Carol Hubberstey et al. · 2019 · International Journal of Environmental Research and Public Health · Open access
Within Canada, several specialized multi-service prevention programs work with highly vulnerable pregnant and early parenting women with substance use issues. Experiences of trauma, mental health, poverty, and other factors associated with the social determinants of health complete the picture. Program evaluations have demonstrated their value, but less has been said as to women's reasons for choosing to seek help from these programs, what they were hoping to gain, or what difference they believe has occurred as a result. The Co-creating Evidence project is a multi-year (2017-2020) national evaluation of holistic programs serving women at high risk of having an infant with prenatal alcohol or substance exposure. The evaluation uses a mixed methods design involving quarterly program output and "snapshot" client data, as well as in-person, semi-structured interviews and questionnaires with clients, program staff, and program partners. This article presents findings from interviews with women regarding why they sought help, how they used the services, and what they perceived to be the most significant change in their lives as a result. Obtaining help with substance use was the top theme for what women hoped to get from their participation in their program; however, women's reasons were often intertwined. Additional motivations included wanting information, support or assistance with: child welfare; pregnancy; housing; getting connected to health care or prenatal care; and opportunities for peer support. With respect to the most significant life change, themes included: reduced substance use; improved housing; stronger mother-child connection; and improved wellness and social connections. Findings demonstrated that vulnerable, marginalized pregnant and parenting women who are using substances will seek help when health and social care services are configured in such a way as to take into consideration and address their unique roles, responsibilities, and realities.
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Wei Li et al. · 2024 · Scientific Reports · Open access
Artificial intelligence (AI) holds immense promise for K-12 education, yet understanding the factors influencing students' engagement with AI courses remains a challenge. This study addresses this gap by extending the technology acceptance model (TAM) to incorporate cognitive factors such as AI intrinsic motivation (AIIM), AI readiness (AIRD), AI confidence (AICF), and AI anxiety (AIAX), alongside human-computer interaction (HCI) elements like user interface (UI), content (C), and learner-interface interactivity (LINT) in the context of using generative AI (GenAI) tools. By including these factors, an expanded model is presented to capture the complexity of student engagement with AI education. To validate the model, 210 Chinese students spanning grades K7 to K9 participated in a 1 month artificial intelligence course. Survey data and structural equation modeling reveal significant relationships between cognitive and HCI factors and perceived usefulness (PU) and ease of use (PEOU). Specifically, AIIM, AIRD, AICF, UI, C, and LINT positively influence PU and PEOU, while AIAX negatively affects both. Furthermore, PU and PEOU significantly predict students' attitudes toward AI curriculum learning. These findings underscore the importance of considering cognitive and HCI factors in the design and implementation of AI education initiatives. By providing a theoretical foundation and practical insights, this study informs curriculum development and aids educational institutions and businesses in evaluating and optimizing AI4K12 curriculum design and implementation strategies.
Anna Edwards-Gaura et al. · 2014 · Western Journal of Emergency Medicine · Open access
INTRODUCTION: Child maltreatment is one of the United States' most significant public health problems. In efforts to prevent maltreatment experts recommend use of Behavioral Parent Training Programs (BPTs), which focus on teaching skills that will replace and prevent maltreating behavior. While there is research to support the effectiveness of BPTs in maltreatment prevention, the reach of such programs is still limited by several barriers, including poor retention of families in services. Recently, new technologies have emerged that offer innovative opportunities to improve family engagement. These technologies include smartphones and social networking; however, very little is known about the potential of these to aid in maltreatment prevention. The primary goal of this study was to conduct 2 pilot exploratory projects. METHODS: The first project administered a survey to parents and providers to gather data about at-risk parents' use of smartphones and online social networking technologies. The second project tested a social networking-enhanced brief parenting program with 3 intervention participants and evaluated parental responses. RESULTS: Seventy-five percent of parents surveyed reported owning a computer that worked. Eighty-nine percent of parents reported that they had reliable Internet access at home, and 67% said they used the Internet daily. Three parents participated in the intervention with all reporting improvement in parent-child interaction skills and a positive experience participating in the social networking-enhanced SafeCare components. CONCLUSION: In general, findings suggest that smartphones, social networking, and Facebook, in particular, are now being used by individuals who show risk factors for maltreatment. Further, the majority of parents surveyed in this study said that they like Facebook, and all parents surveyed said that they use Facebook and have a Facebook account. As well, all saw it as a potentially beneficial supplement for future parents enrolling in parenting programs.
