Impact Of Program Research Articles

The Impact of Microfinance on Community Welfare: A Bibliometric Analysis and Systematic Literature Review (SLR)

ABSTRACT Over the years, microfinance programs have been the major strategy of many developing countries to improve people’s welfare and reduce poverty. Yet several studies on the welfare impacts of microfinance result in contradictory conclusions. While some studies support the mainstream view that microfinance improves the welfare of the unbankable poor, others criticize its limited effect on business development and weak impact measurement methods. This study analyzes 409 articles to bridge the empirical gaps between mainstream and critical views of microfinance impacts on society through synthesizing major themes in existing research and their interconnections and provides recommendations for future research. Using bibliometric and systematic literature review (SLR) approaches, this study found five clusters of empirical research on microfinance impacts, including entrepreneurship and poverty alleviation; self-help groups and women empowerment; financial inclusion; household income; and community welfare. The study also suggests that microfinance programs have positive impacts on welfare across countries. However, future research needs to more deeply focus on the impact of microfinance programs on agricultural finance, specifically financial efficiency, and social efficiency.

Participants' perspectives on a multimodal stress management and comprehensive lifestyle modification program for patients with Crohn's disease-A qualitative interview study.

Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) that is prevalent worldwide and associated with reduced quality of life for patients. Multimodal therapy approaches, which emphasize lifestyle modifications such as mindfulness and stress reduction, can be promising in enhancing health-related quality of life for IBD patients. However, research on multimodal therapy approaches for CD remains insufficient. This qualitative interview study is part of a mixed-methods approach that is embedded in a randomized controlled trial. It investigates the impact of a comprehensive 10-week day clinic lifestyle modification program on the health condition and quality of life of CD patients. Telephone interviews (n = 19) were conducted three months after the program to examine individuals' viewpoints on the intervention, including perceived changes and transfer of elements into daily life. Reflexive thematic analysis was performed using MAXQDA software. The results indicate that CD can have very individual and comprehensive impacts (psychological, physical, social), leading to reduced perceived quality of life and well-being. By participating in the program, patients wanted to find self-help options to complement conventional pharmacotherapy and actively manage their disease. Patients expressed high satisfaction with the program, feeling it provided valuable support for daily disease management. They were able to integrate adequate therapy elements into their routines to complement their care. Patients recognized significant improvements in various domains, mainly in the psychological domain, e.g., improved self-efficacy, symptom management, and, also partly physical/symptomatic and social improvements. A multimodal stress reduction and lifestyle modification day clinic appears to be beneficial as a complementary therapy for CD patients. It offers additional options and helps patients to address individual symptoms and needs, improve their understanding of the disease and their quality of life. Although promising, further research is needed to assess its long-term effects. ClinicalTrials.gov, identifier: NCT05182645.

Impact of a dermatological rehabilitation program on cardiovascular risks of psoriasis patients.

Psoriasis vulgaris is a common chronic inflammatory skin disease, associated with multiple cardiovascular comorbidities, which can ultimately lead to increased mortality. Dermatological rehabilitation programs represent an additional therapeutic option in patients with psoriasis besides the classical outpatient or inpatient management. This study aimed to investigate the impact of dermatological rehabilitation on cardiovascular risk factors, cardiorespiratory fitness and quality of life at the Clinic of Dermatology, Bad Bentheim, Germany. This prospective study included 105 patients (age >18years) with known psoriasis and/or psoriasis (pustulosa) palmoplantaris committing to a 3-week long rehabilitation program. Various patient reported outcomes including dermatological life and quality index, patient global assessment, physical activity, pruritus and smoking and alcohol consumption history were captured. Body mass index (BMI) and physical fitness were also assessed. Study parameters were collected by telephone at baseline, at discharge, and at 3 and 6months. Significant improvements in cardiorespiratory fitness (p<0.001), BMI (p<0.001), quality of life (p<0.001), patients subjective estimation of disease severity (p<0.001) and psoriasis area and severity index (p<0.001) were shown. The findings emphasize the importance of a rehabilitation program for patients with psoriasis due to its positive and sustained effects on cardiovascular risk factors.

