Trained Facilitators Research Articles

Mapping the ‘lifelong journey’ of physical literacy: a biographical assessment method for the physical activity and health context

ABSTRACT Physical literacy (PL) describes individuals’ unique relationship with physical activity by integrating physical, cognitive, affective, and social aspects. The person-centered concept highlights a ‘lifelong journey’ for each individual and postulates beneficial effects on biopsychosocial health. Despite extensive suggestions on how to assess the concept, no instrument has so far sufficiently aligned with these ‘individual journeys’ for PL. Therefore, the goal of this conceptual article is to introduce the biographical PL mapping (BMAP-PL) as a purposive, flexible, and paradigmatically open method for the broad physical activity and health context. Intending to provoke individual narratives by plotting domain-driven courses across the lifespan, the BMAP-PL involves four sequential phases guided by a trained facilitator: (a) introduction and overview; (b) personalization and registration of life events; (c) evaluation and biographical visualization of PL dimensions; (d) final overview. The idiosyncratic courses can undergo both qualitative and quantitative analysis, including a potential for synthetic integration. Qualitative analyses can span the identification of life events, transition phenomena, domain-differential analyses, and inter-individual patterns via narrative analysis, thematic analysis, typological analysis, or the grounded theory approach. We suggest quantitative analyses with descriptive and inferential statistical potential on the intra-individual, inter-individual, and group/population level. Given the profound cognitive engagement with the complex behavior of physical activity, BMAP-PL allows for a smooth transition to interventional endeavors (e.g. self-exploration of identity facets, prospective projections, goal setting). The application of the method has value for both research and practice but is based on requirements on the personal and atmospheric level. Emphasizing the need to complement the conceptual ideas through empirical data, we conclude by outlining an agenda for future activities.

Replicability, adaptability and long-term impact of the 'Healthy Youngsters, Healthy Dads' program in Newcastle, Australia.

'Healthy Youngsters, Healthy Dads' (HYHD) targets fathers to improve the health of their preschool-aged children. In a previous randomized trial, fathers and children experienced meaningful improvements in physical activity and eating behaviours. The next phase is to test the replicability and adaptability of HYHD when delivered in the community by trained facilitators. Fathers/father-figures and children aged 3-5 years were recruited from Newcastle, Australia into a 9-week, non-randomized trial with assessments at baseline, 10 weeks, and 12 months. The primary outcome was achievement of pre-registered targets for recruitment (≥ 96 dyads), attendance (≥ 70%), compliance (completing ≥ 70% of home-based tasks), fidelity (≥ 80% of content delivered as intended) and program satisfaction (≥ 4/5). Secondary outcomes included physical activity, nutrition, screen time and parenting measures. Process targets were surpassed for recruitment (140 fathers, 141 children), attendance (79% for fathers-only workshops, 81% for father-child sessions), compliance (80% of home-tasks completed), fidelity (99% for education, ≥ 97% for practical) and program satisfaction (4.8/5). Mixed effects regression models revealed significant effects in fathers for moderate-to-vigorous physical activity, co-physical activity, dietary intake and parenting practises, which were maintained at 12 months. Significant effects were also established for screen time at 10 weeks only. For children, significant effects were observed for screen time and dietary intake at 10 weeks, while effects on energy-dense, nutrient-poor foods and healthy, nutrient-dense core food intake were maintained at 12 months. Findings demonstrate the replicability and adaptability of HYHD when delivered in the community by local trained facilitators. Further investigation into how to optimally scale-up HYHD is warranted.

Youth Perspectives on the Flint Water Crisis and Its Health Effects.

While the youth of Flint are at risk from the effects of the water crisis, little is known about their perspective of the impact of the water on their health. To explore adolescents' perceptions of living in Flint during the water crisis, its impact on their health, and ways to address the crisis and rebuild trust. In summer 2018, four focus groups were conducted with adolescents in Flint (ages 13 to 17 years). Group sessions were conducted by trained facilitators who were Flint residents along with members of the community-academic research team. Group sessions were audio-recorded and transcribed. Transcripts were reviewed and themes identified by the research team and youth from the focus groups. Of the 53 participants, most identified as Black (66%) and male (64%). Participants expressed concern about the impact of the water on their health. They knew people who developed rashes, experienced cognitive changes, and who died, they believed, owing to the water. The crisis also led to psychological consequences for youth. They expressed ongoing mistrust of the water and of institutions that should protect them, as well as concern that exposure may have long-term effects on their health and their children's health. Despite these concerns, participants expressed resilience and a desire to share that they had the potential to live successful lives. Youth expressed concern about current and long-term health sequelae of the water crisis. Further work is needed to monitor the consequences of the crisis and to identify resident-informed approaches to mitigate its effects and rebuild trust.

