Impact of primary health care providers’ initial role security and therapeutic commitment on implementing brief interventions in managing risky alcohol consumption: a cluster randomised factorial trial

Background: Brief interventions in primary healthcare to detect and intervene in risky alcohol consumption are cost-effective in reducing drinking problems, but poorly implemented in routine care. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation.Methods: In a cluster randomised factorial trial 120 Primary Healthcare Units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design. Results: Data from 746 providers of 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore there were no significant interactions between these characteristics and allocated groups. Conclusions: The extent to which providers’ managed to change their brief intervention proportions when submitted to different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research more attention is needed for the causal relation between these parameters, as it can inform us whether to focus on these or not in implementation trajectories

Patient reported experiences of community rehabilitation and/or support services for people with long term neurological conditions: a narrative review of quantitative studies

Objectives: 1. To identify validated quantitative Patient Reported Experience Measures (PREM’s) being used in Community Rehabilitation and/or Support services for people with long term neurological conditions (PwLTNC). 2. To explore how data from quantitative PREM’s adds to research on patient experiences of Community Rehabilitation and Support for PwLTNC. Method: Eight data bases were searched for peer reviewed studies (2005–2021) which met inclusion criteria. Data extraction and quality assessment for sixteen studies was performed by two reviewers. Narrative synthesis was conducted. Results: Eleven validated PREM’s were identified which captured data for 15,831 PwLTNC. PREM scores indicated positive and negative experiences for people with Multiple Sclerosis (n = 13,123), Parkinson’s Disease (n = 2215) and Acquired Brain Injury (n = 493). Negative experiences related to Picker Institute Principles: 1 (accessibility); 3 (coordination/continuity); 4 (involvement/support for family and carers); 5 (information provision), 6 (Involvement in decision making) and 7 (empathy and emotional support). Conclusion: Quantitative PREM’s provide evidence of process quality and person-centred care within community rehabilitation and support services across large data sets of heterogeneous neurological conditions and geographical locations. Quality improvement initiatives for people with MS, PD and ABI should target processes relating to Picker Institute Principles 1,3,4,5,6, and 7.Implications for RehabilitationQuantitative validated Patient Reported Experience Measures can be used to evaluate process quality and person- centred care within community rehabilitation and support services for people with long term neurological conditions.Experiences of people with Multiple Sclerosis, Parkinson’s Disease and Acquired Brain Injury indicate the need for quality improvement in community rehabilitation.Training in communication skills and person-centred care may enhance information provision and support for self-management for people with long term neurological conditions. Quantitative validated Patient Reported Experience Measures can be used to evaluate process quality and person- centred care within community rehabilitation and support services for people with long term neurological conditions. Experiences of people with Multiple Sclerosis, Parkinson’s Disease and Acquired Brain Injury indicate the need for quality improvement in community rehabilitation. Training in communication skills and person-centred care may enhance information provision and support for self-management for people with long term neurological conditions

Make Scandinavia a Bulwark against Fascism

This data set is related to the published chapter '‘Make Scandinavia a Bulwark Against Fascism!’. Hitler's Seizure of Power and the Transnational Anti-Fascist Movement in the Nordic Countries'. Chapter abstract: Hitler's seizure of power on 30 January 1933 provided an urgent impetus to stage transnational anti-fascist conferences and rallies on a global scale. One of the first, but almost completely overlooked major conferences was organised in Copenhagen in April 1933 in the form of a Scandinavian Anti-Fascist Conference. The chapter will use the event as a prism to look backwards at anti-fascist activism in the Nordic countries during the preceding years and follow its transformation process in its immediate aftermath. What form did these largely overlooked anti-fascist articulations and manifestations take, and how were they connected to the rising transnational and global anti-fascist mobilisation coordinated in Paris and London? The chapter shows that the establishment of the Third Reich, on the one hand, vitalised anti-fascism in Scandinavia but that it paradoxically, on the other, further sharpened the communist critique of reformist social democracy and empowered social democratic anti-communism. Moreover, small neutral states, especially with social democratic governments, were confronted with an acute dilemma as the German foreign office made it clear that sharp critique of Nazi Germany and Hitler in the Nordic press and social movements had to be limited in order to maintain good bilateral relations

