Evidence-based Programs Research Articles

Evaluating the Impact of an Evidence-Based Practice Education Program on Clinical Nurses’ EBP Competencies at HMC, Qatar: A Pre-Post Study

Evaluating the Impact of an Evidence-Based Practice Education Program on Clinical Nurses’ EBP Competencies at HMC, Qatar: A Pre-Post Study

Enhancing food access in a comprehensive cancer center area of influence through local partner capacity building.

Food insecurity, an economic and social condition of limited food access, is associated with poor diet quality-a risk factor for several common cancers. The University of Texas MD Anderson Cancer Center supports healthy food access through community-led evidence translation by actively partnering with community-based organizations (CBOs). These partnerships aim to enhance the capacity of food assistance CBOs to effectively implement evidence-based food insecurity mitigation programs in the cancer center's area of influence. This case study aims to describe the cancer center's model for local food access capacity building and detail operationalization in the context of a whole-community cancer prevention effort (Be Well Baytown) in Baytown, Texas. Elements central to the capacity building model include (i) assessment of baseline needs and capacity, (ii) empowering a community champion within a relevant CBO, (iii) mapping inter-sectoral community partnerships, collaborations, and linkages, and (iv) leveraging systems, connections, and resources to provide an enabling environment for overall food access systems growth. Through this process, Be Well Baytown enhanced the capacity of a local food pantry leading to increases in total reach, pounds of food distributed, and number of food distribution events in collaboration with intersectoral partners from 2018 to 2023. This case study highlights the model's implementation as a co-benefit community partnership strategy to maximize the impact of food security programs integrated with comprehensive cancer center prevention efforts.

The effects of a facilitator-enabled online multicomponent iSupport for dementia programme: A multicentre randomised controlled trial

BackgroundMulticomponent interventions with carers of people with dementia demonstrate positive effects on the health and quality of life for carers and care recipients. The World Health Organization's iSupport for Dementia is an evidence-based online psychoeducation programme for carers. However, the programme was mainly implemented as a self-learning tool which might have limited its positive effects on carers and care recipients. Evidence for online multicomponent interventions with carers that incorporates the iSupport programme remains unknown. ObjectivesThis study aimed to partner with health and social care organisations to evaluate the effects of a facilitator-enabled online multicomponent Chinese iSupport programme, which included psychoeducation using the iSupport programme, facilitator-enabled carer support groups and access to care services. DesignA multicentre randomised controlled trial. Settings and participantsParticipants were family carers in Australia and greater China. We recruited participants to the study from 1st November 2021 to 30th June 2022. MethodsThe intervention group received the Chinese iSupport programme delivered online. The intervention lasted for 6 months. Our primary outcome was carers' quality of life. Our secondary outcomes were carers' self-efficacy, social support, distress reactions to changed behaviours, care recipients' frequency of changed behaviours, quality of life, unplanned hospital admissions, emergency department presentations and permanent admissions to nursing homes. The outcomes were measured at baseline (T0), 6 months (T1) and 9 months (T2). We applied a multivariate mixed effect linear regression model to capture the group effect, time effect and their interaction. ResultsIn total, 266 eligible family carers agreed to participate and were randomly assigned to an intervention group (n = 131) or a usual care group (n = 135). Most carers were women with a mean age of 53 years. The intervention group showed a statistically significant higher score of mental-health-related quality of life (mean difference = 4.1, 95 % CI: 1.5, 6.8, p = 0.002), self-efficacy in controlling upsetting thoughts (mean difference = 7.1, 95 % CI: 2.2, 12.0, p = 0.005) and lower score of distress reactions to changed behaviours (mean difference = −0.1, 95 % CI: −0.3, −0.03, p = 0.012) than the usual care group at T1. ConclusionThe facilitator-enabled online multicomponent Chinese iSupport programme demonstrated positive effects for carers on mental health-related quality of life, controlling upsetting thoughts and distress reactions to changed behaviours of people with dementia. Trial registrationThis study is registered in the Australia New Zealand Clinical Trials Registry on 12th March 2021 (ACTRN12621000276853). Tweetable abstractThe facilitator-enabled online multicomponent Chinese iSupport programme improved family carers' mental health-related quality of life, control of upsetting thoughts and distress reactions to changed behaviours of people with dementia.

