Client Engagement Research Articles

Role and Importance of Communication Skills for Engineering Students

It is absolutely necessary for engineering students to possess skillful communication abilities in order for them to achieve success in both academic and professional settings. In this study work, the complex function that communication skills play in engineering education and practice is investigated, as well as the relevance of these abilities. The purpose of this study is to illustrate the crucial necessity of communication competency for engineering students by evaluating a variety of areas, including but not limited to: cooperation, client engagement, problem-solving, project management, presentations, networking, and cross-disciplinary collaboration. In this paper, we shed light on the ways in which excellent communication skills lead to academic achievement, professional development, and creative contributions to the area of engineering. We do this by drawing upon theoretical frameworks, empirical data, and practical examples.

The role of academics’ socio-demographic characteristics as moderating in WFH productivity: Empirical evidence

The present study examines the faculty staff’s socio-demographic factors (i.e., gender, academic ranking, and experience) as moderating variables on the relationship between the four interrelated factors (organizational, individual, technological, and client engagement) and their productivity (performance) during the Covid‐19 pandemic. A conceptual framework was developed by integrating several relevant studies in the field of Work from Home (WFH) productivity. To end this, we involved (n=388) academic staff working from home during the Covid-19 crisis to test the hypotheses in the higher education context. The findings showed that the academics’ WFH productivity was significantly associated with the four interrelated factors (organizational, individual, technological, and client-related factors) either collectively or individually, and the most important one was the individual-related factors. The moderation analysis reveals that the effect of the socio-demographic characteristics (gender, academic ranking, and experience) on WFH productivity was varied. Surprisingly, the study findings provided evidence for the first time that the client’s engagement (student) factor, which has not been studied before, was found as one of the main determinant factors of WFH productivity during the Covid-19 crisis.

Engaging domestic abuse practitioners and survivors in a review of outcome tools – reflections on differing priorities

Researchers often develop and decide upon the measurement tools for assessing outcomes related to domestic abuse interventions. However, it is known that clients, service providers and researchers have different ideas about the outcomes that should be measured as markers of success. Evidence from non-domestic abuse sectors indicates that engagement of service providers, clients and researchers contributes to more robust research, policy and practice. We reflect on what we have learnt from the engagement of practitioners and domestic abuse survivors in a review of domestic abuse measurement tools where there were clear differences in priorities between survivors, practitioners and researchers about the ideal measurement tools. The purpose of this reflective article is to support the improvement of future outcome measurement from domestic abuse interventions, while ensuring that domestic abuse survivors do not relive trauma because of measurement.

Barriers to Client Engagement and Strategies to Improve Participation in Mental Health and Supported Employment Services.

A few clients in every mental health center present challenging behaviors, have difficulty engaging in services, and create stress within the treatment team. The authors provided consultations on clients with these characteristics over 4 years in the Social Security Administration's Supported Employment Demonstration (SED). Four experienced community mental health leaders provided consultations on 105 of nearly 2,000 clients receiving team-based behavioral health and employment services in the SED. Using document analysis, consultants coded their notes and identified themes that described barriers to client engagement and strategies teams used to overcome them. Clients who were difficult to engage experienced complex and interacting behavioral health, medical, and social conditions, which made it hard for therapists to develop therapeutic relationships and help clients find employment. Faced with engagement barriers, staff were often discouraged and felt hopeless about achieving success. To address these barriers, consultants and teams developed several strategies: using supervisors and teammates for support, providing persistent outreach, pursuing referrals and consultations to help with complex conditions, and developing realistic goals. Supervisors, team leaders, and consultants in community mental health settings should help staff develop realistic strategies to manage the small number of clients whose behaviors present the greatest challenges. Effective strategies involve providing team-based outreach and support, fostering staff morale, obtaining specialist consultations regarding complex conditions, and calibrating realistic goals.

