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Vadrevu L, Jain M, Parsekar SS. Analyzing the usage of theories of change for routine immunization programs -- a review of impact evaluations from LMICs. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:141. [PMID: 39252041 PMCID: PMC11386364 DOI: 10.1186/s41043-024-00615-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 08/11/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND In this article we analyzed the extent of the usage of Theories of Change (TOCs) and causal pathways in the evaluation of immunization programs to identify the challenges to generating evidence on how interventions improve immunization. METHODS We analyzed the use of the TOC in impact evaluations (IEs) of immunization interventions published after 2010, and its associated articles. The review includes studies from Evidence Gap Map and Yale review that were conducted in May and March of 2020, respectively. We synthesized data on six domains using NVIVO - program theory, context, assumptions, usage of TOC, use in evaluation, and description causal pathways. RESULTS Our review included 47 large-scale and 45 small-to medium-scale interventions. Of the included studies, 19% used a TOC, 56% described a causal pathway or used a conceptual diagram with varying degrees of detail, and 25% of the IEs did not provide any information on how their intervention was expected to affect change. Only 19 of the 92 IEs explicitly outlined any assumptions associated with the implementation of the interventions. Forty studies measured the outputs or intermediate outcomes leading to improved immunization coverage. CONCLUSION Future implementers and evaluators need to develop clear TOCs that are based on established theory and have clearly articulated the underlying assumptions. Large-scale health system strengthening initiatives implemented by governments, also need to build TOCs and integrate them into their results frameworks. Additionally, there is a need to combine both impact and process evaluations to understand the how context affects the causal pathways.
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Affiliation(s)
- Lalitha Vadrevu
- Impact Evaluation Initiative (3ie), 3ie, Unit no. 306, 3rd Floor, Rectangle-1, D-4, Saket District Centre, New Delhi, 110017, India.
| | - Monica Jain
- Impact Evaluation Initiative (3ie), 3ie, Unit no. 306, 3rd Floor, Rectangle-1, D-4, Saket District Centre, New Delhi, 110017, India
| | - Shradha S Parsekar
- Impact Evaluation Initiative (3ie), 3ie, Unit no. 306, 3rd Floor, Rectangle-1, D-4, Saket District Centre, New Delhi, 110017, India
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Siniakova T, Lombardi C, Wofford K, Maye J. Assessing the Quality of Postoperative Recovery: A Guide for Making Adjustments in Anesthesia Delivery. J Perianesth Nurs 2024; 39:356-365. [PMID: 38416104 DOI: 10.1016/j.jopan.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 08/30/2023] [Accepted: 09/29/2023] [Indexed: 02/29/2024]
Abstract
PURPOSE The purpose of this project was to develop a plan and then implement a process for improving anesthesia delivery at a surgery center in the Southeast United States over a 2-month period. DESIGN The design of the project was based on utilization of the instrument QoR-15 (Quality of recovery - 15 item questionnaire). This tool is a valid and reliable instrument for the measurement of postoperative outcomes. The QoR-15 includes 15 questions that can each be scored on a 10-point scale. METHODS Methods included a literature search, collecting pre-assessment data, making phone calls to patients utilizing QoR-15 tool, analyzing data, presenting findings to stakeholders, creating a plan of future anesthesia care adjustments. FINDINGS The results revealed the following outcome data: a total of 183 postoperative phone calls were successfully performed. The calls were completed on the first postoperative day during the months of July and August 2021. There were 459 total cases during this 2-month period with 113 successful patient contacts (24.6 % successful contact rate). Mean scores of the QoR-15 data for the total population were above 9 for all 15 items. The data was then analyzed according to surgical specialty. The category of moderate pain scores in patients from the General and Ophthalmology surgical specialties were 7.9 and 7.8 respectively. General surgery patients also had one of the highest scores in severe pain with a mean of 8.7. CONCLUSIONS In conclusion, the leadership team at the ASC received a formal presentation of the results and recommendations for future adjustments that could be potentially implemented in anesthesia care. The benefits of regional anesthesia were suggested to help achieve better patient pain outcomes in both the General and Ophthalmologic surgical populations.
