ORCID Profile
0000-0001-9518-5869
Current Organisations
University of Melbourne
,
Bass Coast Health Wonthaggi Hospital
,
Alfred Health
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Publisher: Wiley
Date: 24-06-2023
DOI: 10.1111/BJHP.12677
Abstract: Methods for assessing acceptability of healthcare interventions have been inconsistent until the development of the theoretical framework of acceptability (TFA). Despite its rapid adoption in healthcare research, the TFA has rarely been used to assess acceptability of surgical interventions. We sought to explore the sufficiency of the TFA in this context and provide methodological guidance to support systematic use of this framework in research. Acceptability was assessed in a consecutive s le of 15 patients at least 3 months post‐joint replacement surgery via theory‐informed semi‐structured interviews. A detailed description of the application of the TFA is reported. This includes: development of the interview guide (including questions to assess theoretical sufficiency), analysis of interview data and interpretation of findings. Interview data were substantially codable into the TFA constructs but required the addition of a construct, labelled ‘perceived safety and risk’, and relabelling and redefining an existing construct (new label: ‘opportunity costs and gains’). Methodological recommendations for theory‐informed interview studies include producing interview support material to enhance precision of the intervention description, conducting background conversations with a range of stakeholders in the healthcare setting, and conducting first inductive and then deductive thematic analysis. The sufficiency of the TFA could be enhanced for use when assessing interventions with an identifiable risk profile, such as surgery, by the inclusion of an additional construct to capture perceptions of risk and safety. We offer these methodological recommendations to guide researchers and facilitate consistency in the application of the TFA in theory‐informed interview studies.
Publisher: Oxford University Press (OUP)
Date: 13-07-2023
Abstract: Health service waiting areas commonly provide health information, resources and supports for consumers however, the effect on health literacy and related outcomes remains unclear. This scoping review of the literature aimed to explore the use of waiting areas as a place to contribute to the health literacy and related outcomes of consumers attending health appointments. Articles were included if they focussed on health literacy or health literacy responsiveness (concept) in outpatient or primary care health service waiting areas (context) for adult consumers (population) and were published after 2010. Ten bibliographic databases, one full-text archive, dissertation repositories and web sources were searched. The search yielded 5095 records. After duplicate removal, 3942 title/abstract records were screened and 360 full-text records assessed. Data were charted into a standardized data extraction tool. A total of 116 unique articles (published empirical and grey literature) were included. Most articles were set in primary and community care (49%) waiting areas. A erse range of health topics and resource types were available, but results demonstrated they were not always used by consumers. Outcomes measured in intervention studies were health knowledge, intentions and other psychological factors, self-reported and observed behaviours, clinical outcomes and health service utilization. Intervention studies overall demonstrated positive trends in health literacy-related outcomes, although the benefit declined after 3–6 months. Research on using waiting areas for health literacy purposes is increasing globally. Future research investigating the needs of consumers to inform optimal intervention design is needed.
Publisher: Informa UK Limited
Date: 03-02-2022
DOI: 10.1080/09593985.2022.2036280
Abstract: Physical activity (PA) participation is important for children born extremely preterm or extremely low birthweight as it provides opportunities to improve motor skills and cardiovascular fitness however there is little evidence on interventions promoting PA participation for this group, particularly at preschool age. This study aims to explore the acceptability, a critical component of intervention feasibility, of a novel dance participation intervention. Semi-structured interviews explored the acceptability of Dance PREEMIE, a Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age (trial registration ACTRN12619001266156), from the perspectives of dance teachers delivering the intervention (n = 6), and parents of participating children (n = 6). Data were analyzed using reflexive thematic analysis. Five themes were developed: 1) placing the child center-stage: a shared motivation to promote child wellbeing and development 2) Dance PREEMIE as a catalyst for participation 3) child development takes time, practice and exposure 4) the value of being informed and 5) dance teachers as architects of the learning environment. Dance PREEMIE was acceptable to both parents of participating children and dance teachers. Findings from this study may inform future interventions aiming to improve PA participation for children with motor impairment at preschool age.
