The Readiness Monitoring Tool: Investigating The Psychometric Evidence For Group-Level Aggregation In Two Samples

Organizational readiness is an essential factor for successful implementation of a particular innovation. Although there is general consensus within the research literature on the importance of organizational readiness, there has been significantly less agreement on the nature of readiness as a construct and how it should be operationalized. Previous research has focused on organizational readiness for change at both the individual and organizational levels, but measures based on these theories of readiness have typically lacked evidence of reliability and validity. The R=MC2 heuristic and its associated measure, the Readiness Monitoring Tool (RMT), offer a compelling and comprehensive approach by which organizations can identify specific areas of readiness which could benefit from capacity-building efforts to strengthen implementation supports. Initial psychometric analysis of the RMT has included establishing internal reliability, content validity, criterion validity, and preliminary factor structure, but additional testing is required to establish the RMT as a theoretically-informed and psychometrically-sound measure. This study presents the results of a psychometric assessment of data from two project samples, including 1) a comparison of internal consistency measures to determine whether this property is maintained across project-specific adaptations and 2) calculation of interrater agreement and interrater reliability statistics to provide evidence for group-level aggregation of individual-level RMT data. Individual-level data was collected from seven projects that had previously adapted the RMT; two projects were selected for analysis based on strong per-site participation. Internal consistency was assessed by calculating alpha coefficients for each RMT subscale. Interrater agreement and interrater reliability was assessed using rWG, ADM, ICC(1), and ICC(2) estimates. Internal reliability analysis showed very good internal consistency for the majority of subscales. Interrater reliability and interrater agreement statistics supported group-level aggregation of individual-level responses. This study provides evidence in support of RMT as an adaptable measure capable of reliably and validly representing an organization’s readiness by surveying its members. Occasional variability in results between subscales, sites, and projects informs recommendations for future study and implications for practical RMT use. Although further development is required, the RMT shows promise as an adaptable measure of organizational readiness capable of informing targeted capacity-building support

The Need for Performance Standards in Preschools: Stealing Shamelessly from Comprehensive School Mental Health Literature

Young children are at-risk for developing significant mental health difficulties just as their older, school-aged peers. Preschool settings have increasingly attempted to proactively address early childhood socioemotional needs by expanding their prevention and intervention activities. A number of emerging best practices in promoting early childhood mental health have been proposed. However, there are no comprehensive performance standards for preschool mental health and limited guidance on how preschools can align themselves with best practices. This expansion in service scope parallels the development of Comprehensive School Mental Health Systems in K-12 schools. Resources and tools developed for K-12 educational settings may serve as a useful example for preschool mental health systems interested in quality comprehensive mental health care. This conceptual article will describe the prevalence of mental health difficulties in young children, review the current guidance on supporting mental health in young children, and provide support for adapting widely used K-12 school mental health performance standards to establish comprehensive standards for organizing and implementing high quality care systems in preschool settings

Preliminary Outcomes and Feasibility of a Brief Online Teacher Training in Culturally Responsive Practices (CRP) To Reduce Disproportionate Discipline in Prek-3rd Grade Classrooms

School discipline policies that rely on exclusionary discipline practices, such as office discipline referrals, suspensions, and expulsions, negatively and disproportionately impact racial minority students, beginning in preschool. Disproportionate discipline persists even when schools implement schoolwide interventions that reduce overall rates of exclusionary discipline, suggesting that schools must do more to address other likely causes of the discipline gap, including implicit racial bias, insufficient teacher training in classroom management, and a cultural mismatch between schools and minority students. There has been an increased call for teacher professional development in culturally responsive behavior management practices, but such interventions are often poorly evaluated and resource-intensive. The current study had three aims: 1) to characterize the preliminary impacts a brief, online teacher professional development training in culturally responsive practices (CRP) on self-efficacy for culturally responsive classroom management (CRCM), expected positive outcomes from CRP, and self-reported implementation of CRP; 2) to determine the social validity and feasibility of the training; and 3) to inform wider dissemination of the training and implementation of CRCM by determining areas for improvement and additional training and support needs. The study utilized a mixed-methods, pre/post non-experimental design using a volunteer sample of 3K-3rd grade educators in South Carolina (N = 74). Results indicated that the online CRP training significantly increased participants’ self-efficacy for CRCM practices, expected positive outcomes from using CRP, and overall level of self-reported implementation of CRP in the classroom. Mixed-method assessment of intervention feasibility and social validity suggested that the online CRP training was acceptable, practical, perceived as efficacious, and demonstrated adequate demand, particularly when teachers were given the option to complete the training during school hours. Findings highlighted broad support for CRP training and provided insight into areas for improvement and implementation support needs that can inform wider dissemination. Implications and directions for future research are discussed

Shedding Light On The Human Auditory Cortex: A Review Of The Advances In Near Infrared Spectroscopy (NIRS)

Imaging the auditory cortex can prove challenging using neuroimaging methodologies due to interfering noise from the scanner in fMRI and the low spatial resolution of EEG. Optical imaging provides a new and exciting option for exploring this key cortical area. This review presents a brief history of optical imaging, followed by an exploration of how advances in optical imaging technologies have increased the understanding of the functions and processes within the auditory cortex. In particular, the benefits and limitations of using functional near infrared spectroscopy (fNIRS) on complex populations such as infants and individuals with hearing loss are explored, along with suggestions for future research developments