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Affiliation(s)
| | | | | | - John Maye
- University of South Florida, Tampa, FL
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Aromatario O, Cambon L, Alla F, Imbert A, Pouchepadass C, Renvoisé N, Dauchy S, Charles C. Conditions for adherence to videoconference-based programs promoting adapted physical activity in cancer patients: a realist evaluation. Implement Sci 2024; 19:6. [PMID: 38287336 PMCID: PMC10823602 DOI: 10.1186/s13012-024-01338-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 01/09/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Although moderate physical activity (PA) during cancer treatment has been associated with improved quality of life, reduced side effects, and even lower mortality, many barriers to successful implementation remain. Digital technology has been perceived as an effective lever for overcoming access and motivational issues but few studies have been performed to confirm this assumption. The "VISIO-AJUST" study explored the factors affecting the conditions of adherence to video-conference-based PA programs in patients undergoing cancer treatment. METHODS The VISIO-AJUST study was based on a qualitative successive case approach, guided by the principles of the realist evaluation, and applied to two French programs of PA, following three main steps: (1) Identification of factors likely to influence conditions of patients' adherence; (2) Elaboration and testing of explanatory "Context-Mechanism-Outcome (CMO)" configurations; (3) Refinement of CMO configurations, in order to understand what, how, for whom, and under what circumstances video-conference-based PA programs work. RESULTS Five main CMO configurations were found to be associated with adherence to video-conferencing-based PA programs, promoting (i) accessibility and a supportive environment for adapted physical activity, (ii) a setting conducive to sociability despite distance, (iii) Confidence and security of practice, (iv) a combination of several motivational levers in favor of continuity of effort and progress, (v) regularity of the sessions, progressiveness in the effort and evaluation of progress as a basis for the adoption of a regular physical practice. CONCLUSION This study provides original insights into the use of videoconferencing to enable patients to improve their PA during cancer treatment. Future research with long-term follow-up would allow for a better understanding of the key conditions promoting sustainable behavior change.
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Affiliation(s)
- Olivier Aromatario
- INSERM, Population Health Research Center (BPH), U1219, Mérisp/PHARES, Team Labelled Ligue Contre le Cancer, CIC1401, University of Bordeaux, F-33000, Bordeaux, France.
| | - Linda Cambon
- INSERM, Population Health Research Center (BPH), U1219, Mérisp/PHARES, Team Labelled Ligue Contre le Cancer, CIC1401, University of Bordeaux, F-33000, Bordeaux, France
| | - François Alla
- INSERM, Population Health Research Center (BPH), U1219, Mérisp/PHARES, Team Labelled Ligue Contre le Cancer, CIC1401, University of Bordeaux, F-33000, Bordeaux, France
| | | | | | | | | | - Cécile Charles
- INSERM, Population Health Research Center (BPH), U1219, Mérisp/PHARES, Team Labelled Ligue Contre le Cancer, CIC1401, University of Bordeaux, F-33000, Bordeaux, France
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Cantrell A, Sworn K, Chambers D, Booth A, Taylor Buck E, Weich S. Factors within the clinical encounter that impact upon risk assessment within child and adolescent mental health services: a rapid realist synthesis. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-107. [PMID: 38314750 DOI: 10.3310/vkty5822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Background Risk assessment is a key process when a child or adolescent presents at risk for self-harm or suicide in a mental health crisis or emergency. Risk assessment by a healthcare professional should be included within a biopsychosocial assessment. However, the predictive value of risk-screening tools for self-harm and suicide in children and adolescents is consistently challenged. A review is needed to explore how best to undertake risk assessment and the appropriate role for tools/checklists within the assessment pathway. Aims To map research relating to risk assessment for child and adolescent mental health and to identify features that relate to a successful risk assessment. Objectives To review factors within the clinical encounter that impact upon risk assessments for self-harm and suicide in children and adolescents: i. to conduct a realist synthesis to understand mechanisms for risk assessment, why they occur and how they vary by context ii. to conduct a mapping review of primary studies/reviews to describe available tools of applicability to the UK. Data sources Databases, including MEDLINE, PsycINFO®, EMBASE, CINAHL, HMIC, Science and Social Sciences Citation Index and the Cochrane Library, were searched (September 2021). Searches were also conducted for reports from websites. Review methods A resource-constrained realist synthesis was conducted exploring factors that impact upon risk assessments for self-harm and suicide. This was accompanied by a mapping review of primary studies/reviews describing risk-assessment tools and approaches used in UK child and adolescent mental health. Following piloting, four reviewers screened retrieved records. Items were coded for the mapping and/or for inclusion in the realist