Pre-intervention Interviews Research Articles

Music Upper Limb Therapy - Integrated (MULT-I) supports a positive transformation in sense of self post stroke: a thematic analysis.

To understand how the experience of Music Upper Limb Therapy - Integrated (MULT-I) interconnects with the experience of stroke. Thematic analysis of semi-structured interviews and video-recorded MULT-I sessions from a larger mixed-methods study. Thirty adults with post-stroke hemiparesis completed pre-intervention interviews, of whom fifteen participated in MULT-I. Thirteen of the participants in MULT-I completed post-intervention interviews. The experience of stroke was characterized by five themes: (1) sudden loss of functional abilities, (2) disrupted participation, (3) desire for independence, (4) emotional distress and the need for support, and (5) difficulty negotiating changes in sense of self. The experience of MULT-I was characterized by three themes: (1) MULT-I activated movement and empowered personal choice, (2) MULT-I created a safe place to process emotional distress and take on challenges, and (3) MULT-I fostered a sense of belonging and a positive transformation in sense of self. These themes combined create a framework which illustrates the process by which MULT-I addressed each challenge described by survivors of stroke, facilitating a positive transformation in sense of self. MULT-I promotes physical, emotional, and social wellbeing following a stroke. This integrated approach supports a positive transformation in sense of self. These findings have implications for improving psychosocial well-being post stroke.

A pilot mixed-methods evaluation of an intervention to reduce Korean undergraduates’ stigma toward autistic people

BackgroundHeightened stigma in South Korea may contribute to the difficulties that autistic undergraduate students experience in college. This study aimed to explore non-autistic Korean undergraduate students’ stigma toward autistic people using semi-structured interviews surrounding a pilot autism anti-stigma training. MethodDuring the pre-intervention interview, 22 Korean undergraduate students were asked to describe autism, rate their agreement with Social Distance Scale (SDS) items, which asked about their willingness to interact with autistic people, and justify their responses. Participants then completed an online autism training. The post-intervention interview asked the same series of questions but omitted the justification-related questions. We analyzed open-ended responses using content analysis and used a paired-sample t-test to compare pre- and post-intervention averaged SDS items. ResultsParticipants reported different justifications for their desired social distance from autistic people. The types and frequency of justifications mentioned differed depending on the types of relationships expected. Intervention participation was associated with reduced stigma toward autistic people (p < .001). Participants’ extreme stereotypes (e.g., savant) and perceptions of autistic individuals as living in their own world shifted toward recognizing autistic individuals as people living in the same world. ConclusionsThis is the first study to explore why non-autistic Korean college students may desire social distance from autistic people and to attempt to reduce heightened autism stigma in South Korea through an autism training. Future work should use a randomized control trial to examine the causal impact of training on stigma and to identify active ingredients of anti-stigma interventions across cultures.

Impact of Interactive Reading Intervention on Vocabulary Development of Deaf and Hard of Hearing Students at Wangsel Institute of the Deaf

Learning English as a second language is challenging for Deaf and Hard of Hearing (DHH) students at Wangsel Institute for the Deaf. One of the most important components for improving English language is vocabulary knowledge. Vocabulary is fundamental for communicating, reading, thinking, and learning. This action research aims at examining the effectiveness of the use of pictures in teaching English vocabulary to DHH students at Wangsel Institute. The research also examined the effective strategies to teach vocabulary to DHH students. A pre-intervention interview was conducted to ask about students’ experience in learning English. A total of thirty students participated in the study. They were provided intervention for this action research for a period of over two months with focus on teaching targeted words using pictures. The participants' understanding of the targeted words were assessed and analysed using pre-intervention and post-intervention vocabulary tests. It was found that all the participants had improved scores during the post-intervention vocabulary test compared to pre-intervention vocabulary test. The finding of the study indicated that the use of pictures to teach English vocabulary to DHH students was effective. It also calls for teachers of the Deaf to use pictures to enhance the effectiveness of the teaching and learning of English vocabulary for DHH students.

Emergency and Disaster Preparedness for Individuals Who Use Augmentative and Alternative Communication: A Pilot Study on Supported Planning Using a Toolkit.

