Objective:This study aimed to explore the strategies used by acute care hospitals in implementing a national standard for comprehensive care.Methods:A qualitative descriptive study was conducted with 28 care professio...Objective:This study aimed to explore the strategies used by acute care hospitals in implementing a national standard for comprehensive care.Methods:A qualitative descriptive study was conducted with 28 care professionals(20 nurses,two doctors,and six allied health professionals)recruited from a broad range of Australian acute care hospitals.Data were collected using semi-structured interviews from March to August 2023.The interviews were audio-recorded,transcribed,and thematically analyzed.Results:Strategies for implementing the Comprehensive Care Standard(CCS)vary,even within a health service organization.We identifiedstrategies hospitals used regarding the implementation team and plan,communication,education and training,documentation system,patient care plan,networking,incentives and pressure,feedback,and reflectingand evaluating.Conclusions:This interview study sheds light on the various strategies adopted by hospitals in implementing the CCS,providing a practical foundation to inform implementation efforts both within Australia and internationally.展开更多
Objective:The World Health Organization recommends annual preventive chemotherapy with a single dose of praziquantel at≥75%treatment coverage,but as of 2021,the national coverage rate in Nigeria among children falls ...Objective:The World Health Organization recommends annual preventive chemotherapy with a single dose of praziquantel at≥75%treatment coverage,but as of 2021,the national coverage rate in Nigeria among children falls below 10%.This qualitative study sought to explore the barriers and facilitators to implementing large-scale praziquantel mass drug administration(MDA)programs for school-aged children in Nigeria to delineate tools and strategies that could improve the scaling-up and effectiveness of school-based praziquantel MDA programs.Methods:An exploratory qualitative study was conducted with stakeholders with experience in MDAs involving praziquantel or related preventive chemotherapy drugs in Nigeria.Through snowball sampling,30 stakeholders with experience in praziquantel school-based MDA in Nigeria were interviewed.An inductive approach was used to generate broad themes based on the barriers and facilitators identified by the key informants.Results:A total of 45 barriers and 36 facilitators were identified and grouped inductively into eight themes:funding and resources,design and composition of praziquantel tablets,knowledge and awareness mobilization,government,nongovernmental organization,and school engagement,data management,logistics,training,and security.Conclusion:This qualitative study reveals a wide range of barriers and facilitators in the MDA of praziquantel in Nigeria and uncovered critical points along the implementation pathway based on the locus of the barriers and facilitators identified.Collaboration with national,international,and non-profit organizations,and drug education through promotional materials,were the most frequently mentioned facilitators of the MDA program.In addition,insufficient program funding,and the complexity of the supply chain were the most cited barriers.展开更多
Implementation science is a systematic research methodology aimed at facilitating the application of research findings and other evidence-based practices into clinical daily routines.It has become highly relevant to s...Implementation science is a systematic research methodology aimed at facilitating the application of research findings and other evidence-based practices into clinical daily routines.It has become highly relevant to scientific research.As the concept of"implementation science"deepens,related theories and practical methods continue to evolve,leading to rapid advancements in implementation science.However,in China,there has been limited application and slower development of implementation research.This study approaches the subject from a problem-oriented perspective and systematically describes several commonly used theoretical frameworks,methodologies,implementation strategies,and applications in implementation research.The goal is to support the development of implementation science in China,promote its integration into evidence-based medicine,and provide reference materials for conducting implementation research more effectively.展开更多
