scholarly journals From Intervention to Innovation: Applying a Formal Implementation Strategy in Community Primary Care

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Andrea S. Wallace ◽  
Andrew L. Sussman ◽  
Mark Anthoney ◽  
Edith A. Parker
Keyword(s):  
Health Care Providers ◽  
Implementation Strategy ◽  
Intervention Strategy ◽  
Self Management ◽  
Management Support ◽  
Care Providers ◽  
Clinic Staff ◽  
Management Intervention ◽  
Health Clinics ◽  
Community Health Clinics

Objective. To describe a comprehensive strategy for implementing an effective diabetes self-management support intervention incorporating goal-setting and followup support in community health clinics (CHCs) serving vulnerable patients.Methods. The Replicating Effective Programs (REP) framework was applied to develop an intervention strategy. In order to create a strategy consistent with the REP framework, four CHCs engaged in an iterative process involving key-informant interviews with clinic staff, ongoing involvement of clinic staff facilitating translational efforts, feedback from national experts, and an instructional designer.Results. Moving through the REP process resulted in an implementation strategy that aims to facilitate commitment, communication, and change at the clinic level, as well as means of providing interactive, time-limited education about patient behavior change and support to health care providers.Conclusion. The REP offered a useful framework for providing guidance toward the development of a strategy to implement a diabetes self-management intervention in CHCs serving medically underserved and underrepresented patient populations.

Intercountry Consensus Building: Lessons From Developing a Chronic-Conditions Self-Management Support Framework

2018 ◽  
Vol 19 (4) ◽  
pp. 613-620
Author(s):  
Susan L. Mills ◽  
Shabnam Ziabakhsh ◽  
Teresa J. Brady ◽  
Janaki Jayanthan ◽  
Peter M. Sargious
Keyword(s):  
Health Promotion ◽  
Health Care Providers ◽  
Chronic Conditions ◽  
Research Policy ◽  
Evidence Base ◽  
Self Management ◽  
Consensus Building ◽  
Management Support ◽  
Care Providers ◽  
Promotion Strategy

Self-management support initiatives that aim to improve the self-care of chronic conditions are considered a key part of a health promotion strategy for addressing the impacts of long-term illness. Given the growth of these activities and still evolving evidence base, thoughtful intercountry collaborations with subject matter experts can be an effective way to expedite building self-management support capacity, promoting the advancement of evidence, and developing effective policies and programs. The challenge is to find an effective consensus building process that promotes linkages between researchers and health promotion decisions makers across vast geographical boundaries and limited resources. This paper describes the international, multistage, face-to-face, and online process that was used for developing an international framework for self-management support by researchers, educators, health care providers, policy makers, program managers/directors, program planners, consultants, patient group representatives, and consumers in 16 countries. We reflect on key lessons from this international initiative and discuss how this type of process may be useful for other health promotion groups trying to exchange knowledge and build consensus on how to move a field of research, policy, and/or practice forward, and advance the evidence-base of practice and the relevance of research.

An Exploratory Mixed Methods Study of Diabetes self-management in Blind Americans

2021 ◽  
pp. 019394592110194
Author(s):  
Nazanin Heydarian ◽  
Allyson S. Hughes ◽  
Osvaldo F. Morera
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Mixed Methods Study ◽  
Self Management ◽  
Diabetes Distress ◽  
Management Support ◽  
Care Providers ◽  
Health Significance ◽  
Coverage Policy

This study used mixed methods to investigate the experiences of 33 participants who are blind (PWB) and have diabetes in managing their diabetes, support (or lack thereof) from their health care providers, and diabetes distress as PWB. Participants most frequently reported barriers to check blood glucose (55%), maintaining a healthy diet (45%), and distress due to their intersectional status of having blindness and diabetes. Those who mentioned intersectional distress of managing diabetes as a PWB tended to be Braille illiterate and less likely to use mobility tools that are symbolic of blindness (e.g., white cane, guide dog). These results illuminate heterogenous characteristics of PWB with diabetes, an understudied population of public health significance, to be considered when setting priorities for diabetes self-management support and health care coverage policy.

