Participant Readiness Research Articles

Implementing quality assurance in tertiary-level colleges in Bangladesh: readiness and leadership support

Bangladesh’s college sector is in crisis. Poor governance and leadership, staff and student quality, inadequate resources and a weak accountability and monitoring system are among the many challenges. In 2017, the Government of Bangladesh established large-scale Continuing Professional Development (CPD) training for leaders, teachers and policymakers from the National University affiliated colleges to build capacity and improve the overall quality of teaching and learning. This mixed-method study uses Holt’s Readiness Instrument and Focus Group Discussions to identify participant readiness and leadership support in implementing quality assurance activities in these colleges. The study shows that CPD participants are generally more ready to implement quality assurance activities than non-participants. However, the study indicates a lack of leadership support for implementing quality assurance activities in the colleges. The article concludes that, irrespective of participant readiness, committed senior leaders are critical for success and improving institutional readiness to implement quality assurance activities.

UNDERSTANDING THE INDIVIDUALIZATION OF EXERCISE PRESCRIPTION FOR PEOPLE WITH CANCER: A SYSTEMATIC REVIEW

PURPOSE The importance of prescribing individualized exercise for people with cancer to minimize injury risk and optimize outcomes has been echoed internationally in position and consensus statements. However, it is unclear what individualization processes are employed in exercise oncology research and how exercise individualisation is implemented for people with cancer. This study aimed to systematically review the available evidence to elucidate the individualisation methods being employed in exercise oncology research. METHODS A systematic search of PubMed, EMBASE, CINAHL, and Web of Science was performed following the PRISMA guidelines. Eligible randomised controlled trials (RCT), controlled trials (CT), pre-post trials, and comparison trials included men and women aged ≥18 years with a histologically confirmed diagnosis of cancer; undertaking any structured exercise protocol that was ‘individualized’, with or without supervision; and that explored outcomes of intervention fidelity (e.g., recruitment, attendance, adherence, attrition), and/or patient health and wellbeing (i.e., quality of life, symptom improvement, medication use, physical activity). Study quality was assessed using the Delphi list tool. RESULTS Forty-nine studies were found to be eligible and subsequently included in the narrative synthesis. Study quality was on average 49% (range 14 to 100%). Individualization of the exercise prescription most occurred prior to intervention commencement (n=23, 47%), based on physiological results from baseline assessments (n=21, 43%). No study individualized exercise based on participant readiness to train. The exercise prescription was predominantly individualized via modulation of both the intensity and volume of exercise (11, 22%). CONCLUSION Exercise prescription individualization for people with cancer is highly prescriptive and predetermined. Seldom has exercise prescription been individualized based on participant readiness to train. Future exercise oncology studies should include greater detail on the reporting of exercise individualization methods and rationale to enhance our understanding of the relationship between individualization and exercise adherence and attrition in people with cancer.

The roles of readiness and dosage in predicting outcomes of a mindful sport performance enhancement intervention with U.S. college student-athletes

Research suggests that Mindfulness- and Acceptance-Based Interventions (MABIs) can impact sport performance and performance-relevant factors, though questions remain regarding when and for whom MABIs are effective. Specifically, inquiries into intervention engagement (i.e., dosage), potentially impacted by participant readiness, are needed. The present study utilized a non-randomized control group design with U.S. collegiate athletes to investigate MABI effects. Four teams from two universities in the Appalachian region (N = 57) engaged in Mindful Sport Performance Enhancement (MSPE) interventions during their offseason or pre-season training period. Participants were assessed on flow, psychological distress, mindfulness, emotion regulation difficulties, life satisfaction, readiness to practice mindfulness, attitudes toward sport psychology, and sport performance and enjoyment. Mindfulness dosage was measured weekly via self-report. Compared to controls, initial MSPE participants reported reductions in depressive symptoms and emotion regulation difficulties, and improvements in self-rated sport performance; at 6-week follow-up, initial MSPE participants reported significant increases in mindfulness and sport enjoyment, in addition to sustained reductions in emotion regulation difficulties. Pre-intervention readiness was not associated with changes across the intervention, though higher post-intervention readiness was associated with improvements in mindfulness, life satisfaction, and sport enjoyment. Higher post-intervention readiness was also associated with significantly more engagement (i.e., dosage), though no evidence indicated that dosage moderated the relationship between readiness and outcomes. These data suggest that post-intervention readiness may impact long-term engagement in mindfulness practice, and that pre-intervention readiness may not be an accurate indicator of engagement in or outcomes of an MABI with athletes.

