scholarly journals Commentary: De-implementation Science: A Virtuous Cycle of Ceasing and Desisting Low-Value Care Before Implementing New High Value Care

2017 ◽  
Vol 27 (4) ◽  
pp. 463 ◽  
Author(s):  
Karina W. Davidson ◽  
Siqin Ye ◽  
George A. Mensah
Keyword(s):  
Behavior Change ◽  
Implementation Science ◽  
Feedback Loop ◽  
Quality Care ◽  
Evidence Based ◽  
High Quality ◽  
Behavior Change Techniques ◽  
Virtuous Cycle ◽  
And Behavior ◽  
Evidence Based Care

<p>Implementation science has traditionally focused on increasing the delivery of evidence-based care. The science of systematically stopping low-value and wasteful care is substantially under-recognized, and if successful, may decrease the workload of clinicians. De-implementation science identifies problem areas of low-value and wasteful practice, carries out rigorous scientific examination of the factors that initiate and maintain such behaviors, and then employs evidence-based interventions to cease these practices. In this commentary, we describe how this approach for de-implementation might require a different set of health systems supports, economic and non-economic levers, and behavior change techniques that can lead to a virtuous cycle, ie, a complex chain of events that positively reinforce themselves through a feedback loop of removing low-value care to make room for high quality care. <em></em></p><p><em>Ethn Dis. </em>2017;27(4):463-468; doi:10.18865/ ed.27.4.463. </p>

scholarly journals Barriers and Facilitators That Influence Providers’ Ability to Educate, Monitor, and Treat Substance Use in First-Episode Psychosis Programs Using the Theoretical Domains Framework

2021 ◽  
pp. 104973232199344
Author(s):  
Oladunni Oluwoye ◽  
Elizabeth Fraser
Keyword(s):  
Substance Use ◽  
Behavior Change ◽  
Theoretical Domains Framework ◽  
First Episode Psychosis ◽  
Barriers And Facilitators ◽  
First Episode ◽  
Evidence Based ◽  
Behavior Change Techniques ◽  
Episode Psychosis ◽  
And Behavior

In this qualitative study, we explore providers’ experiences with addressing substance use among individuals with first-episode psychosis (FEP) enrolled in coordinated specialty care (CSC) programs. Three focus groups were conducted with 24 providers from CSC programs for FEP in Washington. Questions were focused on barriers and facilitators to addressing substance use using the Theoretical Domains Framework (TDF) as a guide. Thematic analysis was used to code all transcripts. Identified TDF domains were then mapped onto the COM-B (Capability, Opportunity, Motivation, Behavior) intervention functions and behavior change techniques. Seven theoretical domains were identified as the most relevant to addressing substance use: “Knowledge,” “Skills,” “Environmental Context and Resources,” “Social Influences,” “Social and Professional Role and Identity,” “Beliefs about Capabilities,” and “Reinforcement.” The use of the TDF provides a framework to explore barriers and facilitators for targeting substance use and suggestions for behavior change techniques when considering implementation of evidence-based strategies to enhance CSC models.

Gamification in Oral Health (Preprint)

2021 ◽  
Author(s):  
Rui Moreira ◽  
Nuno Durão ◽  
Rita Maria Cabral ◽  
Jessica Lourenço ◽  
Augusta Silveira ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Behavior Change ◽  
Well Being ◽  
Health Behavior Change ◽  
Psychological Needs ◽  
Evidence Based ◽  
Care Providers ◽  
Behavior Change Techniques ◽  
And Behavior

BACKGROUND Our modern way of life, health and well-being depend on the individual's health behaviors. Motivation is a major factor of health behaviour change, and intrinsically motivated behavior change is desirable as it is both sustained and directly contributes to well-being. This raises the immediate question about what kind of interventions are best positioned to intrinsically motivate health behavior change. OBJECTIVE With this study we wanted to analyse the presence and efficiency of gamification mechanisms in oral healthcare-themed digital games and apps on promoting user engagement to comply with prevention policies. METHODS The search query was based on the electronic database PubMed. Applying exclusion and inclusion criteria, this study is focused on scholar work reporting original research of the value of gamification on oral healthcare. The final pool of data was scrutinized for the gamification features, evidence-based oral health and behavior change techniques. RESULTS Apps with high quality evidence-based educational content for oral self-care, employing gamification features and behavior change techniques, provide excellent results in functionality, effectiveness, efficiency and satisfaction. However, some authors highlighted issues such as the need to improve engagement, aesthetics, evidence-based information content, behavior change taxonomies, psychological needs, evaluation, validation, quality assessment and professional regulation of the oral healthcare apps. CONCLUSIONS In this systematic review, we did not find any app that included all the segments for learning, performing, and maintaining proper oral health care. Evidence-based oral healthcare gamification features represent potential new approaches for health care providers to change behavior in the form of learning, performing and maintaining proper oral hygiene. Evaluation, validation, quality assurance, best practice standards and guidelines are needed for improving app use.

