Short Take: Lowering the Access Barriers to Ethnographic Methodology.
Ontology highlight
ABSTRACT:
SUBMITTER: Pham TV
PROVIDER: S-EPMC8301212 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:BackgroundIn 2016-18, a large measles outbreak occurred in Romania identified by pockets of sub-optimally vaccinated population groups in the country. The aim of the current study was to gain insight into barriers and drivers from the experience of measles vaccination from the perspectives of caregivers and their providers.MethodsData were collected by non-participant observation of vaccination consultations and individual interviews with health workers and caregivers in eight Romanian clinics with high or low measles vaccination uptake. Romanian stakeholders were involved in all steps of the study. The findings of this study were discussed during a workshop with key stakeholders.ResultsOver 400 h of observation and 161 interviews were conducted. A clear difference was found between clinics with high and low measles vaccination uptake which indicates that being aware of and following recommended practices for both vaccination service delivery and conveying vaccine recommendations to caregivers may have an impact on vaccine uptake. Barriers identified were related to shortcomings in following recommended practices for vaccination consultations by health workers (e.g. correctly assessing contraindications or providing enough information to allow an informed decision). These observations were largely confirmed in interviews with caregivers and revealed significant knowledge gaps.ConclusionsThe identification of key barriers provided an opportunity to design specific interventions to improve vaccination service delivery (e.g. mobile vaccination clinics, use of an electronic vaccination registry system for scheduling of appointments) and build capacity among health workers (e.g. guidance and supporting materials and training programmes).
| S-EPMC10066483 | biostudies-literature
Project description:According to World Health Organization (WHO) prevalence estimates, 1.1 million people in Mexico are infected with Trypanosoma cruzi, the etiologic agent of Chagas disease (CD). However, limited information is available about access to antitrypanosomal treatment. This study assesses the extent of access in Mexico, analyzes the barriers to access, and suggests strategies to overcome them.Semi-structured in-depth interviews were conducted with 18 key informants and policymakers at the national level in Mexico. Data on CD cases, relevant policy documents and interview data were analyzed using the Flagship Framework for Pharmaceutical Policy Reform policy interventions: regulation, financing, payment, organization, and persuasion. Data showed that 3,013 cases were registered nationally from 2007-2011, representing 0.41% of total expected cases based on Mexico's national prevalence estimate. In four of five years, new registered cases were below national targets by 11-36%. Of 1,329 cases registered nationally in 2010-2011, 834 received treatment, 120 were pending treatment as of January 2012, and the treatment status of 375 was unknown. The analysis revealed that the national program mainly coordinated donation of nifurtimox and that important obstacles to access include the exclusion of antitrypanosomal medicines from the national formulary (regulation), historical exclusion of CD from the social insurance package (organization), absence of national clinical guidelines (organization), and limited provider awareness (persuasion).Efforts to treat CD in Mexico indicate an increased commitment to addressing this disease. Access to treatment could be advanced by improving the importation process for antitrypanosomal medicines and adding them to the national formulary, increasing education for healthcare providers, and strengthening clinical guidelines. These recommendations have important implications for other countries in the region with similar problems in access to treatment for CD.
| S-EPMC3798390 | biostudies-other
Project description:Causal agent of witches' broom disease symptoms in bamboo plants
| PRJNA67441 | ENA
Project description:Background/objectivesTo identify major barriers to video-based telehealth use among homebound older adults.DesignCross-sectional survey.SettingA large home-based primary care (HBPC) program in New York City (NYC) serving 873 homebound patients living in the community.ParticipantsSixteen primary care physicians.MeasurementsAn 11-item assessment of provider perceptions of patients' experience with and barriers to telehealth.ResultsAccording to physicians in the HBPC program, more than one-third (35%) of homebound patients (mean age of 82.7; 46.6% with dementia; mean of 4 comorbidities/patient) engaged in first-time video-based telehealth encounters between April and June 2020 during the first COVID-19 surge in NYC. The majority (82%) required assistance from a family member and/or paid caregiver to complete the visit. Among patients who had not used telehealth, providers deemed 27% (n = 153) "unable to interact over video" for reasons including cognitive or sensory impairment and 14% lacked access to a caregiver to assist them with technology. Physicians were not knowledgeable of their patients' internet connectivity, ability to pay for cellular plans, or video-capable device access.ConclusionThe COVID-19 pandemic resulted in a large and dramatic shift to video-based telehealth use in home-based primary care. However, 4 months into the pandemic a majority of patients had not participated in a video-based telehealth encounter due to a number of barriers. Patients lacking caregiver support to assist with technology may benefit from novel approaches such as the deployment of community health workers to assist with device setup. Physicians may not be able to identify potentially modifiable barriers to telehealth use among their patients, highlighting the need for better systematic data collection before targeted interventions to increase video-based telehealth use.
