LOGIC MODEL

逻辑模型
  • 文章类型: Journal Article
    在文献中彻底和一致地报告干预措施允许研究再现性或将干预措施付诸实践。尽管目前在已发表的文献中没有描述委员会认证的精神病学药剂师(BCPP)干预措施的标准,有多个清单或指南已开发用于报告临床干预措施,包括干预描述和复制的模板以及药剂师患者护理干预报告(PaCIR)清单,旨在提高文献中报告干预措施的质量。本文的目的是通过扩展PaCIR清单来描述在文献中报告BCPP干预措施的拟议指南。作者使用美国精神病学药剂师协会开发的逻辑模型,以确保该过程的所有要素在扩展指南中得到解决。
    Reporting interventions thoroughly and consistently in the literature allows for study reproducibility or implementation of the intervention into practice. Although there is currently no standard for describing Board-Certified Psychiatric Pharmacist (BCPP) interventions in the published literature, there are multiple checklists or guides that have been developed for reporting clinical interventions, including the template for intervention description and replication and the pharmacist patient care intervention reporting (PaCIR) checklist, that seek to improve the quality of reporting interventions in the literature. The purpose of this paper is to describe a proposed guide for reporting BCPP interventions in the literature by expanding the PaCIR checklist. Authors use a logic model developed by the American Association of Psychiatric Pharmacists to ensure all elements of the process are addressed in the expanded guide.
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  • 文章类型: Journal Article
    每年仍有越来越多的老年人被拘留,导致越来越多的常见身心健康问题。先前没有基于证据的针对性心理干预措施支持这一群人,对他们的需求知之甚少,当前活动,和健康相关的问题。我们通过一个涉及老年囚犯的项目解决了这些差距,英格兰北部一名男女监狱工作人员和一个项目咨询小组。系统审查证据支持开发一个实施工具包,处理制定和实施可持续干预措施的战略,可接受,在监狱环境中也是可行的。监狱战略需要专门解决被拘留的老年人的需求。相对便宜的活动,有些人认为分娩和灵活性有可能有益于普通的身心健康,提高生活质量,降低高昂的经济和社会成本,死亡率,在这个年龄段再次犯罪。
    A growing number of older people remain in custody each year resulting in an increasing number of common mental and physical health concerns. No prior evidenced-based targeted psychological interventions support this group of people, and little is known about their needs, current activities, and health-related problems. We addressed these gaps through a project involving older prisoners, prison staff and a project advisory group in one male and one female prison site in the North of England. Systematic review evidence supports the development of an implementation tool kit addressing strategies to develop and deliver interventions that are sustainable, acceptable, and feasible in the prison environment. Prison strategies need to specifically address the needs of older people in custody. Relatively inexpensive activities, with some thought to delivery and flexibility have the potential to benefit common mental and physical health, increasing quality of life, reducing high economic and social cost, mortality, and reoffending in this age group.
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  • 文章类型: Journal Article
    背景:社区卫生工作者(CHW)干预措施已在全球范围内显示出积极的影响,随着COVID-19大流行进一步凸显了CHWs在前线支持预防的潜力,外展,和医疗保健交付。随着劳动力的扩大,了解CHW的工作和能力是设计成功干预措施的关键。本研究考察了芝加哥经验丰富的CHW对其当前工作和成功策略的看法。
    方法:作为芝加哥社区-学术伙伴关系的一部分,半结构化访谈完成了与CHW保持一致职位的个人。面试于2022年1月至4月进行。问题集中在参与者的工作和因素,有助于他们的有效性,以深入了解劳动力战略的成功应用在医疗保健和社区环境。使用归纳推理对去识别的转录本进行分析,并将代码组织为先验确定的两个领域下的主题和子主题。这些主题为逻辑模型提供了一个逻辑模型,该模型侧重于早期阶段,以支持CHWs在其角色中的成功。
    结果:14个人参与了这项研究。这项研究中的两个预定领域是:CHW的当前工作和CHW成功的策略。确定了关于CHWs当前工作的五个主题:提供服务,与客户建立联盟,建立和维持合作,收集数据,在角色中经历挑战。从他们的角度来看,所有这些责任都加强了对客户的关怀,并支持劳动力的可持续发展努力。关于CHWs成功战略的五个主题出现了:CHWs的背景,冠军支持CHW的工作,执行CHW工作的材料,准备CHW的作用,和CHW的特征。参与者描述了CHW应该具备的关键特征,能够支持和倡导他们工作的人,以及履行职责所需的具体材料。他们报告说,培训和熟悉社区是发展和完善有效发挥其作用所必需的素质和技能的组成部分。
    结论:CHW在加强医疗保健服务和改善健康结果方面发挥着越来越重要的作用。这项研究为决策者提供了一个框架,社区,和组织用来准备CHW以成功发挥作用。
    BACKGROUND: Community health worker (CHW) interventions have demonstrated positive impacts globally, with the COVID-19 pandemic further highlighting the potential of CHWs at the frontline to support prevention, outreach, and healthcare delivery. As the workforce expands, understanding the work and capabilities of CHWs is key to design successful interventions. This study examines the perspectives of experienced CHWs in Chicago about their current work and strategies for success.
