scholarly journals 2300

2017 ◽  
Vol 1 (S1) ◽  
pp. 5-6 ◽  
Author(s):  
Gillian Feldmeth ◽  
Leidy Gutierrez ◽  
Stacy Tessler Lindau ◽  
Jennifer A. Makelarski ◽  
Edward T. Naureckas ◽  
...  
Keyword(s):  
Minority Groups ◽  
Clinical Care ◽  
Research Participation ◽  
Target Population ◽  
Consent Form ◽  
Recruitment Strategy ◽  
Care Needs ◽  
Usual Practice ◽  
Recruitment Methods ◽  
Return Envelope

OBJECTIVES/SPECIFIC AIMS: To study the rate of recruitment to the Pulmonary Research Registry (PRR) at the University of Chicago using HealtheRx recruitment Versus usual practice. METHODS/STUDY POPULATION: CommunityRx is a health information technology, integrated with electronic medical record (EMR) platforms, that generates personalized referrals (“HealtheRxs”) for community-based programs and services that address basic and other health-related self-care needs. The target population included people ages 18 and older, English speaking, living in 1 of 16 ZIP codes on Chicago’s south and west sides (106 mi2) who received care at ≥1 of 28 CommunityRx partner sites and had a diagnosis of asthma or COPD. Between December 2015 and December 2016, information about pulmonary research participation opportunities was included on the HealtheRxs of eligible patients contemporaneously with usual registry recruitment methods. Usual methods, used since 2010 by the PRR group, included public advertisements requiring the patient to call the research team for more information and education of eligible patients identified during routine clinical care with a Pulmonary/Critical Care clinician or when enrolling in a pulmonary clinical trial. We hypothesized that, compared with usual recruitment practices, the HealtheRx recruitment strategy would increase the rate and decrease the per subject cost of patient recruitment to a prospective registry. Total annual recruitment costs for each method were calculated and divided by the number of consented PRR enrollees per method. RESULTS/ANTICIPATED RESULTS: Between December 22, 2015 and December 15, 2016 13,437 HealtheRxs (8762 for asthma, 3842 for COPD, and 833 for both asthma and COPD) were generated with the recruitment advertisement. In total, 41 patients responded to the ad and participated in the phone survey. In which 15 (36.5%) participants self-reported a diagnosis of asthma only (65% of all HealtheRxs with advertisement were for asthma only), 9 (22%) reported a diagnosis of COPD only (28.5% of all HealtheRxs with advertisement were for COPD only), and 17 (41.5%) reported diagnoses of both asthma and COPD (6.2% of all HealtheRxs with advertisement were for asthma and COPD). Most participants were female (n=28), non-Hispanic black (n=37), and not employed (n=39). The median age was 57. The majority (n=31) had never participated in health or medical research and was not aware of current opportunities to participate in research (n=25). All 41 participants expressed interest in joining PRR and were mailed a blank PRR consent form and a prepaid return envelope with their incentive check for the telephone survey. To date, 5 participants returned a signed consent form via mail and were enrolled in PRR. During the same period, 4 patients enrolled in PRR via usual recruitment methods. The cost per subject to enroll in PRR was $364.40 using the HealtheRx recruitment and $4590 using usual practice. DISCUSSION/SIGNIFICANCE OF IMPACT: NIH has called for innovation in research recruitment methodologies to increase enrollment especially of people who are under-represented in clinical trials research. This study demonstrates the feasibility and efficiency of using an EMR-integrated recruitment method to enroll people of under-represented minority groups to a research registry.

scholarly journals METHODOLOGICAL STRATEGIES AND CHALLENGES FOR EVALUATING PARTICIPANT VIEWS ON DEMENTIA RESEARCH RECRUITMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S706-S706
Author(s):  
Laura Block ◽  
Shannon Mullen ◽  
Gay Thomas ◽  
Betty Kaiser ◽  
Andrea Gilmore-Bykovskyi
Keyword(s):  
Data Collection ◽  
Clinical Care ◽  
Research Participation ◽  
Community Advisory Board ◽  
Research Recruitment ◽  
Recruitment Methods ◽  
Iterative Development ◽  
Primary Specialty ◽  
Shared Language ◽  
Dementia Research