synthesis. The review team examined the validity and limitations of risk-screening tools. In addition, the team identified structured approaches to risk assessment. Reporting of the realist synthesis followed RAMESES guidelines. Results From 4084 unique citations, 249 papers were reviewed and 41 studies (49 tools) were included in the mapping review. Eight reviews were identified following full-text screening. Fifty-seven papers were identified for the realist review. Findings highlight 14 explanations (programme theories) for a successful risk assessment for self-harm and suicide. Forty-nine individual assessment tools/approaches were identified. Few tools were developed in the UK, specifically for children and adolescents. These lacked formal independent evaluation. No risk-screening tool is suitable for risk prediction; optimal approaches incorporate a relationship of trust, involvement of the family, where appropriate, and a patient-centred holistic approach. The objective of risk assessment should be elicitation of information to direct a risk formulation and care plan. Limitations Many identified tools are well-established but lack scientific validity, particularly predictive validity, or clinical utility. Programme theories were generated rapidly from a survey of risk assessment. Conclusions No single checklist/approach meets the needs of risk assessment for self-harm and suicide. A whole-system approach is required, informed by structured clinical judgement. Useful components include a holistic assessment within a climate of trust, facilitated by family involvement. Study registration This study is registered as PROSPERO CRD42021276671. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR135079) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 1. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Anna Cantrell
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Katie Sworn
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Duncan Chambers
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Andrew Booth
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | | | - Scott Weich
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
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Francis-Oliviero F, Loubières C, Grové C, Marinucci A, Shankland R, Salamon R, Perez E, Garancher L, Galera C, Gaillard E, Orri M, González-Caballero JL, Montagni I. Improving Children's Mental Health Literacy Through the Cocreation of an Intervention and Scale Validation: Protocol for the CHILD-Mental Health Literacy Research Study. JMIR Res Protoc 2023; 12:e51096. [PMID: 37796588 PMCID: PMC10587813 DOI: 10.2196/51096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Children's mental health is a public health priority, with 1 in 5 European children younger than 12 years having a behavioral, developmental, or psychological disorder. Mental health literacy (MHL) is a modifiable determinant of mental health, promoting psychological well-being and reducing mental health problems. Despite its significance, no interventions or scales currently exist for increasing and measuring MHL in this population. OBJECTIVE This study has dual objectives: (1) cocreating and evaluating an intervention on children's MHL, and (2) developing and validating a scale that measures children's MHL. METHODS Our study focuses on children aged 9-11 years attending primary school classes in various settings, including urban and rural areas, and priority education zones within a French department. Using a participatory research approach, we will conduct workshops involving children, parents, teachers, and 1 artist to cocreate an intervention comprising multiple tools (eg, a pedagogical kit and videos). This intervention will undergo initial evaluation in 4 classes through observations, interviews, and satisfaction questionnaires to assess its viability. Concurrently, the artist will collaborate with children to create the initial version of the CHILD-MHL scale, which will then be administered to 300 children. Psychometric analyses will validate the scale. Subsequently, we will conduct a cluster randomized controlled trial involving a minimum of 20 classes, using the CHILD-MHL scale scores as the primary end point to evaluate the intervention's efficacy. Additional interviews will complement this mixed methods evaluation. Both the intervention and the scale are grounded in the Child-Focused MHL model. RESULTS The first tool of the intervention is the pedagogical kit Le Jardin du Dedans, supported by the public organization Psycom Santé Mentale Info and endorsed by UNICEF (United Nations Children's Fund) France. The second tool is a handbook by the Pan American Health Organization and the World Health Organization, which is addressed to teachers to sensitize them to children's mental health problems. The third is a 5-page supplementary leaflet produced by the nongovernmental organization The Ink Link, which teaches children the notion of MHL. Finally, we produced 56 items of the MHL Scale and listed existing education policies for children's mental health. CONCLUSIONS After its robust evaluation, the intervention could be extended to several schools in France. The scale will be the first in the world to measure children's MHL. It will be used not only to evaluate interventions but also to provide data for decision makers to include MHL in all educational policies. Both the intervention and the scale could be translated into other languages. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/51096.
