Implementation Of Development Strategy Research Articles

Development and Piloting of Implementation Strategies to Support Delivery of a Clinical Intervention for Postpartum Hemorrhage in Four sub-Saharan Africa Countries.

Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality. A new clinical intervention (E-MOTIVE) holds the potential to improve early PPH detection and management. We aimed to develop and pilot implementation strategies to support uptake of this intervention in Kenya, Nigeria, South Africa, and Tanzania. Implementation strategy development: We triangulated findings from qualitative interviews, surveys and a qualitative evidence synthesis to identify current PPH care practices and influences on future intervention implementation. We mapped influences using implementation science frameworks to identify candidate implementation strategies before presenting these at stakeholder consultation and design workshops to discuss feasibility, acceptability, and local adaptations. Piloting: The intervention and implementation strategies were piloted in 12 health facilities (3 per country) over 3 months. Interviews (n=58), case report forms (n=1,269), and direct observations (18 vaginal births, 7 PPHs) were used to assess feasibility, acceptability, and fidelity. Implementation strategy development: Key influences included shortages of drugs, supplies, and staff, limited in-service training, and perceived benefits of the intervention (e.g., more accurate PPH detection and reduced PPH mortality). Proposed implementation strategies included a PPH trolley, on-site simulation-based training, champions, and audit and feedback. Country-specific adaptations included merging the E-MOTIVE intervention with national maternal health trainings, adapting local PPH protocols, and PPH trollies depending on staff needs. Piloting: Intervention and implementation strategy fidelity differed within and across countries. Calibrated drapes resulted in earlier and more accurate PPH detection but were not consistently used at the start. Implementation strategies were feasible to deliver; however, some instances of limited use were observed (e.g., PPH trolley and skills practice after training). Systematic intervention development, piloting, and process evaluation helped identify initial challenges related to intervention fidelity, which were addressed ahead of a larger-scale effectiveness evaluation. This has helped maximize the internal validity of the trial.

Opportunities to Advance Equity Through Implementation Strategy Design.

Implementation strategies are potential tools for advancing equity goals in healthcare. Implementation scientists have increased attention to the integration of equity considerations into implementation research, but limited concrete guidance is available for developing implementation strategies to improve equity. In parallel to an active hybrid effectiveness-implementation trial in two large health systems, our research team explored potential inequities in implementation across four non-study clinics, developed equity focused audit and feedback procedures, examined the feasibility of our approach, and identified design insights that could be tested in future work to inform equitable program scale-up. Based on our experiences deploying these strategies in pilot format, our research team identified key complexities meriting further examination in future work. These considerations are vital given the dearth of guidance on delivering feedback to clinicians in efforts to improve equity. Key takeaways include the importance of understanding local data culture, engaging constituents in co-design for the full feedback cycle, leveraging feedback for shared discourse, and centering multi-level strategies as part of robust implementation approaches. Prioritizing health equity in implementation science requires that research teams probe, interrogate, and innovate - and in doing so, grapple with central conceptual and pragmatic considerations that arise in the design of implementation strategies. Our work emphasizes the value of bidirectional and continuous learning.

Dynamics of bio-based carbon dioxide removal in Germany

Bio-based carbon dioxide removal encompasses a range of (1) natural sink enhancement concepts in agriculture and on organic soils including peatlands, and in forestry, (2) bio-based building materials, and (3) bioenergy production with CO2 capture and storage (BECCS). A common database on these concepts is crucial for their consideration in strategies and implementation. In this study, we analyse standardised factsheets on these concepts. We find different dynamics of deployment until 2045: for CO2 removal rates from the atmosphere, natural sink enhancement concepts are characterised by gradually increasing rates, followed by a saturation and potentially a decrease after few decades; forest-related measures ramp up slowly and for construction projects and bioenergy plants, annually constant removal rates are assumed during operation which drop to zero afterwards. The expenses for removing 1 t CO2 from the atmosphere were found to be between 8 and 520 € t CO2−1, which arises from high divergence both in capital and operational expenditures among the concepts. This high variability of expenses seems to suggest the more cost-effective concepts should be implemented first. However, aspects from economics, resource base and environmental impacts to social and political implications for Germany need to be considered for developing implementation strategies. All concepts investigated could be deployed on scales to significantly contribute to the German climate neutrality target.

