132 results
Search Results
2. An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds: a protocol paper for Teeth Tales
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Veronika Pradel, Andrea de Silva, Lisa Gold, Christine Armit, Richard G. Watt, Laurence Moore, Michal Morris, Lisa Gibbs, Britt Johnson, Mandy Truong, Dana Young, Mark Gussy, Elizabeth Waters, Hanny Calache, Iqbal Gondal, Bradley Christian, Maryanne Tadic, and Elisha Riggs
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Gerontology ,medicine.medical_specialty ,Urban Population ,Victoria ,Refugee ,education ,Community-based participatory research ,Oral Health ,Health Promotion ,Dental Caries ,Vulnerable Populations ,Peer Group ,CHILD ,Residence Characteristics ,Cultural diversity ,Asia, Western ,Protocol ,Humans ,Medicine ,Early childhood ,Health Education ,Qualitative Research ,Transients and Migrants ,Refugees ,Medical education ,CULTURAL COMPETENCY ,business.industry ,Public health ,Infant ,General Medicine ,Focus Groups ,Focus group ,Health promotion ,Child, Preschool ,INEQUALITIES ,COMMUNITY-BASED PARTICIPATORY RESEARCH ,Health education ,Public Health ,business - Abstract
Introduction Inequalities are evident in early childhood caries rates with the socially disadvantaged experiencing greater burden of disease. This study builds on formative qualitative research, conducted in the Moreland/Hume local government areas of Melbourne, Victoria 2006–2009, in response to community concerns for oral health of children from refugee and migrant backgrounds. Development of the community-based intervention described here extends the partnership approach to cogeneration of contemporary evidence with continued and meaningful involvement of investigators, community, cultural and government partners. This trial aims to establish a model for child oral health promotion for culturally diverse communities in Australia. Methods and analysis This is an exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds. Families from an Iraqi, Lebanese or Pakistani background with children aged 1–4 years, residing in metropolitan Melbourne, were invited to participate in the trial by peer educators from their respective communities using snowball and purposive sampling techniques. Target sample size was 600. Moreland, a culturally diverse, inner-urban metropolitan area of Melbourne, was chosen as the intervention site. The intervention comprised peer educator led community oral health education sessions and reorienting of dental health and family services through cultural Competency Organisational Review (CORe). Ethics and dissemination Ethics approval for this trial was granted by the University of Melbourne Human Research Ethics Committee and the Department of Education and Early Childhood Development Research Committee. Study progress and output will be disseminated via periodic newsletters, peer-reviewed research papers, reports, community seminars and at National and International conferences. Trial registration number Australian New Zealand Clinical Trials Registry (ACTRN12611000532909).
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- 2014
3. Research paper. How do policy advisors and practitioners prioritise the protection of children from secondhand smoke exposure in a country with advanced tobacco control policy?
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Ritchie, Deborah Doreen, Amos, Amanda, Shaw, April, O’Donnell, Rachel, Semple, Sean, Turner, Steve, and Martin, Claudia
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PASSIVE smoking , *ECONOMICS , *FOCUS groups , *INTERVIEWING , *RESEARCH methodology , *MEDICAL personnel , *PEDIATRICS , *POLICY sciences , *PUBLIC administration , *PUBLIC health , *RESEARCH funding , *QUALITATIVE research , *GOVERNMENT policy , *JUDGMENT sampling , *THEMATIC analysis , *DRUG control , *PREVENTION - Abstract
The article focuses on a study in Scotland, United Kingdom of prioritizing protection of children from secondhand smoke exposure (SHSE) in a private space where smoke-free public places are enforced. It discusses the difficulty of political acceptability in enforcing the issue and the intervention over parental autonomy to smoke in their own home. The article also reports on the findings based on the study used called Reducing Families' Exposure to Secondhand Smoke (REFRESH) project.
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- 2015
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4. Research paper. Testing messages to reduce smokers' openness to using novel smokeless tobacco products.
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Popova, Lucy, Neilands, Torsten B., and Ling, Pamela M.
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MARKETING , *HEALTH promotion , *ADVERTISING , *ANALYSIS of variance , *CHI-squared test , *CONSUMER attitudes , *EXPERIMENTAL design , *FOCUS groups , *INDUSTRIES , *PUBLIC health , *QUESTIONNAIRES , *REGRESSION analysis , *RESEARCH funding , *STATISTICAL sampling , *SMOKELESS tobacco , *STATISTICS , *DATA analysis , *PRE-tests & post-tests , *REPEATED measures design , *DATA analysis software , *DESCRIPTIVE statistics - Abstract
Introduction Tobacco manufacturers' aggressive promotion of new smokeless tobacco products such as snus warrants a timely and effective public health response. This study tested potential countermarketing messages to discourage current and former smokers from becoming dual users of smokeless tobacco and cigarettes. Methods In a pretest-post-test experiment, 1836 adult current and recently former smokers from a national sample were randomised to view one of six antismokeless tobacco ads followed by a snus ad, to view a control ad followed by a snus ad; or to view two control ads. Perceived effectiveness of ads and actual changes in attitudes and openness to snus were compared across groups using analyses of variance. Results Some ads that were perceived as most effective did not change attitudes or openness to trying snus, and conversely, some ads not perceived as effective changed attitudes and openness to snus. Ads portraying the negative health effects of smokeless tobacco were perceived as most effective, but ads with antitobacco industry themes significantly decreased favourable attitudes toward snus. Responses to ads were different for smokers who had ever used smokeless tobacco: for this group health effects and humorous/testimonial ads were effective. Conclusions Measures of perceived effectiveness of antitobacco ads need to be augmented with measures of actual effectiveness to assess countermarketing messages. Some of the developed ads, such as ads with anti-industry themes, were effective for the overall population of smokers whereas humorous/testimonial and health effects ads were particularly effective in changing attitudes of past users of smokeless tobacco. [ABSTRACT FROM AUTHOR]
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- 2014
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5. How can patient-held lists of medication enhance patient safety? A mixed-methods study with a focus on user experience.
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Garfield, Sara, Furniss, Dominic, Husson, Fran, Etkind, Mike, Williams, Marney, Norton, John, Ogunleye, Della, Jubraj, Barry, Lakhdari, Hanaa, and Dean Franklin, Bryony
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MEDICATION error prevention ,ATTITUDE (Psychology) ,CAREGIVERS ,COMMUNICATION ,CONCEPTUAL structures ,DRUG interactions ,FOCUS groups ,INTERVIEWING ,RESEARCH methodology ,MEDICAL personnel ,MEDICAL records ,PATIENTS ,PATIENT safety ,RESEARCH funding ,JUDGMENT sampling ,ACCESS to information ,THEMATIC analysis ,HEALTH care reminder systems ,MEDICATION therapy management ,PATIENTS' attitudes ,MEDICATION reconciliation - Abstract
Background Patients often carry medication lists to mitigate information loss across healthcare settings. We aimed to identify mechanisms by which these lists could be used to support safety, key supporting features, and barriers and facilitators to their use. Methods We used a mixed-methods design comprising two focus groups with patients and carers, 16 semistructured interviews with healthcare professionals, 60 semistructured interviews with people carrying medication lists, a quantitative features analysis of tools available for patients to record their medicines and usability testing of four tools. Findings were triangulated using thematic analysis. Distributed cognition for teamwork models were used as sensitising concepts. Results We identified a wide range of mechanisms through which carrying medication lists can improve medication safety. These included improving the accuracy of medicines reconciliation, allowing identification of potential drug interactions, facilitating communication about medicines, acting as an aide-mémoire to patients during appointments, allowing patients to check their medicines for errors and reminding patients to take and reorder their medicines. Different tools for recording medicines met different needs. Of 103 tools examined, none met the core needs of all users. A key barrier to use was lack of awareness by patients and carers that healthcare information systems can be fragmented, a key facilitator was encouragement from healthcare professionals. Conclusion Our findings suggest that patients and healthcare professionals perceive patient-held medication lists to have a wide variety of benefits. Interventions are needed to raise awareness of the potential role of these lists in enhancing patient safety. Such interventions should empower patients and carers to identify a method that suits them best from a range of options and avoid a 'one size fits all' approach [ABSTRACT FROM AUTHOR]
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- 2020
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6. Consulting with young people: informing guidelines for children's palliative care.
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Taylor, Johanna, Murphy, Sarah, Chambers, Lizzie, and Aldridge, Jan
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LONELINESS ,PALLIATIVE treatment ,SADNESS ,PSYCHOTHERAPY ,PEDIATRIC intensive care ,ONCOLOGY nursing ,MEDICAL policy laws ,TERMINAL care & psychology ,MEDICAL quality control ,RESEARCH ,TERMINAL care ,FOCUS groups ,RESEARCH methodology ,MEDICAL cooperation ,EVALUATION research ,MEDICAL protocols ,QUALITATIVE research ,COMPARATIVE studies ,MEDICAL referrals - Abstract
Objective: Increasingly the views of young people are sought when improving healthcare; however, it is unclear how they shape policy or practice. This paper presents a consultation with young people commissioned by the National Institute for Health and Care Excellence (NICE) to inform clinical guidelines for paediatric palliative care (end-of-life care for infants, children and young people).Methods: The consultation involved qualitative thematic analysis of data from 14 young people (aged 12-18 years) with a life-limiting or life-threatening condition who took part in focus groups or interviews. The topics explored were predefined by NICE: information and communication; care planning; place of care; and psychological care. Data collection consisted of discussion points and activities using visual cues and was informed by a pilot consultation group with five young adults (aged 19-24 years). Findings were shared with participants, and feedback helped to interpret the findings.Results: Four overarching themes were identified, cutting across the predetermined topic areas: being treated as individuals with individual needs and preferences; quality of care more important than place; emotional well-being; and living as a young person. Importantly, care planning was viewed as a tool to support living well and facilitate good care, and the young people were concerned less about where care happens but who provides this.Conclusion: Young people's priorities differ from those of parents and other involved adults. Incorporating their priorities within policy and practice can help to ensure their needs and preferences are met and relevant research topics identified. [ABSTRACT FROM AUTHOR]- Published
- 2021
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7. Athlete health and safety at large sporting events: the development of consensus-driven guidelines.
