Pre-post Survey Research Articles

Improving screening, brief intervention and referral to treatment for unhealthy alcohol use in diverse, low-resourced primary care clinics.

Implementation of screening brief intervention and referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) remains low in primary care. ANTECEDENT (Partnerships to Enhance Alcohol Screening, Treatment, and Intervention) was a practice-facilitator led implementation study to increase SBIRT and MAUD use in diverse primary care clinics. From November 2019 - April 2023, we conducted a convergent parallel mixed methods evaluation. Participants were small and medium-sized primary care clinics in the Northwestern U.S. Clinics received foundational support (i.e., baseline/exit assessment, access to SBIRT Oregon website) and the option for supplemental implementation support (e.g., practice facilitation, expert consultation) over the 15-month intervention to improve SBIRT and MAUD. Qualitative and quantitative data regarding clinic characteristics, implementation strategies, and SBIRT/MAUD outcomes were collected through practice facilitator interviews, periodic reflections and clinic contact logs, interviews, pre-post surveys, and electronic health record (EHR) queries. Quantitative analyses included descriptive statistics, logistic regression, and the Wilcoxon sign-ranked test. Qualitative analysis took an immersion crystallization approach. Data were reviewed in a matrix to evaluate intervention adoption, implementation, and effectiveness. We recruited 75 unique clinics; 66 participated and 48 (73%) completed the study. Eight participating clinics chose to receive foundational support only (12%) while 58 chose to engage in supplemental support (88%) activities. Clinics that received supplemental support and completed the intervention (n = 42) engaged in practice facilitation (Mean: 293min, range: 75-550min); data review (38%), HIT support (31%), expert consultation (19%), and peer-to-peer learning (5%). Pre- and post-intervention assessments showed significant improvement in self-reported SBIRT process outcomes. Performance data improved among the subset of completing clinics able to produce data (n = 17). Clinics described positive experiences with ANTECEDENT support and highlighted remaining barriers to SBIRT and MAUD implementation. Participating clinics engaged in a diverse range of supportive activities. A flexible approach using practice facilitation and implementation support could be helpful for low-resourced primary care clinics in improving SBIRT and MAUD for unhealthy alcohol use.

Manual Uterine Aspiration Simulation for Emergency Medicine Learners.

Manual uterine aspiration is a potentially lifesaving procedure for treating patients with hemorrhagic complications of early pregnancy loss. While early pregnancy loss is a common diagnosis seen in the emergency department, manual uterine aspiration education is lacking for emergency medicine physicians. We designed a 90-minute procedural skills training session for 30 emergency medicine learners. The session included a brief lecture and video demonstration, followed by two micro-skills stations before finally completing the simulated procedure in its entirety. At each station, learners were asked to verbalize the steps and landmarks for the procedure before performing them on models. Participants completed a combined pre-post survey evaluating their perceived knowledge of the procedure and self-efficacy in performing the procedure. Thirty learners who participated in the workshop were surveyed, with a 100% response rate. All participants reported increased comfort with the procedure and knowledge about the procedure. All participants completed a successful simulated procedure. Participants also indicated increased interest in learning more about manual uterine aspiration and its potential application within the emergency medicine physician's scope of practice. We developed a workshop to train emergency medicine learners in manual uterine aspiration to stop life-threatening hemorrhage in the setting of early pregnancy loss. The workshop was well received by learners and increased their self-efficacy and desire for additional training with this procedure. Similar curricula should be tried at other institutions.

The Health Equity Scholars Program: Fostering Culturally Competent and Successful Independent Investigators in Alzheimer's Disease and Related Dementia Research.