A qualitative study of individuals with acquired brain injury’ and program facilitators’ experiences in virtual acquired brain injury community support programs

Purpose Acquired brain injury (ABI) community support programs aim to help support long-term needs through informational and psychosocial support. Due to the COVID-19 pandemic, many support programs adopted virtual program delivery. However, the experiences of facilitators and people with ABI who participate in virtual support programs are understudied. This study aimed to describe the experiences of people with ABI and program facilitators participating in virtual ABI community support programs. Materials and Methods This was a qualitative descriptive study. Semi-structured interviews were conducted with people with ABI and program facilitators who participated in virtual ABI community support programs. Data were analyzed using inductive thematic analysis. Results In total, 16 participants were included in this study. Of the 16 participants, 14 were people with ABI (three of whom were also program facilitators) and two were program facilitators without ABI. Our analysis generated three themes including perceived benefits (theme 1), perceived challenges (theme 2), and considerations to improve program quality (theme 3). Each theme outlines subthemes relaying the experiences of participants. Conclusions These findings highlight the need for stakeholders to implement guidelines and training for program facilitators and attendees of virtual ABI support programs to maximize accessibility, usability, inclusivity and safety. IMPLICATIONS FOR REHABILITATION This study described the experiences of people with acquired brain injury and facilitators who participated in virtual support programs. Benefits of virtual support programs include connecting with peers, increased access to resources, and enhanced feasibility and accessibility. Difficulties with virtual support programs include intrapersonal (e.g., increased side effects), interpersonal (e.g., communication barriers), and environmental and contextual (e.g., privacy concerns) challenges. Suggestions to improve program quality include creating a safe and respectful environment, fostering engagement and managing challenging situations, and enhancing accessibility and inclusivity.

Acceptability, feasibility and fidelity of the culturally adapted version of Unplugged (“Yo Se Lo Que Quiero”), a substance use preventive program among adolescents in Chile: a pilot randomized controlled study

IntroductionThe consumption of alcohol, tobacco, and cannabis is a public health problem that impacts the cognitive, social, and emotional development of adolescents. Prevention strategies such as the “Unplugged” program are effective in delaying the progression of daily smoking and episodes of drunkenness among adolescents. “Yo Se Lo Que Quiero” (YSLQQ) corresponds to the adaptation of this program to the Chilean context. This study assesses the acceptability and feasibility of implementing this program to the local reality.Material and methodsThis was a cluster-randomized controlled pilot study conducted on six public schools. All consented students attending 6th, 7th, and 8th grades (n = 1,180) participated in the study. The schools were randomly assigned to one of two conditions in a 1:1 ratio: (1) the “YSLQQ” intervention group (n = 526), and (2) the Control group (n = 654). The program consisted of a 12-hour class-based curriculum based on a comprehensive social-influence approach delivered by a trained facilitator. The acceptability and feasibility were assessed in the intervention group at the end of the intervention using questionnaires answered by students and facilitators. The quality and fidelity of the program were evaluated during the implementation using self-ported surveys answered by the facilitators and the assessment of video-recorded sessions rated by external observers. Finally, a pre-test and a post-test survey assessing past and current substance use and risk and protective factors were conducted before and immediately after the program’s implementation.ResultsA high proportion of students (49.6%) liked the sessions. 79.2% reported that the YSLQQ helped them learn about the dangers of substances, while 65.8% reported having more skills to avoid substance use in the future. Regarding students’ satisfaction with YSLQQ, 62.9% reported being happy or very happy with the program. Facilitators reported implementing the intervention according to the manual in 73.9% of sessions. Regarding substance use, students who participated in the intervention groups reported a significant reduction in drunkenness in the last year and last 30-day prevalence and also a significant reduction in a lifetime and 30-day prevalence of cannabis use when compared with those students in the control group.ConclusionsOur results suggest that YSLQQ has adequate acceptability and feasibility to be implemented in the Chilean context, and there were promising results in reducing drunkenness and cannabis use. Future research should confirm these results in a larger RCT study.Trial registrationThe trial was registered in ClinicalTrials.gov, NCT04566627; registration date: 01/03/2019

