Partnership Intervention Research Articles

Participation in planning and governance: closing the gap between satisfaction and expectation

BackgroundMaking and implementing decisions to improve long term sustainability, particularly in democratic countries, is a significant challenge. This is exacerbated when citizens’ expectations of their relationship with government is significantly at odds with what they experience, since this is likely to further reduce their already low trust in government and its decision-making. Research in the USA has demonstrated a clear gap between citizens’ expectations of their participation in government and their satisfaction with that participation. This finding inspired a research project in regional Western Australia to determine if a similar gap existed between citizens’ expectations and experience of their relationship with government. Additionally, a public participation intervention was devised to determine whether the gap between citizens’ expectations of, and experience with, governance could be reduced and whether the decisions made from such an intervention would be more implementable. To better reflect the partnership relationship citizens expected from government, ‘deliberative democracy’ initiatives were implemented to resolve the local government’s budgeting challenges.ResultsThe results demonstrated that a similar gap to that in the USA was present in Western Australia community and the sample populations used in the partnership interventions. Further, the citizens’ experience of deliberative democracy substantially reduced the gap between their expectations and experience of government participation. These case studies also revealed the existence and details of the nature of this partnership relationship between citizens and government as well as between the citizens themselves. Moreover, the tough budgetary decisions they made were implemented without public outcry.ConclusionsThese case studies show a promising route to close the gap between citizen expectations and satisfaction with participation in government, as well as having the potential to increase the trust in government so necessary for advances in sustainability. Future research directions have been outlined to improve understanding of how these results could impact on sustainability efforts.

Nursing interventions to promote blood donor commitment: A rapid realist literature review

Blood transfusions save lives. Although giving blood is of key importance to health care systems, there is still a long-term shortage of blood. Health services need the help of voluntary donors to provide an adequate supply. Nurses who work in transfusion centers play a crucial role in encouraging blood donor commitment. There is a need to identify and analyze donor motivations and effective nursing interventions. To identify existing donor mechanisms in order to facilitate nursing interventions. A realist literature review was conducted in 2018 following the method outlined by Pawson. Articles were identified from two scientific databases, and nine scientific articles selected. They were then analyzed using the realist evaluation framework. The analysis highlighted three areas of intervention: mechanisms stemming from donors’ individual experiences; existing interventions that enable donors to go from intending to give blood to actually giving blood; and finally interpersonal interventions in the reciprocal partnership between nurses and donors. This relationship should help make giving blood a pleasant experience and have a positive impact on commitment, especially in relation to new donors.

Guideline Development for Technological Interventions for Children and Young People to Self-Manage Attention Deficit Hyperactivity Disorder: Realist Evaluation.

BackgroundAttention deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. ADHD can affect the individual, the individual’s family, and the community. ADHD is managed using pharmacological and nonpharmacological treatments, which principally involves others helping children and young people (CAYP) manage their ADHD rather than learning self-management strategies themselves. Over recent years, technological developments have meant that technology has been harnessed to create interventions to facilitate the self-management of ADHD in CAYP. Despite a clear potential to improve the effectiveness and personalization of interventions, there are currently no guidelines based on existing evidence or theories to underpin the development of technologies that aim to help CAYP self-manage their ADHD.ObjectiveThe aim of this study was to create evidence-based guidelines with key stakeholders who will provide recommendations for the future development of technological interventions, which aim to specifically facilitate the self-management of ADHD.MethodsA realist evaluation (RE) approach was adopted over 5 phases. Phase 1 involved identifying propositions (or hypotheses) outlining what could work for such an intervention. Phase 2 involved the identification of existing middle-range theories of behavior change to underpin the propositions. Phase 3 involved the identification and development of context mechanism outcome configurations (CMOCs), which essentially state which elements of the intervention could be affected by which contexts and what the outcome of these could be. Phase 4 involved the validation and refinement of the propositions from phase 1 via interviews with key stakeholders (CAYP with ADHD, their parents and specialist clinicians). Phase 5 involved using information gathered during phases 1 to 4 to develop the guidelines.ResultsA total of 6 specialist clinicians, 8 parents, and 7 CAYP were recruited to this study. Overall, 7 key themes were identified: (1) positive rewarding feedback, (2) downloadable gaming resources, (3) personalizable and adaptable components, (4) psychoeducation component, (5) integration of self-management strategies, (6) goal setting, and (7) context (environmental and personal). The identified mechanisms interacted with the variable contexts in which a complex technological intervention of this nature could be delivered.ConclusionsComplex intervention development for complex populations such as CAYP with ADHD should adopt methods such as RE, to account for the context it is delivered in, and co-design, which involves developing the intervention in partnership with key stakeholders to increase the likelihood that the intervention will succeed. The development of the guidelines outlined in this paper could be used for the future development of technologies that aim to facilitate self-management in CAYP with ADHD.