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Affiliation(s)
- Florence Francis-Oliviero
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
- Pôle de santé publique, Service d'Information Médicale, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | | | - Christine Grové
- School of Curriculum Teaching & Inclusive Education, Monash University, Clayton, Australia
- Fulbright Association, Science, Technology, Engineering and Mathematics College, Health and Biomedical Sciences, Royal Melbourne Institute of Technology, Canberra, Australia
| | - Alexandra Marinucci
- School of Educational Psychology & Counselling, Monash University, Clayton, Australia
| | - Rebecca Shankland
- Laboratory Développement, Individu, Processus, Handicap, Éducation, Department of Psychology, Education and Vulnerabilities, Université Lumière Lyon 2, Lyon, France
| | - Réda Salamon
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
| | | | | | - Cédric Galera
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
- Charles Perrens Hospital, Bordeaux, France
| | - Elsa Gaillard
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | | | - Ilaria Montagni
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
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Romão DMM, Setti C, Arruda LHM, de Melo RC, de Araujo BC, Tan AR, DeMaio PN, Kuchenmüller T. Integration of evidence into Theory of Change frameworks in the healthcare sector: A rapid systematic review. PLoS One 2023; 18:e0282808. [PMID: 36893160 PMCID: PMC9997872 DOI: 10.1371/journal.pone.0282808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/22/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Theory of Change (ToC) has become an established approach to design and evaluate interventions. While ToC should-in line with the growing international focus on evidence-informed health decision-making-consider explicit approaches to incorporate evidence, there is limited guidance on how this should be done. This rapid review aims to identify and synthesize the available literature on how to systematically use research evidence when developing or adapting ToCs in the health sector. METHODS A rapid review methodology using a systematic approach, was designed. Eight electronic databases were consulted to search for peer-reviewed and gray publications detailing tools, methods, and recommendations promoting the systematic integration of research evidence in ToCs. The included studies were compared, and the findings summarized qualitatively into themes to identify key principles, stages, and procedures, guiding the systematic integration of research evidence when developing or revising a ToC. RESULTS This review included 18 studies. The main sources from which evidence was retrieved in the ToC development process were institutional data, literature searches, and stakeholder consultation. There was a variety of ways of finding and using evidence in ToC. Firstly, the review provided an overview of existing definitions of ToC, methods applied in ToC development and the related ToC stages. Secondly, a typology of 7 stages relevant for evidence integration into ToCs was developed, outlining the types of evidence and research methods the included studies applied for each of the proposed stages. CONCLUSION This rapid review adds to the existing literature in two ways. First, it provides an up-to-date and comprehensive review of the existing methods for incorporating evidence into ToC development in the health sector. Second, it offers a new typology guiding any future endeavors of incorporating evidence into ToCs.