Designing an implementation science clinical trial to integrate hypertension and cardiovascular diseases care into existing HIV services package in Botswana (InterCARE)

BackgroundDespite success in HIV treatment, diagnosis and management of hypertension (HTN) and cardiovascular disease (CVD) remains suboptimal among people living with HIV (PLWH) in Botswana, with an overall HTN control of only 19% compared to 98% HIV viral suppressed. These gaps persist despite CVD primary care national guidelines and availability of free healthcare including antihypertensive medications. Our study aims to develop and test strategies to close the HTN care gap in PLWH, through integration into HIV care, leveraging the successful national HIV care and treatment program and strategies.MethodsThe InterCARE trial is a cluster randomized controlled hybrid type 2 effectiveness-implementation trial at 14 sites designed to enroll 4652 adults living with HIV and HTN plus up to 2326 treatment partners. Primary outcomes included effectiveness (HTN control) and implementation outcomes using the Reach Effectiveness Adoption Implementation and Maintenance framework, with explanatory mixed methods used to understand variability in outcomes.InterCARE trial’s main strategies include healthcare worker HTN and CVD care training plus long-term practice facilitation, electronic health record (EHR) documentation of key indicators and use of reminders, and use of treatment partners to provide social support to people living with HIV and HTN. InterCARE started with formative research to identify contextual factors influencing care gaps using the Consolidated Framework for Implementation Research. Results were used to adapt initial and develop additional implementation strategies to address barriers and leverage facilitators. The package was pilot tested in two clinics, with findings used to further adapt or add strategies for the clinical trial.DiscussionIf successful, the InterCARE model can be scaled up to HIV clinics nationwide to improve diagnosis, management, and support in Botswana. The trial will provide insights for scale-up of HTN integration into HIV care in the region.Trial registrationClinicalTrials.gov reference NCT05414526. Registered 18 May 2022, https://clinicaltrials.gov/study/NCT05414526?term=NCT05414526.&rank=1.

Promoting resilience in mental health nurses: A partially clustered randomised controlled trial

BackgroundThere is a critical global shortage of nurses in mental health, with workforce attrition due in large part to workplace stressors. Proactive strengths-based interventions to strengthen nurses' capacity to manage stress and improve mental health, wellbeing and resilience may also support workforce retention. ObjectiveTo determine the effects of a resilience-building programme on mental health nurses' coping self-efficacy (primary outcome), and psychological distress, wellbeing, resilience, posttraumatic growth, emotional intelligence behaviours, workplace belonging, and turnover intention (secondary outcomes). DesignPartially clustered randomised controlled trial. SettingLarge tertiary metropolitan mental health service in Australia. ParticipantsA total of 144 registered and enrolled nurses working clinically ≥0.6 full-time equivalent (73/intervention, 71/control), with 122 completing 3-month follow-up. MethodsThe Promoting Resilience in Nurses programme is an evidence-based workplace intervention delivered by trained facilitators across two workshops. Surveys were administered online upon registration and prior to randomisation (Time 1) into Intervention or Control (no intervention) arms, and immediately after the final workshop (Time 2), and at three months follow-up (Time 3). Linear mixed models for outcome measures were fitted to Time 2 and 3 responses. ResultsThere were seven intervention groups, with seven to 13 participants per group. Coping self-efficacy improved at Time 2 (estimated intervention effect 21.2 units, 95 % Confidence Intervals: 13.3 to 29.0) and Time 3 (12.1 units, 4.7 to 19.6), as well as wellbeing (Time 2: 9.2 units, 5.0 to 13.4), resilience (Time 2: 0.24 units, 0.01 to 0.46) and posttraumatic growth (Time 2: 16.1 units, 7.0 to 25.3). Psychological distress reduced (Time 2: −3.7 units, −6.2 to −1.31). All were sustained at three months. Emotional intelligence behaviours were improved (Time 2: 3.5 units, 0.6 to 6.5) but not sustained. Workplace belonging improved at Time 3 (0.34 units, 0.02 to 0.65) only. No statistically significant effects for turnover intention. ConclusionsDespite major contextual challenges, the Promoting Resilience in Nurses programme achieved the aims of promoting nurses' efficacy to cope with stress and regulate their emotions and improving mental health and wellbeing. The findings support the programme as a feasible and successful intervention for nurses across other settings and contexts. Trial registrationAustralian New Zealand Clinical Trials Registry (ACTRN12620001052921). Registered 15/10/2020. First recruitment 04/02/2021. Tweetable abstractPromoting Resilience in Nurses intervention improved coping self-efficacy, wellbeing, resilience, posttraumatic growth, emotional intelligence and psychological distress.