The Health Equity Scholars Program (HESP) addresses the critical need for a diverse, culturally competent workforce to study and treat older adults from underrepresented populations (URPs) with Alzheimer's disease and related dementias (AD/ADRD). The HESP offers tailored mentored training in AD/ADRD research concepts, aiming to develop successful independent researchers. It recruits Scholars from underrepresented backgrounds as well as those passionate about AD/ADRD health equity research. We (1) describe the fundamental elements of the HESP, and (2) present preliminary data from the HESP program evaluation results performed by an outside agency, pre-post participation surveys, and Scholar accomplishments. The HESP Scholars reported high rates of proficiency, satisfaction, and competency in nearly all evaluated areas, and have been successful in obtaining grants, promotions, and publications. These initial outcomes data suggest that the HESP is meeting its objective of diversifying the workforce in the field of AD/ADRD research and care. The Health Equity Scholars Program aims to cultivate a diverse and culturally competent workforce, who are well-prepared to study and treat underrepresented older adults with Alzheimer's disease and related dementias (AD/ADRD). The program provides tailored mentored training in AD/ADRD research concepts, with the goal of nurturing successful independent researchers. Rigorous evaluation processes for applications ensure the selection of highly qualified Scholars. The program includes tailored training activities such as seminars and grant writing workshops, and tracks Scholar achievements while undergoing annual external evaluation to enhance its training program iteratively.

Mitigating the Stigma of Mental Illness: The Impact of Story-Telling in the Black Community

Racial/ethnic minorities, including the Black community, experience stigma as a significant barrier to mental health care, with fears of being devalued or discriminated against deterring individuals from seeking help. Racial stigma further exacerbates mental health issues and negatively influences perceptions of service utilization. To address this, our research team partnered with a national non-profit storytelling organization to develop and evaluate a virtual narrative storytelling intervention series that amplifies the voices and experiences of Black Americans living with mental illness and addiction. We randomly assigned 193 participants to either the intervention (n = 102) or an active control condition (n = 91) and used a pre–post survey design to assess the changes in the outcome variables. Contrary to our hypothesis, there were no race-based interactions; instead, the results show significant reductions in public stigma and perceived discrimination and increased positive attitudes toward seeking treatment universally among all the intervention participants. This study provided preliminary evidence that a virtual storytelling intervention is instrumental across varied demographic cohorts, transcending potential cultural barriers in the discourse and understanding of mental health to effectively mitigate stigma and improve attitudes toward mental health treatment.

Evaluation of the Friday Night Live Mentoring Program on Supporting Positive Youth Development Outcomes.

The use of alcohol, tobacco, and other drugs (ATOD) is a leading cause of preventable morbidity and mortality among adolescents. While traditional interventions have targeted specific health-risk behaviors (e.g., substance use, initiation of sexual intercourse, truancy, etc.), the evidence suggests that using a positive youth development (PYD) framework may have positive impacts across a number of domains. Friday Night Live Mentoring (FNLM) is a PYD-based, cross-age peer mentoring program that engages teams of older high school-aged youth to mentor teams of middle school-aged youth in a structured, ongoing, one-on-one relationship. While studies have demonstrated significant but small effect sizes of intergenerational youth mentoring programs in which an adult mentor is paired with the youth mentee, research on cross-age mentoring programs is limited. The purpose of the current study is to evaluate FNLM on its ability to improve participants' knowledge, attitudes, skills, opportunities to develop caring relationships, school engagement, and academic performance. A retrospective, pre-post survey was administered online to FNLM participants across 13 California counties. Participants rated their knowledge and attitudes about ATOD, skills, relationships with peers and adults, and academic indicators. Open-ended questions gathered information about participants' experiences in FNLM. Non-parametric related-samples Wilcoxon signed rank tests (an alternative to paired t-test) were used to compare pre-post differences. Participants were also asked two open-ended questions: "What are the best parts of FNLM?" and "What, if anything, would you change?". The responses to each question were reviewed, coded, and analyzed according to key themes. A total of 512 participants completed the survey (287 mentors and 225 protégés). There were small but statistically significant improvements across all items for both mentors and protégés. Qualitative analyses showed that most mentors and protégés especially enjoyed getting to know and spend time with one another. Several mentors added that it was rewarding to be a positive influence on or to make a positive difference in the protégé's life. Many youth stated that the relationships formed, especially with their partner, and the activities were the best part of FNLM. The overwhelming majority would not change anything about the program. Those who provided recommendations for program improvement suggested more activities or more hands-on and engaging activities and more or longer meetings. FNLM actively engages youth and provides them with support and opportunities that promote knowledge, skill development, positive relationships, academic engagement, and success and raise awareness of the harms that the use of alcohol, tobacco, and other drugs (ATOD) can cause. While ATOD use was low prior to program participation, it was significantly lower after participating in the program.

