Deze review geeft aan de hand van het RE-AIM framework een indruk van de stand van zaken op dit moment als het gaat om het implementeren van psychosociale interventies in de dagelijkse zorg in woon/zorginstellingen voor mensen met dementie. Hoe verloopt de implementatie, welke hobbels moeten er genomen worden. Er worden aanbevelingen gedaan voor de toekomstig implementaties van psychosociale interventies. Schrijvers: Petra Boersma, Julia van Weert, Jeroen Lakerveld, Rose-Marie Droes International Psychogeriatrics (2015), 27:1, 19–35 C International Psychogeriatric Association 2014 doi:10.1017/S1041610214001409
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In the past decades many psychosocial interventions for elderly people with dementia have been developed and implemented. Relatively little research has been done on the extent to which these interventions were implemented in the daily care. The aim of this study was to obtain insight into strategies for successful implementation of psychosocial interventions in the daily residential dementia care. Using a modified RE-AIM framework, the indicators that are considered important for effective and sustainable implementation were defined. Methods: A systematic literature search was undertaken in PubMed, PsycINFO, and Cinahl, followed by a hand search for key papers. The included publications were mapped based on the dimensions of the RE-AIM framework: Reach, Effectiveness, Adoption, Implementation, and Maintenance. Results: Fifty-four papers met the inclusion criteria and described various psychosocial interventions. A distinction was made between studies that used one and studies that used multiple implementation strategies. This review shows that to improve their knowledge, caregivers needed at least multiple implementation strategies, only education is not enough. For increasing a more person-centered attitude, different types of knowledge transfer can be effective. Little consideration is given to the adoption of the method by caregivers and to the long-term sustainability (maintenance). Conclusions: This review shows that in order to successfully implement a psychosocial method the use of multiple implementation strategies is recommended. To ensure sustainability of a psychosocial care method in daily nursing home care, innovators as well as researchers should specifically pay attention to the dimensions Adoption, Implementation, and Maintenance of the RE-AIM implementation framework.
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Presentatie gegeven over de review in Brussel Objectives: In the past decades many psychosocial interventions for elderly people with dementia have been developed and implemented. Relatively little research has been done on the extent to which these interventions were implemented in the daily care. The aim of this study was to obtain insight into strategies for successful implementation of psychosocial interventions in the daily residential dementia care. Using a modified RE-AIM framework, the indicators that are considered important for effective and sustainable implementation were defined.
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Objectives: To present the results of the process evaluation of the PLAYgrounds program, using the RE-AIM framework.Design: This study provides information regarding Reach, Adoption, Implementation and Maintenance.Methods: The PLAYgrounds program promotes increasing levels of physical activity in 6–12 years old children and was evaluated using the RE-AIM framework in 4 intervention schools. Data collection consisted of a physical activity questionnaire with children (n = 765, Reach), SOPLAY observations (Implementation and Maintenance), questionnaires on the satisfaction of the implemented elements with teachers (n = 59) and children (n = 730, Implementation) and interviews for increased depth of information. In addition a simple counting of participating schools, describing of non-participating reasons and characteristics of the schools were documented (Adoption).Results: Reach of the target population (i.e. inactive children) was 60.7% (n = 464) and the target population was representative for populations in low-SES neighbourhoods. The PLAYgrounds program was adopted by 4 schools (80%), at which 5 (from 7) program elements were successfully implemented. At 18 monthsfollow-up, 3 of those 5 elements were completely maintained.Conclusions: Adoption, Implementation, and Maintenance proved to be very high. Most likely due to the PLAYgrounds program being a complete intervention package that included financial, material, and staff support. Therefore, it is recommended to retain this high level of support when introducing the PLAYgrounds (or any other intervention) program in schools. In the future it would be recommended to evaluate the PLAYgrounds program on maintenance in schools where the key-person is employed at the school and funding is not available.
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Purpose. We aimed to evaluate the potential for implementing exercise interventions for patients with breast cancer in the Netherlands, based on findings of the Dutch randomized controlled trials in this population. Methods. We evaluated the implementation of four Dutch exercise trials retrospectively, using the five dimensions of the RE-AIM framework: Reach (exercise participation rate), Effectiveness for physical fitness, fatigue, quality of life, and physical function, Adoption (e.g., satisfaction of physical therapists guiding the exercise intervention), Implementation (cost-effectiveness and exercise adherence correlates thereof), and Maintenance (maintenance of exercise levels by individual patients and sustainability of exercise delivery at organization level). Thereby, we reflect on these results using (international) literature to gain better insight in overall barriers, facilitators, and opportunities for further implementation of exercise interventions. Results. Participation rates of 44-52% not only indicated acceptable Reach in the context of a trial but also indicated room for improvement. Effectiveness of exercise during and after treatment was demonstrated in most trials showing benefits for aerobic fitness, physical fatigue, quality of life and physical function, and high patient satisfaction. Adoption of the exercise interventions by physical therapists was adequate (satisfaction score: 7.5 out of 10). Evaluation of Implementation indicated adequate adherence to supervised exercise, inconsistent findings on potential correlates of adherence, and promising results on cost-effectiveness. Currently, reimbursement for exercise programs is lacking. Maintenance of intervention effects at the patient level was limited and inconsistent. Maintenance of intervention availability at the organizational level was facilitated by an extensive network of specially trained physical therapists, but better communication and collaboration between different healthcare professionals are desired. Conclusions. Improved implementation could particularly be achieved by increasing reach and improved focus on exercise maintenance on both the patient and organizational level.
