Future development and mainstream integration of peer support work must reconcile current tensions between standardization and loss of authenticity. Training in communicating the lived experience, setting boundaries and self-care are important steps forward.
BackgroundDisasters and emergencies from infectious diseases, extreme weather and anthropogenic events are increasingly common. While risks vary for different communities, disaster and emergency preparedness is recognized as essential for all nation-states. Evidence to inform measurement of preparedness is lacking. The objective of this study was to identify and define a set of public health emergency preparedness (PHEP) indicators to advance performance measurement for local/regional public health agencies.MethodsA three-round modified Delphi technique was employed to develop indicators for PHEP. The study was conducted in Canada with a national panel of 33 experts and completed in 2018. A list of indicators was derived from the literature. Indicators were rated by importance and actionability until achieving consensus.ResultsThe scoping review resulted in 62 indicators being included for rating by the panel. Panel feedback provided refinements to indicators and suggestions for new indicators. In total, 76 indicators were proposed for rating across all three rounds; of these, 67 were considered to be important and actionable PHEP indicators.ConclusionsThis study developed an indicator set of 67 PHEP indicators, aligned with a PHEP framework for resilience. The 67 indicators represent important and actionable dimensions of PHEP practice in Canada that can be used by local/regional public health agencies and validated in other jurisdictions to assess readiness and measure improvement in their critical role of protecting community health.
The majority of fully qualified Monash MBBS graduates practicing in rural communities have rural backgrounds. The rural-background effect diminished over time and may need continued support during training and full practice.
The 3B Scale is a valid and reliable tool for measuring Being, Belonging and Becoming needs in an occupation-based mental health program. The 3B Scale is an example of an outcome measure created specifically to quantify program outcomes and demonstrates that instruments suited to unique programs can be individually configured and assist occupational therapists in their efforts to measure client perspectives. These are the essential first steps to client-centred practice and the development of practice-based evidence. The 3B Scale may be useful to similar peer-led programs, as well as community-based occupational programs that foster participation. Further research is needed to determine whether the 3B Scale can detect change over time.
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Background: The purpose of this study was to determine if interprofessional skills, attitudes, and behaviours could be learned during an austere medicine educational activity where interprofessionalism remained within the informal and hidden curriculum.Methods and Findings: We used a mixed-methods approach to examine the potential acquisition of interprofessional competencies during wilderness medicine educational events. Thirty-four participants, over two events, completed interprofessional learner contracts, audio diary entries between patient scenarios, and the Interprofessional Collaborative Competency Attainment Survey (ICCAS) using a retrospective pre-test/post-test design. Audio diary entries showed the reflection that took place between scenarios during the orienteering portion of the event and the adjustments toward interprofessionalism that took place. Both the survey and audio diaries confirmed that participants perceived an improvement of their interprofessional competencies after the WildER Med event.Conclusions: The outcomes confirm that interprofessional competencies can be developed during a learning event such as WildER Med, where the interprofessional curriculum is hidden. Austere medicine, which is at the base of this learning event, represents an opportunity for the further understanding and exploration of interprofessional education.
Introduction: The Fort McMurray Alberta wildfire was one of Canada's largest natural disasters in history, burning 589,995 hectares of land until being controlled on July 5, 2016. In responding to the fire, Alberta Health Services (AHS) prompted a province-wide coordinated response. Through a combination of pre-emptive strategies and responsive activities, the AHS response has been considered a success. Underlying the successful response is the collective experiences and contextual knowledge of AHS staff members acquired from past events. While the frequency and severity of risks associated with extreme weather and climate change are increasing worldwide, there is a persistent knowledge gap in the evidence-base informing public health emergency preparedness. It is imperative that lessons learned from past events inform future preparedness activities. Learning lessons is a systematic implementation process that can be used to inform future responses and best practices that are transferable to similar situations. Aim: To describe strategies employed and challenges encountered during recovery after the Alberta wildfires. Methods: A single-case study approach was employed to understand the AHS method to "learning lessons," and the process involved in translating lessons into actionable goals. Semistructured interviews with senior leaders (n=11) were conducted and internal documents were obtained. Results: The analysis revealed a strategic learning process, including debriefs, staff surveys, interviews, and member validity checking. The implementation process used to translate the lessons identified included a project management framework, evaluation techniques, and the utilization of tacit and explicit knowledge. Key challenges for implementation involve clarification of processes, leadership commitment, resource and time constraints, staff turn-over, and measuring outcomes. Discussion: Translating the lessons from the Alberta wildfires is crucial for enhancing preparedness, and exploratory research in this area can contribute to building a program of research in evaluation during disaster recovery.
Introduction: Being, belonging and becoming are important theoretical constructs for occupational scientists and therapists, and for members of Northern Initiative for Social Action (NISA), located in northern Ontario, Canada. Collaborative research with service users guided the development of NISA and its evaluation tool: the 3B~S Scale. The aim of this paper is to share the results of the 2018 program evaluation. Methods: 113 participants completed a questionnaire consisting of the 3B~S Scale, demographic and program satisfaction questions, and open-ended questions. Quantitative analysis used descriptive statistics followed by ordinal logistic regression to determine the intersectional effects of gender, race and age on becoming and system impact outcomes. Open-ended responses were analysed thematically and triangulated with quantitative findings. Results: Participants agreed-to-strongly agreed that the program met their 3B needs (x = 4.20, SD = 0.24). Participants indicated strong satisfaction with the program (x = 4.38, SD = 0.66), and agreement that participating in the program reduced their reliance on other system-based services (x = 3.96, SD = 0.24). The regression revealed no significant differences in gender, race or age in predicting six of 10 outcomes examined; race was not significant for any outcome. Younger females were more likely to agree that the work they do is part of a larger community charitable purpose, the program is helping them to achieve their goals, and is increasing their involvement in community. Younger participants were more likely to agree that participation facilitated a return to school or employment than older participants. Conclusions: Occupation-based, mental health programs that address participants' being, belonging and becoming needs can contribute to improvements in perceived mental health and well-being, as well as to improved community and system usage outcomes. The NISA model provides a framework for clinically operationalising the 3B's and may provide a unique contribution to ongoing theoretical discussions of these constructs within occupational therapy and science.
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