Developing and implementing a stress and coping intervention in partnership with Latino immigrant coresearchers.

Developing and implementing a stress and coping intervention in partnership with Latino immigrant coresearchers.

Preliminary Study of the Cause of Persistent High Coronary Risk Status and Effect of Applying Family Partnership Intervention Program in Asymptomatic Air Force Officers

OBJECTIVE: Over the past three years, cardiovascular disease (CVD) hasbecome the leading cause of death among Thai military officers. Recent 10-yrcohort study in asymptomatic Air Force (AF) officers suggested that preventionof CVD was feasible by identifying high risk candidates (10-yr risk by themodified Coronary Risk Chart > 20%) for early treatment. At the same time, afailure in risk reduction could lead to catastrophic events. Most of the CVDcases, both acute coronary syndrome (ACS) and stroke, became persistent highrisk candidates for three consecutive years. This study intended to explore thecause of risk reduction failure and to reduce the risk by having family memberparticipation through the Family Partnership Intervention Program (FPIP). MATERAIL AND METHODS: Inclusion criteria were asymptomatic maleofficers, age ranged from 35-60 years, who had persistent high coronary risk score(> 20% over 10 years) for two consecutive years despite receiving medication,had no CVD and had family members available for the FPIP. Exclusion criteriawere officers of age < 35 and > 60 years, had serious illness (such as ACS, stroke,cancer, psychological disease) and had no family members available forparticipation. A personal interview to assess pre-existing risk factors and life stylerecommendations was conducted before and after the eight weeks period of FPIP. RESULTS: Ten AF officers (average age of 55.2 ± 5.3 years) took partvoluntarily. Most of them (70%) had a sedentary job and took prescribedmedication. The common major coronary risk factors were hypercholesterolemia(80%), hypertension (60%), diabetes mellitus (40%), and impaired fasting glucose(40%). Insufficient knowledge was the major cause of persistent high CVD riskstatus. It led to several unhealthy habits including having an atherogenic diet (highanimal fat, low fiber and sweet) 100%, exercise less than twice a week 90%,cigarette smoking 30%, self-reported mental stress 30% and poor medicalcompliance 14.2%. After 8-weeks of FPIP, 60% of candidates were able to reducetheir high risk status to the intermediate group (predicted ris 10-20%) in fivecases and to low risk group (predicted risk 5-10%) in one case. Although, serumtriglyceride and HDL cholesterol were not significantly different, totalcholesterol reduced from 224 ± 26.1 to 191 ± 30.7 mg/dl, p = 0.005, and bloodglucose decreased from 118 ± 22.0 to 103 ± 15.4, p = 0.016. CONCLUSION: Ineffective group education and insufficient preventive knowledgeled to unhealthy life style decisions and caused persisting high CVD risk status.Individual approach by setting common goals and having family memberparticipation could reduce the predicted CVD risk in 60% of cases. The majorlimitation of the study was the small number of cases and the short term study ofonly AF officers. These results may not be applied to general population and maynot guarantee the long term outcome beyond eight weeks. However, this studywas the first one to identify the cause of persistent high CVD risk status of AFofficers and offer a better way of effective risk reduction.