Using bibliotherapy to rebuild identity for people with aphasia: A book club experience

BackgroundAphasia book clubs were developed to support connecting with literature and reading for pleasure within an aphasia-friendly environment. Bibliotherapy is an evidence-based therapeutic approach, in which a book is selected to address the challenges facing the reader. Its aim is to facilitate a deeper understanding of a lived experience in order to promote healing, strategy development, and adjustment. Aphasia book clubs provide an opportunity to discuss books about the challenges associated with aphasia. A recent book, Identity theft: Rediscovering ourselves after stroke recounts the stroke recovery story of Dr. Debra Meyerson and 22 other stroke survivors. Identity Theft focuses on the need to reconstruct positive identities despite remaining disabilities to facilitate rebuilding rewarding lives. The purpose of this study is to understand the impact of reading Identity Theft in an aphasia book club for people with aphasia (PwA). Method27 PwA read the book Identity Theft in one of four online aphasia book clubs offered by two universities. Weekly discussions were facilitated by graduate SLP students under the supervision of experienced clinicians. At the end of the 10 week program, semi-structured qualitative interviews were conducted with participants to understand the lived experience. Interviews were analyzed using reflexive thematic analysis. ResultsAnalysis of the interview data generated four main themes and 13 subthemes. The main themes included: Mechanism for Reflection, Power of Community, Engaged Learning, and Therapeutic Environment. Interview extracts illustrate the way these themes support increasing self-efficacy and rebuilding a positive identity. ConclusionThe themes align positively with outcomes associated with the bibliotherapy process. Themes also integrate into a self-management model that promotes self-efficacy through education, support, awareness, problem solving and goal setting. Caveats included determining participant readiness to examine recovery issues and facilitator preparation. Aphasia book clubs surrounding psychosocial texts may help PwA reconstruct a positive post-stroke identity.

A WIC-Based Behavior Change Intervention for Postpartum Women With Overweight and Obesity: A Pilot Feasibility Randomized Trial.

Background. Postpartum weight retention is a risk factor for obesity and is particularly important among Hispanic women who have an increased rate of obesity. Given its broad reach, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program provides an ideal setting to implement community-based interventions for low-income postpartum women. Purpose. To examine the feasibility, acceptability, and preliminary efficacy of a multicomponent intervention delivered by staff within the WIC program designed to promote behavior changes in urban, postpartum women with overweight/obesity. Method. This was a 12-week pilot trial randomizing participants to a health behavior change (Intervention) or control (Observation) group. The Intervention included monthly visits with trained WIC staff providing patient-centered behavior change counseling, with multiple touchpoints between visits promoting self-monitoring and offering health behavior change support. Results. Participants (n = 41), who were mainly Hispanic (n = 37, 90%) and Spanish-speaking (n = 33, 81%), were randomized to the Intervention (n = 19) or Observation (n = 22) group. In the Intervention group, 79% (n = 15) of eligible participants were retained for the study duration. All Intervention participants endorsed that they would participate again. Regarding physical activity, participant readiness to change and self-efficacy improved for Intervention participants. About one-quarter of women in the Intervention group (27%, n = 4) had a 5% weight loss compared with one woman (5%) in the Observation group; this difference was not statistically significant (p = .10). Conclusions. This pilot demonstrated the feasibility and acceptability of delivering a low-intensity behavior change intervention within the WIC setting for postpartum women with overweight/obesity. Findings support the role of WIC in addressing postpartum obesity.

The Department of Veterans' Affairs Depleted Uranium Cohort in the Time of COVID-19: Translating a Traditional Surveillance Protocol to a Telehealth Platform.

In 2021, 37 members of a cohort of depleted uranium-exposed Gulf War I veterans were evaluated using a protocol tailored to accommodate COVID-19 safety practices on a telehealth platform. Individual elements of the legacy protocol were reviewed for urgency and feasibility of inclusion in a modified, telehealth platform. The redesigned protocol included a participant readiness for telehealth assessment, nurse and physician telehealth visits, collection of usual health questionnaires, and urine collections for exposure monitoring for uranium and other fragment-related metal measures. Despite some limitations in scope, the telehealth platform permitted a visual "visit" with surveillance participants who expressed a high comfort level with the format. The telehealth platform has apparent utility for occupational surveillance and should be explored as a standard approach for surveillance outside of public health emergencies.