Acupuncture enjoys a robust evidence base for dozens of clinical conditions and decades of research exploring its mechanisms of action. It has over 9,000 positive recommendations from official government and clinical ...Acupuncture enjoys a robust evidence base for dozens of clinical conditions and decades of research exploring its mechanisms of action. It has over 9,000 positive recommendations from official government and clinical guidelines. However, it still remains relatively inaccessible in the United States, Europe and elsewhere, especially compared to the strength of evidence-based recommendations for its use. Acupuncture would benefit from robust implementation strategies, utilizing insights and approaches from implementation science. The clinical use of Botox for migraine suffered from weaker evidence of effectiveness and greater evidence of harm, but using a streamlined and robust implementation strategy, Allergan was able to achieve widespread implementation from when it began its efforts around 2010. Such a systematic approach that identifies and overcomes barriers to implementation for acupuncture would benefit millions of people who currently are offered less effective and more invasive treatments, contrary to the recommendations of clinical guidelines.展开更多
Objective:This review aimed to identify the barriers and facilitators to equitable coronavirus disease 2019(COVID-19)vaccine distribution in Nigeria using the consolidated framework for implementation research(CFIR).M...Objective:This review aimed to identify the barriers and facilitators to equitable coronavirus disease 2019(COVID-19)vaccine distribution in Nigeria using the consolidated framework for implementation research(CFIR).Methods:A comprehensive search strategy was applied across five databases—Web of Science,MEDLINE,EMBASE,CAB Direct,and CINAHL.The search,conducted as part of a scoping review,yielded 2,751 citations.Seven studies met the inclusion criteria after screening.Data were extracted and analyzed using CFIR constructs to identify key barriers and facilitators to equitable vaccine distribution.Results:Six barriers were identified:limited physical and socioeconomic access,bribery,nepotism,and insufficient availability of translated information.Facilitators included community involvement as local monitoring agents,unannounced staff inspections,healthcare worker training tailored to community needs,and localized outreach strategies such as jingles and call-in programs.CFIR constructs,including Local Conditions,Tailoring Strategies,Available Resources,and Physical Infrastructure,provided a framework for analyzing the findings.Conclusion:This review highlights significant barriers and promising facilitators to equitable vaccine distribution in Nigeria.Targeted interventions,such as community engagement,anti-corruption measures,and culturally tailored strategies,are critical to addressing these challenges and improving access.These findings underscore the need for localized,equity-focused approaches to enhance vaccine distribution systems in Nigeria and other low-resource settings.展开更多
Objectives Even though guidelines are available to guide dysphagia identification and management practice,there is still a gap between evidence and practice,which requires improvement.The purpose of this study was to ...Objectives Even though guidelines are available to guide dysphagia identification and management practice,there is still a gap between evidence and practice,which requires improvement.The purpose of this study was to determine the effect of using tailored,multifaceted strategies to improve evidence-based post-stroke dysphagia identification and management practice in a community hospital.Methods Guided by the Knowledge to Action framework,the tailored,multifaceted strategies were developed and implemented for 5 months in a community hospital using a before-and-after study design.These strategies consisted of training intervention,policy intervention,and audit and feedback intervention.Nurses’level of knowledge and adherence,were collected in March 2019 and again in January 2020.Patients’quality of life and satisfaction were evaluated during the pre-intervention period(between February 2019 and April 2019)and the post-intervention period(between November 2019 and January 2020).Results A total of 55 patients with post-stroke dysphagia(28 in the pre-intervention period and 27 in the post-intervention period)and 17 registered nurses were recruited.Following implementation,there were statistically significant improvements in patients’outcomes(quality of life and satisfaction)and nurses’outcomes(level of knowledge and adherence).Conclusions This study assists in closing the research-practice gap by using tailored,multifaceted strategies to increase the use of evidence-based nursing care for dysphagia identification and management practices.展开更多
One Health recognizes the close links and interdependence among human health,animal health and environmental health.With the pandemic of COVID-19 and the risk of many emerging or reemerging infectious diseases of zoon...One Health recognizes the close links and interdependence among human health,animal health and environmental health.With the pandemic of COVID-19 and the risk of many emerging or reemerging infectious diseases of zoonotic nature as well as the spreading antimicrobial resistance,One Health has become one of top concerns globally,as it entails the essential global public health challenges from antimicrobial resistance over zoonoses,to climate change,food security and societal well-being.Research priorities in One Health include the study on interactions of human-animal-plants-nature ecology interface,systems thinking,integrated surveillance and response systems,and the overall One Health governance as part of the global health and sustainability governance.The now launched journal,Science in One Health,aims to be a resource platform that disseminates scientific evidence,knowledge,and tools on the One Health approaches and respective possible socio-ecological interventions.Thus,aims at providing fruitful exchanges of information and experience among researchers,and decision makers as well as public health actors.展开更多
