Program Delivery Research Articles

Community‐Driven Health Promotion: Evaluation of a Rural Microgrant Program

ABSTRACTIntroductionMicrogrants for health promotion have the potential to engage communities in designing and implementing place‐based interventions to improve health and social outcomes. However, the evidence base around microgrants for health promotion is limited. This study presents the evaluation of a health service‐funded microgrant program for health promotion in rural Australia.MethodsThe evaluation framework was developed through a participatory approach and involved collaborative logic model building and co‐prioritized evaluation questions with health service staff and grant recipients. Evaluation questions focused on participation, short‐term outcomes, and the perceived value of program activities. Qualitative methods (reflexive thematic analysis) were used to answer the evaluation questions. Data sources included semi‐structured interviews with grantees (n = 11) and the health service's health promotion team (n = 4), electronic field notes kept by the health promotion team (n = 50 documents), electronic progress reports completed by grantees (n = 6) and information and feedback forums (n = 2).ResultsSince the program's inception in 2019, the health service has received 22 grant applications of which 15 were approved and 14 disbursed. Evaluation results show that grantees were community members with multiple roles, often with previous experience in applying for grants. Expected outcomes have been partially met, especially with regard to the program's aim of community empowerment. The most notable impact was the enhancement of participants' perception of and relationship with the health promotion team, as well as the creation of opportunities for community members such as exposure to art and bridging of social groups.ConclusionMicrogrants represent a feasible way to increase health opportunities and foster community participation in the planning and delivery of health promotion programs. The key program activities identified and suggested improvements can help guide program replication and adaptation by other small organizations.Public ContributionCommunity members who had previously received a health service grant were invited to participate in collaborative workshops and follow‐up surveys to codesign the grant program evaluation framework, co‐prioritize evaluation questions and guide the results' dissemination plan.

Assessing the Feasibility and Acceptability of Virtual Reality for Remote Group-Mediated Physical Activity in Older Adults: Pilot Randomized Controlled Trial

Background Physical inactivity represents a major health concern for older adults. Most social, at-home physical activity (PA) interventions use videoconference, email, or telephone communication for program delivery. However, evidence suggests that these platforms may hinder the social connection experienced by users. Recent advancements in virtual reality (VR) suggest that it may be a rich platform for social, at-home interventions because it offers legitimate options for intervention delivery and PA. Objective This pilot study aims to determine the feasibility and acceptability of VR compared to videoconference as a medium for remote group-mediated behavioral intervention for older adults. The information generated from this investigation will inform the use of VR as a medium for intervention delivery. Methods Nine low-active older adults (mean age 66.8, SD 4.8 y) were randomized to a 4-week home-based, group-mediated PA intervention delivered via VR or videoconference. Feasibility (ie, the total number of sessions attended and the number of VR accesses outside of scheduled meetings) and acceptability (ie, the number of participants reporting high levels of nausea, program evaluations using Likert-style prompts with responses ranging from –5=very difficult or disconnected to 5=very easy or connected, and participant feedback on immersion and social connection) are illustrated via descriptive statistics and quotes from open-ended responses. Results None of the participants experienced severe VR-related sickness before randomization, with a low average sickness rating of 1.6 (SD 1.6) out of 27 points. Attendance rates for group meetings were 98% (59/60) and 96% (46/48) for the VR and videoconference groups, respectively. Outside of scheduled meeting times, participants reported a median of 5.5 (IQR 5.3-5.8, range 0-27) VR accesses throughout the entire intervention. Program evaluations suggested that participants felt personally connected to their peers (VR group: median 3.0, IQR 2.5-3.5; videoconference group: median 3.0, IQR 2.7-3.3), found that goals were easy to accomplish (VR group: median 3.0, IQR 2.8-3.3; videoconference group: median 3.0, IQR 2.6-3.4), and had ease in finding PA options (VR group: median 4.0, IQR 3.5-4.3; videoconference group: median 2.0, IQR 1.6-2.4) and engaging in meaningful dialogue with peers (VR group: median 4.0, IQR 4.0-4.0; videoconference group: median 3.5, IQR 3.3-3.8). Open-ended responses regarding VR use indicated increased immersion experiences and intrinsic motivation for PA. Conclusions These findings suggest that VR may be a useful medium for social PA programming in older adults, given it was found to be feasible and acceptable in this sample. Importantly, all participants indicated low levels of VR-related sickness before randomization, and both groups demonstrated very high attendance at meetings with their groups and behavioral coaches, which is promising for using VR and videoconference in future interventions. Modifications for future iterations of similar interventions are provided. Further work using larger samples and longer follow-up durations is needed. Trial Registration ClinicalTrials.gov NCT04756245; https://www.clinicaltrials.gov/study/NCT04756245

