Rapid approaches to collecting and analyzing qualitative interview data can accelerate discovery timelines and intervention development while maintaining scientific rigor. We describe the application ...of these methods to a program designed to improve care coordination between the Veterans Health Administration (VHA) and community providers.
Care coordination between VHA and community providers can be challenging in rural areas. The Telehealth-based Coordination of Non-VHA Care (TECNO Care) intervention was designed to improve care coordination among VHA and community providers. To ensure contextually appropriate implementation of TECNO Care, we conducted preimplementation interviews with veterans, VHA administrators, and VHA and community providers involved in community care. Using both a rapid approach and qualitative analysis, an interviewer and 1-2 note-taker(s) conducted interviews.
Over 5 months, 18 stakeholders were interviewed and we analyzed these data to identify how best to deliver TECNO Care. Responses relevant to improving care coordination include health system characteristics; target population; metrics and outcomes; challenges with the current system; and core components. Veterans who frequently visit VHA or community providers and are referred for additional services are at risk for poor outcomes and may benefit from additional care coordination. Using these data, we designed TECNO Care to include information on VHA services and processes, assist in the timely completion of referrals, and facilitate record sharing.
Rapid qualitative analysis can inform near real-time intervention development and ensure relevant content creation while setting the stage for stakeholder buy-in. Rigorous and timely analyses support the delivery of contextually appropriate, efficient, high-value patient care.
Health economic evaluations are comparative analyses of alternative courses of action in terms of their costs and consequences. The Consolidated Health Economic Evaluation Reporting Standards ...(CHEERS) statement, published in 2013, was created to ensure health economic evaluations are identifiable, interpretable, and useful for decision making. It was intended as guidance to help authors report accurately which health interventions were being compared and in what context, how the evaluation was undertaken, what the findings were, and other details that may aid readers and reviewers in interpretation and use of the study. The new CHEERS 2022 statement replaces the previous CHEERS reporting guidance. It reflects the need for guidance that can be more easily applied to all types of health economic evaluation, new methods and developments in the field, and the increased role of stakeholder involvement including patients and the public. It is also broadly applicable to any form of intervention intended to improve the health of individuals or the population, whether simple or complex, and without regard to context (such as healthcare, public health, education, and social care). This Explanation and Elaboration Report presents the new CHEERS 2022 28-item checklist with recommendations and explanation and examples for each item. The CHEERS 2022 statement is primarily intended for researchers reporting economic evaluations for peer-reviewed journals and the peer reviewers and editors assessing them for publication. Nevertheless, we anticipate familiarity with reporting requirements will be useful for analysts when planning studies. It may also be useful for health technology assessment bodies seeking guidance on reporting, given that there is an increasing emphasis on transparency in decision making.
ObjectiveTo provide researchers with guidance on actions to take during intervention development.Summary of key pointsBased on a consensus exercise informed by reviews and qualitative interviews, we ...present key principles and actions for consideration when developing interventions to improve health. These include seeing intervention development as a dynamic iterative process, involving stakeholders, reviewing published research evidence, drawing on existing theories, articulating programme theory, undertaking primary data collection, understanding context, paying attention to future implementation in the real world and designing and refining an intervention using iterative cycles of development with stakeholder input throughout.ConclusionResearchers should consider each action by addressing its relevance to a specific intervention in a specific context, both at the start and throughout the development process.
Despite treatment according to the current management recommendations, a significant proportion of patients with rheumatoid arthritis (RA) remain symptomatic. These patients can be considered to have ...'difficult-to-treat RA'. However, uniform terminology and an appropriate definition are lacking.
The Task Force in charge of the
Development of EULAR recommendations for the comprehensive management of difficult-to-treat rheumatoid arthritis" aims to create recommendations for this underserved patient group. Herein, we present the definition of difficult-to-treat RA, as the first step.
The Steering Committee drafted a definition with suggested terminology based on an international survey among rheumatologists. This was discussed and amended by the Task Force, including rheumatologists, nurses, health professionals and patients, at a face-to-face meeting until sufficient agreement was reached (assessed through voting).
The following three criteria were agreed by all Task Force members as mandatory elements of the definition of difficult-to-treat RA: (1) Treatment according to European League Against Rheumatism (EULAR) recommendation and failure of ≥2 biological disease-modifying antirheumatic drugs (DMARDs)/targeted synthetic DMARDs (with different mechanisms of action) after failing conventional synthetic DMARD therapy (unless contraindicated); (2) presence of at least one of the following: at least moderate disease activity; signs and/or symptoms suggestive of active disease; inability to taper glucocorticoid treatment; rapid radiographic progression; RA symptoms that are causing a reduction in quality of life; and (3) the management of signs and/or symptoms is perceived as problematic by the rheumatologist and/or the patient.
The proposed EULAR definition for difficult-to-treat RA can be used in clinical practice, clinical trials and can form a basis for future research.
