The evolution of social networks through the implementation of evidence-informed decision-making interventions: a longitudinal analysis of three public health units in Canada

BACKGROUND: We studied the evolution of information-seeking networks over a 2-year period during which an organization-wide intervention was implemented to promote evidence-informed decision-making (EIDM) in three public health units in Ontario, Canada. We tested whether engagement of staff in the intervention and their EIDM behavior were associated with being chosen as information source and how the trend of inter-divisional communications and the dominance of experts evolved over time. METHODS: Local managers at each health unit selected a group of staff to get engage in Knowledge Broker-led workshops and development of evidence summaries to address local public health problems. The staff were invited to answer three online surveys (at baseline and two annual follow-ups) including name generator questions eliciting the list of the staff they would turn to for help integrating research evidence into practice. We used stochastic actor-oriented modeling to study the evolution of networks. We tested the effect of engagement in the intervention, EIDM behavior scores, organizational divisions, and structural dynamics of social networks on the tendency of staff to select information sources, and the change in its trend between year 1 and year 2 of follow-up. RESULTS: In all the three health units, and especially in the two units with higher levels of engagement in the intervention, the network evolved towards a more centralized structure, with an increasing significance of already central staff. The staff showed greater tendencies to seek information from peers with higher EIDM behavior scores. In the public health unit that had highest engagement and stronger leadership support, the engaged staff became more central. In all public health units, the engaged staff showed an increasing tendency towards forming clusters. The staff in the three public health units showed a tendency towards limiting their connections within their divisions. CONCLUSIONS: The longitudinal analysis provided us with a means to study the microstructural changes in public health units, clues to the sustainability of the implementation. The hierarchical transformation of networks towards experts and formation of clusters among staff who were engaged in the intervention show how implementing organizational interventions to promote EIDM may affect the knowledge flow and distribution in health care communities, which may lead to unanticipated consequences. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13012-015-0355-5) contains supplementary material, which is available to authorized users

The incidence of prostate cancer in Iran: Results of a population-based cancer registry

Background: Little is known about the epidemiology of prostate cancer in Iranian men. We carried out an active prostate cancer surveillance program in five provinces of Iran. Methods: Data used in this study were obtained from population-based cancer registries between 1996 and 2000. Results: The age-standardized incidence rate of prostate carcinoma in the five provinces was 5.1 per 100,000 person-years. No significant difference was seen in the age-standardized incidence rate of prostate cancer within the provinces studied. The mean±SD age of patients with prostate cancer was 67±13.5 years. Conclusion: The incidence of prostate cancer in Iran is very low as compared to the Western countries. This can partly be explained by lack of nationwide screening program, younger age structure and quality of cancer registration system in Iran

Spatial Analysis and Ranking of Noise Pollution in 15 Regions of Isfahan Metropolis

Noise pollution, as one of the lesser-known environmental pollutants, has affected the residential areas of the country's metropolises. One of the main reasons for this problem is the lack of attention to spatial factors affecting noise pollution, lack of evaluation studies and insufficient familiarity with the methods of assessing the effects of development measures on noise pollution in the urban planning system. This study aims to spatial analysis and ranking of noise pollution in 15 regions of Isfahan metropolis. In this regard, the mixed research method (quantitative and qualitative) has been used and the required information has been collected through library and field methods. In addition, spatial analysis method in ArcGIS software was used for data analysis and Analytic Hierarchy Process (AHP) method in Expert Choice software was used to weight the indicators. The results indicate that the spatial distribution of noise pollution in the regions of Isfahan is unbalanced. As in the central regions 1, 3 and regions 8 & 10, mainly due to the existence of busy passages and non-observance of construction privacy for them, the impact of noisy land uses, population concentration and compactness, noise pollution is in a more unfavorable situation than other regions. Among the most important solutions to deal with this issue, can be mentioned to the observance of construction privacy for busy passages and noisy land uses in urban development plans, transfer of workshops and terminals from residential areas to non-sensitive areas and reducing congestion and increasing the complexity of designing new patches

Informing the implementation of evidence-informed decision making interventions using a social network analysis perspective; a mixed-methods study

