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Triyana, Margaret M. "The effects of household and community-based interventions| Evidence from Indonesia." Thesis, The University of Chicago, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3568431.
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Low birth weight is a global health problem, especially in developing countries. Approximately 16% of all new-borns in developing countries were born with low birth weight. Motivated by this troublesome fact, this research evaluates policies that target maternal and children's health in low-resource settings. The following three essays analyze community-based and household-based health interventions. Program evaluation is important to inform future policy, and more importantly, to compare policies in order to determine the most effective strategies to improve birth outcomes in developing countries. Indonesia has implemented both community-based and household-based interventions. The three essays in this research evaluate the following three programs. The first two essays evaluate two recent programs: a household-based program, Program Keluarga Harapan (PKH), and a community-based program, PNPM Generasi Sehat dan Cerdas (Generasi ). The third essay evaluates the 'Midwife in the Village' ( Bidan di Desa) program. The 'Midwife in the Village' program is a community-based program that was implemented in the 1980s to provide each village with a trained midwife to provide prenatal care and delivery assistance. The other two programs, PKH and Generasi, were piloted in 2007. PKH is a household Conditional Cash-Transfer (CCT) program, while Generasi, functions a community CCT program; the community CCT program provides villages with block grants to fund activities that promote health and education.
The first essay analyzes the effects of Indonesia's household CCT program on the price and quality of health care services, and how these changes affect poor households. In this paper, I focus on price changes in the health care market because it is directly affected by the program and health care providers may increase prices in response to increased demand. The program is associated with higher utilization of health care, driven by increased utilization among the poor, who also experience higher quality of care. The quality improvement in the target population is driven by increased utilization, and not an improvement in quality at the local health care market. In response to the demand shock from the CCT program, I find a price increase in sub-districts that are randomized into treatment, which suggests the importance of supply response in demand-side interventions.
The second essay compares the relative effectiveness of household CCT and community CCT programs in improving birth outcomes in similar communities. Both programs have been shown to improve health-seeking behavior, but it has not been established whether these indicators translate into improved birth outcomes. To select comparable communities, the sample is restricted to areas with similar characteristics using propensity score matching. Under matching, both programs increase health seeking behavior, but there is no significant change in low birth weight. However, the household CCT program reduces preterm birth. The matching estimates suggest that the targeted household CCT program is more effective in improving birth outcomes than the broad community-based program, even though both programs improve health-seeking behavior.
The third essay analyzes the impact of the 'Midwife in the Village' program in rural Indonesia. In this essay, I extend earlier research by Frankenberg and Thomas (FT, 2001) on the effect of gaining a midwife in the village. FT find improvements in women's health status and birth weight. Using additional data, this essay estimates the longer term effect of midwife presence and the effect of losing the village midwife after the 1998 financial crisis. The effects of gaining a midwife are qualitatively similar to FT's estimates, but they are not statistically significant, which suggests that the program effects diminish over time. I find that losing a midwife has no statistically significant effect on women's health status or low birth weight. These results suggest that the program was effective in maintaining the health status of rural communities.
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Ballard, Madeleine. "Community health workers : efficacy, taxonomy, and performance." Thesis, University of Oxford, 2016. https://ora.ox.ac.uk/objects/uuid:0958a784-e5a1-432f-8980-6f65d93e698f.
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Background: This thesis presents an empirical investigation into the efficacy, types, and performance of community health workers (CHWs)-trained lay people to whom simple medical procedures can be "task shifted" from doctors. It has three objectives: (1) assess the effects of CHW delivered interventions for primary health outcomes in low-and middle-income countries (LMICs), (2) develop a comprehensive taxonomy of CHW characteristics and programme design features, and (3) assess the relative efficacy of different types of CHW programme designs and how they can be used to optimise CHW performance. Structure and Methods: Following the logic of early stage intervention development, this thesis has an iterative and developmental structure in which each section flows out of and builds on the previous section. Objective one is addressed in Chapters 2-4: scoping review, systematic review, and meta-analytic methods are applied to establish the efficacy and effectiveness of CHW-led interventions in LMICs. Objective two is addressed in Chapter 5: inductive, thematic analysis of systematically identified trials, influential papers, and existing information classification systems is used to develop a formal CHW taxonomy for intervention reporting and coding. Objective three is addressed in Chapter 6: systematic review methods are employed to identify interventions for improving the performance of community health workers in LMICs. Results: Objective one: a systematic review of 155 papers reporting 86 trials found high quality evidence that CHW delivered interventions reduce perinatal mortality, improve child nutritional status, and improve tuberculosis completion rates versus facility-based care. There is also moderate quality evidence that CHW delivered interventions improve certain mental, infectious disease, paediatric, and maternal health outcomes. In undertaking this process, an additional, methodological contribution was made in the form of a tool to reduce risk of bias in overviews of reviews. This tool may facilitate early stage intervention development in the future. Objective two: 253 records were used to establish, in a faceted taxonomy, the definitional clarity required for theory building and knowledge accumulation. Two categories (CHW Characteristics and CHW Programme Features) and six dimensions (Integration, Recruitment, Training, Supervision, Incentives, and Equipment) emerged. Objective three: a systematic review of 14 trials identified moderate quality evidence of the efficacy of CHW performance interventions in improving certain behavioural outcomes for patients, utilisation of services, and CHW quality of care. There was no effect on the biological outcomes of interest. Conclusion: In bringing the tools of evidence based practice to bear on community health worker interventions, this dissertation has contributed to the theoretical, methodological, and empirical evidence base from which the field can continue to advance.
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Fennessy, Gabrielle Ann 1968. "Knowledge management in evidence based practice : study of a community of practice." Monash University, School of Information Management and Systems, 2002. http://arrow.monash.edu.au/hdl/1959.1/8023.
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Cuddy, Janet Brooke. "Development of an Evidence-Based Nursing Orientation Program for a Community Health System." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/748.
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Through discussion with the community health system's administration, it was identified that their current nursing orientation program was not well structured or comprehensive. The nursing staff also reported dissatisfaction with the current program. Therefore, a Doctor of Nursing Practice project commenced to develop an evidence-based nursing orientation program for Registered Nurses (RN) and Licensed Practical Nurses (LPN) at a community health system in Virginia. The Competency Outcomes Performance Assessment model guided development of the project through a comprehensive literature review to identify evidence-based data for competencies, learning strategies, and performance evaluations. This review highlighted the importance and benefits of nursing orientation programs as well as the use of evidence-based strategies. As a result of this review, an evidence-based nursing orientation program was developed to meet the needs of the nursing staff as well as the organization. The evidence-based nursing orientation program was translated into an electronic format with an accompanying manual to be used when nurses are hired by the community health system. An advisory board from the organization reviewed the program and their feedback was incorporated. Social change is expected to occur, as nurses will be better prepared for their new position with increased job satisfaction and also to provide optimal care to patients from the community. This project addressed a gap in the literature for generalized nursing orientation programs. Publication in a peer-reviewed journal or oral presentation at the Virginia Community Healthcare Association annual conference was selected for project dissemination.
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Gleicher, Lily R. "Staff Perceptions of an Evidence-based Supervision Model: Implementing Effective Practices in Community Supervision (EPICS)." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1544100753824542.
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Taylor, Liana. "General Responsivity and Evidence-Based Treatment: Individual and Program Predictors of Treatment Outcomes during Adolescent Outpatient Substance Abuse Treatment." Diss., Temple University Libraries, 2014. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/308423.
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Criminal JusticePh.D.
