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Barriers and Facilitators to Implementation of a Preschool Outcome Measure: An Interview Study with Speech-Language Pathologists Abstract Introduction: The Preschool Speech and Language Program in Ontario, Canada implemented the Focus on the Outcomes of Communication Under Six (FOCUS), an outcome measure, in 2012. This study aimed to investigate commonly experienced facilitators of and barriers to implementing the FOCUS in clinical practice from the perspectives of speech-language pathologists (SLPs). Methods: Thirty-seven SLPs participated in semi-structured interviews to share their experiences adopting the FOCUS in clinical practice. A deductive content analysis of interview transcripts was conducted using the Theoretical Domains Framework (TDF), followed by an inductive analysis to identify sub-themes within each domain. Results: SLPs frequently encountered barriers within three TDF domains: Environmental Context and Resources (e.g., difficulties integrating the FOCUS into assessment sessions and intervention schedules), Beliefs about Consequences (e.g., beliefs that data collected using the FOCUS lack relevance to clinical practice), and Social Influences (e.g., administration of the FOCUS harmed rapport with families). Commonly reported facilitators were found in the Behavioural Regulation (e.g., reminder system) and Environmental Context and Resources (e.g., availability of administrative personnel and technology support) domains. Conclusions: SLPs identified barriers and facilitators to implementing an evidence-based outcome measure into practice. Insights drawn from SLPs’ perspectives will support the design of new methods to improve the implementation of functional outcome measurement tools within programs.

The Mandatory use of ict in saudi secondary schools within the framework of the ict-related educational reform is a response to the requirements of the digital age. however, there is a discrepancy between what teachers want to do to promote ict integration and what they can really do since they are limited by poor equipment. Saudi Arabia Has Difficulties moving on from the transition stage of ICT adoption and adaptation to wide-scale ict integration. although all saudi teachers are ict adopters, they are reluctant to adapt western uses of ict tools without understanding their cultural appropriateness with regard to the specific saudi context that is deeply grounded in a multi-century islamic tradition of teaching. this article explores technical, political, and cultural appropriateness of ict tools in saudi secondary schools with a view to promoting ict integration from the mandatory adoption stage to ict integration.

Life cycle cost management is an integral part of buildings construction. The life cycle cost approach can be considered an objective approach because it considers all life cycles of buildings. Information and communication technology is one of the critical factors for the success of construction projects. Several studies point to the importance of information and communication technology use in life cycle cost management. Generally, information and communication technology can be helpful in the cost management process of buildings. However, few implementation factors of information and communication technology are used in the life cycle cost management of buildings. The research assumes that the most critical implementation factor is the investment cost for information and communication technologies used in cost management during the life cycle. The relative importance index method was used to evaluate and quantify the final rank of implementation factors. The Kruskal–Wallis test was used to confirm or reject research results that were statistically significant.

Background Evidence-based guidelines recommend that all newly diagnosed colon cancers be screened for Lynch syndrome (LS). Best practices for implementing universal tumor screening have not been extensively studied. Purpose We interviewed a range of stakeholders in an integrated health care system to identify initial factors that might promote or hinder the successful implementation of a universal (LS) screening program. Methods We conducted interviews with health plan leaders, managers, and staff. Interviews were audio recorded and transcribed. Thematic analysis began with a grounded approach and was also guided by the Practical Robust Implementation and Sustainability Model (PRISM). Results We completed 14 interviews with leaders/managers and staff representing involved clinical and health plan departments. While in general stakeholders supported the concept of universal screening, they identified several internal (organizational) and external (environment) factors that promote/hinder implementation. Facilitating factors included: 1) perceived benefits of screening for patients and organization; 2) collaboration between departments; and 3) availability of organizational resources. Barriers were also found, including: 1) lack of awareness of guidelines; 2) lack of guideline clarity; 3) staffing and program “ownership” concerns; and 4) cost uncertainties. Analysis also revealed nine important infrastructure-type considerations for successful implementation. Conclusion We found that clinical, laboratory, and administrative departments supported universal tumor screening for LS. Requirements for successful implementation may include interdepartmental collaboration and communication; patient and provider/staff education; and significant infrastructure and resource support related to laboratory processing and systems for electronic ordering and tracking.

Статья посвящена вопросу изучения системы государственного регулирования и поддержки аграрного сектора Приморского края. Приведена методика оценки реализации государственной программы развития сельского хозяйства Приморского края с использованием общих и частных показателей. Предложена авторская методика оценки реализации подпрограммы «Обеспечение функций управления реализации к Государственной программе Приморского края развития сельского хозяйства» использованием новых показателей (индикаторов)., The article is devoted to the study of state regulation system and support for agricultural sector in Primorsky Territory. The article presents the methods to assess realization of the state program of agricultural development in Primorsky Territory using general and specific factors. The author suggests his assessment technique of subprogram implementation "Providing management functions to realize the state program in Primorsky Territory for agricultural development» with the use of new factors (indicators).

