It takes a village to break up a match: a systemic analysis of formal youth mentoring relationship endings

BACKGROUND Although early closure of formal youth mentoring relationships has recently begun to receive some attention, more information about factors that contribute to premature endings, and how those factors interact, is needed so that empirically-based program practices can be developed and disseminated to prevent such endings and to ensure that youth reap the benefits mentoring can provide. OBJECTIVE This qualitative interview study applies a systemic model of youth mentoring relationships (Keller in J Prim Prev 26:169–188, 2005a) to the study of mentoring relationship endings in community-based mentoring matches to understand why these matches ended. METHOD Mentors, parents/guardians and program staff associated with 36 mentoring matches that had ended were interviewed about their experiences of these relationships and their understanding of why they had ended. Thematic analysis of the interview transcripts and mentoring program case notes for each match followed by systemic modeling of the relationships yielded three major findings. RESULTS A strong mentor–youth relationship is necessary but not sufficient for match longevity. The mentor–youth relationship, even when relatively strong, is unlikely to withstand disruptions in other relationships in the system. Agency contextual factors, such as program practices and policies and staffing patterns, have a critical role to play in sustaining mentoring matches, as they directly influence all of the relationships in the mentoring system. CONCLUSION These findings highlight the importance of considering not just the mentoring dyad but also the parent/guardian and program context when trying to prevent match closures. They also point to several program practices that may support longer mentoring relationships.Accepted manuscrip

(Not) Minding the Gap: A Qualitative Interview Study of How Social Class Bias Can Influence Youth Mentoring Relationships.

This study sought to examine how social class bias may be enacted by mentors and mentoring program staff within community-based youth mentoring relationships and how these biases may influence the mentoring relationship. A narrative thematic analysis was conducted with interviews from mentors, mentees\u27 parents/caregivers, and mentoring program staff representing 36 matches participating in a larger, prospective, mixed-methods study examining factors associated with early match closures. Findings indicate that although some mentors were able to partner with the youth and family to effectively navigate challenges related to the family\u27s economic circumstances, other mentors and some mentoring program staff held deficit views of the youth and their family that appeared to be at least partially rooted in negative social class-based assumptions about attitudes and behaviors. Specifically, we observed tendencies on the part of some mentors and program staff toward (a) deficit-based views of families and youth, (b) individual-level attributions for the family\u27s economic circumstances and blaming of caregivers, and (c) perceiving mentors as being underappreciated by the youth\u27s caregiver. These deficit perspectives contributed to the minimization of parent/caregiver voice in the mentoring process and negative interpretations of parent/caregiver and, in some cases, youth attitudes and behaviors

Psychological and Behavioural Within-participant Predictors of Adherence to Oral HIV Pre-Exposure Prophylaxis (PrEP)

Oral PrEP's effectiveness relies on adequate adherence during periods of substantial HIV risk. Since most PrEP users will miss doses, understanding predictors within participants can help to explain adherence. We used a cross-sectional, within-participant design with 67 gay, bisexual, and other men who have sex with men taking PrEP daily. Using a questionnaire, informed by the Information Motivation Behavioral Skills Model, participants were asked about an adherent and a non-adherent episode. PrEP non-adherence was associated with non-normality of the day (p < .001), being out of the home (p < .001), weekend days (p = .01), having company (p = .02), using substances (p = .2), not using reminders (p = .03), lower PrEP information (p = .04), lower behavioural skills (p < .001) and less positive affect (p = .002). PrEP adherence assessment could focus on situational variations, supporting the construction of alternative strategies to facilitate adherence in these situations

Airborne cow allergen, ammonia and particulate matter at homes vary with distance to industrial scale dairy operations: an exposure assessment

<p>Abstract</p> <p>Background</p> <p>Community exposures to environmental contaminants from industrial scale dairy operations are poorly understood. The purpose of this study was to evaluate the impact of dairy operations on nearby communities by assessing airborne contaminants (particulate matter, ammonia, and cow allergen, Bos d 2) associated with dairy operations inside and outside homes.</p> <p>Methods</p> <p>The study was conducted in 40 homes in the Yakima Valley, Washington State where over 61 dairies operate.</p> <p>Results</p> <p>A concentration gradient was observed showing that airborne contaminants are significantly greater at homes within one-quarter mile (0.4 km) of dairy facilities, outdoor Bos d 2, ammonia, and TD were 60, eight, and two times higher as compared to homes greater than three miles (4.8 km) away. In addition median indoor airborne Bos d 2 and ammonia concentrations were approximately 10 and two times higher in homes within one-quarter mile (0.4 km) compared to homes greater than three miles (4.8 km) away.</p> <p>Conclusions</p> <p>These findings demonstrate that dairy operations increase community exposures to agents with known human health effects. This study also provides evidence that airborne biological contaminants (i.e. cow allergen) associated with airborne particulate matter are statistically elevated at distances up to three miles (4.8 km) from dairy operations.</p

Designing and implementing two facilitation interventions within the 'Facilitating Implementation of Research Evidence (FIRE)' study: A qualitative analysis from an external facilitators' perspective

