Implementation Of Future Initiatives Research Articles

Prescribers\u2019 perspectives on including reason for use information on prescriptions and medication labels: a qualitative thematic analysis

BackgroundThe indication for prescribing a particular medication, or its reason for use (RFU) is a crucial piece of information for all those involved in the circle of care. Research has shown that sharing RFU information with physicians, pharmacists and patients improves patient safety and patient adherence, however RFU is rarely added on prescriptions by prescribers or on medication labels for patients to reference.MethodsQualitative interviews were conducted with 20 prescribers in Southern Ontario, Canada, to learn prescribers’ current attitudes on the addition of RFU on prescriptions and medication labels. A trained interviewer used a semi-structured interview guide for each interview. The interviews explored how the sharing of RFU information would impact prescribers’ workflows and practices. Interviews were recorded, transcribed and thematically coded.ResultsThe analysis yielded four main themes: Current Practice, Future Practice, Changing Culture, and Collaboration. Most of the prescribers interviewed do not currently add RFU to prescriptions. Prescribers were open to sharing RFU with colleagues via a regional database but wanted the ability to provide context for the prescribed medication within the system. Many prescribers were wary of the impact of adding RFU on their workflow but felt it could save time by avoiding clarifying questions from pharmacists. Increased interprofessional collaboration, increased patient understanding of prescribed medications, avoiding guesswork when determining indications and decreased misinterpretation regarding RFU were cited by most prescribers as benefits to including RFU information.ConclusionsPrescribers were generally open to sharing RFU and clearly identified the benefits to pharmacists and patients if added. Critically, they also identified benefits to their own practices. These results can be used to guide the implementation of future initiatives to promote the sharing of RFU in healthcare teams.

GoActive: a protocol for the mixed\xa0methods process evaluation of a school-based physical activity promotion programme for 13\u201314year old adolescents

BackgroundProcess evaluations are critical for interpreting and understanding outcome trial results. By understanding how interventions function across different settings, process evaluations have the capacity to inform future dissemination of interventions. The complexity of Get others Active (GoActive), a 12-week, school-based physical activity intervention implemented in eight schools, highlights the need to investigate how implementation is achieved across a variety of school settings. This paper describes the mixed methods GoActive process evaluation protocol that is embedded within the outcome evaluation. In this detailed process evaluation protocol, we describe the flexible and pragmatic methods that will be used for capturing the process evaluation data.MethodsA mixed methods design will be used for the process evaluation, including quantitative data collected in both the control and intervention arms of the GoActive trial, and qualitative data collected in the intervention arm. Data collection methods will include purposively sampled, semi-structured interviews and focus group interviews, direct observation, and participant questionnaires (completed by students, teachers, older adolescent mentors, and local authority-funded facilitators). Data will be analysed thematically within and across datasets. Overall synthesis of findings will address the process of GoActive implementation, and through which this process affects outcomes, with careful attention to the context of the school environment.DiscussionThis process evaluation will explore the experience of participating in GoActive from the perspectives of key groups, providing a greater understanding of the acceptability and process of implementation of the intervention across the eight intervention schools. This will allow for appraisal of the intervention’s conceptual base, inform potential dissemination, and help optimise post-trial sustainability. The process evaluation will also assist in contextualising the trial effectiveness results with respect to how the intervention may or may not have worked and, if it was found to be effective, what might be required for it to be sustained in the ‘real world’. Furthermore, it will offer suggestions for the development and implementation of future initiatives to promote physical activity within schools.Trial registrationISRCTN, ISRCTN31583496. Registered on 18 February 2014.

Population-level interventions in government jurisdictions for dietary sodium reduction.

Population-level interventions in government jurisdictions for dietary sodium reduction.

GIS Risk Assessment and GAP Analysis for the Andean Titi Monkey (Callicebus oenanthe)

Abstract: We conducted a predictive GIS (Geographical Information System) analysis to create a realistic Habitat Suitability Model (HSM) and risk analysis throughout the distribution of the Andean titi monkey (Callicebus oenanthe) in order to evaluate the effectiveness of the current protected area (PA) network. This was done to help current conservation work and aid in the planning and implementation of future initiatives. Little was known about this species until recently. Callicebus oenanthe is listed as Critically Endangered on the IUCN Red List of Threatened Species. It is endemic to San Martin region, northeastern Peru. Our results show that the extent of habitat available for this species may be greater than previously thought but that habitat loss in the region is extremely high. GAP analysis indicates that the current protected area network is ineffective in protecting this species, and new reserve areas are urgently needed. We recommend further study into the species' ecology to better understan...

Quality improvement in small office settings: an examination of successful practices

BackgroundPhysicians in small to moderate primary care practices in the United States (U.S.) (<25 physicians) face unique challenges in implementing quality improvement (QI) initiatives, including limited resources, small staffs, and inadequate information technology systems 23,36. This qualitative study sought to identify and understand the characteristics and organizational cultures of physicians working in smaller practices who are actively engaged in measurement and quality improvement initiatives.MethodsWe undertook a qualitative study, based on semi-structured, open-ended interviews conducted with practices (N = 39) that used performance data to drive quality improvement activities.ResultsPhysicians indicated that benefits to performing measurement and QI included greater practice efficiency, patient and staff retention, and higher staff and clinician satisfaction with practice. Internal facilitators included the designation of a practice champion, cooperation of other physicians and staff, and the involvement of practice leaders. Time constraints, cost of activities, problems with information management and or technology, lack of motivated staff, and a lack of financial incentives were commonly reported as barriers.ConclusionThese findings shed light on how physicians engage in quality improvement activities, and may help raise awareness of and aid in the implementation of future initiatives in small practices more generally.