Pre-implementation Stage Research Articles

Can global health security frameworks measure One Health implementation in West Africa?A mixed-methods study

BackgroundThe 2014 outbreak of the Ebola virus disease highlighted the importance of overhauling and transforming healthcare systems in West Africa to improve the ability of individual countries to deal with infectious diseases. As part of this effort, in November 2016 the West African Health Organization (WAHO) began the process of institutionalizing the One Health (OH) approach to health security across the Economic Community of West African States (ECOWAS). The lack of clear metrics and evaluation frameworks to measure the progress of OH implementation in West Africa has been reported as a challenge. Therefore, this study sought to assess and explore whether the existing metrics of global health security frameworks can measure the successful implementation of OH activities, evaluate the progress made since 2016, and identify key areas for improvement in the region.MethodThe study employed predetermined keywords to select indicators from the International Health Regulations (IHR) Monitoring Frameworks, specifically the State Party Self-Assessment Annual Report (SPAR) and Joint External Evaluation (JEE), deemed relevant to the OH approach. In addition, the COVID-19 performance index scores (severity and recovery) for June 2022 were extracted from the Global COVID-19 Index (GCI). The GCI Recovery Index evaluated the major recovery parameters reported daily to indicate how a country performed on the path to recovery from the COVID-19 pandemic compared to other countries. National documents were also analyzed using categorical variables to assess the performance status of OH platforms across implementing countries. A quantitative analysis of these indicators was conducted and supplemented with qualitative data gathered through interviews with key stakeholders. Between March and April 2022, we conducted 18 key informant interviews with purposively selected representatives from regional governmental agencies and international multilateral agencies, including ECOWAS member states. Interviews were conducted online, transcribed, and analysed following the tenets of thematic analysis.ResultsOur quantitative analysis revealed no significant association between the implementation status of OH activities and any of the selected indicators from SPAR and JEE. The descriptive analysis of the JEE scores at the country level revealed that countries with existing OH platforms scored relatively higher on the selected JEE indicators than other countries in the pre-implementation stage. OH implementation status did not significantly affect COVID-19 recovery and severity indices. The qualitative findings with relevant stakeholders revealed noteworthy challenges related to insufficient human capacity, inadequate coordination, and a lack of government funding for the sustainability of OH initiatives. Nonetheless, countries in the ECOWAS region are making progress toward the integration of OH into their health security systems.ConclusionStandardized metrics were used to assess the implementation and efficacy of OH systems in the ECOWAS region. Current indicators for monitoring global health security frameworks lack specificity and fail to comprehensively capture essential OH components, particularly at the sub-national level. To ensure consistency and effectiveness across countries, OH implementation metrics that align with global frameworks such as IHR should be developed.

Pelatihan Menghasilkan Uang Secara Online dengan Bisnis Afiliasi untuk Siswa Magang SMK di Kampus Universitas Mahakarya Asia

This digital era, the internet has opened up new opportunities in the business world, especially through online business models such as affiliate businesses. These businesses allow individuals to promote other people's products or services and earn commissions from any transactions generated through affiliate links. Affiliate businesses offer potential solutions, but not all internship participants have the understanding and/or skills to take advantage of these opportunities. For this reason, Mahakarya Asia University provides practical training on affiliation. This approach combines theoretical understanding and practical experience, ensuring students increase their knowledge and practical skills.The method of implementing this service involves pre-implementation, implementation and evaluation stages. Identification of problems, interviews with internship supervisors, and socialization of material are carried out at the pre-implementation stage. The training was carried out face-to-face involving 25 vocational school students in the Mahakarya Asia University computer laboratory on September 9 2023. Evaluation is carried out to measure students' success in applying the knowledge and skills acquired during training.The training results show that students are able to register and create a Shopee affiliate account, create affiliate video content, and disseminate affiliate links via social media. Evaluation of participants' understanding showed that most students understood the material and were successful in the practicum. Overall, this affiliate business training is expected to provide additional competency and opportunities to earn income online.

