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implementation of an Emergency Department Opioid Use Disorder Initiative: Clinical Processes and Institution Specific Education Improve Care

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JOURNAL OF EMERGENCY MEDICINE 2025年 71卷 104-113页

作者： Krumheuer, Aaron Janke, Alexander Nickel, Alex Kim, Erin Bailes, Carrie Ager, Emily E. Purington, Ella K. Mahmood, Syed Mohammad Hooyer, Mitchell Ryan, Mary Loretta Baker, Jessica E. Purdy, Megan Greineder, Colin F. Commissaris, Carolyn, V Smith, Shawna N. Fung, Christopher M. Losman, Eve D. Univ Michigan Dept Emergency Med Ann Arbor MI USA Univ Michigan VA HSR&D Ctr Study Healthcare Innovat Implementat Ann Arbor MI USA Univ Michigan Inst Healthcare Policy & Innovat Ann Arbor MI USA Corewell Hlth Grand Rapids MI USA Univ Michigan Med Sch Ann Arbor MI USA Univ Calif Davis Div Pain Med Davis CA USA St Lukes Anderson Emergency Med Bethlehem PA USA Denver Hlth Emergency Med Residency Denver CO USA Brigham & Womens Hosp Dept Emergency Med Boston MA USA Univ Michigan Sch Publ Hlth Ann Arbor MI USA

Background: Emergency department (ED) visits associated with opioid use and fatal overdoses increase annually. Emergency clinician-initiated medication for opioid use disorder (MOUD) reduces mortality and improves treatment retention. Objective: We describe and evaluate a program to implement MOUD at an academic ED using the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. Methods: This was a retrospective cohort study of patients presenting to the ED who were eligible for MOUD. A multipronged MOUD program consisting of electronic health record (EHR) order set, email communications, and resident education was delivered over 1 year. Clinical processes were measured before and after program implementation, including buprenorphine and naloxone utilization and outpatient referrals for treatment. Results: We identified 319 eligible encounters over the 2-year study period. Patients were predominantly non-Hispanic white men with a mean age of 40 f 12.8 years. After program initiation, 109/189 patients (57.7%) were offered or initiated on buprenorphine, compared to 46/130 patients (35.4%) before (95% confidence interval). Protocol dosing was used in 92% of initiations. Outpatient treatment provider referrals increased from 46.1% (60/130) to 63% (119/189;95% confidence interval). More patients in the postintervention group period requested buprenorphine during their visit compared to before the intervention (24.6% vs. 10%). Conclusions: We observed improvements in the rate of buprenorphine prescription and outpatient treatment referrals at an academic ED following a quality improvement program implemented using the RE-AIM framework. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

关键词： emergency medicine opioid use disorder buprenorphine RE-AIM program implementation

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Tailoring Trials of Improved Practices (TIPs) to Improve Child Feeding and Use of Indigenous Preserved Foods in Drought-Affected Kenya: Considerations for Climate Shocks

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MATERNAL AND CHILD NUTRITION 2025年第0期 e70018页

作者： Matiri, Everlyn Ramirez, Lacey Elmi, Abdinasir Gaithuma, Joseph Kavithe, Rachel Waweru, Martin Kahiga, Margaret Kavle, Justine. A. Catholic Relief Serv Nairobi Kenya Kavle Consulting Washington DC 20001 USA Kavle Consulting Nairobi Kenya

This program assessment explored the use of indigenous preserved animal-source foods to improve complementary feeding practices, to identify the roles of mothers, fathers, and elder women in supporting infant and young child feeding (IYCF) practices and to develop recommendations for program *** Trials of Improved Practices (TIPs) approach, food frequency, in-depth interviews, and focus group discussions methodologies were used to collect information on complementary feeding and use of indigenous preserved animal-source foods during a program assessment. Data was collected during Round 1-dry season and Round 2-prolonged *** in-depth interviews were carried out with mothers of children 6-23 months of age, 12 elder women, and six focus groups with 26 fathers for a total of 98 program participants in pastoral communities in Marsabit and Isiolo Counties, *** sites were affected by limited access and availability of animal-source foods and worsened household food insecurity. Nearly all mothers introduced camel milk, often fed raw, as a first food, before 1 year of age. Preserved meat and milk products were often prohibited or fed to older children due to cultural beliefs and norms. Most mothers experienced greater success in implementing TIPs recommendations during Round 1 versus Round 2 and stopped chewing food for the child, gave preserved meat, and fed eggs. Gendered divisions of labor and social norms around roles of fathers, elder women and mothers can hinder *** programming should plan for climate-induced shocks, including amplifying indigenous food preservation and addressing gender and social norms to improve IYCF.