Since it was first articulated, the Risk-Need-Responsivity model (RNR; Andrews, Bonta, & Hoge, 1990) has been extensively researched and is regarded as an empirically supported model for providing effective correctional treatment. It is comprised of three core principles: the risk principle, which provides direction for who should receive treatment; the need principle, which identifies intermediate treatment targets; and the responsivity principle, which states how treatment programs should be structured. The RNR model is purported to be relevant for all offender populations, including female offenders (Dowden & Andrews, 1999a), juvenile offenders (Dowden & Andrews, 1999b), violent offenders (Dowden & Andrews, 2000), and sexual offenders (Hanson, Bourgon, Helmus, & Hogdson, 2009). Yet, the majority of RNR research has examined the risk and need principles, and the responsivity principle remains understudied. The responsivity principle includes two sub-principles: general and specific (Andrews, & Bonta, 2010). The current research explored the general responsivity principle, which states that programs should use theoretically relevant models for individual change, specifically cognitive-behavioral and cognitive-social learning models (Andrews & Bonta, 2010). The following techniques are consistent with these models: "role-playing, modeling, repeated practice of alternative behaviors, cognitive restructuring to modify thoughts/emotions, skills building, or reinforcement" (Andrews & Bonta, 2010, p. 50). Despite empirical support, the RNR model has received minimal application to juveniles, and it has not been widely tested in the substance abuse treatment context. Additionally, it is not clear whether adherence to the RNR model is relevant for reducing substance use outcomes in youth. Adolescent substance abuse treatment programs were designed to address substance use among juveniles, and have been widely researched to determine their effectiveness; yet their effectiveness remains understudied among juvenile offenders. These studies include examinations of specific treatment interventions used, such as Multisystemic Therapy. Many of these interventions are considered to be "evidence-based treatment" (EBT), but there is a wide variety of repositories that classify interventions as "evidence-based" with varying criteria used to classify them. The juvenile drug treatment court model (JDTC) was specifically developed to address substance use and crime among juvenile offenders; however, findings from empirical studies have not demonstrated a strong treatment effect. To address these gaps in the literature, secondary analyses were conducted on data collected from 132 adolescent outpatient substance abuse treatment programs (AOPs) and 10 juvenile drug treatment courts nationwide. This research was an application of the general responsivity principle in the AOP and JDTC context to determine the impact of responsivity adherence on the odds of rearrest and substance use severity. The analyses also included an examination of evidence-based treatment (EBT) in both samples to determine the influence of EBT use scores on the odds of rearrests and substance use severity scores. To examine the AOP sample, multilevel models were used to examine the individual- and program-level impact of responsivity adherence and EBT use. To examine the JDTC sample, multivariate analyses were used to examine the individual-level impact of responsivity adherence and EBT use. Overall, responsivity adherence was not significantly associated with rearrests among AOP participants, nor was it significantly associated with substance use severity scores. Additionally, the odds of rearrest were significantly greater among individuals who received interventions with a higher EBT use score; though, there was no association between the average EBT use scores across programs and the odds of rearrest. There was no significant association between individual- and program-level EBT use scores and substance use severity. Among JDTC participants, an increase in responsivity adherence was associated with an increase in the odds of rearrest and substance use severity. A similar association emerged between EBT use scores and both outcomes, wherein increases in EBT use scores were significantly associated with an increase in the odds of rearrest and substance use severity. The results of the analyses suggest the need for further specification of both general responsivity adherence and "evidence-based" treatment for use in future research and theory; specifically, further elaboration of the general responsivity-adherent techniques and clear criteria for classifying interventions as "evidence-based treatment." The findings also imply that certain types of treatment interventions are more compatible with the JDTC model than other interventions. Additional analyses suggest the possibility that general responsivity adherence and evidence-based treatment may not be unique constructs. Future research may benefit through exploring evidence-based treatment as a criterion for adherence to the general responsivity principle.
Temple University--Theses
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Quinoy, Alexis. "Adapting Evidence-Based Treatments for Youth in a Community Mental Health Setting: Single Case Design." VCU Scholars Compass, 2011. http://scholarscompass.vcu.edu/etd/2394.
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This single-case design study examined the effectiveness of adapting evidence-based treatments (EBTs) for children in a community clinic through a university-community partnership. Community clinic therapists treated eight youths (five males), ages 10 to 14, of whom four were Caucasian, two were Latino, one was African-American, and one was Caucasian/African-American. Youths presented with a primary diagnosis of a DSM-IV (American Psychiatric Association, 1994) internalizing disorder (plus multiple comorbidities). An adapted treatment combining multiple elements based on two primary treatment manuals: Coping Cat (Kendall et al., 1990) and PASCET (Weisz et al., 1999) was used. Youths with comorbid externalizing symptoms were also treated with elements from a parent-training manual (Barkley, 1997). Results of visual and clinical significance analysis demonstrated mixed support for the adapted treatment in a community clinic setting. The findings support further efforts to test the effectiveness of adapted EBTs in a community clinic setting and population.
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Velenyi, Edit V. "Modeling demand for community-based health insurance : an analytical framework and evidence from India and Nigeria." Thesis, University of York, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.550247.
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The thesis offers three primary contributions to the evidence base on demand for community-based health insurance (CB HI): (i) a review of the literature; (ii) an extended analytical framework to guide empirical investigations of demand for CBHI; and (iii) applied analyses to test the hypothesis regarding the relevance and fit of the proposed extension, and explore central positive and normative questions related to demand for CBHI by low-income groups in India and Nigeria. Chapter 2 offers an appraisal of the empirical and theoretical literature on demand for CBHI. Consequently, it proposes an extended analytical framework, which includes vectors of covariates at the household, CBHI, community, and state levels. More importantly, it proposes to test the relevance of social capital in models for demand estimation of CBHI. This extension places the central thrust of the thesis at the intersection of insurance theory and development economics. Chapter 3 exploits cross-sectional household data to apply the proposed extended framework to draw inferences on the nature of demand for micro insurance in India. Results from discrete choice and linear models show that the additional vectors have an impact on choice. While our social capital measures are not robust, the model statistics suggest that the community vector plays a role in demand. Chapter 4 explores demand to understand the market potential of a pilot in Lagos. The analysis draws on household and provider data. The results are more robust in terms of the number of significant covariates and their economic effects than those found in India. As a result, there is stronger and more decomposed evidence on the importance of the extended sets of covariates. Heckman, bivariate and multivariate models show significant effects for the CBHI and community vectors that have larger marginal effects than those observed in the household vector. The investigation offers a methodological insight into the double bounded dichotomous choice contingent valuation method. The evidence from these empirical analyses corroborates the relevance of the extended framework. We found that using the individual and household-level vector alone to estimate demand for CBHI is detached from reality and leads to model misspecification. Although the analyses are hampered by data limitations, the economic effects of the additional vectors are substantial. Understanding the role of social capital could improve the impact of community-based interventions. While there is evidence of interest in insurance even among the poor, the economic size of contributions from low-income groups in absolute terms is limited. However, their individual and household efforts are not negligible, as the stated reservation prices constitute a significant share of their household consumption. These facts imply that, while low-income households value insurance and coverage is demanded, their financial constraints may constitute a price barrier if the premiums are not subsidized. The thesis identifies critical gaps for future investigation: (i) combining analytical approaches (ii) improving measurement of factors; (iii) expanding the geographic scope of research on CB HI, especially in countries where community-based resource mobilization is a policy priority, in order to improve the external validity of findings and, consequently the value of information for design and policy making.
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Lukeman, Sionnach. "Understanding Evidence-Informed Decision-Making in a Community-Based Network Working Towards the Baby Friendly Initiative." Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/24401.
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Objective: To understand the use of evidence-informed decision-making within an interorganizational network, and identify the facilitators and barriers to achieving network goals.
Design: Case study.
Setting: Rural health district in Nova Scotia, Canada (2006 to 2011).
Participants: Members from 4 organizations representing community and hospital groups participating in a regional Baby Friendly Initiative network.
Methods: A descriptive mixed methods study using focus group and questionnaire methodology. Data were analyzed using framework analysis and social network analysis (SNA).
Results: The SNA results highlighted the role that relationships have on the sharing of knowledge among network members. The findings highlight the need for leadership at multiple levels (community, network members, primary organizations, and the provincial government). A lack of resources to achieve the network’s goals was a key barrier. Conclusions: The role of multi-level leadership is important for future network development and community consideration. The case study methodology facilitated momentum towards the network’s goals.
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Schultz, Abby, L. Crosnoe-Shipley, Brett T. Morgan, and Ivy A. Click. "Improving Evidence Based Practices of Long Acting Reversible Contraceptives in a Rural Community of Northeast Tennessee." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6411.
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INTRODUCTION: Intrauterine devices (IUDs) and implants have been shown to decrease the rate of unintended pregnancies. These methods also known as Long Acting Reversible Contraceptives (LARCs) are considered the birth control of choice for women of childbearing age, including adolescents, from multiple professional medical associations. However, even with strong recommendations, LARCs are widely underused in the United States, especially in rural areas. This research is based in the Rural Health Services Consortium (RHSC) clinic in Rogersville, Tennessee. This research looks at knowledge and use of LARCs in this clinic before and after receiving training in IUD and implant insertion and removal. METHODS: The physicians, nurse practitioners and physician assistants affiliated with the Rural Health Services Consortium were invited to attend both an IUD and an Implant training. Those who agreed to participate in the study were asked to complete a survey, which addressed current knowledge of LARCs, contraceptive counseling practice and LARC referral practice. Surveys were de-identified and linked to each individual provider through a person specific randomized code. Providers were then trained and certified in the insertion and removal of both IUDs and Implants. Following training the providers provided a survey assessing any change in knowledge and intended practice. At three and six months the same providers will be given an additional surveys with their individualized codes. These surveys assessed the providers' knowledge of LARCs and current practice regarding contraceptive counseling and LARC referral. All survey data was compiled and analyzed for statistical significance using paired T tests. Data was analyzed to identify significant changes in knowledge or practice following training. RESULTS: A t-test revealed a statistically significant increase in provider comfort level with discussing the risks and benefits associated with both IUDs (pretest M=1.92, posttest M=2.92, t = -3.09, p<.01) and implants (pretest M = 1.83, posttest M = 2.83, t = -2.76, p< .05). Regarding practice behavior, a t-test found a statistically significant increase in provider recommendation/discussion of Mirena/Skyla (pretest M= 2.09, posttest M= 3.08, t = -2.14, p<.05) and implants (pretest M = 2.25,
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Cearfoss, Christine. "Los Angeles Community-Based Associate Social Workers' Understanding of Culture and Therapy." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6538.
