Appropriateness Of Implementation Research Articles

Psychometric characteristics of the decision‐making ability scale among high school students

AbstractThe process of decision‐making is a multifaceted cognitive endeavor encompassing various cognitive, emotional, psychological, and social processes. It empowers individuals to select from a range of alternatives. Its significance spans across age groups, impacting both adults and children, and the relevance of which goes beyond aiding learners in choosing their educational or professional paths; it also pertains to preparing them to navigate the diverse situations they will encounter throughout their lives. To approach this ability, we developed a scale comprising 20 items, assessing five distinct decision‐making factors. This scale was administered to a sample of 303 learners in the first and second years of the baccalaureate course (pre‐final and final years of secondary education), representing both genders, and studying in four high schools. The participants’ ages ranged between 16 and 20 years. The results of this study revealed positive psychometric properties of the scale after its apparent validity was verified. Additionally, principal component analysis, using a latent root criterion greater than one (Eigenvalue > 1), and performing Varimax rotation, resulted in five factors that represent decision‐making styles (dependent, avoidant, confident, rational, intuitive) that explain 53.67% of the total variance. Through the application of confirmatory factor analysis (CFA), the outcomes showcased favorable conformity indicators. The ratio of chi‐square value to degrees of freedom was recorded at less than 5 (x²/df = 1.531). The RMSEA index, at 0.041, remained below the accepted threshold of 0.08. The metrics (CFI, TLI, GFI, IFI) all surpassed 0.90, falling within acceptable ranges. Strong internal consistency between item scores and their respective factors was established by Pearson coefficients. The correlation coefficients between each factor's score and the total scale score were robust, ranging from 0.483 to 0.727. The Cronbach's alpha coefficient for the scale's factors ranged from 0.788 (highest) to 0.723 (lowest), with an overall scale stability coefficient of 0.748. These high coefficients collectively confirm the scale's validity, reliability, and appropriateness for implementation within the Middle East and North Africa (MENA) region.

The Mayo Leadership Impact Index Adapted for Matrix Leadership Structures: Initial Validity Evidence.

Physician burnout has reached crisis levels. Supportive leadership is one of the strongest drivers of physician well-being, and monitoring supervisor support is key to developing well-being focused leadership skills. Existing measures of leader support were designed within "direct report" supervision structures limiting their applicability to matrixed leadership reporting structures where direct reports are not the predominant norm. Antecedently, no measure of leadership support is validated specifically for implementation in matrixed leadership structures. Adapt and validate the Mayo Leadership Impact Index (MLII) for settings with matrixed leadership structures. A psychometric validation study utilizing classical test theory and item response theory. A tripartite hospital system in the southwestern US. Physician-respondents to a 2023 cross-sectional survey. After pilot testing, the adapted MLII was examined using a unidimensional graded response model and confirmatory factor analyses. Convergent validity was investigated via correlations with professional fulfillment, perceived autonomy support, self-valuation, and peer connectedness/respect. Divergent validity was tested via correlations with burnout. Of the three candidate revisions of the MLII, the 9-item adaptation was selected for its superior validity/reliability indices. Standardized Cronbach's and Ordinal alpha coefficients were 0.958 and 0.973, respectively. CFA loadings exceeded 0.70 (p < 0.001), and coefficients of variation (R2) exceeded 0.60 for all items. GRM slope parameters indicated "high" to "very high" item discrimination. Items 2, 5, and 8 were the most informative. Positive correlations of the adapted MLII with professional fulfillment, perceived autonomy support, and peer connectedness/respect were observed, supporting convergent validity. Negative correlation with overall burnout supports divergent validity. The findings provide evidence of the adapted MLII's validity, reliability, and appropriateness for implementation within matrixed leadership settings. Prior to this study, no leadership support measure had been validated for use among the growing number of healthcare systems with matrixed leadership reporting structures.

Factors which affect the application and implementation of a spinal motion restriction protocol by prehospital providers in a low resource setting: A scoping review.

The safety and effectiveness of prehospital clinical c-spine clearance or spinal motion restriction (SMR) decision support tools are unclear. The present study aimed to examine the available literature on clinical cervical spine clearance and selective SMR decision support tools to identify possible barriers to implementation, safety, and effectiveness when used by emergency medical service (EMS) practitioners. We performed a focused scoping review of published literature on the prehospital use of clinical c-spine clearance and SMR decision tools in adult blunt trauma patients. The Medline, Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature, Web of Science, Turning Research into Practice and EBSCOhost online databases were searched (February 2021). The type of decision support tool and facilitators and barriers to its use were extracted from each included publication in accordance with a modified descriptive-analytical framework. Extracted data were subjected to thematic analysis. Following screening, forty-two articles were included in this scoping review. No studies conducted specifically in low resource settings were found. The majority of articles (57%) evaluated the use of specific SMR decision support tools, such as the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian C-spine Rule (CCR). Potential facilitators of safe and effective use were identified in 60%, and potential barriers to safe and effective use in 55% of included articles. Only one study evaluated the CCR when used by EMS practitioners, making it difficult to determine its appropriateness for implementation in the prehospital setting. This is the first scoping review, to our knowledge, that has attempted to identify the possible barriers and facilitators to their implementation, safety, and effectiveness when used by EMS practitioners. Key issues identified included terminology, guideline compliance and implementation, and a lack of context-specific evidence. These may provide important considerations for future guideline development.