501 A Change to Virtual Peer Supporter Training and its Effect on Participant Readiness and Satisfaction

IntroductionPeer support gives burn survivors and their loved ones hope for a brighter future helping speed and strengthen recovery for burn survivors and their loved ones. A strategic plan to explore a digital program change from in-person increasing access for burn survivors and burn programs was scheduled for the third quarter of 2021, but the global pandemic expedited the implementation. A 2-week asynchronous and a 4-hour virtual course was designed. This study sought to evaluate the effectiveness and participants' perceptions of asynchronous and virtual training and their post-course readiness in the role of peer supporter.MethodsA 5-point Likert scale was used to evaluate the opinions, perceptions, and satisfaction of the participants. The scale, ranging from strongly agree to disagree strongly, evaluated the modular education (length, relationship to manual, preparation for the virtual course) and the usefulness of a condensed online manual. A 5-point Likert scale (ranging from extremely helpful to not at all helpful) was used to evaluate each component of the course group exercises and the participants' perception of skill development to become peer supporters. Open ended questions collected additional feedback to analyze potential changes to the new platform. The metric Net Promoter Score, or NPS, was used to measure the recommendation of the new program to others.ResultsBurn survivors (n=41) and medical professionals (n=3) participated in 6 courses over eight months. Participants reported the manual helped prepare for the course (86% strongly agree and 14% agree). Respondents felt the asynchronous modular education prepared them for the virtual component of the class (75% strongly agree and 25% agree). Additionally, respondents felt the 2-week timeline for module completion met their expectations (98% yes and 2% no). The participants felt the overall length of the course was just right (89%) to 9% too short and 2% too long. Participants rated their readiness (confidence level) to utilize their learned skills to support another burn survivor (52% extremely confident, 39% very confident, and 9% confident) after the virtual class. The combined courses rated an 82 NPS, equating to a positive participant experience and a course recommendation to others.ConclusionsThis study concluded the asynchronous and virtual education course provided an effective method to train burn survivors to become peer supporters. Overall, burn survivors expressed confidence in utilizing the skills learned from the new training program. Participants also experienced the use of virtual tools to meet the needs of burn survivors for peer support.

Integration of Madrasah diniyah learning systems for strengthening religious moderation in Indonesian universities

<em><span>Madrasah diniyah</span></em><span> is a very special Islamic education system in Indonesia that can be implemented from primary, secondary, and even higher education levels. This study aimed to explain the integration of the madrasah system in Islamic Religious Universities in the framework of strengthening religious moderation. The research method used was qualitative with a symbolic interactionalism approach. The main informants in this study were eleven people from the elements of the chancellor, vice-rector 1, head of <em>Madrasah diniyah</em> (Mudhir), teachers/</span><em><span>ustadz</span></em><span>, and students at State Islamic Institute (IAIN) Tulungagung selected by purposive sampling technique. The research implementation procedure was technically carried out by the stages of data collection, reduction, presentation, and analysis. This study found that the integration of the <em>Madrasah diniyah</em> system into the learning system at IAIN Tulungagung is quite effective in increasing students' religious knowledge. The implementation of <em>Madrasah diniyah</em> needs the support of all stakeholders in higher education. The obstacles faced need to be minimized in terms of infrastructure improvement and participant readiness. The <em>Madrasah diniyah</em> system which is integrated into the learning system in universities is a breakthrough in the world of higher education. With the effective integration of the <em>Madrasah diniyah</em> system into the learning system at Islamic religious universities, the implementation of <em>Madrasah diniyah</em> requires the support of all stakeholders. Therefore, the <em>Madrasah diniyah</em> system integration model is a model that can be developed in other Islamic religious universities.</span>

Strategies to improve smoking cessation rates in primary care.

Strategies to improve smoking cessation rates in primary care.

A combined community health worker and text messagingbased intervention for smoking cessation in India: Project MUKTI - A mixed methods study.

