Program Evaluation Research Articles

Analysis of a theory of change to evaluate the Health Care-Associated Infection Prevention Program (HAI) in Colombia

BackgroundHealthcare-associated infections affect the safety of patients, health personnel, and families and generate expenses for health systems. The Theory of Change allows us to evaluate the strengths and weaknesses of a program, hoping to achieve change and improve its design. The objective was to analyze the change theory underpinning the actions proposed by the Program for the Prevention of Healthcare-Associated Infections (HAI) in Colombia.MethodsThe research used a case study. The case is the implementation of this program in the Colombian context. A documentary review of the Patient Safety Policy and the prevention, surveillance, and control of HAI events from 2006 to 2020 was conducted. Subsequently, semi-structured interviews were conducted with the actors who designed the patient safety policy and the HAI program. Of these, two had the role of national political and administrative authorities; one participated in the design of the guidelines for the implementation of the patient safety policy, and the other in the design of the IAAS program. Likewise, two academics and researchers, one who contributed to the design of the patient safety policy and the other who played a fundamental role in the development of the IAAS program, each of them contributing significantly to the advancement of their respective areas.Qualitative content analysis was used to analyze the data. Data processing, coding, grouping into categories, and network construction were performed in the Atlas Ti 23 program and represented as a theory of change diagram.ResultsThe results show that the desired impacts of the program are to reduce the incidence of HAI, improve the quality of life of patients, and their families, and improve the country's General Social Security Health System. Among the long-term results identified are the strengthening of the prevention and control of HAI, adjusting regulations, strengthening surveillance, implementing actions for the prevention and control of HAI, and improving the knowledge and skills of health personnel to contain these events. Five preconditions and 14 strategies were identified. Finally, four assumptions were identified that potentially influence the achievement of the program's results.ConclusionsThe analyzed theory integrates the elements of a theory of change, explaining how this type of intervention works to generate changes and prevent these infections associated with health care, which is the expected impact. However, strategies and indicators were identified that were not incorporated, and that are needed to assess the impact of these interventions. The study allows us to advance in the development of the design and evaluation of HAI programs, supporting them in a theory of change as a guide to detect failures during their implementation for their improvement.

184 A Coaching and Entrepreneurial Mentoring Program for Women

Objectives/Goals: The STEM-Coaching and Resources for Entrepreneurial Women (CREW) Program was developed to promote systemic change in entrepreneurship by engaging women faculty and post-doctoral fellows through educational opportunities, mentorship, and professional coaching to close the gender gap in entrepreneurial leadership. Methods/Study Population: We solicited applications from women at the junior faculty or post-doctoral fellowship stage. Applications were reviewed by the CREW leadership and mentors. Applicants accepted into the program participated in monthly large group coaching sessions, one-one-one coaching, and small group mentoring sessions. Applicants also completed an online entrepreneurship course and participated in a shark tank-like competition during annual innovation awareness month. Coaches were professionally credentialed and oriented to the biomedical context. Entrepreneurial experts served as mentors. Our program evaluation used the RE-AIM framework. The evaluation included assessments of the program’s ability to reach a diverse population, satisfaction with program offerings, and changes in entrepreneurship outcomes. Results/Anticipated Results: To date, three cohorts consisting of 35 women from 13 states participated in the program. Results from Cohort 1 show significant improvements in self-assessed confidence in entrepreneurial activities and high satisfaction with the program. All measures of confidence showed increases, with the largest gains in the areas of “estimating customer demand for new products or services”; “Clearly and concisely explaining my business idea in everyday terms”; and “Getting others to identify with and believe in my vision and plans for a new business”. The percentage of participants who have invention disclosures significantly increased from 33.3% to 83.3% after completing the program. The percentage who launched start-up companies also increased from 17% to 33%. Cohort 2 results will be available before the conference. Discussion/Significance of Impact: Participants in the CREW program showed improvement in all measures of evaluation. The program is unique in complementing mentoring with coaching. Because the coaching component takes a holistic approach by encouraging women to craft a vision for their work and life, it provides value that will last beyond entrepreneurship activities.