Incentive based continuum of care for people living with HIV including orphan vulnerable children- the Delhi Model

Background: Delhi State AIDS Control Society (DSACS) addressed critical integration of services for Orphan and Vulnerable Children (OVC) in context of HIV. They bridged the policy and implementation divide by formulating a multisectoral-strategy in April 2012, creating a model of "Continuum-of-Care for People-Living with HIV (PLHIV), OVC &amp; Children-Affected-by-HIV (ChABH)” in Delhi. With input from the National Commission for Protection of Child Rights, DSACS sensitized political and administrative machinery about needs and challenges related to HIV/AIDS. DSACS developed an incentive-based system for Antiretroviral Therapy (ART) adherence, incorporating safeguards and robust monitoring. Delhi Government's sustained financial commitment and DSACS programmatic-innovation provide a scalable blueprint for India and global initiatives. Description: This ongoing Delhi Government's scheme focuses on household-economic-strengthening of PLHIV as an incentive for broader behaviour change based-on specific eligibility conditions. Beneficiaries fall into four categories: PLHIV, including children on ART; double orphan HIV positive children (OCI); destitute children living with HIV/in institutional care (DCI); and double orphan ChABH in community-based care in Delhi. Category-wise fixed-monthly financial assistance is released to beneficiaries via direct-bank-transfers leveraging Aadhaar-platform to eliminate corruption. Adherence to treatment is mandatory to continue cash-transfers. Linkages with other schemes established to maximize impact. Lessons learned: In its 11-year evolution, Delhi model has grown from 1110 to 6467 beneficiaries, including 6383 PLHIV, 34 double OCI, 50 DCI, and 27 double orphan ChABH, with 5875 (90.8%) currently active excluding beneficiaries who expired (n=328), migrated/ transferred out of Delhi (n=115), opted-out ART/or lost-to-follow-up (n=135), and 14 CABA who turned major. Steady progress and 98% ART adherence mark positive outcomes. DSACS eased eligibility criteria in 2018, facilitating hurdle-free enrollment, while responding to cost-inflation by enhancing financial assistance, showcasing program adaptability. Achieving &gt;95% ART adherence has significantly boosted survival rates, underscoring program's positive impact on beneficiary health. The scheme's INR 14,69,35,600 expenditure in 2022-23, just 0.13% of Delhi Health Department's plan-outlay, signals a cost-effective investment. Extrapolating this nationally would represent 1.5% of India's Health Ministry's current plan-outlay. Conclusion/next steps: This innovative model is implementable on large-scale in India and around the globe but requires not only financial commitment but also coordinated efforts, policy adjustments, and collaboration between various stakeholders.

Impact of an educational program on oncology nurses' attitudes and behaviors toward care of the dying.

Care of the dying is an essential part of holistic cancer nursing. Improving nurses' attitudes and behaviors regarding care of the dying is one of the critical factors in increasing the quality of nursing service. This study aims to examine the impact of an educational program based on the CARES tool on nurses' attitudes and behaviors toward care of the dying. A quasi-experimental study with pre- and post-intervention measures was conducted. A total of 222 oncology nurses from 14 hospitals in Beijing, China, were enrolled using a convenient sampling method. This online educational course developed based on the CARES framework comprised 7 modules and 10 sessions. Each session was carried out twice a week over 30-60 min. Data were collected using a sociodemographic characteristics questionnaire, the Frommelt Attitude Towards Care of the Dying Scale (FATCOD) and the Nurses' Practice Behavior Toward Care of the Dying Questionnaire (NPBTCOD). Reassessment of attitudes and behaviors was conducted when completed the learning and 6 months after the learning, respectively. The sociodemographic characteristics of the nurses were analyzed using descriptive statistics, and differences in attitudes and behaviors were reported and compared by the paired t-test. All the 222 oncology nurses completed educational courses, and 218 nurses (98.20%) completed the pre- and post-attitudes evaluation and 213 (95.9%) nurses completed the pre- and post-behaviors evaluation. The mean (SD) FATCOD score before and after the educational program was 108.83 (12.07) versus 115.09 (14.91), respectively (t = -8.546, p ≥ 0.001). The mean (SD) NPBTCOD score before and after the educational program was 69.14 (17.56) versus 73.40 (18.96), respectively (t = -3.231, p = 0.001). This educational intervention was found to be an effective method for improving oncology nurses' attitudes and behaviors toward caring for dying patients.