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Social workers have no clear professional guidelines about the application of culturally competent mental health service delivery. Without culturally competent mental health service delivery, clients from diverse cultures do not access needed mental health services and they experience less effective therapy treatment outcomes and overall disparity of service delivery throughout the therapeutic process. The purpose of this descriptive case study was to better understand how community-based social workers are delivering culturally competent services to clients. The theoretical framework for the study was multiculturalism and the primary research questions addressed how associate clinical social workers who provide in-home mental health services in Los Angeles deliver culturally competent services to their clients. Through 8 interviews with associate clinical social workers, this descriptive case study revealed that without clear direction on what culturally competent services are, or how to deliver them, social workers are using a combination of personal experience and personal culture, educational and practice knowledge, and in some cases no attention to culture, to meet the mental health needs of their clients. This study emphasized the need for an industry wide understanding of the term cultural competency, so it could serve as the frame of reference by which practice professional skill level could be assessed, practice protocols measured, and could lead to social change through greater access to counseling services for clients.
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Bonner, Brooke Alexis. "AMERICAN SIGN LANGUAGE CORE STANDARDS AND EVIDENCE BASED INSTRUCTION." Miami University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=miami1397302571.
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Majethia, Nita. "The epidemiology of common symtoms in the community : developing an evidence-based methodological approach to data collection." Thesis, University of Aberdeen, 2010. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=167808.
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Introduction Symptoms are universally experienced and can be bothersome. There have been comparatively few studies of common symptoms in the UK general population. As a result, little is known about the current epidemiology of common symptoms in the UK. There are major methodological challenges to conducting an epidemiological study of common symptoms in the community. Current knowledge about the most appropriate methodological tools for collecting and interpreting data on symptoms is limited. A range of methods has been used in previous studies, but the most appropriate method is not known. An evaluation of the different methods that could be used for investigating common symptoms in the community was therefore required. Aims The overall aim of this study was to investigate and compare the use of different approaches to collecting epidemiological data on common symptoms, with a view to developing an evidence-base for the use of these different approaches. Methods A general review of methods used in epidemiological studies and a comprehensive review of methods used in previous epidemiological studies of symptoms were undertaken. The reviews informed the development of symptoms survey. Symptoms survey was conducted to collect epidemiological data on common symptoms in the community. A total of 1179 individuals was approached from four GP practices in the Aberdeen area and sent an invitation letter, information sheet and consent form. Potential participants were requested to select at least two data collection instruments from four options (postal questionnaire, diary, online questionnaire and telephone interview). All the instruments collected the same data (presence of symptoms, severity of symptoms, management of symptoms and quality of life). This allowed a direct comparison of the data collected by the various measures. Those agreeing to participate in the study were sent one of their chosen instruments in phase one of the study and a second (but different) one of their chosen instruments in phase two, which was conducted three weeks later.
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Parvaneh, Shahriar. "Evidence-based evaluation of programme interventions to achieve positive community integration outcomes for adults with acquired brain injury." Thesis, Curtin University, 2010. http://hdl.handle.net/20.500.11937/808.
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Background. The growing population of people with acquired brain injury (ABI) requires a strong focus on clients to be integrated into the community in order to use their productive skills in society, to help them live with greater independence, and to reduce community expenditure. To date, there is limited theoretical and conceptual development of frameworks documenting the factors influencing community integration as it applies to adults with acquired brain injury. Furthermore, although there is considerable attention paid to community integration as a desired outcome, there exists no evidence-based framework explaining characteristic of successful community interventions for people with acquired brain injury. In addition, fidelity of ABI interventions is not considered in the literature against an evidence-based framework.Objectives. This study was completed in three phases aiming (1) to develop a framework for community integration for adults with post acute ABI; (2) to investigate characteristics of successful community integration programmes in order to develop an instrument to evaluate fidelity of community integration program for adults with ABI; and (3) to field test the instrument to (a) identify implementation issues; (b) explore the relationship between the themes and attributes across the three services; and (c) establish some aspects of the psychometric properties of the instrument.Methodology and Results. The first phase of the study aimed to obtain a framework to define community integration for adults with ABI. The Participant Groups included six researchers, seven health professionals, six policy makers, eight people with ABI and ten family members. Following a pilot study which examined understandability of the documentation and terms used in the study, the Policy Delphi survey method (Hasson, Keeney, & McKenna, 2000; Turoff, 2002; 1995) was applied which included three steps. Each step of the study began with a survey or a semi-structured interview. The data were analysed and the results were used in the next step. At the end of the first phase of the study, a framework to identify community integration for adults with ABI was developed. A broad literature review confirmed its themes. The community integration framework (CIF) included seven community integration themes and descriptors. The themes consisted of Relationships, Acceptance, Community access, Occupation, Being at home, Picking up life again, and Heightened risks and vulnerability.In the second phase of the study, a multi attribute utility (MAU) technique was applied (Camasso & Dick, 1993; Huber, 1974; Lewis, Johnson, & Scholl, 2003). The CIF which resulted from the first phase was used in this phase as a basis to identify the characteristics of programmes that contributed to the achievement of community integration for adults with ABI. This part of the study was completed using four stages. In each stage, surveys or semi-structured interviews were used to gather the participants‘ opinions on the characteristics of a successful community integration programme. Analysis of the results of each stage informed the next stage.In the first stage of the second phase the data (descriptors of community integration programmes) were categorised into seven clusters and 26 sub-clusters. In the second stage, the Participant Groups reviewed and examined the importance of the programme characteristics using a Likert Scale. This stage resulted in determining the priority weights of the items. In the third stage, an Expert Panel reviewed the results during a day-long working group. The Expert Panel including 10 people as a sub-group of the participant groups modified the themes, their descriptors and attributes, and then identified indicators for the attributes as the programme characteristics for community integration for people with ABI. The themes, their descriptors and attributes were compared with ABI outcome measures currently available in the literature.During the fourth stage, the themes and attributes were sent to the Participant Groups and the Expert panel to finally confirm and determine the relative importance of each theme and attribute. This was the final stage in the development of the programme assessment of community integration attributes (PACIA) which included seven themes and 21 attributes. The themes consisted of Person centred approaches and planning, Relationships, Working together, Development of skills, Community based practices, Support for service users, and Service setting and atmosphere. Each attribute was further defined with indicators. Sources of evidence were identified to enable attributes to be rated.The third phase of the study included a field study of PACIA, an examination of possible implementation issues with the tool, and an evaluation of some specific psychometric properties of PACIA. The field study aimed to examine the effectiveness of the evaluation process, and investigate the relationship between the themes and attributes across the three services.A trained evaluation team first individually rated each service by PACIA through observation, reading the documents, and interviews with the staff, service users, and families. A conciliation meeting followed to achieve consensus on the service ratings. The three services achieved a range of scores on the PACIA themes and attributes based on their different qualities. This phase also explored the ease of use and issues in the implementation of the instrument based on the raters‘ feedback, and examined inter-rater reliability, face validity, and content validity of PACIA. Within the limitations of the field test method, the study indicated that PACIA is a valid and reliable instrument to evaluate community integration programmes.Conclusion. Integration or re-integration into the community is a vital social objective for people with ABI for whom intensive medical rehabilitation may be followed by an uncertain pathway of longer-term rehabilitation. This study developed an evidencebased community integration framework (CIF) to describe community integration for adults with ABI. The research method surveyed a wide group of key stakeholders whose views formed the basis of the framework. The framework may be useful as a basis for making policy decisions to enhance community inclusion. The CIF provides an agreed description of a theory or model upon which the characteristics of programmes aimed to facilitate community integration were identified and the fidelity of those programmes were assessed. The other result of this study was the development of a fidelity instrument named as Programme Assessment of Community Integration Attributes (PACIA). While there are obviously additional characteristics of PACIA that remain to be researched, this evidence-based instrument appears to be valid and reliable to test the fidelity of community integration programmes. Community integration programmes can be evaluated more comprehensively by PACIA than has been the position in the past. Such an evaluation instrument may help existing programmes re-focus to provide more efficient services for people with ABI.
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Bailey, Beth A., Judy G. McCook, A. L. Hodge, Andrea D. Clements, and Lana McGrady. "Quitting Smoking During Pregnancy and Birth Outcomes: Evidence of Gains Following Cessation by Third Trimester." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7278.
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Jenkins, Jacqueline D. "Toward the formulation of a community college policy for the evaluation of teaching based on evidence of student learning." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file 0.39 Mb., 174 p, 2006. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3220794.
