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"Realist evaluation"

Philipp Mahrenholtz, Rolf Eligehausen, Tara C Hutchinson, Matthew S Hoehler
Cyclic loads are a characteristic feature of actions acting on structures and anchorages during earthquakes. For this reason, seismic qualification of post-installed concrete anchors according to the internationally recognized American Concrete Institute (ACI) standard ACI 355 is based on cyclic load tests. The protocols for these tests, however, have limited scientific basis. Therefore, in the present paper newly-developed test protocols with stepwise-increasing load amplitudes are utilized to more realistically evaluate anchor seismic performance...
September 2016: ACI Struct J
Laura Desveaux, Payal Agarwal, Jay Shaw, Jennifer M Hensel, Geetha Mukerji, Nike Onabajo, Husayn Marani, Trevor Jamieson, Onil Bhattacharyya, Danielle Martin, Muhammad Mamdani, Lianne Jeffs, Walter P Wodchis, Noah M Ivers, R Sacha Bhatia
BACKGROUND: Management of diabetes through improved glycemic control and risk factor modification can help prevent long-term complications. Much diabetes management is self-management, in which healthcare providers play a supporting role. Well-designed e-Health solutions targeting behavior change can improve a range of measures, including glycemic control, perceived health, and a reduction in hospitalizations. METHODS: The primary objective of this study is to evaluate if a mobile application designed to improve self-management among patients with type 2 diabetes (T2DM) improves glycemic control compared to usual care...
November 15, 2016: BMC Medical Informatics and Decision Making
Brynne Gilmore, Eilish McAuliffe, Fiona Larkan, Magnus Conteh, Nicola Dunne, Michele Gaudrault, Henry Mollel, Nazarius Mbona Tumwesigye, Frédérique Vallières
INTRODUCTION: The proposed research is part of ongoing operations research within World Vision's Access: Infant and Maternal Health Programme. This study aims to identify key context features and underlying mechanisms through which community health committees build community capacity within the field of maternal and child health. This may help to improve programme implementation by providing contextually informed and explanatory findings for how community health committees work, what works best and for whom do they work for best for...
November 2, 2016: BMJ Open
Jennifer M Hensel, Jay Shaw, Lianne Jeffs, Noah M Ivers, Laura Desveaux, Ashley Cohen, Payal Agarwal, Walter P Wodchis, Joshua Tepper, Darren Larsen, Anita McGahan, Peter Cram, Geetha Mukerji, Muhammad Mamdani, Rebecca Yang, Ivy Wong, Nike Onabajo, Trevor Jamieson, R Sacha Bhatia
BACKGROUND: Mental illness is a substantial and rising contributor to the global burden of disease. Access to and utilization of mental health care, however, is limited by structural barriers such as specialist availability, time, out-of-pocket costs, and attitudinal barriers including stigma. Innovative solutions like virtual care are rapidly entering the health care domain. The advancement and adoption of virtual care for mental health, however, often occurs in the absence of rigorous evaluation and adequate planning for sustainability and spread...
October 18, 2016: BMC Psychiatry
Marita Hefler, Robyn Hopkins, David P Thomas
OBJECTIVES: In 2013, the Northern Territory was the first Australian jurisdiction to introduce a smoke-free policy for all correctional facilities. We report on a process evaluation to identify what worked well, key challenges and unintended consequences. METHODS: We interviewed 87 people, comprising remand, medium-security and low-security prisoners; visiting family members; and prison staff (including prison management and health workers). A realist evaluation approach was used...
April 15, 2016: Public Health Research & Practice
Julia E Moore, Sami Uka, Joshua P Vogel, Caitlyn Timmings, Shusmita Rashid, A Metin Gülmezoglu, Sharon E Straus
BACKGROUND: Although there are a growing number of initiatives aimed at supporting guideline implementation in resource-constrained settings, few studies assess progress on achieving next steps and goals after the initial activities are completed and the initial funding period has ended. The aim of the current study was to conduct a qualitative process evaluation of progress, barriers, facilitators, and proposed solutions to operationalize nine recommendations to prepare Kosovo to implement the 2012 World Health Organization (WHO) prevention and treatment of postpartum haemorrhage guideline...
