Staff Perceptions Research Articles

Digital Transformation in Community Radio: Extending the Reach of Social Inclusion Efforts at Mathare FM, Nairobi, Kenya

This study explores the potential of Mathare FM, a community radio station in Nairobi’s Mathare slum, to enhance social inclusion through digital transformation. The main objectives were to assess how digital platforms can expand Mathare FM’s role in promoting social inclusion and to explore the perceptions of listeners and staff regarding the integration of these tools. Purposive sampling method was employed to select participants who could provide relevant insights regarding the station's social inclusion impact for Mathare residents. Grounded in Diffusion of Innovations Theory and Uses and Gratifications Theory, this research analyses the benefits of incorporating social media, mobile applications, and online streaming into the station’s operations. Data collected from the questionnaires were analysed using SPSS to perform descriptive and inferential statistical analyses. A descriptive research approach was used, combining questionnaires and interviews with a sample size of 400 members. Findings indicate that Mathare FM plays a significant role in promoting social inclusion, with 53% of respondents reporting high satisfaction with the station's community engagement efforts. Notably, 76% of respondents believe that digital platforms would facilitate greater engagement for marginalized groups, and 73% expressed a willingness to integrate these tools with traditional broadcasting. The study recommends developing a comprehensive digital strategy, enhancing social media engagement, and leveraging mobile applications to increase accessibility and interaction within the community.

Implementation of a UK supermarket intervention to increase purchasing of fresh fruit and vegetables: process evaluation of the WRAPPED natural experiment

BackgroundPlacement interventions, characterised by greater availability and more prominent positioning of healthy food products in supermarkets and other food stores, are associated with healthier patterns of purchasing and diet. The WRAPPED intervention study is a natural experiment that aims to evaluate a supermarket placement intervention to improve fruit and vegetable sales, household purchasing and the dietary quality of women and their children. Process evaluation, alongside the evaluation of outcomes, is essential to understand how interventions are implemented, under what circumstances they are effective, and their mechanisms of impact. This study aimed to assess the implementation of the WRAPPED placement intervention.MethodsThe study adopted a convergent mixed-methods design. Quantitative data extracted from study store planograms (visual representation of stores and product placement) before and after intervention implementation were used to assess the positioning of fresh fruit and vegetables in the first aisle from the front entrance (intervention dose). The availability of fresh fruit and vegetables in each study store was examined from stock-keeping unit (SKU) figures before and after intervention implementation. An intervention implementation survey (IIS) completed with store managers and senior supervisors before and 1- and 6-months post-intervention implementation enabled examination of the context across study stores. Semi-structured interviews with store managers and senior supervisors provided qualitative data about store staff experiences and perceptions of the intervention between 6-months post-intervention implementation.ResultsThe placement intervention was implemented with close adherence to the study protocol. There were marked differences, post-intervention implementation, in the positioning of fresh fruit and vegetables in intervention stores compared with control stores: median distance in intervention stores was 8.0 m (IQR 5.0 to 10.0) compared with 23.8 m (IQR 21.0 to 30.0) in control stores (P < 0.0001). The availability of varieties of fresh fruit and vegetables increased in intervention stores post-intervention compared with control stores: median (IQR) among intervention stores was 72 (51, 84) compared with 56.5 (50, 62) in control stores (P = 0.03). The mean change from baseline to post-implementation in number of different fruit and vegetables available in intervention stores was 15.3 (SD 16.7) (P = 0.01). IIS and interview data demonstrated little difference between intervention and store contexts over time. Reinforcing factors for intervention implementation included: head-office leadership, store staff views and attitudes and increased awareness of the importance of offering healthy food in prominent locations within stores.ConclusionThis study demonstrated that placement interventions which promote fresh fruit and vegetables to customers in discount supermarkets can be implemented effectively. These findings are encouraging for the implementation of national food policies which modify retail environments to improve population purchasing and dietary patterns.Trial registrationNCT03573973; Pre-results.

The impact of in-house education on staff confidence in delivering palliative and end-of-life care: a service evaluation.

