Browsing by Subject "Implementation"
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- PublicationOpen AccessAnalysis of the implementation of the 11th ASEAN Para Games in Indonesia(Universidad de Murcia, Servicio de publicaciones, 2024) Suryani, Margareta; Purnama, Sapta Kunta; Umar, Fadilah; Riyadi, SlametThis study aimedto analyze theevaluation of theimplementation of the 11th ASEAN Para Games in Indonesia, where there was a transfer of hosts, and Indonesia agreed to organize the event following a 2-year hiatus.The research employed an evaluation method within the qualitative research category. Specifically, the study used the CIPP model for evaluation, with data collected through a questionnaire and observation. The CIPP assessment was conducted both during and at the end of the ASEAN Para Games in Indonesia in 2022.The population of this study comprised all Indonesian athletes who participated in the 2022 ASEAN Para Games in Bengawan, Indonesia. The research subjects included the NPC, KEMENPORA, PELATNAS, and the government, totaling 115 people.Based on the analysis, the 11th ASEAN Para Games in Indonesia in 2022, evaluated using the CIPP method, was successful. Content, input, process, and product evaluations all rated in the moderate category, with scores ranging from 66.7% to 93.3% across competition managers, managersand officials, coaches, athletes, and support personnel, indicating satisfactory performance.Overall, the evaluation results reveal that the implementation of the 11th ASEAN Para Games in Indonesia in 2022 was conducted quite well, adhering to the rules and standards for international sports events
PublicationOpen AccessData Set: review implementation of digital tools and processes in higher education institutions 2021(2021-04) Castañeda Quintero, Linda Johanna; Esteve Mon, Francesc; Postigo Fuentes, Ana Yara; Didáctica y Organización Escolar- PublicationEmbargoDeterminants of dropout from a virtual agent–based app for insomnia management in a self-selected sample of users with insomnia symptoms: longitudinal study(JMIR Publications, 2023) Sánchez Ortuño, María Montserrat; Pecune, Florian; Coelho, Julien; Micoulaud Franchi, Jean Arthur; Salles, Nathalie; Auriacombe, Marc; Serre, Fuschia; Levavasseur, Yannick; De Sevin, Etienne; Sagaspe, Patricia; Philip, Pierre; EnfermeríaBackground: Fully automated digital interventions delivered via smartphone apps have proven efficacious for a wide variety of mental health outcomes. An important aspect is that they are accessible at a low cost, thereby increasing their potential public impact and reducing disparities. However, a major challenge to their successful implementation is the phenomenon of users dropping out early. Objective: The purpose of this study was to pinpoint the factors influencing early dropout in a sample of self-selected users of a virtual agent (VA)–based behavioral intervention for managing insomnia, named KANOPEE, which is freely available in France. Methods: From January 2021 to December 2022, of the 9657 individuals, aged 18 years or older, who downloaded and completed the KANOPEE screening interview and had either subclinical or clinical insomnia symptoms, 4295 (44.5%) dropped out (ie, did not return to the app to continue filling in subsequent assessments). The primary outcome was a binary variable: having dropped out after completing the screening assessment (early dropout) or having completed all the treatment phases (n=551). Multivariable logistic regression analysis was used to identify predictors of dropout among a set of sociodemographic, clinical, and sleep diary variables, and users’ perceptions of the treatment program, collected during the screening interview. Results: The users’ mean age was 47.95 (SD 15.21) years. Of those who dropped out early and those who completed the treatment, 65.1% (3153/4846) were women and 34.9% (1693/4846) were men. Younger age (adjusted odds ratio [AOR] 0.98, 95% CI 0.97‐0.99), lower education level (compared to middle school; high school: AOR 0.56, 95% CI 0.35‐0.90; bachelor’s degree: AOR 0.35, 95% CI 0.23‐0.52; master’s degree or higher: AOR 0.35, 95% CI 0.22‐0.55), poorer nocturnal sleep (sleep efficiency: AOR 0.64, 95% CI 0.42‐0.96; number of nocturnal awakenings: AOR 1.13, 95% CI 1.04‐1.23), and more severe depression symptoms (AOR 1.12, 95% CI 1.04‐1.21) were significant predictors of dropping out. When measures of perceptions of the app were included in the model, perceived benevolence and credibility of the VA decreased the odds of dropout (AOR 0.91, 95% CI 0.85‐0.97). Conclusions: As in traditional face-to-face cognitive behavioral therapy for insomnia, the presence of significant depression symptoms plays an important role in treatment dropout. This variable represents an important target to address to increase early engagement with fully automated insomnia management programs. Furthermore, our results support the contention that a VA can provide relevant user stimulation that will eventually pay out in terms of user engagement.
