The Finnish National Programme for Chronic Bronchitis and Chronic Obstructive Pulmonary Disease (COPD) 1998-2007 was set up to reduce the prevalence of COPD, improve COPD diagnosis and care, reduce the number of moderate to severe cases of the disease, and reduce hospitalisations and treatment costs due to COPD. Over 900 events for 25,000 participating healthcare workers were arranged. The major strengths of this programme included multidisciplinary strategies and web-based guidelines in nearly all primary health care centres around the country.
Data from national registries, epidemiological studies and questionnaires were used to measure whether the goals had been reached.
The prevalence of COPD remained unchanged. Smoking decreased in males from 30% to 26% (p
Comment In: Prim Care Respir J. 2011 Jun;20(2):109-1021603847
The aim of this study was to describe and evaluate the clinical pattern of 14 youths with presenting suicidality, to describe an integrative treatment approach, and to estimate therapy effectiveness. Fourteen patients aged 10 to 18 years from a child and adolescent outpatient clinic in Stockholm were followed in a case series. The patients were treated with active multimodal psychotherapy. This consisted of mood charting by mood-maps, psycho-education, wellbeing practice and trauma resolution. Active techniques were psychodrama and body-mind focused techniques including eye movement desensitization and reprocessing. The patients were assessed before treatment, immediately after treatment and at 22 months post treatment with the Global Assessment of Functioning Scale. The clinical pattern of the group was observed. After treatment there was a significant change towards normality in the Global Assessment of Functioning scale both immediately post-treatment and at 22 months. A clinical pattern, post trauma suicidal reaction, was observed with a combination of suicidality, insomnia, bodily symptoms and disturbed mood regulation. We conclude that in the post trauma reaction suicidality might be a presenting symptom in young people. Despite the shortcomings of a case series the results of this study suggest that a mood-map-based multimodal treatment approach with active techniques might be of value in the treatment of children and youth with suicidality.
Internet-based patient support systems are widely assumed to predict a future trend in patient education. Coherent information is still lacking on how patient education is adopted in psychiatric hospitals and how information technology is used in it. Our aim was to describe nurses' adoption of an Internet-based patient education programme and the variables explaining it. The study was based on Rogers' model of the diffusion of innovation. The Internet-based patient education sessions were carried out by nurses on nine acute psychiatric inpatient wards in two Finnish hospitals. They were evaluated with reports and analysed statistically. Out of 100 nurses, 83 adopted the programme during the study period. The nurses fell into Rogers' groups, late majority (72%), laggards (17%), early majority (7%), early adopters (3%) and innovators (1%). Three groups were formed according to their activity: laggards, late majority, adopters (including early majority, early adopters, innovators). There was a statistical difference between the nurses' programme adoption between the two hospitals (P= 0.045): more laggards (65% vs. 35%) and adopters (73% vs. 27%) in the same hospital. The findings help to provide insight into the contexts and settings when adopting information technology programmes in the area of mental health care.
Cervical cancer screening programmes have markedly reduced the incidence and mortality rates of the disease. A substantial amount of deaths from the disease could be prevented further by organised screening programmes or improving currently running programmes.
We present here a randomised evaluation trial design integrated to the Finnish cervical cancer screening programme, in order to evaluate renewal of the programme using emerging technological alternatives. The main aim of the evaluation is to assess screening effectiveness, using subsequent cancers as the outcome and screen-detected pre-cancers as surrogates. For the time being, approximately 863,000 women have been allocated to automation-assisted cytology, human papillomavirus (HPV) DNA testing, or to conventional cytology within the organised screening programme. Follow-up results on subsequent cervical cancers will become available during 2007-2015.
Large-scale randomised trials are useful to clarify effectiveness and cost-effectiveness issues of the most important technological alternatives in the screening programmes for cervical cancer.
Cites: Br J Cancer. 2004 Aug 31;91(5):935-4115280916
This paper extends the account of a joint project of education and training of doctors and nurses in St. Petersburg, Russia funded by the Know How Fund Health Sector Small Partnership Scheme (Russia) (). It reports the findings of two evaluations of the project. The first, an external evaluation was carried on behalf of the sponsors, the KHF. The second was an 'insider' evaluation utilising a framework developed for the English National Board by Cranfield and Stoneman. The paper concludes with a discussion of issues arising from the cross-cultural evaluations.
Peer support, a cornerstone in recovery programs for mental illness and addiction, has not been widely applied to service programs for survivors of suicide. In 2004-2006 Canadian Mental Health Association Suicide Services in Calgary, Alberta, introduced the Peer Support Program for adults, an adjunct to conventional individual and group intervention. This article reports on a mixed-methods evaluation of the Peer Support Program. Hogan's Grief Response Checklist and the qualitative data tracked positive outcomes for both the peer supporters and the clients. This study challenges the unspoken assumption that survivors of suicide, due to their vulnerability, require the services of highly skilled professionals and would not be in a position to offer unsupervised support to peers. Rather it supports an intervention protocol that consists of peer supporters and professionals working collaboratively to offer cost-effective, client-centered services.
This paper reports on the usefulness of a responsive evaluation model in evaluating the clinical skills assessment and training (CSAT) programme at the Faculty of Medicine, Memorial University of Newfoundland, Canada. The purpose of this paper is to introduce the responsive evaluation approach, ascertain its utility, feasibility, propriety and accuracy in a medical education context, and discuss its applicability as a model for medical education programme evaluation.
Robert Stake's original 12-step responsive evaluation model was modified and reduced to five steps, including: (1) stakeholder audience identification, consultation and issues exploration; (2) stakeholder concerns and issues analysis; (3) identification of evaluative standards and criteria; (4) design and implementation of evaluation methodology; and (5) data analysis and reporting. This modified responsive evaluation process was applied to the CSAT programme and a meta-evaluation was conducted to evaluate the effectiveness of the approach.
The responsive evaluation approach was useful in identifying the concerns and issues of programme stakeholders, solidifying the standards and criteria for measuring the success of the CSAT programme, and gathering rich and descriptive evaluative information about educational processes. The evaluation was perceived to be human resource dependent in nature, yet was deemed to have been practical, efficient and effective in uncovering meaningful and useful information for stakeholder decision-making.
Responsive evaluation is derived from the naturalistic paradigm and concentrates on examining the educational process rather than predefined outcomes of the process. Responsive evaluation results are perceived as having more relevance to stakeholder concerns and issues, and therefore more likely to be acted upon. Conducting an evaluation that is responsive to the needs of these groups will ensure that evaluative information is meaningful and more likely to be used for programme enhancement and improvement.
To develop a set of assessment criteria and assess public health interventions at municipal level in Denmark using the European Community Health Promotion Indicator Development (EUHPID) model to support more effective planning and funding allocation in public health.
Based on knowledge synthesis, a set of assessment criteria were developed to classify interventions into the four types of public health provided by the EUHPID model: health promotion, health protection, disease prevention, and health care. Information was then collected on all current public health interventions in Varde Municipality within a 3-month period in spring 2009. Finally, the interventions were categorised using the developed assessment criteria.
The knowledge synthesis process resulted in the development of a set of assessment criteria and the 154 reported public health interventions were divided into relevant types using these criteria. 57% of the interventions were based on a salutogenic health promotion approach, 33% on a pathogenic disease prevention approach, 10% on the pathogenic health protection approach, and 0% on the pathogenic health care approach.
The assessment criteria based on the EUHPID model can be useful and have wider global significance for planning public health interventions, allocating appropriate funding to support public health interventions, and thereby encouraging and supporting more effective intersectoral working practices.