| S-EPMC8250614 | biostudies-literature
Project description:OBJECTIVE:To explore whether Supplemental Nutrition Assistance Program-Education (SNAP-Ed) stakeholders (individuals involved in work to increase access to farmers' markets [FMs] for low-income populations) perceive the same barriers to shopping at FMs as those reported by SNAP participants in Washington State. DESIGN:Descriptive study; data included a stratified clustered random sample of SNAP participants and stakeholder interviews. SETTING:Washington State. PARTICIPANTS:A total of 400 SNAP participants and 51 SNAP-Ed stakeholders. MAIN OUTCOME MEASURES:The SNAP participants' reported barriers to accessing FMs and the SNAP-Ed stakeholders' perceptions of FM access barriers. ANALYSIS:Thematic content analysis, descriptive statistics, 2-sample tests of proportion, and Pearson chi-square tests (P < .025). RESULTS:A majority of SNAP participants reported they did not shop at an FM because it is inconvenient (n?=?193; 51%) and not financially viable (n?=?84; 22%). Moreover, 9% of SNAP participants (n?=?34) stated that they experienced no barriers. The SNAP-Ed stakeholders placed increased emphasis on transportation and cost barriers compared with the SNAP participants. CONCLUSIONS AND IMPLICATIONS:Comprehensive, multilevel strategies that reflect the perspectives of SNAP participants could increase SNAP use at FMs. Opening FMs in diverse locations at variable operating times may address convenience barriers while engaging the targeted populations' communities to promote FMs, and FM incentive programs may address financial and awareness barriers.
| S-EPMC7416758 | biostudies-literature
Project description:ObjectiveTo identify prevalences and predictors of nonfinancial barriers that lead to unmet need or delayed care among U.S. adults.Data source2007 Health Tracking Household Survey.Study designReasons for unmet need or delayed care in the previous 12 months were assigned to one of five dimensions in the Penchansky and Thomas model of access to care. Prevalences of barriers in each nonfinancial dimension were estimated for all adults and for adults with affordability barriers. Multivariable logistic regression models were used to estimate associations between individual, household, and insurance characteristics and barriers in each access dimension.Principal findingsEighteen percent of U.S. adults experienced affordability barriers and 21 percent experienced nonfinancial barriers that led to unmet need or delayed care. Two-thirds of adults with affordability barriers also reported nonfinancial barriers. Young adults, women, individuals with lower incomes, parents, and persons with at least one chronic illness had higher adjusted prevalences of nonfinancial barriers.ConclusionsNonfinancial barriers are common reasons for unmet need or delayed care among U.S. adults and frequently coincide with affordability barriers. Failure to address nonfinancial barriers may limit the impact of policies that seek to expand access by improving the affordability of health care.
| S-EPMC3393009 | biostudies-literature
Project description:IntroductionAccess to dermatology specialty care is limited in the underserved population. Barrier identification and exploring the potential role of teledermatology are the first steps to address this problem.ObjectivesIdentify the barriers to dermatologist care for the diagnosis and treatment of melanoma and non-melanoma skin cancers in the underserved population. Additionally explored was the potential role of teledermatology to provide dermatology care access in the underserved population.MethodsA quantitative descriptive study was conducted via an online survey instrument. The survey's barriers portion was adapted from the 1998 Ohio Family Health Survey (OFHS). The survey's teledermatology portion was adapted from the McFarland Teledermatology Provider and Imaging Technician Satisfaction Survey. The participants were practicing dermatologists and members of Georgia, Missouri, Oklahoma, and Wisconsin dermatology associations. Thirty-eight responded to demographic questions, of which twenty-two responded to the survey items.ResultsThe top three barriers ranked as the most concerning were "continually uninsured" (n = 8; 36.40%), "resides in a medically underserved county" (n = 5; 22.70%), and "family under federal poverty level" (n = 7; 33.30%). Teledermatology as a potential role for access to care was supported by convenient delivery of healthcare (n = 6; 72.70%), an addition to regular patient care (n = 20; 90.90%), and increase to patient care access (n = 18; 81.80%).ConclusionBarrier identification and teledermatology access to provide care to the underserved population is supported. Further teledermatology research is necessary to address the logistics regarding how to initiate and deliver teledermatology to the underserved.
| S-EPMC9946088 | biostudies-literature
Project description: Not available
| S-EPMC7202803 | biostudies-literature
Project description: Not available
| S-EPMC9665041 | biostudies-literature
Project description:The biomechanical performance of hip prostheses is often suboptimal, which leads to problems such as strain shielding, bone resorption and implant loosening, affecting the long-term viability of these implants for articular repair. Different studies have highlighted the interest of short stems for preserving bone stock and minimizing shielding, hence providing an alternative to conventional hip prostheses with long stems. Such short stems are especially valuable for younger patients, as they may require additional surgical interventions and replacements in the future, for which the preservation of bone stock is fundamental. Arguably, enhanced results may be achieved by combining the benefits of short stems with the possibilities of personalization, which are now empowered by a wise combination of medical images, computer-aided design and engineering resources and automated manufacturing tools. In this study, an innovative design methodology for custom-made short femoral stems is presented. The design process is enhanced through a novel app employing elliptical adjustment for the quasi-automated CAD modeling of personalized short femoral stems. The proposed methodology is validated by completely developing two personalized short femoral stems, which are evaluated by combining in silico studies (finite element method (FEM) simulations), for quantifying their biomechanical performance, and rapid prototyping, for evaluating implantability.
| S-EPMC8778668 | biostudies-literature