Abstract Su505: Impact of a Targeted Automated External Defibrillator (AED) Program on Survival After Ventricular Fibrillation Cardiac Arrest in the Sao Paulo Metropolitan Subway System: A Landmark Initiative in Latin America

The targeted Automated External Defibrillator (AED) program in the Sao Paulo Metro has yielded promising results in improving survival rates for individuals experiencing out-of-hospital cardiac arrest (OHCA) due to ventricular arrhythmias. A longitudinal observational study conducted from September 2006 to November 2023 assessed the program's impact on survival outcomes. The implementation of the full program led to a significant improvement in survival to hospital discharge with minimal neurological impairment (0% vs. 43%, P=0.001). These findings underscore the importance of a targeted AED program in improving survival outcomes for OHCA, particularly in densely populated urban environments such as the Sao Paulo Metro. The short interval between arrest and defibrillation emerged as a critical factor in achieving favorable long-term, neurologically intact survival rates. The success of this program advocates for the strategic expansion of targeted AED initiatives in other large Latin American cities, emphasizing the potential to save lives and enhance public health outcomes through proactive emergency medical response measures.

Abstract 4141434: Real-World Improvement of Cardiometabolic Risk Factors by Treating Obesity at Scale

Intro: Obesity is a critical risk factor for cardiometabolic disease. A growing body of clinical trial data shows GLP-1 receptor agonist medications (GLP-1s) are not only effective in treating obesity but also demonstrate significant impact on the reduction of cardiovascular risk. Yet current models of care have not been able to reach the &gt;200 million Americans who meet criteria for obesity treatment. To improve access to evidence-based treatment, we established a virtual metabolic health company to provide medically-supervised obesity treatment at scale. Research Question: This real-world evaluation examines the impact of a virtual health program on weight and related cardiometabolic markers. Methods: Data were analyzed for individuals who completed at least 12 months (mos) in the core program and for a subset who continued to 24 mos. Obesity treatment involved GLP-1s combined with a proprietary intensive lifestyle intervention delivered with virtual coaching. Weights were submitted via cellular connected scale. Waist circumference, metabolic labs, and patient-completed surveys were analyzed at baseline and 12 mos. Results: The cohort included 6,766 patients, a subset with structured lab data from a larger population of 16,098 patients who had completed 12 mos in the commercial program. Average weight loss at 12 mos was -16.5% (n=5,932) and -17.8% at 24 os (n=1,171). Improvement was observed for all collected metabolic markers: waist circumference, AST/ALT, lipids, HbA1c, insulin, hs-CRP. Specifically for cardiovascular labs, 12 mos results showed improvement in HDL in 56.3% (n= 3,090), in LDL for 64.8% (n=3,066), in hs-CRP for 82.9% (n=2,446). Of n=825 with abnormal A1c at baseline, 77.1% achieve A1c &lt;5.7%. Average reduction in waist circumference was -5.9 inches (n=3,682). Positive changes were also seen for patient-reported outcomes (PROs). Discussion: In the context of significant obesity and cardiovascular results for GLP-1s in clinical trials, it is important to gather data on the efficacy of approaches to scale treatment in the real world since factors such as medication shortages, gaps in insurance coverage, and challenges with adherence occur with treatment outside of clinical trials. Results from 6,766 patients in a virtual metabolic health program available in 50 states and DC demonstrate clinically significant and sustained weight loss through 24 mos, with improvement in associated key cardiometabolic risk markers, health behaviors, and PROs.

A comprehensive meta-analysis of the impact of intervention programmes on psychological capital development: post-intervention and longer-term effects

PurposeThis paper presents the most up-to-date comprehensive meta-analysis of the effectiveness of interventions to enhance psychological capital (PsyCap). It also reports the first meta-analytic examination of longer-term effects (beyond the immediate post-intervention period).Design/methodology/approachThis meta-analysis followed PRISMA 2020 guidelines and utilised the methodologies of Hunter and Schmidt (2004) and Borenstein et al. (2009). The search period was from 2006 until February 2023. A total of 40 studies (N = 4,207) were included in the meta-analyses. The analyses were performed using the Comprehensive Meta-Analysis (CMA) Version 4 software programme.FindingsThe results indicate that the impacts of interventions on PsyCap and each of its component resources are greater than those reported in a previous meta-analysis (Lupșa et al., 2020), with the strongest impacts on hope and optimism. Interventions had sustained positive effects on PsyCap, hope, resilience and optimism, but not efficacy, and the frequency of intervention sessions influenced the effectiveness of interventions on hope, efficacy and optimism. Interestingly, specific PsyCap-focussed interventions did not have the greatest impact on PsyCap or its component resources.Originality/valueThis study contributes to emerging research on wellbeing-oriented HRM and provides valuable insights into more effective design and implementation of interventions to enhance PsyCap and its component resources. These interventions are a promising form of investment in employees which may bring mutual gains for individuals and organisations. The present findings extend those of previous studies and specifically respond to the call for further research on the persistence of PsyCap intervention effects.