Publisher: SAGE Publications
Date: 2022
DOI: 10.1177/10497323211051672
Abstract: In this research, we explore and theorize on the potential of hospital outpatient rehabilitation waiting areas to respond and contribute to the health literacy needs of consumers. Constructivist grounded theory informed the s ling and analytical procedures. Thirty-three consumers attending outpatient rehabilitation for a range of health conditions were recruited to this multi-site study. Semi-structured interview and participant observation data were collected and analyzed concurrently using the constant comparison method. The substantive theory of “seeking choice to fulfill health literacy needs” and five interdependent categories were developed. Results indicated that consumers sought choice reflective of their needs however, the waiting area offered limited choice. Consumers shared ideas to address the lack of choice. Results provide insight into the health literacy needs of consumers in hospital outpatient waiting areas and how health services can appropriately respond to these needs. Future research should investigate the effect of health service environments on health outcomes.
Publisher: Informa UK Limited
Date: 22-11-2023
DOI: 10.1080/09638288.2022.2147226
Abstract: Preschool-aged children (three to five years old) born preterm participate in less physical activity (PA) than term-born children. Circus activities (a type of recreational PA) are a potential avenue to increase PA rates, but further insight into how to tailor these to address the participation gap is needed. This study investigated barriers and facilitators informing participation in recreational PA for preschool-aged children born extremely preterm and explored strategies to enhance participation in circus activities. Sequential mixed-methods study utilizing surveys ( Five themes were developed from the mixed data: the crucial role of the coach and the need for specific training, the therapeutic role of PA and promoting outcomes beyond the physical, the impact of communication and class planning, consideration of convenience and cost, and finally, the role of clinicians. Barriers, facilitators, and strategies were identified which may be used to modify or co-design circus-based PA interventions to enhance participation and improve rates of PA for preschool-aged children born extremely preterm.IMPLICATIONS FOR REHABILITATIONFamilies consider recreational physical activities to be part of the therapeutic agenda for their preschool-aged children born extremely preterm.Key stakeholders feel that recreational physical activity should target outcomes beyond the physical.Coach attributes and capability impact participation of children born preterm and their families, and may be enhanced with specific training.Clinicians should be engaged in design of recreational physical activities for children born preterm.
Publisher: Wiley
Date: 30-06-2022
DOI: 10.1111/HEX.13561
Abstract: Arthroplasty is an effective, yet costly, surgical procedure for end‐stage osteoarthritis. Shorter stays in hospital are being piloted in Australia. In some countries, short stay is established practice, associated with improving perioperative care and enhanced recovery after surgery practices. Exploring the acceptability to patients of a short stay care pathway in hospital postarthroplasty is important for informing health policy, adoption and potential scalability of this model of care. Consecutive patients at one site, at least 3 months post total joint arthroplasty, were invited to participate in theory‐informed semi‐structured qualitative interviews. The Theoretical Framework of Acceptability (TFA) informed development of the interview guide. Interview data were analysed using the Framework Method. Eighteen patients were invited. Fifteen consented to be contacted and were interviewed. Short‐stay post arthroplasty was highly acceptable to patients who had the supports necessary to recover safely at home. Key findings were as follows: flexibility of short‐stay care pathway was essential and valued prior beliefs and expectations informed acceptability and the absence of out‐of‐pocket expenses had an incentivizing effect, but was not the primary reason for patients choosing this care pathway. Further themes analysed within the TFA constructs highlighted nuances of acceptability relating to this model of care. A short stay in hospital post arthroplasty appeared to be acceptable to patients who had experienced this care pathway. Our thematic findings identified aspects of the short‐stay care pathway that enhanced acceptability and some aspects that limited acceptability. These findings can inform refinement of the short‐stay care pathway. Patients eople with lived experience were not involved in the study design or conduct of this preliminary work as this short‐stay model of care was recently introduced, only a small group of patients was eligible to participate in this study. This study is the first step towards understanding the experiences of patients about a short‐stay model of care post arthroplasty. The findings will help inform future patient and public involvement in expanding the programme.
