveness of social skills training for reduction of self-perceived stigma in leprosy patients in rural India--a preliminary study.

PubMed

Augustine, Valsa; Longmore, Miriam; Ebenezer, Mannam; Richard, Joseph

2012-03-01

To assess the effectiveness of social skills training in leprosy patients to raise self-esteem and reduce self-perceived stigma. Five leprosy patients were given 10 day-long group-sessions of social skills training over 3 weeks. Training involved: identification of the emotions and concerns of patients when interacting socially; analysis of positive and negative social interactions and non-verbal and verbal skills training. Role-plays, videos and live models were used. Self-esteem and a reduction in self-perceived stigma were assessed qualitatively before and after training using semi-structured interviews. Assessment of change was scored under the indicators: self-perception, family, wider community and job. Patients were assessed for displaying new ways of interacting with people and changes in expectations for the future. Qualitative analysis of the interviews before and after training suggested that social skills training could raise the self-esteem of leprosy patients and combat self-perceived stigma. Increase in self-esteem, as evident through the verbal interactions with the interviewers and behavioural changes in the community, were noted in the majority of patients. Social skills training along with counseling may be able to increase the self-esteem of leprosy patients, and so be a useful part of leprosy rehabilitation schemes to try and combat the stigma of leprosy.

The Critical Incident Interview and Ethnoracial Identity.

ERIC Educational Resources Information Center

Montalvo, Frank F.

1999-01-01

Describes the critical-incident interview, a cross-cultural training technique that helps social work students assess clients' ethnic- and racial-identity development. Uses examples from student interviews to present the steps involved in teaching the technique. Includes guidelines for selecting and interviewing informants, and gives three scales…

The self-care for people initiative: the outcome evaluation.

PubMed

White, Alan; South, Jane; Bagnall, Anne-Marie; Forshaw, Mark; Spoor, Chris; Marchant, Paul; Witty, Karl

2012-10-01

To determine the effects of a community-based training programme in self-care on the lay population. Self Care is recognised as being a cornerstone of the populations health, but to date there have been few large-scale studies of its effectiveness on the general public. This paper reports on an evaluation of a self-care skills training course delivered in small group sessions within workplace and parent and toddler group settings to a lay population. A quasi-experimental longitudinal study of 12-month duration was conducted in three intervention primary care trusts (PCTs) and two similar comparison PCTs in England. The sample comprised 1568 self-selecting participants: 868 received the intervention and 700 did not. No changes were seen in usage of General Practitioner services, the primary outcome, however, statistical analysis suggested that being in the intervention group may be associated with increased use of out-of-hours and secondary care services. At six months' follow-up small but statistically significant positive effects of being in the intervention group were seen on self-esteem, well-being and anxiety scores. At 12 months' follow-up small but statistically significant positive effects of being in the intervention group were also seen on recovery locus of control, health literacy and self-esteem scores, and on knowledge of adult cough. The clinical significance of these very small changes is unclear. The training programme had a small but positive effect, which was still evident at 12 months, on individuals' knowledge and confidence levels with regard to managing their own health, but did not lead to reductions in health service use.

Towards successful Dissemination of Psychological First Aid: a study of provider training preferences.

PubMed

Hambrick, Erin P; Rubens, Sonia L; Vernberg, Eric M; Jacobs, Anne K; Kanine, Rebecca M

2014-04-01

Dissemination of Psychological First Aid (PFA) is challenging considering the complex nature of disaster response and the various disaster mental health (DMH) trainings available. To understand challenges to dissemination in community mental health centers (CMHCs), interviews were conducted with nine DMH providers associated with CMHCs. Consensual qualitative analysis was used to analyze data. Interviews were targeted toward understanding organizational infrastructure, DMH training requirements, and training needs. Results clarified challenges to DMH training in CMHCs and factors that may promote buy-in for trainings. For example, resources are limited and thus allocated for state and federal training requirements. Therefore, including PFA in these requirements could promote adoption. Additionally, a variety of training approaches that differ in content, style, and length would be useful. To conclude, a conceptual model for ways to promote buy-in for the PFA Guide is proposed.

How home HIV testing and counselling with follow-up support achieves high testing coverage and linkage to treatment and prevention: a qualitative analysis from Uganda.

PubMed

Ware, Norma C; Wyatt, Monique A; Asiimwe, Stephen; Turyamureeba, Bosco; Tumwesigye, Elioda; van Rooyen, Heidi; Barnabas, Ruanne V; Celum, Connie L

2016-01-01

The successes of HIV treatment scale-up and the availability of new prevention tools have raised hopes that the epidemic can finally be controlled and ended. Reduction in HIV incidence and control of the epidemic requires high testing rates at population levels, followed by linkage to treatment or prevention. As effective linkage strategies are identified, it becomes important to understand how these strategies work. We use qualitative data from The Linkages Study, a recent community intervention trial of community-based testing with linkage interventions in sub-Saharan Africa, to show how lay counsellor home HIV testing and counselling (home HTC) with follow-up support leads to linkage to clinic-based HIV treatment and medical male circumcision services. We conducted 99 semi-structured individual interviews with study participants and three focus groups with 16 lay counsellors in Kabwohe, Sheema District, Uganda. The participant sample included both HIV+ men and women (N=47) and HIV-uncircumcised men (N=52). Interview and focus group audio-recordings were translated and transcribed. Each transcript was summarized. The summaries were analyzed inductively to identify emergent themes. Thematic concepts were grouped to develop general constructs and framing propositional statements. Trial participants expressed interest in linking to clinic-based services at testing, but faced obstacles that eroded their initial enthusiasm. Follow-up support by lay counsellors intervened to restore interest and inspire action. Together, home HTC and follow-up support improved morale, created a desire to reciprocate, and provided reassurance that services were trustworthy. In different ways, these functions built links to the health service system. They worked to strengthen individuals' general sense of capability, while making the idea of accessing services more manageable and familiar, thus reducing linkage barriers. Home HTC with follow-up support leads to linkage by building "social bridges," interpersonal connections established and developed through repeated face-to-face contact between counsellors and prospective users of HIV treatment and male circumcision services. Social bridges link communities to the service system, inspiring individuals to overcome obstacles and access care.

Self-criticism in therapist training: A grounded theory analysis.

PubMed

Kannan, Divya; Levitt, Heidi M

2017-03-01

The primary objective of this study is to engender an understanding of how therapists-in-training experience and cope with self-criticism in the context of their clinical training and therapy experiences. In this study, trainees were interviewed about their experience of self-criticism related to psychotherapy practice and these interviews were subjected to a grounded theory analysis generating a core self-critical process. The analysis highlighted the vulnerability of self-criticism in therapists' training experiences, especially when they related to balancing the "expert" role while maintaining authentic interactions with their clients. The results also described ways in which self-criticism is mitigated by a sense of interpersonal safety and the provision of clinical freedom and flexibility in therapists' training. The implications for future psychotherapy research and clinical training within clinical training environments are discussed.

Strategically Leapfrogging Education in Prehospital Trauma Management: Four-Tiered Training Protocols

PubMed Central

Abraham, Rohit; Vyas, Dinesh; Narayan, Mayur; Vyas, Arpita

2016-01-01

Trauma-related injury in fast developing countries are linked to 90% of international mortality rates, which can be greatly reduced by improvements in often non-existent or non-centralized emergency medical systems (EMS)—particularly in the pre-hospital care phase. Traditional trauma training protocols—such as Advanced Trauma Life Support (ATLS), International Trauma Life Support (ITLS), and Basic Life Support (BLS)—have failed to produce an effective pre-hospital ground force of medical first responders. To overcome these barriers, we propose a new four-tiered set of trauma training protocols: Massive Open Online Course (MOOC) Trauma Training, Acute Trauma Training (ATT), Broad Trauma Training (BTT), and Cardiac and Trauma Training (CTT). These standards are specifically differentiated to accommodate the educational and socioeconomic diversity found in fast developing settings, where each free course is taught in native, lay language while ensuring the education standards are maintained by fully incorporating high-fidelity simulation, video-recorded debriefing, and retraining. The innovative pedagogy of this trauma education program utilizes MOOC for global scalability and a “train-the-trainer” approach for exponential growth—both components help fast developing countries reach a critical mass of first responders needed for the base of an evolving EMS. PMID:27419222

Strategically Leapfrogging Education in Prehospital Trauma Management: Four-Tiered Training Protocols.

PubMed

Abraham, Rohit; Vyas, Dinesh; Narayan, Mayur; Vyas, Arpita

2015-12-01

Trauma-related injury in fast developing countries are linked to 90% of international mortality rates, which can be greatly reduced by improvements in often non-existent or non-centralized emergency medical systems (EMS)-particularly in the pre-hospital care phase. Traditional trauma training protocols-such as Advanced Trauma Life Support (ATLS), International Trauma Life Support (ITLS), and Basic Life Support (BLS)-have failed to produce an effective pre-hospital ground force of medical first responders. To overcome these barriers, we propose a new four-tiered set of trauma training protocols: Massive Open Online Course (MOOC) Trauma Training, Acute Trauma Training (ATT), Broad Trauma Training (BTT), and Cardiac and Trauma Training (CTT). These standards are specifically differentiated to accommodate the educational and socioeconomic diversity found in fast developing settings, where each free course is taught in native, lay language while ensuring the education standards are maintained by fully incorporating high-fidelity simulation, video-recorded debriefing, and retraining. The innovative pedagogy of this trauma education program utilizes MOOC for global scalability and a "train-the-trainer" approach for exponential growth-both components help fast developing countries reach a critical mass of first responders needed for the base of an evolving EMS.

Alcohol brief interventions practice following training for multidisciplinary health and social care teams: a qualitative interview study.

