85 results on '"Cargo, Margaret"'
Search Results
2. Additional file 2 of How does integrated knowledge translation (IKT) compare to other collaborative research approaches to generating and translating knowledge? Learning from experts in the field
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Nguyen, Tram, Graham, Ian D., Mrklas, Kelly J., Bowen, Sarah, Cargo, Margaret, Estabrooks, Carole A., Kothari, Anita, Lavis, John, Macaulay, Ann C., MacLeod, Martha, Phipps, David, Ramsden, Vivian R., Renfrew, Mary J., Salsberg, Jon, and Wallerstein, Nina
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Data_FILES ,GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries) - Abstract
Additional file 2. Key literature.
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- 2020
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3. Factors influencing referral to and uptake and attendance of pulmonary rehabilitation for chronic obstructive pulmonary disease: a qualitative evidence synthesis of the experiences of service users, their families, and healthcare providers (Protocol)
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Levack, William, Watson, Jane S., Hay-Smith, E. Jean C., Davies, Cheryl, Ingham, Tristram, Jones, Bernadette, Cargo, Margaret, Houghton, Catherine, and McCarthy, Bernard
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This is a protocol for a Cochrane Review (Qualitative). The objectives are as follows: \ud • To identify factors that influence referral to pulmonary rehabilitation for COPD from the perspective of service users, their family/carers, and healthcare providers. \ud • To identify factors that influence uptake of pulmonary rehabilitation for COPD (i.e. at least one attendance of an assessment or first programme session) from the perspective of service users, their family/carers, and healthcare providers. \ud • To identify factors that influence attendance at pulmonary rehabilitation programmes for COPD from the perspective of service users, their family/carers, and healthcare providers. \ud • To develop an inductive explanatory framework for how these factors may interact to contribute to better or poorer uptake or completion of pulmonary rehabilitation in order to guide actions of healthcare decision-makers to improve opportunities for people with COPD to benefit from pulmonary rehabilitation.
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- 2018
4. Cochrane Qualitative and Implementation Methods Group Guidance Series-paper6: Methods for question formulation, searching and protocol development for qualitative evidence synthesis
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Harris, Janet, Booth, Andrew, Cargo, Margaret, Hannes, Karin, Harden, Angela, Flemming, Kate, Garside, Ruth, Pantoja, Tomas, Thomas, James, and Noyes, Jane
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Objective: This paper updates previous guidance on developing a protocol, with a specific focus on question formulation and searching, reflecting recent developments in methods for conducting qualitative evidence syntheses (QES). Study design and setting: Examples are used to illustrate how decisions about boundaries for a review are formed via an iterative process of constructing lines of inquiry, and mapping the information available to ascertain whether evidence exists to answer questions related to effectiveness, implementation, feasibility, appropriateness, economic evidence, and equity. Results: The process of question formulation allows reviewers to situate the topic in relation to how it informs and explains effectiveness, using the criterion of meaningfulness, appropriateness, feasibility and implementation to construct a set of questions that can produce a useful information set to inform decisions. Conclusion: Questions related to complex questions and interventions can be structured by drawing on an increasingly wide range of question frameworks. Logic models and theoretical frameworks are useful tools for conceptually mapping the literature to illustrate the complexity of the phenomenon of interest. Further, protocol development may require iterative question formulation and searching. Consequently, the final protocol may function as a guide rather than a prescriptive route-map, particularly in reviews that ask more exploratory and open ended questions. ispartof: Journal of Clinical Epidemiology vol:97 issue:97 pages:79-85 ispartof: location:United States status: published
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- 2018
5. Promoting handwashing and sanitation behaviour change in low- and middle-income countries: a mixed-method systematic review. 3ie Systematic Review 36
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De Buck, Emmy, Van Remoortel, Hans, Hannes, Karin, Govender, Tashlin, Naidoo, S, Avau, Bert, Vande Veegaete, Axel, Musekiwa, A, Lutje, V, Cargo, Margaret, and Mosler, HJ
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WASH ,systematic review ,international development - Abstract
ispartof: pages:1-506 status: Published online
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- 2017
6. Protocol: Approaches to Promote Sanitation and Handwashing Behaviour Change in Low- and Middle Income Countries: A Mixed Method Systematic Review
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De Buck, Emmy, Hannes, Karin, Van Remoortel, Hans, Govender, Thashlin, Vande Veegaete, Axel, Musekiwa, Alfred, Lutje, Vittoria, Cargo, Margaret, Mosler, Hans-Joachim, Vandekerckhove, Philippe, and Swarts, Tarynne
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ispartof: Campbell Systematic Reviews pages:1-46 status: published
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- 2016
7. Qualitative Research and Cochrane Reviews
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Noyes, Jane, Hannes, Karin, Booth, Andrew, Harris, Janet, Harden, Angela, Popay, Jenny, Pearson, Alan, Cargo, Margaret, Pantoja, Thomas, Higgins, JPT, and Green, S
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qualitative evidence synthesis ,education - Abstract
Evidence from qualitative studies can play an important role in adding value to systematic reviews for policy, practice and consumer decision-making. Cochrane Intervention reviews now include qualitative and implementation research embedded within, or associated with, the trials. There are five primary roles for qualitative evidence syntheses within the context of Cochrane Intervention reviews: o Scoping review: Qualitative research, either as individual studies or within a synthesis, may be used to inform Cochrane intervention reviews by helping define and refine the question, and to address all important outcomes; o Integrated review: Integration of both quantitative and qualitative evidence within a single coherent Cochrane review product; o Qualitative review of trial sibling studies: Conduct of a qualitative evidence synthesis alongside a Cochrane intervention review using qualitative studies informing the intervention that are directly related to included trials and thus share a common context; o Qualitative review of unrelated qualitative evidence: Conduct of a qualitative evidence synthesis that includes qualitative studies of the intervention but not necessarily related to included trials; and o Qualitative review of wider relevant issues: Conduct of a qualitative evidence synthesis that includes qualitative data beyond that relating to the intervention e.g. attitudes of patients, staff members or carers to the experience of a disease or health condition. Many methods of qualitative evidence synthesis are appropriate to the aims and scope of Cochrane Intervention reviews. The synthesis of qualitative research is an area of debate and evolution. The Cochrane Qualitative and Implementation Methods Group provides a forum for discussion and further development of methodology in this area. Available from http://qim.cochrane.org/supplemental-handbook-guidance ispartof: Cochrane Handbook for Systematic Reviews of Interventions pages:1-26 edition:version ispartof: pages:1-26 edition:version edition: version status: published
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- 2015
8. Additional file 2: of Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries: a realist review protocol
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Subash Thapa, Hannes, Karin, Cargo, Margaret, Buve, Anne, and Mathei, Catharina
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Summary of data extraction tool. (DOCX 196 kb)
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- 2015
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9. Additional file 1: of Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries: a realist review protocol
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Subash Thapa, Hannes, Karin, Cargo, Margaret, Buve, Anne, and Mathei, Catharina
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Draft keyword search strategy. Provides an overview of keyword serch strategy used in several databases in thisstudy. (DOCX 54 kb)
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- 2015
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10. Development of the Physical Activity Interactive Recall (PAIR) for Aboriginal children
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Lévesque, Lucie, Cargo, Margaret, Salsberg, Jon, Canadian Diabetes Association, and Université de Montréal. École de santé publique. Département de médecine sociale et préventive
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Canada ,lcsh:Nutritional diseases. Deficiency diseases ,Aboriginal children ,lcsh:Public aspects of medicine ,Research ,lcsh:RA1-1270 ,lcsh:RC620-627 - Abstract
BACKGROUND:Aboriginal children in Canada are at increased risk for type 2 diabetes. Given that physical inactivity is an important modifiable risk factor for type 2 diabetes, prevention efforts targeting Aboriginal children include interventions to enhance physical activity involvement. These types of interventions require adequate assessment of physical activity patterns to identify determinants, detect trends, and evaluate progress towards intervention goals. The purpose of this study was to develop a culturally appropriate interactive computer program to self-report physical activity for Kanien'kehá:ka (Mohawk) children that could be administered in a group setting. This was an ancillary study of the ongoing Kahnawake Schools Diabetes Prevention Project (KSDPP).METHODS:During Phase I, focus groups were conducted to understand how children describe and graphically depict type, intensity and duration of physical activity. Sixty-six students (40 girls, 26 boys, mean age = 8.8 years, SD = 1.8) from four elementary schools in three eastern Canadian Kanien'kehá:ka communities participated in 15 focus groups. Children were asked to discuss and draw about physical activity. Content analysis of focus groups informed the development of a school-day and non-school-day version of the physical activity interactive recall (PAIR). In Phase II, pilot-tests were conducted in two waves with 17 and 28 children respectively to assess the content validity of PAIR. Observation, videotaping, and interviews were conducted to obtain children's feedback on PAIR content and format.RESULTS:Children's representations of activity type and activity intensity were used to compile a total of 30 different physical activity and 14 non-physical activity response choices with accompanying intensity options. Findings from the pilot tests revealed that Kanien'kehá:ka children between nine and 13 years old could answer PAIR without assistance. Content validity of PAIR was judged to be adequate. PAIR was judged to be comprehensive, acceptable, and enjoyable by the children.CONCLUSIONS:Results indicate that PAIR may be acceptable to children between nine and 13 years old, with most in this age range able to complete PAIR without assistance. The flexibility of its programming makes PAIR an easily adaptable tool to accommodate diverse populations, different seasons, and changing trends in physical activity involvement., Affiliation: Margaret Cargo : Département de médecine sociale et préventive, Faculté de médecine, Université de Montréal
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- 2003
11. Partnering with adults as a process of empowering youth in the community : a grounded theory study
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Cargo, Margaret D.
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Health and social policies identify empowerment as a guiding ideal for health promotion, yet there is little theoretical understanding of youth empowerment. The need for theory to guide practice and research in working with youth in a health promotion context led to this grounded theory study to develop a theory of youth empowerment. A community health nurse acting on BC Ministry of Health's adaptation of the World Health Organisation's Healthy Cities Initiative initiated a community organising project in an inner city community of Vancouver, which merged with the Vancouver Board of Parks and Recreation Blueprint for Youth Services policy. The study was based on 32 months of participant observation where the researcher was a co-facilitator of a community organising effort aimed at engaging youth in identifying their quality-of-life issues, and developing and implementing their solutions. Of the ,123 youth entering the process, 66 attended at least three meetings of which 18 demonstrated ongoing commitment to the community action process. Partnering between adults and youth as the process of empowering youth emerged as the core category in the analysis, comprised of two sub-processes, Creating an Empowering Environment for Youth and Becoming Empowered. An empowering environment allowed youth to take responsibility in a welcoming social climate with enabling support from adults. The adults demonstrated their belief in the capacity of youth to act in the community, expected youth to take responsibility, cared for youth, and offered encouragement through acting-with interactions with young people. Youth felt welcome and participated in the process, taking responsibility for voicing, decision making and action on their qualityof- life issues. The adults transferred the power to youth by giving up their responsibility for voicing, decision making and taking action. By taking responsibility and acting in the community with enabling support, the youth became empowered by controlling the process and incrementally developing their competence, self-esteem, confidence and understanding, which cultivated their belonging to the community. Participating in an empowering process enhanced their development and set in motion a social change process that raised the consciousness of adults and influenced organisational practice. The theory identifies youth empowerment as an ecological construct and a capacity-building process.