    METHODS: As part of a community-academic partnership in Chicago, semi-structured interviews were completed with individuals who held positions aligned with CHW. Interviews were conducted between January and April 2022. Questions focused on participants\' work and factors contributing to their effectiveness to gain insights into workforce strategies for success to be applied in healthcare and community settings. De-identified transcripts were analyzed using inductive reasoning with codes organized into themes and subthemes under two domains identified a priori. The themes informed a logic model focused on the early stages to support the success of CHWs in their role.
    RESULTS: Fourteen individuals participated in the study. The two predetermined domains in this study were: current work of CHWs and strategies for CHWs to be successful. Five themes were identified about CHWs\' current work: providing services, building alliances with clients, establishing and maintaining collaborations, collecting data, and experiencing challenges in role. From their perspectives, all these responsibilities enhance client care and support workforce sustainability efforts. Five themes emerged about strategies for the success of CHWs: background of CHWs, champions to support work of CHWs, materials to perform work of CHWs, preparation for CHW role, and characteristics of CHWs. Participants described key traits CHWs should possess to be hired, individuals who can champion and advocate for their work, and specific materials needed to fulfill responsibilities. They reported that training and familiarity with the community were integral to developing and refining the qualities and skills necessary to be effective in their role.
    CONCLUSIONS: CHWs play an increasingly important role in enhancing healthcare delivery and improving health outcomes. This study offers a framework for policymakers, communities, and organizations to utilize for preparing CHWs to succeed in their roles.
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  • 文章类型: Journal Article
    从以前由伊斯兰国控制的地区返回的妇女和儿童通常经历了高度的创伤和灌输,使重返社会和重新安置的政治努力进一步复杂化。因此,世界各国都在努力如何最好地管理这些妇女和儿童的返回。为了帮助更好地了解哪些类型的编程可以有助于成功,这些人的非暴力重返社会,我们结合了现有遣返和康复(R&R)文献的思想,现场从业人员,R&R主题专家,和来自相邻领域的文献(例如,难民重新安置,刑事司法,心理弹性)成为推荐的最佳实践方法,以支持返回的妇女和儿童。我们建议从“R&R”编程转变为我们所说的“5R”框架:遣返/重新安置,重新整合,康复,和弹性。这种转变提供了与不同程序元素如何瞄准近端目标相关的概念清晰度(例如,福祉和人身安全,归属感和机会,非暴力,和尊严),以及编程如何从更集中和政府拥有的服务转变为非正式和基于社区的支持。
    Women and children returning from areas formerly controlled by the Islamic State typically have experienced high levels of trauma and indoctrination, further complicating politically fraught efforts at reintegration and resettlement. Consequently, countries around the world are grappling with how best to manage the return of these women and children. To help better understand which types of programming can contribute to the successful, non-violent reintegration of these individuals, we incorporated ideas from existing Repatriation and Rehabilitation (R&R) literature, field practitioners, R&R subject matter experts, and literature from adjacent fields (e.g., refugee resettlement, criminal justice, psychological resilience) into a recommended best practice approach to supporting returning women and children. We propose a shift from \"R&R\" programming to what we call the \"5R\" framework: Repatriation/ Resettlement, Reintegration, Rehabilitation, and Resilience. This shift provides conceptual clarity related to how different program elements target proximal goals (e.g., wellbeing and personal safety, belonging and opportunity, non-violence, and dignity), and how programming can shift from more centrally- and government-held services to informal and community-based supports.