Kristen M. McCabe et al. · 2020 · Psychology Research and Behavior Management · Open access
Behavioral Parent Training (BPT) interventions are efficacious for young children with externalizing behavior problems. However, not all families benefit, and ethnic minority families in particular are less likely to enroll, engage, and improve in BPT. Versions of BPT interventions tailored for specific ethnic groups have been successful at improving engagement and outcomes for ethnic minorities; however, the specificity of these models presents challenges for broad dissemination. This article presents a personalization approach (PersIn) that utilizes cultural assessment results to tailor treatment protocols to the characteristics of individual families. We believe this approach has the potential to maximize cultural sensitivity while preserving generalizability to both minority and non-minority ethnic groups. We further propose that personalization on Parent Explanatory Model (PEM) parameters that have been found to vary across ethnic groups and to impact treatment engagement and/or outcomes is a promising approach to decreasing disparities in BPTs. We describe examples of evidence-supported PEMs that present good targets for personalization and provide examples from MY PCIT to illustrate how PersIn can be applied to Parent-Child Interaction Therapy (PCIT).
Tolib Mirzoev et al. · 2015 · Implementation Science · Open access
BACKGROUND: Achievement of improved maternal and child health (MCH) outcomes continues to be an issue of international priority, particularly for sub-Saharan African countries such as Nigeria. Evidence suggests that the use of Community Health Workers (CHWs) can be effective in broadening access to, and coverage of, health services and improving MCH outcomes in such countries. METHODS/DESIGN: In this paper, we report the methodology for a 5-year study which aims to evaluate the context, processes, outcomes and longer-term sustainability of a Nigerian CHW scheme. Evaluation of complex interventions requires a comprehensive understanding of intervention context, mechanisms and outcomes. The multidisciplinary and mixed-method realist approach will facilitate such evaluation. A favourable policy environment within which the study is conducted will ensure the successful uptake of results into policy and practice. A realist evaluation provides an overall methodological framework for this multidisciplinary and mixed methods research, which will be undertaken in Anambra state. The study will draw upon health economics, social sciences and statistics. The study comprises three steps: (1) initial theory development; (2) theory validation and (3) theory refinement and development of lessons learned. Specific methods for data collection will include in-depth interviews and focus group discussions with purposefully identified key stakeholders (managers, service providers and service users), document reviews, analyses of quantitative data from the CHW programme and health information system, and a small-scale survey. The impact of the programme on key output and outcome indicators will be assessed through an interrupted time-series analysis (ITS) of monthly quantitative data from health information system and programme reports. Ethics approvals for this study were obtained from the University of Leeds and the University of Nigeria. DISCUSSION: This study will provide a timely and important contribution to health systems strengthening specifically within Anambra state in southeast Nigeria but also more widely across Nigeria. This paper should be of interest to researchers who are interested in adapting and applying robust methodologies for assessing complex health system interventions. The paper will also be useful to policymakers and practitioners who are interested in commissioning and engaging in such complex evaluations to inform policies and practices.
Alvina Gillani et al. · 2019 · Journal of Business Ethics · Open access
Abstract The article reports the findings of an empirical study among consumers, regarding the impact of physical, social, and psychological proximity on their engagement to the fair trade idea and purchasing behavior. Based on a random sample of 211 British and 112 Indian consumers and using structural equation modeling, it was found that high levels of physical, social, and psychological proximity leads to high consumer fair trade engagement. Moreover, consumer fair trade engagement was confirmed to have a positive impact on fair trade purchasing behavior. Furthermore, consumer empathic concern was found to positively moderate the association between proximity and consumer fair trade engagement, while the opposite was true with regard to consumer hypocrisy. Finally, consumer nationality was found to have a control effect on physical, social, and psychological proximity, with the latter felt stronger among Indian, as opposed to British consumers.