Transforming Business Sustainability: Spherical Model Innovation for Client Engagement and Growth

The shift towards a more sustainable economy has led consumer-facing companies to set ambitious Spherical economy objectives. However, there is a lack of understanding of the innovation activities taking place within these organizations to achieve these goals, specifically in the context of waste management strategies. This study aims to fill this gap by investigating the crucial tasks performed by Spherical Business Model Innovation (SBMI) innovators in companies with a consumer focus. Using a dynamic capabilities perspective, we examine the innovative actions in line with the SBMI phases of visioning, perception, seizing, and transforming. The research inquiry is focused on identifying the procedures and resources that aid businesses in developing flexible skills throughout the SBMI process. We conduct in-depth interviews with target respondents in three businesses and use thematic analysis to map the data to the four SBMI phases. Our findings supplement the existing literature on SBMI innovation efforts and provide additional guidance for corporate operators seeking to transform their businesses sustainably through the adoption of SBMI practices.

The Benefits and Challenges of Shifting to Telehealth During COVID-19: Qualitative Feedback from Kentucky's Sexual Violence Resource Centers and Children's Advocacy Centers.

The onset of the COVID-19 pandemic presented novel challenges for service providers addressing mental health issues with a large shift to the utilization of telehealth. While previous research has examined the benefits and challenges of providing mental health and crisis services remotely through telehealth, little research exists examining the use of telehealth in children's advocacy centers (CACs) and sexual violence resource centers (SVRCs). CACs and SVRCs are multi-disciplinary agencies taking a holistic approach to addressing interpersonal violence, making them unique in that they provide a range of direct services beyond mental health counseling (e.g., legal advocacy, medical exams, and prevention education) but all geared toward public health and safety. The current study explored the experiences of direct service providers in Kentucky CACs and SVRCs and their opinions about the most significant challenges and benefits of adapting their practices at the onset of the COVID-19 pandemic. A total of 118 providers participated in the study, and 88 reported using telehealth (defined as communicating with clients via technology such as videoconferencing, phone calls, or email) since the onset of COVID-19. Qualitative data from those 88 respondents regarding the challenges and benefits of using telehealth were collected and coded using a thematic content analysis. 78.6% of the sample indicated that they served primarily rural areas. Benefits noted included increasing treatment access, increasing treatment flexibility, and advancing continuity of care, while challenges included difficulties with technology, client engagement, privacy, and logistical challenges. Responses highlighted that telehealth presented both a number of advantages and difficulties and that more formal guidance for providers at CACs and SVRCs was desired.

APS PERSPECTIVES ON CHALLENGES AND STRATEGIES SERVING CLIENTS DURING THE COVID-19 PANDEMIC SURGE

Abstract The initial surge of the COVID-19 pandemic and public health measures in response dramatically impacted Adult Protective Services’ (APS) ability to conduct investigations and provide services, requiring agencies to quickly adapt. Our goal was to describe challenges for APS and strategies they developed to respond. We conducted 6 focus groups and 7 interviews during March-April 2021 used a semi-structured topic guide, with 31 participants from APS leadership, supervisors, and case workers in New York City, a community hard hit by the initial COVID surge. Focus groups and interviews were recorded and transcribed, with data analyzed to identify themes. Participants identified 9 major challenges, including: clients using concern about COVID-19 to refuse APS workers’ access to their home, necessity to perform home visits/wellness checks on behalf of other agencies who had suspended home visits, and dependence on in-office activities including receiving paper mail. Participants reported 30 formal and informal strategies adopted to address challenges. These included 13 focusing on maximizing client engagement while maintaining client and APS worker safety, such as: adding a pre-investigation before a home visit to assess COVID-19 risk/exposure, offering clients masks and hand sanitizer to build trust, and close collaboration with other agencies/programs including joint visits. Also, 17 strategies were reported to allow for remote work and support staff, including: modifying processes to replace paper mail with electronic communication/processing, offering counseling services, formally recognizing excellent performance, and leadership reaching out personally to check on staff members. These findings may inform APS planning for future large-scale societal disruptions.