Association Between an Enhanced Clinical Pharmacy Service and Patient Experience in Hospitalized Adults: A Cohort Study

Purpose. To determine if implementation of an enhanced clinical pharmacy service (ECPS) at a community hospital could improve patient experience as measured by medication-related Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. Methods. A cohort study of 260 patients at a community hospital was conducted. Patients in the intervention group received additional pharmacy services from the standard of care (SOC) group, including daily medication counseling, pharmacist-driven medication administration, discharge medication reconciliation and education, consistent offers to enroll in a bedside medication delivery program (BMDP), and a telephone call following discharge. The primary outcome of patient experience was assessed through patients’ responses to a care transitions HCAHPS survey question regarding understanding of the purpose of taking medications following discharge. Results. Among patients in the ECPS cohort, 75.8% had a top-box response to the care transitions HCAHPS question, compared to 63.3% of patients in the SOC cohort (OR = 1.81; 95% CI [0.61-5.37]). Top-box responses increased for all assessed HCAHPS questions but were not statistically significant. The HCAHPS survey response rate was 29.3% in the SOC cohort and 29.9% in the ECPS cohort. Conclusion. Following an ECPS intervention, patient experience as determined by HCAHPS scores increased, but the results did not reach statistical significance. Further, larger studies are needed on this topic.

Overview of CHIC symposia series: Summary of Africa and South Asia symposia

This article presents an overview of the main challenges and lessons learned that were presented during the symposia organized by the Coalition to Strengthen the HPV Immunization Community (CHIC) in Africa and South Asia in 2022. Discussions at these meetings revolved around introduction, planning, implementation, and sustainability of HPV prevention and control programmes, with a particular focus in HPV immunisation, as well as cervical cancer screening in South Asian countries. This article also discusses the recently endorsed off-label single-dose HPV vaccination schedule and its potential impact on programme delivery and access. Furthermore, it highlights the importance of intersectional collaboration, effective communication and advocacy strategies, and the need for robust health information systems. Some of the critical factors identified for reducing the burden of cervical cancer in low- and middle-income countries (LMICs) included strategies for increasing access and coverage, addressing vaccine hesitancy, and building capacity among health care providers. The symposia emphasized the importance of face-to-face interactions for collaboration and decision making, with live translation services enabling full participation by stakeholders from diverse backgrounds. The paper concludes with a call for continued collaboration to make progress in reducing the burden of cervical cancer in LMICs.

Zooming In and Out of Programming: Developing an Approach to Trauma-and Violence-Informed Physical Activity “Post-Pandemic”

Researchers have found that physical activity is an effective health promotion tool due to its positive effect on wellbeing, however, despite the overwhelming evidence on the benefits of physical activity, many structural and systemic inequities exist that affect access and uptake particularly for women. These barriers have been exacerbated over the last few years as conditions surrounding the COVID-19 pandemic has made engagement in physical activity even more difficult for equity-deserving populations. Community organizations have reported an increase in gender-based violence and a strain on support services. In this qualitative research study, we present findings that demonstrated how COVID-19 complicated the delivery of in-person programs for equity-deserving populations. Using a feminist participatory action research approach, community-specific barriers to physical activity from the perspectives of individuals who deliver physical activity programming and social services to self-identified women were generated in three themes using thematic analysis: 1) Increased Need, Decreased Services; 2) Online Service Provision was Not Effective for Clients or Providers; 3) Physical Activity was Not Deemed an “Essential Service”-Transitioning from Survival Mode to a New Normal. Taken together, findings underlined the importance of effective and sustainable resources and strategies to improve access for women to engage in physical activity programs.

