Nominal Group Sessions Research Articles

Developing Spiritually Framed Breast Cancer Screening Messages in Consultation With African American Women

Despite efforts to increase breast cancer screening (BCS) among African American women, disparities in breast cancer mortality persist. Culturally framed health communication may provide a useful strategy to address this issue. Spirituality not only represents an integral aspect of African American culture, but it has also been identified as a potential barrier to BCS among this population. Rather than continuing to focus on spirituality as a barrier, there is an opportunity to develop promotional messages that tap into the protective properties of spirituality among this population. The goals of this study were to engage a group of African American women to identify important spiritual elements to be included in health communication materials, and to subsequently develop a spiritually framed BCS message in response to their feedback. Three nominal group sessions were conducted with 15 African American women. Results revealed three important spiritual elements that can be incorporated into BCS health messages: (a) the body as a temple; (b) going to the doctor does not make you faithless; and (c) God did not give us the spirit of fear. These elements were used to draft a spiritually framed BCS message. Next, 20 face-to-face semistructured interviews were conducted to help finalize the spiritually framed BCS message for use in a future study on culturally framed health communication.

Prioritization among ethical issues of dental practice in Iran. A modified nominal group study

This study was designed in order to generate a priority list of dentistperceived important ethical issues in dental practice in Iran. A two-stage modified nominal group study was conducted. At first, the main ques tion of the study was presented to 24 dental specialists through direct interview (16) or e-mail (8, response rate was 75%). After analyzing the interview transcripts and email responses, a list of issues was extracted. The list was presented to a nominal group of 10 dental specialists to prioritize ethical issues according to their frequency and ethical signifi cance. Each participant selected and ranked the five most important is sues and then, the sum of ranks for each issue was calculated. The first stage of the study resulted in a list of 26 ethical issues. After grouping and combining related items, the list was condensed into 18 issues. The nominal group session resulted in a prioritised list. The first six issues of the list included: performing procedures without adequate competency, not taking responsibility for one’s errors, over-treatment (or unnecessary treatment), inappropriate manners towards patients, unprofessional discussion of a colleague’s work, and unprincipled behaviors towards disadvantaged patients. Conclusions: The results suggest that the problems occurring in the therapeutic relationship between dentists and their patients are the major ethical issues of dentistry in Iran. Issues such as respecting patient’s autonomy, confidentiality, taking informed consent, third-party issues, and dentists’ duties toward society don’t seem to be considered of high priority by dentists in Iran as a developing country.

PMS63 Assessment of the Osteoporosis Self-Efficacy Scale in Relation to Osteoprotective Behaviors among Type 2 Diabetics Patients in North Malaysia

test the feasibility of using the nominal group technique (NGT) to select attributes for DCEs. METHODS: Patients group discussions (4-8 participants) were conducted in Belgium and the Netherlands to prioritize a list of twelve potentially important attributes for osteoporosis drug therapy that were retrieved from literature review and expert discussions. The NGT consisted of three steps: 1) an individual ranking of the twelve attributes by importance from 1 to 12; 2) a group discussion on each of the attributes including a group review of the aggregate score of the initial rankings; and 3) a second ranking task of the same attributes. The selection of attributes for the DCE was based on groups’ ranking and NGT discussions followed by experts’ discussion. RESULTS: In total, 26 osteoporotic patients participated in five nominal group sessions. Most (80%) patients changed their ranking after the discussion. However, the average initial and final ranking did not markedly differ, with two exceptions. In the final rank, the most important medication attributes were effectiveness, side-effects, frequency and mode of administration. It was also observed that some (15%) patients did not correctly rank from 1 to 12, and the order of attributes did play a role in the ranking. CONCLUSIONS: The nominal group technique is feasible and useful for selecting attributes for DCE, although the ranking task may be cognitively difficult and attributes order should vary over different NGT sessions.

Establishing faculty needs and priorities for peer-mentoring groups using a nominal group technique

Peer-mentoring groups are purported to enhance faculty productivity and retention, but the literature about implementation is sparse. Nominal Group Sessions (n = 5) with 66 faculty members in different tracks developed prioritized lists of unmet professional development needs and potential group activities. Common items included mentor relationships, research skills, informal peer discussions of successes and challenges, and professional skills workshops. Items particular to specific academic tracks included integration of non-clinical faculty, and gaining recognition in non-research tracks.