Development of educational game “WEB technologies”

This paper proposes a model of an educational game with a multi-level hierarchical structure. The game is designed for users with different background levels - both applicants and students. The game is implemented as an application for mobile devices based on the Android operating system and designed to increase user interest to the disciplines of the WEB technology stack, as well as to improve the effectiveness of training in general. A multi-level structure of the game is developed, containing various levels of data representation. The lower levels contain information on the HTML, CSS, and PHP languages needed to create own website. Upper level contains information regarding SEO tools, the knowledge of which allows website optimization and promotion to the visibility range of information retrieval systems. Information for the first basic level of the hierarchical structure of the game is available for applicants, which allows familiarizing the user with the basic concepts and practical aspects in the field of WEB-technologies. Students, in turn, gain access to all information. The navigation scheme of the game is presented as a UML diagram. The game is designed for users aged 16-22 and has restrictions on access to the test part of the game – only to registered users. At the preparatory stage of game development, a survey was conducted to identify the most significant indicators that affect quality. Data processing is carried out using the method of expert assessments. Among the proposed options, the most significant were: design and speed, ease of navigation, game content and the ability to pass thematic tests. Upon completion of the development of the game, questionnaire and interview methods were applied, which made it possible to evaluate the results obtained, determine the level of the developed application and the appropriateness of implementation. The survey analysis showed that the opinions of experts are consistent. The game meets the expectations of experts in general and is suitable for implementation. The developed application allows for training in a playful way and, in general, to increase the interest of users in studying the disciplines of the WEB technology stacks.

Identifying policies and strategies for general practitioner retention in direct patient care in the United Kingdom: a RAND/UCLA appropriateness method panel study

BackgroundThe United Kingdom (UK) is experiencing a general practitioner (GP) workforce retention crisis. Research has focused on investigating why GPs intend to quit, but less is known about the acceptability and effectiveness of policies and strategies to improve GP retention. Using evidence from research and key stakeholder organisations, we generated a set of potential policies and strategies aimed at maximising GP retention and tested their appropriateness for implementation by systematically consulting with GPs.Methods28 GP Partners and GPs working in national stakeholder organisations from South West England and London were purposively sampled, and asked to take part in a RAND/UCLA Appropriateness Method panel. Panellists were asked to read an evidence briefing summary, and then complete an online survey on two occasions. During each round, participants rated the appropriateness of policies and strategies aimed at improving GP retention using a nine point scale (1 ‘extremely inappropriate’ to 9 ‘extremely appropriate’). Fifty-four potential policies and strategies (equating to 100 statements) were tested, focusing on factors influencing job satisfaction (e.g. well-being, workload, incentives and remuneration, flexible working, human resources systems). Ratings were analysed for panel consensus and categorised based on appropriateness (‘appropriate’, ‘uncertain’, ‘inappropriate’).Results12/28 GPs approached agreed to take part, 9/28 completed two rounds of the online survey between February and June 2018. Panellists identified 24/54 policy and strategy areas (41/100 statements) as ‘appropriate’. Examples included providing GP practices ‘at risk’ of experiencing GP shortages with a toolkit for managing recruitment and retention, and interventions to facilitate peer support to enhance health and wellbeing, or support portfolio careers. Strategies to limit GP workload, and manage patient demand were also endorsed.ConclusionsThe panel of experienced GPs identified a number of practical ways to improve GP retention through interventions that might enhance job satisfaction and work-life balance. Future research should evaluate the impact of implementing these recommendations.

Has Empowerment Program Been Appropriate for the Need of Fisheries Business Player? : Case Study in Lampung Province, Indonesia

This study analyzed the appropriateness of empowerment program regarding the needs of traditional fish processors. This study applied the descriptive qualitative method using the model of Context – Input – Process – Product (CIPP) and Focus Group Discussion. Various activities were described based on observation and interview data. This study was conducted in three areas in Lampung Province, namely: East Lampung Regency, Pringsewu Regency, and Tanggamus Regency. Those areas are considered as a center the traditional fish processing with activities include fish salting, fish smoking, fish salty steamed, and fish fermentation. The research was conducted from July until September 2017. The result show, Generally, empowerment program for fisheries business players has been quite appropriate to their need, particularly in the sector of fish capture, aquaculture, and fish processing as seen from the high value in the aspect of context (appropriateness of program and problem, needs, and solving problem) and input (number and capability of extension officer, facility and infrastructure, fund). However, the value obtained in the aspect of process (socialization activity, assistance, appropriateness of implementation and plan) and product (target achievement, fulfillment of needs, and increasing income of fish processor) was still limited and need to be increased through intensive assistance by extension agent to achieve the objective of empowerment program of food self-sufficiency and welfare improvement of business players in fisheries sector.