PubMed

Fitzgerald, Niamh; Molloy, Heather; MacDonald, Fiona; McCambridge, Jim

2015-03-01

Few studies of the implementation of alcohol brief interventions (ABI) have been conducted in community settings such as mental health, social work and criminal justice teams. This qualitative interview study sought to explore the impact of training on ABI delivery by staff from a variety of such teams. Fifteen semi-structured telephone interviews were carried out with trained practitioners and with managers to explore the use of, perceived need for and approaches to ABI delivery and recording with clients, and compatibility of ABIs with current practice. Interviews were analysed thematically using an inductive approach. Very few practitioners reported delivery of any ABIs following training primarily because they felt ABIs to be inappropriate for their clients. According to practitioners, this was either because they drank too much or too little to benefit. Practitioners reported a range of current activities relating to alcohol, and some felt that their knowledge and confidence were improved following training. One practitioner reported ABI delivery and was considered a training success, while expectations of ABIs did not fit with current practice including assessment procedures for the remainder. Identified barriers to ABI delivery included issues relating to individual practitioners, their teams, current practice and the ABI model. They are likely to be best addressed by strategic team- and setting-specific approaches to implementation, of which training is only one part. © 2014 The Authors. Drug and Alcohol Review published by Wiley Publishing Asia Pty Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

Making and Maintaining Lifestyle Changes with the Support of a Lay Health Advisor: Longitudinal Qualitative Study of Health Trainer Services in Northern England

PubMed Central

Visram, Shelina; Clarke, Charlotte; White, Martin

2014-01-01

Objective To explore and document the experiences of those receiving support from a lay health trainer, in order to inform the optimisation and evaluation of such interventions. Design Longitudinal qualitative study with up to four serial interviews conducted over 12 months. Interviews were transcribed and analysed using the constant comparative approach associated with grounded theory. Participants 13 health trainers, 5 managers and 26 clients. Setting Three health trainer services targeting disadvantaged communities in northern England. Results The final dataset comprised 116 interviews (88 with clients and 28 with staff). Discussions with health trainers and managers revealed a high degree of heterogeneity between the local services in terms of their primary aims and activities. However, these were found to converge over time. There was agreement that health trainer interventions are generally ‘person-centred’ in terms of being tailored to the needs of individual clients. This led to a range of self-reported outcomes, including behaviour changes, physical health improvements and increased social activity. Factors impacting on the maintenance of lifestyle changes included the cost and timing of health-promoting activities, ill-health or low mood. Participants perceived a need for ongoing access to low cost facilities to ensure that any lifestyle changes can be maintained in the longer term. Conclusions Health trainers may be successful in terms of supporting people from socio-economically disadvantaged communities to make positive lifestyle changes, as well as achieving other health-related outcomes. This is not a ‘one-size-fits-all’ approach; commissioners and providers should select the intervention models that best meet the needs of their local populations. By delivering holistic interventions that address multiple lifestyle risks and incorporate relapse prevention strategies, health trainers could potentially have a significant impact on health inequalities. However, rigorous, formal outcome and economic evaluation of the range of health trainer delivery models is needed. PMID:24801173

Support during pregnancy for women at increased risk of low birthweight babies.

PubMed

Hodnett, Ellen D; Fredericks, Suzanne; Weston, Julie

2010-06-16

Studies consistently show a relationship between social disadvantage and low birthweight. Many countries have programs offering special assistance to women thought to be at risk for giving birth to a low birthweight infant. These programs may include advice and counseling (about nutrition, rest, stress management, alcohol, and recreational drug use), tangible assistance (e.g., transportation to clinic appointments, household help), and emotional support. The programs may be delivered by multidisciplinary teams of health professionals, specially trained lay workers, or combination of lay and professional workers. The primary objective was to assess effects of programs offering additional social support compared with routine care, for pregnant women believed at high risk for giving birth to babies that are either preterm or weigh less than 2500 gm, or both, at birth. Secondary objectives were to determine whether effectiveness of support was mediated by timing of onset (early versus later in pregnancy) or type of provider (healthcare professional or lay woman). We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2010). Randomized trials of additional support during at-risk pregnancy by either a professional (social worker, midwife, or nurse) or specially trained lay person, compared to routine care. We defined additional support as some form of emotional support (e.g., counseling, reassurance, sympathetic listening) and information or advice or both, either in home visits or during clinic appointments, and could include tangible assistance (e.g., transportation to clinic appointments, assistance with care of other children at home). Two review authors evaluated methodological quality. We performed double data entry. We included 17 trials (12,264 women). Programs offering additional social support for at-risk pregnant women were not associated with improvements in any perinatal outcomes, but there was a reduction in the likelihood of antenatal hospital admission (three trials; n = 737; RR 0.79, 95% CI 0.68 to 0.92) and caesarean birth (nine trials; n = 4522; RR 0.87, 95% CI 0.78 to 0.97). Pregnant women need the support of caring family members, friends, and health professionals. While programs which offer additional support during pregnancy are unlikely to prevent the pregnancy from resulting in a low birthweight or preterm baby, they may be helpful in reducing the likelihood of antenatal hospital admission and caesarean birth.

34 CFR 200.89 - MEP allocations; Re-interviewing; Eligibility documentation; and Quality control.

Code of Federal Regulations, 2011 CFR

2011-07-01

... determinations being tested) trained to conduct personal interviews and to understand and apply program... child eligibility determinations through the re-interview of a randomly selected sample of children previously identified as migratory. In conducting these re-interviews, an SEA must— (i) Use, at least once...

76 FR 4700 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

.... Questions vary by respondent type. 5. Post-training semi-structured interview--The purpose of this interview.... Questions vary by respondent type. 6. Post-implementation semi-structured interview--The purpose of this... in this interview. Questions do not vary by respondent type. Estimated Annual Respondent Burden...

34 CFR 200.89 - MEP allocations; Re-interviewing; Eligibility documentation; and Quality control.

Code of Federal Regulations, 2010 CFR

2010-07-01

... determinations being tested) trained to conduct personal interviews and to understand and apply program... child eligibility determinations through the re-interview of a randomly selected sample of children previously identified as migratory. In conducting these re-interviews, an SEA must— (i) Use, at least once...

Development and Evaluation of a Training Program for Organ Procurement Coordinators Using Standardized Patient Methodology.

PubMed

Odabasi, Orhan; Elcin, Melih; Uzun Basusta, Bilge; Gulkaya Anik, Esin; Aki, Tuncay F; Bozoklar, Ata

2015-12-01

The low rate of consent by next of kin of donor-eligible patients is a major limiting factor in organ transplant. Educating health care professionals about their role may lead to measurable improvements in the process. Our aim was to describe the developmental steps of a communication skills training program for health care professionals using standardized patients and to evaluate the results. We developed a rubric and 5 cases for standardized family interviews. The 20 participants interviewed standardized families at the beginning and at the end of the training course, with interviews followed by debriefing sessions. Participants also provided feedback before and after the course. The performance of each participant was assessed by his or her peers using the rubric. We calculated the generalizability coefficient to measure the reliability of the rubric and used the Wilcoxon signed rank test to compare achievement among participants. Statistical analyses were performed with SPSS software (SPSS: An IBM Company, version 17.0, IBM Corporation, Armonk, NY, USA). All participants received higher scores in their second interview, including novice participants who expressed great discomfort during their first interview. The participants rated the scenarios and the standardized patients as very representative of real-life situations, with feedback forms showing that the interviews, the video recording sessions, and the debriefing sessions contributed to their learning. Our program was designed to meet the current expectations and implications in the field of donor consent from next of kin. Results showed that our training program developed using standardized patient methodology was effective in obtaining the communication skills needed for family interviews during the consent process. The rubric developed during the study was a valid and reliable assessment tool that could be used in further educational activities. The participants showed significant improvements in communication skills.

Barriers to the implementation and uptake of simulation-based training programs in general surgery: a multinational qualitative study.

PubMed

Hosny, Shady G; Johnston, Maximilian J; Pucher, Philip H; Erridge, Simon; Darzi, Ara

2017-12-01

Despite evidence demonstrating the advantages of simulation training in general surgery, it is not widely integrated into surgical training programs worldwide. The aim of this study was to identify barriers and facilitators to the implementation and uptake of surgical simulation training programs. A multinational qualitative study was conducted using semi-structured interviews of general surgical residents and experts. Each interview was audio recorded, transcribed verbatim, and underwent emergent theme analysis. All data were anonymized and results pooled. A total of 37 individuals participated in the study. Seventeen experts (Program Directors and Surgical Attendings with an interest in surgical education) and 20 residents drawn from the United States, Canada, United Kingdom, France, and Japan were interviewed. Barriers to simulation-based training were identified based on key themes including financial cost, access, and translational benefit. Participants described cost (89%) and access (76%) as principal barriers to uptake. Common facilitators included a mandatory requirement to complete simulation training (78%) and on-going assessment of skills (78%). Participants felt that simulation training could improve patient outcomes (76%) but identified a lack of evidence to demonstrate benefit (38%). There was a consensus that simulation training has not been widely implemented (70%). There are multiple barriers to the implementation of surgical simulation training programs, however, there is agreement that these programs could potentially improve patient outcomes. Identifying these barriers enable the targeted use of facilitators to deliver simulation training programs. Copyright © 2017 Elsevier Inc. All rights reserved.

