Data management system for diabetes clinical trials: a pre-post evaluation study.

BACKGROUND: Data management system for diabetes clinical trials is used to support clinical data management processes. The purpose of this study was to evaluate the quality and usability of this system from the users' perspectives. METHODS: This study was conducted in 2020, and the pre-post evaluation method was used to examine the quality and usability of the designed system. Initially, a questionnaire was designed and distributed among the researchers who were involved in the diabetes clinical trials (n = 30) to investigate their expectations. Then, the researchers were asked to use the system and explain their perspectives about it by completing two questionnaires. RESULTS: There was no statistically significant differences between the users' perspectives about the information quality, service quality, achievements, and communication before and after using the system. However, in terms of the system quality (P = 0.042) and users' autonomy (P = 0.026), the users' expectations were greater than the system performance. The system usability was at a good level based on the users' opinions. CONCLUSION: It seems that the designed system largely met the users' expectations in most areas. However, the system quality and users' autonomy need further attentions. In addition, the system should be used in multicenter trials and re-evaluated by a larger group of users.

[Pre-post evaluation of an intergenerational program to improve wellbeing in older adults and age stereotypes in primary and secondary students: CRENCO project]. / Evaluación pre-post de un programa intergeneracional para mejorar el bienestar en personas mayores y los estereotipos edadistas en alumnos de primaria y secundaria: proyecto CRENCO.

OBJECTIVE: The present study aims to evaluate the effectiveness of the CRENCO project which was carried out during the COVID-19 pandemic including intergenerational activities shared by students from primary and secondary education and users of two centers for older adults and a day hospital in Catalonia. The effectiveness was assessed in terms of well-being in older adults and on negative stereotypes about the elderly in primary and secondary students. METHODS: Three interventions were carried out in which 32 older persons (9 users of centers for older adults and 23 of a day hospital), 99 primary students and 56 secondary students participated. Participants answered a questionnaire before and after the interventions. Through multilevel linear models for repeated measures, changes in feelings of loneliness, social support, anxiety and depressive symptoms, self-reported health and health-related quality of life were evaluated in older people. In primary and secondary students, changes in age stereotypes were evaluated. RESULTS: Health-related quality of life and self-reported health improved statistically after the interventions in older persons. Users of the day hospital also reported an improvement in social support. Primary school students improved their age stereotypes; no statistically significant changes were detected in secondary students. CONCLUSION: The results of the present study contribute to underlining the importance of intergenerational programs such as the one proposed by CRENCO, capable of improving well-being and providing a more realistic vision of the older adults. Our results suggest that these programs should be implemented during childhood in order to prevent the proliferation of ageist stereotypes in later life stages.

Evaluación pre-post de un programa intergeneracional para mejorar el bienestar en personas mayores y los estereotipos edadistas en alumnos de primaria y secundaria: proyecto CRENCO / Pre-post evaluation of an intergenerational program to improve wellbeing in older adults and age stereotypes in primary and secondary students: CRENCO project

Objetivo: El presente estudio tiene como objetivo evaluar la efectividad del proyecto CRENCO, que se desarrolló durante la pandemia por COVID-19, incluyendo actividades intergeneracionales compartidas por alumnos de primaria y secundaria y personas mayores en Cataluña. Se evalúa su efecto en el bienestar de las personas mayores y en los estereotipos negativos sobre las personas mayores de los alumnos.Métodos: Se llevaron a cabo tres intervenciones en las que participaron 32 personas mayores (9 usuarios de centros para mayores y 23 de un hospital de día), 99 alumnos de primaria y 56 alumnos de secundaria. Los participantes fueron entrevistados antes y después de las intervenciones. A través de modelos lineales multinivel de efectos aleatorios para medidas repetidas, se evaluaron, en personas mayores, cambios en sentimientos de soledad, soporte social, sintomatología ansiosa y depresiva, salud autopercibida y calidad de vida relacionada con la salud. En alumnos de primaria y secundaria se evaluaron cambios en estereotipos edadistas.Resultados: Las personas mayores reportaron una mejor calidad de vida relacionada con la salud y una mejor salud autopercibida al finalizar las intervenciones. Los usuarios del hospital de día reportaron también una mejora en el soporte social. Los alumnos de primaria mejoraron sus estereotipos edadistas, lo cual no sucedió en estudiantes de secundaria.Conclusiones: Los resultados del presente estudio contribuyen a subrayar la importancia de programas intergeneracionales como el que plantea CRENCO, capaces de mejorar el bienestar y aportar una visión más realista de las personas mayores. Nuestros resultados sugieren que estos proyectos deben ser implantados durante la infancia con el objetivo de impedir la proliferación de los estereotipos edadistas en las posteriores etapas vitales. (AU)

