Pre-post Survey Research Articles

Development and Beta-Testing of the CONFIDENCE Intervention to Increase Pediatric COVID-19 Vaccination

Innovative strategies are needed to improve pediatric COVID-19 vaccination rates. We describe the process for developing a clinic-based intervention, CONFIDENCE, to improve pediatric COVID-19 vaccine uptake and present results of our beta-test for feasibility and acceptability. CONFIDENCE included communication training with providers, a poster campaign, and parent-facing educational materials. We assessed feasibility and acceptability through interviews and measured preliminary vaccine intention outcomes with a pre-post parent survey. Interviews were analyzed using rapid qualitative methods. We generated descriptive statistics for variables on the parent survey and used Fisher's exact test to assess pre-post differences. Participating providers (n=4) reported high levels of feasibility and acceptability. We observed positive trends in parents' (n=69) reports of discussing vaccination with their provider and the parental decision to accept COVID-19 vaccination. Our next steps will be to use more rigorous methods to establish the efficacy and effectiveness of the CONFIDENCE intervention.

Evaluation of a comprehensive maternal newborn health intervention in rural Tanzania: single-arm pre-post coverage survey results

ABSTRACT Background In Tanzania, maternal and newborn deaths can be prevented via quality facility-based antenatal care (ANC), delivery, and postnatal care (PNC). Scalable, integrated, and comprehensive interventions addressing demand and service-side care-seeking barriers are needed. Objective Assess coverage survey indicators before and after a comprehensive maternal newborn health (MNH) intervention in Misungwi District, Tanzania. Methods A prospective, single-arm, pre- (2016) and post-(2019) coverage survey (ClinicalTrials.gov #NCT02506413) was used to assess key maternal and newborn health (MNH) outcomes. The Mama na Mtoto intervention included district activities (planning, leadership training, supportive supervision), health facility activities (training, equipment, infrastructure upgrades), and plus community health worker mobilization. Implementation change strategies, a process model, and a motivational framework incorporated best practices from a similar Ugandan intervention. Cluster sampling randomized hamlets then used ‘wedge sampling’ protocol as an alternative to full household enumeration. Key outcomes included: four or more ANC visits (ANC4+); skilled birth attendant (SBA); PNC for mother within 48 hours (PNC-woman); health facility delivery (HFD); and PNC for newborn within 48 hours (PNC-baby). Trained interviewers administered the ‘Real Accountability: Data Analysis for Results Coverage Survey to women 15–49 years old. Descriptive statistics incorporated design effect; the Lives Saved Tool estimated deaths averted based on ANC4+/HFD. Results Between baseline (n = 2,431) and endline (n = 2,070), surveys revealed significant absolute percentage increases for ANC4+ (+11.6, 95% CI [5.4, 17.7], p < 0.001), SBA (+16.6, 95% CI [11.1, 22.0], p < 0.001), PNC-woman (+9.2, 95% CI [3.2, 15.2], p = 0.002), and HFD (+17.2%, 95% CI [11.3, 23.1], p < 0.001). A PNC-baby increase (+6.1%, 95% CI [−0.5, 12.8], p = 0.07) was not statistically significant. An estimated 121 neonatal and 20 maternal lives were saved between 2016 and 2019. Conclusions Full-district scale-up of a comprehensive MNH package embedded government health system was successfully implemented over a short time and associated with significant maternal care-seeking improvements and potential for lives saved.

Facilitating and Implementing a Process for the Delivery of Pediatric Oncology New Diagnosis Education Among Nursing Staff Through the Electronic Medical Record.

