Conectar
To identify implementation strategies that effectively facilitate the adoption of social needs care coordination activities using enabling technologies among care management teams serving patients in community-based health centres.
Modified Delphi process.
Discrete, feasible implementation strategies were identified through literature review and semi-structured interviews with care management staff and subject matter experts in clinical informatics, workflow redesign, and product engineering. A modified Delphi was conducted with eight subject matter experts and nine health centre care management staff. Iterative rounds of online surveys were used to achieve consensus on the most relevant implementation strategies and their delivery methods.
The modified Delphi process achieved consensus on nine discrete implementation strategies needed to advance care management teams' ability to screen, refer and track social needs. Prioritised strategies included developing champions, enhancing quality improvement capacity, training staff on using enabling technologies and providing tailored technical assistance for workflow refinement. Consensus was also reached on a monthly cadence for most of the implementation strategies.
Consensus was reached on strategies to enhance care management teams' implementation of social needs screening, referrals and tracking using enabling technologies. These strategies will comprise an intervention to be pilot tested, refined and assessed in a cluster randomised clinical trial.
Findings from this study will inform the development of strategies to further the adoption of enabling technologies to support social needs care coordination.
This work is key to the design of a type 2 hybrid implementation-effectiveness trial that will assess whether user-informed, evidence-based implementation strategies can improve care management teams' adoption of enabling technologies to facilitate social needs care coordination for patients.
The research team includes a patient advisor with community-based nursing expertise and a nurse practitioner-clinical informaticist leader who was involved in data collection and interpretation of findings.
Trial registration: Clinicaltrials.gov registration # NCT06489002. Registered July 5, 2024, https://clinicaltrials.gov/study/NCT06489002?term=NCT06489002&rank=1.
Adolescent parents are at an increased risk for loneliness and mental health challenges compared to childless peers. Nature-based interventions are shown to promote social connectedness.
To identify elements of a nature-based intervention to reduce loneliness and foster nature connection among pregnant and parenting adolescents.
Sequential exploratory mixed methods.
In 2020 and 2021, we piloted the 8-week MINT program at a school for pregnant and parenting teens. Our qualitative approach (n = 17) included online and in-person group meetings with nature-based educational content, discussion, park excursions, mindfulness activities, journaling and nature photography. Subsequently, we recruited 131 young mothers at a children's hospital for a cross-sectional survey based on qualitative school findings.
Qualitative results from the school-based intervention showed a preference for meditative and contemplative activities and for spending time in nature with extended family. Participants typically accessed nature close to home. Our clinic-based teen parent survey illustrated that participants' access to nature were most limited by lack of time (25% of responses), company (18%) and energy (28%). While participants showed a close nature connection (mean NR-6 score = 3.9 (SD = 0.84)), they also showed moderate levels of loneliness (mean UCLA Loneliness score = 4.78 (SD = 1.60)). Walking, hiking and/or running were the most preferred nature activity.
These findings provide key details to define nature-based activities to address loneliness and psychological well-being among teen mothers.
Nature-based health interventions can address loneliness and nature disconnection by building community resilience, improving provider and patient well-being and motivating environmental stewardship.
We identify key features of a nature-based intervention for adolescent mothers. These findings support teen mothers in the US and abroad and may serve as a foundation for using nature-based solutions for vulnerable mothers and for adolescents facing loneliness and mental health challenges.
No patient or public contribution.
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