Publisher: Oxford University Press (OUP)
Date: 13-05-2021
DOI: 10.1093/PTJ/PZAB130
Abstract: For people with hematological malignancies treated with bone marrow transplantation (BMT), this systematic review aimed to identify, evaluate, and synthesize the evidence examining the effect of exercise training on the outcomes of exercise capacity, health-related quality of life (HRQoL), and hospital length of stay (LOS) and to identify any difference in the effect on people treated with allogeneic versus autologous transplantation. Five electronic databases were systematically searched from inception to December 5, 2020. Prospective studies with a comparator group, with or without randomization, were included if they investigated the effects of an exercise intervention compared with usual care or another intervention in adults who had a hematological malignancy and were undergoing BMT. Primary outcomes of interest were functional exercise capacity and HRQoL secondary outcomes included strength, fatigue, hospital LOS, and feasibility. Only randomized controlled trials were included in the meta-analyses. Risk of bias was evaluated using the Physiotherapy Evidence Database or Newcastle-Ottawa Scale the quality of evidence for meta-analyses was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Twenty-four randomized controlled trials and 3 prospective nonrandomized experimental trials were included (n = 2432). There was moderate-quality evidence that exercise improves functional exercise capacity (mean difference [MD] = 29 m 95% CI = 12.59 to 45.4), global HRQoL (MD = 3.38 points 95% CI = 0.37 to 6.39), and fatigue (MD = 2.52 points 95% CI = 0.42 to 4.63) and low-quality evidence for reduced hospital LOS (MD = 2.07 days 95% CI = 0.43 to 3.72). These effects were more pronounced in recipients of allogeneic transplantation. No serious adverse events were associated directly with exercise in the included studies. Exercise is safe and improves outcomes, including functional exercise capacity, HRQoL, and hospital LOS in adults undergoing BMT. The results of this systematic review support the implementation of exercise programs in adults undergoing BMT, particularly recipients of allogeneic transplantation.
Publisher: SAGE Publications
Date: 13-08-2022
DOI: 10.1177/19375867211032926
Abstract: The study aim was to (1) investigate the barriers and enablers experienced by consumers to accessing and engaging with health tools in hospital waiting areas and (2) evaluate consumers’ ideas for designing a health literacy responsive waiting area. Health information, resources, and supports (“health tools”) in waiting areas should be responsive to the health literacy needs of consumers. However, consumers’ experiences of using health tools and their ideas for improving them are not known. Multicenter study was set in hospital waiting areas of outpatient rehabilitation services. Semistructured in-person interviews were conducted with 33 adult consumers attending appointments for various health conditions. Seven stages of the Framework Method were used to analyze data. Six themes were identified which explained barriers and enablers from the perspective of consumers. The barriers were accessibility issues personal factors—physical condition, emotional state, and preferences and poorly presented and outdated resources. The enablers were design suits consumer needs and preferences usable in available time or portable and compatible environment for engaging and sharing. Consumers shared design ideas which fit within four typologies. A range of barriers and enablers exist which have an impact on consumers’ ability to engage with available health information, resources, and supports in hospital outpatient waiting areas. Practical insights from the perspective of consumers can be applied to future health service design. Consumer’s design ideas suggest that partnerships with consumers should be formed to design health literacy responsive waiting areas.
Publisher: Cold Spring Harbor Laboratory
Date: 03-06-2023
DOI: 10.1101/2023.05.25.23290507
Abstract: Co-design involves stakeholders in designing rehabilitation interventions that impact their health (end-users) or professional lives (clinicians and researchers). Partnership-focussed Principles-driven Online co-Design (P-POD) is proposed and evaluated as an authentic approach to adapting research co-design into an online environment. A community-based participatory research approach scaffolded the co-design process and convergent mixed-methods evaluation. P-POD involved 10 stakeholders (parents, clinicians, coaches, and researchers) in eight 90-minute workshops to co-design a circus-based rehabilitation intervention to improve participation for preschool-aged children born preterm (premmies). P-POD was evaluated via anonymous surveys during workshops and semi-structured interviews upon completion of the process. Data were analysed using descriptive statistics and reflexive thematic analysis. The resulting co-designed intervention is “CirqAll: preschool circus for premmies”. Evaluation of P-POD indicated adherence to guiding principles of stakeholder involvement and co-design. Themes describe participants’ experiences of the supportive online culture, room for healthy debate, power-sharing, and multiple definitions of success. P-POD appears to provide an authentic transition of research co-design into an online environment. P-POD was successfully used with stakeholders to produce a paediatric rehabilitation intervention, and benefits from the online approach align with, and extend on, those reported in the literature on in-person co-design approaches.
No related grants have been discovered for Cassie McDonald.