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  • 1
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: Older adults (≥65 years) with diabetes and multiple chronic conditions (MCC) ( 〉 2 chronic conditions) experience reduced function and quality of life, increased health service use, and high mortality. Many community-based self-management interventions have been developed for this group, however the evidence for their effectiveness is limited. This paper presents the protocol for a randomized controlled trial (RCT) comparing the effectiveness and implementation of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) to usual care in older adults with diabetes and MCC and their caregivers. Methods We will conduct a cross-jurisdictional, multi-site implementation-effectiveness type II hybrid RCT. Eligibility criteria are: ≥65 years, diabetes diagnosis (Type 1 or 2) and at least one other chronic condition, and enrolled in a primary care or diabetes education program. Participants will be randomly assigned to the intervention (ACHRU-CPP) or control arm (1:1 ratio). The intervention arm consists of home/telephone visits, monthly group wellness sessions, multidisciplinary case conferences, and system navigation support. It will be delivered by registered nurses and registered dietitians/nutritionists from participating primary care or diabetes education programs and program coordinators from community-based organizations. The control arm consists of usual care provided by the primary care setting or diabetes education program. The primary outcome is the change from baseline to 6 months in mental functioning. Secondary outcomes will include, for example, the change from baseline to 6 months in physical functioning, diabetes self-management, depressive symptoms, and cost of use of healthcare services. Analysis of covariance (ANCOVA) models will be used to analyze all outcomes, with intention-to-treat analysis using multiple imputation to address missing data. Descriptive and qualitative data from older adults, caregivers and intervention teams will be used to examine intervention implementation, site-specific adaptations, and scalability potential. Discussion An interprofessional intervention supporting self-management may be effective in improving health outcomes and client/caregiver experience and reducing service use and costs in this complex population. This pragmatic trial includes a scalability assessment which considers a range of effectiveness and implementation criteria to inform the future scale-up of the ACHRU-CPP. Trial registration Clinical Trials.gov Identifier NCT03664583 . Registration date: September 10, 2018.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2059865-8
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  • 2
    Online Resource
    Online Resource
    SAGE Publications ; 1997
    In:  Journal of Human Lactation Vol. 13, No. 3 ( 1997-09), p. 203-208
    In: Journal of Human Lactation, SAGE Publications, Vol. 13, No. 3 ( 1997-09), p. 203-208
    Abstract: The purpose of this study was to determine if consumer infant feeding publications and products distributed by physicians' offices protect, promote, and support breastfeeding. A total of 127 physician office practices completed a mailed questionnaire that measured the types of print and nonprint materials available and policies and practices regarding these resources. Commerciaily produced pamphlets were available in 114 (90%) of the offices surveyed, and were twice as likely to be routinely distributed as pamphlets from nonprofit agencies and government. Many publications contained outdated recommendations about breastfeeding; the most accurate publications were available in only 29 (23%) of practices surveyed. Magazines contravening the WHO Code were widely available (91 offices; 72%) and routinely distributed (58 offices; 46%). One hundred one offices (80%) accepted frec formula and 43 (38%) routinely distributed it. Few offices had a policy (n=25; 20%) or criteria (n=17; 13%) for selecting infant feeding resources. Those with policies were less likely to distribute commercial pamphlets. In the majority of offices surveyed, physicians' offices accepted and routinely distributed publications and products which do not "protect, promote, and support" breastfeeding. Offices are encouraged to have policies guiding the distribution of infant feeding materials.