A Qualitative Exploration of Frontline Homeless Service Worker Experiences during the COVID-19 Pandemic

Research has illustrated how homeless service organizations have adjusted policies and services during the COVID-19 pandemic and how frontline workers have taken on the work of implementing new procedures, fine-tuning service strategies, and navigating challenges. This qualitative study sought to describe how the pandemic has impacted the day-to-day service provision experiences of homeless service workers to gain insight into how the sector might prepare itself for the next COVID-19 wave, next pandemic, or other crisis. Drawing on interviews conducted with 21 frontline workers across Texas in fall of 2021, findings highlight the challenges of shifting to remote work and virtual service provision, reduced client engagement and rapport building, creating and enforcing health policies, and persistent service system disruptions. Recommendations include investing time and resources into creating more nimble work systems, moving away from paper-based processes, and making telehealth strategies a permanent part of homeless service provision. Additionally, there are research opportunities to develop and test coworker peer support models and to study the value and viability of tele-health in this sector, including worker and client perspectives of these technologies. Findings underscore how the pandemic disrupted homeless service design and delivery, which in turn hampered service access, use, and engagement.

Promoting permanency in families with parental substance misuse: lessons from a process evaluation of a multi-system program

BackgroundFamilies affected by substance misuse are at increased risk for child maltreatment and child welfare system involvement. The Enhancing Permanency in Children and Families (EPIC) program uses four evidence-based and informed multi-system practices to promote safety and permanency outcomes for children involved with the child welfare system due to parental substance misuse: 1) Peer Recovery Support (PRS), 2) Family Treatment Drug Court (FTDC), 3) Medications for Opioid Use Disorder (MOUD) and 4) Nurturing Parent Program (NPP) relational skill-building. The purpose of the current study was to identify barriers, facilitators, and lessons learned in the implementation of and client engagement with the main components of EPIC.MethodsSeventeen key EPIC personnel participated in the study. Individual semi-structured interviews were conducted. Qualitative analysis involved the thematic coding of the interviews, and program facilitators and barriers were revealed.ResultsPRS were identified as a primary strength of the EPIC program, providing experiential connection to participating families and a valuable source of information. High turnover and matching PRS to families were barriers to PRS implementation. FTDC contributed to client success as judges developed interpersonal relationships with the clients that balanced support with accountability. Client attitudes toward court presented barriers to FTDC engagement. MOUD provided stabilization and was perceived by caseworkers as an engagement facilitator and a layer of client accountability; however, the lack of availability of MOUD service providers presented a barrier for some clients. Parental relational skill-building was not valued by clients and was perceived as conflicting with sobriety-focused activities.ConclusionsThe EPIC program provides comprehensive, coordinated multi-system support and care to families affected by parental substance misuse. Continued efforts to improve recruitment and retention of PRS, reframing client perceptions of FTDC, and increasing access to MOUD may contribute to increased engagement in the program. Findings highlight the utility of tracking process outcomes in community-based interventions to promote participant engagement in programs set in complex systems.Trial registrationNCT04700696. Registered January 7, 2021-retrospectively registered.

Rhythms of learning — a model of practice supporting youth mental health in the era of COVID-19

The COVID-19 pandemic has led to a significant increase in demand for mental health services for young people. This demand comes on top of a preexisting surge in mental health presentations for our youth, and it places extraordinary demand on support services and the professionals who deliver them. Concurrently, it is recognised that engaging and working with young people and their mental health has its own unique challenges, and that many young people find direct ‘talk-based’ therapies confronting. This article examines the use of a model of group work practice combining the benefits of rhythmic music with reflective discussions as a response to the dual challenges of workplace burnout and client engagement. It reflects on the important role music has to play in young lives and how this can be extended into therapy in a fun and uplifting manner. It draws attention to the long history of rhythmic music within traditional healing practices and the emerging scientific evidence supporting this approach.

Veterinary technicians contribute to shared decision-making during companion animal veterinary appointments.