Acknowledgement: We extend our sincere thanks to FIRE project team colleagues, in particular lead investigators and research fellows involved in data collection and analysis that contributed to the current paper. We also acknowledge the facilitators and their buddy colleagues that we were worked with during the course of the study.Background The 'Facilitating Implementation of Research Evidence' study found no significant differences between sites that received two types of facilitation support and those that did not on the primary outcome of documented compliance with guideline recommendations. Process evaluation highlighted factors that influenced local, internal facilitators' ability to enact the roles as envisaged. In this paper, the external facilitators responsible for designing and delivering the two types of facilitation intervention analyse why the interventions proved difficult to implement as expected, including the challenge of balancing fidelity and adaptation. Methods Qualitative data sources included notes from monthly internal-external facilitator teleconference meetings, from closing events for the two facilitation interventions and summary data analyses from repeated interviews with 16 internal facilitators. Deductive and inductive data analysis was led by an independent researcher to evaluate how facilitation in practice compared to the logic pathways designed to guide fidelity in the delivery of the interventions. Results The planned facilitation interventions did not work as predicted. Difficulties were encountered in each of the five elements of the logic pathway: recruitment and selection of appropriate internal facilitators; preparation for the role; ability to apply facilitation knowledge and skills at a local level; support and mentorship from external facilitators via monthly teleconferences; working collaboratively and enabling colleagues to implement guideline recommendations. Moreover, problems were cumulative and created tensions for the external facilitators in terms of balancing the logic pathway with a more real-world, flexible and iterative approach to facilitation. Conclusion Evaluating an intervention that is fluid and dynamic within the methodology of a randomised controlled trial is complex and challenging. At a practical level, relational aspects of facilitation are critically important. It is essential to recruit and retain individuals with the appropriate set of skills and characteristics, explicit support from managerial leaders and accessible mentorship from more experienced facilitators. At a methodological level, there is a need for attention to the balance between fidelity and adaptation of interventions. For future studies, we suggest a theoretical approach to fidelity, with a focus on mechanisms, informed by prospective use of process evaluation data and more detailed investigation of the context-facilitation dynamic.Funding: The research leading to these results has received funding from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 223646. The funder had no role in designing, conducting, or interpreting study findings.Funder: FP7 Health, Grants: 223646https://implementationscience.biomedcentral.com/articles13pubpub

Protocol for a randomised controlled trial comparing laparoscopic cholecystectomy with observation/conservative management for preventing recurrent symptoms and complications in adults with uncomplicated symptomatic gallstones (C-Gall trial)

Acknowledgments Previous CHaRT director John Norrie for his work with the concept of this study. Funding The trial is funded by the NIHR Health Technology Assessment (HTA) Programme (funder number: 14/192/71).Peer reviewedPublisher PD

Exploring people’s beliefs about the experience of time

Philosophical debates about the metaphysics of time typically revolve around two contrasting views of time. On the A-theory, time is something that itself undergoes change, as captured by the idea of the passage of time; on the B-theory, all there is to time is events standing in before/after or simultaneity relations to each other, and these temporal relations are unchanging. Philosophers typically regard the A-theory as being supported by our experience of time, and they take it that the B-theory clashes with how we experience time and therefore faces the burden of having to explain away that clash. In this paper, we investigate empirically whether these intuitions about the experience of time are shared by the general public. We asked directly for people’s subjective reports of their experience of time – in particular, whether they believe themselves to have a phenomenology as of time’s passing – and we probed their understanding of what time’s passage in fact is. We find that a majority of participants do share the aforementioned intuitions, but interestingly a minority do not

Evaluating the successful implementation of evidence into practice using the PARiHS framework : theoretical and practical challenges

Background The PARiHS framework (Promoting Action on Research Implementation in Health Services) has proved to be a useful practical and conceptual heuristic for many researchers and practitioners in framing their research or knowledge translation endeavours. However, as a conceptual framework it still remains untested and therefore its contribution to the overall development and testing of theory in the field of implementation science is largely unquantified. Discussion This being the case, the paper provides an integrated summary of our conceptual and theoretical thinking so far and introduces a typology (derived from social policy analysis) used to distinguish between the terms conceptual framework, theory and model – important definitional and conceptual issues in trying to refine theoretical and methodological approaches to knowledge translation. Secondly, the paper describes the next phase of our work, in particular concentrating on the conceptual thinking and mapping that has led to the generation of the hypothesis that the PARiHS framework is best utilised as a two-stage process: as a preliminary (diagnostic and evaluative) measure of the elements and sub-elements of evidence (E) and context (C), and then using the aggregated data from these measures to determine the most appropriate facilitation method. The exact nature of the intervention is thus determined by the specific actors in the specific context at a specific time and place. In the process of refining this next phase of our work, we have had to consider the wider issues around the use of theories to inform and shape our research activity; the ongoing challenges of developing robust and sensitive measures; facilitation as an intervention for getting research into practice; and finally to note how the current debates around evidence into practice are adopting wider notions that fit innovations more generally. Summary The paper concludes by suggesting that the future direction of the work on the PARiHS framework is to develop a two-stage diagnostic and evaluative approach, where the intervention is shaped and moulded by the information gathered about the specific situation and from participating stakeholders. In order to expedite the generation of new evidence and testing of emerging theories, we suggest the formation of an international research implementation science collaborative that can systematically collect and analyse experiences of using and testing the PARiHS framework and similar conceptual and theoretical approaches. We also recommend further refinement of the definitions around conceptual framework, theory, and model, suggesting a wider discussion that embraces multiple epistemological and ontological perspectives