MODEL PEMBELAJARAN PROBLEM BASED LEARNING BAGI SISWA SMA NEGERI 13 PEKANBARU DENGAN KONSEP SERVICE LEARNING

This service aims to find out how the application of the problem-based learning model and its influence on increasing student learning motivation economic in public senior high school 13 Pekanbaru The dedication method is Service Learning using the Experimental Learning model, which is carried out in direct service, namely where students are directly involved in activities accompanied by supervisors. The stages are Pre-Implementation, implementation, and Post-Implementation. The results of the dedication were that at the Pre-Implementation stage, it was found that during a survey at schools, there were still students who were less than optimal in their learning motivation, and teachers still used conventional learning models. In the Implementation stage, the results at this stage are using the problem-based learning learning model to increase learning motivation. In the Post-Implementation Stage, the assessment and reflection of students and teachers in the application of the problem-based learning model are good.

The impacts of tobacco control legislation on public view of e-cigarette usage in Macao—The co-word analysis of Macao daily

IntroductionMacao has been certified as a “Healthy City” by the World Health Organization, and has been adhering to the principle of combining prevention with proper medical care to build its medical system. As tobacco epidemic is a risk factor leading to a series of non-communicable diseases, the Macao SAR Government has continuously improved tobacco control measures.MethodsThe data for this study were derived from a news report on “e-cigarettes” published in Macao Daily. Co-word analysis and thematic analysis were conducted to analyze the development of tobacco control legislation against e-cigarettes. Co-word analysis examined the association and frequency of keywords, while thematic analysis identified prevalent themes within the data.ResultsThe study identified three stages of legislation against e-cigarettes: the pre-implementation stage, the early implementation stage, and the epidemic period. Each stage exhibited distinct characteristics and attention toward specific groups, particularly “teenagers” and “students,” increased significantly. Thematic analysis further highlighted the potential issues of drug use and smuggling associated with e-cigarettes.DiscussionThe findings suggest that the Macao SAR Government should prioritize the development of healthy behaviors among adolescents in the context of e-cigarette control. Additionally, considering regional cooperation to promote the “Healthy Bay Area” could be beneficial. Social media platforms and effective data management should be utilized as tools in these efforts.

The multiple makings of a supervised consumption service in a hospital setting

BackgroundWhereas supervised consumption services (SCSs) are common in many community settings, they are seldomly found in acute care hospitals. As hospitals present unique circumstances that can shape the impacts of an SCS, careful consideration of local implementation contexts and practices is required. We explored the pre-implementation stage of an SCS, to examine how an SCS is made and made differently in relation to the material-discursive context of the hospital. MethodsWe conducted 11 focus groups with 83 staff and clinicians at an inner-city hospital in Toronto, Canada. Data analysis followed principles of grounded theory and was informed by an ‘evidence making interventions’ framework. ResultsWhile most participants indicated they would support the establishment of an SCS at the hospital, multiple enactments of an SCS emerged. An SCS was enacted: as a means to reduce drug-related risks for all people who use drugs, as an opportunity to intervene on patients’ drug use, as a means to centralize drug use, and as a transformative intervention for the hospital. In our findings, harm reduction, abstinence, security, and risk mitigation goals existed closely together, yielding overlaying realities. ConclusionOur findings revealed various enactments of an SCS, some of which are likely to negatively affect people who use drugs and service access. As more hospitals consider the implementation of an SCS, understanding how an SCS is made in practice will be key to building a service that focuses on the needs of people who use drugs.

Impact of the MEESSI-AHF tool to guide disposition decision-making in patients with acute heart failure in the emergency department: a before-and-after study

ObjectivesTo determine the impact of risk stratification using the MEESSI-AHF (Multiple Estimation of risk based on the Emergency department Spanish Score In patients with acute heart failure) scale to guide...

Can Cap-and-Trade Be a Regulatory Option to Address Groundwater Depletion and Irrigation Crises in India? Reflections, Issues & Options.