JPRS Report, Soviet Union, Military Affairs

DTIC Science & Technology

1988-09-08

war. This is an objective reality . By laying emphasis on land forces only, in particular on tanks and artillery, in solving the issues of removing...for the realities of army life in a friendly country, but nonethe- less on foreign territory. ...A few months ago, during the visit of the Soviet...victori- ous, were available in time. Nevertheless, there were virtually no offensive air units. The majority of pilots had not been trained for the

The Coast Artillery Journal. Volume 79, Number 2, March-April 1936

DTIC Science & Technology

1936-04-01

communications, field telephones and wire laying. 4. Tables of Organization and Equipment. For preliminary training, a binaural trainer and an over...with a normal binaural sense and especially acute hearing. After a sufficiently large group of these men has been selected to provide for ex- pected...casualties, they should be given special instruction and practice on the binaural trainer, using a moving sound source. This sound source may be easily

[Draft of Guidelines for Human Body Dissection for Clinical Anatomy Education and Research and commentary].

PubMed

Shichinohe, Toshiaki; Kondo, Satoshi; Ide, Chizuka; Higuchi, Norio; Aiso, Sadakazu; Sakai, Tatsuo; Matsumura, George; Yoshida, Kazunari; Kobayashi, Eiji; Tatsumi, Haruyuki; Yaginuma, Hiroyuki; Hishikawa, Shuji; Sugimoto, Maki; Izawa, Yoshimitsu; Imanishi, Nobuaki

2011-07-01

This article analyses the Draft of Guidelines for Human Body Dissection for Clinical Anatomy Education and Research drawn by the Study Group for Future Training Systems of Surgical Skills and Procedures established by the Fiscal Year 2010 research program of the Ministry of Health, Labor and Welfare. The purpose of the Draft of Guidelines is: First, to lay out the required basic guidelines for human cadaver usage to allow medical and dental faculty to conduct clinical education and research in accordance with existing regulations. Second, the guidelines are expected to give physicians a regulatory framework to carry out cadaver training in accordance with the current legal framework. This article explains the Draft of Guidelines in detail, outlines the future of cadaver training, and describes issues which must still be solved.

[Draft of guidelines for human body dissection for clinical anatomy education and research and commentary].

PubMed

Shichinohe, Toshiaki; Kondo, Satoshi; Ide, Chizuka; Higuchi, Norio; Aiso, Sadakazu; Sakai, Tatsuo; Matsumura, George; Yoshida, Kazunari; Kobayashi, Eiji; Tatsumi, Haruyuki; Yaginuma, Hiroyuki; Hishikawa, Shuji; Sugimoto, Maki; Izawa, Yoshimitsu; Imanishi, Nobuaki

2011-06-01

This article analyses the Draft of Guidelines for Human Body Dissection for Clinical Anatomy Education and Research drawn by the Study Group for Future Training Systems of Surgical Skills and Procedures established by the Fiscal Year 2010 research program of the Ministry of Health, Labor and Welfare. The purpose of the Draft of Guidelines is: First, to lay out the required basic guidelines for human cadaver usage to allow medical and dental faculty to conduct clinical education and research in accordance with existing regulations. Second, the guidelines are expected to give physicians a regulatory framework to carry out cadaver training in accordance with the current legal framework. This article explains the Draft of Guidelines in detail, outlines the future of cadaver training, and describes issues which must still be solved.

Development of a novel motivational interviewing (MI) informed peer-support intervention to support mothers to breastfeed for longer.

PubMed

Phillips, Rhiannon; Copeland, Lauren; Grant, Aimee; Sanders, Julia; Gobat, Nina; Tedstone, Sally; Stanton, Helen; Merrett, Laura; Rollnick, Stephen; Robling, Michael; Brown, Amy; Hunter, Billie; Fitzsimmons, Deborah; Regan, Sian; Trickey, Heather; Paranjothy, Shantini

2018-04-11

Many women in the UK stop breastfeeding before they would like to, and earlier than is recommended by the World Health Organization (WHO). Given the potential health benefits for mother and baby, new ways of supporting women to breastfeed for longer are required. The purpose of this study was to develop and characterise a novel Motivational Interviewing (MI) informed breastfeeding peer-support intervention. Qualitative interviews with health professionals and service providers (n = 14), and focus groups with mothers (n = 14), fathers (n = 3), and breastfeeding peer-supporters (n = 15) were carried out to understand experiences of breastfeeding peer-support and identify intervention options. Data were audio-recorded, transcribed, and analysed thematically. Consultation took place with a combined professional and lay Stakeholder Group (n = 23). The Behaviour Change Wheel (BCW) guided intervention development process used the findings of the qualitative research and stakeholder consultation, alongside evidence from existing literature, to identify: the target behaviour to be changed; sources of this behaviour based on the Capability, Opportunity and Motivation (COM-B) model; intervention functions that could alter this behaviour; and; mode of delivery for the intervention. Behaviour change techniques included in the intervention were categorised using the Behaviour Change Technique Taxonomy Version 1 (BCTTv1). Building knowledge, skills, confidence, and providing social support were perceived to be key functions of breastfeeding peer-support interventions that aim to decrease early discontinuation of breastfeeding. These features of breastfeeding peer-support mapped onto the BCW education, training, modelling and environmental restructuring intervention functions. Behaviour change techniques (BCTTv1) included social support, problem solving, and goal setting. The intervention included important inter-personal relational features (e.g. trust, honesty, kindness), and the BCTTv1 needed adaptation to incorporate this. The MI-informed breastfeeding peer-support intervention developed using this systematic and user-informed approach has a clear theoretical basis and well-described behaviour change techniques. The process described could be useful in developing other complex interventions that incorporate peer-support and/or MI.

Learning Support Centers and International Tutor Training Program Certification: An Interview with Rick A. Sheets

ERIC Educational Resources Information Center

Walker, Luann

2016-01-01

This article presents an interview with Rick A. Sheets, who has been working in learning assistance, faculty training, and technology support for over 30 years. He collaborated with Frank Christ as the co-founder and webmaster of the Learning Support Centers in Higher Education (LSCHE) website, a resource established in 1996 for learning center…

The Effect of Brief Training in Motivational Interviewing on Client Outcomes and Trainee Skill Development

ERIC Educational Resources Information Center

Young, Tabitha L.

2010-01-01

Motivational Interviewing (MI) is an evidence-based practice that focuses on working through client ambivalence and increasing clients' motivation to change. The purposes of this study were to investigate the effect that a unique student-based training in MI had on counselor trainees' ability to perform MI, and on client outcomes. This training…

Logistical considerations for establishing reliable surgical telementoring programs: a report of the SAGES Project 6 Logistics Working Group.

PubMed

Camacho, Diego R; Schlachta, Christopher M; Serrano, Oscar K; Nguyen, Ninh T

2018-03-30

Surgical telementoring programs (STMPs) as educational tools have consistently demonstrated success in the training of surgeons in a variety of surgical disciplines. The goal of an STMP is to train and educate practicing surgeons by improving or remediating surgical skills or assisting in the safe adoption of new procedures. STMPs may even have a role in assisting with recertification. In 2015, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) launched the SAGES Telementoring Initiative at the Project 6 Summit. Herein, we provide a report on the SAGES Project 6 Logistics working group and lay out a plan for the recommended logistical framework to carry out an STMP.

A national curriculum for ophthalmology residency training

PubMed Central

Grover, Ashok Kumar; Honavar, Santosh G; Azad, Rajvardhan; Verma, Lalit

2018-01-01

We present a residency curriculum for Ophthalmology in India. The document derives from a workshop by the All India Ophthalmological Society (AlOS) which adapted the International Council of Ophthalmology residency curriculum and refined and customized it based on inputs by the residency program directors who participated in the work shop. The curriculum describes the course content, lays down the minimum requirements of infrastructure and mandates diagnostic and therapeutic procedures required for optimal training. It emphasises professionalism, management, research methodology, community ophthalmology as integral to the curriculum. The proposed national ophthalmology residency curriculum for India incorporates the required knowledge and skills for effective and safe practice of ophthalmology and takes into account the specific needs of the country. PMID:29785982

Novice to expert practice via postprofessional athletic training education: a grounded theory.

PubMed

Neibert, Peter J

2009-01-01

To discover the theoretic constructs that confirm, disconfirm, or extend the principles and their applications appropriate for National Athletic Trainers' Association (NATA)-accredited postprofessional athletic training education programs. Interviews at the 2003 NATA Annual Meeting & Clinical Symposia. Qualitative study using grounded theory procedures. Thirteen interviews were conducted with postprofessional graduates. Participants were purposefully selected based on theoretic sampling and availability. The transcribed interviews were analyzed using open coding, axial coding, and selective coding procedures. Member checks, reflective journaling, and triangulation were used to ensure trustworthiness. The participants' comments confirmed and extended the current principles of postprofessional athletic training education programs and offered additional suggestions for more effective practical applications. The emergence of this central category of novice to expert practice is a paramount finding. The tightly woven fabric of the 10 processes, when interlaced with one another, provides a strong tapestry supporting novice to expert practice via postprofessional athletic training education. The emergence of this theoretic position pushes postprofessional graduate athletic training education forward to the future for further investigation into the theoretic constructs of novice to expert practice.

Motivational interviewing-based training enhances clinicians' skills and knowledge in psoriasis: findings from the Pso Well® study.

