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Fidelity intervention

Dan Nguyen, David Thomas, Minsong Cao, Daniel O'Connor, James Lamb, Ke Sheng
PURPOSE: Magnetic resonance imaging (MRI)-guided Co-60 provides daily and intrafractional MRI soft tissue imaging for improved target and critical organ tracking. To increase delivery efficiency, the system uses three Co-60 sources at 120° apart, allowing up to 600 cGy combined dose rate at isocenter. Despite the potential tripling in output, creating a delivery plan that uses all three sources is considerably unintuitive. Here, the authors computerize the triplet orientation optimization using column generation, an approach that was demonstrated effective in integrated beam orientation and fluence optimization for noncoplanar therapies...
October 2016: Medical Physics
A Ntouva, R Sanatinia, R G Watt
INTRODUCTION: Primary care dentists are in a unique position to screen for alcohol misuse and provide brief advice to patients; however, lack of knowledge and confidence are some of the barriers cited for their reluctance to do so. AIMS: This study describes the evaluation of a novel brief alcohol advice training programme specifically designed and tailored to the needs of NHS general dental practitioners. MATERIALS AND METHODS: The training programme was developed as part of a feasibility trial and included a mixture of theoretical and practical elements...
October 26, 2016: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
Edward Ivor Broughton, Lani Marquez
There is little evidence to direct health systems toward providing efficient interventions to address medical errors, defined as an unintended act of omission or commission or one not executed as intended that may or may not cause harm to the patient but does not achieve its intended outcome. We believe that lack of guidance on what is the most efficient way to reduce medical errors and improve the quality of health-care limits the scale-up of health system improvement interventions. Challenges to economic evaluation of these interventions include defining and implementing improvement interventions in different settings with high fidelity, capturing all of the positive and negative effects of the intervention, using process measures of effectiveness rather than health outcomes, and determining the full cost of the intervention and all economic consequences of its effects...
2016: Frontiers in Public Health
Enrique Castro-Sánchez, Yiannis Kyratsis, Michiyo Iwami, Timothy M Rawson, Alison H Holmes
BACKGROUND: The uptake of improvement initiatives in infection prevention and control (IPC) has often proven challenging. Innovative interventions such as 'serious games' have been proposed in other areas to educate and help clinicians adopt optimal behaviours. There is limited evidence about the application and evaluation of serious games in IPC. The purposes of the study were: a) to synthesise research evidence on the use of serious games in IPC to support healthcare workers' behaviour change and best practice learning; and b) to identify gaps across the formulation and evaluation of serious games in IPC...
2016: Antimicrobial Resistance and Infection Control
Stacy Cooper Bailey, Michael K Paasche-Orlow, William G Adams, Samantha A Brokenshire, Ryan P Hickson, Christine U Oramasionwu, Laura M Curtis, Mary J Kwasny, Michael S Wolf
BACKGROUND: Adverse drug events (ADEs) affect millions of patients annually and place a significant burden on the healthcare system. The Food and Drug Administration (FDA) has developed patient safety information for high-risk medications that pose serious public health concerns. However, there are currently few assurances that patients receive this information or are able to identify or respond correctly to ADEs. OBJECTIVE: To compare the effectiveness of the Electronic Medication Complete Communication (EMC(2)) Strategy to promote safe medication use and reporting of ADEs in comparison to usual care...
October 21, 2016: Contemporary Clinical Trials
B M Donda, R J Hift, V S Singaram
BACKGROUND: In terms of the Nelson Mandela Fidel Castro Medical Collaboration programme, an agreement between the governments of South Africa and Cuba, cohorts of South African students receive their initial five years medical training at a Cuban university before returning to South Africa for a six to twelve months orientation before integration into the local final year class. It is common for these students to experience academic difficulty on their return. Frequently this is viewed merely as a matter of a knowledge deficit...
October 24, 2016: BMC Medical Education
Cathleen E Willging, Amy E Green, Mary M Ramos
BACKGROUND: Reducing youth suicide in the United States (U.S.) is a national public health priority, and lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) youth are at elevated risk. The Centers for Disease Control and Prevention (CDC) endorses six evidence-based (EB) strategies that center on meeting the needs of LGBTQ youth in schools; however, fewer than 6 % of U.S. schools implement all of them. The proposed intervention model, "RLAS" (Implementing School Nursing Strategies to Reduce LGBTQ Adolescent Suicide), builds on the Exploration, Preparation, Implementation, and Sustainment (EPIS) conceptual framework and the Dynamic Adaptation Process (DAP) to implement EB strategies in U...