India is a global hotspot for irrigation-induced groundwater withdrawal, leading to widespread lowering of water levels, in turn resulting in disproportionate access to irrigation supplies among farming communities. Efforts to mitigate the situation, however, have fallen short, largely due to technocentric vision (e.g. microirrigation adoption) of the regulatory authorities (RAs), which does little to integrate the vast groundwater-dependent socioecologies with the decision making system. In view of that, we invite the RAs to deliberate upon a cap-and-trade mechanism that proposes to mobilize the farmers at every aspect of planning and execution, while to tackling multiple challenges simultaneously: (a) restrict groundwater pumping to a pre-defined safe level (cap), (b) creating a shared space/quotas for all to pump (allocation); and (c) making provisions for trade of allocations. The latter further augments farmers' access to groundwater (and irrigation). Using a systematic bibliometric analysis of relevant world literature and contextual appraisal of groundwater-irrigation landscape in India, we develop a conceptual framework of cap-and-trade in three parts. In the first Pre-implementation stage, we emphasize a reality check study to assess ground conditions, if favorable for a cap-and-trade approach (existing social, economic, institutional circumstances). Next, in the Implementation stage, (1) we recommend an integrated hydrogeological-hydrometeorological modeling to determine flexible capping arrangements, with the possibility of delineating certain priority regions (coastal ecosystems); (2) for allocations, a reasonable fraction of the cap over a defined period; we envision a thoroughly participatory arrangement, centering on four action areas: identifying, informing, consulting, and involving the farmers, alongside all stakeholders engaged in the groundwater-irrigation decision making; (3) for trade, we urge the RAs to create win-win situations for both the sellers and buyers; develop the transaction protocols on certain foundational principles (e.g. simplicity, transparency and consistency); strengthening of local institutions, and development of targeted financial support schemes. We consider the third part of the narrative, Post-implementation stage, as a real game changer, comprising of a monitoring, auditing (performance benchmarking) component coupled with multitiered outreach-mentoring drives that demonstrate to the farmers the benefits of becoming part of the cap-and-trade program. Overall, a main motivation to present this research is to shatter the age-old socio-cognitive beliefs/taboos around groundwater pumping (My land, My Water), breaking the hegemony of the water sellers (rich/wealthy large landholder clans), to potentially, create a social norm whereby the farmers realize the value of restricting groundwater pumping and sharing for mutual prosperity.

Conducting Hybrid Training for Teacher Professionalism at SMP Wahid Hasyim Malang

This article presents an explanation of the implementation of hybrid training as a form of teacher professional development at Wahid Hasyim Junior High School in Malang. Hybrid training is a pedagogical approach that combines online and face-to-face learning to improve the quality of education and teachers' abilities. This programme is implemented with stages (1) pre-implementation, (2) implementation and (3) post-implementation. The pre-implementation stage is passed by preparing all aspects needed. The implementation stage includes the training process which is conducted online but participants follow it simultaneously in one room. The post-implementation stage is carried out through reflections from the training instructor during the activity. This mode of training is expected to provide opportunities for teachers to explore their learning experiences widely through the application of online learning as exemplified in this training programme.

SD-AETO: Service-Deployment-Enabled Adaptive Edge Task Offloading Scheme in MEC

In recent years, edge computing, as an important pillar for future networks, has been developing rapidly. Task offloading is a key part of edge computing that can provide computing resources for resource-constrained devices to run computing-intensive applications, accelerate computing speed and save energy. An efficient and feasible task offloading scheme can not only greatly improve the quality of experience (QoE) but also provide strong support and assistance for 5G/B5G networks, the industrial Internet of Things (IIoT), computing networks, etc. To achieve these goals, this paper proposes an adaptive edge task offloading scheme assisted by service deployment (SD-AETO) focusing on optimizing the energy utilization ratio (EUR) and the processing latency. In the pre-implementation stage of the SD-AETO scheme, a service deployment scheme is invoked to assist with task offloading considering each service’s popularity. The optimal service deployment scheme is obtained by using the approximate deployment graph (AD-graph). Furthermore, a task scheduling and queue offloading design procedure is proposed to complete the SD-AETO scheme based on task priority. The task priority is generated by corresponding service popularity and task offloading. Finally, we analyze our SD-AETO scheme and compare it with related approaches, and the results show that our scheme has a higher edge offloading rate and lower resource consumption for massive task scenarios in the edge network.

