Implementation pathway report: Community Resource Person An intervention by the Technical Support Unit Uttar Pradesh, India, February 2015

A report describing the methodology behind an implementation pathway for the Community Resource Person innovation being implemented by the Technical Support Unit (a large-scale collaboration between the Bill & Melinda Gates Foundation and the Uttar Pradesh government) in Uttar Pradesh, India

The interaction between policy and education using stroke as an example

This paper discusses the interaction between healthcare policy at the European, UK and Scottish levels and the funding of education that underpins specific health policy priorities. Stroke is used throughout to illustrate the relationship between a designated European and UK health priority and the translation of that priority into clinical delivery. The necessity to build a responsive and sustainable culture to address the healthcare education that underpins changing healthcare policies is emphasized

Influences on Pregnancy: An Exploration of Maternal Discrimination, an Alternative Model of Prenatal Care and Health Information Online

In the United States metrics of perinatal health lag far behind peer countries and is characterized by stark disparities. The studies that make up this dissertation seek to elucidate factors influencing perinatal health. The first and second chapters provide an introduction and extensive review of the literature of factors contributing to perinatal health with specific focus on discrimination and perinatal health; group prenatal care and digital pregnancy health information. The third chapter introduces the methodology to be used by each of the following studies. Subsequent chapters are formatted as individual manuscripts, each presenting background, methodology, results, and discussion. The fourth chapter (Manuscript 1) sought to explore pregnant persons intersectional experience of discrimination and the association with adverse perinatal health outcomes. This study was a secondary analysis of data collected in a randomized controlled trial of pregnant persons at a single practice (CRADLE study). Latent class analysis was used to identify distinct subgroups of discrimination experience based on patterns of response to Everyday Discrimination Scale items and between subgroup differences in rate of adverse perinatal health outcomes examined utilizing a BCH three-step approach. Four discrimination subgroups were identified among racial and ethnic groups. The general discrimination latent class was associated with elevated risk of postpartum depression symptoms (among Black and White participants) and low infant birthweight (among White participants) relative to the no discrimination latent class. No significant subgroup differences were observed among Hispanic participants. Findings demonstrate the importance of intersectional discrimination exposure in shaping perinatal health. The fifth chapter (Manuscript 2) applied a concurrent mixed methods approach in the examination of patient characteristics associated with group prenatal care and the exploration of patient experiences in group compared to individual prenatal care. This study was a secondary analysis of data collected in the CRADLE study, as well as patient interviews collected in a coordinated process evaluation. The association of patient sociodemographic, psychosocial and health characteristics with group prenatal care session attendance were examined using zero-inflated poison regression models. Thematic analysis of patient interviews was conducted. Varied patient characteristics were found to be associated with session attendance. Group prenatal care was identified to offer alternative opportunities for education, engagement, and peer support. Findings offer insight into model modifications, recruitment, and retention strategies. The sixth chapter (Manuscript 3) utilized topic modeling to describe topics of discussion in online pregnancy forums. Data was gathered from three active online pregnancy forums for a one-year period. Discussion threads were processed, converted to a document term matrix and Latent Dirichlet Allocation performed. Forty-six percent of threads were determined to be health related. The largest health-related topic categories included fertility, planning for delivery, miscarriage and pregnancy symptoms. Findings offer insight into dominant health related topics being discussed among online peer communities, potentially reflecting unmet information needs during pregnancy

