Delivery Model Research Articles

Rehabilitation delivery models to foster healthy ageing - a scoping review

Abstract Background Rehabilitation is crucial for healthy ageing among older adults, who face heightened risks of non-communicable diseases, infections, injuries, and mental health issues. Yet, understanding tailored rehabilitation for this demographic remains limited. To fill this gap, we conducted a scoping review to identify rehabilitation delivery models targeting older adults’ functioning and healthy ageing. Methods We systematically searched Medline and Embase (January 2015 to May 2022) for English-language studies on rehabilitation approaches for older adults. Three authors independently screened records for eligibility and synthesized findings through quantitative and qualitative analysis. Results Among 6,933 records, we assessed 585 articles, identifying 283 studies with 69,257 participants. Six main rehabilitation delivery models emerged, with outpatient (24%) and telerehabilitation (22%) being predominant. Multidisciplinary teams (31.5%) often followed integrated care principles (30.4%). However, most studies adopted a disease-centric approach (59.0%), neglecting prevalent issues like pain, sensory impairments, incontinence, and sexual dysfunctions. Therapeutic exercises (54.1%) and self-management education (40.1%) were common interventions. Conclusions Our scoping review outlines diverse rehabilitation delivery models for older adults, highlighting gaps in addressing prevalent issues and emphasizing evidence-based strategies to promote healthy ageing. It underscores the need for systematic functional assessment and expansion of rehabilitation programs to cover prevalent health concerns. While limitations include reliance on published research and not assessing model effectiveness, this review lays groundwork for future research and innovation in rehabilitation and healthy ageing. Key messages • The scoping review identifies six rehabilitation delivery models for older adults. • The scoping review advocates for evidence-based strategies for enhancing healthy ageing through rehabilitation.

Applying theories, models, and frameworks to help genetic counselors and students achieve clinical and professional goals.

Some genetic counselors (GCs) may find theories, models, and frameworks (TMFs) useful in clinical skills selection and when reflecting on or evaluating genetic counseling practice. This paper aims to demonstrate how TMFs can be used to postulate how different skills may impact patients'/clients' decisions, behaviors, and outcomes and consider how multiple TMFs can inform the use of various skills or strategies to achieve different goals. Additionally, we provide examples of TMFs that may help GCs in nonclinical aspects of their work, such as implementing and evaluating new interventions or service delivery models. To guide the selection of appropriate TMFs, we provide a set of questions to consider and include examples of skills and approaches that align with different TMFs. While TMFs provide a structured approach and valuable guidance that may help advance genetic counseling practice, they have certain limitations. Additional research is necessary to determine the effectiveness of using TMFs to guide clinical practice and improve patient/client outcomes.

Structural barriers and facilitators to accessing HIV services for marginalized working populations: Insights from farm workers in South Africa.

Farm workers are a vulnerable working population that face significant inequalities in accessing health services, including those for HIV prevention, treatment, and care. This descriptive phenomenological study aimed to explore farm workers' experiences when accessing HIV services, and was conducted in Limpopo province, South Africa. Eighteen in-depth interviews (IDIs) were conducted in four health facilities from two districts, and two focus group discussions (FDGs) were conducted in one of the farms within the province. Purposive and systematic random sampling were used to select study participants. A deductive thematic approach was used to analyze data, informed by the social-ecological model of health. The results reveal that farm workers perceive multiple interdependent factors that inhibit or enable their access to HIV healthcare services. Key barriers to HIV healthcare were transport affordability, health worker attitudes, stigma and discrimination, models of HIV healthcare delivery, geographic location of health facilities, and difficult working conditions. Key facilitators to HIV healthcare included the availability of mobile health services, the presence of community health workers, and a supportive work environment. The findings suggest disparities in farm workers' access to HIV services, with work being the main determinant of access. We, therefore, recommend a review of HIV policies and programs for the agricultural sector, and models of HIV healthcare delivery that address the unique needs of farm workers.

Research on Social Network Advertisement Delivery Platform Based on Blockchain

This paper briefly introduces the advertisement delivery model based on blockchain and the storage of key point information that can reflect the whole delivery process. After that, the simulation experiment was carried out on the advertisement delivery platform in a laboratory with the local server and the virtual server provided by Ethereum. The experiment detected the advertisement delivery function and the resistance to click fraud. The results showed that the advertisement delivery platform successfully completed the advertisement delivery and left a complete record. Facing the attack of tampering with the click frequency record of advertisements, the advertisement delivery platform using blockchain still maintained accurate records.