192 Building inclusive research: A training program for CRP students and staff on equitable participant engagement, recruitment, and retention

Objectives/Goals: Clinical trial success requires recruiting and retaining diverse participants. The ER&R Certificate Program trains clinical research professionals (CRPs) in equity, diversity, and inclusion (EDI), addressing biases, and integrating regulatory knowledge with practical skills to foster inclusive research practices. Methods/Study Population: An interdisciplinary Steering Committee, supported by Duke CTSI and DOCR, developed and implemented an engagement, recruitment, and retention certificate program (ER&R) for CRPs. With expert-led instruction, including e-learning, group sessions, and hands-on activities, ER&R integrates EDI into participant engagement practices. Participants complete 7 core courses and at least 3 elective courses, reflecting their unique responsibilities. Program evaluation uses the Kirkpatrick model to assess participant learning, competency, and EDI integration into clinical research. Since launch, the program has expanded to include clinical research trainees from Durham Technical Community College. All elements of the program were designed to allow for sharing across academic medical institutions. Results/Anticipated Results: A total of 202 CRPs and trainees have participated since launch (2020), including 17 trainee participants from Durham Technical Community College (2022–2024). Post-program evaluations showed significant growth in recruitment and retention self-efficacy. An early evaluation of the first 2 cohorts (n = 59) included a self-assessment across defined competencies showing marked increases in comfort across all learning objectives, with notable gains in: Community and Stakeholder Engagement, Recruitment on a Shoestring Budget, Community-Engaged Research Initiatives, and Social Marketing. Participants valued the program’s focus on EDI and sought more practical strategies and peer collaboration. 50 additional institutions have engaged with our implementation consultations and program repository. Discussion/Significance of Impact: Barriers to equitable ER&R exist at the individual, study, and system levels. Addressing these requires more intentional engagement practices. The ER&R certificate program is an innovative model for integrating equity principles with practical and required knowledge and skills training for participant-facing research professionals.

How, why, and under what circumstances can supportive supervision programs improve malaria case management? A realist program theory.

Supportive supervision (SS) programs aim to enhance the quality of care by strengthening the performance of health providers. Commonly part of broader quality improvement efforts, SS programs are increasingly used in low-and middle-income countries to improve malaria case management. Despite substantial investments and some positive outcomes, little is known about what drives their effectiveness. A realist evaluation was conducted in Tanzania and Benin to explain how, why, and under what circumstances SS programs can improve the facility-based management of uncomplicated malaria in children under five. A program theory was developed through a team-based analysis of empirical data collected in both countries at two time points. Data included 218 in-depth and 12 structured interviews with stakeholders, 154 audits of febrile case management decisions, and four health facility audits. Stakeholder perspectives identified three acceptability mechanisms driving SS program outcomes in the studied contexts: the affective attitude, self-efficacy, and burden of the program as perceived by key actors. The pathway through which these mechanisms were perceived to shape malaria case management (diagnosis and treatment) practices was defined by the 1) extent to which the program was integrated into the public health system; 2) frequency with which SS visits were conducted by appropriate supervisors; 3) degree to which supervisors coached, rather than policed, supervisees; and 4) level of collaboration achieved between supervisees and supervisors. The program actors' perception of the program's effectiveness was also found to be crucial to its sustainability. This study explains the dynamics driving SS program outcomes and underscores the role played by the cognitive and emotional responses of program actors. These insights are likely to be transferable to other settings with similar contexts and can help inform the design, implementation, monitoring, and evaluation of new and ongoing SS programs.

Prediction of Energy Balance Based on Milk Parameters Across Different Lactation Stages