Effect of preoperative inspiratory muscle training combined with preoperative education on postoperative pulmonary complications in high-risk patients with lung cancer: protocol for a randomised controlled trial.

Preoperative inspiratory muscle training (IMT) is recognised as an important component of the preoperative management of lung cancer, although there is limited evidence for the delivery of a home-based IMT programme combined with preoperative education. We developed a programme combining short-term home-based IMT and preoperative physiotherapy education ('the programme'). This study aims to evaluate the effectiveness of this programme in reducing postoperative pulmonary complications (PPCs) after lung cancer resection compared with standard care. In this randomised controlled trial, 114 participants scheduled for lung cancer surgery at the First Affiliated Hospital of Fujian Medical University will be randomly assigned (1:1) to either receive usual care (information booklet) or usual care combined with the programme, which consist of short-term home-based IMT and preoperative physiotherapy education. The primary outcome measure will be PPCs using the Melbourne Group Score. Secondary outcomes will include health-related quality of life, maximal inspiratory pressure, 6 min walk distance, length of hospital stay, anxiety and depression levels, and hospital costs. The study has received ethics approval from the ethics committee of the first affiliated hospital of Fujian Medical University (approval no: MRCTA, ECFAH of MFU [2021]569). Participants will be required to provide written informed consent. The results of the study will be submitted for publication in peer-reviewed journals. ChiCTR2300067464.

Planning and evaluating an integrated clinical exercise oncology service: an exploratory mixed-methods study

BackgroundThis project aimed to design and evaluate the potential to integrate an exercise oncology service into clinical care in a local healthcare system. The goal was to inform the design of an implementation strategy to promote its sustainable use in standard care.MethodsThis two-phase, exploratory study used a mixed-methods approach. First, qualitative measures were used to understand the context for exercise integration into oncology care by clinicians and administrators in the healthcare system. Next, the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework guided a comprehensive evaluation of the exercise service. Reach and Adoption were measured via number of patients enrolled in the program relative to those treated. Adoption was measured via referrals from stakeholders. Implementation was described using the program structure and delivery. Maintenance was described using hospital funding decisions. Effectiveness was assessed using the Bellarmine Norton Assessment Tool (BNAT) and Functional Assessment of Cancer Therapy – Fatigue Scale.ResultsPhase 1 context analysis suggested critical elements to guide program delivery, including limiting participants to post-primary treatment (surgery, chemotherapy and radiation) and streamlining referral process. The Phase 2 evaluation demonstrated suboptimal program reach (2%); significant program effectiveness (improved physical function (BNAT; p = 0.05 ) and decreased fatigue (p < 0.05)); receptiveness to program adoption (75%); and strong potential for program maintenance.ConclusionsTraditional approaches to exercise oncology research trials are not easily integrated into healthcare systems. Designing an exercise program for meaningful integration and sustainment requires understanding the context where the program will be delivered, followed by intentional and continuous engagement with key stakeholders to ensure the program continues to meet the needs of the system. Initial exploration of the settings is critical to inform a comprehensive implementation strategy.Trial registrationclinicaltrials.gov: NCT06039488. Prospectively Registered Sept 15th, 2023.

