Mobile clinics in conflict-affected communities of North West and South West regions of Cameroon: an alternative option for differentiated delivery service for internally displaced persons during COVID-19.

INTRODUCTION: The guidelines for differentiated service delivery (DSD) for HIV treatment became operational in Cameroon in 2017 with the Test and Treat national strategy elaborating services that can be decentralized and task shifted at community level, but with little to no guidelines for DSD in fragile and conflict-affected settings. Since 2016, more than 680,000 Cameroonians have been internally displaced due to the conflict in the North West and South West regions (NWSW). This conflict has impacted on the health system with numerous attacks on health facilities and staff, reducing access to health care for internally displaced persons. The outbreak of COVID-19 further reduced humanitarian responses for fear of spreading COVID-19. Mobile clinics were utilized as a model of care in piloting DSD for HIV in conflict-affected settings within the COVID-19 context. METHODS: The HIV DSD framework was used to evaluate a project that used mobile clinics in 05 divisions across the NWSW to provide primary health care to internally displaced persons in hard-to-reach areas. These mobile clinics were operated in the COVID-19 context and integrated HIV services in the benefit package. The mobile clinics mainstreamed HIV and COVID-19 sensitization during community mobilization, HIV consultations, HIV testing and referrals, and in some cases antiretroviral (ARV) dispensation. The project ran from March to October 2020. The results from the evaluation of this model of HIV care delivery were analysed in 06 of 08 mobile clinics. RESULTS: In 07 months, a total of 14,623 persons living in conflict-affected settings were sensitized on HIV, 1979 received HIV testing from which 122 were positive and 33 placed on ARVs. 28 loss-to-follow up people living with HIV were relinked to treatment and 209 consultations for persons living with HIV were conducted. Despite the good collaboration at regional and field level, there was distrust by ARV centers for humanitarian organizations. CONCLUSION: Mobile clinics are a model of care which could be leveraged in fragile and conflict-affected settings as an alternative model of care for HIV DSD to ensure continuum of HIV care and treatment. However this should be integrated within the benefit package of primary health care services offered by mobile clinics

FNP led Mobile Health Services for the Homeless population

A small percentage of the U.S. population uses the greatest portion of the healthcare services. Homeless people are often such a group of “super-utilizers” of the healthcare system. Due to multiple medical and psychosocial conditions, people experiencing homelessness face numerous barriers to accessing healthcare, thus leading increased utilization of hospitals and emergency departments (EDs) services. Many of these events are preventable through improved primary care interventions. The literature on Respite/Recuperative Care, Transitional Care, and Mobile Health interventions have shown effectiveness in providing safe and quality care to homeless individuals during the critical transitional period post hospital discharge while also reducing the readmission rates to hospitals and EDs. The goal of this DNP project was to establish a Mobile Health Services program and function as a part of a larger Recuperative Care pilot program for Marin County\u27s homeless population. The partnership between the University of San Francisco School of Nursing and Health Professions (USF-SONHP) and local organizations in Marin endeavored to improve the quality of care for the homeless population and reduce rehospitalizations and ED visits. This goal was accomplished through the successful implementation of the pilot project. Outcome evaluation demonstrated that the project team was able to prevent rehospitalization in all eight patients that enrolled in the program. These results also showed a potential for a significant positive financial impact on the overall healthcare system by reducing utilization rates of EDs and hospitals and costs associated with i

Työterveyshuollon etänä toteutettavan neuvonnan ja ohjauksen käyttöönottoa edistävät ja estävät tekijät

Technological development enables the production of achievable and customer-centred preventive occupational health services for employees working in multiple locations. Occupational health care has also encountered the need for digital health care services due to the expansion of mobile work, as the companies and work are more digitalized and internationalized. This research, conducted in three different occupational health care organizations in 2016-2018, aims to explore the features affecting the development of preventive digital services in occupational health care. The research comprised of exploring the current situation of preventive services in occupational health care and the co-creation, piloting, and evaluation of preventive digital services. The research utilized the realistic evaluation method. The results describe the functional environments of occupational health services and the facilitating and hindering factors found in the environments during the piloting process. The results can be utilized in occupational health care services as they develop and implement new digital services.Teknologiaa hyödyntämällä on mahdollista tarjota saavutettavia ja asiakaslähtöisiä työterveyshuollon tietojen annon, neuvonnan ja ohjauksen palveluita. Myös tarve etäpalveluille on kasvanut teknologian kehittymisen ja työterveyshuoltojen asiakasyritysten kansainvälistymisen myötä lisääntyneen mobiilin työn vuoksi. Tämän tutkimuksen tarkoituksena oli selvittää työterveyshuollon etänä toteutettavan tietojen annon, neuvonnan ja ohjauksen kehittämiseen ja käyttöönottoon liittyviä tekijöitä. Tutkimus toteutettiin kolmessa työterveyshuollossa vuosina 2016–2018. Tutkimus koostui työterveyshuoltojen neuvonnan ja ohjauksen nykykäytäntöjen määrittelystä sekä etänä toteutettavan neuvonnan ja ohjauksen yhteiskehittelystä, kokeiluista ja arvioinnista. Analyysissa hyödynnettiin realistisen arviointitutkimuksen menetelmää. Tulokset kuvaavat työterveyshuoltojen toimintaympäristöjä ja niissä syntyviä etäpalveluiden käyttöönottoa edistäviä ja estäviä tekijöitä. Tutkimus tuottaa tietoa työterveyshuollon etänä toteutettavan neuvonnan ja ohjauksen kehittämisen ja käyttöönoton tueksi