Abstract There is an urgent need to expand enrollment in clinical Alzheimer’s disease (AD) research. Current recruitment methods for AD research predominantly identify patients from primary/specialty clinic settings, potentially creating barriers for individuals unconnected to care. In response to these challenges, the 2018 National Strategy for Research Recruitment and Participation has called for the development of an applied science of recruitment to inform best strategies. However, progress in this area is hindered by methodological challenges to accurately measure AD patient/caregiver participant views on research participation. The objective of this presentation is to report methodological strategies developed to during a prospective qualitative study to investigate AD patient/caregiver views on acute care research recruitment and participation. Participants included patients with dementia (N=2) who had recently been hospitalized and/or their informal caregivers (N=15). We engaged in iterative development and revision of data collection approaches (i.e. semi-structured questions, audiovisual tools, interview guidance) through collaboration with a Community Advisory Board (CAB). Detailed memos were generated to document interview-related challenges, successes and revisions. Therapeutic misconception in delineating research from clinical care was common during interviews regardless of prior research participation. Interview strategies that focus on lived experiences, remove ambiguity from hypothetical recruitment scenarios, and incorporate supportive visual tools that clarify processes around recruitment improved data collection. Challenges included the lack of a common, shared language around recruitment, which was addressed through CAB guidance and input. In conclusion, thoughtful collaboration with community/lay advisers can successfully inform and data collection methods used in applied recruitment research.

scholarly journals Electronic medical record–based cohort selection and direct-to-patient, targeted recruitment: early efficacy and lessons learned

2019 ◽  
Vol 26 (11) ◽  
pp. 1209-1217 ◽  
Author(s):  
Hailey N Miller ◽  
Kelly T Gleason ◽  
Stephen P Juraschek ◽  
Timothy B Plante ◽  
Cassie Lewis-Land ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Response Rate ◽  
Target Population ◽  
Lessons Learned ◽  
Recruitment Strategy ◽  
Eligibility Criteria ◽  
Health Network ◽  
Recruitment Methods ◽  
Cohort Selection

Abstract Objective The study sought to characterize institution-wide participation in secure messaging (SM) at a large academic health network, describe our experience with electronic medical record (EMR)–based cohort selection, and discuss the potential roles of SM for research recruitment. Materials and Methods Study teams defined eligibility criteria to create a computable phenotype, structured EMR data, to identify and recruit participants. Patients with SM accounts matching this phenotype received recruitment messages. We compared demographic characteristics across SM users and the overall health system. We also tabulated SM activation and use, characteristics of individual studies, and efficacy of the recruitment methods. Results Of the 1 308 820 patients in the health network, 40% had active SM accounts. SM users had a greater proportion of white and non-Hispanic patients than nonactive SM users id. Among the studies included (n = 13), 77% recruited participants with a specific disease or condition. All studies used demographic criteria for their phenotype, while 46% (n = 6) used demographic, disease, and healthcare utilization criteria. The average SM response rate was 2.9%, with higher rates among condition-specific (3.4%) vs general health (1.4%) studies. Those studies with a more inclusive comprehensive phenotype had a higher response rate. Discussion Target population and EMR queries (computable phenotypes) affect recruitment efficacy and should be considered when designing an EMR-based recruitment strategy. Conclusions SM guided by EMR-based cohort selection is a promising approach to identify and enroll research participants. Efforts to increase the number of active SM users and response rate should be implemented to enhance the effectiveness of this recruitment strategy.

scholarly journals Structure and processes of emergency observation units with a geriatric focus: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pieter Heeren ◽  
Annabelle Hendrikx ◽  
Janne Ceyssens ◽  
Els Devriendt ◽  
Mieke Deschodt ◽  
...  
Keyword(s):  
Scoping Review ◽  
Emergency Care ◽  
Older Patients ◽  
Clinical Care ◽  
Care Needs ◽  
Post Discharge ◽  
Care Services ◽  
Observation Units ◽  
Primary Care Services ◽  
Healthcare Professions