Eksistensi dan Fungsi Sosial Ritual Ratib Samman pada Masyarakat Desa Sei Paham Kecamatan Sei Kepayang Kabupaten Asahan

This study aims to determine the exixtence, practice, meaning and social function of the Ratib Samman ritual in the people of Sei Paham Village, Sei Kepayang District, Asahan Regency. The ritual which is carried out by gathering many people is carried out by men at night after the Isha Prayer. This study uses a qualitative method with a descriptive approach. In this case, to obtain the data inquestion, obtained trough observation, interviews and documentation. The results of this study indicate that the existence of the Ratib Samman ritual is a cultural form that is believed and known by the community to have existed from the time of the Atok ancestors and was passed down from generation to generation. Its existence has a high value in society, the practice starts from the pre-implementation stage, the implementation stage and the post-implementation stage. The movements used are sitting, rotating and standing positions as well as the movements of the pencak silat moves. The community interprets this ritual as the practice of remembrace of Allah Swt to draw closer Allah Swt. It is known that these rituals are part of the teaching of the Tarekat. Howefer, in this area, it has become a public Ratib, meaning that anyone may follow it. The ritual also has a social function, among others, as a form of social solidarity an integration and as a means of overcoming epidemics or diseases, famine, crime, and disturbances by spirits.

Factors Affecting Variation Orders in the Construction Project of Antasari Place Jakarta Apartment

A Variation Order is a modification of the contract content that has been agreed at the pre-implementation stage. Variation Order often occurs in a construction project and has the possibility to have a positive or negative impact on the project implementation time. In the implementation of the Antasari Place Jakarta apartment construction project, there are 22 site instructions as an order for Variation Order work. In identifying factors affecting the Variation Order in this study, a questionnaire that has been validated by experts was used. This study identified 21 factors from the aspects of construction, administration, parties involved, and others that affect the Variation Order on the Antasari Place Jakarta Apartment construction project, with the most dominant factor affecting the Variation Order is the addition of work scope. Ranking of the most dominant factors using the Relative Importance Index (RII) method and ranked three factors with the highest RII values, namely due to the addition of the scope of work with an RII score of 0.900, design changes from planning with an RII score of 0.680, and changes in the scope of work at the construction implementation stage with an RII score of 0.620. The Variation Order work in the Antasari Place Jakarta Apartment construction project has no impact on the final completion time of the project contract because the project implementation has not entered the critical trajectory of the implementation time and is carried out during slack time.

Kebijakan Keamanan Teknologi Informasi Pada Perangkat Keras Di Perusahaan Distributor Sepatu

<p><em>A shoe distributor company is a company engaged in the distribution of shoes to consumers. In its daily practice, shoe distributor companies have not implemented the IT Security Policy properly. Then the Community Service program is carried out with the aim of enforcing the established information security policy. The method is in the form of exposing material to shoe distributor companies regarding the importance of having and implementing an IT Security Policy, especially an IT Security Policy on Hardware. The implementation of the program was carried out in two major stages, namely the pre-implementation stage where the research team received data on company problems, conducted an analysis of these problems, prepared presentation materials/materials and the implementation stage where the PKM implementing team coordinated and executed the PKM material presentation activities. The presentation of the material was carried out face to face at the Head Office of the shoe distributor company. The activity began with an opening & introductory session, followed by presentation of material, which was divided into five major topics, namely explanation of system security, explanation of Policy, Standards, Procedures, Guidelines, explanation of Sample Template Policy, Standards, Procedures, Guidelines, explanation of Hardware security, and explanation of company Case Study. Then, the activity continued in the question-and-answer session and after that continued with the evaluation activities carried out by filling out the Google feedback link in the program implementation form for the participants. The results obtained in the PKM activities were that the implementation was carried out well and was beneficial for the shoe distributor company with several suggestions for improvement, namely the delivery of material that could be slower, examples that were more specific and appropriate.</em></p>

Investigating The Stakeholders' Attitudes Towards Prioritizing Agile Project Management Strategies as A Change Management Tool in Construction Projects

