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In 2016 WHO launched the priority assistive products list (APL) consisting of 50 products and recommended that using this as a reference, countries should develop their own contextually relevant national APLs. This paper describes the development of Malawi's APL. Two hundred and ninety-six persons with disabilities participated in a rapid Assistive Technology Assessment (rATA) survey. Six focus group discussions (FGDs) with people with various types of disabilities were conducted. The rATA questionnaire and FGDs collected data on assistive products (APs) participants used, APs they needed and the challenges they experienced. Data collection was done in six districts spread across the three regions in Malawi. All age groups were included in the survey. Persons with disabilities aged less than 18 participated but went with their guardians. All persons who participated in this study provided consent. Survey and FGDs results were presented at an APL consensus meeting with policymakers, service providers, disabled peoples' organizations and development partners in the disability sector. Based on the results and further discussions, a consensus was reached on the priority APs for Malawi. More than a third of respondents used wheelchairs (32%), followed by auxiliary crutches (25%), walking sticks (13%), reading glasses (11%), prosthesis (10%), elbow crutches (9%) and orthosis (8%). There is also a high demand for products such as pull-up underwear (incontinence products) (79%), hearing aids (70%), reading glasses (59%) and diapers (63%). After intensive discussions during a consensus meeting, an agreement was reached on the 22 priority APs for Malawi. There is a wide range of APs being used by people with different functional limitations in Malawi. There is also a demand for APs that are not readily available. When developing an APL, the list should include products in use, those in demand, and those recommended by service providers. Following the development of the priority assistive products list (APL) by WHO, member states should develop their own contextually based APL. The development of the APL should be based on research evidence. All key stakeholders including persons with disabilities and other functional limitations, government, and development partners should participate in this process. The APL should be part of the national health system or community services. The Department of Disability and Elderly Affairs in the Ministry of Gender, Community Development, being the Government of Malawi line ministry coordinating disability issues participated actively in this study including inviting participants in the stakeholders' validation workshop. [ABSTRACT FROM AUTHOR]

Inclusion is a core philosophy for health practitioners and human service users, and co-production is a way to achieve inclusion. Australia's assistive technology (AT) community seeks to include and amplify the voices of service and product users at multiple levels. Implementation of genuine partnerships for inclusion is however challenging. This paper describes the iterative co-design process undertaken to structure and deliver a peer-led information and support program, enabling AT users and supporters to build their AT decision making capability and share their expertise with each other and the broader community. A living labs approach was grounded in co-design principles and drew on the peer education, AT competency and capability-building knowledge base. Methods included embedding intersectional capabilities within the service, and the engagement of over 600 people in design thinking and program iterations through surveys, focus groups, journey mapping and think tanks. A national, peer-led, co-designed online community for AT users was established and has been running since 2017. The community of 5000 users contribute to a peer-led information and support initiative geared to share expertise and build AT decision making capability. Service delivery by the AT user community and for the AT user community requires a commitment to co-design, and an engagement with concepts of risk, competency, scope of practice and capability. The learnings from AT Chat have implications for AT services on this journey everywhere. Active co-design of AT services meets human rights and good practice benchmarks required by contemporary services. Foregrounding AT users within program design and delivery, brings a range of positive outcomes and possibilities for the way services are delivered. AT users have substantial untapped potential which brings tangible outcomes for other AT users, health professionals, service provider organizations and for society. Development of paid roles and pathways to recognize the skills of AT users, and indeed AT communities has potential to improve AT user self-efficacy as well as to contribute to the AT workforce. [ABSTRACT FROM AUTHOR]

Online activities have spiked due to the COVID-19 pandemic, including language learning activities. As the world is aging, this affects senior citizens too. Yet, few studies have been conducted studying online (language) learning in this age-group. Moreover, no concrete pointers exist on how to go about such an online language learning course. This paper examines what should be considered when designing and implementing online language learning courses for seniors. To that end we present data from 73 senior language learners from two independent language learning contexts: the Netherlands and Scotland. The data were collected between May 2020 and August 2021. Data includes spoken and written samples from lessons, focus groups, interviews and questionnaires. Given the qualitative nature of the data and the aim of identifying patterns of meaning across the respective datasets, a reflexive thematic analysis (TA) approach was adopted. We employed an inductive approach to coding, using both semantic (explicit or overt) and latent (implicit, underlying) coding frameworks, in order to inform two overarching themes: "Navigating the digital highway" and "Camera ready for new friends." We discuss these themes and their sub-themes and arrive at concrete recommendations for the third-age language learning classroom. [ABSTRACT FROM AUTHOR]