Group decision making through nominal group technique: an empirical study

As a decision making tool in a group setting, the nominal group technique (NGT) has been widely applied by policy makers in numerous organisations. Many researchers have also conducted experimental studies on NGT to explore its various features that make the technique distinguishable from other related techniques including traditional interactive group and Delphi techniques. The purpose of the present research is to empirically investigate the outputs generated from various uniform nominal group sessions on a common issue. Conducting eight nominal group sessions that consist of 244 undergraduate students in Business Administration, Accounting and Engineering across several academic sessions, we find that most of the important inputs on the issue appear in every list of top ten inputs obtained from the sessions. The implication of this finding is that, once the outcomes of a nominal group session are known, should there a need arise in future for a different nominal group session but the issue is the same, if the session is conducted, major outcomes of this session will be the same as the previously conducted nominal group session. Therefore, the results of this research are expected to save a considerable amount of time in making decisions using nominal groups.

Oral Program

Community-based public health interventions are often criticised because they do not reach those most in need of the intervention. Target group and stakeholder engagement in intervention design and decision making is a central theme in community development approaches to public health. This sharing of decision making regarding interventions serves to increase target group participation and ownership of interventions and empower communities to help themselves. It also values the knowledge, insights and experiences of the community regarding solutions to identified problems. This study involved a process of stakeholder and target group engagement conducted as part of strategy design in a community-based nutrition and physical activity promotion project targeting young and disadvantaged women and infants (The Growing Years Project). Stakeholder engagement was facilitated by a modified nominal group series that encouraged discussion and assessment against a range of assessment criteria reflecting feasibility and effectiveness for a portfolio of intervention options. Group discussions were conducted amongst nutrition and physical activity specialists, front-line community child health staff and purposively sampled meetings of the target group. The portfolio of interventions developed for testing with stakeholders were based on determinant analysis facilitated by earlier community consultations with stakeholders and the target group, intervention research and service review. Discussions and ratings from each of the nominal group sessions was then analysed qualitatively and quantitatively to assist intervention modification and prioritisation. This shared-decision making process has helped prioritise a mix of strategies for implementation and has value as a process for community engagement in community nutrition practice.

Evaluating a Blended‐Learning Course Taught to Different Groups of Learners in a Dental School

The purpose of this study was to present and evaluate a blended-learning course developed for undergraduate (B.D.S.), postgraduate, and diploma (hygiene and therapy) students at the University of Sheffield School of Clinical Dentistry. Blended learning is the integration of classroom face-to-face learning with online learning. The overall methodology used for this study was action research. The data were collected using three processes: questionnaires to collect contextual data from the students taking the course; a student-led, nominal group technique to collect group data from the participants; and a non-participant observer technique to record the context in which certain group and individual behaviors occurred. The online component of the course was accepted as a valuable resource by 65 percent of those responding. While online information-sharing occurred (31 percent of the students posted in forums), there was no evidence of online collaboration, with only 8 percent replying to forum postings. Accessibility of the online environment was one of the main concerns of the students at the nominal group sessions. Differences regarding overall engagement with the course between the student groups (years) were observed during the sessions. The majority of the students were satisfied with the Information and Communication Technologies (ICT) course. No statistically significant differences between males and females were found, but there were differences between different student cohorts (year groups).

Factors influencing the implementation of quality use of medicines in residential aged care.