scholarly journals Effects of Perceived Risk and Patient Anxiety on Intention to Use Community Healthcare Services in a Big Modern City

SAGE Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 215824402093360
Author(s):  
Hui Sang ◽  
Jiuqing Cheng
Keyword(s):  
Community Health ◽  
Health Care Providers ◽  
Perceived Risk ◽  
Structural Equation Models ◽  
Policy Implications ◽  
Care Providers ◽  
Patient Anxiety ◽  
Community Based ◽  
Health Clinics ◽  
Community Health Clinics

In Shanghai, one of the biggest modern cities in the world, community-based health care providers are largely underutilized. As a result, valuable medical resources are wasted. The present study examined the relationship between the variables of perceived risk and patient anxiety on intentions to use community health clinics, because these two variables are closely related to decision making. A survey measuring these variables was distributed near community health clinics in Shanghai ( n = 869), and structural equation models were constructed to analyze the data. Results show that patient anxiety was associated with contracting diseases and positively related to the intention to seek services from community-based providers, whereas their perceived risk of these providers had a negative relationship with such an intention. Moreover, the knowledge that some community clinics were not as good as large hospitals was positively related to perceived risk. Policy implications are discussed based on the findings.

scholarly journals Health care providers’ experiences of pain management and attitudes towards digitally supported self-management interventions for chronic pain: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cecilie Varsi ◽  
Ingrid Konstanse Ledel Solem ◽  
Hilde Eide ◽  
Elin Børøsund ◽  
Olöf B. Kristjansdottir ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Health Care Providers ◽  
Health Care Services ◽  
Self Management ◽  
Care Providers ◽  
Design Elements ◽  
Management Intervention ◽  
Management Interventions

Abstract Background Chronic pain constitutes a significant burden for the individuals affected, and is a frequent reason why patients seek health care services. While in-person psychosocial interventions can be of support to people living with chronic pain, such interventions are not always accessible. eHealth interventions may provide greater accessibility, but the evidence and use of digital self-management solutions for chronic pain are still limited and the lack of health care provider input in the development process of such solutions a concern. Therefore, the aim of the current study was to investigate health care providers’ experiences of treating patients with chronic pain, their attitudes towards, and use of, digital solutions in pain management, and their suggestions for content and design elements for a potential digital pain self-management intervention. Methods Twelve health care providers representing a variety of health care disciplines participated in semi-structured interviews. The interviews were analyzed using thematic analysis. Results The material was analyzed into three main themes: [1] Patients with chronic pain and their current use of the health care services, [2] Health care providers’ own motivation and impression of patient prerequisites for use of digital self-management interventions, and [3] Suggestions for content and design elements in a digital self-management intervention for people living with chronic pain. The challenges faced by patients living with chronic pain were described as numerous. Despite interest and positive attitudes, few of the health care providers had used or recommended eHealth solutions to their patients. A range of potential content and functionality elements were identified, including aspects of motivation and engagement and providers also emphasized the importance of easy access and positive, personal content to support existing treatment. Conclusions This study offers insights into health care providers’ considerations for the potential of digital self-management interventions supporting patients living with chronic pain. Findings indicate the need for change and a more comprehensive treatment approach to pain management. eHealth solutions may contribute to such change, and providers pointed to a need for health care provider involvement, timely support and follow-up as important factors for integrating digital pain self-management interventions into clinical care. Trial registration ClinicalTrials.gov: NCT03705104

scholarly journals N05 A Systematic Review of Self-Management Intervention Study for Patients with Inflammatory Bowel Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S610-S610
Author(s):  
M Iizawa ◽  
L Hirose ◽  
A Tairaka ◽  
N Maya
Keyword(s):  
Inflammatory Bowel Disease ◽  
Health Care Providers ◽  
Bowel Disease ◽  
Action Plan ◽  
Risk Of Bias ◽  
Self Management ◽  
Care Providers ◽  
Inclusion Criteria ◽  
Management Intervention ◽  
Inflammatory Bowel