关键词： climate shocks complementary feeding food preservation program implementation Trials of Improved Practices

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Creating Lasting Conditions for Meaningful Recess Reform: A 5-School Exploration

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JOURNAL OF SCHOOL HEALTH 2025年第2期95卷 117-125页

作者： London, Rebecca A. Alvarez, Gabriella Massey, William V. Farello, Anna Santos, Betania Univ Calif Santa Cruz Sociol Santa Cruz CA USA Univ Calif Santa Cruz Santa Cruz CA USA Oregon State Univ Kinesiol Corvallis OR 97331 USA Ball State Univ Kinesiol Muncie IN USA

BACKGROUNDWhen well implemented, recess is a critical part of the school day for children's healthy development. We explored the implementation of a recess improvement process in 5 elementary schools across 3 *** conducted a mixed-methods implementation study in which we visited each school 3 times over 1 school year, collecting observational, interview, survey, and focus group data. Qualitative data were coded thematically and analyzed across schools. Quantitative data were tabulated and aggregated over time and across *** observed improvements in aspects of recess quality at each school, with three schools demonstrating the most progress. Quantitative data showed null effects in aggregate;however one school demonstrated significant improvements. Four criteria contributed to the quality and sustainability of recess reform: staff engagement, integration with other programs, student leadership, and recess *** FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITYprogram implementation research often refers to "buy-in" as a key ingredient to successful adoption. We provide a tool that helps to operationalize buy-in in the recess *** the recess environment requires individual and institutional commitment to valuing recess as an important learning environment. School administrators must lead the change process and create institutional infrastructure to support success.

关键词： recess school climate program implementation

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Age-friendly CMS measure implementation: Leveraging geriatric quality programs in an age-friendly health system

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GERIATRIC NURSING 2025年 61卷 712-715页

作者： Mackwell, Cristen Mack, Karen Atlantic Hlth Syst Hackettstown & Newton Med Ctr Clin Nurse Specialist Res Innovat NICHE GEDA Age F 651 Willow Grove St Hackettstown NJ 07840 USA Nurses Improving Care Healthsystem Elders NICHE 380 Second Ave Suite 306 New York NY 10010 USA

The age-friendly approach ensures older adults receive care that optimizes their well-being, particularly through episodes of illness and at end-of-life. Geriatric clinical quality organizations, including NICHE, establish age-friendly standards and provide education and implementation resources to healthcare organizations. The Centers for Medicare and Medicaid Services will require organizations participating in the inpatient prospective payment system and the long-term care hospital payment system to submit data about compliance with the Age-Friendly Measure starting in 2025. This month's NICHE column discusses the measure's alignment with quality programs, their resources, and a case example of a health system leveraging these programs. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

关键词： Age-friendly care Geriatric nursing Geriatric quality programs program implementation

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Piloting Multiple Micronutrient Supplementation Within the Routine Antenatal Care System in Ethiopia: Insights From Stakeholders

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MATERNAL AND CHILD NUTRITION 2025年第2期21卷 e13809页

作者： Berhanu, Anene Tesfa Defar, Atkure Taye, Girum Daba, Alemneh Kabeta Alemayehu, Senait Tessema, Bedasa Zenebe, Kalkidan Opondo, Charles Tollera, Getachew Hailu, Mesay Schellenberg, Joanna Persson, Lars Ake Marchant, Tanya Tessema, Masresha Ethiopian Publ Hlth Inst Hlth Syst & Reprod Hlth Directorate Addis Ababa Ethiopia London Sch Hyg & Trop Med Dept Dis Control London England Ethiopian Publ Hlth Inst Food Sci & Nutr Res Dept Addis Ababa Ethiopia London Sch Hyg & Trop Med Dept Med Stat London England Ethiopian Publ Hlth Inst Deputy Director Off Addis Ababa Ethiopia

