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Abstract Background Pediatric brain tumor survivors (PBTS) are at risk of physical, cognitive, and psychosocial challenges related to their diagnosis and treatment. Routine follow-up care as adults is therefore essential to their long-term health and quality of life. In order to successfully navigate to adult healthcare, it is recommended that youth develop transition readiness skills. Existing transition readiness interventions often focus on disease management. However, PBTS are also at risk of social competence and cognitive functioning challenges. In this paper, we describe the protocol of this pilot study and the methodology that will be used for the evaluation of the feasibility, acceptability, and preliminary efficacy testing of the first targeted transition intervention workshops specifically designed to meet the needs of PBTS and their caregivers. Methods This study will use a mixed method to evaluate three 1 ½-h workshops targeted for dyads (N = 40) of PBTS (14 years or older) and their parents. Dyads will be recruited via a community pediatric cancer organization and the long-term follow-up clinic of a large pediatric hospital. Participants will complete an online survey which includes the Transition Readiness Assessment Questionnaire (TRAQ) before and after the workshops. Each workshop will cover a specific topic related to PBTS transition readiness: disease management, social competence, and cognitive functioning. Workshops will follow the same structure: topic presentation, discussion by a post-transfer survivor or parent, teaching two strategies, and workshop evaluation. Workshops will be co-led by healthcare specialists and patient partners. Feasibility and acceptability will be assessed via recruitment, attendance, retention, and Likert scales, and they will be analyzed by describing and comparing rates. Satisfaction will be measured using satisfaction surveys and audio-recorded focus groups. Qualitative data will be described through thematic content analysis. In order to test the preliminary efficacy of this study, we will compare transition readiness skills pre- and post-workshops using paired samples T test and ANCOVA to examine the impact of workshop on TRAQ skills. Discussion Results of the study will inform refinement and future broader implementation of targeted transition readiness workshops for the specific needs of pediatric brain tumor survivors.

Background: Pediatric brain tumor survivors (PBTS) are at risk of physical, cognitive, and psychosocial challenges related to their diagnosis and treatment. Routine follow-up care as adults is therefore essential to their long-term health and quality of life. In order to successfully navigate to adult healthcare, it is recommended that youth develop transition readiness skills. Existing transition readiness interventions often focus on disease management. However, PBTS are also at risk of social competence and cognitive functioning challenges. In this paper, we describe the protocol of this pilot study and the methodology that will be used for the evaluation of the feasibility, acceptability, and preliminary efficacy testing of the first targeted transition intervention workshops specifically designed to meet the needs of PBTS and their caregivers. Methods: This study will use a mixed method to evaluate three 1 ½-h workshops targeted for dyads (N = 40) of PBTS (14 years or older) and their parents. Dyads will be recruited via a community pediatric cancer organization and the long-term follow-up clinic of a large pediatric hospital. Participants will complete an online survey which includes the Transition Readiness Assessment Questionnaire (TRAQ) before and after the workshops. Each workshop will cover a specific topic related to PBTS transition readiness: disease management, social competence, and cognitive functioning. Workshops will follow the same structure: topic presentation, discussion by a post-transfer survivor or parent, teaching two strategies, and workshop evaluation. Workshops will be co-led by healthcare specialists and patient partners. Feasibility and acceptability will be assessed via recruitment, attendance, retention, and Likert scales, and they will be analyzed by describing and comparing rates. Satisfaction will be measured using satisfaction surveys and audio-recorded focus groups. Qualitative data will be described through thematic content analysis. In order to test the preliminary efficacy of this study, we will compare transition readiness skills pre- and post-workshops using paired samples T test and ANCOVA to examine the impact of workshop on TRAQ skills. Discussion: Results of the study will inform refinement and future broader implementation of targeted transition readiness workshops for the specific needs of pediatric brain tumor survivors. [ABSTRACT FROM AUTHOR]

Background: Non-communicable chronic diseases are the leading causes of mortality globally, and nearly 80% of these deaths occur in low- and middle-income countries (LMICs). In high-income countries (HICs), inequitable distribution of resources affects poorer and otherwise disadvantaged groups including Aboriginal peoples. Cardiovascular mortality in high-income countries has recently begun to fall; however, these improvements are not realized among citizens in LMICs or those subgroups in high-income countries who are disadvantaged in the social determinants of health including Aboriginal people. It is critical to develop multi-faceted, affordable and realistic health interventions in collaboration with groups who experience health inequalities. Based on community-based participatory research (CBPR), we aimed to develop implementation tools to guide complex interventions to ensure that health gains can be realized in low-resource environments. Methods: We developed the I-RREACH (Intervention and Research Readiness Engagement and Assessment of Community Health Care) tool to guide implementation of interventions in low-resource environments. We employed CBPR and a consensus methodology to (1) develop the theoretical basis of the tool and (2) to identify key implementation factor domains; then, we (3) collected participant evaluation data to validate the tool during implementation. Results: The I-RREACH tool was successfully developed using a community-based consensus method and is rooted in participatory principles, equalizing the importance of the knowledge and perspectives of researchers and community stakeholders while encouraging respectful dialogue. The I-RREACH tool consists of three phases: fact finding, stakeholder dialogue and community member/patient dialogue. The evaluation for our first implementation of I-RREACH by participants was overwhelmingly positive, with 95% or more of participants indicating comfort with and support for the process and the dialogue it creates. Conclusions: The I-RREACH tool was designed to (1) pinpoint key domains required for dialogue between the community and the research team to facilitate implementation of complex health interventions and research projects and (2) to identify existing strengths and areas requiring further development for effective implementation. I-RREACH has been found to be easily adaptable to diverse geographical and cultural settings and can be further adapted to other complex interventions. Further research should include the potential use of the I-RREACH tool in the development of blue prints for scale-up of successful interventions, particularly in low-resource environments. [ABSTRACT FROM AUTHOR]

