Evaluation & the Health Professions最新文献

Self-regulated learning (SRL) plays a pivotal role in medical education. There is a pressing need for a meta-analytical review to comprehensively evaluate the effect sizes of SRL strategies across diverse learning outcomes and levels of medical trainees. A meta-analysis was executed by searching five databases and resulted in 61 studies that met our inclusion criteria. A three-level meta-analysis was performed to examine the association between SRL strategies and various levels of learning outcomes (i.e., affective, cognitive, and behavioral learning outcomes). Moderator analyses were conducted using meta-regression, considering factors such as types of learning outcomes, training levels, SRL subscales, and quality of the studies. The analysis yielded an average effect size of .212, using Pearson's correlation coefficient, demonstrating a positive and significant association between SRL strategies and overall learning outcomes. Although our moderator analyses indicated that SRL subscales and study quality did not significantly influence the relationship between SRL strategies and learning outcomes, SRL strategies had a more pronounced effect on affective outcomes than on test scores, behavioral outcomes, and mental health outcomes. In addition, the association between SRL strategies and learning outcomes were significantly higher among the clerkship phase of undergraduate medical education than the pre-clerkship phase.

Role modelling is important in developing professionalism with a need for reliable, evidence-based tools to assess professionalism in the learning environment (LE). The Learning Environment for Professionalism (LEP) survey is brief, anonymous and balanced assessing medical trainees' and attendings' positive and negative professionalism behaviours that can be tracked longitudinally and identify problem areas in the LE. Seven training programs agreed to facilitate administration of the LEP survey at four hospitals in Ottawa, Canada. The survey was carried out iteratively between 2013 and 2020. A total of 3783 LE ratings of training programs and hospitals were assessed longitudinally using univariate linear regression. A Bonferroni corrected p-value of ≤.0045 was used to account for multiple comparisons. Positive professional behaviours were observed across time with some of the negative behaviors having improved. A negative signal was found, with attendings appearing to be treating patients unfairly because of their financial status, ethnic background, sexual or religious preferences. Applying LEP survey longitudinally across diverse training programs and institutions is feasible and may assist programs to identify areas requiring attention and acknowledging areas of exemplary professionalism. Continuous monitoring of LE to meet requirements of accrediting bodies can also be considered an important quality improvement metric.

The general population struggles to meet physical activity recommendations, risking mental and physical health. Validated, culturally adapted tools are essential for identifying barriers and implementing effective, context-specific strategies to promote exercise participation. Despite its wide use, the cross-cultural equivalence, and psychometric properties of the Barriers to Being Active Quiz (BBAQ) have not been confirmed. The purpose of this study was to validate the BBAQ cross-culturally into European Spanish (BBAQ-ES). Following international guidelines, the BBAQ underwent a systematic four-step process involving a multidisciplinary translation, synthesis, reconciliation, review, and a population-based comprehensibility test. Measurement properties-including structural and construct validity, and internal consistency, measurement error and test-retest reliability-were assessed following COSMIN guidelines on a sample of 589 Spanish University students. The IPAQ-SF was used as comparator instrument during hypothesis testing for construct validity (i.e. convergent, and discriminative validity). The BBAQ-ES demonstrates strong cross-cultural equivalence and good measurement properties (RMSEA = 0.0485, CFI = 0.946; Cronbach's alpha = 0.875; ICC = 0.724 -0.878; confirmed hypotheses testing >75%). The BBAQ-ES is a cross-culturally adapted, reliable and valid measure to assess multidimensional obstacles to physical activity. This study provides valuable new insights for international research and clinical practice.

In the present study, we aimed to translate and validate two instruments designed to assess self-stigmatization: the Self-Stigma of Mental Illness Scale and the Paradox of Self-Stigma Scale, among Romanian psychiatric patients. Responses from 326 psychiatric patients (58% women) diagnosed with internalizing and externalizing disorders were collected to evaluate the instruments' structural validity, measurement invariance, reliability, convergent and criterion validity. Confirmatory factor analyses offered support for the intended structure of both instruments and the pattern of associations with the other investigated variables further sustained their validity. Reliability was optimal, as revealed by excellent internal consistency estimates. For the first time, the invariance of these instruments was tested based on gender and psychiatric diagnosis. Our results suggest that both instruments can be confidently used by Romanian specialists, providing an effective toolkit for measuring self-stigmatization related to mental health.

