ORCID Profile
0000-0002-9090-7479
Current Organisations
Monash University
,
Macquarie University
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Publisher: BMJ
Date: 24-03-2015
Publisher: CSIRO Publishing
Date: 25-11-2021
DOI: 10.1071/PY21122
Abstract: There is a push for greater promotion of dementia risk reduction (DRR) by primary care practitioners (PCPs). The aims of this study were to understand the views of non-medically trained Australian contributors in a Massive Open Online Course (MOOC) about dementia prevention regarding the role of PCPs in promoting DRR and to consider the implications of those views for developing implementation strategies. Discussion board posts of MOOC enrollees were analysed regarding the actions that organisations, communities and/or governments should take to help people work towards DRR. Of the 1641 eligible contributors to the discussion, 160 (10%) indicated that PCPs had a role in promoting DRR. This subset of participants particularly wanted earlier identification of risk by PCPs and a discussion about DRR. Some participants thought PCPs did not currently prioritise DRR, lacked knowledge about DRR and faced Medicare and resource restrictions to promoting DRR. We suggest that PCPs need: better publicity for their role in promoting DRR to prioritise DRR knowledge about DRR and to take advantage of existing opportunities to promote DRR quickly. The findings of this study should be considered when attempting to implement DRR guidelines in primary care.
Publisher: SAGE Publications
Date: 19-10-2016
Abstract: Process evaluations are essential to understand the contextual, relational, and organizational and system factors of complex interventions. The guidance for developing process evaluations for randomized controlled trials (RCTs) has until recently however, been fairly limited. A nested process evaluation (NPE) was designed and embedded across all stages of a stepped wedge cluster RCT called the CORE study. The aim of the CORE study is to test the effectiveness of an experience-based codesign methodology for improving psychosocial recovery outcomes for people living with severe mental illness (service users). Process evaluation data collection combines qualitative and quantitative methods with four aims: (1) to describe organizational characteristics, service models, policy contexts, and government reforms and examine the interaction of these with the intervention (2) to understand how the codesign intervention works, the cluster variability in implementation, and if the intervention is or is not sustained in different settings (3) to assist in the interpretation of the primary and secondary outcomes and determine if the causal assumptions underpinning the codesign interventions are accurate and (4) to determine the impact of a purposefully designed engagement model on the broader study retention and knowledge transfer in the trial. Process evaluations require prespecified study protocols but finding a balance between their iterative nature and the structure offered by protocol development is an important step forward. Taking this step will advance the role of qualitative research within trials research and enable more focused data collection to occur at strategic points within studies.
Publisher: Cambridge University Press (CUP)
Date: 2019
DOI: 10.1017/S1463423619000744
Abstract: Primary care practitioners (PCPs) do not routinely promote dementia risk reduction. The purpose of this study was to map the published literature on the views of PCPs about dementia risk reduction, in order to identify implementation constructs and strategies crucial to the development of an implementation intervention to support dementia risk reduction in primary care. We undertook a scoping review of the PCPs’ views about promoting brain health for reducing dementia risk. We searched MEDLINE, PsycINFO, CINAHL, and Embase for English-language articles published between 1995 and December 2017. We then applied the Consolidated Framework for Implementation Research (CFIR) and matched Expert Recommendations for Implementing Change to the scoping review findings in order to develop a preliminary implementation model. Eight articles reported views of PCPs about dementia prevention. Study findings were mapped to 5 of the 39 CFIR constructs: (i) knowledge and beliefs about dementia risk reduction, (ii) evidence strength and quality, (iii) relative priority, (iv) available resources, and (v) external policy and incentives. The findings suggest implementation strategies to consider in our preliminary model include (i) educational meetings, (ii) identifying and preparing ch ions, (iii) conducting local consensus discussions, (iv) altering incentive structures, and (v) capturing and sharing local knowledge. There have been few studies about the views of PCPs about dementia risk reduction. Implementation in the primary care setting is fundamental to early identification of risk and supporting preventive practices, but it needs to focus on more than just education for PCPs. We need more up-to-date and in-depth data on the views of PCPs about dementia risk reduction and context-specific analyses of implementation needs. Further research into effective primary care interventions to reduce dementia risk is expected to support implementation efforts.
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/PY19249
Abstract: Dementia is now a global health priority. With no known cure, the best way to reduce the number of people who will be living with dementia is by promoting dementia risk reduction (DRR). However, despite evidence-based guidelines, DRR is not yet routinely promoted in Australian general practice. Previously, we proposed a preliminary conceptual model for implementing DRR in primary care based on our scoping review of practitioners’ views. The present study aimed to refine this model for the Australian context by incorporating the current perspectives of Australian general practitioners (GPs) and general practice nurses (GPNs) about DRR. Interviews with 17 GPs and GPNs were analysed using the framework method, underpinned by the Consolidated Framework for Implementation Research (CFIR). We identified 12 barriers to promoting DRR in Australian general practice, along with five facilitators. Using the CFIR–Expert Recommendations for Implementing Change (ERIC) Matching Tool to select prioritised implementation strategies from the ERIC project, the findings were incorporated into a refined conceptual model. The refined model points to an implementation intervention that uses educational materials and meetings to reach consensus with GPs and GPNs on the importance of promoting DRR and an appropriate approach. Ch ion GPs and GPNs should be prepared to drive the agreed implementation forward, and general practices should share successes and lessons learned. This model is a crucial step in bridging the gap between DRR guidelines and routine practice.
