Key Informant Interviews (key + informant_interview)

Distribution by Scientific Domains


Selected Abstracts


Alcohol in Mayan Guatemala: consumption, distribution, production and composition of cuxa

ADDICTION, Issue 5 2009
Fotis Kanteres
ABSTRACT Aims To describe the consumption, distribution, production and chemical composition of alcohol, including cuxa (pronounced ,coo sha'), in Nahualá, a highland Mayan municipality in Guatemala. Cuxa is a sugarcane-derived spirit, in part produced clandestinely, that has been distributed in the community for several decades. Methods Key informant interviews with alcohol distributors and consumers, cuxa producers and health professionals, as well as analyses of questionnaires from a sample of 47 spouses who came to the local health centre for problems related to their husband's drinking. Sampling and chemical analysis of cuxa from 12 of 13 identified sales points in the head-town of Nahualá and its nearby settlements (10 km radius). Fieldwork was conducted between November 2007 and March 2008. Results Alcohol consumption was found to be integrated culturally in this community. The overall drinking culture was marked by irregular heavy drinking occasions, especially around market days, with substantial inebriation and health problems, especially among street inhabiting drinkers. Cuxa contributed to these problems, and cuxa drinking was socially stigmatized. Cuxa was produced both clandestinely and industrially, and sold legally by taverns and illegally by clandestine distributors. The alcoholic strength of the samples was typically between 17 and 19% vol.; clandestinely produced cuxa samples showed acetaldehyde contamination. Conclusions Measures should be taken to reduce the harm associated with alcohol in this community, including efforts to reduce acetaldehyde levels in cuxa. [source]


Factors influencing rural health care professionals' access to continuing professional education

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2006
Vernon R. Curran
Abstract Objectives:,The purposes of this study were to explore the perceived barriers and challenges to continuing professional education (CPE) access for Canadian health care professionals and to identify best practices for improving access to CPE. Design:,Key informant interviews and Web-based online surveys were conducted. Participants:,Key informant interviews were conducted with national CPE accreditation bodies and health professional associations. An online survey was distributed to health professional education programs, as well as provincial professional associations, licensing and professional regulatory bodies. Main outcome measures:,The perceived barriers and challenges to CPE access for Canadian health care professionals and best practices for improving access to CPE. Results and conclusions:,Geographic isolation and poor technological and telecommunications infrastructure were identified as key barriers to CPE delivery and access. Financial factors, such as funding to support travel or cost of attendance, were also identified as major challenges. Tele-education programming was identified as a best practice approach to improve CPE access, as were regional CPE activities and self-directed learning programs. Employer-sponsored initiatives, including staff coverage or locum support, remuneration for time off and paid travel expenses for CPE participation were also identified as best practice approaches. [source]


Near misses: Paradoxical realities in everyday clinical practice

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2008
Lianne Jeffs RN PhD (c)
This qualitative study was conducted to define and describe what constitutes and contributes to near miss occurrences in the health-care system and what is needed to ensure safer processes of care. Nine health-care organizations (13 sites total) including six academic health sciences centres (acute care, mental health and geriatric) and three community hospitals participated in this study. The final sample consisted of 37 focus groups (86 in the nursing staff only; 62 in the pharmacy staff only; and 99 in the mixed nursing and pharmacy focus groups respectively) and 120 interviews involving 144 health-care consumers. Data were collected using focus groups (health-care professionals) and key informant interviews (health-care consumers). A multi-level content analyses schema (transcription, coding, categorizing, internal consistency, thematic analysis and community validation) was used. Six themes emerged from the multi-level content analyses that combined focus group (health-care professionals) and key informant interview (health-care consumers) data. These themes are discussed under the three original research questions with supporting data derived from codes and categories. Study findings implicate changes for the health-care landscape relative to system, health policy, professional development and quality improvement. [source]


Psychotic and behavioural symptoms in a population-based sample of the very elderly subjects

