The codesign of implementation strategies for children's growth assessment guidelines in the dental setting

Background: Considering the interdisciplinary role dental staff can play in addressing overweight and obesity in childhood, this study aimed to codesign guideline implementation strategies for children’s growth assessment and dietary advice guidelines in the dental setting. Methods: This qualitative study utilised principles of codesign and appreciative inquiry through a series of four, two hour focus groups with dental staff and parents. Focus groups were analysed using content analysis. Results: Discussion fell into two main themes, engaging patients throughout their care journey and supporting staff to engage with the guidelines. Six strategies were developed within these themes: (1) providing growth assessment information to patients and families before appointments, (2) providing refresher training to staff, (3) involving dental assistants in the growth assessment, (4) keeping dental staff updated regarding referral outcomes, (5) culturally appropriate information resources for patients and families, and (6) enabling longitudinal growth tracking in patient information systems. Conclusions: This study successfully designed six implementation strategies for children’s growth assessment guidelines in the dental setting. Further research is required to determine their impact on guideline adherence

The effectiveness of guideline implementation strategies in the dental setting : a systematic review

Background: Guideline implementation has been an ongoing challenge in the dental practice setting. Despite this, there are no reviews summarising the existing evidence regarding effective guideline implementation strategies in this setting. In order to address this, this systematic review examines the effectiveness of guideline implementation strategies in the dental practice setting. Methods: A systematic search was undertaken according to the PRISMA statement across nine electronic databases, targeting randomised controlled trials and quasi-experimental studies which evaluated the effectiveness of guideline implementation strategies in improving guideline adherence in the dental setting. All records were independently examined for relevance and appraised for study quality by two authors, with consensus achieved by a third author. Data were extracted from included studies using a standardised data extraction pro forma. Results: A total of 15 records were eligible for inclusion in this review, which focused on the effects of audit and feedback, reminders, education, patient-mediated interventions, pay for performance and multifaceted interventions. Although there were some conflicting evidence, studies within each category of implementation strategy indicated a positive effect on guideline adherence. Conclusions: This study has identified education, reminders and multifaceted interventions as effective implementation strategies for the dental practice setting. Although this is similar to research findings from other health sectors, there is some evidence to suggest patient-mediated interventions may be less effective and pay for performance may be more effective in the dental setting. These findings can inform policy makers, professional associations, colleges and organisations in the future adoption of clinical guidelines in the dental practice setting

Conducting population health research during the COVID-19 pandemic : impacts and recommendations

The COVID-19 pandemic has resulted in many changes, including restrictions on indoor gatherings and visitation to residential aged care facilities, hospitals and certain communities. Coupled with potential restrictions imposed by health services and academic institutions, these changes may significantly impact the conduct of population health research. However, the continuance of population health research is beneficial for the provision of health services and sometimes imperative. This paper discusses the impact of COVID-19 restrictions on the conduct of population health research. This discussion unveils important ethical considerations, as well as potential impacts on recruitment methods, face-to-face data collection, data quality and validity. In addition, this paper explores potential recruitment and data collection methods that could replace face-to-face methods. The discussion is accompanied by reflections on the challenges experienced by the authors in their own research at an oral health service during the COVID-19 pandemic and alternative methods that were utilised in place of face-to-face methods. This paper concludes that, although COVID-19 presents challenges to the conduct of population health research, there is a range of alternative methods to face-to-face recruitment and data collection. These alternative methods should be considered in light of project aims to ensure data quality is not compromised

[In Press] Development and validation of a scale to measure self-efficacy and self-management in people with coronary heart disease

Background: Self-management is important in reducing coronary risk factors and in preventing recurrent cardiac events. An enabling factor that promotes self-management among patients with coronary heart disease (CHD) is self-efficacy. However, there is no standardized measure that captures self-efficacy and self-management concurrently in this population. Aim: The authors of this study report on the development and validation of a brief scale to measure self-efficacy and self-management in patients with CHD. Methods: Scale development and testing comprised (1) item generation, (2) content validity, and (3) pilot testing. The Heart Health Self-Efficacy and Self-Management (HH-SESM) scale includes 2 constructs: self-efficacy and self-management, measured concurrently. Components of the HH-SESM scale consisted of items related to behavioral and coronary risk factor modification. Survey data from 143 participants were used in exploratory factor analyses to test the factorial validity and internal consistency of the scale. Results: Twelve items with the same response format were included in the exploratory factor analysis. The factor analysis revealed a single-factor solution accounting for 36.7% and 36.5% of the variance in scores of the self-efficacy and self-management scales, respectively. The correlation (r = 0.72, P < .001) between the self-efficacy and self-management constructs indicates moderate convergent validity. Cronbach α of self-efficacy (0.83) and self-management (0.81) constructs showed good internal consistency. Conclusion: The HH-SESM is a brief, easy-to-administer, and reliable measure of self-efficacy and self-management in patients with CHD