    Type of Medium: Online Resource
    ISSN: 0890-3344 , 1552-5732
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1997
    detail.hit.zdb_id: 2092674-1
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  • 3
    Online Resource
    Online Resource
    SAGE Publications ; 2009
    In:  Western Journal of Nursing Research Vol. 31, No. 3 ( 2009-04), p. 312-329
    In: Western Journal of Nursing Research, SAGE Publications, Vol. 31, No. 3 ( 2009-04), p. 312-329
    Abstract: In this study nursing faculty perceptions of the implementation of simulation in schools of nursing across Ontario, Canada, were explored using the Q-methodology technique. Following Q-methodology guidelines, 104 statements were collected from faculty and students with exposure to simulation to determine the concourse (what people say about the issue). The statements were classified into six domains, including teaching and learning, access/reach, communication, technical features, technology set-up and training, and comfort/ease of use with technology. They were then refined into 43 final statements for the Q-sample. Next, 28 faculty from 17 nursing schools participated in the Q-sorting process. A by-person factor analysis of the Q-sort was conducted to identify groups of participants with similar viewpoints. Results revealed four major viewpoints held by faculty including: (a) Positive Enthusiasts, (b) Traditionalists, (c) Help Seekers, and (d) Supporters. In conclusion, simulation was perceived to be an important element in nursing education. Overall, there was a belief that clinical simulation requires (a) additional support in terms of the time required to engage in teaching using this modality, (b) additional human resources to support its use, and (c) other types of support such as a repository of clinical simulations to reduce the time from development of a scenario to implementation. Few negative voices were heard. It was evident that with correct support (human resources) and training, many faculty members would embrace clinical simulation because it could support and enhance nursing education.
    Type of Medium: Online Resource
    ISSN: 0193-9459 , 1552-8456
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 2067773-X
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  • 4
    Online Resource
    Online Resource
    SAGE Publications ; 2010
    In:  Western Journal of Nursing Research Vol. 32, No. 8 ( 2010-12), p. 1055-1072
    In: Western Journal of Nursing Research, SAGE Publications, Vol. 32, No. 8 ( 2010-12), p. 1055-1072
    Abstract: Learning needs assessment is an important stage of every educational process that aims to inform changes in practice and policy for continuing professional development. Professional competencies have been widely used as a basis for the development of learning needs assessment. The Canadian Community Health Nursing Standards of Practices (CCHN Standards) were released in 2003. However, it is not known whether community health nurses (CHNs) have the educational background to enable them to meet these standards. This article reports on the development of a learning needs assessment questionnaire for CHNs. Exploratory and confirmatory factor analyses were conducted to examine the consistency of factors underpinning the CCHN Standards. Also, validity and reliability of the questionnaire were evaluated using appropriate techniques. This process resulted in a valid and reliable CHN learning needs assessment questionnaire to measure learning needs of large groups of practitioners, where other forms of measurement cannot be feasibly conducted.
    Type of Medium: Online Resource
    ISSN: 0193-9459 , 1552-8456
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
    detail.hit.zdb_id: 2067773-X
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  • 5
    Online Resource
    Online Resource
    SAGE Publications ; 2021
    In:  Journal of Applied Gerontology Vol. 40, No. 12 ( 2021-12), p. 1807-1817
    In: Journal of Applied Gerontology, SAGE Publications, Vol. 40, No. 12 ( 2021-12), p. 1807-1817
    Abstract: It is widely recognized that the engagement of older adults with multimorbidity and their caregivers as partners in health care research is important and invaluable. The objective of this study was to examine how researchers can best engage and support older adults with multimorbidity and informal friend or family caregivers of older adults with multimorbidity as research partners in health care research teams. The persona-scenario method was used for participants to create fictional stories. These stories were analyzed to shed light on specific strategies that can support older adults and caregivers as partners on health care research teams, such as a patient-centered approach, identifying and addressing barriers to engagement, and clarifying roles and responsibilities on the research team. The results from this study can be used to inform research, policy, and education on supporting older adults with multimorbidity and caregivers of older adults with multimorbidity as research partners.
    Type of Medium: Online Resource
    ISSN: 0733-4648 , 1552-4523
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2089028-X
    detail.hit.zdb_id: 155897-3
    SSG: 5,2
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  • 6
    Online Resource
    Online Resource
    SAGE Publications ; 2005
    In:  Health Promotion Practice Vol. 6, No. 4 ( 2005-10), p. 464-471
    In: Health Promotion Practice, SAGE Publications, Vol. 6, No. 4 ( 2005-10), p. 464-471
    Abstract: The Internet is an innovative strategy to increase public participation. It is important to include pregnant and parenting teens' perspectives when planning programs to meet their needs. This qualitative study explored online discussions as a strategy to enhance participation by this population. Findings showed that online communication was preferred over face-to-face group discussions. Being anonymous online encouraged open and honest feedback. Participants experienced various forms of social support, however, there was an overall lack of teen involvement online. Strategies to engage adolescents in online discussions and reduce barriers are discussed. Strategies included the use of teen moderators, home computer access, technical support, and engagement in naturally flowing online discussions to meet social support needs. Blending researchers' with teens' needs for social support in an online environment is encouraged. With careful planning and design, online communications can result in mutual benefits for researchers, service providers, and pregnant and parenting adolescents.