Background: An estimated 11,060 children between the ages of 1 and 14 years and 4,900 adolescents between the ages of 15 and 19 years are diagnosed with cancer in the United States. Parents with children newly diagnosed with cancer must acquire new knowledge related to the diagnosis, treatment plan, psychosocial care, and home management therapies to safely provide care following discharge. Expert consensus and review of current evidence demonstrate that utilizing a new diagnosis education checklist allows the delivery of essential information to patients and caregivers. The checklist divides educational topics into three sections: primary, secondary, and tertiary topics. This project followed the completion of an evidence-based fellowship through Children's Oncology Group focusing upon the feasibility and efficacy of implementing a standardized new diagnosis education checklist. The fellowship identified secondary topic documentation and an electronic medical record (EMR) checklist as areas of future work. Methods: This quality improvement project focused upon nursing staffs' documentation of secondary topics and the development/utilization of an EMR checklist. A pre-post survey design evaluated the outcomes of secondary topic documentation and EMR checklist implementation. Results: This nurse-led initiative created templates for primary and secondary topic checklists using Epic's SmartPhrase feature ".PHOPTED1" and ".PHOPTED2." Secondary topic completion and documentation increased 26% following implementation, and over 40% of the nursing staff indicated that they were very likely to continue to use the new templates. Discussion: Project templates are readily applicable to institutions that utilize Epic. Template examples and strategies to facilitate inpatient/outpatient checklist completion are discussed.

Outcomes of a Peer Mentoring Circle: An Innovation to Improve Academic Physician Career Advancement in a Community Hospital Setting.

Faculty retention is a prominent topic in academic medicine. Investment in faculty career development supports faculty vitality, advancement, and retention. Academic physicians in community-based settings far from their academic affiliate may find identifying local career advancement mentorship challenging. In June 2018, a career advancement in-service day at The Children's Hospital of San Antonio and Baylor College of Medicine in Houston was convened to design a peer mentoring circle (PMC). Using self-determination theory, this program aimed to help PMC members develop goals; schedule and attend regular meetings; format, review, and critique member curricula vitae and portfolios; and hold one another accountable to submitting award and promotion applications. Eleven inaugural PMC cohort members attended regular monthly meetings from July 2018 to June 2019 (median, 6 members per meeting). All members were competent in accessing the PMC repository of materials. Statistically significant improvement ( P < .01) was seen in self-reported knowledge and skills relevant to award or academic promotion support and resources. Compared with no patient care or teaching awards and 1 academic promotion among non-PMC faculty, 5 PMC members (45.5%) earned a patient care award, 4 (36.4%) earned a teaching award, and 5 of 10 faculty members (50.0%) achieved academic promotion ( P < .001 for all). On the retrospective pre-post survey, members endorsed several PMC strengths, including personal and emotional support, professional support, and accountability. Next steps include establishing a local faculty development office, convening a second cohort, revising evaluation methods, expanding membership, and offering 1-on-1 career counseling. Community-based academicians who aim to replicate this program should organize a career advancement and faculty development in-service day, identify local faculty members to manage meetings, retain a repository of resources, set deadlines and hold one another accountable to them, and celebrate achievements and support one another in failure.

Characterizing the Identity Formation and Sense of Belonging of the Students Enrolled in a Data Science Learning Community

Student attrition is a challenge experienced by higher education institutions. One of the key reasons for student attrition is the inability of students to develop an identity and a sense of belonging. This study aims to understand the role of a data science learning community in helping students to develop identity and a sense of belonging. The study used a mixed-methods approach to collect and analyze the data. The study used a pre–post survey to understand students’ perceptions regarding identity formation and sense of belonging. The results of the survey study indicated that the perception of identity formation and sense of belonging increased as students progressed through the semester. To further investigate the reasons for the increase in the perception of identity formation and sense of belonging, in-depth semi-structured interviews were conducted. The results of the interview revealed that living in the data science learning community, participating in various events and interacting with faculty, staff and working with peers of similar interest helped students to develop a data science identity and leader identity, as well as experience sense of belonging.

Synthesizing the Evidence: Best Practices for Trauma-Informed Care Education Across the Health Professions Workforce.