A Delphi Study Investigating Clinicians’ Views on Access to, Delivery of, and Adaptations of MBCT in the UK Clinical Settings

Objectives Mindfulness-based cognitive therapy (MBCT) is a well-evidenced relapse-prevention intervention for depression with a growing evidence-base for use in other clinical populations. The UK initiatives have outlined plans for increasing access to MBCT in clinical settings, although evidence suggests that access remains limited. Given the increased popularity and access to MBCT, there may be deviations from the evidence-base and potential risks of harm. We aimed to understand what clinicians believe should be best clinical practice regarding access to, delivery of, and adaptations to MBCT. Methods We employed a two-stage Delphi methodology. First, to develop statements around best practices, we consulted five mindfulness-based experts and reviewed the literature. Second, a total of 59 statements were taken forward into three survey rating rounds. Results Twenty-nine clinicians completed round one, with 25 subsequently completing both rounds two and three. Forty-four statements reached consensus; 15 statements did not. Clinicians agreed with statements regarding sufficient preparation for accessing MBCT, adherence to the evidence-base and good practice guidelines, consideration of risks, sufficient access to training, support, and resources within services, and carefully considered adaptations. The consensus was not reached on statements which reflected a lack of evidence-base for specific clinical populations or the complex decision-making processes involved in delivering and making adaptations to MBCT. Conclusions Our findings highlight the delicate balance of maintaining a client-centred and transparent approach whilst adhering to the evidence-base in clinical decisions around access to, delivery of, and adaptations in MBCT and have important wide-reaching implications

A Delphi Study Investigating Clinicians’ Views on Access to, Delivery of, and Adaptations of MBCT in the UK Clinical Settings

From Springer Nature via Jisc Publications RouterHistory: accepted 2021-07-13, registration 2021-07-14, pub-electronic 2021-07-30, online 2021-07-30, pub-print 2021-09Publication status: PublishedAbstract: Objectives: Mindfulness-based cognitive therapy (MBCT) is a well-evidenced relapse-prevention intervention for depression with a growing evidence-base for use in other clinical populations. The UK initiatives have outlined plans for increasing access to MBCT in clinical settings, although evidence suggests that access remains limited. Given the increased popularity and access to MBCT, there may be deviations from the evidence-base and potential risks of harm. We aimed to understand what clinicians believe should be best clinical practice regarding access to, delivery of, and adaptations to MBCT. Methods: We employed a two-stage Delphi methodology. First, to develop statements around best practices, we consulted five mindfulness-based experts and reviewed the literature. Second, a total of 59 statements were taken forward into three survey rating rounds. Results: Twenty-nine clinicians completed round one, with 25 subsequently completing both rounds two and three. Forty-four statements reached consensus; 15 statements did not. Clinicians agreed with statements regarding sufficient preparation for accessing MBCT, adherence to the evidence-base and good practice guidelines, consideration of risks, sufficient access to training, support, and resources within services, and carefully considered adaptations. The consensus was not reached on statements which reflected a lack of evidence-base for specific clinical populations or the complex decision-making processes involved in delivering and making adaptations to MBCT. Conclusions: Our findings highlight the delicate balance of maintaining a client-centred and transparent approach whilst adhering to the evidence-base in clinical decisions around access to, delivery of, and adaptations in MBCT and have important wide-reaching implications

Moving anticoagulation initiation and monitoring services into the community:Evaluation of the Brighton and hove community pharmacy service

Abstract Background As part of the NHS desire to move services closer to where people live, and provide greater accessibility and convenience to patients, Brighton and Hove Clinical Commissioning Group (CCG) underwent a review of their anticoagulation services during 2008. The outcome was to shift the initiation and monitoring service in secondary care for non-complex patients, including domiciliary patients, into the community. This was achieved via a procurement process in 2008 resulting in the Community Pharmacy Anticoagulation Management Service (CPAMs) managed by Boots UK (a large chain of community pharmacies across the United Kingdom). Methods This evaluation aims to review the outcomes (International Normalised Ratio [INR] readings) and experiences of those patients attending the anticoagulation monitoring service provided by community pharmacists in Brighton and Hove. All patients on warfarin are given a target INR range they need to achieve; dosing of and frequency of appointment are dependent on the INR result. Outcome measures for patients on the CPAM service included percentage INR readings that were within target range and the percentage time the patient was within therapeutic range. Data collected from 2009 to 2016 were analysed and results compared to the service targets. Patient experience of the service was evaluated via a locally developed questionnaire that was issued to patients annually in the pharmacy. Results The evaluation shows that community pharmacy managed anticoagulation services can achieve outcomes at a level consistently exceeding national and local targets for both percentage INR readings in therapeutic target range (65.4%) compared to the recommended minimum therapeutic target range of 60.0% and percentage time in therapeutic range (72.5%, CI 71.9–73.1%) compared to the national target of 70.0%. Patients also indicated they were satisfied with the service, with over 98.6% patients rating the service as good, very good or excellent. Conclusion The Brighton and Hove CPAM service achieved above average national target management of INR and positive patient feedback, demonstrating that community pharmacy is ideally placed to provide this service safely and deliver enhanced clinical outcomes and positive patient experience