scholarly journals The Effects of Gamification and Oral Self-Care on Oral Hygiene in Children: Systematic Search in App Stores and Evaluation of Apps (Preprint)

2019 ◽  
Author(s):  
Nino Fijačko ◽  
Lucija Gosak ◽  
Leona Cilar ◽  
Alenka Novšak ◽  
Ruth Masterson Creber ◽  
...  
Keyword(s):  
Public Health ◽  
Behavior Change ◽  
Oral Hygiene ◽  
Rating Scale ◽  
Self Care ◽  
Public Health Problem ◽  
Mobile App ◽  
Evidence Based ◽  
Behavior Change Techniques ◽  
Evidence Based Dentistry

BACKGROUND Poor oral hygiene is a great public health problem worldwide. Oral health care education is a public health priority as the maintenance of oral hygiene is integral to overall health. Maintaining optimal oral hygiene among children is challenging and can be supported by using relevant motivational approaches. OBJECTIVE The primary aim of this study was to identify mobile smartphone apps that include gamification features focused on motivating children to learn, perform, and maintain optimal oral hygiene. METHODS We searched six online app stores using four search terms (“oral hygiene game,” “oral hygiene gamification,” “oral hygiene brush game,” and “oral hygiene brush gamification”). We identified gamification features, identified whether apps were consistent with evidence-based dentistry, performed a quality appraisal with the Mobile App Rating Scale user version (uMARS), and quantified behavior scores (Behavior Change score, uMARS score, and Coventry, Aberdeen, and London-Refined [CALO-RE] score) using three different instruments that measure behavior change. RESULTS Of 612 potentially relevant apps included in the analysis, 17 met the inclusion criteria. On average, apps included 6.87 (SD 4.18) out of 31 possible gamification features. The most frequently used gamification features were time pressure (16/17, 94%), virtual characters (14/17, 82%), and fantasy (13/17, 76%). The most common oral hygiene evidence-based recommendation was brushing time (2-3 minutes), which was identified in 94% (16/17) of apps. The overall mean uMARS score for app quality was high (4.30, SD 0.36), with good mean subjective quality (3.79, SD 0.71) and perceived impact (3.58, SD 0.44). Sufficient behavior change techniques based on three taxonomies were detected in each app. CONCLUSIONS The majority of the analyzed oral hygiene apps included gamification features and behavior change techniques to perform and maintain oral hygiene in children. Overall, the apps contained some educational content consistent with evidence-based dentistry and high-quality background for oral self-care in children; however, there is scope for improvement.

The global elements of vital signs' assessment: a guide for clinical practice

2021 ◽  
Vol 30 (16) ◽  
pp. 956-962
Author(s):  
Malcolm Elliott
Keyword(s):  
Clinical Practice ◽  
Outcomes Research ◽  
Quality Care ◽  
Vital Signs ◽  
Clinical Judgement ◽  
Evidence Based ◽  
Valuable Insight ◽  
High Quality ◽  
Culture Tradition ◽  
Insight Into

The assessment of vital signs is critical for safe, high-quality care. Vital signs' data provide valuable insight into the patient's condition, including how they are responding to medical treatment and, importantly, whether the patient is deteriorating. Although abnormal vital signs have been associated with poor clinical outcomes, research has consistently found that vital signs' assessment is often neglected in clinical practice. Factors contributing to this include nurses' knowledge, clinical judgement, culture, tradition and workloads. To emphasise the importance of vital signs' assessment, global elements of vital signs' assessment are proposed. The elements reflect key principles underpinning vital signs' assessment and are informed by evidence-based literature.