October 22, 2016: Implementation Science: IS
Stacey Cutbush, Deborah Gibbs, Kathleen Krieger, Monique Clinton-Sherrod, Shari Miller
Fidelity of implementation is an essential factor in realizing outcomes of evidence-based interventions. Yet perspectives vary on the degree to which fidelity is necessary or desirable, implementers may receive limited guidance on fidelity, and research on implementers' understanding and operationalization of fidelity is lacking. We conducted key informant interviews with 20 individuals who implemented an evidence-based teen dating violence prevention curriculum in seven sites. Interviews addressed how implementers defined fidelity and the adaptations they made in implementing the curriculum...
October 20, 2016: Health Promotion Practice
Abdullah Turhan, Simone Onrust, Peter Ten Klooster, Marcel Pieterse
AIMS: To test effectiveness of the Healthy School and Drugs (HSD) program on tobacco and alcohol use in Dutch secondary special education (SE) schools, and whether this depends on subtypes of SE-schools and the level of implementation. DESIGN: In a quasi-experimental design with baseline and post-treatment follow-up 35 classes (N = 363) were allocated arbitrarily or depending on teacher motivation to either intervention condition (N = 205) or usual curriculum (N = 158)...
October 21, 2016: Addiction
C Huxley, J Achten, M L Costa, F Griffiths, X L Griffin
OBJECTIVES: The annual incidence of hip fracture is 620 000 in the European Union. The cost of this clinical problem has been estimated at 1.75 million disability-adjusted life years lost, equating to 1.4% of the total healthcare burden in established market economies. Recent guidance from The National Institute for Health and Clinical Excellence (NICE) states that research into the clinical and cost effectiveness of total hip arthroplasty (THA) as a treatment for hip fracture is a priority...
October 2016: Bone & Joint Research
Rena Zendedel, Barbara C Schouten, Julia C M van Weert, Bas van den Putte
OBJECTIVE: To explore the perspective of Turkish-Dutch general practitioner (GP) patients on informal interpreting from an integrated theory base, focusing on interpreters' roles, trust and power. DESIGN: Semi-structured in depth interviews were conducted with 21 first-generation Turkish-Dutch migrant patients who made use of informal interpreters to communicate with their GPs. An interview guide was designed based on the theoretical framework of interpreter's roles, trust and power, covering questions about interpreters' role, trust in informal/professional interpreters and power division in the medical consultation...
October 21, 2016: Ethnicity & Health
Lisa Jamieson, Julia Bradshaw, Herenia Lawrence, John Broughton, Kamilla Venner
OBJECTIVES: This paper assessed the fidelity of an early childhood caries MI intervention among Aboriginal mothers in South Australia. METHODS: Four MI-trained staff delivered the intervention and all interviews were recorded. A randomly selected subset (n = 164, 41.2%) were tested for MI fidelity using the Motivational Interviewing Treatment Integrity (MITI) code 3.1.1. A further randomly selected 20 taped sessions were additionally scored by an external expert to assess external reliability...
2016: Journal of Health Care for the Poor and Underserved
Joanna Granich, Alena Dass, Margherita Busacca, Dennis Moore, Angelika Anderson, Svetha Venkatesh, Thi Duong, Pratibha Vellanki, Amanda Richdale, David Trembath, Darin Cairns, Wendy Marshall, Tania Rodwell, Madeleine Rayner, Andrew J O Whitehouse
BACKGROUND: Evidence for early intensive behavioural interventions (EIBI) by therapists as an effective treatment for children with an Autism Spectrum Disorder (ASD) is growing. High-intensity and sustained delivery of quality EIBI is expensive. The TOBY (Therapy Outcomes by You) Playpad is an App-based platform delivering EIBI to facilitate learning for young children with ASD, while enabling parents to become co-therapists. Intervention targets include increasing joint attention, imitation and communication of children with ASD...
October 19, 2016: BMC Pediatrics
Karol Kumpfer, Catia Magalhães, Jing Xie
Family evidence-based interventions (FEBIs) are effective in creating lasting improvements and preventing children's behavioral health problems, even in genetically at-risk children. Most FEBIs, however, were designed for English-speaking families. Consequently, providers have difficulty engaging non-English-speaking populations in their own country or in other countries where the content, language, and recruitment methods of the FEBIs do not reflect their culture. The practical solution has been to culturally adapt existing FEBIs...