Influences on improved confidence among allied health students in working with Australian Indigenous people during a rural placement: a pre-post survey study

BackgroundTogether with addressing social determinants of health, culturally safe healthcare provision is essential for closing the health outcomes gap experienced by Aboriginal and Torres Strait Islander (Indigenous) Australians. Rural placements potentially provide students of the health professions with opportunities to enhance their knowledge and skills regarding cultural safety. We used rural placements data systematically collected from allied health students, including commencement- and end-of-placement questionnaire responses, to investigate the determinants of confidence in working with Indigenous people.MethodsThe study comprised data from all students who provided survey data at both commencement and end of their first placement directly supervised by the administering University Department of Rural Health during the period 2019–2022. Five-point ordered responses to the question ‘How confident do you feel about working with Aboriginal people?’ were used to assess student and placement-related determinants of confidence (Confident/Very confident versus other) at baseline and increased confidence (≥ 1 point) during the placement using crude and adjusted multivariable robust Poisson regression.ResultsParticipating students (N = 489) were from diverse allied health disciplines (including pharmacy n = 94, 19.2%; chiropractic n= 66, 13.5%; physiotherapy n= 65, 13.3%; social work n = 59, 12.1%; and occupational therapy 58, 11.9%). Confidence in dealing with Aboriginal people was lower at commencement among females compared with males (adjusted relative risk [aRR] 0.65; 95% confidence interval [CI] 0.53–0.80), and higher among students of Australian rural origin compared with others (aRR 1.49; CI 1.22–1.83) and those who reported previous experience working with Indigenous people compared with those reporting none (aRR 1.40; CI 1.14–1.72). Placement attributes associated with increased confidence working with Indigenous people between placement commencement and end were interaction with Indigenous people within the placement (aRR 2.32; CI 1.24–4.34), placement model reflecting more structured academic supervision (aRR 1.18; CI 1.02–1.37), and placement length (aRR per additional day 1.002; CI 1.001–1.004). These associations were robust to modelling that accounted for a ceiling effect on increased confidence.ConclusionsWhile influenced by students’ demographic attributes and prior experiences, confidence of allied health students in working with Indigenous people is enhanced during rural placements, particularly through direct contact with Indigenous people.

Effects of a Simulation-Based Care After-Death Mentoring Program for New Nurses: Augmented Reality End-of-Life Experience.

Background: Nurses who provide person-centered care even after death must possess essential competencies to perform their duties effectively. Therefore, it is imperative to develop educational programs to enhance the capabilities of new nurses in care after death. Objective: To develop a care after-death mentoring program that includes an augmented reality (AR) end-of-life experience for new nurses and to describe its effectiveness. Design: A quasi-experimental pre- to post-test design was followed to evaluate program outcomes. Setting/Participants: The participants (n = 18) were nurses with <12 months of experience working at a tertiary general hospital in South Korea. Measurements: A pre-post survey was conducted on comfort in bereavement/end-of-life care, death anxiety, and compassion competency. Data were analyzed using the SPSS program, employing descriptive statistics and paired sample t-tests. Results: Significant improvements were observed in both comfort during bereavement/end-of-life careand compassion competency (t = -8.43, p < 0.001; t = -4.90, p < 0.001). Conclusions: This study demonstrated enhancements in participants' comfort levels regarding bereavement and end-of-life care, as well as their ability to exhibit compassion after participating in the program. Consequently, it was confirmed that simulation-based care after-death mentoring education utilizing an AR app helped enhance the capabilities of new nurses.

