Early Detection and Intervention for the Prevention of Psychosis: Outreach Evaluation Report Year 3

The Robert Wood Johnson Foundation contracted with the University of Southern Maine’s Muskie School to evaluate the community outreach and training efforts of the Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP). This report provides a brief description of program, the evaluation methodology, and preliminary results from the first three years of the evaluation. The evaluation includes an assessment of: 1) implementation efforts across five demonstration sites, 2) contextual factors that may influence outreach efforts, and 3) specific outcomes related to the education and outreach activities. In an effort to evaluate these three elements, a number of data collection tools were used, including quantitative and qualitative methods

Northern New England Clinical and Translational Research Network Assesses the Training Needs of Investigators

INTRODUCTION The Northern New England Clinical and Translational Research (NNE-CTR) Network was created to enhance the region’s research capacity and infrastructure. The NNE-CTR provides research design consultation and technical assistance, research technologies support, professional development opportunities and mentorship, as well as funding for pilot projects. This study sought to describe the characteristics of NNE-CTR investigators and to identify their research interests, training needs, and perceived barriers to research. METHODS A registration survey and 13-item needs assessment module were developed and administered to capture data on the characteristics, background, and research-related training needs, interests and barriers among investigators in Maine, New Hampshire and Vermont. Investigators were recruited via email, direct communication and the NNECTR website. Univariate statistics (frequency distributions and percentages) were calculated for all structured items. Bivariate frequencies were also generated to assess the relationship between training interests and level of research experience. Content analysis was performed on select open-ended items to identify common themes. RESULTS A total of 272 investigators participated. More than half of participants were women (60%), white (85%), and physicians (54%). A majority of respondents reported participating in a research project (88%) and indicated an interest in translational science research (51%), yet fewer than half reported receiving extramural funding. While lack of time and funding were identified as common barriers to research, many respondents expressed interest in receiving mentorship and/or pursuing training. A majority (54%) of participants were “very” interested in training related to study design. Participants with fewer than three years of research experience were more likely to report barriers related to lack of time to conduct research, while inadequate institutional support and challenges recruiting and identifying patients were more frequently reported by researchers with three or more years of experience. DISCUSSION The results revealed a range of research expertise and interests. Echoing findings from other similarly funded efforts, this study underscores the need to build core research skills through professional development. Yet, the study also demonstrates an opportunity to tailor training opportunities. CONCLUSIONS Ongoing efforts to match the identified needs and interests with the appropriate resources remains a key feature of the NNE-CTR

Using the QI Maturity Tool to Classify Agencies Along a Continuum

Major investments have been made to encourage health departments to implement quality improvement (QI) efforts. Yet, there are few empirically tested tools for public health agencies that assess these efforts and classify health departments along a QI continuum. This paper presents a new classification scheme for measuring QI Maturity in public health agencies based on a validated tool. The findings can be used to establish benchmarks, make comparisons and conduct future research linking QI and population health outcomes

Monitoring QI Maturity of Public Health Organizations and Systems in Minnesota: Promising Early Findings and Suggested Next Steps

Public health departments and systems are increasing investments in quality improvement. This paper presents methods used to identify a select number of items from a previously validated QI Maturity Tool as the basis for calculating organizational and system-level QI maturity scores that could be followed over time. Findings suggest that the abbreviated tool measures variation in QI maturity across LHDs, and differences in scores among divisions within a state health department. Minnesota has incorporated the abbreviated tool into an annual reporting system for the MN Local Public Health Act, thereby enabling stakeholders to monitor a system median score and distribution of scores every year. Such information will be used by state and local partners to identify opportunities for system-wide improvements

Monitoring QI Maturity of Public Health Organizations and Systems in Minnesota: Promising Early Findings and Suggested Next Steps