Abstract Background Patients with inflammatory bowel disease (IBD) have to deal with abdominal symptoms for a long time because the disease often develops at a young age, and radical treatment has not been established. To prevent worsening of symptoms associated with IBD and delay the progression of the disease, and lead a better daily life, patients must self-manage in their daily lives. At this moment, it is not clear which kinds of self-management are effective for IBD patients. Therefore, we conducted a systematic literature review (SLR) to clarify the present status and efficacy of self-management for IBD patients and find out the effective methods of self-management intervention. Methods The SLR was conducted in accordance with the methods recommended by the Cochrane Collaboration Handbook7, to reduce the risk of bias and errors. The searches were performed in Embase, Medline, and Cochrane databases. Additionally, the PsychInfo and the cumulative index of nursing and allied health literature (CINAHL) databases were searched, and relevant articles were included as other sources. Abstracts and full texts were screened to select relevant articles based on the inclusion criteria. A quality assessment was undertaken by using the Cochrane risk of bias tool checklist. Results Fifty studies met the inclusion criteria and were finally included in this review. In 31 studies, the overall population of IBD patients was included. Fourteen studies included only UC patients, 5 studies included only CD patients. Among 50 studies, 33 studies have statistically significant differences in the outcomes. We categorized the interventions and outcomes of all the studies based on Barlow’s study in 2002 and analyzed the efficacy of the intervention on the outcomes. The most common intervention was informational, subsequently management of psychological effects. The most common outcome was Inflammatory Bowel Disease Questionnaire (IBDQ). We found that psychological management and interventions related to problem-solving, goal setting, action plan, and coping skills had a positive effect on the body and psychology of IBD patients. There were six studies that investigated the effects of intervention by online medical care. Half of the online intervention showed an improvement in the use of medical services. Conclusion It is important for IBD patients and health care providers to work together to share the problem, followed by setting goals and decide on an action plan. To succeed in this process, multidisciplinary collaboration is necessary and continuous support by health care providers will be meaningful for IBD patients.

scholarly journals The effectiveness of nurse-led self-management support program for people with chronic kidney disease stage 3-4 (CKD-NLSM): Study protocol for a randomized controlled trial

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110261
Author(s):  
Al Sawad Ayat Ali ◽  
Soo Kun Lim ◽  
Li Yoong Tang ◽  
Aneesa Abdul Rashid ◽  
Boon-How Chew
Keyword(s):  
Kidney Disease ◽  
Controlled Trial ◽  
Self Management ◽  
Control Group ◽  
Management Support ◽  
Disease Knowledge ◽  
Management Intervention ◽  
Randomized Controlled ◽  
Ckd Stage ◽  
Management Behaviors

The complexity of chronic kidney disease (CKD) and its treatments have made self-management behaviors inevitably challenging. However, supplementing education with self-management skills may improve numerous health outcomes in people with nondialysis CKD. This study protocol describes a randomized controlled trial (RCT) aimed to evaluate the effects of a nurse-led self-management support program as an intervention for kidney disease knowledge and CKD self-management behaviors among people with pre-dialysis CKD. In Phase 1, people with CKD stage 3–4 and their family members are involved in co-designing, development and pilot testing of a theory-based self-management intervention. In Phase 2, we perform a cross-cultural adaptation of the Kidney Disease Knowledge Survey, CKD Self-Management and Self-efficacy for Managing Chronic Disease questionnaires. In Phase 3, a parallel RCT will be conducted to evaluate the intervention where 154 participants with CKD stage 3–4 will be randomly assigned to either the intervention ( n = 77) or control group ( n = 77). The intervention group will receive 6-week self-management program from a nurse-coach in addition to standard usual care, while the control group will receive only standard usual care. Outcome measures include kidney disease knowledge, CKD self-management behavior, self-efficacy, quality of life, blood pressure control and adherence to CKD diet as indicated by 24-h urine urea nitrogen, 24-h urine sodium and net endogenous acid production. Data will be collected at baseline and 12-week post-baseline. The between- and within-group intervention effects will be estimated using the Generalized Estimating Equations. The self-management intervention offers strategies to delay CKD progression and to encourage motivation to better self-manage at home. This study integrates self-management education and psychosocial support with culturally relevant scenarios, and evaluates important self-reported and objective outcomes. Clinical Trials Registration: www.ClinicalTrials.gov , identifier: NCT03974646.