Palliative and end-of-life care (EoLC) education is available to all community and hospital healthcare staff in one NHS trust in the north-east of England. It is also available to care home and domiciliary care staff within the geographical area of the trust. This service evaluation assessed the effect of current in-house education on staff confidence levels in delivering palliative and EoLC. It also examined staff perceptions of how attendance at these courses impacted on the palliative and EoLC patients receive across the locality. A mixed-methods approach was undertaken. Anonymous data were collected via surveys (n=238) sent out in March 2023 covering educational courses that were delivered from 1 January to 31 December 2022 with a 13% response rate. Quantitative data were analysed using descriptive statistics. Qualitative data were explored using Braun and Clarke's (2012) six-stage approach to thematic analysis. A second staff member was asked to review the data to increase the trustworthiness of the study. Staff confidence levels in delivering palliative and EoLC increased by 19% (somewhat confident) and 23% (extremely confident) following attendance at trust education. Staff perceived that those patients received better palliative and EoLC as a result their attendance at these courses. The qualitative data identified five main themes: symptom control, psychological support, holistic care, patient advocacy, and advance care planning. Limitations of the study included the low survey response rate and lack of exploration of patient/carer perceptions directly. Palliative and EoLC education can increase staff confidence levels in care delivery and, as perceived by staff, results in better care for patients receiving palliative and EoLC. These findings provide evidence for the trust to consider making palliative and EoLC training mandatory, which could also be considered more widely regionally and nationally.

Developing and validating the diversity, equity, inclusion, and antiracism staff perceptions of college climate (DEIA SPCC) scale in pharmacy staff

Background: This study focuses on the development and validation of the Diversity, Equity, Inclusion, and Antiracism Staff Perceptions of College Climate (DEIA SPCC) Scale. The goal of this study was to create and validate a standardised tool to assess pharmacy staff perceptions of DEIA within their institutions, thereby aiding in the evaluation and advancement of DEIA initiatives in colleges of pharmacy. Methods: A 20-item survey covering four domains - diversity, equity, inclusion, and antiracism - was distributed to pharmacy staff through the American Association of Colleges of Pharmacy (AACP) directory. The survey's validity was assessed using factor analysis and reliability analysis. Results: There was a total of 135 staff member responses. Results demonstrated high reliability and consistency across all four domains, with the Cronbach’s alpha ranging between 0.764 to 0.951. Conclusion: The study concluded that the DEIA SPCC survey is a practical, validated tool for pharmacy institutions to assess and enhance their DEIA climate from the perspective of their staff, potentially extendable to other healthcare academic disciplines. Further research is suggested to validate the survey in broader contexts and explore the predictors of survey scores.

UNLOCKING THE TRANSFORMATIVE POWER OF ARTIFICIAL INTELLIGENCE FOR SUSTAINABLE DEVELOPMENT IN HIGHER EDUCATION

The rapid transformative power advancement of Artificial Intelligence (AI) is revolutionising various aspects of higher education, offering a transformative potential to reshape the way higher education teachers and students learn, teach, and interact as the global higher education sector strives to achieve sustainable development. Artificial intelligence has become a current phenomenon that everyone needs to tap into to promote inclusive and equitable access and drive innovation in teaching and learning environments through staff and students' perceptions. The study approach employed Structural Equation Modeling and gathered staff and students' perceptions of the potential AI sustainability in Higher Education. Two hundred fifty (250) samples were gathered using cluster and multi-stage sampling methods based on the study population. The researcher disseminated surveys through face-to-face and social media platforms, including WhatsApp. The data was analysed using two different software, AMOS and SPSS, and the outcome of the data collected based on the relationship of variables towards adaptation of AI in higher institutions of learning for a better educational system and enhancing qualities of education based on a set of descriptive and testing the relationship between four different variables. The findings revealed that artificial intelligence adoption in higher education enhances and transform the educational system. The study identified that awareness, attitude, and performance expectancy play significant roles in influencing AI adaptation in Higher education. The study recommends that policymakers, educators, and institutions harness the transformative potential of AI for sustainable higher educational development, emphasising the importance of collaboration, professional development, and ethical standards in enhancing higher education to become more effective, efficient, and inclusive, and ultimately contributing to a more sustainable future for individuals and society.