Parent training of early language facilitation skills: parent and child outcomes from a large-scale effectiveness study in a diverse clinical population

ABSTRACT This study examined the effectiveness of parent-led early language facilitation training via the Hanen® It Takes Two To Talk® (ITTT) (Pepper & Weitzman [2004]. It takes two to talk: A practical guide for parents of children with language delays. The Hanen Centre.) programme, within a large linguistically and demographically diverse community sample of early language-delayed children. Measures of expressive vocabulary, mean length of utterance (M3LU), and parent–child interaction were taken at multiple time-points, with change benchmarked against growth-curves for typical language maturation where possible. Significant improvements were evident pre–post intervention on all outcome measures regardless of linguistic or demographic diversity. Results indicated that gains in expressive vocabulary and M3LU were significantly greater than those predicted from age-matched typically developing children over the same time-period; M3LU in early language-delayed children was expedited to within estimated normal limits based on age. Gains in parent–child interaction were maintained at 3 months post-ITTT. These results point to the effectiveness of early language facilitation training in promoting expressive language and lasting improvements in parent–child interaction skills when implemented at scale within a demographically and linguistically diverse clinical referral group.

Identification of the most relevant aspects of spinal muscular atrophy (SMA) with impact on the quality of life of SMA patients and their caregivers: the PROfuture project, a qualitative study

BackgroundSMA is a hereditary neuromuscular disease that causes progressive muscle weakness and atrophy. Several studies have shown that the burden of SMA is very high at many levels. Functional assessment tools currently used do not completely address the impact of the disease in patients’ life. The objective of this qualitative study was to identify aspects of SMA that are relevant to patients and to design items useful for assessment purposes.ResultsFive focus group sessions were run during an annual SMA families meeting in Madrid, Spain. Focus groups were composed by parents of SMA type I children, sitter children type II-III, parents of sitter children type II-III, adult patients, and parents of walker children. Two trained facilitators conducted the focus groups using a semi-structured guideline to cover previously agreed topics based on the input of a Scientific and Patient Advisory Committee. The guideline was adapted for the different groups. According to what was communicated by participants, SMA entails a high burden of disease for both patients and their parents. Burden was perceived in physical, psychological, and social areas. Patient’s physical domain was the most relevant for participants, especially for parents of non-ambulant children, followed by limitations of motor scales to capture all changes, parents psychological burden, treatment expectations and patient’s psychological burden. Ten domains were the main areas identified as impacted by the disease: mobility and independence, fatigue and fatigability, infections and hospital consultations, scoliosis and contractures, vulnerability, pain, feeding, time spent in care, breathing, and sleep and rest.ConclusionsThis study confirms the necessity of evaluating other aspects of the disease that are not assessed in the functional motor scale. Measures of other aspects of the disease, such as pain, fatigue, feeding, should be also considered. A patient-reported outcomes instrument measuring such aspects in a valid and reliable way would be very useful. This study generated a list of new items relevant to be systematically measured in the assessment of the impact of SMA on the patients’ everyday life.