scholarly journals Gestational diabetes mellitus: a qualitative study of lived experiences of South Asian immigrant women and perspectives of their health care providers in Melbourne, Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mridula Bandyopadhyay
Keyword(s):  
Health Care ◽  
Gestational Diabetes ◽  
South Asian ◽  
Health Care Providers ◽  
Lived Experiences ◽  
Lifestyle Modification ◽  
Self Management ◽  
Asian Women ◽  
Care Providers ◽  
South Asian Women

Abstract Background South Asian women are at a high risk of developing gestational diabetes mellitus than other women in Australia. Gestational diabetes affects up to 14–19% of all pregnancies among South Asian, South East Asian, and Arabic populations placing women at risk of adverse pregnancy outcomes. Although, gestational diabetes resolves after childbirth, women with gestational diabetes are up to seven times more likely to develop type 2 diabetes within five to ten years of the index pregnancy. Increasingly, South Asian women are being diagnosed with gestational diabetes in Australia. Therefore, we aimed to gain a better understanding of the lived experiences of South Asian women and their experiences of self-management and their health care providers’ perspectives of treatment strategies. Methods Using an ethnographic qualitative research methodology, semi-structured one-on-one, face-to-face interviews were conducted with 21 health care providers involved in gestational diabetes management and treatment from the three largest tertiary level maternity hospitals in Melbourne, Victoria, Australia. In-depth interviews were conducted with 23 South Asian women post diagnosis between 24–28 weeks gestation in pregnancy. Results Health care providers had challenges in providing care to South Asian women. The main challenge was to get women to self-manage their blood glucose levels with lifestyle modification. Whilst, women felt self-management information provided were inadequate and inappropriate to their needs. Women felt ‘losing control over their pregnancy’, because of being preoccupied with diet and exercise to control their blood glucose level. Conclusions The gestational diabetes clinical practice at the study hospitals were unable to meet consumer expectations. Health care providers need to be familiar of diverse patient cultures, rather than applying the current ‘one size fits all’ approach that failed to engage and meet the needs of immigrant and ethnic women. Future enabling strategies should aim to co-design and develop low Glycaemic Index diet plans of staple South Asian foods and lifestyle modification messages.

scholarly journals Patients’ Views on Self-Management of Chronic Musculoskeletal Pain

2020 ◽  
Vol 5 (4) ◽  
pp. 254-266
Author(s):  
Barbka Huzjan ◽  
Ivana Hrvatin
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Health Care Providers ◽  
Multidisciplinary Approach ◽  
Research Question ◽  
Chronic Musculoskeletal Pain ◽  
Self Management ◽  
Care Providers ◽  
The Individual