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Mountjoy, Margo, Moran, Jane, Ahmed, Hosny, Bermon, Stephane, Bigard, Xavier, Doerr, Dominik, Lacoste, Alain, Miller, Stuart, Weber, Alexis, Foster, Jeremy, Budgett, Richard, Engebretsen, Lars, Burke, Louise M., Gouttebarge, Vincent, Grant, Marie-Elaine, McCloskey, Brian, Piccininni, Paul, Racinais, Sebastien, Stuart, Mark, and Zideman, David
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ATHLETES' health ,SPORTS events ,SPORTS safety ,INTERNATIONAL organization ,SCIENTIFIC literature ,MEDICAL care standards ,SAFETY ,FOCUS groups ,SPORTS ,ATHLETES ,PUBLIC health ,RISK assessment ,EMERGENCY medical services ,INTERNATIONAL agencies - Abstract
All sport events have inherent injury and illness risks for participants. Healthcare services for sport events should be planned and delivered to mitigate these risks which is the ethical responsibility of all sport event organisers. The objective of this paper was to develop consensus-driven guidelines describing the basic standards of services necessary to protect athlete health and safety during large sporting events. By using the Knowledge Translation Scheme Framework, a gap in International Federation healthcare programming for sport events was identified. Event healthcare content areas were determined through a narrative review of the scientific literature. Content experts were systematically identified. Following a literature search, an iterative consensus process was undertaken. The outcome document was written by the knowledge translation expert writing group, with the assistance of a focus group consisting of a cohort of International Federation Medical Chairpersons. Athletes were recruited to review and provide comment. The Healthcare Guidelines for International Federation Events document was developed including content-related to (i) pre-event planning (eg, sport medical risk assessment, public health requirements, environmental considerations), (ii) event safety (eg, venue medical services, emergency action plan, emergency transport, safety and security) and (iii) additional considerations (eg, event health research, spectator medical services). We developed a generic standardised template guide to facilitate the planning and delivery of medical services at international sport events. The organisers of medical services should adapt, evaluate and modify this guide to meet the sport-specific local context. [ABSTRACT FROM AUTHOR]
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- 2021
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8. A qualitative positive deviance study to explore exceptionally safe care on medical wards for older people.
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Baxter, Ruth, Taylor, Natalie, Kellar, Ian, and Lawton, Rebecca
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EVALUATION of medical care ,ELDER care ,CONCEPTUAL structures ,FOCUS groups ,HEALTH care teams ,HOSPITAL wards ,INTERVIEWING ,MEDICAL care ,NATIONAL health services ,PATIENTS ,PATIENT safety ,RESEARCH funding ,QUALITATIVE research ,JUDGMENT sampling ,DESCRIPTIVE statistics ,FIELD notes (Science) - Abstract
Background The positive deviance approach seeks to identify and learn from those who demonstrate exceptional performance. This study sought to explore how multidisciplinary teams deliver exceptionally safe care on medical wards for older people. Methods A qualitative positive deviance study was conducted on four positively deviant and four slightlyabove- average matched comparator wards, which had been identified using routinely collected NHS Safety Thermometer data. In total, 70 multidisciplinary staff participated in eight focus groups to explore staff perceptions about how their teams deliver safe patient care. A thematic analysis was conducted in two stages: first to identify the tools, processes, strategies, and cultural and social contexts that facilitated safety across all wards; and second to generate hypotheses about the characteristics that facilitated 'positively deviant' patient care. Results Based on identifiable qualitative differences between the positively deviant and comparison wards, 14 characteristics were hypothesised to facilitate exceptionally safe care on medical wards for older people. This paper explores five positively deviant characteristics that healthcare professionals considered to be most salient. These included the relational aspects of teamworking, specifically regarding staff knowing one another and working together in truly integrated multidisciplinary teams. The cultural and social context of positively deviant wards was perceived to influence the way in which practical tools (eg, safety briefings and bedside boards) were implemented. Conclusion This study exemplifies that there are no 'silver bullets' to achieving exceptionally safe patient care on medical wards for older people. Healthcare leaders should encourage truly integrated multidisciplinary ward teams where staff know each other well and work as a team. Focusing on these underpinning characteristics may facilitate exceptional performances across a broad range of safety outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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9. Balancing measures or a balanced accounting of improvement impact: a qualitative analysis of individual and focus group interviews with improvement experts in Scotland.
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Toma, Madalina, Dreischulte, Tobias, Gray, Nicola M., Campbell, Diane, and Guthrie, Bruce
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CLINICAL medicine ,FOCUS groups ,INTERVIEWING ,RESEARCH methodology ,MEDICAL quality control ,NATIONAL health services ,QUALITY assurance ,QUALITATIVE research ,JUDGMENT sampling ,KEY performance indicators (Management) - Abstract
Background As quality improvement (QI) programmes have become progressively larger scale, the risks of implementation having unintended consequences are increasingly recognised. More routine use of balancing measures to monitor unintended consequences has been proposed to evaluate overall effectiveness, but in practice published improvement interventions hardly ever report identification or measurement of consequences other than intended goals of improvement. Methods We conducted 15 semistructured interviews and two focus groups with 24 improvement experts to explore the current understanding of balancing measures in QI and inform a more balanced accounting of the overall impact of improvement interventions. Data were analysed iteratively using the framework approach. Results Participants described the consequences of improvement in terms of desirability/undesirability and the extent to which they were expected/ unexpected when planning improvement. Four types of consequences were defined: expected desirable consequences (goals); expected undesirable consequences (trade-offs); unexpected undesirable consequences (unpleasant surprises); and unexpected desirable consequences (pleasant surprises). Unexpected consequences were considered important but rarely measured in existing programmes, and an improvement pause to take stock after implementation would allow these to be more actively identified and managed. A balanced accounting of all consequences of improvement interventions can facilitate staff engagement and reduce resistance to change, but has to be offset against the cost of additional data collection. Conclusion Improvement measurement is usually focused on measuring intended goals, with minimal use of balancing measures which when used, typically monitor trade-offs expected before implementation. This paper proposes that improvers and leaders should seek a balanced accounting of all consequences of improvement across the life of an improvement programme, including deliberately pausing after implementation to identify and quantitatively or qualitatively evaluate any pleasant or unpleasant surprises. [ABSTRACT FROM AUTHOR]
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- 2018
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10. RESPOND: a patient-centred programme to prevent secondary falls in older people presenting to the emergency department with a fall--protocol for a mixed methods programme evaluation.
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Morris, R. L., Brand, C. A., Hill, K. D., Ayton, D. R., Redfern, J., Nyman, S. R., Lowthian, J. A., Hill, A. M., Etherton-Beer, C. D., Flicker, L., Hunter, P. C., and Barker, A. L.
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ACCIDENTAL fall prevention ,RISK factors of falling down ,FOCUS groups ,HOSPITAL emergency services ,INTERVIEWING ,RESEARCH methodology ,MEDICAL protocols ,QUESTIONNAIRES ,REGRESSION analysis ,RESEARCH funding ,STATISTICAL sampling ,HOME environment ,SECONDARY analysis ,THEMATIC analysis ,RANDOMIZED controlled trials ,INDEPENDENT living ,PATIENT-centered care ,EVALUATION of human services programs - Abstract
Background Programme evaluations conducted alongside randomised controlled trials (RCTs) have potential to enhance understanding of trial outcomes. This paper describes a multi-level programme evaluation to be conducted alongside an RCT of a falls prevention programme (RESPOND). Objectives (1) To conduct a process evaluation in order to identify the degree of implementation fidelity and associated barriers and facilitators. (2) To evaluate the primary intended impact of the programme: participation in fall prevention strategies and the factors influencing participation. (3) To identify the factors influencing RESPOND RCT outcomes: falls, fall injuries and emergency department (ED) re-presentations. Methods/design 528 community-dwelling adults aged 60-90 years presenting to two EDs with a fall will be recruited and randomly assigned to the intervention or standard care group. All RESPOND participants and RESPOND clinicians will be included in the evaluation. A mixed methods design will be used and a programme logic model will frame the evaluation. Data will be sourced from interviews, focus groups, questionnaires, clinician case notes, recruitment records, participant-completed calendars, hospital administrative datasets and audio-recordings of intervention contacts. Quantitative data will be analysed via descriptive and inferential statistics and qualitative data will be interpreted using thematic analysis. Discussion The RESPOND programme evaluation will provide information about contextual and influencing factors related to the RESPOND RCT outcomes. The results will assist researchers, clinicians and policy makers regarding decisions about future falls prevention interventions. Insights gained may be applicable to a range of chronic conditions where similar preventive intervention approaches are indicated. [ABSTRACT FROM AUTHOR]
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- 2016
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11. Clinical user experiences of observation and response charts: focus group findings of using a new format chart incorporating a track and trigger system.
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Elliott, Doug, Allen, Emily, Perry, Lin, Fry, Margaret, Duffield, Christine, Gallagher, Robyn, Iedema, Rick, McKinley, Sharon, and Roche, Michael
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CLINICAL medicine ,DATABASE management ,FOCUS groups ,MEDICAL quality control ,NURSING records ,PHYSICIANS ,RESEARCH funding ,KEY performance indicators (Management) ,ACQUISITION of data - Abstract
Background Optimising clinical responses to deteriorating patients is an international indicator of acute healthcare quality. Observation charts incorporating track and trigger systems are an initiative to improve early identification and response to clinical deterioration. A suite of track and trigger 'Observation and Response Charts' were designed in Australia and initially tested in simulated environments. This paper reports initial clinical user experiences and views following implementation of these charts in adult general medical-surgical wards. Methods Across eight trial sites, 44 focus groups were conducted with 218 clinical ward staff, mostly nurses, who received training and had used the charts in routine clinical practice for the preceding 2-6 weeks. Transcripts of audio recordings were analysed for emergent themes using an inductive approach. Findings In this exploration of initial user experiences, key emergent themes were: tensions between vital sign 'ranges versus precision' to support decision making; using a standardised 'generalist chart in a range of specialist practice' areas; issues of 'clinical credibility', 'professional autonomy' and 'influences of doctors' when communicating abnormal signs; and 'permission and autonomy' when escalating care according to the protocol. Across themes, participants presented a range of positive, negative or mixed views. Benefits were identified despite charts not always being used up to their optimal design function. Participants reported tensions between chart objectives and clinical practices, revealing mismatches between design characteristics and human staff experiences. Overall, an initial view of 'increased activity/uncertain benefit' was uncovered. Conclusions Findings particularly reinforced the significant influences of organisational work-based cultures, disciplinary boundaries and interdisciplinary communication on implementation of this new practice chart. Optimal use of all chart design characteristics will be possible when these broader cultural issues are addressed. [ABSTRACT FROM AUTHOR]
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- 2015
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12. Emergency medical systems education may improve knowledge of pre-hospital stroke triage protocols.