    Type of Medium: Online Resource
    ISSN: 1524-8399 , 1552-6372
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
    detail.hit.zdb_id: 2036801-X
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  • 7
    Online Resource
    Online Resource
    SAGE Publications ; 2009
    In:  Qualitative Health Research Vol. 19, No. 2 ( 2009-02), p. 194-206
    In: Qualitative Health Research, SAGE Publications, Vol. 19, No. 2 ( 2009-02), p. 194-206
    Abstract: We used a qualitative descriptive approach to explore and describe the situated experiences of socioeconomically disadvantaged (SED) postpartum women in the first 4 weeks after hospital discharge. Qualitative content analysis was used to analyze the data from in-depth interviews with 24 SED postpartum women. Two intertwining, overarching themes emerged: (a) the ongoing burden of their day-to-day lives, with subthemes of poverty and material deprivation, stigmatization through living publicly examined lives, and precarious social support; and (b) the ongoing struggles to adjust to changes that came with the baby's arrival, with subthemes of “the first weeks were hard,” “feeling out of control,” “absence of help at home,” “complex relationship with the baby's father,” and “health and well-being.” Knowledge of SED women's situated experiences is vital to the development of health policies and services that will truly meet their needs.
    Type of Medium: Online Resource
    ISSN: 1049-7323 , 1552-7557
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 2010333-5
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  • 8
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2014
    In:  Health Research Policy and Systems Vol. 12, No. 1 ( 2014-12)
    In: Health Research Policy and Systems, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2014-12)
    Type of Medium: Online Resource
    ISSN: 1478-4505
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2014
    detail.hit.zdb_id: 2101196-5
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  • 9
    In: BMC Family Practice, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2019-12)
    Type of Medium: Online Resource
    ISSN: 1471-2296
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2041495-X
    detail.hit.zdb_id: 3107315-3
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  • 10
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: By understanding the information seeking behaviors of older adults, we can better develop or iterate effective information technologies, such as the McMaster Optimal Aging Portal, that provide evidence-based health information to the public. This paper reports health-related information seeking and searching behaviours and provides strategies for effective knowledge translation (KT) to increase awareness and use of reliable health information. Methods We conducted a qualitative study with eighteen older adults using the persona-scenario method, whereby participants created personas and scenarios describing older adults seeking health information. Scenarios were analyzed using a two-phase inductive qualitative approach, with the personas as context. From the findings related to pathways of engaging with health information, we identified targeted KT strategies to raise awareness and uptake of evidence-based information resources. Results Twelve women and six men, 60 to 81 years of age, participated. In pairs, they created twelve personas that captured rural and urban, male and female, and immigrant perspectives. Some scenarios described older adults who did not engage directly with technology, but rather accessed information indirectly through other sources or preferred nondigital modes of delivery. Two major themes regarding KT considerations were identified: connecting to information via other people and personal venues (people included healthcare professionals, librarians, and personal networks; personal venues included clinics, libraries, pharmacies, and community gatherings); and health information delivery formats , (e.g., printed and multimedia formats for web-based resources). For each theme, and any identified subthemes, corresponding sets of suggested KT strategies are presented. Conclusions Our findings underline the importance of people, venues, and formats in the actions of older adults seeking trusted health information and highlight the need for enhanced KT strategies to share information across personal and professional networks of older adults. KT strategies that could be employed by organizations or communities sharing evidence-based, reliable health information include combinations of educational outreach and materials, decision support tools, small group sessions, publicity campaigns, champions/opinion leaders, and conferences.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2059865-8
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