Managing ecosystems is challenging because of the high number of stakeholders, the permeability of man-made political and jurisdictional demarcations in relation to the temporal and spatial extent of ...biophysical processes, and a limited understanding of complex ecosystem and societal dynamics. Given these conditions, collaborative governance is commonly put forward as the preferred means of addressing environmental problems. Under this paradigm, a deeper understanding of if, when, and how collaboration is effective, and when other means of addressing environmental problems are better suited, is needed. Interdisciplinary research on collaborative networks demonstrates that which actors get involved, with whom they collaborate, and in what ways they are tied to the structures of the ecosystems have profound implications on actors' abilities to address different types of environmental problems.
The private sector provides lessons and models
Science is a social enterprise. Many scientific programs interact with a wide range of communities and stakeholders to secure various types of access ...and permission, to seek cooperation and collaboration for scientific studies, to fulfill regulatory and ethical requirements, and to try to shape research strategies and to improve the translation of their findings into policy or practice. But these interactions are motivated disproportionately by the interests and goals of the scientific programs and less by the need to elicit and understand their implications for stakeholders. However, there is increasing recognition that substantive community and stakeholder engagement (CSE) can improve the performance, and even make or break the success, of some science programs by providing a means of navigating, and responding to, the complex social, economic, cultural, and political settings in which science programs are conducted. For CSE to become more widely accepted by funders and researchers, and to contribute more conspicuously to the success of science programs and policy, it will have to establish a more coherent and convincing body of evidence about the nature of CSE strategies and their specific contributions to the performance of science programs.
Personalised oncology, whereby patients are given therapies based on their molecular tumour profile, is rapidly becoming an essential part of optimal clinical care, at least partly facilitated by ...recent advances in next-generation sequencing-based technology using liquid- and tissue-based biopsies. Consequently, clinical trials have shifted in approach, from traditional studies evaluating cytotoxic chemotherapy in largely histology-based populations to modified, biomarker-driven studies (e.g. basket, umbrella, platform) of molecularly guided therapies and cancer immunotherapies in selected patient subsets. Such modified study designs may assess, within the same trial structure, multiple cancer types and treatments, and should incorporate a multistakeholder perspective. This is key to generating complementary, fit-for-purpose and timely evidence for molecularly guided therapies that can be used as proof-of-concept to inform further study designs, lead to approval by regulatory authorities and be used as confirmation of clinical benefit for health technology assessment bodies. In general, the future of cancer clinical trials requires a framework for the application of innovative technologies and dynamic design methodologies, in order to efficiently transform scientific discoveries into clinical utility. Next-generation, modified studies that involve the joint efforts of all key stakeholders will offer individualised strategies that ultimately contribute to globalised knowledge and collective learning. In this review, we outline the background and purpose of such modified study designs and detail key aspects from a multistakeholder perspective. We also provide methodological considerations for designing the studies and highlight how insights from already-ongoing studies may address current challenges and opportunities in the era of personalised oncology.
•Personalised oncology is rapidly becoming a key part of optimal clinical care.•Traditional clinical trials of tailored therapies are not always feasible.•Modified, multistakeholder study designs can support decision-making.•Ongoing studies may provide insights into methodological considerations.
Designing for dissemination and sustainability (D4DS) refers to principles and methods for enhancing the fit between a health program, policy, or practice and the context in which it is intended to ...be adopted. In this article we first summarize the historical context of D4DS and justify the need to shift traditional health research and dissemination practices. We present a diverse literature according to a D4DS organizing schema and describe a variety of dissemination products, design processes and outcomes, and approaches to messaging, packaging, and distribution. D4DS design processes include stakeholder engagement, participatory codesign, and context and situation analysis, and leverage methods and frameworks from dissemination and implementation science, marketing and business, communications and visualarts, and systems science. Finally, we present eight recommendations to adopt a D4DS paradigm, reflecting shifts in ways of thinking, skills and approaches, and infrastructure and systems for training and evaluation.
Husodo T, Megantara EN, Mutaqin AZ, Kendarto DR, Wulandari I, Shanida SS. 2024. The protection effort of leopard cats (Prionailurus bengalensis Kerr, 1792) in the Upper Cisokan Pumped Storage, West ...Java, Indonesia. Biodiversitas 25: 169-176. Humans develop various infrastructures to meet electricity needs so that it is to improve human welfare besides the increasing population. Hydropower development cannot be separated from land clearing, which damages and eliminates the habitats of wild animals, including leopard cats (Prionailurus bengalensis Kerr, 1792). Humans also cleared land as agricultural land to fulfill their needs. Fulfilling the needs of electricity and agriculture is necessary to improve human welfare. Besides, leopard cats need a suitable habitat to meet their needs. Therefore, protection effort is required to fulfill leopard cats' and humans' needs. The study aims to reveal the protection efforts in the Upper Cisokan Pumped Storage, West Java, Indonesia. A qualitative approach was applied through literature reviews. The protection effort of leopard cats was conducted through stakeholder participation in the UCPS area. As the initiator, Indonesia Hydropower Company (PT. PLN) involves various stakeholders related to the construction of the UCPS hydropower plant, including Perum Perhutani, contractors, and the local people. Indonesia Hydropower Company (PT. PLN) protects leopard cats by managing the impacts produced by the UCPS hydropower plant and biodiversity.
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