INTRODUCTIONWe sought to evaluate the effectiveness of a community health worker (CHW) led smoking cessation intervention, supplemented by text messages, and tailored to an individual’s readiness to quit.METHODSWe conducted a cluster randomized controlled trial (April 2018–August 2019) in adult smokers residing in a semi-urban region of India. Participants in the intervention arm received CHW-led home visits and had the option of choosing to receive regular text messages. The dose and content of CHW counseling and text messages were tailored to the participant’s readiness to quit. The control group received brief education only. Primary outcome was biochemically verified smoking cessation at the end of 12 months. Both intention-to-treat and as-treated analyses were performed.RESULTSA total of 238 (mean age 43±12.3 years, male 96.2%) participants were enrolled; 151 (64%) in the intervention arm and 83 (35.4%) in the control arm. At 12 months, 31 (20.5%) participants in the intervention arm and 9 (10.8%) in the control arm quit smoking (absolute risk difference=9.7%; RR=1.69; 95% CI: 0.04–71.33, p=0.74). In the as-treated analysis, 17 (36.9%) of the 46 participants who received optimal dose of the intervention quit smoking.CONCLUSIONSCHW-led home-based counseling, supplemented by regular text messages, led to an increase in quit rates for smoking, especially among those exposed to a higher dose of the intervention. However, the difference in cessation rates was not statistically significant. Future studies should consider testing mobile application-based multimedia messaging with larger populations, as a supplement to CHW-based counseling.

THE DEVELOPMENT OF SCIENTIFIC, ACADEMIC AND PRACTICAL CAPACITY OF RESEARCHERS AND EDUCATORS IN THE FIELD OF TRANSFORMATIVE DIGITAL LEARNING

Transformative Digital Learning (TDL) is a progressive form of fully online, problem-based, constructivist learning, developed by research associates of the Educational Informatics Lab (EILAB), University of Ontario Institute of Technology, Canada. TDL transforms higher educational practices from: authoritarian instruction to democratized learning, individualistic learning to socially distributed and tool-mediated, knowledge building, a mechanism of the status quo to a catalyst for social progress, offer a truly novel approach to the theory of teaching and education, introduce new methodology and practical techniques to learners of all ages. Moving from lecture- and book-based, classroom learning to TDL proved to be a significant adjustment requiring a good level of participant readiness. The main aim of the project “Implementation of Transformative Digital Learning in Doctoral Program of Pedagogical Science in Latvia” is to create new pedagogical knowledge and technological know-how in the field of transformative digital learning (TDL) in higher education in Latvia based on Canadian experience and to ensure transfer of knowledge and skills in the further development of the doctoral study program "Pedagogy", as well as the development of scientific, academic and practical capacity of researchers and educators.The specific objectives of the research meet the main challenges and priorities of the project, originality and novelty in the field of research:Implementation of interdisciplinary research, capacity building and the creation of a new knowledge base by studying the situation and transferring innovation to implement TDL in doctoral studies;Development of new prototypes: e-platform, innovative methodologies (approaches, methods, techniques) for completing experiments, approbation, implementation and provision of new services in the context of higher education, which will provide world-wide recognized knowledge transfer in the development of innovative and advanced didactic materials which meet the most topical priorities of the Smart Specialization Strategy set out in Latvia:Productive innovation system; modern ICT; Modern education; Knowledge base; Information and Communication Technologies for Education and Economics.

Understanding Participants' Perceptions of Access to and Satisfaction With Chronic Disease Prevention Programs.

Despite the promise of incentive-based chronic disease prevention programs, comprehensive evidence on their accessibility among low-income populations remains limited. We adapted Aday and Andersen's framework to examine accessibility and consumer satisfaction within the Medicaid Incentives for the Prevention of Chronic Disease (MIPCD) cross-site demonstration. MIPCD provided 10 states with 5-year grants to implement incentivized chronic disease prevention and management programs for low-income and/or disabled-Medicaid enrolled-Americans. We conducted 36 focus group discussions between July 2014 and December 2015 with Medicaid enrollees participating in the MIPCD programs. We assessed participants' satisfaction by program type (i.e., diabetes prevention, diabetes management, hypertension reduction, smoking cessation, and weight management) related to three components: program enrollment and participation, staff courtesy, and program convenience. Based on Aday and Andersen's framework, we conducted thematic analysis to determine similarities and differences across MIPCD programs by type. Participant feedback confirmed the importance of several features of the Aday and Andersen framework, particularly programs with easy enrollment and participation procedures, courteous and helpful staff, and those that are convenient and flexible for participants. Participants valued programming around the clock via telephone and flexible, in-person hours of operation as well as proximity of the program to reliable transportation. We observed that most participants, despite enrollment and participation barriers, perceived programs as accessible and were willing to engage and continue to participate. This finding may reflect behavior change theory's perspective on personal readiness to change. Individuals in the preparation stage of change can effectively change health habits despite barriers they may encounter. In some cases, personal readiness to change was more impactful than consumer satisfaction at encouraging ongoing participation and perceived access to the programs. Thus, program developers may want to consider individual participant readiness to change and its impact on consumer satisfaction when designing, implementing, and evaluating behavior change initiatives.

