12 research outputs found
Shared Decision-Making Models Acknowledging an Interprofessional Approach: A Theory Analysis to Inform Nursing Practice
Additional file 1 of Evaluation of an integrated knowledge translation approach used for updating the Cochrane Review of Patient Decision Aids: a pre-post mixed methods study
Additional file 1: The ACTIVE framework of involvement in a systematic review
Evaluation of an integrated knowledge translation approach used for updating the Cochrane Review of Patient Decision Aids: a pre-post mixed methods study
Abstract Background When people who can use or benefit from research findings are engaged as partners on study teams, the quality and impact of findings are better. These people can include patients/consumers and clinicians who do not identify as researchers. They are referred to as “knowledge users”. This partnered approach is called integrated knowledge translation (IKT). We know little about knowledge users’ involvement in the conduct of systematic reviews. We aimed to evaluate team members’ degree of meaningful engagement and their perceptions of having used an IKT approach when updating the Cochrane Review of Patient Decision Aids. Methods We conducted a pre-post mixed methods study. We surveyed all team members at two time points. Before systematic review conduct, all participating team members indicated their preferred level of involvement within each of the 12 steps of the systematic review process from “Screen titles/abstracts” to “Provide feedback on draft article”. After, they reported on their degree of satisfaction with their achieved level of engagement across each step and the degree of meaningful engagement using the Patient Engagement In Research Scale (PEIRS-22) across 7 domains scored from 100 (extremely meaningful engagement) to 0 (no meaningful engagement). We solicited their experiences with the IKT approach using open-ended questions. We analyzed quantitative data descriptively and qualitative data using content analysis. We triangulated data at the level of study design and interpretation. Results Of 21 team members, 20 completed the baseline survey (95.2% response rate) and 17/20 (85.0% response rate) the follow-up survey. There were 11 (55%) researchers, 3 (15%) patients/consumers, 5 (25%) clinician-researchers, and 1 (5%) graduate student. At baseline, preferred level of involvement in the 12 systematic review steps varied from n = 3 (15%) (search grey literature sources) to n = 20 (100%) (provide feedback on the systematic review article). At follow-up, 16 (94.1%) participants were totally or very satisfied with the extent to which they were involved in these steps. All (17, 100%) agreed that the process was co-production. Total PEIRS-22 scores revealed most participants reported extremely (13, 76.4%) or very (2, 11.8%) meaningful degree of engagement. Triangulated data revealed that participants indicated benefit to having been engaged in an authentic research process that incorporated diverse perspectives, resulting in better and more relevant outputs. Reported challenges were about time, resources, and the logistics of collaborating with a large group. Conclusion Following the use of an IKT approach during the conduct of a systematic review, team members reported high levels of meaningful engagement. These results contribute to our understanding of ways to co-produce systematic reviews
Feasibility and usefulness of a leadership intervention to implement evidence-based falls prevention practices in residential care in Canada
Background: Leadership is critical to supporting and facilitating the implementation of evidence-based practices in health care. Yet, little is known about how to develop leadership capacity for this purpose. The aims of this study were to explore the (1) feasibility of delivering a leadership intervention to promote implementation, (2) usefulnessof the leadership intervention, and (3) participants’ engagement in leadership to implement evidence-based fall prevention practices in Canadian residential care. Methods: We conducted a mixed-method before-and-after feasibility study on two units in a Canadian residential care facility. The leadership intervention was based on the Ottawa model of implementation leadership (O-MILe) and consisted of two workshops and two individualized coaching sessions over 3 months to develop leadership capacity for implementing evidence-based fall prevention practices. Participants (n = 10) included both formal (e.g., managers) and informal (e.g., nurses and care aids leaders). Outcome measures were parameters of feasibility (e.g., number of eligible candidates who attended the workshops and coaching sessions) and usefulness of the leadership intervention (e.g., ratings, suggested modifications). We conducted semi-structured interviews guided by the Implementation Leadership Scale (ILS), a validated measure of 12-item in four subcategories (proactive, supportive, knowledgeable, and perseverant), to explore the leadership behaviors that participants used to implement fall prevention practices. We repeated the ILS in a focus group meeting to understand the collective