Development and evaluation of an online education module to improve clinician knowledge and management of eating disorders in the peripartum: a pre-post survey study

ObjectiveEating disorders (EDs) comprise a range of illnesses characterised by disordered eating, distressing thoughts, and changes in weight. EDs in the perinatal period are a growing concern. Maternity staff receive little training in this area and often report feeling ill-equipped to recognise or respond to presentations of ED during this time. The study aimed to develop and evaluate an online educational module for clinicians and support workers to improve knowledge of EDs in the perinatal period.MethodEducation modules were developed using a co-design process with consumer advocates, peer support workers, clinicians, and experts. Consumer perspectives, evidence-based videos, activities, and text relating to screening, management, monitoring and referral of perinatal individuals with EDs were included in the module. Quantitative and qualitative data from pre- and post- surveys were used to evaluate changes in knowledge and confidence before and after completing the module, and to assess staff satisfaction, usability, and obtain feedback for improvement.ResultsUse of the online education module significantly increased staff knowledge of EDs in the perinatal period. Participants also felt more confident in discussing the topic with patients, screening, supporting, and referring a person with ED in the perinatal period. Participants also reported the module was engaging and easy-to-use.ConclusionsFindings indicate that the ED online education module is an engaging and easy-to-use tool for improving the knowledge and skills of the healthcare workforce, thereby improving patient care and health outcomes. The development of additional online resources for clinicians would be beneficial for increasing staff capability and improving patient services.

Restorative and regenerative green spaces for vulnerable communities in social housing: The impact of a community greening program

Vulnerable communities represent the most at-risk populations facing inequities and negative health, economic and social wellbeing outcomes. Community gardening has emerged globally as a community-based remedy to reduce these inequities and enhance wellbeing. This paper examines the psychological, socio-cultural and health impact of social housing design that includes access to, and engagement with green spaces. The project was multi-disciplinary and used mixed-method research to examine the impact of community gardening for people in social housing. Two interrelated studies were conducted; study 1 involved 33 social housing gardeners in a pre-post program survey. Statistically significant improvements were found in participants' satisfaction with personal wellbeing, health, and community connectedness; as well as increased gardening skills, positive social experiences, and time spent in nature. Study 2 involved 34 semi-structured interviews conducted with program facilitators and partner organisation staff. Results uncovered that participant's engagement with gardening was restorative and regenerative. Four salient themes emerged from our mixed methods study: 1) connection to self; 2) connection to others, 3) connection to place; and 4) connection to purpose. The findings showcase some of the key principles of a successful social and nature prescription intervention for vulnerable people. Community gardening was shown to amplify civic pride and bolster community resilience. Our research suggests the broad impact of community gardening on participant outcomes for vulnerable populations and enhances the capacity of practitioners to translate research into policy and practice for sustainable, restorative residential communities.

Examining the impact of an online educational video on the contraceptive knowledge, awareness and choices of young women living in rural and remote Australia

ObjectiveTo assess whether an online educational video, tailored to young women living in rural and remote areas, increases their contraceptive knowledge, preference for and uptake of long-acting reversible contraception (LARC). Study DesignA single group pre-post survey design, in which participants completed the pre-video survey (S1), watched the 13-min video, then completed a survey immediately after (S2) and 6 months later (S3). Outcomes were analysed using McNemar tests and multivariate logistic regression. ResultsA total of 153 participants watched the video and completed S1 and S2; 56 % of these completed S3. Prevideo (S1) 33 % of participants were unaware of LARC methods. Only 3 % rated their knowledge about every method as high. Knowledge improved immediately post video (S2) for all methods (aOR 12.5, 95 % CI 5.2 to 29.8) and LARC methods (aOR 7.9, 95 % CI 4.3 to 11.8). Overall method preference for LARC increased from 23.5 % (n = 36) at S1 to 48 % (n = 74) at S2. Likelihood of using a LARC increased at S2 (aOR 2.1, 95 % CI 1.5 to 2.9). The overall proportion of participants using a LARC increased from 18 % at S1 to 21 % at S3, however, this increase was not significant (p = 0.3). ConclusionOur findings underscore the effectiveness of tailored online educational videos in enhancing contraceptive knowledge and preference for LARCs amongst young women living in rural and remote areas. However preference did not translate into uptake, suggesting that structural and other barriers may be prominent. ImplicationsThis study emphasises the need for a multifaceted approach to facilitating young womens’ access to effective methods of contraception, including LARC. Efforts to promote knowledge should be coordinated with place-based initiatives and policies that directly address the structural barriers to accessing critical sexual and reproductive health services unique to women in rural and remote areas.

