Event History Modeling, first published in 2004, provides an accessible guide to event history analysis for researchers and advanced students in the social sciences. The substantive focus of many ...social science research problems leads directly to the consideration of duration models, and many problems would be better analyzed by using these longitudinal methods to take into account not only whether the event happened, but when. The foundational principles of event history analysis are discussed and ample examples are estimated and interpreted using standard statistical packages, such as STATA and S-Plus. Critical innovations in diagnostics are discussed, including testing the proportional hazards assumption, identifying outliers, and assessing model fit. The treatment of complicated events includes coverage of unobserved heterogeneity, repeated events, and competing risks models. The authors point out common problems in the analysis of time-to-event data in the social sciences and make recommendations regarding the implementation of duration modeling methods.
Background
Health systems increasingly need to implement complex practice changes such as the routine capture of patient-reported outcome (PRO) measures. Yet, health systems have met challenges when ...trying to bring practice change to scale across systems at large. While implementation science can guide the evaluation of implementation determinants, teams first need tools to systematically understand and compare workflow activities across practice sites. Structured analysis and design technique (SADT), a system engineering method of workflow modeling, may offer an opportunity to enhance the scalability of implementation evaluation for complex practice change like PROs.
Method
We utilized SADT to identify the core workflow activities needed to implement PROs across diverse settings and goals for use, establishing a generalizable PRO workflow diagram. We then used the PRO workflow diagram to guide implementation monitoring and evaluation for a 1-year pilot implementation of the electronic Patient Health Questionnaire-9 (ePHQ). The pilot occurred across multiple clinical settings and for two clinical use cases: depression screening and depression management.
Results
SADT identified five activities central to the use of PROs in clinical care: deploying PRO measures, collecting PRO data, tracking PRO completion, reviewing PRO results, and documenting PRO data for future use. During the 1-year pilot, 8,596 patients received the ePHQ for depression screening via the patient portal, of which 1,719 (21%) submitted the ePHQ; 367 patients received the ePHQ for depression management, of which 174 (47%) submitted the ePHQ. We present three case examples of how the SADT PRO workflow diagram augmented implementation monitoring, tailoring, and evaluation activities.
Conclusions
Use of a generalizable PRO workflow diagram aided the ability to systematically assess barriers and facilitators to fidelity and identify needed adaptations. The use of SADT offers an opportunity to align systems science and implementation science approaches, augmenting the capacity for health systems to advance system-level implementation.
Plain Language Summary
Health systems increasingly need to implement complex practice changes such as the routine capture of patient-reported outcome (PRO) measures. Yet these system-level changes can be challenging to manage given the variability in practice sites and implementation context across the system at large. We utilized a systems engineering method—structured analysis and design technique—to develop a generalizable diagram of PRO workflow that captures five common workflow activities: deploying PRO measures, collecting PRO data, tracking PRO completion, reviewing PRO results, and documenting PRO data for future use. Next, we used the PRO workflow diagram to guide our implementation of PROs for depression care in multiple clinics. Our experience showed that use of a standard workflow diagram supported our implementation evaluation activities in a systematic way. The use of structured analysis and design technique may enhance future implementation efforts in complex health settings.
Background:
In light of short lengths of stay and proximity to communities of release, jails are well-positioned to intervene in opioid use disorder (OUD). However, a number of barriers have resulted ...in a slow and limited implementation.
Methods:
This paper describes the development and testing of a Medication for Opioid Use Disorder (MOUD) Implementation Checklist developed as part of a Building Bridges project, a two-year planning grant which supported 16 US jail systems as they prepared to implement or expand MOUD services.
Results:
Although initially developed to track changes within sites participating in the initiative, participants noted its utility for identifying evidence-based benchmarks through which the successful implementation of MOUDs could be tracked by correctional administrators.
Conclusions:
The findings suggest that this checklist can both help guide and illustrate progress toward vital changes facilitated through established processes and supports.
