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Article ; Online: Comment on "Misunderstanding the Match: Do Students Create Rank Lists Based on True Preferences?"

Connors, Nicholas J / French, David M

The western journal of emergency medicine

2021 Volume 22, Issue 4, Page(s) 1020

Language	English
Publishing date	2021-07-20
Publishing country	United States
Document type	Letter
ZDB-ID	2375700-0
ISSN	1936-9018 ; 1936-9018
ISSN (online)	1936-9018
ISSN	1936-9018
DOI	10.5811/westjem.2021.4.52194
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: What behaviour change technique content is offered to service users of the nationally implemented English NHS Digital Diabetes Prevention Programme: Analysis of multiple sources of intervention content.

Hawkes, Rhiannon E / Miles, Lisa M / French, David P

Preventive medicine reports

2023 Volume 32, Page(s) 102112

Abstract: The National Health Service Digital Diabetes Prevention Programme (NHS-DDPP) is a behavioural intervention for adults in England at risk of developing Type 2 diabetes, rolled out nationally via independent providers and their digital partners. The NHS ... ...

Abstract	The National Health Service Digital Diabetes Prevention Programme (NHS-DDPP) is a behavioural intervention for adults in England at risk of developing Type 2 diabetes, rolled out nationally via independent providers and their digital partners. The NHS England programme specification indicated 19 behaviour change techniques (BCTs) which should be present in the intervention, including BCTs to support self-regulation. A previous evaluation of the face-to-face service found an under-delivery of some self-regulatory BCTs. This study assessed whether those 19 BCTs were offered in the different interventions delivered by four digital providers. A cross-sectional analysis of BCT content in the NHS-DDPP was elicited from the following sources: (a) online platforms (e.g. apps), (b) educational materials, and (c) health coaching (assessed via interviews with health coaches and audio-recorded telephone consultations). All materials were coded using the Behaviour Change Technique Taxonomy v1. A total of 17, 15, 15 and 14 of the 19 specified BCTs were identified across the four digital provider programmes. A mean proportion of 43% of specified BCTs were present via providers' apps, 74% via educational materials, and 62% via health coaching. An additional 41 BCTs were included in at least one of the four providers' programmes. Fidelity of BCT content in the NHS-DDPP was better than previously identified for the face-to-face DPP service. However, BCTs were offered via multiple modalities, thus the degree to which users engage with the modalities will impact on their exposure to BCTs and likely effectiveness of the digital programme.
Language	English
Publishing date	2023-01-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2785569-7
ISSN	2211-3355
ISSN	2211-3355
DOI	10.1016/j.pmedr.2023.102112
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Article ; Online: Description of the nationally implemented National Health Service digital diabetes prevention programme and rationale for its development: mixed methods study.

Miles, Lisa M / Hawkes, Rhiannon E / French, David P

BMC health services research

2023 Volume 23, Issue 1, Page(s) 373

Abstract: Background: The National Health Service (NHS) Digital Diabetes Prevention Programme (DDPP) is a behaviour change programme for adults in England who are at high risk of developing type 2 diabetes. Four independent providers deliver the NHS-DDPP ... ...

Abstract	Background: The National Health Service (NHS) Digital Diabetes Prevention Programme (DDPP) is a behaviour change programme for adults in England who are at high risk of developing type 2 diabetes. Four independent providers deliver the NHS-DDPP following a competitive tendering process. Although providers work to a single service specification, there is potential for some variation in the service across providers. This study (1) assesses fidelity of the structural features of the design of the NHS-DDPP compared to the service specification, (2) describes the structural features of delivery of the NHS-DDPP as implemented (3) reports developers' views on how the structural components of the NHS-DDPP were developed and why changes were made following implementation. Methods: Using mixed methods, we conducted a document review of providers' NHS-DDPP design and delivery documentation, and extracted information using the Template for Intervention Description and Replication checklist, which was adapted to capture features of digital delivery. Documentation was supplemented by content analysis of interviews with 12 health coaches involved in delivering the NHS-DDPP. Semi-structured interviews were also conducted with 6 programme developers employed by the digital providers. Results: Provider plans for the NHS-DDPP show relatively high fidelity to the NHS service specification. Despite this, there was wide variation in structural features of delivery of the NHS-DDPP across providers, particularly for delivery of 'support' (e.g. use, dose and scheduling of health coaching and/or group support). Interviews with developers of the programmes showed that much of this variation is likely to be attributable to the origin of each provider's programme, which was usually a pre-existing programme that was adapted to conform to the NHS-DDPP service specification. The NHS-DDPP is continually improved and developed based on user experience feedback and research conducted by the providers. Conclusion: Indirect evidence suggests that variation in delivery of support could affect effectiveness of the NHS-DDPP. A priority for future research is ascertaining whether the variation in delivery of the NHS-DDPP across providers is related to any differences in health outcomes. It is recommended that future rounds of commissioning the NHS-DDPP pre-specify the type of support participants should receive, including expected dose and scheduling.
MeSH term(s)	Adult ; Humans ; Diabetes Mellitus, Type 2/prevention & control ; State Medicine ; England ; Health Promotion ; Research Report
Language	English
Publishing date	2023-04-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-09210-3
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Article ; Online: How the Behavior Change Content of a Nationally Implemented Digital Diabetes Prevention Program Is Understood and Used by Participants: Qualitative Study of Fidelity of Receipt and Enactment.