In response to concerns about, and issues pertaining to, medication use practices in residential aged-care facilities (RACFs), the Australian Pharmaceutical Advisory Council (APAC) established a working party on quality use of medicines (QUM) in nursing homes and hostels. The APAC is a representative ministerial advisory forum bringing together key stakeholders from the medical, nursing and pharmacy professions, as well as pharmaceutical industry, consumer and government sectors. The working party developed the integrated best practice model for medication management in RACFs. This study arose from concerns that, despite the availability of such guidelines to inform best practice in RACFs, there remain barriers to its implementation. Thus, the focus of this research was to explore factors influencing the implementation of best practice with respect to QUM in RACFs. This multimethod, multidisciplinary study was conducted in a representative sample of 12 RACFs in one Australian state - South Australia. The methods used were Critical Incident Technique (CIT) interviews, focus groups, nominal groups and Participatory Action Research. In stage one of the research the CIT interviews identified four major issues/factors influencing the implementation of best practice: contextual/structural, boundaries, day-to-day practices and keeping up. These themes were developed in the focus and nominal group sessions and the project team prepared a discussion paper summarising stage one results. In stage two participants were asked to use the discussion paper to develop a way forward. Medication Advisory Committees (MACs) emerged as a key strategy. Each participating RACF was then supported to establish and maintain a MAC. A second workshop heard feedback from the facilities on factors supporting the MACs and barriers to their functioning. Eleven of the 12 RACFs had a functioning MAC at the end of the project. Key support factors included: an external facilitator to help organise MAC meetings, provision of resources, such as terms of reference, agendas, policy statements and the sharing of information between MACs. In stage three a set of agreed recommendations was prepared and submitted to the funding body. The recommendations reported here informed the development of the peak guidelines for medication management and administration in Australia. This project has been groundbreaking in its impact on Australian aged-care practice. A major outcome has been significantly improved communication and collaboration between industry organisations, academic disciplines, professional bodies and educators involved in the RACFs.

Community health needs assessment for health service planning: realising consumer participation in the health service setting

Issue addressed: The aims of this paper are to describe a four- step process for community health needs assessment used in one community, to discuss satisfaction with the community consultation processes, and to examine the cost and usefulness of the process for guiding health service planning. Methods: The community health needs assessment included: collation of local health statistical data; community consultation using focus groups; community survey; and priority setting using a nominal group approach. This process was accompanied by an intensive communication strategy. Results: Health statistics data were collected for people living in Tomaree Planning District, NSW; four focus groups were held with 59 key community stakeholders; 391 community members participated in a community survey (78% consent rate); and 10 community representatives participated in a priority setting nominal group session. The types of service needs identified varied for each step, as did community satisfaction with each consultation process. Conclusions: Community consultations were an acceptable method for directly engaging community members in the health service planning process. The list of health service priorities generated through this process was used to inform the future health service planning process for the Tomaree community. (author abstract)

Perceived Barriers to Medical-Error Reporting: An Exploratory Investigation

Medical-error reporting is an essential component for patient safety enhancement. Unfortunately, medical errors are largely underreported across healthcare institutions. This problem can be attributed to different factors and barriers present at organizational and individual levels that ultimately prevent individuals from generating the report. This study explored the factors that affect medical-error reporting among physicians and nurses at a large academic medical center located in the midwest United States. A nominal group session was conducted to identify the most relevant factors that act as barriers for error reporting. These factors were then used to design a questionnaire that explored the likelihood of the factors to act as barriers and their likelihood to be modified. Using these two parameters, the results were analyzed and combined into a Factor Relevance Matrix. The matrix identifies the factors for which immediate actions should be undertaken to improve medical-error reporting (immediate action factors). It also identifies factors that require long-term strategies (long-term strategy factors) as well as factors that the organization should be aware of but that are of lower priority (awareness factors). The strategies outlined in this study may assist healthcare organizations in improving medical-error reporting, as part of the efforts toward patient-safety enhancement. Although factors affecting medical-error reporting may vary between different organizations, the process used in identifying the factors and the Factor Relevance Matrix developed in this study are easily adaptable to any organizational setting.

Determining Social Science Research Needs in Interpretation: A Case Study

The objective of this paper is to report and analyze the results of two nominal group sessions that sought to determine the social science research needs and priorities of the Harpers Ferry Center (HFC), a unit in the National Park Service (NPS) dedicated to the creation of interpretive media, as perceived by HFC personnel and individual NPS site interpretive personnel, respectively. The Nominal Group Technique, or NGT (Delbecq & Van de Ven, 1971), is a collective decision-making technique that has been used widely within recreation research to determine and prioritize concerns of practitioners, including research agenda items (Ewert, 1990). This study indicates that those involved in different aspects of interpretation have different perspectives on social science needs. Not only do such groups need to understand each other's perspectives and contributions better, but this study also suggests that their collaboration is critical to the crafting of well-rounded social science research agendas in interpretation.