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Affiliation(s)
| | | | | | | | | | | | | | - Tanja Kuchenmüller
- Evidence to Policy and Impact, World Health Organization, Geneva, Switzerland
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Timotheou S, Miliou O, Dimitriadis Y, Sobrino SV, Giannoutsou N, Cachia R, Monés AM, Ioannou A. Impacts of digital technologies on education and factors influencing schools' digital capacity and transformation: A literature review. EDUCATION AND INFORMATION TECHNOLOGIES 2022; 28:6695-6726. [PMID: 36465416 PMCID: PMC9684747 DOI: 10.1007/s10639-022-11431-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/27/2022] [Indexed: 05/25/2023]
Abstract
Digital technologies have brought changes to the nature and scope of education and led education systems worldwide to adopt strategies and policies for ICT integration. The latter brought about issues regarding the quality of teaching and learning with ICTs, especially concerning the understanding, adaptation, and design of the education systems in accordance with current technological trends. These issues were emphasized during the recent COVID-19 pandemic that accelerated the use of digital technologies in education, generating questions regarding digitalization in schools. Specifically, many schools demonstrated a lack of experience and low digital capacity, which resulted in widening gaps, inequalities, and learning losses. Such results have engendered the need for schools to learn and build upon the experience to enhance their digital capacity and preparedness, increase their digitalization levels, and achieve a successful digital transformation. Given that the integration of digital technologies is a complex and continuous process that impacts different actors within the school ecosystem, there is a need to show how these impacts are interconnected and identify the factors that can encourage an effective and efficient change in the school environments. For this purpose, we conducted a non-systematic literature review. The results of the literature review were organized thematically based on the evidence presented about the impact of digital technology on education and the factors that affect the schools' digital capacity and digital transformation. The findings suggest that ICT integration in schools impacts more than just students' performance; it affects several other school-related aspects and stakeholders, too. Furthermore, various factors affect the impact of digital technologies on education. These factors are interconnected and play a vital role in the digital transformation process. The study results shed light on how ICTs can positively contribute to the digital transformation of schools and which factors should be considered for schools to achieve effective and efficient change.
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Affiliation(s)
- Stella Timotheou
- CYENS Center of Excellence & Cyprus University of Technology (Cyprus Interaction Lab), Cyprus, CYENS Center of Excellence & Cyprus University of Technology, Nicosia-Limassol, Cyprus
| | - Ourania Miliou
- CYENS Center of Excellence & Cyprus University of Technology (Cyprus Interaction Lab), Cyprus, CYENS Center of Excellence & Cyprus University of Technology, Nicosia-Limassol, Cyprus
| | | | | | | | - Romina Cachia
- JRC - Joint Research Centre of the European Commission, Seville, Spain
| | | | - Andri Ioannou
- CYENS Center of Excellence & Cyprus University of Technology (Cyprus Interaction Lab), Cyprus, CYENS Center of Excellence & Cyprus University of Technology, Nicosia-Limassol, Cyprus
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Cambon L. [Evaluating population health interventions : The contributions of theory-driven evaluations]. Rev Epidemiol Sante Publique 2022; 71:101398. [PMID: 36085120 DOI: 10.1016/j.respe.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 10/14/2022] Open
Abstract
Population health intervention research has been characterized by the deployment of scientific methods designed to produce knowledge on policy and program interventions directly or indirectly involving the health sector, and potentially affecting population health. The proposed solutions encompass a multitude of interventions of variable types, scale, focus and implementation, rendering them particularly complex and difficult to understand. This complexity raises major conceptual and methodological issues because in reality, we assess not an intervention, but rather a set of interventional elements interacting with those specific to the context in which they appear. It is the interactions that produce effects, to the extent that it makes little sense to speak of an intervention, and more sense to consider an interventional system defined by the interactions. To grasp the numerous elements brought into play, it behooves us to amalgamate evaluation paradigms and approaches. In a precise context, theory-driven evaluations are of pronounced interest. This article presents the main principles of this type of evaluation by focusing on its capacity to shed light on the stakes involved in intervention/context interplay, and by putting forward conclusions transferable to population health research.