Promoting equality in utilization of basic public health services in China: the role of the family doctor contract service

Background The Family Doctor Contract Service (FDCS) system is a service model for primary care reform launched in 2016 to offer families and individuals active and continuous health care by a team of family doctors within primary care institutions in China. Objectives This study aimed to estimate socioeconomic-related inequalities in the utilization of basic public health services, and to identify the contribution of FDCS to promoting equality. Methods Data for the study were collected from a 2023 cross-sectional household health survey in western China, involving 39,456 participants. The concentration index (C) was employed for analyzing the extent of socioeconomic-related inequalities in the utilization of basic public health services and the coarsened exact matching technique was employed for sensitivity analysis in order to reduce selection bias. Results Our results indicated pro-poor inequalities in the utilization of health records (C = −0.046), free health check-ups (C = −0.009), and follow-ups for hypertension (C = −0.051). Additionally, a more equitable distribution across the economic spectrum was observed within the FDCS group (people who voluntarily contracted for services) compared to the non-FDCS group. The FDCS demonstrated more favorable positive impacts among individuals with higher (quintiles 60–80%) and the highest (top 20%) socioeconomic status. The FDCS contributed 83.94%, 59.24%, and 36.92% to pro-poor inequalities in the utilization of three basic public health services. These contributions reflected the positive impact of the FDCS on utilization. Conclusions Government policy and service delivery models require a paradigm shift to promote a stronger primary healthcare approach to practice, as evidenced by the effectiveness of the FDCS in promoting equality.

Development and evaluation of an online professional development course to support delivery of tiered school-based rehabilitation services

Purpose The Facilitating Integration of Rehabilitation Services Through Training (FIRST) Course provides online professional development on tiered service delivery models for rehabilitation professionals working in education settings. Created by content and e-learning experts, this study describes our use of the Analysis, Design, Development, Implementation, Evaluation (ADDIE) instructional design model and the Successive Approximation Model (SAM) to develop, implement, and evaluate the FIRST Course, and reports the findings of an initial program evaluation. Method Rehabilitation professionals who completed the FIRST Course were invited to complete a cross-sectional survey to evaluate its utility. Results Between May 1, 2020, and August 11, 2023, 314 occupational therapists, 54 physiotherapists, and 170 speech-language pathologists completed the online course and survey. Respondents perceived the FIRST Course content to be relevant to their practice and to meet their learning needs regarding tiered services in education settings. Most respondents viewed the course positively and would recommend it to colleagues. More experienced respondents suggested a need for training on tiered service delivery models beyond an introductory level. Conclusions The ADDIE and SAM instructional design models were successfully applied to develop, implement, and evaluate online professional development for school-based rehabilitation professionals who wish to learn about tiered service delivery models.

Acceptability of six-monthly PrEP dispensing supported with interim HIV self-testing to simplify PrEP delivery in Kenya: findings from qualitative research

BackgroundIn Africa, dispensing oral HIV pre-exposure prophylaxis (PrEP) within already strained public health facilities has led to prolonged waiting periods and suboptimal experiences for clients. We sought to explore the acceptability of dispensing PrEP semiannually with interim HIV self-testing (HIVST) versus quarterly PrEP dispensing with clinic-based HIV testing to optimize clinic-delivered PrEP services.MethodsWe conducted a qualitative study within a non-inferiority individual-level randomized controlled trial testing the effect of six-monthly PrEP dispensing with HIVST compared to the standard-of-care three-monthly PrEP dispensing on PrEP clinical outcomes in Kenya (ClinicalTrials.gov: NCT03593629). Eligible participants were ≥ 18 years, refilling PrEP for the first time, and either in an HIV serodifferent relationship (men and women) or singly enrolled (women only). A subset of participants in the intervention group completed serial in-depth interviews (IDIs) at enrollment, six months, and 12 months. We utilized stratified purposive sampling to ensure representation across participant groups. We analyzed our qualitative data thematically using a combination of inductive and deductive approaches, the latter guided by the Theoretical Framework of Acceptability (TFA).ResultsBetween May 2018 and June 2021, we conducted 120 serial IDIs with 55 participants; 64% (35/55) were in a serodifferent relationship, 64% (35/55) were women, and the median age was 32 years (IQR 27–40). Overall, participants found this novel PrEP delivery model highly acceptable; it was well-liked, private (TFA construct: affective attitude), and less burdensome (TFA construct: burden) compared to standard PrEP delivery. Additionally, participants were confident in their ability to participate in the intervention (TFA construct: self-efficacy). Some participants, however, highlighted model disadvantages, including fewer opportunities for in-person counseling and potentially less accurate HIV testing (TFA construct: opportunity costs). Ultimately, most participants reported that the intervention allowed them to achieve their HIV prevention goals (TFA construct: perceived effectiveness) and that their confidence in at-home HIVST and PrEP continuation increased following each semiannual clinic visit.ConclusionsSemiannual PrEP clinic visits supported with six-monthly drug dispensing and interim HIVST was acceptable among PrEP users who experienced the intervention in Kenya. More comprehensive pre-intervention counseling and training on HIVST may help alleviate the client concerns presented, which were often resolved over time with intervention experience.