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Dibiasio, Eleanor L., Jayaraman, Mahesh V., Oliver, Lori, Paolucci, Gino, Clark, Michael, Watkins, Cristina, Delisi, Karen, Wilks, Ann, Yaghi, Shadi, Hemendinger, Morgan, Baird, Grayson L., Oostema, J. Adam, and McTaggart, Ryan A.
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CONFIDENCE intervals ,CURRICULUM ,EMERGENCY medical services ,EMERGENCY medical services education ,FOCUS groups ,PROFESSIONS ,STROKE ,MEDICAL triage ,SEVERITY of illness index ,DESCRIPTIVE statistics - Abstract
Background Following the results of randomized clinical trials supporting the use of mechanical thrombectomy (MT) with tissue plasminogen activator for emergent large vessel occlusion (ELVO), our state Stroke Task Force convened to: update legislation to recognize differences between Primary Stroke Centers (PSCs) and Comprehensive Stroke Centers (CSCs); and update Emergency Medical Services (EMS) protocols to triage direct transport of suspected ELVO patients to CSCs. Purpose We developed a single-session training curriculum for EMS personnel focused on the Los Angeles Motor Scale (LAMS) score, its use to correctly triage patients as CSC-appropriate in the field, and our state-wide EMS stroke protocol. We assessed the effect of our training on EMS knowledge. Methods We assembled a focus group to develop a training curriculum and assessment questions that would mimic real-life conditions under which EMS personnel operate. Ten questions were formulated to assess content knowledge before and after training, and scores were compared using generalized mixed models. Results Training was provided for 179 EMS providers throughout the state. Average pre-test score was 52.4% (95% CI 49% to 56%). Average post-test score was 85.6% (83%-88%, P<0.0001). Each of the 10 questions was individually assessed and all showed significant gains in EMS knowledge after training (P<0.0001). Conclusions A brief educational intervention results in substantial improvements in EMS knowledge of prehospital stroke severity scales and severity-based field triage protocols. Further study is needed to establish whether these gains in knowledge result in improved real-world performance. [ABSTRACT FROM AUTHOR]
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- 2020
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13. Culture and behaviour in the English National Health Service: overview of lessons from a large multimethod study.
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Dixon-Woods, Mary, Baker, Richard, Charles, Kathryn, Dawson, Jeremy, Jerzembek, Gabi, Martin, Graham, McCarthy, Imelda, McKee, Lorna, Minion, Joel, Ozieranski, Piotr, Willars, Janet, Wilkie, Patricia, and West, Michael
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BEHAVIORAL assessment ,CORPORATE culture ,QUALITY assurance ,MANAGEMENT ,ANALYSIS of variance ,COGNITION disorders ,COMMITMENT (Psychology) ,DOCUMENTATION ,FOCUS groups ,GOAL (Psychology) ,INFORMATION storage & retrieval systems ,MEDICAL databases ,INTERVIEWING ,LEADERSHIP ,RESEARCH methodology ,CASE studies ,MEDICAL cooperation ,NATIONAL health services ,SCIENTIFIC observation ,EVALUATION of organizational effectiveness ,PATIENT safety ,REINFORCEMENT (Psychology) ,RESEARCH ,RESEARCH evaluation ,RESEARCH funding ,SURVEYS ,EVIDENCE-based medicine ,MANAGEMENT styles ,PROFESSIONAL practice ,INFORMATION needs ,CLINICAL supervision ,META-synthesis - Abstract
Background Problems of quality and safety persist in health systems worldwide. We conducted a large research programme to examine culture and behaviour in the English National Health Service (NHS). Methods Mixed-methods study involving collection and triangulation of data from multiple sources, including interviews, surveys, ethnographic case studies, board minutes and publicly available datasets. We narratively synthesised data across the studies to produce a holistic picture and in this paper present a highlevel summary. Results We found an almost universal desire to provide the best quality of care. We identified many 'bright spots' of excellent caring and practice and high-quality innovation across the NHS, but also considerable inconsistency. Consistent achievement of high-quality care was challenged by unclear goals, overlapping priorities that distracted attention, and compliance-oriented bureaucratised management. The institutional and regulatory environment was populated by multiple external bodies serving different but overlapping functions. Some organisations found it difficult to obtain valid insights into the quality of the care they provided. Poor organisational and information systems sometimes left staff struggling to deliver care effectively and disempowered them from initiating improvement. Good staff support and management were also highly variable, though they were fundamental to culture and were directly related to patient experience, safety and quality of care. Conclusions Our results highlight the importance of clear, challenging goals for high-quality care. Organisations need to put the patient at the centre of all they do, get smart intelligence, focus on improving organisational systems, and nurture caring cultures by ensuring that staff feel valued, respected, engaged and supported. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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14. Huddling for high reliability and situation awareness.
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Goldenhar, Linda M., Brady, Patrick W., Sutcliffe, Kathleen M., and Muething, Stephen E.
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HUMAN services programs ,QUALITY assurance ,MANAGEMENT ,CHILDREN'S hospitals ,CONCEPTUAL structures ,EXECUTIVES ,FOCUS groups ,INTERVIEWING ,RESEARCH methodology ,MEDICAL personnel ,ORGANIZATIONAL effectiveness ,PATH analysis (Statistics) ,PATIENT safety ,RESPONSIBILITY ,STATISTICAL sampling ,SELF-efficacy ,TEAMS in the workplace ,QUALITATIVE research ,ACCESS to information ,THEMATIC analysis - Abstract
Background Studies show that implementing huddles in healthcare can improve a variety of outcomes. Yet little is known about the mechanisms through which huddles exert their effects. To help remedy this gap, our study objectives were to explore hospital administrator and frontline staff perspectives on the benefits and challenges of implementing a tiered huddle system; and propose a model based on our findings depicting the mediating pathways through which implementing a huddle system may reduce patient harm. Methods Using qualitative methods, we conducted semi-structured interviews and focus groups to obtain a deeper understanding of the huddle system and its outcomes as implemented in an academic tertiary care children's hospital with 539 inpatient beds. We recruited healthcare providers representing all levels using a snowball sampling technique (10 interviews), and emails, flyers, and paper invitations (six focus groups). We transcribed recordings and analysed the data using established techniques. Results Five themes emerged and provided the foundational constructs of our model. Specifically we propose that huddle implementation leads to improved efficiencies and quality of information sharing, increased levels of accountability, empowerment, and sense of community, which together create a culture of collaboration and collegiality that increases the staff's quality of collective awareness and enhanced capacity for eliminating patient harm. Conclusions While each construct in the proposed model is itself a beneficial outcome of implementing huddles, conceptualising the pathways by which they may work allows us to design ways to evaluate other huddle implementation efforts designed to help reduce failures and eliminate patient harm. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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15. The patient is in: patient involvement strategies for diagnostic error mitigation.
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McDonald, Kathryn M., Bryce, Cindy L., and Graber, Mark L.
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DIAGNOSTIC errors ,CONCEPTUAL structures ,DECISION making ,DIAGNOSIS ,EXPERIMENTAL design ,FOCUS groups ,PSYCHOLOGY information storage & retrieval systems ,MEDLINE ,ONLINE information services ,PATIENTS ,PHYSICIAN-patient relations ,QUALITY assurance ,UNCERTAINTY ,PATIENT participation ,EVIDENCE-based medicine ,PROFESSIONAL practice ,INFORMATION needs ,PATIENT-centered care ,PATIENTS' attitudes ,PREVENTION - Abstract
Although healthcare quality and patient safety have longstanding international attention, the target of reducing diagnostic errors has only recently gained prominence, even though numerous patients, families and professional caregivers have suffered from diagnostic mishaps for a long time. Similarly, patients have always been involved in their own care to some extent, but only recently have patients sought more opportunities for engagement and participation in healthcare improvements. This paper brings these two promising trends together, analysing strategies for patient involvement in reducing diagnostic errors in an individual's own care, in improving the healthcare delivery system's diagnostic safety, and in contributing to research and policy development on diagnosis-related issues. [ABSTRACT FROM AUTHOR]
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- 2013
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16. e-Prescribing: characterisation of patient safety hazards in community pharmacies using a sociotechnical systems approach.
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Odukoya, Olufunmilola K. and Chui, Michelle A.
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COGNITION ,DRUGSTORES ,FOCUS groups ,EVALUATION of medical care ,MEDICATION errors ,SCIENTIFIC observation ,PATIENT safety ,PHARMACEUTICAL arithmetic ,PHARMACISTS ,PHARMACY technicians ,RESEARCH funding ,USER interfaces ,QUALITATIVE research ,COMMUNICATION barriers ,DISTRACTION ,SOCIAL context ,THEMATIC analysis ,CROSS-sectional method - Abstract
Objective To characterise the safety hazards related to e-prescribing in community pharmacies. Methods The sociotechnical systems framework was used to investigate the e-prescribing technology interface in community pharmacies by taking into consideration the social, technical and environmental work elements of a user's interaction with technology. This study focused specifically on aspects of the social subsystem. Study design and setting The study employed a cross-sectional qualitative design and was conducted in seven community pharmacies in Wisconsin. Direct observations, think aloud protocols and group interviews were conducted with 14 pharmacists and 16 technicians, and audio recorded. Recordings were transcribed and subjected to thematic content analysis guided by the sociotechnical systems' theoretical framework. Results Three major themes that may increase the potential for medication errors with e- prescribing were identified and described. The three themes included: (1) increased cognitive burden on pharmacy staff, such as having to memorise parts of e-prescriptions or having to perform dosage calculations mentally; (2) interruptions during the e-prescription dispensing process; and (3) communication issues with prescribers, patients and among pharmacy staff. Pharmacy staff reported these consequences of e-prescribing increased the likelihood of medication errors. Conclusions This study is the first of its kind to identify patient safety risks related to e-prescribing in community pharmacies using a sociotechnical systems framework. The findings shed light on potential interventions that may enhance patient safety in pharmacies and facilitate improved e-prescribing use. Future studies should confirm patient safety hazards reported and identify ways to use e-prescribing effectively and safely in community pharmacies. [ABSTRACT FROM AUTHOR]
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- 2013
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17. Examining perceptions about IQOS heated tobacco product: consumer studies in Japan and Switzerland.
