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- Hasson, R, et al.
(författare)
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Treatment Effects of Climate Change Risk on Mitigation and Adaptation Behavior in an Experimental Setting
- 2012
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Ingår i: South African Journal of Economics. - 0038-2280. ; 80:3, s. 415-430
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores the collective action problem as it relates to climate change and develops two models that capture the mitigation–adaptation trade-off. The first model presents climate change as a disaster that will occur with certainty, and where both mitigation and adaptation reduce the size of the loss associated with the disaster (the so-called deterministic model). The second model presents climate change as an uncertain event, where mitigation affects the probability of disaster while adaptation again reduces the size of the loss (this is the so-called stochastic model). Comparing the two models in a one-shot public goods experiment with students, we find no significant differences in subjects' choice to mitigate. The experiments also reveal a relatively low rate of mitigation for both models compared with earlier studies.
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| 4. |
- Mosson, R., et al.
(författare)
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Building implementation capacity (BIC) : A longitudinal mixed methods evaluation of a team intervention
- 2019
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Ingår i: BMC Health Services Research. - : BioMed Central Ltd.. - 1472-6963. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Managers and professionals in health and social care are required to implement evidence-based methods. Despite this, they generally lack training in implementation. In clinical settings, implementation is often a team effort, so it calls for team training. The aim of this study was to evaluate the effects of the Building Implementation Capacity (BIC) intervention that targets teams of professionals, including their managers. Methods: A non-randomized design was used, with two intervention cases (each consisting of two groups). The longitudinal, mixed-methods evaluation included pre-post and workshop-evaluation questionnaires, and interviews following Kirkpatrick's four-level evaluation framework. The intervention was delivered in five workshops, using a systematic implementation method with exercises and practical working materials. To improve transfer of training, the teams' managers were included. Practical experiences were combined with theoretical knowledge, social interactions, reflections, and peer support. Results: Overall, the participants were satisfied with the intervention (first level), and all groups increased their self-rated implementation knowledge (second level). The qualitative results indicated that most participants applied what they had learned by enacting new implementation behaviors (third level). However, they only partially applied the implementation method, as they did not use the planned systematic approach. A few changes in organizational results occurred (fourth level). Conclusions: The intervention had positive effects with regard to the first two levels of the evaluation model; that is, the participants were satisfied with the intervention and improved their knowledge and skills. Some positive changes also occurred on the third level (behaviors) and fourth level (organizational results), but these were not as clear as the results for the first two levels. This highlights the fact that further optimization is needed to improve transfer of training when building teams' implementation capacity. In addition to considering the design of such interventions, the organizational context and the participants' characteristics may also need to be considered to maximize the chances that the learned skills will be successfully transferred to behaviors.
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| 5. |
- Mosson, R., et al.
(författare)
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Exploring the role of line managers in implementing evidence-based practice in social services and older people care
- 2017
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Ingår i: British Journal of Social Work. - : Oxford University Press. - 0045-3102 .- 1468-263X. ; 47:2, s. 542-560
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Tidskriftsartikel (refereegranskat)abstract
- This qualitative study explored the vital role of line managers, namely the managerial level directly above employees, in effectively implementing evidence-based practice (EBP) from their own perspectives. Interviews were carried out with twenty-eight line managers within social services and older people care in seven Swedish municipalities. Thematic analysis was performed. Findings revealed that managers in social care perceived their role as important in implementing EBP. However, notable differences were observed between the two settings, where social services managers had more knowledge and held more positive attitudes towards working according to EBP, and described a more active role in the implementation process than managers in older people care. Overall, the implementation of EBP was performed ad hoc rather than systematically, and with little consideration to analysis of needs according to the local context and limited focus on follow-up and sustainability. This study highlighted that line managers in social services and older people care have different prerequisites for implementing EBP, and are greatly dependent on organisational strategies and context. Gaining knowledge of line managers' perceptions is essential for making informed decisions regarding the support required to achieve EBP in social care, and thus for providing the best possible care for clients.
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| 6. |
- Mosson, R., et al.
(författare)
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How do iLead? : Validation of a scale measuring active and passive implementation leadership in Swedish healthcare
- 2018
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Ingår i: BMJ Open. - : BMJ Publishing Group. - 2044-6055. ; 8:6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This study aims to describe the creation of a scale-the iLead scale-through adaptations of existing domain-specific scales that measure active and passive implementation leadership, and to describe the psychometric properties of this scale. Methods Data collected from a leadership intervention were used in this validation study. Respondents were 336 healthcare professionals (90% female and 10% male; mean age 47 years) whose first-line and second-line managers participated in the intervention. The data were collected in the Stockholm regional healthcare organisation that offer primary, psychiatric, rehabilitation and acute hospital care, among other areas. The items for measuring implementation leadership were based on existent research and the full-range leadership model. Confirmatory factor analysis was performed to evaluate the dimensionality of the scale, followed by tests for reliability and convergent, discriminant and criterion-related validity using correlations and multilevel regression analyses. Results The final scale consists of 16 items clustered into four subscales representing active implementation leadership, and one scale signifying passive implementation leadership. Findings showed that the hypothesised model had an acceptable model fit (Ï ‡ 2 (99) =382.864∗∗, Comparative Fit Index=0.935, Tucker-Lewis Index=0.911, root mean square error of approximation=0.059). The internal consistency and convergent, discriminant and criterion-related validity were all satisfactory. Conclusions The iLead scale is a valid measure of implementation leadership and is a tool for understanding how active and passive leader behaviours influence an implementation process. This brief scale may be particularly valuable to apply in training focusing on facilitating implementation, and in evaluating leader training. Moreover, the scale can be useful in evaluating various leader behaviours associated with implementation success or failure.
