Routine Communication Research Articles

Parental perspectives on the clinician's approach to serious illness communication: A qualitative study.

To explore the perceptions of parents caring for a child with a life-limiting condition on approaches to communication used by clinicians engaging in routine serious illness communication. An exploratory qualitative design was used, employing a thematic analysis of data derived through semi-structured interviews which presented hypothetical vignettes of serious illness conversations to elicit parental perspectives. Adult parents of children with a life-limiting condition, in a stable phase of care, known to the Neurodevelopment and Disability Department of a tertiary Children's Hospital in Melbourne, Australia, were purposively sampled to achieve a broad representation of relevant clinical and sociodemographic factors. Eleven parents (72% female) of children aged 7months to 18years participated. Two major themes characterized parental perspectives on serious illness communication: "Approaches clinicians can use to lay the foundation for quality communication" including checking in, validation, aligning with hopes and a commitment to listening and being present; and "Approaches clinicians can use to aid the delivery of information" including honesty and compassion, presenting possibilities, providing a plan, and conveying the clinician's experience. This study provides novel insights into the perspectives of parents of children with life-limiting conditions that inform how clinicians may best approach serious illness communication. The findings highlight the need for clinicians working in pediatric health care to be cognizant of parents' needs before and during conversations. Laying the foundation for quality communication is important alongside the approaches outlined that aid in the delivery of information.

Does routine communication predict marital satisfaction? Between- and within-person effects

ABSTRACT Previous studies have almost exclusively examined the between-person associations between couple communication and marital satisfaction. However, relationship dynamics have also been theorized at the within-person level. This study examined the bidirectional associations between routine communication and marital satisfaction at the between-person (interindividual) level and within-person (intraindividual) level using three annual waves of data from 268 Chinese newlyweds (Mage = 29.59, SD = 3.25 for husbands; Mage = 28.08, SD = 2.51 for wives). Participants reported separately on their experiences of routine communication and marital satisfaction. The cross-lagged panel model (CLPM) was applied to examine between-person concurrent and lagged effects, and the random intercept cross-lagged panel model (RI_CLPM) was applied to examine within-person concurrent and lagged effects. Results from the CLPM revealed unidirectional lagged between-person associations from positive routine communication to marital satisfaction (instead of reciprocal associations). Results from the RI_CLPM showed a unidirectional lagged within-person association from positive routine communication to marital satisfaction (husbands only). Additionally, significant concurrent associations emerged in both models. This study provides additional insight into the within-person examination of non-conflict communication processes and highlights the importance of disaggregating between-person and within-person effects in understanding the nature of the dynamic association between routine communication and marital satisfaction.

FEATURES OF SOCIALIZATION AND INTEGRATION OF THE YOUTH WITH DISABILITIES AT THE EXAMPLE OF POLISH INTEGRATION PROGRAM «REHABILITACJA 25 PLUS»

The urgency of the researched problem is determined by the need for successful socialization and integration of youth with disabilities into society and the development of effective ways and mechanisms for their implementation. Having analyzed the activities of main organizations providing psychological and pedagogical support in Kropyvnytskyi, it was concluded that their work is aimed at providing pedagogical, psychological, material, socio-pedagogical, informational services to children and youth with functional limitations, as well as to their members families, but none of these institutions ensure the implementation of socialization and integration of youth with disabilities to involve them in full-fledged social life outside such institutions and provide opportunities for self-development and self-realization. The considers the experience of Polish pilot program "Rehabilitacja 25 plus", which is aimed at providing non-formal and civic education, meaningful leisure time, providing opportunities for self-development and self-realization. Psychotherapists within the framework of the program "Rehabilatacja 25 plus", in order to facilitate the conditions of the course of classes with psychologists and social pedagogues within the framework of the program "Rehabilatacja 25 plus" contribute to the improvement of routine skills and communication and speech abilities of young people with disabilities, their social and everyday life and socio-psychological adaptation, distracting disabled people from a pessimistic assessment of their future and changing the young person's focus on everyday interests and a positive perspective. Classes with psychologists and social educators within the framework of the "Rehabilitacja 25 plus" program contribute to the improvement of routine skills and communication and speech abilities of young people with disabilities, their social and everyday life and socio-psychological adaptation, distracting disabled people from a pessimistic assessment of their future and changing the young person's focus on everyday interests and a positive outlook.