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- 1999
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12. Prioritizing Built Environmental Factors to Tackle Chronic and Infectious Diseases in Remote Northern Territory (NT) Communities of Australia: A Concept Mapping Study
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Alwin Chong, Margaret Cargo, Mark Daniel, Nicola Slavin, Amal Chakraborty, Alex Brown, Natasha J. Howard, Chakraborty, Amal, Howard, Natasha J, Daniel, Mark, Chong, Alwin, Slavin, Nicola, Brown, Alex, and Cargo, Margaret
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environmental indicators ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Health, Toxicology and Mutagenesis ,public policy ,Public policy ,Water supply ,environmental health ,communicable diseases ,perception ,Indigenous ,Article ,chronic diseases ,03 medical and health sciences ,0302 clinical medicine ,Population Groups ,Sewerage ,medicine ,Northern Territory ,Humans ,030212 general & internal medicine ,Health Workforce ,Environmental planning ,Built environment ,housing ,Social policy ,030505 public health ,business.industry ,indigenous populations ,Public health ,public health ,Public Health, Environmental and Occupational Health ,built environment ,Geography ,Workforce ,Medicine ,0305 other medical science ,business - Abstract
High prevalence of chronic and infectious diseases in Indigenous populations is a major public health concern both in global and Australian contexts. Limited research has examined the role of built environments in relation to Indigenous health in remote Australia. This study engaged stakeholders to understand their perceptions of the influence of built environmental factors on chronic and infectious diseases in remote Northern Territory (NT) communities. A preliminary set of 1120 built environmental indicators were systematically identified and classified using an Indigenous Indicator Classification System. The public and environmental health workforce was engaged to consolidate the classified indicators (n = 84), and then sort and rate the consolidated indicators based on their experience with living and working in remote NT communities. Sorting of the indicators resulted in a concept map with nine built environmental domains. Essential services and Facilities for health/safety were the highest ranked domains for both chronic and infectious diseases. Within these domains, adequate housing infrastructure, water supply, drainage system, reliable sewerage and power infrastructure, and access to health services were identified as the most important contributors to the development of these diseases. The findings highlight the features of community environments amenable to public health and social policy actions that could be targeted to help reduce prevalence of chronic and infectious diseases Refereed/Peer-reviewed
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- 2021
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13. Identifying Environmental Determinants Relevant to Health and Wellbeing in Remote Australian Indigenous Communities: A Scoping Review of Grey Literature
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Alwin Chong, Nicola Slavin, Margaret Cargo, Natasha J. Howard, Alex Brown, Mark Daniel, Amal Chakraborty, Chakraborty, Amal, Daniel, Mark, Howard, Natasha J, Chong, Alwin, Slavin, Nicola, Brown, Alex, and Cargo, Margaret
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environmental indicators ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Health, Toxicology and Mutagenesis ,public policy ,Public policy ,lcsh:Medicine ,environmental health ,Review ,Indigenous ,03 medical and health sciences ,Gray Literature ,0302 clinical medicine ,Population Groups ,social planning ,medicine ,Northern Territory ,Health Services, Indigenous ,Humans ,030212 general & internal medicine ,indigenous ,Environmental planning ,Built environment ,Social policy ,030505 public health ,High prevalence ,community infrastructure ,Public health ,lcsh:R ,public health ,Public Health, Environmental and Occupational Health ,Grey literature ,built environment ,community capacity ,Identification (information) ,Geography ,grey literature ,Chronic Disease ,Public Health ,0305 other medical science - Abstract
The high prevalence of preventable infectious and chronic diseases in Australian Indigenous populations is a major public health concern. Existing research has rarely examined the role of built and socio-political environmental factors relating to remote Indigenous health and wellbeing. This research identified built and socio-political environmental indicators from publicly available grey literature documents locally-relevant to remote Indigenous communities in the Northern Territory (NT), Australia. Existing planning documents with evidence of community input were used to reduce the response burden on Indigenous communities. A scoping review of community-focused planning documents resulted in the identification of 1120 built and 2215 socio-political environmental indicators. Indicators were systematically classified using an Indigenous indicator classification system (IICS). Applying the IICS yielded indicators prominently featuring the “community infrastructure” domain within the built environment, and the “community capacity” domain within the socio-political environment. This research demonstrates the utility of utilizing existing planning documents and a culturally appropriate systematic classification system to consolidate environmental determinants that influence health and disease occurrence. The findings also support understanding of which features of community-level built and socio-political environments amenable to public health and social policy actions might be targeted to help reduce the prevalence of infectious and chronic diseases in Indigenous communities Refereed/Peer-reviewed
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- 2021
14. Cochrane Qualitative and Implementation Methods Group guidance series—paper 5: methods for integrating qualitative and implementation evidence within intervention effectiveness reviews
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Andrew Booth, Janet Harris, Angela Harden, Jane Noyes, Kate Flemming, Margaret Cargo, Tomas Pantoja, Ruth Garside, Karin Hannes, James Thomas, Harden, Angela, Thomas, James, Cargo, Margaret, Harris, Janet, Pantoja, Tomas, Flemming, Kate, Booth, Andrew, Garside, Ruth, Hannes, Karin, and Noyes, Jane
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Biomedical Research ,Evidence-Based Medicine ,Epidemiology ,Process (engineering) ,Computer science ,Management science ,Multimethodology ,Guidelines as Topic ,Context (language use) ,Evidence-based medicine ,03 medical and health sciences ,0302 clinical medicine ,Systematic review ,Intervention (counseling) ,Humans ,systematic reviews ,mixed methods research ,qualitative research ,implementation research ,process evaluations ,Cochrane collaboration ,qualitative evidence synthesis ,030212 general & internal medicine ,Implementation research ,Delivery of Health Care ,Qualitative Research ,030217 neurology & neurosurgery ,Systematic Reviews as Topic ,Qualitative research - Abstract
The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method evidence from process evaluations. Despite a proliferation of methods for the synthesis of qualitative research, less attention has focused on how to integrate these syntheses within intervention effectiveness reviews. In this article, we report updated guidance from the group on approaches, methods, and tools, which can be used to integrate the findings from quantitative studies evaluating intervention effectiveness with those from qualitative studies and process evaluations. We draw on conceptual analyses of mixed methods systematic review designs and the range of methods and tools that have been used in published reviews that have successfully integrated different types of evidence. We outline five key methods and tools as devices for integration which vary in terms of the levels at which integration takes place; the specialist skills and expertise required within the review team; and their appropriateness in the context of limited evidence. In situations where the requirement is the integration of qualitative and process evidence within intervention effectiveness reviews, we recommend the use of a sequential approach. Here, evidence from each tradition is synthesized separately using methods consistent with each tradition before integration takes place using a common framework. Reviews which integrate qualitative and process evaluation evidence alongside quantitative evidence on intervention effectiveness in a systematic way are rare. This guidance aims to support review teams to achieve integration and we encourage further development through reflection and formal testing. Refereed/Peer-reviewed
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- 2018
15. Cochrane Qualitative and Implementation Methods Group guidance series—paper 4: methods for assessing evidence on intervention implementation
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Ruth Garside, Margaret Cargo, Karin Hannes, Janet Harris, James Thomas, Tomas Pantoja, Andrew Booth, Angela Harden, Jane Noyes, Kate Flemming, Cargo, Margaret, Harris, Janet, Pantoja, Tomas, Booth, Andrew, Harden, Angela, Hannes, Karin, Thomas, James, Flemming, Kate, Garside, Ruth, and Noyes, Jane
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Program evaluation ,Biomedical Research ,Epidemiology ,Process (engineering) ,Computer science ,Decision Making ,systematic reviews ,03 medical and health sciences ,0302 clinical medicine ,qualitative evidence synthesis ,Causal chain ,Humans ,Intervention implementation ,Review process ,030212 general & internal medicine ,implementation ,Qualitative Research ,Evidence-Based Medicine ,Management science ,030503 health policy & services ,mixed-method synthesis ,Work in process ,process evaluation ,Data Accuracy ,Cochrane ,Systematic review ,Process evaluation ,0305 other medical science ,Systematic Reviews as Topic - Abstract
Objectives: This article provides reviewers with guidance on methods for identifying and processing evidence to understand intervention implementation. Study Design and Setting: Strategies, tools, and methods are applied to the systematic review process to illustrate how process and implementation can be addressed using quantitative, qualitative, and other sources of evidence (i.e., descriptive textual and nonempirical). Results: Reviewers can take steps to navigate the heterogeneity and level of uncertainty present in the concepts, measures, and methods used to assess implementation. Activities can be undertaken in advance of a Cochrane quantitative review to develop program theory and logic models that situate implementation in the causal chain. Four search strategies are offered to retrieve process and implementation evidence. Recommendations are made for addressing rigor or risk of bias in process evaluation or implementation evidence. Strategies are recommended for locating and extracting data from primary studies. The basic logic is presented to assist reviewers to make initial review-level judgments about implementation failure and theory failure. Conclusion: Although strategies, tools, and methods can assist reviewers to address process and implementation using quantitative, qualitative, and other forms of evidence, few exemplar reviews exist. There is a need for further methodological development and trialing of proposed approaches. Refereed/Peer-reviewed
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- 2018
16. A prospective evaluation of first people’s health promotion program design in the goulburn-murray rivers region
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Tui Crumpen, Margaret Cargo, Julie Calleja, Kevin G. Rowley, Therese Riley, Sharon Atkinson-Briggs, Petah Atkinson, Rachel Reilly, Joyce Doyle, Bradley Firebrace, Doyle, Joyce, Atkinson-Briggs, Sharon, Atkinson, Petah, Firebrace, Bradley, Calleja, Julie, Reilly, Rachel, Cargo, Margaret, Riley, Therese, Crumpen, Tui, and Rowley, Kevin
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Male ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Victoria ,health promotion ,Culture ,Ecological ,Health Promotion ,Community Based ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Rivers ,ecological ,medicine ,Health Services, Indigenous ,Humans ,030212 general & internal medicine ,Social determinants of health ,Healthy Lifestyle ,Prospective Studies ,community based ,Indigenous Peoples ,Aboriginal and Torres Strait Islander people ,Evaluation ,Exercise ,Health policy ,indigenous peoples ,HRHIS ,evaluation ,business.industry ,030503 health policy & services ,Health Policy ,Public health ,lcsh:Public aspects of medicine ,International health ,lcsh:RA1-1270 ,15. Life on land ,Public relations ,Health promotion ,Occupational health nursing ,Health education ,Female ,0305 other medical science ,business ,Research Article ,Program Evaluation ,Sports - Abstract
Background: Aboriginal Community Controlled Organisations (ACCOs) provide community-focussed and culturally safe services for First Peoples in Australia, including crisis intervention and health promotion activities, in a holistic manner. The ecological model of health promotion goes some way towards describing the complexity of such health programs. The aims of this project were to: 1) identify the aims and purpose of existing health promotion programs conducted by an alliance of ACCOs in northern Victoria, Australia; and 2) evaluate the extent to which these programs are consistent with an ecological model of health promotion, addressing both individual and environmental determinants of health. Methods: The project arose from a long history of collaborative research. Three ACCOs and a university formed the Health Promotion Alliance to evaluate their health promotion programs. Local community members were trained in, and contributed to developing culturally sensitive methods for, data collection. Information on the aims and design of 88 health promotion activities making up 12 different programs across the ACCOs was systematically and prospectively collected. Results: There was a wide range of activities addressing environmental and social determinants of health, as well as physical activity, nutrition and weight loss. The design of the great majority of activities had a minimal Western influence and were designed within a local Aboriginal cultural framework. The most common focus of the activities was social connectedness (76 %). Physical activity was represented in two thirds of the activities, and nutrition, weight loss and culture were each a focus of about half of the activities. A modified coding procedure designed to assess the ecological nature of these programs showed that they recruited from multiple settings; targeted a range of individual, social and environmental determinants; and used numerous and innovative strategies to achieve change. Conclusion: First Peoples' health promotion in the Goulburn-Murray Rivers region encompasses a broad range of social, cultural, lifestyle and community development activities, including reclaiming and strengthening cultural identity and social connectedness as a response to colonisation. Refereed/Peer-reviewed
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- 2016
17. Strategies to support culturally safe health and wellbeing evaluations in Indigenous settings in Australia and New Zealand: a concept mapping study
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Amal Chakraborty, Jenni Judd, Amohia Boulton, Lynley Cvitanovic, Margaret Cargo, Lisa Warner, Sharon Clarke, Gill Potaka-Osborne, Cargo, Margaret, Potaka-Osborne, Gill, Cvitanovic, Lynley, Warner, Lisa, Clarke, Sharon, Judd, Jenni, Chakraborty, Amal, and Boulton, Amohia
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Program evaluation ,Native Hawaiian or Other Pacific Islander ,Cultural safety ,Project commissioning ,health promotion ,Māori ,Context (language use) ,concept mapping ,Health Promotion ,Indigenous ,Maori ,03 medical and health sciences ,0302 clinical medicine ,Cluster Analysis ,Health Services, Indigenous ,Humans ,cultural safety ,Commissioning ,commissioning ,030212 general & internal medicine ,Sociology ,Aboriginal and Torres Strait islander ,Evaluation ,Health policy ,030505 public health ,evaluation ,business.industry ,lcsh:Public aspects of medicine ,Research ,Health Policy ,Australia ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Health Status Disparities ,Public relations ,Culturally Competent Care ,Health promotion ,Accountability ,Concept mapping ,0305 other medical science ,business ,New Zealand ,Program Evaluation - Abstract
Background In recent decades, financial investment has been made in health-related programs and services to overcome inequities and improve Indigenous people’s wellbeing in Australia and New Zealand. Despite policies aiming to ‘close the gap’, limited evaluation evidence has informed evidence-based policy and practice. Indigenous leaders have called for evaluation stakeholders to align their practices with Indigenous approaches. Methods This study aimed to strengthen culturally safe evaluation practice in Indigenous settings by engaging evaluation stakeholders, in both countries, in a participatory concept mapping study. Concept maps for each country were generated from multi-dimensional scaling and hierarchical cluster analysis. Results The 12-cluster Australia map identifies four cluster regions: An Evaluation Approach that Honours Community; Respect and Reciprocity; Core Heart of the Evaluation; and Cultural Integrity of the Evaluation. The 11-cluster New Zealand map identifies four cluster regions: Authentic Evaluation Practice; Building Māori Evaluation Expertise; Integrity in Māori Evaluation; and Putting Community First. Both maps highlight the importance of cultural integrity in evaluation. Differences include the distinctiveness of the ‘Respecting Language Protocols’ concept in the Australia map in contrast to language being embedded within the cluster of ‘Knowing Yourself as an Evaluator in a Māori Evaluation Context’ in the New Zealand map. Participant ratings highlight the importance of all clusters with some relatively more difficult to achieve, in practice. Notably, the ‘Funding Responsive to Community Needs and Priorities’ and ‘Translating Evaluation Findings to Benefit Community’ clusters were rated the least achievable, in Australia. The ‘Conduct of the Evaluation’ and the ‘Prioritising Māori Interests’ clusters were rated as least achievable in New Zealand. In both countries, clusters of strategies related to commissioning were deemed least achievable. Conclusions The results suggest that the commissioning of evaluation is crucial as it sets the stage for whether evaluations: reflect Indigenous interests, are planned in ways that align with Indigenous ways of working and are translated to benefit Indigenous communities Identified strategies align with health promotion principles and relational accountability values of Indigenous approaches to research. These findings may be relevant to the commissioning and conduct of Indigenous health program evaluations in developed nations.