Purpose: Trauma-exposed persons often experience difficulties accessing medical care, remaining engaged in treatment plans, and feeling psychologically safe when receiving care. Trauma-informed care (TIC) is an established framework for health care professionals, but TIC education for clinicians has not been well examined. To remedy this, the authors conducted a multidisciplinary, scoping literature review to discern best practices for design, implementation, and evaluation of TIC curricula for health care professionals. Method: The research team searched Ovid Medline, Cochrane Library, Elsevier’s Scopus, Elsevier’s Embase, Web of Science, and the Published International Literature on Traumatic Stress database. Two independent reviewers screened 1,824 abstracts and excluded 1,697. After assessing 127 full-text articles, they excluded 76 based on predefined exclusion criteria; subsequently, they identified 4 additional articles through hand searching. Results: Fifty-five studies met inclusion criteria, with medicine being the most common discipline represented. The most prevalent learning objectives were cultivating skills in screening for trauma, responding to disclosures, defining trauma, and understanding trauma’s impact on health. Forty-seven of the studies included curricular evaluations, most commonly pre- and postsurveys. A minority used only postsurveys or a retrospective pre–post survey. The most common survey items included confidence in TIC skills, training content knowledge, participant demographics, and attitudes regarding the importance of TIC. Discussion: Future curricula should include applying a foundational lens of cultural humility, understanding the impacts of marginalization and oppression on individual and collective experiences of trauma, interprofessional collaboration, and incorporating survivors’ voices in education. Additional considerations include mandated reporting, medical record documentation, and vicarious trauma experienced by health care providers. Significance: Although medical school curricula are increasingly including TIC education, best practices in TIC curricula have not been developed. This scoping review lays the groundwork for evidence-based strategies for the design, implementation, and evaluation of TIC curricula in the health professions.

Promoting Medication Management Skills Among Home Health Occupational Therapists: A Quality Improvement Project

Medication management is a national patient safety goal for home care practice. Medication management is an occupation within the scope of occupational therapy. Occupational therapists are able to assess and provide intervention for cognitive, visual, motor, process, environmental and personal factors that impact an individual’s ability to manage their medication independently. This quality improvement project describes a program developed to promote medication management competence in occupational therapists practicing in a large, academic home health agency. The quality improvement project consisted of an online module providing education on the Performance Assessment of Self-Care Skills (PASS) and a 1-hour training session combining didactic education with case-based learning. Pre-post assessment surveys revealed a 25% increase in perceived medication management competence after the intervention. Occupational therapists identified 4 barriers to medication management practice: role ambiguity, documentation challenges, pharmacology knowledge deficit, and reconciliation process barriers.

Targeted Telehealth Education Increases Interest in Using Telehealth among a Diverse Group of Low-Income Older Adults.

Telehealth allows older adults to take control over their health and preventive care; however, they are less likely to use telehealth. Minority older adults use telehealth services less than their White counterparts. During COVID-19, the U.S. Medicare system allowed for telehealth delivery of Annual Wellness Visits, which are known to improve use of preventive services. To increase telehealth use, we targeted vulnerable, low-income, minority older adults and provided education to improve knowledge of and identify barriers to telehealth use. Ultimately, this could serve as a means of improving health and preventive care services. Participants resided at independent living facilities, low-income housing, and elders of the Native American coalition; N = 257. Participants received written education materials; a subset attended a 20-min presentation. In this quasi-experimental study, participants completed a pre-post survey. Results were analyzed using Chi-Squared and Fisher’s Exact tests. Participants included 54 ‘in-person’ and 203 ‘at-home’ learners. Most were female (79%), single/widowed (51%), and white (65%). At baseline, 39% were familiar with telehealth; following education 73% stated understanding on accessing telehealth. Nearly 40% of participants said they would use telehealth in the future; a larger proportion of “in-person” (73%) learners were willing to use telehealth than “at-home” learners (41%) (p = 0.001). Divorced older adults and Blacks voiced greater likelihoods of using telehealth than their married/widowed and White counterparts, respectively (Χ2(3, N = 195) = 9.693, p = 0.02), (p = 0.01). This education program demonstrates an increase likelihood in health promotion among older adults by increasing confidence in accessing and future use of telehealth; therefore, we achieved our aim of promoting telehealth use and improving health promotion.