Assessment of Environmental Risks during the Implementation of Infrastructure Projects in the Arctic Region

The Arctic Zone of Russia (AZR), due to its significant potential, for the implementation of which infrastructure projects and strategic plans are envisaged, is of great importance for the country. Particular attention is paid to the transport and related infrastructure development. The implementation of such projects requires the creation and implementation of modern integrated solutions based on new technical and technological solutions. The development of new territories is accompanied by problems such as urbanization and the disruption of ecosystems, which will have a particularly negative impact on the Arctic zone. The situation is complicated by the fact that the work must be carried out in difficult conditions, which are associated with a large number of risks, including environmental ones. Currently, many types of businesses are characterized by a transition to the implementation of the concepts of green and blue economy, as well as ESG principles when building strategic development plans that include risk reduction. Achieving this goal is possible through an environmental risk management system. To create a suchlike system, it is necessary to identify the most significant risk characteristics of each type of activity, taking into account their negative impact on the environment, after which it will be possible to plan measures to either prevent risks or minimize their consequences. Taking into account the above, we plan to develop the concept of an environmental risk management system (ERMS) as part of the region’s development strategy implementation. To reach this purpose, identifying the main groups of environmental risks depending on the danger source based on the scientific article review results, systematizing concepts aimed at improving the environmental situation under different types of anthropogenic impacts on the environment, developing an algorithm for implementing an environmental risk management system depending on the risk type, and proposing a concept for building an environmental risk management system are needed. The scientific novelty of the work lies in the fact that the main directions of negative anthropogenic impact on the environment are systematized, and possible ways to reduce environmental risks are outlined. The practical significance of the work lies in the fact that when implementing such a system, it will be possible to manage not only risks of a certain category, but also monitor the situation as a whole, identifying the consequences for related areas.

How does green finance affect human well-being in the context of aging populations? Evidences from China

Purpose The purpose of this study is to investigate the influence of green finance on human well-being in China in the context of urbanization and aging population. It aims to explore the contributions of green finance in such demographic scenarios. Design/methodology/approach This study innovates and optimizes the calculation of the carbon intensity of human well-being (CIWB) index and strengthens the integrity of the assessment model for green finance development. It uses the serial multiple mediator model and moderation effect analysis to address the impact of green finance on human well-being in China on the provincial level from 2009 to 2020. Findings Green finance has a significant, positive and direct impact on human well-being. Simultaneously, it influences human well-being indirectly through three transmission channels. Urbanization and an ageing population are significant individual mediators through which green finance contributes to human well-being improvement. Notably, these two mediators also work together to transfer the promotional impact of green finance to human well-being. Practical implications The government can perfect the regulations to strengthen the market ecosystem to accelerate the development of green finance. Reforms on the administrative division to expand the size of cities with the implementation of ageing friendly development strategy is also necessary. Attracting incoming foreign direct investment in sustainable projects and adjusting public projects and trade activities to fulfil the sustainable principles are also regarded as essential. Social implications The findings challenge traditional views on the impact of aging populations, highlighting the beneficial role of green finance in improving well-being amidst demographic changes. This offers a new perspective on economic and environmental sustainability in aging societies. Originality/value A multi-dimensional well-being indicator, CIWB and the serial multiple mediator model are used and direct and indirect impacts of green finance on human well-being is exhibited. It offers novel insights on the transmission channels behind, identifies the mediating role of urbanization and ageing population and offers empirical evidences with strong academic and policy implications.

Community-Engaged Implementation Strategies in Occupational Therapy: A Scoping Review.