Using the Socioecological Model to Understand Medical Staff and Older Adult Patients' Experience with Chronic Pain: A Qualitative Study in an Underserved Community Setting.

Chronic pain is highly prevalent and disabling for older adults, particularly those from underserved communities. However, there is an absence of research on how contextual (eg, community/societal) factors interact with pain for these patients. Informed by the socio-ecological model, this study aimed to elucidate the individual, interpersonal, community, and societal factors associated with chronic pain from the perceptions of older adult patients and medical staff in a community clinic. In this qualitative study, we conducted four focus groups and two interviews with medical staff (n=25) and three focus groups and seven individual interviews with older adult patients with chronic pain (n=18). Participants were recruited using purposive sampling from an ethnically and economically diverse primary care clinic in the greater Boston community. We transcribed assessments and thematically analyzed data using a hybrid deductive-inductive approach. At the individual level, we identified three themes: (1) older adults with complex care needs, (2) impact of pain (including on physical, emotional, work, and identity functioning), and (3) coping with pain. At the interpersonal level, complex relationships with (1) social supports and (2) medical staff emerged as themes. The need for (1) resources and (2) culturally informed care was identified at the community level, and socioeconomic status impacting the availability of resources for managing chronic pain emerged for the societal domain. Findings underscore the intersection of factors contributing to the experience of pain among older adults from underserved communities. Our findings highlight the need to develop and implement treatments that fully address the experience of older adults with chronic pain at the individual, interpersonal, community, and societal levels.

The Impact of Leadership Styles on Employee Retention: A Case Study of High School Teachers in Battambang, Cambodia

The study of leadership styles plays a crucial role in understanding how effective leadership can influence organizational success and employee satisfaction. This study aims to 1) examine the influence of democratic leadership, transformational leadership, and laissez-faire leadership on public organization employees' retention; 2) search for the perceptions of civil servants, comparing male and female staff, regarding the variability of democratic leadership, transformational leadership, laissez-faire leadership, and employee retention; and 3) study the views of civil servants on leadership variability in the three types of leadership styles in public organizations in Battambang Province. The quantitative research method employed questionnaires with 261 civil servants working at ministries, universities, and high schools in Battambang Province. The results revealed that democratic leadership (β = .247, T = 2.299, P = .022, P &lt; 0.05) and transformational leadership (β = .901, T = 8.19, P = .000, P &lt; .001) had positive effects on the retention of staff and civil servants. However, laissez-faire leadership harmed the retention of staff and civil servants (β=.165, T=2.465, P=.014, P&lt;0.05). This study concluded that democratic and transformational leadership positively influence employee retention in public organizations in Battambang Province, whereas laissez-faire leadership has a negative impact. Ministries, universities, and institutions should foster democratic and transformational leadership styles through targeted training programs and minimize laissez-faire leadership practices to improve employee retention.

Improving Interprofessional Provider Perceptions About Opioid Use Disorder in the Acute Care Setting Through a Blended Educational Simulation Intervention

Background The influx of patients in the acute care setting with opioid use disorder (OUD) has outpaced many hospitals’ ability to educate interprofessional staff. This creates distressing experiences for interprofessional staff and patients, leading to moral distress and burnout in staff and poor patient outcomes. Objective The purpose of this study was to improve interprofessional staff knowledge, attitudes, and perceptions toward working with patients who have OUD using a blended classroom-simulation–based curriculum. Methods A preintervention and postintervention design was selected. Interprofessional staff (n = 46) participated in a blended classroom-simulation educational intervention focused on the neurobiology of OUD, stigma reduction, pain management, and harm reduction principles, followed by 3 high-fidelity simulation scenarios. Participants completed the Drug and Drug Problems Perceptions Questionnaire to measure staff self-perceived knowledge, skills, and attitudes when working with patients who use drugs before, immediately after, and again 3 and 6 months postintervention. Results Most respondents were nurses with an average of 7.6 (SD, 9.6) years of experience. The majority did not have prior training in substance use disorder before (75.6%). There was a statistically significant decrease in mean Drug and Drug Problems Perceptions Questionnaire scores across the total score mean: 55.2 (95% confidence interval, 52.2-58.3) versus 45.5 (95% confidence interval, 43.9-47.1), P &lt; .001. Decreased score indicates improved attitude and perception. Discussion A curriculum consisting of a blended classroom-simulation intervention was successful at improving several domains regarding perceptions of caring for patients with OUD. This educational intervention can serve as a model for health care systems with goal of improving patient outcomes and staff well-being.

