Hyvinvoinnin haasteet ja työelämä. Mielekäs elämä -ohjelma. Mielenterveyden ja työllistymisen edistämisen asiantuntijatyöryhmän julkaisu

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Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries

Background Process evaluation is increasingly recognized as an important component of effective implementation research and yet, there has been surprisingly little work to understand what constitutes best practice. Researchers use different methodologies describing causal pathways and understanding barriers and facilitators to implementation of interventions in diverse contexts and settings. We report on challenges and lessons learned from undertaking process evaluation of seven hypertension intervention trials funded through the Global Alliance of Chronic Diseases (GACD). Methods Preliminary data collected from the GACD hypertension teams in 2015 were used to inform a template for data collection. Case study themes included: (1) description of the intervention, (2) objectives of the process evaluation, (3) methods including theoretical basis, (4) main findings of the study and the process evaluation, (5) implications for the project, policy and research practice and (6) lessons for future process evaluations. The information was summarized and reported descriptively and narratively and key lessons were identified. Results The case studies were from low- and middle-income countries and Indigenous communities in Canada. They were implementation research projects with intervention arm. Six theoretical approaches were used but most comprised of mixed-methods approaches. Each of the process evaluations generated findings on whether interventions were implemented with fidelity, the extent of capacity building, contextual factors and the extent to which relationships between researchers and community impacted on intervention implementation. The most important learning was that although process evaluation is time consuming, it enhances understanding of factors affecting implementation of complex interventions. The research highlighted the need to initiate process evaluations early on in the project, to help guide design of the intervention; and the importance of effective communication between researchers responsible for trial implementation, process evaluation and outcome evaluation. Conclusion This research demonstrates the important role of process evaluation in understanding implementation process of complex interventions. This can help to highlight a broad range of system requirements such as new policies and capacity building to support implementation. Process evaluation is crucial in understanding contextual factors that may impact intervention implementation which is important in considering whether or not the intervention can be translated to other contexts

Cohort Profile: Burden of Obstructive Lung Disease (BOLD) study

The Burden of Obstructive Lung Disease (BOLD) study was established to assess the prevalence of chronic airflow obstruction, a key characteristic of chronic obstructive pulmonary disease, and its risk factors in adults (≥40 years) from general populations across the world. The baseline study was conducted between 2003 and 2016, in 41 sites across Africa, Asia, Europe, North America, the Caribbean and Oceania, and collected high-quality pre- and post-bronchodilator spirometry from 28 828 participants. The follow-up study was conducted between 2019 and 2021, in 18 sites across Africa, Asia, Europe and the Caribbean. At baseline, there were in these sites 12 502 participants with high-quality spirometry. A total of 6452 were followed up, with 5936 completing the study core questionnaire. Of these, 4044 also provided high-quality pre- and post-bronchodilator spirometry. On both occasions, the core questionnaire covered information on respiratory symptoms, doctor diagnoses, health care use, medication use and ealth status, as well as potential risk factors. Information on occupation, environmental exposures and diet was also collected

Bulletin No. 257 - Factors Promoting Positive Health in School Children

It is necessary only to observe groups of rural children to become convinced that too many of them are deprived of their rightful heritage of positive health. Why children playing together, working together, under conditions which apparently vary but little, should exhibit such wide variation in health conditions, is a question of vital importance to all concerned with the care of children. It was with the hope of finding some of the causes behind these variations that the present study was initiated. That the problem is complex and intricate was fully realized, and no hope was entertained that its solution could be accomplished by the methods and the extent of the present study. Two hopes, however, were entertained: One was that some of the factors which promote the physical well-being of children might be discovered and brought to the attention of parents and others whose business it is to direct the care of children. The other hope was that this modest attempt might be followed by other studies similar in objective, broader in extent, more intensive in nature, and with improved technique. It would be extremely enlightening if such a study, involving the life history of several hundred children, should enlarge in like proportion the findings discussed in this paper

Nutritional Status of some Utah Population Groups

The science of nutrition is the science of life. Though man is still ignorant of the true nature of that elusive force we call life, he has learned by means of the discovered laws of nutrition how to preserve and prolong life as well as how to add to the satisfactions of living. The emergence of the sicence of nutrition from the maze of superstition which for centuries clouded man\u27s thinking is a fascinating story. A story, however, that arouses a feeling of regret that for so long a time man was willing to attribute to supernatural forces all phenomena that were to him not easily explainable. This tendency to superstition together with the effortless effie· iency with which the healthy body functions, obscured for a long time the relationship between ingested food and bodily development and activity. Small wonder, therefore, that Galen and Paracelsus, dimly aware of the body\u27s smooth functioning, were willing to credit their so-called natural spirits, or vital spirits, with the operation of a splendid mechanism that was beyond their understanding. To Vesalius is due in large part, the beginning of a substitution of observation and inquiry for unthinking superstition. The science of nutrition as we know it today is greatly indebted to the fact that Vesalius was able to impress his many capable and influential students with the value of this substitution

Bulletin No. 266 - Comparative Size of Rural and Urban Utah School Children as Determined by the Weight - Height - Age Relationship

The problem investigated was as to whether significant differences occur in size of rural and urban Utah school children. Through cooperation of school officials weight-height-age measurements were secured for the following groups of children from 6 to 15 years of age

Bulletin No. 213 - Food Habits of Utah Farm Families

This report is merely an attempt to set forth the findings of the investigation without making claim to their being conclusive except for the families included in the study. While the study was carried into a relatively large portion of the state, the records are too few in number for any claim to be made that they represent community food conditions. It is believed, however, that the records which form the basis of this report are representative of the food situation in the homes from which they come

Bulletin No. 246 - Food Habits of Rural School Children in Relation to Their Physical Well-Being

A study of school children\u27s diet and of their physical status was made in six rural Utah communities, similar in size, and in social, economic, and physical characteristics