Process evaluation of the HealtheSteps™ lifestyle prescription program.

Physical inactivity, sedentary behavior, and poor diet are contributing to the rise in chronic disease rates throughout the world. HealtheSteps™ is a lifestyle prescription program focused on reducing risk factors for chronic disease through in-person coaching sessions, goal setting and tracking, and technology supports. A process evaluation was conducted alongside a pragmatic randomized controlled trial to: (a) explore the acceptability of HealtheSteps™ program from coach and participant perspectives; and (b) identify where the program can be improved. Participants at risk or diagnosed with a chronic disease were recruited from five primary care/health services organizations into HealtheSteps™. Participants met with a trained coach bi-monthly for 6 months and set goals for physical activity (step counts), exercise (moderate to vigorous activity), and healthy eating. Coaches were interviewed at month 6 and participants at month 12 (6 months postprogram). All coach interviews (n = 12) were analyzed along with a purposeful sample of participant interviews (n = 13). Coaches found that HealtheSteps™ was easy to deliver and recommendations for exercise and healthy eating were helpful. Including discussions on participant readiness to change, along with group sessions, and more in-depth healthy eating resources were suggested by coaches to improve the program. Participants described the multiple avenues of accountability provided in the program as helpful. However, more feedback and interaction during and postprogram from coaches were suggested by participants. HealtheSteps™ is an acceptable program from the perspectives of both coaches and participants with suggested improvements not requiring significant changes to the core program design.

The Association of Socioeconomic Conditions and Readiness to Learn New Ways of Performing Daily Activities in Older Adults With Functional Difficulties.

Behavioral interventions for older adults can reduce difficulties in performing daily activities, hospitalizations, and mortality risk. The success of behavior change interventions, however, can be affected by a participant's readiness to adopt changes. This study evaluates whether socioeconomic conditions, particularly financial strain affording food, are associated with readiness to change. We conducted a cross-sectional, descriptive study of baseline data from disabled older adults ( N = 147) participating in an intervention to reduce physical disability. Readiness to change score was rated at the start of the intervention by interventionists as either pre-action (precontemplation = 1, contemplation = 2, preparation = 3) or action (=4). Participants reporting high financial strain affording food were more likely to have high readiness at the start of intervention; the association of this specific socioeconomic condition with readiness may be an important consideration in implementing interventions to reduce disability.

Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults

ObjectiveTo describe functional goals and factors associated with goal attainment among low-income older adults with disabilities living in the community. DesignSecondary analysis. SettingParticipants' homes. ParticipantsOlder adults (N=226) with disability who participated in the Community Aging in Place, Advancing Better Living for Elders trial. InterventionsA 5-month, home-based, person-directed, structured program delivered by an interprofessional team: occupational therapist, registered nurse, and handyman. Main Outcome MeasuresProcess of occupational therapist goal setting and attainment at the final occupational therapist visit. ResultsParticipants identified 728 functional goals (mean of 3.2 goals per participant), most commonly related to transferring (22.0%; n=160 goals), changing or maintaining body position (21.4%; n=156 goals), and stair climbing (13.0%; n=95 goals). Participants attained 73.5% (n=535) of goals. Goal attainment was highest for stair climbing (86.3%), transferring (85.6%), and self-care (84.6%); walking goals were less likely attained (54.0%). Goal attainment was not associated with age, sex, education, depressive symptoms, function, or health-related quality of life but was less likely among participants who had severe pain compared with those without pain (adjusted odds ratio, 0.38; 95% confidence interval, 0.17–0.86). When participant readiness to change score increases by 1 point on the 4-point scale, goal attainment was 62% more likely (adjusted odds ratio, 1.62; 95% confidence interval, 1.14–2.29). ConclusionsHome-based collaborative goal setting between older adults and occupational therapists is feasible and particularly effective when individuals are ready or willing to adopt new strategies to achieve identified goals.