Critical incidents in schools. Staff wellbeing and perceptions of psychological support

AimsAcross the United Kingdom (UK), schools are required to respond to and support students, families and staff following a traumatic event and Educational Psychology (EP) Services often provide support to schools. This study explored school staff wellbeing in the context of critical incidents in schools along with their views and perspectives of psychological support.MethodsAn explanatory sequential mixed methods design was utilised consisting of two phases. In phase one, quantitative data was collected through an online questionnaire which gathered information on staff wellbeing, the impact of the event and EP support. For phase two, interviews explored staff perspectives on the support provided by the EPs.FindingsAnalysis found a significant positive relationship between wellbeing and EP support. Themes provide insight into the impact of the support provided by the EPs, including barriers and negative perceptions of the support as well as benefits.LimitationsIt is likely that there is a selection bias operating in teachers who chose to take part in the research. Additionally, the number of teachers taking part was not as high as might have been hoped for.ConclusionsA number of implications and conclusions are set out. In particular, effective articulation of what support will look like and being clear what is offered by an EP service is a crucial element of the support provided.

Pervasiveness and clinical staff perceptions of HPV vaccination feedback.

This study describes the use of data-based feedback, such as human papillomavirus (HPV) vaccination rates, to advance HPV vaccination uptake in pediatric and family medicine clinics. A survey of primary care clinical staff in the US who provided HPV vaccination to children aged 9 to 12years (N = 2527; response rate, 57%). The primary outcome was a mutually exclusive categorical variable that described the type of quality metrics for which providers received feedback in the past year: HPV vaccine, other pediatric vaccinations, other quality metrics, or none. Secondary outcomes were provider perceptions of HPV vaccine feedback helpfulness and their comfort with colleagues seeing their HPV vaccination rates. Logistic models adjusted for clinical staff and cliniccharacteristics. Only 36.2% (n = 916) of respondents received HPV feedback. Feedback on HPV vaccination rates was more likely in nonrural clinics (OR, 2.03; 95% CI, 1.38-2.99), clinics in systems of 5 or more (OR, 1.81; 95% CI, 1.38-2.36), and in clinics serving 50 or more children per week (OR, 3.08; 95% CI, 2.03-4.66). Hispanic, Latino, or Spanish (OR, 1.54; 95% CI, 1.00-2.36) and Black or African American clinical staff (OR, 2.12; 95% CI, 1.44-3.12) were more likely than White clinical staff to find HPV vaccine feedback helpful. Relative to pediatricians, family medicine clinical staff were less comfortable with colleagues seeing their HPV vaccination rates (OR, 0.70; 95% CI, 0.57-0.87). Clinical staff seldom receive feedback about HPV vaccination in primary care.

Patient and staff perspectives on pain treatment experiences in a community clinic serving under-resourced older adults.

Chronic pain affects up to 37.8% of older adults with higher prevalence among those in under-resourced communities. While there are many treatments for chronic pain, there are complexities to treating under-resourced older adults in community clinics, including multimorbidity, barriers to treatment access, and varying degrees of openness to different treatment approaches. Understanding patient and clinic staff perceptions of treatment options for chronic pain is critical for implementing treatment approaches that will work sustainably in the community. This study aimed to understand clinic staff and patients' perspectives on chronic pain treatment experiences. Focus groups and individual interviews were analyzed using a hybrid inductive-deductive approach. Themes are: (1) Limited patient and clinic resources and availability affecting pain treatment experiences (e.g., copays, transportation challenges, and conflicting responsibilities), (2) Discrepancies in patient and staff approaches to treatment and the importance of trialing different pain management techniques to alleviate pain (e.g., trialing multiple treatments with varied success), and (3) Conflict between patients' desire for pain elimination vs. staffs' focus on symptom reduction and function (e.g., patient-staff disconnect). These findings are important for determining how treatments can best fit the needs of under-resourced older adults with chronic pain.