Background: Experience-based co-design (EBCD) is a methodology for service improvement and development, which puts service-user voices at the heart of improving health services. Aims: The aim of this paper was to implement the EBCD methodology in a mental health setting, and to investigate the challenges which arise during this process. Method: In order to achieve this, a modified version of the EBCD methodology was undertaken, which involved listening to the experiences of the people who work in and use the mental health setting and sharing these experiences with the people who could effect change within the service, through collaborative work between service-users, staff and managers. Results: EBCD was implemented within the mental health setting and was well received by service-users, staff and stakeholders. A number of modifications were necessary in this setting, for example high levels of support available to participants. Conclusions: It was concluded that EBCD is a suitable methodology for service improvement in mental health settings. [ABSTRACT FROM AUTHOR]

Comprehending praxis is a critical step in developing interventions that can have a real-world impact on people's lives. In this paper, we reflect on the lessons learned in the development of a curriculum for young people living in informal settlements in eThekwini, who are exposed to numerous vulnerabilities, including HIV-related risks associated with precarious urban livelihoods. Behavioural interventions have not led to commensurate reductions in HIV incidence, and the impact of these approaches remains regulated by numerous contextual conditions affecting those participating. Our collaborative project tested the impact of implementing a combination of the well-tested gender transformation intervention, Stepping Stones, with a new livelihood transformation curriculum, Creating Futures, among young people in eThekwini's informal settlements. Creating Futures was grounded in the theory and practice of sustainable livelihoods, but equally in the experience of the multi-disciplinary project team members who have conducted both research and development work among youth in the eThekwini area. Our approach was founded on the work of Doug Kirby, and we are indebted to him for his inputs. His logical model approach ensured that the team remained orientated to specific curriculum outcomes. Analysis of the results at 12 months post-baseline indicates positive livelihood outcomes. [ABSTRACT FROM AUTHOR]

Suicide is a public health priority. International guidance on prevention, epidemiology and treatment-based research indicates the potential of gatekeeper training in this area. Whilst there is some evidence to suggest that interventions enhance the knowledge and skill set of gatekeepers, evidence regarding changes to intervention-related behaviour remains unclear. This disruption to the causal pathway between competency and action suggests the need to address contextual mediators of the implementation of gatekeeper training and to consider the individual as a situated agent, who is both enabled and constrained by the discourses and working practices of the organisation in which they work. To explore organisational influences on intervention behaviour, this paper draws upon a qualitative study of the applied suicide intervention skills training (ASIST) gatekeeper intervention in Wales. Thirty-three individual interviews and six focus groups (n = 25 individuals) with those employed by a range of statutory and non-statutory organisations and networks were included. Three key organisational influences were identified as impacting on gatekeeper’s intervention behaviour. These include: the democratisation of intervention; organisational attempts to enhance opportunities to intervene; and the creation of a positive context for intervention. This study concludes that both policy and practice need to move beyond a reductionist approach to gatekeeper training and attend to the organisational influences and contextual factors affecting intervention-related behaviour. [ABSTRACT FROM PUBLISHER]

To address child protection concerns countries often implement mandatory reporting (MR) laws. This ensures that relevant professionals alert child protection services of children who are at risk of or are currently experiencing abuse. However, these well-intended mandatory requirements can sometimes have unintended negative consequences that affect all those who are involved in the process. The current research investigated the experiences of Irish psychologists in implementing MR and examined if there was any personal or professional impact resulting from this process. All participants were qualified psychologists of various disciplines working in the HSE, the national health service of Ireland. A qualitative research design was implemented that consisted of thematic analysis of focus group transcripts. Three focus groups (n = 18) were conducted. Three major themes were identified within the data; the unintentional harm that is caused by MR, the contexts where reporting is needed, and the issues with the current MR system. Some benefits to MR exist but these advantages need to be considered within a greater context. The findings of the current study outlined how participants perceived aspects of MR as having significant detrimental consequences for victims of abuse. [ABSTRACT FROM AUTHOR]