On the Journey: a qualitative study of a community-based, client-centred eating disorder recovery group

BackgroundCommunity-based eating disorder (ED) treatment frequently includes manualized group-based psychoeducation facilitated by a mental health clinician. Body Brave, a non-profit ED organization, developed a novel, participant-guided, community-based virtual healthcare provider (HCP)-facilitated support program called On the Journey (OtJ). The program was designed for people with longstanding EDs who had previously participated in group or individual ED programs but require continued support in their recovery. The purpose of the study was to describe the development and components of OtJ and to understand participant perceptions of the program and its effect on their recovery.MethodsUsing a formative and community-engaged research design, we conducted semi-structured interviews with three OtJ facilitators and focus groups with twelve OtJ clients. Transcripts were analyzed using Braun and Clarke’s six-stage approach to reflexive thematic analysis.ResultsFour main themes were generated from the data (1) “Designing and Evolving OtJ” (2) “Is OtJ a Treatment or Support Group?” (3) “Fostering a Safe Environment throughout Program Delivery” and (4) “The Power of Lived Experience.” Clients noted several strengths of the OtJ program: fostering a sense of community, valuing client autonomy, and providing accessible ED support.ConclusionsKey considerations for other organizations looking to offer programming similar to OtJ include having skilled and clinically trained facilitators and prescreening discussion topics to ensure that conversations are productive towards recovery. OtJ supports people with longstanding EDs, and other organizations could consider adopting a similar model of care. This study contributes to the growing body of including lived ED experience in research.

Sexual Assault and Domestic Violence Prevention Programming During the Pandemic: How Prevention Educators Navigated COVID-19

Abstract Purpose Domestic violence and sexual assault (DVSA) primary prevention programming is often implemented during the school year, but the delivery of such programming was radically altered during the first year of the COVID-19 pandemic when traditional in-person classrooms were often replaced by virtual learning. The immediate issue facing schools was getting academic content to students in this new environment, but there has been little research into what those priorities meant for supplementary programming like DVSA prevention education. How DVSA prevention education was affected by the switch to virtual learning remains largely unknown, but prevention educators’ experiences navigating virtual learning environments can offer insight into the implementation and delivery of virtual programming by community agencies. Method We conducted 20 interviews with DVSA prevention educators across the midwestern region of the United States. Reflexive thematic analysis was used to understand how DVSA prevention programming was impacted during the COVID-19 pandemic. Results We identified four themes through our analysis: Disconnection, New Expectations, Reduced Access, and Safety Concerns. Interviews with prevention educators highlighted the many challenges of delivering DVSA prevention programming online, as well as ways that they adapted and even made improvements in this new environment. Conclusion Many students lost access to DVSA prevention education during the COVID-19 pandemic or received a version strongly impacted by social distancing protocols. Findings indicate that students who would have received DVSA prevention programming during the 2020–2021 school year likely did not receive the full dose of intended programming. Curriculum researchers should develop programming suitable for remote delivery for future incidental and fully online learning environments.

Empowering Continuing Medical Education (CME) in India: leveraging Kern’s instructional design model

IntroductionContinuing Medical Education (CME) is vital for healthcare professionals to remain current with advancements and maintain their competence. In India, CME remains in its early stages, lacking a systematic approach. There is a pressing need for a comprehensive framework that addresses needs assessment, program development, accreditation, and credit allocation. Specifically, there is a gap in delivering targeted CME that meets the needs of different medical professionals at appropriate times. The aim of this study is to employ Kern’s six steps of curriculum design to plan and evaluate a faculty development program focused on Entrustable Professional Activities (EPAs) for MD (Doctor of Medicine) Biochemistry professionals.MethodsThis study utilized Kern’s six-step approach to design a training program on Entrustable Professional Activities (EPAs) tailored for MD Biochemistry professionals. Approval was obtained from the Institutional Human Ethics Committee. Following problem identification, a targeted needs assessment was conducted through expert consultations. The goal of the program was established, focusing on the development and delivery of an interactive online CME program. The program was developed, implemented and evaluated using surveys and feedback questionnaires.ResultsA comprehensive literature review revealed a notable gap in EPA-related works for MD Biochemistry program. Expert consultations highlighted significant training needs and barriers, such as limited resources and professional commitments. Consequently, the program’s primary objective was to raise awareness and sensitize participants to EPA development. A 4-h online CME was designed, featuring expert-led sessions and collaborative group activities. The program attracted 152 participants and utilized interactive elements, such as polls and chats, to foster engagement. Group activities allowed participants to apply concepts in EPA validation. Pre- and post-program surveys demonstrated significant improvements in participants’ knowledge and confidence. Feedback highlighted the practical relevance of the content and the interactive, hands-on nature of the sessions.ConclusionKern’s six-step approach provided a structured and effective framework for developing the CME program, addressing identified needs and barriers, and enhancing faculty development in MD Biochemistry. This study underscores the importance of a systematic approach in CME to improve program effectiveness.Trial registrationNot applicable.

