Models, Strategies, and Tools.

Sales, Anne E.; Smith, Jeffrey L.; Curran, Geoffrey M.; Kochevar, Laura

doi:10.1111/j.1525-1497.2006.00362.x

Cited by 75 publications

(23 citation statements)

References 58 publications

(49 reference statements)

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“…The field of medical psychodiagnosis, which involves psychological reflections of problems, suffers from a lack of theorybased diagnostic tools (Fine, 2006). The present approach and findings support the suggestion that the unique combination of IIT and FM can provide both a theory and a set of measurement tools to the psychodiagnosis and assessment (see Sales, et al, 2006). Nevertheless, there should be a long way to go from the pre-preliminary stage of tool creation to the desired phase where a psychodiagnostic work, including the final integrative decision, will be based on a combination of scientific conception and methodology.…”

Section: Discussionsupporting

confidence: 74%

Functional Cognitive Psychodiagnosis: An Exploratory Examination of a Complementary Tool

Tevelev¹,

Wolf²

2017

PSYCH

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A major goal of evidence-based psychotherapy is to assess specific cognitive or emotional schemata and behavioral patterns associated with a particular disorder. The present study is an exploratory attempt to form a quantitative basis for this sort of clinical work in terms of Anderson's Information Integration Theory and the theory's methodological counterpart-Functional Measurement. The participants of the study' s three experiments were 24 adolescents who suffer from disruptive behavior disorders, 17 patients who suffer from a dual diagnosis (a combination of substance dependence and psychopathology), and 14 patients diagnosed as suffering from emotional disorders such as anxiety, depression, and panic attacks. The following three types of functional cognitive schemata were diagnosed: bio-psycho-social in the participants with disruptive behavior disorders; addiction in the participants with dual diagnosis, and inner speech schemata in the participants with emotional disorders. The results are presented in terms of the relative importance assigned to the components of each sort of schema. It is concluded that the study's findings exemplify the viability of the information integration as an infrastructure of a complementary psychodiagnostic tool.

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Section: Discussionsupporting

confidence: 74%

Functional Cognitive Psychodiagnosis: An Exploratory Examination of a Complementary Tool

Tevelev¹,

Wolf²

2017

PSYCH

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“…Realist evaluation is about theory-testing and refinement [21], whereby the evaluator assesses whether a programme is designed in such a way that it can achieve its intended outcomes and how it does so [22]. The initial programme theory guides the assessment of the effectiveness of the intervention and the consistency of the implementation [23]. The outcome of this process is a ‘generative theory’ of causation, whereby there is an interaction between the actors and the components of the intervention leading to a transformation (outcome) through causal powers (reasoning of the actors) [24].…”

Section: Methodological Approachmentioning

confidence: 99%

Unravelling how and why the Antiretroviral Adherence Club Intervention works (or not) in a public health facility: A realist explanatory theory-building case study

et al. 2019

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BackgroundAlthough empirical evidence suggests that the adherence club model is more effective in retaining people living with HIV in antiretroviral treatment care and sustaining medication adherence compared to standard clinic care, it is poorly understood exactly how and why this works. In this paper, we examined and made explicit how, why and for whom the adherence club model works at a public health facility in South Africa.MethodsWe applied an explanatory theory-building case study approach to examine the validity of an initial programme theory developed a priori. We collected data using a retrospective cohort quantitative design to describe the suppressive adherence and retention in care behaviours of patients on ART using Kaplan-Meier methods. In conjunction, we employed an explanatory qualitative study design using non-participant observations and realist interviews to gain insights into the important mechanisms activated by the adherence club intervention and the relevant contextual conditions that trigger the different mechanisms to cause the observed behaviours. We applied the retroduction logic to configure the intervention-context-actor-mechanism-outcome map to formulate generative theories.ResultsA modified programme theory involving targeted care for clinically stable adult patients (18 years+) receiving antiretroviral therapy was obtained. Targeted care involved receiving quick, uninterrupted supply of antiretroviral medication (with reduced clinic visit frequencies), health talks and counselling, immediate access to a clinician when required and guided by club rules and regulations within the context of adequate resources, and convenient (size and position) space and proper preparation by the club team. When grouped for targeted care, patients feel nudged, their self-efficacy is improved and they become motivated to adhere to their medication and remain in continuous care.ConclusionThis finding has implications for understanding how, why and under what health system conditions the adherence club intervention works to improve its rollout in other contexts.