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  • 文章类型: Journal Article
    目的:本研究旨在开发和阐明一种逻辑模型和方案理论,用于对被认为有自杀死亡风险的监狱男性实施一种新的认知行为自杀预防干预措施。与主要利益相关者进行的半结构化一对一访谈以及定性分析技术的结合被用于发展计划理论。
    结果:与28个利益相关者的访谈得出了五种计划理论,专注于:信任,意愿和参与;准备和能力;评估和制定;从业人员在监狱环境中面对面地提供干预的“变革工作”阶段;以及从业人员培训,整合干预和后续护理。每种理论都提供了在每个阶段需要考虑哪些上下文因素的细节,以及哪些活动可以促进实现干预的预期结果,中期和长期。
    结论:根据五种理论制定的PROSPECT实施策略可以适应不同的情况和环境。
    OBJECTIVE: This study aimed to develop and articulate a logic model and programme theories for implementing a new cognitive-behavioural suicide prevention intervention for men in prison who are perceived to be at risk of death by suicide. Semi-structured one-to-one interviews with key stakeholders and a combination of qualitative analysis techniques were used to develop programme theories.
    RESULTS: Interviews with 28 stakeholders resulted in five programme theories, focusing on: trust, willingness and engagement; readiness and ability; assessment and formulation; practitioner delivering the \'change work\' stage of the intervention face-to-face in a prison environment; and practitioner training, integrating the intervention and onward care. Each theory provides details of what contextual factors need to be considered at each stage, and what activities can facilitate achieving the intended outcomes of the intervention, both intermediate and long term.
    CONCLUSIONS: The PROSPECT implementation strategy developed from the five theories can be adapted to different situations and environments.
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  • 文章类型: Journal Article
    随着研究成为医学教育中越来越重要的组成部分,更加强调将方案增强纳入研究经验。本研究建立了一个逻辑模型来总结研究项目输入,输出,以及全国研究型医学院的成果,提供机构可以用来设计和改进他们的医学生研究培训计划的框架。
    在2021年11月至2022年2月之间,我们进行了一项评估机构特征的调查,研究产品,课程,资金,根据《美国新闻与世界报道》,2021年医学院的学生学术产品在研究中排名1-50。结果以逻辑模型的形式进行编译。
    37家机构(72.5%)做出了回应。共同的项目投入包括至少一名资助项目主管(97.3%)等人员,而医学生研究活动的资金变化很大(8-72%)。教师研究导师的资金少得多(2.7%),顾问(18.9%),和教学教师(29.7%)。共同产出包括医学生研究办公室或项目(97.3%),正式研究课程(83.8%),以及研究日等服务和计划(91.9%)。最常见的结果是出版物(48.6%),演示文稿/海报(43.2%),学生参与(29.7%),并完成研究要求(29.7%)。
    医学生研究培训计划中的常见主题可以用学校可以用来开发的逻辑模型概念化,评估,并反复改进他们的程序。机构在设计投入之前应考虑其期望的计划成果(例如,资金,人员)和产出(例如,课程,培训)。
    在线版本包含补充材料,可在10.1007/s40670-024-02001-3获得。
    UNASSIGNED: As research becomes an increasingly important component of medical education, there is greater emphasis on incorporating programmatic enhancements to the research experience. This study builds a logic model to summarize research program inputs, outputs, and outcomes from research-oriented medical schools across the country, providing a framework that institutions can use to design and improve their medical student research training programs.