Demographic isolation and attitudes toward group work in student-selected lab groups.

Small group work has been shown to improve students' achievement, learning, engagement, and attitudes toward science. Previous studies that focused on different methods of group formation and their possible impacts mainly focused on measures of students' academic ability, such as GPA, SAT scores, and previous familiarity with course content. However little attention has been given to other characteristics such as students' social demographic identities in research about group formation and students' experiences. Here, we studied the criteria students use to form lab groups, examined how the degree of demographic isolation varies between student-selected and randomly-formed groups, and tested whether demographic isolation is associated with group work attitudes. We used a pre-post survey research design to examine students' responses in a large-enrollment biology laboratory course. Descriptive analyses showed that "students sitting next to me" (57%) followed by the combination of "students sitting next to me" and "friends" (22%) were the two most common criteria students reported that they considered when forming research groups. Notably, over 80 percent of students reported forming groups with those who sat nearby. We studied instances where students were isolated by being the only members of a historically marginalized population in their lab groups. The prevalence of demographic isolation in student-selected groups was found to be lower than in the simulated randomly assigned groups. We also used multilevel linear regression to examine whether being an isolated student was associated with attitudes about group work, yielding no consistent statistically significant effects. This study contributes to growing knowledge about the relationship between students' demographic isolation in groups and group work attitudes.

Impact of a collaborative model on community clinician confidence in child and adolescent mental health care, wellbeing, and access to child psychiatry expertise.

The COVID-19 pandemic was associated with an increase in child and adolescent mental health disorders, with subsequent worsening of patient access to specialist mental health care. Clinicians working in the community were faced with increased demands to diagnose and manage pediatric mental health disorders, without always having the confidence and knowledge to do so. We therefore developed COnnecting Mental-health PAediatric Specialists and community Services (COMPASS)-a collaborative model designed to upskill community clinicians in child and adolescent mental health care and provide them with better access to child and adolescent psychiatry expertise. COMPASS comprises (1) an online Community of Practice (CoP) with fortnightly one-hour sessions covering: anxiety; aggression and challenging behaviours; depression; self-harm and suicidality; eating disorders; and autism spectrum disorder/complex cases and (2) primary and secondary consultations for general practitioners and paediatricians with an experienced child psychiatrist. We aimed to assess the impact of COMPASS on community clinician self-reported confidence in: managing common child and adolescent mental health disorders (Objective 1, primary outcome); navigating the mental health care system (i.e. knowing how services are organised, accessed, and how to refer patients, Objective 2); diagnosing conditions (Objective 3); prescribing psychotropic medications (Objective 4) as well as the impact on, clinician practice and wellbeing (Objective 5) and outcomes of patients referred by COMPASS clinicians to the child psychiatrist (Objective 6). We evaluated COMPASS in its first year, with COMPASS running from March to July 2021. Participating clinicians completed pre-post surveys evaluating change in Objectives 1 to 4 above, using study-designed measures. A purposive sample of clinicians was then invited to a semi-structured interview to understand their experience of COMPASS and its impacts on practice and wellbeing (Objective 5). We adopted an inductive approach to the qualitative analysis using the Framework Method. This involved selecting five random transcripts which were double coded and categorized, to generate an initial framework against which all subsequent transcripts were analysed. Themes and subthemes were generated from the data set, by reviewing the matrix and making connections within and between clinicians, codes and categories One child psychiatrist completed a 2-week logbook of the nature and outcomes of primary and secondary consultations (Objective 6). 51 (86%) clinicians attended CoP sessions and completed pre-post surveys, with 92% recommending COMPASS to peers. Clinicians reported increased confidence in the pharmacological and non-pharmacological management of all conditions, most notably for management of self-harm. They also reported increased knowledge of how to navigate the mental health system and prescribe medications. Qualitative analysis (n = 27 interviews) found that COMPASS increased clinician wellbeing and reduced feelings of professional isolation and burnout. Over the 2-week snapshot, the child psychiatrist consulted on 22 patients and referred all back to the community clinician. COMPASS is associated with improved clinician confidence to manage child and adolescent mental health concerns, navigate the mental health system, improved clinician wellbeing, and reduced need for ongoing mental health care by specialists.