Background:The School Wellness Integration Targeting Child Health(SWITCH)intervention has demonstrated feasibility as an implementation approach to help schools facilitate changes in students’physical activity(PA),se...Background:The School Wellness Integration Targeting Child Health(SWITCH)intervention has demonstrated feasibility as an implementation approach to help schools facilitate changes in students’physical activity(PA),sedentary screen time(SST),and dietary intake(DI).This study evaluated the comparative effectiveness of enhanced(individualized)implementation and standard(group-based)implementation.Methods:Twenty-two Iowa elementary schools participated,with each receiving standardized training(wellness conference and webinars).Schools were matched within region and randomized to receive either individualized or group implementation support.The PA,SST,and DI outcomes of 1097 students were assessed at pre-and post-intervention periods using the Youth Activity Profile.Linear mixed models evaluated differential change in outcomes by condition,for comparative effectiveness,and by gender.Results:Both implementation conditions led to significant improvements in PA and SST over time(p<0.01),but DI did not improve commensurately(p value range:0.02‒0.05).There were no differential changes between the group and individualized conditions for PA(p=0.51),SST(p=0.19),or DI(p=0.73).There were no differential effects by gender(i.e.,non-significant condition-by-gender interactions)for PA(p_(for interaction)=0.86),SST(p_(for interaction)=0.46),or DI(p_(for interaction)=0.15).Effect sizes for both conditions equated to approximately 6 min more PA per day and approximately 3 min less sedentary time.Conclusion:The observed lack of difference in outcomes suggests that group implementation of SWITCH is equally effective as individualized implementation for building capacity in school wellness programming.Similarly,the lack of interaction by gender suggests that SWITCH can be beneficial for both boys and girls.Additional research is needed to understand the school-level factors that influence implementation(and outcomes)of SWITCH.展开更多
Objectives:To share a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in health-care.Methods:We applied Walker and Avant method to clarify the concept of so...Objectives:To share a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in health-care.Methods:We applied Walker and Avant method to clarify the concept of social movement in the context of knowledge uptake and sustainability.Peer-reviewed and grey literature databases were systematically searched for relevant reports that described how social movement action led to evidence-based practice changes in health and community settings.Titles,abstracts and full texts were reviewed independently and in duplicate,resulting in 38 included articles.Results:Social movement action for knowledge uptake and sustainability can be defined as individuals,groups,or organizations that,as voluntary and intrinsically motivated change agents,mobilize around a common cause to improve outcomes through knowledge uptake and sustainability.The 10 defining attributes,three antecedents and three consequences that we identified are dynamic and interrelated,often mutually reinforcing each other to fortify various aspects of the social movement.Examples of defining attributes include an urgent need for action,collective action and collective identity.The concept analysis resulted in the development of the Social Movement Action Framework.Conclusions:Social movement action can provide a lens through which we view implementation science.Collective action and collective identity e concepts less frequently canvassed in implementation science literature e can lend insight into grassroots approaches to uptake and sustainability.Findings can also inform providers and change leaders on the practicalities of harnessing social movement action for realworld change initiatives.By mobilizing individuals,groups,or organizations through social movement approaches,they can engage as powered change agents and teams that impact the individual,organizational and health systems levels to facilitate knowledge uptake and sustainability.展开更多