Impact of a multifaceted intervention programme on antibiotic prescribing and dispensing in four patient-centred settings in five European countries. The HAPPY PATIENT project.

The primary cause of antimicrobial resistance is excessive and non-indicated antibiotic use. To evaluate the impact of a multifaceted intervention aimed at various healthcare professionals (HCPs) on antibiotic prescribing and dispensing for common infections. Before-and-after study set in general practice, out-of-hours services, nursing homes, and community pharmacies in France, Greece, Lithuania, Poland, and Spain. Following the Audit Project Odense method, HCPs from these four settings self-registered encounters with patients related to antibiotic prescribing and dispensing before and after an intervention (February-April 2022 and February-April 2023). Prior to the second registration, the HCPs undertook a multifaceted intervention, which included reviewing and discussing feedback on the first registration's results, enhancing communication skills, and providing communication tools. Indicators to identify potentially unnecessary prescriptions and non-first-line antibiotic choices were developed, and the results of the two registrations were compared. A total of 345 HCPs registered 10 744 infections in the first registration period and 10 207 infections in the second period. In general practice, participants showed a significant 9.8% reduction in unnecessary antibiotic prescriptions in the second period, whereas limited or no effect was observed in out-of-hours services and nursing homes (0.8% reduction and 4.5% increase, respectively). Pharmacies demonstrated an 18% increase in safety checks, and correct advice in pharmacies rose by 17%. External factors like COVID-19, antibiotic shortages, and a streptococcal epidemic impacted the intervention's benefits. Despite this, the intervention successfully improved antibiotic use in both settings.

Impact of High-Fidelity Simulation on the Confidence Level of Pediatric Residents to Manage Pediatric Emergencies

Background: Children having seriously ill health conditions pose new challenges to healthcare professionals in pediatric emergencies. The training based on simulation is a promising procedure for equipping junior professionals with the required potential. Objectives: Studying the impact of High-Fidelity Simulation (HFS) on the confidence levels of pediatric residents for taking care of patients having complications that are critical and also considering emergency procedures. Methodology: A quasi-experimental design utilized having surveys done before and after training to evaluate confidence levels. The research was executed in October 2023. The evaluation model of Kirkpatrick was supposed to evaluate the training program impact. After that, data was collected and entered into MS Excel and then analyzed on SPSS. Results: The research executed two sorts of surveys, including a pre-course survey and a post-course survey. Out of 40 residents, only 30 gave responses with a 75% rate. Descriptive analysis revealed varying levels of confidence across different domains of pediatric care. However, statistical analysis revealed no significant changes in confidence levels post-training in certain areas. These findings suggest that while the training program may have positively influenced confidence in some domains, further investigation is needed to determine its comprehensive impact on the confidence of residents. Conclusion: Our study emphasizes the effectiveness of HFS in enhancing the confidence of pediatric residents in managing critically ill patients and emergency procedures. While statistical significance was not achieved across all domains, the overall trend indicates a positive impact on residents' perceptions of their abilities in pediatric emergency care. Research in the future should revolve around more strategies augmenting the confidence of the residents in the care of pediatric emergencies.