M-PACT+: supporting families affected by parental substance misuse

PurposeThe purpose of this paper is to present the findings from an evaluation of an intervention (Moving Parents and Children Together (M-PACT+)) aiming to address the effects of parental substance misuse (PSM) in school settings. The paper considers the evidence of effectiveness, and goes on to explore how schools were involved with the intervention.Design/methodology/approachA theory of change was developed for the intervention, which identified key steps of change that were expected for the beneficiaries (family members and children). Mixed methods were then used to form a portfolio of data to support or refute the theory. The data included quantitative validated scale data and questionnaires at various points in time with staff, and participants (including children), and qualitative data obtained from school staff, intervention staff, families and children.FindingsThis paper concludes that the evidence supports the theory that providing M-PACT+ in school settings can begin to address the effects of PSM for the families that engage with it. Further, the paper shows that the ethos of the schools involved influences how families are identified and referred, and that interventions of this kind are most likely to succeed where they are integrated into an ethos where there is a shared responsibility for a broad child well-being agenda between schools and other community agencies.Originality/valueThis paper explores the evaluation of a unique family intervention. The findings will be of value to those seeking to implement such interventions in partnership with schools and/or community agencies.

Integrating research and system-wide practice in public health to enhance the evidence-base of interventions: lessons learnt from Better Start Bradford

BackgroundMany interventions that are delivered within public health services have little evidence of effectiveness. An efficient way to improve the evidence-base of public health interventions is to integrate research into system-wide practice, and to evaluate interventions in partnership with stakeholders and the local community. Evaluation of interventions that are being delivered as a part of usual practice offers valuable opportunities to contribute to the evidence base but also generates challenges. We aimed to develop innovative methods and pragmatic strategies to overcome these challenges and achieve relevant and robust evaluations within a complex and changing system. MethodsBetter Start Bradford is a partnership programme offering multiple public health interventions to young families in Bradford, a deprived and ethnically diverse northern city in the UK. Between Jan 1, 2016, and Dec 31, 2017, we have worked to integrate research and practice across these multiple interventions. We identified challenges and used a codesign approach to develop strategies to overcome them across five core stages: engaging the community and stakeholders; clarifying the design of the intervention; harnessing routinely collected data; monitoring implementation; and evaluating the process and outcomes using innovative methods. FindingsAs a result of our learning we developed comprehensive toolkits: an operational guide through the service design process including templates to ensure that evaluation needs are considered alongside operational plans; an implementation and monitoring guide including methods for selecting progression criteria to monitor performance; and an evaluation framework that incorporates implementation evaluations to enable understanding of intervention performance in practice, and quasi-experimental approaches to infer causal effects in a timely manner. We also offer strategies to harness routinely collected data to enhance the efficiency and affordability of evaluations that are directly relevant to policy and practice. InterpretationThis framework aims to aid the translation of rigorous research methods into the standard development, monitoring, and evaluation cycles of commissioned health interventions, and to support researchers to evaluate real-life interventions. Registration is required before the tools can be downloaded, thus allowing us to commission an independent evaluation of these tools, planned for 2019. FundingBig Lottery Fund (as part of the A Better Start programme), National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber.

Problems Experienced in the Second and Third Months After Discharge From a Heart Failure-Related Hospitalization.