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- 2019
18. Improving the content validity of the Mixed Methods Appraisal Tool: a modified e-Delphi study
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Hong, Quan Nha, Pluye, Pierre, Fàbregues Feijóo, Sergi, Bartlett, Gillian, Boardman, Felicity, Cargo, Margaret, Dagenais, Pierre, Gagnon, Marie-Pierre, Griffiths, Frances, Nicolau, Belinda, O'Cathain, Alicia, Rousseau, Marie-Claude, and Vedel, Isabelle
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Investigación cualitativa ,Delphi technique ,Qualitative research ,Quality appraisal ,Systematic review ,Mixed methods research ,Surveys ,Survey ,Enquestes ,Investigació qualitativa ,Encuestas - Abstract
Objective: The mixed methods appraisal tool (MMAT) was developed for critically appraising different study designs. This study aimed to improve the content validity of three of the five categories of studies in the MMAT by identifying relevant methodological criteria for appraising the quality of qualitative, survey, and mixed methods studies. Study Design and Setting: First, we performed a literature review to identify critical appraisal tools and extract methodological criteria. Second, we conducted a two-round modified e-Delphi technique. We asked three method-specific panels of experts to rate the relevance of each criterion on a five-point Likert scale. Results: A total of 383 criteria were extracted from 18 critical appraisal tools and a literature review on the quality of mixed methods studies, and 60 were retained. In the first and second rounds of the e-Delphi, 73 and 56 experts participated, respectively. Consensus was reached for six qualitative criteria, eight survey criteria, and seven mixed methods criteria. These results led to modifications of eight of the 11 MMAT (version 2011) criteria. Specifically, we reformulated two criteria, replaced four, and removed two. Moreover, we added six new criteria. Conclusion: Results of this study led to improve the content validity of this tool, revise it, and propose a new version (MMAT version 2018).
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- 2019
19. Cochrane Qualitative and Implementation Methods Group guidance paper 3: methods for assessing methodological limitations, data extraction and synthesis, and confidence in synthesized qualitative findings
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Margaret Cargo, Tomas Pantoja, Andrew Booth, Angela Harden, Jane Noyes, Kate Flemming, Ruth Garside, Karin Hannes, James Thomas, Simon Lewin, Noyes, Jane, Booth, Andrew, Flemming, Kate, Garside, Ruth, Harden, Angela, Lewin, Simon, Pantoja, Tomas, Hannes, Karin, Cargo, Margaret, and Thomas, James
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Data Analysis ,Biomedical Research ,Epidemiology ,Computer science ,Qualitative evidence ,Decision Making ,education ,Psychological intervention ,Intervention effect ,Formal testing ,methodological limitations ,03 medical and health sciences ,0302 clinical medicine ,systematic review ,qualitative evidence synthesis ,Humans ,030212 general & internal medicine ,GRADE CERQual ,Qualitative Research ,Protocol (science) ,Evidence-Based Medicine ,Management science ,Data Accuracy ,Data extraction ,cochrane ,030217 neurology & neurosurgery ,qualitative research ,Systematic Reviews as Topic ,Qualitative research - Abstract
The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method implementation evidence. Choice of appropriate methodologies, methods, and tools is essential when developing a rigorous protocol and conducting the synthesis. Cochrane authors who conduct qualitative evidence syntheses have thus far used a small number of relatively simple methods to address similarly written questions. Cochrane has invested in methodological work to develop new tools and to encourage the production of exemplar reviews to show the value of more innovative methods that address a wider range of questions. In this paper, in the series, we report updated guidance on the selection of tools to assess methodological limitations in qualitative studies and methods to extract and synthesize qualitative evidence. We recommend application of Grades of Recommendation, Assessment, Development, and Evaluation-Confidence in the Evidence from Qualitative Reviews to assess confidence in qualitative synthesized findings. This guidance aims to support review authors to undertake a qualitative evidence synthesis that is intended to be integrated subsequently with the findings of one or more Cochrane reviews of the effects of similar interventions. The review of intervention effects may be undertaken concurrently with or separate to the qualitative evidence synthesis. We encourage further development through reflection and formal testing. Refereed/Peer-reviewed
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- 2018
20. Engagement of stakeholders in the development of a Theory of Change for handwashing and sanitation behaviour change
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Emmy De Buck, Margaret Cargo, Thashlin Govender, Hans Van Remoortel, Axel Vande Veegaete, Taryn Young, Hans Joachim Mosler, Philippe Vandekerckhove, Karin Hannes, De Buck, Emmy, Hannes, Karin, Cargo, Margaret, Van Remoortel, Hans, Vande veegaete, Axel, Mosler, Hans-Joachim, Govender, Thashlin, Vandekerckhove, Philippe, and Young, Taryn
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Sanitation ,Health, Toxicology and Mutagenesis ,media_common.quotation_subject ,sanitation ,Health Behavior ,Stakeholder engagement ,Context (language use) ,handwashing ,010501 environmental sciences ,behaviour change ,01 natural sciences ,Stakeholder engagement, Theory of Change, handwashing, sanitation, behaviour change, low- and middle-income countries ,03 medical and health sciences ,0302 clinical medicine ,Hygiene ,Humans ,030212 general & internal medicine ,low- and middle-income countries ,0105 earth and related environmental sciences ,media_common ,business.industry ,stakeholder engagement ,Public Health, Environmental and Occupational Health ,Stakeholder ,General Medicine ,Theory of change ,Theory of Change (ToC) ,Public relations ,Pollution ,Work (electrical) ,Business ,Qualitative research ,Hand Disinfection - Abstract
A Theory of Change (ToC) is an approach to map programmes aimed at inducing change in a specific context, with the goal of increasing their impact. We applied this approach to the specific case of handwashing and sanitation practices in low- and middle-income countries and developed a ToC as part of a systematic review exercise. Different existing sources of information were used to inform the initial draft of the ToC. In addition, stakeholder involvement occurred and peer review took place. Our stakeholders included methodological (ToC/quantitative and qualitative research) and content experts (WASH (Water, Sanitation, Hygiene)/behaviour change), as well as end-users/practitioners, policy-makers and donors. In conclusion, the development of a ToC, and the involvement of stakeholders in its development, was critical in terms of understanding the context in which the promotional programmes are being implemented. We recommend ToC developers to work with stakeholders to create a ToC relevant for practice. ispartof: International Journal of Environmental Health Research vol:28 issue:1 pages:8-22 ispartof: location:England status: published
- Published
- 2018
21. A Systematic Review of Community Readiness Tool Applications: Implications for Reporting
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Margaret Cargo, Agustina Gancia, Iordan Kostadinov, Linda R. Stanley, Mark Daniel, Kostadinov, Iordan, Daniel, Mark, Stanley, Linda, Gancia, Agustina, and Cargo, Margaret
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Community-Based Participatory Research ,medicine.medical_specialty ,Health, Toxicology and Mutagenesis ,Psychological intervention ,MEDLINE ,Community of interest ,Community-based participatory research ,lcsh:Medicine ,Review ,Health Promotion ,Community Health Planning ,Rigour ,systematic review ,Humans ,Medicine ,Medical physics ,Protocol (science) ,evaluation ,Community engagement ,business.industry ,Environmental resource management ,lcsh:R ,Public Health, Environmental and Occupational Health ,community interventions ,Community health ,Public Health ,business ,community readiness - Abstract
Background: A systematic review characterised and synthesised applications of the Community Readiness Tool (CRT) and synthesised quantitative results for readiness applications at multiple time points. Methods: Eleven databases in OvidSP and EBSCHOhost were searched to retrieve CRT applications. Information from primary studies was extracted independently by two researchers. Results: Forty applications of the CRT met inclusion criteria focussing on 14 different health and social issues. The community of interest was most often defined solely on the basis of its geographical location (52.5%). Most studies used the CRT to plan (85%) and/or evaluate programs (40%). The CRT protocol was modified in 40% of studies. Six applications evaluated readiness at multiple time points, however limited reporting in primary studies precluded any synthesis of results. Applications identified methodological rigour, contextual information and community engagement as strengths, and time and resource costs as limitations. Conclusions: The CRT is well suited for planning and evaluating complex community health interventions given its flexibility to accommodate diverse definitions of community and issues. CRT applications would benefit from improved reporting; reporting recommendations for use of the CRT are outlined. Refereed/Peer-reviewed
- Published
- 2015
22. Building a Conceptual Framework to Study the Effect of HIV Stigma-Reduction Intervention Strategies on HIV Test Uptake:a Scoping Review
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Anne Buvé, Karin Hannes, Margaret Cargo, Catharina Matheï, Subash Thapa, Arja R. Aro, Thapa, Subash, Hannes, Karin, Cargo, Margaret, Buve, Anne, Aro, Arja R, and Mathei, Catharina
- Subjects
Health Knowledge, Attitudes, Practice ,HIV stigma ,Applied psychology ,Social Stigma ,Human immunodeficiency virus (HIV) ,Social Discrimination/prevention & control ,HIV Infections ,medicine.disease_cause ,03 medical and health sciences ,HIV test uptake ,0302 clinical medicine ,Hiv test ,Regulatory law ,Intervention (counseling) ,medicine ,Humans ,030212 general & internal medicine ,Hiv stigma ,Advanced and Specialized Nursing ,030505 public health ,Social Discrimination ,Patient Acceptance of Health Care ,HIV Infections/diagnosis ,Conceptual framework ,Normative ,HIV stigma-reduction intervention strategies ,conceptual framework ,scoping review ,0305 other medical science ,Psychology ,Social psychology - Abstract
A scoping review of grey and peer-reviewed literature was conducted to develop a conceptual framework to illustrate mechanisms involved in reducing HIV stigma and increasing HIV test uptake. We followed a 3-step approach to exploring the literature: developing concepts, organizing and categorizing concepts, and synthesizing concepts into a framework. The framework contains 4 types of intervention strategies: awareness creation, influencing normative behavior, providing support, and developing regulatory laws. The awareness creation strategy generally improves knowledge and the influencing normative behavior strategy changes stigmatizing attitudes and behaviors, and subsequently, increases HIV test uptake. Providing support and development of regulatory law strategies changes actual stigmatizing behaviors of the people and, subsequently, increases HIV test uptake. The framework further outlines that the mechanisms described are influenced by the interaction of various social-contextual and individual factors. The framework sheds new light on the effects of HIV stigma reduction intervention strategies and HIV test uptake. publisher: Elsevier articletitle: Building a Conceptual Framework to Study the Effect of HIV Stigma-Reduction Intervention Strategies on HIV Test Uptake: A Scoping Review journaltitle: Journal of the Association of Nurses in AIDS Care articlelink: http://dx.doi.org/10.1016/j.jana.2017.04.004 content_type: article copyright: © 2017 Association of Nurses in AIDS Care ispartof: Journal of the Association of Nurses in Aids Care vol:28 issue:4 pages:545-560 ispartof: location:United States status: published
- Published
- 2017
23. Disparities in cancer stage at diagnosis and survival of Aboriginal and non-Aboriginal South Australians
