Browsing by Author "Benzies, Karen M."
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Item Open Access Association between social relationship of mentors and depressive symptoms in first-time mothers during the transition from pregnancy to 6-months postpartum(2024-02-02) Gasperowicz, Malgorzata; Benzies, Karen M.Abstract Background First-time motherhood is characterized by high psychosocial distress, which untreated, has serious consequences. Informal social support provided by specially trained mentors may be protective against postpartum depressive symptoms but may vary by women’s social relationship with the mentor. The objective of this study was to evaluate the association of types of mentors on women’s depressive symptoms between late pregnancy to 6-months postpartum and the characteristics of women associated with mentor type. Methods This study was a secondary analysis of data from a community sample of 312 primiparous women from a single-group, longitudinal intervention study of Welcome to Parenthood. Welcome to Parenthood provided education and mentorship for women during the transition from pregnancy to postpartum. Women completed the Edinburgh Postnatal Depression Scale (EPDS) in late pregnancy, and 2- and 6-months postpartum. Results Women who recently relocated were less likely to be mentored by their mothers and more likely to be mentored by friends or volunteers. Women who were mentored by their mothers or sisters scored the lowest on the EPDS; those mentored by their mothers-in-law scored the highest. Women who were mentored by other family, friends, or volunteers scored between the two extremes. EPDS scores of women mentored by each type of mentor decreased from pregnancy to 6-months postpartum; only for mother-, sister-, and volunteer-mentored groups was this decrease significant. Conclusions During transition to parenthood, support provided by mothers or sisters is best for women’s mental health but may not always be available to women who have recently relocated. In such situations, specially trained community volunteers may be the second-best option.Item Open Access Knowledge translation strategies used for sustainability of an evidence-based intervention in child health: a multimethod qualitative study(2024-02-17) Cassidy, Christine E.; Flynn, Rachel; Campbell, Alyson; Dobson, Lauren; Langley, Jodi; McNeil, Deborah; Milne, Ella; Zanoni, Pilar; Churchill, Megan; Benzies, Karen M.Abstract Background Sustainability of evidence-based interventions (EBIs) is suboptimal in healthcare. Evidence on how knowledge translation (KT) strategies are used for the sustainability of EBIs in practice is lacking. This study examined what and how KT strategies were used to facilitate the sustainability of Alberta Family Integrated Care (FICare)™, a psychoeducational model of care scaled and spread across 14 neonatal intensive care units, in Alberta, Canada. Methods First, we conducted an environmental scan of relevant documents to determine the use of KT strategies to support the sustainability of Alberta FICare™. Second, we conducted semi-structured interviews with decision makers and operational leaders to explore what and how KT strategies were used for the sustainability of Alberta FICare™, as well as barriers and facilitators to using the KT strategies for sustainability. We used the Expert Recommendations for Implementation Change (ERIC) taxonomy to code the strategies. Lastly, we facilitated consultation meetings with the Alberta FICare™ leads to share and gain insights and clarification on our findings. Results We identified nine KT strategies to facilitate the sustainability of Alberta FICare™: Conduct ongoing training; Identify and prepare local champions; Research co-production; Remind clinicians; Audit and provide feedback; Change record systems; Promote adaptability; Access new funding; and Involve patients/consumers and family members. A significant barrier to the sustainability of Alberta FICare™ was a lack of clarity on who was responsible for the ongoing maintenance of the intervention. A key facilitator to sustainability of Alberta FICare was its alignment with the Maternal, Newborn, Child & Youth Strategic Clinical Network (MNCY SCN) priorities. Co-production between researchers and health system partners in the design, implementation, and scale and spread of Alberta FICare™ was critical to sustainability. Conclusion This research highlights the importance of clearly articulating who is responsible for continued championing for the sustainability of EBIs. Additionally, our research demonstrates that the adaptation of interventions must be considered from the onset of implementation so interventions can be tailored to align with contextual barriers for sustainability. Clear guidance is needed to continually support researchers and health system leaders in co-producing strategies that facilitate the long-term sustainability of effective EBIs in practice.Item Open Access Knowledge translation strategies used for sustainability of an evidence-based intervention in child health: a multimethod qualitative study(2024-02-17) Cassidy, Christine E.; Flynn, Rachel; Campbell, Alyson; Dobson, Lauren; Langley, Jodi; McNeil, Deborah; Milne, Ella; Zanoni, Pilar; Churchill, Megan; Benzies, Karen M.Abstract Background Sustainability of evidence-based interventions (EBIs) is suboptimal