Value Based Conduct Confirmation in BPaaS Configuration

Business Process as a Service (BPaaS) is a cloud-based delivery model that combines business process outsourcing (BPO) with the scalability and flexibility of cloud computing. In BPaaS, organizations outsource specific business processes—such as payroll, customer support, or inventory management—to a cloud service provider. These services are designed for multitenancy, meaning they serve multiple clients simultaneously. By leveraging the cloud, companies gain cost efficiency, access to cutting-edge technologies, and the ability to scale on demand. Essentially, BPaaS streamlines operations, allowing businesses to focus on their core competencies while leaving process management to experts in the cloud. The purpose behind BPaaS is to turn multiple service companies into a corporate process system that can then be provided as its own service to consumers. Naturally, BPaaS providers target common or proven business processes applicable to a broad potential market, or require multiple complex components management. This is attractive for customers, because it offers a cheap, low risk outsource option for integral business activities. Business Process as a Service (BPaaS) is an emerging sort of cloud provider that gives configurable and executable business processes to customers over the internet. As BPaaS is still in early years of research, many open troubles remain managing the configuration of BPaaS builds on regions which include software product strains and configurable commercial enterprise approaches. The problem has concerns to recollect from numerous perspectives, along with the different forms of variable features, constraints among configuration options, and gratifying the necessities supplied by the client. In this method, the system uses temporal logic templates to elicit transactional requirements from customers that the configured carrier ought to adhere to. For formalizing constraints over configuration, feature fashions are used. To manage all these issues at some stage in BPaaS configuration, the system developed a structured approach that applies formal techniques whilst directing customers via specifying transactional necessities and choosing configurable features.

Value-based care as a solution to resolve the open debate on public healthcare outsourcing in Europe: What do the available data say?

Controversy surrounds the current debate regarding the effects of outsourcing health services, as recent studies claim that increased outsourcing leads to reduced costs at the expense of worse patient outcomes. The goal of the value-based model is to enable healthcare systems to create more value for patients, and evidence points to improvements in public health outcomes, patient experience, and health expenditure in systems incorporating components of value-based healthcare. Some emerging evidence indicates promising results for outsourced hospitals which follow a value-based model of healthcare delivery. Although additional future studies are still needed to confirm these benefits, value-based healthcare merits discussion as a new perspective on the public versus private management debate. In fact, we argue that outsourcing to value-based health providers could represent a valid alternative for public health management, encouraging greater competition within the healthcare sector while ensuring quality of care for both public and private sectors.

Using Collective Impact to Examine Direct Service Worker Training and Credentialing in North Carolina: Recommendations for Change.

Older adults and people living with disabilities receive home- and community-based services (HCBS) from approximately 113,000 often under-resourced and inadequately supported direct service workers (e.g., personal care aides, direct support professionals, nurse aides) in North Carolina. The demand in NC is projected to be ∼ 23,000 new direct service jobs from 2020 to 2030. We conducted a Medicaid-funded landscape analysis of direct service training/credentialing requirements and practices across service delivery models using the Collective Impact (CI) framework. With input from HCBS, licensing entities, advocates, and those with lived experience, we characterized NC's HCBS training/credentialing landscape and generated a first-of-its-kind comprehensive crosswalk resource. This project revealed the complexity and limitations of the multiple and varied training and credentialing requirements for direct service workers in NC. Robust community engagement efforts drove the development of preliminary findings and recommendations for improving the training and credentialing requirements for direct service workers in NC.

