RESUMO
AIMS: In Envigado, Colombia, the Secretariat of Health has implemented, since 2011, an interprofessional program involving nurses to support and train relatives to improve the quality of life of people with a loss of autonomy and their family caregivers. The objectives of this study are to assess the outcomes of this program and to explore the contextual elements and mechanisms that can explain these outcomes. DESIGN: This article presents the research protocol for a realist evaluation that will be carried out to gather the perspectives of various local stakeholders involved. METHODS: Four outcomes on family caregivers will be measured quantitatively using self-administered questionnaires and numerical scales. Contextual elements and mechanisms will then be explored qualitatively through focus groups and individual interviews. An iterative analysis will enable the refinement of a program theory. RESULTS: The results will inform a program theory that underlies the outcomes of the family caregiver support and training program. PATIENT OR PUBLIC CONTRIBUTION: Community stakeholders, family caregivers, people with a loss of autonomy and their relatives will be involved in data collection and/or in the validation of the program theory.
Assuntos
Cuidadores , Qualidade de Vida , Humanos , Inquéritos e Questionários , Projetos de Pesquisa , Cuidados PaliativosRESUMO
BACKGROUND: Intersectoral oral health promotion entails the participation of local communities. IOHP interventions were introduced in Peru in primary schools in 2013 but oral health among schoolchildren living in rural Andean communities remains suboptimal. OBJECTIVES: To understand the contextual elements and the underlying mechanisms associated with intersectoral oral health promotion interventions' current effects on schoolchildren living in remote rural Andean communities. METHOD: A realist evaluation was carried out in three rural Andean communities where intersectoral oral health promotion interventions aimed at schoolchildren have been implemented. Following an evaluation of the effects among schoolchildren, contextual elements and mechanisms were explored with various stakeholders involved in intersectoral oral health promotion through focus groups and semi-structured interviews. Subsequently, an iterative data analysis and a validation process resulted in the identification of context-mechanism configurations. RESULTS: Previous positive experiences of collaboration, a focus on communication, feelings of being respected and considered, and development of leadership and trust among stakeholders involved in intersectoral oral health promotion were elements of configurations that positively influence intersectoral oral health promotion. On the other hand, unfavorable physical, social and political environments, previous negative health experiences, feelings of not being respected or considered, demotivation, development of mistrust and insufficient leadership were shown to negatively influence outcomes. CONCLUSION: This research highlights the complexity associated with the deployment of intersectoral oral health promotion interventions in rural communities. Local stakeholders should be further involved to build trust, to facilitate coordination processes among remote rural communities and oral health professionals, and to optimize deployment of intersectoral oral health promotion interventions.
Assuntos
Promoção da Saúde , Saúde Bucal , Criança , Humanos , Peru , População Rural , Instituições AcadêmicasRESUMO
Objetivos: Efectuar la traducción y la adaptación transcultural al español del Questionnaire on Knowledge, At- titudes and Behaviors related to Oral Health (QKAB-OH) y estudiar la coherencia interna de esta versión del cuestionario. Material y métodos: El proceso de traducción, adaptación y validación del QKAB-OH se realizó en base a la síntesis de varias líneas directrices relacionadas con el proceso de traducción y adaptación de cues- tionarios. La coherencia interna de la versión traducida de este cuestionario se evaluó mediante una muestra no probabilística de niños de 9 a 13 años que viven en distritos o comunidades rurales andinas. Resultados: La coherencia interna se evaluó mediante una muestra de 70 niños. Para el conjunto de las secciones de la versión al español del QKAB-OH, el alfa de Cronbach es de 0,73. Conclusiones: Este proceso proporciona validez al con- tenido del cuestionario y una coherencia interna satisfactoria. Puede utilizarse para evaluar los comportamientos, las actitudes y los conocimientos relacionados con la salud bucodental de los niños peruanos (9 a 13 años) que viven en el área rural alto andino.
Objectives: To carry out the translation, cross-cultural adaptation and internal coherence of the Questionnaire on Knowledge, Attitudes and Behaviors related to Oral Health (QKAB-OH) Spanish version. Material and methods: The translation, adaptation and preliminary validation process of QKAB-OH was carried out based on a synthesis of several guidelines related to the process of translation and adaptation of questionnaires. The internal consistency of the translated version of the questionnaire was evaluated using a non-probabilistic sam- ple of children aged 9 to 13 years old living in rural Andean districts or communities. Results: Seventy children were recruited for the study. Cronbach's alpha of the QKAB-OH Spanish version (all sections included) was 0.73. Conclusions: This questionnaire adaptation appears to have a good face validity and a satisfactory internal consistency. It could therefore be used to evaluate behaviors, attitudes and knowledge related to oral health with Peruvian children (aged 9-13) living in high Andean rural area.
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BACKGROUND: Intersectoral collaboration, known to promote more sustainable change within communities, will be examined in an oral health promotion program (OHPP). In Peru, an OHPP was implemented by the Ministry of Health, to reduce the incidence of caries in schoolchildren. In rural Andean communities, however, these initiatives achieved limited success. The objectives of this project are: (1) to understand the context and the underlying mechanisms associated with Peruvian OHPP's current effects among school children living in rural Andean communities and (2) to validate a theory explaining how and under which circumstances OHP intersectoral interventions on schoolchildren living in rural Andean communities produce their effects. METHODS AND ANALYSIS: Through a realist evaluation, the context, underlying mechanisms and programme outcomes will be identified. This process will involve five different steps. In the first and second steps, a logic model and an initial theory are developed. In the third step, data collection will permit measurement of the OHHP's outcomes with quantitative data, and exploration of the elements of context and the mechanisms with qualitative data. In the fourth and fifth steps, iterative data analysis and a validation process will allow the identification of Context-Mechanism-Outcome configuration, and validate or refine the initial theory. ETHICS AND DISSEMINATION: This research project has received approval from the Comité d'éthique de la recherche en santé chez l'humain du Centre hospitalier universitaire de Sherbrooke. The initial theory and research results will be published in relevant journals in public health and oral health. They will also be presented at realist evaluation and health promotion international conferences.