- PublicationOpen AccessDeterminants of Evidence Implementation by Nurses: #Evidencer Model for the Use of Evidence-Based Practice (#EvidencerMUSEBP)—A Structural Equation Model(2024-02-28) Ruzafa-Martinez, Maria; Fernández-Salazar, Serafín; Leal-Costa, César; Ramos-Morcillo, Antonio Jesús; EnfermeríaExisting studies have identified specific factors influencing some dimensions of evidence-based practice (EBP) competence and use. However, the way these factors interact still needs to be clarified. The purpose of the study was to test a model based on the Determinant Frameworks that explain the relationships and the direct pathways between the characteristics of the nurses, the context, and the implementation strategies and the dimensions of EBP competence, attitude, knowledge, skills, and use of EBP. A cross-sectional study was carried out in Spain during January and February 2020, involving 2,370 nurses employed in public health centers across all autonomous communities within the National Health System. An online survey was administered to gather data, addressing various topics related to the nurses’ characteristics, the context in which they worked, the implementation strategy, and their competence in evidence-based practice (EBP). As depicted in the conceptual framework, a structural equation model was constructed to test the hypothesized relationships among key study variables. The model obtained showed a good fit (χ2/df = 3.20, p < 0.001; RMSEA = 0.030 [90% CI 0.025, 0.036]; CFI = 0.989; GFI = 0.990; TLI = 0.983). The context, more specifically, the dimensions of nurse participation in the center’s affairs, nursing foundations for quality of care, nurse manager ability leadership and support of nurses, and implementation strategy have a direct and positive effect on EBP use. Training in EBP, reading scientific articles, and having a doctorate are associated with higher competence and knowledge in EBP. The final fit shows the #Evidencer model for the use of EBP (#EvidencerMUSEBP) with two main components: the contextual and strategic factors that influence the implementation of EBP and the characteristics of the professionals, such as their training and reading of articles, which have an impact on EBP competence. This model could guide healthcare organizations in proposing comprehensive interventions to improve EBP use and the competency of nurses.
- PublicationOpen AccessEvidence-based practice nurses' competency: Spanish national survey and establishment of a scale of the EBP-COQ-Prof©(2021-05) Ramos Morcillo, Antonio Jesús; Fernández Salazar, Serafín; Leal Costa, Cesar; Ruzafa Martinez, Maria; EnfermeríaAbstract Aims: To discover the level of evidence-based practice competency of Spanish nurses, to develop a scale of the EBP-COQ-Prof© and to analyse the influence of different variables on the level of competency. Background: The evidence-based practice competency has previously been assessed using a wide variety of instruments, although these have methodological limitations and lack associated scales that allow for the interpretation of the score obtained. Method: Observational, cross-sectional, national study. Using an online questionnaire, data were obtained between January and March 2020 from nurses working in the National Health System. An ANOVA was performed along with multiple regression analyses. The T-score and percentiles were calculated to obtain the scale of the EBP-COQ-Prof©. Results: 2,942 nurses participated. The score for the evidence-based practice competency was 130.29 (standard deviation 17.55). The multiple regression analysis showed a model comprised of 8 variables that explained 33% of the variance. Conclusions: The Spanish nurses have a moderate level of evidence-based practice competency. The scale classifies the subjects into 3 levels: low, moderate and high competency. Implications for nursing management: The scale proposed for the EBP-COQ-Prof© could be utilized to facilitate the diagnosis of evidence-based practice competency, and to monitor and plan individual and collective strategies to improve this competency.