Plain Language Summary:
People incarcerated in jails are more likely to have opioid use disorder than the general population. Despite this, jails in the United States (U.S.) often offer limited or no access to Medication for Opioid Use Disorder (MOUD). The Building Bridges project was designed to address this gap in 16 U.S. jail systems as they prepared to implement or expand MOUD services. This article addresses the use of a MOUD checklist that was initially designed to help the jails track changes toward evidence-based benchmarks. The findings suggest that this checklist can both help guide and illustrate progress toward vital changes facilitated through established processes and supports.
Research design is fundamental to all scientific endeavors, at all levels and in all institutional settings. In many social science disciplines, however, scholars working in an ...interpretive-qualitative tradition get little guidance on this aspect of research from the positivist-centered training they receive. This book is an authoritative examination of the concepts and processes underlying the design of an interpretive research project. Such an approach to design starts with the recognition that researchers are inevitably embedded in the intersubjective social processes of the worlds they study.
In focusing on researchers' theoretical, ontological, epistemological, and methods choices in designing research projects, Schwartz-Shea and Yanow set the stage for other volumes in the Routledge Series on Interpretive Methods. They also engage some very practical issues, such as ethics reviews and the structure of research proposals. This concise guide explores where research questions come from, criteria for evaluating research designs, how interpretive researchers engage with "world-making," context, systematicity and flexibility, reflexivity and positionality, and such contemporary issues as data archiving and the researcher's body in the field.
BACKGROUND: Public health applications using geographic information system (GIS) technology are steadily increasing. Many of these rely on the ability to locate where people live with respect to ...areas of exposure from environmental contaminants. Automated geocoding is a method used to assign geographic coordinates to an individual based on their street address. This method often relies on street centerline files as a geographic reference. Such a process introduces positional error in the geocoded point. Our study evaluated the positional error caused during automated geocoding of residential addresses and how this error varies between population densities. We also evaluated an alternative method of geocoding using residential property parcel data. RESULTS: Positional error was determined for 3,000 residential addresses using the distance between each geocoded point and its true location as determined with aerial imagery. Error was found to increase as population density decreased. In rural areas of an upstate New York study area, 95 percent of the addresses geocoded to within 2,872 m of their true location. Suburban areas revealed less error where 95 percent of the addresses geocoded to within 421 m. Urban areas demonstrated the least error where 95 percent of the addresses geocoded to within 152 m of their true location. As an alternative to using street centerline files for geocoding, we used residential property parcel points to locate the addresses. In the rural areas, 95 percent of the parcel points were within 195 m of the true location. In suburban areas, this distance was 39 m while in urban areas 95 percent of the parcel points were within 21 m of the true location. CONCLUSION: Researchers need to determine if the level of error caused by a chosen method of geocoding may affect the results of their project. As an alternative method, property data can be used for geocoding addresses if the error caused by traditional methods is found to be unacceptable.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Qualitative Research in Tourism Goodson, Lisa; Phillimore, Jenny
2004, 20040731, 2002, 2004-03-05, 2004-07-31, 20030101
eBook
The first to focus solely upon qualitative research in tourism, this book combines discussions of the philosophies underpinning qualitative research, with reflexive chapters that demonstrate how ...these techniques can be used.
Incorporating a range of case studies written by leading international scholars, this book makes clear the ways in which these pieces of research have been informed by the authors' epistemological, ontological and methodological standpoint. Based on a range of empirical tourism studies set in the context of theoretical discussion, it demonstrates the benefits of using a range of qualitative approaches to research tourism, exploring the ways in which a number of techniques, including participants observation, memory work, biographical diaries, focus groups and visual exercises, have been adopted by researchers from a range of disciplinary backgrounds to undertake empirical research in tourism.
An indispensable text for final year undergraduates, Masters and PhD students embarking on research in the field, it also will be a valuable title for academics with an interest in either tourism research or qualitative methodology. Linking theory with research practice, it offers a holistic account of qualitative research in tourism.