Educational programs to improve nurses' knowledge, attitude, and practice in adolescent and young adult health : an integrative review

Objective: Nurses working in adolescent health often lack educational opportunities to develop their knowledge and practical skills to address the challenges faced by adolescents and young adults. This integrative review synthesised the evidence from peer-reviewed research that focused on educational programs to improve nurses' knowledge, attitude, and practice in adolescent and young adult health. Design: The five-stage framework by Whittemore and Knafl guided the integrative literature review and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Data sources: A single search strategy was replicated across five electronic databases (CINAHL Plus, APA PsycInfo, PubMed, Scopus, and ERIC). Studies of educational interventions or training programs for nurses on adolescent and young adult health, published in English in the last 10 years were included. Review methods: All studies found were reviewed for relevance independently by two authors, who likewise critically appraised the quality using the “Critical appraisal checklist for an article on an educational intervention” adapted from Morrison et al. (1999), with a third author providing consensus. Data were extracted using study specific standardised proforma and thematically analysed. Results: Seven studies met the inclusion criteria. Topics covered included cancer care, mental health and self-harm, with only one program including general adolescent health. A mix of face-to-face and digital asynchronous mode of delivery was employed in these programs with multi-strategic approaches used to enhance accessibility and engagement. While all studies reported improvement in knowledge and practice, including enhanced communication skills, some studies reported limited change in attitude. Success of the interventions was attributed to the flexibility of programs to accommodate nurses' workloads. Conclusion: Education interventions for nurses delivering care to adolescent and young adults enhance knowledge and skills, however, programs with institutional support for flexibility and accessibility are needed to influence a positive change in attitude

Accuracy of body weight estimation among Palestinian refugee adolescents living in Jordan : a cross-sectional study

Purpose: We aimed to examine the prevalence of obesity among adolescents living in a refugee camp in Jordan and analyze the factors influencing their weight perceptions. Design: Cross-sectional survey. Methods: We examined the body weight perception, and the influence of psychological, cultural, and social factors, among Palestinian refugee adolescents living in Jordan using a cross-sectional survey. Univariate, bivariate, and multiple logistic regression analyses were used to investigate the relationships between body weight status, weight perception, satisfaction with weight, screen time, and depression status of these adolescents. Results: A total of 620 adolescents participated in the study, of which 24% were either overweight or obese. Overweight or obese adolescents were more likely to underestimate their weight (p 14), were more likely to overestimate their body weight (p =.021). Having symptoms indicative of depression (adjusted odds ratio [AOR] = 1.70; 95% confidence interval [CI] = 1.16–2.50) and having a body mass index in the overweight/obese range (AOR = 4.16; 95% CI = 2.73–6.35) were predictors of discordant weight perception. Conclusions: This study showed that excess body weight is a significant issue among Palestinian refugee adolescents living in a refugee camp in Jordan. Underlying depression is an important factor in excess weight and distorted weight perceptions especially among this vulnerable group. Clinical Relevance: The study highlights the importance of addressing discordant body weight perception and depression in weight management in nursing interventions for vulnerable adolescent groups

Health literacy and self-management in people with coronary heart disease : a systematic review protocol

OBJECTIVE: The objective of the review is to assess the association between health literacy levels and self-management behaviors in people with coronary heart disease. INTRODUCTION: Initiating and maintaining self-management behaviors following a coronary event can be challenging. The capacity to initiate behavioral changes requires adequate health literacy, which is the ability to understand and use health care information to make appropriate health decisions. INCLUSION CRITERIA: This review will consider studies including individuals at any age who have been diagnosed with coronary heart disease. Studies that used a standardized measure of health literacy with the primary outcome of self-management behaviors or an element of self-management (eg, medication adherence) will be considered for inclusion. METHODS: The review will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases to be searched include CINAHL, Embase, PubMed, APA PsycINFO, Cochrane, Scopus, ScienceDirect, ProQuest Dissertations and Theses, Google Scholar, and OpenGrey. This will be followed by a forward and backward search of relevant articles. Cross-sectional, case-control, cohort, and mixed methods studies (quantitative component only) will be included. Studies will be screened by 2 independent reviewers and undergo a critical appraisal process. Included studies will be assessed for methodological quality, and data will be extracted using a JBI data extraction tool in the JBI System for the Unified Management, Assessment and Review of Information. The results will be presented as a narrative synthesis and, where possible, a meta-analysis will be conducted. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to assess the certainty of evidence. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021257407