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Assistive technology supports maintenance or improvement of an individual’s functioning and independence, though for people in need the access to assistive products is not always guaranteed. This paper presents a generic quality framework for assistive technology service delivery that can be used independent of the setting, context, legislative framework, or type of technology. Based on available literature and a series of discussions among the authors, a framework was developed. It consists of 7 general quality criteria and four indicators for each of these criteria. The criteria are: accessibility; competence; coordination; efficiency; flexibility; user centeredness, and infrastructure. This framework can be used at a micro level (processes around individual users), meso level (the service delivery scheme or programme) or at a macro level (the whole country). It aims to help identify in an easy way the main strengths and weaknesses of a system or process, and thus guide possible improvements. As a next step in the development of this quality framework the authors propose to organise a global consultancy process to obtain responses from stakeholders across the world and to plan a number of case studies in which the framework is applied to different service delivery systems and processes in different countries.
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The concept of immersion has been widely used for the design and evaluation of user experiences. Augmented, virtual and mixed-reality environments have further sparked the discussion of immersive user experiences and underlying requirements. However, a clear definition and agreement on design criteria of immersive experiences remains debated, creating challenges to advancing our understanding of immersive experiences and how these can be designed. Based on a multidisciplinary Delphi approach, this study provides a uniform definition of immersive experiences and identifies key criteria for the design and staging thereof. Thematic analysis revealed five key themes – transition into/out of the environment, in-experience user control, environment design, user context relatedness, and user openness and motivation, that emphasise the coherency in the user-environment interaction in the immersive experience. The study proposes an immersive experience framework as a guideline for industry practitioners, outlining key design criteria for four distinct facilitators of immersive experiences–systems, spatial, empathic/social, and narrative/sequential immersion. Further research is proposed using the immersive experience framework to investigate the hierarchy of user senses to optimise experiences that blend physical and digital environments and to study triggered, desired and undesired effects on user attitude and behaviour.
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Engineering students have to learn to create robust solutions in professional contexts where new technologies emerge constantly and sometimes disrupt entire industries. The question rises if universities design curricula that enable engineering students to acquire these cognitive skills. The Cynefin Framework (Kurtz & Snowden, 2003; Snowden & Boone, 2007) can be used to typify four complexity contexts a system or organisation can be found in: chaos, complex, complicated and obvious.The Cynefin framework made it possible to create the research question for a case-study: To what extend does the Business Engineering curriculum enable bachelors to find business solutions in the complexity contexts of the Cynefin framework? The results show that 80% of the methods are suitable for complicated contexts and no distinction is made between contexts. This means students are taught to approach most contexts in the same way and are not made aware of differences between the contexts. Making sense of the methods in the curriculum with the Cynefin framework was insightful and suggestions for improvement and further research could be substantiated
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This paper presents four Destination Stewardship scenarios based on different levels of engagement from the public and private sector. The scenarios serve to support destination stakeholders in assessing their current context and the pathway towards greater stewardship. A Destination Stewardship Governance Diagnostic framework is built on the scenarios to support its stakeholders in considering how to move along that pathway, identifying the key aspects of governance that are either facilitating or frustrating a destination stewardship approach, and the required actions and resources to achieve an improved scenario. Moreover, the scenarios and diagnostic framework support stakeholders to come together to debate and scrutinise how tourism is managed in a way that meets the needs of the destination, casting new light on the barriers and opportunities for greater destination stewardship.
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Analyzing historical decision-related data can help support actual operational decision-making processes. Decision mining can be employed for such analysis. This paper proposes the Decision Discovery Framework (DDF) designed to develop, adapt, or select a decision discovery algorithm by outlining specific guidelines for input data usage, classifier handling, and decision model representation. This framework incorporates the use of Decision Model and Notation (DMN) for enhanced comprehensibility and normalization to simplify decision tables. The framework’s efficacy was tested by adapting the C4.5 algorithm to the DM45 algorithm. The proposed adaptations include (1) the utilization of a decision log, (2) ensure an unpruned decision tree, (3) the generation DMN, and (4) normalize decision table. Future research can focus on supporting on practitioners in modeling decisions, ensuring their decision-making is compliant, and suggesting improvements to the modeled decisions. Another future research direction is to explore the ability to process unstructured data as input for the discovery of decisions.
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