METHOD: This study was conducted using an exploratory qualitative approach on purposely selected healthcare providers at primary healthcare clinics. Twenty focus group discussions and three in-depth interviews were conducted using a semi-structured interview guide. Consent was obtained prior to interviews and for audio-recordings. Interviews were transcribed verbatim and thematically analysed, guided by the Consolidated Framework for Implementation Research (CFIR), a framework comprised of five major domains promoting implementation theory development and verification across multiple contexts.
RESULTS: The study revealed via CFIR that most primary healthcare providers were receptive towards any proposed changes or intervention for the betterment of NCD care management. However, many challenges were outlined across four CFIR domains-intervention characteristics, outer setting, inner setting, and individual characteristics-that included perceived barriers to implementation. Perception of issues that triggered proposed changes reflected the current situation, including existing facilitating aspects that can support the implementation of any future intervention. The importance of strengthening the primary healthcare delivery system was also expressed.
CONCLUSION: Understanding existing situations faced at the primary healthcare setting is imperative prior to implementation of any intervention. Healthcare providers' receptiveness to change was explored, and using CFIR framework, challenges or perceived barriers among healthcare providers were identified. CFIR was able to outline the clinics' setting, individual behaviour and external agency factors that have direct impact to the organisation. These are important indicators in ensuring feasibility, effectiveness and sustainability of any intervention, as well as future scalability considerations.
METHOD: A qualitative methodological approach was performed between March-May 2018. Semi-structured interviews were used to explore current RT policy and service availability. Key-informants were identified from a detailed stakeholder analysis of RT system in Malaysia. Interviews were digitally audio-recorded, transcribed verbatim, coded with ATLAS.ti software and underwent thematic analysis thoroughly.
RESULTS: Eight key-informants participated in the study. Barriers and related solutions were classified using the socio-ecological model (SEM). As reported, the barriers and solutions of RT in Malaysia are the results of a complex interplay of personal, cultural, and environmental factors. Key barriers are linked to public's attitude and perception towards RT and the unaccommodating practices in the healthcare fraternity for RT. Key-informants provided a systematic solution that shed light on how RT could be improved at each SEM level via effective communication, education and inter-agency collaboration.
CONCLUSION: The SEM provided a framework to foster a better understanding of current practice, barriers, and solutions to RT in Malaysia. This study is the first to explore the barriers and related solutions to RT comprehensively as a whole. Implications of these findings could prompt a policy change for a better RT service delivery model not just for Malaysia but also for other LMIC. Further stakeholder engagement and evaluation of the systems are required to provide insight into best practices that will help to improve the RT rates and service in Malaysia.
MATERIALS AND METHODS: The study followed a cross-sectional design and was conducted among 1032 Bangladeshi older adults aged 60 years and above during October 2020 through telephone interviews. Self-reported information on nine non-communicable chronic conditions (osteoarthritis, hypertension, heart disease, stroke, hypercholesterolemia, diabetes, chronic respiratory diseases, chronic kidney disease, cancer) was collected. Participants were asked if they faced any difficulties in accessing medicine and receiving routine medical care for their medical conditions during the COVID-19 pandemic. The association between non-communicable chronic conditions and accessing medication and health care was analysed using binary logic regression model.
RESULTS: Most of the participants aged 60-69 years (77.8%), male (65.5%), married (81.4%), had no formal schooling (58.3%) and resided in rural areas (73.9%). Although more than half of the participants (58.9%) reported having a single condition, nearly one-quarter (22.9%) had multimorbidity. About a quarter of the participants reported difficulties accessing medicine (23%) and receiving routine medical care (27%) during the pandemic, and this was significantly higher among those suffering from multimorbidity. In the adjusted analyses, participants with at least one condition (AOR: 1.95, 95% CI: 1.33-2.85) and with multimorbidity (AOR: 4.75, 95% CI: 3.17-7.10) had a higher likelihood of experiencing difficulties accessing medicine. Similarly, participants with at least one condition (AOR: 3.08, 95% CI: 2.11-4.89) and with multimorbidity (AOR: 6.34, 95% CI: 4.03-9.05) were significantly more likely to face difficulties receiving routine medical care during the COVID-19 pandemic.
CONCLUSIONS: Our study found that a sizeable proportion of the older adults had difficulties in accessing medicine and receiving routine medical care during the pandemic. The study findings highlight the need to develop an appropriate health care delivery pathway and strategies to maintain essential health services during any emergencies and beyond. We also argue the need to prioritise the health of older adults with non-communicable chronic conditions in the centre of any emergency response plan and policies of Bangladesh.