Openness disposition: Readiness characteristics that influence participant benefits from scenario planning as strategic conversation

In this paper we examine the impact of participant readiness to engage with, perform and benefit from scenario planning processes. Central to our examination is the concept of ‘openness disposition’, which in the context of scenario planning refers to the tendency to seek either to hold open ambiguity, complexity and uncertainty, or look for closure, simplification and surety when engaging in strategic conversations. Readiness indicates the capacity of individuals and collectives to work with competing narratives, dilemmas, tensions and differences of opinion, as may occur in scenario work. A focus on readiness through openness disposition enables critical evaluation of the utility of scenario planning to different individuals and groups based on their capacity to engage with equivocality during structured, exploratory strategic conversations. Based on findings emerging from a longitudinal field study with ProRail B.V. Holland, we empirically identify three characteristics of participant readiness, which are theorised to extend understanding of how individuals and groups might engage in, cope and benefit from, scenario planning processes.

Knowledge and Competency of Nursing Faculty Regarding Evidence-Based Practice.

The Institute of Medicine recommended that 90% of clinical decisions should be evidenced based by 2020. Both the IOM and the American Association of Critical-Care Nurses identified evidenced-based practice (EBP) as a core competency for practice. EBP can reduce costs, improve patient outcomes, and ensure optimal nursing interventions. Because nursing faculty may have deficits in knowledge, attitudes, and competencies to teach EBP, few nursing students conduct EBP reviews. The purpose of this project was to develop EBP educational resources to increase nursing faculty knowledge and competency of EBP in a southeastern college with both a multicultural faculty and student body. A pre- and postsurvey design using Stevens' ACE Star Model of Knowledge Transformation and Evidence Based Practice Readiness Inventory (ACE-ERI) determined the effectiveness of the educational intervention. Results indicated that faculty's self-confidence about their competency in EBP increased significantly from presurvey to postsurvey, t(17) = -2.04, p = .028, but there was no significant change from pretest to posttest, t(17) = -0.576, p =.572, for the EBP knowledge component of ACE-ERI. The results of the study suggest that educational programs for RN-to-BSN faculty are vital in increasing participant's readiness for EBP. J Contin Educ Nurs. 2016;47(9):409-419.

Short-term effects of a brief intervention to reduce alcohol use and sexual risk among homeless young adults: results from a randomized controlled trial

Background: Homeless young adults are more likely than their never-homeless counterparts to abuse alcohol and engage in risky sexual behaviors, yet no interventions to simultaneously reduce both these behaviors among this vulnerable population have been systematically designed and evaluated. We therefore developed a brief intervention (BI) to reduce both alcohol use and sexual risk behaviors among homeless young adults. The results of a randomized trial testing the BI against an education comparison (EC) are presented.Method: Young adults (N = 61; age 17–22 years) from an urban, Northeastern crisis shelter were randomly assigned to either the two-session, individual-level BI or a time-matched, two-session, individual-level EC. Generalized linear mixed models for repeated measures determined effects of treatment condition on outcomes.Results: The BI significantly increased participant readiness to change alcohol use. However, it did not significantly decrease primary alcohol or HIV sexual risk outcomes, independently or relative to EC (all ps > 0.05). Participants in the EC reduced times engaged in unprotected sex between baseline and post-intervention to a significantly greater extent (p < 0.01) than those in the BI condition. Participants in both conditions reported satisfaction with respective interventions.Conclusions: Findings suggest that the BI was acceptable and successful in getting participants to consider changing their drinking. However, lack of change in alcohol and sexual behavior outcomes indicates the need for further research to determine how to translate readiness to change into actual behavioral change among homeless young adults.

The Diabetes Educator and the Diabetes Self-management Education Engagement: The 2015 National Practice Survey.