Construction projects face several problems in order to achieve their goals (time – cost – quality) especially since it has many inputs such as materials, labor and machinery. Measuring these goals in the money language is the key to their integration, so reducing costs is an important aspect of any project. One of the ways to reduce costs is to focus on how to avoid implementation problems and the financial implications of it. Several factors including irregular financial flows, poor management due to the lack of programs that support the administrative awareness of projects, financial and administrative instability, poor control and supervision, unskilled labor, insufficient machinery, inappropriate timing for the arrival of materials, changes in the construction conditions, lack of clarity of specifications, insufficient preparation during the pre-implementation stages, imposed regulations and laws, and other factors that contribute to problems in the implementation of major national projects. This study aimed to enhance the general understanding concerning the factors that affect the adoption of APM strategies in construction industry. The research relied on the inductive-analytical approach through conducting a questionnaire among stakeholders to analyze major development construction projects which can be benefited from applying the concept of agility to reduce project failure, then presenting and analyzing results of the survey questionnaire conducted with a sample of Egyptian design and construction firms to investigate their perception and application of prioritizing agile project management strategies as a change management tool in construction. The results of the thesis suggested that the Agile methodology is likely to yield significant benefits, primarily characterized by enhanced client engagement. The Agile approach significantly encourages increased customer engagement in the project as opposed to the current scenario. Additionally, it has the potential to reduce uncertainty and enhance risk management. The implementation of time management techniques and regular meetings is advantageous in monitoring the development and status of the project.

Implementasi Sistem Raport Digital Madrasah Berbasis Web di Ma Al-Mubarokah Banyuasin

This research aims to understand how the implementation of a web-based digital school report system in Ma Al-Mubarokah Banyuasin madrasah works. The research object consists of three stages: (1) Pre-Implementation Stage, (2) Implementation Stage, and (3) Evaluation Reporting Stage. This study follows a qualitative descriptive research approach, with a research group of 12 participants including the school principal, deputy principal in charge of the curriculum, educational staff, and teaching staff. Data is collected through three methods: interviews, observations, and documentation. The data analysis technique involves data collection, data presentation, and data verification. The research findings indicate that: (1) The Pre-Implementation Stage involves tasks such as registration, enrollment, creating madrasah accounts, and teacher accounts for the implementation of the web-based digital school report system. (2) The Implementation Stage shows successful collaboration between operators, teachers, and class guardians, supported by the school principal, resulting in a smooth implementation process. (3) The Evaluation Reporting Stage involves holding meetings to evaluate and improve the web-based digital school report system

Assessment of Business Process Maturity Model in Culinary SMEs as a Pre-Stage of Enterprise Resource Planning Implementation

The SMEs sector is predicted to have a surplus of ERP implementation projects in 2024, with 60% of the total implementation projects. However, the ERP implementation growth cannot be separated from the threat of project failure (35%) and project delays (55%). This study measured the maturity of business processes as a pre-implementation stage to reduce the risk of ERP implementation failure. The object studied was three culinary SMEs in Yogyakarta. This paper used McCormack’s theory of business process management maturity model, combined with the ICT maturity model developed by Pham. The assessment showed that the three SMEs were at the lowest level of business process maturity, the ad hoc level. Meanwhile, the ICT maturity varies from inactive to substantial. However, SME A had the eligibility to implement an ERP system but first needed to perform the business process re-engineering. The recommendations were designed for SME A to enhance its business process flow by proposing a business process based on the best practice process used by ERP system providers.

Pré-implémentation d’indicateurs de fragilité et de complexité dans les soins à domicile : une analyse à l’aide de l’Implementation Research Logic Model