The effectiveness of Hope Groups, a mental health, parenting support, and violence prevention program for families affected by the war in Ukraine: Findings from a pre-post study

BackgroundNearly one in six children lived in war zones in 2023. Evidence-based psychosocial and parenting support has potential to mitigate negative impacts for parents and children co-exposed to war and displacement, especially in relation to mental health and harsh parenting reactions. In the current war in Ukraine, local mental health experts co-created and evaluated, with global experts, the effectiveness of psychosocial and parenting support groups, called ‘Hope Groups’ on improvements in mental health, positive parenting, and violence against children. This paper aimed to assess the effectiveness of psychosocial and parenting support groups, called 'Hope Groups,' on improvements in caregiver mental health, positive parenting, and prevention of violence against children, for families affected by the war in Ukraine, using a pre/post study design. MethodsParticipants (n = 577) included Ukrainian caregivers, 66% (381) of whom were parents and co-residing caregivers of children ages 0–17, while the remaining 34% were non-resident informal caregivers. Internally displaced, externally displaced, and those living at-home in war-torn regions were invited to groups by trained Ukrainian peer facilitators. Using a pre-post design, we compared individual level frequency measures at three time-points – baseline, midline, and endline, to assess changes in 4 mental health, and 9 parenting and child health outcomes. We analyzed these outcomes using paired t-tests to compare outcomes at baseline-to-midline (after 4-sessions) and baseline-to-endline (after 10-sessions), which estimated the mean changes in days per week and associated percent change, during the respective periods; we quantified uncertainties using bias-corrected and accelerated (BCa) bootstrapping with 95% uncertainty ranges for baseline-midline and baseline-endline estimates. We used this same approach for stratified analyses to assess potential effect modification by displacement status and facilitator type. We further used linear models to adjust for age and sex. FindingsCompared to baseline, every mental health, parenting, and child health outcome improved significantly at midline and endline. Mental health ratings showed endline reductions in depressive symptoms of 56.8% (95% CI: -59.0,-54.3; -1.8 days/week), and increases in hopefulness, coping with grief, and self-care, ranging from 62.0% (95% CI: 53.6,71.3; 2.2 days/week) to 77.0% (95% CI: 66.3,88.3; 2.2 days/week). Significant improvements in parenting and child health outcomes included monitoring children, reinforcing positive behavior, supporting child development, protecting child, nonviolent discipline, and child verbalizing emotions. By endline, emotional violence, physical violence, and child despondency had dropped by 57.7% (95% CI: -63.0%,-51.9; -1.3 days/week), 64.0% (95% CI: -79.0,-39.5; -0.22 days/week), and 51.9% (95% CI: -45.1,-57.9; -1.2 days/week), respectively. Outcomes stratified by displacement status remained significant across all groups, as did those according to facilitator type (lay versus professional). InterpretationThis study demonstrates preliminary evidence, using a brief survey and pre-post design as is appropriate for acute and early protracted emergency settings, of the feasibility and effectiveness of Hope Groups for war-affected Ukrainian caregivers, on improved mental health, positive parenting, and reduced violence against children.

Psychoeducation group facilitation training for nurses: A quality improvement project.

According to the 2020-2021 National Survey of Children's Health, 23.3% of children and adolescents met criteria for one or more mental, emotional, developmental, or behavioral problems. However, the prevalence of depression, anxiety, and post traumatic stress disorder have risen dramatically since the COVID-19 pandemic, leading to an increase in suicidal ideations, completed suicides, and pediatric psychiatric hospitalizations. There is a critical need for high quality mental healthcare treatments, including psychoeducation. Inpatient psychiatric nurses are well positioned to lead psychoeducation groups, but few receive training. Nurses at a designated inpatient pediatric psychiatric unit expressed discomfort in facilitating psychoeducation groups. This is a one-group prepost and follow-up quality improvement study designed to improve the quality of psychoeducation group facilitation skills provided by nurses at a child and adolescent inpatient psychiatric unit. A convenience sample of nurses (N = 16) participated. Baseline (T1), post-test (T2), and follow-up (T3) data were collected regarding nurses' self-efficacy, evidence based-practice attitudes, and knowledge of psychoeducation group facilitation. Nurses received 45 min of psychoeducation group facilitation education and 15 min of skills simulation. The nurses' knowledge, self-efficacy, and attitudes toward evidence-based practice when facilitating psychoeducation groups increased significantly from the baseline to the post-test, which was sustained from the post-test to the follow-up period. Study findings indicate the importance of supporting nurses in their role of psychoeducation group facilitation through education and program structure. Further research is needed to assess longer term sustainability and efficacy in leading psychoeducation groups.