The purpose of this study was to identify high-priority problems experienced by individuals during the second and third month after discharge from an acute care facility for heart failure. This descriptive, exploratory study, an extension of a previous analysis that examined high-priority problems in the first month, comprised 19 participants who were assigned to an intervention group that received a randomized, 12-week-pilot coping partnership (COPE-HF) intervention. A trained research nurse provided the intervention, and participants used a standard list to identify high-priority heart failure-related problems. Quantitative and content data analysis was conducted. While the highest-priority problem continued to be managing their treatment regimens, the frequency of this problem lessened by week 12. Comorbidities emerged as a new problem in managing heart failure treatment and symptoms. Coping emerged as a new problem, as individuals with heart failure dealt with the impending morbidity of their diagnosis and how it would affect loved ones. Resource issues (ie, financial, social) became more prevalent for individuals with heart failure as potential and actual resources were depleted. Health providers should develop strategies to address these problems to improve outcomes in individuals with heart failure.

Exploring the roots of antagony in the safe male circumcision partnership in Botswana.

BackgroundPartnerships in global health and development governance have been firmly established as a tool to achieve effective outcomes. Botswana implements Safe Male Circumcision (SMC) for HIV prevention through a North-South partnership comprising the local Ministry of Health, US Centers for Disease Control and Prevention (funded by PEPFAR) and Africa Comprehensive HIV/AIDS Partnership (funded by the Bill and Melinda Gates Foundation). The SMC partnership experienced significant antagony and the aim of this paper is to illuminate the actions and processes in the SMC program that contributed to that antagony.MethodsMethods used to gather data include observation of the partners’ planning and strategic meeting in 2012, in-depth interviews with lead officers at national level, focus group discussions with district officers and implementers, younger male officers and old community members as recipients of the service.ResultsThe findings reveal that the partnership experienced antagony during operational processes and as the ultimate outcome. Target setting, financial power of the North, superficial ownership given to the South, ignoring local traditional realities results in antagony. Three roots of antagony have been identified: 1. therapeutic domination–medical expertise given with arrogance; 2.iatrogenic violence–good intentions that cause unintended harm; 3. the Trojan horse–Reckless acceptance of the gift as well as deceptive power positioned under the pretext of benevolence.ConclusionThe three roots of antagony; therapeutic domination, iatrogenic violence and the Trojan horse, constitute attitudes, hidden intentions and unintended consequences that influence program implementation and cause harm at different levels. Examples of therapeutic domination and the Trojan horse have highlighted the need for vigilance at the stage of establishing a partnership, to prevent more powerful partners from developing and applying hidden agendas and to strengthen accountability from the local partner. Iatrogenic violence has highlighted the need for partnership interventions to prevent good partner intentions accidentally producing bad outcomes.

The Strong Heart Water Study: Informing and designing a multi-level intervention to reduce arsenic exposure among private well users in Great Plains Indian Nations

Elevated arsenic exposure from drinking water is associated with an increased risk of cardiovascular disease, diabetes, kidney disease, and skin, lung, and bladder cancer. Arsenic contamination in groundwater supplies disproportionately affects rural populations using private wells. Arsenic mitigation programs for American Indian communities are limited. There is an urgent need for targeted approaches to reduce arsenic exposure for at-risk communities using private wells. Formative research was conducted to inform and design a community-based arsenic mitigation intervention for Lakota and Dakota Nations in the Great Plains Area of the United States, where, in some communities, one-quarter of private wells are estimated to have elevated arsenic. Formative research included semi-structured interviews, a community workshop, intervention-planning workshops, and a pilot study of the developed intervention. Community members prioritize aesthetic qualities of water (e.g. taste, color), safety, and other situational factors (e.g. cost) when considering their drinking and cooking water. Although water safety is a concern, awareness and concern for arsenic vary substantially within communities. To reduce arsenic exposure, community members recommended communication of water test results, home visits for intervention delivery, and reminders to use arsenic-safe water. Findings informed the development of an intervention to prevent arsenic exposure through drinking water and cooking, including health promotion messages and household items to facilitate use of an arsenic removal device (e.g. tankards to store filtered water). The pilot study indicated promising acceptability and operability of the developed intervention. This research provides a model for the development of environmental health interventions in partnership with American Indian and other private well-using communities.