Objective: The present study aims to evaluate the effectiveness of the CRENCO project which was carried out during the COVID-19 pandemic including intergenerational activities shared by students from primary and secondary education and users of two centers for older adults and a day hospital in Catalonia. The effectiveness was assessed in terms of well-being in older adults and on negative stereotypes about the elderly in primary and secondary students.Methods: Three interventions were carried out in which 32 older persons (9 users of centers for older adults and 23 of a day hospital), 99 primary students and 56 secondary students participated. Participants answered a questionnaire before and after the interventions. Through multilevel linear models for repeated measures, changes in feelings of loneliness, social support, anxiety and depressive symptoms, self-reported health and health-related quality of life were evaluated in older people. In primary and secondary students, changes in age stereotypes were evaluated.Results: Health-related quality of life and self-reported health improved statistically after the interventions in older persons. Users of the day hospital also reported an improvement in social support. Primary school students improved their age stereotypes; no statistically significant changes were detected in secondary students.Conclusion: The results of the present study contribute to underlining the importance of intergenerational programs such as the one proposed by CRENCO, capable of improving well-being and providing a more realistic vision of the older adults. Our results suggest that these programs should be implemented during childhood in order to prevent the proliferation of ageist stereotypes in later life stages. (AU)

Can stigmatizing attitudes be prevented in psychology students?

BACKGROUND: Stigmatizing attitudes have been found among psychology students in many studies, and they are becoming more common with time. AIMS: This study examines whether participation in clinical psychology lessons reduces levels of stigmatization in a population of psychology students and whether it leads to any change in stigmatization. METHODS: The study is a pre/post evaluation of the effectiveness of clinical psychology lessons (63 hours of lectures) as a tool to fight stigma. The presence of stigmatizing attitudes was detected using the Italian version of the Attribution Questionnaire-27 (AQ-27-I). Stigmatization was described before and after the lessons with structured equation modeling (SEM). RESULTS: Of a total of 387 students contacted, 302 (78.04%) agreed to be involved in the study, but only 266 (68.73%) completed the questionnaires at both t0 and t1. A statistically significant reduction was seen in all six scales and the total score on the AQ-27-I. The models defined by the SEM (pre- and post-intervention) showed excellent model fit indices and described different dynamics of the phenomenon of stigma. CONCLUSIONS: A cycle of clinical psychology lessons can be a useful tool for reducing stigmatizing attitudes in a population of students seeking a psychology degree.

Healthcare Providers' Knowledge and Attitude Towards Abortions in Thailand: A Pre-Post Evaluation of Trainings on Safe Abortion.