Immersion matters: The medium is the message for wind energy

The U.S. offshore wind energy industry is projected to experience a thousand-fold growth from less than 45 MW today to the target of 110 GW by 2050. The industry's modus operandi of presenting the public with 2D photos or 2D videos is inadequate as it does not resolve concerns about projects' visibility and noisiness, but rather perpetuates pre-existing erroneous beliefs. In the present study, we exposed respondents in Massachusetts to either photos, videos (2D, 360°), or immersive cinematic virtual reality displays depicting a real wind turbine. We tracked attitude shifts in a pre-post survey about the respondents' views on wind energy, including their perceptions of the wind turbine and the expected impact of a hypothetical wind project in their community. Exposure to more immersive media resulted in more positive perceptions, as well as larger and more positive changes in support for wind projects. We also found large changes in expectations about the soundscape of wind turbines, including when volume levels were not controlled in a lab. These findings suggest that traditional media (2D photos, videos) may be counterproductive for informing the public about proposed wind projects. Immersive, multimodal media (VR, 360° video) provide more accurate audiovisual information in a format that is easily understood by audiences less familiar with wind technology, leading to more positive attitudes toward wind projects.

Feasibility and acceptability of an education and training e-resource to support the sexuality, intimacy and relationship needs of older care home residents: a mixed methods study.

sexuality, intimacy and relationship needs are often a neglected aspect of the care of older adults in residential care facilities. Improving awareness, knowledge and improving attitudes about these needs among care staff could enhance quality of care and lead to better outcomes for residents. to evaluate the feasibility and acceptability of a co-designed education and training e-resource to help care staff support their residents' sexuality, intimacy and relationship needs. we delivered the education and training e-resource to five UK care homes over a 6-month period in a pre-post mixed methods study using surveys, focus groups and individual interviews. fifty-nine members of staff from participating care homes undertook the education and training e-resource. 18/59 (31%) of participants completed all six modules and the pre-post surveys. Eleven participants participated in focus groups/interviews to explore experiences of using the e-resource. The e-resource was successfully implemented in the study homes and found to be acceptable. We found preliminary evidence of positive changes in staff attitudes. Factors that facilitated implementation included support from the care home manager. Barriers identified included IT infrastructure and technology. the findings provide initial evidence that a co-designed education and training e-resource raised awareness of, and improved attitudes towards, older adults' sexuality and intimacy needs. This work provides the foundation for a next phase to establish the effectiveness of the e-resource on staff practice and resident outcomes.

Educating students while recruiting underrepresented populations for Alzheimer’s disease research: the Student Ambassador Program

BackgroundIncreasing numbers of patients with Alzheimer’s Disease and related disorders (ADRD) necessitates increasing numbers of clinicians to care for them. Educational programming related to community outreach with older adults may help inspire interest in future ADRD clinical careers, while increasing awareness of ADRD in the community and aiding recruitment of underrepresented participants into research studies.MethodThe Boston University Alzheimer’s Disease Research Center (BU ADRC) created the BU ADRC Student Ambassador Program, where medical students, graduate students, and undergraduates interested in medicine completed a curriculum during the academic year that included six educational and three outreach events, including monthly dementia-focused didactic meetings and outreach focusing on Black participant recruitment. A pre-post program survey design was implemented to assess changes in students’ knowledge of and attitudes toward dementia and related disorders.ResultsBetween September 2015 and May 2020, thirty-seven students completed the program. Following program completion, students demonstrated increased knowledge of dementia and willingness to work with patients with dementia, as well as more positive attitudes toward patients and the role of empathy in physician practice. In terms of recruitment benefits, the students helped the BU ADRC reach older adults from underrepresented groups who could serve as participants in future research studies.ConclusionsThe BU ADRC Student Ambassador Program can serve as a model for other clinical research programs who wish to encourage students to consider a career in a specific field. In addition, this model has the potential to increase enrollment of participants to research studies. We discuss limitations of our initial efforts and directions for future work to quantify the anticipated benefits for student education and participant recruitment.