Background Tuberculosis (TB) is a major cause of death worldwide, and Chinese TB burden ranked the second globally. Chinese primary healthcare (PHC) sectors implement the TB Control Program (TCP) to improve active cas...Background Tuberculosis (TB) is a major cause of death worldwide, and Chinese TB burden ranked the second globally. Chinese primary healthcare (PHC) sectors implement the TB Control Program (TCP) to improve active case finding, referral, treatment adherence, and health education. This study aimed to identify barriers and enablers of TCP implementation in high TB burden regions of West China.Methods We conducted a representative study using mixed-methods in 28 counties or districts in Chongqing Municipality and Guizhou Province of West China from October 2021 to May 2022. Questionnaire surveys and semi-structured in-depth interviews were conducted with 2720 TB healthcare workers (HCWs) and 20 interviewees in PHC sectors. Descriptive statistical analysis was used to investigate TB HCWs’ characteristics, and path analysis model was utilized to analyze the impact of associated factors on TCP implementation. Thematic framework analysis was developed with the guide of the adapted Consolidated Framework for Implementation Research (CFIR) on factors of TCP implementation.Results This study found that 84.6% and 94.1% of community and village HCWs had low professional titles. Based on the results of multiple regression analysis and correlation analysis, lower TB core knowledge scores (-0.09) were identified as barriers for TCP implementation in community PHC sectors, and low working satisfaction (-0.17) and low working willingness (-0.10) are barriers for TPC implementation in village PHC sectors. The results of in-depth interviews reported barriers in all domains and enablers in four domains of CFIR. There were identified 19 CFIR constructs associated with TCP implementation, including 22 barriers such as HCWs’ heavy workload, and 12 enablers such as HCWs’ passion towards TCP planning.Conclusions With the guide of the CFIR framework, complex factors (barriers and enablers) of TCP implementation in PHC sectors of West China were explored, which provided important evidences to promote TB program in high TB burden regions. Further implementation studies to translate those factors into implementation strategies are urgent needed.展开更多
At the first gathering of its kind on the role of science in implementing the Sendai Framework for Disaster Risk Reduction 2015–2030,over 750 scientists,policymakers,business people,and practitioners met in Geneva fr...At the first gathering of its kind on the role of science in implementing the Sendai Framework for Disaster Risk Reduction 2015–2030,over 750 scientists,policymakers,business people,and practitioners met in Geneva from January 27–29,2016.The UNISDR Science and Technology Conference on the Implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030 fea-展开更多
Background:China is still faced with the public health challenge of tuberculosis(TB),and a robust surveillance system is critical for developing evidence-based TB control policies.The Tuberculosis Information Manageme...Background:China is still faced with the public health challenge of tuberculosis(TB),and a robust surveillance system is critical for developing evidence-based TB control policies.The Tuberculosis Information Management System(TBIMS),an independent system launched in 2005,has encountered several challenges in meeting the current needs ofTB control.The Chinese government also planned to establish the National Health Information System(NHIS)aggregating data in different areas.The China National Health Commission-Gates TB Project Phase III launched a new TB surveillance system to address these challenges and also as a pilot for the countrywide implementation of the NHIS.This commentary highlights the improvements and challenges in implementing the newTB system and also discusses the implications for the roll-out of the NHIS.展开更多
基金supported by an Australian Government Research Training Program Scholarshippart of the project“Improving quality of care for people with dementia in the acute care setting(eQC)”which is funded by the National Health and Medical Research Council of the Australian Government(No.APP1140459)。
文摘Objective:This study aimed to explore the strategies used by acute care hospitals in implementing a national standard for comprehensive care.Methods:A qualitative descriptive study was conducted with 28 care professionals(20 nurses,two doctors,and six allied health professionals)recruited from a broad range of Australian acute care hospitals.Data were collected using semi-structured interviews from March to August 2023.The interviews were audio-recorded,transcribed,and thematically analyzed.Results:Strategies for implementing the Comprehensive Care Standard(CCS)vary,even within a health service organization.We identifiedstrategies hospitals used regarding the implementation team and plan,communication,education and training,documentation system,patient care plan,networking,incentives and pressure,feedback,and reflectingand evaluating.Conclusions:This interview study sheds light on the various strategies adopted by hospitals in implementing the CCS,providing a practical foundation to inform implementation efforts both within Australia and internationally.
