1,552 research outputs found

    What Works? A Study of Effective Early Childhood Mental Health Consultation Programs

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    Examines factors that lead to desirable outcomes in mental health consultation programs: solid program infrastructure, highly qualified consultants, and quality support services. Analyzes targeted outcomes, measurements, and intensity of interventions

    PRSP Processes in Eight African Countries: Initial Impacts and Potential for Institutionalization

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    Poverty, Policy process, Political systems, Participation

    ‘Learning across the continuum’ : a guide to collaborative practice : ‘sharing practice: supporting inclusion’

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    The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis.

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    BACKGROUND: Child maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems. OBJECTIVES: To synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment. STUDY DESIGN: For effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views. PARTICIPANTS: Children and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months. INTERVENTIONS: Any psychosocial intervention provided in any setting aiming to address the consequences of maltreatment. MAIN OUTCOME MEASURES: Psychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability. METHODS: Young Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible. RESULTS: We identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive-behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) -0.44 (95% CI -4.43 to -1.53)], depression [mean difference -2.83 (95% CI -4.53 to -1.13)] and anxiety [SMD -0.23 (95% CI -0.03 to -0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist-child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself. CONCLUSIONS: It is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions. LIMITATIONS: Studies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses. FUTURE WORK: Studies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes. STUDY REGISTRATION: This study is registered as PROSPERO CRD42013003889. FUNDING: The National Institute for Health Research Health Technology Assessment programme

    Civil society's role in health system monitoring and strengthening : evidence from Khayelitsha, South Africa

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    Introduction: Historically in South Africa, civil society has played a key role within the health system, including advocating for equitable and quality health care services. The purpose of this research is to explore the implementation of a pilot health systems strengthening intervention in primary health facilities in Khayelitsha, South Africa. The study is built on Treatment Action Campaign, a civil society organization, which has recently implemented a health system monitoring tool within health care facilities in Khayelitsha. Specifically, this study considers the functioning and potential impact of the monitoring tool introduced as a community accountability mechanism at the local level. The development and implementation of the monitoring tool can also be seen as part of a policy implementation process. Methods: Using an action research approach, the researcher engaged with implementing actors in the development and implementation of the monitoring tool. Qualitative methods were used to explore: the understandings of various stakeholders about the tool, their interests or concerns, potential positions, power and influence on its implementation. Quantitative data allowed for the ability to track potential improvements in clinic performance in terms of operational research. The challenges during tool development and implementation and how these were overcome were also explored. Results: Analysis of the stakeholders demonstrated how actors exerted their power in various ways to influence the development and implementation of the tool. Results suggest it can be an empowering process for members of civil society and there is a role for civil society in improving health system performance. Findings have highlighted the need for civil society organization monitoring tools to be not only methodologically sound but, more importantly, accepted by the activist. If carefully considered and driven by civil society itself, rather than imposed, there does seem to be some tentative examples of service delivery improvement and scope for their engagement. Conclusions: The findings offer relevant and useful insights for understanding how this tool acts as an accountability mechanism at a local level within Khayelitsha sub-district. Such findings may have implications for further adaptations to the tool, potential scale-up by Treatment Action Campaign and for other low and middle income contexts

    Good Health Counts: A 21st Century Approach to Health and Community for California

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    Takes a comprehensive look at community health, encompassing both access to quality, culturally competent medical care and community environments that support health. Includes an evaluation of community indicator reports and options for next steps

    A Study of Elementary Teachers\u27 Data Driven Decision-Making Practices and School Performance

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    The notion of using data to inform educational decisions is not novel; in fact, teachers and school leaders have used data in various forms and for a variety of reasons for decades. However, challenges remain with the timely availability of data, accessibility to the data, and teachers’ understanding of how these data can be transformed into action that impacts instructional decisions. Without appropriate professional development, support, and leadership, teachers may struggle to use data to make sound decisions and take action in their classrooms. This quantitative correlation study examined elementary school teachers’ levels of readiness regarding data-driven decision-making (DDDM) practices and school performance in mathematics and ELA proficiency. The data were collected using the Statewide Data-Driven Readiness Study Teacher Survey authored by McLeod and Seashore (2006). Readiness levels were calculated from teacher responses in four areas: assessment, acting upon data, school support systems, and school culture. School proficiency levels were collected from the 2018–2019 New Jersey School Performance Report in ELA and mathematics. The results indicated that significant relationships existed between K–5 elementary teachers’ self-reported readiness on overall DDDM practices and high student achievement levels in ELA. No significant relationships were discovered between teachers’ DDDM readiness levels and mathematics achievement. This study adds to the existing body of research on DDDM practices and supports the foundational work of previous studies and theoretical frameworks on DDDM. Developing teachers’ capacity for DDDM is an essential part of effective practice. Improving data literacy must be a priority for school leaders to improve instructional practice and increase students’ learning outcomes
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