A telehealth curriculum: A pre-post study of physiotherapy students’ perceived knowledge, self-efficacy and intentions for future use

Introduction: With the ever-increasing adoption of telehealth into clinical practice, the need for physiotherapists to be competent with these technologies is paramount. Given the lack of literature detailing effective approaches to prepare physiotherapists for telehealth practice, a telehealth curriculum has been designed, implemented and evaluated in an Australian physiotherapy program. This study aimed to evaluate the effect of the telehealth curriculum on the perceived knowledge, skills, self-efficacy and future intentions of physiotherapy students. Methods: A cohort study was undertaken, with two research arms: 1) a pre- and post-test self-report survey of perceived knowledge, skills and self-efficacy against empirically derived telehealth competencies and 2) focus groups exploring effects of the curriculum on students’ perceptions of telehealth and intentions for future use. Participants undertook a telehealth curriculum, including 19 hours of online modules and 6 hours of accompanying simulations. The curriculum was specific to the practice of telehealth in physiotherapy and aimed to provide knowledge and skills about telehealth fundamentals, technology and use in practice. Results: From an eligible 117 participants, complete and matched pre-post surveys were obtained from 72 students (61.5%) and eight of these 72 students participated in focus groups. All six telehealth competencies were significantly higher following the intervention (p &lt; 0.001). From the focus group data, two themes were generated: perceptions of telehealth following the curriculum and feedback regarding the curriculum structure. Conclusion: This study demonstrates positive impacts of a telehealth curriculum involving online content and simulations on physiotherapy student perceived knowledge, skills and self-efficacy aligned with telehealth competencies. The study further supports the integration of telehealth curricula in pre-professional healthcare training.

Evaluating the effectiveness of a virtual reality simulation for preclinical local anaesthesia dental education.

Traditional manikin training has limitations that virtual reality can address. This study investigated the effectiveness of two part-task training simulation methods, a virtual reality (VR Sim) vs a plastic manikin (PM Sim), on learning outcomes for local anaesthesia skills for second-year pre-clinical dental students. In an experimental study, 58 second-year students were randomly assigned to one of two groups, VR Sim or PM Sim. Both groups completed the same pre-post survey. The VR Sim group practiced with a VR simulation, completed a built-in treatment test and a transfer test with a live person, and was evaluated by an expert teaching assistant (TA) with a rubric. The PM Sim group practiced with a plastic manikin and completed a treatment test on the same manikin evaluated by a TA, followed by the same transfer test with a live person and evaluated by a TA with a rubric. Covering knowledge and skills in the delivery of local anaesthesia, mean final transfer test scores were statistically significantly higher for the PM Sim compared to VR Sim, F(1, 57)=9.719, p=.003 with effect size, η2 p = 0.148. Scores on respective treatment tests were similar to final transfer test scores for each group suggesting differences were localised to the practice methods. Pre-survey results indicated participants had low prior experience with VR technology. Whilst outcomes showed higher results for plastic manikin tutor training over the VR training method, they are complementary. As students practice more with the technology and the VR simulation they may improve further. Likewise, as the technology for haptics with VR improves beyond hand controllers so may the experience and learning of this skill for students.

Professional contacts and the decision to become an auditor. An analysis using linkedIn

ABSTRACT This paper aims to analyse how contact with professional auditors influences undergraduates’ career decisions to become an auditor as a public interest profession. Students may decide not to join an auditing company due to stereotypes of auditors and, consequently, audit firms may not find professionals with needed skills. Undergraduates were selected by a professional body to shadow an audit team for a workday. A pre-post survey was conducted with the participants of the activity to analyse their perceptions. Some years later, their LinkedIn profiles were checked to determine whether the alumni work or have been working in the auditing industry. The survey responses were linked to the employment history that the former participants have posted on LinkedIn. Our results corroborate the effectiveness of contacts with auditors that improve participants’ perceptions about their intention to become an auditor and consideration of auditing as a public interest profession. Thus, negative perceptions of auditors could be minimised with greater understanding of the job.

예비 유아교사를 위한 소프트웨어 교육 효과성 검증

Objectives The purpose of this study was to specify pre-service early childhood teachers could improve their computational thinking and cooperative problem-solving skills through the subject which provides software education to be used in the field of early childhood education. Methods For this purpose, the ‘AI Multimedia’ subject class was applied to 63 first-year students in the department of early childhood education and pre-post surveys were conducted in the first and last weeks of class to measure computational thinking and collaborative problem-solving competency. The collected data was subjected to paired t-test to compare and analyze the results of pre-post surveys on the computational thinking and cooperative problem-solving competency of pre-service early childhood teachers. Results After participation in the software education, the average score of the pre-service early childhood teachers' computational thinking was 4.189 and the standard deviation was .604. The average score of the cooperative problem-solving competency was 4.315 and the standard deviation was .664, confirming the overall improvement. Conclusions The results of this study showed that the computational thinking program tailored for pre-service early childhood teachers had a significant effect on the competency improvement of them. Plus, instructors should consider the instructional design that can enhance the collaboration between the students who have difference in collaborative problem solving competency.