Home healthcare is a widely adopted health policy to address the needs of aging societies. This study examined Taiwan's home healthcare policy as a case example, assessing its implementation through the five dimensions of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Taiwan's home healthcare policy, launched in 2016 as the "Integrated Home-Based Medical Care" (iHBMC) program, is reimbursed by the National Health Insurance. The study utilized data from the National Health Insurance Research Database and publicly available government sources. A total of 15,761 adults aged 50 years and above in the iHBMC program during its first year were identified, with 16% receiving home-based primary care (S1) and 84% receiving home-based advanced care (S2) (Reach). Prescriptions for chronic diseases and emergency department visits were significantly decreased among S1 and S2 patients after the iHBMC program (Effectiveness). Among all institutions delivering home healthcare, the majority were clinics (74%), followed by home nursing care agencies (18.3%) and hospitals (7.5%) (Adoption). Continuity of care was higher in S1 than in S2 (Implementation). More than 70% of participants engaged in the program for more than 6 months (Maintenance). These findings suggest the iHBMC program is feasible, improves healthcare utilization, and reduces hospital burden.

The present study aimed to validate the Italian 8-item, 9-item, and 12-item versions of the Depression, Anxiety and Stress Scale-21 (DASS-21), addressing the need for shorter yet psychometrically robust measures. Two studies were conducted with different samples. In Study 1 (n = 541), confirmatory factor analysis (CFA) and reliability testing of the short-form versions of the DASS were performed, and their convergent validity with life satisfaction and mental well-being was examined. Study 2 (n = 321) extended this validation by reassessing factor structure, reliability, and convergent validity using constructs associated with psychological distress, including positive and negative affect, self-esteem, and perceived stress. Results demonstrated that all short-form versions retained the three-factor structure of the original DASS-21, with overall sufficient fit indices, especially the 9-item model. Reliability metrics confirmed internal consistency (all Cronbach's alpha and McDonald's omega ≥0.70). Convergent validity analyses indicated strong correlations between the short-form versions of DASS-21 (min = 0.675, max = 0.956) and associated psychological constructs, aligning with theoretical expectations. The scales captured the relationships between psychological distress, positive and negative affect, perceived stress, mental well-being, self-esteem, and life satisfaction. Findings suggest that the Italian versions of the DASS-8, DASS-9, and DASS-12 provide feasible and reliable alternatives to the DASS-21 for assessing depression, anxiety, and stress, supporting their usefulness in clinical and research contexts, particularly in circumstances in which brevity is essential.

Instagram's popularity has raised concern about its problematic use. However, no validated scales assessing Instagram addiction exist in the Indian context. The present study evaluated the psychometric properties of the 15-item Instagram Addiction Scale (IAS-15) among Indian adults. In total, 301 participants (M_age = 22.89 years) were recruited using a convenience sampling technique. Confirmatory factor analysis indicated that the two components of the IAS-15, social effect and compulsion, had suitable factor loadings: CMIN/DF (chi-square/degree of freedom) = 2.531, GFI (goodness of fit index) = 0.903, IFI (incremental fit index) = 0.965, TLI (Tucker-Lewis index) = 0.958, CFI (comparative fit index) = 0.965, and RMSEA (root mean square error of approximation) = 0.071. This was further improved by drawing covariances between theoretically linked items (CMIN/DF = 2.273, GFI = 0.916, IFI = 0.972, TLI = 0.965, CFI = 0.971, and RMSEA = 0.065). Strong convergent validity with a significant and positive correlation with social media addiction (r = 0.899), and strong concurrent validity with depression (r = 0.778), anxiety (r = 0.777), stress (r = 0.815), and negative correlations with self-esteem (r = -0.635) were observed. The IAS-15 demonstrated excellent internal consistency with Cronbach's alpha (α) and McDonald's omega (ω) coefficients of reliability for the overall scale (α = 0.962 and ω = 0.963) and its two subscales, social effect (α = 0.941 and ω = 0.942) and compulsion (α = 0.922 and ω = 0.922). Findings confirm that the IAS-15 is a valid and reliable instrument for assessing Instagram addiction among Indian adults.