Does combining two evidence-based exercise programs in elderly people with incontinence have a triple effect on incontinence symptoms, balance and functional status?

Improving pelvic floor muscle training (PFMT), balance and functional activity is recommended in the treatment of urinary incontinence (UI) in the elderly people. The aim of this study is to examine whether PFMT combined with Otago exercises is effective on symptoms, balance and functional status in elderly people with UI compared to PFMT alone. This study is an assessor-blinded, randomized controlled trial. Participants with UI aged 65 and over living in a nursing home were randomly assigned to the intervention (IG) and control groups (CG). The intervention group attended an exercise program that included Otago exercises combined with PFMT. The control group was included in the PFMT program with different positions. The duration of exercise for both groups was 45-60min per session three times a week for 12weeks. UI symptoms and severity (Pelvic Floor Distress Inventory-20, bladder diary), PFM muscle function (superficial electromyography), balance (Berg Balance Scale), functional status (Senior Fitness Test) and fear of falling (Falls Efficacy Scale) were measured at baseline and after the intervention. The median age of the IG (n: 22) and CG (n: 21) was 73.5 and 77years, respectively. At baseline and after the intervention within the group, a significant improvement was observed in the PTDE-20 score (IG and CG, p: 0.00) and the 2-min step test in the IG (p: 0.02) and CG (p: 0.01). A significant decrease was found in the 2.45m get up-and-go test, PFM work average onset, and PFM rest MVC EMG values (p: 0.01, p: 0.01, p: 0.00) in the IG. The PFM rest average value decreased (p: 0.04) in the CG. The findings of this study show that combining PFMT with Otago exercises, two evidence-based interventions, is beneficial for effectively treating incontinence symptoms, balance and functional status in elderly people. Thus, a triple effect can be achieved with a single exercise training in the same treatment session and for the same duration. Clinical trial number: NCT06331039.

How Social Work Education Fosters Professional Resilience: Student and Newly Qualified Practitioner Perspectives

ABSTRACT Navigating complex and evolving practice environments requires resilient social workers. However, education's contribution to professional resilience development is underinvestigated. As part of a longitudinal, qualitative study, this article reports the findings on how social workers as students and then newly qualified practitioners perceived how their education fostered professional resilience. In stage one, interviews were conducted with 23 social work students from eight Australian universities in the final 12 months of their Master of Social Work (Qualifying) degree. In stage two, the sample was reduced to 19, with interviews occurring after approximately six months of practice. Framed by critical theory and social constructionism, narrative inquiry guided the analysis of participants’ perceptions. The results revealed professional resilience is relational and developed through curricula and pedagogy facilitating connection, building knowledge through critical reflection, and preparing students for the realities and complexities of practice. The study extends evidence that transitioning from student to practitioner is a crucial time in social workers’ careers. The findings identify that professional resilience can be fostered by responsive external resources and evidence-based programs offered by universities, practice organisations, and professional bodies. IMPLICATIONS Social workers' resilience relies upon education fostering connection between students, academics, and qualified social workers, incorporating critical reflection and developing knowledge and skills in navigating practice contexts. Field education is integral to this process. Social workers in Australia could benefit from a nationwide program creating a consistent and evidence-informed approach to support newly qualified social workers as they transition into the workforce.

Development of a framework for community health workers to contribute to interprofessional learning teams

Background. Community health workers’ knowledge, skills and training seem to affect their contribution to 4th-year health sciences student teams who are following an interprofessional learning programme aimed at improving two South African rural communities’ health outcomes related to diabetes. Objective. To develop a framework for community health workers to contribute to interprofessional learning teams. Methods. The framework development forms part of previous phases of a multi-method study. The theory of change logic model guided the development of the draft framework, informed by data from two ecogram sessions, five nominal group technique discussions and a scoping review. The final framework was validated by experts during a workshop using forward and backward mapping. Results. The framework addresses the need for community health workers to gain knowledge, skills and training related to diabetes to effectively contribute to interprofessional learning teams. The theory of change process identified community needs and assets, desired results, influential factors, evidence-based strategies and assumptions required to address the problem. Conclusion. The framework focuses on a problem within specific interprofessional learning teams. Collaboration with stakeholders contributed to a rigorous research process, and the validation, refinement and future implementation of the framework. The framework eventually led to the development of an evidence-based training programme comprising knowledge, skills and training strategies related to diabetes. It is predicted that once community health workers have completed this training programme, they will be able to contribute effectively to the interprofessional learning teams.