Differing needs for Advance Care Planning in the Veterans Health Administration: use of latent class analysis to identify subgroups to enhance Advance Care Planning via Group Visits for veterans

BackgroundAdvance Care Planning via Group Visits (ACP-GV) is a patient-centered intervention facilitated by a clinician using a group modality to promote healthcare decision-making among veterans. Participants in the group document a “Next Step” to use in planning for their future care needs. The next step may include documentation of preferences in an advance directive, discussing plans with family, or anything else to fulfill their ACP needs. This evaluation seeks to determine whether there are identifiable subgroups of group participants with differing needs prior to delivery of the ACP-GV program and, if so, to use information about the subgroups to enhance the program offered to veterans in United States Department of Veterans Affairs (VA) healthcare settings.MethodsWe conducted a secondary analysis of national data from a quality improvement evaluation. Patient- and provider-level data from administrative healthcare records for VA users in all 50 states, territories, and the District of Columbia provides data on veterans attending ACP-GV during federal fiscal years 2018–2022 (N = 26,857). Latent class analysis seeks to identify the various subgroups of veterans based on their level of ACP self-efficacy before attending ACP-GV and any demographic differences across the resulting subgroups of veterans attending ACP-GV. ACP self-efficacy is derived from seven items obtained from a participant worksheet used during the group.ResultsAnalysis revealed two distinct groups of veterans, distinguishable by their pre-ACP-GV levels of one aspect of ACP self-efficacy: prior knowledge of ACP. Veterans with higher prior knowledge of ACP are associated with an identified next step focused on checking their current AD status and updating it, and veterans with lower ACP prior knowledge are associated with identifying a next step to discuss ACP more fully with family. Differences in age, sex, race, ethnicity, and marital status exist across subgroups of veterans.ConclusionGreater attention must be paid to ACP and veterans’ prior knowledge of ACP to consistently encourage annual review and status updates.

Building the OAChangeMap to improve the service delivery of the New South Wales Osteoarthritis Chronic Care Program: a worked example of using a co-design framework.

The Osteoarthritis Chronic Care Program (OACCP) has been implemented in Australian public hospitals to deliver best-evidence OA care. It is important to ensure that the OACCP continues to deliver evidence-based OA care as intended. We aimed to identify barriers and enablers to delivering the OACCP, prioritise the barriers, and generate strategies to address them. This study provides a worked example of a seven-step theory-informed co-design framework. We invited OACCP coordinators to participate in semi-structured interviews (analysed thematically) and complete a questionnaire to identify barriers and enablers to delivery of the OACCP. We then invited a broader group of stakeholders (OACCP coordinators, health managers, policy makers, consumers, researchers) to prioritise the barriers via a short survey (survey 2). We held five co-design workshops where we mapped the priority barriers to the Theoretical Domains Framework and developed strategies to address them. Sixteen coordinators were interviewed and the main barriers identified were: 1. patients often have beliefs that are inconsistent with best-evidence care; 2. there are aspects of clinical care that are not delivered optimally; and 3. system level factors are a barrier to optimal patient care and sustainability of the OACCP. We co-designed a plan for action with patient educational materials, shared decision-making tools, and health professional education and training. Our worked example of co-design used a theory-based, data driven approach with key stakeholders, identified and prioritised barriers to the delivery of the OACCP, acknowledged enablers, and generated a plan for feasible strategies to improve the program.