Despite the potential of community-engaged implementation research (CEIR) in developing strategies to accelerate the translation of evidence-based interventions (EBIs), there is a noticeable knowledge gap in the current state of CEIR in occupational therapy. A synthesis of the concept, purpose, and operationalization of CEIR is necessary. To identify the contexts, purposes, and operationalization of CEIR, focusing on implementation strategies in occupational therapy. PubMed/MEDLINE, Embase, CINAHL, Scopus, and Web of Science. We included studies that were explicit and intentional about CEIR and that focused on implementation strategies to support the translation of occupational therapy interventions, clinical guidelines, practice models, theories, or assessments. We extracted the research context (e.g., partners, recruitment), purpose (e.g., why community-engaged research was used), and operationalization (e.g., community engagement [CE] activities, how their findings inform the research) using thematic analysis. Of 3,219 records, 6 studies were included. Involved partners were mainly occupational therapy practitioners from existing networks. CEIR that focuses on implementation strategies informs various aspects of research design, ranging from study design to sustainability, by developing community-academia partnerships, building implementation capacity, and creating implementation strategies across diverse research areas. Current research has used various but mostly traditional CE activities (e.g., focus groups). We synthesized evidence on CEIR focused on implementation strategies in occupational therapy. Intentional efforts are needed to collaborate with diverse partners, explore innovative CE activities, produce equitable outputs, and develop multilevel implementation strategies to accelerate the translation of EBIs into practice. Plain-Language Summary: In this review, we synthesize evidence on the contexts, purposes, and operationalization of community-engaged implementation research (CEIR), focusing on implementation strategies in occupational therapy research. We found that current implementation efforts mainly rely on occupational therapy practitioners as community partners and use traditional recruitment methods and community engagement activities. In turn, they develop implementation strategies that mainly target practitioners without comprehensive, multilevel implementation support. We suggest more equitable collaboration with diverse partners to effectively promote the implementation and dissemination of evidence-based interventions in occupational therapy practice.

Research on Management and Sustainable Development Strategy of Food Enterprises under ESG Concepts

In the field of economic and social development, people often mention and pay attention to the development of enterprises. However, in the past, people's attention was often focused on the sustainable development of enterprises based on the evaluation of enterprise financial indicators. As an important part of China's economy, enterprises shoulder the heavy responsibility of taking the road of sustainable development, and the implementation of sustainable development strategy is an inevitable choice faced by enterprises in China. ESG (Environmental, Social and Governance) concept is a key factor for the sustainable development of enterprises, and it is also an investment decision-making concept recognized by the international community.

KSPPS Development Strategy for Bina Ummat Sejahtera to Improve the Welfare of Cooperative Members

This article examines the implementation of development strategies by KSPPS BMT Bina Ummat Sejahtera in improving member welfare through sharia financial services. Using qualitative methodology, this research evaluates the influence of adequate infrastructure, innovation in services, and human resource development on members' economic empowerment. The results show that adopting a holistic approach to cooperative operations—including improving the accessibility and efficiency of financial services as well as training programs to improve members' financial competency—significantly supports member empowerment and community economic growth. This initiative not only strengthens members' financial stability but also stimulates inclusive economic growth in the community. This study confirms that KSPPS BMT Bina Ummat Sejahtera has been effective in forming an ethical financial ecosystem and supporting the economic independence of its members.

Barriers and Facilitators to the Implementation of Digital Health Services for People With Musculoskeletal Conditions in the Primary Health Care Setting: Systematic Review.