- PublicationOpen AccessMonitoring of the Implementation of a Breastfeeding Guideline for 6 Years: A Mixed-Methods Study Using an Interrupted Time Series Approach(2021-05) Ruzafa Martinez, Maria; Ramos Morcillo, Antonio Jesús; Harillo Acevedo, Francisco David; EnfermeríaBackground: Current literature provides poor information about the implementation of health-promoting clinical practice guidelines (CPGs) and their longitudinal monitoring. Purpose: The aim of this study was to evaluate the longitudinal impact of a CPG implementation program that promotes breastfeeding, its associated quantitative and qualitative indicators, and direct costs. Design: A mixed-methods design with a longitudinal approach was utilized, with an interrupted time series design and the analysis of reports from the implementation program as the qualitative approach. Methods: The study setting was maternity and pediatric units of a health area in the Spanish health system. The implementation of a CPG for the promotion of breastfeeding was evaluated, which included a pre-implementation year (2011), 3 years of implementation (2012-2014), and 2 years of post-implementation (2015-2016). The sample was composed of mother-infant dyads. A segmented logistic regression analysis was utilized to evaluate the changes in the most important breastfeeding indicators. A deductive thematic content analysis was performed starting with quality indicators and a descriptive economic analysis. Findings: In the 6 years of monitoring, 7,842 mother-infant dyads were recorded. The results of the quantitative indicators showed the presence of four stages: baseline, gain, adjustment, and sustainability or saturation. The breast milk at the first feeding had an increasing slope in the gain stage (24% per quarter; odds ratio [OR] = 1.24, 95% confidence interval [CI] 1.12-1.37). The exclusive breastfeeding at hospital discharge showed significant changes in the period of gain (OR = 2.45, 95% CI 1.95-3.08), which was maintained in the adjustment period, with an increase of 18% in the slope of the gain stage (OR = 1.18, 95% CI 1.06-1.32). The longitudinal distribution of the qualitative indicators showed a greater concentration of indicators towards the first half of each phase. The total cost was 209,575€ ($248,670.17). Conclusions: The implementation of the breastfeeding CPG showed early, positive, and sustained results in the exclusive breastfeeding rates. The implementation implied the application of a complex intervention, with its qualitative indicators showing a wave-shaped dynamic. Clinical relevance: Our findings contribute to the understanding and evolution of the main indicators of the implementation of a breastfeeding CPG, providing details on the magnitude of the effect, the process of change, and the associated costs.
- PublicationRestrictedMonitoring the sustainability of a breastfeeding guideline during the COVID-19 pandemic: a mixed-methods study(Wiley, 2025-02-17) Harillo Acevedo, Francisco David; Molina Rodríguez, Alonso; Ramos Morcillo, Antonio Jesús; Suárez Cortés, María; Ruzafa Martínez, María; Enfermería; Facultad de EnfermeríaAim: To analyse the impact of the COVID- 19 pandemic on the sustainability of a breastfeeding (BF) clinical practice guideline (CPG) for women without COVID- 19, throughout the 5 waves of the pandemic. Desing: A mixed- methods design was utilised. Methods: For the quantitative approach, an interrupted time series design was utilised, as well as the analysis of CPG sustaina bility reports as a qualitative approach. The study setting was in a health area in the Spanish health system from April 2019, until October 2021. The sample was composed of 2239 mother–infant dyads. Results: The exclusive- BF rate at hospital discharge obtained values between 90% and 94.8%, without statistically significant changes. A significant increase in the risk of not starting BF in the first feeding was observed (adjusted odds ratio = 9.36; 95% CI: 1.04–84.13), between the pre- pandemic period and the first wave. Skin- to- skin contact (SSC) decreased in the first wave to 82.20%, and the oscillations observed throughout the pandemic were not statistically significant. In general, the qualitative indicators were maintained. A decrease was observed in the spaces used for postpartum care due to the re- assigning to the intensive care unit. Also, the acquisition of materials and equipment decreased. Conclusions: The measures implemented for the sustainability of the BF CPG during the 5 waves of the pandemic were positive. The programmes of implementation of BF guidelines were shown to resist the COVID- 19 pandemic. Impact: Our findings contribute to the understanding and evolution of the main indicators of the sustainability of a BF CPG on COVID- 19 context, providing details on the magnitude of the effect and the process of change. Reporting Method: The Preferred Reporting Items for observational studies (STROBE) checklist was followed. Patient or Public Contribution: No Patient or Public Contribution.
- PublicationOpen AccessStudy on the use, acceptability and implementation of the Unified Protocol in general health psychologists in Spain(Universidad de Murcia. Servicio de Publicaciones, 2022) Peris Baquero, Óscar; Osma, Jorge; Martínez Segura, VioletaThe dissemination of evidence-based psychological treatments (EBPT) is a pending task for Clinical Psychology. Through an online sur-vey and following the Theoretical Framework of Acceptability, we ana-lyzed the opinions about use, acceptability and intention to use in the fu-ture of the Unified Protocol for the transdiagnostic treatment of emotional disorders (UP) in a sample of 153 professionals of General Health Psy-chology (GHPs). All participants took a training course in the UP and were grouped depending on their previous experience in the UP application. The results showed high scores in acceptability and intention to use in the future in GHPs regardless of the group. Finally, statistically significant cor-relations were found between intention to use in the future and affective attitude, consistency of the intervention and perceived efficacy (in both groups) and self-efficacy (in the group of GHPs without experience in the use of UP). The UP is an EBPT that presents high levels of acceptance and intention to use by the GHPs who received training in this interven-tion, this will facilitate its dissemination and implementation and will allow a greater number of people to benefit from this treatment.