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Marion Eckert, David Roder, Gelareh Farshid, Alex Brown, Dorothy M. K. Keefe, David Banham, Margaret Cargo, Banham, David, Roder, David, Keefe, Dorothy, Farshid, Gelareh, Eckert, Marion, Cargo, Margaret, and Brown, Alex
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Male ,Cancer Research ,Native Hawaiian or Other Pacific Islander ,Epidemiology ,0302 clinical medicine ,cancer stage ,Neoplasms ,030212 general & internal medicine ,Stage (cooking) ,indigenous ,Child ,Aboriginal ,Cancer ,Aged, 80 and over ,disadvantage ,Middle Aged ,medicine.anatomical_structure ,Oncology ,disparity ,030220 oncology & carcinogenesis ,Child, Preschool ,Female ,geographic remoteness ,Adult ,Risk ,medicine.medical_specialty ,Adolescent ,survival ,03 medical and health sciences ,Young Adult ,medicine ,Humans ,Healthcare Disparities ,Cervix ,Cancer staging ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Australia ,Infant, Newborn ,Infant ,Odds ratio ,medicine.disease ,Survival Analysis ,Cancer registry ,Residence ,business ,Demography - Abstract
Background/Aim: This study tested the utility of retrospectively staging cancer registry data for comparing stage and stage-specific survivals of Aboriginal and non-Aboriginal people. Differences by area level factors were also explored. Methods: This test dataset comprised 950 Aboriginal cases and all other cases recorded on the South Australian cancer registry with a 1977–2010 diagnosis. A sub-set of 777 Aboriginal cases diagnosed in 1990–2010 were matched with randomly selected non-Aboriginal cases by year of birth, diagnostic year, sex, and primary site of cancer. Competing risk regression summarised associations of Aboriginal status, stage, and geographic attributes with risk of cancer death. Results: Aboriginal cases were 10 years younger at diagnosis, more likely to present in recent diagnostic years, to be resident of remote areas, and have primary cancer sites of head & neck, lung, liver and cervix. Risk of cancer death was associated in the matched analysis with more advanced stage at diagnosis. More Aboriginal than non-Aboriginal cases had distant metastases at diagnosis (31.3% vs 22.0, p < 0.001). After adjusting for stage, remote-living Aboriginal residents had higher risks of cancer death than Aboriginal residents of metropolitan areas. Non-Aboriginal cases had the lowest risk of cancer death. Conclusion: Retrospective staging proved to be feasible using registry data. Results indicated more advanced stages for Aboriginal than matched non-Aboriginal cases. Aboriginal people had higher risks of cancer death, which persisted after adjusting for stage, and applied irrespective of remoteness of residence, with highest risk of death occurring among Aboriginal people from remote areas. Refereed/Peer-reviewed
- Published
- 2016
24. Cancer Data and Aboriginal Disparities (CanDAD)—developing an Advanced Cancer Data System for Aboriginal people in South Australia: a mixed methods research protocol
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Janet Stajic, Harold Stewart, Paul Yerrell, David Banham, Michael Norris, David Roder, Margaret Cargo, Rachel Reilly, Jasmine Micklem, Kim Morey, Alex Brown, Yerrell, Paul Henry, Roder, David, Cargo, Margaret, Reilly, Rachel, Banham, David, Micklem, Jasmine May, Morey, Kim, Stewart, Harold Bundamurra, Stajic, Janet, Norris, Michael, and Brown, Alex DH
- Subjects
Research design ,Male ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,epidemiological data ,Datasets as Topic ,Indigenous ,03 medical and health sciences ,0302 clinical medicine ,Knowledge translation ,Neoplasms ,South Australia ,Protocol ,Medicine ,cancer ,Health Services, Indigenous ,Humans ,030212 general & internal medicine ,Retrospective Studies ,business.industry ,Multimethodology ,Health services research ,Australia ,General Medicine ,Health Status Disparities ,QUALITATIVE RESEARCH ,Data linkage ,mortality ,indigenous population ,3. Good health ,Cancer registry ,narrative data ,Oncology ,Research Design ,030220 oncology & carcinogenesis ,Family medicine ,Population Surveillance ,Indigenous Health ,Female ,Thematic analysis ,business ,Qualitative research - Abstract
In Australia, Aboriginal and Torres Strait Islander People carry a greater burden of cancerrelated mortality than non-Aboriginal Australians. The Cancer Data and Aboriginal Disparities Project aims to develop and test an integrated, comprehensive cancer monitoring and surveillance system capable of incorporating epidemiological and narrative data to address disparities and advocate for clinical system change. Methods and analysis: The Advanced Cancer Data System will integrate routinely collected unit record data from the South Australian Population Cancer Registry and a range of other data sources for a retrospective cohort of indigenous people with cancers diagnosed from 1990 to 2010. A randomly drawn non-Aboriginal cohort will be matched by primary cancer site, sex, age and year at diagnosis. Cross-Tabulations and regression analyses will examine the extent to which demographic attributes, cancer stage and survival vary between the cohorts. Narratives from Aboriginal people with cancer, their families, carers and service providers will be collected and analysed using patient pathway mapping and thematic analysis. Statements from the narratives will structure both a concept mapping process of rating, sorting and prioritising issues, focusing on issues of importance and feasibility, and the development of a real-Time Aboriginal Cancer Measure of Experience for ongoing linkage with epidemiological data in the Advanced Cancer Data System. Aboriginal Community engagement underpins this Project. Ethics and dissemination: The research has been approved by relevant local and national ethics committees. Findings will be disseminated in local andinternational peer-reviewed journals and conference presentations. In addition, the research will provide data for knowledge translation activities across thepartner organisations and feed directly into the Statewide Cancer Control Plan. It will provide a mechanism for monitoring and evaluating theimplementation of the recommendations in these documents. Refereed/Peer-reviewed
- Published
- 2016
25. Policy, Research and Residents' Perspectives on Built Environments Implicated in Heart Disease: A Concept Mapping Approach
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Mark Daniel, Ivana Stankov, Natasha J. Howard, Margaret Cargo, Stankov, Ivana, Howard, Natasha J, Daniel, Mark, and Cargo, Margaret
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Male ,Health, Toxicology and Mutagenesis ,Concept Formation ,lcsh:Medicine ,0302 clinical medicine ,cardiometabolic risk ,11. Sustainability ,South Australia ,researcher perspectives ,030212 general & internal medicine ,Sociology ,Built environment ,Health Policy ,Environmental resource management ,Stakeholder ,Public relations ,Middle Aged ,3. Good health ,Cardiovascular Diseases ,Female ,community participation ,0305 other medical science ,Attitude to Health ,policy ,Adult ,medicine.medical_specialty ,Community-Based Participatory Research ,Community-based participatory research ,concept mapping ,Article ,03 medical and health sciences ,Metabolic Diseases ,Concept learning ,built environment ,medicine ,Humans ,Cities ,Health policy ,Aged ,Government ,030505 public health ,business.industry ,Public health ,lcsh:R ,Public Health, Environmental and Occupational Health ,Urban Health ,Citizen journalism ,Environment Design ,business - Abstract
An underrepresentation of stakeholder perspectives within urban health research arguably limits our understanding of what is a multi-dimensional and complex relationship between the built environment and health. By engaging a wide range of stakeholders using a participatory concept mapping approach, this study aimed to achieve a more holistic and nuanced understanding of the built environments shaping disease risk, specifically cardiometabolic risk (CMR). Moreover, this study aimed to ascertain the importance and changeability of identified environments through government action. Through the concept mapping process, community members, researchers, government and non-government stakeholders collectively identified eleven clusters encompassing 102 built environmental domains related to CMR, a number of which are underrepresented within the literature. Among the identified built environments, open space, public transportation and pedestrian environments were highlighted as key targets for policy intervention. Whilst there was substantive convergence in stakeholder groups’ perspectives concerning the built environment and CMR, there were disparities in the level of importance government stakeholders and community members respectively assigned to pedestrian environments and street connectivity. These findings support the role of participatory methods in strengthening how urban health issues are understood and in affording novel insights into points of action for public health and policy intervention. Refereed/Peer-reviewed
- Published
- 2016
26. Improving the content validity of the mixed methods appraisal tool: a modified e-Delphi study
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Isabelle Vedel, Felicity K. Boardman, Sergi Fàbregues, Frances Griffiths, Pierre Pluye, Quan Nha Hong, Alicia O’Cathain, Gillian Bartlett, Pierre Dagenais, Marie-Pierre Gagnon, Belinda Nicolau, Marie-Claude Rousseau, Margaret Cargo, McGill University = Université McGill [Montréal, Canada], Universitat Oberta de Catalunya [Barcelona] (UOC), University of Warwick [Coventry], University of Canberra, Université de Sherbrooke (UdeS), Université Laval [Québec] (ULaval), University of Sheffield [Sheffield], Institut Armand Frappier (INRS-IAF), Institut National de la Recherche Scientifique [Québec] (INRS)-Réseau International des Instituts Pasteur (RIIP), The authors gratefully acknowledge the sponsorship from the Method Development platform of the Québec SPOR SUPPORT Unit (#BRDV-CIHR-201-2014-05), the CIHR Doctoral Fellowship Award (#301011), and the FRSQ Senior Investigator Award (#29308)., The research team would like to acknowledge and sincerely thank all the e-Delphi panel experts for their contributions., Hong, Quan Nha, Pluye, Pierre, Fàbregues Feijóo, Sergi, Bartlett, Gillian, Boardman, Felicity, Cargo, Margaret, Dagenais, Pierre, Gagnon, Marie-Pierre, Griffiths, Frances, Nicolau, Belinda, O'Cathain, Alicia, Rousseau, Marie-Claude, and Vedel, Isabelle
- Subjects
Delphi Technique ,Epidemiology ,Computer science ,[SDV]Life Sciences [q-bio] ,Applied psychology ,Delphi method ,Mixed methods research ,Surveys ,Enquestes ,Investigació qualitativa ,Likert scale ,03 medical and health sciences ,0302 clinical medicine ,Delphi technique ,Qualitative research ,Content validity ,Relevance (information retrieval) ,030212 general & internal medicine ,Survey ,Investigación cualitativa ,Multimethodology ,Clinical study design ,Reproducibility of Results ,Encuestas ,Critical appraisal ,Research Design ,Systematic review ,Quality appraisal ,030217 neurology & neurosurgery - Abstract
International audience; Objective : The mixed methods appraisal tool (MMAT) was developed for critically appraising different study designs. This study aimed to improve the content validity of three of the five categories of studies in the MMAT by identifying relevant methodological criteria for appraising the quality of qualitative, survey, and mixed methods studies.Study Design and Setting : First, we performed a literature review to identify critical appraisal tools and extract methodological criteria. Second, we conducted a two-round modified e-Delphi technique. We asked three method-specific panels of experts to rate the relevance of each criterion on a five-point Likert scale.Results : A total of 383 criteria were extracted from 18 critical appraisal tools and a literature review on the quality of mixed methods studies, and 60 were retained. In the first and second rounds of the e-Delphi, 73 and 56 experts participated, respectively. Consensus was reached for six qualitative criteria, eight survey criteria, and seven mixed methods criteria. These results led to modifications of eight of the 11 MMAT (version 2011) criteria. Specifically, we reformulated two criteria, replaced four, and removed two. Moreover, we added six new criteria.Conclusion : Results of this study led to improve the content validity of this tool, revise it, and propose a new version (MMAT version 2018).