Feasibility and end-user perceptions of a novel digital care assistant and support program for people after stroke or transient ischemic attack (CAPS)

Abstract Background The Care Assistant and support Program for people after Stroke (CAPS) or transient ischaemic attack (TIA) is a clinician-led program designed to improve the secondary prevention of stroke. The program combines person-centred goal setting and risk-factor monitoring through a web-based clinician portal, SMS goal-aligned messages, a mobile application (app), and a wearable device. We aimed to determine the feasibility of CAPS among people living with stroke or TIA, and clinicians who would deliver the program in future. Methods Open label single group pre-posttest mixed-methods evaluation of the 12-week program. Eligible lived-experience participants were recruited through the Australian Stroke Clinical Registry. Eligibility: diagnosis of stroke or TIA in preceding 6 months - 3 years, ≥18 years old, smartphone/tablet ownership, living in the community. Following surveys and interviews of lived-experience participants, ten clinicians experienced in stroke care were invited to participate in focus groups to discuss the program. We used descriptive statistics to evaluate feasibility outcomes, i.e. participant perceptions of usability, acceptability and satisfaction, and clinician perceptions on program design and delivery. Results From 600 invitations, 34 eligible participants commenced the program (27% female, 33% TIA, median 1.7 years from index event; one withdrew). Usability of the CAPS app was rated as ‘Good’ to ‘Excellent’ (System Usability Scale), with moderate sustained usage by study conclusion (&amp;gt;60%). Participants frequently reviewed their health data within the app (average twice a day/participant over 12 weeks), and entered their health measurements an average 73 times/participant. The majority (≥90%) of participants thought the program fitted well into their daily lives or helped engage them in self-monitoring, with 76% indicating they would use the program, if publicly available. Clinician participants included three nurses, three allied health professionals, two neurologists, a stroke consultant, and a general practitioner (GP) in focus groups. Overall, eight had positive perceptions of the CAPS program. Three clinicians indicated the measurements collected in the app captured "vital information", and five saw the value of CAPS to improve secondary prevention. Recommended modifications to the program included tracking atrial fibrillation and blood cholesterol. Seven believed participants would receive the most benefit from the program if delivered within three months post-discharge. Six indicated that GP-led multidisciplinary care was the best model to deliver CAPS. Conclusions The CAPS program was feasible to deliver and acceptable to people living with stroke or TIA. Clinicians saw the value of CAPS for secondary prevention, with feedback prompting further focus groups with GPs to develop the potential model of care. Findings have informed the design of a Phase II randomised feasibility trial.

Mapping the Public Health and Health Promotion Capacity in Oman

Abstract Background An essential condition to enabling people to increase control over their health is to have sufficient capacity for public health (PH) and health promotion (HP). Despite the recognition of its importance, a comprehensive view of the PH and HP capacity in the sultanate of Oman is not yet available. This study provides a mapping of the country’s PH and HP capacity at national, governorate and district levels. Methods An online quantitative survey was performed amongst 70 health policy maker and experts in PH and HP using a questionnaire based on the PH capacity framework of Aluttis et al., yielding data on the country specific context with relevance for PH and 6 PH capacity domains, each divided in subdomains: leadership and governance; organizational structures, workforce, financial resources, partnerships, and knowledge development. Internal consistencies of the scales measuring the capacity subdomains ranged from .75 to .99. Results The survey revealed relatively low scores, representing partial development of capacities, for most of the public health capacity domains. The highest levels of capacity were observed for knowledge development (health information and monitoring systems, reporting systems and knowledge infrastructure), organizational structures (institutional capacity, program delivery structures, PH within health services, and response emergencies) and partnerships (formal consortia, informal partnerships and multisectoral coordination). In contrast, leadership and governance, workforce development, and financial resources score lower. Conclusions Mapping the strengths and weaknesses of PH and HP capacity in Oman allows to make recommendations for improving population health. Whereas all domains of PH and HP capacity are partially developed, there is a need to further improve capacity in all domains. Key messages • PH and HP capacities are partially developed in Oman. • Mapping the PH and HP capacity allows to identify strengths and weaknesses and make recommendations for improving public health.

The Effectiveness of Trauma-Informed Parenting Programs for Traumatized Parents and Their Components: A Meta-Analytic Study.

