A training needs analysis of health care providers within Malta’s Primary Health Department : a boon or a bane?

In 2009, the Practice Development Unit and the Specialist Training Programme in Family Medicine within Malta’s Primary Health Department carried out a training needs analysis of health care providers working in government primary health centres and clinics so as to investigate their educational requirements. Method: After a questionnaire was developed as a tool, a pilot study was conducted in a particular health centre to test its validity. The amended version of the questionnaire was then mailed individually to all health providers working at that time in the various health centres and peripheral clinics. Out of the 498 questionnaires sent, 215 were completed and returned, with a resulting response rate of 43%. One main finding was that, irrespective of one’s discipline, the programme topic and the lecturer were the important decisive factors of whether one attended a training course or not. On the other hand, specific obstacles to training emerged that are directly related to one’s profession: these included shortage of staff, lack of time and other commitments. From the information revealed by the training needs analysis, the department revamped its training strategy to consist of three-monthly Saturday seminars dealing with topics relevant to primary health care, with such activities being oversubscribed and well-received. In this manner a thriving continuing professional development programme was designed and delivered for health care professionals within Malta’s Primary Health Departmentpeer-reviewe

Testing Enhanced Active Choice to Optimize Acceptance and Participation in a Population-Based Colorectal Cancer Screening Program in Malta

Opt-out strategies have been shown to improve participation in cancer screening; however, there are ethical concerns regarding the presumed consent. In this study, we tested an alternative opt-in strategy, called: "enhanced active choice," in which the response options summarize the consequences of the decision. The study was conducted as part of the Maltese colorectal cancer screening program, which offers men and women, aged 60-64, a "one-off" fecal immunochemical test (FIT). A total of 8349 individuals were randomly assigned to receive either an invitation letter that featured a standard opt-in strategy (control condition), or an alternative letter with a modified opt-in strategy (enhanced active choice condition). Our primary outcome was participation three months after the invitation was delivered. Additionally, we also compared the proportion who said they wanted to take part in screening. We used multivariable logistic regression for the analysis. Overall, 48.4% (N = 4042) accepted the invitation and 42.4% (N = 3542) did the screening test. While there were no statistically significant differences between the two conditions in terms of acceptance and participation, enhanced active choice did increase acceptance among men by 4.6 percentage points, which translated to a significant increase in participation of 3.4 percentage points. We conclude that enhanced active choice can improve male screening participation. Given the higher risk of CRC in men, as well as their lower participation screening, we believe this to be an important finding