The National Practice Study (NPS) is conducted biannually to assess current diabetes education practices in the United States with the goal of understanding current trends in the work in which diabetes educators engage. The 2015 NPS contained 54 questions about the individuals providing diabetes education, people with diabetes participating in education, and programs providing the education. The survey was sent electronically to approximately 21 975 people who were members of the American Association of Diabetes Educators (AADE) or who were Certified Diabetes Educators with the National Certification Board for Diabetes Educators but were not currently AADE members. In addition, both the AADE and the National Certification Board for Diabetes Educators promoted participation in the NPS via social media. The combination of efforts resulted in completion of the survey by 4855 respondents. Testing was completed with a significance level of 0.05 or 95% confidence. Diabetes educators continue to represent a diverse group of health care professionals-nurses (50%), dietitians (35%), pharmacists (6%), and others (6%). By far, the most commonly held credential for the specialty continues to be the Certified Diabetes Educator (86%), with only 5% of survey respondents indicating that they held the Board Certified-Advanced Diabetes Management credential. Diabetes educators are working with individuals across the diabetes continuum, as well as with people who do not have diabetes but have other chronic conditions. The data demonstrate that much of the diabetes educator's work with people with diabetes is beyond the first year of diagnosis. Diabetes educators are increasingly seen to be providing a broader array of the integrated AADE7 Self-Care Behaviors™. The specialty of diabetes educator continues to be populated by a professionally diverse workforce, meeting the needs of people across a wide spectrum. Diabetes educators can be found providing services in primary prevention of diabetes, education and management for those diagnosed with diabetes, prevention of secondary complications, and more complex management of diabetes and its secondary complications. While diabetes educators were found to work with those newly diagnosed with diabetes, they continue to engage with people with diabetes at various times other than the year that they were diagnosed. There are still issues with participant readiness, as evidenced by program completion rates. Nonetheless, diabetes educators are increasingly seen to be providing the integrated engagement that is needed to better ensure that people with diabetes attain and maintain competency in self-management skills.

Self-reported knee function can identify athletes who fail return-to-activity criteria up to 1 year after anterior cruciate ligament reconstruction: a delaware-oslo ACL cohort study.

Cohort study, cross-sectional. To determine if self-reported knee function assessed with the International Knee Documentation Committee 2000 Subjective Knee Form (IKDC 2000) could discriminate between successful and nonsuccessful performance on return-to-activity criteria (RTAC) tests after anterior cruciate ligament (ACL) reconstruction. Selecting appropriate performance-based and patient-reported tests that can detect side-to-side asymmetries, assess global knee function, and determine a participant's readiness to return to activity after ACL reconstruction can be a challenge for rehabilitation specialists. A simple tool or questionnaire to identify athletes with neuromuscular impairments or activity limitations could provide rehabilitation specialists with crucial data pertinent to their patients' current knee function and readiness to return to higher-level activities. One hundred ninety-four level I and level II athletes who underwent ACL reconstruction participated in the study. One hundred fifty-eight athletes at 6 months after ACL reconstruction and 141 of the athletes at 12 months after ACL reconstruction completed a battery of functional tests to determine readiness to return to activity and the IKDC 2000 to determine self-reported knee function. For each athlete, status on the RTAC test battery was dichotomized into "passed" or "failed," and status on the IKDC 2000 scores was dichotomized into "within" or "below" age- and sex-matched normal ranges. Comparisons were made between status on the RTAC test battery and the IKDC 2000 using chi-square tests. Accuracy statistics were also calculated. Six months after ACL reconstruction, 112 athletes (70.9%) failed RTAC and 76 (48.1%) were classified as having self-reported knee function below normal ranges. Among the 76 participants with IKDC 2000 scores below normal ranges, 69 (90.8%) failed the RTAC test battery (P<.001). However, among the 82 participants whose IKDC 2000 scores were within normal limits at 6 months, only 39 (47.6%) passed the RTAC test battery (P = .74). Twelve months after ACL reconstruction, 67 athletes (47.5%) failed RTAC and 31 (22.0%) had knee function below normal ranges. Among the 31 participants with IKDC 2000 scores below normal ranges, 25 (80.6%) failed the RTAC test battery (P<.001). However, among the 110 participants whose IKDC 2000 scores were within normal limits at 12 months, only 68 (61.8%) passed the RTAC test battery (P = .017). The IKDC 2000 may be a clinically relevant tool to determine the timeliness or necessity of RTAC testing. For scores obtained 6 and 12 months after ACL reconstruction, low IKDC 2000 scores were reasonably indicative of failure on the RTAC test battery, whereas normal IKDC 2000 scores were not predictive of passing scores on the RTAC test battery.