Parents who have been exposed to trauma face distinct challenges in parenting that can lead to negative child developmental outcomes and intergenerational transmission of trauma. Parenting programs for traumatized parents seem promising, but the existing evidence on their effectiveness has not yet been synthesized. This study aimed to examine the overall effect of trauma-informed parenting programs on (a) parenting and (b) parental mental health outcomes by conducting two three-level meta-analyses. Moderator analyses were performed to identify whether program components, delivery techniques, and other study and program characteristics were associated with effectiveness. A literature search conducted up to August 2024 yielded 15 studies reporting on 110 effect sizes. Significant overall effects were found of trauma-informed parenting programs on both parenting outcomes (d = 0.75, 95% CIs = [0.09, 1.15], p = .027) and parental mental health outcomes (d = 0.21, 95% CIs = [0.09, 0.32], p < .001). The first meta-analysis on parenting found no significant moderators, while the second meta-analysis on parental mental health indicated that programs emphasizing child disciplining skills yielded smaller effects (d = 0.04) compared to programs without this component (d = 0.31). Programs using modeling techniques yielded larger effects (d = 0.32) compared to programs without (d = 0.14). Larger program effects on parental mental health were also found for programs with longer durations and when individual sessions were used. Thus, evidence supports the effectiveness of trauma-informed parenting programs in improving parenting and reducing parental mental health problems.

PENINGKATAN SUMBER PENDAPATAN MASYARAKAT DESA SOROPIA KECAMATAN SOROPIA KABUPATEN KONAWE MELALUI PELATIHAN PEMBUATAN BAKSO AYAM

Community service activities carried out by a team of lecturers from the Faculty of Animal Husbandry integrated with the Thematic KKN program from the Research and Community Service Institute (LPPM) of Halu Oleo University in 2024 were carried out in Soropia village, Soropia sub-district, Konawe district. Introducing post-harvest livestock meat processing techniques into chicken meatballs to the Soropia village community. This is intended to increase community creativity in processing food ingredients and become a source of income. Community service activities in Soropia village were carried out in two stages. The first stage is a village community meeting regarding the delivery of work programs. Furthermore, the second stage is the demonstration stage of making meatballs. Meatball processing in principle consists of four stages, namely, crushing, grinding meat, making dough, molding meatballs and cooking and packaging. The output achieved in this activity is an increase in the insight and knowledge of the Soropia village community regarding post-harvest livestock processing.

Determining Factors to Develop Periodic Plan, Strategic Plan and Medium-Term Expenditure Framework in Local Governments in Nepal

This research article explores the factors influencing the development and implementation of periodic plan, strategic plans, and the Medium-Term Expenditure Framework (MTEF) in local governments of Nepal, particularly focus on Bharatpur Metropolitan City. The study adopts a qualitative research design, employing document analysis, focus group discussions, and interviews with key stakeholders, including government officials, local communities, NGOs and civil societies. The findings identify key determinants: public responsible governance; efficiency, financial integrity, and systematic implementation of programs; proper resource allocation; and risk identification and management. Major findings emphasize the importance of public responsible governance, which includes public voice, participation, and shared responsibility in decision-making processes. Additionally, the study highlights the necessity of efficiency, financial integrity, and systematic implementation of programs for effective service delivery. Proper resource allocation and risk management are also crucial, ensuring that development projects meet community needs and sustainable goals. These elements collectively contribute to the successful governance and development of local governments in Nepal. The research also highlights the need for further studies, particularly in other regions of Nepal, using diverse methodologies to strengthen the understanding of local-level planning and its implications. Int. J. Soc. Sc. Manage. Vol. 11, Issue-4: 88-94.