基金the Flourish Collective,a Cluster of Scholarly Prominence at the University of Toronto,Scarborough。
文摘Objective:The World Health Organization recommends annual preventive chemotherapy with a single dose of praziquantel at≥75%treatment coverage,but as of 2021,the national coverage rate in Nigeria among children falls below 10%.This qualitative study sought to explore the barriers and facilitators to implementing large-scale praziquantel mass drug administration(MDA)programs for school-aged children in Nigeria to delineate tools and strategies that could improve the scaling-up and effectiveness of school-based praziquantel MDA programs.Methods:An exploratory qualitative study was conducted with stakeholders with experience in MDAs involving praziquantel or related preventive chemotherapy drugs in Nigeria.Through snowball sampling,30 stakeholders with experience in praziquantel school-based MDA in Nigeria were interviewed.An inductive approach was used to generate broad themes based on the barriers and facilitators identified by the key informants.Results:A total of 45 barriers and 36 facilitators were identified and grouped inductively into eight themes:funding and resources,design and composition of praziquantel tablets,knowledge and awareness mobilization,government,nongovernmental organization,and school engagement,data management,logistics,training,and security.Conclusion:This qualitative study reveals a wide range of barriers and facilitators in the MDA of praziquantel in Nigeria and uncovered critical points along the implementation pathway based on the locus of the barriers and facilitators identified.Collaboration with national,international,and non-profit organizations,and drug education through promotional materials,were the most frequently mentioned facilitators of the MDA program.In addition,insufficient program funding,and the complexity of the supply chain were the most cited barriers.
文摘Implementation science is a systematic research methodology aimed at facilitating the application of research findings and other evidence-based practices into clinical daily routines.It has become highly relevant to scientific research.As the concept of"implementation science"deepens,related theories and practical methods continue to evolve,leading to rapid advancements in implementation science.However,in China,there has been limited application and slower development of implementation research.This study approaches the subject from a problem-oriented perspective and systematically describes several commonly used theoretical frameworks,methodologies,implementation strategies,and applications in implementation research.The goal is to support the development of implementation science in China,promote its integration into evidence-based medicine,and provide reference materials for conducting implementation research more effectively.
文摘Acupuncture enjoys a robust evidence base for dozens of clinical conditions and decades of research exploring its mechanisms of action. It has over 9,000 positive recommendations from official government and clinical guidelines. However, it still remains relatively inaccessible in the United States, Europe and elsewhere, especially compared to the strength of evidence-based recommendations for its use. Acupuncture would benefit from robust implementation strategies, utilizing insights and approaches from implementation science. The clinical use of Botox for migraine suffered from weaker evidence of effectiveness and greater evidence of harm, but using a streamlined and robust implementation strategy, Allergan was able to achieve widespread implementation from when it began its efforts around 2010. Such a systematic approach that identifies and overcomes barriers to implementation for acupuncture would benefit millions of people who currently are offered less effective and more invasive treatments, contrary to the recommendations of clinical guidelines.
文摘Objective:This review aimed to identify the barriers and facilitators to equitable coronavirus disease 2019(COVID-19)vaccine distribution in Nigeria using the consolidated framework for implementation research(CFIR).Methods:A comprehensive search strategy was applied across five databases—Web of Science,MEDLINE,EMBASE,CAB Direct,and CINAHL.The search,conducted as part of a scoping review,yielded 2,751 citations.Seven studies met the inclusion criteria after screening.Data were extracted and analyzed using CFIR constructs to identify key barriers and facilitators to equitable vaccine distribution.Results:Six barriers were identified:limited physical and socioeconomic access,bribery,nepotism,and insufficient availability of translated information.Facilitators included community involvement as local monitoring agents,unannounced staff inspections,healthcare worker training tailored to community needs,and localized outreach strategies such as jingles and call-in programs.CFIR constructs,including Local Conditions,Tailoring Strategies,Available Resources,and Physical Infrastructure,provided a framework for analyzing the findings.Conclusion:This review highlights significant barriers and promising facilitators to equitable vaccine distribution in Nigeria.Targeted interventions,such as community engagement,anti-corruption measures,and culturally tailored strategies,are critical to addressing these challenges and improving access.These findings underscore the need for localized,equity-focused approaches to enhance vaccine distribution systems in Nigeria and other low-resource settings.
基金This work was supported by the Postgraduate Independent Project of Beijing University of Chinese Medicine(No.2017-JYB-XS-085).