When emergencies or disasters arise, individuals who use augmentative and alternative communication (AAC) are particularly vulnerable. It is critical that individuals who use AAC are supported to make decisions that impact their own lives and are able to communicate during such a crisis. Preparedness efforts that include a plan around communication needs and supports are necessary for ensuring that individuals who use AAC are able to understand options that ensure personal safety and express their needs during a time of crisis. Qualitative methods were used to identify and describe the experiences of two young adults who use AAC and their caregivers when engaging in person-centered planning intervention sessions to complete the activities of the United States Society for Augmentative and Alternative Communication (USSAAC) emergency/disaster preparedness toolkit. Pre-intervention interviews and subjective, objective, assessment, and plan (SOAP) notes taken after each intervention session were done to describe their preparedness and experiences completing the toolkit. Themes were identified to describe participant experiences and change in their perceived preparedness. Five themes and 18 subthemes emerged from the pre-intervention interviews and the SOAP notes across 14 intervention sessions that captured each participant and their caregiver's awareness of needs, barriers in emergency situations, challenges in completing the toolkit, and actions during person-centered planning with the toolkit (e.g., personalizing communication boards, making a go bag, and scheduling visits with local emergency agencies). This study highlights the need for preparedness activities that are person-centered and account for the communication support needs of individuals who use AAC if faced with an emergency/disaster. Outcomes suggest that these methods were feasible and supported positive change in perceived preparedness in the young adults who used AAC and their caregivers. https://doi.org/10.23641/asha.24415567.

Assessing the feasibility, fidelity and acceptability of a behaviour change intervention to improve tractor safety on farms: protocol for the BeSafe tractor safety feasibility study

BackgroundIn Ireland, the agriculture sector reports the highest number of fatalities even though farmers constitute only 6% of the working population. Tractor-related behaviours are implicated in 55% of all vehicle work-related fatalities and 25% of reported injuries, and many of these occur in farmyards. There is limited research on the feasibility and acceptability of behaviour change interventions to improve tractor safety. Target behaviours that promote safe operation in farmyards, determining and addressing blind spots of tractors, were identified, and an intervention was developed following the Behaviour Change Wheel Approach. The objective of the study is to examine the feasibility, fidelity and acceptability of a behaviour change intervention to enhance the safe operation of tractors in farmyards with a particular focus on tractor blind spots.MethodA single group feasibility study will be undertaken. Approximately 16 farmers from four major farm types will be recruited for the study between August and September 2022. The intervention involves an in-person demo session, facilitated discussion and personalised safety training procedure with safety goals. The study will collect data from participants at three time points: baseline (3–10 days prior to the intervention), during the intervention and at the follow-up session (7–30 days post-intervention). Quantitative data will be collected through a pre-intervention interview and feedback surveys. A pre- and post-intervention qualitative interview will also be conducted with the participants and will be supplemented with qualitative data from recruitment logs, observational memos and logs and feedback from recruiters. Evaluation of the feasibility, acceptability and fidelity of the intervention will be guided by a pre-determined feasibility checklist, fidelity framework and theoretical framework of acceptability, respectively. Interviews will be analysed using the content analysis.DiscussionThe current study can determine the feasibility and fidelity of delivering a systematic, theoretically driven, tailored behaviour change intervention. It will also assess whether the intervention, its ingredients and delivery are acceptable to the farming population. This study will also inform the development of a future larger trial to test the effectiveness of the intervention.Trial registrationISRCTN Identifier: ISRCTN22219089. Date applied 29 July 2022

From improved sleep regularity to reduced sleep complaints and mental health conditions: a population-based interventional study using a smartphone-based virtual agent.

To explore the effect of sleep regularity on sleep complaints and mental health conditions (i.e. insomnia, fatigue, anxiety, and depressive symptoms) in a population-based interventional study using a smartphone-based virtual agent. A populational cohort based on the Kanopée application, which provided interactions with a virtual companion to collect data on sleep and make personalized recommendations to improve sleep over 17 days. A pre-intervention sleep diary and interview were used for cross-sectional analysis (n = 2142), and a post-intervention sleep diary and interview were used for longitudinal analysis (n = 732). The intra-individual mean (IIM) and standard deviation (ISD) of total sleep time (TST) were calculated to measure sleep quantity and sleep regularity. The mean age at baseline was 49 years, 65% were female, 72% reported insomnia, 58% fatigue, 36% anxiety, and 17% depressive symptoms. Before the intervention, irregular and short sleep was associated with a higher likelihood of insomnia (Relative risk [RR] = 1.26 [1.21-1.30] for irregular TST and RR = 1.19 [1.15-1.23] for short TST), fatigue, anxiety, and depressive symptoms. After the intervention, the IIM of the TST increased while the ISD of the TST and sleep complaints and mental health conditions decreased. More regular TST was associated with reduced insomnia and depressive symptoms (RR = 1.33 [1.10-1.52] and RR = 1.55 [1.13-1.98], respectively). Our results reveal a longitudinal association between sleep regularity and sleep complaints and mental health conditions. Policymakers, health professionals, and the general population should be aware that, beyond its positive effect on sleep health, regular sleep could promote mental health.