in healthcare. Evidence on how knowledge translation (KT) strategies are used for the sustainability of EBIs in practice is lacking. This study examined what and how KT strategies were used to facilitate the sustainability of Alberta Family Integrated Care (FICare)™, a psychoeducational model of care scaled and spread across 14 neonatal intensive care units, in Alberta, Canada. Methods First, we conducted an environmental scan of relevant documents to determine the use of KT strategies to support the sustainability of Alberta FICare™. Second, we conducted semi-structured interviews with decision makers and operational leaders to explore what and how KT strategies were used for the sustainability of Alberta FICare™, as well as barriers and facilitators to using the KT strategies for sustainability. We used the Expert Recommendations for Implementation Change (ERIC) taxonomy to code the strategies. Lastly, we facilitated consultation meetings with the Alberta FICare™ leads to share and gain insights and clarification on our findings. Results We identified nine KT strategies to facilitate the sustainability of Alberta FICare™: Conduct ongoing training; Identify and prepare local champions; Research co-production; Remind clinicians; Audit and provide feedback; Change record systems; Promote adaptability; Access new funding; and Involve patients/consumers and family members. A significant barrier to the sustainability of Alberta FICare™ was a lack of clarity on who was responsible for the ongoing maintenance of the intervention. A key facilitator to sustainability of Alberta FICare was its alignment with the Maternal, Newborn, Child & Youth Strategic Clinical Network (MNCY SCN) priorities. Co-production between researchers and health system partners in the design, implementation, and scale and spread of Alberta FICare™ was critical to sustainability. Conclusion This research highlights the importance of clearly articulating who is responsible for continued championing for the sustainability of EBIs. Additionally, our research demonstrates that the adaptation of interventions must be considered from the onset of implementation so interventions can be tailored to align with contextual barriers for sustainability. Clear guidance is needed to continually support researchers and health system leaders in co-producing strategies that facilitate the long-term sustainability of effective EBIs in practice.Item Open Access Mobilizing strategic inflection points for sustainment of an effective intervention in an integrated learning health system: an interpretive description(2024-09-30) Benzies, Karen M.; Zanoni, Pilar; McNeil, Deborah A.Abstract Background Innovative models of care have the potential to improve the sustainability of health systems by improving patient and provider experiences and population outcomes while simultaneously reducing costs. Yet, it is challenging to recognize the distinctive points during research and quality improvement processes that contribute to sustainment of effective interventions. The business concept of an inflection point—the position on the curve of a trajectory where the progress in implementation of an intervention is accelerated or decelerated—may be useful to understand implementation and improve sustainability and ultimately sustainment of effective interventions. The purpose of this study was to retrospectively identify and describe strategic inflection points that accelerated the sustainability process and led to the sustainment of Alberta Family Integrated Care. Methods This qualitative study was conducted in Alberta, Canada and employed an interpretive description design. Purposively sampled documents (proposals, project management plans, reports to funders and sponsors, meeting minutes, and fidelity audit and feedback checklists) from the Alberta Family Integrated Care cluster randomized controlled trial and quality improvement project constituted data for this study. Results To accelerate sustainability in the research context, we identified (1) alignment with strategic priorities, (2) iterative, user-centered co-design, and (3) contextualization of implementation as strategic inflection points. To accelerate sustainability in the health system context, we identified (1) the learning health system, (2) enduring partnerships, (3) responsivity to societal and system change, (4) embedded governance, and (5) intentional integration into the health system as strategic inflection points. Capitalizing on these strategic inflection points led to sustainment of Alberta Family Integrated Care in the provincial health system. Conclusions We identified key inflection points in the research and health system contexts that led to sustainment of Alberta Family Integrated Care. By anticipating, recognizing, and leveraging inflection points in the sustainability process, researchers may be able to accelerate implementation and achieve sustainment of multi-component interventions in complex systems. Trial registration ClinicalTrials.gov: NCT02879799. Registration date: May 27, 2016. Protocol version: June 9, 2016; version 2. Protocol publication: https://doi.org/10.1186/s13063-017-2181-3 .Item Open Access Mother Positivity and Family Adjustment in Households with Children with a Serious Disability(SpringerOpen, 2011-04-21) Trute, Barry; Benzies, Karen M.; Worthington, Catherine