Matching Items (3)

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Implementing the Exercise is MedicineTM solution: a process evaluation conducted in a university-based healthcare system

Description

Background: Exercise is Medicine (EIM) is a health promotion strategy for addressing physical inactivity in healthcare. However, it is unknown how to successfully implement the processes.

Purpose: The purpose of

Background: Exercise is Medicine (EIM) is a health promotion strategy for addressing physical inactivity in healthcare. However, it is unknown how to successfully implement the processes.

Purpose: The purpose of this study was to understand how implementing EIM influenced provider behaviors in a university-based healthcare system, using a process evaluation.

Methods: A multiple baseline, time series design was used. Providers were allocated to three groups. Group 1 (n=11) was exposed to an electronic medical record (EMR) systems change, EIM-related resources, and EIM training session. Group 2 (n=5) received the EMR change and resources but no training. Group 3 (n=6) was only exposed to the systems change. The study was conducted across three phases. Outcomes included asking about patient physical activity (PA) as a vital sign (PAVS), prescribing PA (ExRx), and providing PA resources or referrals. Patient surveys and EMR data were examined. Time series analysis, chi-square, and logistic regression were used.

Results: Patient survey data revealed the systems change increased patient reports of being asked about PA, χ2(4) = 95.47, p < .001 for all groups. There was a significant effect of training and resource dissemination on patients receiving PA advice, χ2(4) = 36.25, p < .001. Patients receiving PA advice was greater during phase 2 (OR = 4.7, 95% CI = 2.0-11.0) and phase 3 (OR = 2.9, 95% CI = 1.2-7.4). Increases were also observed in EMR data for PAVS, χ2(2) = 29.27, p <. 001 during implementation for all groups. Increases in PA advice χ2(2) = 140.90, p < .001 occurred among trained providers only. No statistically significant change was observed for ExRx, PA resources or PA referrals. However, visual analysis showed an upwards trend among trained providers.

Conclusions: An EMR systems change is effective for increasing the collection of the PAVS. Training and resources may influence provider behavior but training alone increased provider documentation. The low levels of documented outcomes for PA advice, ExRx, resources, or referrals may be due to the limitations of the EMR system. This approach was effective for examining the EIM Solution and scaled-up, longer trials may yield more robust results.

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Created

Date Created
  • 2019

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A post occupancy evaluation of the education spaces at the Ngeruka Health Center in Rwanda: can the design of the built environment effect healing?

Description

A post occupancy evaluation (POE) was conducted at the Ngeruka Health Center (NHC) in the Bugesera District of Rwanda. The POE was limited to the education spaces within the health

A post occupancy evaluation (POE) was conducted at the Ngeruka Health Center (NHC) in the Bugesera District of Rwanda. The POE was limited to the education spaces within the health center, its participants, and staff. A POE is a combination of methods both quantitative and qualitative to determine user satisfaction and whether the design intent of the built environment was met.

In rural Rwanda where healthcare facilities are scarce and people become seriously ill from preventable diseases, help is needed. The smallest injuries become life threatening. Healthcare facilities and providers must develop approaches that stop these minor illnesses and diseases from costing further problems.

The healthcare facility is a healing environment. Healing environments nurture health and provide a sense of safety and security. The Ngeruka facility has incorporated education spaces within their facility to teach the community ways to prevent minor health problems from becoming major ones.

The research that was conducted at this healthcare facility sought to answer the main questions: Does the built environment of the NHC contribute to healing by engaging education program attendees to learn about preventing illness and disease and other health promotion strategies? In addition, can you measure healing effects of the built environment?

The research took measurements of the built environment and combined them with user satisfaction questionnaires. Site observations and a participant engagement questionnaire were used to determine the amount of engagement the participants put forth into the education programs within the designated design space. Measuring engagement is a tool schools use to find out if their facilities are producing their intended results. This same thought process was incorporated into this research. The participants did prove to be engaged, but it is not definitive that the built environment was responsible. It was a combination of many factors.

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Agent

Created

Date Created
  • 2015

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Salud con Sabor Latino para los Niños: a feasibility study

Description

Obesity in Hispanic youth has reached alarmingly high levels, increasing the risk of type 2 diabetes, hyperlipidemia, hypertension, and cardiovascular disease. In Mexican American children ages 6-11 years, 41.7% are

Obesity in Hispanic youth has reached alarmingly high levels, increasing the risk of type 2 diabetes, hyperlipidemia, hypertension, and cardiovascular disease. In Mexican American children ages 6-11 years, 41.7% are overweight and obese, 24.7% are obese and 19.6% have a Body Mass Index (BMI) greater than the 97th percentile. While personal, behavioral, and environmental factors contribute to these high rates, emerging literature suggests acculturation, self-efficacy and social support are key influences. The one-group, pre- and post-test, quasi-experimental design used a community-based participatory research (CBPR) method to test the feasibility, acceptability, and preliminary efficacy of the 8-week intervention. Social Cognitive Theory (SCT) was used to guide the design. Measurements included an analysis of recruitment, retention, participant satisfaction, observation of intervention sessions, paired t-tests, effect sizes, and bivariate correlations between study variables (acculturation, nutrition and physical activity [PA] knowledge, attitude and behaviors, perceived confidence and social support) and outcome variables (BMI z-score, waist circumference and BP percentile) Findings showed the SSLN program was feasible and acceptable. Participants (n = 16) reported that the curriculum was fun and they learned about nutrition and PA. The retention rate was 94%. The preliminary effects on adolescent nutrition and PA behaviors showed mixed results with small-to-medium effect sizes for nutrition knowledge and attitude, PA and sedentary behavior. Correlation analysis among acculturation and study variables was not significant. Positive associations were found between perceived confidence in eating and nutrition attitude (r = .61, p < .05) and nutrition behavior (r = .62, p < .05), perceived confidence in exercise and nutrition behavior (r = .66, p < .05), social support from family for exercise and PA behavior (r = .67, p < .01) and social support from friends for exercise and PA behavior (r = .56, p < .05). These findings suggest a culturally specific healthy eating and activity program for adolescents was feasible and acceptable and warrants further investigation, since it may fill a gap in existing obesity programs designed for Hispanic youth. The positive correlations suggest further testing of the theoretical model.

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Created

Date Created
  • 2011