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Affiliation(s)
- L Cambon
- Centre Inserm U 1219, BPH, Université de Bordeaux, Bordeaux, France; CHU de Bordeaux, Bordeaux, France; ISPED, Université de Bordeaux, 146 Rue Leo Saignat, 33000 Bordeaux, France.
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Cambon L, Alla F. Understanding the complexity of population health interventions: assessing intervention system theory (ISyT). Health Res Policy Syst 2021; 19:95. [PMID: 34147105 PMCID: PMC8214800 DOI: 10.1186/s12961-021-00743-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/08/2021] [Indexed: 11/17/2022] Open
Abstract
Given their inherent complexity, we need a better understanding of what is happening inside the “black box” of population health interventions. The theory-driven intervention/evaluation paradigm is one approach to addressing this question. However, barriers related to semantic or practical issues stand in the way of its complete integration into evaluation designs. In this paper, we attempt to clarify how various theories, models and frameworks can contribute to developing a context-dependent theory, helping us to understand the black box of population health interventions and to acknowledge their complexity. To achieve this goal, we clarify what could be referred to as “theory” in the theory-driven evaluation of the interventional system, distinguishing it from other models, frameworks and classical theories. In order to evaluate the interventional system with a theory-driven paradigm, we put forward the concept of interventional system theory (ISyT), which combines a causal theory and an action model. We suggest that an ISyT could guide evaluation processes, whatever evaluation design is applied, and illustrate this alternative method through different examples of studies. We believe that such a clarification can help to promote the use of theories in complex intervention evaluations, and to identify ways of considering the transferability and scalability of interventions.
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Affiliation(s)
- Linda Cambon
- Chaire de Prévention ISPED/SPF, Université de Bordeaux, Bordeaux, France. .,Centre Inserm Université de Bordeaux U1219, BPH, Bordeaux, France. .,CHU Bordeaux, Bordeaux, France.
| | - François Alla
- Chaire de Prévention ISPED/SPF, Université de Bordeaux, Bordeaux, France.,Centre Inserm Université de Bordeaux U1219, BPH, Bordeaux, France.,CHU Bordeaux, Bordeaux, France
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10
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Ahmed S, Pinnock H, Steed E. Developing theory-based asthma self-management interventions for South Asians and African Americans: A systematic review. Br J Health Psychol 2021; 26:1040-1068. [PMID: 33724618 DOI: 10.1111/bjhp.12518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Intervention development guidelines suggest that behavioural interventions benefit from being theory-based. Minority populations typically benefit less from asthma self-management interventions, and the extent to which appropriate theory has been used for culturally tailored interventions has not been addressed. We aimed to determine theory use and theoretical domains targeted in asthma self-management interventions for South Asian and Black populations. METHODS We systematically searched electronic databases, research registers, manually searched relevant journals and reference lists of reviews for randomised controlled trials of asthma self-management for South Asian and Black populations, and extracted data using the Theory Coding Scheme to inform if/how theory was used and explore its associations with asthma outcomes, and the Theoretical Domains Framework was used to identify targeted theoretical domains and its relationship to effectiveness of asthma outcomes. RESULTS 20 papers (19 trials) were identified; theory was not extensively used in interventions. It was unclear whether theory use or theoretical domains targeted in interventions improved asthma outcomes. South Asian interventions included 'behavioural regulation', while 'reinforcement' was mostly used in African American interventions. 'Knowledge' was central for all populations, though there were differences related to 'environmental context and resources' e.g., language adaptations for South Asians; asthma resources provided for African Americans. Author descriptions of interventions targeting providers were limited. CONCLUSIONS There was little evidence of theory-based approaches used in cultural interventions for asthma self-management. Demystifying theoretical concepts (and cultural interpretations of constructs) may provide clarity for 'non-experts', enabling mainstream use of theory-driven approaches in intervention development.