Affective Experiences of Older Adults Enrolled in a Multi-Component Health Promotion Program: A Focu-Group Study

The purpose of this qualitative study using focus groups was to explore the affective experiences of older adults enrolled in Bingocize®, a health promotion program that combines bingo and exercise after program facili-tators received a supplemental training developed by a recreational therapist titled, FUNctional Movement. The training emphasized participant enjoyment and autono-my support utilizing The Self-Determination Enjoyment Enhancement Service Delivery Model. Focus groups, comprised of 17 participants across three sessions, re-vealed that while the supplemental training may have improved engagement, many were unaware of the fall prevention components of Bingocize®. Focus group themes included autonomy sup-port, enjoyment, future desired activities, and barriers to physical activity. This may highlight a need to explicitly incorporate fall prevention and functional movement into Bingocize® training for facilitators. Additionally, integrating health education topics like sexual health and incontinence into Bingocize® could address participant needs and enhance program offerings. These findings may provide insights for refining Bin-gocize® training, aligning it more closely with participant expectations through a rec-reational therapy approach to physical activity in long-term care settings. The authors provide practice recommendations.

Prioritising Patients and Planet: Advocating for Change in Respiratory Care

The global burden of respiratory diseases, particularly asthma and chronic obstructive pulmonary disease (COPD), continues unabated. Suboptimal management places a significant strain on both patients and urgent or emergency care services. With an ageing population in many countries, the demand for these services is set to increase further. At the same time, healthcare systems are striving to reduce their carbon footprint and achieve net zero emissions, as the healthcare sector is a significant contributor to carbon emissions worldwide. Although these two goals may appear contradictory, they need not be in conflict. This article reviews an industry-sponsored symposium held at the European Respiratory Society (ERS) Congress 2024 in Vienna, Austria, in September 2024. The session addressed the urgent need to change the delivery model for respiratory healthcare in response to the increasing prevalence of respiratory diseases and the challenges posed by climate change. Co-chair John Hurst, Professor of Respiratory Medicine at University College London (UCL), UK, underscored the importance of innovative solutions for managing respiratory diseases and highlighted the challenges faced by healthcare decision-makers. This was further elaborated on by Omar Usmani, Professor of Respiratory Medicine at Imperial College London, UK, who emphasised the importance of clinical choice. He stated that inhaled medicines, which form the cornerstone of treatment, should not be considered interchangeable. He also discussed ongoing efforts to maintain access to essential medicines by developing novel next-generation propellants (NGP) for pressurised metered-dose inhaler (pMDI) devices, which will reduce their carbon footprint to levels comparable with dry powder inhalers (DPI). Additionally, he described the European Chemicals Agency (ECHA) proposal to restrict a broad range of chemicals classed as per- and polyfluoroalkyl substances (PFAS). This precautionary measure would affect both current propellants in pMDIs and the transition to NGPs, with global implications for inhaled medicines. Erika Penz, Associate Professor of Respirology, Critical Care, and Sleep Medicine at the University of Saskatchewan, Canada, noted that suboptimal management of respiratory disease is associated with a disproportionately high burden on both patients and the environment. The forthcoming availability of pMDI medicines with NGPs alone will not resolve this larger issue. As every healthcare interaction carries a carbon footprint, which increases with the intensity of treatment, the implementation of guidelines into clinical practice would improve patient outcomes and reduce the demand on healthcare services and the associated carbon emissions. Co-chair Helen Reddel, Clinical Professor and Research Leader at the Woolcock Institute of Medical Research, Australia, concluded by re-emphasising the urgent need to implement guidelines immediately for the benefit of both patients and the environment.

The FLASHFIT Interactive Device in Healthcare: Revolutionizing Patient Engagement and Monitoring

The study investigates the effectiveness of the FLASHFIT interactive device in enhancing patient engagement and monitoring within healthcare settings. As digital health solutions become increasingly vital, FLASHFIT aims to bridge the gap between patients and healthcare providers by promoting active participation in health management. This research employs a mixed-methods approach, combining quantitative data from patient usage metrics with qualitative feedback from users and healthcare professionals. Preliminary findings indicate that FLASHFIT significantly improves patient adherence to treatment plans and fosters a sense of autonomy in health management. Moreover, real-time monitoring capabilities facilitate timely interventions, enhancing overall patient outcomes. The study concludes that integrating interactive devices like FLASHFIT into healthcare practices empowers patients and streamlines communication between patients and providers, suggesting a transformative potential for future healthcare delivery models. Keywords: FLASHFIT interactive device, patient engagement and monitoring