In Eswatini (formerly Swaziland), the increasing number of orphans and vulnerable children due to HIV/AIDS has spurred demand for psychosocial support services. When the Ministry of Education and Training assumed responsibility for delivering psychosocial support, educators were burdened with the additional role of looking after orphans and vulnerable learners. This exploratory, sequential, mixed-methods study was employed to analyse factors that enhance the provision of psychosocial support services and the perceptions of educators towards psychosocial support delivery. The qualitative study phase entailed 16 in-depth interviews with multi-sectoral psychosocial support specialists and seven focus group discussions with orphans and vulnerable learners. In the quantitative study phase, 296 educators were surveyed. Thematic analysis was used for the qualitative data, and the quantitative data was analysed using Statistical Package for the Social Sciences version 25 software. The findings reveal problems associated with psychosocial support service delivery at strategy, policy and operational levels. The results indicate that orphans and vulnerable children are offered material support (e.g. food and sanitary pads) and spiritual support, but were rarely referred for social and psychological needs. There were no proper counselling facilities and not all teachers received relevant training in children's psychosocial needs. Training of educators in specific psychosocial support areas was considered significant to enhance service delivery and the psychosocial well-being of the learners. Overall, accountability was difficult to establish because the administration of psychosocial support is split among the Ministry of Education and Training, the Deputy Prime Minister's office and Tinkhundla administration. There is unequal distribution of qualified early childhood development teachers to cater for early childhood educational needs. [ABSTRACT FROM AUTHOR]

Background: Early integration of oncology and patient-centered palliative care is the recommended clinical practice model for patients with advanced cancer. General and specific communication skills are necessary to achieve integrated patient-centered care, but require organized training to be adequately mastered. Challenges and barriers on several levels, i.e. organizational, professional and individual may, however, hamper implementation. The development, implementation, and evaluation of such an educational program focusing on communication skills contain many steps, considerations and lessons learned, which are described in this article. Methods: A multi-professional faculty developed, implemented, and evaluated an educational program through a 5-step approach. The program was part of a Norwegian cluster-randomized controlled trial aiming to test the effect of early integration of oncology and palliative care for patients with advanced cancer. Results: The result is the PALLiON educational program; a multi-faceted, evidence-based, and learner-centered program with a specific focus on physicians' communication skills. Four modules were developed: lectures, discussion groups, skills training, and coaching. These were implemented at the six intervention hospitals using different teaching strategies. Evaluation in a subgroup of participants showed a positive appraisal of the group discussions and skills training. Conclusion:We present our experiences and reflections regarding implementation and lessons learned, which should be considered in future developments and implementations; (1) Include experienced faculty with various backgrounds, (2) Be both evidence-based and learner-centered, (3) Choose teaching strategies wisely, (4) Expect resistance and skepticism, (5) Team up with management and gatekeepers, (6) Expect time to fly, and (7) Plan thorough assessment of the evaluation and effect. Trial registration: ClinicalTrials.gov identifier: NCT03088202. [ABSTRACT FROM AUTHOR]

The iWalk study showed that 10-meter walk test (10mWT) and 6-minute walk test (6MWT) administration post-stroke increased among physical therapists (PTs) following introduction of a toolkit comprising an educational guide, mobile app, and video. We describe the use of theory guiding toolkit development and a process evaluation. We used the knowledge-to-action framework to identify research steps; and a guideline implementability framework, self-efficacy theory, and the transtheoretical model to design and evaluate the toolkit and implementation process (three learning sessions). In a before-and-after study, 37 of the 49 participating PTs completed online questionnaires to evaluate engagement with learning sessions, and rate self-efficacy to perform recommended practices pre- and post-intervention. Thirty-three PTs and 7 professional leaders participated in post-intervention focus groups and interviews, respectively. All sites conducted learning sessions; attendance was 50-78%. Self-efficacy ratings for recommended practices increased and were significant for the 10mWT (p ≤ 0.004). Qualitative findings highlighted that theory-based toolkit features and implementation strategies likely facilitated engagement with toolkit components, contributing to observed improvements in PTs' knowledge, attitudes, skill, self-efficacy, and clinical practice. The approach may help to inform toolkit development to advance other rehabilitation practices of similar complexity. Toolkits are an emerging knowledge translation intervention used to support widespread implementation of clinical practice guideline recommendations. Although experts recommend using theory to inform the development of knowledge translation interventions, there is little guidance on a suitable approach. This study describes an approach to using theories, models and frameworks to design a toolkit and implementation strategy, and a process evaluation of toolkit implementation. Theory-based features of the toolkit and implementation strategy may have facilitated toolkit implementation and practice change to increase clinical measurement and interpretation of walking speed and distance in adults post-stroke. [ABSTRACT FROM AUTHOR]

