The effect of reminders in a web-based intervention study

Knowledge on effective strategies to encourage participation in epidemiological web-based research is scant. We studied the effects of reminders on overall participation. 3,876 employees were e-mailed a baseline web-based lifestyle questionnaire. Nine months later, a follow-up questionnaire was sent. To encourage study participation, 4-5 and 11 e-mail reminders were sent at baseline and follow-up, respectively. Additional reminders (media articles, flyers, SMS etc) were also administered. Reminders (e-mails + additional) were given in low (≤ 6 reminders), medium (7-9 reminders) or high amounts (>9 reminders). Participation was examined with respect to participant characteristics (i.e. age, sex, Body Mass Index, occupation), type/number of reminders, and time of participation. Most participants were males, 35-49 years, and field workers (non-office based). About 29 % responded before any e-mail reminder, following 26 and 45 % after 1 respective ≥ 2 e-mail reminders. Participant characteristics were not related to when the participants responded. The 4-5 e-mail reminders increased total response rate by 15 %, the eleven by 21 % (greatest increases in September). Those receiving medium amounts of reminders (reference) had the highest response rate (75 %), likewise office workers (54 %) compared to field workers (33 %). High amounts of reminders were particularly effective on office workers. The participants' characteristics were not related to when they responded in this web-based study. Frequent reminders were effective on response rates, especially for those with high Internet availability. The highest increases in response rates were found in September.     

The global pharmacy workforce: a systematic review of the literature

The importance of health workforce provision has gained significance and is now considered one of the most pressing issues worldwide, across all health professions. Against this background, the objectives of the work presented here were to systematically explore and identify contemporary issues surrounding expansion of the global pharmacy workforce in order to assist the International Pharmaceutical Federation working group on the workforce.     

The Generation-Y workforce in health care: the new challenge for leadership

The new generation of workforce entering health care today is the new challenge for leadership. This young workforce, known as the "Generation-Y," is demanding a different organizational culture to meet its needs. These new spoilers, once the babies of the baby boomers, will once again test the creativity and patience of their parents, who are now the leaders in health care. The baby boomer leaders of today face a delicate balance to meet the new demands of the Generation-Y workforce, along with the patients' demands. At stake in this balance is the viability of health care as we know it today. If the leadership of health care fails to grab hold of this new generation of employees, the ability to provide safe and quality health care and the survivability of the organization will be compromised. This article identifies the problem and provides guidelines to journey through this new wave of spoilers.     

高危型人乳头瘤病毒阴性宫颈癌的研究进展

  目的   了解和掌握“一带一路”沿线国家宫颈癌流行病学负担现状。  方法  对照2018年世界卫生组织（WHO）癌症登记数据库,从“一带一路”政务网中选取127个宫颈癌流行病学数据较为完整的“一带一路”沿线国家作为研究对象。按照WHO划分的世界区域标准,对127个“一带一路”沿线国家进行归类。运用统计学参数检验法,比较分析不同WHO区域2018年“一带一路”沿线国家宫颈癌流行病学负担差异,应用聚类分析法分析不同WHO区域国家的宫颈癌流行程度。  结果  不同WHO区域“一带一路”沿线国家宫颈癌的流行病学负担差异性显著。WHO非洲区域国家的宫颈癌平均标化发病率和标化死亡率最高,分别是32.4/10万和21.9/10万;相反,东地中海地区国家的平均标化发病率为4.4/10万,标化死亡率为2.9/10万,位居六大WHO区域最低。WHO美洲区域的伤残调整寿命年（DALYs）最高（458.2/10万）,东地中海地区最低（69/10万）。聚类分析结果表明,WHO非洲区域国家的宫颈癌多为中、高度流行;低度流行国家主要分布在WHO欧洲、西太平洋和东地中海地区。  讨论  地理区域是影响“一带一路”沿线国家宫颈癌流病负担的主要因素,但并不是唯一因素,未来将综合考虑国家社会经济发展水平、自然和社会环境等因素,并纳入研究范畴。     

Improving patient safety during insertion of peripheral venous catheters: an observational intervention study

