Practitioners' views and barriers to implementation of the Keeping Birth Normal tool: A pilot study

Background: Poor implementation of evidence in practice has been reported as a reason behind the continued rise in unnecessary interventions in labour and birth. A validated tool can enable the systematic measurement of care to target interventions to support implementation of evidence. The Keeping Birth Normal tool has been developed to measure and support implementation of evidence to reduce unnecessary interventions in labour and birth. Aims: This pilot sought the views of midwives about the usefulness and relevance of the Keeping Birth Normal tool in measuring and supporting practice; it also identified barriers to implementation. Methods: Five midwives supported by five preceptors tested the tool on a delivery suite and birth centre in a local NHS Trust. Mixed methods were employed. Participants completed a questionnaire about the relevance and usefulness of the tool. Semi-structured interviews explored participants' experience of using the tool in practice. Findings: The domains and items in the tool were viewed as highly relevant to reducing unnecessary interventions. Not all midwives were open to their practice being observed, but those who were reported benefits from critical reflection and role-modelling to support implementation. An important barrier is a lack of expertise among preceptors to support the implementation of skills to reduce unnecessary interventions. This includes skills in the use of rating scales and critical reflection. Where expertise is available, there is a lack of protected time for such structured supportive activity. Norms in birth environments that do not promote normal birth are another important barrier. Conclusions: Midwives found the items in the tool relevant to evidence-informed skills to reduce unnecessary interventions and useful for measuring and supporting implementation. To validate and generalise these findings, further evidence about the quality of items needs to be gathered. Successful implementation of the tool requires preceptors skilled in care that reduces unnecessary interventions, using rating scales, role-modelling and critical reflection. Such structured preceptorship requires protected time and can only thrive in a culture that promotes normal birth

The Role of Consequences in validity Theory

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72502/1/j.1745-3992.1998.tb00826.x.pd

Test development and use in five Iberian Latin American countries

The abundance of scholarship on test development and use generally is higher in English-speaking than in Iberian Latin American countries. The purpose of this article is to help overcome this imbalance by describing and identifying similarities and differences in test development and use in two Iberian (Portugal and Spain) and three of the largest Latin American (Argentina, Brazil, and Venezuela) countries. The stages of test development in each country, roles of professional associations, presence of standards for test use, professionals’ educational training, commonly used tests, together with prominent challenges to continued progress are discussed. Test development and use in these five countries are transitioning from a dependence on the use of translated tests to greater reliance on adapted and finally nationally constructed tests. Continued growth requires adherence to international standards guiding test development and use. Stronger alliance among professional associations in the Iberian Latin American countries could serve as a catalyst to promote test development in these regions.A abundância de estudos sobre o desenvolvimento do teste e usar geralmente é maior em Inglês de língua do que nos países latino-americanos ibéricos. O objetivo deste artigo é ajudar a superar este desequilíbrio, descrever e identificar semelhanças e diferenças no desenvolvimento de testes e uso em dois Ibérica (Portugal e Espanha) e três dos maiores países da América Latina (Argentina, Brasil e Venezuela). Os estágios de desenvolvimento do teste em cada país, os papéis das associações profissionais, presença de padrões para uso de teste, a formação dos profissionais da educação, os testes comumente utilizados, juntamente com desafios importantes ao progresso continuado são discutidos. Desenvolvimento de testes e uso nestes cinco países estão em transição de uma dependência do uso de testes traduzidos para uma maior dependência de testes adaptados e finalmente construídos nacionalmente. O crescimento contínuo exige a adesão a padrões internacionais orientadores desenvolvimento de testes e uso. Aliança mais forte entre as associações profissionais dos países latino-americanos ibéricos poderia servir como um catalisador para promover o desenvolvimento do teste nessas regiões

The Motivational Thought Frequency scales for increased physical activity and reduced high-energy snacking

The Motivational Thought Frequency (MTF) Scale has previously demonstrated a coherent four-factor internal structure (Intensity, Incentives Imagery, Self-Efficacy Imagery, Availability) in control of alcohol and effective self-management of diabetes. The current research tested the factorial structure and concurrent associations of versions of the MTF for increasing physical activity (MTF-PA) and reducing high-energy snacks (MTF-S).Study 1 examined the internal structure of the MTF-PA and its concurrent relationship with retrospective reports of vigorous physical activity. Study 2 attempted to replicate these results, also testing the internal structure of the MTF-S and examining whether higher MTF-S scores were found in participants scoring more highly on a screening test for eating disorder.In Study 1, 626 participants completed the MTF-PA online and reported minutes of activity in the previous week. In Study 2, 313 participants undertook an online survey that also included the MTF-S and the Eating Attitudes Test (EAT-26).The studies replicated acceptable fit for the four-factor structure on the MTF-PA and MTF-S. Significant associations of the MTF-PA with recent vigorous activity and of the MTF-S with EAT-26 scores were seen, although associations were stronger in Study 1.Strong preliminary support for both the MTF-PA and MTF-S was obtained, although more data on their predictive validity are needed. Associations of the MTF-S with potential eating disorder illustrate that high scores may not always be beneficial to health maintenance