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Konstantinus, Abisai. "Opportunities for short-sea shipping in the Southern African Development Community (SADC) region: evidence based on discrete choice modelling." Doctoral thesis, Faculty of Engineering and the Built Environment, 2019. http://hdl.handle.net/11427/31365.
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The thesis investigates the development of short-sea shipping (SSS) in the Southern African Development Community (SADC) region by studying the determinants of SSS, the stated choice preference of shippers and freight forwarders and the stated intentions of maritime carriers for SSS. It is purported the introduction of SSS in SADC could reduce socio-environmental problems currently faced such as road damage, road congestion, pollution and transport related accidents. Discrete choice modeling (DCM) is employed as the main methodology to study shipper and carrier behavior. Discrete choice modeling permits the construction of general utility functions incorporating various decision maker characteristics and choice attributes to elicit preference of respondents. The general postulate in DCM is that utility is derived from the properties of things rather than the actual thing per se. A particular benefit of DCM in this study is the elicitation of preference for services and interventions that have not been introduced by SSS. The first step in the study is a theoretical investigation of the potential of SSS in the SADC region. It highlights the policy initiatives, the barriers and enablers related to the development of SSS. The proposed SSS system would have three main roles: to offer an alternative mode of freight transport service between port cities, to serve as the main leg in an intermodal transport network, and to serve feeder services between hub-and-spoke ports. The findings reveal that, SSS has the theoretical potential to work in the SADC region, given the large geographic region, projected freight volumes and customs and trade policies the SADC region is pursuing. The second step in the study involves an a-priori study conducted to develop a general understanding of freight transport in SADC. For this purpose, a uniquely developed online survey was conducted across the SADC region to ascertain in particular: who the decision maker is in terms of freight mode choice; and what the significant attributes that influence freight mode choice are. The results reveal that both the shipper and the freight forwarder are involved in mode choice decisions, however the shipper being the dominant decision maker. Furthermore, the results of the exploded logit model reveal that the top five modal attributes that shippers consider most important are: reliability, transport cost, risk of damage, frequency of service and transit time. These results were subsequently employed to inform the shipper and carrier behavior studies. The third step entails the assessment of shipper behavior, where trip specific mode choice decisions are studied along five intra-urban origin-destination (O-D) paired routes (which would form the study corridors). Three of these corridors considered unimodal SSS, and the two considered intermodal SSS. Unimodal SSS was studied along the following corridors: Cape Town (South Africa)~ Walvis Bay (Namibia), Walvis Bay (Namibia) ~ Luanda (Angola) and Durban (South Africa) ~Beira (Mozambique); and intermodal SSS was studied along the following corridors: Durban (South Africa) ~ Harare (Zimbabwe) and Cape Town (South Africa) ~ Windhoek (Namibia). To develop the choice scenarios, d-efficient stated choice experiments were uniquely developed for each of the corridors with the following key modal attributes systematically varied and analyzed across respondents: service frequency, reliability in terms of arriving on time, expected delay, transport cost and transport time. Subsequently, the following choice models were developed: Binary Logit, Mixed Logit and Integrated Choice and Latent Variable Structure models for the unimodal corridors; and Multinomial Logit, Nested Logit and Cross Nested Logit models for the intermodal corridors. The results highlight that in addition to the modal attributes, mode choice decisions are driven by shipper characteristics and situational characteristics. Moreover, the unimodal SSS study reveals that underlying latent perceptions also influence freight mode choice decisions; while the intermodal SSS study reveal strong correlations in the intermodal SSS alternatives, which requires improved intermodal capability if SSS is to become competitive. The fourth step in the study entail the assessment of maritime carriers preference for SSS given varying levels of maritime conditions that include: dedicated freight volumes, income from freight, port dues discount, terminal handling fees discount and ship registration requirements. The results of an ordered logit model reveal that ship registration provisions and terminal handling charges are the most important to the development of SSS from a carrier side. Moreover, ship registration and maritime cabotage provisions require visitation to boost the participation of carriers in SSS. The last step of the study revisits the modeling results and considers their implications through the estimation of willingness-to-pay and attribute elasticities. The results were then employed to suggest policy actions and interventions to develop SSS.
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Ammendolia, Carlo. "Implementing evidence-based guidelines for x-ray use in acute low back pain, a pilot study in a chiropractic community." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0003/MQ45505.pdf.
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陳意筠 and Yee-kwan Chan. "An evidence-based guideline for reducing fear of falling among community-dwelling older adults : a multi-component psycho-therapeutic intervention." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193044.
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Falls among the elderly are a major health issue in Hong Kong. This problem has been worsening and has become a public concern for the aging population. In Hong Kong, over 30,000 community-dwelling older adults have needed hospital admission after falling, and billions of dollars are spent on the related medical costs. The prevalence of recurrent falls is high. However, a lack of concern in helping community-dwelling older adults to prevent recurrent falling currently persists in clinical field.
A local study reported that most community-dwelling older adults have a fear of falling (FOF) after an accidental fall. Thus, reducing FOF can reduce the fall rate because FOF and falls are interdependent. A systematic review can show that multi-component psycho-therapeutic intervention is effective in reducing FOF. Therefore, the establishment of a standardized evidence-based practice (EBP) guideline to reduce FOF among community-dwelling older adults via multi-component psycho-therapeutic intervention is necessary.
This thesis aims to develop an EBP guideline to reduce FOF among community-dwelling older adults via multi-component psycho-therapeutic intervention. Seven related studies were reviewed and appraised as having a high level of evidence. These studies also reported to have significantly positive effects on the clients. The transferability and feasibility of the proposed program in Hospital A were examined, and the results show that the transferability and feasibility of the proposed program were high. An EBP guideline and an implementation plan were then developed. A pilot test was proposed to determine and solve the difficulties in the implementation process. Then, the guideline was refined. A comprehensive evaluation plan of the proposed program is included in the final chapter.
The standardized EBP guideline, which is an evidence-based approach, provides a clear pathway for practitioners to educate community-dwelling older adults in reducing FOF via multi-component psycho-therapeutic intervention. This method contributes to the reduction in the recurrent fall rate and the decrease in related medical costs.published_or_final_version
Nursing Studies
Master
Master of Nursing
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Snyder, Nichole M. "An Examination of Coalition Functioning and Use of Evidence-Based Practices: A Case Study of Four Community Substance Abuse Coalitions." Scholar Commons, 2014. https://scholarcommons.usf.edu/etd/5393.
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There has been a recent expansion of community-based coalitions to address issues related to youth substance use. Research on their overall effectiveness, however, has produced mixed results. Recommendations to improve coalition success have emphasized the high-quality implementation of evidence-based programs targeting specific community needs. Coalitions vary extensively, however, in their organization and functioning. In addition, the lack of a universally accepted theoretical framework to understand coalition functioning has led to inconsistencies in the coalition research and the specific constructs used to describe coalition functioning.
Purpose of the Study: To address these gaps, the current study used a case study approach to describe the organization and functioning of four local substance abuse coalitions and to identify factors related to coalition high-quality implementation of evidence-based programs.
Methods: Using constructs based on Community Coalition Action Theory, the current study used coalition member surveys and key leadership interviews to produce separate case study descriptions of four participating community substance abuse coalitions. An exploratory factor analysis was conducted to examine the structure of the survey measure. Univariate statistics were used to describe coalition functioning and attitudes toward evidence-based practice and implementation. One-way analysis of variance tests were employed to examine differences across the coalitions and Pearson's product-moment correlations were used to identify coalition characteristics associated with attitudes toward evidence-based practice. A thematic analysis of interview data was conducted for an in-depth examination of coalition functioning and perceptions of evidence-based practice.
Results: Coalition members and leaders reported high levels of functioning across all of the included domains. However, several differences in coalition background and structure were discussed. Community support was described as a major functioning challenge across both surveys and interviews. Interview results also revealed several different coalition belief patterns surrounding evidence-based practice and quality implementation. Coalition members and leaders generally indicated positive attitudes toward the use of evidence-based prevention programs and strategies. However, varying levels of knowledge and experience with evidence-based practices was identified across interviews. Interviews also highlighted several factors that influence coalition decision-making and identified several perceived challenges associated with the use of evidence-based practices. Results include a discussion of coalition knowledge, perceptions, and experiences with program implementation.
Conclusions and Implications: Taken together, these findings form a basis for better understanding the current environment surrounding community substance abuse coalition functioning and implementation of evidence-based practices. Several factors were shown to influence coalition decision-making processes and overall functioning. In addition, the present study highlights strengths and gaps related to coalition leadership knowledge, attitudes, and implementation of evidence-based programs and strategies. These identified relationships can be used to guide future research and community practice. With their growing popularity, it is likely that community coalitions will take on a major role in future community-based prevention efforts across the country. As such, there is a need to design substance abuse prevention programming with coalitions in mind and to identify alternative avenues to disseminate information surrounding community-focused evidence-based practices. Identifying new ways to measure and build coalition processes, leadership skills, and structures could result in greater coalition capacity to plan for and support prevention activities, including use of evidence-based practices.