In recent years, the effectiveness and cost-effectiveness of digital health services for people with musculoskeletal conditions have increasingly been studied and show potential. Despite the potential of digital health services, their use in primary care is lagging. A thorough implementation is needed, including the development of implementation strategies that potentially improve the use of digital health services in primary care. The first step in designing implementation strategies that fit the local context is to gain insight into determinants that influence implementation for patients and health care professionals. Until now, no systematic overview has existed of barriers and facilitators influencing the implementation of digital health services for people with musculoskeletal conditions in the primary health care setting. This systematic literature review aims to identify barriers and facilitators to the implementation of digital health services for people with musculoskeletal conditions in the primary health care setting. PubMed, Embase, and CINAHL were searched for eligible qualitative and mixed methods studies up to March 2024. Methodological quality of the qualitative component of the included studies was assessed with the Mixed Methods Appraisal Tool. A framework synthesis of barriers and facilitators to implementation was conducted using the Consolidated Framework for Implementation Research (CFIR). All identified CFIR constructs were given a reliability rating (high, medium, or low) to assess the consistency of reporting across each construct. Overall, 35 studies were included in the qualitative synthesis. Methodological quality was high in 34 studies and medium in 1 study. Barriers (-) of and facilitators (+) to implementation were identified in all 5 CFIR domains: "digital health characteristics" (ie, commercial neutral [+], privacy and safety [-], specificity [+], and good usability [+]), "outer setting" (ie, acceptance by stakeholders [+], lack of health care guidelines [-], and external financial incentives [-]), "inner setting" (ie, change of treatment routines [+ and -], information incongruence (-), and support from colleagues [+]), "characteristics of the healthcare professionals" (ie, health care professionals' acceptance [+ and -] and job satisfaction [+ and -]), and the "implementation process" (involvement [+] and justification and delegation [-]). All identified constructs and subconstructs of the CFIR had a high reliability rating. Some identified determinants that influence implementation may be facilitators in certain cases, whereas in others, they may be barriers. Barriers and facilitators were identified across all 5 CFIR domains, suggesting that the implementation process can be complex and requires implementation strategies across all CFIR domains. Stakeholders, including digital health intervention developers, health care professionals, health care organizations, health policy makers, health care funders, and researchers, can consider the identified barriers and facilitators to design tailored implementation strategies after prioritization has been carried out in their local context.

Gelingens- und Hindernisfaktoren bei der Implementierung von Gesundheitsförderung in Kitas und Grundschulen anhand von 4 ausgewählten Projekten

ZusammenfassungHintergrundGesundheitsförderung (GF) ist eine komplexe, politisch geforderte Aufgabe. Die Implementierungsgüte korreliert mit der Wirksamkeit von GF. Sie erfolgreich zu implementieren, erfordert die Beachtung von Kontextbedingungen, was in Wirksamkeitsstudien eher unterbleibt. Ziel ist es, Gelingens- und Hindernisfaktoren für die Implementierung von GF in Kindertagesstätten und Grundschulen anhand von 4 Projekten (Fit fürs Leben, fit für pisa +, Buchprojekt Sonnige Traurigtage und The Daily Mile) in der Gesundheitsregion Göttingen/Südniedersachsen zu identifizieren. Die Auswirkungen der COVID-19-Pandemie werden als implementierungsrelevant für diese Projekte angenommen.MethodenIn 24 semistrukturierten Interviews und 2 Fokusgruppendiskussionen wurden im Zeitraum 08/2021–03/2022 hauptsächlich Lehrer*innen und Erzieher*innen zur Umsetzung der Projekte in ihren Tätigkeitsbereichen befragt. Nach Transkription wurde mittels qualitativer Inhaltsanalyse ausgewertet. Das Consolidated Framework for Implementation Research unterstützte die Analyse.ErgebnisseInsgesamt wurden 22 Faktorengruppen identifiziert, auf deren Basis 22 Handlungsempfehlungen für die Implementierung von GF formuliert wurden. Im Vordergrund standen Gelingensfaktoren auf der Individuen- und Interventionsebene. Die COVID-19-Pandemie wirkte sich positiv auf den Stellenwert der GF aus, obgleich ihre Umsetzbarkeit erschwert war.DiskussionZahlreiche Ergebnisse zur Implementierung von GF in kindlichen Lebenswelten konnten durch die Studie bestätigt werden. Auffällig ist der hohe Stellenwert der Individuenfaktoren, was sich auf die Befragung projektnaher Interviewpersonen zurückführen lassen könnte. Die Studienergebnisse tragen zur Weiterentwicklung von Implementierungsstrategien in der GF bei.

FORECASTING ECONOMIC TIME SERIES WITH EXOGENOUS VARIA-BLES: OPPORTUNITIES IN COMPUTATIONAL PARAMETRIZATION TECHNIQUES FOR SUPPORTING PUBLIC DEVELOPMENT POLICIES

This study presents a comprehensive literature review exploring the integration of exogenous variables in economic time series forecasting, focusing on supporting public development policies. It systematically examines various computational parametrization techniques incorporating these external variables, emphasizing their potential to enhance prediction accuracy and address practical challenges in policy-driven contexts. By meticulously analyzing the existing body of research, this review identifies significant gaps and outlines future opportunities for advancing computational techniques and model development. Addressing these gaps could lead to more robust and precise economic forecasting models, offering valuable insights for both academic researchers and policymakers in the formulation and implementation of effective public development strategies. This paper consolidates current knowledge and paves the way for innovative computational approaches that can revolutionize economic forecasting by integrating multidimensional data from diverse external sources.