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| 7. |
- Patro, SC, et al.
(författare)
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Combined HIV-1 sequence and integration site analysis informs viral dynamics and allows reconstruction of replicating viral ancestors
- 2019
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 1091-6490. ; 116:51, s. 25891-25899
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Tidskriftsartikel (refereegranskat)abstract
- Understanding HIV-1 persistence despite antiretroviral therapy (ART) is of paramount importance. Both single-genome sequencing (SGS) and integration site analysis (ISA) provide useful information regarding the structure of persistent HIV DNA populations; however, until recently, there was no way to link integration sites to their cognate proviral sequences. Here, we used multiple-displacement amplification (MDA) of cellular DNA diluted to a proviral endpoint to obtain full-length proviral sequences and their corresponding sites of integration. We applied this method to lymph node and peripheral blood mononuclear cells from 5 ART-treated donors to determine whether groups of identical subgenomic sequences in the 2 compartments are the result of clonal expansion of infected cells or a viral genetic bottleneck. We found that identical proviral sequences can result from both cellular expansion and viral genetic bottlenecks occurring prior to ART initiation and following ART failure. We identified an expanded T cell clone carrying an intact provirus that matched a variant previously detected by viral outgrowth assays and expanded clones with wild-type and drug-resistant defective proviruses. We also found 2 clones from 1 donor that carried identical proviruses except for nonoverlapping deletions, from which we could infer the sequence of the intact parental virus. Thus, MDA-SGS can be used for “viral reconstruction” to better understand intrapatient HIV-1 evolution and to determine the clonality and structure of proviruses within expanded clones, including those with drug-resistant mutations. Importantly, we demonstrate that identical sequences observed by standard SGS are not always sufficient to establish proviral clonality.
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| 8. |
- Pettersson, Kristoffer, et al.
(författare)
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Fidelity-consistency and deliberateness of modifications in parenting programs
- 2024
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Ingår i: Implementation Science Communications. - : BioMed Central Ltd. - 2662-2211. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Evidence-based interventions (EBIs) are frequently modified in practice. It is recommended that decisions to modify EBIs should be made deliberately to ensure fidelity-consistency, yet the relationship between fidelity-consistency and deliberateness is not well understood. This study aims to explore modifications in a sample of practitioners delivering evidence-based parenting programs (i.e., interventions to strengthen parent–child relationships, reduce harmful interactions, and improve child health and well-being). The study investigated three research questions: (1) What kind of modifications are made during the delivery of parenting programs? (2) To what degree are the identified modifications consistent with the core functions of each program? and (3) Is deliberateness associated with the fidelity-consistency of the identified modifications? Methods: In total, 28 group leaders of five widely disseminated parenting programs in Sweden participated in five focus groups, and two participants from each group also participated in individual interviews (n = 10). A content analysis approach was used where the identification of modifications was directed by the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) and then assessed for fidelity-consistency and four levels of deliberateness (universal, situational, conditional, and unintentional). Chi-square tests were performed to compare consistent and inconsistent modifications, and logistic regression was performed to explore whether deliberateness predicted consistency. Results: A total of 137 content modifications were identified, covering most of the content modification categories in FRAME. The most common were tailoring/tweaking/refining, adding elements, shortening/condensing, lengthening/extending, and integrating another treatment. Modifications were mostly fidelity-consistent but consistency varied greatly among categories. Furthermore, modifications made unintentionally or situationally were more likely to be fidelity-inconsistent. Conclusions: These results indicate that explicit consideration of modifications and their impact could be essential for sustaining the fidelity-consistent use of EBIs, even as such interventions are continuously modified.
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| 9. |
- von Thiele Schwarz, Ulrica, 1975-, et al.
(författare)
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Understanding the value of adhering to or adapting evidence-based interventions : a study protocol of a discrete choice experiment
- 2021
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Ingår i: Implementation Science Communications. - : Springer Science and Business Media LLC. - 2662-2211. ; 2:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Whereas the value of an evidence-based intervention (EBI) is often determined by its effect on clinicaloutcomes, the value of implementing and using EBIs in practice is broader, reflecting qualities such asappropriateness, equity, costs, and impact. Reconciling these value conflicts involves a complicated decision processthat has received very limited scholarly attention. Inspired by studies on decision-making, the objective of thisproject is to explore how practitioners appraise the values of different outcomes and to test how this appraisalinfluences their decisions surrounding the so-called fidelity–adaptation dilemma. This dilemma is related to thebalance between using an EBI as it was designed (to ensure its effectiveness) and making appropriate adaptations(to ensure alignment with constraints and possibilities in the local context).Methods: This project consists of three sub-studies. The participants will be professionals leading evidence-basedparental programs in Sweden and, in Sub-study 1, parents and decision-makers. Sub-study 1 will use sequentialfocus groups and individual interviews to explore parameters that influence fidelity and adaptation decisions—thedilemmas encountered, available options, how outcomes are valued by practitioners as well as other stakeholders,and value trade-offs. Sub-study 2 is a discrete choice experiment that will test how value appraisals influencedecision-making using data from Sub-study 1 as input. Sub-study 3 uses a mixed-method design, with findingsfrom the two preceding sub-studies as input in focus group interviews to investigate how practitioners make senseof findings from optimal decision situations (experiment) and constrained, real-world decision situations.Discussion: The project will offer unique insights into decision-making processes that influence how EBIs are usedin practice. Such knowledge is needed for a more granular understanding of how practitioners manage thefidelity–adaptation dilemma and thus, ultimately, how the value of EBI implementation can be optimized. Thisstudy contributes to our knowledge of what happens once EBIs are adopted—that is, the gap between the way inwhich EBIs are intended to be used and the way in which they are used in practice.
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