Miles, Lisa M / Hawkes, Rhiannon E / French, David P

Journal of medical Internet research

2023 Volume 25, Page(s) e41214

Abstract: Background: The National Health Service Digital Diabetes Prevention Programme (NHS-DDPP) is a program for adults in England at risk of developing type 2 diabetes mellitus (T2DM). It is based on NHS England specifications that stipulate specific behavior ...

Abstract	Background: The National Health Service Digital Diabetes Prevention Programme (NHS-DDPP) is a program for adults in England at risk of developing type 2 diabetes mellitus (T2DM). It is based on NHS England specifications that stipulate specific behavior change techniques (BCTs), that is, active ingredients to produce behavior change to target diet and physical activity. Now rolled out nationally, the NHS-DDPP is being delivered by 4 independent providers as a 9-month intervention via apps, educational material, and remote health coaching. To optimize effectiveness, participants need to be able to understand and use behavior change content (eg, goal setting and problem solving) of an intervention delivered to them digitally. Previous research has shown that people benefit from support to aid the understanding and use of BCTs. Objective: The objectives of this qualitative study were to evaluate how participants in the NHS-DDPP understand and use BCT content, investigate how participants describe the role of health coaches in supporting their behavior change, and examine how the understanding and use of behavior change content of the NHS-DDPP varies across providers. Methods: In total, 45 service users were interviewed twice by telephone at 2 to 4 months into, and at the end of, the program. Topics included participants' understanding and use of key BCTs to support self-regulation (eg, goal setting) and the support they received via the program. Transcripts were analyzed thematically, informed by the framework method. Results: Participants described their understanding and use of some behavior change content of the program as straightforward: use of BCTs (eg, self-monitoring of behavior) delivered digitally via provider apps. Participants valued the role of health coaches in supporting their behavior change through the emotional support they offered and their direct role in delivery and application of some BCTs (eg, problem solving) to their specific circumstances. Participants expressed frustration over the lack of monitoring or feedback regarding their T2DM risk within the program. Variations in the understanding and use of behavior change content of the NHS-DDPP were present across provider programs. Conclusions: Health coaches' support in delivery of key components of the program seems to be pivotal. To improve the understanding and use of BCTs in digital interventions, it is important to consider routes of delivery that offer additional interactive human support. Understanding of some self-regulatory BCTs may benefit from this support more than others; thus, identifying the optimal mode of delivery for behavior change content is a priority for future research. The NHS-DDPP could be improved by explicitly setting out the need for health coaches to support understanding of some self-regulatory BCT content such as problem solving in the service specification and amending the discharge process so that knowledge of any change in T2DM risk is available to participants.
MeSH term(s)	Adult ; Humans ; Diabetes Mellitus, Type 2/prevention & control ; State Medicine ; Behavior Therapy/methods ; Exercise ; Health Promotion
Language	English
Publishing date	2023-01-11
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2028830-X
ISSN	1438-8871 ; 1438-8871
ISSN (online)	1438-8871
ISSN	1438-8871
DOI	10.2196/41214
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Article ; Online: The authors respond: "Efficacy of bolus-dose epinephrine to manage hypotension in the prehospital setting: Is systolic blood pressure the optimal target?"