Abstract P6-05-15: Standard of Care for HR+/HER2- Breast Cancer: Integrating The “Yale Model Shared Decision-Making Multidisciplinary Team Solution” into the Practice Setting

Abstract Background: Breast cancer patients are faced with treatment choices that can involve complex preference-sensitive decisions. The National Quality Forum initiated a “Call to Action” to integrate shared decision-making (SDM) processes into practice where clinicians and patients work together to make healthcare decisions that align with what matters most to patients. Projects In Knowledge, @Point of Care, Dartmouth and Yale collaborated to develop a pilot educational initiative to address and improve patient-centered care and SDM processes in the institutional cancer care setting. Methods: Training materials co-developed for the Yale Breast Cancer multidisciplinary team (N=11: oncologists, nurses/NPs, pharmacist) address SDM, CDK4/6 Inhibitor treatment of metastatic HR+ HER2- breast cancer, and clinician-patient role play methods implementing SDM in treatment discussions/decisions with patients. Reinforcement training, based on interim interview and case role play assessments, was customized to meet specific needs of the team. Qualitative semi-structured interviews and simulation case role play observational methods, using a two-rater system, were used to assess improved SDM performance. Baseline pre-intervention interviews and case role play assessments were compared to interim post-intervention and end of pilot (EOP) post-reinforcement training intervention interviews and case role play assessments (using a Likert scale 0-4 rating score: 0=0%; 1=25%, 2=50%; 3=75%; 4=100%). Following the training and assessments, a focus group of team members provided insights into the performance of the group, assessed the acceptability, feasibility, and repeatability of the program, and informed future education. Results: Semi-structured interview findings revealed that clinicians learned about nuances of CDK 4/6 inhibitors, crystallized their understanding of SDM through reinforcement training (customized in real time), and felt they were better able to implement SDM as a result of their case role play assessments. Training empowered the Yale Breast Cancer team to show pre- to post-education improvement in SDM case role play scenarios, ranging from 16% to 39%. Areas of greatest improvement: 1) determining decision style preference (+36%); 2) determining patients’ risk/burden tolerance (+32%); 3) determining patients’ activation, engagement, and self-efficacy (+34%), 4) determining trade-off decisions with patients (+39%), and 5) determining patients’ readiness to make a decision (+32%). Future research should explore how best to integrate SDM into the real world time restricted clinical practice. Conclusions: Educational training improved SDM skills for the multidisciplinary Yale Breast Cancer team, which can lead to improved clinician-patient decision-making and patient-centric care. The training process also facilitated team building and encouraged ongoing participation in SDM. Overall Yale Breast Cancer SDM Pilot Case Study Role-Play Assessments (Data reflect findings for 11 participants who completed their case role play) Citation Format: Elaine Rudell, Tarjani Agrawal, Patty Peterson, Michele Fallon Ingram, Brant Oliver, Kerin Adelson. Standard of Care for HR+/HER2- Breast Cancer: Integrating The “Yale Model Shared Decision-Making Multidisciplinary Team Solution” into the Practice Setting [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-15.

Supporting care home residents in the last year of life through 'Needs Rounds': Development of a pre-implementation programme theory through a rapid collaborative online approach.