Αn integrated framework to monitor progress of sustainable urban development strategies, addressing societal, ecological and innovation dilemmas

This paper presents an integrated Monitoring and Evaluation (M&E) framework, an all-encompassing approach suitable for European cities and regions aiming to monitor and evaluate the implementation and results of sustainable urban development strategies or projects related to urban planning, transport planning, or urban energy management. The framework features a co-created and co-implemented reflexive and adaptive method tailored specifically for strategies or projects that introduce innovative elements from contemporary research and innovation in science and technology, such as net-zero development, systemic solutions for cities, or integrated urban mobility and planning. The approach to designing and implementing the M&E framework was realized through a six-phase process: (i) development of the M&E framework, (ii) tailoring indicators to each region’s specificities, (iii) developing data collection questionnaires and a reporting database, (iv) collecting the data, (v) populating the database, and (vi) writing the final report. The framework was tested and enhanced with four European regional authorities over a 19-month period, enabling them to address their so-called 'policy dilemmas,' defined as the challenges they face in balancing societal and inclusivity objectives with economic and innovation goals. This framework is designed for replication in future sustainable urban development strategies or projects with similar societal, ecological, and innovation objectives.

New development: A resilient framework for optimizing the Republic of Kosovo's sustainable development

IMPACT This article offers critical insights for policy-makers, development strategists, environmental advocates, and academics engaged in the rigorous pursuit of sustainable development within the context of political uncertainties and evolving global challenges. It amplifies the discourse on integrating and reporting the United Nations Sustainable Development Goals (SDGs) into national development strategies, using Kosovo's endeavours as a pivotal case study. By emphasizing the role of resilience theory in enhancing adaptive governance and multi-sectoral collaboration for SDG achievement, this article substantiates the imperative for innovative, inclusive, and resilient approaches to SDG integration and reporting in national development planning. The findings and recommendations advocate for the strategic alignment of national development initiatives with global sustainability objectives, underscoring the importance of establishing environmental sustainability as a core pillar and the necessity for comprehensive stakeholder engagement in the policy-making process. As such, this work contributes to the broadening evidence base supporting the integration of resilience and sustainability principles into the governance and implementation of development strategies.

Bridging the Gap between Intuition and Theory: A Comparison of Different Approaches to Implementation Strategy Development for Improving Lynch Syndrome Detection

Introduction: Despite growing calls for the explicit application of theory when designing behaviour change interventions, limited empirical evidence exists regarding the effectiveness of these methods compared to non-theoretical approaches. A cluster randomized controlled trial (Hide and Seek Project – HaSP) tested two implementation approaches for improving hereditary cancer referral practices with one key distinction: implementation strategies were designed based explicitly on psychological theory or based on stakeholder intuition. This study presents the detailed methods and resources used to facilitate this comparison, whilst examining the strategies generated through both approaches. Methods: Across seven Australian hospitals, clinical stakeholders attended focus groups to co-design site-specific strategies for improving Lynch syndrome referral. Co-design methods differed according to trial arm. Implementation strategy content was examined, with intuitively derived strategies retrospectively coded to determine theoretical alignment. Results: Fifty-one strategies were proposed across all sites (theory-based arm = 32, intuition-based arm = 19). Overall, nine behaviour change technique (BCT) categories were used on 77 occasions. In the theory-based trial arm, eight BCT categories were identified on 53 occasions; and five BCT categories on 24 occasions in the intuition-based arm. BCT categories were largely similar across both arms. After retrospectively coding intuitively derived strategies, 42% contained mechanistic links, thereby demonstrating theoretical alignment. Conclusion: Methods facilitated robust comparison of theoretical and intuitive approaches to implementation strategy design. Recognizing the known benefits of theory for enhancing scientific learning, applying these methods on a larger scale may provide definitive evidence about the comparative effectiveness of theoretical approaches.

