Co-implementation: collaborative and concurrent approaches to advance embedded implementation in the health sciences

There is a global movement towards stakeholder engagement in healthcare research. This movement has been catalyzed by a need to create context relevant evidence of maximal utility to health service provision and policy. The concept of “co-implementation” has potential to inform and extend these discussions of partnership and to complement the growing literature on collaborative implementation. Attending to this concept may preempt conceptual confusion and provide opportunities for sustainable and context-responsive embedded research necessary for the strengthening of health systems. In this perspective article, I seek to advance the discussion of co-implementation through an examination of the concept and through consideration of it merits to the health sciences

Valuing Arts-based Academic Projects in a Faculty of Nursing: Experiences of Graduate Students and Supervisors

Purpose: The purpose of this article is to explore student and supervisor experiences and perspectives regarding the advantages and challenges of arts-based projects in the context of graduate nursing education programs. We define arts-based academic projects as graduate level projects that incorporate a significant artistic component, and that culminate in a final written report of a capping exercise, a thesis or a dissertation. Procedures: Three graduate students were asked to briefly summarize their arts-based academic projects and to reflect upon their experiences with their projects, noting the advantages and challenges that they encountered in the process. The students’ supervisors also reported their experiences with supervising students conducting arts-based academic projects. The resulting written reflections were collated and summarized. Results: The arts-based academic projects included a set of comics, a story-based digital education tool and a digital knowledge whiteboard animation video. All of these projects integrated visual art into products for the purpose of knowledge translation. The students and their supervisors identified numerous advantages to arts-based projects, such as being able to address the complexities of context and to engage broad audiences. They reported challenges such as misunderstanding and devaluing the nature of these less traditional academic projects. Conclusions: This study has implications for future arts-based projects that may be conducted in Schools or Faculties of Nursing. Supervisors and committee members play a key role in fostering the creativity of students, building on their strengths, and encouraging them to pursue innovative theses or capping exercises. Similarly, graduate program coordinators/associate deans of graduate programs can also support these students by encouraging and approving projects that are less conventional and by helping others understand the value of these projects. Résumé Objectif : Cet article a pour but d’explorer les expériences et les perspectives d’étudiantes et de directrices de projets quant aux avantages et aux défis inhérents aux projets de nature artistique dans le cadre de programmes d’études supérieures en sciences infirmières. Nous définissons les projets d’études de nature artistique comme étant des travaux des cycles supérieurs qui comportent un important volet artistique et aboutissent à la rédaction d’un rapport de fin d’études, d’une thèse ou d’un mémoire. Approche : Nous avons demandé à trois étudiantes des cycles supérieurs de résumer leur projet artistique et de réfléchir sur leur expérience en soulignant les avantages et les défis rencontrés au court du processus. Les directrices de ces projets étudiants ont également décrit leur expérience de suivi de projets d’études de nature artistique. Nous avons colligé les réflexions écrites pour en faire la synthèse. Résultats : Les projets d’études de nature artistique qui ont été présentés comprenaient une bande dessinée comme moyen de diffusion de résultats de recherche, un outil numérique d’apprentissage basé sur un récit pour des parents et des enfants asthmatiques ,et une vidéo d’animation numérique de partage de connaissances sur tableau blanc pour les parents d’enfants qui ont gastroentérite aiguë. Tous ces projets intégraient les arts visuels dans des produits destinés au transfert de connaissances. Les étudiantes et les directrices de projets ont soulevé de nombreux avantages liés à de tels projets, comme la possibilité de rendre compte de la complexité du contexte et d’intéresser un large public. Les défis soulignés incluaient notamment l’incompréhension et la dévalorisation de tels projets d’études moins conventionnels. Conclusions : Cette synthèse peut avoir des répercussions sur d’éventuels projets d’études de nature artistique menés dans les écoles ou les facultés de sciences infirmières. Les directrices et les membres de comités jouent un rôle prépondérant auprès des étudiantes, soit de favoriser leur créativité, de développer leurs forces et de les encourager à envisager des thèses et des rapports de fin d’études avant-gardistes. De même, les responsables et les vice-doyennes des programmes de cycles supérieurs peuvent soutenir ces étudiantes en favorisant et en approuvant des travaux moins conventionnels, tout en aidant les autres à en comprendre la valeur

Developing “My Asthma Diary”: a process exemplar of a patient-driven arts-based knowledge translation tool