We present EGDA, an educational game development approach focused on the teaching of procedural knowledge using a cost-effective approach. EGDA proposes four tasks: analysis, design, implementation, and quality assurance that are subdivided in a total of 12 subtasks. One of the benefits of EGDA is that anyone can apply it to develop a game since it keeps development as simple as possible and uses tools for modeling and implementation that do not require a highly technical profile. EGDA has been applied to the creation of seven educational games in healthcare, and has been iteratively refined after each experience. EGDA is evaluated on two aspects. First, the effort and cost needed for creating these games is estimated and compared to current industry standards. Second, impact on knowledge acquisition and a student acceptance are discussed. Results suggest that EGDA can make game development more affordable, which is critical for increased adoption and scalability of game-based learning (GBL), while assuring a high educational value of the resulting games. [ABSTRACT FROM PUBLISHER]

According to the Interactive Systems Framework for Dissemination and Implementation, implementation is a major mechanism and concern in bridging research and practice. The growing number of implementation frameworks need to be synthesized and translated so that the science and practice of quality implementation can be furthered. In this article, we: (1) use the synthesis of frameworks developed by Meyers et al. (Am J Commun Psychol, ) and translate the results into a practical implementation science tool to use for improving quality of implementation (i.e., the Quality Implementation Tool; QIT), and (2) present some of the benefits and limitations of the tool by describing how the QIT was implemented in two different pilot projects. We discuss how the QIT can be used to guide collaborative planning, monitoring, and evaluation of how an innovation is implemented. [ABSTRACT FROM AUTHOR]

Background and objective: During recent years, the World Health Organization (WHO) proposed new software for improving the tuberculosis (TB) laboratory services. The protocol is known as “quality stepwise implementation tool” and is based on enforcement of quality assurance services through accreditation by the International Organization for Standardization (ISO) 15189. As a national reference TB laboratory (NRL) of Iran, the benefit and challenges of implementing this standard were analyzed. Material and Methods: The investigation was a cross-sectional study and was underlined by the committee of the Quality Management System (QMS) in the NRL. The required information was collected in two steps: first, the QC form that contains 334 quality questions (designed by WHO) was filled out. These questions determine 12 main organizational blocks of laboratory (facilities and safety1, organization and personnel2, documents and records3, management reviews4, client management and customer service5, equipment6, internal audit7, purchasing and inventory8, information management9, process control and internal / external quality management10, corrective actions occurrence11, and incident management and process improvement12). The minimum rating of laboratories is stated to be from 55% to a maximum of 95%. In the second step, using the quality stepwise implementation tool, these blocks were in four phases, and 41 steps were analyzed. The data were compared using Fisher's Exact test and Pearson Chi-Square. Results: In the period 2013–2014, the rate of OMS in three focal points (pre-analytical, analytical, and post-analytical) in the NRL was in the range of 80–100%; whereas in previous years the rate ranged from 48% to 79%. Therefore, through QMS the NRL scores had reached a higher level. Based on available results, the NRL-assigned score was a 5-star rating. Conclusions: As the internal score of NRL reaches 5, an international evaluation of accreditation scheme is sought. This is the first investigation that used the quality stepwise implementation tool in Iran.

Background and objective During recent years, the World Health Organization (WHO) proposed new software for improving the tuberculosis (TB) laboratory services. The protocol is known as “quality stepwise implementation tool” and is based on enforcement of quality assurance services through accreditation by the International Organization for Standardization (ISO) 15189. As a national reference TB laboratory (NRL) of Iran, the benefit and challenges of implementing this standard were analyzed. Material and methods The investigation was a cross-sectional study and was underlined by the committee of the Quality Management System (QMS) in the NRL. The required information was collected in two steps: first, the QC form that contains 334 quality questions (designed by WHO) was filled out. These questions determine 12 main organizational blocks of laboratory (facilities and safety 1 ¸ organization and personnel 2 ¸ documents and records 3 ¸ management reviews 4 ¸ client management and customer service 5 ¸ equipment 6 ¸ internal audit 7 ¸ purchasing and inventory 8 ¸ information management 9 ¸ process control and internal / external quality management 10 ¸ corrective actions occurrence 11 , and incident management and process improvement 12 ). The minimum rating of laboratories is stated to be from 55% to a maximum of 95%. In the second step, using the quality stepwise implementation tool, these blocks were in four phases, and 41 steps were analyzed. The data were compared using Fisher’s Exact test and Pearson Chi-Square. Results In the period 2013–2014, the rate of OMS in three focal points (pre-analytical¸ analytical¸ and post-analytical) in the NRL was in the range of 80–100%; whereas in previous years the rate ranged from 48% to 79%. Therefore, through QMS the NRL scores had reached a higher level. Based on available results, the NRL-assigned score was a 5-star rating. Conclusions As the internal score of NRL reaches 5, an international evaluation of accreditation scheme is sought. This is the first investigation that used the quality stepwise implementation tool in Iran. [ABSTRACT FROM AUTHOR]