Motivating Adolescents to Participate in Literacy Intervention: A Case Example From Telepractice

2021 ◽  
pp. 1-15
Author(s):  
Ginger G. Collins
Keyword(s):  
Behavior Change ◽  
Self Determination Theory ◽  
Literacy Skills ◽  
Language Intervention ◽  
Self Determination ◽  
Literacy Intervention ◽  
Behavior Change Techniques ◽  
Language Interventions ◽  
And Behavior ◽  
Motivation To Participate

Purpose: Motivation declines as children reach adolescence. Poor motivation inhibits participation and engagement in language-based interventions. The purpose of this tutorial is to demonstrate how intervention can be designed to increase client motivation to participate while improving language-based literacy skills. Method: Motivation and behavior change techniques based on self-determination theory are presented, as are examples of how to integrate these techniques into contextualized language intervention with adolescent clients. Conclusion: Incorporating motivation and behavior change techniques into contextualized language interventions with adolescents promotes self-determination and motivation through satisfaction of their need for autonomy, relatedness, and competence while simultaneously addressing language-based literacy deficits.

Preparing for an Epidemic: Cancer Care in an Aging Population

2014 ◽  
pp. 133-137 ◽  
Author(s):  
Ya-Chen Tina Shih ◽  
Arti Hurria
Keyword(s):  
Older Adults ◽  
Cancer Care ◽  
Care Delivery ◽  
Quality Care ◽  
Aging Population ◽  
Population Based ◽  
Cancer Drug ◽  
Evidence Based ◽  
Evidence Based Care

The Institute of Medicine's (IOM) Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population was charged with evaluating and proposing recommendations on how to improve the quality of cancer care, with a specific focus on the aging population. Based on their findings, the IOM committee recently released a report highlighting their 10 recommendations for improving the quality of cancer care. Based on those recommendations, this article highlights ways to improve evidence-based care and addresses rising costs in health care for older adults with cancer. The IOM highlighted three recommendations to address the current research gaps in providing evidence-based care in older adults with cancer, which included (1) studying populations which match the age and health-risk profile of the population with the disease, (2) legislative incentives for companies to include patients that are older or with multiple morbidities in new cancer drug trials, and (3) expansion of research that contributes to the depth and breadth of data available for assessing interventions. The recommendations also highlighted the need to maintain affordable and accessible care for older adults with cancer, with an emphasis on finding creative solutions within both the care delivery system and payment models in order to balance costs while preserving quality of care. The implementation of the IOM's recommendations will be a key step in moving closer to the goal of providing accessible, affordable, evidence-based, high-quality care to all patients with cancer.

scholarly journals Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men: A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project)

2015 ◽  
Vol 11 (4) ◽  
pp. 1096-1123 ◽  
Author(s):  
Clare Robertson ◽  
Alison Avenell ◽  
Fiona Stewart ◽  
Daryll Archibald ◽  
Flora Douglas ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Weight Loss ◽  
Confidence Interval ◽  
Behavior Change ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Behavior Change Techniques ◽  
Randomized Controlled ◽  
And Behavior

Men are underrepresented in obesity services, suggesting current weight loss service provision is suboptimal. This systematic review evaluated evidence-based strategies for treating obesity in men. Eight bibliographic databases and four clinical trials’ registers were searched to identify randomized controlled trials (RCTs) of weight loss interventions in men only, with mean/median body mass index of ≥30 kg/m2 (or ≥28 kg/m2 with cardiac risk factors), with a minimum mean/median duration of ≥52 weeks. Interventions included diet, physical activity, behavior change techniques, orlistat, or combinations of these; compared against each other, placebo, or a no intervention control group; in any setting. Twenty-one reports from 14 RCTs were identified. Reducing diets produced more favorable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise program −3.2 kg, 95% confidence interval −4.8 to −1.6 kg, reported p < .01). The most effective interventions combined reducing diets, exercise, and behavior change techniques (mean difference in weight at 1 year compared with no intervention was −4.9 kg, 95% confidence interval −5.9 to −4.0, reported p < .0001). Group interventions produced favorable weight loss results. The average reported participant retention rate was 78.2%, ranging from 44% to 100% retention, indicating that, once engaged, men remained committed to a weight loss intervention. Weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behavior change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed.

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