leadership behaviors used by the intervention team. Barriers and facilitators to leading implementation were also explored. Results: Delivery of the leadership intervention was feasible. All participants (n = 10) attended the workshops and eight participated in at least one coaching session. Workshops and coaching were rated useful (≥ 3 on a 0–4 Likert scale where 4 = highly useful) by 71% and 86% of participants, respectively. Participants rated the O-MILe subcategories of supportive and perseverant leadership highest for individual leadership, whereas supportive and knowledgeable leadership were rated highest for team leadership. Conclusions: The leadership intervention was feasible to deliver, deemed useful by participants, and fostered engagement in implementation leadership activities. Study findings highlight the complexity of developing implementation leadership and modifications required to optimize impact. Future trials are now required to test the effectiveness of the leadership intervention on developing leadership for implementing evidence-based practices
Using an integrated knowledge translation or other research partnership approach in trainee-led research: a scoping review protocol
Introduction Collaborative research approaches, such as co-production, co-design, engaged scholarship and integrated knowledge translation (IKT), aim to bridge the evidence to practice and policy gap. There are multiple benefits of collaborative research approaches, but studies report many challenges with establishing and maintaining research partnerships. Researchers often do not have the opportunity to learn how to build collaborative relationships, and most graduate students do not receive formal training in research partnerships. We are unlikely to make meaningful progress in strengthening graduate and postgraduate training on working collaboratively with the health system until we have a better understanding of how students are currently engaging in research partnership approaches. In response, this scoping review aims to map and characterise the evidence related to using an IKT or other research partnership approach from the perspective of health research trainees.Methods and analysis We will employ methods described by the Joanna Briggs Institute and Arksey and O’Malley’s framework for conducting scoping reviews. The reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews checklist. We will include both published and unpublished grey literature and search the following databases: MEDLINE, Embase, CINAHL, PsycINFO, ProQuest Dissertations & Theses Global databases, Google Scholar and websites from professional bodies and other organisations. Two reviewers will independently screen the articles and extract data using a standardised data collection form. We will narratively describe quantitative data and conduct a thematic analysis of qualitative data. We will map the IKT and other research partnership activities onto the Knowledge to Action cycle and IAP2 Levels of Engagement Framework.Ethics and dissemination No ethical approval is required for this study. We will share the results in a peer-reviewed, open access publication, conference presentation and stakeholder communications
Are Patient Decision Aids Used in Clinical Practice after Rigorous Evaluation? A Survey of Trial Authors
Decision coaching for people making healthcare decisions
Background Decision coaching is non -directive support delivered by a healthcare provider to help patients prepare to actively participate in making a hea[th decision. 'Healthcare providers' are considered to be aEl people who are engaged in actions whose primary intent is to protect and improve health (e.g. nurses, doctors, pharmacists, social workers, health support vvorkers such as peer health workers). Little is known about the effectiveness of decision coaching. Objectives To determine the effects of decision coaching (I) for people facing healthcare decisions for themselves or a family member (P) compared to (C) usual care or evidence -based intervention only, on outcomes (0) related to preparation for decision making, decisional needs and potential adverse effects. Search methods We searched the Cochrane Library (Wiley), Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), CI NAHL (Ebsco), Nursing and Allied Health Source (ProQuest), and Web of Science from database inception to June 2021. Selection criteria We included randomised controlled trials (RCTs) where the intervention was provided to adults or children preparing to make a treatment or screening healthcare decision for themselves or a family member. Decision coaching was defined as: a) delivered individually by a healthcare provider who istrained or using a protocol; and b) providing non -directive support and preparing an adult or child to participate in a healthcare decision. Comparisons included usual care or an alternate intervention. There were no language restrictions. Data collection and analysis Two authors independently screened citations, assessed risk of bias, and extracted data on characteristics of the intervention(s) and outcomes. Any disagreements were resolved by discussion