Background: Peripheral venous catheters are frequently used in hospitalized patients but increase the risk of nosocomial bloodstream infection. Evidence-based guidelines describe specific steps that are known to reduce infection risk. However, the degree of guideline implementation in clinical practice is not known. The aim of this study was to determine the use of specific steps for insertion of peripheral venous catheters in clinical practice and to implement a multimodal intervention aimed at improving both compliance and the optimum order of the steps.Methods: The study was conducted at University Hospital Hamburg. An optimum procedure for inserting a peripheral venous catheter was defined based on three evidence-based guidelines (WHO, CDC, RKI) including five steps with 1A or 1B level of evidence: hand disinfection before patient contact, skin antisepsis of the puncture site, no palpation of treated puncture site, hand disinfection before aseptic procedure, and sterile dressing on the puncture site. A research nurse observed and recorded procedures for peripheral venous catheter insertion for healthcare workers in four different departments (endoscopy, central emergency admissions, pediatrics, and dermatology). A multimodal intervention with 5 elements was established (teaching session, dummy training, e-learning tool, tablet and poster, and direct feedback), followed by a second observation period. During the last observation week, participants evaluated the intervention.Results: In the control period, 207 insertions were observed, and 202 in the intervention period. Compliance improved significantly for four of five steps (e.g., from 11.6% to 57.9% for hand disinfection before patient contact; p<0.001, chi-square test). Compliance with skin antisepsis of the puncture site was high before and after intervention (99.5% before and 99.0% after). Performance of specific steps in the correct order also improved (e.g., from 7.7% to 68.6% when three of five steps were done; p<0.001). The intervention was described as helpful by 46.8% of the participants, as neutral by 46.8%, and as disruptive by 6.4%.Conclusions: A multimodal strategy to improve both compliance with safety steps for peripheral venous catheter insertion and performance of an optimum procedure was effective and was regarded helpful by healthcare workers.     

Developing a web-based health promotion intervention: a case study from a brief motivational alcohol program

Public health researchers and practitioners reporting findings from intervention studies seldom report in depth the processes of intervention development. However, such information would be useful for several reasons: (a) it would help guide the development of new interventions and refinement or revision of existing ones, (b) it would provide a framework and methodology on which other health practitioners and researchers could build, and (c) it would increase transparency of the development process and enhance the interpretation of the intervention's effects. The purpose of this article is to begin addressing the "black box" of Web-based intervention development by presenting the method for developing a Web-based, brief, motivational alcohol intervention program that has shown evidence of efficacy for college students, called Michigan Prevention & Alcohol Safety for Students.     

Public health workforce information: a state-level study.

A two-stage sample survey was used to estimate the size of Texas' professional public health workforce and to describe its composition in terms of employment settings, job characteristics, and individual characteristics. The estimated 17,700 public health professionals employed in 1995 represented approximately three percent of the state's total health workforce. About 55 percent of all these professionals worked in agencies that provide population-based public health services. An estimated seven percent had formal public health education. These findings raise issues concerning the numerical adequacy of the state's supply of public health professionals, the adequacy of their educational preparation, and the human resources capacity of the state's official public health agencies.     

Drug education practice: results of an observational study.

Understanding normative practice in drug education is a key to identifying means of improving preventive intervention outcomes. In this paper, we report findings of an observational study in which drug education in multiple periods of 146 middle school classes was categorized minute-by-minute according to the type of instruction provided to students. Results indicate that nearly half of all drug education focused on providing students with knowledge. Alternative methods, particularly those that have shown programmatic effectiveness, and those that address risk and protective factors known to be highly predictive of drug use onset, were relatively ignored. Further, teachers showed relatively low consistency in understanding concepts other than knowledge based on comparisons of their ratings of intended instructions with those of trained observers. Nonetheless, there is evidence that some teachers systematically attempted to address drug prevention from either a social influence or an affective education perspective. These findings suggest that if improvements in the effectiveness of drug education are to be seen in the future, a relatively radical transformation of approaches to teaching will be needed.     

Four minutes for a patient,twenty seconds for a relative - an observational study at a university hospital

Background  

In the modern hospital environment, increasing possibilities in medical examination techniques and increasing documentation tasks claim the physicians' energy and encroach on their time spent with patients. This study aimed to investigate how much time physicians at hospital wards spend on communication with patients and their families and how much time they spend on other specific work tasks.     