Is physical co-presence a prerequisite for Durkheimian collective effervescence? Reflections on remote working during the COVID-19 pandemic

ABSTRACT This paper explores why it is that so many of us regard virtual communication technologies as imperfect substitutes for co-present organisational interaction. In so doing, it invokes Durkheim’s concept of collective effervescence; that is, the bonding phenomenon experienced between people in physical proximity. Initially, ethnographic data are presented from a Scottish commune known as the Findhorn Foundation, where the word ‘energy’ is widely used by participants to describe the feelings associated with co-present interaction. Macrosocial data are then drawn from the ‘Return, Reimagine, Reinvent’ series of reports published by McKinsey & Co. which documents remote working experiences during the pandemic. Both data sets suggest that even in an era of advanced virtual connectivity, physical co-presence remains a prerequisite for collective effervescence. Furthermore, the data reveal that while virtual connections are useful for routine communication, our sense of collective effervescence must be periodically ‘recharged’ by means of intermittent physical assembly.

PR TIKET.COM COMMUNICATION CRISIS IN RESPONDING TO COMMENTS BY USERS ON INSTAGRAM @TIKETCOM DURING THE COVID-19 PANDEMIC

This study was designed to understand how Tiker.com responded to the crisis of comments posted on Instagram @tiketcom by tiket.com users during the COVID-19 pandemic. If social media is your vehicle for discovering the problems users are facing, you can follow up by interacting in the comments section of @tiketcom Instagram posts regarding the crisis. This survey data is in the form of text, images, and videos from @tiketcom Instagram posts from 18 September 2020 to 2 July 2021. This research is a qualitative research. The methodology used in this study is Situational Crisis Communication (SCCT) to understand the crisis model used by PR Tiket.com. SCCT theory suggests that a crisis in an organization is a threat because it affects the reputation created by the crisis, so that the right strategy is needed to deal with the crisis. The research was conducted in three stages: data exploration, data analysis, and discussion of the resulting data. PR Tiket.com uses a messaging strategy in every post to provide information on the latest developments during the COVID-19 pandemic, the messaging strategy consists of eight messaging categories, namely; accommodative strategies, anti-social or defensive, emphasising inter-organisational relationship, excellence or renewal, framing the crisis, framing the organization, routine communication, self-enhancement. The results of this study indicate that Tiket.com PR uses SCCT theory in every crisis given by user comments on @tiketcom Instagram posts when facing a comment crisis during the COVID-19 pandemic.

The effect of using illustrated materials for communication on the anxiety and comfort of cardiac surgery patients receiving mechanical ventilator support: A randomized controlled trial

BackgroundUsing illustrated communication materials with patients receiving mechanical ventilation support increases patient satisfaction and reduces communication difficulties. However, there are no randomized controlled clinical studies showing the effect of the use of these materials on patient care outcomes. ObjectiveTo determine the effect of using illustrated communication materials on the anxiety and comfort levels of patients receiving mechanical ventilation support. MethodsIn this controlled clinical trial, patients were randomly assigned to either the intervention group that used illustrated communication materials or the control group that used routine communication methods. In the first minute of contact with patients in the intensive care unit, then at 30 min and 60 min, patients’ numerical pain-rating scale scores, hemodynamic values, and face-anxiety scale scores were recorded. Satisfaction with communication and perianesthesia comfort scale scores were obtained the day after operation. ResultsAfter 30 min of communication, the percentage of face-anxiety points difference decreased in the intervention group (-14.16) compared to the control group (-6.11), and the difference was statistically significant (p < 0.05). In terms of perceived comfort during postoperative mechanical ventilation, the mean score of the patients in the intervention group (106.10) was higher than the control group (88.53), and the difference was statistically significant (p < 0.05). Furthermore, 90% of the patients in the intervention group and 30% of the patients in the control group were satisfied with the communication method used, and the difference between the groups was statistically significant. ConclusionUsing illustrated communication materials reduces anxiety and increases patient satisfaction and comfort levels. In communicating with intubated patients, the use of illustrated communication materials is recommended.