To describe and compare veterinary professionals' use of shared decision-making during companion animal appointments. Multi-practice cross-sectional study. A purposive sample of 4 companion animal veterinary clinics in a group practice in Texas. A convenience sample of veterinary appointments were recorded January to March 2018 and audio-recordings were analyzed using the Observer OPTION5 instrument to assess shared decision-making. Each decision was categorized by veterinary professional involvement. A total of 76/85 (89%) appointments included at least 1 decision between the client and veterinary professional(s), with a total of 129 shared decisions. Decisions that involved both a veterinary technician and veterinarian scored significantly higher for elements of shared decision-making (OPTION5 = 29.5 ± 8.4; n = 46), than veterinarian-only decisions (OPTION5 = 25.4 ± 11.50; P = .040; n = 63), and veterinary technician-only decisions (OPTION5 = 22.5 ± 7.15; P = .001; n = 20). Specific elements of shared decision-making that differed significantly based on veterinary professional involvement included educating the client about options (OPTION5 Item 3; P = .0041) and integrating the client's preference (OPTION5 Item 5; P = .0010). Findings suggest that clients are more involved in decision making related to their pet's health care when both the veterinary technician and veterinarian communicate with the client. Veterinary technicians' communication significantly enhanced client engagement in decision-making when working collaboratively with the veterinarian.

Improving health system readiness to address violence against women and girls: a conceptual framework

BackgroundThere is an increasing focus on readiness of health systems to respond to survivors of violence against women (VAW), a global human rights violation damaging women’s health. Health system readiness focuses on how prepared healthcare systems and institutions, including providers and potential users, are to adopt changes brought about by the integration of VAW care into services. In VAW research, such assessment is often limited to individual provider readiness or facility-level factors that need to be strengthened, with less attention to health system dimensions. The paper presents a framework for health system readiness assessment to improve quality of care for intimate partner violence (IPV), which was tested in Brazil and Palestinian territories (oPT).MethodsData synthesis of primary data from 43 qualitative interviews with healthcare providers and health managers in Brazil and oPT to explore readiness in health systems.ResultsThe application of the framework showed that it had significant added value in capturing system capabilities - beyond the availability of material and technical capacity - to encompass stakeholder values, confidence, motivation and connection with clients and communities. Our analysis highlighted two missing elements within the initial framework: client and community engagement and gender equality issues. Subsequently, the framework was finalised and organised around three levels of analysis: macro, meso and micro. The micro level highlighted the need to also consider how the system can sustainably involve and interact with clients (women) and communities to ensure and promote readiness for integrating (and participating in) change. Addressing cultural and gender norms around IPV and enhancing support and commitment from health managers was also shown to be necessary for a health system environment that enables the integration of IPV care.ConclusionThe proposed framework helps identify a) system capabilities and pre-conditions for system readiness; b) system changes required for delivering quality care for IPV; and c) connections between and across system levels and capabilities.

Revisiting the Rainbow: Culturally Responsive Updates to a Standard Clinical Resource.

Cultural responsivity is essential for efficacious and affirming clinical relationships. This may be especially important with historically marginalized clients, such as transgender and gender-diverse (TGD) people seeking behaviorally based affirming communication services. We recommend modifications to standard tools for diagnostics and training that otherwise might undermine our efforts to create an inclusive and affirming environment. Modifications to the Rainbow Passage, a standardized paragraph utilized for eliciting speech samples in clinical settings, focused on nongendered terminology and the elimination of content with religious connotations. The recommended edits to the Rainbow Passage maintain similar length, cadence, and phonetic balance while considering cultural and health care context for TGD people and other clients. Simple linguistic changes to a standardized paragraph maintain clinical benefits and facilitate SLP efforts toward cultural responsivity, client engagement, and good clinical outcomes.

Development of a Medication Management Program in Permanent Supportive Housing.

We describe a nurse-led project that aimed to assist a permanent supportive housing facility for chronically homeless individuals to improve medication adherence by refining a medication management program. Client and staff engagement through needs assessment, feedback, and evaluation formed the foundation for a sustainable medication management program.