This study adapted the Health Sciences Evidence-Based Practice (HS-EBP) Questionnaire, which measures evidence-based practice knowledge and attitudes, into Turkish and tested its validity and reliability among physiotherapists in Turkey. Data were obtained from 268 physiotherapists. The Quality of Professional Life (PRoQOL) Scale, Resistance to Change Scale (RCS), Maslach Burnout Inventory (MBI), and Information Literacy Self-Efficacy Scale (ILSES) were used concurrently to test the convergent validity. The confirmatory factor analysis (CFA) was created to examine construct validity. The reliability of the Turkish HS-EBP questionnaire was evaluated by internal consistency (Cronbach's alpha), correlation values between items and total scores, and test-retest reliability (intraclass correlation coefficient (ICC). The Cronbach's alpha of the scale (0.985) demonstrated high internal consistency and test-retest reliability (ICC = 0.992). The item-total correlations ranged from 0.528 to 0.867. The MDC for the scale was determined to be 7.518. The fit indices (χ2/sd) were 2.331, RMSEA 0.071, SRMR 0.062, IFI 0.907, CFI 0.906, GFI 0.862, and TLI 0.917. There was a positive statistically significant correlation between the Turkish HS-EBP questionnaire and PRoQOL, ILSES, and a negative correlation between RCS, MBI subscores (p < 0,05). The Turkish version of the HS-EBP questionnaire is a practical, valid, and reliable scale that measures the knowledge, skills, beliefs, and attitudes of Turkish-speaking physiotherapists.

Contribution Analysis (CA) is a promising theory-based evaluation approach for complex interventions, yet its application in health interventions remains largely unexplored. To bridge this gap, we conducted a scoping review to examine the extent of such applications and the methodologies, strengths, and limitations of this approach in health programming. Our comprehensive search strategy was developed and used in 15 databases to identify peer-reviewed articles from 1999 to 2023 that focused on using CA to evaluate health interventions. We then implemented rigorous double- and triple-screening processes for abstracts and full-text papers, respectively. Data were extracted and narratively summarized. Our review found seven relevant studies, which showed that CA has been employed in health promotion programs, health policies, and targeted health issues such as nutrition, cardiovascular disease, substance misuse, and suicide prevention. The studies identified strengths of using CA, including its flexible impact evaluation approach, capacity to inform decision-making, and potential to enhance understanding of health programs and policies. However, challenges such as how to determine suitable evidence levels and how to best manage resource intensity were also identified. The limited number of studies indicates that CA is still a novel approach, whereas the variation in the reporting of the studies suggests that this approach could benefit from more standardized methods and detailed stakeholder engagement strategies.

Examining ways of reducing physical inactivity has been at the forefront of public health research. Moreover, valid and reliable scales are needed to objectively assess physical activity (PA) avoidance. Previous research has shown that experiencing weight stigma and physical appearance-related concerns are associated with physical inactivity. However, there is currently no Thai instrument that assesses physical inactivity in relation to weight stigma. Therefore, the present study examined the psychometric properties of the Thai version of the Tendency to Avoid Physical Activity and Sport Scale (TAPAS). Thai university students (N = 612) recruited via convenience sampling completed an online survey using SurveyMonkey between September 2022 and January 2023. Confirmatory factor analysis (CFA), multigroup CFA, and Pearson correlations (between TAPAS scores, age, body mass index, and time spent exercising) were used to analyze the data. The CFA showed robust psychometric properties for the Thai version of TAPAS regarding its unidimensional structure. The TAPAS was measurement invariant across sex, weight status, and daily hours of exercise. However, no significant Pearson correlations were found. In general, the results showed that the TAPAS is a good scale for assessing PA avoidance among Thai young adults across different sexes, weight status, and daily hours of exercise.