© The Author(s). 2018 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Abstract Background Although it is well established that family-centered education is critical to managing childhood asthma, the information needs of parents of children with asthma are not being met through current educational approaches. Patient-driven educational materials that leverage the power of the storytelling and the arts show promise in communicating health information and assisting in illness self-management. However, such arts-based knowledge translation approaches are in their infancy, and little is known about how to develop such tools for parents. This paper reports on the development of “My Asthma Diary” – an innovative knowledge translation tool based on rigorous research evidence and tailored to parents’ asthma-related information needs. Methods We used a multi-stage process to develop four eBook prototypes of “My Asthma Diary.” We conducted formative research on parents’ information needs and identified high quality research evidence on childhood asthma, and used these data to inform the development of the asthma eBooks. We established interdisciplinary consulting teams with health researchers, practitioners, and artists to help iteratively create the knowledge translation tools. Results We describe the iterative, transdisciplinary process of developing asthma eBooks which incorporates: (I) parents’ preferences and information needs on childhood asthma, (II) quality evidence on childhood asthma and its management, and (III) the engaging and informative powers of storytelling and visual art as methods to communicate complex health information to parents. We identified four dominant methodological and procedural challenges encountered during this process: (I) working within an inter-disciplinary team, (II) quantity and ordering of information, (III) creating a composite narrative, and (IV) balancing actual and ideal management scenarios. Conclusions We describe a replicable and rigorous multi-staged approach to developing a patient-driven, creative knowledge translation tool, which can be adapted for use with different populations and contexts. We identified specific procedural and methodological challenges that others conducting comparable work should consider, particularly as creative, patient-driven knowledge translation strategies continue to emerge across health disciplines

Feasibility, acceptability and diagnostic test accuracy of frailty screening instruments in community-dwelling older people within the Australian general practice setting: a study protocol for a cross-sectional study

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Introduction Frailty is one of the most challenging aspects of population ageing due to its association with increased risk of poor health outcomes and quality of life. General practice provides an ideal setting for the prevention and management of frailty via the implementation of preventive measures such as early identification through screening. Methods and analysis Our study will evaluate the feasibility, acceptability and diagnostic test accuracy of several screening instruments in diagnosing frailty among community-dwelling Australians aged 75+ years who have recently made an appointment to see their general practitioner (GP). We will recruit 240 participants across 2 general practice sites within South Australia. We will invite eligible patients to participate and consent to the study via mail. Consenting participants will attend a screening appointment to undertake the index tests: 2 self-reported (Reported Edmonton Frail Scale and Kihon Checklist) and 5 (Frail Scale, Groningen Frailty Index, Program on Research for Integrating Services for the Maintenance of Autonomy (PRISMA-7), Edmonton Frail Scale and Gait Speed Test) administered by a practice nurse (a Registered Nurse working in general practice). We will randomise test order to reduce bias. Psychosocial measures will also be collected via questionnaire at the appointment. A blinded researcher will then administer two reference standards (the Frailty Phenotype and Adelaide Frailty Index). We will determine frailty by a cut-point of 3 of 5 criteria for the Phenotype and 9 of 42 items for the AFI. We will determine accuracy by analysis of sensitivity, specificity, predictive values and likelihood ratios. We will assess feasibility and acceptability by: 1) collecting data about the instruments prior to collection; 2) interviewing screeners after data collection; 3) conducting a pilot survey with a 10% sample of participants. Ethics and dissemination The Torrens University Higher Research Ethics Committee has approved this study. We will disseminate findings via publication in peer-reviewed journals and presentation at relevant conferences

Living labs for patient engagement and knowledge exchange: an exploratory sequential mixed methods study to develop a living lab in paediatric rehabilitation

Introduction Despite recognition of the importance of patient engagement in research and knowledge translation, systematic approaches to engagement and co-ideation remain limited. Living labs are collaborative knowledge sharing systems that use multimethod, user-centred approaches that hold potential to catalyse these aims. However, their use in healthcare is limited, and no living lab has been developed in paediatric rehabilitation. In response to this gap and to propel innovative knowledge exchange, we propose a mixed methods study to co-develop a living lab prototype (ie, preliminary infrastructure with opportunity for scale up) in paediatric rehabilitation, with relevance to other healthcare contexts.Methods An exploratory sequential mixed methods study will be undertaken to determine research and knowledge exchange priorities and to inform the development of the living lab prototype. Stage 1: we will use a multipronged approach to sample 18–21 youth with developmental differences or rehabilitation needs, their youth siblings and parents/guardians from a provincial paediatric rehabilitation centre, to participate in qualitative and arts-based data collection. Data will provide insight into desirable features of the living lab. Stage 2: E-surveys to youth, siblings, parents/guardians and clinicians who receive or provide services at this same centre will expand on priorities and living lab features. Stage 3: integrated analysis will inform the living lab prototype development.Analysis Inductive thematic analysis using interpretive description, integrated analysis of visual data and descriptive and content analysis of e-survey data will be undertaken. Joint displays will facilitate data integration. Priorities will be identified using a modified rank-order method for each key living lab domain.Ethics and dissemination Institutional ethics and site approval have been granted. A parent advisory group and rehabilitation engineering partners will confer on data and inform the development of the living lab prototype. User engagement with the prototype will occur during an online or in-person event, and findings shared through non-technical research summaries, journal articles and academic presentations