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“…Implementation studies have shown that interventions designed with a theoretical basis are more likely to be successful [42,43]. Therefore, we utilized several theory-based strategies to encourage provider uptake of the eCDSS and participant uptake of provider and/or pharmacist recommendations.…”

Section: Methodsmentioning

confidence: 99%

A Pragmatic Cluster Randomized Trial of an Electronic Clinical Decision Support System to Improve Chronic Kidney Disease Management in Primary Care: Design, Rationale, and Implementation Experience

Khoong¹,

Karliner²,

Lo³

et al. 2019

JMIR Res Protoc

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Background The diagnosis of chronic kidney disease (CKD) is based on laboratory results easily extracted from electronic health records; therefore, CKD identification and management is an ideal area for targeted electronic decision support efforts. Early CKD management frequently occurs in primary care settings where primary care providers (PCPs) may not implement all the best practices to prevent CKD-related complications. Few previous studies have employed randomized trials to assess a CKD electronic clinical decision support system (eCDSS) that provided recommendations to PCPs tailored to each patient based on laboratory results. Objective The aim of this study was to report the trial design and implementation experience of a CKD eCDSS in primary care. Methods This was a 3-arm pragmatic cluster-randomized trial at an academic general internal medicine practice. Eligible patients had 2 previous estimated-glomerular-filtration-rates by serum creatinine (eGFR Cr ) <60 mL/min/1.73m 2 at least 90 days apart. Randomization occurred at the PCP level. For patients of PCPs in either of the 2 intervention arms, the research team ordered triple-marker testing (serum creatinine, serum cystatin-c, and urine albumin-creatinine-ratio) at the beginning of the study period, to be completed when acquiring labs for regular clinical care. The eCDSS launched for PCPs and patients in the intervention arms during a regular PCP visit subsequent to completing the triple-marker testing. The eCDSS delivered individualized guidance on cardiovascular risk-reduction, potassium and proteinuria management, and patient education. Patients in the eCDSS+ arm also received a pharmacist phone call to reinforce CKD-related education. The primary clinical outcome is blood pressure change from baseline at 6 months after the end of the trial, and the main secondary outcome is provider awareness of CKD diagnosis. We also collected process, patient-centered, and implementation outcomes. Results A multidisciplinary team (primary care internist, nephrologists, pharmacist, and informaticist) designed the eCDSS to integrate into the current clinical workflow. All 81 PCPs contacted agreed to participate and were randomized. Of 995 patients initially eligible by eGFR Cr , 413 were excluded per protocol and 58 opted out or withdrew, resulting in 524 patient participants (188 usual care; 165 eCDSS; and 171 eCDSS+). During the 12-month intervention period, 53.0% (178/336) of intervention patient participants completed triple-marker labs. Among these, 138/178 (77.5%) had a PCP appointment after the triple-marker labs resulted; the eCDSS was opened for 73.9% (102/138), with orders or education signed for 81.4% (83/102). Conclusions Successful integration of an eCDSS into primary care workflows and high eCDSS utilization rates at eligible visits suggest ...

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Models, Strategies, and Tools.

Cited by 75 publications

References 58 publications

Functional Cognitive Psychodiagnosis: An Exploratory Examination of a Complementary Tool

Functional Cognitive Psychodiagnosis: An Exploratory Examination of a Complementary Tool

Unravelling how and why the Antiretroviral Adherence Club Intervention works (or not) in a public health facility: A realist explanatory theory-building case study

A Pragmatic Cluster Randomized Trial of an Electronic Clinical Decision Support System to Improve Chronic Kidney Disease Management in Primary Care: Design, Rationale, and Implementation Experience

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