- Published
- 2019
27. A Role for Communities in Primary Prevention of Chronic Illness? Case Studies in Regional Australia
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Margaret Cargo, Robyn Preston, Sarah Larkins, Annette J Braunack-Mayer, Judy Taylor, Taylor, Judy, Braunack-Mayer, Annette, Cargo, Margaret, Larkins, Sarah, and Preston, Robyn
- Subjects
Typology ,community and public health ,health promotion ,Local society ,Health Promotion ,Fitness Centers ,Affect (psychology) ,Public-Private Sector Partnerships ,case studies ,Capital Financing ,Nursing ,Primary prevention ,Health Planning Support ,Humans ,participation ,Community psychology ,Community Health Services ,Sociology ,health care economics and organizations ,business.industry ,Australia ,Public Health, Environmental and Occupational Health ,social ,Health Care Coalitions ,Public relations ,Community-Institutional Relations ,Additional research ,Primary Prevention ,Leadership ,Health promotion ,Chronic Disease ,Organizational Case Studies ,Community interaction ,business ,community-based programs - Abstract
In regional Australia "communities of place," defined as bounded geographic locations with a local society, undertake community-wide primary prevention programs. In helping to prevent chronic illness, communities provide valuable resources to the health system. To understand the role of community-health sector partnerships for primary prevention and the community contextual factors that affect them, we studied eight partnerships. We used an embedded multiple case study design and collected data through interviews, nonparticipant observation, and document analysis. These data were analyzed using a typology of community-health sector partnerships and community interaction theory to frame the key community contextual factors that affected partnerships. The dominant factor affecting all partnerships was the presence of a collective commitment that communities brought to making the community a better place through developing health. We call this a communitarian approach. Additional research to investigate factors influencing a communitarian approach and the role it plays in partnerships is required. Refereed/Peer-reviewed
- Published
- 2013
28. A psychological autopsy study of suicide among Inuit in Nunavut: methodological and ethical considerations, feasibility and acceptability
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Jack Hicks, Margaret Cargo, Laurence J. Kirmayer, Eduardo Chachamovich, Jack Haggarty, Gustavo Turecki, Chachamovich, E, Haggarty, J, Cargo, Margaret, Hicks, J, Kirmayer, Laurence, Turecki, G, and CIHR, Government of Nunavut
- Subjects
Research design ,medicine.medical_specialty ,Canada ,Health (social science) ,lcsh:Arctic medicine. Tropical medicine ,Epidemiology ,lcsh:RC955-962 ,Poison control ,Nunavut ,Models, Psychological ,Suicide prevention ,Occupational safety and health ,Ethics, Research ,03 medical and health sciences ,Social support ,suicide ,Inuit ,psychological autopsy ,mental health ,cross-cultural ,Aboriginal ,risk factors ,0302 clinical medicine ,Humans ,Medicine ,Interpersonal Relations ,Original Research Article ,030212 general & internal medicine ,Psychiatry ,Retrospective Studies ,Motivation ,Research ethics ,Arctic Regions ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Social Support ,General Medicine ,16. Peace & justice ,Mental health ,030227 psychiatry ,3. Good health ,Socioeconomic Factors ,Research Design ,Family Relations ,business - Abstract
Introduction: The increasing global prevalence of suicide has made it a major public health concern. Research designed to retrospectively study suicide cases is now being conducted in populations around the world. This field of research is especially crucial in Aboriginal populations, as they often have higher suicide rates than the rest of the country. Objective: This paper presents the methodological aspects of the first psychological autopsy study on suicide among Inuit in Nunavut. Qaujivallianiq Inuusirijauvalauqtunik (‘Learning from lives that have been lived’) is a large case-control study including all 120 cases of suicide that occurred in Nunavut between January 1 st , 2003 and December 31 st , 2006. The paper describes the research design, ethical considerations and strategies used to adapt the psychological autopsy method to Nunavut Inuit. Specifically, we present local social and cultural issues, data collection procedures, and the acceptability, reliability and validity of the method. Method: A retrospective case-control study using the psychological autopsy approach was carried out in 21 communities in Nunavut. A total of 498 individuals were directly interviewed, and medical and correctional charts were also reviewed. Results: The psychological autopsy method was well received by participants as they appreciated the opportunity to discuss the loss of a family member or friend by suicide. During interviews, informants readily identified symptoms of psychiatric disorders, although culture-specific rather than clinical explanations were sometimes provided. Results suggest that the psychological autopsy method can be effectively used in Inuit populations. Keywords: suicide; Inuit; psychological autopsy; mental health; cross-cultural; Canada; Aboriginal; Nunavut; risk factors (Published: 26 March 2013) Citation: Int J Circumpolar Health 2013, 72 : 20078 - http://dx.doi.org/10.3402/ijch.v72i0.20078
- Published
- 2013
29. Cochrane Qualitative and Implementation Methods Group guidance series-paper 1: introduction
- Author
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Simon Lewin, Angela Harden, Andrew Booth, Margaret Cargo, Tomas Pantoja, Jane Noyes, Kate Flemming, Ruth Garside, Janet Harris, Karin Hannes, James Thomas, Noyes, Jane, Booth, Andrew, Cargo, Margaret, Flemming, Kate, Garside, Ruth, Hannes, Karin, Harden, Angela, Harris, Janet, Lewin, Simon, Pantoja, Tomas, and Thomas, James
- Subjects
Epidemiology ,education ,Decision Making ,systematic reviews ,MEDLINE ,Context (language use) ,Guidelines as Topic ,03 medical and health sciences ,0302 clinical medicine ,Health care ,Humans ,030212 general & internal medicine ,Health policy ,Qualitative Research ,Publishing ,Medical education ,Evidence-Based Medicine ,business.industry ,Multimethodology ,Cochrane Qualitative and Implementation Methods Group ,Systematic review ,Implementation research ,business ,Psychology ,030217 neurology & neurosurgery ,Qualitative research ,Systematic Reviews as Topic - Abstract
Cochrane Reviews are systematic reviews of primary research in human health care and health policy, and are internationally recognized health care resources for use in a decision-making process.1 Cochrane works collaboratively with contributors around the world to produce authoritative, relevant, and reliable reviews. Cochrane reviews are commonly used in a guideline development process to determine recommendations for practice. The Cochrane Qualitative and Implementation Methods Group provide methodological advice and guidance to Cochrane as well as leading methodological development to benefit the wider qualitative evidence synthesis community. In this introductory paper 1 we briefly outline the evolution of qualitative and mixed-method synthesis methods, the role of qualitative and mixedmethod syntheses in a decision-making process, and the contribution of qualitative and mixed-method syntheses to understanding complexity in complex intervention reviews. We then introduce a series of papers that provide Cochrane guidance on conducting qualitative and mixed-method evidence syntheses for a decision-making context. ispartof: Journal of Clinical Epidemiology vol:97 issue:97 pages:35-38 ispartof: location:United States status: published
- Published
- 2016
30. Cochrane Qualitative and Implementation Methods Group guidance series-paper 6: reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses
- Author
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Margaret Cargo, Karin Hannes, Andrew Booth, Jane Noyes, Kate Flemming, Flemming, Kate, Booth, Andrew, Hannes, Karin, Cargo, Margaret, and Noyes, Jane
- Subjects
Process management ,Biomedical Research ,Epidemiology ,Computer science ,Process (engineering) ,media_common.quotation_subject ,Decision Making ,systematic reviews ,Guidelines as Topic ,reporting guidelines ,methods ,03 medical and health sciences ,Presentation ,0302 clinical medicine ,qualitative evidence synthesis ,Humans ,030212 general & internal medicine ,implementation ,Qualitative Research ,media_common ,Evidence-Based Medicine ,030503 health policy & services ,Multimethodology ,Evidence-based medicine ,Transparency (behavior) ,Data Accuracy ,Systematic review ,Implementation research ,0305 other medical science ,Qualitative research ,Systematic Reviews as Topic - Abstract
Objectives: To outline contemporary and novel developments for the presentation and reporting of syntheses of qualitative, implementation, and process evaluation evidence and provide recommendations for the use of reporting guidelines. Study Design and Setting: An overview of reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses drawing on current international literature and the collective expert knowledge of the Cochrane Qualitative and Implementation Methods Group.Results: Several reporting guidelines exist that can be used or adapted to report syntheses of qualitative, implementation, and process evaluation evidence. Methods to develop individual guidance varied. The use of a relevant reporting guideline can enhance the transparency, consistency, and quality of reporting. Guidelines that exist are generic, method specific, and for particular aspects of the reviewing process, searching.Conclusion: Caution is expressed over the potential for reporting guidelines to produce a mechanistic approach moving the focus away from the content and toward the procedural aspects of the review. The use of a reporting guideline is recommended and a five-step decision flowchart to guide the choice of reporting guideline is provided. Gaps remain in method-specific reporting guidelines such as mixed-study, implementation, and process evaluation evidence syntheses. Refereed/Peer-reviewed
- Published
- 2016
31. OPALesence: epistemological pluralism in the evaluation of a systems-wide childhood obesity prevention program
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Megan Warin, Fiona Verity, Margaret Cargo, Matthew Jones, Lynne Cobiac, Julie Ratcliffe, Boyd Swinburn, Jones, Michelle, Verity, Fiona, Warin, Megan, Ratcliffe, Julie, Cobiac, Lynne, Swinburn, Boyd, and Cargo, Margaret
- Subjects
Research design ,Program evaluation ,Sociology and Political Science ,Cost effectiveness ,Process (engineering) ,Psychological intervention ,Context (language use) ,Development ,Childhood obesity ,03 medical and health sciences ,0302 clinical medicine ,0504 sociology ,medicine ,childhood obesity prevention ,Epistemological pluralism ,030212 general & internal medicine ,complex systems ,Management science ,business.industry ,05 social sciences ,epistemology ,050401 social sciences methods ,methodology ,medicine.disease ,evaluation research ,business - Abstract
The evaluation of complex systems-wide public health interventions requires evaluation research that is underpinned by theory. This article presents and discusses the trans-disciplinary evaluation research framework developed to support the evaluation of a South Australian program called OPAL (Obesity Prevention and Lifestyle). The aim is to provide insights into the research design, methods and implementation of the evaluation and contribute to the debate on how to evaluate community-based interventions with complicated and complex aspects. In an attempt to capture the complexity of childhood obesity and the intervention, the OPAL evaluation research employs post positivist, interpretive and critical epistemologies, valuing epistemological pluralism. Each component of the multi-phase mixed methods evaluation captures different yet complementary information concerning the context, process, cost effectiveness and outcomes providing a more complete understanding of the impacts of the complex program. Evaluation research is not without challenges. Some of the tensions and challenges that arose in the establishment, planning and conduct of the OPAL program and evaluation are discussed. Refereed/Peer-reviewed
- Published
- 2016
32. Assessing change in perceived community leadership readiness in the Obesity Prevention and Lifestyle Program
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Kostadinov, Iordan, Daniel, Mark, Jones, Michelle, and Cargo, Margaret
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community development ,evaluation methods ,program evaluation - Abstract
The context of community-based childhood obesity prevention programs can influence the effects of these intervention programs. Leadership readiness for community mobilisation for childhood obesity prevention is one such contextual factor. This study assessed perceived community leadership readiness (PCLR) at two time points in a state-wide, multisite community-based childhood obesity prevention program. Methods: PCLR was assessed across 168 suburbs of 20 intervention communities participating in South Australia's Obesity Prevention and Lifestyle (OPAL) program. Using a validated online PCLR tool, four key respondents from each community rated each suburb within their respective community on a nine-point scale for baseline and 2015. Average PCLR and change scores were calculated using the general linear model with suburbs nested in communities. Relationships between demographic variables and change in PCLR were evaluated using multiple regression. Ease of survey use was also assessed. Results: Average PCLR increased between baseline (3.51, s.d.≤0.82) and 2015 (5.23, s.d.≤0.89). PCLR rose in 18 of 20 intervention communities. PCLR was inversely associated with suburb population size (r2≤0.03, P≤0.03, β≤-0.25) and positively associated with intervention duration (r2 change≤0.08, P≤0.00, β≤0.29). Only 8% of survey respondents considered the online assessment tool difficult to use. Conclusions: PCLR increased over the course of the OPAL intervention. PCLR varied between and within communities. Online assessment of PCLR has utility for multisite program evaluations. So what? Use of a novel, resource-efficient online tool to measure the key contextual factors of PCLR has enabled a better understanding of the success and generalisability of the OPAL program. Refereed/Peer-reviewed
- Published
- 2016
33. Community and health sector partnerships for primary prevention in Australia: Developing a typology
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Robyn Preston, Sarah Larkins, Annette J Braunack-Mayer, Judy Taylor, Margaret Cargo, Taylor, Judy, Braunack-Mayer, Annette, Cargo, Margaret, Larkins, Sarah, and Preston, Robyn
- Subjects
Typology ,Gerontology ,Sociology and Political Science ,health promotion ,business.industry ,Australia ,Public relations ,community health partnerships ,primary healthcare ,Economic sustainability ,Orientation (mental) ,Primary prevention ,Relevance (information retrieval) ,Sociology ,Health sector ,business ,chronic illness - Abstract
The Australian health system requires novel strategies to implement widespread primary prevention to reduce the burden of chronic illness. One approach is for health sectors to draw on resources available in communities of place and to form partnerships which maximize the relevance and uptake of initiatives designed to promote healthy lifestyles. This article presents a typology of conceptual approaches to community and health sector partnerships, developed through an extensive literature search and empirically tested using in-depth case studies across regional Australia. The article finds that the health sector’s orientation to primary prevention is generally instrumental involving highly targeted outcomes and pre-defined programmes. Communities of place have multifaceted priorities that include building the social and economic sustainability of their community. While these approaches might appear incompatible, careful ‘manipulation’ and ‘massaging’ of instrumental objectives to adjust to community agendas and the presence of ‘boundary crossers’ can lead to successful primary prevention outcomes. Refereed/Peer-reviewed
- Published
- 2012
34. Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries: a realist review protocol
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Karin Hannes, Anne Buvé, Catharina Matheï, Subash Thapa, Margaret Cargo, Thapa, Subash, Hannes, Karin, Cargo, Margaret, Buve, Anne, and Mathei, Catharina
- Subjects
Realist synthesis ,HIV stigma ,Stigma reduction intervention strategies ,HIV test uptake ,Low- and middle-income countries ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,Social stigma ,medicine.medical_treatment ,Social Stigma ,Applied psychology ,Psychological intervention ,Medicine (miscellaneous) ,Stigma (botany) ,HIV Infections ,Support group ,Acquired immunodeficiency syndrome (AIDS) ,Intervention (counseling) ,Protocol ,Humans ,Medicine ,Psychiatry ,Developing Countries ,business.industry ,Social Discrimination ,Patient Acceptance of Health Care ,medicine.disease ,Risk perception ,Research proposal ,Research Design ,business ,Systematic Reviews as Topic - Abstract
Background Several stigma reduction intervention strategies have been developed and tested for effectiveness in terms of increasing human immunodeficiency virus (HIV) test uptake. These strategies have been more effective in some contexts and less effective in others. Individual factors, such as lack of knowledge and fear of disclosure, and social-contextual factors, such as poverty and illiteracy, might influence the effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries. So far, it is not clearly known how the stigma reduction intervention strategies interact with these contextual factors to increase HIV test uptake. Therefore, we will conduct a review that will synthesize existing studies on stigma reduction intervention strategies to increase HIV test uptake to better understand the mechanisms underlying this process in low- and middle-income countries. Methods A realist review will be conducted to unpack context-mechanism-outcome configurations of the effect of stigma reduction intervention strategies on HIV test uptake. Based on a scoping review, we developed a preliminary theoretical framework outlining a potential mechanism of how the intervention strategies influence HIV test uptake. Our realist synthesis will be used to refine the preliminary theoretical framework to better reflect mechanisms that are supported by existing evidence. Journal articles and grey literature will be searched following a purposeful sampling strategy. Data will be extracted and tested against the preliminary theoretical framework. Data synthesis and analysis will be performed in five steps: organizing extracted data into evidence tables, theming, formulating chains of inference from the identified themes, linking the chains of inference and developing generative mechanisms, and refining the framework. Discussion This will be the first realist review that offers both a quantitative and a qualitative exploration of the available evidence to develop and propose a theoretical framework that explains why and how HIV stigma reduction intervention strategies influence HIV test uptake in low- and middle-income countries. Our theoretical framework is meant to provide guidance to program managers on identifying the most effective stigma reduction intervention strategies to increase HIV test uptake. We also include advice on how to effectively implement these strategies to reduce the rate of HIV transmission. Systematic review registration PROSPERO CRD42015023687 Electronic supplementary material The online version of this article (doi:10.1186/s13643-015-0130-3) contains supplementary material, which is available to authorized users.