Impact of an Asian Community-Based Cancer Rehabilitation Program on Health-Related Quality of Life

Background/Objectives: Inpatient exercise-based rehabilitation has been shown to improve health-related quality of life (HRQOL) in cancer survivors. However, there is a lack of studies on the impact of community-based cancer rehabilitation programs on health-related quality of life, especially in Asian countries. Methods: This was a retrospective cohort study involving patients with cancer at an outpatient community-based rehabilitation center. There were 197 patients who were recruited and enrolled in a physician-led rehabilitation program which included physiotherapists, occupational therapists, nutritionists and exercise physiologists. Results: Most of the patients had a diagnosis of breast cancer (61.4%), while 76 (38.6%) had a diagnosis of other cancers. On initial assessment, we found a mean Distress Thermometer (DT) level of 3.37 (SD = 2.41) and a mean Functional Assessment of Cancer Therapy-General-7 Item Version (FACT-G7) score of 11.83 (SD = 4.01). On follow-up assessment after 3–6 months of rehabilitation, there was a significant reduction in mean DT level to 2.42 (SD = 2.25) and an improvement in mean FACT-G7 score to 13.09 (SD = 4.77). Multivariate regression analysis revealed that significant factors for improvement in FACT-G7 scores were age (p = 0.046) and number of exercise therapy sessions (p &lt; 0.001). Conclusions: This study demonstrates the positive impact of a community-based cancer rehabilitation program on HRQOL among cancer patients.

“Discover your potential to raise your children”: A psychoeducational infancy parenting intervention in Spain

AbstractBackgroundThe quality of parenting has a significant impact on healthy development across the life cycle. Recent research has highlighted the financial return of evidence‐based parenting programs that are well designed and implemented.ObjectiveTo analyze the impact of a psychoeducational guidance intervention program aimed at improving parenting skills.MethodThirty‐five families with children aged between 0 and 3.5 years referred from the educational, social, and health departments of the Vitoria‐Gasteiz City Council (Spain) participated in the study. Using a longitudinal approach, the intervention took place over the course of three home visits: initial pretest assessment visit, feedback and orientation visit, and a final posttest assessment visit.ResultsStatistically significant pretest–posttest differences were observed in parenting skills, including cognitive and socio‐emotional development scaffolding, parental self‐efficacy, parental adaptive stress, and diversity of experiences.ConclusionsSeveral areas for improvement were detected in the context of an intervention based on customized guidance for individual families. The implementation process indicated issues to be improved in future program editions.ImplicationsOur findings provide family and public health policy makers with empirical support for the implementation of parenting programs designed to help families to acquire and improve parenting competencies to foster their children's comprehensive development, focused on the period between 0 and 3.5 years of life. Results of the study favor the propagation among Spanish professionals who work with families of the use of quality standards of the evidence‐based approach related to quality of implementation and assessment of the impact of parenting programs.

Prognostic impact of a 3-week multimodal prehabilitation program on frail elderly patients undergoing elective gastric cancer surgery: a randomized trial.

Research indicates that prehabilitation is effective in optimizing physical status before surgery, although this method may be considered "aggressive" for frail elderly patients. This study aimed to evaluate whether multimodal prehabilitation decreases postoperative complications and improves functional recovery in frail elderly patients undergoing gastric cancer surgery, in comparison to usual clinical care. This study was a single-center, single-blind, randomized controlled trial. Patients over 65 years old with a Fried Frailty Index of 2 or higher, scheduled for gastric cancer surgery, were considered for inclusion. Eligible participants were randomized in a 1:1 ratio to either the intervention or control group. The intervention group underwent a 3-week multimodal prehabilitation program prior to surgery, in addition to perioperative care guided by ERAS protocols. The control group received only the latter. The primary outcome was the comprehensive complications index (CCI) measured at 30 days after surgery. Secondary outcomes included 30-day overall complications, functional walking capacity as assessed by 6-minute walking distance (6MWD) at 4 weeks postoperatively, and 3-month postoperative quality of life. This study was registered at ClinicalTrials.gov (No. NCT06510088). Among the 112 eligible patients, the median age was 74 years, with 58 (52.7%) being female.No between-group difference was found in the primary outcome measure, 30-day CCI. The Median (Q1-Q3) CCI for the intervention and control groups was 0 (0-12.2) and 0 (0-22.6) (P = 0.082), while the mean (SD) CCI was 6.1 (15.8) and 9.8 (12.7), respectively (P = 0.291). Notably, the incidence of severe complications (CCI > 20) was significantly lower in the intervention group compared to the control group (11.1% vs. 25.9%, P = 0.046), particularly in terms of medical complications (12.3% vs. 29.3%, P = 0.025). Preoperatively, 27 patients (47.4%) in the intervention group exhibited an increase in the 6MWD of at least 20m, compared to 16 patients (27.6%) in the control group (P = 0.028). At 4 weeks postoperatively, more patients in the intervention group returned to their baseline 6MWD levels (63.2% vs. 43.1%, P = 0.031). Secondary parameters of functional capacity in the postoperative period generally favored the multimodal prehabilitation approach. In frail elderly patients undergoing elective gastric cancer surgery, a prehabilitation program did not affect the 30-day postoperative complication rate or CCI but reduced severe complications and improved perioperative functional capacity. [ClinicalTrials.gov], [NCT06510088], [07/15/2024], [Retrospectively registered].