Police Knowledge Exchange: Full Report 2018

[Executive Summary] This report was commissioned to explore the enablers and barriers to sharing within and between police forces and between police forces and partners, including the public. This was completed from an interdisciplinary review of international literature covering sharing, knowledge exchange, learning and organisational learning. The literature broke down into four main factors; who, why, what and how. An introduction to the literature is presented with ‘Who’ is sharing which considers both personal identity and different institutional issues. The ‘Why’ literature covers issues of cultural and community motivators and barriers. The ‘What’ segment reviews concepts of data, information and knowledge and related legislative issues. Finally, the ‘how’ section spans face to face sharing approaches to technologies that produce both enablers and barriers. A series of 42 in-depth interviews and focus groups were completed and combined with 47 survey responses . The aim of the interviews, focus groups and survey was to show perceptions and beliefs around knowledge sharing from a small sample across policing in order to complement the findings from the literature review. The survey was adapted from a standardised questionnaire (Biggs, 1987). The Biggs questionnaire focused on what motivated students to learn and how they approached their learning. Our adapted survey looked at what motivated police to share, and how they approached sharing. The responses showed a trend, across the police, towards a motivation for sharing to develop a deeper understanding of issues. However, the approaches and the strategies they used to share with others, which were primarily driven by achieving and surface approaches (to get promoted and get the job done). According to Biggs (1987) this could leave them discontented as they never progress to a deeper understanding of issues. Scaffolding sharing within the police through processes that are clearly defined, effective and valued could help to overcome these issues. Within the interviews and focus group findings a similar structured approach to sharing was adopted. Within the ‘who’ section some key aspects around personal relationships, reciprocity and reputation were identified. The ‘why’ the police share was one of the largest discussion points. Not only was there a deep motivation to solve key policing issues there was an approach of reciprocity. Police sharing was deeply motivated to support ‘good practice’ in the prevention and detection of crime. However, a sharing barrier was identified in the parity of value given to different types of knowledge for example between professional judgement and research evidence knowledge. Sharing was achieved when there were reciprocal benefits, in particular with personal networks or face to face sharing which was noted as ‘safe’. Again, this was inhibited by misunderstandings around the ‘risks’ of sharing, frequently attributed to data protection legislation; producing cautious reactions and as an avoidance tactic to save time and effort sharing. However, a divide was noted between technical users and those who avoided any online systems for sharing; often due to poorly designed systems and a lack of confidence in how to use systems. The police culture was identified as being risk-adverse, and competitive due to multiple factors, a lack of supported time to share, Her Majesty’s Inspectorate of Constabulary (HMIC) reviews and promotion criteria. The result was perceived to be a poor cultural ability to learn from mistakes and a likelihood to repeat errors. A set of strategic recommendations are given and include the use of a sharing authorised professional practice for HMIC reviews, sharing networks and training. A further set of operational recommendations are given such as; sharing impact cases for evidence based practice, data sharing officers and evaluating mechanisms for sharing. This full report is supported by the Police Knowledge Exchange Summary Report 2018 which gives an overview of the findings and recommendations

An Australian survey of women's use of pregnancy and parenting apps.

Background There are now many pregnancy and parenting apps available on the market for both pregnancy and parenting. Aims To investigate how Australian women use pregnancy and parenting apps, their attitudes about the information provided and data privacy and security related to such use, and what features they look for in these apps. Methods An online survey was completed by 410 women who were pregnant or had given birth to at least one child in the past three years, were aged between 18 and 45 and were competent in English. Findings The use of pregnancy and parenting apps was common among the respondents. Almost three quarters of respondents had used at least one pregnancy app; half reported using at least one parenting app. Respondents found the apps useful or helpful, particularly for providing information, monitoring foetal or child development and changes in their own bodies and providing reassurance. Yet many users were not actively assessing the validity of the content of these apps or considering issues concerning the security and privacy of the personal information about themselves and their children that these apps collect. Conclusion Apps are becoming important as a source of information and self-monitoring and for providing reassurance for Australian pregnant women and mothers with young children. Midwives and other healthcare professionals providing care and support for pregnant women and women in the early years of motherhood need to take women's app use into account and recognise both the potential and limitations of these apps

Managing Motherhood Online: Authority, Assemblage, and Fetal Personhood

Senior Project submitted to The Division of Social Studies of Bard College

Shaping the future for primary care education and training project. Integrated health and social care: the perspectives of people using services: a mixed methods analysis

The aim of this study was to explore service users' perspectives concerning integrated health & social care, and to identify the perceived strengths and weaknesses associated with the current workforce and services provided. The findings will be used to inform the education and training of the health and social care workforce in the North West of Englan