Nurse-led web-based self-management program to improve patient activation and health outcomes in patients with chronic low back pain: an acceptability and feasibility pilot study

BackgroundPatients with chronic low back (cLBP) pain report reduced physical function and ability to participate in social roles and are more likely to use opioid pain medications. While self-management interventions have been shown to support these patients, their effectiveness has been limited due to poor patient engagement. “Patient activation” encompasses the skills, knowledge, and motivation that a person has to manage their health. Supporting patient activation may improve the effectiveness of self-management for cLBP.MethodsIn this single-masked pilot study of adults with cLBP, patients were randomized to receive either no intervention (control) or 6 weekly sessions of an evidence-based web-based self-management program (SMP) with or without health behavior change counseling (HBCC) using motivational interviewing. Participants were assessed at baseline and at 12 and 26 weeks using the Patient Activation Measure, Oswestry Disability Index and PROMIS physical function, social role participation, and pain interference. We assessed acceptability and feasibility based on recruitment, session attendance, and follow-up.ResultsOf 187 individuals screened, 105 were eligible and 34 were randomized to control (n = 12), SMP (n = 4), or SMP + HBCC (n = 18). The population had 19 women, 22 patients married or living with significant other, 13 Black or African American patients, and 4 Hispanic or Latino patients. Participants had a mean (SD) Oswestry Disability Index score of 42 (12), moderate impairments in physical function (40 (6.6)) and social roles (45 (10)), and moderately severe pain interference (61 (6.7)). Of 22 participants receiving SMP sessions, 20 participated in at least 1, 15 participated in at least 3, and 7 participated in all 6 sessions. Loss to follow-up was 6 over the 26-week study. Participants in the SMP and SMP + HBCC groups had at least medium effect size improvements in Patient Activation Measures and small-to-medium effect size improvements in Oswestry Disability Index scores and physical function and large effect size improvement in social roles at 12 weeks. Improvements persisted in the SMP + HBCC group at 26 weeks.ConclusionsA web-based SMP is acceptable and feasible in this population. Participants who received augmentation with HBCC had persistent improvements in health outcomes at 26 weeks.Trial RegistrationClinicalTrials.gov Identifier NCT06236529 (2/1/2024 – retrospectively registered).Level of Evidence3.

Motor development: A precursor to support Grade R literacy learning – Lessons from BuddingQ

Background: In South Africa, low literacy rates among children, particularly in early grades, present a critical challenge to the nation’s educational development. This study addresses the pressing issue of inadequate early childhood literacy education, aiming to bridge the gap between research and practice by advocating for effective interventions in the South African context.Objectives: The study seeks to understand the systemic challenges that hinder early literacy development in South Africa and to explore evidence-informed methods for improving literacy outcomes. By focusing on key elements of effective interventions, such as early initiation, evidence-based programme design, resource allocation, and monitoring and evaluation frameworks, this research aims to provide practical insights into reshaping literacy education in the country.Method: We conducted a qualitative case study of the BuddingQ intervention in Makhanda, South Africa, using interviews, observations, and content analysis.Results: The study revealed that prioritising early intervention, investing in evidence-informed programmes, proper resource allocation, and implementing robust monitoring and evaluation mechanisms are critical components of successful early literacy interventions. BuddingQ, by emphasising foundational skills development through play and movement, demonstrated a positive impact on children’s emergent literacy capabilities.Conclusion: South Africa needs transformative leadership and policy reforms for early childhood literacy. Evidence-based methods can promote educational equity, social justice, and improved literacy outcomes.Contribution: This study provides insights into effective early literacy interventions in South Africa, offering practical recommendations for policymakers, educators, and researchers to reshape literacy education and foster progress.