BACKGROUND: Workforce development is an important aspect of evidence-informed decision making (EIDM) interventions. The structure of formal and informal social networks can influence, and be influenced, by the implementation of EIDM interventions. METHODS: In a mixed methods study we assessed the outcomes of a targeted training intervention to promote EIDM among the staff in three public health units in Ontario, Canada. This report focuses on the qualitative phase of the study in which key staff were interviewed about the process of engagement in the intervention, communications during the intervention, and social consequences. RESULTS: Senior managers identified staff to take part in the intervention. Engagement was a top-down process determined by the way organizational leaders promoted EIDM and the relevance of staff’s jobs to EIDM. Communication among staff participating in the workshops and ongoing progress meetings was influential in overcoming personal and normative barriers to implementing EIDM, and promoted the formation of long-lasting social connections among staff. Organization-wide presentations and meetings facilitated the recognition of expertise that the trained staff gained, including their reputation as experts according to their peers in different divisions. CONCLUSION: Selective training and capacity development interventions can result in forming an elite versus ordinary pattern that facilitates the recognition of in-house qualified experts while also strengthening social status inequality. The role of leadership in public health units is pivotal in championing and overseeing the implementation process. Network analysis can guide and inform the design, process, and evaluation of the EIDM training interventions

The change in attitude and knowledge of health care personnel and general population following trainings provided during integration of mental health in Primary Health Care in Iran: a systematic review

<p>Abstract</p> <p>Background</p> <p>Mental health has been integrated in the primary health care program in small cities and villages of Iran in a national level since the late 1980s. We performed a systematic review of literature to investigate the effect of education on change in attitude and knowledge of mental health care providers and the population covered in the program during the recent two decades in Iran.</p> <p>Methods</p> <p>Electronic bibliographic databases including Pubmed, PsycINFO and EMBase as well as the main Iranian databases (Scientific Information Database, IranMedex, IranPsych, and IranDoc) were searched. Additionally, hand searching, personal contacts and tracking of reference lists were performed. All of the studies which compared the attitude and knowledge of the related population before and after an educational intervention were recruited.</p> <p>Results</p> <p>Six articles met the inclusion criteria and entered the review. All of these studies showed an improvement in the attitude and knowledge of the studied population. Although the studies were different in many respects, a meta-analysis on the two more similar studies showed a significant effect of training on long term improvement of the knowledge and attitude of the population.</p> <p>Conclusion</p> <p>A short term training improved knowledge and attitude of the population and health personnel immediately after the intervention. There is also evidence for a long term change in the attitude and knowledge of general population after short term training.</p

An Assessment of Cycling Routes in Terms of Movement and Accessibility Using the MABAC Method (Case Study: Districts 1 and 3 of Isfahan City)