Revealing the heterogeneity of socio-economic impacts on resource-environmental pressure: A novel three-dimensional framework applied to the Yellow River Basin

Assessing resource-environmental pressure and exploring its driving mechanisms are key to the sustainable management of resources and the promotion of high-quality development. To quantify the resource-environmental pressure and analyze the driving factor responses in the process of socio-economic development, an integrated Assessment-Identification-Analysis framework is proposed. First, footprint family models were used to assess the ecological pressure, water ecological pressure, carbon emission pressure, and synthesized resource-environmental pressure. Subsequently, the imbalanced relationship between resource-environmental improvements and socio-economic development was quantitatively identified using K-means cluster analysis. The response relationship between resource-environmental pressures and different socio-economic system factors, such as population, affluence, resource utilization, and technological progress, was further analyzed in combination with the STIRPAT model for provinces with underdeveloped resource-environmental systems. Finally, a case study of nine provinces in China’s Yellow River Basin was conducted. The main results are as follows: (a) The overall resource-environmental pressure index (REPI) of the nine provinces shows an increasing trend, with the upstream provinces demonstrate superior REPI compared to midstream and downstream provinces. Furthermore, three provinces maintain a multi-year average REPI surpassing the threshold of 0.6. (b) A majority of the regions within the Yellow River Basin suffer from an imbalance between resource-environmental management and socio-economic development. Among them, Ningxia, Shanxi, Henan, and Shandong have underdeveloped resource-environmental systems. (c) Population size, demographic structure, and economic level have a consistent contributing effect on REPI in the four provinces. Energy consumption structure and technological progress have spatial heterogeneity. The findings of the study can provide valuable insights for the implementation of regional high-quality development strategies and the realization of sustainable resource utilization.

Strategies for Achieving Better Cognitive Health in Individuals with Schizophrenia Spectrum: A Focus on the Canadian Landscape: Stratégies pour atteindre une meilleure santé cognitive chez les personnes souffrant du spectre de la schizophrénie : un regard sur le paysage canadien.

Schizophrenia spectrum disorders (SSDs) are a group of psychiatric disorders characterized by positive and negative symptoms as well as cognitive impairment that can significantly affect daily functioning. We reviewed evidence-based strategies for improving cognitive function in patients with SSDs, focusing on the Canadian landscape. Although antipsychotic medications can address the positive symptoms of SSDs, cognitive symptoms often persist, causing functional impairment and reduced quality of life. Moreover, cognitive function in patients with SSDs is infrequently assessed in clinical practice, and evidence-based recommendations for addressing cognitive impairment in people living with schizophrenia are limited. While cognitive remediation (CR) can improve several domains of cognitive function, most individuals with SSDs are currently not offered such an intervention. While the development of implementation strategies for CR is underway, available and emerging pharmacological treatments may help overcome the limited capacity for psychosocial approaches. Furthermore, combining pharmacological with non-pharmacological interventions may improve outcomes compared to pharmacotherapy or CR alone. This review highlights the challenges and discusses the potential solutions related to the assessment and management of cognitive impairment to help mental health-care practitioners better manage cognitive impairment and improve daily functioning in individuals with SSDs.

Understanding the multilevel factors influencing the implementation of digital health interventions for supportive care in Adolescents and Young Adult (AYA) cancer survivorship: determinants of adopting mindfulness-based mobile applications

BackgroundAdolescents and Young Adult (AYA) cancer survivors are at risk for psychological distress due to their unique developmental and medical needs. Healthcare providers can leverage the convenience and appeal of technology to provide supportive care for this vulnerable population. Using evidence-based mindfulness-based mobile interventions as a case example, the goal of this study was to identify key patient-, provider-, and organization-level barriers and facilitators to supportive care and implementing digital health interventions in AYA survivorship care.MethodsTwenty semi-structured interviews were conducted with stakeholders including AYA survivors (n = 10; between 18–29 years old) and clinical providers and administrators (n = 10). Interviews were transcribed and deductively mapped using the Consolidated Framework for Implementation Research (CFIR) and Theoretical Domains Framework (TDF) complementary frameworks.ResultsResults indicated that factors like cost and patients’ needs and resources were prevalent among both survivors and providers. There were key differences between providers and AYA survivors. Providers’ adoption and promotion of digital health interventions were influenced most strongly by contextual factors, including available resources (Inner Setting), culture (Outer Setting), and networks and communications (Outer Setting). On the other hand, survivors emphasized individual and intervention-related factors; they reported that social influence and knowledge influenced their adoption and use of digital health interventions, including meditation apps.ConclusionsThese results identified barriers and facilitators to the adoption of supportive care digital health interventions from multiple stakeholders. Results can be used to guide the development of implementation strategies to improve the uptake of digital health interventions in survivorship care, ultimately improving the psychosocial well-being of AYA cancer survivors.