In low and middle-income countries, addressing maternal and child nutrition needs is crucial. Prenatal multiple micronutrient supplementation (MMS) holds promise in reducing low birthweight and preterm births. Ethiopia is considering a transition from the provision of iron-folate supplementation to the provision of MMS in antenatal care, guided by WHO guidelines. This paper explores stakeholders' early perceptions and experiences in piloting that transition in five Ethiopian regions, informing decision making about future policy and scale-up. We used a qualitative study involving interviews and document reviews to assess the MMS pilot, analyzing themes with Nvivo 12 software. Key informant interviews revealed challenges such as supply chain issues and funding constraints, along with proposed improvement strategies such as closer coordination within existing structures. The importance of engaging with communities to create demand was emphasized, as was the need for capacity-building efforts utilizing existing staff in the health system with a clear plan for ongoing refresher training. Finally, enhancing the monitoring and evaluation framework, including a dedicated regional team for supportive supervision, was vital for accountability. In conclusion, prioritizing supply chain strengthening, community engagement through demand creation, coordination, and continuous capacity building for healthcare workers were thought to be crucial for the MMS program's *** Registration Identifier: NCT05708183 Registered 01 February 2023-Retrospectively registered, .

关键词： antenatal care capacity-building child nutrition maternal nutrition micronutrient deficiencies program implementation stakeholder perceptions

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CHALLENGES IN THE implementation OF OUTCOMES-BASED ASSESSMENT program REVIEW IN A CALIFORNIA COMMUNITY COLLEGE DISTRICT

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COMMUNITY COLLEGE JOURNAL OF RESEARCH AND PRACTICE 2011年第11期35卷 855-876页

作者： Bresciani, Marilee J. San Diego State Univ Postsecondary Educ Leadership San Diego CA 92182 USA

The purpose of this study was to explore the manner in which a community college district planned to implement a systematic outcomes-based assessment program review process in order to have results inform institutional, district, and state policy discussions. Data derived from this grounded theory study indicated that there was not a shared conceptualization across institutional and district leadership for the identification of the audience that would use the data generated from the program review process. This finding is typical for many institutions, particularly as leadership desires to honor the individual uniqueness of each college.

关键词： Grounded Theory Community Colleges program Effectiveness Outcome Based Education program Evaluation program implementation Barriers Performance Factors Formative Evaluation Interviews Content Analysis Position Papers program Attitudes Research Methodology Research DesignCaliforniaCalifornia State Policy

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Improving Student Reading Through Parents' implementation of a Structured Reading program

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SCHOOL PSYCHOLOGY REVIEW 2014年第1期43卷 41-58页

作者： Mitchell, Courtney Begeny, John C. N Carolina State Univ Raleigh NC 27695 USA

Parent tutoring offers potential as a means for assisting the large percentage of students who need to improve their reading skills. The primary purpose of this study was to examine the impact of a reading fluency intervention program when used by parents in the home during the summer months. Specifically, this study evaluated the effects of the Helping Early Literacy with Practice Strategies (HELPS) program when implemented by parents with struggling readers. By use of a one-group pretest-posttest quasi-experimental design with the addition of two nonequivalent dependent variables, findings showed that students participating in the HELPS program significantly improved on four different measures of early reading, with effect sizes ranging from medium to large. Simultaneously, students did not show growth on nontargeted skills, as measured with the nonequivalent dependent variables. Parents also showed strong implementation integrity of the HELPS program and reported high acceptability. The implications of these findings and future research directions are discussed, including how the HELPS program may help to prevent summer learning loss.

关键词： Elementary School Students Primary Education Reading Difficulties Reading Improvement Reading programs Parent Participation Parents as Teachers Tutors program implementation Reading Fluency Intervention Summer programs Reading Tests Pretests Posttests Quasiexperimental Design Early Reading Effect Size Integrity Achievement Tests Standardized Tests Emergent Literacy Oral Reading Statistical Analysis Interrater Reliability program Effectiveness

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INCREASING THE QUALITY OF TIER 1 READING INSTRUCTION: USING PERFORMANCE FEEDBACK TO INCREASE OPPORTUNITIES TO RESPOND DURING implementation OF A CORE READING program

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PSYCHOLOGY IN THE SCHOOLS 2016年第1期53卷 89-105页

作者： Cuticelli, Mari Collier-Meek, Melissa Coyne, Michael Univ Connecticut Storrs CT 06269 USA Univ Massachusetts Boston Boston MA USA