Exploring the factors affecting the implementation of tobacco and substance use interventions within a secondary school setting: a systematic review

Abstract Background The aim of this mixed-methods, systematic literature review was to develop an understanding of the factors affecting the implementation of tobacco and substance use intervention programmes in the secondary school setting using NPT as an analytical framework. Methods A search strategy was developed that combined implementation, school and intervention search terms. Literature searches were conducted in MEDLINE, Embase, PsycHINFO, Scopus, ERIC, CINAHL, Web of Science and the Cochrane Library. PROSPERO was also searched for similar systematic reviews and a grey literature search of policy documents and relevant material was also conducted. Papers were eligible for inclusion if they were based in a secondary school and focused on the implementation of a tobacco or substance use programme. Both quantitative and qualitative methodologies were considered for inclusion. Normalisation Process Theory (NPT) was used as a conceptual framework to identify facilitators and barriers of implementation and to structure the synthesis. Results Inclusion criteria were met by 15 papers. The included papers were both quantitative and qualitative and focused on a range of tobacco and substance use interventions, delivered by differing providers. Key facilitating factors for implementation were positive organisational climate, adequate training and teacher's and pupilâ s motivation. Barriers to implementation included heavy workloads, budget cuts and lack of resources or support. Quality appraisal identified papers to be of moderate to weak quality, as papers generally lacked detail. Conclusion NPT highlighted the need for studies to extend their focus to include reflexive monitoring around appraisal and the evaluation processes of implementing new tobacco or substance use programs. Future research should also focus on employing implementation theory as a tool to facilitate bridging the gap between school health research and practice

Exploring the factors affecting the implementation of tobacco and substance use interventions within a secondary school setting: a systematic review

Abstract Background The aim of this mixed-methods, systematic literature review was to develop an understanding of the factors affecting the implementation of tobacco and substance use intervention programmes in the secondary school setting using NPT as an analytical framework. Methods A search strategy was developed that combined implementation, school and intervention search terms. Literature searches were conducted in MEDLINE, Embase, PsycHINFO, Scopus, ERIC, CINAHL, Web of Science and the Cochrane Library. PROSPERO was also searched for similar systematic reviews and a grey literature search of policy documents and relevant material was also conducted. Papers were eligible for inclusion if they were based in a secondary school and focused on the implementation of a tobacco or substance use programme. Both quantitative and qualitative methodologies were considered for inclusion. Normalisation Process Theory (NPT) was used as a conceptual framework to identify facilitators and barriers of implementation and to structure the synthesis. Results Inclusion criteria were met by 15 papers. The included papers were both quantitative and qualitative and focused on a range of tobacco and substance use interventions, delivered by differing providers. Key facilitating factors for implementation were positive organisational climate, adequate training and teacher's and pupilâ s motivation. Barriers to implementation included heavy workloads, budget cuts and lack of resources or support. Quality appraisal identified papers to be of moderate to weak quality, as papers generally lacked detail. Conclusion NPT highlighted the need for studies to extend their focus to include reflexive monitoring around appraisal and the evaluation processes of implementing new tobacco or substance use programs. Future research should also focus on employing implementation theory as a tool to facilitate bridging the gap between school health research and practice

Additional file 1: of Exploring the factors affecting the implementation of tobacco and substance use interventions within a secondary school setting: a systematic review

Data extraction worksheet. (XLSX 52 kb

Additional file 1: of Exploring the factors affecting the implementation of tobacco and substance use interventions within a secondary school setting: a systematic review

Data extraction worksheet. (XLSX 52 kb

Additional file 1: of Socio-ecological influences on adolescent (aged 10â 17) alcohol use and linked unhealthy eating behaviours: protocol for a systematic review and synthesis of qualitative studies

PRISMA-P Checklist. (DOCX 15Â kb

Additional file 2: of A qualitative study of health promotion in academy schools in England

Topic Guide. Guide for qualitative interviews. (DOCX 20 kb