2016: BMC Public Health
Louise Caffrey, David Wyatt, Nina Fudge, Helena Mattingley, Catherine Williamson, Christopher McKevitt
OBJECTIVES: Gender inequity has persisted in academic medicine. Yet equity is vital for countries to achieve their full potential in terms of translational research and patient benefit. This study sought to understand how the gender equity programme, Athena SWAN, can be enabled and constrained by interactions between the programme and the context it is implemented into, and whether these interactions might produce unintended consequences. DESIGN: Multimethod qualitative case studies using a realist evaluation approach...
2016: BMJ Open
Animesh Pan, Tanmoy Kar, Animesh K Rakshit, Satya P Moulik
The "enthalpy-entropy compensation" (EEC) effect has been a long-standing fascinating yet unresolved phenomenon in chemical thermodynamics. The reasons for the observation of EEC are not clear. Various views such as empirical, extrathermodynamic, error-related, solvation, and so forth as reasons for the H/S linear correlation are floating. Statistical reasons and a hidden Carnot's cycle (involving microscopic "heating and cooling" machines) have also been proposed recently for the observation of EEC. In this work, we have attempted a different line of approach to understand and explain the phenomenon...
October 3, 2016: Journal of Physical Chemistry. B
Ferdinand C Mukumbang, Sara van Belle, Bruno Marchal, Brian van Wyk
BACKGROUND: The antiretroviral adherence club intervention was rolled out in primary health care facilities in the Western Cape province of South Africa to relieve clinic congestion, and improve retention in care, and treatment adherence in the face of growing patient loads. We adopted the realist evaluation approach to evaluate what aspects of antiretroviral club intervention works, for what sections of the patient population, and under which community and health systems contexts, to inform guidelines for scaling up of the intervention...
2016: PloS One
Sadiq Bhanbhro, Melanie Gee, Sarah Cook, Louise Marston, Melanie Lean, Helen Killaspy
BACKGROUND: Long-term change in recovery-based practice in mental health rehabilitation is a research priority. METHODS: We used a qualitative case study analysis using a blend of traditional 'framework' analysis and 'realist' approaches to carry out an evaluation of a recovery-focused staff training intervention within three purposively selected mental health rehabilitation units. We maximised the validity of the data by triangulating multiple data sources. RESULTS: We found that organisational culture and embedding of a change management programme in routine practice were reported as key influences in sustaining change in practice...
2016: BMC Psychiatry
Brynne Gilmore, Ben Jack Adams, Alex Bartoloni, Bana Alhaydar, Eilish McAuliffe, Joanna Raven, Miriam Taegtmeyer, Frédérique Vallières
INTRODUCTION: Understanding what enhances the motivation and performance of community health workers (CHWs) in humanitarian emergencies represents a key research gap within the field of human resources for health. This paper presents the research protocol for the Performance ImprovEment of CHWs in Emergency Settings (PIECES) research programme. Enhancing Learning and Research in Humanitarian Action (ELRHA) funded the development of this protocol as part of their Health in Humanitarian Crises (R2HC) call (No...
2016: BMJ Open
Karl Blanchet, James J Lewis, Francisco Pozo-Martin, Arsene Satouro, Serge Somda, Patrick Ilboudo, Sophie Sarrassat, Simon Cousens
BACKGROUND: Burkina Faso introduced the Integrated Management of Childhood Illnesses (IMCI) strategy in 2003. However, an evaluation conducted in 2013 found that only 28 % of children were assessed for three danger signs as recommended by IMCI, and only 15 % of children were correctly classified. About 30 % of children were correctly prescribed with an antibiotic for suspected pneumonia or oral rehydration salts (ORS) for diarrhoea, and 40 % were correctly referred. Recent advances in information and communication technologies (ICT) and use of electronic clinical protocols hold the potential to transform healthcare delivery in low-income countries...
2016: Implementation Science: IS
Steve Iliffe, Nathan Davies, Jill Manthorpe, Peter Crome, Sam H Ahmedzai, Myrra Vernooij-Dassen, Yvonne Engels
BACKGROUND: There is a gap between readily available evidence of best practice and its use in everyday palliative care. The IMPACT study evaluated the potential of facilitated use of Quality Indicators as tools to improve palliative care in different settings in England. METHODS: 1) Modelling palliative care services and selecting a set of Quality Indicators to form the core of an intervention, 2) Case studies of intervention using the Quality Indicator set supported by an expert in service change in selected settings (general practice, community palliative care teams, care homes, hospital wards, in-patient hospices) with a before-and-after evaluation, and 3) realist evaluation of processes and outcomes across settings...