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009
S. Östling
Objective:, The aim was to elucidate the relationship between psychotic and behavioural symptoms in the elderly. Method:, A representative sample of 85 year old subjects living in Gothenburg, Sweden (n = 451) was assessed with neuropsychiatric examinations, key informant interviews and record reviews. Results:, Fourteen percent of these very elderly subjects had paranoid symptoms with concomitant anxious agitation and/or irritability/anger. Hallucinations and paranoid symptoms were both associated with a pattern of behavioural symptoms including both anxious agitation and irritability/anger simultaneously in both demented [hallucinations, Odds ratio (OR) 2.8, Confidence interval (CI) 1.2,6.7, paranoid symptoms OR 5.6 CI 2.2,14.2] and non-demented (hallucinations OR 3.2 CI 1.2,8.3, paranoid symptoms OR 4.8 CI 2.0,11.8). Conclusion:, Psychotic symptoms are associated with behavioural symptoms regardless of dementia status. Since these symptoms lead to decreased ability to function in daily life and increased caregiver burden, it is important for health professionals to identify and treat these symptoms also in non-demented. [source]


Psychiatric epidemiology of old age: the H70 study , the NAPE Lecture 2003

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2004
I. Skoog
Objective: To describe methodological issues and possibilities in the epidemiology of old age psychiatry using data from the H70 study in Göteborg, Sweden. Method: A representative sample born during 1901,02 was examined at 70, 75, 79, 81, 83, 85, 87, 90, 92, 95, 97, 99 and 100 years of age, another during 1906,07 was examined at 70 and 79 years of age, and samples born between 1922 and 1930 were examined at 70 years of age. The study includes psychiatric examinations and key informant interviews performed by psychiatrists, physical examinations performed by geriatricians, psychometric testings, blood sampling, computerized tomographies of the brain, cerebrospinal fluid analyses, anthropometric measurements, and psychosocial background factors. Results: Mental disorders are found in approximately 30% of the elderly, but is seldom detected or properly treated. Incidence of depression and dementia increases with age. The relationship between blood pressure and Alzheimer's disease is an example of how cross-sectional and longitudinal studies yield completely different results. Brain imaging is an important tool in epidemiologic studies of the elderly to detect silent cerebrovascular disease and other structural brain changes. The high prevalence of psychotic symptoms is an example of the importance to use several sources of information to detect these symptoms. Dementia should be diagnosed in all types of studies in the elderly, as it influences several outcomes such as mortality, blood pressure, and rates of depression. Suicidal feelings are rare in the elderly and are strongly related to mental disorders. Conclusion: Modern epidemiologic studies in population samples should be longitudinal and include assessments of psychosocial risk factors as well as comprehensive sets of biologic markers, such as brain imaging, neurochemical analyses, and genetic information to maximize the contribution that epidemiology can provide to increase our knowledge about the etiology of mental disorders. [source]


Zimbabwe's Child Supplementary Feeding Programme: A Re,assessment Using Household Survey Data

DISASTERS, Issue 3 2002
Lauchlan T. Munro
In 1992,3 and 1995,6, Zimbabwe used a Child Supplementary Feeding Programme (CSFP) to combat child malnutrition during drought,induced emergencies. Previous evaluations of the CSFP relied on routine administrative data and key informant interviews and made only cursory use of available household survey data. These evaluations concluded that the CSFP was effective in preventing an increase in malnutrition among children under five, especially in 1992,3. The more,detailed analysis of household surveys provided in this article suggests that CSFP coverage was generally patchy and disappointingly low, especially in 1995,6. There is little evidence that children from poor or nutritionally vulnerable households got preferential access to supplementary feeding. The CSFP failed to feed many malnourished and nutritionally vulnerable children even in areas where the programme was operating. Household survey evidence suggests that the CSFP's impact on nutritional status was likely marginal, especially in 1995,6. [source]


Managed Behavioral Health Care: An Instrument to Characterize Critical Elements of Public Sector Programs

HEALTH SERVICES RESEARCH, Issue 4 2002
M. Susan Ridgely
Objective. To develop an instrument to characterize public sector managed behavioral health care arrangements to capture key differences between managed and ,unmanaged" care and among managed care arrangements. Study Design. The instrument was developed by a multi-institutional group of collaborators with participation of an expert panel. Included are six domains predicted to have an impact on access, service utilization, costs, and quality. The domains are: characteristics of the managed care plan, enrolled population, benefit design, payment and risk arrangements, composition of provider networks, and accountability. Data are collected at three levels: managed care organization, subcontractor, and network of service providers. Data Collection Methods. Data are collected through contract abstraction and key informant interviews. A multilevel coding scheme is used to organize the data into a matrix along key domains, which is then reviewed and verified by the key informants. Principal Findings This instrument can usefully differentiate between and among Medicaid fee-for-service programs and Medicaid managed care plans along key domains of interest. Beyond documenting basic features of the plans and providing contextual information, these data will support the refinement and testing of hypotheses about the impact of public sector managed care on access, quality, costs, and outcomes of care. Conclusions. If managed behavioral health care research is to advance beyond simple case study comparisons, a well-conceptualized set of instruments is necessary. [source]