CASE DESCRIPTION: Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste.
DISCUSSION AND EVALUATION: These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders.
CONCLUSIONS: Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.
Methods: In this descriptive, cross-sectional study, a census sample of 76 midwives from two public hospitals and urban health centers in Torbat Heydariyeh, a city east of Iran were surveyed. Data collection tools were two reliable and valid questionnaires that measure midwives' attitudes and barriers of implementation of evidence-based practice. Data were analysed using SPSS version 16.
Results: The mean age and years of experience were 29.30 ± 4.86 and 5.22 ± 4.21 years, respectively. The mean score of attitude was 40.85 ± 4.84 (range = 30-60). This study also found time constraints (2.70 ± 0.92), inadequate facilities (2.64 ± 0.72), non-compilation of literature in one place (2.59 ± 0.92), lack of cooperation of physicians (2.48 ± 1.06) and the feeling of inadequate authority (2.45 ± 0.88) as the top five barriers to implementing EBP.
Conclusion: Survey participants demonstrated a positive attitude toward EBP. Organisational comprehensive strategies such as time efficiency, adequate material and human resources, familiarity with organisations such as the Cochrane Collaboration and managerial support for increasing professional legitimate authority are recommended to promote the use of Evidence-Based Practice in Iran.
Methods: In this exploratory qualitative study, two focus group discussion (15 teachers) and 30 individual in-depth interviews were conducted among female adolescents in the eighth grade in Zahedan, Iran. Qualitative content analysis was used for data evaluation.
Results: The views of students and teachers demonstrated nine of needs including: informing students about the schools' health project aims, education and training all dimensions of health with an emphasis on mental health, use of experts in various fields for education from other organisations, employing capable and trusted counselors in schools, utilisation of a variety of teaching methods, activating reward systems for encouraging students' participation in group activities, teaching communication and the ability to establish good relationships with parents and strategies for resolving family conflict, teaching parents and students high-risk behaviours and strategies for handling them as well as reforming wrong attitudes and indigenous sub-culture.
Conclusion: This study found the different needs of Iranian female students compared to other cultures about a health promoting school programme. Therefore, their contribution can provide an insight for formulating policies and intervention in schools.
METHOD: The content of the questionnaire was developed based on the content of Annex 1 of the Assessment Measures for Physical Education in Primary and Secondary Schools issued by the Ministry of Education of China in 2014 and was modified based on feedback from the expert panel and pre-test participants. The questionnaire was initially tested for validity by 5 expert reviewers, and then we collected data information from 350 participants and conducted exploratory factor analysis (EFA) to explore the factor structure of the initial version. One week later, 40 of the 350 participants were randomly selected to assess test-retest reliability.
RESULTS: The I-CVI and KAPPA value analysis results of the expert review results show that the questionnaire has extremely high reliability and consistency among experts. EFA results indicate that the five dimensions of this questionnaire are highly reliable. In the test-retest reliability, the Pearson correlation coefficients of the initial test data and the retest data of each dimension are all greater than 0.7, and the significance probability values are all less than 0.05, reaching the significance level, the results show that the questionnaire has good stability.
CONCLUSIONS: This study concluded that the 5 dimensions and 38 items of this questionnaire had high reliability and validity and could be used as a preliminary tool to measure the implementation level of physical education programs in junior high schools in China. However, future research should explore the potential need for adjustment to suit different regions and cultures.
MATERIALS AND METHODS: This questionnaire-based study consisted of convenience samples of 174 patients of Chinese, Indian and Malay ethnicity. Importance-performance analysis for 20 attributes were compared using Likert's scale. The data obtained were statistically analysed using the Kruskal-Wallis test.
RESULTS: Chinese and Indians both emphasised low performance on the interpersonal relationship attribute in terms of the receptionist's courtesy, whereas the Malay participants were concerned with convenience attributes. All the ethnic groups favoured maintaining existing major attributes towards technical competency, interpersonal relationship and facility factors. This study demonstrated priority differences between the ethnic groups' perception of the quality of dental services, where ethnic Chinese showed the highest gap (measure of dissatisfaction) between importance and performance compared to ethnic Malays, followed by ethnic Indians.
CONCLUSION: The patients from the three major ethnic groups of Malaysia were generally well satisfied. Perhaps more priority should be placed on improving the interpersonal relationship attribute, especially with the receptionists.