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Hair, Elizabeth C., Bennett, Morgane, Sheen, Emily, Cantrell, Jennifer, Briggs, Jodie, Fenn, Zoe, Willett, Jeffrey G., and Vallone, Donna
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MARKETING ,PACKAGING ,COMMERCIAL product evaluation ,CUSTOMER satisfaction ,CONSUMER attitudes ,FOCUS groups ,HEATING ,INTERPROFESSIONAL relations ,INTERVIEWING ,QUALITY assurance ,QUALITATIVE research ,CULTURAL values ,TOBACCO products ,ELECTRONIC cigarettes - Published
- 2018
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18. Investigating the over-representation of older persons in do-it- yourself home maintenance injury and barriers to prevention.
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Ashby, K., Ozanne-Smith, J., and Fox, B.
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COMMUNITY health services ,RISK management in business ,HOSPITALS ,FOCUS groups ,PUBLIC hospitals - Abstract
Objective: To examine why older persons undertake high-risk do-it-yourself (DIY) home maintenance and under what circumstances, what constitutes acceptable low-risk alternatives to DIY, and to assess if alternatives are feasible in the current context. Design: Exploratory qualitative study using focus-group methodology. Setting and subjects: Fifteen focus groups were conducted, involving 118 persons aged 60 years and older, in two Melbourne communities. Participants resided locally, participated in local seniors groups, or received treatment for a DIY injury at one of two public hospitals serving these communities. Results: Older persons' involvement in DIY ranged From necessity to choice. A number chose DIY for general fitness enhancement, satisfaction and pride in a job well done, and giving meaning and enjoyment to daily tasks. However, some older, frailer seniors were forced into DIY because of difficulties in choosing appropriate alternatives; lack of knowledge of some available resources and services; the challenge of accessing cost-effective and reliable private service providers; and fear of vulnerability to overcharging, overservicing or their personal security. Preferred DIY alternatives were local government providers, local paper advertised services, recommendations to private service providers and family, friends or neighbors. Lack of knowledge of other existing alternatives was an impediment to preventing DIY injury, or accessing DIY alternatives. A number of potentially feasible alternatives to DIY were identified from our review. Conclusions: This research is an important first step in understanding issues facing community-dwelling seniors remaining at home, and provides a basis on which government agencies and other providers can develop services to meet increasing needs. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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19. Willingness of tobacco farmers to accept compensation for tobacco crop substitution in Lichuan City, China.
- Author
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Xinyu Wan, Jianjun Jin, and Shenghong Ran
- Subjects
ECONOMIC impact ,FOCUS groups ,GOVERNMENT regulation ,INTERVIEWING ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,RESEARCH funding ,DAMAGES (Law) ,TOBACCO ,AGRICULTURAL laborers - Published
- 2023
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- View/download PDF
20. Index of tobacco control sustainability (ITCS): a tool to measure the sustainability of national tobacco control programmes.
- Author
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Jackson-Morris, Angela and Latif, Ehsan
- Subjects
SMOKING prevention ,SMOKING cessation ,CLINICAL medicine ,DELPHI method ,EXPERIMENTAL design ,FOCUS groups ,INTERVIEWING ,RESEARCH methodology ,RESEARCH funding ,KEY performance indicators (Management) - Published
- 2017
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21. Hiding the tobacco power wall reduces cigarette smoking risk in adolescents: using an experimental convenience store to assess tobacco regulatory options at retail point-of-sale.
- Author
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Shadel, William G., Martino, Steven C., Setodji, Claude M., Scharf, Deborah M., Kusuke, Daniela, Sicker, Angela, and Min Gong
- Subjects
SMOKING ,TOBACCO products ,ADVERTISING ,CHI-squared test ,CONFIDENCE intervals ,FOCUS groups ,HABIT ,QUESTIONNAIRES ,RESEARCH funding ,SALES personnel ,STATISTICAL sampling ,SCALE analysis (Psychology) ,PILOT projects ,GOVERNMENT regulation ,DATA analysis software ,MEDICAL coding ,DESCRIPTIVE statistics ,ADOLESCENCE ,ECONOMICS - Published
- 2016
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- View/download PDF
22. 'If I hadn't seen this picture, I'd be smoking'--perceptions about innovations in health warnings for cigarette packages in Brazil: a focus group study.
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de Abreu Perez, Cristina, Bastos Camacho, Luiz Antonio, Lacerda Mendes, Felipe, Oliveira da Silva, Andre Luiz, Figueiredo, Valeska Carvalho, de Oliveira Latuf, Gloria Maria, Messeder Sebrao Fernandes, Ana Marcia, Duarte Albertassi, Patrícia Gonçalves, Castello Branco, Patricia Aleksitch, Branco, Patricia Francisco, Schimaneski Piras, Stefania, and Carvalho Suarez, Maribel
- Subjects
FOCUS groups ,ATTITUDE (Psychology) ,COMMUNICATION barriers ,FEAR ,LANGUAGE & languages ,LABELS ,RISK perception ,HEALTH ,INFORMATION resources ,SOCIAL status ,ATTENTION ,HEALTH attitudes ,RESEARCH funding ,SMOKING ,TOBACCO products ,DIFFUSION of innovations ,PUBLIC opinion ,HEALTH promotion ,COLOR - Published
- 2023
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- View/download PDF
23. '95% less harmful'? Exploring reactions to quantitative modified risk claims for snus and e-cigarettes.
- Author
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Wackowski, Olivia A., O'Connor, Richard J., Diaz, Destiny, Rashid, Mariam, Lewis, M. Jane, and Greene, Kathryn
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ELECTRONIC cigarettes ,FOCUS groups ,SMOKELESS tobacco ,CONSUMER attitudes ,LABELS ,HARM reduction ,DESCRIPTIVE statistics ,SMOKING ,PUBLIC opinion - Published
- 2022
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- View/download PDF
24. Breathing clean air is Sa'áh Naagháí Bik'eh Hózhóó (SNBH): a culturally centred approach to understanding commercial smoke-free policy among the Diné (Navajo People).
- Author
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Chief, Carmenlita, Sabo, Samantha, Clark, Hershel, Henderson, Patricia Nez, Yazzie, Alfred, Nahee, Jacqueline, and Leischow, Scott J.
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PASSIVE smoking ,SMOKING ,TOBACCO products ,POLICY sciences ,ATTITUDE (Psychology) ,FOCUS groups ,NATIVE Americans ,LIFE ,HEALTH policy ,RESEARCH funding ,CULTURAL values ,PREVENTION ,ECONOMICS ,TOBACCO laws ,PSYCHOLOGY - Published
- 2016
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- View/download PDF
25. Adolescents' and adults' perceptions of 'natural', 'organic' and 'additive-free' cigarettes, and the required disclaimers.
- Author
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Byron, M. Justin, Baig, Sabeeh A., Moracco, Kathryn E., and Brewer, Noel T.
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PREVENTION of drug addiction ,FOCUS groups ,DATA analysis ,THEMATIC analysis ,TOBACCO products - Published
- 2016
- Full Text
- View/download PDF
26. Smokers' and ex-smokers' understanding of electronic cigarettes: a qualitative study.
- Author
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Rooke, Catriona, Cunningham-Burley, Sarah, and Amos, Amanda
- Subjects
CONSUMER attitudes ,FOCUS groups ,INTERVIEWING ,MOTIVATION (Psychology) ,RESEARCH funding ,SMOKING ,SMOKING cessation ,QUALITATIVE research ,TOBACCO products ,ELECTRONIC cigarettes ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Objective To explore among a diverse range of smokers and recent ex-smokers, particularly those from disadvantaged groups, how nicotine-containing products, particularly electronic cigarettes (e-cigarettes), are understood and experienced. Methods Qualitative study of 64 smokers and exsmokers in Central Scotland. Twelve focus groups and 11 individual interviews were carried out with a range of purposively selected groups. Results Nicotine replacement therapies and e-cigarettes were regarded as being very different products. Nicotine replacement therapies were viewed as medical products for smokers who want to quit, while e-cigarettes emerged as an ambiguous product whose meanings are still being negotiated. Participants' attitudes and intentions about smoking and quitting were especially important in shaping their understanding of these products. Four main interpretations of e-cigarettes were identified: a more satisfying replacement for smoking, an ambiguous but potentially useful device, a less desirable cigarette and a threat to smoking cessation. The acceptability of continued nicotine addiction and the similarity of e-cigarettes to conventional cigarettes were central themes on which participants held conflicting views. There was considerable uncertainty among participants around the constituents and safety of e-cigarettes. Conclusions Different groups of smokers bring diverse expectations, requirements and concerns to their evaluations and therefore to the potential use of nicotine-containing products. The ambiguity around e-cigarettes in public health debates and medical practice is reflected in the positions and concerns of smokers. There is a need for both clear, up-to-date trustworthy information about their benefits and risks, and stronger regulation. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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- View/download PDF
27. 'It brings light to what you really put into your body': a focus group study of reactions to messages about nicotine reduction in cigarettes.