Following the changes observed in milk parameters throughout the lactation period will offer an easy and practical method for the evaluation of the feeding programs of animals as well as presenting opportunities to improve the quality of milk. For this purpose, the milk samples collected from 1390 Holstein cows Bursa Province in Turkey on the test day of the month (at an interval of 30 days) were examined and their fat, protein, dry matter and lactose contents were measured. The cows with boundary values for the fat/ protein accepted for the metabolic states of the cows in the study are considered to be at risk of acidosis if they are lower than 1.2, to be healthy if they are between 1.2 and 1.4 and to have a ketosis risk if the values are over 1.4. The results of the study have shown that the risk for acidosis among the animals are 39.5%, 32.4% and 33.9% respectively during the lactation periods 1, 2 and 3. The percentage of animals at risk of ketosis was determined to be 30.2%, 37.9%, 36.6% respectively. Energy balance is defined as the difference between energy intake from feed and energy required for animal performance. It is an important concept in cattle management and nutrition because it directly impacts the health, productivity, and reproductive success of cows, particularly during lactation. The percentages of the animals at the positive energy balance are 30.3, 29.7 and 29.6 respectively. Estimates for early, mid and late lactation show that in early lactation 31% of cows have acidosis, 37% have ketosis and 32% have positive energy balance, in mid lactation 31% have acidosis, 28% have ketosis and 32% have positive energy balance, while in late lactation 34% have acidosis, 34% have ketosis and 32% have positive energy balance.

Advancing Women Physicians in Academic Medicine: A Scoping Review

Abstract Purpose Multiple studies have described higher rates of attrition for women in academic medicine, but actionable strategies to retain women in the field have not been well studied in the current era. This study reviewed the existing literature for studied interventions to support the advancement of women physicians in academic medicine. Method A scoping review was conducted by searching the PubMed, Embase, and Scopus databases for articles describing interventions intended to support women physicians on September 12, 2022, and updated on August 23, 2024. All articles from inception of the databases through the search dates were included. Search terms included female physician, mentoring, leadership, career development, job satisfaction, advancement, and synonyms. Articles related to inequities in patient care, interventions related to nonphysician health care workers, and studies describing sexism without measured solutions were excluded from the analysis. Kirkpatrick’s framework for the evaluation of educational programs was used to further classify results by 4 levels of evaluation for an educational or training program: reaction, learning, behavior, and results. Results A total of 2,813 articles underwent abstract screening and full-text review, with 64 articles included in the final analysis. Seven studies (10.9%) were randomized controlled trials. Only 2 studies (3.1%) specifically examined mid- or late-career women. Career development programs (15 [23.4%]), mentorship programs (10 [15.6%]), and women’s interest groups (7 [10.9%]) were the most described interventions. Outcome measures were most commonly satisfaction with the intervention (22 [34.4%]), self-perceived improvement in skills (17 [26.6%]), and representation or recruitment of women into a field (12 [18.8%]). Conclusions This study describes 64 articles of studied interventions to support the advancement of women in medicine. Additional studies are needed and should emphasize rigorous study methods, a focus on institutional solutions, and identifying and targeting the needs of women physicians beyond their early career.

269 Systems Marketing Analysis for Research Translation (SMART) innovation program

Objectives/Goals: The goal of the RC2 Systems Marketing Analysis for Research Translation (SMART) special innovation program is to develop and test a structured approach for working with research teams and communities to accelerate the translation of clinical and community innovations to address health inequities by integrating social marketing with community-based system dynamics. Methods/Study Population: The SMART program is a consultancy service for CTS teams focused on selecting and tailoring implementation strategies for advancing equity. We use social marketing for understanding the alignment of practice innovation feature sets with community priorities for advancing health equity; and community-based system dynamics to understand and refine the dynamics of scaling up and sustaining the implementation of innovations with sufficient reach to address regional health inequities. The program is implemented as community-engaged group model-building workshops with research teams, with follow-up marketing analyses and computer simulation of implementation strategies of innovations and development of implementation roadmaps. We use developmental program evaluation to revise the SMART program. Results/Anticipated Results: Anticipated results from piloting the SMART innovation program with four research teams include (1) design matrices pre and post-workshop for each innovation; (2) system dynamics simulation models and analyses of implementation and scale-up of innovations; (3) analysis of the SMART program for highest impact, with priors for estimating subsequent SMART program performance; and (4) a revised SMART program based on results from the developmental program evaluation. Discussion/Significance of Impact: This work highlights the feasibility and benefits of combining methods that have been cited in implementation science for understanding the complexity of implementation to accelerate the translation of innovations into clinical and community settings for advancing health equity.