Rural Teacher Practices and Partnerships to Address Behavioral Challenges: The Efficacy and Mechanisms of Conjoint Behavioral Consultation

AbstractThe efficacy of conjoint behavioral consultation (CBC), a family-school partnership intervention, for teachers’ practices and process skills was evaluated. Participants were 152 teachers of...

Family Caregiver Strain and Likelihood of Heart Failure Patient Clinical Events: A Replication Study

Introduction Higher caregiver strain was identified as a predictor of lower patient clinical event-risk in a previous analysis of Italian heart failure (HF) patient-caregiver dyads. The purpose of this analysis was to determine whether this trade-off in patient and caregiver outcomes was culturally bound, or replicable in a North American sample. Hypothesis We hypothesized that, similar to the Italian study, higher strain in North American caregivers would predict lower patient event-risk. Methods This was a secondary analysis of data from a 3-arm (usual care, patient-family education, and family partnership intervention) randomized controlled trial to improve HF self-care. Data collection occurred pre-intervention and 4 and 8 months post-intervention. Caregiver strain was measured pre-intervention using the 15-item Bakas Caregiving Outcomes Survey (BCOS: range 15-105, higher scores indicate more positive outcomes related to caregiving), and tertiles were used to divide caregivers into low, moderate, or high strain for analysis. Generalized linear regression was used to examine caregiver strain as a predictor of the likelihood of having any event (HF hospitalization, HF emergency room visit, or all-cause mortality) over time, controlling for intervention group and recent HF hospitalization (previous 4 months). Results All patients (n=92) were NYHA Class II or III, with the majority being Class II (n=68, 73.9%). Patients and caregivers were in their mid-fifties on average (56.3±10.1 and 53.4±12.4 years, respectively) and racially diverse (n=58, 63.0% and n=59, 64.8% African American, respectively), with most patients being male (n=57, 62.0%) and most caregivers being female (n=75, 84.2%). The most common dyad type was spousal (n=40, 44.0%). Over the 8 months, 28 patients were hospitalized, 6 had an emergency room visit and 6 died. The average BCOS scores for the low, moderate, and high strain groups were 82.9±12.5 (range 66-105), 61.1±1.6 (range 60-65), and 52.1±7.4 (range 31-59), respectively. There was no difference in events by intervention group. High caregiver strain (as compared to low strain) was associated with 91.9% lower likelihood of the patient having an event over 8 months follow-up (OR=0.081, 95%CI=0.008-0.850, p=0.036). There was no significant difference in event-risk by moderate caregiver strain. Conclusions Similar to previous findings in an Italian cohort, higher caregiver strain predicted lower HF patient clinical event-risk in this North American sample. Patient event-risk reductions may come with a cost for the family caregiver - a cost that has known sequelae (morbidity, mortality) and must be assessed and addressed.

Exploring and Improving Student Engagement in an Accelerated Undergraduate Nursing Program through a Mentoring Partnership: An Action Research Study.

This Participatory Action Research (PAR) project aimed to engage students from an accelerated 'fast track' nursing program in a mentoring collaboration, using an interdisciplinary partnership intervention with a group of academics. Student participants represented the disciplines of nursing and paramedicine with a high proportion of culturally and linguistically diverse (CALD) students. Nine student mentors were recruited and paired with academics for a three-month 'mentorship partnership' intervention. Data from two pre-intervention workshops and a post-intervention workshop were coded in NVivo11 using thematic analysis. Drawing on social inclusion theory, a qualitative analysis explored an iteration of themes across each action cycle. Emergent themes were: 1) 'building relationships for active engagement', 2) 'voicing cultural and social hierarchies', and 3) 'enacting collegiate community'. The study offers insights into issues for contemporary accelerated course delivery with a diverse student population and highlights future strategies to foster effective student engagement.

Problems Experienced in the First Month After Discharge From a Heart Failure-Related Hospitalization.