This paper presents methods used by the MN PBRN to identify a select number of items from the QI Maturity Tool as the basis for calculating organizational and system-level QI maturity scores. The findings suggest that the abbreviated tool measures variation in QI maturity across LHDs, and differences in scores among divisions within the larger state health department. The results have several implications. This modified tool shows promise and may accelerate measurement of QI in practice settings. Future additional testing may help refine the score and assure that it reflects emerging research related to QI maturity

Improved detection of Pneumocystis jirovecii in upper and lower respiratory tract specimens from children with suspected pneumocystis pneumonia using real-time PCR: a prospective study

<p>Abstract</p> <p>Background</p> <p><it>Pneumocystis </it>pneumonia (PCP) is a major cause of hospitalization and mortality in HIV-infected African children. Microbiologic diagnosis relies predominantly on silver or immunofluorescent staining of a lower respiratory tract (LRT) specimens which are difficult to obtain in children. Diagnosis on upper respiratory tract (URT) specimens using PCR has been reported useful in adults, but data in children are limited. The main objectives of the study was (1) to compare the diagnostic yield of PCR with immunofluorescence (IF) and (2) to investigate the usefulness of upper compared to lower respiratory tract samples for diagnosing PCP in children.</p> <p>Methods</p> <p>Children hospitalised at an academic hospital with suspected PCP were prospectively enrolled. An upper respiratory sample (nasopharyngeal aspirate, NPA) and a lower respiratory sample (induced sputum, IS or bronchoalveolar lavage, BAL) were submitted for real-time PCR and direct IF for the detection of <it>Pneumocystis </it><it>jirovecii</it>. A control group of children with viral lower respiratory tract infections were investigated with PCR for PCP.</p> <p>Results</p> <p>202 children (median age 3.3 [inter-quartile range, IQR 2.2 - 4.6] months) were enrolled. The overall detection rate by PCR was higher than by IF [180/349 (52%) vs. 26/349 (7%) respectively; p < 0.0001]. PCR detected more infections compared to IF in lower respiratory tract samples [93/166 (56%) vs. 22/166 (13%); p < 0.0001] and in NPAs [87/183 (48%) vs. 4/183 (2%); p < 0.0001]. Detection rates by PCR on upper (87/183; 48%) compared with lower respiratory tract samples (93/166; 56%) were similar (OR, 0.71; 95% CI, 0.46 - 1.11). Only 2/30 (6.6%) controls were PCR positive.</p> <p>Conclusion</p> <p>Real-time PCR is more sensitive than IF for the detection of <it>P. jirovecii </it>in children with PCP. NPA samples may be used for diagnostic purposes when PCR is utilised. Wider implementation of PCR on NPA samples is warranted for diagnosing PCP in children.</p

Writing Community-centered Evaluation Reports.

Documenting the process, results, impact, and effectiveness of community-based health promotion programs is an important part of any evaluation. This article provides information on how to write community-centered evaluation reports for program stake-holders. Specific prerequisites and principles are provided. In addition, several tips for increasing the use of the results are highlighted

Introduction to Case Reports: One Goal - Many Journeys

This article describes case reports that highlight the journey of accreditation through the lens of 11 health departments at various stages in the process. These case reports call attention to the link between accreditation and quality improvement

Early Detection and Intervention for the Prevention of Psychosis. Outreach Evaluation Report: Year 1 Annual Report

Under contract with the Robert Wood Johnson Foundation, researchers at the Muskie School of Public Service are evaluating the community outreach and training efforts of the Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP). This Year One report (8/15/2007 - 8/15/2008) provides an overview of the initiative and the five demonstration sites; a description of the evaluation framework and design; the evaluation questions and methods; preliminary evaluation results; and a summary of preliminary findings and next steps. Preliminary Findings: Outreach and training efforts are reaching the intended audiences; Trainings are a critical component of the outreach model; EDIPPP is perceived as a credible program; Most referrals are appropriate and given by a professional; Several factors are associated with intentions to refer; EDIPPP operates in different community and policy contexts