Theorization and translation in information technology institutionalization: evidence from Danish home care

Although institutional theory has become a more dominant perspective in information systems research, studies have only paid scant attention to how field dynamics and organizational processes coevolve during information technology institutionalization. Against this backdrop, we present a new conceptualization based on the “traveling of ideas” metaphor that distinguishes between theorization of ideas about IT usage across an organizational field and translation of such ideas into practical use of IT within particular organizations. Drawing on these distinct analytical views, we posit that IT institutionalization is constituted through recursive intertwining of theorization and translation involving both linguistic and material objects. To illustrate the detailed workings of this conceptualization, we apply it to a longitudinal study of mobile IT institutionalization within Danish home care. We demonstrate how heterogeneous actors within the Danish home care field theorized ideas about mobile IT usage and how these ideas translated into different local arrangements. Further, our account reveals a complex institutionalization process in which mobile IT was first seen as a fashionable recipe for improvement but subsequently became the subject of controversy. The paper adds to the emerging process and discourse literature on IT institutionalization by shedding new light on how IT ideas travel across a field and within individual organizations, how they transform and become legitimized over time, and how they take on different linguistic and material forms across organizational settings

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California FreshWorks: A Case Study Examining the Development and Implementation of FreshWorks

TCE commissioned a two-year evaluation of FreshWorks to better understand the impact of the program on fresh food access, as well as social and economic outcomes. The evaluation also sought to document the development and implementation of FreshWorks while identifying key lessons and insights. Given that FreshWorks is an early example of a state-level healthy food financing initiative, the evaluation offers an opportunity to inform the broader healthy food movement going forward.This case study focuses on the development and implementation of FreshWorks, as well as key challenges encountered and lessons learned during the program's first years of operation. The evaluation team conducted interviews with FreshWorks investors, advisors, and other stakeholders in order to collect qualitative data documenting the Fund's origins and implementation process. These interviews formed the basis for the findings presented herein

The Social and Economic Impacts of FreshWorks: An Examination of Three Northgate Gonzalez Grocery Store Investments

In order to better understand and maximize FreshWorks' impact, TCE commissioned a two-year evaluation of the program's food access, social, and economic outcomes. The evaluation also sought to document the development and implementation of FreshWorks while identifying key lessons and insights. Given that FreshWorks is an early example of a statelevel fresh food financing initiative, the evaluation provides an opportunity to inform the greater healthy food movement going forward. The evaluation was led by a team of researchers experienced in evaluating health, social and economic outcomes. The team consists of the Sarah Samuels Center for Public Health Research and Evaluation, PCV InSight, Dr. Allison Karpyn of the University of Delaware, and Dr. Karen Glanz of the University of Pennsylvania.This report, one component of the evaluation, focuses on the economic and social impacts of the three Northgate González stores funded by FreshWorks. It seeks to answer two key research questions: * How does FreshWorks impact employment and job quality of workers in local communities, particularly in underserved communities? * What broader economic impacts do FreshWorks investments have in the communities where they are located

Emerging Opportunities: Monitoring and Evaluation in a Tech-Enabled World

Various trends are impacting on the field of monitoring and evaluation in the area of international development. Resources have become ever more scarce while expectations for what development assistance should achieve are growing. The search for more efficient systems to measure impact is on. Country governments are also working to improve their own capacities for evaluation, and demand is rising from national and community-based organizations for meaningful participation in the evaluation process as well as for greater voice and more accountability from both aid and development agencies and government.These factors, in addition to greater competition for limited resources in the area of international development, are pushing donors, program participants and evaluators themselves to seek more rigorous – and at the same time flexible – systems to monitor and evaluate development and humanitarian interventions.However, many current approaches to M&E are unable to address the changing structure of development assistance and the increasingly complex environment in which it operates. Operational challenges (for example, limited time, insufficient resources and poor data quality) as well as methodological challenges that impact on the quality and timeliness of evaluation exercises have yet to be fully overcome