Smartphones: A Catalyst for Tobacco Control Training in India

The tobacco crisis confronting low- and middle-income countries (LMICs) requires scale-up of effective tobacco control programs, such as Tobacco Free Teachers-Tobacco Free Society (TFT-TFS). We previously demonstrated the efficacy of TFT-TFS in increasing tobacco use cessation among teachers and schools’ adoption of tobacco control policies in Bihar, India. To scale TFT-TFS, we are now pioneering a smartphone-based mobile learning strategy to train principals (or their designees) in Madhya Pradesh to implement and monitor TFT-TFS in schools. Research underscores the transformative potential of mobile learning: a flexible, scalable, and cost-effective alternative to in-person training methods. Our study is a unique opportunity to test a training approach that could have implications for wider and more efficient delivery of other public health programs. The strategic use of gamification and digital storytelling enhances the TFT-TFS mobile training app. Gamification mechanics—including points, leaderboards, and digital badging—foster a dynamic learning environment to enhance learning outcomes. This approach propels continuous participant engagement toward understanding and implementation of TFT-TFS’s six monthly themes and four program components. The TFT-TFS smartphone training program weaves in elements of Indian culture, notably the symbolic use of colors and kites. The Indian kite festival celebrates communal harmony through healthy competition. Similarly, the app employs the idea of school kites, which are divided into six blank segments corresponding to the TFT-TFS monthly themes. Participants navigate each module, engaging with animated videos, digital assessments, and interactive activities. Upon a principal’s successful completion of each monthly theme’s program components, the school’s kite receives a new color, unlocking the subsequent theme. The TFT-TFS smartphone training showcases a unique interactive mobile learning application that integrates gamification and tests how to scale up an effective tobacco control program in schools in India and other LMICs. The TFT-TFS smartphone-based training app may also have relevance to other public health-related training efforts in resource-constrained areas.

Case study: lessons learned from a community-based early frailty intervention programme in Singapore.

Frailty is a dynamic and evolving state of health which involves the gradual loss of physiological in-built reserves. In Singapore, there is growing interest in delivering frailty intervention programmes at scale in the community to meet the demands of an ageing population. New methods of programme delivery such as community-led models that do not rely on healthcare professional manpower are critical to address this unmet need. In this paper, we describe our experience and some lessons learned from the implementation of a community-based early frailty intervention programme for older adults, delivered for the first time by trained laypersons. From August to September 2022, "Steady Lah," a community-based early frailty intervention programme with physical activity and nutrition-based elements, was conducted at an Active Ageing Centre in Singapore. A total of 23 participants with mean age of 73.8 years were enrolled in the 12-session programme comprising of progressive strength and balance-based exercises and workshop-based learning focusing on nutrition. In the implementation of this run of "Steady Lah," modifications were made from a healthcare professional-led model to a trained layperson-led model with additional steps taken to ensure participant safety and assess overall effectiveness when delivered by trained laypersons. Good collaboration between stakeholders in healthcare institutions and the community is necessary to co-develop a model that prioritises the needs of the frail older adults.

Telehealth-delivered physical activity interventions provided by maternal healthcare services influence postpartum women’s engagement in physical activity: a systematic review

The benefits of physical activity in the postpartum population are well documented, and regarded as being vitally important to the recovery process. Psychological health, musculoskeletal conditions, cardiorespiratory fitness and weight retention are among the postpartum health issues that physical activity can positively influence. Although international guidelines for physical activity postpartum have been published, there is a lack of current research into the effectiveness of, and patient compliance with, physical activity programmes in this population. Physiotherapists are well placed to deliver physical activity interventions for these women because of the multidisciplinary maternal healthcare services that are provided for them. The focus of this paper is to examine the available evidence regarding how the delivery and accessibility of physical activity programmes have changed with the exponential growth of telehealth. A detailed systematic literature search limited to randomized controlled trials published in English was performed for the period from 2014 to 2022. Four relevant publications were identified that utilized an element of telehealth physical activity in the postpartum population, although the timescale and definition of postpartum was not standardized across the papers. The findings of this literature review indicate that there is tentative support for the use of remote intervention as a means of improving physical activity in postpartum patients. The literature does not provide a consensus on the most appropriate length, type or duration of telehealth-delivered postpartum physical activity intervention for this population. There is a need for future high-quality research to investigate the effect of remote physical activity delivery on cost-effectiveness and patient satisfaction.