Exploring Professional Development Practices: Insights from Gurukul, Sanskrit, and General Schools

This study aims to examine the professional development strategies used by teachers in Gurukul, Sanskrit, and general schools in Karnali and Gandaki provinces. The purpose of the study is to gain insight into the strategies teachers employ to advance their professional development. Through focus group discussions with a purposeful sample of six teachers, the study investigated the variety of professional development strategies used in these institutions. The study's findings revealed that teachers employ numerous strategies, including professional development training, field trips, peer collaboration, workshops, seminars, sharing of best practices, and technology integration. In addition, the study considered cultural norms, infrastructure constraints, and regional challenges as contextual factors that influence the implementation and efficacy of professional development strategies.

Implementation of School Nutrition Policies to Address Noncommunicable Diseases in Uzbekistan and Kyrgyzstan.

Noncommunicable diseases (NCDs), including cardiovascular diseases, cancer, and diabetes, account for over 80% of mortality in Uzbekistan and Kyrgyzstan in 2019, and unhealthy dietary behaviors are a major risk factor for NCDs in both countries. In 2021, national stakeholders, in consultation with the World Health Organization, identified school nutrition policies (SNPs) as a major approach to reducing the burden of NCDs in both countries. The SNPs included interventions implemented through a multistakeholder and multisectoral arrangement that aimed to improve the health and nutrition status of children and young people by providing healthy food/beverages and restricting unhealthy foods or beverages in schools. We used a multimethod approach of document review, participatory workshops, and key informant interviews to generate theories of change for the large-scale implementation of SNPs and describe the implementation processes to date, including key implementation and health system challenges, salient implementation strategies, and implementation outcomes in both countries. Multiple pathways for enacting and implementing SNPs successfully were identified. However, significant health system challenges, such as the lack of accountability for contracting and tender processes and coordination among different sectors, continue to hamper the large-scale implementation of these policies in both countries. The pathways, theories, and implementation outcomes identified will facilitate the development of implementation strategies and systematic learning and evaluation around SNPs for NCD prevention and control programs in the Central Asian region and other low- and middle-income countries more broadly.

Frailty management in older patients: a best practice implementation project

ABSTRACT Introduction: Frailty in older adults can lead to a gradual decline in organ function. Without timely diagnosis and intervention, this condition can progress rapidly, increasing the risk of disability and mortality. Objectives: The aim of this project was to implement evidence-based practices for managing frailty in the medical ward to prevent disability in older patients. Methods: This project was conceptually informed by the JBI Evidence Implementation Framework. This framework uses an audit and feedback approach and a pre- and post-test design to measure baseline compliance, develop implementation strategies responsive to gaps in compliance, and conduct a final evaluation to measure changes in compliance. JBI PACES and JBI GRiP situational analysis software were used to support data collection and implementation planning. Ten audit criteria were used with a sample of 30 patients in a regional teaching hospital in southern Taiwan. Results: The baseline audit showed poor compliance, with rates below 30% for all ten audit criteria. Through strategies such as professional training and education, the implementation of evidence-based care guidelines, and interdisciplinary consensus-building, the follow-up audit revealed an increase in compliance to over 90% for each audit criterion. Conclusions: Frailty management strategies based on evidence-based audit criteria were implemented and routinely measured. The most effective strategies for improving compliance included the development of a training course, a digitized assessment tool, team meetings, interdisciplinary collaboration, communication, and consensus-building. Spanish abstract: http://links.lww.com/IJEBH/A225