文摘Objectives Even though guidelines are available to guide dysphagia identification and management practice,there is still a gap between evidence and practice,which requires improvement.The purpose of this study was to determine the effect of using tailored,multifaceted strategies to improve evidence-based post-stroke dysphagia identification and management practice in a community hospital.Methods Guided by the Knowledge to Action framework,the tailored,multifaceted strategies were developed and implemented for 5 months in a community hospital using a before-and-after study design.These strategies consisted of training intervention,policy intervention,and audit and feedback intervention.Nurses’level of knowledge and adherence,were collected in March 2019 and again in January 2020.Patients’quality of life and satisfaction were evaluated during the pre-intervention period(between February 2019 and April 2019)and the post-intervention period(between November 2019 and January 2020).Results A total of 55 patients with post-stroke dysphagia(28 in the pre-intervention period and 27 in the post-intervention period)and 17 registered nurses were recruited.Following implementation,there were statistically significant improvements in patients’outcomes(quality of life and satisfaction)and nurses’outcomes(level of knowledge and adherence).Conclusions This study assists in closing the research-practice gap by using tailored,multifaceted strategies to increase the use of evidence-based nursing care for dysphagia identification and management practices.
基金supported by China Medical Board(No.20-365)Shanghai Jiao Tong University Integrated Innovation Fund(No.2020-01).
文摘One Health recognizes the close links and interdependence among human health,animal health and environmental health.With the pandemic of COVID-19 and the risk of many emerging or reemerging infectious diseases of zoonotic nature as well as the spreading antimicrobial resistance,One Health has become one of top concerns globally,as it entails the essential global public health challenges from antimicrobial resistance over zoonoses,to climate change,food security and societal well-being.Research priorities in One Health include the study on interactions of human-animal-plants-nature ecology interface,systems thinking,integrated surveillance and response systems,and the overall One Health governance as part of the global health and sustainability governance.The now launched journal,Science in One Health,aims to be a resource platform that disseminates scientific evidence,knowledge,and tools on the One Health approaches and respective possible socio-ecological interventions.Thus,aims at providing fruitful exchanges of information and experience among researchers,and decision makers as well as public health actors.
基金The U.S.Department of Agriculture National Institute of Food and Agriculture(USDA NIFA)grant:2015-68001-23242.The USDA was not involved in the design of the study and collection,analysis,and interpretation of data or writing of the manuscript.The authors wish to thank the School Wellness Teams(SWT)who participated in the intervention and led programming.The authors acknowledge the students and staff who helped facilitate data collection and analysis procedures:Andra Luth,Marisa Rosen,Laura C.Liechty,Ann Torbert,and Quinn M.Zuercher(Iowa State University Extension and Outreach),made contributions to the distribution,implementation,and evaluation of SWITCH.
文摘Background:The School Wellness Integration Targeting Child Health(SWITCH)intervention has demonstrated feasibility as an implementation approach to help schools facilitate changes in students’physical activity(PA),sedentary screen time(SST),and dietary intake(DI).This study evaluated the comparative effectiveness of enhanced(individualized)implementation and standard(group-based)implementation.Methods:Twenty-two Iowa elementary schools participated,with each receiving standardized training(wellness conference and webinars).Schools were matched within region and randomized to receive either individualized or group implementation support.The PA,SST,and DI outcomes of 1097 students were assessed at pre-and post-intervention periods using the Youth Activity Profile.Linear mixed models evaluated differential change in outcomes by condition,for comparative effectiveness,and by gender.Results:Both implementation conditions led to significant improvements in PA and SST over time(p<0.01),but DI did not improve commensurately(p value range:0.02‒0.05).There were no differential changes between the group and individualized conditions for PA(p=0.51),SST(p=0.19),or DI(p=0.73).There were no differential effects by gender(i.e.,non-significant condition-by-gender interactions)for PA(p_(for interaction)=0.86),SST(p_(for interaction)=0.46),or DI(p_(for interaction)=0.15).Effect sizes for both conditions equated to approximately 6 min more PA per day and approximately 3 min less sedentary time.Conclusion:The observed lack of difference in outcomes suggests that group implementation of SWITCH is equally effective as individualized implementation for building capacity in school wellness programming.Similarly,the lack of interaction by gender suggests that SWITCH can be beneficial for both boys and girls.Additional research is needed to understand the school-level factors that influence implementation(and outcomes)of SWITCH.