- Published
- 2015
35. Community Capacity as an 'Inside Job': Evolution of Perceived Ownership within a University-Aboriginal Community Partnership
- Author
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Alex M. McComber, Lucie Lévesque, Treena Delormier, Margaret Cargo, Ann C. Macaulay, Cargo, Margaret D, Delormier, Treena, Levesque, Lucie, McComber, Alex, and Macaulay, Ann C
- Subjects
Health (social science) ,Universities ,health promotion ,media_common.quotation_subject ,Statistics as Topic ,self-determination ,Community-based participatory research ,Health Promotion ,Grassroots ,Indians ,Nursing ,Political science ,Humans ,Community Health Services ,Longitudinal Studies ,Cooperative Behavior ,community-based participatory research ,media_common ,Chi-Square Distribution ,business.industry ,capacity building ,Quebec ,Public Health, Environmental and Occupational Health ,Capacity building ,Public relations ,Aboriginal community ,Self-determination ,Health promotion ,Social Perception ,prevention research ,Social Marketing ,General partnership ,Indians, North American ,business ,Administration (government) ,North American - Abstract
Purpose. To assess the evolution of perceived ownership of a university-Aboriginal community partnership across three project stages. Design. Survey administration to project partners during project formalization (1996—T1), mobilization (1999—T2), and maintenance (2004—T3). Setting. Aboriginal community of Kahnawake, outside Montreal, Quebec, Canada. Participants. Partners involved in influencing decision making in the Kahnawake Schools Diabetes Prevention Project (KSDPP). Measure and Analysis. A measure of perceived primary ownership subjected to linear trend analysis. Results. KSDPP staff were perceived as primary owner at T1 and shared ownership with Community Advisory Board (CAB) members at T2 and T3. Trend tests indicated greater perceived ownership between T1 and T3 for CAB (χ21 = 12.3, p < .0001) and declining KSDPP staff (χ21 = 10.5, p < .001) ownership over time. Academic partners were never perceived as primary owners. Conclusion. This project was community driven from the beginning. It was not dependent on an external academic change agent to activate the community and develop the community's capacity to plan and implement a solution. It still took several years for the grassroots CAB to take responsibility from KSDPP staff, thus indicating the need for sustained funding to build grassroots community capacity.
- Published
- 2011
36. Environmental Risk Conditions and Pathways to Cardiometabolic Diseases in Indigenous Populations
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Alex Brown, Margaret Cargo, Ivana Stankov, Mark Daniel, Peter Lekkas, Daniel, Mark, Lekkas, Peter, Cargo, Margaret Danna, Stankov, Ivana, and Brown, Alex
- Subjects
Cardiometabolic risk ,Public Health, Environmental and Occupational Health ,Context (language use) ,General Medicine ,Population health ,Environment ,Indigenous ,aboriginal ,cardiovascular diseases ,Geography ,Metabolic Diseases ,Population Groups ,Environmental risk ,Cardiovascular Diseases ,Risk Factors ,Environmental health ,diabetes mellitus ,composition versus context ,Humans ,population health ,Psychosocial ,Disadvantage - Abstract
This review examines environments in relation to cardiometabolic diseases in Indigenous populations in developed countries. Environmental factors are framed in terms of context (features of places) and composition (features of populations). Indigenous peoples are seen to have endured sociopolitical marginalization and material disadvantage spanning generations. Past adverse collective experiences, modified by culture, are reflected by current heterogeneity in environmental context and composition. As risk conditions, unfavorable contextual and compositional exposures influence the expression of cardiometabolic risk for individuals. Minimal research has evaluated heterogeneity in risk conditions against heterogeneity in cardiometabolic diseases between or within Indigenous populations. Thus far, the features of populations, not of places themselves, have been implicated in relation to cardiometabolic diseases. Behavioral, psychosocial, and stress-axis pathways may explain the relationships between risk conditions and cardiometabolic diseases. Implications of environmental factors and their pathways as well as important research needs are discussed in relation to ecological prevention to reduce cardiometabolic diseases. Refereed/Peer-reviewed
- Published
- 2011
37. Reliability of an instrument for direct observation of urban neighbourhoods
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Mark Daniel, Catherine Paquet, Yan Kestens, Margaret Cargo, Paquet, Catherine, Cargo, Margaret Danna, Kestens, Yan, and Daniel, Mark
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reliability and validity ,Social characteristics ,Ecology ,media_common.quotation_subject ,education ,Applied psychology ,Direct observation ,Management, Monitoring, Policy and Law ,epidemiologic measurements ,residence characteristics ,Metropolitan area ,Urban Studies ,neighbourhood observations ,Geography ,Cronbach's alpha ,Internal consistency ,Quality (business) ,Social determinants of health ,Reliability (statistics) ,Nature and Landscape Conservation ,media_common - Abstract
There is an increasing interest in evaluating physical and social characteristics of deprived and wealthy neighbourhoods to explain social health disparities. Direct observations enable obtaining a comprehensive and objective representation of such characteristics. The quality of this representation rests on the use of a reliable and valid observation tool. This study reports measurement properties of an instrument that was developed to directly observe structural and contextual environmental characteristics of urban neighbourhoods with respect to urban form (e.g., street safety elements, parking), negative attributes (e.g., rubbish, crumbling masonry, graffiti), and positive attributes (e.g., maintained dwellings, sitting benches). Two trained evaluators rated the condition of streets, public spaces, dwelling units and the presence/absence of specific characteristics of 250 street blocks within 30 socio-economically diverse census tracts of the Montreal Metropolitan Census Area in 2003. Inter- and intra-rater reliability was assessed using kappa and internal consistency was ascertained using Cronbach's alpha. Inter- and intra-rater reliability was excellent (>0.80) for items pertaining to urban form, and substantial (>0.60) for domains pertaining to positive and negative characteristics. Internal consistency was acceptable (>0.70) for urban form and negative characteristics, but not for positive characteristics. This study demonstrates the psychometric properties of an instrument designed to measure positive, negative, and urban form characteristics which has utility for examining various environmental effects on many aspects of health in a wide range of research contexts.
- Published
- 2010
38. Policy implementation: Implications for evaluation
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Amy DeGroff, Margaret Cargo, DeGroff, Amy, and Cargo, Margaret
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Government ,business.industry ,Strategy and Management ,Corporate governance ,Social change ,Public policy ,implementation processes ,program evaluation ,Context (language use) ,Management Science and Operations Research ,Public relations ,policy implementation ,Interconnectedness ,Education ,New public management ,Accountability ,Sociology ,business - Abstract
Policy implementation reflects a complex change process where government decisions are transformed into programs, procedures, regulations, or practices aimed at social betterment. Three factors affecting contemporary implementation processes are explored: networked governance, sociopolitical context and the democratic turn, and new public management. This frame of reference invites evaluators to consider challenges present when evaluating macrolevel change processes, such as the inherent complexity of health and social problems, multiple actors with variable degrees of power and influence, and a political environment that emphasizes accountability. The evaluator requires a deep and cogent understanding of the health or social issues involved; strong analysis and facilitation skills to deal with a multiplicity of values, interests, and agendas; and a comprehensive toolbox of evaluation approaches and methods, including network analysis to assess and track the interconnectedness of key champions (and saboteurs) who might affect intervention effects and sustainability. © Wiley Periodicals, Inc., and the American Evaluation Association.
- Published
- 2009
39. A realist evaluation of community-based participatory research: partnership synergy, trust building and related ripple effects
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Justin Jagosh, Margaret Cargo, Geoff Wong, Paula L. Bush, Carol P. Herbert, Jon Salsberg, Pierre Pluye, Trisha Greenhalgh, Ann C. Macaulay, Lawrence W. Green, Jagosh, Justin, Bush, Paula L, Salsberg, Jon, Macaulay, Ann C, Greenhalgh, Trish, Wong, Geoff, Cargo, Margaret, Green, Lawrence W, Herbert, Carol P, Pluye, Pierre, and Canadian Institutes of Health Research
- Subjects
medicine.medical_specialty ,Community-Based Participatory Research ,Health Knowledge, Attitudes, Practice ,Time Factors ,Universities ,Health Status ,Poison control ,Participatory action research ,Community-based participatory research ,Trust ,Ripple effect ,03 medical and health sciences ,Partnership synergy ,0302 clinical medicine ,Environmental health ,Medicine ,Humans ,030212 general & internal medicine ,Cooperative Behavior ,Public health ,Systemic transformations ,business.industry ,030503 health policy & services ,Research ,Public Health, Environmental and Occupational Health ,Public relations ,Community-Institutional Relations ,Sustainability ,General partnership ,Community health ,Realist analysis ,Spin-off projects ,0305 other medical science ,business ,Research Article ,Realist synthesis - Abstract
Background Community-Based Participatory Research (CBPR) is an approach in which researchers and community stakeholders form equitable partnerships to tackle issues related to community health improvement and knowledge production. Our 2012 realist review of CBPR outcomes reported long-term effects that were touched upon but not fully explained in the retained literature. To further explore such effects, interviews were conducted with academic and community partners of partnerships retained in the review. Realist methodology was used to increase the understanding of what supports partnership synergy in successful long-term CBPR partnerships, and to further document how equitable partnerships can result in numerous benefits including the sustainability of relationships, research and solutions. Methods Building on our previous realist review of CBPR, we contacted the authors of longitudinal studies of academic-community partnerships retained in the review. Twenty-four participants (community members and researchers) from 11 partnerships were interviewed. Realist logic of analysis was used, involving middle-range theory, context-mechanism-outcome configuration (CMOcs) and the concept of the ‘ripple effect’. Results The analysis supports the central importance of developing and strengthening partnership synergy through trust. The ripple effect concept in conjunction with CMOcs showed that a sense of trust amongst CBPR members was a prominent mechanism leading to partnership sustainability. This in turn resulted in population-level outcomes including: (a) sustaining collaborative efforts toward health improvement; (b) generating spin-off projects; and (c) achieving systemic transformations. Conclusion These results add to other studies on improving the science of CBPR in partnerships with a high level of power-sharing and co-governance. Our results suggest sustaining CBPR and achieving unanticipated benefits likely depend on trust-related mechanisms and a continuing commitment to power-sharing. These findings have implications for building successful CBPR partnerships to address challenging public health problems and the complex assessment of outcomes. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1949-1) contains supplementary material, which is available to authorized users.
