Context: People living in rural and remote British Columbia (BC) in Canada experience complex barriers to care, resulting in poorer health outcomes compared to their urban counterparts. Virtual ...healthcare (VH) can act as a tool to address some of the care barriers, including reducing travel time, cost, and disruptions to people's lives. Conversely, VH can exacerbate inequities through unique difficulties in rural implementation, such as a lack of access to necessary infrastructure (eg internet), social supports, and technological capacity (eg devices and literacy). Issue: The impacts of the COVID-19 pandemic induced a rapid shift to VH, providing new opportunities for health care while simultaneously highlighting and exacerbating inequities for people living in rural and remote settings. Equity-informed knowledge translation processes can help address these concerns. This commentary reports on an equity-informed knowledge translation process engaged by a diverse group of health researchers, community members, and practitioners in BC. Lessons learned: Informed by equity principles from the Canadian Coalition for Global Health Research, this knowledge exchange and translation process led to the co-creation of two practical tools: a set of VH appointment tip sheets and an open access report. Through stakeholder engagement and literature consultation, VH appointments were found to have many benefits for those in rural and remote communities, including expanding access to basic and specialized health services. However, some hesitation was noted when relying solely on these modes of care, as they can lack relationality, clarity, and time to process medical information. The tip sheets resulting from this process are an interactional-level tool developed to address this concern and optimize VH appointments, for rural patients and care providers. They offer the respective stakeholder group insights on how to actively prepare for and participate in inclusive virtual care. On a systems level, there is a continually echoed need for equity-based processes to ensure that VH is striking the balance of meeting rural health needs without exacerbating inequities. Additionally, incorporating the voices of rural and remote community members is essential. To help address this gap, an open-access report was compiled to serve as a smallscale example of integrating rural voices with existing literature to recommend systems-level adjustments. Overall, VH holds promise as an effective tool for addressing inequities experienced by those living in rural areas. To maximize this potential, rural and remote stakeholders must be proactively engaged and listened to throughout the processes of considering, planning, and implementing shifts in the utilization of VH options.
To examine how the quality of spinal cord injury peer mentorship relationships and mentor-mentee behaviors are impacted by interaction modality.
Using a within-subjects, repeated measures, ...experimental design, peer mentors (n = 8) completed two mentoring sessions with a standardized mentee in a telephone and a video chat condition. Measures of therapeutic alliance and autonomy supportiveness were administered following each session. Mentors’ leadership behaviors, motivational interviewing skills, and behavior change techniques were compared across conditions. Mentors’ and mentees’ use of motivational interviewing skills and behavior change techniques were further analyzed using state space grids.
Mentors’ therapeutic alliance, autonomy supportiveness, use of leadership behaviors, motivational interviewing skills, and behavior change techniques did not significantly differ across the two conditions (ps > 0.123; Cohen’s d range = 0.218–0.619). State space grids analyses revealed that the dynamic structure of mentoring conversations was similar when interactions occurred through the telephone versus video chat.
Mentors were effective at forming positive, autonomy supportive relationships with mentees in telephone and video chat interaction conditions. Mentors also used leadership/counselling behaviors to a similar extent when interacting through these two modalities.
Organizations that provide peer mentorship can have confidence in using both telephone and video chat modalitites.
•Interaction modality does not impact mentors leadership and counselling behaviours.•State space grids are useful for examining mentoring conversations patterns.•Organizations should continue providing mentorship through telephone and video-chat.
Translucency of shaded zirconia core material Spyropoulou, Panagiota-Eirini, DDS, MS; Giroux, Emily C., DDS, MS; Razzoog, Michael E., DDS, MS, MPH ...