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Marder, Alyssa M. "Measuring Therapist Adherence to a Manual-Based Treatment Tested in a Community Setting: The PASCET Manual Adherence Scale (P-MAS)." VCU Scholars Compass, 2007. http://scholarscompass.vcu.edu/etd/682.
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The goal of the current study was to develop and test a rigorous measure of therapist adherence to a cognitive-behavioral, manual-based treatment for childhood and adolescent depression. This project employed data from the recently completed UCLAYouth Anxiety and Depression Treatment study. This study aimed to advance the literature by devoting the full focus of the project to the development of a manual-based measure that would demonstrate interrater reliability across multiple raters. This study reported on the psychometric development of the PASCET Manual Adherence Scale (PMAS) (e.g. scoring strategy, item development, reliability), a unique measure of therapist adherence that represents the content of the treatment manual for the "Primary and Secondary Control Enhancement Training" program (PASCET; Weisz et al., 1999). In sum, the P-MAS showed strong interrater reliability for most items of the scale. The items with poorer ICCs may have been influenced by instrumentation problems, small sample size, and range restriction. Some session content showed evidence that more meetings may be required to sufficiently cover the material, particularly for those that involve heavy in-vivo content, require the use of technology, or involve cognitive interventions which may be challenging for children and young teenagers. The results indicated that therapists adhered to slightly more than half of the prescribed manual content overall. The variability in adherence appeared greater for session-specific content than for standard session items, reflecting the variability within that content and the myriad of factors which may have influenced adherence to diverse material. Adherence for session-specific content demonstrated a slightly downward trend over time, with a significant drop off between the first and second phases of treatment and a leveling off between second and third phases. For all but two relevant sessions, therapist adherence to didactic content was significantly higher than adherence to in-vivo content, highlighting the challenges of engaging depressed youth in active learning. As this active involvement is theorized to be an essential component in addressing depressive symptoms, the challenges in implementation of this content may represent the most significant barrier to therapist adherence with this manual.
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Walden, Rachel R., Nakia J. Woodward, and Rick L. Wallace. "Reevaluating Point-of-Care Resources: Community Engagement in Difficult Collection Choices." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8676.
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Rising collection costs sometimes necessitate tough decisions regarding cancellation of popular products. In 2015–2016, the East Tennessee State University Medical Library subscribed to UpToDate and DynaMed Plus, both clinical point-of-care products, with the understanding that one product would be canceled at the fiscal year end. The librarian team undertook a year-long community engagement campaign to inform library users about the pending product cancellation decision. Ultimately, DynaMed Plus was selected and UpToDate was cancelled. The campaign generated user engagement with the decision making, along with perceived benefits including increased awareness of the library's budget constraints, increased discussion of scholarly publishing, and greater faculty/student knowledge of evaluating evidence-based products.
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Tiede, Gabrielle Marie. "Exportable Communication Intervention for Classroom Staff Serving Children with Autism Spectrum Disorder: Towards Improving the Feasibility of Evidence-Based Practices in Community Settings." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1499684839741718.
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MacPherson, Heather Ann. "Treatment Adherence and Longitudinal Clinical Outcomes in an Effectiveness Evaluation of Community-Based Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders." The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1432831469.
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Sen, Keya. "The Relationship between Social Isolation and Wellbeing in Older Adults." Thesis, University of North Texas, 2020. https://digital.library.unt.edu/ark:/67531/metadc1707364/.
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This dissertation contributes to research on social isolation in older adults aged 65 years and above through three essays that expand our understanding of the social determinants of health and identify the social and interpersonal factors that contribute to elderly wellbeing. This dissertation examines the significant factors contributing to the problem of social isolation, and how the availability of interest-based, low-cost engagement resources in the community can alleviate social isolation and foster healthy aging. Essay 1 is a systematic literature review with implications for future research that explores how technological skills and training based on user intention and availability of resources can alleviate social isolation. Essay 2 is a qualitative study that evaluates the effectiveness of a unique community-based senior exercise program in fostering social integration and in reducing social isolation. Essay 3 is a quantitative study that examines the magnitude and direction of the correlated relationships among the determinants of social inclusion and the impact of social and interpersonal processes on senior wellbeing. These three essays provide insight into the social isolation phenomenon that negatively impacts senior wellbeing and recommends solutions derived from a data driven examination of the problem that is especially applicable to economically disadvantaged senior communities. Moreover, this research provides community partners and gatekeepers a foundation for future research on the social isolation phenomenon and strategies for developing digital confidence and mobility program strategies that foster social inclusion and reduce social isolation for older adults.
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Abera, Muluemebet [Verfasser], and Ulrich [Akademischer Betreuer] Mansmann. "Effect of community level intervention on maternal health care utilization : evidence from population based interventional-study in South-West Ethiopia / Muluemebet Abera ; Betreuer: Ulrich Mansmann." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2015. http://d-nb.info/1128594161/34.
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Rukundo, Emmanuel Nshakira [Verfasser]. "Effects of community-based health insurance on child health outcomes and utilisation of preventive health services : Evidence from rural south-western Uganda / Emmanuel Nshakira Rukundo." Bonn : Universitäts- und Landesbibliothek Bonn, 2018. http://d-nb.info/1173898611/34.
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Hearn, Jody. "Family preservation in families’ ecological systems: Factors that predict out-of-home placement and maltreatment for service recipients in Richmond City." VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/2086.
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Family preservation services are intended to prevent the out-of-home placement (into foster care or some other alternative arrangement) of children and youth in families at risk of maltreating them. An Ecological Systems perspective of these families might suggest that a family’s context (represented by the variables of poverty, agency services, family history, and individual/caretaker characteristics) must be considered as an over-arching influence in families’ risk and outcomes. The purpose of this cross-sectional secondary data analysis study was to identify layered factors that distinguish family preservation cases in Richmond, VA that experience removal or subsequent abuse or neglect from those that do not, in order to make recommendations about how services can be better directed to support families in caring for their children and youth. Using Hierarchical Discriminant Function Analysis, this research project evaluated the “predictive” values of the external conditions and internal characteristics of family recipients of the Richmond, Virginia Department of Social Services corollary to family preservation services on the outcomes of (a) successful case closure, (b) out-of-home placement during services, and (c) child maltreatment after case closure. Contextual factors (poverty), Agency factors (number of services and ratio of concrete services), Family factors (history of placement, chronicity of maltreatment, abuse risk score, and neglect risk score), and Individual/Caretaker factors (caretaker substance abuse, caretaker mental health, and family structure) were investigated. The findings of this study showed that poverty, agency characteristics, and family characteristics each directly explained substantial amounts of variance among the outcomes and that poverty, provision of concrete services, and a family history of foster care placement best distinguished among families experiencing these different outcomes. These findings highlight the need of family preservation programming to directly address conditions of poverty in abuse and neglect risk, and suggest that the services provided to the families need better targeting to families’ needs. Recommendations based on this study include the development of a theory-based, local-evidence-based model of services for family preservation services at the agency for which the research was conducted.
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Einarsson, Catrin, and Jenny Pettersson. "I riktning mot evidensbaserad praktik? : En kvalitativ studie av Polismyndighetens implementering av evidensbaserad praktik." Thesis, Linnéuniversitetet, Institutionen för samhällsstudier (SS), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-80349.
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The aim of the study was to illustrate how evidence-based praxis is implemented in the police agencies activities with crime prevention work. We asked two questions: a) What actions does the Swedish Police authority take when implementing evidence-based praxis in its operations? and b) What opportunities contra difficulties do the managers, community police officers and teachers at the police institute see with evidence-based praxis? This was investigated through qualitative interviews in order to capture the participants personal opinions and experiences about the subject. Evidence-based policies are practiced through the crime-prevention work that takes place through local cooperations. The role of community police officers constitutes an important strategic role as being cosmopolitan, which ensures that communication between the police and society works, which in turn forms the basis for the crime-prevention work. The result also shows that the police cannot take care of law enforcement on their own initiative; responsibility also rests on individuals, groups and other organizations. We see patterns of a majorly positive attitude within the police, which contradicts previous research. There are not enough evidence-based methods within all working fields of the police, which has emerged as an important factor in order to implement evidence-based praxis. Whilst the police may be positive towards evidence-based methods, they can not solely rely on them. The resources are too lacking in order for the evidence-based praxis to also permeate the police authority's work. In order for the police authority's work to be carried out by evidence-based methods, community police officers need to have a higher status internally. They also need a mandate in the form of being able to make decisions about operative resources. The main contribution of the study´s is that evidence-based praxis needs to be strategically implemented, and the key people who work primarily with evidence-based praxis needs a higher status within the organization.