- Author
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Hue Trong Duong, Loud, Emily E., Thrasher, James F., Henderson, Katherine C., Ashley, David L., and Popova, Lucy
- Subjects
HEALTH education ,SMOKING cessation ,FOCUS groups ,NICOTINE ,DRUG withdrawal symptoms ,HARM reduction ,HEALTH literacy ,INSTANT messaging ,COMMUNICATION ,HEALTH behavior ,TOBACCO products ,THEMATIC analysis ,DATA analysis software ,HEALTH promotion - Published
- 2022
- Full Text
- View/download PDF
28. The potential of shame as a message appeal in antismoking television advertisements.
- Author
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Amonini, Claudia, Pettigrew, Simone, and Clayforth, Cassandra
- Subjects
SMOKING prevention ,ADVERTISING ,FOCUS groups ,HEALTH promotion ,RESEARCH methodology ,MOTIVATION (Psychology) ,QUESTIONNAIRES ,RESEARCH funding ,STATISTICAL sampling ,SHAME ,SMOKING cessation ,TELEVISION ,DESCRIPTIVE statistics - Abstract
Background As smoking is increasingly de-normalised, different messages may become more appropriate for use in tobacco control advertisements to reflect the changing social environment. To date, more commonly used messages have included fear appeals relating to physical health and guilt appeals focusing on the effects of smoking on loved ones. Objective This study investigated the relative effectiveness of varying advertising appeals to promote smoking cessation. The study was conducted in Australia, where only 12% of the population smokes and legislation restricts smoking in many public places. The aim was to provide insight into ways to motivate the small segment of existing smokers to consider quitting. Methods Across a qualitative phase and an ad testing phase, shame was found to be highly salient to current smokers and those who had quit recently. On the basis of these results, a television advertisement featuring a shame appeal was developed and broadcast. The ad featured various scenarios of individuals hiding their smoking from others. The campaign was evaluated using the measures of awareness, believability, perceived relevance and smoking behaviours. Results The shame appeal television advertisement was found to resonate with smokers and encourage quitting/reducing behaviours. Around 4 in 5 (78%) smokers surveyed recalled seeing the ad, almost all of whom could nominate at least one correct take-out message (94%). Around three-quarters (72%) found the ad to be personally relevant and half (53%) reported that they had successfully quit, attempted to quit or cut down the number of cigarettes they smoked since the start of the campaign. Conclusions The use of shame appeals may be an effective method of motivating smokers to quit in an environment where they are members of a small minority and supportive legislation exists to discourage smoking in public places. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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- View/download PDF
29. Mitigating errors caused by interruptions during medication verification and administration: interventions in a simulated ambulatory chemotherapy setting.
- Author
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Prakash, Varuna, Koczmara, Christine, Savage, Pamela, Trip, Katherine, Stewart, Janice, McCurdie, Tara, Cafazzo, Joseph A., and Trbovich, Patricia
- Subjects
MEDICATION error prevention ,ACTION research ,CANCER chemotherapy ,CHI-squared test ,CLINICS ,FOCUS groups ,HUMAN anatomical models ,MEDICAL protocols ,NURSES' attitudes ,NURSING ,RESEARCH funding ,QUALITATIVE research ,DATA analysis ,DATA analysis software - Abstract
Background Nurses are frequently interrupted during medication verification and administration; however, few interventions exist to mitigate resulting errors, and the impact of these interventions on medication safety is poorly understood. Objective The study objectives were to (A) assess the effects of interruptions on medication verification and administration errors, and (B) design and test the effectiveness of targeted interventions at reducing these errors. Methods The study focused on medication verification and administration in an ambulatory chemotherapy setting. A simulation laboratory experiment was conducted to determine interruption-related error rates during specific medication verification and administration tasks. Interventions to reduce these errors were developed through a participatory design process, and their error reduction effectiveness was assessed through a postintervention experiment. Results Significantly more nurses committed medication errors when interrupted than when uninterrupted. With use of interventions when interrupted, significantly fewer nurses made errors in verifying medication volumes contained in syringes (16/18; 89% preintervention error rate vs 11/19; 58% postintervention error rate; p=0.038; Fisher's exact test) and programmed in ambulatory pumps (17/18; 94% preintervention vs 11/19; 58% postintervention; p=0.012). The rate of error commission significantly decreased with use of interventions when interrupted during intravenous push (16/18; 89% preintervention vs 6/19; 32% postintervention; p=0.017) and pump programming (7/18; 39% preintervention vs 1/19; 5% postintervention; p=0.017). No statistically significant differences were observed for other medication verification tasks. Conclusions Interruptions can lead to medication verification and administration errors. Interventions were highly effective at reducing unanticipated errors of commission in medication administration tasks, but showed mixed effectiveness at reducing predictable errors of detection in medication verification tasks. These findings can be generalised and adapted to mitigate interruption-related errors in other settings where medication verification and administration are required. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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30. Adolescent and adult perceptions of traditional and novel smokeless tobacco products and packaging in rural Ohio.
- Author
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Liu, Sherry T., Nemeth, Julianna M., Klein, Elizabeth G., Ferketich, Amy K., Mei-Po Kwan, and Wewers, Mary Ellen
- Subjects
FOCUS groups ,INTERVIEWING ,RESEARCH methodology ,PACKAGING ,SENSORY perception ,RESEARCH funding ,RURAL conditions ,SMOKELESS tobacco ,QUALITATIVE research ,INTER-observer reliability ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Objective As smokeless tobacco (ST) marketing increases and new products emerge on the market, very little is known about consumer perceptions of ST products. To inform development of future ST counter-marketing approaches, this qualitative study examined consumer perceptions of traditional and novel ST products and packaging. Methods Focus groups and qualitative interviews were held with adolescent (n=23; mean age of 17 years) and adult (n=38; mean age of 29 years) male ST users from rural Ohio counties. Participants were shown a variety of traditional (eg, Copenhagen, Timber Wolf) and novel (eg, Camel Snus, Orbs) ST products and asked about perceptions of these products and their packaging. Transcriptions were coded independently for common themes by two individuals. Findings Adolescents and adults generally had similar beliefs and reactions about ST products. While participants were familiar with a variety of traditional ST products, Copenhagen was the most frequently used product. Perceptions of quality and price of traditional products were closely tied to product taste and packaging material. Colours, design and size of ST packaging appealed to participants and influenced decisions to purchase. Adults believed novel ST products had a weak taste and were targeted at untraditional ST users. While the vast majority was unfamiliar with dissolvable tobacco, adolescents noted that they would be more convenient to use during school than traditional ST. Conclusions Packaging has a significant role in shaping perceptions of ST and consumer behaviour. Regulation of product packaging such as shape, size and images should be part of comprehensive tobacco control. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
31. Understanding decisions about antibiotic prescribing in ICU: an application of the Necessity Concerns Framework.
- Author
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Pandolfo, Alyssa M., Horne, Robert, Jani, Yogini, Reader, Tom W., Bidad, Natalie, Brealey, David, Enne, Virve I., Livermore, David M., Gant, Vanya, and Brett, Stephen J.
- Subjects
ANTIBIOTICS ,INTENSIVE care units ,FOCUS groups ,JUDGMENT (Psychology) ,RESEARCH methodology ,PHYSICIANS' attitudes ,INTERVIEWING ,UNCERTAINTY ,CONCEPTUAL structures ,DRUGS ,CASE studies ,RESEARCH funding ,DECISION making in clinical medicine ,THEMATIC analysis ,DATA analysis software ,PSYCHOLOGY of physicians ,DRUG toxicity - Abstract
Background Antibiotics are extensively prescribed in intensive care units (ICUs), yet little is known about how antibiotic-related decisions are made in this setting. We explored how beliefs, perceptions and contextual factors influenced ICU clinicians' antibiotic prescribing. Methods We conducted 4 focus groups and 34 semistructured interviews with clinicians involved in antibiotic prescribing in four English ICUs. Focus groups explored factors influencing prescribing, whereas interviews examined decision-making processes using two clinical vignettes. Data were analysed using thematic analysis, applying the Necessity Concerns Framework. Results Clinicians' antibiotic decisions were influenced by their judgement of the necessity for prescribing/not prescribing, relative to their concerns about potential adverse consequences. Antibiotic necessity perceptions were strongly influenced by beliefs that antibiotics would protect patients from deterioration and themselves from the ethical and legal consequences of undertreatment. Clinicians also reported concerns about prescribing antibiotics. These generally centred on antimicrobial resistance; however, protecting the individual patient was prioritised over these societal concerns. Few participants identified antibiotic toxicity concerns as a key influencer. Clinical uncertainty often complicated balancing antibiotic necessity against concerns. Decisions to start or continue antibiotics often represented 'erring on the side of caution' as a protective response in uncertainty. This approach was reinforced by previous experiences of negative consequences ('being burnt') which motivated prescribing 'just in case' of an infection. Prescribing decisions were also context-dependent, exemplified by a lower perceived threshold to prescribe antibiotics out-of-hours, input from external team members and local prescribing norms. Conclusion Efforts to improve antibiotic stewardship should consider clinicians' desire to protect with a prescription. Rapid molecular microbiology, with appropriate communication, may diminish clinicians' fears of not prescribing or of using narrower-spectrum antibiotics. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
32. Out of sight, out of mind? Removal of point-of-sale tobacco displays in Norway.
- Author
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Scheffels, Janne and Lavik, Randi
- Subjects
SMOKING ,SMOKING prevention ,TOBACCO laws ,ADVERTISING ,AGE distribution ,CHI-squared test ,CONSUMER attitudes ,FOCUS groups ,INTERVIEWING ,LEGAL status of sales personnel ,QUESTIONNAIRES ,RESEARCH funding ,VIDEO recording ,ECONOMICS - Abstract
Aim To evaluate retailer’s compliance and consumer’s perceptions of and experiences with the point-of-sale (POS) tobacco display ban in Norway, implemented 1 January 2010. Methods Retailer compliance was measured using audit surveys. Consumer’s perceptions of the ban were assessed in three web surveys: one conducted before and two after implementation of the ban. The sample for each of these consisted of about 900 people aged 15-54 years and an extra sample of smokers and snus users. 10 focus group interviews with male and female daily, occasional and former smokers aged 16-50 years (N¼62) were also conducted, before and after implementation of the ban. Results Immediately following implementation of the POS display ban, compliance was 97% for cigarettes and rolling tobacco and 98% for snus. Preimplementation, young people were tempted by tobacco products when seeing them in the shop more often than older people. Postimplementation, young people also more often found it difficult to choose brand. The POS tobacco display ban was supported by a majority of the population, and by one out of three daily smokers. The removal of POS tobacco displays was perceived as a barrier for young people’s access to tobacco products, as affecting attachment to cigarette brands and as contributing to tobacco denormalisation. Conclusions Retailer’s compliance with the POS display ban in Norway was high, and the ban was well supported in the population. Consumers believed that the ban could contribute to preventing smoking initiation among young people and to some extent also support cessation efforts. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
33. A gift and a burden: the purchase and distribution of duty-free tobacco and its potential impact upon Pacific people in New Zealand.