- Published
- 2015
40. Development, inter-rater reliability and feasibility of a checklist to assess implementation (Ch-IMP) in systematic reviews: the case of provider-based prevention and treatment programs targeting children and youth
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James Thomas, Patricia Rogers, Ivana Stankov, Margaret Cargo, Michael Saini, Evan Mayo-Wilson, Karin Hannes, Cargo, Margaret, Stankov, Ivana, Thomas, James, Saini, Michael, Rogers, Patricia, Mayo-Wilson, Evan, and Hannes, Karin
- Subjects
Program evaluation ,Male ,Adolescent ,Epidemiology ,MEDLINE ,Psychological intervention ,systematic reviews ,Health Informatics ,Process evaluation ,Young Adult ,Complex interventions ,complex interventions ,Meta-Analysis as Topic ,provider-based interventions ,Provider-based interventions ,Medicine ,Humans ,children and youth ,implementation ,Child ,checklist development ,Reliability (statistics) ,Checklist development ,Medical education ,business.industry ,Infant, Newborn ,Infant ,Reproducibility of Results ,Systematic reviews ,Checklist ,process evaluation ,Theory-driven reviews ,Inter-rater reliability ,theory-driven reviews ,Review Literature as Topic ,Systematic review ,Child, Preschool ,Implementation ,Feasibility Studies ,Female ,Children and youth ,business ,Clinical psychology ,Research Article - Abstract
Background Several papers report deficiencies in the reporting of information about the implementation of interventions in clinical trials. Information about implementation is also required in systematic reviews of complex interventions to facilitate the translation and uptake of evidence of provider-based prevention and treatment programs. To capture whether and how implementation is assessed within systematic effectiveness reviews, we developed a checklist for implementation (Ch-IMP) and piloted it in a cohort of reviews on provider-based prevention and treatment interventions for children and young people. This paper reports on the inter-rater reliability, feasibility and reasons for discrepant ratings. Methods Checklist domains were informed by a framework for program theory; items within domains were generated from a literature review. The checklist was pilot-tested on a cohort of 27 effectiveness reviews targeting children and youth. Two raters independently extracted information on 47 items. Inter-rater reliability was evaluated using percentage agreement and unweighted kappa coefficients. Reasons for discrepant ratings were content analysed. Results Kappa coefficients ranged from 0.37 to 1.00 and were not influenced by one-sided bias. Most kappa values were classified as excellent (n = 20) or good (n = 17) with a few items categorised as fair (n = 7) or poor (n = 1). Prevalence-adjusted kappa coefficients indicate good or excellent agreement for all but one item. Four areas contributed to scoring discrepancies: 1) clarity or sufficiency of information provided in the review; 2) information missed in the review; 3) issues encountered with the tool; and 4) issues encountered at the review level. Use of the tool demands time investment and it requires adjustment to improve its feasibility for wider use. Conclusions The case of provider-based prevention and treatment interventions showed relevancy in developing and piloting the Ch-IMP as a useful tool for assessing the extent to which systematic reviews assess the quality of implementation. The checklist could be used by authors and editors to improve the quality of systematic reviews, and shows promise as a pedagogical tool to facilitate the extraction and reporting of implementation characteristics. Electronic supplementary material The online version of this article (doi:10.1186/s12874-015-0037-7) contains supplementary material, which is available to authorized users.
- Published
- 2015
41. Strengths and limitations of a tool for monitoring and evaluating First Peoples' health promotion from an ecological perspective
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Leah Johnston, Leisa McCarthy, Mayatili Marika, Bradley Firebrace, Julie Calleja, Joyce Doyle, Kevin G. Rowley, Therese Riley, Rachel Reilly, Margaret Cargo, Petah Atkinson, Rowley, Kevin, Doyle, Joyce, Johnston, Leah, Reilly, Rachel, McCarthy, Leisa, Marika, Mayatili, Riley, Therese, Atkinson, Petah, Firebrace, Bradley, Calleja, Julie, and Cargo, Margaret
- Subjects
Program evaluation ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Human Rights ,health promotion ,Social Determinants of Health ,media_common.quotation_subject ,Ecological ,Health Promotion ,Environment ,Determinants of health ,Social Environment ,03 medical and health sciences ,0302 clinical medicine ,determinants of health ,Ecological psychology ,ecological ,Medicine ,Mainstream ,Humans ,030212 general & internal medicine ,Social determinants of health ,first peoples ,Cultural Competency ,Evaluation ,media_common ,Aboriginal and Torres Strait Islander ,030505 public health ,evaluation ,First Peoples ,Human rights ,Ecology ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Australia ,Systems ,Health promotion ,North America ,systems ,Public Health ,0305 other medical science ,business ,Cultural competence ,Program Evaluation ,Research Article - Abstract
Background: An ecological approach to health and health promotion targets individuals and the environmental determinants of their health as a means of more effectively influencing health outcomes. The approach has potential value as a means to more accurately capture the holistic nature of Australian First Peoples' health programs and the way in which they seek to influence environmental, including social, determinants of health. Methods: We report several case studies of applying an ecological approach to health program evaluation using a tool developed for application to mainstream public health programs in North America - Richard's ecological coding procedure. Results: We find the ecological approach in general, and the Richard procedure specifically, to have potential for broader use as an approach to reporting and evaluation of health promotion programs. However, our experience applying this tool in academic and community-based program evaluation contexts, conducted in collaboration with First Peoples of Australia, suggests that it would benefit from cultural adaptations that would bring the ecological coding procedure in greater alignment with the worldviews of First Peoples and better identify the aims and strategies of local health promotion programs. Conclusions: Establishing the cultural validity of the ecological coding procedure is necessary to adequately capture the underlying program activities of community-based health promotion programs designed to benefit First Peoples, and its collaborative implementation with First Peoples supports a human rights approach to health program evaluation. Refereed/Peer-reviewed
- Published
- 2015
42. Assessing community readiness online : a concurrent validation study
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Margaret Cargo, Linda R. Stanley, Iordan Kostadinov, Mark Daniel, Kostadinov, Iordan, Daniel, Mark, Stanley, Linda, and Cargo, Margaret
- Subjects
Gerontology ,Community readiness ,Health Knowledge, Attitudes, Practice ,Pediatric Obesity ,community-based interventions ,Concurrent validity ,Psychological intervention ,Poison control ,Context (language use) ,Health Promotion ,Suicide prevention ,Community Networks ,Resource (project management) ,Residence Characteristics ,South Australia ,Medicine ,Humans ,obesity prevention ,Medical education ,Community-based interventions ,Internet ,business.industry ,Public Health, Environmental and Occupational Health ,Concurrent validation ,Leadership ,Health promotion ,Knowledge ,concurrent validation ,Obesity prevention ,Biostatistics ,business ,community readiness ,Research Article - Abstract
Background: Community readiness for facilitation and uptake of interventions can impact the success of community-based prevention efforts. As currently practiced, measuring community readiness can be a resource intensive process, compromising its use in evaluating multisite community-based prevention efforts. The purpose of this study was to develop, test and validate a more efficient online version of an existing community readiness tool and identify potential problems in completing assessments. This study was conducted in the context of a complex community-based childhood obesity prevention program in South Australia. Methods: Following pre-testing, an online version of the community readiness tool was created, wherein respondents, with detailed knowledge of their community and prevention efforts, rated their communities on five anchored rating scales (Knowledge of Efforts, Leadership, Knowledge of the Issue, Community Climate, and Resources). Respondents completed the standard, over-the-phone community readiness interview ("gold standard") and the new online survey. Paired t-test, St. Laurent's correlation coefficient and intra-class correlation (ICC) were used to determine the validity of the online tool. Contact summary forms were completed after each interview to capture interview quality. Results: Twenty-five respondents completed both assessments. There was a statistically significant difference in the overall community readiness scores between the two methods (paired t-test p = 0.03); online scores were consistently higher than interview scores. St. Laurent's correlation of 0.58 (95 % CI 0.42-0.73) was moderate; the ICC of 0.65 (95 % CI 0.35-0.83) was good. Only for the leadership and resources dimensions was there no statistically significant difference between the scores from the two methods (p = 0.61, p = 0.08 respectively). St Laurent's correlation (r = 0.83, 95 % CI 0.71-0.92) and the ICC (0.78, 95 % CI 0.57-0.90) were excellent for leadership. Qualitative results from the standard interview method suggest that some respondents felt reluctant to answer questions on behalf of other community members. This may have impacted their self-selected ratings and/or responses to questions during the interview. Conclusions: Concurrent validity for the online method was supported for the Leadership dimension only. However, the online method holds promise as it reduces time and resource burden, allowing for a quicker return of results to the community to inform program planning, implementation and evaluations to improve community health. Refereed/Peer-reviewed
- Published
- 2015
43. Suicide among Inuit: results from a large, epidemiologically representative follow-back study in Nunavut
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Gustavo Turecki, Rod McCormick, Margaret Cargo, Eduardo Chachamovich, John M. Haggarty, Laurence J. Kirmayer, Chachamovich, Eduardo, Kirmayer, Laurence J, Haggarty, John M, Cargo, Margaret, McCormick, Rod, and Turecki, Gustavo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Substance-Related Disorders ,Population ,Poison control ,Personality Disorders ,Suicide prevention ,Northwest Territories ,Young Adult ,Risk Factors ,medicine ,Humans ,education ,Psychiatry ,suicide ,Original Research ,Depressive Disorder, Major ,education.field_of_study ,business.industry ,Alcohol dependence ,medicine.disease ,psychopathology ,Mental health ,Personality disorders ,psychiatry ,Suicide ,Psychiatry and Mental health ,Adult Survivors of Child Adverse Events ,Inuit ,social determinants of health ,Major depressive disorder ,Female ,business ,Psychopathology - Abstract
Objective: The Inuit population in Canada's North has suffered from high rates of death by suicide. We report on the first large-scale, controlled, epidemiologically representative study of deaths by suicide in an Indigenous population, which investigates risk factors for suicide among all Inuit across Nunavut who died by suicide during a 4-year period. Methods: We identified all suicides by Inuit ( n = 120) that occurred between January 1, 2003, and December 31, 2006, in Nunavut. For each subject, we selected a community-matched control subject. We used proxy-based procedures and conducted structured interviews with informants to obtain life histories, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I and II diagnoses, and measures of impulsive and (or) aggressive traits. Results: Compared with control subjects, subjects who died by suicide were more likely to have experienced childhood abuse (OR 2.38; 95% CI 1.39 to 4.08), have family histories of major depressive disorder ( P = 0.002) and suicide completion ( P = 0.02), and have been affected by major depressive disorder (OR 13.00; 95% CI 6.20 to 27.25), alcohol dependence (OR 2.90; 95% CI 1.59 to 5.24), or cannabis dependence (OR 3.96; 95% CI 2.29 to 6.8) in the last 6 months. In addition, subjects who died by suicide were more likely to have been affected with cluster B personality disorders (OR 10.18; 95% CI 3.34 to 30.80) and had higher scores of impulsive and aggressive traits ( P < 0.001). Conclusions: At the individual level, clinical risk factors for suicide among Inuit are similar to those observed in studies with the general population, and indicate a need for improved access to mental health services. The high rate of mental health problems among control subjects suggests the need for population-level mental health promotion.