Realist evaluation aims to address the knowledge to practice gap by explaining how an intervention is expected to work, as well as what is likely to impact upon the success of its implementation, by developing programme theories that link contexts, mechanisms and outcomes. Co-production approaches to the development of programme theories offer substantial benefits in addressing power relations, including and valuing different types of knowledge, and promoting buy-in from stakeholders while navigating the complex social systems in which innovations are embedded. This paper describes the co-production of an initial programme theory of how an evidence based intervention developed in Australia - called 'Palliative Care Needs Rounds' - might work in England and Scotland to support care home residents approaching their end of life. Using realist evaluation and iPARIHS (integrated Promoting Action on Research Implementation in Health Services) we sought to determine how contexts and mechanisms of change might shape implementation outcomes. Pre-intervention online interviews (n = 28) were conducted (February-April 2021), followed by four co-design online workshops with 43 participants (April-June 2021). The online interviews and workshops included a range of stakeholders, including care home staff, specialist palliative care staff, paramedics, general practitioners, and relatives of people living in care homes. This methodology paper reports developments in realist evaluation and co-production methodologies, and how they were used to develop context, mechanisms, outcomes (CMOs) configurations, and chains of inference. The initial (pre-intervention) programme theory is used to illustrate this process. Two developments to iPARIHS are described. First, involving stakeholders in the collaborative co-design workshops created opportunities to commence facilitation. Second, we describe developing iPARIHS' innovation component, to include novel stakeholder interpretations, perceptions and anticipated use of the intervention as they participated in workshop discussions. This rapid and robust co-production methodology draws on interactive collaborative research practices (interviews, workshop discussions of data, illustrative vignettes and visual methods). These innovative and engaging methods can be packaged for online processes to develop, describe and interrogate the CMOs in order to co-produce a programme theory. These approaches also commence facilitation and innovation, and can be adopted in other implementation science and realist studies.

An evaluation of a prescribed joint book reading intervention for preschool children with speech, language and communication needs

Purpose: The aims of the present study were twofold: first, to investigate reading and screen time habits in a large clinical sample of caregivers of children with speech, language and communication needs (SLCN) before and after an 8 week intervention focussed on daily joint book reading and, second, to capture the caregivers’ experiences of the activity. Method: Preschool aged children with SLCN and their caregivers were consecutively recruited during their first visit to the department of Speech and Language Pathology, Gävle County Hospital, Sweden. They participated in a survey-based interview before and after receiving an intervention with recommendations of at least 10 minutes of daily book reading with an interactional focus, as an add-on to ordinary speech-language pathology services. The results were analysed using descriptive statistics of the answers to the questions in the interview, as well as a thematic analysis of free-text comments. Result: The 135 families who participated in the pre-intervention interview survey reported variable reading frequency and screen time. The post-intervention interview survey was completed by 107 families. The results demonstrated significant increases in reading frequency and reading time, and a significant decrease in screen time per day. Caregivers also reported positive experiences of the daily interactive book reading. Conclusion: The results of this study demonstrate that a speech-language pathologist-(SLP) managed, caregiver-led book reading intervention is feasible and might have a positive impact on reading, other factors related to reading, and screen time in families of children with SLCN.

Could a culturally and age-appropriate song contribute towards malaria prevention in primary school learners?

BackgroundAlthough it is a preventable disease, malaria continues to present one of the major global health challenges. The disease is especially deadly to children under the age of 5 years. This is partly due to the fact that they have yet to build up an immune system to help protect them against malaria. As a prevention strategy, music is one way of communicating knowledge to young children and could therefore potentially be used to change children’s behaviour in order to avoid getting sick from malaria. This exploratory study aimed to compare intervention strategies designed to educate and improve knowledge growth about malaria and its prevention in Grade 3 learners in a high-risk malaria region in Vhembe District, Limpopo Province, South Africa.MethodsVarious intervention strategies were employed and evaluated to determine the most effective intervention method. The study was split into two Phases. Phase 1 used a culturally and age-appropriate song as an intervention, along with a drama piece, a song and drama piece combination, and a control group. The most effective intervention strategy determined during Phase 1 was then subjected to Phase 2, against a control group to validate its efficacy. Questionnaires were used during pre-intervention and post-intervention interviews to evaluate the knowledge growth, if any, of the learners of selected primary schools in two different areas in Vhembe District. Pre-intervention interviews were followed by a specific intervention, based on the respective study groups. After 6 weeks, the post-intervention interviews were done to determine how much learners managed to learn and retain from the intervention received.ResultsThe study found that the group that had only the song as intervention was the most effective learning intervention method in both Phases 1 and 2. Both phases showed that there was statistical significance in almost all of the nine questions asked on the questionnaires.ConclusionsThe study concluded that a culturally and age-appropriate song can play a significant role in developing behavioural changes and spreading awareness against disease in a high-risk malaria region.