156 Empowering Clinical Research Coordinators: A Mentorship Program Evaluation at University of Florida’s (UF) Gainesville and Jacksonville Campuses

Objectives/Goals: Create a supportive Clinical Research Coordinator (CRC) and Clinical Research Nurse consortium at UF. Facilitate mentorship groups to enhance knowledge on key topics. Build strong professional relationships among members. Empower members through collaboration. Develop future leaders and mentor in clinical research. Methods/Study Population: The CRC Group Mentorship Program at UF’s Gainesville and Jacksonville campuses addresses mentorship needs identified in a recent needs assessment, reflecting strong interest among CRC/CRNs. Small groups are formed using the Group Mentorship and Co-Mentoring Circles models, meeting bimonthly for six months on shared research interests. Co-lead mentors guide learning, peer support, communication skills, and goal setting while tracking progress. Mentees engage in peer learning, skill development, and networking. A dedicated Microsoft Teams platform provides resources to enhance confidence in Joint Task Force Clinical Trial Competencies and fosters collaboration through Q&A sessions, activities, assessments, and meetings, improving real-time and asynchronous interactions. Results/Anticipated Results: To measure mentor program impact, pre- and post-program surveys assess changes in knowledge, skills, and confidence among mentors and mentees, providing insights into effectiveness and areas for improvement. Monthly, the program features two meetings focusing on Joint Task Force competencies: a workshop for all groups on essential mentorship and CRC/CRN competencies, followed by evaluations, quizzes, and continuing education credits. The second meeting is group-specific, led by co-lead mentors, requiring submissions that demonstrate the application of learned knowledge and skills. This structure ensures continuous relevance and quality enhancement in future programs. Discussion/Significance of Impact: The program meets CRCs and CRNs’ critical needs through structured mentorship, fostering a supportive environment. It promotes continuous learning and professional development, enhancing job satisfaction and ensuring the sustainability of valuable research professionals.

236 Mixed-method approaches to evaluating UIC’s CTSA Hub

Objectives/Goals: The University of Illinois Chicago’s Center for Clinical and Translational Science has implemented an innovative approach to program evaluation. We blend high-impact quantitative and in-depth qualitative approaches to identify local and national impacts and areas for improvement that are not captured solely by traditional quantitative methods. Methods/Study Population: CCTS manages service requests and investigator demographics through an in-house system that our evaluation program utilizes to report on service requests, investigator satisfaction, and investigator demographics to service groups, CTSA and campus leadership, and other stakeholders throughout the year. Through this system, we are able to regularly survey and interview investigators about their experiences and solicit feedback about the service process. During interviews, we focus on questions about receiving services, recommendations for CCTS and colleagues, and plans to work with CCTS in the future. This mixed-methods approach helps us lay the foundation to expand evaluation beyond reporting and establish a robust CQI program that focuses both on CCTS staff needs and improving investigator experiences. Results/Anticipated Results: Soliciting both quantitative and qualitative feedback from investigators has enabled our service groups to make significant changes to their internal processes to ensure that investigators are aware of services and supports available. Our quantitative data show us that investigators return time and again to CCTS for services and supports. Yet the feedback we receive through short, targeted interviews also helps identify challenges that investigators experience that could improve the services they come to us to receive. We have already used this system to recommend improved marketing of existing services within certain service groups that were highly requested by investigators, which increased utilization of that service. Discussion/Significance of Impact: Our mixed-method approach to evaluation allows us to easily and rapidly identify areas for improvement within our service groups, an instrumental part of implementing a CQI program that is focused on staff-identified areas of improvement. This approach can be easily replicated by other CTSA hubs with minimal impact to existing resources.

174 Career Mentorship in Clinical Research Pathways in Medicine: UCLA Mentorship and Advocacy in Teaching Clinical Health-Related Research (MATCH) Program