- Published
- 2015
44. Association between smoking, insulin resistance and beta-cell function in a North-western First Nation
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Margaret Cargo, Mark Daniel, Cargo, Margaret Danna, and Daniel, Mark
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Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Type 2 diabetes ,Disease ,Islets of Langerhans ,Endocrinology ,Insulin resistance ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,Humans ,Medicine ,Aged ,British Columbia ,business.industry ,Insulin ,Smoking ,Middle Aged ,medicine.disease ,Former Smoker ,Confidence interval ,Diabetes Mellitus, Type 2 ,Multivariate Analysis ,Indians, North American ,Female ,Insulin Resistance ,business ,Body mass index ,Demography - Abstract
Aims Aboriginal peoples have a high prevalence of smoking and are at major risk for diabetes. The role of insulin resistance vs. compromised β-cell function in the link between smoking and glycaemic disease is not clear. This study tested whether relations between insulin resistance and β-cell function differ between current smokers, former smokers and non-smokers, and if having diabetes modifies smoking-related effects. Methods A community-based diabetes screening initiative was mounted for a North-western First Nation (Interior Salishan) in rural British Columbia, Canada. Respondents were on-reserve Aboriginal people (n = 156), all adults 18 + years. Glycaemic status was determined by oral glucose tolerance test. Fasting values for glucose and insulin were used to estimate β-cell function and insulin resistance by homeostasis model assessment (HOMA). Analyses adjusted for age, sex, alcohol intake, education, body mass index and physical activity. Results For normoglycaemic persons (n = 119) current smokers relative to non-smokers had high β-cell values [difference (95% confidence interval) 19.5 (17.1, 21.9)], while former smokers had low β-cell values [difference −22.8 (−20.3, −25.3)] (P
- Published
- 2004
45. Healing Traditions: Culture, Community and Mental Health Promotion with Canadian Aboriginal Peoples
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Cori Simpson, Laurence J. Kirmayer, Margaret Cargo, Cargo, Margaret Danna, Kirmayer, Laurence, and Simpson, Cori
- Subjects
youth ,Oppression ,Government ,health promotion ,media_common.quotation_subject ,Clinical Sciences ,Metis ,Psychological intervention ,Community integration ,Criminology ,Social issues ,Mental health ,culture ,Psychiatry and Mental health ,trauma ,Health promotion ,Nursing ,Inuit ,Middle Eastern Mental Health Issues & Syndromes ,Cognitive Sciences ,Sociology ,residential schools ,First Nations ,media_common - Abstract
Objective: To identify issues and concepts to guide the development of culturally appropriate mental health promotion strategies with Aboriginal populations and communities in Canada.Methods: We review recent literature examining the links between the history of colonialism and government interventions (including the residential school system, out-adoption, and centralised bureaucratic control) and the mental health of Canadian Aboriginal peoples.Results: There are high rates of social problems, demoralisation, depression, substance abuse, suicide and other mental health problems in many, though not all, Aboriginal communities. Although direct causal links are difficult to demonstrate with quantitative methods, there is clear and compelling evidence that the long history of cultural oppression and marginalisation has contributed to the high levels of mental health problems found in many communities. There is evidence that strengthening ethnocultural identity, community integration and political empowermen...
- Published
- 2003
46. Implementing participatory intervention and research in communities: lessons from the Kahnawake Schools Diabetes Prevention Project in Canada
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Ann C. Macaulay, Treena Delormier, Alex M. McComber, Louise Potvin, Margaret Cargo, Cargo, Margaret Danna, Potvin, Louise, McComber, Alex, Delormier, Treena, and Macaulay, Ann
- Subjects
Program evaluation ,medicine.medical_specialty ,Health (social science) ,media_common.quotation_subject ,Psychological intervention ,Participatory action research ,Guidelines as Topic ,Health Promotion ,Public administration ,Community Health Planning ,Participatory research ,Diabetes prevention ,Programme implementation ,Community health promotion ,Canada ,Promotion (rank) ,Sociology ,History and Philosophy of Science ,Social Justice ,medicine ,Humans ,Program Development ,Child ,School Health Services ,media_common ,business.industry ,Public health ,Community Participation ,Quebec ,Public relations ,Primary Prevention ,Intervention (law) ,Diabetes Mellitus, Type 2 ,Organizational Case Studies ,Community health ,Indians, North American ,Health education ,Patient Participation ,business ,Program Evaluation - Abstract
Community public health interventions based on citizen and community participation are increasingly discussed as promising avenues for the reduction of health inequalities and the promotion of social justice. However, very few authors have provided explicit principles and guidelines for planning and implementing such interventions, especially when they are linked with research. Traditional approaches to public health programming emphasise expert knowledge, advanced detailed planning, and the separation of research from intervention. Despite the usefulness of these approaches for evaluating targeted narrow-focused interventions, they may not be appropriate in community health promotion, especially in Aboriginal communities. Using the experience of the Kahnawake Schools Diabetes Prevention Project, in Canada, this paper elaborates four principles as basic components for an implementation model of community programmes. The principles are: (1) the integration of community people and researchers as equal partners in every phase of the project, (2) the structural and functional integration of the intervention and evaluation research components, (3) having a flexible agenda responsive to demands from the broader environment, and (4) the creation of a project that represents learning opportunities for all those involved. The emerging implementation model for community interventions, as exemplified by this project, is one that conceives a programme as a dynamic social space, the contours and vision of which are defined through an ongoing negotiation process.
- Published
- 2003
47. An ecological and theoretical deconstruction of a school-based obesity prevention program in Mexico
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Margarita Safdie, Lucie Richard, Lucie Lévesque, Margaret Cargo, Safdie, Margarita, Cargo, Margaret, Richard, Lucie, and Levesque, Lucie
- Subjects
Program evaluation ,medicine.medical_specialty ,Nutrition policy ,education ,Health Behavior ,Behavioural sciences ,physical activity ,Medicine (miscellaneous) ,Nutritional Status ,Physical Therapy, Sports Therapy and Rehabilitation ,Health Promotion ,Social Theory ,Motor Activity ,children ,Intervention (counseling) ,medicine ,Humans ,Obesity ,Child ,Children ,Life Style ,Mexico ,School Health Services ,nutrition policy ,Nutrition and Dietetics ,Schools ,Ecology ,Physical activity ,4. Education ,Public health ,Research ,social cognitive theory ,Reciprocal determinism ,Feeding Behavior ,Overweight ,3. Good health ,Health promotion ,Psychology ,Construct (philosophy) ,Social cognitive theory ,Program Evaluation - Abstract
Background: Ecological intervention programs are recommended to prevent overweight and obesity in children. The National Institute of Public Health (INSP) in Mexico implemented a successful ecological intervention program to promote healthy lifestyle behaviors in school age children. This study assessed the integration of ecological principles and Social Cognitive Theory (SCT) constructs in this effective school-based obesity prevention program implemented in 15 elementary schools in Mexico City. Methods: Two coders applied the Intervention Analysis Procedure (IAP) to “map” the program’s integration of ecological principles. A checklist gauged the use of SCT theory in program activities. Results: Thirty-two distinct intervention strategies were implemented in one setting (i.e., school) to engage four different target-groups (students, parents, school representatives, government) across two domains (Nutrition and Physical Activity). Overall, 47.5% of the strategies targeted the school infrastructure and/or personnel; 37.5% of strategies targeted a key political actor, the Public Education Secretariat while fewer strategies targeted parents (12.5%) and children (3%). More strategies were implemented in the Nutrition domain (69%) than Physical Activity (31%). The most frequently used SCT construct within both intervention domains was Reciprocal Determinism (e.g., where changes to the environment influence changes in behavior and these behavioral changes influence further changes to the environment); no significant differences were observed in the use of SCT constructs across domains. Conclusions: Findings provide insight into a promising combination of strategies and theoretical constructs that can be used to implement a school-based obesity prevention program. Strategies emphasized school-level infrastructure/personnel change and strong political engagement and were most commonly underpinned by Reciprocal Determinism for both Nutrition and Physical Activity.
- Published
- 2014
48. Participant views on participating in a pragmatic randomised controlled trial: the Aboriginal and Torres Strait Islander Women's Fitness Program
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Margaret Cargo, Karla Canuto, Robyn McDermott, Canuto, Karla Joy, McDermott, Robyn, and Cargo, Margaret
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Research design ,Adult ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Research Subjects ,Physical fitness ,physical activity ,Vulnerable Populations ,Indigenous ,law.invention ,Interviews as Topic ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Qualitative research ,medicine ,Pragmatic RCTs ,Humans ,030212 general & internal medicine ,Health policy ,randomisation ,Randomisation ,Aboriginal and Torres Strait Islander ,business.industry ,Physical activity ,030503 health policy & services ,Public health ,Health Policy ,Research ,Health services research ,Public Health, Environmental and Occupational Health ,Australia ,Middle Aged ,pragmatic RCTs ,Physical Fitness ,Family medicine ,Women's Health ,Female ,Waist Circumference ,0305 other medical science ,business ,qualitative research - Abstract
Introduction The inequity of randomising participants to control groups in randomised controlled trials (RCTs) is often considered inappropriate, especially for research trials that include vulnerable populations such as Indigenous peoples. The Aboriginal and Torres Strait Islander Women’s Fitness Program conducted a trial that randomly assigned participants to ‘active’ and ‘waitlisted’ groups. This paper reports on participant views of the randomisation protocol. Methods A pragmatic RCT was conducted in an urban setting to assess the effectiveness of the 12-week Aboriginal and Torres Strait Islander Women’s Fitness Program on metabolic health outcomes and waist circumference. Qualitative interviews were conducted at follow-up, one of the objectives was to explore participant perspectives on the research protocol, including participant randomisation to ‘Active’ and ‘Waitlisted’ groups. Results A total of 49 interviews were conducted (26 Active and 23 Waitlisted participants). Two key factors influenced participant views on the protocol: 1) group assignment; and 2) how well they understood the research design, including the justification for randomisation. ‘Active’ participants were concerned about the inequity of the randomisation process but overall supported the study protocol. Although most Waitlisted participants were disappointed about having to wait 12-months for the program, some participants derived motivation from being waitlisted, whilst others lost motivation. Well-informed participants were more likely to express both support for the randomisation process and an understanding of the research benefits than participants not attending an information session prior to registration. Conclusions Participants were more accepting of the research protocol if it was clearly explained to them, if they understood the randomisation process and felt the randomisation was justified in terms of the potential for the results to benefit other Aboriginal and Torres Strait Islander women. Our study suggests that the time and resources required to adequately explain the research protocol in research trials should not be undervalued. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12610000224022).
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- 2014
49. Assessing implementation fidelity and adaptation in a community-based childhood obesity prevention intervention
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Iordan Kostadinov, Matthew Jones, Margaret Cargo, Lucie Richard, Zoe Richards, Richards, Zoe, Kostadinov, Iordan, Jones, Michelle, Richard, Lucie, and Cargo, Margaret
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Program evaluation ,Male ,Pediatric Obesity ,obesity ,media_common.quotation_subject ,Applied psychology ,Fidelity ,Interpersonal communication ,Health Promotion ,Community Networks ,Childhood obesity ,Education ,South Australia ,medicine ,Humans ,Child ,Life Style ,media_common ,Implementation fidelity ,weight loss programs ,business.industry ,Multimethodology ,Public Health, Environmental and Occupational Health ,Prevention intervention ,medicine.disease ,Health promotion ,community ,Female ,business ,Social psychology ,Program Evaluation - Abstract
Little research has assessed the fidelity, adaptation or integrity of activities implemented within community-based obesity prevention initiatives. To address this gap, a mixed-method process evaluation was undertaken in the context of the South Australian Obesity Prevention and Lifestyle (OPAL) initiative. An ecological coding procedure assessed fidelity and adaptation of activity settings, targets and strategies implemented in the second year of four communities. Implementation integrity reflected fidelity and adaptation to local context, whereas efforts resulting in significant deviations from the original plan were deemed to lack fidelity and integrity. Staff implemented 284 strategies in 205 projects. Results show that 68.3 and 2.1% of strategies were implemented with fidelity or adapted, respectively. Overall, 70.4% of all strategies were implemented with integrity. Staff experienced barriers with 29.6% of strategies. Chi-square analyses show statistically significant associations between implementation integrity and strategy type, intervention and behavioural targets. These relationships are weak to modest. The strongest relationship was found between implementation integrity and proximal target. Staff experienced implementation barriers at the coalition, policy, organization, interpersonal and community levels. The greatest range of barriers was encountered working with organizations. To overcome these barriers, staff took greater ownership, invested more time, persisted and allocated more financial resources. Refereed/Peer-reviewed
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- 2014
50. Critical reflections on realist review: insights from customizing the methodology to the needs of participatory research assessment
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Jagosh, Justin, Pluye, Pierre, Wong, Geoff, Cargo, Margaret Danna, Salsberg, Jon, Bush, Paula, Herbert, C, Green, Lawrence, Greenhalgh, Trish, and Macaulay, Ann
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middle-range theory ,health research ,context-mechanism-outcome configuring ,critical realism ,participatory research ,realist review - Abstract
Realist review has increased in popularity as a methodology for complex intervention assessment. Our experience suggests that the process of designing a realist review requires its customization to areas under investigation. To elaborate on this idea, we first describe the logic underpinning realist review and then present critical reflections on our application experience, organized in seven areas. These are the following: (1) the challenge of identifying middle range theory; (2) addressing heterogeneity and lack of conceptual clarity; (3) the challenge of appraising the quality of complex evidence; (4) the relevance of capturing unintended outcomes; (5) understanding the process of context, mechanism, and outcome (CMO) configuring; (6) incorporating middle-range theory in the CMO configuration process; and (7) using middle range theory to advance the conceptualization of outcomes - both visible and seemingly 'hidden'. One conclusion from our experience is that the degree of heterogeneity of the evidence base will determine whether theory can drive the development of review protocols from the outset, or will follow only after an intense period of data immersion. We hope that presenting a critical reflection on customizing realist review will convey how the methodology can be tailored to the often complex and idiosyncratic features of health research, leading to innovative evidence syntheses. Refereed/Peer-reviewed
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- 2014
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