文摘Objectives:To share a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in health-care.Methods:We applied Walker and Avant method to clarify the concept of social movement in the context of knowledge uptake and sustainability.Peer-reviewed and grey literature databases were systematically searched for relevant reports that described how social movement action led to evidence-based practice changes in health and community settings.Titles,abstracts and full texts were reviewed independently and in duplicate,resulting in 38 included articles.Results:Social movement action for knowledge uptake and sustainability can be defined as individuals,groups,or organizations that,as voluntary and intrinsically motivated change agents,mobilize around a common cause to improve outcomes through knowledge uptake and sustainability.The 10 defining attributes,three antecedents and three consequences that we identified are dynamic and interrelated,often mutually reinforcing each other to fortify various aspects of the social movement.Examples of defining attributes include an urgent need for action,collective action and collective identity.The concept analysis resulted in the development of the Social Movement Action Framework.Conclusions:Social movement action can provide a lens through which we view implementation science.Collective action and collective identity e concepts less frequently canvassed in implementation science literature e can lend insight into grassroots approaches to uptake and sustainability.Findings can also inform providers and change leaders on the practicalities of harnessing social movement action for realworld change initiatives.By mobilizing individuals,groups,or organizations through social movement approaches,they can engage as powered change agents and teams that impact the individual,organizational and health systems levels to facilitate knowledge uptake and sustainability.
基金The study was funded by the National Natural Science Foundation of China(No.72374207)the Chongqing outstanding youth project(No.cstc2020jcyjjq0035)。
文摘Background Tuberculosis (TB) is a major cause of death worldwide, and Chinese TB burden ranked the second globally. Chinese primary healthcare (PHC) sectors implement the TB Control Program (TCP) to improve active case finding, referral, treatment adherence, and health education. This study aimed to identify barriers and enablers of TCP implementation in high TB burden regions of West China.Methods We conducted a representative study using mixed-methods in 28 counties or districts in Chongqing Municipality and Guizhou Province of West China from October 2021 to May 2022. Questionnaire surveys and semi-structured in-depth interviews were conducted with 2720 TB healthcare workers (HCWs) and 20 interviewees in PHC sectors. Descriptive statistical analysis was used to investigate TB HCWs’ characteristics, and path analysis model was utilized to analyze the impact of associated factors on TCP implementation. Thematic framework analysis was developed with the guide of the adapted Consolidated Framework for Implementation Research (CFIR) on factors of TCP implementation.Results This study found that 84.6% and 94.1% of community and village HCWs had low professional titles. Based on the results of multiple regression analysis and correlation analysis, lower TB core knowledge scores (-0.09) were identified as barriers for TCP implementation in community PHC sectors, and low working satisfaction (-0.17) and low working willingness (-0.10) are barriers for TPC implementation in village PHC sectors. The results of in-depth interviews reported barriers in all domains and enablers in four domains of CFIR. There were identified 19 CFIR constructs associated with TCP implementation, including 22 barriers such as HCWs’ heavy workload, and 12 enablers such as HCWs’ passion towards TCP planning.Conclusions With the guide of the CFIR framework, complex factors (barriers and enablers) of TCP implementation in PHC sectors of West China were explored, which provided important evidences to promote TB program in high TB burden regions. Further implementation studies to translate those factors into implementation strategies are urgent needed.
文摘At the first gathering of its kind on the role of science in implementing the Sendai Framework for Disaster Risk Reduction 2015–2030,over 750 scientists,policymakers,business people,and practitioners met in Geneva from January 27–29,2016.The UNISDR Science and Technology Conference on the Implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030 fea-
文摘Background:China is still faced with the public health challenge of tuberculosis(TB),and a robust surveillance system is critical for developing evidence-based TB control policies.The Tuberculosis Information Management System(TBIMS),an independent system launched in 2005,has encountered several challenges in meeting the current needs ofTB control.The Chinese government also planned to establish the National Health Information System(NHIS)aggregating data in different areas.The China National Health Commission-Gates TB Project Phase III launched a new TB surveillance system to address these challenges and also as a pilot for the countrywide implementation of the NHIS.This commentary highlights the improvements and challenges in implementing the newTB system and also discusses the implications for the roll-out of the NHIS.