Heart failure is a global health concern with high morbidity and mortality rates. Individuals with heart failure commonly experience problems that impact daily life. However, little is known regarding which problems are most significant during the immediate posthospitalization period. Thus, the purpose of this study was to identify high-priority problems experienced by individuals the first month after discharge from an acute care facility with a diagnosis of heart failure. This descriptive, exploratory study was part of a 12-week randomized controlled pilot study that examined the efficacy of a coping partnership intervention (COPE-HF Partnership) between a trained research nurse and individuals with heart failure in managing self-care and depressive symptoms. Data from participants randomized to the intervention group (N=19; 58% Caucasian, 58% male) were used in this study. Participants were provided a list of potential heart failure-related problems, from which they identified those of highest priority. Content and quantitative data analysis was conducted. Difficulty in managing heart failure symptoms, adhering to treatment plan, completing daily activities, and experiencing negative emotions and moods were the most common problems experienced by individuals with heart failure. Other less common problems for the group were inadequate resources and managing interpersonal issues. Individuals with heart failure experience complex problems in the home that impact all aspects of their lives. Incorporating strategies to address these problems could assist in the development of interventions to reduce negative heart failure outcomes.

Adapting a Sexually Transmitted Infection Prevention Intervention Among Female Adolescents in Hawai'i.

Epidemiological data suggest that Native Hawaiian, Pacific Islander, and Asian American (NHPIA) adolescent females in Hawai'i are at elevated risk for sexually transmitted infections (STIs). These data also indicate that teen girls in Hawai'i are more likely to engage in high-risk sexual behaviors than boys. Despite this compelling evidence, there is a paucity of published research on effective STI prevention protocols that target NHPIA female adolescents. In light of this need, the purpose of this study was to adapt an evidence-based, group-level STI behavioral prevention intervention targeting local NHPIA adolescent girls in Hawai'i for implementation by community-based organizations (CBOs). This article describes the adaptation of an evidence-based STI prevention intervention in partnership with a CBO, using a locally modified ADAPT-ITT model as a basis for the adaptation process. This research consisted of two phases: (1) development of an initial test version of an adapted intervention and (2) the development of the final version of the adapted intervention, Girl Power Hawai'i. The results provide the empirical and foundational research necessary for a tailored intervention that can be readily implemented by CBOs for local teen girls in Hawai'i.

A mental health home visit service partnership intervention on improving patients' satisfaction

AimsTo investigate a partnership intervention of the community-based and hospital-based home visit to improve patients' satisfaction. MethodsA time series quasi-experimental quantitative design was used. The experimental group had “partnership intervention”, while the control group maintained routine home visits. Patient satisfaction was measured pre-intervention, six months and 12 months after the partnership intervention. ResultsSix and 12 months after partnership intervention, in the experimental group, items related to stabilizing disease conditions, improving daily living abilities, enhancing communication ability and providing relevant resources were significantly higher than pre-intervention. However, 12 months after the intervention, the influence of the intervention became weaken. ConclusionsThe partnership intervention can significantly improve patients' satisfaction with home visit service.

Police partnership working: Lessons from a co-located group pilot

Recent literature on police partnership working has challenged the orthodoxy established during the 1980s and 1990s that this is an unpopular area of police activity. Instead, recent research suggests that partnership working can reinforce and enhance the policing value of pragmatism (O’Neill and McCarthy, 2014), due to its focused and bottom-up approach to problem solving. Using a casestudy approach to investigate a co-located partnership group tasked with reducing demands for policing services, I explore the precise nature of the processes that enable these apparently effective elements of partnership working to emerge. I suggest a core role for “authority work” defined as the process through which particular interpretations of people, events and outcomes are warranted and rendered legitimate. I use the insights generated from the analysis to reflect on why partnership working may sometimes succeed in both producing successful multi-agency collaboration and what such success might mean for those individuals that are the targets of partnership interventions.