Inclusive educational leaders promote teacher team functioning. To support leader inclusiveness, we designed and implemented a faculty development programme focusing on leader identity formation. We investigated (1) how participants' leader identity developed throughout the programme and (2) how the design principles contributed to this process, according to participants. A design-based research approach was followed. Participants were 7 course coordinators, leading an interdisciplinary teacher team. To study leader identity development, participants repeatedly filled out a validated questionnaire. To investigate how design principles contributed, observational field notes, facilitator debriefings, a programme evaluation questionnaire and a semi-structured focus group were used. Thematic analysis was applied for qualitative data. Participants gained broader views on leadership, moving from individual dominance towards engaging team members. Most participants initially experienced a deconstruction of their former leader identity and became motivated to improve leadership qualities. Competence-building, reflecting and receiving feedback on workplace experiences, and practicing in a safe environment were perceived to be key for identity development. We developed and evaluated a leader identity programme which can convert teachers' classic leadership views towards views incorporating social interactions and relationships. We demonstrated how social interactions provide opportunities to learn from pe.ers in the work environment. [ABSTRACT FROM AUTHOR]

This project aimed to develop, implement and evaluate a train-the-trainer initiative for community rehabilitation workers (CRWs) and rehabilitation specialists within a community rehabilitation program for children with delayed development in Tamil Nadu, India. Guided by the Knowledge to Action framework, non-governmental and academic partners collaboratively developed two 2-day workshops for (1) rehabilitation specialists and (2) CRWs. Outcomes were evaluated using mixed methods, with pre and 2.5-months post surveys (59 participants) and three focus groups (17 participants) involving trainers and trainees (including rehabilitation specialists and CRWs). There were significant increases in the CRWs' self-perception of their capacity to assess comprehension, provide explanations, respond to questions, adjust teaching, motivate learners, communicate effectively, and provide feedback. Significant changes were noted for rehabilitation specialists in five of seven domains, and for rehabilitation specialist leads in six of seven domains. Participants appreciated the interactive training style, and the use of immersive methods such as role play, though noted challenges when instructions were unclear or when they felt that material was more theoretical. This collaboratively developed train-the-trainer project demonstrates the value of such an intervention, provides an example of how a tailored program can be developed, and suggests the importance of stakeholder-driven design processes. The ability to provide effective training is a core skill set for people engaged in community-based rehabilitation (CBR) programs, yet examples of initiatives to train trainers are lacking, as is their evaluation. This project demonstrates the value of a collaborative and tailored train-the-trainer program to support community rehabilitation workers and rehabilitation specialists in their training roles within a CBR program in India. A stakeholder-driven design process supported by a collaboration between non-governmental organization and academic partners enhanced the capacity to develop, implement and evaluate the train-the-trainer program. [ABSTRACT FROM AUTHOR]

We describe the implementation of psychotherapeutic weight loss groups involving an intuitive eating approach, carried out within a deprived area with a highly diverse population. Challenges to implementation were identified through thematic analysis of data from the group facilitators' reflexive practice meetings. These challenges included: attending to power processes related to culture and gender, respecting cultural norms around familial eating and ideal weight, acknowledging group participants' stress, and accommodating group participants' employment and caring responsibilities. We offer some practice recommendations, highlighting facilitators' adoption of the non-expert stance, and explicit acknowledgement of differences as well as commonalities. We argue for the need for sensitively tailored psychotherapeutic interventions for weight loss when working with differences among diverse populations in deprived areas. [ABSTRACT FROM AUTHOR]