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Medina, Maldonado Venus Elizabeth [Verfasser], M. [Akademischer Betreuer] Landenberger, A. [Akademischer Betreuer] Wienke, and M. [Akademischer Betreuer] Camacaro. "Public health program based on the evidence of nursing for prevention and assistance of gender-based violence in collaboration with specialized personnel and community members / Venus Elizabeth Medina Maldonado. Betreuer: M. Landenberger ; A. Wienke ; M. Camacaro." Halle, Saale : Universitäts- und Landesbibliothek Sachsen-Anhalt, 2014. http://d-nb.info/1052893848/34.
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Cohen, Colin. "No magic bullets : a mixed methods case study to evaluate the implementation of an e-health system designed to support evidence-based practice in primary and community care settings." Thesis, University of Bath, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.616581.
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The literature on e-health systems is frequently characterised by reports of success accompanied by the promise of a bright future, but the future never seems to arrive. The story of health informatics in England over the last decade has been dominated by the NHS National Programme for IT. One element of that programme is the Map of Medicine, a software tool designed to deliver evidence-based clinical knowledge from authoritative sources. Although the system had been made available to users across the NHS, very little was known about whether health professionals actually used it. The aim of this project was to undertake a mixed methods case study to evaluate the implementation of the Map of Medicine in primary and community care settings. The main findings from the quantitative phase of the case study were that around half of the GPs and around a quarter of Community health staff used the system. The findings from the qualitative phase indicated some marked differences between the two groups in terms of why they did, or did not, use the system. Normalisation Process Theory was used as a lens to understand how practices became embedded, or failed to become embedded, into their social context. It is concluded that emphasising the technical aspects of system implementation at the expense of the social aspects probably accounted for much of the variation in use, but there are no simple project management checklists that can guarantee successful implementation. Finally, the implications are considered. Policy makers need to take account of the social factors when implementing e-health systems, to recognise that it can take a long time for systems to become normalised and that there are risks from withdrawing project support before changes in working practices have become embedded. The health informatics profession needs to become more evidence-based, and the evaluation of e-health should play the same role as clinical audit does for the medical profession.
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Juntunen, Lindberg Linda, and Therese Thette Lindström. "“Vi gör nog många saker som är rätt, men vi vet nog inte vilka saker som gör vad” : - En kvalitativ studie om polisers attityd kring forskning och evidensbaserade polisiära metoder." Thesis, Högskolan i Gävle, Kriminologi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-33022.
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Syftet med studien var att undersöka polisanställdas attityd kring forskning och evidensbaserade polisiära metoder inom det brottsförebyggande arbetet. Vi genomförde semistrukturerade intervjuer med 9 poliser och analyserade dessa med en kvalitativ innehållsanalys. Studiens resultat visade att delar av evidensbaserade metoder gick att återfinna i Polisens arbete, framförallt Problem Oriented Policing och Community Oriented Policing. Dock fanns varken struktur i hur metoderna används eller kunskap i hur metoderna fungerar. De intervjuade poliserna efterfrågade forskning och menade att forskning gärna får ta större plats för att kunna utveckla arbetet och göra det mer effektivt.The aim of the study was to examine police officers’ attitudes towards research and evidence-based methods of policing in the field of crime prevention. We conducted semi-structured interviews of 9 police officers’ and performed a qualitative content analysis. Our results showed that the police are using parts of evidence-based methods, specifically Problem Oriented Policing and Community Oriented Policing. There were no organization around which methods were used and no knowledge about how the methods work. The police interviewed wanted research to play a larger role in their work and believed incorporating research would make their crime-prevention work more effective.
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Ducore, Susan Elizabeth. "FALL PREVENTION SERVICES FOR OLDER ADULT, AMERICAN INDIANS/ALASKA NATIVES: AN EXAMINATION OF KNOWLEDGE, ATTITUDES, AND PRACTICES OF HEALTH CARE PROVIDERS." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=casednp152581877516155.
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Canty, Kenika Kiante'. "A Survey of Probation Officers' Opinions: Risk Assessments." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1684.
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The U. S. criminal justice system has used risk assessment tools in an effort to reduce recidivism and risk assessment tools are now commonplace. Correctional organizations, however, have struggled with officers' resistance to these tools in spite of the evidence for their utility. There is limited research that explores the impact of resistance to organizational change within the context of correctional agencies. To address that gap, this correlational study used organizational change theory to examine officers' resistance to the use of risk assessment tools based on officers' opinions of the risk assessment tool being used in North Carolina. Data were collected through an online survey of 109 North Carolina probation and parole officers. Multiple linear regression analysis was used to examine the statistical relationship between officer use of risk assessment tools and the dependent variables which included officers' opinions of the risk assessment tool, knowledge of risk assessments, training for use of risk assessments, risk assessments in the sentencing process, and officers' length of time employed. Findings indicated that opinions of the risk assessment tool and training to use the tool statistically impact officers' use of the tool in daily supervision of offenders. Organizational change theory predicted these findings as officers' resistance to policy change was manifested in their opinions of that policy. Implications for positive social change include recommendations for corrections agencies to refine training regarding risk assessments in efforts to minimize officer resistance of properly applying risk assessment tools in daily job duties with the intended outcome of reducing recidivism, and therefore preventing future harms to the community.
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Zabaleta, del Olmo Edurne. "Adaptación del cuestionario "Developing Evidence-Based Practice" al contexto de la enfermería de salud comunitaria en España y evaluación de sus propiedades psicométricas." Doctoral thesis, Universitat de Girona, 2014. http://hdl.handle.net/10803/283968.
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Objective: To adapt the community nursing version of the “Developing Evidence-Based Practice (DEBP )” questionnaire in to the primary health care (PHC) setting in Spain and to evaluate its psychometric properties. Methods: The DEBP questionnaire was translated, back-translated, and pilot-tested. During the first six months of 2010, 513 nurses participated in the study. Internal structure was analyzed by exploratory factor analysis. Reliability scores and sensitivity to change were assessed. Results: Factor analysis showed six components that explained 49 % of the variance. Reliability was satisfactory (consistency and agreement coefficients >0.70). Overall score and the “Skills for evidence-based practice (EBP)” component score showed a medium and a large effect respectively. Conclusions: The DEBP questionnaire adapted has satisfactory psychometric properties. It is a useful tool for measuring the development of EBP and assessing the barriers for its implementationObjetivo: Adaptar el cuestionario "Developing Evidence-Based Practice (DEBP)" en su versión para enfermeras comunitarias al contexto de la atención primaria (AP) en España y evaluar sus propiedades psicométricas. Metodología: Se realizó la traducción, la retrotraducción y el pilotaje del cuestionario. Durante el primer semestre de 2010, 513 enfermeras participaron en el estudio. Se analizó la estructura interna mediante un análisis factorial exploratorio. Se evaluó la fiabilidad de las puntuaciones y la sensibilidad al cambio. Resultados: El análisis factorial mostró seis componentes que explicaban un 49% de la variancia. La fiabilidad fue satisfactòria (coeficientes de consistencia y acuerdo >0,70). La puntuación global y la del componente "Habilidades para la pràctica basada en pruebas (PBP)" mostraron un efecto moderado e importante respectivamente. Conclusiones: El cuestionario DEBP adaptado presenta unas propiedades psicométricas satisfactorias. Representa una herramienta útil para medir el desarrollo de la PBP y evaluar las barreras para su implementación
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Walsh, Anne Majella. "Parents' management of childhood fever." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16522/.
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Despite decades of research about educational interventions to correct parents' childhood fever management their knowledge remains poor and practices continue to be based on beliefs about harmful outcomes. The purpose of this thesis was to 1) identify Australian parents' fever management knowledge, attitudes, practices and methods of learning to manage fever and 2) undertake a theoretical exploration of the determinants of parents' intentions to reduce fever using the Theory of Planned Behavior (TPB). Two studies were undertaken: a qualitative study with 15 parents; and survey of 401 Queensland parents with a child aged between 6 months and 5 years. Parents determine childhood fever through behavioural changes they have learnt to associate with fever. Few were aware of the immunological beneficial effects associated with fever and most believed fever harmful causing febrile convulsions and brain damage. To prevent harm they monitored temperatures, used antipyretics, dressed children in light clothing and sponged them with tepid, cool or cold water. Despite believing antipyretics harmful most parents reduced temperatures of 38.3 degrees Celsius ± 0.6 degrees Celsius with antipyretics, alternating two antipyretics when fever was not reduced or returned. In addition to temperature reduction antipyretics were used to reduce distress or general unwellness and pain or discomfort. Multiple factors were used to determine antipyretic dosage including temperature, irritability and illness severity. Over one-third of parents had overdosed their child with too frequent antipyretic administration; more frequently with ibuprofen than paracetamol, 12:1. Fever management information was learnt from numerous sources. Doctors were the most frequently reported followed by personal experience. With the variety of information sources nearly half received conflicting information about how to manage fever increasing concerns and creating uncertainty about how to best care for their child. Despite this many believed they knew how to manage fever. Some parents' practices changed over time as a result of either positive or negative experiences with fever indicating more positive or negative attitudes toward fever. Positive experiences reduced antipyretic and medical service use; negative ones had the adverse effect with increase in antipyretic use including alternating antipyretics and double dosing with one antipyretic. Child medication behaviours also influenced attitudes and practice intentions. Parents of children who readily took antipyretics had more negative attitudes and intended to reduce their child's next fever with antipyretics. Negative attitudes were a significant determinant of fever management intentions. Parents' practices were strongly influenced by their perception that doctors and partners expected them to reduce fever. This expectation from partners is understandable; from doctors it is not and indicates doctors' propensity to recommend reducing fever. There is an urgent need to identify doctors' fever management beliefs and rationales for practice recommendations. Parents also learn to manage fever from nurses and pharmacists; their beliefs and management rationales must also be determined and addressed. There is an urgent need to educate parents about evidence-based fever management and reduce their unnecessary antipyretic use. They must be encouraged to delay antipyretic administration using them to reduce pain rather than fever. Findings from this thesis have identified the determinants of parents' intentions to reduce fever; negative attitudes and normative influences and positive child medication behaviours. Future studies should examine the efficiency and cost effectiveness of fever management educational programs for parents using different presentation methods in multiple settings.