Abstract  The ever-increasing expansion of urbanization has caused an increase in activity density in cities and has created many problems in urban transportation. The development of sustainable types of travel for inner-city traffic, such as cycling, is inevitable to face the factors disturbing the comfort of citizens. On the other hand, the inadequacies in the bicycle path network have decreased this mode of transportation. It is noteworthy that Districts 3 and 1 in Isfahan, located in the historical and valuable center, are pioneers in bicycle path construction. This research seeks to investigate the movement and accessibility in the cycling routes of Districts 3 and 1 of Isfahan City. This is a mixed-method research, collecting the data through documentary analysis and field studies. The authors used the MABAC analytical method for data integration and the final research analysis. The results show that out of a total of 22 cycling routes in Districts 1 and 3 of Isfahan City, Motahari (0.183), Chaharbagh Abbasi (0.174), and Saeb (0.132) are the best cycling routes. On the other hand, Pasdaran (-0.127), Bagh Goldaste (-0.086), and Ayatollah Khorasani (-0.084) have the lowest scores of all. Finally, some suggestions to improve the condition of these routes are presented.Keywords: Assessment, Movement and Accessibility, Cycling Route, MABAC, Districts 1 and 3 of Isfahan City. IntroductionThe expansion of urbanization has caused an increase in population density and activity in cities and has created many problems for urban settlements. One of the most critical challenges in the metropolitan area is transportation. In recent years, planners have welcomed active mobility in the form of walking and cycling as a global strategy. Using active transportation methods in trips reduces traffic and increases the quality and health of the environment; on the other hand, the inadequacies in the network of cycling routes have led to a decrease in the use of this mode of transportation. Movement and accessibility in cycling routes can make cycling a very efficient tool for solving environmental, transportation, and social problems. In our country, in recent years, city managers have been encouraging people to use alternative methods for moving around the city instead of using cars, considering the cycling routes and providing suitable facilities and services. Considering the importance of replacing the transportation modes, in Isfahan, cycling routes with 777 kilometers are being built in 15 Districts. Districts 3 and 1 of Isfahan City (located in the historical, tourist, and commercial center of Isfahan City) are a pioneer in constructing a 12150-meter-long cycling path. In this research, we analyze the cycling routes of districts 3 and 1 of Isfahan regarding movement and accessibility indicators. Materials and MethodsThe current applied research is descriptive-analytical. At first, the data were extracted using documentary and field (observation) studies. Then, the data were analyzed using two quantitative and qualitative methods. Topography analysis, access analysis, and GIS software were used to evaluate the quantitative metrics. Qualitative research metrics were also identified using the analytical tables of possibilities and limitations. Finally, the MABAC method was used to combine research data and the final analysis. Compared to other multi-criteria decision-making methods, this method is considered one of the newest methods to weigh and evaluate the criteria and alternatives. Research FindingsThe results indicate that the measures of the radius of the arc of cycling paths (0.003), the amount of open sight distance (0.006), the amount of stopping sight distance (0.009), and the integration between cycling paths and public transport (0.012) are most useful in cycling routes. On the other hand, the measures of the variety and beauty of the elements, the bicycle parking accessibility, the length of the cycling route, and the placement of the guide signs along the road have the lowest level of desirability among the cycling routes.Regarding cycling routes, Motahari (0.183), Chaharbagh Abbasi (0.174), and Saeb (0.132) routes are the most desirable, respectively. Pasdaran cycling routes (-0.127), Ayatollah Khorasani (-0.084), Bagh Guldasteh (-0.086) and Seyed Alikhan (-0.077), respectively, have the lowest favorability in terms of the determined indicators. Discussion of Results and ConclusionsThere are several reasons for the formation of problems in the cycling routes of Districts 1 and 3 of Isfahan. These reasons include the existing weaknesses of decision-making and policy-making in urban management, environmental and physical limitations, financial limitations, legal limitations, the inadequacy of existing plans, and traffic limitations. The operational proposals presented are prioritized in the order of action priority so that it can be a way to overcome the existing constraints

Ditching the Driving: A Cross-Sectional Study on the Determinants of Remote Work From Home for Sign Language Interpreters.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic dramatically impacted the working conditions for sign language interpreters, shifting the provision of interpreting services from onsite to remote. The goal of this cross-sectional study was to examine the perceptions of determinants of remote interpreting implementation from home by sign language interpreters during the pandemic. We hypothesized that interpreters working across the primary settings of staff (agency, government, business, or hospital employees), educational (K-12 or postsecondary), community/freelance (independent contractor), video remote (the two-way connection between onsite participants and remote interpreter), and video relay (three-way telecommunication) would present with differing experiences of the implementation process. METHODS: The Determinants of Implementation Behavior Questionnaire was adapted for sign language interpreters (DIBQ-SLI) and administered to certified interpreters working remotely at least 10 h per week. The DIBQ-SLI included eight constructs (knowledge, skills, self-efficacy, perceived behavioral control, innovation characteristics, organizational resources and support, innovation strategies, and social support) and 30 items. Parametric statistics assessed differences in interpreters' perceptions across settings. Principal component analysis was conducted for data reduction and affirmation of the most critical constructs and items. RESULTS: One hundred and six interpreters (37 video relay, 27 video remote, 18 educational, 11 community/freelance, 11 staff interpreters, and two from "other" settings) completed the DIBQ-SLI. The video relay and staff interpreters consistently demonstrated the most favorable and the educational interpreters demonstrated the least favorable perceptions. Of the total variance, 58.8% of interpreters' perceptions was explained by organizational (41%), individual (10.7%), and social (7.1%) dimensions. There were significant differences across settings for the organizational and individual principal components; however, no differences were detected for the social principal component. CONCLUSIONS: An administrative infrastructure devoted to ensuring that interpreters receive sufficient managerial support, training, materials and resources, experience with remote interpreting before having to commit, and insights based on the results of their remote work (organizational principal component) may be necessary for improving perceptions. Remote interpreting is expected to continue after the pandemic ends; thus, settings with the least favorable ratings across behavior constructs may borrow strategies from settings with the most favorable ratings to help promote perceptions of the contextual determinants of future remote interpreting implementation