Abstract Background Combining observation principles and geriatric care concepts is considered a promising strategy for risk-stratification of older patients with emergency care needs. We aimed to map the structure and processes of emergency observation units (EOUs) with a geriatric focus and explore to what extent the comprehensive geriatric assessment (CGA) approach was implemented in EOUs. Methods The revised scoping methodology framework of Arksey and O’Malley was applied. Manuscripts reporting on dedicated areas within hospitals for observation of older patients with emergency care needs were eligible for inclusion. Electronic database searches were performed in MEDLINE, EMBASE and CINAHL in combination with backward snowballing. Two researchers conducted data charting independently. Data-charting forms were developed and iteratively refined. Data inconsistencies were judged by a third researcher or discussed in the research team. Quality assessment was conducted with the Methodological Index for Non-Randomized Studies. Results Sixteen quantitative studies were included reporting on fifteen EOUs in seven countries across three continents. These units were located in the ED, immediately next to the ED or remote from the ED (i.e. hospital-based). All studies reported that staffing consisted of at least three healthcare professions. Observation duration varied between 4 and 72 h. Most studies focused on medical and functional assessment. Four studies reported to assess a patients’ medical, functional, cognitive and social capabilities. If deemed necessary, post-discharge follow-up (e.g. community/primary care services and/or outpatient clinics) was provided in eleven studies. Conclusion This scoping review documented that the structure and processes of EOUs with a geriatric focus are very heterogeneous and rarely cover all elements of CGA. Further research is necessary to determine how complex care principles of ‘observation medicine’ and ‘CGA’ can ideally be merged and successfully implemented in clinical care.

Evaluating a Model of Service Integration for Older People with Complex Health Needs

2005 ◽  
Vol 4 (1-2) ◽  
pp. 34-41 ◽  
Author(s):  
Steve Bird ◽  
William Kurowski ◽  
Gillian Dickman
Keyword(s):  
Health Care ◽  
Older People ◽  
Service Integration ◽  
Evaluation Process ◽  
Target Population ◽  
Multiple Chronic Conditions ◽  
Health Care Needs ◽  
Care Needs ◽  
Community Based ◽  
Quantitative And Qualitative Methods

Background Older people with multiple chronic conditions and complex health care needs require a comprehensive, accessible and well-coordinated system of services. To address this growing problem, a consortium of acute and community-based health care organisations implemented a ‘Patients First’ model of service integration for the target population. The project evaluation utilised a combination of quantitative and qualitative methods in an action research framework. Findings The evaluation process not only demonstrated the benefits of the project to patients and the health care system, but also contributed to the identification of pivotal components in the model, aspects requiring attention and consequently their refinement. It was also a vehicle for the development of a sense of ownership amongst staff and has evolved into an integral part of the model.

scholarly journals Domiciliary Care Providers Views on Provision of Palliative Care for their Cancer Patients

2018 ◽  
Vol 4 (1) ◽  
pp. 1-7
Author(s):  
Meegoda MKDL ◽  
Fernando DMS ◽  
Sivayogan S ◽  
Atulomah NOS ◽  
Marasinghe RB
Keyword(s):  
Palliative Care ◽  
Sri Lanka ◽  
Cancer Patients ◽  
Family Care ◽  
Sampling Technique ◽  
Target Population ◽  
Care Providers ◽  
Care Needs ◽  
Domiciliary Care ◽  
Depth Interviews