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Walsh, Anne Majella. "Parents' management of childhood fever." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16522/1/Anne_Majella_Walsh_Thesis.pdf.
Full textAbstract:
Despite decades of research about educational interventions to correct parents' childhood fever management their knowledge remains poor and practices continue to be based on beliefs about harmful outcomes. The purpose of this thesis was to 1) identify Australian parents' fever management knowledge, attitudes, practices and methods of learning to manage fever and 2) undertake a theoretical exploration of the determinants of parents' intentions to reduce fever using the Theory of Planned Behavior (TPB). Two studies were undertaken: a qualitative study with 15 parents; and survey of 401 Queensland parents with a child aged between 6 months and 5 years.
Parents determine childhood fever through behavioural changes they have learnt to associate with fever. Few were aware of the immunological beneficial effects associated with fever and most believed fever harmful causing febrile convulsions and brain damage. To prevent harm they monitored temperatures, used antipyretics, dressed children in light clothing and sponged them with tepid, cool or cold water.
Despite believing antipyretics harmful most parents reduced temperatures of 38.3 degrees Celsius ± 0.6 degrees Celsius with antipyretics, alternating two antipyretics when fever was not reduced or returned. In addition to temperature reduction antipyretics were used to reduce distress or general unwellness and pain or discomfort. Multiple factors were used to determine antipyretic dosage including temperature, irritability and illness severity. Over one-third of parents had overdosed their child with too frequent antipyretic administration; more frequently with ibuprofen than paracetamol, 12:1.
Fever management information was learnt from numerous sources. Doctors were the most frequently reported followed by personal experience. With the variety of information sources nearly half received conflicting information about how to manage fever increasing concerns and creating uncertainty about how to best care for their child. Despite this many believed they knew how to manage fever.
Some parents' practices changed over time as a result of either positive or negative experiences with fever indicating more positive or negative attitudes toward fever.
Positive experiences reduced antipyretic and medical service use; negative ones had the adverse effect with increase in antipyretic use including alternating antipyretics and double dosing with one antipyretic. Child medication behaviours also influenced attitudes and practice intentions. Parents of children who readily took antipyretics had more negative attitudes and intended to reduce their child's next fever with antipyretics. Negative attitudes were a significant determinant of fever management intentions.
Parents' practices were strongly influenced by their perception that doctors and partners expected them to reduce fever. This expectation from partners is understandable; from doctors it is not and indicates doctors' propensity to recommend reducing fever. There is an urgent need to identify doctors' fever management beliefs and rationales for practice recommendations. Parents also learn to manage fever from nurses and pharmacists; their beliefs and management rationales must also be determined and addressed.
There is an urgent need to educate parents about evidence-based fever management and reduce their unnecessary antipyretic use. They must be encouraged to delay antipyretic administration using them to reduce pain rather than fever. Findings from this thesis have identified the determinants of parents' intentions to reduce fever; negative attitudes and normative influences and positive child medication behaviours. Future studies should examine the efficiency and cost effectiveness of fever management educational programs for parents using different presentation methods in multiple settings.
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Auburn, Stephen Donald, and sauburn@optusnet com au. "Trust the process: stakeholder management using a transparent, evidence-based policy approach." RMIT University. Education, 2005. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20060515.113429.
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In Australia, the development and implementation of National Training Packages has been a major tool in the drive to reform of the vocational education and training system. The main aim of the reform is to establish a national vocational and education system within a federal political system and to make vocational educations and training providers more responsive to the needs of industry, by industry specifying its skill needs through the mechanism of national Training Packages. The background to this workplace project, the Review of the Community Services Training Package, and this study, is established by a review of policy and literature in relation to national training reform issues and stakeholder management within a public policy context. This review established some principles of good practice in relation to stakeholder management. The industry context of the workplace project is discussed. The workplace project is then unpacked in some detail with specific reference to stakeholder management strategies and issues and some specific stakeholder groups. This exegesis goes on to explore stakeholder behaviour in this particular workplace project in its historical context of the introduction of Training Packages to the vocational education and training system. It explores the perspectives of teachers and industry on the implementation of Training Packages and in particular the gap between educational technologies and industry expectations of standards of work performance. The exegesis concludes with some suggestions of opportunities for enhanced workplace practice in stakeholder management and for further research. It also suggests a job of work for industry and teachers to develop new communities of practice around Training Packages as a means of bringing together their sometimes divergent interests.
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Walker, Candice. "Stakeholders' Perceptions of Available Services in a Rural Community to Effectively Educate Individuals With Autism Spectrum Disorder." BYU ScholarsArchive, 2021. https://scholarsarchive.byu.edu/etd/9143.
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Prevalence of autism spectrum disorder (ASD) has increased 150% over the last 20 years, affecting all communities, with future projections of further rise. This is a particular concern for the public education system, where laws mandate that schools provide meaningful education to all students. Resources must be in place to provide the level of support children with ASD require for a successful educational experience. These resources are often expensive and require specialized training to secure. Rural schools face unique barriers meeting the standards set forth through federal law. To determine the most productive use of available resources as well as to identify critical needs, a study was conducted in a rural community to assess stakeholder perceptions of students with ASD. We provided an online needs assessment questionnaire to stakeholders involved with children who have ASD in a rural school district. These stakeholders included parents, caregivers, educators, and community care providers of children with ASD. Also included were individuals 12 years and older with an ASD educational classification. In addition to the online assessment, we invited participants who wished to elaborate further on their responses for an in- person interview. We used mixed methods for analysis of the data. To determine response patterns among groups, descriptive statistics were used. Further analysis included consensual qualitative research methods to analyze open-ended questions in the survey and the in-person interviews. Results show that stakeholders perceive needs for better training, resources, and peer relationships as a focus for improvement within the rural community. The results will have greatest implications for the school district as it allocates resources to better meet the needs of students with ASD within the community. Key points of feedback to the local school district will focus on training and support resources, primarily for educators, but also for families. Accessible (e.g., free, online) training options will be the first recommendation for immediate implementation.
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Finn, Natalie K. "Identifying Targets for Quality Improvement in a Community Child Mental Health Agency." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/6107.
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The implementation of evidence-based practices has great potential to improve the quality of children’s services; however, with a large variety of available practices, it can be challenging to select targets for quality improvement in community-based treatment. This study used a method called relevance mapping to identify how thoroughly evidence-based programs could cover a specific population of children seeking services at a large public agency and identify practice elements relevant to these clients. A therapist survey was used to examine current practice at the agency. Eight therapists at the agency reported on their practice delivery for 141 clients. Results from relevance mapping and therapist surveys were combined to create practice profiles for two predominant diagnostic categories seen at the agency: substance use and depression. These practice profiles were used to identify three areas of interest for agency quality improvement with regard to practice element delivery: Agency Strengths, Opportunities, and Weaknesses. Results demonstrate a potential blueprint for tailoring specific feedback to an agency for use in quality improvement efforts.
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Beesdo, Katja, Jürgen Hoyer, Frank Jacobi, Nancy C. P. Low, Michael Höfler, and Hans-Ulrich Wittchen. "Association between generalized anxiety levels and pain in a community sample: Evidence for diagnostic specificity." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-111251.
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Background: It is unclear whether generalized anxiety disorder (GAD) has a specific relationship to pain syndromes, going beyond the established association of pain with anxiety syndromes in general.
Methods: Mental disorders were assessed in a community sample (N = 4181; 18–65 years) using the DSM-IV/M-CIDI. Several threshold definitions were used to define GAD and medically unexplained pain.