Organization and delivery of primary health care services in Petrópolis, Brazil

INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 4 2004
James Macinko
Abstract The objective of the study was to adapt and apply an instrument to measure the organizational features of the primary care system in the municipality of Petrópolis. The study compared the performance of the new Family Health Program (Programa Saúde da Família or PSF) with traditional primary care facilities using data from facility surveys and key informant interviews. The main results include: (a) the methodology was capable of distinguishing between the two types of primary care services in the municipality; (b) the PSF clinics scored higher on most dimensions of primary care, although in some areas the traditional health units had equivalent scores; and (c) data obtained from interviewing key informants was generally compatible with that obtained by conducting facility surveys. The results suggests that in spite of making important advances in primary care, the municipality of Petrópolis continues to face several challenges including the need to improve access, enforce the gatekeeper role of primary care, and improve the coordination and community orientation of both types of primary care services. The methodology could be used to set objectives and monitor progress towards improving the organization and delivery of primary care in Petrópolis and elsewhere. Copyright © 2004 John Wiley & Sons, Ltd. [source]


Near misses: Paradoxical realities in everyday clinical practice

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2008
Lianne Jeffs RN PhD (c)
This qualitative study was conducted to define and describe what constitutes and contributes to near miss occurrences in the health-care system and what is needed to ensure safer processes of care. Nine health-care organizations (13 sites total) including six academic health sciences centres (acute care, mental health and geriatric) and three community hospitals participated in this study. The final sample consisted of 37 focus groups (86 in the nursing staff only; 62 in the pharmacy staff only; and 99 in the mixed nursing and pharmacy focus groups respectively) and 120 interviews involving 144 health-care consumers. Data were collected using focus groups (health-care professionals) and key informant interviews (health-care consumers). A multi-level content analyses schema (transcription, coding, categorizing, internal consistency, thematic analysis and community validation) was used. Six themes emerged from the multi-level content analyses that combined focus group (health-care professionals) and key informant interview (health-care consumers) data. These themes are discussed under the three original research questions with supporting data derived from codes and categories. Study findings implicate changes for the health-care landscape relative to system, health policy, professional development and quality improvement. [source]


The influence of HIV/AIDS on the practice of primary care nurses in Jordan: Rhetoric and reality

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2005
Hani Nawafleh PhD(Cand)
The role of nurses in raising community awareness about HIV/AIDS is well-reported. However, little is known about the practice of Jordanian nurses and the role they play in the prevention and control of HIV/AIDS. This interpretive ethnographic study sought to illuminate the role of primary care nurses and examine the influence of HIV/AIDS on their practice. The study was undertaken in Jordan in three rural and three urban primary health-care centres. Data collection included participant observation, key informant interviews and document analysis. These data informed the development of descriptive ethnographic accounts that allowed for the subsequent identification of common and divergent themes reflective of factors recognized as influencing the practice of the nurse participants. The findings indicate that the rhetoric offered by all levels of administration and endorsed in policy is not reflective of the reality of practice. Poor resources and educational preparation, a limited nursing skill mix and access to professional development, lack of nursing leadership and role models, cultural beliefs and geographic isolation are factors that reduced the capacity of the primary care nurses to raise awareness and, therefore, influence the prevention and control of HIV/AIDS. [source]


Attitudes of intensive care nurses towards brain death and organ transplantation: instrument development and testing