Protecting the gains: analysis of HIV treatment and service delivery programme data and interventions implemented in 19 African countries during COVID-19.

The potential disruption in antiretroviral therapy (ART) services in Africa at the start of the COVID-19 pandemic raised concern for increased morbidity and mortality among people living with HIV (PLHIV). We describe HIV treatment trends before and during the pandemic and interventions implemented to mitigate COVID-19 impact among countries supported by the US Centers for Disease Control and Prevention (CDC) through the President's Emergency Plan for AIDS Relief (PEPFAR). We analysed quantitative and qualitative data reported by 10,387 PEPFAR-CDC-supported ART sites in 19 African countries between October 2019 and March 2021. Trends in PLHIV on ART, new ART initiations and treatment interruptions were assessed. Viral load coverage (testing of eligible PLHIV) and viral suppression were calculated at select time points. Qualitative data were analysed to summarize facility- and community-based interventions implemented to mitigate COVID-19. The total number of PLHIV on ART increased quarterly from October 2019 (n = 7,540,592) to March 2021 (n = 8,513,572). The adult population (≥15 years) on ART increased by 14.0% (7,005,959-7,983,793), while the paediatric population (<15 years) on ART declined by 2.6% (333,178-324,441). However, the number of new ART initiations dropped between March 2020 and June 2020 by 23.4% for adults and 26.1% for children, with more rapid recovery in adults than children from September 2020 onwards. Viral load coverage increased slightly from April 2020 to March 2021 (75-78%) and viral load suppression increased from October 2019 to March 2021 (91-94%) among adults and children combined. The most reported interventions included multi-month dispensing (MMD) of ART, community service delivery expansion, and technology and virtual platforms use for client engagement and site-level monitoring. MMD of ≥3 months increased from 52% in October 2019 to 78% of PLHIV ≥ age 15 on ART in March 2021. With an overall increase in the number of people on ART, HIV programmes proved to be resilient, mitigating the impact of COVID-19. However, the decline in the number of children on ART warrants urgent investigation and interventions to prevent further losses experienced during the COVID-19 pandemic and future public health emergencies.

Consolidate gains, implement more change – The 2021 Business Information Review survey: Part II

Consolidate gains, implement more change is the seventh step of John P. Kotter’s Eight Step Process for Leading Change. Sustaining acceleration seems an appropriate theme for the 2021 survey following the 2020/21 health crisis which was the catalyst for massive change across almost all organisations. It created a sense of urgency, with the leaders reporting many quick wins in the new operating environment in the 2020 survey. The opportunity now is to maintain their momentum by consolidating their current gains and accelerating change, driving their business towards the new normal. Part II captures the leaders’ reflections on a range of topics that are shaping their operations including the technology and content trends, vendor engagement, client engagement as well as summarising their future priorities.

Respectful maternity care in health centers of Addis Ababa city: a mixed method study

ObjectiveThe study aims to assess quality of obstetric and newborn care including respectfulness of the maternity care.DesignThe study used explanatory sequential mixed methods design .SettingThis study was conducted in 50 health centres in Addis Ababa city administration January 25 to April 31, 2021.MethodsDuring the quantitative phase 500 women in postpartum period were interviewed using structured questionnaire. In the second phase in-depth interview was conducted with 20 midwives and 13 health centre managers. The quantitative data was analysed using Statistical Package for Social Sciences (SPSS). The qualitative data was analysed using Colaizzi’s seven step process.ResultsOnly 24.6% of women had respectful maternity care (RMC). Only 46% of women had effective communication during child birth. Only 9.6% of women had emotional support during child birth. Majority of women were encouraged to mobilize, take food and be on labor position of their choice. However, only 22.4 and 18.8% of women respectively had a companion of choice and any pharmacologic pain relief during child birth. One in seven women (15%) had one form of disrespect and abuse during child birth.ConclusionEnsuring respectful maternity care needs strong policy direction to health facilities, public education on their right to respectful maternity care, training of care givers and monitoring care through engagement of frontline staff and clients.