The influence of a mental health home visit service partnership intervention on the caregivers' home visit service satisfaction and care burden.

To investigate a community-based and hospital-based home visit partnership intervention in improving caregivers' satisfaction with home service and reducing caregiver burden. The community-oriented mental healthcare model prevails internationally. After patients return to the community, family caregivers are the patients' main support system and they also take the most of the burden of caring for patients. It is important to assist these caregivers by building good community healthcare models. A longitudinal quasi-experimental quantitative design. The experimental group (n=109) involved "partnership" intervention, and the control group (n=101) maintained routine home visits. The results were measured before the intervention, 6 and 12months after the partnership intervention. Six months after the partnership intervention, the satisfaction of the experimental group was higher than the control group for several aspects of care. Although the care burden was reduced in the experimental group, there was no significant difference between the two groups. This study confirms that the partnership intervention can significantly improve caregiver satisfaction with home services, without reducing the care burden. The community-based and hospital-based mental health home visit service partnership programme could improve the main caregiver's satisfaction with the mental health home visit services, while the reduction in care burden may need government policies for the provision of more individual and comprehensive assistance.

Diagnosing institutional logics in partnerships and how they evolve through institutional bricolage: Insights from soybean and cassava value chains in Ghana

Trade globalisation and climate change pose new challenges for food security in Africa. To unlock smallholder productivity, more understanding is needed of the institutional context and the role of development interventions, such as partnerships, in the food sector. This article proposes institutional logics as a theory and methodology for institutional diagnosis to gain insight into context-embedded negotiation and change processes created by project-based partnership interventions. We analyse the institutional logics of organisations active in the development of two value chains in Ghana to subsequently show how, in partnerships, these logics are negotiated in light of the objectives and interests of the intervention. The main findings are that donors, with their market and professionalisation logics, are quite influential, but many other development actors still adhere to principles of grassroots empowerment and social security. In the evolving partnership process, market logic remains strong, but coupled with institutional logics endorsing farmer empowerment and solidarity with the resource-poor. This is done in a process of bricolage in which field level implementers go against the dominant logic of project initiators: showing that newly introduced development logics are mitigated by an existing local structure fostering other development logics. The broader implication is that new development paradigms may need a considerable transition period to become mainstream. The concepts of institutional logics and bricolage as a diagnostic tool allow researchers to characterise the adherence to and blending of institutional logics by actors. This tool helps to understand the mobilisation strategy of the initiator and to follow the negotiation of logics that takes place amongst partners in partnerships. Detailed insights into the blending of potential partners’ logics, pathways of negotiation processes and the plausible outcomes enable development practitioners to strategically prepare and manage their collaborative interventions.

Efficacy of a social support and problem-solving intervention on heart failure self-care: A pilot study

ObjectiveThe purpose of this study was to examine the preliminary effects of a coping partnership intervention comprised of social support and problem-solving on HF self-care maintenance, management, and confidence. MethodsA 3-group randomized controlled pilot study was conducted. The intervention group received 1 home visit, weekly (month 1), and biweekly (months 2 and 3) telephone calls. The attention group received telephone calls starting at week 2, following a similar pattern. The control group received usual care only. The Self-care of Heart Failure Index, was administered at baseline, 5, 9, and 13 weeks. Linear mixed modeling examined intervention effect on study outcomes. ResultsA total of 66 participants completed the study. The participants were mean age 61 years; 54.2% male; 56% Non-Caucasian; and 43.9% New York Heart Association HF Class II. Significant treatment-by-time interaction effects were noted for self-care maintenance (F=4.813; p=0.010) and self-care confidence (F=4.469; p=0.014). There was no significant treatment-by-time interaction effect on self-care management. ConclusionsCoping partnership interventions that strengthen support and social problem- solving may improve self-care maintenance and confidence in individuals with HF. Practice implicationsClinicians should consider including these components in HF patient education and clinical follow-up.