Evaluating the Efficacy and Social Validity of a Culturally Adapted Training Program for Parents and Service Providers in India.
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ABSTRACT:
SUBMITTER: Sivaraman M
PROVIDER: S-EPMC7666248 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Objective:To improve the awareness and knowledge regarding Maternal Near Miss (MNM) among health service providers in the selected districts and women's hospitals in Maharashtra, India. Methods:A one-day training programme on MNM was conducted at four Family Welfare Training Centres in the state of Maharashtra, India, for the health service providers, viz. gynaecologists, pathologists, anaesthesiologists, medical officers, staff nurses, other paramedical workers of the selected 29 districts/women's hospitals in Maharashtra. A total of 147 participants participated in the training programme. The participants filled a questionnaire before (pretest) and after the training (post-test) with the same set of questions pertaining to knowledge on the basic and operational aspects of MNM. Results:There was a significant improvement in the level of knowledge (post-test responses vs pretest responses) about the correct definition and classification of MNM, as per the instructions in the MNM-R guidelines by the Government of India. The service providers informed regarding the challenges in the implementation of the MNM-R guidelines at their hospitals such as shortage of manpower in terms of specialists and need of quality assurance. Conclusion:The training programme improved the knowledge of the service providers about MNM, which would help them to implement the MNM-R guidelines effectively at their hospitals. This training effectively upgraded the knowledge level, and therefore, such trainings should be organized for all obstetricians, high-dependency unit (HDU) personnel and critical care teams.
| S-EPMC6888782 | biostudies-literature
Project description:Legacy for Children™ (Legacy) is an evidence-based program focused on promoting sensitive, responsive parenting for socioeconomically disadvantaged families. Legacy has recently been culturally and linguistically adapted for Spanish-monolingual Latino families and is being piloted in partnership with an early childhood education program. We conducted a mixed methods study to identify barriers and facilitators to engagement, using program monitoring data sources from both participant and group leader perspectives. We conducted qualitative analyses of open-ended data to identify distinct barriers (e.g., employment challenges, health-related challenges and appointments) and facilitators (e.g., other mothers in group, interest in program topics) to engagement that emerged across English and Spanish language curriculum versions; curriculum-specific barriers and facilitators were also documented. We interpret these findings in light of quantitative data on measures of engagement, showing that participants in the Spanish curriculum evidenced comparable levels of parent-group leader relationship quality relative to the English group, and higher levels of parent's group support/connectedness and overall satisfaction. These results offer promising considerations for optimizing families' engagement in parenting programs in the context of early care and education settings.
| S-EPMC7322668 | biostudies-literature
Project description:A pediatric assessment service for children with Intellectual Disability (ID) was established in a culturally diverse region of Sydney, Australia, to meet the health needs of children and young people with ID. This paper reports on parents' and providers' experiences using qualitative and quantitative analysis of surveys. The survey responses from the parents' enumerated their key concerns and the practical help they received from the service. Responses from service providers reported a high level of satisfaction with the services and valued the quality of assessment reports. The service facilitated inter-agency collaboration and enhanced the access to quality health care.
| S-EPMC8114321 | biostudies-literature
Project description:Background: This paper explores how implementation and refinement of an early intervention (EI) program for children with delayed development was informed by an iterative, intentional and structured process of measurement. Providing access to early intervention therapy for children in rural areas of India is challenging due to a lack of rehabilitation therapists and programs. Following a biopsychosocial framework and principles of community-based rehabilitation, a non-governmental organization, Amar Seva Sangam (ASSA), overcame those barriers by designing a digital technology supported EI program in rural Tamil Nadu, India. Program objectives included providing service access; supporting program engagement, child development and school enrollment; and positioning the intervention for scale-up. This paper contributes to a growing body of literature on how program design and implementation can be informed through a cyclical process of data collection, analysis, reflection, and adaptation. Methods: Through several strands of data collection, the design and implementation of the EI program was adapted and improved. This included qualitative data from focus groups and interviews with caregivers and service providers, and a mobile application that collected and monitored longitudinal quantitative data, including program engagement rates, developmental progression, caregiver outcomes, and school enrollment status. Results: Measurements throughout the program informed decision-making by identifying facilitators and barriers to service providers' quality of work-life, family program engagement, and school enrollment. Consultation with key stakeholders, including caregivers and service providers, and data driven decision making led to continual program changes that improved service provider quality of work-life, program engagement and school enrollment. These changes included addressing gender-related work challenges for service providers; forming caregiver support networks; introducing psychological counseling for caregivers; providing medical consultations and assistive devices; creating community awareness programs; improving access to therapy services; focusing on caregiver education, motivation and support; and advocacy for accessibility in schools. Conclusion: The process of using evidence-informed and stakeholder driven adaptations to the early intervention program, led to improved service provider quality of work-life, greater program engagement, improved school enrollment and positioned the intervention for scale-up, providing lessons that may be beneficial in other contexts.
