Background: Selecting effective implementation strategies to support guideline-concordant dental care is a complex process. We are drawing on data collected during the DISGO study to reflect on barriers we encountered in implementing a deliberative engagement process for discussing implementation strategies relevant to the evidence-based guideline targeted in this intervention. The goal is to identify factors that may influence the success of deliberative engagement as a technique to involve healthcare staff in identifying priorities for implementation strategies.
Methods: We drew on online chat transcripts from the deliberative engagement forums collected during the DISGO study. The chat transcripts were automatically generated for each discussion and captured the written exchanges between participants and moderators in all participating dental clinics. Chat transcripts were analyzed following a content analysis approach.
Results: Our findings revealed barriers to the successful implementation of deliberative engagement in the context of the DISGO study. Participants were not familiar with the materials that had been prepared for the forum and lacked familiarity with the topic of deliberation. Participants also did not share divergent viewpoints and reinforced existing ideas rather than introducing new ideas.
Conclusions: In order to ensure that obstacles that were encountered in this study are not repeated, it is important to carefully consider how staff can effectively be prepared for the deliberations. Participants must be familiar with the content of the guideline, and most questions about the content and evidence should be answered before the deliberative engagement sessions. If perspectives among staff on a guideline are homogenous, briefing materials should introduce perspectives that complement existing views among staff. It is also necessary to create an environment in which staff are comfortable introducing opinions that may not be held by the majority of colleagues.
Trial Registration: This project is registered at ClinicalTrials.gov with ID NCT04682730. The trial was first registered on 12/18/2020. https://clinicaltrials.gov/ct2/show/NCT04682730 .
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http://dx.doi.org/10.1186/s43058-023-00496-2 | DOI Listing |
Med Law Rev
January 2025
University of Bristol, University of Bristol Business School, Bristol, UK.
System-level decisions around the commissioning and provision of healthcare services in England have contributed to barriers in accessing the National Health Service. In this article, we ask how to better regulate resource allocation to ensure greater equity in access to healthcare services. First, we focus on the Health and Care Act 2022, which, drawing on principles of deliberative regulation to address health inequalities, initiates a shift away from previous regulatory approaches towards a collaborative decision-making model.
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December 2024
Appleton Institute; School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia.
When self-regulatory resources are depleted, people tend to act more on "autopilot", with minimal forethought. It follows that when sleepy, people should be more likely to act habitually, based on learned cue-behaviour associations that trigger behaviour automatically when the cue is encountered. This ecological momentary assessment study investigated whether, over the course of a week, between-person differences and momentary within-person variation in daytime sleepiness were associated with the reported habit strength of behaviours.
View Article and Find Full Text PDFGenet Med Open
July 2024
Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX.
Purpose: A primary challenge in clinical genetics is accurate interpretation of identified variants and relaying the information to patients and providers. Inconsistencies around handling variant reclassifications and notifying patients, combined with the lack of prescriptive guidelines on re-evaluation, reanalysis, and return of variants, has created practice challenges. Although relevant empirical work has emerged, the scope and outcomes of this research have not been characterized.
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December 2024
Laboratoire de Psychologie Médicale et d'Addictologie, Université Libre de Bruxelles (ULB), place Van Gehuchten 4, 1020 Brussels, Belgium.
Dialogues Hum Geogr
November 2024
University of British Columbia, Canada.
In dialogue with responses to my article on the emergent practice of conjunctural methodologies, I pick up the question of collaboration and the shared challenges of developing, in a deliberative and reflexive manner, this demanding approach to problem specification, research design, and contextual theorizing. Although explicit engagement with conjunctural methodologies is a relatively recent phenomenon, its connections and resonances with geographical research practice run deeper. This means that there is much for geographers to give as well as to gain from the interdisciplinary conversation around conjunctural analysis.
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