Background: Coaching can improve the quality of care in primary-level birth facilities and promote birth attendant adherence to essential birth practices (EBPs) that reduce maternal and perinatal mortality. The intensity of coaching needed to promote and sustain behavior change is unknown. We investigated the relationship between coaching intensity, EBP adherence, and maternal and perinatal health outcomes using data from the BetterBirth Trial, which assessed the impact of a complex, coaching-based implementation of the World Health Organization's Safe Childbirth Checklist in Uttar Pradesh, India.
Methods: For each birth, we defined multiple coaching intensity metrics, including coaching frequency (coaching visits per month), cumulative coaching (total coaching visits accrued during the intervention), and scheduling adherence (coaching delivered as scheduled). We considered coaching delivered at both facility and birth attendant levels. We assessed the association between coaching intensity and birth attendant adherence to 18 EBPs and with maternal and perinatal health outcomes using regression models.
Results: Coaching frequency was associated with modestly increased EBP adherence. Delivering 6 coaching visits per month to facilities was associated with adherence to 1.3 additional EBPs (95% confidence interval [CI]=0.6, 1.9). High-frequency coaching delivered with high coverage among birth attendants was associated with greater improvements: providing 70% of birth attendants at a facility with at least 1 visit per month was associated with adherence to 2.0 additional EBPs (95% CI=1.0, 2.9). Neither cumulative coaching nor scheduling adherence was associated with EBP adherence. Coaching was generally not associated with health outcomes, possibly due to the small magnitude of association between coaching and EBP adherence.
Conclusions: Frequent coaching may promote behavior change, especially if delivered with high coverage among birth attendants. However, the effects of coaching were modest and did not persist over time, suggesting that future coaching-based interventions should explore providing frequent coaching for longer periods.
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http://dx.doi.org/10.9745/GHSP-D-19-00317 | DOI Listing |
GMS J Med Educ
November 2024
Heidelberg University Hospital, Department of General Medicine and Health Services Research, Heidelberg, Germany.
Objective: To aid the shortage of general practitioners (GPs) in Germany, since 2011 medical specialists from other fields may switch specialisation by undergoing a slim-lined training programme (lateral entry) into general practice (GP). Available published qualitative and quantitative data on lateral entrants (LEs) is scarce. Aim of the study was an explorative analysis of LEs in the competence centre for postgraduate medical education Baden-Wuerttemberg (KWBW).
View Article and Find Full Text PDFSAGE Open Nurs
December 2024
School of Nursing, University of Washington, Seattle, WA, USA.
Objective: The purpose of this study was to determine what activities and skills interprofessional health science preceptors (IHSPs) perform and value as a part of their pedagogical practice in order to support the development of a preceptor self-assessment tool and assist in preceptor training.
Methods: We administered an online survey to identify core preceptor activities across health sciences disciplines that interact with nursing. The initial survey items were developed based on the Interprofessional Education Collaborative (IPEC) core competencies as well as a search of literature on expected preceptor competencies and activities across individual health sciences professions.
Clin Teach
February 2025
Department of Internal Medicine, Division of General and Geriatric Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
Background: With increasing patient care responsibilities, administrative work and education demands, physicians may find it challenging to provide high-quality and engaging clinical education to third-year medical students on clerkships. Fourth-year students in the role of near-peer teachers can help fill this role, but they often also have competing responsibilities.
Approach: A 4-week Internal Medicine Student Chief (Student Chief) elective was created, designed such that fourth-year students would apply for dedicated time to serve as student leaders, coaches and educators for the third-year students on the Internal Medicine clerkship.
Asian J Endosc Surg
December 2024
Department of Digestive Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
Introduction: Regional disparities in medical practice between urban and rural areas in Japan represent a critical issue, and extend to the field of surgical education. To address these disparities, we evaluated the effectiveness of simultaneous remote coaching across multiple facilities using a standardized laparoscopic training method.
Methods: A total of 28 trainees from a university hospital and 3 rural hospitals were categorized into remote and on-site coaching groups.
Appl Neuropsychol Child
December 2024
Institute on Development and Disability, Department of Pediatrics, School of Medicine, Oregon Health & Science University, Portland, Oregon, USA.
Executive functions (EF) affect child competencies across domains in early childhood. Thus, this study examined: 1) the EF differences between young children with global developmental delays (GDD) and those with typical development (TD); 2) the relationship between mastery motivation (MM) and EF; 3) the association between developmental abilities and EF in both groups. Participants included 26 mother-child dyads of preschoolers with GDD (age 24-55 months) and 26 sex- and mental-age-matched dyads of TD preschoolers (age 15-29 months).
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