Objectives/Goals: To assess the impact of the MATCH Program on mentees and mentors over the years, we have surveyed both groups on the effectiveness of the mentorship process, how the MATCH program influenced mentees’ future career plans, and their ongoing interest in clinical research. Methods/Study Population: To evaluate impact on mentees and mentors in the most recent cycle, we fielded two program evaluation surveys, for mentors and mentees. The surveys were distributed and collected using Qualtrics in May 2024. The mentee survey collected data on relationship with mentors, quality of mentorship, future career/education plans, and self-assessment of the program impact. The mentor survey collected data on relationship with mentees, mentees’ engagement, and a self-assessment of the program impact. Qualitative analysis was conducted to determine key themes expressed by participants. The responses were compared to assess the effectiveness of the mentoring relationship from both parties. Results/Anticipated Results: Respondents included 15/20 (75%) mentees and 15/20 (75%) mentors. All mentees (100%) and mentors (100%) stated they would like to continue their relationship outside of the program. The majority of mentees 13/15 (87%) and mentors 13/25 (87%) also viewed their mentee/mentor relationship to be excellent or good. Most mentors 10/15 (67%) stated it was their first time serving as a mentor for the program. Mentees also found their experience in the program very beneficial with 6/15 (40%) stating that MATCH changed their career plans. In addition, most mentees 14/15 (93%) indicated that they are community college or four-year college/university bound. Most mentees 11/15 (73%) indicated an interest in pursuing a health or medical career. Also, 10/15 (67%) mentees stated an interest in pursuing a career in research. Discussion/Significance of Impact: Both mentees and mentors have benefited from the program’s daisy chain mentoring and the program has helped facilitate a potential lifelong mentorship between mentees and mentors. The program also demonstrates promise of developing a pre-health pathway for historically underrepresented students in STEM.

8 A decade of excellence and impact: The UCLA Clinical And Translational Science Institute – Research Associates Program (CTSI-RAP)

Objectives/Goals: The impact of the program on alumni students was measured in a 2023 survey, which assessed key factors and student perspectives on motivation to apply/remain in the program, their engagement activities, how they used the skills acquired in RAP upon graduating, and if they were currently serving in a health profession and/or clinical research. Methods/Study Population: Survey questions were based upon specific components of CTSI-RAP that make it unique. Covered topics related to motivation for participation, meaningful experiences, program effectiveness, future use of RAP knowledge/training, and current career roles in the health professions and/or clinical research. The survey was built and analyzed in REDCap and deployed May–July 2023. The study received exempt certification from the IRB. The survey was sent to 123 alumni from the 2013 to 2021 cohorts. Bounced e-mails were followed up on and two reminder e-mails were sent to initial non-responders. Identifiable demographic information was separated from program evaluation questions for analysis. A subanalysis was performed to determine program impact on students who identified as underserved or disadvantaged. Results/Anticipated Results: Respondents included 82/123 (66.7%) alumni. The survey took approximately 15 minutes. Most of the students 64/82 (78.0%) had 1 year or less research experience. The top three motivating factors for joining the RAP program were gaining clinical research experience, exposure to healthcare settings, and interest in pursuing a healthcare related career. Most alumni rated the overall effectiveness of the RAP program as very or somewhat valuable and the majority felt that the program ranked high or very high among their undergraduate experiences. The program was very influential or influential in defining their long-term plans and goals. Just under half felt that their career aspirations were changed or influenced by the program, which was especially true for those who identified as underserved/disadvantaged. Discussion/Significance of Impact: CTSI-RAP alumni highly value their experience in the program. They have benefitted professionally and are motivated to keep their connection to the program alive. With a decade of clinical research excellence and programming, CTSI-RAP’s impact is well established as a proven model benefiting both students and the clinical research infrastructure.

Participants' evaluation of an internet-based group compassion-focused therapy program for young people in Sweden

IntroductionOnline group compassion-focused therapy (CFT) has not been thoroughly studied in young people, and the participants' perspectives on the treatment are highly relevant.MethodsA seven-session internet-based group CFT program was evaluated for young people aged 15–20 (n = 42, females = 37). A self-report evaluation questionnaire, specifically designed for this study, was administered post-intervention. The current study investigated: (1) Potential factors influencing the treatment program goals (increase self-compassion, reduce self-criticism and increase affect-regulation abilities) and the participants' overall experience of the treatment; and (2) The effect each intervention exercise had on the program goals according to the participants' ratings.ResultsParticipants generally reported high satisfaction and had a high attendance rate. Only 2.4% of the participants completed less than half of the sessions and 71% of the participants attended at least six of the seven sessions. Exercises that integrated traditional cognitive-behavioral therapy (CBT) and Compassion-Focused Therapy (CFT) principles received high ratings, whereas breathing and mindfulness exercises were rated lower in many cases. Several compassion exercises were also highly rated, such as the Threat-drive and security system, based on CFT affect-regulation theory. The majority did not find home assignments helpful.DiscussionThe findings suggest that internet-based group CFT could be an easily accessible and acceptable intervention for young people in primary care, though further research is warranted.