The Feasibility of a Pediatric Distance Learning Curriculum for Emergency Nurses During the COVID-19 Pandemic: An Improving Pediatric Acute Care Through Simulation Collaboration

IntroductionTo develop and evaluate the feasibility and effectiveness of a longitudinal pediatric distance learning curriculum for general emergency nurses, facilitated by nurse educators, with central support through the Improving Acute Care Through Simulation collaborative. MethodsKern’s 6-step curriculum development framework was used with pediatric status epilepticus aimed at maintaining physical distancing, resulting in a 12-week curriculum bookended by 1-hour telesimulations, with weekly 30-minute online asynchronous distance learning. Recruited nurse educators recruited a minimum of 2 local nurses. Nurse educators facilitated the intervention, completed implementation surveys, and engaged with other educators with the Improving Pediatric Acute Care through Simulation project coordinator. Feasibility data included nurse educator project engagement and curriculum engagement by nurses with each activity. Efficacy data were collected through satisfaction surveys, pre-post knowledge surveys, and pre-post telesimulation performance checklists. ResultsThirteen of 17 pediatric nurse educators recruited staff to complete both telesimulations, and 38 of 110 enrolled nurses completed pre-post knowledge surveys. Knowledge scores improved from a median of 70 of 100 (interquartile range: 66-78) to 88 (interquartile range: 79-94) (P = .018), and telesimulation performance improved from a median of 60 of 100 (interquartile range: 45-60) to 100 (interquartile range: 85-100) (P = .016). Feedback included a shortened intervention and including physician participants. DiscussionA longitudinal pediatric distance learning curriculum for emergency nurses collaboratively developed and implemented by nurse educators and Improving Pediatric Acute Care through Simulation was feasible for nurse educators to implement, led to modest engagement in all activities by nurses, and resulted in improvement in nurses’ knowledge and skills. Future directions include shortening intervention time and broadening interprofessional scope.

Undergraduate Students In Kinesiology Exploring Health Disparities

Undergraduate pre-health professional students are graduating from Kinesiology programs with little to no understanding about disproportionate health outcomes that impact the well-being of marginalized groups. Health disparities (HD) are differences in health outcomes that disproportionately impact individuals based on race and ethnicity, gender, sexuality, socioeconomic status, ability, and geographic location. Integrating HD into undergraduate academic courses proves beneficial for informing, equipping, and engaging future health and medical professionals in re-imaging equitable systems of health that minimize disparities. PURPOSE: The purpose of this ethnographic case study was to explore how 142 undergraduate (Sophomores 2%, Juniors 54%, and Seniors 45%) pre-health professionals engaged in learning about health disparities. METHODS: The health disparities curriculum consisted of four online self-paced learning modules embedded into a Kinesiology course. The instruction was designed to improve student awareness of HD, engage them in reflective writing practices and collaborative learning. Pre-post surveys, student reflections, and online discussions were triangulated to observe how students were making sense of HD topics. Drawing on constructs of Critical Consciousness, data were coded using thematic analysis. RESULTS: A small percentage (29%) of students reported learning about HD in their undergraduate courses, research, or volunteer experiences. Students overall reported an increase (75%-95%) in their understanding of the term HD and the groups most impacted by them. Three themes emerged that represented how students navigated HD learning: eye-opening experiences, lived experiences, and learning in motion. Broader themes included seeking mentorship for improving learning and implementing equitable practices. CONCLUSIONS: Disparities are linked to conscious or unconscious bias of health professionals and result in poor care and treatment. Engaging in HD learning early increases the level of consciousness and strategies for critiquing inequitable practices that have major implications for eliminating disparities.