PubMed

Chisholm, A; Nelson, P A; Pearce, C J; Littlewood, A J; Kane, K; Henry, A L; Thorneloe, R; Hamilton, M P; Lavallee, J; Lunt, M; Griffiths, C E M; Cordingley, L; Bundy, C

2017-03-01

Psoriasis is a common long-term, immune-mediated skin condition associated with behavioural factors (e.g. smoking, excess alcohol, obesity), which increase the risk of psoriasis onset, flares and comorbidities. Motivational interviewing (MI) is an evidence-based approach to health-related behaviour change that has been used successfully for patients with long-term conditions. This study assessed change in clinicians' MI skills and psoriasis knowledge following Psoriasis and Wellbeing (Pso Well ® ) training. To investigate whether the Pso Well training intervention improves clinicians' MI skills and knowledge about psoriasis-related comorbidities and risk factors; and to explore the acceptability and feasibility of the Pso Well training content, delivery and evaluation. Clinicians attended the 1-day training programme focused on MI skills development in the context of psoriasis. MI skills were assessed pre- and post-training using the Behaviour Change Counselling Index. Knowledge about psoriasis-related comorbidity and risk factors was assessed with a novel 22-point measure developed for the study. Interviews with clinicians were analysed qualitatively to identify perceptions about the feasibility and acceptability of the training. Sixty-one clinicians completed the training (35 dermatology nurses, 23 dermatologists and three primary-care clinicians). Clinicians' MI skills (P < 0·001) and knowledge (P < 0·001) increased significantly post-training. Clinicians found the training valuable and relevant to psoriasis management. Attendance at the Pso Well training resulted in improvements in clinicians' knowledge and skills to manage psoriasis holistically. Clinicians deemed the training itself and the assessment procedures used both feasible and acceptable. Future research should investigate how this training may influence patient outcomes. © 2016 British Association of Dermatologists.

Rating the raters: assessing the quality of Hamilton rating scale for depression clinical interviews in two industry-sponsored clinical drug trials.

PubMed

Engelhardt, Nina; Feiger, Alan D; Cogger, Kenneth O; Sikich, Dawn; DeBrota, David J; Lipsitz, Joshua D; Kobak, Kenneth A; Evans, Kenneth R; Potter, William Z

2006-02-01

The quality of clinical interviews conducted in industry-sponsored clinical drug trials is an important but frequently overlooked variable that may influence the outcome of a study. We evaluated the quality of Hamilton Rating Scale for Depression (HAM-D) clinical interviews performed at baseline in 2 similar multicenter, randomized, placebo-controlled depression trials sponsored by 2 pharmaceutical companies. A total of 104 audiotaped HAM-D clinical interviews were evaluated by a blinded expert reviewer for interview quality using the Rater Applied Performance Scale (RAPS). The RAPS assesses adherence to a structured interview guide, clarification of and follow-up to patient responses, neutrality, rapport, and adequacy of information obtained. HAM-D interviews were brief and cursory and the quality of interviews was below what would be expected in a clinical drug trial. Thirty-nine percent of the interviews were conducted in 10 minutes or less, and most interviews were rated fair or unsatisfactory on most RAPS dimensions. Results from our small sample illustrate that the clinical interview skills of raters who administered the HAM-D were below what many would consider acceptable. Evaluation and training of clinical interview skills should be considered as part of a rater training program.

Enhanced information regarding exercise training as treatment is needed. An interview study in patients with chronic obstructive pulmonary disease.

PubMed

Nordvall Strömberg, Petronella; Fjellman-Wiklund, Anncristine; Wadell, Karin

2015-01-01

The purpose of this study is to describe thoughts and attitudes of patients with chronic obstructive pulmonary disease (COPD) when talking about exercise training as treatment. Semi-structured interviews were performed and analyzed with the grounded theory method. Four men and six women were interviewed (ages 66-84 years), with moderate to severe COPD, and no experience of organized exercise training as treatment for COPD. The analysis resulted in one core category, unknown territory, and three categories, good for those who can, but not for me; fear of future; and mastering. Exercise training as treatment was perceived by the participants as something unknown. It was also described as important for others but not for them. Their perceptions were that they could not perform exercise training, and did not have the knowledge of what or how to perform exercise that was good for them. Patients with COPD, with no previous experience of exercise training as treatment for their disease, describe exercise training as something unknown and unimportant for them. The results provide important knowledge for healthcare professionals regarding how to educate patients with COPD about the content and benefits of exercise training as treatment. Implications for Rehabilitation Exercise training is effective for patients with chronic obstructive pulmonary disease (COPD) with regard to dyspnea, physical capacity, health-related quality of life, and health care use. Patients with COPD perceive a lack of information regarding exercise training as treatment. The information and the presentation of exercise training as treatment might be of importance to get better adherence to this treatment.

Well, you have hepatic metastases: Use of technical language by medical students in simulated patient interviews.

PubMed

Bourquin, Céline; Stiefel, Friedrich; Mast, Marianne Schmid; Bonvin, Raphael; Berney, Alexandre

2015-03-01

This research explored medical students' use and perception of technical language in a practical training setting to enhance skills in breaking bad news in oncology. Terms potentially confusing to laypeople were selected from 108 videotaped interviews conducted in an undergraduate Communication Skills Training. A subset of these terms was included in a questionnaire completed by students (N=111) with the aim of gaining insight into their perceptions of different speech registers and of patient understanding. Excerpts of interviews were analyzed qualitatively to investigate students' communication strategies with respect to these technical terms. Fewer than half of the terms were clarified. Students checked for simulated patients' understanding of the terms palliative and metastasis/to metastasize in 22-23% of the interviews. The term ambulatory was spontaneously explained in 75% of the interviews, hepatic and metastasis/to metastasize in 22-24%. Most provided explanations were in plain language; metastasis/to metastasize and ganglion/ganglionic were among terms most frequently explained in technical language. A significant number of terms potentially unfamiliar and confusing to patients remained unclarified in training interviews conducted by senior medical students, even when they perceived the terms as technical. This exploration may offer important insights for improving future physicians' skills. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Constructing Adult Literacies at a Local Literacy Tutor-Training Program

ERIC Educational Resources Information Center

Roderick, Ryan

2013-01-01

This study investigates how literacy was constructed at an adult literacy organization's volunteer tutor-training program. By drawing on qualitative analysis of training texts used during training, such as training evaluations, and data gathered from interviews with experienced tutors, it is possible to identify the assumptions about literacy…

Study of basic-life-support training for college students.

PubMed

Srivilaithon, Winchana; Amnaumpatanapon, Kumpon; Limjindaporn, Chitlada; Imsuwan, Intanon; Daorattanachai, Kiattichai

2015-03-01

To study about attitude and knowledge regarding basic-life-support among college students outside medical system. The cross-sectional study in the emergency department of Thammasat Hospital. The authors included college students at least aged 18 years old and volunteers to be study subjects. The authors collected data about attitudes and knowledge in performing basic-life-support by using set of questionnaires. 250 college students participated in the two hours trainingprogram. Most ofparticipants (42.4%) were second-year college students, of which 50 of 250 participants (20%) had trained in basic-life-support program. Twenty-seven of 250 participants (10.8%) had experience in basic-life-support outside the hospital. Most of participants had good attitude for doing basic-life-support. Participants had a significant improved score following training (mean score 8.66 and 12.34, respectively, p<0.001). Thirty-three of 250 participants (13.2%) passed the minimum score before trained testing, whereas 170 of 250 participants (68%) passed the minimum score after trained testing. With accurate knowledge and experience, lay rescuers may have more confidence tope7form basic-life-support to cardiac arrest patient. The training program in basic-life-support has significant impact on knowledge after training.

A qualitative investigation of lay perspectives of diagnosis and self-management strategies employed by people with progressive multiple sclerosis.

PubMed

Frost, Julia; Grose, Jane; Britten, Nicky

2017-05-01

This article explores how people with progressive multiple sclerosis give meaning to their experiences. It builds upon the self-management literature, which has captured the tension between the desire for retaining normalcy and the increasing burden of self-management associated with chronic disease progression. This repeat interview study is empirically grounded in 28 interviews with 14 people with progressive multiple sclerosis. We identified gender differences in diagnosis-seeking which impacted subsequent sense-making. Male respondents found a diagnosis of multiple sclerosis difficult to come to terms with, and an enduring sense of loss or anger could inhibit further sense-making. A diagnosis of multiple sclerosis was more difficult to obtain for women respondents, and any sense of certainty that diagnosis provided framed their subsequent sense-making strategies. The complex sequelae of multiple sclerosis require that self-management strategies are both contextual and timely, although even the most accomplished self-managers can lose their sense of self with neurodegeneration. Disease progression can be associated with suicidal ideation, suggesting the need for greater dialogue to ensure that people with multiple sclerosis are adequately supported to fulfil their quality of life at all stages of neurodegeneration. These lay perspectives emphasise the articulation of affect rather than the rendering of a medical diagnosis, although diagnosis may provide a degree of certainty in the short term. The ethos of self-management ensures people attempt to retain their sense of 'normality' and existent social roles for as long as possible, but this ethos can negate both one's ability to self-manage and the management of self.

What constitutes meaningful engagement for patients and families as partners on research teams?

PubMed

Black, Agnes; Strain, Kimberly; Wallsworth, Christine; Charlton, Sara-Grey; Chang, Wilma; McNamee, Kate; Hamilton, Clayon

2018-01-01

Objective There is growing emphasis on health care organizations to ensure that lay people are meaningfully engaged as partners on research teams. Our aim was to explore the perspectives of patients, family members and informal caregivers who have been involved on health care research teams in Canada and elicit their recommendations for meaningful engagement. Methods We conducted a qualitative study guided by thematic analysis of transcripts of focus groups and interviews of 19 experienced patient research partners in Canada. Results We identified four main themes: research environment, expectations, support and value, which highlight participants' combined perspectives on important factors to ensure their engagement in research is meaningful. Conclusions Our findings add to the evolving evidence base on the perspectives of lay people involved in health care research and their recommendations for research leaders on meaningful engagement. Our study suggests that research leaders should provide a welcoming research environment, outline appropriate expectations for patient research partners on research teams, support patient research partners' engagement in projects and recognize the value patient research partners bring to health research.

Women's health and social change: the case of lay midwives.