Prevalence and determinants of risky behaviors: a comprehensive review of substance use and sexual risk behaviors among adolescents in the United States

Adolescents are often the most vulnerable to risky behaviors due to their quest for independence, experimentation, and identity development, resulting in deep-rooted patterns that affect health across the life course. This review examines the prevalence and determinants of substance use and sexual risk behaviors among adolescents in the United States. A systematic search of peer-reviewed literature published between 1980-2023 was conducted using multiple databases. Studies focusing on U.S. adolescents aged 12-19 and reporting on prevalence or associated factors of substance use (alcohol, tobacco, marijuana, or any illicit drugs) or sexual risk behaviors (early sexual initiation, multiple partners, or inconsistent condom use) were included. The review synthesized data from 40 studies meeting inclusion criteria. Results indicate concerning rates of substance use and sexual risk-taking, with variations by demographic factors. Alcohol and marijuana use were most prevalent, reported by 30-40% of adolescents. Nearly half of high school students reported having sexual intercourse, with 40% not using condoms consistently. Prevalence was generally higher among older adolescents, sexual minorities, and some racial minority groups. Key determinants of risk behaviors were reviewed based on socioecological models including individual, interpersonal, community and societal factors. The review highlights the multilevel nature of influences on adolescent risk behaviors. Findings underscore the need for tailored interventions addressing multiple determinants. Particular attention to vulnerable groups such as African American Adolescents and social determinants of health inequities is warranted. More research on risk and protective factors and effective interventions is needed. This synthesis can inform the development of evidence-based policies and programs to reduce substance use and sexual risk behaviors among U.S. adolescents.

Site-initiated adaptations in the implementation of an evidence-based inpatient walking program.

There is increasing recognition of the importance of maximizing program-setting fit in scaling and spreading effective programs. However, in the context of hospital-based mobility programs, there is limited information on how settings could consider local context and modify program characteristics or implementation activities to enhance fit. To fill this gap, we examined site-initiated adaptations to STRIDE, a hospital-based mobility program for older Veterans, at eight Veterans Affairs facilities across the United States. STRIDE was implemented at eight hospitals in a stepped-wedge cluster randomized trial. During the pre-implementation phase, sites were encouraged to adapt program characteristics to optimize implementation and align with their hospital's resources, needs, and culture. Recommended adaptations included those related to staffing models, marketing, and documentation. To assess the number and types of adaptations, multiple data sources were reviewed, including implementation support notes from site-level support calls and group-based learning collaborative sessions. Adaptations were classified based on the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME), including attention to what was adapted, when, why, and by whom. We reviewed the number and types of adaptations across sites that did and did not sustain STRIDE, defined as continued program delivery during the post-implementation period. A total of 25 adaptations were reported and classified across seven of the eight sites. Adaptations were reported across five areas: program documentation (n = 13), patient eligibility criteria (n = 5), program enhancements (n = 3), staffing model (n = 2), and marketing and recruitment (n = 2). More than one-half of adaptations were planned. Adaptations were common in both sustaining and non-sustaining sites. Adaptations were common within a program designed with flexible implementation in mind. Identifying common areas of planned and unplanned adaptations within a flexible program such as STRIDE may contribute to more efficient and effective national scaling. Future research should evaluate the relationship between adaptations and program implementation.

Challenges in Disseminating Evidence-Based Health Promotion Programs in Faith Community Settings: What We Need to Include.

Effective dissemination of information about evidence-based programs (EBPs) is essential for promoting health equity. Faith-based and other community organizations have difficulty locating EBPs for implementation in their settings. A research team engaged in a systematic search to identify a menu of EBPs that could be offered to African American FBOs as part of a community-engaged implementation study. Methods. A four-stage process was developed to search for EBPs meeting seven inclusion criteria for dissemination in faith-based organizations (FBOs). Criteria included relevance to identified health disparity topics, endorsement on a federal website, free access to downloadable program materials, facilitator guidance, no requirements for health care providers, and culturally relevant materials for African American communities. Nineteen government websites were searched. Sixty-six potential EBPs were identified. Six EBPs met all inclusion criteria. The search for EBPs that met seven criteria for implementation in African American FBOs demonstrated challenges that have been described in the literature. Researchers encountered a lack of standardized terminology for identifying EBPs on federal websites, frequent requirement for health care providers or clinics and/or fees for training and materials. FBOs are supportive and safe places to offer EBPs to promote health, and EBPs need to be designed and disseminated to meet the needs and preferences of FBOs. Including members of FBOs and others in the community in EBP development, design, and dissemination, such as searchable health promotion EBP registries, can increase the likelihood that effective programs intended to address health disparities are readily accessible to FBOs for implementation.