Purpose: To explore and analyse the experience of work situation and professional role for midwives at a labour ward pre and post the implementation of a midwifery model of care (MiMo). Methods: A simultaneous mixed method was used. The qualitative core component departed from three focus group interviews (n = 16 midwives). Secondary inductive and deductive content analysis was performed using an unconstrained matrix to make a corresponding comparison of the different time points. The supplemental component was a quantitative survey about the work situation (n = 58). Results: The qualitative results pre the implementation showed three categories: Balance between Women and Organization, Midwives—Diverse as both Profession and Person, and Strained Work Situation. Post the intervention they transformed to Balance between Midwifery and Organization, Midwives—An Adaptable Profession, Strained Work Situation, and a new category Ability to concretize midwifery was found. There were no significant differences in the measures of work situation in the quantitative analyses. Conclusions: The synthesized findings based on the qualitative part show that MiMo has a potential to strengthen the professional role and midwifery practice. As such, MiMo has the capability to offer benefits to the labour wards with additional considerations. [ABSTRACT FROM AUTHOR]

We report the implementation of a new framework supporting teacher practice for inclusion of children with disabilities in mainstream classrooms. Eight schools in one Scottish authority took part. Questionnaire, focus group, and interview data were gathered. Results indicated that the framework was well-received and provided a useful resource for class teachers. The framework was perceived as a feasible method for supporting teachers and related personnel to think systematically about key issues relating to children with disabilities in the classroom. It was suggested that the provision of a common language was supportive of collaborative working. Areas for revision included a system of navigation and simplification in the framework manual. [ABSTRACT FROM AUTHOR]

Background and Purpose: Little is known about the process of engaging key stakeholders to select and design a knowledge translation (KT) intervention to increase the use of an outcome measure using audit and feedback. The purpose of this case report was to describe the development of a KT intervention designed with organizational support to increase physical therapists' (PTs) use of a selected outcome measure in an inpatient sub-acute rehabilitation hospital. Case Description: Eleven PTs who worked at a sub-acute rehabilitation hospital participated. After determining organizational support, a mixed methods barrier assessment including a chart audit, questionnaire, and a focus group with audit and feedback was used to select an outcome measure and design a locally tailored intervention. The intervention was mapped using the Theoretical Domains Framework (TDF). One investigator acted as knowledge broker and co-designed the intervention with clinician and supervisor support. Outcomes: The 4-m walk test was selected through a group discussion facilitated by the knowledge broker. Support from the facility and input from the key stakeholders guided the design of a tailored KT intervention to increase use of gait speed. The intervention design included an interactive educational meeting, with documentation and environmental changes. Discussion: Input from the clinicians on the educational meeting, documentation changes and placement of tracks, and support from the supervisor were used to design and locally adapt a KT intervention to change assessment practice among PTs in an inpatient sub-acute rehabilitation hospital. Implementation and evaluation of the intervention is underway. [ABSTRACT FROM AUTHOR]

Background and aim: Cognitive impairments following brain injury, including difficulty with problem solving, can pose significant barriers to successful community reintegration. Problem-solving strategy training is well-supported in the cognitive rehabilitation literature. However, limitations in insurance reimbursement have resulted in fewer services to train such skills to mastery and to support generalization of those skills into everyday environments. The purpose of this project was to develop and evaluate an integrated, web-based programme, ProSolv, which uses a small number of coaching sessions to support problem solving in everyday life following brain injury. Method: We used participatory action research to guide the iterative development, usability testing, and within-subject pilot testing of the ProSolv programme. The finalized programme was then evaluated in a between-subjects group study and a non-experimental single case study. Results: Results were mixed across studies. Participants demonstrated that it was feasible to learn and use the ProSolv programme for support in problem solving. They highly recommended the programme to others and singled out the importance of the coach. Limitations in app design were cited as a major reason for infrequent use of the app outside of coaching sessions. Conclusions: Results provide mixed evidence regarding the utility of web-based mobile apps, such as ProSolv to support problem solving following brain injury. Implications for Rehabilitation: People with cognitive impairments following brain injury often struggle with problem solving in everyday contexts. Research supports problem solving skills training following brain injury. Assistive technology for cognition (smartphones, selected apps) offers a means of supporting problem solving for this population. This project demonstrated the feasibility of a web-based programme to address this need. [ABSTRACT FROM AUTHOR]