PubMed

Kay, B J; Butter, I H; Chang, D; Houlihan, K

1988-01-01

One reaction to the medicalization of birth has been the comeback of lay midwives in the past 10 years. While many practice alone as did midwives 80 years ago, now midwives are networking and organizing in regional and statewide groups, an important new distinction in the light of increasing regulatory policy formation by many states. Are these groups the beginnings of traditional bureaucratic health professional organizations or are they better described as alternative women's health groups that espouse nonhierarchical philosophies of women's health? In this article, we describe an empirical study of one such group, the Michigan Midwives' Association, and explore the philosophies and practices of individual members as well as the internal organization of the group and its influence on members. Data were collected using individual telephone interviews with 48 of 50 members, group newsletters and documents, and two spokespersons who developed an oral history of the Association since its origin in 1978. Results suggest that the group plays an important role in reinforcing individually held philosophies about women-controlled birth and in providing social support to health workers practicing outside the traditional system.

Association of lay beliefs about causes of depression with social distance.

PubMed

Cleveland, H-R; Baumann, A; Zäske, H; Jänner, M; Icks, A; Gaebel, W

2013-11-01

The aim of this study was to examine the association of lay attributions about causes of depression with attitudes and prejudiced behaviour towards people with depression. Subjects (1631 German-speakers aged 18 and over, randomly selected) were interviewed in two German cities by telephone using a standardized questionnaire. The survey assessed knowledge about depression, stereotypical attitudes and social distance towards persons with depression. The results indicate that a majority of the respondents holds predominantly non-pejorative attitudes towards persons with depression. The majority estimated psychosocial causes as being most important for the genesis of depression. Stronger social distance was linked to an estimation of personal causes as relevant. Subgroup differences were apparent with respect to age, sex and reported contact to people with depression. Improvements in the education of the public about depression should be based on a multifactorial model. Future interventions should promote contact with people with depression and place special emphasis on conveying information in a suitable manner depending on the needs of different target groups. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Impact of online training on delivering a difficult medical diagnosis: Acquiring communication skills.

PubMed

Saint-Dizier de Almeida, Valérie; Agnoletti, Marie-France

2015-09-01

This paper deals with developing and assessing the training of physicians to deliver a difficult diagnosis to patients. The training is provided by a web-based self-training package. This online training emphasizes the structural, functional and relational dimensions of interviews delivering a serious diagnosis, and a logical set of recommendations for behavior towards the patient. The content is illustrated by numerous delivery interview sequences that are described and for which commentary is provided. This online package was expected to enable physicians to acquire new skills and change their mental picture of diagnosis delivery. Here we discuss the assessment of training in managing the delivery of a serious diagnosis. The approach taken and the methods used to measure knowledge and skills are presented. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

[Evaluating psychological injury in motor vehicle accidents (MVA): development and validation of a protocol for detecting pretense].

PubMed

Arce, Ramón; Fariña, Francisca; Carballal, Alicia; Novo, Mercedes

2006-05-01

In order to assess the feigning ability of the psychological injury in a motor vehicle accident (MVA), a total of 105 subjects, which never had suffered a serious MVA and lay in psychopathology, responded to the MMPI-2 in line with the standard instructions. Thereafter, subjects were instructed to feign moral damage generated by a MVA prior to being evaluated using a clinical-forensic interview a week later, and responding to the MMPI-2 another week later. The results show that 60.9% of the subjects were able to effectively feign moral damage on the MMPI-2, and 3.8% in the forensic clinical interview. The analysis of the instruments and procedures for the validation of subject responses i.e., the original validity control scales of the MMPI-2 and the analysis of feigning strategies in the forensic clinical interview, revealed no efficacy in feigning detection. Nevertheless, collectively, all the control measures and procedures were effective for the detection of feigning. Therefore, a protocol for the detection of feigning of moral damage has been proposed.

Could situational judgement tests be used for selection into dental foundation training?

PubMed

Patterson, F; Ashworth, V; Mehra, S; Falcon, H

2012-07-13

To pilot and evaluate a machine-markable situational judgement test (SJT) designed to select candidates into UK dental foundation training. Single centre pilot study. UK postgraduate deanery in 2010. Seventy-four candidates attending interview for dental foundation training in Oxford and Wessex Deaneries volunteered to complete the situational judgement test. The situational judgement test was developed to assess relevant professional attributes for dentistry (for example, empathy and integrity) in a machine-markable format. Test content was developed by subject matter experts working with experienced psychometricians. Evaluation of psychometric properties of the pilot situational judgement test (for example, reliability, validity and fairness). Scores in the dental foundation training selection process (short-listing and interviews) were used to examine criterion-related validity. Candidates completed an evaluation questionnaire to examine candidate reactions and face validity of the new test. Forty-six candidates were female and 28 male; mean age was 23.5-years-old (range 22-32). Situational judgement test scores were normally distributed and the test showed good internal reliability when corrected for test length (α = 0.74). Situational judgement test scores positively correlated with the management, leadership and professionalism interview (N = 50; r = 0.43, p <0.01) but not with the clinical skills interview, providing initial evidence of criterion-related validity as the situational judgement test is designed to test non-cognitive professional attributes beyond clinical knowledge. Most candidates perceived the situational judgement test as relevant to dentistry, appropriate for their training level, and fair. This initial pilot study suggests that a situational judgement test is an appropriate and innovative method to measure professional attributes (eg empathy and integrity) for selection into foundation training. Further research will explore the long-term predictive validity of the situational judgement test once candidates have entered training.

Laying foundations for health: food provision for under 5s in day care.

PubMed

Moore, Helen; Nelson, Pauline; Marshall, Joyce; Cooper, Mary; Zambas, Helen; Brewster, Kevin; Atkin, Karl

2005-04-01

This study investigated the food offered to children under 5 years of age in UK day care, the influence of the childcare providers on a child's diet and their attitudes towards this role. A postal survey of a randomised quota sample of childcare providers enquired after the range of food on offer and explored attitudes towards the role of food in health and the role of promoting health. Themes emerging from these data were explored by in-depth interviews with a sample of 18 childcare providers and 7 Local Authority Early Years Service staff. We received 194 (56%) responses to 345 copies of the questionnaire. Half (46%) of nurseries and 23% of childminders provided a fruit or vegetable with the main meal 5 days a week. Only 14% of nurseries and 21% of childminders provided a dairy food (i.e. calcium-rich) at the main meal every day. Almost all the childcare providers saw themselves as responsible for promoting healthy diet, but it was rare for them to have had any formal training in nutrition, while current dietary guidance was perceived as too vague to be useful. The study also highlighted tensions on the issue of food provision between those delivering childcare and parents; further research should explore the parents' perspectives. Nursery staff and childminders should have access to carefully designed advice on nutritionally appropriate food and drink services for under-fives.

Community Researchers Conducting Health Disparities Research: Ethical and other insights from fieldwork journaling

PubMed Central

Mosavel, Maghboeba; Ahmed, Rashid; Daniels, Doria; Simon, Christian

2011-01-01

Lay persons who are trained to conduct research in their own communities form an essential part of many research projects. However, the effects of conducting research in their own communities have not been adequately explored. This paper examines the experiences, perceptions, and challenges faced by a group of community researchers during their involvement in a research project that examined if, and how, the relationships between mothers and their adolescent daughters could be harnessed to develop a daughter-initiated cervical cancer intervention. Seven community researchers interviewed 157 mother-daughter pairs in Cape Town, South Africa. We examine the use of journaling as a tool to document the experiences of community researchers, and we consider how journaling may help the community-based researcher grapple with the research process, and, more broadly, what such journal content illustrates with respect to the nature and challenges of community-engaged health research. An analysis of the content of the journals provides a strong indication of how personal and intimate the research process can be for community researchers by virtue of the background that they bring into the process as well as the additional weight of the research process itself. The complexities of navigating dual and somewhat oppositional roles – the role of impartial scientist or researcher and the role of invested community person - has been both underestimated and insufficiently researched. PMID:21680071

A pilot evaluation of Arthritis Self-Management Program by lay leaders in patients with chronic inflammatory arthritis in Hong Kong.

PubMed

Leung, Ying-Ying; Kwan, Jackie; Chan, Patsy; Poon, Peter K K; Leung, Christine; Tam, Lai-Shan; Li, Edmund K; Kwok, Anna

2016-04-01

The objectives of this paper are to evaluate the efficacy of a community-based lay-led Arthritis Self-Management Program (ASMP) among patients with chronic inflammatory arthritis and evaluate the effectiveness of "shared care collaboration" between hospital and community. We trained 17 lay leaders and recruited patients with chronic inflammatory arthritis via a new shared-care model between hospital rheumatology centers and community organizations. Participants were allocated to interventional group or a wait list control group. Evaluations were completed before, after (6 weeks), and 3 months after ASMP. We performed analysis of covariance with adjustment with age, sex, marital status, education, employment, duration of illness, and disability at baseline. A total of 65 participants and 32 controls completed the study. The mean (SD) age and duration of illness were 52.0 (11.4) and 5.6 (7.3) years, 90.7 % were female, 80.4 % had rheumatoid arthritis; 25.8, 53.6, and 12.4 % referrals were from hospitals, community organizations, and patient self-help groups, respectively. The interventional group had significantly less pain (p = 0.049 at 6 weeks), used more cognitive coping methods (p = 0.008 at 6 weeks, p = 0.041 at 3 months) and practiced more aerobic exercise (p = 0.049 at 6 weeks, p = 0.008 at 3 months) after adjustment of covariance. The interventional group had a trend of improvement in self-efficacy, fatigue, self-rated health, and health distress. A community-based lay-led ASMP showed positive beneficial effects on participants with chronic inflammatory arthritis. Shared-care collaboration between hospitals, community organizations, and patient self-help groups was demonstrated.