Leveraging Blockchain Technology for Public Health

This study delves into the metamorphic potential pertaining to blockchain technology public health, concentrating on its aptness towards addressing the critical challenges related to data security, privacy, and it enroute for improving health service outcomes. By incorporating decentralized structures and smart contracts, blockchain intensify data integrity, ensuring consistency and protective access control, which is principally effective for sensitive medical information. The study enlightens on the advantages of blockchain in entrusting patients as well as healthcare providers with control over public health related information, ensuring privacy and reinforcing regulatory compliance. It delves into the process of how blockchain can streamline healthcare processes, upgrading interoperability among healthcare systems, and create more systematic and affordable models for healthcare service delivery. Based on the case studies from different healthcare stakeholders, the paper provides factual and feasible insights for real-world implementations of blockchain in healthcare, exhibiting its potential to transfigure supply chain management, different insurance claims processing and managing electronic health records. Moreover, the study also recognizes the challenges, including technical constraints, ethical reviews, and the complication of integrating blockchain with existing healthcare framework. The study widens it discussion towards the legal and regulatory aspect, emphasizing the need for a comprehensive approach to adoption. Looking forward, the paper covers the emerging trends and offers guidance for healthcare stakeholders considering blockchain implementation, summarizing that blockchain could be a catalyst for remarkable improvements in public healthcare data administration and patient care.

The Road Home: Building the evidence base for a service delivery model that integrates housing, mental health, medical and legal services.

The evaluation of the Road Home (RH) program has revealed many learnings of interest to practitioners, researchers and evaluators. The focus of this analysis is twofold - on an innovative approach to building an evidence base using a developmental evaluation and action learning design and how research knowledge and skills can be applied in practitioner contexts and be robust, rigorous and above all useful. It particularly features the role of reflective practice, an affordable, underutilised and easy to access evaluation and program improvement method for practitioners working with evaluators and researchers. Appreciating what is involved in approaching evaluation and other forms of organisational research in this way is important if industry collaborations and innovations that bring theory to practice and practice to theory are to be successful.

Scope of nursing work and models of service delivery in Australian primary and secondary schools: a scoping review protocol.

The objective of this review is to generate a national picture of the scope of nursing work and models of service delivery in Australian primary and secondary schools. Schools are an important setting for providing health services to school-aged children and youth. Early intervention with identified health needs has the potential to improve health and educational outcomes across the life course. Additionally, many children and young people present with health issues requiring sophisticated management at school. Nurses have worked in Australian schools for more than a century, but there is a lack of clarity about the scope of nursing work and models of service delivery in Australian schools. The review will include papers describing the work of registered or enrolled nurses in primary and secondary Australian schools providing education to children aged 3-18 years, in urban, regional, and remote areas of all states and territories. Peer-reviewed, non-peer-reviewed, and gray literature, not limited by publication date or language, will be included. The review will be conducted in accordance with the JBI methodology for scoping reviews. Databases to be searched will include CINAHL, MEDLINE, PsycINFO (all via EBSCOhost), together with ERIC, Informit, and Google. Two authors will independently screen titles and abstracts, and extract data from included papers. Data will be analyzed by state/territory and by education sector (government/non-government) to generate a national picture. The findings will be reported in a narrative synthesis aligned with the review questions. Open Science Framework https://osf.io/6yqrm.

Feasibility and Acceptability of Providing Cognitive Remediation in a Large USA System of Coordinated Specialty Care for Early Psychosis.

Multinational treatment guidelines support providing cognitive remediation to people recently diagnosed with schizophrenia, but the feasibility of implementing the treatment on a large scale is less well understood. This study took place between 2019 and 2023 at 14 clinics within a large network of programs providing early intervention services to people aged 16-30 experiencing nonaffective psychosis. Clinics were randomly assigned to deliver cognitive remediation as twice-weekly clinician-led groups (N = 5), cognitive remediation as once-weekly clinician-led groups with homework (N = 6), or treatment as usual (N = 3). All clinics screened for cognitive health need to guide treatment planning. Clinical teams (N = 11) received training to provide cognitive remediation. Program evaluation data were analysed for feasibility and acceptability. Screening for cognitive health needs was completed on 77% of the 1193 participants enrolled at the 11 clinics offering cognitive remediation. Clinicians identified cognitive difficulties in 53.9% (n = 496) of screened participants and referred 27% (n = 134) of these participants to cognitive remediation. Of referred participants, 77.6% (n = 104) initiated treatment, and n = 41 completed the treatment. The rate of referral was nearly double, and treatment initiation was significantly higher at programs delivering once-weekly (84.3%) than twice-weekly (64.4%) treatment but the difference in the rate of treatment completion was statistically nonsignificant. Satisfaction among treatment completers was high. Referrals to cognitive remediation required systemic support of a feasible cognitive health screening process. About a quarter of people with clinician-identified cognitive health needs were referred to cognitive remediation. Feasibility data suggest a flexible model of treatment delivery may facilitate implementation in this service setting.