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Affiliation(s)
- Salina Ahmed
- Asthma UK Centre for Applied Research, Institute of Population Health Sciences, Barts and the London, School of Medicine and Dentistry, Queen Mary, University of London, UK
| | - Hilary Pinnock
- Asthma UK Centre for Applied Research, Usher Institute, The University of Edinburgh, UK
| | - Elizabeth Steed
- Asthma UK Centre for Applied Research, Institute of Population Health Sciences, Barts and the London, School of Medicine and Dentistry, Queen Mary, University of London, UK
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Aromatario O, Charles C, Moysan P, Alla F, Cambon L. Prise en compte des inégalités sociales de santé dans l’évaluation de programmes en visioconférence destinés à promouvoir l’activité physique des patients en cours de traitement d’un cancer. Glob Health Promot 2021. [DOI: 10.1177/1757975920987381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
La prise en compte des inégalités sociales de santé (ISS) est une des préoccupations des programmes de santé. Ceux développés à partir d’interfaces numériques imposent un regard spécifique sur les ISS lié aux caractéristiques de l’outil. Ce commentaire a pour but de présenter une méthode d’analyse innovante des ISS dans les dispositifs numériques, basée sur une théorie d’intervention, à partir d’un exemple d’application sur un programme utilisant une interface numérique de visioconférence pour le développement de l’activité physique de patients suivis en oncologie. Il illustre l’intérêt et la faisabilité d’une mobilisation des acteurs du soin et de la recherche autour d’un outil d’évaluation et de réflexion simple, pour une retombée clinique concrète et immédiatement disponible allant dans le sens de la réduction des ISS.
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Affiliation(s)
- Olivier Aromatario
- Population Health Research Center (BPH), Inserm, Université de Bordeaux, Bordeaux, France
| | | | - Perrine Moysan
- École des hautes études en santé publique (EHESP), Rennes, France
| | - François Alla
- Population Health Research Center (BPH), Inserm, Université de Bordeaux, Bordeaux, France
| | - Linda Cambon
- Population Health Research Center (BPH), Inserm, Université de Bordeaux, Bordeaux, France
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Trovato GM. Non-alcoholic fatty liver disease and Atherosclerosis at a crossroad: The overlap of a theory of change and bioinformatics. World J Gastrointest Pathophysiol 2020; 11:57-63. [PMID: 32435522 PMCID: PMC7226912 DOI: 10.4291/wjgp.v11.i3.57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/24/2020] [Accepted: 03/01/2020] [Indexed: 02/06/2023] Open
Abstract
Atherosclerosis (ATH) and non-alcoholic fatty liver disease (NAFLD) are medical conditions that straddle a communal epidemiology, underlying mechanism and a clinical syndrome that has protean manifestations, touching every organ in the body. These twin partners, ATH and NAFLD, are seemingly straightforward and relatively simple topics when considered alone, but their interdependence calls for more thought. The study of the mutual relationship of NAFLD and ATH should involve big data analytics approaches, given that they encompass a constellation of diseases and are related to several recognized risk factors and health determinants and calls to an explicit theory of change, to justify intervention. Research studies on the “association between aortic stiffness and liver steatosis in morbidly obese patients”, published recently, sparsely hypothesize new mechanisms of disease, claiming the “long shadow of NAFLD” as a risk factor, if not as a causative factor of arterial stiffness and ATH. This statement is probably overreaching the argument and harmful for the scientific credence of this area of medicine. Despite the verification that NAFLD and cardiovascular disease are strongly interrelated, current evidence is that NAFLD may be a useful indicator for flagging early arteriosclerosis, and not a likely causative factor. Greater sustainable contribution by precision medicine tools, by validated bioinformatics approaches, is needed for substantiating conjectures, assumptions and inferences related to the management of big data and addressed to intervention for behavioral changes within an explicit theory of change.
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Affiliation(s)
- Guglielmo M Trovato
- Department of Clinical and Experimental Medicine, the School of Medicine of the University of Catania, Catania 95125, Italy
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