Strengthening Computational Thinking in Engineering and Health Students Through Iot Activities and Block-Based Programming

Objective: The objective of this study is to evaluate computational thinking skills in engineering and health students at a public university in Peru. Theoretical Framework: To support the research, various theories on computational thinking, IoT, and block-based programming were reviewed. Additionally, evaluation instruments and problem-solving steps were analyzed. Method: These activities were developed using technological resources and block-based programming, integrated into an IoT environment. A quasi-experimental design with pre- and post-tests was employed to measure the impact of IoT activities and block-based programming in the classroom. Results and Discussion: The results obtained revealed [synthesize the main results of the research]. In the discussion section, these results are contextualized in light of the theoretical framework, highlighting the implications and relationships identified. Possible discrepancies and limitations of the study are also considered in this section. Research Implications: The results revealed that both engineering and health students improved their computational thinking skills in a balanced manner. However, it was observed that health students placed greater emphasis on the use of sensors, actuators, and block-based programming. Originality/Value: This study enriches the literature by applying methods that integrate technological resources in the classroom. The relevance and value of this research are evident in the urgent need to develop innovations that break the monotony of traditional educational approaches, offering students more dynamic learning experiences.

Evaluating the Impact of an Online Mindfulness Program on Healthcare Workers in Korean Medicine Institutions: A Two-Year Retrospective Study

Background/Objectives: This retrospective study evaluated the effectiveness of a two-year online mindfulness program (five biweekly sessions) combined with a smartphone application for healthcare workers (HCWs) in Korean medicine (KM) institutions. Methods: Twenty-three participants, including KM University students, KM doctors, and nurses, completed a 9-week online mindfulness program in 2023 or 2024. The pre- and post-intervention surveys assessed subjective health status (SHS), knowledge of mind–body modalities (MBMs), hwa-byung (HB) symptoms, emotional labor (EL), burnout, and program satisfaction. Results: Participants showed significant improvements in SHS (p = 0.008) and MBM knowledge (p = 0.035). HB personality scores decreased significantly (p = 0.027), while the reduction in HB symptoms approached statistical significance (p = 0.052). The frequency of interactions among job-focused EL increased (p = 0.003). The subgroup analysis revealed significant reductions in HB personality traits (p = 0.017) and symptoms (p = 0.006) among practicing KM doctors and nurses. No significant changes were observed in burnout levels. Participants reported high satisfaction (median 8.00 [IQR 8.0–9.0]) and willingness to recommend the program (median 5.00 [IQR 4.0–5.0]). Conclusions: Analysis of the 2-year results suggests that the online mindfulness program effectively improved SHS, MBM knowledge, and HB-related symptoms among HCWs in KM institutions, particularly among practicing professionals. High satisfaction rates indicated the acceptability of the program. Future research should use larger sample sizes and randomized controlled designs to further validate these findings and explore long-term outcomes. This intervention shows promise as a tool to promote mental health in Korean healthcare settings.

Expansive conceptualisation of the impact of continuous learning programmes: An analysis of research-based workshops in higher vocational education and training

Finnish higher education institutions offer continuous learning opportunities, including professional specialisation education programmes for the health and social sector. This article focuses on the conceptualisation of the impact of these programmes, which was the topic of discussion by education and working-life actors in research-based workshops. Drawing on the cultural–historical activity theory (CHAT) approach, the study seeks to answer the following research questions: What are the main themes through which the participants conceptualise the impact of education? How do the themes expand the conceptualisation of the impact of education? A qualitative study analysed data from the multi-professional discussions facilitated by researcher-developers in online workshops during the COVID-19 pandemic. The findings describe the impact-related discussion themes and analyse their expansive potential. Participants’ discursive actions in research-based online workshops manifest expansive conceptuali-sation on multiple dimensions, but also reveal dilemmatic impact-related questions that reflect the underlying contradictions of continuous learning programmes in the health and social sector.