Evaluation of Indigenous status completeness in vaccine preventable disease notification data in the NNDSS.

High quality Indigenous status data for vaccine preventable diseases (VPDs) in the National Notifiable Diseases Surveillance System (NNDSS) is important for evaluation of immunisation programs and ultimately for improving health outcomes for Aboriginal and Torres Strait Islander peoples. We evaluated Indigenous status completeness, and factors influencing it, for VPDs in the NNDSS. Literature review (published and grey); descriptive analysis of NNDSS data for selected VPDs over the 2010-2019 period; standardised online survey (containing closed- and open-ended questions) of key informants; semi-structured follow-up interviews. National level Indigenous status completeness for those VPDs with a Communicable Diseases Network Australia (CDNA) target of 95% was above that target for Haemophilus influenzae type b, measles, invasive meningococcal disease and invasive pneumococcal disease (IPD: < 5 and ≥ 50 years); and was within four percentage points for hepatitis A, newly acquired hepatitis B and pertussis (< 5 years). For VPDs with an 80% target, completeness was ≥ 90% for diphtheria, mumps, rubella and tetanus; ≥ 80% for IPD (≥ 5 to < 50 years); and below target for unspecified hepatitis B (54%), laboratory confirmed influenza (47%), pertussis (≥ 5 years; 60%) and rotavirus (71%). However, completeness was above 90% for all VPDs in the Northern Territory, and all except laboratory confirmed influenza (89%) in Western Australia. Key barriers to Indigenous status completeness include the absence of an Indigenous status field on most pathology request forms and limited public health authority resource capacity to follow up missing data, particularly for high incidence diseases. National level Indigenous status completeness is high for most VPDs but low for others, particularly for high incidence diseases predominantly notified by laboratories. Completeness is uniformly high for all VPDs in the Northern Territory and Western Australia; however, this is due to the resource-intensive public health follow-up of all notifications and manual cross-checking of other databases when Indigenous status is missing. To more efficiently optimise Indigenous status completeness in the NNDSS across all jurisdictions, a mix of additional strategies is needed to ensure accurate identification and recording in primary care, hospital, laboratory and public health settings, and effective transfer between them.

Post‐Release Performance of Hatchery‐Reared Tibetan Fish Schizopygopsis younghusbandi Juveniles in a Tributary of Lhasa River

ABSTRACTStock enhancement is essential for China's fishery resource conservation. However, research evaluating the stocking effectiveness of plateau fish species is scare. Schizopygopsis younghusbandi, a Tibetan fish endemic to the middle Yarlung Zangbo River, is currently facing a decline in resource availability. In the present study, an 11‐month mark–release–recapture experiment was conducted to evaluate the post‐release performance of hatchery‐reared juvenile S. younghusbandi released into a tributary of the Lhasa River from September 2023 to August 2024. The overall recapture rate of the released fish was 8.04%, with 92.0% of the individuals being recaptured within 10 days of their release. As the time since release increased, the occurrence rate of the released fish at various capture sites demonstrated a declining trend. The last recapture of a released fish occurred 248 days post‐release, demonstrating that the experimental fish can successfully overwinter in the field environment. The average weight of the released fish increased by 66.4% over the 11 months following their initial release. The condition factors of the released fish exhibited notable variations, with a significant decline during the winter months. Changes in gut fullness indicate that the released fish resumed feeding as early as the second day post‐release and maintained feeding activity throughout the subsequent experimental period. The movement patterns of the released fish reveal that they primarily dispersed upstream of the release site during the early stages; however, after 8 days of their release, they predominantly moved downstream. The population contribution rate of the released fish ranged from 0.36% to 1.09% over the 2–8 months following their release. The results of this study not only enhance our understanding of the adaptability of hatchery‐reared plateau fish to wild environments but also provide a reference for the management and effectiveness evaluation of plateau fish stock enhancement programs.