Environmental risk perception from visual cues: the psychophysics of tornado risk perception

NASA Astrophysics Data System (ADS)

Dewitt, Barry; Fischhoff, Baruch; Davis, Alexander; Broomell, Stephen B.

2015-12-01

Lay judgments of environmental risks are central to both immediate decisions (e.g., taking shelter from a storm) and long-term ones (e.g., building in locations subject to storm surges). Using methods from quantitative psychology, we provide a general approach to studying lay perceptions of environmental risks. As a first application of these methods, we investigate a setting where lay decisions have not taken full advantage of advances in natural science understanding: tornado forecasts in the US and Canada. Because official forecasts are imperfect, members of the public must often evaluate the risks on their own, by checking environmental cues (such as cloud formations) before deciding whether to take protective action. We study lay perceptions of cloud formations, demonstrating an approach that could be applied to other environmental judgments. We use signal detection theory to analyse how well people can distinguish tornadic from non-tornadic clouds, and multidimensional scaling to determine how people make these judgments. We find that participants (N = 400 recruited from Amazon Mechanical Turk) have heuristics that generally serve them well, helping participants to separate tornadic from non-tornadic clouds, but which also lead them to misjudge the tornado risk of certain cloud types. The signal detection task revealed confusion regarding shelf clouds, mammatus clouds, and clouds with upper- and mid-level tornadic features, which the multidimensional scaling task suggested was the result of participants focusing on the darkness of the weather scene and the ease of discerning its features. We recommend procedures for training (e.g., for storm spotters) and communications (e.g., tornado warnings) that will reduce systematic misclassifications of tornadicity arising from observers’ reliance on otherwise useful heuristics.

The Structured Clinically Relevant Interview for Psychiatrists in Training (SCRIPT): A New Standardized Assessment Tool for Recruitment in the UK

ERIC Educational Resources Information Center

Rao, Rahul

2007-01-01

Objective: The multifaceted nature of training and the diverse backgrounds of potential Senior House Officers (Postgraduate Residents) require a novel approach to the selection of trainees wishing to pursue a career in psychiatry. The author reports the properties of a semi-structured interview (the SCRIPT) for assessing doctors short-listed for a…

The Whole Is Greater than the Sum of the Parts: The Effects of an Antenatal Orientation Interviews Training for Prospective Parents Postnatal Depression Levels

ERIC Educational Resources Information Center

Bulut, Pinar; Barut, Yasar

2016-01-01

The aim of this study was to examine an antenatal orientation interviews training for prospective parents' postnatal depression levels. A quasi-experimental study carried out with 26 (12 experimental, 14 control) prospective mother and father. Participants completed the Edinburgh Postnatal Depression Scale one week before the intervention and 12…

Survey on the Policy of Continuing Training in Large Firms. Case Studies in Belgium, Spain, France, the Netherlands, and the United Kingdom.

ERIC Educational Resources Information Center

Dupont, Georges; Reis, Fernanda

A study examined employee training policies and their implementation in four or five large companies in five countries (Belgium, Spain, France, the Netherlands, and the United Kingdom). Data were gathered through interviews by an expert in each of the countries using an interviewer's guide developed for the project (resulting in approximately 30…

Communicating Scientific Findings to Lawyers, Policy-Makers, and the Public (Invited)

NASA Astrophysics Data System (ADS)

Thompson, W.; Velsko, S. P.

2013-12-01

This presentation will summarize the authors' collaborative research on inferential errors, bias and communication difficulties that have arisen in the area of WMD forensics. This research involves analysis of problems that have arisen in past national security investigations, interviews with scientists from various disciplines whose work has been used in WMD investigations, interviews with policy-makers, and psychological studies of lay understanding of forensic evidence. Implications of this research for scientists involved in nuclear explosion monitoring will be discussed. Among the issues covered will be: - Potential incompatibilities between the questions policy makers pose and the answers that experts can provide. - Common misunderstandings of scientific and statistical data. - Advantages and disadvantages of various methods for describing and characterizing the strength of scientific findings. - Problems that can arise from excessive hedging or, alternatively, insufficient qualification of scientific conclusions. - Problems that can arise from melding scientific and non-scientific evidence in forensic assessments.

Science learning through scouting: an understudied context for informal science education

NASA Astrophysics Data System (ADS)

Jarman, Ruth

2005-04-01

Worldwide, voluntary youth organizations such as the Scouts and Guides attract a large following. As part of their programme they provide science experiences for children and young people. From a research perspective, however, this context for informal science education has gone largely unexamined. This study explores the field, focusing on the Cub Scouts that cater, in the UK, for children aged between 8 and 10.5 years. The investigation involved an e-mail survey, in-depth interviews with 10 leaders, short interviews with 10 Cub Scouts and an unscripted role-play performed by the children. Documented is a distinctive and engaging out-of-school science provision for participants. The research revealed this learning experience to have features that, in terms of a continuum spanning formal to informal, lay more toward the informal than anticipated in respect of curriculum and assessment, although not pedagogy. The children's responses, affective and cognitive, suggest a fruitful area for further study.

Removing user fees for health services: A multi-epistemological perspective on access inequities in Senegal.

PubMed

Mladovsky, Philipa; Ba, Maymouna

2017-09-01

Plan Sésame (PS) is a user fee exemption policy launched in 2006 to provide free access to health services to Senegalese citizens aged 60 and over. Analysis of a large household survey evaluating PS echoes findings of other studies showing that user fee removal can be highly inequitable. 34 semi-structured interviews and 19 focus group discussions with people aged 60 and over were conducted in four regions in Senegal (Dakar, Diourbel, Matam and Tambacounda) over a period of six months during 2012. They were analysed to identify underlying causes of exclusion from/inclusion in PS and triangulated with the household survey. The results point to three steps at which exclusion occurs: (i) not being informed about PS; (ii) not perceiving a need to use health services under PS; and (iii) inability to access health services under PS, despite having the information and perceived need. We identify lay explanations for exclusion at these different steps. Some lay explanations point to social exclusion, defined as unequal power relations. For example, poor access to PS was seen to be caused by corruption, patronage, poverty, lack of social support, internalised discrimination and adverse incorporation. Other lay explanations do not point to social exclusion, for example: poor implementation; inadequate funding; high population demand; incompetent bureaucracy; and PS as a favour or moral obligation to friends or family. Within a critical realist paradigm, we interpret these lay explanations as empirical evidence for the presence of the following hidden underlying causal mechanisms: lacking capabilities; mobilisation of institutional bias; and social closure. However, social constructionist perspectives lead us to critique this paradigm by drawing attention to contested health, wellbeing and corruption discourses. These differences in interpretation lead to subsequent differential policy recommendations. This demonstrates the need for the adoption of a "multi-epistemological" perspective in studies of health inequity and social exclusion. Copyright © 2017 Elsevier Ltd. All rights reserved.

Social support during delivery in rural central Ghana: a mixed methods study of women's preferences for and against inclusion of a lay companion in the delivery room.

PubMed

Alexander, Amir; Mustafa, Aesha; Emil, Sarah A V; Amekah, Ebenezer; Engmann, Cyril; Adanu, Richard; Moyer, Cheryl A

2014-09-01

This study aimed to explore pregnant women's attitudes towards the inclusion of a lay companion as a source of social support during labour and delivery in rural central Ghana. Quantitative demographic and pregnancy-related data were collected from 50 pregnant women presenting for antenatal care at a rural district hospital and analysed using STATA/IC 11.1. Qualitative attitudinal questions were collected from the same women through semi-structured interviews; data were analysed using NVivo 9.0. Twenty-nine out of 50 women (58%) preferred to have a lay companion during facility-based labour and delivery, whereas 21 (42%) preferred to deliver alone with the nurses in a facility. Women desiring a companion were younger, had more antenatal care visits, had greater educational attainment and were likely to be experiencing their first delivery. Women varied in the type of companion they prefer (male partner vs female relative). What was expected in terms of social support differed based upon the type of companion. Male companions were expected to provide emotional support and to 'witness her pain'. Female companions were expected to provide emotional support as well as instrumental, informational and appraisal support. Three qualitative themes were identified that run counter to the inclusion of a lay helper: fear of an evil-spirited companion, a companion not being necessary or helpful, and being 'too shy' of a companion. This research challenges the assumption of a unilateral desire for social support during labour and delivery, and suggests that women differ in the type of companion and type of support they prefer during facility deliveries. Future research is needed to determine the direction of the relationship--whether women desire certain types of support and thus choose companions they believe can meet those needs, or whether women desire a certain companion and adjust their expectations accordingly.

Rewarding altruism: addressing the issue of payments for volunteers in public health initiatives.

PubMed

South, Jane; Purcell, Martin E; Branney, Peter; Gamsu, Mark; White, Judy

2014-03-01

Lay involvement in public health programmes occurs through formalised lay health worker (LHW) and other volunteer roles. Whether such participation should be supported, or indeed rewarded, by payment is a critical question. With reference to policy in England, UK, this paper argues how framing citizen involvement in health only as time freely given does not account for the complexities of practice, nor intrinsic motivations. The paper reports results on payment drawn from a study of approaches to support lay people in public health roles, conducted in England, 2007-9. The first phase of the study comprised a scoping review of 224 publications, three public hearings and a register of projects. Findings revealed the diversity of approaches to payment, but also the contested nature of the topic. The second phase investigated programme support matters in five case studies of public health projects, which were selected primarily to reflect role types. All five projects involved volunteers, with two utilising forms of payment to support engagement. Interviews were conducted with a sample of project staff, LHWs (paid and unpaid), external partners and service users. Drawing on both lay and professional perspectives, the paper explores how payment relates to social context as well as various motivations for giving, receiving or declining financial support. The findings show that personal costs are not always absorbed, and that there is a potential conflict between financial support, whether sessional payment or expenses, and welfare benefits. In identifying some of the advantages and disadvantages of payment, the paper highlights the complexity of an issue often addressed only superficially. It concludes that, in order to support citizen involvement, fairness and value should be considered alongside pragmatic matters of programme management; however policy conflicts need to be resolved to ensure that employment and welfare rights are maintained. Copyright © 2013 Elsevier Ltd. All rights reserved.