Although physicians in Thailand can carry out abortions legally, unsafe abortion rates remain high and have serious consequences for women's health. Training programs for healthcare providers on the 'Care of unplanned and adolescent pregnancies for the prevention of unsafe abortions' have been implemented in Thailand with the aim of providing information and challenging negative attitudes about abortions. This study investigated the participants of the training courses in order to: (i) evaluate their knowledge and attitudes towards safe abortions; and (ii) investigate the factors that determine their knowledge and attitudes. A pre-post study design was applied. Descriptive statistics were calculated to provide an overview of the data. Bivariate analysis, a Wilcoxon signed rank test and a multivariable analysis using multiple linear regression were applied to determine the changes in attitudes and assess the likelihood of behaviour change towards adolescents and women experiencing unplanned pregnancy and abortions, according to demographic and professional characteristics. Having had the training, healthcare providers' change in attitudes towards adolescents and women experiencing unplanned pregnancies and abortions were found to be 0.67 points for the nine responses of attitudes and 0.79 points for the 14 responses on various abortion scenarios. Changes in attitude were significantly different among the varying health professional types, with non-doctors increasing by 0.53 points, non-obstetricians and non-gynaecologists increasing by 0.46 points and obstetricians and gynaecologists (OBGYN) increasing by 0.32 points. Positive attitudes towards unplanned pregnancies and unsafe abortions and attitudes towards abortion scenarios significantly increased. The career type of the health professional was a significant factor in improving attitudes. The training program was more effective among non-doctor healthcare providers. Therefore, non-doctors could be the target population for training in the future.

Think time: A novel approach to analysis of clinicians' behavior after reduction of drug-drug interaction alerts.

OBJECTIVES: Pharmacologic interaction alerting offers the potential for safer medication prescribing, but research reveals persistent concerns regarding alert fatigue. Research studies have tried various strategies to resolve this problem, with low overall success. We examined the effects of targeted alert reduction on clinician behavior in a resource constrained hospital. METHODS: A physician and a pharmacy informaticist reduced alert levels of several drug-drug interactions (DDI) that clinicians almost always overrode with approval from and knowledge of the medical staff. This study evaluated the behavioral changes in prescribers and non-prescribers as measured by "think time", a new metric for evaluating the resolution time for an alert, before and after suppression of selected DDI alerts. RESULTS: The user-seen DDI alert rate decreased from 9.98% of all orders to 9.20% (p=0.0001) with an overall volume reduction of 10.3%. There was no statistical difference in the reduction of cancelled (-10.00%) vs. proceed orders (-11.07%). Think time decreased overall by 0.61s (p<0.0001). Think time unexpectedly increased for cancelled orders 1.00s which while not statistically significant (p=0.28) is generally thought to be clinically noteworthy. For overrides, think time decreased 0.67s which was significant (p<0.0001). Think time lowered for both prescribers and non-prescribers. Targeted specialists had shorter think times initially, which shortened more than non-targeted specialists. CONCLUSIONS: Targeted DDI alert reductions reduce alert burden overall, and increase net efficiency as measured by think time for all prescribers better than for non-prescribers. Think time may increase when cancelling or changing orders in response to DDI alerts vs. a decision to override an alert.

Pilot evaluation of an optimized context-specific drug-drug interaction alerting system: A controlled pre-post study.

OBJECTIVES: Clinical decision support (CDS) systems are frequently used to reduce unwanted drug-drug interactions (DDIs) but often result in alert fatigue. The main objective of this study was to investigate whether a newly developed context-specific DDI alerting system would improve alert acceptance. METHODS: A controlled pre-post intervention study was conducted in 4 departments in a university hospital. After a 7-month pre-intervention period, the new system was activated in the intervention departments, while the old system remained activated in the control departments. Post-intervention data was collected for a 7-month period. RESULTS: A significant increase of the overall acceptance rate was observed between the pre- and post-intervention period (2.2% versus 52.4%; p<0.001) for the intervention departments and between the intervention and control departments (2.5% versus 52.4%; p<0.001) in the post-intervention period. There were no significant differences in acceptance rates between the pre- and post-intervention period in the control departments and also not between the control and intervention departments in the pre-intervention period. CONCLUSIONS: The improvement was probably related to several optimization strategies including the customization of the severity classification, the creation of individual screening intervals, the inclusion of context factors for risk assessment, the new alert design and the creation of a follow-up system. The marked increase in alert acceptance looks promising and should be further evaluated after hospital wide implementation. System aspects that require further optimization were identified and will be developed. Further research is warranted to develop context-aware algorithms for complex class-class interactions.