Impact of Conditional Cash Transfer Program on Household Welfare in Southern Ethiopia: A matching estimator approach

Cash transfers (CTs) are now high on the agenda of most governments in low- and middle-income countries. Chronic food insecurity is one of the problems that has plagued millions of Ethiopians for centuries. This study evaluated the impact of participation in the conditional cash transfer (CCT) component of the PSNP (Public Works or PW) on household welfare in Karat Zuria District, Konso Zone, Southern Ethiopia. The cross-sectional survey data was gathered from 244 sample households, which were taken from beneficiary and control groups by using a multistage sampling procedure. Propensity score matching (PSM) was used to evaluate the program's impact on livestock holdings and total income. The result obtained from logit regression indicated that participation in a conditional cash transfer program was negatively influenced by access to credit and cultivated land size, whereas it was positively influenced by shock experience and an iron-roofed house. The econometrics model result shows that, as compared to control households, the program intervention increased the beneficiary households’ livestock holding (measured in TLU) by 24.8 percent (0.53 TLU) and total income by 33 percent (1705.095 ETB), respectively. This study demonstrated how the program had a considerable impact on household livestock holdings and total income.

Exploring Rural, Black Women's Lived Experiences With Physical Activity and Nutrition: A Photo-Elicitation Study.

Eastern North Carolina (ENC) residents have higher rates of type 2 diabetes, lower life expectancy, less physical activity (PA), and higher food insecurity than the rest of North Carolina. Black individuals in ENC may face health disparities due to systemic and societal barriers to PA and a nutritious diet; modifiable behaviors that may improve overall health. The purpose of this study was to explore the lived experiences of rural Black women who live in ENC and who meet the criteria for overweight and obesity in the context of PA and healthful diet promotion. Photo-elicitation was used to explore this population's specific experiences with PA and nutrition, including barriers and facilitators, through photos and focus groups. Participants (N = 14; 43.5 ± 8.7 years old; body mass index (BMI) = 34.6 ± 5.9 kg/m2) were Black women in the rural Southeastern United States. Recruitment strategies included community outreach, listservs, social media, and word of mouth. Using photos submitted, our team conducted focus groups and completed content analyses to identify themes to tailor the development of a future health promotion program for Black women. Overarching themes were (a) Reframing the Mindset, (b) Accountability, and (c) Cultural Relativity. Findings demonstrate that Black women living in rural areas desire culturally relevant PA and nutrition programming focusing on healthy lifestyles versus weight loss. Future practice and research should utilize these findings to develop and examine the health impact of a health promotion program designed for Black women by Black women on PA levels, diet quality, and quality of life.

An evaluation of the impact of the Lambeth PCN pharmacist anticoagulation skills development project

Abstract Background Atrial Fibrillation (AF) is a prevalent heart condition linked to significant morbidity and mortality due to its association with stroke.1 Despite the clear benefits of anticoagulation in reducing stroke risk, its underuse and suboptimal monitoring remain a concern.2 Aim This study aims to evaluate the impact of a pharmacist-led training programme in Lambeth, London, focusing on improving pharmacists' competency and confidence in managing Direct Oral Anticoagulants (DOACs). It assesses if the training met pharmacists' needs, evaluates current monitoring patterns to determine if training was warranted, and identified areas for further training improvement. Methods The study involved 41 GP practices across 9 Primary Care Networks (PCNs) in Lambeth. Practices were eligible based on their involvement in the management of AF patients prescribed DOACs. All pharmacists at these practices who were actively engaged in anticoagulation management and willing to participate in pre- and post-training assessments were invited to take part. Recruitment involved direct communication through practice managers and emails detailing the study’s objectives and benefits. DOAC monitoring data was extracted from patient medication records and subsequently compared to the South East London anticoagulation guidelines3 to establish compliance percentages. A competency assessment was conducted on pharmacists using a pre- and post-training checklist framework devised by the Consultant Anticoagulant Team at Guy’s and St Thomas’ NHS Foundation Trust (GSTT). The Wilcoxon signed-rank test analysed this paired data, with a p &amp;lt; 0.05 set for statistical significance. Additionally, semi-structured interviews were conducted to gather insights on their training experience and perceptions. Transcripts were coded using NVIVO software to identify themes. Ethical approval was obtained from Kingston University London. Results Of the 2,987 AF patients across the 41 GP practices, 87.6% were on DOACs. Prescribing and monitoring trends were consistent across all GPs, with scope to improve compliance across all parameters, such as CHA₂DS₂-VASc score assessment prior to DOAC initiation. The competency assessment, completed by ten pharmacists, showed a significant improvement post-training, with mean scores rising from 3.3 to 4.1 (p&amp;lt; 0.00001). Improvements were seen across all domains, particularly in explaining the rationale for anticoagulation, showing CHA₂DS₂-VASc and HASBLED scores, and discussing modifiable HASBLED factors. Competency in patient communication remained highest, while managing particular cases like reversal procedures and patients with cancer showed lower competency, indicating areas for training improvement. The interviews, conducted with ten pharmacists, revealed three main themes: (1) Confidence and competence in anticoagulant prescribing and optimisation, (2) Evaluation of the training programme's effectiveness, and (3) Professional growth and career development. Pharmacists reported greater confidence in managing DOACs post-training, though challenges remained in patient engagement and collaboration with GPs lacking DOAC knowledge. Discussion / Conclusion The evaluation proved a positive impact on pharmacists' competency and confidence in DOAC management. Suboptimal monitoring practices in Lambeth highlighted the need for this training programme and its crucial role in improving patient outcomes. Limitations include a small interview sample and potential biases in self-reported evaluations. A longitudinal study is recommended to assess long-term impacts. Ongoing training and systematic data collection are essential, and similar training should be extended to other healthcare professionals.