- Author
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Tautolo, El-Shadan, Edwards, Richard, and Gifford, Heather
- Subjects
SMOKING prevention ,ASIANS ,CONSUMER attitudes ,CULTURE ,FOCUS groups ,SENSORY perception ,RESEARCH funding ,SALES personnel ,SMOKING ,TAXATION ,TOBACCO ,QUALITATIVE research ,GIFT giving ,THEMATIC analysis - Abstract
Background High smoking rates among Pacific people living within New Zealand (26.9%) are a significant and poorly understood problem. A proposed approach to tobacco control is to enhance restrictions on or ban duty-free sales, a pertinent notion for Pacific people given their frequent travel between New Zealand and the Pacific Islands. This study examines the purchase and distribution of duty-free tobacco by Pacific people, whether it is being used as a strategy to circumvent the tobacco excise tax increases and how duty-free cigarette sales are perceived within the Pacific community. Methods We undertook a qualitative research study using six focus groups with Pacific smokers and nonsmokers aged between 18 and 54 years. Half of the focus groups consisted of smokers and half nonsmokers. We used a thematic analysis approach to identify, explore and report key themes within the data. Results Pacific smokers and non-smokers frequently purchase duty-free tobacco when travelling, and the usage of duty-free cigarettes for gift giving is a strongly embedded cultural value for Pacific peoples. However, nearly all participants strongly supported a proposal to reduce or ban duty-free tobacco sales. Conclusions The findings suggest a ban on duty-free sales could be an important measure to help achieve the smokefree 2025 goal among Pacific communities in New Zealand. This measure would eliminate duty-free tobacco as a cheap form of supply, and efforts to denormalise the practice of gifting duty-free tobacco among Pacific people may also be helpful in reducing high prevalence rates within these communities. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
34. Is snus the same as dip? Smokers' perceptions of new smokeless tobacco advertising.
- Author
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Bahreinifar, Sareh, Sheon, Nicolas .M., and Ling, Pamela .M.
- Subjects
ADVERTISING ,CONSUMER attitudes ,FOCUS groups ,RESEARCH funding ,SMOKELESS tobacco ,SMOKING ,VIDEO recording ,WORLD Wide Web ,DATA analysis software - Abstract
BackgroundSince 2006, leading US cigarette companies have been promoting new snus products as line extensions of popular cigarette brands. These promotional efforts include direct mail marketing to consumers on cigarette company mailing lists. This study examines smokers' reactions to this advertising and perceptions of the new snus products.MethodsEight focus groups (n=65 participants) were conducted in San Francisco and Los Angeles in 2010 with smokers who received tobacco direct mail advertising. The focus group discussions assessed smokers' perceptions of the new snus products. Focus group videos were transcribed and coded using Transana software to identify common themes.ResultsMost participants were aware of snus advertising and many had tried free samples. Most were aware that snus was supposed to be ‘different’ from traditional chewing tobacco but consistently did not know why. Participants willing to try snus still identified strongly as smokers, and for some participants, trying snus reinforced their preference for smoking. Snus' major benefits were use in smoke-free environments and avoiding social stigma related to secondhand smoke. Participants were sceptical of the idea that snus was safer than cigarettes and did not see it as an acceptable substitute for cigarettes or as a cessation aid.ConclusionsSmokers repeated some messages featured in early snus advertising. Snus was not seen as an acceptable substitute for smoking or way to quit cigarettes. Current smoker responses to snus advertising are not consistent with harm reduction. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
35. Gainfully employed? An inquiry into bidi-dependent livelihoods in Bangladesh.
- Author
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Roy, Anupom, Efroymson, Debra, Jones, Lori, Ahmed, Saifuddin, Arafat, Islam, Sarker, Rashmi, and FitzGerald, Sian
- Subjects
INCOME ,SMOKING ,AGRICULTURAL laborers ,COST effectiveness ,FOCUS groups ,INTERVIEWING ,RESEARCH methodology ,POVERTY ,QUESTIONNAIRES ,RESEARCH funding ,TAXATION ,TOBACCO ,WORK environment ,SOCIOECONOMIC factors ,ETHICS ,ECONOMICS - Abstract
Objectives This study sought to increase government, civil society and media attention to the tobacco-poverty connection in Bangladesh, particularly as it relates to bidi-dependent livelihoods. Data sources This study consisted of a literature review that examined the socioeconomic impacts of tobacco farming, the working conditions of tobacco workers and the impact of tobacco on consumers, and a primary research study among bidi workers and users. The research included in-depth and semistructured interviews and focus group discussions among bidi workers and a closed-ended quantitative survey among bidi users. Data synthesis Most bidi worker families earn about $6.40 per 7-day work week, leaving them below the poverty line. The majority of bidi workers are women and children, classified as unpaid assistants, who toil long hours in toxic environments. Bidi users are primarily low-income earners who spend up to 10% of their daily income on bidis; the average proportion of income spent on bidis decreased as income increased. If bidi expenditures were reduced and spent instead on food or local transportation, many higher value jobs could be created. This could also mean better health and nutrition for those currently engaged in bidi work. Conclusions The results of this study illustrate the linkages between tobacco and poverty. Tobacco control is not simply about health and the environment, but also about the living conditions of the poorest of the poor. If we are to improve the lives of the poor, we must address the root causes of poverty, which include the production and use of tobacco. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
36. Young adult smokers' perceptions of plain packaging: a pilot naturalistic study.
- Author
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Moodie, Crawford, Mackintosh, Anne Marie, Hastings, Gerard, and Ford, Allison
- Subjects
INDUSTRIES & economics ,SMOKING & psychology ,ANALYSIS of variance ,FOCUS groups ,HEALTH behavior ,INTERVIEWING ,RESEARCH methodology ,HEALTH policy ,PACKAGING ,SENSORY perception ,RESEARCH funding ,STATISTICAL sampling ,SMOKING cessation ,STATISTICS ,PILOT projects ,DATA analysis ,ADULTS - Abstract
Aims To explore the impact, if any, that using plain (non-branded) cigarette packs in real-life settings has on young adult smokers. Methods Naturalistic-type research was employed, where smokers used brown 'plain' packs for 2 weeks and their regular packs for 2 weeks, in real-life settings. Participants were recruited in Glasgow, Scotland. Of the 140 smokers aged 18-35 years who participated in the naturalistic study, 48 correctly completed and returned all questionnaires. Over the 4-week study period, participants completed a questionnaire twice a week assessing pack perceptions and feelings, feelings about smoking, salience of health warnings and smoking-related behaviours. A subsample of 18 participated in a post-study interview, which employed a semistructured topic guide to assess perceptions and experiences of using plain packs. Results Trends in the data show that in comparison with branded packaging, plain packaging increased negative perceptions and feelings about the pack and about smoking. Plain packaging also increased avoidant behaviour (hiding the pack, covering the pack), certain smoking cessation behaviours, such as smoking less around others and forgoing cigarettes, and thinking about quitting. Almost half (n=8) of those in the post-study interview, predominantly women (n=6), reported that the use of plain packs had either increased avoidant behaviour or reduced consumption. Conclusions This pilot naturalistic study suggests that plain packaging could potentially help reduce tobacco consumption among some young adult smokers, and women in particular. Employing an innovative research methodology, the findings of this study are consistent with, and indeed support, past plain packaging research. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
37. Whose butt is it? tobacco industry research about smokers and cigarette butt waste.
- Author
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Smith, Elizabeth A. and Novotny, Thomas E.
- Subjects
ARCHIVES ,BEHAVIOR modification ,CELLULOSE ,DATABASE searching ,FOCUS groups ,HEALTH behavior ,INDUSTRIES ,MOTIVATION (Psychology) ,NEW product development ,POLLUTION ,RECORDS ,WASTE management ,RESEARCH funding ,STATISTICAL sampling ,SMOKING ,SOCIAL marketing ,TOBACCO ,SOCIAL responsibility ,SOCIAL attitudes - Abstract
Background Cigarette filters are made of nonbiodegradable cellulose acetate. As much as 766 571 metric tons of butts wind up as litter worldwide per year. Numerous proposals have been made to prevent or mitigate cigarette butt pollution, but none has been effective; cigarette butts are consistently found to be the single most collected item in beach clean-ups and litter surveys. Methods We searched the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) and http:// tobaccodocuments.org using a snowball strategy beginning with keywords (eg, 'filter', 'biodegradable', 'butts'). Data from approximately 680 documents, dated 1959e2006, were analysed using an interpretive approach. Results The tobacco industry has feared being held responsible for cigarette litter for more than 20 years. Their efforts to avoid this responsibility included developing biodegradable filters, creating anti-litter campaigns, and distributing portable and permanent ashtrays. They concluded that biodegradable filters would probably encourage littering and would not be marketable, and that smokers were defensive about discarding their tobacco butts and not amenable to antilitter efforts. Conclusions Tobacco control and environmental advocates should develop partnerships to compel the industry to take financial and practical responsibility for cigarette butt waste. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
38. Attitudes, practices and beliefs towards worksite smoking among administrators of private and public enterprises in Armenia.