A qualitative study was conducted to describe views and life experiences of domiciliary care providers in meeting the palliative care needs of adult cancer patients at the National Cancer Institute, Maharagama, Sri Lanka. The target population for this study was Domiciliary Care Providers (DCPs) who were the family care givers of patients at National Institute of Cancer, Maharagam (NICM), Cancer Home (CH), Maharagama, Shantha Sevana Hospice (SSH) and Ceylinco Oncology Unit (COU), Colombo, Sri-Lanka. Purposive sampling technique was used to select participants for the study. In-depth interviews were conducted using validated semi-structured interviewer guide. Data saturation was reached after 15 in-depth interviews with DCPs. Trustworthiness of the study was maintained. Phenomenological-hermeneutic approach was followed to analyze qualitative data and thematic analysis was performed. Data analysis was done concurrently with data gathering. Being reassured, having more expectations, need psychosocial help and inadequate knowledge were the key themes identified. They expect knowledge improvement to provide better care. As patients’ level of satisfaction on domiciliary care provided by DCPs was high, improving their knowledge on palliative care may be a cost effective method of improving palliative care.

scholarly journals Lupus patient decisions about clinical trial participation: a qualitative evaluation of perceptions, facilitators and barriers

2020 ◽  
Vol 7 (1) ◽  
pp. e000360
Author(s):  
Cristina Arriens ◽  
Teresa Aberle ◽  
Fredonna Carthen ◽  
Stan Kamp ◽  
Aikaterini Thanou ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Focus Groups ◽  
Minority Groups ◽  
Research Participation ◽  
Qualitative Evaluation ◽  
Control Beliefs ◽  
Trial Participation ◽  
Clinical Trial Participation ◽  
Personal Benefit ◽  
Advantages And Disadvantages

ObjectiveAlthough SLE disproportionately affects minority racial groups, they are significantly under-represented in clinical trials in the USA. This may lead to misleading conclusions in race-based subgroup analyses. We conducted focus groups to evaluate the perceptions of diverse patients with lupus about clinical trial participation.MethodsA qualitative research design employed three 90 min focus groups led by a trained moderator and guided by the Theory of Planned Behaviour. Open-ended questions about trial participation included advantages and disadvantages (behavioural beliefs), approving and disapproving significant others (normative beliefs), and participation enhancers and barriers (control beliefs). Discussions were recorded, transcribed and analysed to identify emerging themes.ResultsPatients with SLE (n=23) aged 21–72, with increased proportion of minority groups (65%), participated. Reported advantages of trial participation included altruism and personal benefit. Disadvantages included uncertainties, disappointment, information burden, and life–health balance. Although some patients had discussed research participation with approving or disapproving family or friends, self-approval superseded external approval. Barriers included logistics and time, and facilitators included flexibility in scheduling, advance notice of studies, streamlined forms, and hope for SLE improvement.ConclusionsKnowledge about potential benefits of clinical trial participation was high. Minority patients demonstrated confidence in making their own informed decisions, but major barriers for all participants included burdensome forms, travel, childcare, and work. These suggest a major impact on minority and all recruitment from behavioural and control aspects, which should be considered in the logistics of trial design. This does not minimise the potential importance of improved access and education about clinical research.

scholarly journals AN ACADEMIC-HEALTH SYSTEM COLLABORATION TO DEVELOP A PROGRAM FOR FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S439-S439
Author(s):  
Elena Siegel ◽  
Ladson Hinton ◽  
Elizabeth Rice ◽  
Nilpa Shah ◽  
Vanessa McElroy ◽  
...  
Keyword(s):  
Health System ◽  
Family Caregivers ◽  
Clinical Care ◽  
Organizational Capacity ◽  
Lessons Learned ◽  
System Level ◽  
Quality Improvement Initiative ◽  
Care Needs ◽  
Academic Practice ◽  
Time Investment

Abstract Hospitalization of persons with dementia can pose specific challenges for family caregivers, with post-discharge issues in managing acute clinical care needs coupled with dementia-related care that can exacerbate caregiver fatigue and capacity. We established an academic-practice collaboration to develop an evidence-based and innovative multi-component health system-level program to support family caregivers of persons with dementia in transition from hospital to community. Using an implementation science approach aimed to decrease the gap in translation of caregiver research into practice, we co-designed the program/implementation plan as a quality improvement initiative reflecting an integration of evidence from family caregiving literature and the health system’s unique context, workflows, stakeholder perspectives, resources, and values/priorities. This paper highlights insights gained and lessons learned in establishing a successful academic-practice collaboration, including time/investment to establish a shared project vision and identify/leverage existing organizational capacity to successfully deliver a program to improve the health and wellbeing of family caregivers.