Supporting students’ transition from college to university: Staff perspectives on developing a coherent tertiary system in Scotland

Scottish policy, funding, and quality systems have been tasked to provide “a more coherent and streamlined tertiary education system from the student perspective that delivers the best learning experience for students” (Scottish Funding Council, n.d.). This paper helps to inform this process, by presenting the findings from the second stage of Quality Assurance Agency Enhancement Theme project: Mind the Gap? College Students’ Experience of University. This stage investigated the perspectives of staff who support students making the transition from college to university. While there is a relatively broad literature covering the student perspective of this transition, the staff perspective is less well understood. This paper uses the themes developed from the first stage of the project – a qualitative research synthesis on the lived experiences of students (Robertson &amp; Cunningham, 2023) – to investigate staff perceptions of this transition. These themes considered are: (1) the responsibility for enabling effective transition; (2) the extent to which alignment between colleges and universities is achievable or, indeed, desirable; and (3) the extent to which college to university transitions genuinely widen participation. This paper reports the findings from a series of focus groups with university academic staff, university student support staff, and college academic staff from three institutions (two universities and one college). Using theoretical thematic analysis, the paper considers how sectoral, academic, identity and social, and logistical factors affect, or are identified in, the practice of the participants and what this means for the development of policy and practice around a ‘coherent tertiary model’.

Abolishing age criterion to determine organ transplant recipients in Israel: A qualitative study of medical staff perceptions

Abolishing age criterion to determine organ transplant recipients in Israel: A qualitative study of medical staff perceptions

RESOURCE MANAGEMENT AND IMPLEMENTATION OF EDUCATION PROGRAMS BY NON-GOVERNMENT ORGANIZATIONS IN RWANDA A CASE OF EDUCATE! RWANDA

This research aimed at ascertaining the relationship between resource management and programs in Rwandan NGO implementations, with a focus on education-related projects. Evaluating the effects of time resource on the effectiveness of non-governmental organizations operations was a clear objective of the research. Determining the impact of time management during program implementation in NGOs was the studys primary goal. The literature review gives detailed assertion on the implementation of educational sector based programs run by NGOs in Rwanda and how they are linked to resource management which eventually have significant influence on operation of such programs. The study will be relied upon by education stakeholders to establish the role played by NGOs via different programs towards the achievement of educational goals in Rwanda. This study highlighted the contribution of proper management of resources on the implementation of education programs both by NGOs and other concerned stakeholders. The study is valuable through creating basis for other scholars and researchers to rely on it for further research as it adds on the existing knowledge. The target population comprised of NGO staff, school staff plus students totaling to two hundred and thirty-five (235) participants from whom simple random and purposive sampling techniques were used to come up with sample size of the study respondents. In order to accomplish the studys aim, a mixed method approach was utilized to collect both qualitative and quantitative data through structured questionnaires as well as interviews.In easy to reach locations, the questionnaires were handed by hand, and those who were found difficult to interact with received them via email. The study data was analyzed and interpreted using tools like SPSS (Version 25.0), ANOVA and Descriptive statistics to organize and summarize the data using Pearsons correlation (for correlation analysis). This helped to present the findings as well as coming up with valid conclusions and recommendations.The study revealed that from the perception of Students, School staff and Educate! Staff, the expression of r = 0.354, r = 0.950 and r = 0.769 respectively proves that management of resources have positive correlation and greatly influence implementation of education programs.

Clinical Staff Perceptions of Pay-for-Performance Financial Incentives for HPV Vaccine Promotion.