The Journal of prosthetic dentistry,
05/2011, Letnik:
105, Številka:
5
Journal Article
Recenzirano
Statement of problem With the development of various zirconia core shades, questions arise regarding the effect of the shaded zirconia on the translucency of ceramic crowns. Purpose The purpose of ...this study was to investigate the translucency of the 3 Procera Zirconia shaded core materials. The hypothesis was that differences exist in the translucency of various shaded zirconia cores. Material and methods Disk-shaped (0.6 ± 0.01 × 12 mm) zirconia core (Procera Zirconia) specimens (n=90) were fabricated by the manufacturer using a CAD/CAM process. The disks were fabricated in 3 groups according to shade (light, medium, intense) (n=30). A spectrophotometer was used to measure contrast ratio (CR) which is indicative of translucency. One-way ANOVA was conducted to determine significant differences among the shades (α=.05). Results A significant difference in translucency between the light and intense shades ( P =.030) and the medium and intense shades ( P <.001) was observed. There was no significant difference between the light and medium shades ( P =.15). Conclusions Shaded zirconia is partially translucent. In addition, significant differences in translucency measurements were identified between specific shades.
To identify characteristics (1) of high- and low-quality spinal cord injury (SCI) peer mentors; (2) that should be used to match SCI peer mentors and mentees.
The study was conducted in partnership ...with three Canadian provincial SCI organizations using an integrated knowledge translation approach. The Delphi exercise was completed in three rounds. In Round 1, people with SCI completed a thought-listing exercise to identify characteristics of high- and low-quality peer mentors and for matching. In Rounds 2 and 3, people with SCI and community organization staff rated characteristics from the previous round on an 11-point scale. After the final round, the remaining characteristics were thematically analyzed.
Community-based peer mentorship programs in three Canadian provinces.
People with SCI and SCI community organization staff (Round 1, n=45; Round 2, n=27; Round 3, n=25).
Not applicable.
Consensus-based list of characteristics.
Participants reached consensus on 215 characteristics of quality peer mentors and 11 characteristics for peer mentor-mentee matching (ICC=0.96). A consensus-based characterization of high- and low-quality peer mentorship was created and included six overarching themes: competencies, personality characteristics, emotional state, mentor outlook, reason for mentoring, and role model.
A consensus-based characterization of quality peer mentorship was co-developed with input from over 50 members of the SCI community. Findings highlight that peers have both interpersonal and intrapersonal characteristics that contribute to quality mentorship. The findings highlighted the importance of matching mentors on lived experience and shared interests. Findings will inform future research and SCI peer mentorship programs.
Study designKnowledge translation study.ObjectivesUse the Theoretical Domains Framework (TDF) and Behaviour Change Wheel (BCW) to (1) identify barriers and facilitators to participation in daily ...activities and social roles among people aging with spinal cord injury (SCI); and, (2) systematically co-develop participation-focused intervention recommendations with SCI community organizations that can support people aging with SCI.SettingCanadian SCI community.MethodsSemi-structured interviews were conducted with 22 people (minimum 45 years of age; minimum 10 years post injury). Participants were asked about their experiences with participating in daily activities and social roles while aging and preferences for what participation-focused interventions should entail. Transcripts were analyzed to address three stages of behaviour change intervention design: (1) identify barriers and facilitators; (2) identify intervention functions and policy categories; (3) identify implementation options. Findings were synthesized into intervention recommendations and assessed for feasibility.ResultsParticipation in daily activities and social roles was heavily influenced by three TDF domains: environmental context and resources, skills, and social influences. Six intervention functions and all policy categories within the BCW were considered viable intervention options. Multiple messengers and modes of delivery were identified as important. The synthesized recommendations included educating SCI organization membership, partnering with other disability organizations, and advocating to the provincial government.ConclusionsFindings suggest that multiple intervention formats delivered through a variety of implementation options are needed to enhance participation in daily activities and social roles while aging with SCI. Future efforts should focus on translating the recommendations into real-world behaviour change interventions.
To develop an in-depth understanding of spinal cord injury (SCI) researchers' barriers and facilitators to deciding to use 1) a partnered approach to research and, 2) systematically developed ...principles for guiding Integrated Knowledge Translation (IKT) in spinal cord injury research (IKT Guiding Principles).