The implementation status of prehabilitation during neoadjuvant chemotherapy for patients with locally advanced esophageal cancer: a questionnaire survey to the board-certified facilities in Japan.

Prehabilitation during neoadjuvant therapy has the potential to improve clinical outcomes. However, information on its global dissemination status is limited. This Japanese nationwide survey investigated the implementation status of and barriers to prehabilitation during neoadjuvant chemotherapy (NAC) for patients with locally advanced esophageal cancer in hospitals. This multicenter nationwide survey was conducted by post. The eligible facilities were 155 Japanese hospitals that had been certified within the last 10years as authorized institutes for board-certified esophageal surgeons by the Japan Esophageal Society. We administered an original questionnaire to investigate the current status of prehabilitation during NAC. The response rate was 75% (117/155 facilities). Forty-six facilities (39%) provided prehabilitation during NAC. The most frequently selected reasons for not providing or providing insufficient prehabilitation were lack of human resources, issues with the reimbursement of medical fees, difficulty in providing continuous prehabilitation during repeated inpatient and outpatient care, the lack of established standard prehabilitation programs, challenges in providing multidisciplinary prehabilitation, and difficulty in managing physical symptoms. We observed that the implementation rate of prehabilitation during NAC was low. Critical reasons were not only the lack of medical resources but also the lack of evidence-based standard prehabilitation programs during NAC and the lack of evidence for how to continuously deliver prehabilitation during NAC to patients with physical symptoms.

Identifying and Prioritizing Factors to Improve Implementation of an Evidence-Based Program for Child Maltreatment Prevention in Rural Missouri Communities

AbstractPrevention of child abuse and maltreatment is critical in the Ozark region of Missouri where rates are higher than in other areas of the state. Community-based organizations seeking to address these issues in rural areas face significant challenges both internal and external to the organization. Guided by the Consolidated Framework for Implementation Research (CFIR), Whole Kids Outreach (WKO) utilized a modified concept mapping approach to identify strategies needed to address these challenges and more effectively implement the Healthy Families America (HFA) program in seven counties in the rural Missouri Ozark region. Semi-structured interviews were used to identify barriers and supports to the implementation of HFA. Statements were generated via in-person and telephone interviews with key stakeholders (WKO internal staff and external partners). These stakeholders then sorted statements into like piles and rated them according to importance. Concept mapping systems software, using multidimensional scaling and hierarchical cluster analysis, was used to determine the most salient cluster solution. The resulting cluster map depicted six thematic clusters and provided a visual representation of relationships between clusters. Stakeholders were then guided through a nominal group process to prioritize key issues and begin to develop strategies to address them.

Outcomes from Partner2Lose: a randomized controlled trial to evaluate 24-month weight loss in a partner-assisted intervention

BackgroundPartner support is associated with better weight loss outcomes in observational studies, but randomized trials show mixed results for including partners. Unclear is whether teaching communication skills to couples will improve weight loss in a person attempting weight loss (index participant).PurposeTo compare the efficacy of a partner-assisted intervention versus participant-only weight management program on 24-month weight loss.MethodsThis community-based study took place in Madison, WI. Index participants were eligible if they met obesity guideline criteria to receive weight loss counseling, were aged 18–74 years, lived with a partner, and had no medical contraindications to weight loss; partners were aged 18–74 years and not underweight. Couples were randomized 1:1 to a partner-assisted or participant-only intervention. Index participants in both arms received an evidence-based weight management program. In the partner-assisted arm, partners attended half of the intervention sessions, and couples were trained in communication skills. The primary outcome was index participant weight at 24 months, assessed by masked personnel; secondary outcomes were 24-month self-reported caloric intake and average daily steps assessed by an activity tracker. General linear mixed models were used to compare group differences in these outcomes following intent-to-treat principles.ResultsAmong couples assigned to partner-assisted (n = 115) or participant-only intervention (n = 116), most index participants identified as female (67%) and non-Hispanic White (87%). Average baseline age was 47.27 years (SD 11.51 years) and weight was 106.55 kg (SD 19.41 kg). The estimated mean 24-month weight loss was similar in the partner-assisted (2.66 kg) and participant-only arms (2.89 kg) (estimated mean difference, 0.23 kg [95% CI, -1.58, 2.04 kg], p=0.80). There were no differences in 24-month average daily caloric intake (estimated mean difference 50 cal [95% CI: -233, 132 cal], p=0.59) or steps (estimated mean difference 806 steps [95% CI: -1675, 64 steps], p=0.07). The percentage of participants reporting an adverse event with at least possible attribution to the intervention did not differ by arm (partner-assisted: 9%, participant-only, 3%, p = 0.11).ConclusionsPartner-assisted and individual weight management interventions led to similar outcomes in index participants.Trial registrationClinicaltrials.gov NCT03801174, January 11, 2019.