Contemporary science practice in the classroom: a phenomenological exploration into how online curriculum resources can facilitate learning

ABSTRACT Using a phenomenological lens, we investigated how online curriculum resources can support secondary science teachers to explore contemporary science practices with their students. The research used a social constructivist theoretical and a hermeneutic phenomenology methodological framework to describe and interpret the teacher/participants’ experience. Seven participants teaching science to Year 7–10 students (12–15 years old) engaged in the research project, trialling selected contemporary science resources in their class. Pre and post intervention interviews were conducted with each participant along with classroom observations of one lesson to view aspects of the effectiveness of the resource, the teachers’ approach and their perceptions of student learning and engagement. Discussion focuses on how the online curriculum resources presented alternative views about science in practice to what students expect, providing an in-depth view of scientists and their research practices in varied settings. Affordances of this approach for bringing real science into the classroom and for improving student engagement and learning are considered. The findings point to the approach being potentially a productive, scalable way forward for introducing contemporary science practice into classrooms. We advocate further research investigating the potential of this type of online curriculum resource to connect students more powerfully with scientists and their practices.

Implementation of START (STrAtegies for RelaTives) for dementia carers in the third sector: Widening access to evidence-based interventions.

Family members remain the main care providers for the increasing numbers of people with dementia, and often become depressed or anxious. In an implementation research project, we aimed to widen access to Strategies for RelaTives (START), a clinically and cost-effective intervention for the mental health of family carers, by laying the foundations for its implementation in the third sector. We used the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to guide implementation of START, a manual-based, individually-delivered, multicomponent eight-session coping strategy intervention. We interviewed a maximum variation sample of twenty-seven stakeholders from the English Alzheimer’s Society (AS), about possible difficulties in management, training, and delivery of START. We trained and supervised three AS dementia support workers in different locations, to each deliver START to three family carers. Two researchers independently coded pre-intervention interviews for themes. We assessed intervention feasibility through monitoring delivery fidelity, rating audio-recordings from 1–5 (5 being high) and interviewing facilitators, family carers and AS managers about their experiences. We assessed effectiveness on family carers’ mental health using the Hospital Anxiety and Depression Scale (HADS) before and after receiving START (scores 0–42). We changed START’s format by reflecting carer diversity more and increasing carer stories prominence, but core content or delivery processes were unchanged. All carers received START and attended every session. The mean fidelity score was 4.2. Mean HADS-total score reduced from baseline 18.4 (standard deviation 7.4) to follow-up 15.8 (9.7). Six (67%) carers scored as clinically depressed on baseline HADS and 2 (22%) at follow-up. Facilitators and carers rated START positively. Appropriately experienced third sector workers can be trained and supervised to deliver START and it remains effective. This has the potential for widened access at scale.

Faculty Service-Learning Students as Home-Visitors: Outcomes of a Lifestyle Modification Program for Vulnerable Families With Residents in Rural Indonesian Communities.

Background: Risks attributed to chronic diseases, cancer, musculoskeletal discomfort, and infectious diseases among Indonesians were found to be associated with lifestyle behaviors, particularly in rural areas. The aim of this study was to examine the outcomes of a home-visiting lifestyle modification program on improving health risk behaviors among Indonesians living in rural areas.Methods: A total of 160 Indonesians living in rural hamlets in the Yogyakarta Region of Indonesia participated in the program in the period of June 21 to July 21, 2019. In the pre-intervention home interview, learning needs of diet, exercise, hand hygiene, and substance use were identified by using structured assessment tools. In the next home visit, the visitors provided health education and facilitated lifestyle planning based on the related affective and cognitive domains of learning. Subsequent follow-up interviews were conducted 3 weeks after intervention.Results: The results showed that the self-reported intake of vegetables, fruits, meat and salt, cooking with less oil, hand hygiene before eating, number of cigarettes smoked, and symptoms of muscle stiffness significantly improved after the intervention. The lifestyle modification program consisted of the affective and cognitive domains of learning, and could lead to the target behavioral changes in self-reported and observable measures over 1 month.Conclusions: The findings contributed to the framework of community-based health education for health risk reduction and behavioral modification in developing rural communities where health care resources were limited. Further studies with control groups and vigorous objective measures were recommended to elucidate its long-term impacts. The factors leading to its sustainability concerning collaborative care partnerships between community residents and faculty resources are worthy of continued exploration.