This research studies the influence range of the organizational, planning and technical factors within the information quality, system quality and information systems services quality, in the user satisfaction, based on the designed model research for this purpose. The empirical study takes place in six Higher Education Institutes (94 questionnaires) by the Partial Least Square statistic tool. The results has shown that Organizational Factor (information needs, management support, institutional objectives satisfaction) is which has the most impact because its high correlation value (R=0.624; R=0.435 yR=0.428) and signifi cance (p Esta investigación estudia el nivel de influencia de los factores organizacional, planificación y técnico con la calidad de la Información, del sistema y de los servicios en la satisfacción del usuario, basado en un modelo diseñado para este propósito. El estudio empírico hecho en seis universidades mexicanas por medio de PLS, muestra que el Factor Organizacional es el que tiene un mayor impacto por sus altos valores de correlación (R=0.624; R=0.435 y R=0.428) y significancia en las tres hipótesis planteadas con una varianza explicada del 78.8% en la Satisfacción del Usuario, quienes piensan que la calidad de los sistemas les ayudan a aumentar la productividad en su toma de decisiones.

Reaching individuals who can benefit from evidence-based health promotion and disability prevention programs is a goal of federal, state, and local agencies as well as researchers, providers, community agencies, and other stakeholders. Implementation effectiveness at the organizational level must be achieved in order to reach these individuals and sustain the program. This mixed methods study examined eight organizations within two states that successfully implemented the Chronic Disease Self-Management Program (CDSMP) and sustained it from 4 to 10 years. There were two types of organizations: aging services and health care. Internal and external implementation factors and influences were explored. Additional examination of state activities (as a key external agent supporting CDSMP implementation) was conducted. The examination found agreement among the eight organizations regarding why they had adopted the CDSMP – citing the alignment between the program and their organizations’ mission and purpose to improve health status and promote better self-care, and the demonstrated value (benefits) of the program. Organizations were also alike in that they described the importance of an internal champion and supportive senior leader. Organizations differed in how they experienced and valued peer support and collaborative networks. Organizations also differed in how they filled their CDSMP workshops. Internal drivers and capability were more often discussed as facilitating successful implementation than external factors. However, state activities and external support enabled successful adoption – particularly funding and training. The primary challenges identified by this set of organizations included difficulty in recruiting participants (filling workshops) and irregular or insufficient funding sources. These challenges were identified as significant and represented barriers to sustaining the program.

Background Interoperable electronic health record (EHR) solutions are currently being implemented in Canada, as in many other countries. Understanding EHR users’ perspectives is key to the success of EHR implementation projects. This Delphi study aimed to assess in the Canadian context the applicability, the importance, and the priority of pre-identified factors from a previous mixed-methods systematic review of international literature. Methods A three-round Delphi study was held with representatives of 4 Canadian EHR user groups defined as partners of the implementation process who use or are expected to use EHR in their everyday activity. These groups are: non-physician healthcare professionals, health information professionals, managers, and physicians. Four bilingual online questionnaire versions were developed from factors identified by the systematic review. Participants were asked to rate the applicability and the importance of each factor. The main outcome measures were consensus and priority. Consensus was defined a priori as strong (≥ 75%) or moderate (≥ 60-74%) according to user groups’ level of agreement on applicability and importance, partial (≥ 60%) when participants agreed only on applicability or importance, or as no consensus (< 60%). Priority for decision-making was defined as factors with strong consensus with scores of 4 or 5 on a five-point Likert scale for applicability and importance. Results Three Delphi rounds were completed by 64 participants. Levels of consensus of 100%, 64%, 64%, and 44% were attained on factors submitted to non-physician healthcare professionals, health information professionals, managers, and physicians, respectively. While agreement between and within user groups varied, key factors were prioritized if they were classified as strong (≥ 75% from questionnaire answers of user groups), for decision-making concerning EHR implementation. The10 factors that were prioritized are perceived usefulness, productivity, motivation, participation of end-users in the implementation strategy, patient and health professional interaction, lack of time and workload, resources availability, management, outcome expectancy, and interoperability. Conclusions Amongst all factors influencing EHR implementation identified in a previous systematic review, ten were prioritized through this Delphi study. The varying levels of agreement between and within user groups could mean that users’ perspectives of each factor are complex and that each user group has unique professional priorities and roles in the EHR implementation process. As more EHR implementations in Canada are completed it will be possible to corroborate this preliminary result with a larger population of EHR users.

This article describes and analyzes the critical implementation factors of Activity-Based Costing method (ABC) in the Romanian steel industry in case of success or failure. Also, the article presents the successful implementation itinerary of ABC and the conclusions of worldwide specialty studies about adopting or not adopting this method.