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20. Developing middle-range theories within a realist evaluation of how health committees support community capacity for health.

Author

Gilmore, Brynne, Power, Jessica, Tumwesigye, Nazarius, Mollel, Henry, McAuliffe, Eilish, and Vallières, Frédérique

Subjects
COMMUNITY health services, WORKS councils, MANAGEMENT committees, FACILITY management, HEALTH facilities
Abstract

Health committees link formalised health services and the community. However, 'how, why, and for whom' health committees work warrants further exploration. This article presents the development of a middle-range theory for how health committees work for building community capacity for health. Resulting programme theories from a realist evaluation in Uganda were synthesised for demi-regularities and supplemented by four key informant interviews – substantive theories were used to help explain the findings from the case studies to develop the final middle-range theories. Eighteen existing programme theories and 47 supporting context-mechanism-outcome configurations were synthesised into four middle-range theories for how health committees work for community capacity building for health at the individual, organisational, community and societal levels. The middle-range theories developed in this study provide important insight for those implementing health committees. Given the little guidance available for developing and refining middle-range theories, this study provides transparent methodological processes, which may assist future research. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Mental health in Ukraine in 2023

Author

Martsenkovskyi, Dmytro, primary, Shevlin, Mark, additional, Ben-Ezra, Menachem, additional, Bondjers, Kristina, additional, Fox, Robert, additional, Karatzias, Thanos, additional, Martsenkovska, Inna, additional, Martsenkovsky, Igor, additional, Pfeiffer, Elisa, additional, Sachser, Cedric, additional, Vallières, Frédérique, additional, and Hyland, Philip, additional

Published
2024
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28. From PERFORM to PERFORM2Scale: lessons from scaling-up a health management strengthening intervention to support Universal Health Coverage in three African countries.

Author

Raven, Joanna, Mansour, Wesam, Aikins, Moses, Bulthuis, Susan, Chikaphupha, Kingsley, Dieleman, Marjolein, Kok, Maryse, Martineau, Tim, Ssengooba, Freddie, Wyss, Kaspar, and Vallières, Frédérique

Subjects
HEALTH care teams, CHANGE theory, RESEARCH teams, AUTONOMY (Psychology), EMOTIONS
Abstract

Strengthening management and leadership competencies among district and local health managers has emerged as a common approach for health systems strengthening and to achieve Universal Health Coverage (UHC). While the literature is rich with localized examples of initiatives that aim to strengthen the capacity of district or local health managers, particularly in sub-Saharan Africa, considerably less attention is paid to the science of 'how' to scale-up these initiatives. The aim of this paper is thus to examine the 'process' of scaling-up a management strengthening intervention (MSI) and identify new knowledge and key lessons learned that can be used to inform the scale-up process of other complex health interventions, in support of UHC. Qualitative methods were used to identify lessons learned from scaling-up the MSI in Ghana, Malawi and Uganda. We conducted 14 interviews with district health management team (DHMT) members, three scale-up assessments with 20 scale-up stakeholders, and three reflection discussions with 11 research team members. We also kept records of activities throughout MSI and scale-up implementation. Data were recorded, transcribed and analysed against the Theory of Change to identify both scale-up outcomes and the factors affecting these outcomes. The MSI was ultimately scaled-up across 27 districts. Repeated MSI cycles over time were found to foster greater feelings of autonomy among DHMTs to address longstanding local problems, a more innovative use of existing resources without relying on additional funding and improved teamwork. The use of 'resource teams' and the emergence of MSI 'champions' were instrumental in supporting scale-up efforts. Challenges to the sustainability of the MSI include limited government buy-in and lack of sustained financial investment. [ABSTRACT FROM AUTHOR]

Published
2024
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32. Delay discounting and under-valuing of recent information predict poorer adherence to social distancing measures during the COVID-19 pandemic

Author

Lloyd, Alex, McKay, Ryan, Hartman, Todd K., Vincent, Benjamin T., Murphy, Jamie, Gibson-Miller, Jilly, Levita, Liat, Bennett, Kate, McBride, Orla, Martinez, Anton P., Stocks, Thomas V. A., Vallières, Frédérique, Hyland, Philip, Karatzias, Thanos, Butter, Sarah, Shevlin, Mark, Bentall, Richard P., and Mason, Liam

Published
2021
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37. Is Dissociation a Fundamental Component of ICD-11 Complex Posttraumatic Stress Disorder?

Author

Hyland, Philip, Hamer, Ruby, Fox, Robert, Vallières, Frédérique, Karatzias, Thanos, Shevlin, Mark, and Cloitre, Marylene

Subjects
DIAGNOSIS of post-traumatic stress disorder, STRUCTURAL equation modeling, ADVERSE childhood experiences, NOSOLOGY, DISSOCIATIVE disorders, SELF-evaluation, MATHEMATICAL models, CHILD abuse, FUNCTIONAL status, HEALTH status indicators, THEORY, DESCRIPTIVE statistics
Abstract

ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) is a disorder of six symptom clusters including reexperiencing, avoidance, sense of threat, affective dysregulation, negative self-concept, and disturbed relationships. Unlike earlier descriptions of complex PTSD, ICD-11 CPTSD does not list dissociation as a unique symptom cluster. We tested whether the ICD-11 CPTSD symptoms can exist independently of dissociation in a nationally representative sample of adults (N = 1,020) who completed self-report measures. Latent class analysis was used to identify unique subsets of people with distinctive symptom profiles. The best fitting model contained four classes including a "low symptoms" class (48.9%), a "PTSD" class (14.7%), a "CPTSD" class (26.5%), and a "CPTSD + Dissociation" class (10.0%). These classes were related to specific adverse childhood experiences, notably experiences of emotional and physical neglect. The "PTSD," "CPTSD," and "CPTSD + Dissociation" classes were associated with a host of poor health outcomes, however, the "CPTSD + Dissociation" class had the poorest mental health and highest levels of functional impairment. Findings suggest that ICD-11 CPTSD symptoms can occur without corresponding dissociative experiences, however, when CPTSD symptoms and dissociative experiences occur together, health outcomes appear to be more severe. [ABSTRACT FROM AUTHOR]

Published
2024
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45. Co-developing, piloting, and evaluating a translational simulation (TS) delivery model for the promotion of psychological trauma-informed care (TIC) to improve service delivery within acute hospital settings: A Research Protocol

Author

Vallières, Frédérique, primary, Ward, Marie E, additional, Shields, Darragh, additional, Geary, Una, additional, Gardner, Caroline, additional, King, Dermot, additional, McCarthy, Gerry, additional, Conolly, John, additional, Brown, Joseph, additional, Wiedemann, Nana, additional, Staunton, Paul, additional, Halpin, Rory, additional, McGinty, Tara, additional, Brazil, Victoria, additional, Ali, Aliza, additional, Buckley, Alan, additional, Dowds, Joanne, additional, Lambert, Sharon, additional, McGarry, Sinead, additional, McLoughlin, Paul, additional, Murphy, Muireann, additional, Murphy, Rebecca, additional, O'Carroll, Austin, additional, Ryan, Meg, additional, Slattery, Sharon, additional, Sweeney, Eileen, additional, Swords, Mel, additional, Zihindula, Ganzamungu, additional, and NíCheallaigh, Clíona, additional

Published
2023
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