Application of an electronic frailty index in Australian primary care: data quality and feasibility assessment

Background: The primary care setting is the ideal location for identifying the condition of frailty in older adults. Aims: The aim of this pragmatic study was twofold: (1) to identify data items to extract the data required for an electronic Frailty Index (eFI) from electronic health records (EHRs); and (2) test the ability of an eFI to accurately and feasibly identify frailty in older adults. Methods: In a rural South Australian primary care clinic, we derived an eFI from routinely collected EHRs using methodology described by Clegg et al. We assessed feasibility and accuracy of the eFI, including complexities in data extraction. The reference standard for comparison was Fried’s frailty phenotype. Results: The mean (SD) age of participants was 80.2 (4.8) years, with 36 (60.0%) female (n = 60). Frailty prevalence was 21.7% by Fried’s frailty phenotype, and 35.0% by eFI (scores > 0.21). When deriving the eFI, 85% of EHRs were perceived as easy or neutral difficulty to extract the required data from. Complexities in data extraction were present in EHRs of patients with multiple health problems and/or where the majority of data items were located other than on the patient’s summary problem list. Discussion: This study demonstrated that it is entirely feasible to extract an eFI from routinely collected Australian primary care data. We have outlined a process for extracting an eFI from EHRs without needing to modify existing infrastructure. Results from this study can inform the development of automated eFIs, including which data items to best access data from

Music Connects Us: Development of a Music-Based Group Activity Intervention to Engage People Living with Dementia and Address Loneliness

There is a need for intervention research to understand how music-based group activities foster engagement in social interactions and relationship-building among care home residents living with moderate to severe dementia. The purpose of this conceptual paper is to describe the design of ‘Music Connects Us’, a music-based group activity intervention. Music Connects Us primarily aims to promote social connectedness and quality of life among care home residents living with moderate to severe dementia through engagement in music-making, supporting positive social interactions to develop intimate connections with others. To develop Music Connects Us, we adapted the ‘Music for Life’ program offered by Wigmore Hall in the United Kingdom, applying an intervention mapping framework and principles of engaged scholarship. This paper describes in detail the Music Connects Us program, our adaptation approach, and key adaptations made, which included: framing the project to focus on the engagement of the person living with dementia to ameliorate loneliness; inclusion of student and other community-based musicians; reduced requirements for care staff participation; and the development of a detailed musician training approach to prepare musicians to deliver the program in Canada. Description of the development, features, and rationale for Music Connects Us will support its replication in future research aimed to tests its effects and its use in clinical practice

Music Connects Us: Development of a Music-Based Group Activity Intervention to Engage People Living with Dementia and Address Loneliness

There is a need for intervention research to understand how music-based group activities foster engagement in social interactions and relationship-building among care home residents living with moderate to severe dementia. The purpose of this conceptual paper is to describe the design of ‘Music Connects Us’, a music-based group activity intervention. Music Connects Us primarily aims to promote social connectedness and quality of life among care home residents living with moderate to severe dementia through engagement in music-making, supporting positive social interactions to develop intimate connections with others. To develop Music Connects Us, we adapted the ‘Music for Life’ program offered by Wigmore Hall in the United Kingdom, applying an intervention mapping framework and principles of engaged scholarship. This paper describes in detail the Music Connects Us program, our adaptation approach, and key adaptations made, which included: framing the project to focus on the engagement of the person living with dementia to ameliorate loneliness; inclusion of student and other community-based musicians; reduced requirements for care staff participation; and the development of a detailed musician training approach to prepare musicians to deliver the program in Canada. Description of the development, features, and rationale for Music Connects Us will support its replication in future research aimed to tests its effects and its use in clinical practice