Organizational attributes and client engagement in community opiate substitute prescribing services

Introduction Little is known about the relationship between treatment organization characteristics and client outcomes or drug-related harms in community opiate substitution therapy. In the absence of sufficient scientific evidence, the organizational configuration of addiction treatment services is often decided on an ad hoc and sometimes politically motivated basis as the evaluation of the impact of policies or practices on clients at the organizational level is limited. The objective of this multi-site cross-sectional study was to identify and understand how client characteristics and staff perceptions of organizational functioning related to client engagement in community-based opiate substitution therapy services in Ireland. Methods This paper reports on a cross-sectional survey of clients (n = 262) and staff (n = 132) questionnaires across 12 discrete community-based prescribing service providers (organizations) in Ireland. Results Measures of client engagement in treatment were shown to be higher in organizations with more positive staff ratings of organizational functioning. In particular, in organizations where staff reported having greater job autonomy, clients reported better overall engagement. Specifically, greater staff autonomy in organizations related to greater levels of treatment participation (p = 0.034), treatment satisfaction (p < 0.001), and better rapport with staff (p < 0.001). Clients who were the longest in treatment expressed significantly poorer rapport with staff (p = 0.44) and were less likely to seek out support from peers (p = 0.023), while those in stable accommodation reported greater participation in treatment (p = 0.009). Levels of peer support were not related to organizational characteristics, but clients with lower levels of education (p = 0.002) and those in early treatment (p = 0.017) were more likely to seek support from peers. Conclusion The findings establish the importance of assessing organizational and client attributes as part of an overall strategy for enhancing the quality of treatment. This paper provides valuable information for policymakers and provides an ample basis for further exploration of how treatment organizations work, and not just that they work. Policymakers and planners need to consider introducing specific interventions for clients or staff in the context of a ‘whole systems’ approach. From an organizational and planning perspective, this should involve further consideration of measures that relate to increasing staff’s sense of autonomy. This paper provides further evidence that the success of policy-making or planning relating to treatment organizations can be successfully measured at the client and organizational levels.

The Effect of Peer Support on Treatment Engagement for Opioid Use Disorder.

Opioid misuse has been a growing problem in the United States that has escalated into a national public health emergency. Despite substance abuse programs that offer assistance in the treatment of opioid use disorder (OUD), keeping clients engaged in recovery treatment can be very challenging. Relapse prevention is a priority concern due to the higher risk of overdose following a period of sobriety. This research compares two different approaches to treatment of OUD to assess relative treatment adherence. The purpose of this research is to establish whether a peer support-based treatment methodology, combined with increased medication-assisted treatment, provided by an outpatient facility is more effective than treatment-as-usual in improving client engagement in recovery treatment. The research analyzed data collected over a 6-month period by a facility. The retrospective review of data compared a total of 1,570 clients enrolled in a certified recovery services (CRSs) program versus individuals engaged in treatment-as-usual program. Inclusion criteria consisted of clients with at least one diagnoses of OUD who met level of care requirements. Statistical t-test analysis revealed greater engagement in recovery services among those enrolled in the CRS program. The findings support the benefits of a peer support program as a treatment methodology for clients with OUD. This research will be of value in the design and development of future program policy and treatment guidelines.

Artificial intelligence in insurance companies

In this article given is the analysis of the development of artificial intelligence- AI in insurance companies, which has caused the execution of the following tasks: analysis of the role and significance of artificial intelligence in insurance;description of software tools in insurance; description of implementation of artificial intelligence in insurance industry. Based on the conducted analysis it is concluded that possibilities of artificial intelligence in insurance are almost infinite. Technology contributes to better clarified claims, helps insurance companies to identify fraud and automatically avoid losses. Due to all this, the insurance companies on the market improve their production cycle while clients are provided with better service and better rates. Artificial intelligence assists us in improving the business today and will do so in the future: increase competitiveness, enhance the engagement of clients, accelerate innovations, increase profitability and productivity of employees.