A Novel Framework for Routine Versus Critical Communication in Surgical Education-Don't Take It Personally.

Despite their impressive academic track records and mastery of controlled classroom-based didactic learning, many orthopaedic surgery residents struggle to adjust from learning in the classroom environment in medical school to learning in the operating room as surgical residents. Instead of learning in lectures, surgical residents take on a more apprenticeship-based role with the goal of mastering technical skills in an experiential learning environment. Yet, no framework has been explicitly described in the literature to help learners make this transition. Consequently, we feel there is a need to clearly define the different learning environments and modes of communication, such that the residents can better understand how information is acquired and retained as well as how feedback is delivered in the operating room compared with more traditional spaces (eg, medical school classroom). The objectives of this summary are to (1) identify the major differences between learning in the classroom environment and the operating room and (2) introduce the concept of routine versus critical communication. We hope that by better defining the new learning environment with an emphasis on communication styles that may be encountered in this setting, learners can more easily make the transition from high-performing academicians to high-performing surgeons.

1273. Implementation of a Mobile Phone Intervention Method to Improve Clinical Outcomes in Patients with HIV

Abstract Background Antiretroviral therapy (ART) adherence decreases morbidity and mortality; however, this is often complicated by various external factors. Strategies implementing cellular technology have demonstrated improved medication adherence. The objective of this pilot study was to assess the effectiveness of utilizing weekly mobile phone calls or text messages to improve clinical outcomes among patients with HIV. Methods This study was conducted at an infectious disease clinic at an academic medical center 2019-21. Twenty-two patients were selected based on a history of poor ART adherence. For a period of 6 months, patients were contacted weekly by text message or phone call to determine medication adherence and to encourage continued adherence. Outcomes during the 12-month intervention period (6m intervention and subsequent 6m) were compared to the 12-month pre-intervention period and included viral load, CD4 count, clinic visits, emergency department (ED) visits, hospitalizations, and new-onset opportunistic infections (OI). Wilcoxon signed rank test and McNemar’s test were performed, though study is not powered for true analysis. Results Twenty-two patients were selected for inclusion and 13 (55%) maintained persistent communication throughout the intervention. For all 22 enrolled participants, this intervention resulted in increased mean yearly clinic visits (2.6 vs 3.8), decreased median viral load (32,979 vs 852 copies/mL, p=0.017), and increased median CD4 (142.5 vs 249 cells/uL). This also led to a decrease in patients with &amp;gt; 1 ED visit (54.6% vs 36.4%), &amp;gt; 1 inpatient hospitalization (36.4% vs 13.6%), and diagnosis of an OI (18.2% vs 13.6%). These outcomes were most remarkable in the 13 patients who maintained scheduled communication [mean yearly clinic visits (2.9 vs 5.2), median viral load (27,633 vs 118 copies/mL, p=0.0248), median CD4 cells/uL (76 vs 253), &amp;gt; 1 ED visit (61.5% vs 30.8%), &amp;gt; 1 inpatient hospitalization (38.5% vs 23.1%), and new OI (23.1% vs 7.7%)]. Impact of Intensifying Outpatient HIV Management Clinical outcomes for the pre-intervention year (routine communication) and the intervention year (enhanced communication) for all 22 patients initially selected for the study are compared to outcomes for the 13 patients who maintained persistent communication throughout the intervention period. Conclusion Enhanced communication through weekly mobile phone reminders may serve as a useful tool in the outpatient setting to improve ART adherence and reduce morbidity among adults with HIV. The findings of this small pilot study provide support for the need of a larger study to prove the benefit of this care model. Disclosures All Authors: No reported disclosures.