“Being a Parent in Finland” - psycho-educative intervention: development and acceptability of a group programme aimed at increasing trust among migrant parents

ABSTRACT The existing literature highlights distrust among migrant parents in Nordic countries towards child welfare and other services. However, interventions to enhance parental trust are few in number, and descriptions of their development and feasibility testing in a Nordic context are lacking. This paper describes the development of ‘Being a Parent in Finland’, a psycho-educative group intervention designed for migrant parents to foster institutional trust. The intervention’s content and structure are outlined using the Six Steps for Quality Intervention Development framework (6SQuID). Additionally, the paper presents findings from a small-scale pilot study involving thematic interviews with 16 parents and a pre-post survey with 14 parents to assess programme acceptability. The pilot study indicated high acceptability and perceived benefits among parents, although no changes in institutional trust emerged in the quantitative survey. Implications for future development, practice, and research are discussed.

Impact of an Education Module on the Knowledge and Attitudes of EM Physicians Towards Prescribing Buprenorphine/Naloxone for Opioid Use Disorder.

Opioid overdose continues to be a major cause of morbidity and mortality. Buprenorphine is an important treatment for patients with opioid-use disorder (OUD) and initiation in the emergency department (ED) has been shown to improve outcomes for these patients. Our objective was to assess the impact of a three-pronged education package on the knowledge and attitudes of emergency physicians towards using buprenorphine for treatment of OUD. Procedures/data/observations: We developed a three-pronged educational package including back- ground rationale for OUD treatment with buprenorphine, an evidence-based ED buprenorphine induction pathway and electronic medical record tools. This package was deployed to providers in an urban academic ED. A voluntary confidential pre-post survey was administered. Using a 6-point Likert Scale, participants were asked about their understanding, experience, and confidence with prescribing. A one-hour, three-pronged educational package changed the attitudes of emergency physicians towards buprenorphine treatment and demonstrated an increase in willingness and confidence to prescribe it for patients with OUD. Our findings suggest that healthcare entities that wish to boost buprenorphine prescribing can impact willingness and confidence to prescribe with a short education package.

Power to the People? How Participatory Budgets Affect Citizens’ Populist Attitudes

So-called populist citizens feel excluded from political decision-making, which in their eyes is dominated by an unresponsive political elite. While democratic innovation scholars suggest that empowering citizens in the decision-making process can affect populist sentiments, this article addresses the lack of theorization and empirical research on the mechanisms behind such effects as well as the scarcity of qualitative research regarding populist attitudes. It generates a theory that accounts for changes in participants’ populist attitudes and tests this theory in a most-likely case study. An analysis of pre–post survey data and 35 semi-structured interviews from three participatory budgeting events in the Netherlands shows that for populist citizens, the inclusion of politically marginalised groups and the empowerment of citizens can explain populist attitudes change. On the contrary, the representativeness of the participants and the ability to have deeper discussions are drivers of populist attitudes change for non-populist citizens.