Background: Depression in late life is a major, yet unrecognized public health problem in low- and middle-income countries (LMICs). The dearth of specialist resources, together with the limited ability of current depression treatments to avert years lived with disability, underscores the need for preventive interventions that can be delivered by lay health workers in primary care settings. We describe the development of an intervention for the indicated prevention of depression in older adults at risk due to subsyndromal symptoms, attending rural and urban public primary care clinics in Goa, India. Objectives: (1) to describe a mixed-methods approach (qualitative and quantitative)to the development of 'DIL,' an intervention for preventing the onset of major depression in older adults living with subsyndromal symptoms in Goa, India; (2) to describe resulting components of the 'DIL' intervention; and (3) to present data on the feasibility, acceptability, and benefit of DIL to participants. Methods: We followed a mixed-methods design, including in-depth interviews, focus group discussions, a theory of change workshop to develop a logic model, and an open-case series. Results: The mixed-method approach led to the development and adaptation of the DIL (Depression in Later Life) intervention for the indicated prevention of depression in older adults. The intervention was delivered by lay health counselors (LHCs). 'DIL' is a hybrid model of simple behavioral strategies grounded in Problem-solving Therapy for Primary Care, improved self-management of common, co-occurring medical disorders such as diabetes mellitus, and pragmatic assistance in navigating to needed social services. The use of 'DIL' in an open-case series with 19 participants led to a moderate reduction in symptoms of depression and anxiety on the General Health Questionnaire. A pictorial flipchart was developed to assist in delivering the intervention to participants with low levels of literacy. High rates of participant retention and satisfaction were achieved. Conclusion: The DIL intervention was adapted to the local context for delivery by lay health counselors and was found to be acceptable and feasible among the elderly participants in the study. [ABSTRACT FROM AUTHOR]

Although experts have noted that adolescent athletes should be educated about concussions to improve their safety, there is no agreement on the most effective strategy to disseminate concussion education. The purpose of this study was to develop, implement and assess a concussion education programme. More precisely, four interactive oral presentations were delivered to high school student-athletes (N = 35,Mage = 15.94,SD = 0.34) in a large urban centre. Participants completed a questionnaire at three time-points during the season to measure changes in their knowledge (CK) and attitudes (CA) of concussions, and focus group interviews were conducted following the concussion education programme. Questionnaire data revealed participants’ post-intervention CK scores were higher than their pre-intervention scores. During the focus groups, the student-athletes said they acquired CK about the role of protective equipment and symptom variability, and in terms of CA, they intended to avoid dangerous in-game collisions in the future. Our study was the first to create and deliver a concussion education intervention across multiple time-points, and to use mixed-methods in its assessment. These findings may be of interest to researchers, practitioners and stakeholders in sport who are invested in making the sport environment safer through concussion education and awareness. [ABSTRACT FROM AUTHOR]

The Office on Women’s Health funded five pilot healthy weight intervention studies for lesbian and bisexual (LB) women, which included a program called Strong. Healthy. Energized (SHE). SHE was a 12-session program, targeted toward LB women age 60 and older, which focused on exercise, including a pedometer to track steps; nutrition; stress management; and group discussions. The program enrolled 39 participants. Waist circumference decreased by 3.7% across the group (p < .01). Participants with the lowest one-third baseline step count saw a marked step increase. This intervention was effective in improving health behaviors and short-term health outcomes for older LB women. [ABSTRACT FROM PUBLISHER]

As a foundation of most cultures, with roots in persons’ early development, religion can be a source of hope as well as denigration. Some religious institutions have made attempts to help persons with mental health problems, and some mental health professionals have sought to engage religion resources. These programs have rarely been sustained. In 2008, the Mental Health Center of Denver (MHCD) developed a program to assess the utility of religion resources within mental health care. In response to positive feedback, MHCD appointed a director of Faith and Spiritual Wellness who facilitates community outreach to faith communities and spiritual integration training to MHCD staff. This director initiated a Clergy Outreach & Professional Engagement (COPE) conference for consumers, clergy, and clinicians. The goal was to acknowledge borders between parts of persons’ lives, and to build bridges of collaboration to facilitate care. Participants described lived examples of collaboration to improve mental wellness, including the need for a “solid welcome” from congregations. Subsequent, online surveys generated quantitative data on the usefulness of the conference to encourage and to generate ideas for interaction. Each group affirmed the utility of the conference; consumers and clinicians found the conference more useful than clergy. Qualitative assessment confirmed that across culture differences, participants found common language to demonstrate that persons of different traditions can provide care inclusive of religious resources. This assessment concludes with recommendations for future collaboration, led by consumer input, to expand recovery networks. [ABSTRACT FROM PUBLISHER]