Comparison of management and workers' perception, attitudes and beliefs toward health and safety in the Ontario manufacturing sector

Introduction: The Ontario manufacturing sector is over-represented when it comes to workers’ compensation claims in the province. A previous study suggested that this may be the result of compliance gaps with respect to the province’s occupational health and safety (OHS) legislation. These gaps may be, in part, due to differences in perceptions, attitudes, and beliefs toward OHS between workers and management. This is noteworthy as these two cohorts, when working well together, can foster a healthy and safe work environment. Therefore, this study sought to ascertain the perceptions, attitudes, and beliefs of workers and management with respect to OHS in the Ontario manufacturing sector and to identify differences between the groups, if any. Methods: A survey was created and disseminated online to get the widest reach across the province as possible. Descriptive statistics were used to present the data and chi-square analyses were performed to determine if there were any statistically significant differences in responses between workers and managers. Results: In total, 3,963 surveys were included in the analysis, which consisted of 2,401 (60.6%) workers and 1,562 (39.4%) managers. Overall, workers were more likely to state that their workplace was ‘a bit unsafe’ relative to managers and this difference was statistically significant. There were also statistically significant differences between the two cohorts with respect to health and safety communication matters, the perception of safety as a high priority, whether people work safely when unsupervised, and whether control measures are adequate. Conclusions: In summary, there were differences in perception, attitudes, and beliefs toward OHS between workers and managers in Ontario manufacturing and these differences must be addressed in order to improve the sector’s health and safety performance. Practical Applications: Manufacturing workplaces can improve their health and safety performance by strengthening labor-management relationships, including having routine health and safety communication.

Outcomes of family-centred auditory and tactile stimulation implementation on traumatic brain injured patients.

To determine the outcomes of Family-centred Auditory and Tactile Stimulation Implementation on Traumatic Brain Injured Patients in Egypt. Family engagement in the care of their relatives in the Intensive care units is limited due to patients' life-threatening conditions, in addition to the use of high technology in these settings. Auditory and tactile sensory stimulations are among the diverse sensory stimulations that have received more attention in brain injured patients than other senses as being considered safe, and effective measures. A Quasi-experimental design was used to test the hypotheses of this study. A convenience sample of 60 adult patients suffering from Traumatic Brain Injury and admitted to the intensive care units of two University Hospitals in Egypt was included in the study. Patients were assigned into two equal groups: control and study groups (30 patients each). The auditory and tactile stimulations were provided by trained family members, once daily for 2 weeks for the study group. Whereas routine communication was provided by the family of traumatic brain injured patients in the ICU for the control group. Two tools were used for data collection; tool one, the "Glasgow Coma Scale" to assess patient's level of consciousness, and tool two the "Physiological Adverse Events Assessment" to monitor patients for the occurrence of physiological adverse events. January to October 2019. The implementation of an organized auditory and tactile stimulation by trained family members is associated with highly statistically significant positive effects . Patients in the study group showed a higher mean of consciousness, lower incidence rate of physiological adverse events, and a lower mean duration of ICU stay. Implementation of an organized auditory and tactile stimulation by trained family members enhanced the consciousness level of comatose Traumatic Brain Injured patients, decreased the occurrence of physiological adverse events, and ICU length of stay. Thus, it is recommended for use in the daily routine nursing care of comatose Traumatic Brain Injured patients. This study gives a deeper understanding of how family engagement in the care of their critically ill relative enhances their recovery and improve their level of consciousness.

Negativity in online news coverage of vaccination rates in Serbia: a content analysis

Objective This content analysis study explored how online news media communicates and frames vaccination rates and herd immunity (the effect where enough people are immune, the virus is contained). Methods We analyzed 160 vaccination-related news stories by nine highest-trafficked news websites in Serbia, published July–December 2017, around the start of the measles outbreak. We coded both the news story as a whole and every vaccination-rate mention (N = 339). Results News stories framed current vaccination rates and changes in them in a predominantly negative way (175/241 and 67/98 mentions, respectively) (e.g., “only 50% vaccinated”, “fewer parents vaccinating their children”), especially when referring to the measles vaccine (202/262 mentions). A total of 23/86 of news stories mentioning vaccination rates did not provide any numerical values. Reference groups for vaccination rates were rarely specified. Out of the 32 news stories mentioning herd immunity, 11 explained the effect. Conclusions Even routine communication of vaccination rates can be biased through negative frames and imprecise descriptions. Lamenting low immunization rates could activate a negative descriptive social norm (“many people are not getting vaccinated”), which may be especially ill-advised in the absence of an explanation of the social benefit of achieving herd immunity through vaccination.