| S-EPMC7734086 | biostudies-literature
Project description:IntroductionHealthy Beginnings is an established nurse-led early childhood obesity prevention program that promotes healthy infant feeding practices and active play in the early years of life. To improve engagement with culturally and linguistically diverse populations, the Healthy Beginnings program delivered by telephone was culturally adapted and implemented with Arabic- and Chinese-speaking mothers in Sydney, Australia. The cultural adaptation process has been published separately. In this article, we aimed to evaluate the feasibility of the culturally adapted program.MethodsIn 2018-2019, the culturally adapted Healthy Beginnings program was implemented with Arabic- and Chinese-speaking women recruited from antenatal clinics in Sydney. At four staged timepoints (from third trimester until 6 months of age), mothers were sent culturally adapted health promotion booklets and text messages and offered four support calls from bi-cultural child and family health nurses in Arabic and Chinese. A mixed methods evaluation included a) baseline and 6-month telephone surveys, followed by b) semi-structured follow-up interviews with a subset of participating mothers and program delivery staff. Main outcomes of this feasibility study were reach (recruitment and retention), intervention dose delivered (number of nurse support calls completed) and acceptability (appropriateness based on cognitive and emotional responses).ResultsAt recruitment, 176 mothers were eligible and consented to participate. Of 163 mothers who completed the baseline survey, 95% completed the program (n = 8 withdrew) and 83% completed the 6-month survey (n = 70 Arabic- and n = 65 Chinese-speaking mothers). Most mothers (n = 127, 78%) completed at least one nurse support call. The qualitative analysis of follow-up interviews with 42 mothers (22 Arabic- and 20 Chinese-speaking mothers) and 10 program delivery staff highlighted the perceived value of the program and the positive role of bi-cultural nurses and in-language resources. Mothers who completed more nurse support calls generally expressed greater acceptability.ConclusionsThe culturally adapted Healthy Beginnings program was feasible to deliver and acceptable to Arabic- and Chinese-speaking mothers. Our results highlight the importance of in-language resources and individualised bi-cultural nurse support by telephone for supporting culturally and linguistically diverse migrant families with infant feeding and active play. These findings support the potential for program refinements and progression to an effectiveness trial.
| S-EPMC8207722 | biostudies-literature
Project description:BackgroundArthritis remains an important public health problem.Questions/purposesThis study aims to determine the effects of an adapted (vs. the original) Arthritis Self-Help Program (ASHP) among older adults. Specifically, this study sought to determine (1) whether the adapted ASHP improved attendance, retention, and adherence with the use of self-management exercises, and (2) if the original ASHP's beneficial outcomes were maintained following program adaptation.Patient and methodsIndividuals age ≥60 with self-reported arthritis were recruited from eight New York City senior centers. Participants were assessed at baseline to assess their demographic and clinical status and at 6 and 24 weeks to ascertain study outcomes using validated measures.ResultsTwo-hundred-one participants (64 non-Hispanic African Americans, 86 Hispanics, and 51 non-Hispanic Whites) enrolled. Participants in the adapted (vs. original) ASHP had better average attendance in the six session program (4.7 vs. 3.2 classes attended, p < 0.01) and program retention (93% vs. 74%, p < 0.01). Adherence with use of the self-management exercises (number of days using endurance, stretching, and relaxation exercises) was similar in both groups. Significant positive physical/psychosocial outcomes were documented in both the adapted and original program.ConclusionThe adapted ASHP improved program attendance and retention while maintaining improvements in physical and psychosocial functions. These results support future efforts to employ controlled designs to quantify the benefits of adapted evidence-based programs to ensure that adaptation maintains program effectiveness.