The effects of drama-based activities as a language learning tool on learners’ motivation in Non-Malay-medium national schools in Malaysia

Transitioning from Non-Malay-medium national primary schools to Malay-medium or English-medium secondary schools proved to be a struggle for many students due to the lack of emphasis on audio-lingual skills of the second language (L2) throughout their six-years of primary education. This study aims to explore the effects of drama-based activities as a language learning strategy on L2 learning motivation among students aged between 12 to 13 years old from Non-Malay-Medium National Schools. Six students were recruited through purposive sampling to participate in this qualitative experimental research. Over a period of 14 weeks, pre-intervention interviews (on the first week), intervention (over the span of 2 hours per week for 12 weeks), and post-intervention interviews (on the fourteenth week) were carried out. The content of the intervention was adapted from the Trinity College London’s Grade 4 Communication Skills syllabus. The instruments used for data collection include:(1) pre-determined pre-and post-intervention interview protocols and (2) classroom observation rubric. Two themes emerged in the analysis of this study: (a) language learning motivation and (b) affective filter. Findings revealed that participants were motivated and possessed self-confidence in the language learning process. The current study provides instructional implications for instructors and learners besides contributing to the novelty in the area of the research setting and sampling for future studies.

Impact of Positive Reinforcement on Pupils’ Absenteeism: A Case Study at Felicomfort Junior High School (JHS), Amamoma in Cape Coast, Ghana

Purpose: This study focused on finding out the impact of positive reinforcement on pupils’ absenteeism at Felicomfort JHS at Amamoma within the University of Cape Coast community.Methodology: The quasi-experimental and descriptive designs were used in conducting the study. Both quantitative and qualitative approaches were employed in carrying out the study to get to the bottom of the phenomenon investigated. The population was 56 comprising Junior High School (JHS) One and Two pupils of the school. The sample size for the study was 14 pupils purposively sampled out of the total number of 56. Pre-intervention test, post-intervention test, interviews and questionnaires were used to collect data from respondents. Data analysis was done, using paired sample t-test, frequency and percentage counts with the Predictive Analytical Software (PASW) version 21.Findings: The study revealed a statistically significant difference in the pre-intervention results (Mean = 2.643, Std. Dev. = 1.382) and that of the post intervention (Mean =4.786, Std. Dev. = 1.829) [t = 6.382, df = 13, p = 0.001]. The eta square analysis was 89 percent (η2 = 0.89) indicating a significant impact of positive reinforcement on modifying pupils’ behaviour of absenteeism. Analysis of the questionnaire revealed that 80% of the pupils became regular at school as a result of the application of positive reinforcement.Unique contribution to theory, practice and policy: It was recommended that the government through the District Assemblies should offer financial assistance to poor parents and single parents to enable them adequately cater for their children at school.

Acceptability of Routine Point-of-Care Early Infant Diagnosis in Eight African Countries: Findings From a Qualitative Assessment of Clinical and Laboratory Personnel.

The Elizabeth Glaser Pediatric AIDS Foundation introduced point-of-care (POC) testing for early infant diagnosis (EID) of HIV in 8 African countries. Understanding experiences and opinions of users can help facilitate introduction and sustainability. Cameroon, Côte d'Ivoire, Eswatini, Kenya, Lesotho, Mozambique, Rwanda, and Zimbabwe. Structured interviews with health care workers (HCWs) providing EID services and semistructured interviews with national and regional laboratory managers or EID program managers were conducted before and after the implementation of POC EID. Survey responses were analyzed and compared; open-ended responses were analyzed by theme. In total, 234 and 175 interviews with HCWs and 28 and 14 interviews with laboratory or program managers were conducted before and after the introduction of POC EID, respectively. In preintervention interviews, challenges identified with laboratory-based EID testing included distance from patients' residence to the health facility, time-consuming sample transportation to central laboratories, stockout of testing kits, and long wait times for results. Postintervention data revealed that HCWs found POC EID easy to use and were very satisfied with the fast turnaround time and ability to initiate treatment for HIV-infected infants sooner. Laboratory managers were also supportive of scaling-up POC testing although cautious of the need for reliable infrastructure to operate platforms. The recommendation was that POC EID be integrated within the national diagnostic testing network. Support for POC EID from key stakeholders is essential for sustainability. Overall, participants supported the rollout of POC testing for EID, noting challenges and opportunities for scaling-up POC EID and recommending integration into the overall EID system.