to reach consensus. We used the standardised mean difference (SMD) with 95% confidence intervals (CI) as the measures of treatment effect and, where possible, synthesised results using a random -effects model. If more than one study measured the same outcome using different tools, we used a random -effects model to calculate the standardised mean difference (SMD) and 95% Cl. We presented outcomes in summary of findings tables and applied GRADE methods to rate the certainty of the evidence. Main results Out of 12,984 citations screened, we included 28 studies of decision coaching interventions alone or in combination with evidence based information, involving 5509 adult participants (aged 18 to 85 years; 640/0 female, 520/0 white, 330/0 African-American/Black; 68% post-secondary education). The studies evaluated decision coaching used for a range of healthcare decisions (e.g. treatment decisions for cancer, menopause, mental illness, advancing kidney disease; screening decisions for cancer, genetic testing). Four of the 28 studies included three comparator arms. For decision coaching compared with usual care (n = 4 studies), we are uncertain if decision coaching compared with usual care im proves any outcomes (i.e. preparation for decision making, decision self-confidence, knowledge, decision regret, anxiety) as the certainty of the evidence was very low. For decision coaching compared with evidence -based information only (n = 4 studies), there is low certainty -evidence that participants exposed to decision coaching may have little or no change in knowledge (SMD -0.23, 95 /o CI: -0.50 to 0.04; 3 studies, 406 participants). There is low certainty-evidence that participants exposed to decision coaching may have little or no change in anxiety, compared with evidence -based information. We are uncertain if decision coaching compared with evidence -based information improves other outcomes (i.e. decision self-confidence, feeling uninformed) as the certainty of the evidence was very low. For decision coaching plus evidence -based information compared with usual care (n = 17 studies), there is low certainty -evidence that participants may have improved knowledge (SMD 9.3, 95% CI: 6.6 to 12.1; 5 studies, 1073 participants). We are uncertain if decision coaching plus evidence -based information compared with usual care improves other outcomes (i.e. preparation for decision making, decision selfconfidence, feeling uninformed, unclear values, feeling unsupported, decision regret, anxiety) as the certainty of the evidence wasvery low. For decision coaching plus evidence -based information compared with evidence -based information only (n = 7 studies), we are uncertain if decision coaching plus evidence-based information compared with evidence -based information only improves any outcomes (i.e. feeling uninformed, unclear values, feeling unsupported, knowledge, anxiety) as the certainty of the evidence was very low. Authors' conclusions Decision coaching may improve participants' knowledge when used with evidence -based information. Our findings do not indicate any significant adverse effects (e.g. decision regret, anxiety) with the use of decision coaching. It is not possible to establish strong conclusions for other outcomes. It is unclear if decision coaching always needs to be paired with evidence -informed information. Further research is needed to establish the effectiveness of decision coaching for a broader range of outcomes. PLAIN LANGUAGE SUMMAR
sj-docx-3-tva-10.1177_15248380231193444 – Supplemental material for Trauma-Informed Care Interventions Used in Pediatric Inpatient or Residential Treatment Mental Health Settings and Strategies to Implement Them: A Scoping Review
Supplemental material, sj-docx-3-tva-10.1177_15248380231193444 for Trauma-Informed Care Interventions Used in Pediatric Inpatient or Residential Treatment Mental Health Settings and Strategies to Implement Them: A Scoping Review by Yehudis Stokes, Krystina B. Lewis, Andrea C. Tricco, Erin Hambrick, Jean Daniel Jacob, Melissa Demery Varin, Justine Gould, Dhiraj Aggarwal, Paula Cloutier, Catherine Landriault, Stephanie Greenham, Michelle Ward, Allison Kennedy, Jennifer Boggett, Roxanna Sheppard, David Murphy, Marjorie Robb, Hazen Gandy, Sonia Lavergne and Ian D. Graham in Trauma, Violence, & Abuse</p
sj-docx-2-tva-10.1177_15248380231193444 – Supplemental material for Trauma-Informed Care Interventions Used in Pediatric Inpatient or Residential Treatment Mental Health Settings and Strategies to Implement Them: A Scoping Review
Supplemental material, sj-docx-2-tva-10.1177_15248380231193444 for Trauma-Informed Care Interventions Used in Pediatric Inpatient or Residential Treatment Mental Health Settings and Strategies to Implement Them: A Scoping Review by Yehudis Stokes, Krystina B. Lewis, Andrea C. Tricco, Erin Hambrick, Jean Daniel Jacob, Melissa Demery Varin, Justine Gould, Dhiraj Aggarwal, Paula Cloutier, Catherine Landriault, Stephanie Greenham, Michelle Ward, Allison Kennedy, Jennifer Boggett, Roxanna Sheppard, David Murphy, Marjorie Robb, Hazen Gandy, Sonia Lavergne and Ian D. Graham in Trauma, Violence, & Abuse</p