Communication Competence in Pilot-Controller Interactions: Repair and Accommodation Strategies

Due to the exponential growth in the aviation industry, the number of non-native speaker pilots and air traffic controllers has significantly increased. Naturally, the interaction has become more challenging since the communication shifted to intercultural communication within a lingua franca setting. This study identifies and discusses the repair and accommodation strategies pilots and air traffic controllers use in their routine in-flight communication. The corpus consists of 30 hours of actual pilot-controller audio communication collected from the Malaysian airspace. Audio data collected from three frequencies (Alpha, Bravo and Charlie) were analysed using the conversation analysis method. The findings extend existing knowledge on miscommunications in pilot-controller discourse. The study found that in most instances, pilots and controllers made conscious efforts to repair the various types of miscommunications that took place. The findings also show that communication errors and misunderstandings are commonly caused by cultural differences and inadequate language competency amongst the pilots and controllers. The paper concludes by suggesting that repair strategies and intercultural communication competence should be integrated within aviation communication training modules to improve pilot and controller communication strategies in intercultural settings.

The role of day-respite centres in supporting people with dementia to age in place: An interpretive phenomenological study.

Day-respite care opportunities for people with dementia help prevent informal carer burnout and enable ageing in place. Care workers in these settings are an under-researched workforce who play a pivotal role in providing an engaging and supportive environment for clients with dementia. This study aimed to understand their experiences of providing care for people with dementia. An interpretive phenomenological analysis explored the factors that challenge and enable day-respite centre workers of the sole facility in one regional Australian town to provide, what they perceive to be high-quality, person-centred care for people with dementia. Thematic analysis revealed four themes relating to the experience of providing care to people with dementia in this day-respite centre. Care challenges associated with the symptoms of dementia were recognised by participants; however, these issues were mitigated by the powerful enabling factors, including a strong focus on dementia-friendly care, operating within the centre. Thematic analysis yielded four themes of a person-centred workplace culture and strategy, embedded communication practices, provision of a safe and engaging environment and positive staff attributes. These themes were perceived to make participants' jobs more enjoyable, as well as improve their clients' and carers' quality of life. Day-respite centres offer a valuable resource for people with dementia and their carers, and their success depends on several key environmental and workforce factors. Accordingly, other facilities targeted at caring for this population should assess the feasibility of adopting similar strategies, including selecting and training specialised care staff, adapting the care environment to suit clients' physical and behavioural needs. and establishing routine multi-channel communication methods that effectively connect staff with other care providers, their clients, and their clients' carers. SO WHAT?: The lessons learned in this research could be implemented throughout the wider web of dementia care. Strategies might include the careful selection and training of staff; the provision of dedicated, safe dementia-friendly wards; and routine communication key stakeholders to ensure met-needs care. While there would be a need to scale such care to suit different individual care providers, even seemingly simple strategies would likely have positive effects in optimising care for people diagnosed with this debilitating neurocognitive disease.

Effect of CICARE Communication Mode on Disease Uncertainty, Self-Nursing Ability, and Quality of Life in Patients with Coronary Atherosclerotic Heart Disease after Percutaneous Coronary Intervention.