Incorporating hypnotic suggestion into teacher education programs: Emotional and cognitive implications for teachers

This study is a report on the emotional and cognitive impact of hypnotic suggestion on EFL teachers’ practices. Twenty-five EFL teachers participated in two hypnotic suggestion sessions plus a self suggestion training class to enhance their emotional and cognitive experiences. To understand teachers’ emotional state, pre-intervention interviews were used, and post-intervention interviews were employed to assess the effects of the hypnotic suggestion intervention. Through content analysis, we found that the emotional experience of novice and expert teachers differed significantly. Furthermore, the effect of hypnotic suggestion on teachers’ emotions, cognition, and practice was significant and conducive to change in their perspectives toward hypnotic suggestion programs. Thorough theoretical and practical implications are discussed.

Lessons Learned From Implementing of Garden Education Program in Early Child Care.

Background. Early childhood is a critical life period for promoting health behaviors, and early child care and education centers (ECECs) are critical settings, as 60% of U.S. children attend ECECs. Yet few programs or curricula that promote physical activity and nutrition in this setting exist. This study explored the acceptability, feasibility, and sustainability of the Sustainability via Active Garden Education (SAGE) program. Method. Preintervention interviews were conducted to inform the design of SAGE and postintervention interviews were conducted to evaluate the implementation of SAGE in the ECEC setting. A constant comparison approach was used to capture emergent themes on acceptability, feasibility, and sustainability from interviews. Participants. ECEC directors (N = 10, 90% female, 20% Hispanic, 30% African American). Results. Directors expressed that SAGE was acceptable and feasible as it was age-appropriate, engaging, and aligned with existing curricula and accreditation standards. Most directors reported that SAGE improved activity and nutrition related knowledge while building other social and academic skills (e.g., expanding vocabulary) that are critical to this important developmental period. Suggestions for improving the sustainability of the program included stronger parental involvement and opportunities for ECEC staff trainings.

Factors Influencing the Implementation of a Hospital-wide Intervention to Promote Professionalism and Build a Safety Culture: A Qualitative Study

There is widespread recognition that creating a safety culture supports high-quality health care. However, the complex factors affecting cultural change interventions are not well understood. This study examines factors influencing the implementation of an intervention to promote professionalism and build a safety culture at an Australian hospital. The study was completed midway into the three-year intervention and involved collecting qualitative data from two sources. First, face-to-face interviews were conducted pre- and mid-intervention with a purposely selected sample. Second, a survey with three open-ended questions was completed one year into the intervention by clinical and patient support staff. Data from interviews and survey questions were analyzed using a combination of inductive and deductive approaches. A total of 25 participants completed preintervention interviews, and 24 took part mid-intervention. Of the 2,047 staff who completed the survey (61% response rate), 59.1% of respondents answered at least one open-ended question. Multiple interrelated factors were identified as enhancing intervention implementation. These include sustaining a favorable implementation climate, leaders consistently demonstrating behaviors that support a safety culture, increasing compatibility of working conditions with intervention aims, building confidence in systems to address unprofessional behaviors, and responding to evolving needs. Strengthening safety culture remains an enduring challenge, but this study yields valuable insights into factors influencing implementation of a multifaceted behavior change intervention. The findings provide a basis for practical strategies that health care leaders seeking cultural improvements can employ to enhance the delivery of similar interventions and address potential impediments to success.

Exploring the Use of Drama-Based Activities as a Learning Tool in English Oral Proficiency Development among Students from Non-Malay-Medium Nation Schools: A Preliminary Study

Transitioning from Non-Malay-medium national schools to Malay-medium or English-medium secondary schools proved to be a struggle for many students due to the negligence in developing audio-lingual skills of the second language (L2) throughout the six-years of primary education. This study aims to explore the effectiveness of drama-based activities as a language learning strategy on L2 oral proficiency among the students aged between 12 to 13 years old from Non-Malay-Medium National School. Over a period of five weeks, pre-intervention interviews (on the first week), intervention (over the span of three weeks with two hours per week), and post-intervention interviews (on the fifth week) were carried out. The content of the intervention was adapted from Trinity College London's Grade 4 Communication Skills syllabus. The instruments used for data collection included: (1) pre-determined pre- and post-intervention speaking assessments, (2) classroom observation speaking assessments and (3) oral proficiency assessment rubric adapted from Cambridge English speaking assessment of Common European Framework of Reference Level B1 and a published drama assessment tool focusing on elements such as Grammar and Vocabulary, Pronunciation, Discourse Management, and Task Completion. The results of the post-intervention oral proficiency assessment showed that the there was an overall improvement especially in discourse management and task completion.