Recent data on reading achievement indicates that a majority of young students are reading below proficiency. However, current research has shown that providing students with quality, research-based reading instruction can help prevent many reading difficulties. Through the use of core reading programs, teachers have tools available to be able to provide students with evidence-based instruction in the Tier 1 setting. However, classroom teachers need support in instructing core reading programs with the highest quality to increase student reading outcomes. This study provides evidence that providing teachers with performance feedback can improve quality of instruction by increasing the numbers of OTRs delivered during Tier 1 reading instruction. Teachers were observed during core reading program instruction, number of opportunities to respond were counted at the end of each observed lesson. Baseline data trends were used to determine what type of feedback was given during the intervention phase (i.e., teachers were encouraged to increase individual, group, or both OTRs during instruction). During intervention phase, teachers were provided graphic and oral feedback on implementation of the core reading program;suggestions were provided for increasing opportunities to respond during instruction. (C) 2015 Wiley Periodicals, Inc.

关键词： Reading Instruction Reading Achievement Reading Difficulties Reading programs Evidence Based Practice Feedback (Response) program implementation Response to Intervention

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Comparing Virtual and In-Person implementation of a School-Based Sexual Health Promotion program in High Schools with Large Latino Populations

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PREVENTION SCIENCE 2023年第SUPPL 2期24卷 251-261页

作者： Faccio, Bianca McClay, Alison McConnell, Krystle Gates, Christopher Finocharo, Jane Tallant, Julia Martinez, Valerie Manlove, Jennifer Child Trends 7315 Wisconsin AveSte 1200W Bethesda MD 20814 USA Univ Maryland College Pk MD USA Identity Inc Gaithersburg MD USA

Many sexual health programs transitioned to virtual implementation during the COVID-19 pandemic. Despite its devastation, the pandemic provided an opportunity to learn about virtual compared to in-person implementation of a sexual health promotion program-El Camino. This study assessed differences in program attendance, engagement, quality, and student ratings for virtual versus in-person implementation of El Camino as part of a rigorous evaluation in high schools with high Latino populations in Maryland. Drawing on positive youth development practices, El Camino helps participants identify personal goals and learn about sexual reproductive health and healthy relationships. This mixed-methods study incorporates data from performance measures, baseline and post-intervention participant surveys, observations, monthly implementation reports, and debriefs with facilitators to describe and compare virtual and in-person program implementation. At baseline, participants were an average of 16.2 years old;between 8 and 12(th) grade;61% female;79% Hispanic, Latino, or of Spanish origin;and 54% spoke mostly Spanish at home. Recruitment and retention of students outside of school classes were challenging for both forms of implementation. However, attendance was higher during in-person implementation and in schools where the organization implementing El Camino had a strong presence before the pandemic. Findings indicate high fidelity, excellent quality ratings, and positive student perceptions of the program and facilitators in both the virtual and in-person cohorts, which suggest that both forms of implementation were comparable and furthermore highlight the strength of the virtual adaptation of the El Camino program.

关键词： program implementation Teen pregnancy prevention program evaluation COVID-19 Sexual health promotion Latino youth Positive youth development program

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Closing the research-practice gap: Factors affecting adoption and implementation of a children's mental health program

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JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2006年第1期35卷 2-12页

作者： Henderson, JL MacKay, S Peterson-Badali, M Ctr Addict & Mental Hlth Child Youth & Family Program Toronto ON M5T 1R8 Canada Univ Toronto Ontario Inst Studies Educ Toronto ON Canada

Despite the availability of effective interventions, they are not widely used in community mental health centers. This study examined the adoption and implementation of The Arson Prevention program for Children (TAPP-C), a program for juvenile firesetters developed at a teaching hospital and disseminated to community settings. Questionnaire data from mental health professionals were used to evaluate the roles of adopter, innovation, and dissemination characteristics in TAPP-C adoption and implementation. Results indicate that different factors are important at different diffusion stages. Moreover, they suggest that innovation characteristics may be particularly important to adoption, whereas adopter and dissemination characteristics may be more influential in implementation.

关键词： program implementation Adoption (Ideas) Mental Health programs Children Prevention Theory Practice Relationship Research and Development Mental Health Workers Innovation

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