Introduction : Des indicateurs cliniques de fragilité et de complexité des situations de soins à domicile sont dérivés de l’interRAI HC, mais leur implémentation dans la pratique demande une analyse précise et préalable du contexte de soins dans lequel ils pourraient être utilisés. L’Implementation Research Logic Model (IRLM) est un cadre de référence mobilisable pour l’ensemble du processus d’implémentation notamment pour la pré-implémentation, une étape indispensable, bien que souvent négligée. Objectif : Cet article vise à présenter une démarche d’application du modèle IRLM qui précise les éléments clés (déterminants, stratégies, mécanismes et retombées) de l’étape de pré-implémentation. Démarche : L’implémentation prend place à l’institution genevoise de maintien à domicile (imad) en Suisse. Les données recueillies (ex. caractéristiques de l’institution, questionnaire auprès des infirmières) sont classées dans l’IRLM par un groupe de travail. Évaluation : L’analyse des éléments de pré-implémentation pointe les déterminants contextuels pouvant favoriser l’implémentation (ex. disponibilité des indicateurs cliniques et protocoles de prise en soins) ou la freiner (ex. multiplicité des informations). Par ailleurs, les stratégies mises en place et les retombées recueillies à ce stade (ex. intégration des indicateurs dans le dossier du patient, peu de résistance au changement) sont décrites. Discussion et conclusion : L’anticipation et l’analyse des conditions dans lesquelles prend place l’implémentation dès la phase de pré-implémentation permettent de recueillir des informations essentielles sur des recommandations d’adaptation des actions aux contextes spécifiques et aux réalités concrètes. La mise en place de stratégies étape par étape devrait contribuer à relever le défi du transfert de nouvelles connaissances à la pratique clinique contextualisée.

The relative value of Pre-Implementation stages for successful implementation of evidence-informed programs

BackgroundMost implementations fail before the corresponding services are ever delivered. Measuring implementation process fidelity may reveal when and why these attempts fail. This knowledge is necessary to support the achievement of positive implementation milestones, such as delivering services to clients (program start-up) and competency in treatment delivery. The present study evaluates the extent to which implementation process fidelity at different implementation stages predicts achievement of those milestones.MethodsImplementation process fidelity data—as measured by the Stages of Implementation Completion (SIC)—from 1287 implementing sites across 27 evidence-informed programs were examined in mixed effects regression models with sites nested within programs. Implementation process fidelity, as measured by the proportion of implementation activities completed during the three stages of the SIC Pre-Implementation phase and overall Pre-Implementation (Phase 1) and Implementation (Phase 2) proportion scores, was assessed as a predictor of sites achieving program start-up (i.e., delivering services) and competency in program delivery.ResultsThe predicted probability of start-up across all sites was low at 35% (95% CI [33%, 38%]). When considering the evidence-informed program being implemented, that probability was nearly twice as high (64%; 95% CI [42%, 82%]), and 57% of the total variance in program start-up was attributable to the program. Implementation process fidelity was positively and significantly associated with achievement of program start-up and competency. The magnitude of this relationship varied significantly across programs for Pre-Implementation Stage 1 (i.e., Engagement) only. Compared to other stages, completing more Pre-Implementation Stage 3 (Readiness Planning) activities resulted in the most rapid gains in probability of achieving program start-up. The predicted probability of achieving competency was very low unless sites had high scores in both Pre-Implementation and Implementation phases.ConclusionsStrong implementation process fidelity—as measured by SIC Pre-Implementation and Implementation phase proportion scores—was associated with sites’ achievement of program start-up and competency in program delivery, with early implementation process fidelity being especially potent. These findings highlight the importance of a rigorous Pre-Implementation process.

An educational program of reducing moral distress (PRMD) in nurses; designing and evaluating

BackgroundMoral distress is common phenomenon that has negative consequences on nurses, patients, and healthcare systems. This study aims to design and evaluate an educational program to reduce moral distress in nurses.MethodsThis multiphase mixed-method study was done in three stage on February 2021 in Shiraz/Iran. In pre-implementation stage, a content analysis study was conducted on 12 participants were interviewed using purposive sampling and then the program was designed according to qualitative data, panel of expertise and literature review according the seven steps of Ewles and Sminett’s model and implemented in one group on 40 nurses using a quasi-experimental design. In Post-Implementation stage, effectiveness of program was evaluated through quantitative and qualitative methods. Quantitative data were gathered by Hamric's 21-question moral distress questionnaire analyzed via SPSS v.25 and analysis of variance repeated measures test. Also, a content analysis study was conducted on 6 PRMD participants using purposive sampling. In Program evaluation stage, convergence of quantitative and qualitative data and the effects of the program were examined. Trustworthiness of qualitative data was accomplished by Lincoln and Guba criteria.ResultsFirst quantitative study revealed the causes of moral distress consisted of deficiency in professional competency, unsuitable organizational culture, personal factors, environmental and organizational factors, management factors, insufficiencies in proficient and efficient communication and nurses' observation of moral dilemma. Results of quantitative stage showed that there was a significant difference (p < 0.05) between the mean score of moral distress before, after, 1 and 2 months after the intervention. The participants in secondary qualitative stage, reported increasing their moral knowledge and skills, improving ethical climate, and moral empowerment.ConclusionThe use of different educational tools and teaching methods and the participation of managers in designing strategies had a very effective role in the effectiveness of this educational program.