Qualitative interview study with North American SCI researchers who were interested in using a partnered research approach. The research was conducted using an IKT approach, and interview data were analyzed using reflexive thematic analysis.
Thirteen SCI researchers whose research focused on prevention, clinical, rehabilitation, and/or community SCI research were interviewed. Three themes were co-constructed with partners: 1) the principles are necessary but not sufficient for the implementation of a partnered approach to research; 2) relational capacity building is needed; and 3) institutional transformation is needed to value, resource, and support meaningful engagement.
Supporting change that enables SCI researchers to adopt and implement the IKT Guiding Principles will require transformation at the individual (
), relational (
), and institutional levels (
). Findings provide clear, practical, and tangible actions to promote change that can support meaningful engagement in the SCI Research System.
Spinal cord injury (SCI) research and policy decisions are rarely made in partnership with people with SCI, making them less relevant, applicable, and used by those whom the decisions are intended to ...support. Across disciplines, consensus methods have been promoted as a viable solution for supporting shared research and policy-based decision-making. In this paper, we describe a partnered approach between academic researchers and the Ontario SCI Alliance, a non-profit, SCI community mobilization network to co-develop and co-disseminate a community-based consensus exercise. The community-based consensus exercise included two modified Delphi surveys and one in-person retreat. The partnership's goal with this exercise was to facilitate shared decision-making for the development of their upcoming strategic plan. We then interviewed partners and participants from the Delphi and in-person retreat to discuss successes, challenges, and lessons learned from the exercise. Survey 1 was disseminated to over 2,500 members of the Ontario SCI community and received 374 responses (276 coming from people with SCI). Survey 2 had 118 responses, with 87 coming from people with SCI. The retreat had 73 attendees, including people with SCI, family/friends of people with SCI, clinicians, researchers, and SCI community and research organization staff/volunteers. The retreat included a presentation of the survey results, a clinician/researcher panel, and externally-facilitated working groups. All survey responses and retreat materials were synthesized. Using the synthesized feedback, the Ontario SCI Alliance was able to implement several changes for the Ontario SCI community, including higher-quality primary care experiences (reduced wait times, more accessible examining rooms), the development of a wound care strategy with the Ontario government, and an advocacy campaign for public coverage for catheters and urinary care supplies. From the five interviews conducted, five themes were co-constructed regarding the successes, challenges, and lessons learned from the exercise: (1) Inclusion, Diversity, Equity, and Accessibility; (2) Partnership; (3) Design Considerations; (4) Transparency and Clarity in Communication; and (5) Sustainability. Findings from this community case study demonstrate the feasibility of conducting a community-level consensus exercise among an equity-deserving group while providing detailed guidance for how to ensure future research and policy-based decision-making is shared across diverse knowledge users.
This study aimed to: (1) develop a coding manual to characterize topics discussed and conversation techniques used during peer mentorship conversations between people with spinal cord injury (SCI); ...(2) assess the reliability of the manual; and (3) apply the manual to characterize conversations.
The study was conducted in partnership with three Canadian provincial SCI organizations. Twenty-five phone conversations between SCI peer mentors and mentees were audio-recorded and transcribed verbatim. Ten transcripts were inductively analyzed to develop a coding manual identifying topics and techniques used during the conversations. Inductive technique codes were combined and deductively linked to motivational interviewing and behaviour change techniques. Two coders independently applied the coding manual to all transcripts. Code frequencies were calculated.
The coding manual included 14 topics and 31 techniques. The most frequently coded topics were personal information, recreational programs, and chronic health services for mentors and mentees. The most frequently coded techniques were giving personal information, social smoothers, and closed question for mentors; and giving personal information, social smoothers, and sharing perspective for mentees.
This research provides insights into topics and techniques used during real-world peer mentorship conversations. Findings may be valuable for understanding and improving SCI peer mentorship programs.
Implications for Rehabilitation
SCI peer mentorship conversations address a wide range of rehabilitation topics ranging from acute care to living in the community.