Workplace wellness across the lifespan: A pilot program for health promotion in a low- and middle-income country.

Considering that a sizable segment of the population spends significant amount of time at work, workplaces have been identified as practical platforms for health educational programs. Although employee wellness programs in high-income countries have shown measurable benefits in productivity and physical and mental health, evidence-based programs in low- and middle-income countries, such as Lebanon, are unavailable. The aim is to develop and implement a pilot workplace wellness program focusing on health-related areas to improve health knowledge and behavior among working men and women of reproductive age. In collaboration with March of Dimes, the National Collaborative Perinatal Neonatal Network developed a culturally sensitive health education program focusing on lifestyle, infection, nutrition and family planning. Sessions were delivered by a multidisciplinary team of specialists at a local bank in Lebanon. To assess the impact of the program, participants completed Knowledge and Behavior Assessment Questionnaire (KBAQ) before and after implementation. KBAQ was conducted 6 months after implementation to measure retention and continuing impact. Forty-seven participants completed the program, of whom 44.7% are male, 98% have university degree and 56.5% are married. Total knowledge score improved significantly from 64.2 to 74.3 and remained significant at 6 months post-implementation with a score of 71.7 (p < 0.001). At 6-month follow-up, emotional score improved (p = 0.028), while smoking decreased (p = 0.008). Also, employees' health knowledge and behavior showed sustained and significant improvement. We plan to implement our program at other sites and among employees from different backgrounds to understand the impact of the wellness program on employees' knowledge and behaviors at a larger scale.

Facilitating well-being: an examination of an online trauma-informed faculty/staff training designed to support college student resilience

College students report high psychological distress, mental health problems and anxiety. Research indicates that faculty and staff can help support these students in crisis, but there is limited trauma-informed training for higher education professionals who are not mental health counselors. This study explored an evidence-based online training program designed to help faculty/staff members facilitate well-being and resilience among college students. To test the training, a systematic program evaluation was conducted. Prior to completing the training, participants (n = 52) took a pretest. Then, after completing the training, they took a posttest. Results indicated a significant difference between pre and posttest. There were more positive attitudes toward trauma-informed approaches and resilience resources; stronger beliefs about prevalence and effects of psychological trauma; greater self-efficacy to perform trauma-informed approaches; and greater confidence in trauma-informed knowledge. Additionally, participants reported they were likely to use tools learned during the training. Thus, indicating that a self-paced, convenient, and culturally sensitive training may be beneficial for faculty and staff as they aid in student success. Practical implications, participant comments and specific suggestions for colleges are also discussed.

Understanding potential determinants of menstruation-related school absenteeism in Zimbabwe: a cross-sectional study

ABSTRACT Menstrual health and hygiene (MHH) plays a vital role in protecting the dignity, safety, privacy, and wellbeing of girls and women. In low- and medium-income countries, students often face challenges to manage their menstruation in schools. In 2019, Zimbabwe conducted the first national formative research to inform MHH programming in schools. This study conducted a secondary analysis of cross-sectional data from the national formative research to explore potential determinants of menstruation-related school absenteeism in Zimbabwe. The analysis included 1,393 students from 50 schools, and the main outcome variable measured if students ever missed school due to menstruation. Multivariate analysis employed nested logistic regression models after controlling for the complex survey design. The results revealed that 20.6% of students had ever been absent from school due to menstruation-related issues. Students' age, challenges with concentration, physical sickness, and pain were significantly associated with school absenteeism in this context. Presence of a reliable school water source and availability of adequate handwashing resources at sanitation facilities were protective factors. The evidence-based MHH programming can be further advocated and scaled up to promote students' good health and wellbeing, maximize their educational opportunities, and develop their fullest potential in life.