- Author
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Narine K Movsisyan
- Subjects
SMOKING in the workplace -- Law & legislation ,EXECUTIVES' attitudes ,SMOKING laws ,CIGARETTE smokers ,PASSIVE smoking -- Law & legislation ,ANALYSIS of variance ,COGNITION disorders ,FOCUS groups ,HEALTH attitudes ,MANAGEMENT ,RESEARCH methodology ,RESEARCH funding ,STATISTICAL sampling ,SMOKING ,SOCIAL marketing ,SURVEYS ,WORK environment ,PRIVATE sector ,PUBLIC sector ,HEALTH literacy - Abstract
BACKGROUND: In March 2005, Armenia enacted legislation protecting employees from secondhand smoke. This research was the first attempt to understand the attitudes, beliefs and practices of managers of public and private enterprises regarding smoke-free worksite policies. METHODS: Mixed methods were used. The study team conducted focus group discussions with worksite administrators to explore their beliefs, attitudes and practices related to worksite smoking. These findings guided development of a quantitative instrument to collect more representative data on the same issues. Using stratified random sampling, 243 worksites were interviewed from June-July 2005, representing state/municipal, health, educational, culture and business institutions in three of Armenia's largest cities. RESULTS/DISCUSSION: Smoking-related practices differed significantly across institutions. More than half of the managers (55.6%) reported having smoking restrictions at worksites, including 37.0% who reported smoke-free workplaces; however, smoking or the presence of ashtrays was observed in 27.8% of workplaces reported to be smoke-free. A substantial proportion of the administrators favored both banning indoor smoking and allowing smoking in special areas. Only 38.0% of managers were aware of employees' existing legal protections from exposure to secondhand smoke. Knowledge of these regulations was not related to adherence to smoke-free worksite policies. The research also revealed widespread confusion between the concepts of worksite smoking restrictions and smoke-free workplaces. Public awareness campaigns that promote promulgation and enforcement of worksite smoking regulations could increase employee demand for smoke-free worksites. CONCLUSION: As one of the first studies to investigate smoking-related worksite practices, attitudes and beliefs in former Soviet countries, these findings provide insight into law enforcement processes in economies in transition. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
39. Tobacco in prisons: a focus group study.
- Author
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R Richmond
- Subjects
PHYSIOLOGICAL effects of tobacco ,PRISON conditions ,FOCUS groups ,SMOKING cessation ,INSTITUTIONALIZED persons ,QUALITATIVE research - Abstract
OBJECTIVE: To examine the role of tobacco use in prison and possible influences of the prison environment on smoking among inmates in the context of developing inmate smoking cessation programmes. METHOD: Qualitative study based on seven focus groups with prisoners and ex-prisoners. SETTINGS: A maximum security prison in rural New South Wales (NSW), Australia, and a community justice restorative centre and accommodation service for ex-prisoners in Sydney, NSW, Australia. PARTICIPANTS: 40 participants (28 men and 12 women) comprising nine prisoners (including four Indigenous inmates) and 31 ex-prisoners. RESULTS: Prisoners reported that tobacco serves as a de facto currency in correctional settings and can be exchanged for goods, used to pay debts and for gambling. Smoking helps manage the stressful situations such as transfers, court appearances and prison visits. Inmate smoking cessation programmes need to address the enmeshment of tobacco in prison life, improve availability of pharmacotherapies (for example, nicotine patches, bupropion) and the quitline (a free telephone helpline providing information on stopping smoking), provide non-smoking cells and areas within prisons, encourage physical activity for inmates and maintain monitoring of smoking cessation status after release. CONCLUSIONS: Tobacco is integrally bound up in the prison "culture". Our findings are relevant to inform prison health authorities concerned with improving the health of prisoners, and for support organisations attempting to facilitate smoking cessation both in prison and after release. Smoking cessation programmes in prisons should be tailored to the unique stresses of the prison environment. Programmes need to acknowledge the difficulties of quitting smoking in prison arising from the stresses posed by this setting. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
40. Improving the quality of self-management support in ambulatory cancer care: a mixed-method study of organisational and clinician readiness, barriers and enablers for tailoring of implementation strategies to multisites.
- Author
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Howell, Doris, Powis, Melanie, Kirkby, Ryan, Amernic, Heidi, Moody, Lesley, Bryant-Lukosius, Denise, O'Brien, Mary Ann, Rask, Sara, and Krzyzanowska, Monika
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ONCOLOGY nursing ,HEALTH services administrators ,OUTPATIENT medical care ,SPECIALTY hospitals ,FOCUS groups ,NURSES' attitudes ,SELF-management (Psychology) ,ATTITUDE (Psychology) ,RESEARCH methodology ,HEALTH facility administration ,DIETITIANS' attitudes ,ATTITUDES of medical personnel ,CHANGE ,MEDICAL personnel ,INTERVIEWING ,PHYSICIANS' attitudes ,HUMAN services programs ,CANCER treatment ,PHARMACISTS ,ORGANIZATIONAL change ,QUALITY assurance ,QUESTIONNAIRES ,SOCIAL worker attitudes ,DESCRIPTIVE statistics ,RESEARCH funding ,THEMATIC analysis ,CANCER patient medical care ,CORPORATE culture ,ONCOLOGISTS - Abstract
Introduction Improving the quality of self-management support (SMS) for treatment-related toxicities is a priority in cancer care. Successful implementation of SMS programmes depends on tailoring implementation strategies to organisational readiness factors and barriers/enablers, however, a systematic process for this is lacking. In this formative phase of our implementation-effectiveness trial, Self-Management and Activation to Reduce Treatment-Related Toxicities, we evaluated readiness based on constructs in the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT) and developed a process for mapping implementation strategies to local contexts. Methods In this convergent mixed-method study, surveys and interviews were used to assess readiness and barriers/enablers for SMS among stakeholders in 3 disease site groups at 3 regional cancer centres (RCCs) in Ontario, Canada. Median survey responses were classified as a barrier, enabler or neutral based on a priori cut-off values. Barriers/enablers at each centre were mapped to CFIR and then inputted into the CFIR-Expert Recommendations for Implementing Change Strategy Matching Tool V.1.0 (CFIR-ERIC) to identify centrespecific implementation strategies. Qualitative data were separately analysed and themes mapped to CFIR constructs to provide a deeper understanding of barriers/enablers. Results SMS in most of the RCCs was not systematically delivered, yet most stakeholders (n=78; respondent rate=50%) valued SMS. For centre 1, 7 barriers/12 enablers were identified, 14 barriers/9 enablers for centre 2 and 11 barriers/5 enablers for centre 3. Of the total 46 strategies identified, 30 (65%) were common across centres as core implementation strategies and 5 tailored implementation recommendations were identified for centres 1 and 3, and 4 for centre 2. Conclusions The CFIR and CFIR-ERIC were valuable tools for tailoring SMS implementation to readiness and barriers/enablers, whereas NPT helped to clarify the clinical work of implementation. Our approach to tailoring of implementation strategies may have relevance for other studies. [ABSTRACT FROM AUTHOR]
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- 2022
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41. Diagnosis of genital chlamydia in primary care: an explanation of reasons for variation in chlamydia testing.
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McNulty, C. A. M., Freeman, E., Bowen, J., Shefras, J., and Fenton, K. A.
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CHLAMYDIA ,GENITOURINARY diseases ,DIAGNOSIS ,PRIMARY care ,EPIDEMIOLOGY ,MEDICAL care ,CHLAMYDIA infection diagnosis ,CHLAMYDIA trachomatis ,FAMILY medicine ,FOCUS groups ,MEDICAL specialties & specialists ,PRIMARY health care ,RURAL health ,URBAN health - Abstract
Objectives: To explore the reasons for the 40-fold variation in diagnostic testing for genital Chlamydia trachomatis by general practices.Methods: A qualitative study with focus groups. We randomly selected urban and rural high and low testing practices served by Bristol, Hereford, and Gloucester microbiology laboratories. Open questions were asked about the investigation of C trachomatis in men and women in different clinical contexts.Results: The high and low testing practices did not differ in their age/sex make-up or by deprivation indices. There were major differences between high and low chlamydia testing practices. Low testing practices knew very little about the epidemiology and presentation of genital chlamydia infection and did not consider it in their differential diagnosis of genitourinary symptoms until patients had consulted several times. Low testers were less aware that chlamydia was usually asymptomatic, thought it was an inner city problem, and had poor knowledge of how to take diagnostic specimens. High testing practices either had a general practitioner with an interest in sexual health or a practice nurse who had completed specialist training in family planning. High testing practices were more cognizant of the symptoms and signs of chlamydia and always considered it in their differential diagnosis of genitourinary symptoms, including patients attending family planning clinics.Conclusions: Any programme to increase chlamydia testing in primary care must be accompanied by an education and awareness programme especially targeted at low testing practices. This will need to include information about the benefits of testing and who, when, and how to test. [ABSTRACT FROM AUTHOR]- Published
- 2004
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42. Australian smokers' experiences and perceptions of recessed and firm filter cigarettes.
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Wakefield, Melanie A., Dunstone, Kimberley, Brennan, Emily, Vittiglia, Amanda, Scollo, Michelle, Durkin, Sarah J., Hoek, Janet, Thrasher, James, Hatsukami, Dorothy, Benowitz, Neal, and Samet, Jonathan M.
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RESEARCH ,SENSES ,FOCUS groups ,ATTITUDE (Psychology) ,EXPERIENCE ,SURVEYS ,HEALTH attitudes ,RESEARCH funding ,SMOKING ,TOBACCO products - Published
- 2021
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43. i-CONTENT tool for assessing therapeutic quality of exercise programs employed in randomised clinical trials.
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Hoogeboom, Thomas J., Kousemaker, Martijn C., van Meeteren, Nico LU, Howe, Tracey, Bo, Kari, Tugwell, Peter, Ferreira, Manuela, de Bie, Rob A., van den Ende, Cornelia H. M., Stevens Lapsley, Jennifer E., and van den Ende, Cornelia Hm
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EXERCISE therapy ,CLINICAL trials ,FOCUS groups ,PHYSICAL therapy ,CONSENSUS (Social sciences) ,RESEARCH ,RESEARCH methodology ,EVALUATION research ,COMPARATIVE studies ,RANDOMIZED controlled trials ,DELPHI method - Abstract
Objective: When appraising the quality of randomised clinical trial (RCTs) on the merits of exercise therapy, we typically limit our assessment to the quality of the methods. However, heterogeneity across studies can also be caused by differences in the quality of the exercise interventions (ie, 'the potential effectiveness of a specific intervention given the potential target group of patients')-a challenging concept to assess. We propose an internationally developed, consensus-based tool that aims to assess the quality of exercise therapy programmes studied in RCTs: the international Consensus on Therapeutic Exercise aNd Training (i-CONTENT) tool.Methods: Forty-nine experts (from 12 different countries) in the field of physical and exercise therapy participated in a four-stage Delphi approach to develop the i-CONTENT tool: (1) item generation (Delphi round 1), (2) item selection (Delphi rounds 2 and 3), (3) item specification (focus group discussion) and (4) tool development and refinement (working group discussion and piloting).Results: Out of the 61 items generated in the first Delphi round, consensus was reached on 17 items, resulting in seven final items that form the i-CONTENT tool: (1) patient selection; (2) qualified supervisor; (3) type and timing of outcome assessment; (4) dosage parameters (frequency, intensity, time); (5) type of exercise; (6) safety of the exercise programme and (7) adherence to the exercise programme.Conclusion: The i-CONTENT-tool is a step towards transparent assessment of the quality of exercise therapy programmes studied in RCTs, and ultimately, towards the development of future, higher quality, exercise interventions. [ABSTRACT FROM AUTHOR]- Published
- 2021
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44. Barriers and enablers to the implementation of multidisciplinary team meetings: a qualitative study using the theoretical domains framework.