Engaging with crisis-affected populations using the user-centred community engagement methodology: lessons learned in Tukaley, Ethiopia

ABSTRACT Conducting research (a) in a humanitarian context and (b) with children aged 5–12 presents such unique challenges that those responding to a crisis often design programmes based on their anecdotal experience rather than evidence. The user-centred community engagement (UCCE) methodology was designed by Save the Children and Eclipse Experience to engage with crisis-affected communities to generate practical solutions to their priority needs. This paper has assessed the use of the UCCE methodology in Tukaley using Bowen et al.'s proposed areas of focus for a feasibility study. It has found that all elements of the UCCE process were implemented in practice as they were designed to be implemented; both the participants and facilitators found the UCCE methodology acceptable; and the UCCE methodology could be adapted for use in alternative contexts. However, the recruitment and training of facilitators were identified as the biggest challenge as the methodology continues on its journey to scale, especially due to the risk that if any component of the UCCE methodology is not done well enough, it could damage the willingness of a community to engage in future projects.

Successful implementation of interprofessional education: A pedagogical design perspective

Interprofessional collaboration (IPC) is crucial within healthcare teams that must provide safe and quality care to their patients. Competent professionals in this area offer better care and contribute to a medical culture where IPC and teamwork are valued. To become competent, they must be adequately trained. Unfortunately, the literature describes that collaboration training is uneven across professions. Interprofessional education (IPE) could fill this educational gap but remains challenging to implement. This article aims to present ten clear and concise considerations to implementing IPE initiatives successfully, following a well-described pedagogical designing process. After reading, the clinician-educator will be informed of the newest evidence in IPE as well as the common pitfalls to avoid. From the starting point of a recent synthesis article on IPE, several additional syntheses, analyses, and recommendations articles were consulted and synthesized. From that, the findings are organized according to the “ADDIE” model, a flexible methodology used in pedagogical design through iterative cycles in context. The phases of “ADDIE” are analysis, design, development, implementation, and evaluation. According to these phases, the considerations will be presented to allow the reader to apply them "step by step" in their educational planning process. Ten considerations are presented, from the needs analysis, stakeholders and Faculty involvement, composition of the design team, selection of students and types of learning activity, the role of reflexivity, training of facilitators, supervision, and the continuous improvement process. Taken together, these will contribute to highlighting the essential nature of training in collaboration in modern professionalizing programs.

Mitigating Harms of Social Media for Adolescent Body Image and Eating Disorders: A Review.

Social media has negative effects on adolescent body image and disordered eating behaviors, yet adolescents are unlikely to discontinue engaging with these platforms. Thus, it is important to identify strategies that can reduce the harms of social media on adolescent mental health. This article reviews research on social media and adolescent body image, and discusses strategies to reduce risks associated with social media use. Topics covered include interventions aimed at mitigating social media's negative impacts, the body-positivity movement, and policies regulating adolescents' social media use. Overall, this review highlights specific factors (such as staffing, duration, modality, facilitator training, and cultural sensitivity) to consider when designing and implementing social media interventions targeting adolescents. This review also discusses psychosocial outcomes associated with body positivity on social media. Finally, policy efforts to reduce the negative impact of social media on adolescents' body image and eating behaviors are described. In sum, there is a strong need to conduct further research identifying optimal approaches to reduce the harms of social media for adolescent body image and eating behavior.

Personalized goals of people living with dementia and family carers: A content analysis of goals set within an individually tailored psychosocial intervention trial.