    UNASSIGNED: Between November 2021 and February 2022, we administered a survey assessing institutional characteristics, research offerings, curriculum, funding, and student scholarly products to the medical schools ranked 1-50 in research in 2021 by US News and World Report. Results were compiled in the form of a logic model.
    UNASSIGNED: Thirty-seven institutions (72.5%) responded. Common program inputs included personnel such as at least one funded program director (97.3%), while funding for medical student research activities was highly variable (8-72%). There was much less funding for faculty research mentors (2.7%), advisors (18.9%), and teaching faculty (29.7%). Common outputs included a medical student research office or program (97.3%), formal research curricula (83.8%), and services and programs such as research day (91.9%). The most common outcomes tracked were publications (48.6%), presentations/posters (43.2%), student participation (29.7%), and completion of a research requirement (29.7%).
    UNASSIGNED: Common themes in medical student research training programs may be conceptualized with a logic model that schools can use to develop, evaluate, and iteratively improve their programs. Institutions should consider their desired program outcomes prior to designing inputs (e.g., funding, personnel) and outputs (e.g., curriculum, training).
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s40670-024-02001-3.
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  • 文章类型: Journal Article
    背景:急性精神卫生服务报告了涉及患者和工作人员的高水平安全事件。在心理健康环境中,患者参与干预以提高安全性的潜力是公认的。并且需要积极寻求患者安全观点的干预措施。数字技术可以提供解决这一需求的机会。
    目的:这项研究旨在设计和开发一种数字实时监测工具(WardSonar),以收集和整理急性精神卫生病房患者对安全的看法的日常信息。我们介绍了设计和开发过程以及基础逻辑模型和程序理论。
    方法:第一阶段包括系统回顾和证据扫描的综合发现,与患者(n=8)和卫生专业人员(n=17)的访谈,和利益相关者的参与。与患者进行设计活动和讨论的循环,工作人员,和利益相关者团体,设计和开发原型工具。
    结果:我们借鉴了患者安全理论以及传染病和环境的概念。数据综合,设计,和开发过程导致了数字监控工具(WardSonar)的三个原型组件:(1)患者记录界面,要求患者将其感知输入平板电脑,为了评估病房的感觉以及方向是否在改变,也就是说,“变得更糟”或“变得更好”;(2)员工仪表板和功能,以询问不同级别的数据;(3)面向公众的病房界面。该技术作为开源代码提供。
    结论:最近的患者安全政策和研究重点鼓励采用创新方法来测量和监测安全性。我们开发了一种数字实时监控工具,用于从急性精神卫生病房的患者那里收集有关感知安全性的信息,支持工作人员更主动地应对和干预临床环境的变化。
    BACKGROUND: Acute mental health services report high levels of safety incidents that involve both patients and staff. The potential for patients to be involved in interventions to improve safety within a mental health setting is acknowledged, and there is a need for interventions that proactively seek the patient perspective of safety. Digital technologies may offer opportunities to address this need.
    OBJECTIVE: This research sought to design and develop a digital real-time monitoring tool (WardSonar) to collect and collate daily information from patients in acute mental health wards about their perceptions of safety. We present the design and development process and underpinning logic model and programme theory.
    METHODS: The first stage involved a synthesis of the findings from a systematic review and evidence scan, interviews with patients (n=8) and health professionals (n=17), and stakeholder engagement. Cycles of design activities and discussion followed with patients, staff, and stakeholder groups, to design and develop the prototype tool.
    RESULTS: We drew on patient safety theory and the concepts of contagion and milieu. The data synthesis, design, and development process resulted in three prototype components of the digital monitoring tool (WardSonar): (1) a patient recording interface that asks patients to input their perceptions into a tablet computer, to assess how the ward feels and whether the direction is changing, that is, \"getting worse\" or \"getting better\"; (2) a staff dashboard and functionality to interrogate the data at different levels; and (3) a public-facing ward interface. The technology is available as open-source code.
    CONCLUSIONS: Recent patient safety policy and research priorities encourage innovative approaches to measuring and monitoring safety. We developed a digital real-time monitoring tool to collect information from patients in acute mental health wards about perceived safety, to support staff to respond and intervene to changes in the clinical environment more proactively.