Identification of the topics discussed, and techniques used in SCI peer mentorship conversations can help to inform formalized efforts to train and educate acute and community-based rehabilitation professionals.
Identifying commonly discussed topics in SCI peer mentorship conversation may help to ensure that peer mentors are equipped with the necessary knowledge and resources, or the development of those resources be prioritized.
Developing a method to characterize the topics discussed and techniques used during SCI peer mentorship conversations may aid in designing methods to evaluate how rehabilitation professionals provide support to people with SCI.
Health, fitness and lifestyle professionals can play important roles in promoting physical activity in groups at risk of developing an inactive lifestyle, such as people with spinal cord injury ...(SCI). Tailored counselling is a promising tool to promote and improve physical activity levels. To support professionals to effectively have a conversation about physical activity with clients with SCI, evidence-based training and resources are needed. This project aimed to (1) co-develop an e-learning course on best practices for SCI physical activity counselling and, (2) examine the effectiveness and usability of this course.
Guided by the technology-enhanced learning (TEL) evaluation framework, we used a systematic, multistep approach to co-develop and evaluate an e-learning course. The development process was informed by input and feedback from a diverse group of end-users and experts (n > 160) via online surveys and (think-aloud) interviews. A randomized controlled trial was used to compare learning outcomes (post-knowledge and self-efficacy) between participants who completed the course (intervention group) and the wait-listed control group. Usability, learning experiences, and satisfaction were assessed among all participants.
Forty-one participants (21 intervention-group; 20 control-group) with various backgrounds (e.g., lifestyle counsellors, physiotherapists, occupational therapists, recreation therapists, fitness trainers) enrolled in the randomized controlled trial. After completing the course, participants in the intervention group showed significantly improved knowledge on the best practices for SCI physical activity counselling and higher self-efficacy for using these best practices in conversations with clients with SCI compared to the control group (p <.001). Participants reported above average usability scores, positive learning experiences, and high levels of satisfaction when completing the course.
We used a systematic, multi-step, theory-informed approach to co-develop and evaluate an evidence-based e-learning course on SCI physical activity counselling to support professionals to promote physical activity in their daily practices. The overall positive findings demonstrate that the e-learning course is feasible and ready for further implementation in various health and community settings. Implementation of the e-learning course can help professionals improve the physical activity support they provide to their clients, and subsequently increase physical activity participation in people with SCI.
Purpose/Objective: The purpose of the present study was to develop an understanding of successful aging (SA) meanings and influences that is informed by the lived experiences of people aging with ...long-term spinal cord injury (SCI). Method: This study was conducted in partnership with three Canadian provincial SCI organizations using an integrated knowledge translation (IKT) approach. To ensure findings were meaningful and practical to the three SCI organizations, the study was grounded in pragmatic philosophical assumptions. Semistructured interviews were conducted with 22 people aging with long-term SCI (minimum 45 years of age; minimum 10-years postinjury). All interviews were audio-recorded, transcribed verbatim, and subjected to a reflexive thematic analysis. Results: SA was understood as an interconnected and multifaceted concept that prioritizes health, participation, and independence. Participants discussed how SA was influenced negatively by personal (aging-related complications, intrapersonal emotional distress) and environmental (lack of available resources, differing community priorities) barriers. Participants reported that SA was positively influenced when individuals acted as self-advocates, were prepared and aware of aging-related changes, and maintained strong relationships with others. Conclusions/Implications: This study presents an initial, SCI-specific understanding of meanings and influences on SA. Although there were similarities between our findings and previous SA models, pertinent differences were also identified. Findings highlight that supporting quality participation experiences for people aging with long-term SCI may be an important direction SCI organizations can take to support their membership.
Impact and Implications
This study extends the aging with spinal cord injury (SCI) literature by presenting an initial, SCI-specific understanding of successful aging that is informed by lived experience. Findings from this study highlight relevant research gaps in the area of aging and SCI that future research studies should address. Findings from this study have the potential to inform the development of programs and resources that SCI community organizations offer to support their aging clients.
PDF