October 18, 2016: Prevention Science: the Official Journal of the Society for Prevention Research
Myriam Cielo Pérez, Nanor Minoyan, Valéry Ridde, Marie-Pierre Sylvestre, Mira Johri
BACKGROUND: Cluster randomised trials (CRTs) are a key instrument to evaluate public health interventions, particularly in low- and middle-income countries (LMICs). Fidelity assessment examines study processes to gauge whether an intervention was delivered as initially planned. Evaluation of implementation fidelity (IF) is required to establish whether the measured effects of a trial are due to the intervention itself and may be particularly important for CRTs of complex interventions...
October 19, 2016: Systematic Reviews
Dawn P Gill, Wendy Blunt, Ashleigh De Cruz, Brendan Riggin, Kate Hunt, Guangyong Zou, Shannon Sibbald, Karen Danylchuk, Merrick Zwarenstein, Cindy M Gray, Sally Wyke, Christopher Bunn, Robert J Petrella
BACKGROUND: Effective approaches that engage men in weight loss and lifestyle change are important because of worldwide increases, including in Canada, in obesity and chronic diseases. Football Fans in Training (FFIT), developed in Scotland, successfully tackled these problems by engaging overweight/obese male football fans in sustained weight loss and positive health behaviours, through program deliveries at professional football stadia. METHODS: Aims: 1) Adapt FFIT to hockey within the Canadian context and integrate with HealtheSteps™ (evidence-based lifestyle program) to develop Hockey Fans in Training (Hockey FIT); 2) Explore potential for Hockey FIT to help overweight/obese men lose weight and improve other outcomes by 12 weeks, and retain these improvements to 12 months; 3) Evaluate feasibility of recruiting and retaining overweight/obese men; 4) Evaluate acceptability of Hockey FIT; and 5) Conduct program optimization via a process evaluation...
October 19, 2016: BMC Public Health
Jay Thakkar, Ganesan Karthikeyan, Gaurav Purohit, Swetha Thakkar, Jitender Sharma, Sunilkumar Verma, Neeraj Parakh, Sandeep Seth, Sundeep Mishra, Rakesh Yadav, Sandeep Singh, Rohina Joshi, Aravinda Thiagalingam, Clara K Chow, Julie Redfern
BACKGROUND: Coronary heart disease (CHD) is a leading cause of morbidity and mortality in India. Text message based prevention programs have demonstrated reduction in cardiovascular risk factors among patients with CHD in selected populations. Customisation is important as behaviour change is influenced by culture and linguistic context. OBJECTIVES: To customise a mobile phone text message program supporting behaviour and treatment adherence in CHD for delivery in North India...
2016: Heart Asia
Mark Xavier Cicero, Travis Whitfill, Frank Overly, Janette Baird, Barbara Walsh, Jorge Yarzebski, Antonio Riera, Kathleen Adelgais, Garth D Meckler, Carl Baum, David Christopher Cone, Marc Auerbach
OBJECTIVE: Paramedics and emergency medical technicians (EMTs) triage pediatric disaster victims infrequently. The objective of this study was to measure the effect of a multiple-patient, multiple-simulation curriculum on accuracy of pediatric disaster triage (PDT). METHODS: Paramedics, paramedic students, and EMTs from three sites were enrolled. Triage accuracy was measured three times (Time 0, Time 1 [two weeks later], and Time 2 [6 months later]) during a disaster simulation, in which high and low fidelity manikins and actors portrayed 10 victims...
October 17, 2016: Prehospital Emergency Care
Elizabeth Murray, Eric B Hekler, Gerhard Andersson, Linda M Collins, Aiden Doherty, Chris Hollis, Daniel E Rivera, Robert West, Jeremy C Wyatt
Digital health interventions have enormous potential as scalable tools to improve health and healthcare delivery by improving effectiveness, efficiency, accessibility, safety, and personalization. Achieving these improvements requires a cumulative knowledge base to inform development and deployment of digital health interventions. However, evaluations of digital health interventions present special challenges. This paper aims to examine these challenges and outline an evaluation strategy in terms of the research questions needed to appraise such interventions...
November 2016: American Journal of Preventive Medicine
M Hirschvogel, M Bassilious, L Jagschies, S M Wildhirt, M W Gee
A model for patient-specific cardiac mechanics simulation is introduced, incorporating a 3-dimensional finite element model of the ventricular part of the heart which is coupled to a reduced-order 0-dimensional closed-loop vascular system, heart valve and atrial chamber model.The ventricles are modeled by a nonlinear orthotropic passive material law. The electrical activation is mimicked by a prescribed parametrized active stress acting along a generic muscle fiber orientation. Our activation function is constructed such that the start of ventricular contraction and relaxation as well as the active stress curve's slope are parameterized...
October 15, 2016: International Journal for Numerical Methods in Biomedical Engineering
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