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  • 文章类型: Journal Article
    背景:女性生殖器整容手术在世界大部分地区发展迅速。专业组织已就这些做法的并发症和长期后果发出警告。为了能够采取正确的卫生政策,有必要知道为什么妇女决定执行这些程序。因此,本研究旨在发现伊朗女性生殖器整容手术所涉及的决策过程,并构建和验证健康公共政策的基于结果的逻辑模型.
    方法:本研究分三个阶段进行。在初始阶段,将使用Corbin和Strauss基础理论方法进行定性研究。该研究的参与者将是健康的女性,她们希望或已经接受了没有医学适应症的女性生殖器整容手术。在这个阶段,目的和理论抽样将指导招聘和数据收集。数据将通过半结构化访谈收集,现场笔记和个人互动的观察。数据将使用Corbin和Strauss(2015)的方法进行分析。使用MAXQDA2007软件管理数据分析过程。在第二阶段,基于第一阶段研究的结果,为健康的公共政策开发基于结果的逻辑模型,采访关键线人,并回顾该领域的文献结果。最后,在第三阶段,在一组专家在场的情况下,将通过名义组技术对所设计的程序进行验证。
    结论:这项研究的结果,通过确定女性与所研究现象相关的主要问题,现有的背景,参与者的反应和所采纳反应的后果,在设计一个符合伊朗文化特征的项目时非常重要。在这项研究中,将提出一个适合决策者的使用逻辑模型的程序,规划者和医疗服务提供者将在研究的社会文化背景下实施。
    女性生殖器美容程序是指一组美容程序,改变女性外生殖器的结构和健康外观,以改善性表现或身体形象。执行这些技术的愿望在世界大部分地区已经变得流行。然而,科学社会已经警告了效率,这些技术的有效性和副作用。根据这些观点,本研究旨在发现为伊朗妇女执行FGCP的决策过程,并构建和验证健康公共政策计划。这项研究将分三个阶段进行。首先,将进行定性研究,并与希望或已接受女性生殖器美容手术的健康女性进行访谈。在下文中,根据第一阶段的发现,采访主要举报人和文献综述,将提出一个程序来减少或防止这些程序,然后这个程序将被验证。使用设计的程序,保健医生将能够为妇女提供更有效的建议和指导,以做出正确和明智的决定。此外,该方案将使规划者和决策者能够采取措施减少对这些行动的需求,并通过改变和调整条件和背景,由妇女做出明智的决定。
    BACKGROUND: Female genital cosmetic procedures have grown rapidly in most parts of the world. Professional organizations have issued warnings about the complications and long-term consequences of these practices. To be able to adopt the right health policies, it is necessary to know why women decide to perform these procedures. Therefore, the present study will be aim to discover the decision-making process involved in performing female genital cosmetic procedures for Iranian women and construct and validate a results-based logic model for healthy public policy.
    METHODS: The present study was conducted in three phases. In the initial phase, a qualitative study will be conducted with the Corbin and Strauss ground theory approach. The participants in the study will be healthy women who desire or have undergone female genital cosmetic procedures without medical indications. In this phase, purposive and theoretical sampling will guide recruitment and data collection. The data will be collected via semi-structured interviews, field notes and observations of individual interactions. The data will be analysed using the approach of Corbin and Strauss (2015). MAXQDA 2007 software was used for managing the process of data analysis. In the second phase, the development of a results-based logic model for a healthy public policy is performed based on the findings of the first phase of the study, interviews with key informants and a review of the results of the literature in this field. Finally, validation of the designed program will be performed by the nominal group technique with the presence of a group of experts in the third phase.
    CONCLUSIONS: The findings of this study, by identifying women\'s main concerns related to the studied phenomenon, the existing context, participants\' reactions and the consequences of the adopted reactions, can be very important in designing a program that fits Iran\'s cultural characteristics. In this research, a program using a logical model will be presented that is suitable for policymakers, planners and healthcare service providers to be implemented in the social-cultural context of the study.