Applying cognitive walkthrough methodology to improve the usability of an equity-focused implementation strategy

BackgroundOur research team partnered with primary care and quality improvement staff in Federally Qualified Community Health Centers (CHCs) to develop Partnered and Equity Data-Driven Implementation (PEDDI) to promote equitable implementation of evidence-based interventions. The current study used a human-centered design methodology to evaluate the usability of PEDDI and generate redesign solutions to address usability issues in the context of a cancer screening intervention.MethodsWe applied the Cognitive Walkthrough for Implementation Strategies (CWIS), a pragmatic assessment method with steps that include group testing with end users to identify and prioritize usability problems. We conducted three facilitated 60-min CWIS sessions with end users (N = 7) from four CHCs that included scenarios and related tasks for implementing a colorectal cancer (CRC) screening intervention. Participants rated the likelihood of completing each task and identified usability issues and generated ideas for redesign solutions during audio-recorded CWIS sessions. Participants completed a pre-post survey of PEDDI usability. Our research team used consensus coding to synthesize usability problems and redesign solutions from transcribed CWIS sessions.ResultsUsability ratings (scale 0–100: higher scores indicating higher usability) of PEDDI averaged 66.3 (SD = 12.4) prior to the CWIS sessions. Scores averaged 77.8 (SD = 9.1) following the three CWIS sessions improving usability ratings from “marginal acceptability” to “acceptable”. Ten usability problems were identified across four PEDDI tasks, comprised of 2–3 types of usability problems per task. CWIS participants suggested redesign solutions that included making data fields for social determinants of health and key background variables for identifying health equity targets mandatory in the electronic health record and using asynchronous communication tools to elicit ideas from staff for adaptations.ConclusionsUsability ratings indicated PEDDI was in the acceptable range following CWIS sessions. Staff identified usability problems and redesign solutions that provide direction for future improvements in PEDDI. In addition, this study highlights opportunities to use the CWIS methodology to address inequities in the implementation of cancer screening and other clinical innovations in resource-constrained healthcare settings.

Empowering pharmacy technicians as vaccine champions: A pilot study in independent community pharmacies

BackgroundIncreasing vaccine uptake in communities has been essential, even before coronavirus disease 2019. The use of "vaccine champions" or "VaxChamps" has shown promise. VaxChamps, who are often community members with specialized training but no special credentials, advocate for vaccination by sharing their experiences and knowledge. Pharmacy technicians’ scope of practice, coupled with their frequent interactions with pharmacy patients, make them ideal vaccine champions and a natural fit for the VaxChamp program. This study assessed the implementation and impact of the VaxChamp program in North Dakota community pharmacies. ObjectivesTo describe the development and implementation of the VaxChamp program in community pharmacies and evaluate its effect on vaccination rates and vaccine-related tasks within each pharmacy’s organizational context. MethodsThe VaxChamp program involved training one technician per participating pharmacy to spend 5 hours per week on vaccine-related tasks. Data collection included pre-post surveys, monthly reports, and semi-structured interviews with VaxChamps and pharmacists-in-charge from 6 pharmacies. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed using inductive methods to identify key themes. ResultsThe 6 participating pharmacies varied in location and staffing. Most had prior vaccine administration experience. VaxChamps’ roles ranged from administrative tasks to direct vaccine administration, depending on the pharmacy’s staffing and workflow. Vaccination rates for pneumococcal and hepatitis B vaccines increased in several pharmacies, while shingles vaccination rates declined. The presence of advanced pharmacy practice experience students often influenced VaxChamps’ responsibilities, underscoring the need for clear role delineation. ConclusionIntegrating pharmacy technicians as VaxChamps in community pharmacies is a promising strategy to increase vaccination rates and enhance public health. Future research should explore ways to better integrate technicians into comprehensive immunization strategies and address the contextual factors that influence program implementation.