Recruitment lessons learned from a tailored web-based health intervention Project Y.E.A.H. (Young Adults Eating and Active for Health)

2015 ◽  
Vol 115 (5) ◽  
pp. 470-479 ◽  
Author(s):  
Onikia Brown ◽  
Virginia Quick ◽  
Sarah Colby ◽  
Geoffrey Greene ◽  
Tanya M. Horacek ◽  
...  
Keyword(s):  
College Students ◽  
Community Based Participatory Research ◽  
Health Intervention ◽  
Lessons Learned ◽  
Recruitment Strategy ◽  
Recruitment Strategies ◽  
Web Based ◽  
Content Type ◽  
Recruitment Methods ◽  
Successful Recruitment

Purpose – Recruiting college students for research studies can be challenging. The purpose of this paper is to describe the lessons learned in the various recruitment strategies used for enrolling college students in a theory-based, tailored, and web-delivered health intervention at 13 US universities. Design/methodology/approach – The community-based participatory research (CBPR) model was used to develop a staged-tailored, web-based, randomized control trial, focussing on eating behavior, physical activity, and stress management. Participant feedback during baseline assessments was used to evaluate recruitment strategies. Findings – Findings from this feedback suggest that traditional recruitment strategies, such as newspaper ads and flyers, may not be the best approach for recruiting college students; instead, web-based efforts proved to be a better recruitment strategy. Research limitations/implications – This project included results from 13 US universities and thus may not be generalizable: more research is needed to determine successful recruitment methods for 18-24 years old college students. Originality/value – This paper lessens the gap regarding successful recruitment strategies for 18-24 years old college students.

scholarly journals Patient-Related Complexity of Care in Healthcare Organizations: A Management and Evaluation Model

2020 ◽  
Vol 17 (10) ◽  
pp. 3463 ◽  
Author(s):  
Fiorella Pia Salvatore ◽  
Simone Fanelli
Keyword(s):  
Evaluation Model ◽  
Clinical Care ◽  
Decision Rules ◽  
Healthcare Services ◽  
Primary Objective ◽  
Healthcare Organizations ◽  
Care Needs ◽  
Patient Admissions ◽  
Clinical Instability ◽  
The Right

In times of economic stringency, the prerequisite for the provision of healthcare services differentiated by complexity is identified in the right patients’ allocation. Since access to high-intensity care units is restricted, it is necessary both to promptly diagnose patients who are at risk of rapid clinical deterioration or death and to define criteria to identify the correct allocation of patients based on clinical-care needs. Although the so-called “early warning scores” were used by healthcare professionals to alert medical staff, nowadays, they can also be used as decision rules for managing patient admissions, increasing their effective usefulness. The procedure for assessing the complexity of care profiles needs to be based on a multidisciplinary approach. The primary objective of scientific research was to determine the intensity of care (clinical instability and care dependence) of the patients allocated in different settings of the medical area. To correctly frame the phenomenon, the main methods and strategies developed for different care models were discussed. In the Italian healthcare organization, the indicators, methodologies and tools to evaluate the clinical-care complexity were identified and subsequently applied. In conclusion, the findings and proposals for improvement actions are shown.

scholarly journals Optimizing primary care research participation: a comparison of three recruitment methods in data-sharing studies

2016 ◽  
Vol 33 (2) ◽  
pp. 200-204 ◽  
Author(s):  
Paul A Lord ◽  
Thomas A Willis ◽  
Paul Carder ◽  
Robert M West ◽  
Robbie Foy
Keyword(s):  
Primary Care ◽  
Data Sharing ◽  
Research Participation ◽  
Primary Care Research ◽  
Recruitment Methods ◽  
Care Research
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