JOURNAL OF ADVANCED NURSING, Issue 5 2006
Jung Ran Kim BN MClinN DipN RN
Aims., This paper reports the development and testing of an instrument assessing attitudes of Korean intensive care unit nurses. Background., Reluctance by healthcare professionals to identify brain-dead patients as a potential donor is one reason for a shortfall in transplantable organs in all countries. Organ donation from brain-dead patients is a particularly contentious issue in Korea, following recent legal recognition of brain death within the cultural context of Confucian beliefs. Method., A 38-item instrument was developed from the literature and key informant interviews, and validated by an expert panel and a pilot study. A survey was conducted with Korean intensive care unit nurses (n = 520) from October 2003 to January 2004. Principal component analysis with varimax rotation was used to determine construct validity. Item-to-total correlations and Cronbach's coefficient alpha were used to determine the scale's internal consistency and unidimensionality. Results., The scale demonstrated high internal consistency (alpha = 0·88). Principal component analysis yielded a four-component structure: Discomfort, Enhancing quality of life, Willingness to be a donor and Rewarding experience. Overall, Korean intensive care unit nurses showed positive attitudes towards organ transplantation, despite some mixed feelings. Conclusion., The attitude scale was reliable and valid for this cohort. Areas were identified where professional development may enhance positive attitudes towards organ transplantation from brain-dead donors. Effective education for intensive care unit nurses is necessary to increase the organ donor pool in Korea. Further research could test the instrument with other populations. [source]


Ecotourism and biodiversity conservation in Jozani,Chwaka Bay National Park, Zanzibar

AFRICAN JOURNAL OF ECOLOGY, Issue 2009
Layla A. Salum
Abstract This study is based on a study undertaken to assess how ecotourism has influenced biodiversity conservation in Jozani,Chwaka Bay National Park (JCBNP). It involved two communities surrounding the park, namely Pete and Kitogani. Field data were collected using structured questionnaires, key informant interviews and field observations. Questionnaires were administered to 76 households, whereas key informant interviews were conducted with foresters and JCBNP officials. Data analysis was undertaken using standard statistical methods. Findings from the study show that biodiversity management in the JCBNP has improved considerably after the introduction of ecotourism. The number of endemic colobus monkeys (Piliocolobus kirkii) and other rare species has increased. However, this achievement has been attained by restricting surrounding communities from using forest resources without providing alternative sources of livelihood. Findings also show that the benefits from ecotourism do not reach individual households, but the community as whole, in form of various social services. This has caused some resentment among the local people leading to their reluctance to reduce their direct use of ecosystem services available in the JCBNP, claiming that they cannot sustain their livelihood without such services. This has become a major source of conflict between the JCBNP and surrounding communities. Increased awareness and knowledge on biodiversity conservation would be needed for the communities surrounding the park to realize the potential and long-term benefits of ecotourism, and hence the need for their increased involvement in biodiversity management. [source]


School Wellness Policies: Perceptions, Barriers, and Needs Among School Leaders and Wellness Advocates,

JOURNAL OF SCHOOL HEALTH, Issue 11 2010
Peggy Agron MA
BACKGROUND: School wellness policies are a key component to the prevention of adolescent obesity. This national research study sought to understand the wellness environment in school districts across the country and to identify challenges districts face and needs they have in order to effectively implement, monitor, and evaluate school wellness policies. The study determined (1) perceptions, barriers, and opportunities regarding the development, implementation, and monitoring/evaluation of school wellness policies among school board members, state school boards association leaders, state public health nutrition directors, and school wellness advocates; (2) the readiness and capacity of survey groups to address nutrition and physical activity policies; (3) the extent to which survey groups collaborate; and (4) the acceptability of wellness tools. METHODS: In 2006, over 2900 individuals participated in online surveys, focus groups, and key informant interviews. School board members represented 1296 school districts across the nation. RESULTS: School board members expressed the highest level of confidence among all survey groups that their district has the capacity to develop, implement, and monitor/ evaluate the wellness policy. The disparities among groups are most notable with regard to perceptions of district capacity to monitor/evaluate the policy. School board members are interested in school wellness policy tools and trainings. CONCLUSIONS: There is an opportunity for state school boards associations, state public health nutrition directors, and school wellness advocates to build their own capacity to provide training and resources to districts on wellness issues, particularly physical education/activity, school-based wellness initiatives, and strategies for implementing and monitoring/evaluating wellness policies. [source]


California School Board Members' Perceptions of Factors Influencing School Nutrition Policy

JOURNAL OF SCHOOL HEALTH, Issue 2 2004
Kelli McCormack Brown
ABSTRACT: Enactment and enforcement of school nutrition policies represent key components in adolescent overweight and obesity prevention. This study determined: 1) California school board members' attitudes, perceptions, and motivations related to enactment of policies that support healthy eating in schools; and 2) barriers to adopting school policies that support healthy eating. To understand board members' decision-making process, key informant interviews were conducted and a survey was administered to 404 school board members. Though school board members care about the well-being of pupils, competing priorities limit the extent to which nutrition issues get addressed at board meetings. Members' decisions center primarily around academic achievement issues, yet they are interested in nutrition's overall impact on children's health and academic achievement. [source]