Assessing the impact of a leadership development programme on self-reported confidence of Community Pharmacy Neighbourhood Leads in South East London

Abstract Introduction Community Pharmacy (CP) integration is a key NHS England strategy, including for South East London (SEL) Integrated Care Board (ICB). To drive forward this strategy in SEL, the ICB medicines team created and funded community pharmacy neighbourhood lead (CPNL) roles. The CPNLs provide local leadership to strengthen CP-GP relationships and increase uptake of CP services (now badged Pharmacy First). To support implementation, a leadership programme was developed with system partners and delivered by Kaleidoscope,1 building on previous work.2 Core themes were building trust, driving collaboration and embedding innovation. Aim To measure the confidence level of CPNLs in SEL throughout the development programme, and associated outcomes. Methods There were five leadership sessions delivered to invited CPNLs and ICB colleagues between November 2023 and March 2024. The first and last sessions were face-to-face with the others virtual. Sessions covered both theory and implementation. At the end of each session all participants were asked to complete an online Microsoft forms survey compiled by Kaleidoscope, asking about their confidence in the CPNL role (where 1 is not at all confident and 5 is extremely confident), current relationships locally and actions planned and completed to date, using tick box, Likert scale and free text responses. Data was analysed in Microsoft Excel and through content analysis, with analysis completed for all attendees per session and separately for those attending 4 or 5 sessions. This study received ethics approval from Kingston University Ethics Committee (3396). Results A total of 37 individuals attended one or more sessions, with 16 attending 4 or 5 sessions. For all attendees, mean confidence score increased from 3.7 in session one to 4.14 in session five (out of 5) (session two:3.77; session three:4.05; session 4:4.17). Those who attended four or five sessions finished with a mean confidence score of 4.33, starting at 4.00 (session two:3.86; session three:4.19; session four:4.27). Comments showed participants initially reporting that there was room to improve relationships with key stakeholders, such as clinical directors, GPs, ICB and CP colleagues. By session five confidence had increased with comments noting that there was confidence to meet new people, network appropriately, and fulfil the required role. ‘Through the network we have created through this programme, confidence has grown with shared learning and new relationships.’ Comments were also received relating to improved joint working supporting the rollout of community pharmacy initiatives such as the Pharmacy First scheme. ‘Our confidence has grown, and we are arranging training sessions with the clinical directors with the local surgeries for some of the newer services like Pharmacy First.’ Discussion / Conclusion Our programme has increased CPNL confidence and engagement with local stakeholders, with greater confidence seen in those engaging most with the leadership programme. Limitations include not having consistent attendance at sessions. The launch of the national ‘Pharmacy First’ service halfway through the programme had a significant impact on the community pharmacy sector,3 with CPNLs being pivotal in building success in partnership. Further evaluation should assess impact of CPNLs on community pharmacy service provision and referrals by GPs.