Pre-Post Survey Analysis on Pharmacy Students' Perceptions of Pharmacist Roles in the Pharmaceutical Industry

The pharmaceutical industry is undergoing rapid evolution, characterized by a complex regulatory landscape and the need for diverse skill sets. This study aimed to assess pharmacy students’ perceptions of the pharmaceutical industry and the impact of a dedicated seminar on their career aspirations and knowledge. A pre-post online survey was administered to 55 undergraduate pharmacy students at the National Pharmacy Seminar 2024, hosted by Jakarta Global University. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test (p ≤0.05). Results indicate a strong preference for careers in state-owned pharmaceutical companies (63.6%) and research and development departments (34%). The seminar significantly enhanced participants’ understanding of pharmacists’ roles, industry complexities, drug development challenges, and regulatory requirements. Notably, 93% of participants reported that the seminar met their expectations and provided valuable insights for future career exploration. These findings underscore the importance of educational interventions in shaping pharmacy students’ career trajectories and aligning their knowledge with the dynamic pharmaceutical industry.

Developing and testing a community based, online vs. face-to-face peer led intervention to improve mental well-being in Cambodian adults with physical disabilities.

Despite growing international attention, there remains an urgent need to develop mental health services within low and middle income countries. The Khmer Rouge period in Cambodia saw the destruction of all health services infrastructure in the 1970s. Consequently, Cambodia has struggled to rebuild both its economy and healthcare system, with the number of qualified mental health clinicians remaining disproportionately low. Resultantly, there is a pressing need to develop low-cost community based alternatives of mental healthcare. Using a mixed methods design, researchers developed an 8-week peer-led intervention, known as a Friendship Group, for adults with physical disabilities using both face-to-face and online delivery methods. The Wilcoxon Signed-Rank test was used to assess changes in pre-post survey scores and qualitative data was collected in form of five focus groups post intervention. 41 participants were allocated across four Friendship groups - two were online and two face-to-face. Attrition rate was 22% post-intervention (n = 32). ITT analyses showed a statistically significant decrease in psychological distress scores [Z = -3.808, p < .001] from pre [Mdn = 20, IQR = 16.5-25.5] to post [Mdn = 16, IQR = 14-18.5] intervention. A Wilcoxon signed-ranks test also showed a statistically significant decrease in PTSD scores [Z = -2.239, p < .025] from pre [Mdn = 4, IQR = 3-5] to post [Mdn = 3, IQR = 2.75-4] intervention. There was also a statistically significant decrease in worry scores [Z = -3.904, p < .001] from pre [Mdn = 5, IQR = 3.5-6.5] to post [Mdn = 3, IQR = 3-4] intervention. There were no significant group differences between the face to face and online groups. A number of interconnected themes emerged from focus group data (n = 5), these included the mental health benefits of Friendship Groups as conceptualised through knowledge acquisition, skill development and peer support. The Friendship group intervention delivered in both online and face-to-face formats appears feasible and acceptable within the Cambodian context. Initial data revealed positive findings in terms of reduction in psychological distress, worry and PTSD symptoms as well increased feeling as calm.

Telementoring to Strengthen Child and Youth Mental Health Care Capacity in Primary Care Providers: Session Duration and Learning Outcomes.

Primary care providers (PCPs) report insufficient capacity for child and youth mental health care (CYMH). The telementoring program Project ECHO (Extension for Community Healthcare Outcomes) can build capacity, but 75- to 120-minute sessions are a participation barrier. Using a Lean health care paradigm, we designed a 60-minute session, and compared self-reported CYMH capacity strengthening (10 constructs) and satisfaction between 60- and 90-minute sessions. Pre-post (n = 139) and post-cycle (n = 146) survey data were analyzed using generalized linear mixed-effects logistic regression. Capacity strengthening was demonstrated when analyzing both groups together (all Ps ≤ .002). Session duration did not affect capacity strengthening for 9/10 constructs (all Ps > .05), but medication management development was higher with 90-minute sessions (P = .002). Satisfaction was high in both groups. The 60-minute ECHO CYMH sessions can be used without negative learning outcomes, but more mentoring may be needed to build capacity for psychopharmacologic treatment.