The purpose was to investigate clinical staff perceptions of pay-for-performance human papillomavirus (HPV) vaccination financial incentives. In 2022, the authors conducted a national survey of clinical staff (N = 2527; response rate = 57%). Respondents were (1) certified to practice in the United States; (2) practiced as a physician, physician assistant, nurse practitioner, advanced practice nurse, registered nurse, licensed practical/vocational nurse, medical assistant, or certified nursing assistant; (3) worked in pediatrics, family medicine, or general medicine specialties; and (4) had a role in HPV vaccination for children ages 9 through 12 years. The team used ordered regressions to model whether respondents agreed with (ie, "Strongly agreed" or "Agreed" on a 5-point Likert scale) each of the 9 statements. The statements were mapped to domains based on the theory of planned behavior: attitudes (5 statements), perceived behavioral control (2), and norms (2). Favorable responses to 9 statements ranged from 32% to 85%; 5/9 items had more than 50% favorable responses. The following example odds ratios (ORs) are for "agree" versus "neutral" or "disagree" to change their behavior to obtain the incentive. Clinical staff with prior experience with incentives were more likely to agree with 8/9 positive statements about incentives (eg, OR = 1.32 [95% confidence interval {CI}: 1.12-1.57]). Family medicine clinics were more likely than pediatric clinics to agree with 5/9 statements (eg, OR = 1.42 [95% CI: 1.18-1.70]). Clinical staff with more years of experience were less likely to agree with 6/9 statements (eg, OR = 0.97 [95% CI: 0.97-0.98]). Clinical staff's perceptions of pay-for-performance HPV vaccination financial incentives were generally favorable.

Academic Staff Perceptions on Graduate Students’ Attitudes towards Academic Writing and Research in Selected Public Universities in Uganda

The study aimed to find out academic staff perceptions of graduate students’ attitudes towards academic writing and research skills in selected Public Universities in Uganda. It employed a phenomenological design and a qualitative approach. Graduate students, academic staff, and academic administrative staff as the study population. Study participants depended on the saturation of the findings collected. These participants were selected using a purposive sampling technique. Data from academic administrative staff and academic staff were collected using an interview guide. A focus group discussion guide for graduate students was the second data collection tool. Data were analysed using the thematic data analysis technique. Results showed that academic staff perceptions of graduate students’ attitudes on academic writing and research skills were negative. Negative perceptions were recorded on the generation of research ideas, enthusiasm, text structure, formal academic language, paraphrasing, plagiarism, and making citations. The study concluded that the perceptions of academic staff on graduate students’ attitudes towards academic writing and research were generally negative on the generation of research ideas, enthusiasm, use of formal academic research language, paraphrasing, plagiarism, and making citations. Thus, it was recommended that supervisors/mentors should be retooled in active research-based instructional supervision where they can be encouraged to work in groups, and initiate professional activities, such as mentoring and coaching, to assist them in supervising and evaluating graduate students’ research projects

Knowledge, Attitude and Perception on Casemix System Among the Hospital Staff in Malaysia and Indonesia

Objective: The aim of this study is to assess the Knowledge, Attitude, and Perception (KAP) of hospital staff regarding the Casemix System in Developing countries. Methods: A cross-sectional study was carried among the hospital staffs in Indonesia and Malaysia. The study hospitals and respondents were selected via random and purposive sampling, respectively. Data was collected via self-administered questionnaires. Results: Total 350 hospital staffs participated, out of this 58.6% of participants were from Indonesia. Most of the respondents (58.0%) had a moderate level of knowledge score, medium level of perception score (84.9%) and negative attitude (90.0%) on Casemix. The study found that years of working experience, type of occupation, hospital type, country, and those with training in Casemix were significantly related to knowledge score. No independent variable except for country was related to perception score. It was also found that majority (66.7%) of the participating hospitals (N=36) completely captured the demographic data in their HIS, 47.2% completely implementing the coding module as per Casemix requirement and 27.8% of the hospitals recorded the Activity Daily Living (ADL) score in their system. Conclusion: Among the participants, only 2.3% demonstrated a high level of knowledge about Casemix. When it comes to attitudes, majority of respondents expressed a negative view towards Casemix. Regarding perceptions, only 11.4% of respondents had a high perception of Casemix, while the majority, 84.9%, had a medium perception.

Use and perceptions of involuntary civil commitment among post-overdose outreach staff in Massachusetts, United States: A mixed-methods study.