Person-centered goals capture individual priorities in personal contexts. Goal Attainment Scaling (GAS) has been used in drug trials involving people living with dementia (PLWD) but GAS has been characterized as difficult to incorporate into trials and clinical practice. We used GAS in a trial of New Interventions for Independence in Dementia Study (NIDUS)-family, a manualized care and support intervention, as the primary outcome and to tailor the interventions to goals set. We aimed to assess the feasibility and content of baseline goal-setting. We developed training for nonclinical facilitators to set individualized GAS goals remotely with PLWD and family carer dyads, or carers alone, in the intervention trial, during the COVID-19 pandemic. A qualitative content analysis of the goals set explored participants' priorities and unmet needs, to consider how existing GAS goal domains might be extended in a psychosocial intervention trial context. Eleven facilitators were successfully trained to set and score GAS goals. A total of 313/328 (95%) participants were able to collaboratively set three to five goals with the facilitators. Of these, 302 randomized participating dyads set 1043 (mean 3.5, range 3 to 5) goals. We deductively coded 719 (69%) goals into five existing GAS domains (mood, behavior, self-care, cognition, and instrumental activities of daily living); 324 (31%) goals were inductively coded into four new domains: carer break, carer mood, carer behavior, and carer sleep. The most frequently set goals pertained to social support. There was little variation in types of goals set based on the context of who set them or level of pandemic restrictions in place. It is feasible for people without clinical training to set GAS holistic goals for PLWD and family carers in the community. GAS has potential to facilitate personalization of care and support interventions, such as NIDUS-family, and facilitate the roll out of more personalized care. Goal Attainment Scaling (GAS) can capture meaningful priorities of people with dementia and their family carers.A psychosocial intervention RCT used GAS as the primary outcome measure and goals were set collaboratively by non-clinically trained facilitators.The findings underscore the feasibility of using GAS as an outcome measure with this population.The content analysis findings unveiled the diversity in experiences and priorities of the study participants.GAS has the potential to support the implementation of more person-centred approaches to dementia care.

Faculty Experiences: Virtual versus Traditional Problem-based Learning during COVID-19 in a Saudi Medical College

Abstract Background: The COVID-19 pandemic has forced a fast change to new teaching approaches based on online education. Problem-based learning (PBL) was one of the modified teaching strategies. The current study sought to examine faculty perceptions of virtual versus traditional PBL during the COVID-19 pandemic at a Saudi medical college. Methods: This is a retrospective cross-sectional study conducted at King Saud University’s College of Medicine. We compared the perceptions of faculty members who facilitated traditional face-to-face PBL in 2019–2020 and virtual PBL in 2020–2021. An online survey with demographic and practice data was distributed. The faculty’s perception of PBL facilitation, student learning, and overall satisfaction was investigated using a 5-degree Likert scale: 15 items grouped into three main areas. All of the questions were written in a way that compares traditional and virtual PBL. Mean scores were determined for all parts, and the findings were reported as mean standard deviation, with scores of 3 and above considered positive, and scores of <3 considered negative. The data were analyzed with SPSS version 25.0. Results: In the study period, 57 faculty members facilitating PBL replied to the survey (response rate 67.85%). There were no gender variations in the representation of participants (male 56.1%, female 43.9%), and they come from a variety of basic and clinical departments. The majority of participants (91.3%) have more than 2 years of PBL facilitation experience, and 64.2% have received training in both virtual and traditional PBL facilitation. The faculty assessment of facilitating virtual PBL was favorable as overall satisfaction, with the mean of the components in the satisfaction section being 3.67. In terms of facilitation preferences, we discovered that despite the amount of effort involved in facilitating traditional PBL sessions (mean = 3.47), their motivation to facilitate traditional PBL was higher than that of virtual PBL (mean = 3.33). Faculty perceptions of students’ learning in PBL were more traditional, with the mean of the items in this section (such as students’ motivation, participation, and group dynamics) being higher (3.616). Conclusions: The faculty’s satisfaction with their abilities to properly facilitate virtual PBL sessions did not detract from their motivation to be in direct personal interaction with students during PBL sessions. To ensure faculty care about students’ learning in virtual PBL, their perception had to be correlated to their learning outcomes.

Pendampingan dan Fasilitasi Pendaftaran Merek UMKM Bantarsari Berbasis Kolaborasi Peran Pemerintah Desa dan Kampus

The partners in this program include the Head of Bantarsari Village and his staff, representatives of associations, and Bantarsari Small and medium enterprises (SMEs). The partners face several issues: the absence of producer organizations, underutilization of information technology, unregistered product trademarks, limited online marketing reach, and low marketing management competence. The program aims to provide education and training on trademark legality and to assist and facilitate the creation and registration of trademarks. Activities are conducted using persuasive and participatory methods through lectures, discussions, training, mentoring, and trademark registration facilitation. Based on data analysis before and after the program implementation, it was concluded that the mentoring and facilitation of trademark registration for Bantarsari SMEs were effectively addressed through continuous outreach and mentoring. The average increase in the effectiveness of mentoring and facilitation activities for Bantarsari SMEs trademark registration based on the collaboration between the village government and the campus reached 31.4%.