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Maharaj, Ashika D., Evans, Sue M., Zalcberg, John R., Ioannou, Liane J., Graco, Marnie, Croagh, Daniel, Pilgrim, Charles H. C., Dodson, Theresa, Goldstein, David, Philip, Jennifer, Kench, James G., Merrett, Neil D., Neale, Rachel E., White, Kate, Evans, Peter, Leong, Trevor, and Green, Sally E.
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PANCREATIC tumors ,CANCER patient psychology ,MEETINGS ,FOCUS groups ,RESEARCH methodology ,VIDEOCONFERENCING ,INTERVIEWING ,QUALITATIVE research ,CONCEPTUAL structures ,HEALTH care teams ,THEMATIC analysis ,STATISTICAL sampling - Abstract
Background Evidence- based clinical practice guidelines recommend discussion by a multidisciplinary team (MDT) to review and plan the management of patients for a variety of cancers. However, not all patients diagnosed with cancer are presented at an MDT. Objectives (1) To identify the factors (barriers and enablers) infuencing presentation of all patients to, and the perceived value of, MDT meetings in the management of patients with pancreatic cancer and; (2) to identify potential interventions that could overcome modifable barriers and enhance enablers using the theoretical domains framework (TDF). Methods Semistructured interviews were conducted with radiologists, surgeons, medical and radiation oncologists, gastroenterologists, palliative care specialists and nurse specialists based in New South Wales and Victoria, Australia. Interviews were conducted either in person or via videoconferencing. All interviews were recorded, transcribed verbatim, deidentifed and data were thematically coded according to the 12 domains explored within the TDF. Common belief statements were generated to compare the variation between participant responses. Results In total, 29 specialists were interviewed over a 4-month period. Twenty- two themes and 40 belief statements relevant to all the TDF domains were generated. Key enablers infuencing MDT practices included a strong organisational focus (social/professional role and identity), beliefs about the benefts of an MDT discussion (beliefs about consequences), the use of technology, for example, videoconferencing (environmental context and resources), the motivation to provide good quality care (motivation and goals) and collegiality (social infuences). Barriers included: absence of palliative care representation (skills), the number of MDT meetings (environmental context and resources), the cumulative cost of staff time (beliefs about consequences), the lack of capacity to discuss all patients within the allotted time (beliefs about capabilities) and reduced confdence to participate in discussions (social infuences). Conclusions The internal and external organisational structures surrounding MDT meetings ideally need to be strengthened with the development of agreed evidence- based protocols and referral pathways, a focus on resource allocation and capabilities, and a culture that fosters widespread collaboration for all stages of pancreatic cancer. [ABSTRACT FROM AUTHOR]
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- 2021
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45. 'It has candy. You need to press on it': young adults' perceptions of flavoured cigarettes in the Philippines.
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Brown, Jennifer, Meng Zhu, Moran, Meghan, Hoe, Connie, Frejas, Ferdie, and Cohen, Joanna E.
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FLAVORING essences ,PACKAGING ,FOCUS groups ,PHARMACEUTICAL encapsulation ,CONSUMER attitudes ,ORGANIC compounds ,PSYCHOSOCIAL factors ,TOBACCO products ,THEMATIC analysis ,TASTE ,FILIPINOS ,COLOR ,ADULTS - Published
- 2021
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46. Technology and implementation science to forge the future of evidence- based psychotherapies: the PRIDE scale- up study.
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Wainberg, Milton L., Gouveia, Maria Lídia, Stockton, Melissa Ann, Feliciano, Paulino, Suleman, Antonio, Mootz, Jennifer J., Mello, Milena, Salem, Andre Fiks, Greene, M. Claire, Bezuidenhout, Charl, Ngwepe, Phuti, Lovero, Kathryn L., Santos, Palmira Fortunato dos, Schriger, Simone H., Mandell, David S., Mulumba, Rogerio, Anube, Anibal Neves, Mabunda, Dirceu, Mandlate, Flavio, and Cournos, Francine
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PROFESSIONAL practice ,FOCUS groups ,MOBILE apps ,DIGITAL technology ,EVIDENCE-based medicine ,ALLIED mental health personnel ,PRIMARY health care ,MENTAL health services ,PSYCHOTHERAPY ,DIFFUSION of innovations ,MENTAL illness - Abstract
Objective To report the interim results from the training of providers inevidence-based psychotherapies (EBPs) and use of mobile applications. Design and Setting The Partnerships in Research to Implement and Disseminate Sustainable and Scalable Evidence (PRIDE) study is a cluster-randomised hybrid effectiveness-implementation trial comparing three delivery pathways for integrating comprehensive mental healthcare into primary care in Mozambique. Innovations include the use of EBPs and scaling-up of task-shifted mental health services using mobile applications. Main outcome measures We examined EBP training attendance, certification, knowledge and intentions to deliver each component. We collected qualitative data through rapid ethnography and focus groups. We tracked the use of the mobile applications to investigate early reach of a valid screening tool (Electronic Mental Wellness Tool) and the roll out of the EBPs Participants Psychiatric technicians and primary care providers trained in the EBPs. Results PRIDE has trained 110 EBP providers, supervisors and trainers and will train 279 community health workers in upcoming months. The trainings improved knowledge about the EBPs and trainees indicated strong intentions to deliver the EBP core components. Trained providers began using the mobile applications and appear to identify cases and provide appropriate treatment. Conclusions The future of EBPs requires implementation within existing systems of care with fidelity to their core evidence-based components. To sustainably address the vast mental health treatment gap globally, EBP implementation demands: expanding the mental health workforce by training existing human resources; sequential use of EBPs to comprehensively treat mental disorders and their comorbid presentations and leveraging digital screening and treatment applications. [ABSTRACT FROM AUTHOR]
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- 2021
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47. Do bedside whiteboards enhance communication in hospitals? An exploratory multimethod study of patient and nurse perspectives.
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Goyal, Anupama, Glanzman, Hanna, Quinn, Martha, Tur, Komalpreet, Singh, Sweta, Winter, Suzanne, Snyder, Ashley, and Chopra, Vineet
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ACADEMIC medical centers ,CHI-squared test ,CLINICAL medicine ,COMMUNICATION ,FOCUS groups ,HOSPITAL patients ,INFORMATION storage & retrieval systems ,MEDICAL databases ,RESEARCH methodology ,NURSES' attitudes ,QUALITY assurance ,RESEARCH ,ROOMS ,SURVEYS ,SYSTEMS design ,ACCESS to information ,USER-centered system design ,PATIENTS' attitudes ,DESCRIPTIVE statistics ,HOSPITAL nursing staff - Abstract
Objective To understand patient and nurse views on usability, design, content, barriers and facilitators of hospital whiteboard utilisation in patient rooms. Design Multimethods study. Setting Adult medical- surgical units at a quaternary care academic centre. Participants Four hundred and thirty- eight adult patients admitted to inpatient units participated in bedside surveys. Two focus groups with a total of 13 nurses responsible for updating and maintaining the whiteboards were conducted. Results Most survey respondents were male (55%), ≥51 years of age (69%) and admitted to the hospital ≤4 times in the past 12 months (90%). Over 95% of patients found the whiteboard helpful and 92% read the information on the whiteboard frequently. Patients stated that nurses, not doctors, were the most frequent user of whiteboards (93% vs 9.4%, p<0.001, respectively). Patients indicated that the name of the team members (95%), current date (87%), upcoming tests/procedures (80%) and goals of care (63%) were most useful. While 60% of patients were aware that they could use the whiteboard for questions/comments for providers, those with ≥5 admissions in the past 12 months were significantly more likely to be aware of this aspect (p<0.001). In focus groups, nurses reported they maintained the content on the boards and cited lack of access to clinical information and limited use by doctors as barriers. Nurses suggested creating a curriculum to orient patients to whiteboards on admission, and educational programmes for physicians to increase whiteboard utilisation. Conclusion Bedside whiteboards are highly prevalent in hospitals. Orienting patients and their families to their purpose, encouraging daily use of the medium and nurse--physician engagement around this tool may help facilitate communication and information sharing. [ABSTRACT FROM AUTHOR]
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- 2020
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48. Reactions to electronic nicotine delivery system (ENDS) prevention messages: results from qualitative research used to inform FDA's first youth ENDS prevention campaign.
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Roditis, Maria L., Dineva, Atanaska, Smith, Alexandria, Walker, Matthew, Delahanty, Janine, D'lorio, Emily, and Holtz, Kristen D.
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FOCUS groups ,HEALTH promotion ,NICOTINE ,SMOKING cessation ,THEMATIC analysis ,ELECTRONIC cigarettes ,ADOLESCENCE - Published
- 2020
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49. 'The lesser devil you don't know': a qualitative study of smokers' responses to messages communicating comparative risk of electronic and combusted cigarettes.
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Owusu, Daniel, Lawley, Rachel, Bo Yang, Henderson, Katherine, Bethea, Brittaney, LaRose, Christopher, Stallworth, Sam, and Popova, Lucy
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SMOKING prevention ,ATTITUDE (Psychology) ,COMMUNICATION ,COMPARATIVE studies ,FOCUS groups ,HEALTH promotion ,SENSORY perception ,SMOKING ,ELECTRONIC cigarettes - Published
- 2020
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50. Feasibility of Safe- Tea: a parent-targeted intervention to prevent hot drink scalds in preschool children.
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Bennett, C. Verity, Hollén, Linda, Quinn-Scoggins, Harriet Dorothy, Emond, Alan, and Kemp, Alison Mary
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BURNS & scalds prevention ,BURNS & scalds -- Risk factors ,COMMUNITY health services ,ATTITUDE (Psychology) ,BEVERAGES ,COMMUNICATION ,CONFIDENCE ,FOCUS groups ,MEDICAL personnel ,QUESTIONNAIRES ,PARENT attitudes ,HEALTH literacy ,CHILDREN - Published
- 2020
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