Involuntary civil commitment (ICC) is a legal process by which people are compulsorily admitted to substance use treatment. This study explored views about and promotion of ICC procedures for substance use disorders among public health-public safety post-overdose outreach programs and their outreach team members in Massachusetts, USA. In this mixed-methods study, survey data were collected from post-overdose outreach programs in 2019, and semi-structured interviews were conducted with outreach team members in 2019 and 2020. Massachusetts, USA. We received 138 survey responses and conducted 38 interviews with post-overdose outreach team members (law enforcement officers, recovery coaches, social workers and harm reductionists) who were majority male (57%) and white (66%). We used the survey instrument to categorize programs as more (discussed ICC at 50% or more of outreach encounters) or less ICC focused (discussed ICC at less than 50% of outreach encounters) and to identify program characteristics that corresponded with each categorization. Semi-structured interviews explored staff perceptions of ICC effectiveness. Among 138 programs, 36% (n = 50) discussed ICC at 50% or more of outreach encounters. Discussing ICC at a majority of visits was positively associated with abstinence-only program philosophies (36% v. 6%, P < 0.001) and collaborating with drug courts (60% v. 30%, P < 0.001), but negatively associated with naloxone distribution (48% v. 75%, P < 0.001) and referring to syringe service programs (26% v. 65%, P < 0.001). Qualitative interviews identified three themes: 1) some programs viewed ICC as a first line tool to engage overdose survivors in treatment; 2) other programs considered ICC a last resort, skeptical of its benefits and concerned about potential harms; 3) families commonly initiated discussions about ICC, reportedly out of desperation. Promotion of involuntary civil commitment (ICC) appears to vary widely across post-overdose outreach programs in Massachusetts, USA, with approaches ranging from seeing it as a first step to treatment to being a tool of last resort. Demand for ICC among family members may relate to inadequate access to voluntary treatment. Family interest in ICC appears to be driven by inadequate availability of treatment and other services. ICC at post-overdose outreach visits should be limited, if used at all.

School staff perceptions of the impact of school counselling on young people, the school and integration into the school system

AbstractIntroductionThis research explored the views of staff in secondary schools on school counselling for young people. Data were drawn from the Effectiveness and Cost Effectiveness Trial of Humanistic Counselling in Schools (ETHOS) study, an RCT of school counselling across 18 state‐funded secondary schools in London.MethodsQualitative semi‐structured interviews were held with school staff (n = 16) from a sub‐sample of 10 participating schools from the RCT. The interviews explored the perceived impact of school counselling on the school and students. Thematic analysis was conducted using the NVivo qualitative data analysis software.ResultsThree key themes were identified: (1) school context: rising mental health need and varying provision for mental health; (2) school staff perspectives on the impact of counselling: increased openness and improvements in mood, dedicated space to open up, putting skills into practice, one size does not fit all, and role of personal connection; and (3) long‐term impact of counselling in schools: integration as central to success and counselling as a stepping stone for further support.ConclusionThis research provides insights into school staff views of secondary school counselling in the context of delivery through a research trial. Effective ways of integrating counselling services into schools are identified.

An exploration of factors leading to readiness for organizational health literacy change in community-based health organizations.

Healthcare systems have a responsibility to improve organizational health literacy (OHL) to increase health equity. This study explored two organizational cultural factors, leadership support and staff buy-in, for organizations planning OHL change. Ten community-based health organizations participated in an OHL program. The study design was mixed methods. The qualitative inquiry was interviews with senior leaders to explore awareness of OHL and: impetus to transform, leadership commitment, staff engagement, alignment to organizational goals, and integration of health literacy change with current practices. The quantitative assessment was the Organizational Readiness for Implementing Change (ORIC) questionnaire to assess staff's perceptions about OHL change readiness. Senior leaders articulated the effects of low health literacy in their patient and client population. Support for OHL change was seen at both leadership and staff levels. Impetus for change was primarily a response to a community need or for quality improvement. Most of the non-clinical organizations had higher ORIC scores than the clinical organizations, indicating a perceived higher level of readiness for OHL change. Leadership commitment and staff buy-in are important factors of readiness for OHL change. A novel finding is that community-based health organizations are able and willing to engage in OHL change.