Publisher: CSIRO Publishing
Date: 11-02-2021
DOI: 10.1071/PY20189
Abstract: This study examined Australian primary healthcare providers’ knowledge about dementia risk factors and risk reduction and their perspectives on barriers and enablers to risk reduction in practice. Primary healthcare providers were recruited through Primary Health Networks across Australia (n = 51). Participants completed an online survey that consisted of fixed-responses and free-text components to assess their knowledge, attitudes and current practices relating to dementia risk factors and risk reduction techniques. The results showed that Australian primary healthcare providers have good knowledge about the modifiable risk factors for dementia however, face several barriers to working with patients to reduce dementia risk. Commonly reported barriers included low patient motivation and healthcare system level limitations. The most commonly reported recommendations to helping primary healthcare providers to work with patients to reduce dementia risk included increasing resources and improving dementia awareness and messaging. While the results need to be interpreted in the context of the limitations of this study, we conclude that collaborative efforts between researchers, clinicians, policy makers and the media are needed to support the uptake of risk reduction activities in primary care settings.
Publisher: Public Library of Science (PLoS)
Date: 17-09-2021
DOI: 10.1371/JOURNAL.PONE.0257540
Abstract: Evidence for the potential prevention of dementia through lifestyle risk factor modification is growing and has prompted examination of implementation approaches. Understanding the general population’s perspectives regarding dementia risk reduction is key to implementation. This may provide useful insights into more effective and efficient ways to help people change relevant beliefs, motivations and behaviour patterns. We conducted a systematic review and thematic synthesis of qualitative evidence to develop an integrated model of general population dementia risk reduction perspectives and the implications for intervention in research and implementation contexts. We searched electronic databases, supplemented by lateral search techniques, to identify studies published since 1995 reporting qualitative dementia risk reduction perspectives of the non-expert general population who do not have dementia. Thematic synthesis, incorporating an expert panel discussion, was used to identify overarching themes and develop an integrated model to guide intervention to support in iduals to adopt and maintain dementia risk reduction behaviour patterns. Quality of included studies and confidence in review findings were systematically appraised. We included 50 papers, reflecting the views of more than 4,500 in iduals. Main themes were: 1) The need for effective education about a complex topic to prevent confusion and facilitate understanding and empowerment 2) Personally relevant short- and long-term benefits of dementia risk reduction behaviour patterns can generate value and facilitate action 3) In iduals benefit from trusted, reliable and sensitive support to convert understanding to personal commitment to relevant behaviour change 4) Choice, control and relevant self-regulatory supports help in iduals take-action and direct their own progress 5) Collaborative and empowering social opportunities can facilitate and propagate dementia risk reduction behaviour change 6) In idual behaviour patterns occur in social contexts that influence beliefs through heuristic processes and need to be understood. Findings indicate that, for intervention: 1) education is key, but both content and delivery need to be tailored 2) complementary interventions to support self-regulation mechanisms and social processes will increase education effectiveness 3) co-design principles should guide intervention design and delivery processes 4) all interventions need to be supported by context-specific data. This systematic review and thematic synthesis provides a comprehensive, integrated model of the dementia risk reduction perspectives of the general population and intervention approaches to support behaviour change that can be applied in clinical trial and real-world implementation settings. Findings extend existing knowledge and may assist more effective intervention design and delivery.
Publisher: Springer Science and Business Media LLC
Date: 08-04-2017
Publisher: Oxford University Press (OUP)
Date: 07-04-2020
Publisher: Wiley
Date: 04-08-2021
DOI: 10.1111/HEX.13334
Abstract: Mental health policies outline the need for codesign of services and quality improvement in partnership with service users and staff (and sometimes carers), and yet, evidence of systematic implementation and the impacts on healthcare outcomes is limited. The aim of this study was to test whether an adapted mental health experience codesign intervention to improve recovery‐orientation of services led to greater psychosocial recovery outcomes for service users. A stepped wedge cluster randomized‐controlled trial was conducted. Four Mental Health Community Support Services providers, 287 people living with severe mental illnesses, 61 carers and 120 staff were recruited across Victoria, Australia. The 24‐item Revised Recovery Assessment Scale (RAS‐R) measured in idual psychosocial recovery. A total of 841 observations were completed with 287 service users. The intention‐to‐treat analysis found RAS‐R scores to be similar between the intervention (mean = 84.7, SD= 15.6) and control (mean = 86.5, SD= 15.3) phases the adjusted estimated difference in the mean RAS‐R score was −1.70 (95% confidence interval: −3.81 to 0.40 p = .11). This first trial of an adapted mental health experience codesign intervention for psychosocial recovery outcomes found no difference between the intervention and control arms. More attention to the conditions that are required for eight essential mechanisms of change to support codesign processes and implementation is needed. The State consumer (Victorian Mental Illness Awareness Council) and carer peak bodies (Tandem representing mental health carers) codeveloped the intervention. The adapted intervention was facilitated by coinvestigators with lived‐experiences who were coauthors for the trial and process evaluation protocols, the engagement model and explanatory model of change for the trial.
No related grants have been discovered for Kali Godbee.