    Female genital cosmetic procedures refer to a group of cosmetic procedures that change the structure and healthy appearance of the female external genitalia to improve sexual performance or body image. The desire to perform these techniques has become popular in most parts of the world. However, scientific societies have warned about the efficiency, effectiveness and side effects of these techniques. According to these points, the present study aims to discover the decision-making process of performing FGCPs for Iranian women and to construct and validate a program for healthy public policy. This study will be performed in three stages. First, a qualitative study and interviews with healthy women who desire or have undergone female genital cosmetic procedures will be performed. In the following, based on the findings of the first stage, interviews with key informants and a review of literature, a program will be presented to reduce or prevent these procedures, and then this program will be validated. Using the designed program, healthcare practitioners will be able to provide women with more effective advice and guidance to make correct and informed decisions. In addition, this program will enable planners and policymakers to take steps to reduce the demand for these actions and make informed decisions by women by changing and adjusting the conditions and context.
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  • 文章类型: Journal Article
    背景:社区卫生工作者(CHW)在将社区与基于设施的医疗保健联系起来方面发挥着重要作用。然而,CHW计划经常受到员工积极性低的阻碍,需要旨在改善员工积极性和工作环境的新工具。其中一种干预措施是“从卓越中学习”(LfE)计划。我们的目的是评估可行性,输出,以及共同设计的LfE计划对CHW动机的影响,在内诺区。
    方法:我们对LfE计划进行了融合混合方法评估。该计划和表格的共同设计于2019年10月至2020年1月期间进行。在2020年9月至11月之间提交的LfE表格使用描述性统计数据和备忘录进行了分析,总结了开放式问题的答案。为了调查LfE的经验,我们对主要利益相关者进行了深入的半结构化访谈,CHWs,和现场主管,进行了主题分析。制定了干预前问卷,以评估共同设计的LfE干预对CHW动机和感知监督的影响。结果被三角化为逻辑模型。
    结果:总共提交了555份LfE表格,内诺区34.4%的CHW至少提交了一份LfE报告。访谈中确定了四个主题:LfE实施过程,经验,后果,和建议。2020年1月共有50名CHWs参与问卷,其中46名于2020年12月完成问卷。在动机(站点F:p=0.86;站点G:p=0.31)和感知监督(站点F:p=0.95;站点G:p=0.45)的LfE前后测量之间没有统计学上的显着差异。逻辑模型,解释LfE计划如何影响CHW的开发。
    结论:许多CHW在2020年9月至2020年11月期间参与了LfE干预。LfE受到CHWs和利益相关者的欢迎,因为它使他们能够在没有其他机会的情况下欣赏出色的工作。然而,在CHW动机和感知监督方面没有发现统计学上的显著差异.虽然干预在内诺区是可行的,我们确定了实施的几个障碍和促进者。我们开发了一个逻辑模型来解释上下文因素,以及可能导致内诺区CHWsLfE结果的机制。那些为卫生工作者设计和实施LfE等干预措施的人可以使用开发的逻辑模型。
    BACKGROUND: Community Health Workers (CHWs) play an essential role in linking communities to facility-based healthcare. However, CHW programmes have often been hampered by low levels of staff motivation, and new tools aimed at improving staff motivation and work environment are needed. One such intervention is the \"Learning from Excellence\" (LfE) programme. We aimed to assess feasibility, outputs, and impact of a co-designed LfE programme on CHW motivation, in Neno District.
    METHODS: We conducted a convergent mixed-method evaluation of the LfE programme. Co-design of the programme and forms took place between October 2019 and January 2020. LfE forms submitted between September and November 2020 were analysed using descriptive statistics and memos summarising answers to the open-ended question. To investigate experiences with LfE we conducted in-depth semi-structured interviews with key stakeholders, CHWs, and site supervisors, which were analysed thematically. A pre-post intervention questionnaire was developed to assess the impact of the co-designed LfE intervention on CHW motivation and perceived supervision. Outcomes were triangulated into a logic model.
