Supported Standing and Supported Stepping Devices for Children with Non-Ambulant Cerebral Palsy: An Interdependence and F-Words Focus

International Journal of Environmental Research and Public Health, Journal Year: 2024, Volume and Issue: 21(6), P. 669 - 669

Published: May 23, 2024

Children functioning at Gross Motor Function Classification System (GMFCS) levels IV–V cannot maintain an aligned standing position or take steps without support. Upright positioning and mobility devices have psycho-social significance for these children their families, enhancing use of vision, communication, emotional well-being. Standers supported stepping facilitate opportunities biomechanical loading, potentially helping to build muscle bone integrity, they promote physical development. However, families are often required choose between two young child. This study aims synthesize evidence benefits both through the lens contemporary theoretical frameworks support clinical reasoning implementation. The F-words childhood development (functioning, family, fitness, fun, friends, future) interdependence-Human Activity Assistive Technology (iHAAT) models were combined illustrate complex interactions child, caregivers, peers contextual factors when implementing with GMFCS IV V. Supported provide complementary benefits, may be necessary starting 9–15 months. We propose included ON-Time, along other age-appropriate devices, more equitable developmental non-ambulant cerebral palsy.

Language: Английский

Contingency management needs implementation science

Addiction, Journal Year: 2024, Volume and Issue: 119(9), P. 1522 - 1524

Published: June 16, 2024

Khazonov et al. offer recommendations to address one of the greatest research-to-practice gaps our time: gap between evidence for contingency management and patients' ability access it. Achieving authors' mission requires using rigorous methods implementation science. The (CM) it is so dire that, in Fall 2021, New York Times ran an article titled, 'This addiction treatment works. Why underused?' elucidated myriad barriers that limit widespread CM United States including (but not limited to) insufficient funding, restrictive federal policies provider attitudes/stigma. Readers were left asking most pressing public health questions 'How do we close gap?' Khazanov [1] articulate a set answer this very question. Specifically, authors recommend modifying protocols align with harm reduction goals, investing research on virtual delivery, incentivizing delivery providers systems, removing obstacles point-of-care testing, employing direct-to-consumer marketing increase awareness adapting be culturally responsive. These are grounded extensive expertise as clinical researchers, clinicians, advocates leaders nation's largest initiatives [2-4]. In addition expert viewpoint, major strength consideration levers change at multiple levels such influence CM, professionals systems who deliver intervention itself. However, also has notable omission—it does situate robust field lay terms, science study equitably intentionally bridge what know (public health/medical knowledge) practice) [5]. emerged response recognition typical enterprise minimal benefits patients; indeed, oft-cited statistic takes 17 years translate only 14% into patient benefit [6]. Implementation aims generate translatable can used across populations, settings interventions accelerate uptake effective services. case handful teams have led large-scale initiatives, leaving us knowledge. Fortunately, already great deal about how effectively implement behavioral from literature [7, 8]. Research Logic Model (IRLM) [9] help researchers practitioners think through components effort, all which rooted strong partner engagement. Four key IRLM include: (a) innovation—the specific model being implemented; (b) contextual determinants—barriers facilitators, is, conditions make harder or easier [10]; (c) strategies—specific actions taken organizations [11]; (d) outcomes—specific measures success [12]. focus predominantly (b). They consider optimize (e.g. rethinking design parameters, enabling cultural adaptation) remove making tests obtain, reimbursable eliminating restrictions incentives). suggest strategies demand CM. This latter approach well-supported conceptually [13, 14], but unlikely live up its full potential unless there sufficient supply community settings. Taken together, al.'s suggestions (summarized their Table 1) arguably necessary sufficient. To bring scale, essential prioritize invest (d). optimizing barriers, need learn resource-constrained systems. We design, specify evaluate strategies. encouraging news work underway. now convincing data multi-level strategy (didactic training + performance feedback organizational coaching) associated significantly higher rates speed adoption than didactic [15, 16]. feasibly engaged selection [17]. There ongoing trials [18, 19] testing include team-based facilitation staff-based bonuses (distinct compensate/reimburse recommended article). Kharzanov aptly conclude by asserting 'the widely accessible'. Addressing paramount importance curb stimulant overdose deaths improve population health. more rapidly efficiently achieve if use Sara J. Becker was sole author responsible conceptualizing, writing editing commentary. I wish acknowledge my scientific things implementation, Bryan Garner, PhD. am grateful Mark McGovern, PhD, his Finally, appreciate England ATTC team organizations, Departments Health partnered over years, without whom none would possible. None.

Language: Английский

Implementing and evaluating a project to enable and encourage Caribbean data-sharing

Revista Panamericana de Salud Pública, Journal Year: 2024, Volume and Issue: 48, P. 1 - 1

Published: Dec. 16, 2024

The CaribData project, funded by the Inter-American Development Bank and implemented University of West Indies, aims to enhance data-handling, -sharing reuse capabilities in Caribbean. project focuses on four main objectives: developing an online data-handling platform, creating a sustainable training mentoring program, launching data communication initiative conducting availability audits. To evaluate its progress, integrates two implementation science frameworks, RE-AIM (for Reach, Effectiveness, Adoption, Implementation, Maintenance) Consolidated Framework for Implementation Research. evaluation will use quantitative qualitative methods, including monitoring usage metrics, surveys, interviews thematic content analysis. Informed consent be obtained all activities. Positive outcomes would include enhanced regional data-sharing capabilities, improved skills among participants, increased production dissemination impactful stories, identification gaps priorities. platform is anticipated streamline processes collection sharing, while program expected bolster expertise analytics management. If successful, Caribbean's infrastructure, promoting sovereignty enhancing utility evidence-based decision-making. project's technology, educational strategies lay foundation sustained impact. However, sustainability depend ongoing stakeholder engagement, funding from multiple sources adapting evolving governance frameworks. Ensuring robust plan critical maintaining benefits beyond initial period (2023-2025).

Language: Английский