Promoting healthy sleep in 0-2-year-old infants: a study protocol for the development and mixed method evaluation of a sleep health program tailored to Dutch youth healthcare regions

BackgroundSleep problems are common among infants and can have a serious impact on the health and wellbeing of both child and parents. To sustainably promote infant sleep on a population level, it is necessary to develop evidence-based programs that can be implemented on a large scale. The Youth Health Care setting, with its focus on prevention, child health promotion and services widely available for parents, can be a suitable setting to do so. Currently however, sleep health promotion in this setting seems to be suboptimal. To promote healthy infant sleep on a population level, programs need to be accessible and comprehensible for all parents, including parents with limited (health) literacy. Therefore, this study aims to develop, implement and evaluate a program called ‘Sleep on number 1’, that is tailored to Dutch Youth Health Care, to sustainably promote healthy sleep in 0-2-year-old infants.MethodsThe program was developed based on co-creation with parents and Youth Health Care professionals, evidence-based behaviour change theories and sleep health promotion methods. Program effectiveness is investigated with a quasi-experimental study design comparing the program group with the care as usual control group. Participants consist of parents of 0-2-year-old children. Primary outcome is infant sleep quality at the age of 10 weeks and 6, 9, 14 and 24 months, measured with a sleep diary. The primary data analysis focuses on night awakenings at 9 months. Secondary outcomes focus on parental behaviour regarding infant sleep, related behavioural determinants and parental satisfaction with Youth Health Care sleep advice. Program effectiveness is analysed using a linear mixed-model in case of data clustering, and an independent samples T-test or linear regression in case no substantial clustering effects are found. A mixed methods process evaluation is performed with parents and Youth Health Care professionals, assessing program reach, adoption, implementation, maintenance and working mechanisms.DiscussionThe ‘Sleep on number 1’ program is an evidence-based sleep health program for 0-2-year-old children, tailored to Dutch Youth Health Care. If effective, this program has the potential to improve infant sleep on a population level.Trial registrationISRCTN, ISRCTN27246394, registered on 10/03/2023. https://www.isrctn.com/ISRCTN27246394.

Creating a community advisory board for pediatric bladder health.

Pediatric lower urinary tract symptoms (LUTS) are highly prevalent in neurologically healthy school-aged children. However, no evidence-based programs exist to prevent or treat LUTS in the community setting. To address this, we established the first community advisory board (CAB) that aims to identify individual and societal structures impacting pediatric bladder health in Northern California's Bay Area and co-design culturally relevant bladder health interventions. Probability and non-probability sampling methods were used to recruit community stakeholders to the CAB. Our final CAB comprised of two parents, two community health workers, one educator, one pediatric urology registered nurse, and one pediatrician. The CAB met quarterly during the 1-year study period. Bi-directional feedback identified community-level barriers to bladder health, particularly in the school environment, and the need for tailored resources to teach children and families about healthy bladder behaviors. The CAB co-designed school-based bladder health interventions, including bladder health posters, and provided feedback on three school-based research study proposals. The CAB will continue to guide and inform future community-engaged research efforts.

Mobility Assessment Instruments

ObjectivesReview commonly used mobility assessment instruments and discuss their use in multidisciplinary research and clinical practice. MethodsData sources include peer-reviewed articles sourced in electronic databases (PubMed, CINAHL), government websites, national, and international best practice guidelines to describe frequently used mobility assessment instruments. ResultsNumerous clinician-, observer-, patient-reported, and performance outcome instruments and evidence-based implementation program resources exist, though these vary in their intended purpose and setting. Wearable and ambient sensors provide new opportunities to collect passive, objective physical activity data and observe changes in mobility across settings. ConclusionsSelection among multiple assessment tools requires consideration of the available evidence for use in the desired population, the outcomes of interest, whether use is feasible for the setting, and the strength of validity and reliability data for the tool. Implications for Nursing PracticeNurses, especially in the inpatient setting, are typically in most frequent contact with patients and are well-positioned to assess mobility and ensure that safe, progressive mobility care plans are in place. Development of an organization-wide mobility culture requires a systematic, multidisciplinary approach and long-term commitment.