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OBJECTIVES: Limited research has assessed how virtual care (VC) affects cardiovascular disease (CVD) risk management, especially in community clinic settings. This study assessed change in community clinic patients' CVD risk management during the COVID-19 pandemic and CVD risk factor control among patients who had primarily in-person or primarily VC visits. STUDY DESIGN: Retrospective interrupted time-series analysis. METHODS: Data came from an electronic health record shared by 52 community clinics for index (March 1, 2019, to February 29, 2020) and follow-up (July 1, 2020, to February 28, 2022) periods. Analyses compared follow-up period changes in slope and level of population monthly means of 10-year reversible CVD risk score, blood pressure (BP), and hemoglobin A1c (HbA1c) among patients whose completed follow-up period visits were primarily in person vs primarily VC. Propensity score weighting minimized confounding. RESULTS: There were 10,028 in-person and 6593 VC patients in CVD risk analyses, 9874 in-person and 5390 VC patients in BP analyses, and 8221 in-person and 4937 VC patients in HbA1c analyses. The VC group was more commonly younger, female, White, and urban. Mean reversible CVD risk, mean systolic BP, and percentage of BP measurements that were 140/90 mm Hg or higher increased significantly from index to follow-up periods in both groups. Rate of change between these periods was the same for all outcomes in both groups, regardless of care modality. CONCLUSIONS: Among community clinic patients with CVD risk, receiving a majority of care in person vs a majority of care via VC was not significantly associated with longitudinal trends in reversible CVD risk score or key CVD risk factors. [ABSTRACT FROM AUTHOR]

In response to the demand for more STEM-certified teachers, identity has emerged as a theoretical lens for examining how candidates can be recruited into and retained in the teaching profession. This study explores the intersection between teaching identity and disciplinary identity as they relate to the development of a disciplinary teaching identity. Survey responses were collected from students in a teaching recruitment class for STEM majors, and regression models were developed to predict disciplinary teaching identity and program persistence. Findings from both models indicated that teaching identity is a strong predictor of both disciplinary teaching identity and program persistence, but disciplinary identity plays less of a role. These findings align with previous qualitative research on teacher identity development. Additionally, these findings highlight a need to engage STEM faculty in efforts to recruit students who strongly identify with STEM into the teaching profession. [ABSTRACT FROM AUTHOR]

Objective: We evaluated the extent to which providing training and technical assistance to early childcare centre (ECC) directors, faculty and staff in the implementation of evidence-based nutrition strategies improved the nutrition contexts, policies and practices of ECC serving racially and ethnically diverse, low-income children in Broward County, Florida, USA. The nutrition strategies targeted snack and beverage policies and practices, consistent with Caring for Our Children National Standards.Design: We used the nutrition observation and document review portions of the Environment and Policy Assessment and Observation (EPAO) instrument to observe ECC as part of a one-group pre-test/post-test evaluation design.Setting: ECC located within areas of high rates of poverty, diabetes, minority representation and unhealthy food index in Broward County, Florida, USA.Subjects: Eighteen ECC enrolled, mean 112·9 (sd 53·4) children aged 2-5 years; 12·3 (sd 7·2) staff members; and 10·2 (sd 4·6) children per staff member at each centre.Results: We found significant improvements in centres' overall nutrition contexts, as measured by total EPAO nutrition scores (P=0·01). ECC made specific significant gains within written nutrition policies (P=0·03) and nutrition training and education (P=0·01).Conclusions: Our findings support training ECC directors, faculty and staff in evidence-based nutrition strategies to improve the nutrition policies and practices of ECC serving racially and ethnically diverse children from low-income families. The intervention resulted in improvements in some nutrition policies and practices, but not others. There remains a need to further develop the evaluation base involving the effectiveness of policy and practice interventions within ECC serving children in high-need areas. [ABSTRACT FROM AUTHOR]

The Indiana Science Initiative ( ISI) is a systemic effort to reform K-8 science education. The program provides teachers with professional development, reform-oriented science modules, and materials support. To examine the impact of the initiative's professional development, a participant observation study was conducted in the program's pilot year. Five teachers in grades 3-6 were observed and interviewed as they implemented the ISI-provided modules. Analysis of the observation data revealed that the teachers incorporated each of the features of inquiry science instruction. However, they did not consistently teach in a way that was aligned with the intent of the ISI. Examination of interview data provided insight into influences on teachers' use of inquiry with the ISI-provided modules. These data revealed that teachers were aware of the intent of the ISI and attempted to align their instruction. However, teachers were influenced by their perceptions of students' behavior and abilities as well as timing and the appropriate level of teacher control needed to facilitate science instruction. The research suggests that professional development activities should prepare teachers to help learners evaluate explanations against alternatives, connect explanations to scientific knowledge, and provide strategies to address teachers' perceptions of students, timing, and teacher control. [ABSTRACT FROM AUTHOR]

Behavioral interventions for children with ASD typically target disability specific behaviors such as social skills and communication. There is a particular need for age-appropriate interventions/programs for school-aged children with ASD to teach age-appropriate behaviors (Dawson & Burner, 2011). Adapted physical activity appears to be an appropriate means to help eliminate this disparity and teach agea-ppropriate motor behaviors (Staples & Reid, 2010; MacDonald, Esposito & Ulrich, 2011; MacDonald, Lord & Ulrich, 2013). The purpose of this paper is to outline the behavior management strategies used in a two-wheeled bicycle riding intervention for children with autism, and provide examples of how these techniques can be transferred to the home environment. Examples are provided as to how parents or other family members can utilize these behavior modification techniques to increase two-wheeled bicycle riding frequency at home for school-aged children with ASD. [ABSTRACT FROM AUTHOR]