Changes in blood pressure among users of lay health worker or volunteer operated community-based blood pressure programs over time: a systematic review protocol.

PubMed

Skar, Pål; Young, Lynne; Gordon, Carol

2015-10-01

The objective of this review is to identify studies reporting on lay health worker- or volunteer-led community-based programs for blood pressure screening and cardiovascular awareness in order to determine if these programs contribute to changes in blood pressure among participants over time.The specific question for this review is: What are the changes in blood pressure among adult users of community-based blood pressure screening and awareness programs operated by lay health workers or volunteers as measured by the differences in systolic and diastolic blood pressure between the user's first visit to the program and their last visit to the program? Cardiovascular diseases, such as stroke and heart disease, are quickly becoming global diseases manifesting in countries and communities where they traditionally had not been widespread. The World Health Organization (WHO) has reported that "in the Asia/Pacific region, [cardiovascular disease] has become increasingly prevalent in recent decades, and now accounts for about one third of all deaths". One risk factor that can lead to cardiovascular disease is hypertension. Based on WHO data from 2008, hypertension is now a global problem affecting 27% of the population 25 years of age or older.The risk for cardiovascular disease also appears to be higher among people in urban areas. A recent United Nations population report indicates that in the next 40 years we could see an increase in the world's population by 2.3 billion people. The majority of these people will be residing in urban areas, particularly in developing nations. Between 2011 and 2050, "the population living in urban areas is projected to gain 2.6 billion, passing from 3.6 billion in 2011 to 6.3 billion in 2050". Population growth in urban areas is therefore not only projected to include the expected population growth but also expected to include a shift of rural population to urban centers and "most of the population growth expected in urban areas will be concentrated in the cities and towns of the less developed regions". This growth of urban areas has the potential to put enormous pressures on health care systems that are already struggling to cope with the rapid increase in diseases thought to be more prevalent in Western societies, such as cardiovascular diseases.Hypertension may be difficult to treat due to a number of factors. Globally, access to antihypertensive medications, hypertension screening, and access to medical care vary from one country to another. Lifestyle factors, such as salt and alcohol consumption, stress, smoking, body weight, and exercise, are risk factors for hypertension that may be influenced by culture, which can in turn support or hinder lifestyle decisions that could significantly affect blood pressure. Hypertension, however, is easy to detect. A trained person with access to a low-cost sphygmomanometer can detect abnormal blood pressures quickly; however, access to trained personnel is not universally guaranteed. Globally - according to one model of skilled health care worker density and total requirement offered for discussion by the Global Health Workforce Alliance and WHO - there could currently be an estimated shortage of over seven million skilled health care workers (midwifes, nurses and physicians), as measured against a theoretical density of skilled health care workers to population. The shortage of skilled health care workers in this model could grow to over 12 million by 2035 if the assumptions of the model and population growth estimates are valid. Through rapid urbanization the potential for inequities in access to healthcare is also increased.Over the last few years, a number of community-based blood pressure screening and education initiatives have been established. These initiatives have been created either as part of research, as part of community outreach programs by publicly funded agencies, or as part of an outreach by not-for-profit organizations with a particular interest in reducing cardiovascular disease in specific hard-to-reach populations. Several systematic reviews have been conducted to assess different models for delivering services to people living with high blood pressure to assess community-based programs with a focus on cardiovascular disease, and to assess effectiveness of community health workers (CHW) in a variety of settings. These systematic reviews point to the importance of distinguishing between different categories of health care providers, their training and their roles in program delivery when assessing studies for possible inclusion in a systematic review.In a systematic review of studies from the US by Brownstein et al. focusing on the effectiveness of community health workers (CHWs) in the care of people with hypertension, this category of health care providers went under many different names. Community health workers in this review were defined as "any health workers who carried out functions related to health care deliver, were trained as part of an intervention, had no formal paraprofessional or professional designation, and had a relationship with the community being served". One of the findings from this review was the wide variety of formal training of the CHWs. In other parts of the world, a CHW might be defined differently. In their review of CHW-based programs focusing on children's health, Bhattacharyya, Winch, LeBan and Tien found that "in general CHWs are not paid salaries because the MOH (Ministry of Health) or donors do not consider salaries to be sustainable. Yet CHWs are often held accountable and supervised as if they were employees. Community health worker programs must recognize that CHWs are volunteers (emphasis in original), even if they receive small monetary or nonmonetary incentives. They are volunteering their time to serve the community". One Canadian model for delivering a cardiovascular awareness program designed to reach older adults through their primary care provider is based on volunteers with basic training to perform blood pressure measurements and cardiovascular health information.In a global review of a wide range of public health and health promotion initiatives operated by lay health workers from 2005, Lewin et al. identified over 40 different names or terms for a lay health worker. However, the definition of a lay health worker used by Lewin et al. is very similar to the definition of CHWs offered by Brownstein et al. Lewin et al.'s systematic review was the only study with a global focus that was located that reviewed studies of programs with a cardiovascular component using lay health workers. In this study, the sample size of studies focusing on lay health workers and cardiovascular disease was small (N=3) and the results from two of the studies were inconclusive to the point where the authors felt they could not pool the results.While a lay health worker may or may not receive some compensation for their work, volunteers in higher income areas of the world such as in North America typically do not receive any compensation. Volunteers, as observed by Bhattacharyya et al., are common in many parts of the world, and in some areas they provide delivery of programs and services that reach hundreds of thousands of individuals. One challenge for this systematic review will therefore be to isolate those programs that are delivered by lay health workers or volunteers who receive little or no compensation and programs where staff is paid. The importance of this distinction is on one hand related to cost - as observed by Bhattacharyya et al., many organizations responsible for delivery of community-based programs do not have funding for salaried staff. On the other hand there might be other factors in the relationship between a community being served by a program and the staff delivering the program. One such factor could be linked to the role of the person delivering the program as either a paid health care professional or an unpaid lay health worker or volunteer.Through this proposed JBI systematic review, the reviewers will focus on community-based blood pressure screening and health information programs delivered by either lay health workers or volunteers. Previous systematic reviews have indicated that programs focusing on blood pressure reduction delivered in a variety of settings and delivered by a variety of health care professionals might lower blood pressure among program participants over time. This systematic review will be limited to community-based programs rather than hospital or research facility-based programs, and to programs delivered by lay health workers or volunteers rather than programs delivered by paid community health workers, nurses or teams of health care providers under direction of a primary care provider. Compared to other recent systematic reviews which focused on studies with comparison groups and included few studies where lay health workers were involved, this systematic review will attempt to fill this gap in knowledge about programs delivered by lay health workers or volunteers by focusing on non-randomized controlled studies which report blood pressure changes over time in programs targeting the general population. Community-based programs might have a variety of designs with a number of different interventions, and where possible these designs and interventions will be identified and subgroup analysis conducted as appropriate. It is hoped that this systematic review can extend the work by Lewin et al. by identifying additional studies globally, focusing on programs delivered by lay health workers or volunteers but limited to studies reporting changes in blood pressure over time. Where possible, a meta-analysis of the changes in blood pressure over time among participants in these programs will be conducted. (ABSTRACT TRUNCATED)

Life After the Event: A Review of Basic Life Support Training for Parents Following Apparent Life-Threatening Events and Their Experience and Practices Following Discharge.

PubMed

Macken, W L; Clarke, N; Nadeem, M; Coghlan, D

2017-05-10

Apparent Life-Threatening Events (ALTEs) are a common presentation to paediatric hospitals and represent a significant cause of parental anxiety. Basic Life Support (BLS) training is recommended for all caregivers following ALTEs. This study aimed to assess the rate of caregiver BLS training and reviewed parents experience following discharge. Parents were interviewed by phone following discharge. Over the study period 25 children attended the Emergency Department with ALTE, 17/25 (68%) were trained and 13/17 (76%) were contactable for interview. All parents found training decreased their anxiety level and were interested in attending for re-training. BLS resuscitation was subsequently required by 2/13 (15%) of children. Non-medical grade monitors were in use by 10/13 (77%) of caregivers following discharge. Caregivers are eager to engage in BLS training and it effectively reduces their caregiver anxiety. We recommend an increase in instructor staff and use of group re-training post discharge.

Performance Support Technology to Assess Training Effectiveness: Functional and Test-Bed Requirements

DTIC Science & Technology

1992-10-01

Su22ort Technologv SN Conge ~t ------------------ ------------------------------ 1. Compliance with TRADOC policy 1.1 Job aid that lays out SOP. 1.2 Tutorial...Inverse area . .Mark area after matched I-Custom cursor w rong respons,,e ¶Try again (Change Response TUpe jane) Erase feedback: SOK" Edit dlsplag OK...MANAGER for GROUP rou Choose an option: U - USER NAMES *2* A - ACTIVITIES *2* F - FILE MANAGEMENr C - CODEWORD E - ERROP REPORT *PRESENT* S - SPECIAL

jsc2018e008068

NASA Image and Video Library

2018-02-22

jsc2018e008068 - At Red Square in Moscow, Expedition 55 crewmember Drew Feustel of NASA lays flowers at the Kremlin Wall where Russian space icons are interred in traditional pre-launch activities Feb. 22. Feustel, Oleg Artemyev of Roscosmos and Ricky Arnold of NASA will launch March 21 on the Soyuz MS-08 spacecraft from the Baikonur Cosmodrome in Kazakhstan for a five-month mission on the International Space Station...Gagarin Cosmonaut Training Center/Andrey Shelepin and Irina Spektor .