Expectations on implementation of a health promotion practice using individually targeted lifestyle interventions in primary health care: a qualitative study

BackgroundThere is moderate to strong evidence of the effectiveness of health-promotion interventions, but implementation in routine primary health care (PHC) has been slow. In the Act in Time project implementation support is provided for a health promotion practice using individually targeted lifestyle interventions in a PHC setting. Identifying health care professionals’ (HCPs’) perceptions of barriers and facilitators helps adapt implementation activities and achieve a more successful implementation. This study aimed, at a pre-implementation stage, to describe the expectations of managers, appointed internal facilitators (IFs) and HCPs on implementing a healthy lifestyle-promoting practice in PHC.MethodsIn this qualitative study five focus group discussions with 27 HCPs and 16 individual interviews with managers and appointed IFs were conducted at five PHC centres in central Sweden. The PHC centres are participating in the Act in Time project, evaluating the process and outcomes of a multifaceted implementation strategy for a healthy lifestyle-promoting practice. A deductive qualitative content analysis based on the Consolidated Framework for Implementation Research (CFIR) was followed using inductive analysis.ResultsTwelve constructs from four of five CFIR domains were derived: Innovation characteristics, Outer setting, Inner setting, and Characteristics of individuals. These domains are related to the expectations of HCPs to implement a healthy lifestyle-promoting practice, which includes facilitating factors and barriers. The inductive analysis showed that the HCPs perceived a need for a health-promotion approach to PHC. It serves the needs of the patients and the expectations of the HCPs, but lifestyle interventions must be co-produced with the patient. The HCPs expected that changing routine practice into a healthy lifestyle-promoting practice would be challenging, requiring sustainability, improved structures, cooperation in inter-professional teams, and a common purpose. A collective understanding of the purpose of changing practice was vital to successful implementation.ConclusionsThe HCPs valued implementing a healthy lifestyle-promoting practice in a PHC setting. However, changing routine methods was challenging, implying that the implementation strategy should address obstacles and facilitating factors identified by the HCPs.Trial registrationThis study is part of the Act in Time project, registered in ClinicalTrials.gov with the number NCT04799860. Registered 03 March 2021.

Pendampingan Menulis Cerita Fabel Berbasis Kearifan Budaya Lamaholot di SMPS Ratu Damai, Flores Timur

Assistance in writing fairy tales for students at school is very important. Fairy tales are stories from the animal world that aim to entertain as well as a medium of moral education. Fable writing skills can only be achieved through directed, guided, and continuous practice in learning literature where students can translate their ideas, creative thoughts, and feelings into written language. This assistance aims to explain the implementation of the Lamaholot culture-based fable story writing activity with image media to the students of Ratu Damai class. The method used is the KKN method which directly assists students in writing fables using media images with implementation stages, including (1) the pre-implementation stage, (2) the analysis stage, (3) the training stage, (4) the mentoring stage, and (5) evaluation stage. This stage of activity is adjusted to the structure of the fable story which includes orientation, complication, resolution, and coda. Through fable writing assistance using image media, students can write fables which can be seen from the work in the form of fables written with imagination, high creativity, and interesting titles and moral messages conveyed regarding Lamaholot's cultural wisdom towards the marine environment. This guided activity can monitor students' interest and creativity in writing fables based on a given theme.