Part 1 1. Progress in Qualitative Research in Tourism: Epistemology, Ontology and Methodology 2. The Inquiry Paradigm in Qualitative Tourism Research 3. Knowing About Tourism: Epistemological Issues 4. A Primer in Ontological Craft: The Creative Capture of People and Places Through Qualitative Research 5. Ontological Craft in Tourism Studies: The Productive Mapping of Identity and Image in Tourism Settings 6. (Dis)Embodied Experience and Power Dynamics in Tourism Research 7. Standpoint Research: Multiple Versions of Reality in Tourism Theorising and Research 8. Reflexivity and Tourism Research: Situating Myself and/with Others 9. Trustworthiness in Qualitative Tourism Research 10. New Wine in Old Bottles: An Adjustment of Priorities in the Anthropological Study of Tourism 11. From Ontology, Epistemology and Methodology to the field Part 2 12. The Research Process as a Journey: From positivist traditions into the realms of qualitative inquiry 13. Let your Data do the Talking: Researching the Solo Travel Experiences of British and American Women 14. The Life and Work History Methodology: A Discussion of its Potential use for Tourism and Hospitality Research 15. Memory 16. Contributions of Qualitative Research to Understanding the Politics of Community Ecotourism 17. Shared Benefits: Longitudinal Research in Eastern Indonesia 18. Translators, Trust and Truth: Cross-Cultural Issues in Sustainable Tourism Research
Background
Despite efforts to use standardized taxonomy and research reporting, documenting implementation strategies utilized in community settings remains challenging. This case study demonstrates ...a practical approach to gather use of and satisfaction with implementation strategies utilized within community-based sites to understand community providers’ perspectives of implementing an early intensive behavioral intervention (EIBI) for children on the autism spectrum across different settings.
Methods
Using a sequential explanatory mixed-methods design, survey and interview data were collected from directors/supervisors and direct providers (n = 26) across three sites (one university and two community-based replication sites). The Implementation Strategies and Satisfaction Survey (ISSS) was administered to identify staff-reported implementation strategy use and satisfaction. Informed by quantitative results, follow-up semi-structured interviews were conducted with a subsample (n = 13) to further understand staff experiences with endorsed implementation strategies and elicit recommendations for future efforts.
Results
Survey results were used to demonstrate frequencies of implementation strategies endorsed by site and role. Overall, staff felt satisfied with implementation strategies used within their agencies. Content analysis of qualitative data revealed three salient themes related to implementation strategy use—context, communication, and successes and challenges—providing in-depth detail on how strategies were utilized, and strategy effectiveness based on community providers’ experiences. Recommendations were also elicited to improve strategy use within “broader” community settings.
Conclusions
The project demonstrated a practical approach to identifying and evaluating implementation strategies used within sites delivering autism services. Reporting implementation strategies using the ISSS can provide insight into community providers’ perspectives and satisfaction with agency implementation strategy use that can generate more relevant and responsive strategies to address barriers in community settings.
Plain language abstract
Examining community providers’ preferences and experiences with implementation strategies used to facilitate evidence-based practice uptake can broaden our understanding of what, how, and why implementation strategies work in community-based settings (
Chaudoir et al., 2013;
Leeman et al., 2017;
Proctor et al., 2013). Such efforts have great potential to tailor implementation strategies to address barriers/facilitators typically found in community-based settings.
This case study demonstrates a practical approach using mixed methodology to: (a) gather self-reported use of and satisfaction with implementation strategies to understand community providers’ perspectives of implementation strategy success. Using a new survey, the Implementation Strategies and Satisfaction Survey (ISSS) conjoined with interviews, the study demonstrated a practical approach using standardized language to report strategies used in one university-based site and two community-based replication sites that deliver an early intensive behavioral intervention (EIBI) for children on the autism spectrum. This paper contributes to one of the five priorities to enhance public health impact—improve tracking and reporting of implementation strategies utilized when translating research into practice (
Dingfelder & Mandell, 2011;
Powell et al., 2019;
Stahmer et al., 2019). This approach emphasizes the importance of understanding context (e.g., community organizations providing services to children on the autism spectrum) to develop strategies that work better for EIBI implementation and scale-up. Understanding community provider's preferences and experiences with implementation strategies can support use of implementation strategies that better fit usual care contexts, with the ultimate goal of improving implementation practice in community-based settings.
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