JUMPSTART: evaluation of an early mobilization program following transcatheter aortic valve replacement

BackgroundPatients with aortic stenosis undergoing a transcatheter aortic valve replacement (TAVR) are typically discharged from hospital the next day, leaving little time to support their mobilization needs. Therefore, to improve the early mobilization of post-TAVR patients, we investigated the adoption and acceptability of a self-directed, tailored and home-based exercise program (JUMPSTART), which consists of four exercise modules, available in virtual and paper formats.MethodsThis prospective, observational, non-randomized and comparative study was conducted at one regional cardiac centre in Ontario, Canada. The development of the JUMPSTART program was informed by the Knowledge-to-Action Cycle and the choice of study outcomes were guided by the RE-AIM Framework. Program adoption and acceptability were captured through two follow-up surveys, 14-days and three-months post-TAVR; survey questions were informed by the Consolidated Framework for Implementation Research. The target program adoption rate was 70% by three-months post-TAVR. Impact of program participation on quality-of-life scores, and study participants’ cardiac rehabilitation attendance, were also assessed.ResultsThere were 144 study participants. Survey response rates were 86% at 14-days post-TAVR, and 78% at three-months post-TAVR. The program adoption rate was 75% while the cardiac rehabilitation attendance rate was 30%. Approximately 70% of participants preferred the paper-based program format. The technological requirement was the most common barrier to engaging with virtual formats. Most (70%) rated the exercises as being the right level of difficulty. There were no reports of major health or safety concerns while exercising. Quality-of-life scores significantly increased from baseline to three-months post-TAVR; however, this could not be attributed to frequency of program participation. Furthermore, 73% of program participants felt that their recovery was improved because of their participation in the program, and 96% reported that they would recommend it to others. The study team regularly reviewed preliminary findings and took action to improve the program and the implementation process.ConclusionsParticipants were satisfied with the JUMPSTART program, which will continue to be offered to post-TAVR patients. Despite the increasing use of virtual technologies, most of this patient population prefers paper-based resources. Future planning will involve developing additional modules and exploring ways to increase program adoption, as well as cardiac rehabilitation attendance.Clinical trial numberNot applicable.

Examining the Efficacy of the Telehealth Assessment and Skill-Building Kit (TASK III) Intervention for Stroke Caregivers: Protocol for a Randomized Controlled Clinical Trial.

Stroke is a leading cause of serious, long-term disability and has a sudden onset. Upon discharge to the home setting, families are thrust into providing care, often without sufficient training from health care providers. Aligned with current patient and caregiver guidelines, the Telehealth Assessment and Skill-Building Kit (TASK III) is a nurse-led intervention designed to empower caregivers to address their own needs and those of the survivor using innovative skill-building strategies. This study aims to test the short-term (immediately after the intervention at 8 wk) and long-term (12, 24, and 52 wk) efficacy of the TASK III intervention, compared with an information, support, and referral (ISR) group, to improve caregiver life changes (ie, changes in physical health, physical functioning, emotional well-being, and general health) as a result of providing care. A randomized controlled clinical trial design will be used with baseline data collection from 296 family caregivers by telephone after the stroke survivor is discharged home. Caregivers randomly assigned to the ISR group (n=148, 50%) will receive information from the American Heart Association about stroke family caregiving. Caregivers randomly assigned to the TASK III group (n=148, 50%) will receive a TASK III resource guide and information from the American Heart Association. Both groups will receive 8 weekly calls from a nurse, with a booster call a month later. Outcomes will be assessed by blinded data collectors at 8, 12, 24, and 52 weeks. The primary outcome (at 8 wk) is caregiver life changes measured by the Bakas Caregiving Outcomes Scale. Secondary outcomes are depressive symptoms; other symptoms (eg, stress, fatigue, sleep, pain, and shortness of breath); unhealthy days; diet; exercise; and self-reported health care use. Mediators are task difficulty, threat appraisal, and self-efficacy. Program evaluation outcomes (satisfaction and technology ratings) will also be analyzed. The trial was registered on March 10, 2022. Enrollment and random assignment of the first participant was on November 30, 2022, with an anticipated completion of recruitment by November 30, 2025. Completion of the primary end point data analysis is anticipated by August 31, 2026, with results expected to be reported on ClinicalTrials.gov by April 1, 2027. As of October 9, 2024, a total of 198 (66.9% of the proposed total sample of 296) family caregivers have been enrolled and randomly assigned to the TASK III group (n=98, 49.5%) or the ISR group (n=100, 50.5%). The last update was performed on January 25, 2024. If the TASK III intervention is shown to be efficacious in the proposed randomized controlled clinical trial, our next goal will be to translate TASK III into ongoing stroke systems of care, providing a tremendous public health impact. ClinicalTrials.gov NCT05304078; https://clinicaltrials.gov/study/NCT05304078. DERR1-10.2196/67219.

