Comparing a mobile decision support system versus the use of printed materials for the implementation of an evidence-based recommendation : protocol for a qualitative evaluation

1-9Background: The distribution of printed materials is the most frequently used strategy to disseminate and implement clinical practice guidelines, although several studies have shown that the effectiveness of this approach is modest at best. Nevertheless, there is insufficient evidence to support the use of other strategies. Recent research has shown that the use of computerized decision support presents a promising approach to address some aspects of this problem. Objective: The aim of this study is to provide qualitative evidence on the potential effect of mobile decision support systems to facilitate the implementation of evidence-based recommendations included in clinical practice guidelines. Methods: We will conduct a qualitative study with two arms to compare the experience of primary care physicians while they try to implement an evidence-based recommendation in their clinical practice. In the first arm, we will provide participants with a printout of the guideline article containing the recommendation, while in the second arm, we will provide participants with a mobile app developed after formalizing the recommendation text into a clinical algorithm. Data will be collected using semistructured and open interviews to explore aspects of behavioral change and technology acceptance involved in the implementation process. The analysis will be comprised of two phases. During the first phase, we will conduct a template analysis to identify barriers and facilitators in each scenario. Then, during the second phase, we will contrast the findings from each arm to propose hypotheses about the potential impact of the system. Results: We have formalized the narrative in the recommendation into a clinical algorithm and have developed a mobile app. Data collection is expected to occur during 2018, with the first phase of analysis running in parallel. The second phase is scheduled to conclude in July 2019. Conclusions: Our study will further the understanding of the role of mobile decision support systems in the implementation of clinical practice guidelines. Furthermore, we will provide qualitative evidence to aid decisions made by low- and middle-income countries’ ministries of health about investments in these technologies

Design and implementation of the data collection tools for National Mental Health Survey of Colombia, 2015

Introducción: Como parte de los insumos necesarios para la creación, la implementación y la evaluación de políticas relacionadas con la salud mental, en todo el mundo y como iniciativa de la Organización Mundial de la Salud, se llevan a cabo encuestas poblacionales relacionadas con el tema. Durante el primer semestre de 2015, se llevó a cabo la cuarta Encuesta Nacional de Salud Mental (ENSM 2015), con una muestra de 2.727 niños entre 7 y 12 años, 1.754 adolescentes y 10.870 adultos seleccionados de diferentes lugares del país. Objetivos: Describir la selección y definición de los instrumentos que utilizar para la medición de la salud mental (incluyendo cognición social y violencias), los problemas, los trastornos mentales y la valoración de estados de salud, así como los mecanismos emplea-dos para derivar en el instrumento final de recolección. Resultados: La medición de trastornos mentales en niños se realizó utilizando el Diagnostic Interview Schedule for Children (DISC), y para adolescentes y adultos se utilizó el Composite International Diagnostic Interview (CIDI). Para los demás componentes evaluados en la ENSM 2015, se realizó una búsqueda de los instrumentos utilizados dentro y fuera de Colombia. La selección de los instrumentos utilizados para la evaluación se basó en las preguntas de cada instrumento, así como la validez científica que se podría obtener en los resultados. En algunos casos se utilizó el instrumento completo (como fue validado), se construyó uno nuevouniendo partes de diferentes instrumentos o se redactaron las preguntas partiendo de los conceptos o características que se va a medir. Se realizó una validación de contenido, de concepto y de semántica de todos los instrumentos, incluyendo CIDI y DISC. Los instrumentos resultantes se aplicaron a un grupo de sujetos de diferentes características y se detecta-ron algunas aclaraciones necesarias para la comprensión de algunas preguntas. Dado que la recolección de la información en la encuesta sería totalmente en formato electrónico, tras la construcción y la redacción de cada instrumento, se generó un formato de flujo para orientar la implementación del formato en el software Blaise. Luego de la implementación, tuvo lugar un proceso de validación de la encuesta implementada para garantizar la integridad en el orden de las preguntas y los saltos. Para este proceso se generaron casos ficticios y también se contó con la participación de voluntarios para realizar las pruebas. Conclusiones: Se presentan los apartes del instrumento utilizado en la ENSM 2015.Q4Artículo original9-18NiñosIntroduction: Population surveys on mental health are performed as part of the inputs required for the creation, implementation and evaluation of policies related to mental health, worldwide, and as an initiative of the World Health Organisation (WHO). was held The fourth National Survey of Mental Health (ENSM 2015) was carried out during the first half of 2015 on a representative sample of 2,727 children between 7 and 11 years of age, 1,754 adolescents, and 10, 870 adults who were selected throughout the country. Objective: To describe the selection and definition of the tools used to measure mental health (including social cognition and violence), problems, mental disorders, and the evaluation of health states, as well as to describe the process used to develop the data collection tools finally used. Results: The measurement of mental disorders in children was performed using the Diagnostic Interview Schedule for Children (DISC), and the Composite International Diagnostic Interview (CIDI) was used for adolescents and adults. For the remaining components evaluated in the survey, a search was conducted on the tools used at a national and international level. The selection of the toos used for the evaluation was based on the questions made by each tool, as well as the scientific validity that could be obtained from the results. In some cases the complete tool (as published) was used, in other cases the tools were constructed unifying parts of different ones, or questions were written based on the concepts or characteristics to be measured. Subsequently, a validation of content, concept and semantic of every tool was carried out, including the CIDI and DISC. The resulting tools were used on a group of people with different characteristics. It was noted that further clarification was necessary for some people to fully understand what was being asked. Because the collection of all the information in the survey would be computer assisted, a stream format was generated to guide the implementation in Blaise software, after the creation and wording of each tool in order to review the validation process of the survey and to ensure the integrity in the order of questions and their format. Fictitious cases were generated during the process, and volunteers participated in the testing. Conclusions: The tools for information collection used in the National Survey of Mental Health 2015 are presented