"Connecting the dots" : the transfer of bioscience knowledge by new graduate nurses to the clinical setting : a qualitative study

Background: Little is known regarding the transfer of bioscience knowledge gained during undergraduate nursing studies into clinical practice. Objective: To explore the experiences of new registered nurses in applying bioscience concepts in their day-to-day nursing practice. Design: Descriptive qualitative design. Participants: Fifteen recently graduated registered nurses (RNs) who were working in acute care settings participated in the study. Methods: Semi-structured, face-to-face individual interviews were conducted. Interview data were audio-recorded and thematically analysed. Results: Four themes were identified from the qualitative interviews. The first and second themes demonstrated nurses’ realisation of the relevance of theoretical bioscience knowledge learnt within the classroom to their practice and how this evidence-based knowledge translated into confidence in decisions made. The third and fourth themes revealed the impact bioscience knowledge had on RNs’ relationships with patients and family members, which was viewed as providing compassionate care. Conclusions: The application of knowledge in biosciences gained during their undergraduate years, provided the basis for RNs to trust in their own clinical judgment and to speak with conviction. ‘Connecting the dots’ between bioscience knowledge and clinical practice provided the platform for RNs to gain and build trust with their patients. The practical utility of bioscience knowledge in everyday practice allowed RNs to contextualise their nursing care regimen and tailor holistic nursing care delivery to individual patient needs

Expanding the role of dental practitioners to address childhood overweight and obesity

Introduction: It is a priority in Australia to address the increasing prevalence of overweight and obesity among children. While present guidelines suggest the involvement of dental practitioners in addressing childhood overweight and obesity, there is a lack of evidence regarding their role and how this is best implemented in practice. Two comprehensive reviews were conducted to: 1. Determine the role of dental practitioners in addressing childhood overweight and obesity 2. Identify effective guideline implementation strategies that would facilitate role expansion in the dental setting Methods: A scoping review and a systematic review were undertaken involving extensive searches across multiple databases including Scopus, CINAHL, Medline, PsycINFO, Embase, Cochrane and Google Scholar. To address the study objectives, customised search strategies were developed for each database, using combinations of Boolean operators, truncations and Medical Subject Headings. Studies included in the scoping review explored weight interventions for children in the dental setting, while the systematic review sought studies which evaluated the effectiveness of guideline implementation strategies in the dental setting. Results: Eleven studies were included in the scoping review, which identified a clear role for dental practitioners in addressing overweight and obesity among children. However, empirical research was scarce, with only three studies evaluating existing interventions, of which two found improvements in children’s dietary and physical activity behaviours. In addition, two other studies found that parents would be accepting of such interventions if they were implemented. The systematic review identified 16 studies regarding guideline implementation strategies, which reported audit and feedback, reminders, education, patient-mediated interventions, pay for performance and multifaceted interventions as effective. However, when compared to other settings, research highlighted pay for performance might be superior in the dental setting. Conclusion: Current evidence suggests a clear role for dental professionals in addressing childhood overweight and obesity and highlights potential implementation strategies that could effectively facilitate role expansion

"Some say no, some say yes" : receiving inconsistent or insufficient information from healthcare professionals and consequences for diabetes self-management : a qualitative study in patients with Type 2 Diabetes

Aims: To explore the information-seeking experiences of patients with Type 2 diabetes and how these influenced self-management behaviours. Methods: We interviewed 18 patients with Type 2 Diabetes attending outpatient diabetes centers in South Western Sydney. Data were analyzed thematically. Results: Patients described a number of challenges they faced when seeking information about diabetes self-management. One major challenge was receiving inconsistent and insufficient information from healthcare professionals, which consequently undermined patients’ ability to self-manage diabetes. This became a disincentive in carrying out self-management tasks, and led to confusion and mistrust regarding the veracity of information received. Participants also described finding reliable information, and difficulty understanding and accessing relevant information as challenges. Medical jargon and lack of comprehensive explanations exacerbated knowledge deficits compounded by the complex maze of internet resources that some patients accessed. In response to what they perceived as confusing or inconsistent information, some patients followed “their own way” of managing their diabetes. Conclusions: Inconsistent information not tailored to the needs of patients adversely affects self-management. Taking time to provide simple explanations and assisting patients in navigating reliable web resources is becoming a vital role of healthcare professionals to reduce knowledge gaps in patients with low health literacy. © 201