2016: BMC Palliative Care
S Witter, C Boukhalfa, J A Cresswell, Z Daou, V Filippi, R Ganaba, S Goufodji, I L Lange, B Marchal, F Richard
BACKGROUND: Across the Africa region and beyond, the last decade has seen many countries introducing policies aimed at reducing financial barriers to obstetric care. This article provides evidence of the cost and effects of national policies focussed on improving financial access to caesarean and facility deliveries in Benin, Burkina Faso, Mali and Morocco. METHODS: The study uses a comparative case study design with mixed methods, including realist evaluation components...
2016: International Journal for Equity in Health
Rob Anderson, Rebecca Hardwick
To be successfully and sustainably adopted, policy-makers, service managers and practitioners want public programmes to be affordable and cost-effective, as well as effective. While the realist evaluation question is often summarised as what works for whom, under what circumstances, we believe the approach can be as salient to answering questions about resource use, costs and cost-effectiveness - the traditional domain of economic evaluation methods. This paper first describes the key similarities and differences between economic evaluation and realist evaluation...
July 2016: Evaluation: the International Journal of Theory, Research and Practice
Adam Fletcher, Farah Jamal, Graham Moore, Rhiannon E Evans, Simon Murphy, Chris Bonell
The integration of realist evaluation principles within randomised controlled trials ('realist RCTs') enables evaluations of complex interventions to answer questions about what works, for whom and under what circumstances. This allows evaluators to better develop and refine mid-level programme theories. However, this is only one phase in the process of developing and evaluating complex interventions. We describe and exemplify how social scientists can integrate realist principles across all phases of the Medical Research Council framework...
July 2016: Evaluation: the International Journal of Theory, Research and Practice
S McHugh, M L Tracey, F Riordan, K O'Neill, N Mays, P M Kearney
BACKGROUND: Over the last three decades in response to the growing burden of diabetes, countries worldwide have developed national and regional multifaceted programmes to improve the monitoring and management of diabetes and to enhance the coordination of care within and across settings. In Ireland in 2010, against a backdrop of limited dedicated strategic planning and engrained variation in the type and level of diabetes care, a national programme was established to standardise and improve care for people with diabetes in Ireland, known as the National Diabetes Programme (NDP)...
2016: Implementation Science: IS
Aku Kwamie, Juliet Nabyonga-Orem
BACKGROUND: Harmonisation is a key principle of the Paris Declaration. The Universal Health Coverage (UHC) Partnership, an initiative of the European Union, the Government of Luxembourg and the World Health Organization, supported health policy dialogues between 2012 and 2015 in identified countries in the WHO African Region. The UHC Partnership has amongst its key objectives to strengthen national health policy development. In Guinea and Chad, policy dialogue focused on elaborating the national health plan and other key documents...
2016: BMC Health Services Research
Vivian A Welch, Andrea C Tricco
An increasing number of realist evaluations are being conducted from a wide range of disciplinary perspectives and with diverse, fit-for-purpose methods. This commentary discusses the recent BMC Medicine publication of RAMESES II reporting guidelines for realist evaluations. Knowledge users such as program implementers and decision-makers will benefit from the increased transparency of reporting and interpretation in light of the totality of evidence encouraged by this guidance. It is hoped that these reporting guidelines will eventually lead to improved knowledge synthesis and contribute to the cumulative science regarding realist evaluation...
July 21, 2016: BMC Medicine
Martin Scaiano, Grant Middleton, Luk Arbuckle, Varada Kolhatkar, Liam Peyton, Moira Dowling, Debbie S Gipson, Khaled El Emam
OBJECTIVES: It has become regular practice to de-identify unstructured medical text for use in research using automatic methods, the goal of which is to remove patient identifying information to minimize re-identification risk. The metrics commonly used to determine if these systems are performing well, do not accurately reflect the risk of a patient being re-identified. We present a framework for measuring the risk associated with textual data releases. METHODS: We apply the proposed evaluation framework to a data set from the University of Michigan Medical School...
July 14, 2016: Journal of Biomedical Informatics
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