| S-EPMC3903959 | biostudies-literature
Project description:The purpose of the study is to evaluate pilot sexuality education intervention for parents of children with disabilities between ages of 6 and 25 years old. A within subjects design was utilized and 15 parents of children with disabilities were recruited to receive a two-week sexuality education without a control group. A paired-samples t-test results showed that there was a significant difference between the participants' pre-test and post intervention scores in their: attitude and beliefs, sexual communication, knowledge, and self-efficacy of sexuality education among children with disabilities (all p<.001). The intervention change the participants sexual communication behavior and increased knowledge about sexuality education with children with disabilities.
| S-EPMC5500202 | biostudies-other
Project description:In this study, researchers implemented a brief training plus coaching program in naturalistic developmental behavioral intervention with three participant triads. Each triad consisted of an early intervention provider, an English-speaking Latinx parent, and that parent's young child with autism spectrum disorder (ASD) or early signs of ASD who had limited vocal speech. The effects a single training session, plus two researcher coaching sessions were evaluated using a nonconcurrent multiple probes across participants design. Primary dependent variables included (a) the number of completed targeted communication turns between the parent and child and (b) the number of child independent target communication responses (gestures and manual signs) during family-selected routines. Additional measures examined whether parents used strategies taught to them during training, and whether early intervention providers addressed strategies taught via coaching. A social validity measure was used to determine parent and provider views of the training. Due to COVID-19 restrictions, training and post-training sessions were delivered via telehealth for two triads. While data trends and variability differed across triads, following training, all three families increased the number of completed target communication turns and all three children showed higher rates of independent communication responses. Parents and providers implemented strategies taught and reported positive effects of the program. Implications regarding the use of naturalistic intervention methods for Latinx families, the utility of brief training models to meet the needs of under-resourced early intervention programs, and potential uses of telehealth are discussed.Supplementary informationThe online version contains supplementary material available at 10.1007/s10882-021-09794-w.
| S-EPMC8079838 | biostudies-literature
Project description:To improve hypertension care for ethnic minority patients of African descent in the Netherlands, we developed a provider intervention to facilitate the delivery of culturally appropriate hypertension education. This pilot study evaluates how the intervention affected the attitudes and perceived competence of hypertension care providers with regard to culturally appropriate care.Pre- and post-intervention questionnaires were used to measure the attitudes, experienced barriers, and self-reported behaviour of healthcare providers with regard to culturally appropriate cardiovascular and general care at three intervention sites (N = 47) and three control sites (N = 35).Forty-nine participants (60%) completed questionnaires at baseline (T0) and nine months later (T1). At T1, healthcare providers who received the intervention found it more important to consider the patient's culture when delivering care than healthcare providers who did not receive the intervention (p = 0.030). The intervention did not influence experienced barriers and self-reported behaviour with regard to culturally appropriate care delivery.There is preliminary evidence that the intervention can increase the acceptance of a culturally appropriate approach to hypertension care among hypertension educators in routine primary care.
| S-EPMC2891606 | biostudies-other
Project description:PurposeTo conduct a cross-cultural adaptation of the Core Outcome Measures Index (COMI) into French according to established guidelines.MethodsSeventy outpatients with chronic low back pain were recruited from six spine centres in Switzerland and France. They completed the newly translated COMI, and the Roland Morris disability (RMQ), Dallas Pain (DPQ), adjectival pain rating scale, WHO Quality of Life, and EuroQoL-5D questionnaires. After ~14 days RMQ and COMI were completed again to assess reproducibility; a transition question (7-point Likert scale; "very much worse" through "no change" to "very much better") indicated any change in status since the first questionnaire.ResultsCOMI whole scores displayed no floor effects and just 1.5% ceiling effects. The scores for the individual COMI items correlated with their corresponding full-length reference questionnaire with varying strengths of correlation (0.33-0.84, P < 0.05). COMI whole scores showed a very good correlation with the "multidimensional" DPQ global score (Rho = 0.71). 55 patients (79%) returned a second questionnaire with no/minimal change in their back status. The reproducibility of individual COMI 5-point items was good, with test-retest differences within one grade ranging from 89% for 'social/work disability' to 98% for 'symptom-specific well-being'. The intraclass correlation coefficient for the COMI whole score was 0.85 (95% CI 0.76-0.91).ConclusionsIn conclusion, the French version of this short, multidimensional questionnaire showed good psychometric properties, comparable to those reported for German and Spanish versions. The French COMI represents a valuable tool for future multicentre clinical studies and surgical registries (e.g. SSE Spine Tango) in French-speaking countries.
| S-EPMC3252438 | biostudies-literature