Objective To study the effect of CICARE (Connect, Introduce, Communicate, Ask, Respond, Exit) communication mode on disease uncertainty, self-nursing ability, and quality of life in patients with coronary atherosclerotic heart disease (CAD) after percutaneous coronary intervention (PCI). Methods From January 2021 to December 2021, 102 patients with CAD after PCI were randomly divided into a research group (n =51) and a control group (n =51). The former received CICARE communication model nursing intervention, and the latter received routine doctor-patient communication nursing. To study the scores of disease uncertainty scale (MUIS), Frankl treatment compliance scale (Frankl), self-care ability scale (exercise of self-care-a), quality of life scale (WHOQOL-BREF), and Newcastle nursing satisfaction scale (NSNS) before and 1 week after nursing. Results After one week of nursing, the MUIS score of the research group was lower than that of the control group, and the score of Frankl treatment compliance scale of the research group was higher than that of the control group. After 1 week of nursing, the ESCA score of the research group was higher compared to the control group (p < 0.05), and the WHOQOL-BREF score of the research group was higher compared to the control group (p < 0.05). After one week of nursing, the NSNS score of the research group was higher compared to the control group (p < 0.05). Conclusion The application value of CICARE communication mode nursing intervention in patients with CAD after PCI is more remarkable, and it is more helpful to reduce patients' disease uncertainty, enhance treatment compliance, promote patients' self-nursing ability, and strengthen quality of life and nursing satisfaction.

Newborn Screening by Genomic Sequencing: Opportunities and Challenges.

Newborn screening for treatable disorders is one of the great public health success stories of the twentieth century worldwide. This commentary examines the potential use of a new technology, next generation sequencing, in newborn screening through the lens of the Wilson and Jungner criteria. Each of the ten criteria are examined to show how they might be applied by programmes using genomic sequencing as a screening tool. While there are obvious advantages to a method that can examine all disease-causing genes in a single assay at an ever-diminishing cost, implementation of genomic sequencing at scale presents numerous challenges, some which are intrinsic to screening for rare disease and some specifically linked to genomics-led screening. In addition to questions specific to routine screening considerations, the ethical, communication, data management, legal, and social implications of genomic screening programmes require consideration.

Authentic routine ship-shore communication in the Northern Adriatic Sea area – A corpus analysis of discourse features

In the global maritime industry, ineffective and ambiguous communication often is a main or contributing cause of shipping accidents. Nevertheless, because of the limited availability of authentic data, quantitative studies in maritime communication are rare. In addition, previous studies seem to have used the Standard Marine Communication Phrases as the prescriptive maritime communication standard, thus overlooking the superordinate role of the Manual for Use by the Maritime Mobile and Maritime Mobile-Satellite Services published by the International Telecommunication Union. Therefore, this paper uses a specialised spoken corpus of authentic routine ship-shore communication to quantify the rate of compliance of authentic routine ship-shore communication with the standard protocol of communication for ships and shore services as the key communication agents in the provision of navigational safety and efficiency. The findings show that authentic routine ship-shore communication still significantly deviates from the standard protocol of communication. In addition, the rate of compliance varies across the analysed elements and between the two communication agents examined in this study. Finally, the results indicate the need for harmonisation between the documents that define the standard protocol of communication.

Effectiveness of augmented alternative communication method on physiological parameters among conscious mechanical ventilation patients

Background: Conscious mechanical ventilation patients in intensive care unit experience intense anxiety due to inability to communicate which might also affect their physiological parameters. Aim: to evaluate the effectiveness of augmented alternative communication method on physiological parameters (heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate and SpO2-oxygen saturation) among conscious MV patients in the ICU. Methodology/Design: Quantitative evaluative approach with quasi experimental (pretest, posttest with control group) research design was adopted in the present study.120 conscious mechanical ventilated patients were randomized into two groups, experimental and conventional care group (60 in each group).The experimental group, mechanical ventilation patients who were awake, aware and responsive to verbal communication was served by a simple assistive communication tool ( augmented alternative communication) for continuous three days. In contrast, only routine or usual nursing communication practice or standard care was provided to the control group. The socio-demographic data, clinical profile, communication difficulties self-evaluation questionnaire, patient satisfaction self-evaluation questionnaire, self-rating Face anxiety scale and Physiological parameters was used to measure study parameters.

Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study

BackgroundGiven chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor maternal and fetal outcomes, these women would benefit from effective preconception care. However, there is a lack of understanding of how these women use or don’t use contraception to inform such interventions. This study examined patterns of contraceptive use among an Australian cohort of young women and investigated the influence of chronic disease on contraceptive use over time.MethodsUsing data from 15,244 young women from the Australian Longitudinal Study on Women’s Health (born 1989–1995), latent transition analysis was performed to identify distinct contraceptive patterns among women who were at risk of an unintended pregnancy. Multinomial mixed-effect models were used to evaluate the relationship between contraceptive combinations and chronic disease.ResultsContraceptive use for women with cardiac and autoinflammatory diseases differed to women without chronic disease over the observation period. Compared to women without chronic disease using the pill, women with cardiac disease had double the odds of using ‘other’ contraception and condoms (OR = 2.20, 95% CI 1.34, 3.59) and a modest increase in the odds of using the combined oral contraceptive pill and condoms (OR = 1.39, 95% CI 1.03, 1.89). Compared to women without chronic disease who used the pill, women with autoinflammatory disease had increased odds of using LARC and condoms (OR = 1.58, 95% CI 1.04, 2.41), using ‘other’ contraception and condoms (OR = 1.69, 95% CI 1.11, 2.57), and using the combined oral contraceptive pill and condoms (OR = 1.38, 95% CI 1.09, 1.75). No differences in contraceptive patterns over the observation period were found for women with asthma or diabetes when compared to women without chronic disease.ConclusionThe findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between health care providers and women with chronic disease to improve young women’s contraceptive knowledge and agency in contraceptive choice, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.

Prepared to Act: Lessons Learned by the Special Pathogens Research Network, Based on Collaborations with the NIAID-Led Adaptive COVID-19 Treatment Trial.

The need for well-controlled clinical trials is fundamental to advancing medicine. Care should be taken to maintain high standards in trial design and conduct even during emergency medical events such as an infectious disease outbreak. In 2020, SARS-CoV-2 emerged and rapidly impacted populations around the globe. The need for effective therapeutics was immediately evident, prompting the National Institutes of Health to initiate the Adaptive COVID-19 Treatment Trial. The Special Pathogens Research Network, made up of 10 Regional Emerging Special Pathogens Treatment Centers, was approached to participate in this trial and readily joined the trial on short notice. By trial closure, the Special Pathogens Research Network sites, making up 19% of all study sites, enrolled 26% of the total participants. The initial resources available and experience in running clinical trials at each treatment center varied from minimal experience and few staff to extensive experience and a large staff. Based on experiences during the first phase of this trial, the Special Pathogens Research Network members provided feedback regarding operational lessons learned and recommendations for conducting future studies during a pandemic. Communication, collaboration, information technology, regulatory processes, and access to resources were identified as important topics to address. Key stakeholders including institutions, institutional review boards, and study personnel must maintain routine communication to efficiently and effectively activate when future research needs arise. Regular and standardized training for new personnel will aid in transitions and project continuity, especially in a rapidly evolving environment. Trainings should include local just-in-time training for new staff and sponsor-designed modules to refresh current staff knowledge. We offer recommendations that can be used by institutions and sponsors to determine goals and needs when preparing to set up this type of trial for critical, short-notice needs.

Words of Warning: A Randomized Study of the Impact of Assorted Warning Letters on Academic Probation Students

Objective: Superiority experiments supply a critical lens to probe higher education interventions because they can dismantle the collective effect of a program and identify the relative contribution of the core components. However, such lines of inquiry are generally absent in higher education literature. We draw on experimental data to probe the dominant mechanisms of a simple but promising academic probation intervention. Methods: We used a 2 × 2 factorial experiment designed to unpack the effects of an academic probation intervention and identify the dominant mechanism. Within this framework, 500 academic probation students were assigned to one of four treatment conditions or a control condition. Treatment groups were assigned to receive notification of academic probation status by either certified or regular mail (factor A) that contained either a standard or embellished letter (factor B). Results: We found that students who received embellished warning letters significantly improved subsequent academic performance. The impact on performance was 0.35 grade points when notification sent by regular mail and amplified to 0.48 grade points when sent via certified mail. The routine notification communication message did not differ from the treatment as usual method regardless of mail delivery method. Conclusions: These findings suggest the availability of low-cost, scalable interventions are available and can be identified to positively impact at-risk students’ academic achievement.