Post-opioid overdose response team intervention barriers and facilitators to substance use treatment: Perspectives of patients and team members

Post-opioid overdose response team intervention barriers and facilitators to substance use treatment: Perspectives of patients and team members

Measuring the Longitudinal Impact of a Health Professions Education Academy on Scholarship: A Bibliometric Analysis.

Academies highlight the educational mission that is often second to clinical and basic science scholarship on health professions campuses. They help bridge the gap between faculty development and continuing professional development. Owing to their popularity, academies have proliferated across the United States and Canada during the past 3 decades. Yet the evidence of the extent to which academies have had impact on their organizations remains largely underdeveloped. In this article, the authors used logic modeling as a framework to align the research mission, programming, and longitudinal goals of the Duke Academy for Health Professions, Education and Academic Development across the span of a decade. Furthermore, we used bibliometric analysis as a program evaluation tool. Through three different case examples, we share how bibliometrics may be used to track faculty publications in health professions education journals and to assess the impact of an academy's investment on its members and the institution at large. Finally, we illustrate that longitudinal implementation of scholarship and grants programming can be an effective strategy for fostering the development of health professions education research and encouraging scholarly innovation.

Making evaluations useful for healthcare leadership development programmes

BackgroundEffective healthcare leadership has been linked to improved individual and organisational outcomes globally. However, evaluations of healthcare leadership development programmes have often been of low quality. This study investigates the...

Structured care after a DSD diagnosis in childhood: a mixed methods evaluation of the Empower-DSD program

IntroductionDifferences of sex development (DSD) encompass several rare diagnoses with medical and social implications. If a child is suspected of having DSD, timely and comprehensive information to the family is crucial for an undisturbed parent-child relationship and a good outcome. Providing information and competent care for a child with DSD is challenging for medical staff and parents, especially at the beginning of care, when many diagnostic results are still pending. The Empower-DSD information management program provides a structured multidisciplinary care and information exchange for children and their parents in the first 8–12 weeks after presenting to a specialized DSD center.MethodsFrom June 2020 to August 2022, 51 families completed the structured care pathway in 4 DSD centers in Germany as part of the government-funded Empower-DSD study. The program was evaluated with a quantitative and a qualitative approach. Diagnosis, age of child, total duration, number of appointments, and completed elements of care were documented. Semi-structured guided interviews with parents, peers and professionals were used to explore expectations and the experience of the involved stakeholders.ResultsCare elements were documented in 11 children with congenital adrenal hyperplasia (CAH) and 28 children with other DSD-diagnoses (chromosomal DSD; 46, XY-DSD; 46, XX-DSD) with a mean age of 1.8 years (0–18 years). In total 45 people were interviewed. The information management program alleviated stress and uncertainties for parents and encouraged a trusting relationship with the DSD team. Professionals rated the developed materials as a valuable tool to provide consistent and thorough care. Parents underlined the importance of the early access to specialized DSD teams, a clear and open communication and the reassuring attitude of professionals in DSD care. Parents and professionals stated that the program required time and resources and would prefer an individualized approach instead of a predefined duration.ConclusionThe structured, multidisciplinary support within the first weeks after a DSD diagnosis was perceived to be of high quality by all stakeholders involved. Information on the nature of the decision-making process and peer narratives could be added to the information material.