Results: The association between pain and GAD (odds ratio, OR = 5.8 pain symptoms; OR = 16.0 pain disorder) is stronger than the association between pain and other anxiety disorders (OR = 2.4 pain symptoms; OR = 4.0 pain disorder). This association extends to subthreshold level definitions of GAD with some indication for a non-linear dose–response relationship. The GAD-pain link cannot sufficiently be explained by demographic factors, comorbid mental or physical disorders.
Conclusions: The association of pain and generalized anxiety is not artifactual. Compared to other anxiety syndromes, it appears to be stronger and more specific suggesting the need to explore clinical and public health implications.
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Beesdo, Katja, Jürgen Hoyer, Frank Jacobi, Nancy C. P. Low, Michael Höfler, and Hans-Ulrich Wittchen. "Association between generalized anxiety levels and pain in a community sample: Evidence for diagnostic specificity." Technische Universität Dresden, 2009. https://tud.qucosa.de/id/qucosa%3A26835.
Full textAbstract:
Background: It is unclear whether generalized anxiety disorder (GAD) has a specific relationship to pain syndromes, going beyond the established association of pain with anxiety syndromes in general.
Methods: Mental disorders were assessed in a community sample (N = 4181; 18–65 years) using the DSM-IV/M-CIDI. Several threshold definitions were used to define GAD and medically unexplained pain.
Results: The association between pain and GAD (odds ratio, OR = 5.8 pain symptoms; OR = 16.0 pain disorder) is stronger than the association between pain and other anxiety disorders (OR = 2.4 pain symptoms; OR = 4.0 pain disorder). This association extends to subthreshold level definitions of GAD with some indication for a non-linear dose–response relationship. The GAD-pain link cannot sufficiently be explained by demographic factors, comorbid mental or physical disorders.
Conclusions: The association of pain and generalized anxiety is not artifactual. Compared to other anxiety syndromes, it appears to be stronger and more specific suggesting the need to explore clinical and public health implications.
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Chambers, David A. "An exploration of the influences on evidence-based change to clinical practice : a comparative study of US/UK health care initiatives." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.365600.
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Willmott, Lynn Anita. "Developing an evidence-based disclosure intervention to facilitate recovery and health behaviour changes associated with secondary prevention following first myocardial infarction." Thesis, University of Sussex, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.289222.
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Williams, Dale, of Western Sydney Hawkesbury University, Faculty of Agriculture and Horticulture, and School of Agriculture and Rural Development. "A participatory approach to evaluating voluntary rural community-based organizations is an effective tool for organizational learning and ensuing rural community development, as evidenced in the participative evaluation of the Southern Riverina Rural Advisory Service." THESIS_FAH_ARD_Williams_D.xml, 1995. http://handle.uws.edu.au:8081/1959.7/69.
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The central argument of this thesis is that participative approaches to evaluating voluntary rural community-based organisations are an effective tool for organisational learning and ensuing rural community development. This proposition is explored through the evaluation and strategic planning of the Southern Riverina Rural Advisory Service, a community-based counselling organisation. The Service works with families experiencing financial hardship and associated stress. The thesis is multi-faceted and generic issues included: the importance of commitment by rural communities and organisations to creating frameworks for understanding and acting in integrated ways to the diversity, inter-relatedness and conflict of issues, wishes and needs of members, and to develop the capacity to transform contexts of dependency-oriented crisis situations to ones of self-responsible, interdependent change; the need to view contexts through integration of local, regional, national and global perspectives and to develop networks to integrate understanding and action; and to continue learning how to better enhance organisational and community-based learning.Master of Science (Hons)
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Arnold, Cassidy C. "EVALUATION OF A COMMUNITY MENTAL HEALTH CENTER’S ASSESSMENT CLINIC: DEVELOPMENT OF A NOVEL ASSESSMENT EVALUATION TOOL." VCU Scholars Compass, 2011. http://scholarscompass.vcu.edu/etd/2597.
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High quality assessment services are the linchpin connecting youth with mental health problems to diagnosis-specific, evidence-based treatments. The effort to improve assessment services is in its early days and faces a number of substantial challenges. This study was an initial effort to address these challenges through the development of a standardized, multi-dimensional Assessment Instrument evaluation tool—the Strength of Measure (SoM)—based on operationally defined criteria supported by decades of psychometric research. The SoM and other criteria addressing assessment practices were piloted with data from 32 consecutive assessment reports from a community mental health center’s Assessment Clinic. Results indicate that none of the Assessment Instruments used by the Assessment Clinic met the “Adequate” level of support on each of the SoM dimension. Additional results address Reason for Referral, Primary Axis I Diagnosis, Informants, and Method of Assessment. Implications and directions for future research are discussed.
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Rees, Gethin. "Corroboration, consent and community : a 'meaning finitist' account of the forensic medical examination of rape and penetrative sexual assault complainers in Scotland." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/3428.
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This thesis examines the construction of forensic medical evidence in penetrative sexual assault cases and the procedures that Forensic Medical Examiners (FMEs) employ in order to ensure the authority of that evidence. Drawing upon interviews and on the texts and artefacts that FMEs use in their work, the thesis employs the concept of “meaning finitism” to analyse how FMEs perform forensic examinations for evidential purposes. The thesis starts with an exploration of how medical practitioners are taught to identify and classify injuries of medico-legal significance, culminating in their being judged “safe” to provide expert testimony by other members of the clinical forensic medical community. The thesis next addresses the construction of what I call the “morphological account”: a set of judgements about the nature of a case based upon a combination of the observed injuries, the FME’s training and their previous experience of cases. While there is considerable agreement amongst practitioners about how to interpret injuries (a result of their training), because the morphological account involves personal judgement, there is also scope for differences of opinion. The thesis therefore explores the methods that FMEs employ to limit the risk of being seen to disagree with one another during trials. The thesis also examines the role that guidelines play in the forensic medical examination. The thesis argues that standardised medical kits and associated guidance documents were originally introduced in the early 1980s in response to sustained criticism of FMEs’ practices, and further developed in the late 1990s and early 2000s with the rise of Evidence-Based Medicine. Kits and guidance documents provide a means for FMEs to legitimate and explain their work to others, particularly during trials: they codify collective practice and provide FMEs with an aide memoire of the requisite procedures, without overly determining or constraining practice. Finally, I will argue that FMEs’ concern to ensure the authority of their evidence may sometimes limit the value of that evidence. Caution over drawing inferences that might be challenged in court, and a concern not to be seen as “prosecution-minded”, commonly leads FME to compose so-called “Neutral Reports” which neither confirm nor deny the complainer’s allegations. As Scottish Procedural Law makes provision for non-contentious evidence to be removed from trial, such neutral reports are likely to be dismissed from consideration.
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Witney, Cynthia Ann. "Just a “Click” away from evidence-based online breast cancer information, advice and support provided by a specialist nurse: An ethnonetnographic study." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2015. https://ro.ecu.edu.au/theses/1679.
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Breast cancer has had, and will continue to have, a devastating impact on the lives of many Australian women, their families, friends and the wider community. The concomitant treatment of this disease places a considerable burden on the health care system and the supporters of the person diagnosed with this disease. While there are many government and non-government organisations that provide treatment and support services for the person with breast cancer, these services are usually provided in person either in the home or at the organisation’s offices. This study extended the information advice and support aspects of these services to the online or Internet based realm via the design and development of a breast cancer focused online support community www.breastcancerclick.com.au and explored the role of the expert nurse through the employment of a specialist breast care nurse as a member, moderator and health professional within this online community.
This study used an ethnonetnographic approach, including online (on the Internet) and offline (face-to-face) methods, to explore the role of the specialist breast care nurse within the online, breast cancer support, community. The study was comprised of three phases, Phase One, the offline and online identification of the information, advice and support needs of Western Australian women with breast cancer and their Internet use; development of a website designed to meet those needs and to foster the development of an online support community; Phase Two, the employment and introduction of a specialist breast care nurse as a member and provider of evidence-based information, advice and support for online community members; Phase Three, the online and offline collection of data relevant to the role of the specialist breast care nurse within the online support community.
The identification of the expert nurse as a linchpin in the patient’s care and communication has implications for future nursing practice and curricula as well as consumers of health care. Recommendations arose from the findings in relation to further research, nursing practice, education these recommendations indicate an innovative extension to expert nursing practice and together the elementary guidelines for health professional when developing an illness specific online support community foreshadow a future direction for nursing, in line with the digital age.
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Williams, Dale. "A participatory approach to evaluating voluntary rural community-based organizations is an effective tool from organizational learning and ensuing rural community development, as evidenced in the participative evaluation of the Southern Riverina Rural Advisory Service /." View thesis View thesis, 1995. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030603.110449/index.html.
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MacPherson, Heather Ann. "Pilot Effectiveness and Transportability Trial of Multi-Family Psychoeducational Psychotherapy (MF-PEP) for Childhood Mood Disorders in a Community Behavioral Health Setting." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1282572794.
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