The incidence of land tenure insecurity in Southern Africa: Policy implications for sustainable development

NATURAL RESOURCES FORUM, Issue 3 2007
Gladys Mutangadura
Abstract The study presented in this article used a combination of key informant interviews and a review and synthesis of existing country level literature to identify the major sources of land tenure insecurity in six Southern African countries: Botswana, Lesotho, Malawi, Mozambique, South Africa, and Zambia. Findings reveal that the main causes of land tenure insecurity experienced in Southern Africa include lack of land rights of minority groups, unclear or overlapping land rights, overcrowding, land alienation into leasehold, insecurity of farm workers and farm labour tenants, inappropriate and exploitative administrative practices, land encroachment and illegal settlers and limited women's land rights. The article presents a summary of land tenure security related initiatives that the study countries have or are in the process of adopting. Analysis of these initiatives shows that tenure reforms have focused on changing the law and rules but little has been done to translate new laws into implementable programs; capacity building; prioritization of resources to support tenure reform; provision of complementary policies and incentives; addressing HIV/AIDS-land tenure related problems; and monitoring and evaluation. The paper contends that these policy issues should be addressed in order to ensure realization of land tenure security for all. [source]


Nonprofit organization financial performance measurement: An evaluation of new and existing financial performance measures

NONPROFIT MANAGEMENT & LEADERSHIP, Issue 4 2003
William J. Ritchie
Consensus about financial performance measurement remains elusive for nonprofit organization (NPO) researchers and practitioners alike, due in part to an overall lack of empirical tests of existing and new measures. The purpose of the current study was to explore potential similarities of financial performance measures derived from two sources: current NPO research and key informant interviews with NPO foundation constituencies. The authors examined financial performance measurement ratios with data from fifteen Internal Revenue Service (IRS) Form 990 line items. Using factor analytic techniques, they found three performance factors, each with two associated financial measurement ratios, to be present. They categorized the performance factors as fundraising efficiency, public support, and fiscal performance. This article discusses implications of the findings and future research. [source]


Implementation Theory Revisited . . . Again: Lessons from the State Children's Health Insurance Program

POLITICS & POLICY, Issue 2 2009
ROBERT J. MCGRATH
This article examines the implementation of the State Children's Health Insurance Program (SCHIP) in three states: Massachusetts, Georgia, and Ohio. It examines the effectiveness of four theoretical driving forces in explaining implementation using a multiple case study analysis. Data were compiled using legislative histories, key informant interviews, public record, and media content analysis and were analyzed using a triangulation of sources. Findings suggest that the driving forces as conceptualized in the literature are only partially helpful when examining the implementation of federal redistributive health policy in these states. A pursuit of rationality approach was the most explanatory of the driving forces followed by an organizational-policy fit when there was limited capacity to implement new policy. Overall, implementation was found to be more related to state-level capacity and the state's previous programmatic experiences. Policy innovation was more likely to occur when capacity was high and where goals agreement drove the process. [source]


THE CO-OPERATIVE REFORM PROCESS IN TANZANIA AND SRI LANKA

ANNALS OF PUBLIC AND COOPERATIVE ECONOMICS, Issue 3 2010
Johnston Birchall
ABSTRACT**:,This article reports on findings from a three year study of co-operatives in Sri Lanka and Tanzania. The article asks three questions: why do co-operative sectors need reforming; what is the co-operative reform process; and why has reform succeeded in some countries but not others? It provides a short history of co-operatives in three phases: the colonial period, the post-colonial nationalist period and the period of market liberalisation. It shows that the control exercised by colonial governments was deepened under nationalist governments, with co-operatives becoming parastatals. Liberalisation brought a sustained attempt by international agencies to reassert the distinctive nature of co-operatives as member-owned businesses. However, co-ops were ill-prepared to adjust to a competitive market and the lifting of government regulation; many failed, some were corrupted, while a few became truly member-controlled. The article draws on documentary analysis and key informant interviews to provide accounts of the reform process in Tanzania and Sri Lanka. It finds that the process is incomplete and often contested. [source]