Research Priorities of the Oncology Nursing Society: 2024-2027.

To define the Oncology Nursing Society Research Agenda for 2024-2027. An iterative, multiple data sources consolidation through the Research Agenda Project Team. Previous research priorities, literature review, stakeholder survey, and research priorities from other cancer care organizations and funding agencies. 10 evergreen statements articulated foundational values for oncology nurse scientists, and 5 topics emerged as research priorities for the upcoming three years: Advance patient-centric, precision symptom science; provide evidence for safe and effective cancer care delivery models and support of the oncology nursing workforce; describe the impact of the environment on cancer care outcomes; integrate patient navigation into cancer care across the trajectory; and advance the use of innovative methodologies in oncology nursing research. The Oncology Nursing Society Research Agenda is an effective resource for directing the organization's research vision. This foundational document directs funding awards and requests, mentorship, and policy initiatives.

Adopting sustainable innovations for remote access to TB and HIV care in South Africa.

For the last decade, South Africa has made substantial progress to control the dual HIV and TB epidemics. However, disruptions in TB and HIV treatment during the COVID-19 pandemic threatened to reverse this. This study aimed to identify adaptations in HIV and TB service delivery models in response to COVID-19 and government restrictions. This information informed the development of an online survey, which was utilized as part of a consultation exercise to further capture adaptations made to HIV/TB service delivery within the South African context. The literature review involved screening 380 titles and abstracts, identifying 30 HIV and TB studies across 19 countries, and categorizing 90 individual interventions into ten thematic areas. Common themes included interventions addressing screening, testing, diagnosis, medication collection and delivery support, and virtual models. Digital health interventions and adaptations to medication collection/delivery were reported in 38% of studies. Analysis of survey responses from 33 stakeholders in South Africa revealed that 47% of interventions targeted HIV, 11% TB, and 23% HIV/TB integrated service delivery. Most interventions (81%) were integrated into the national HIV or TB program, with implementation occurring at various levels: 39% at facility level, 35% at sub-district or district level, and 18% at provincial level. Programmatic data was available for 86% of interventions, with 50% being funded. This study demonstrated that services can be delivered in locations other than in health facilities (e.g., community-based or home-based) and that integrated services can also free up additional resources. Although studies varied, COVID-19 accelerated the adoption of differentiated service delivery (DSD) models for TB care, including multi-month dispensing (MMD) for TB preventative therapy (TPT) and TB treatment, home-based or mobile outreach screening and testing, and community pickup points (PuP) for TB medications. These initiatives had previously lagged behind HIV-focused DSD models, and it is crucial to sustain these services beyond the pandemic. To achieve universal health coverage, it will also be important to capitalize on these experiences and learn from HIV-focused DSD models so programs can deliver integrated person-centered chronic care services for TB, HIV, and non-communicable diseases.

A First-Passage Model of Intravitreal Drug Delivery and Residence Time-Influence of Ocular Geometry, Individual Variability, and Injection Location.

Standard of care for various retinal diseases involves recurrent intravitreal injections. This motivates mathematical modeling efforts to identify influential factors for ocular drug residence time, aiming to minimize administration frequency. We sought to describe the vitreal diffusion of therapeutics in nonclinical species frequently used during drug development assessments. In human eyes, we investigated the impact of variability in vitreous cavity size and eccentricity, and in injection location, on drug disposition. Using a first-passage time approach, we modeled the transport-controlled distribution of two standard therapeutic protein formats (Fab and IgG) and elimination through anterior and posterior pathways. Anatomical three-dimensional geometries of mouse, rat, rabbit, cynomolgus monkey, and human eyes were constructed using ocular images and biometry datasets. A scaling relationship was derived for comparison with experimental ocular half-lives. Model simulations revealed a dependence of residence time on ocular size and injection location. Delivery to the posterior vitreous resulted in increased vitreal half-life and retinal permeation. Interindividual variability in human eyes had a significant influence on residence time (half-life range of 5-7days), showing a strong correlation to axial length and vitreal volume. Anterior exit was the predominant route of drug elimination. Contribution of the posterior pathway displayed a 3% difference between protein formats but varied between species (10%-30%). The modeling results suggest that experimental variability in ocular half-life is partially attributed to anatomical differences and injection site location. Simulations further suggest a potential role of the posterior pathway permeability in determining species differences in ocular pharmacokinetics.