Outcomes from a community-based, participatory lay health advisor HIV/STD prevention intervention for recently arrived immigrant Latino men in rural North Carolina, USA

PubMed Central

Rhodes, Scott D.; Hergenrather, Kenneth C.; Bloom, Fred R.; Leichliter, Jami S.; Montaño, Jaime

2012-01-01

Background Latinos in the United States are at increased risk for HIV and sexually transmitted disease (STD) infection. We evaluated the efficacy of a pilot, lay health advisor (LHA) intervention designed to increase condom use and HIV testing among Latino men. Methods Fifteen LHAs (mean age=35.6; range 23–60 years) from 15 Latino soccer teams were trained and worked with their teammates for 18 months. Another 15 teams served as the control group. Data were collected at baseline and 18-months post-LHA training from a random sample of teammates from intervention and control teams. Results Data were collected from 222 men (mean age=29 years) who participated in one of the 30 teams. Relative to the control condition, participants in the intervention reported more consistent condom use in the 30 days preceding follow-up (unadjusted analysis, intervention, 65.6% vs. control, 41.3%; P<.001). Participants in the intervention were more likely to report condom use (adjusted odds ratio=2.3; CI=1.2–4.3) and HIV testing (adjusted odds ratio=2.5; CI=1.5–4.3). Conclusions LHA interventions for Latino men that are developed in partnership with community members, rely on male-centered intrapersonal networks, and are culturally congruent can enhance preventive behaviors and may reduce HIV infection. PMID:19824838

76 FR 54732 - Proposed Information Collection; Comment Request: Field Representative/Decennial Field Staff Exit...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-02

... on data quality, the retention of trained field interviewing staff is a major concern for the Census... interviewers, the Census Bureau collects data on the reasons interviewers voluntarily quit their jobs with the... the Census Bureau might have done, or can do, to influence interviewers not to leave their jobs. The...

From novice to proficient general practitioner: a critical incident study.

PubMed

Sim, M G; Kamien, M; Diamond, M R

1996-09-01

To obtain information about any change in the performance or perceptions of doctors undertaking the Royal Australian College of General Practitioners (RACGP) Training Program, with advancing general practice experience. The critical incident technique' was used, which is a comparative qualitative analysis. It involved interviews at 12 to 18 months after the basic term interview. Eighteen Western Australian doctors, who had been interviewed in 1992, at the end of their first 6 months of general practice training and were now completing their advanced or mentor terms in the RACGP Training Program took part in the study. Doctors reported an average of 4.4 critical incidents in their first interview and 5.0 in their second interview. The major areas of positive change included relationships with patients and other health care professionals, including supervisors; paediatrics and orthopaedics skills; the skills of developing a therapeutic relationship to enhance patient compliance and the ability to manage complex cardiovascular and psychiatric problems without reliance on specialist referral; attitudes of responsibility for and enjoyment of long term care of patients and families; and reduced levels of anxiety over difficult problems. New or continuing areas of difficulty were found in gynaecology; pharmacotherapy and dermatology; the diagnosis of common complaints with uncommon presentations; the skill of managing difficult or angry patients; the organisation for the follow-up of patients with potentially severe disorders; and in managing feelings of guilt over missed diagnoses or poor management. An analysis of commonly occurring positive and negative critical incidents shows that RACGP Training Program doctors develop competence, confidence and reduced levels of performance anxiety with advancing experience. All but one doctor found the Training Program helpful in achieving these proficiencies. However, many ongoing areas of difficulty remain. The Critical Incident method is a useful tool for learning and assessment in a vocational training program.

A test of the validity of the motivational interviewing treatment integrity code.

PubMed

Forsberg, Lars; Berman, Anne H; Kallmén, Håkan; Hermansson, Ulric; Helgason, Asgeir R

2008-01-01

To evaluate the Swedish version of the Motivational Interviewing Treatment Code (MITI), MITI coding was applied to tape-recorded counseling sessions. Construct validity was assessed using factor analysis on 120 MITI-coded sessions. Discriminant validity was assessed by comparing MITI coding of motivational interviewing (MI) sessions with information- and advice-giving sessions as well as by comparing MI-trained practitioners with untrained practitioners. A principal-axis factoring analysis yielded some evidence for MITI construct validity. MITI differentiated between practitioners with different levels of MI training as well as between MI practitioners and advice-giving counselors, thus supporting discriminant validity. MITI may be used as a training tool together with supervision to confirm and enhance MI practice in clinical settings. MITI can also serve as a tool for evaluating MI integrity in clinical research.

Learning motivational interviewing in a real-life setting: a randomised controlled trial in the Swedish Prison Service.

PubMed

Forsberg, Lars; Ernst, Denise; Farbring, Carl Åke

2011-07-01

Motivational interviewing (MI) is a client-centred, directive counselling style for helping people to explore and resolve ambivalence about behaviour change and shown to decrease drug and alcohol use. A five-session semi-structured MI intervention [Beteende, Samtal, Förändring (BSF; Behaviour, Counselling, Change)] was implemented in Swedish prisons. To examine whether, in a real-life implementation of semi-structured MI, staff receiving ongoing MI training, based on audio-recorded feedback in peer groups (BSF+), possess greater MI skill compared with staff receiving workshop-only MI training (BSF), and staff conducting usual prison planning interviews (UPI). Prisoners were randomised to one of the three interventions. The fi rst sessions between staff and prisoner with complete data were assessed with the Motivational Interviewing Treatment Integrity Code 3.0. Content analysis of 45 staff: prisoner sessions revealed that counsellors in the BSF+ group were significantly more competent in MI than those in the UPI group, but there was no difference in MI competency between the BSF and UPI groups. Overall, staff were rated as not having achieved beginning proficiency. Our findings suggest that staff delivering motivational interviewing programmes for substance-misusing prisoners in Sweden are not being given sufficient training for the task. Previous literature has suggested that staff need more than a basic 3- to 5-day workshop training, but our findings suggest that they may need longer-term continuing supervision and support than previously recognised.

Parents' perceptions of reasons for excess weight loss in obese children: a peer researcher approach.

PubMed

Gillison, Fiona; Cooney, Geraldine; Woolhouse, Valerie; Davies, Angie; Dickens, Fiona; Marno, Penny

2017-01-01

This study reports on the process of conducting participatory research by training peer researchers to conduct interviews and analyse data collected with parents of overweight children. The methodology was chosen as a means of (a) encouraging participation among a hard-to-engage group (i.e., parents of overweight children), and (b) generating novel insights and challenging academic/health professional assumptions through the involvement of parents in the interpretation of findings. Four parents (all female) were recruited as peer researchers and trained in research processes, ethics, and interview skills over three half-day workshops. The intended interviewees were parents of children identified as obese through the National Child Measurement Programme (NCMP) at the start of primary school (age 4-5) but who had lost their excess weight by age 10-11; little is currently known about how this excess weight loss is achieved. Interviews were conducted by peer researchers, transcribed verbatim and analysed thematically by both peer- and university-based investigators. The peer researchers felt confident to conduct interviews after three training sessions. Recruitment of interviewees was challenging, resulting in only four volunteers (all mothers) over a 5-month period; thus peer researchers were only able to conduct one interview each. All interviews were considered good quality in comparison to those conducted by Masters-level research assistants. The process of co-analysis resulted in a change in emphasis from that initially generated by the university research team; the role of health professionals in weight management was de-emphasised, and the importance of 'not singling out' overweight children accentuated. Given the limited number of interviews, the results of the study are only provisional but resulted in three themes: Whole Family Action, Support (and lack of support), and Protecting Childhood. Training peer researchers to conduct and analyse interviews was feasible within a short period of training. Peer researchers found the experience interesting, informative and worthwhile. Two of the four volunteered to be involved in a related study 12 months later. The different perspective brought through co-analysis suggests that this approach to conducting participatory research may be a useful means of working with the public to generate new ideas to tackle intransigent issues.

Testing the feasibility of training peers with a spinal cord injury to learn and implement brief action planning to promote physical activity to people with spinal cord injury

PubMed Central

Gainforth, Heather L.; Latimer-Cheung, Amy E.; Davis, Connie; Casemore, Sheila; Martin Ginis, Kathleen A.

2015-01-01

Objective The present study tested the feasibility of training peers with spinal cord injury (SCI) to learn brief action planning (BAP), an application of motivational interviewing principles, to promote physical activity to mentees with SCI. Method Thirteen peers with SCI attended a half-day BAP workshop. Using a one-arm, pre-, post-test design, feasibility to learn BAP was assessed in terms of peers' (1) BAP and motivational interviewing spirit competence; (2) training satisfaction; and (3) motivations to use BAP as assessed by measures of the theory of planned behavior constructs. Measures were taken at baseline, immediately post-training, and 1 month follow up. Results Following the training, participants' BAP and motivational interviewing competence significantly increased (P's < 0.05, d's > 2.27). Training satisfaction was very positive with all means falling above the scale midpoint. Participants' perceived behavioral control to use BAP increased from baseline to post (P < 0.05, d = 0.91) but was not maintained at follow up (P > 0.05). Conclusion Training peers with a SCI to learn to use BAP is feasible. Practical implications BAP is a tool that can be feasibly learned by peers to promote physical activity to their mentees. PMID:25429692