Heather MR Ames et al. · 2019 · Cochrane Database of Systematic Reviews · Open access
BACKGROUND: Governments and health systems are increasingly using mobile devices to communicate with patients and the public. Targeted digital client communication is when the health system transmits information to particular individuals or groups of people, based on their health or demographic status. Common types of targeted client communication are text messages that remind people to go to appointments or take their medicines. Other types include phone calls, interactive voice response, or multimedia messages that offer healthcare information, advice, monitoring, and support. OBJECTIVES: To explore clients' perceptions and experiences of targeted digital communication via mobile devices on topics related to reproductive, maternal, newborn, child, or adolescent health (RMNCAH). SEARCH METHODS: We searched MEDLINE (OvidSP), MEDLINE In-Process & Other Non-Indexed Citations (OvidSP), Embase (Ovid), World Health Organization Global Health Library, and POPLINE databases for eligible studies from inception to 3-6 July 2017 dependant on the database (See appendix 2). SELECTION CRITERIA: We included studies that used qualitative methods for data collection and analysis; that explored clinets' perceptions and experiences of targeted digital communication via mobile device in the areas of RMNCAH; and were from any setting globally. DATA COLLECTION AND ANALYSIS: We used maximum variation purposive sampling for data synthesis, employing a three-step sampling frame. We conducted a framework thematic analysis using the Supporting the Use of Research Evidence (SURE) framework as our starting point. We assessed our confidence in the findings using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. We used a matrix approach to explore whether potential implementation barriers identified in our synthesis had been addressed in the trials included in the related Cochrane Reviews of effectiveness. MAIN RESULTS: We included 35 studies, from a wide range of countries on six continents. Nineteen studies were conducted in low- and middle-income settings and sixteen in high-income settings. Some of the studies explored the views of people who had experienced the interventions, whereas others were hypothetical in nature, asking what people felt they would like from a digital health intervention. The studies covered a range of digital targeted client communication, for example medication or appointment reminders, prenatal health information, support for smoking cessation while pregnant, or general sexual health information.Our synthesis showed that clients' experiences of these types of programmes were mixed. Some felt that these programmes provided them with feelings of support and connectedness, as they felt that someone was taking the time to send them messages (moderate confidence in the evidence). They also described sharing the messages with their friends and family (moderate confidence).However, clients also pointed to problems when using these programmes. Some clients had poor access to cell networks and to the internet (high confidence). Others had no phone, had lost or broken their phone, could not afford airtime, or had changed their phone number (moderate confidence). Some clients, particularly women and teenagers, had their access to phones controlled by others (moderate confidence). The cost of messages could also be a problem, and many thought that messages should be free of charge (high confidence). Language issues as well as skills in reading, writing, and using mobile phones could also be a problem (moderate confidence).Clients dealing with stigmatised or personal health conditions such as HIV, family planning, or abortion care were also concerned about privacy and confidentiality (high confidence). Some clients suggested strategies to deal with these issues, such as using neutral language and tailoring the content, timing, and frequency of messages (high confidence).Clients wanted messages at a time and frequency that was convenient for them (moderate confidence). They had preferences for different delivery channels (e.g. short message service (SMS) or interactive voice response) (moderate confidence). They also had preferences about message content, including new knowledge, reminders, solutions, and suggestions about health issues (moderate confidence). Clients' views about who sent the digital health communication could influence their views of the programme (moderate confidence).For an overview of the findings and our confidence in the evidence, please see the 'Summary of qualitative findings' tables.Our matrix shows that many of the trials assessing these types of programmes did not try to address the problems we identified, although this may have been a reporting issue. AUTHORS' CONCLUSIONS: Our synthesis identified several factors that can influence the successful implementation of targeted client communication programmes using mobile devices. These include barriers to use that have equity implications. Programme planners should take these factors into account when designing and implementing programmes. Future trial authors also need to actively address these factors and to report their efforts in their trial publications.
Stephanie M. Topp & Julien M Chipukuma · 2015 · Health Policy and Planning · Open access
BACKGROUND: Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. METHODS: This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. RESULTS: Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers' organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers' clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients' trust in health workers' service values and professionalism. Lack of patient-provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. CONCLUSION: Lack of resourcing and poor leadership were key factors leading to providers' weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient-provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational management to strengthen providers' trust in their employer(s) and colleagues, as an entry-point for developing both the capacity and a work culture oriented towards respectful and patient-centred care.
Jerusha Conner · 2017 · Michigan journal of community service learning · Open access
Two recent literature reviews have affirmed the host of positive outcomes associated with servicelearning experiences. In their meta-analysis of 62 studies in which service-learning participants were compared to control students, Celio, Durlak, and Dymnicki (2011) found significant gains for