Challenging HIV-infected patients, those neither adherent nor actively engaged in care, represent an important opportunity for intervention if the HIV epidemic is to be contained. This pilot study assessed the feasibility and acceptability of an adapted patient adherence intervention and a motivational interview-based provider intervention in urban Buenos Aires, Argentina, in order to optimize health benefits in challenging HIV-infected patients. To maximize implementation and uptake of both strategies, interventions were adapted to the local setting. Qualitative data and a short quantitative assessment from patients, staff, fellows, residents and physicians (n = 84) were examined to establish the feasibility and acceptability of offering patient and provider evidencebased interventions in both public and private health-care settings. Results identified key themes on provision of information, use of specialized communication techniques and group support in the utilization of the interventions. Both providers (n = 12) and patients (n = 120) endorsed the acceptability and value of the interventions, and the feasibility of their delivery. Findings support the use of both intervention modalities with challenging patients in diverse urban health-care settings. [ABSTRACT FROM AUTHOR]

Background/Purpose: This study investigates challenges that students and faculty face to implement assessment for learning; and the activities, capabilities, enablers, and indicators which could impact performance. Method: The study is a mixed methods research, cross-sectional, exploratory study. The study was organized through two phases of data collection and analysis (QUAL → quan). Based on qualitative focus group discussions (FGD), we first gathered data through field notes. Later, we engaged in analysis using techniques drawn from qualitative data including categorization, theme identification, and connection to existing literature. Based on this analysis, we developed a questionnaire that could provide quantitative measures based on the qualitative FGD. We then administered the questionnaire, and the quantitative data were analyzed to quantitatively test the qualitative findings. Twenty-four faculty and 142 students from the 4th and 5th clinical years participated voluntarily. Their perception of FA and the cultural challenges that hinder its adoption were evaluated through a FGD and a questionnaire. Results: The mean score of understanding FA concept was equal in faculty and students ( p = 0.08). The general challenge that scored highest was the need to balance work and academic load in faculty and the need to balance study load and training and mental anxiety in students. There was no difference between faculty and students in perceiving 'learning is teacher-centered' ( p = 0.481); and 'past learning and assessment experience' ( p = 0.322). There was a significant difference between them regarding interaction with opposite gender ( p <0.001). Students showed higher value as regards the 'gap between learning theories and assessment practice', 'grade as a priority', and 'discrimination by same faculty gender'. Conclusion: The authors suggested a 'Framework of Innovation in Endorsing Assessment for Learning'. It emphasizes a holisitic approach through all levels of the System: Government, Accreditation Bodies, Policy makers; Institution, and Classroom levels. [ABSTRACT FROM AUTHOR]

Tobacco cessation treatments have not been evaluated among Alaska Native (AN) adolescents. This pilot study evaluated the feasibility and acceptability of a targeted cessation intervention developed for AN youth. Intervention components were informed by prior focus groups assessing treatment preferences among AN youth, a social cognitive theoretical framework and feedback obtained from a teen advisory group. The intervention consisted of a weekend program where youth traveled by small airplane from their villages to stay overnight with other adolescents who quit tobacco use together. The program included recreational activities, talking circles, personal stories from elders and teen advisors, and cognitive behavioral counseling. Two intervention pilots were conducted from October 2010 to January 2011 using a non-randomized, uncontrolled study design with assessments at baseline and six-week follow-up. One village in Western Alaska was selected for each pilot with a targeted enrollment of 10 adolescents each. Participants were recruited for each pilot within five days, but recruitment challenges and 'lessons learned' are described. The first pilot enrolled nine adolescents (all female) aged 13-16 years; all nine attended the intervention program and 78% (7/9) completed follow-up. The second pilot enrolled 12 adolescents (eight females, four males) aged 12-17 years, of which seven attended the intervention program. Six of these seven participants (86%) completed follow-up. In both pilots, participants rated the intervention as highly acceptable. A targeted cessation intervention was feasible and acceptable to AN youth. The intervention will be tested for efficacy in a subsequent randomized controlled trial. [ABSTRACT FROM AUTHOR]

The article describes the development and implementation and lessons learnt from parent nutrition education workshops conducted for a low-income, primarily Spanish-speaking population in an urban school district setting. The participating parents showed positive changes in their knowledge attitudes, self-efficacy and behaviors related to healthy eating indicating that this would lead to healthier eating habits among students.

Purpose: Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden. Method: The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact. Results: The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations. Conclusion: The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures. [ABSTRACT FROM AUTHOR]