Research Question (RQ): Chronic musculoskeletal pain is a complex condition and one of the most important causes of suffering of modern times. Self-management refers to the individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and life style changes inherent in living with a chronic condition. The research question is; what is the view on the selfmanagement of chronic musculoskeletal pain from the patient's perspective? Purpose: The purpose of this literature review was to review original articles that reported how selfmanagement educational programmes are viewed from the patient’s perspective. Method: We used an integrative review of the literature. The search was conducted from November 2019 to March 2020 on the PubMed, PEDro and OTseeker databases. We included original studies, written in English that examined the patients’ point of view on self-management. The included studies, needed to be conducted on adult patients of both sexes, that were suffering from chronic pain and were educated on self-management of their pain. Two authors independently searched for original studies. Results: Nine article were included in the review. Most of the studies included a multidisciplinary approach. Patients reported they more frequently used passive strategies to manage their pain. They want to be included in the management and be able to communicate with the provider of selfmanagement. There are several positive aspects of a multidisciplinary and groups approach. Organization: Health care providers can encourage an individual to proactively behave through ongoing processes of communication, partnerships and the creation of appropriate self-management plans over time. Society: We assume that the analysis will help to identify the social responsibility of the individual and society in the common concern for the health of the population and the individual within it. Originality: The research provides an up-to-date, new overview of the patients' perspective on self management on chronic pain. The review can be helpful to health care providers s they can compare their expectations with patients's. Limitations / further research: Further research would focus on high quality studies, and specific forms of multidisciplinary approach, and finding what patients use at a home setting and how to help them continue in the self management of their pain. Limitations of this review include the lack of risk of bias assessment and the fact that this is not a systematic review.

scholarly journals MALAYSIAN DIABETES PATIENTS’ PERCEPTIONS, ATTITUDES AND PRACTICES IN RELATION TO SELF-CARE AND ENCOUNTERS WITH PRIMARY HEALTH CARE PROVIDERS

2018 ◽  
Vol 2 (3) ◽  
pp. 1-10
Author(s):  
Lim Shiang Cheng ◽  
Jens Aagaard-Hansen ◽  
Feisul Idzwan Mustapha ◽  
Ulla Bjerre-Christensen
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Self Management ◽  
Care Providers ◽  
Attitudes And Practices ◽  
Primary Health ◽  
Primary Health Care Providers ◽  
Primary Healthcare Clinics ◽  
Diabetes Patients

Introduction: Studies from many parts of the world have explored factors associated with poor diabetes self-management including Diabetes Self-Management Education (DSME). Research Methodology: This study was conducted among 162 diabetes patients at primary healthcare clinics in Malaysia using semi-structured exit-interviews to explore their perceptions, attitudes and practices in relation to self-care and encounters with primary health care providers. Results and Discussion: Generally, the patients had limited knowledge, lack of motivation and encountered difficulties in diabetes self-management. The DSME was inadequate due to limited time allocated for consultations with doctors, language barriers and the lack of interpersonal and communication skills of HCPs. Conclusion: In view of the positive effects of quality DSME on the health outcomes and quality of life among diabetes patients, it is important for the primary healthcare clinics in Malaysia to strengthen the diabetes services through training in communication of all HCPs, awareness of language difference and task shifting.

scholarly journals Designing a Cocreated Intervention with African American Older Adults for Hypertension Self-Management

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Kathy D. Wright ◽  
Carolyn H. Still ◽  
Lenette M. Jones ◽  
Karen O. Moss
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
African American ◽  
Health Care Providers ◽  
Mode Of Delivery ◽  
Self Management ◽  
Semistructured Interview ◽  
Care Providers ◽  
Group Sessions ◽  
African American Older Adults

Hypertension is a lifelong disease that requires self-management. Additionally, there are disparities in hypertension self-management that disproportionately affect African Americans. Interventions designed in collaboration with older adults have the potential to improve hypertension self-management. The purpose of this design paper is to describe the process in which African American older adults and nurse researchers cocreated an intervention to address stress in the self-management of hypertension. A semistructured interview guide was used to elicit feedback on self-management behaviors to cocreate an intervention with the participants. Participants provided constant iterative feedback on the design used for the intervention. Participants prioritized the content and mode of delivery. African American older adults with hypertension (N=31; 87% women) participated in two focus group sessions. The primary stressors identified by the group that influenced their blood pressure self-management were as follows: (a) measuring blood pressure and using home blood pressure monitors; (b) difficulty communicating with family and friends; (c) sleep management and pain at night; and (d) healthy eating. Based on the participants’ feedback, we created four biweekly (2-hour) group sessions that incorporated their suggestions and addressed their concerns. Health care providers can use this technique to engage African American older adults in participant-centered hypertension self-management.

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