    RESULTS: In total 555 LfE forms were submitted, with 34.4% of CHWs in Neno District submitting at least one LfE report. Four themes were identified in the interviews: LfE implementation processes, experience, consequences, and recommendations. A total of 50 CHWs participated in the questionnaire in January 2020 and 46 of them completed the questionnaire in December 2020. No statistically significant differences were identified between pre-and post-LfE measurements for both motivation (Site F: p = 0.86; Site G: p = 0.31) and perceived supervision (Site F: p = 0.95; Site G: p = 0.45). A logic model, explaining how the LfE programme could impact CHWs was developed.
    CONCLUSIONS: Many CHWs participated in the LfE intervention between September 2020 and November 2020. LfE was welcomed by CHWs and stakeholders as it allowed them to appreciate excellent work in absence of other opportunities to do so. However, no statistically significant differences in CHW motivation and perceived supervision were identified. While the intervention was feasible in Neno District, we identified several barriers and facilitators for implementation. We developed a logic model to explain contextual factors, and mechanisms that could lead to LfE outcomes for CHWs in Neno District. The developed logic model can be used by those designing and implementing interventions like LfE for health workers.
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  • 文章类型: Journal Article
    务实试验可能需要调整干预措施以增强当地的适应性,适应性跟踪对评估至关重要。这项研究描述了多站点的跟踪方法,楔形混合语用试验测试癌症症状管理干预措施的实施和有效性。
    研究活动按日期和类别记录在电子表格中。在围绕报告适应和修改扩展框架(FRAME)域构建的数据库中,跨多个工作组跟踪干预适应。例如,改变的原因。使用纵向实施策略跟踪系统(LISTS)方法对实施策略进行纵向跟踪,并在数据库中进行聚类。在研究结束时创建了一个逻辑模型,以描述核心干预组件和实施策略以及适应日期。
    在2019年1月至2023年1月期间,记录了187项研究活动。大多数干预活动都是在早期进行的,但是在试验过程中有重要的干预措施,包括扩大干预主义者的角色,以增加两个新学科。记录了11项干预适应。大多数都是计划外的,旨在改善健康或增加参与度。记录了33项实施战略,其中与教育利益相关者有关的数量最多。大多数(但不是全部)组件和策略的添加与试验启动时假设的变更机制一致。
    适应跟踪的多方面方法,结合逻辑模型,支持识别用于评估的有意义的变化,但是需要进一步的工作来尽量减少负担,并确保为评估和及时决策提供信息的强大和实用的系统。
    注册:ClinicalTrials.gov,NCT03892967。2019年3月25日注册。https://www.临床试验.gov/.
    UNASSIGNED: Pragmatic trials may need to adapt interventions to enhance local fit, and adaptation tracking is critical to evaluation. This study describes the tracking approach for a multisite, stepped-wedge hybrid pragmatic trial testing implementation and effectiveness of a cancer symptom management intervention.
    UNASSIGNED: Study activities were documented in a spreadsheet by date and category. Intervention adaptations were tracked across multiple workgroups in a database structured around the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) domains, e.g., reasons for change. Implementation strategies were tracked longitudinally and by cluster in a database using the Longitudinal Implementation Strategy Tracking System (LISTS) method. A logic model was created at the end of the study to describe core intervention components and implementation strategies with dates of adaptations.
    UNASSIGNED: Between January 2019 and January 2023, 187 study activities were documented. Most intervention activities took place early, but there were important intervention refinements during the course of the trial, including the expansion of interventionist roles to add two new disciplines. Eleven intervention adaptations were documented. Most were unplanned and aimed at improving fit or increasing engagement. Thirty-three implementation strategies were documented, the largest number of which were related to educating stakeholders. Most (but not all) component and strategy additions were consistent with the mechanisms of change as hypothesized at trial launch.
    UNASSIGNED: A multifaceted approach to adaptation tracking, combined with a logic model, supported identification of meaningful changes for use in evaluation, but further work is needed to minimize burden and ensure robust and practical systems that inform both evaluation and timely decision-making.
    UNASSIGNED: Registration: ClinicalTrials.gov, NCT03892967. Registered on March 25, 2019. https://www.clinicaltrials.gov/.
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