South Asian Youth as Vaccine Agents of Change (SAY-VAC): evaluation of a public health programme to mobilise and empower South Asian youth to foster COVID-19 vaccine-related evidence-based dialogue in the Greater Toronto and Hamilton Area, Canada

ObjectivesThere have been substantial amounts of misinformation surrounding the importance, safety and effectiveness of the COVID-19 vaccine. The impacts of this misinformation may be augmented as they circulate among ethnic...

An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison Analysis.

BackgroundDespite the increasing attention to electronic health management information systems (HMISs) in global health, most African countries still depend on inefficient paper-based systems. Good Neighbors International and Evaluate 4 Health have recently supported the Ghana Health Service on the rollout of a mobile health–based HMIS called the e-Tracker system in 2 regions in Ghana. The e-Tracker is an Android-based tracker capture app that electronically manages maternal and child health (MCH) data. The Ghana Health Service has implemented this new system in Community Health Planning and Services in the 2 regions (Volta and Eastern).ObjectiveThis study aims to evaluate changes in health workers’ capacity and behavior after using the e-Tracker to deliver MCH services. Specifically, the study assesses the changes in knowledge, attitude, and practice (KAP) of the health workers toward the e-Tracker system by comparing the pre- and postsurvey results.MethodsThe KAP of frontline health workers was measured through self-administered surveys before and after using the e-Tracker system to assess their capacity and behavioral change toward the system. A total of 1124 health workers from the Volta and Eastern regions responded to the pre-post surveys. This study conducted the McNemar chi-square test and Wilcoxon signed-rank test for a pre-post comparison analysis. In addition, random-effects ordered logistic regression analysis and random-effects panel analysis were conducted to identify factors associated with KAP level.ResultsThe pre-post comparison analysis showed significant improvement in health workers’ capacity, with higher knowledge and practice levels after using the e-Tracker system. As for knowledge, there was a 9.9%-point increase (from 559/1109, 50.41% to 669/1109, 60.32%) in the proportion of the respondents who were able to generate basic statistics on the number of children born in a random month within 30 minutes. In the practice section, the percentage of respondents who had scheduled client encounters increased from 91.41% (968/1059) to 97.83% (1036/1059). By contrast, responses to the attitude (acceptability) became less favorable after experiencing the actual system. For instance, 48.53% (544/1121) initially expressed their preferences for an electronic system; however, the proportion decreased to 33.45% (375/1121) after the intervention. Random-effects ordered logistic regression showed that days of overwork were significantly associated with health workers’ attitudes toward the e-Tracker system.ConclusionsThis study provides empirical evidence that the e-Tracker system is conducive to enhancing capacity in MCH data management for providing necessary MCH services. However, the change in attitude implies that the users appear to feel less comfortable using the new system. As Ghana plans to scale up the electronic HMIS system using the e-Tracker to the national level, strategies to enhance health workers’ attitudes are necessary to sustain this new system.

Enhancing Geriatric Workforce Competency: Impact of 3 Distinct Geriatric Interprofessional Education Programs

INTRODUCTION An aging population with increasingly complex health care needs necessitates a diverse health care workforce prepared to deliver geriatric care in interprofessional teams. It is unclear what educational approaches effectively prepare health professions students for such practice. This study examines two indicators of preparedness for students from seven professions who participated in at least one of three geriatric interprofessional education (IPE) programs, reflecting different educational strategies. METHODS Four cohorts of students (n=697) completed pre-post surveys assessing indicators of preparedness for geriatric interprofessional practice. These included self-reported 1) familiarity with the roles and responsibilities of other health professions and 2) their capability to conduct common geriatric health assessments. RESULTS Students in two programs, and those who participated in multiple programs, reported statistically significant gains in familiarity with other professions (range: familiarity with 0.73 to 1.55 more professions). Students in all three programs, and those in multiple programs, reported gains in their self-reported capability to conduct geriatric health assessments (range: capability with 1.38 to 3.15 more health assessments). DISCUSSION Each program helped students prepare for future team practice. The gains appeared largest in the program that involved the most direct contacts with an older adult in a community setting. Gains were also larger for students who participated in multiple programs. This suggests that both direct contact with older adults, dose of IPE exposure, and composition of IPE teams may be particularly important in training future health care professionals.