An evaluation of a public health nutrition workforce development intervention for the nutrition and dietetics workforce

Background: Workforce development is a key element for building the capacity to effectively address priority population nutrition issues. On‐the‐job learning and mentoring have been proposed as strategies for practice improvement in public health nutrition; however, there is limited evidence for their effectiveness. Methods: An evaluation of a mentoring circle workforce development intervention was undertaken. Thirty‐two novice public health nutritionists participated in one of three mentoring circles for 2 h, every 6 weeks, over a 7‐month period. Pre‐ and post‐intervention qualitative (questionnaire, interview, mentor diary) and quantitative (competence, time working in public health nutrition) data were collected. Results: The novice public health nutritionists explained the intervention facilitated sharing of ideas and strategies and promoted reflective practice. They articulated the important attributes of the mentor in the intervention as having experience in and a passion for public health, facilitating a trusting relationship and providing effective feedback. Participants reported a gain in competency and had an overall mean increase in self‐reported competence of 15% (range 3–48% change; P < 0.05) across a broad range of competency elements. Many participants described re‐orienting their practice towards population prevention, with quantifiable increases in work time allocated to preventive work post‐intervention. Conclusions: Mentoring supported service re‐orientation and competency development in public health nutrition. The nature of the group learning environment and the role and qualities of the mentor were important elements contributing to the interventions effects. Mentoring circles offer a potentially effective strategy for workforce development in nutrition and dietetics.     

Down your drink: a web-based intervention for people with excessive alcohol consumption

AIMS: To conduct a pilot study of the usefulness of Down Your Drink (DYD), a web-based intervention to encourage excessive drinkers to adopt a healthy pattern of drinking and reduce alcohol-associated harm. The DYD website was structured as a 6-week programme, derived from a manual which included elements of motivational approaches and cognitive behavioural therapy. METHODS: Visitors whose responses to the Fast Alcohol Screening Test were positive, and those indicating excessive alcohol consumption, were encouraged to register. Users completed alcohol dependence and mental health questionnaires before the programme, and a drinking diary at each of the weekly sessions. Follow-up questionnaires were sent electronically to those who completed the programme, or who missed three or more sessions. RESULTS: During the 6-month study there were 7581 visits to the site and 1319 registrations. Of the registrants, 61.8% completed week 1, and 6.0% stayed with the programme until the end. The 6% who stayed for 6 weeks provided encouraging feedback about the value of the site. Little information was obtained from those who dropped out, but some reported that the programme was too time-consuming. CONCLUSIONS: Web site interventions for excessive drinkers are feasible and merit evaluation of their effectiveness.     

The assessment of organ doses from plutonium for an epidemiological study of the Sellafield workforce.

An epidemiological study of mortality and cancer rates in plutonium workers at the Sellafield nuclear installation has been carried out by researchers at the London School of Hygiene and Tropical Medicine. The study required the assessment of organ-specific doses from plutonium for more than 5000 workers over a period of 40 years. This was a major undertaking as it involved the reconstruction of annual received doses from the results of some 223,000 urine samples that had been provided by the workers in the study. This paper outlines the techniques and strategies adopted in order to generate best estimates of dose from the available data, and presents summaries of these doses.     

Teachers' health - a challenge for an interdisciplinary prevention concept

The early retirement of teachers because of illness is presently a great social and sociomedical problem. In Bavaria, currently more than every second case of early retirement in the profession is the result of psychic or psychosomatic illness. The aim of all preventive measures must therefore be first of all the preservation or restoration of psychic health of teachers. With an underlying comprehensive biopsychosocial understanding of health and performance, preventive measures should take into consideration both circumstances and behaviour, as well as pathogenetic and salutogenetic aspects of the disease. The preventive concept developed under these premises is characterised by the terms interdisciplinary, multidimensional, integrative and institutionalised. Interdisciplinary means the concerted effort of all disciplines involved in the health of teachers. Multidimensional implies action at all levels of disease prevention and includes therapy and rehabilitation. Integrative stands for the formation of networks for optimising processes and the linking of interfaces in the sense of case/disability management. Institutionalised means the creation of structures for co-ordinating and controlling. In addition, potential areas of activity for those involved in prevention, in particular also occupational medicine, are described, resulting in an appeal that the insights gained may be translated into practical reality.     

5 Million Lives Campaign. Case study: an MRSA intervention at Evanston Northwestern Healthcare

PCR-based testing offers superiority to culture in reduction of unisolated days. The ICU-based surveillance intervention had little impact after one year with surveillance compliance at 67%. However, once compliance improved, surveillance was expanded to the entire hospital and decolonization was implemented, MRSA BSIs were significantly reduced. Our experience parallels that of the European countries and other United States facilities that have implemented aggressive MRSA control measures. All successful programs have included active surveillance testing and barrier precautions. Finally, according to the Centers for Disease Control and Prevention's just-released report on invasive MRSA, since most MRSA infections are associated with health care contact, strategies to prevent and control MRSA among inpatients still may have a positive impact on infection, as demonstrated by our intervention.