Resident Feedback on Incorporating Reflection Rounds Into a Family Medicine Residency Wellness Curriculum: A Brief Report.

We sought to understand well-being from the perspectives of residents in a family medicine residency program and to assess the residents' opinions on implementing "Reflection Rounds" (RR) to promote wellness and combat burnout through self-reflection. These aims were achieved through descriptive qualitative analysis of a focus group of family medicine residents. Participation was voluntary and open to all 45 residents in the program. The final participant sample consisted of 14 residents who shared similar characteristics, including level of training and being exposed to similar training stressors. Both a priori and open coding were used for this analysis. An iterative process identified themes based on focus group responses. The residents were in favor of initiating RR and recommended discussion topics unique to family medicine residency. They also identified logistical preferences for this intervention, such as conducting confidential and unrecorded groups, splitting rounds by training year, offering RRs led by a trained facilitator, providing snacks if feasible, and making the RRs available on a regular basis during protected didactic time. This project elucidates how residents are identifying and managing wellness and burnout as well as informs effective ways that family medicine residency programs can incorporate RR into their wellness curriculum.

Implementation of standardized patient safety and quality improvement rounds in a tertiary care paediatric centre.

Patient safety is increasingly becoming a major priority for healthcare institutions, and various models of these rounds exist. The Ottawa M&M Model (OM3) is a structured and standardized approach to patient safety and quality improvement rounds that has been implemented at other institutions across Canada with good success. This quality improvement project invited divisions within the Children's Hospital in London, Ontario to participate in the implementation of the OM3 for M&M rounds. The project aligned with the Institute for Health Improvement's Model for Improvement. Baseline needs assessments and facilitator training were performed. The main outcome was implementation of a version of the OM3 for PSQI rounds, action items generated from these rounds, and systemic hospital changes. The baseline needs assessment showed that 18 (66.7%) respondents were members of divisions with pre-existing M&M rounds. Most found their rounds at least valuable, but only two-thirds found that action items were generated following each meeting. After implementation of the OM3, 58.3% (21 of 36) of action items submitted to the CH-QCC were partially or completed actioned by the end of 2022. A post-implementation survey showed that of the 11 division representatives who responded, 7 (64%) were still participating in PSQI rounds and using the new OM3 format, which they agreed was more organized. We were able to successfully implement a new standardized approach to Patient Safety and Quality Improvement Rounds that has led to systemic changes within the paediatrics hospital and continues to be used today.

Living Well: Protocol for a web-based program to improve quality of life in rural and urban ovarian cancer survivors

BackgroundOvarian cancer (OC) survivors commonly experience chronic symptoms including anxiety, depression, sleep disturbances, fatigue, physical symptoms, poor health-related quality of life (HRQOL), and a generally poor prognosis. Additionally, factors such as social isolation, stress, and depression are associated with key biological processes promoting tumor progression and poorer survival. Accessible psychosocial interventions to improve HRQOL and clinical outcomes are needed. This need is particularly true in rural settings where survivors may have less access to clinic-based support systems. MethodsThe Living Well Study, a cluster-randomized Phase II multi-site clinical trial, is designed to evaluate the efficacy of a group-based, web-delivered psychosocial intervention (Mindful Living) verses a Health Promotion active control (Healthy Lifestyles) in increasing HRQOL and decreasing perceived stress (primary outcomes), depressive mood, anxiety, and fatigue (secondary outcomes) for 256 OC survivors who are <5 years post-primary therapy. Mindful Living targets key concerns of OC survivors and teaches stress reduction skills and coping strategies utilizing cognitive behavioral, mindfulness, and acceptance and commitment therapies. Healthy Lifestyles provides lifestyle information including exercise, nutrition, sleep, and other survivorship topics. Interventions consist of 11 consecutive weekly group sessions lasting 1.5–2 h led by trained facilitators and two booster sessions. Participants complete psychosocial questionnaires at baseline, post-intervention, at 6-months, and at 12-months. A subset completes bloodspots for analysis of inflammatory biology. ConclusionEasily accessible psychosocial interventions addressing key concerns of OC survivors are an unmet need. The Mindful Living intervention has the potential to substantially enhance HRQOL and decrease distress in OC survivors.Trial registrationclinicaltrials.gov Identifier: NCT04533763