Developing a toolkit to implement the Statin Choice Conversation Aid at scale: application of a work reduction model

BackgroundGuidelines recommend shared decision making (SDM) for determining whether to use statins to prevent cardiovascular events in at-risk patients. We sought to develop a toolkit to facilitate the cross-organizational spread and scale of a SDM intervention called the Statin Choice Conversation Aid (SCCA) by (i) assessing the work stakeholders must do to implement the tool; and (ii) orienting the resulting toolkit’s components to communicate and mitigate this work.MethodsWe conducted multi-level and mixed methods (survey, interview, observation, focus group) characterizations of the contexts of 3 health systems (n = 86, 84, and 26 primary care clinicians) as they pertained to the impending implementation of the SCCA. We merged the data within implementation outcome domains of feasibility, appropriateness, and acceptability. Using Normalization Process Theory, we then characterized and categorized the work stakeholders did to implement the tool. We used clinician surveys and IP address-based tracking to calculate SCCA usage over time and judged how stakeholder effort was allocated to influence outcomes at 6 and 18 months. After assessing the types and impact of the work, we developed a multi-component toolkit.ResultsAt baseline, the three contexts differed regarding feasibility, acceptability, and appropriateness of implementation. The work of adopting the tool was allocated across many strategies in complex and interdependent ways to optimize these domains. The two systems that allocated the work strategically had higher uptake (5.2 and 2.9 vs. 1.1 uses per clinician per month at 6 months; 3.8 and 2.1 vs. 0.4 at 18 months, respectively) than the system that did not. The resulting toolkit included context self-assessments intended to guide stakeholders in considering the early work of SCCA implementation; and webinars, EMR integration guides, video demonstrations, and an implementation team manual aimed at supporting this work.ConclusionsWe developed a multi-component toolkit for facilitating the scale-up and spread of a tool to promote SDM across clinical settings. The theory-based approach we employed aimed to distinguish systems primed for adoption and support the work they must do to achieve implementation. Our approach may have value in orienting the development of multi-component toolkits and other strategies aimed at facilitating the efficient scale up of interventions.Trial registrationClinicalTrials.govNCT02375815.

Vessel traffic in the Canadian Arctic: Management solutions for minimizing impacts on whales in a changing northern region

Warming weather conditions in the Arctic are already resulting in changes in both sea ice extent and thickness. The resulting extended ‘open water’ season has many implications for vessel traffic and marine life. For example, an increase in vessel traffic due to ice-free waters will most likely lead to an increased risk of impact on cetaceans through increased noise pollution, strike risk for some cetacean species, and the possibility of exposure to chemical pollutants. The objective of this study was to pre-empt a predicted increase in vessels by investigating and exploring possible management scenarios, with the aim of mitigating negative impacts on locally important species such as bowhead and beluga whales. Utilizing insights gained from established vessel management schemes in more southerly regions, this paper evaluates the current suite of tools being implemented and their appropriateness for implementation in a more extreme Arctic environment.

Field Trip Education Approach Beyond Classroom: Microwave Course Case

This research was conducted to identify the perception of Diploma in Electronic Engineering (DKE) students who had attended the trip to Beserah earth satellite station. The research instrument was a two-page self-administered questionnaires consisting of a dependent variable measures appropriateness of implementation and two independent variables measure benefits to individual and helpful in effective learning. The total of 103 samples only focused on the students who are studying microwave course. This study conducted a quantitative perception study in which the questionnaires were used to process the received data to produce a conclusion. Data collection of self-administered questionnaire was conducted at Beserah earth satellite station, Kuantan. Reliability analysis of the instruments was processed by using Statistical Package for the Social Sciences (SPSS). The internal consistency of the variables was estimated by the Cronbach’s Alpha reliability coefficient, which above 0.7. The finding provides concrete evidence to support a field trip as an approach of microwave education relate to appropriateness of implementation. The two factors, viz., benefits to individual and helpful in effective learning are positively and significantly correlated with appropriateness of implementation. Besides, 43.4% of the factors are able to explain appropriateness of field trip implementation. DOI: 10.5901/mjss.2015.v6n4s1p89

An Examination of the Acceptability of Instructional Practices for Students with Severe Disabilities in General Education Settings

This study investigated 51 instructional methods specifically targeted as best practices for the education of students with severe disabilities. A survey was mailed to 120 project directors, professors, administrators, and researchers who provided direct and/or indirect services to individuals with severe disabilities. A total of 53 surveys (44%) was returned and 51 were included in the final data analysis. Participants judged each method on familiarity, soundness, and appropriateness for implementation in general education settings. Findings indicated that all methods were judged both sound and appropriate by the majority of participants. Twelve methods, however, were considered inappropriate in academic settings by 20% or more of the respondents, whereas one method was considered inappropriate by at least 20% of participants in other regular education settings. Implications for practice, research, and preservice teacher preparation programs are discussed.