Community-based physical activity, provided by the community sector, allows for a safe and effective delivery of physical activity for children with disabilities (USDHHS, 2008). To assist community- based health professionals in providing community-based physical activity to children with disabilities, three evidence-based resources will be presented: (1) Global and national resources and certifications (2) Facility and program accessibility measures such as AIMFREE, and (3) Collaboration with academic and clinical sectors by the utilization of the Healthy People 2010 Toolkit. Through the use of these tangible resources, community health professionals can become better prepared in the delivery of community-based physical activity for children with disabilities. [ABSTRACT FROM AUTHOR]

This paper explores the transition of talk to text in the process of performing and recording semi-structured interviews over the telephone. In particular, it considers the ways respondents and the materials enjoined in the process of interviewing exceed their role in the research process. Drawing on my experience of conducting telephone interviews in the UK, I position the interview as an uncertain encounter: one framed by earlier narrations as much as the aims and objectives of the research project; and an orientation towards ‘talk’ as much as the reduction of performance to text. Far from losing track of these uncertainties I argue that tape-recorders are well equipped to document these in/audible realms. [ABSTRACT FROM AUTHOR]

Introduction: The NSW Integrated Care Strategy involves implementing innovative, locally led models of integrated care across the State to transform the NSW healthcare system. The Agency for Clinical Innovation's Patient Reported Measures (PRMs) Program is an important enabler of this strategy. The PRMs Program aims to enable patients to provide direct, timely feedback in order to drive improvement and integration of health care across NSW. Short description of practice change implemented: The PRMs Program enables the collection and use of Patient Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs). The program has used a collaborative co-design approach working with a range of consumers and clinicians throughout each phase. The program is currently working with 11 proof of concept sites (geographical areas) from rural, regional and metropolitan NSW and has facilitated the development of strong partnerships between the acute, community and primary health care services. The program has significantly built capability and capacity of the health care system to transform how care is delivered and how people think about patient outcomes using a range of resources. Aim and theory of change: A formative evaluation of the program was completed to assess the short-term and intermediate outcomes and identify the barriers and enablers of embedding PRMs into routine clinical practice. Targeted population and stakeholders: The targeted population for the program was people living with complex and long term conditions. The PRMs Program has worked with a variety of consumers, clinicians and managers from the proof of concept sites across a range of different settings. Timeline: The Integrated care strategy commenced in 2014 and will run over six years. The PRMs Program commenced late 2014 initially with four proof of concept sites and, due to heavy demand for support and broadening of the program, the program has expanded to 11 proof of concept areas which comprises 81 sites. Highlights (innovation, Impact and outcomes): The PRMs Program formative evaluation identified that having a genuine co-design approach (working from the start with consumers and clinicians) of the program was identified as a key strength of the program as was the co mmitment to travelling out to visit the sites to localise implementation and the education and training was well received. There was early evidence that care planning changed following completion of PROMs and that PRM data has been used to monitor quality and refine service delivery. There was also early evidence that care was more patient-centred, more responsible to patient's needs, clinical practices improved, service delivery more effective and added to reduction in unplanned hospital admissions. Conclusions (comprising key findings): PRMs Program demonstrates how the use of co-design and technology can be used to improve the integration of care and change the way care is delivered to ensure that we really hear what matters most to patients. The results of the program evaluation will be shared and will highlight the enablers and barriers to embedding PRMs into routine clinical practice. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Understanding how the COVID-19 pandemic affected cardiovascular disease (CVD) risk monitoring in primary care may inform new approaches for addressing modifiable CVD risks. This study examined how pandemic-driven changes in primary care delivery affected CVD risk management processes. STUDY DESIGN: This retrospective study used electronic health record data from patients at 70 primary care community clinics with scheduled appointments from September 1, 2018, to September 30, 2021. METHODS: Analyses examined associations between appointment type and select care process measures: appointment completion rates, time to appointment, and up-to-date documentation for blood pressure (BP) and hemoglobin A1c (HbA1c). RESULTS: Of 1,179,542 eligible scheduled primary care appointments, completion rates were higher for virtual care (VC) vs in-person appointments (10.7 percentage points [PP]; 95% CI, 10.5-11.0; P < .001). Time to appointment was shorter for VC vs in-person appointments (--3.9 days; 95% CI, --4.1 to --3.7; P < .001). BP documentation was higher for appointments completed pre-- vs post pandemic onset (16.2 PP; 95% CI, 16.0-16.5; P < .001) and for appointments completed in person vs VC (54.9 PP; 95% CI, 54.6-55.2; P < .001). HbA1c documentation was higher for completed appointments after pandemic onset vs before (5.9 PP; 95% CI, 5.1-6.7; P < .001) and for completed VC appointments vs in-person appointments (3.9 PP; 95% CI, 3.0-4.7; P < .001). CONCLUSIONS: After pandemic onset, appointment completion rates were higher, time to appointment was shorter, HbA1c documentation increased, and BP documentation decreased. Future research should explore the advantages of using VC for CVD risk management while continuing to monitor for unintended consequences. [ABSTRACT FROM AUTHOR]