Weant, Kyle A / French, David M

The American journal of emergency medicine

2021 Volume 48, Page(s) 330

MeSH term(s)	Blood Pressure ; Emergency Medical Services ; Epinephrine ; Humans ; Hypotension/chemically induced ; Hypotension/drug therapy
Chemical Substances	Epinephrine (YKH834O4BH)
Language	English
Publishing date	2021-08-24
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2021.08.050
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Article: Intraoperative Anaphylaxis to Gelatin during Alveolar Bone Grafting for Cleft Palate.

Gehring, Michael B / Freedman, Jonathan D / Wolfe, Brandon / French, Brooke M / Khechoyan, David Y

Plastic and reconstructive surgery. Global open

2024 Volume 12, Issue 3, Page(s) e5636

Abstract: Intraoperative anaphylaxis can be life threatening. Anaphylaxis to gelatin-based topical hemostatic agents is an underrecognized hypersensitivity. To date, only 21 cases of intraoperative anaphylaxis have been reported for gelatin-based hemostatic agents. ...

Abstract	Intraoperative anaphylaxis can be life threatening. Anaphylaxis to gelatin-based topical hemostatic agents is an underrecognized hypersensitivity. To date, only 21 cases of intraoperative anaphylaxis have been reported for gelatin-based hemostatic agents. In this article, we report the case of a 10-year-old male patient who sustained anaphylaxis after the use of Gelfoam during harvest of a bone graft. Rapid diagnosis and treatment of intraoperative anaphylaxis is imperative to prevent adverse outcomes. Referral to an allergist for identification of the allergen and appropriate notation in the medical record are paramount to avoid future anaphylactic events. Surgeons should avoid gelatin-based hemostatic agents, such as Gelfoam, in patients with reported intolerance of gelatin-based foods and medicines.
Language	English
Publishing date	2024-03-01
Publishing country	United States
Document type	Case Reports
ZDB-ID	2851682-5
ISSN	2169-7574 ; 2169-7574
ISSN (online)	2169-7574
ISSN	2169-7574
DOI	10.1097/GOX.0000000000005636
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Article ; Online: Emotion constructs and outcome measures following false positive breast screening test results: A systematic review of reporting clarity and selection rationale.

Long, Hannah A / Hindmarch, Sarah / Martindale, John-Paul / Brooks, Joanna M / Harvie, Michelle / French, David P

Psycho-oncology

2024 Volume 33, Issue 4, Page(s) e6334

Abstract: Objective: (i) To systematically identify constructs and outcome measures used to assess the emotional and mood impact of false positive breast screening test results; (ii) to appraise the reporting clarity and rationale for selecting constructs and ... ...

Abstract	Objective: (i) To systematically identify constructs and outcome measures used to assess the emotional and mood impact of false positive breast screening test results; (ii) to appraise the reporting clarity and rationale for selecting constructs and outcome measures. Methods: Databases (MEDLINE, CINAHL, PsycINFO) were systematically searched from 1970. Studies using standardised and non-standardised outcome measures to evaluate the emotion or mood impact of false positive breast screening test results were eligible. A 15-item coding scheme was devised to appraise articles on clarity and rationale for selected constructs and measures. Results: Forty-seven articles were identified. The most investigated constructs were general anxiety and depression and disease-specific anxiety and worry. Twenty-two standardised general outcome questionnaire measures and three standardised disease-specific outcome questionnaire measures were identified. Twenty articles used non-standardised scales/items. Reporting of constructs and outcome measures was generally clear, but rationales for their selection were lacking. Anxiety was typically justified, but justification for depression was almost always absent. Practical and psychometric justification for selecting outcome measures was lacking, and theoretical rationale was absent. Conclusions: Heterogeneity in constructs and measures, coupled with unclear rationale for these, impedes a thorough understanding of why there are emotional effects of false positive screening test results. This may explain the repeated practice of investigating less relevant outcomes such as depression. There is need to develop a consensual conceptual model of and standardised approach to measuring emotional impact from cancer screening test results, to address heterogeneity and other known issues of interpreting an inconsistent evidence base.
MeSH term(s)	Humans ; Emotions ; Anxiety/diagnosis ; Affect ; Anxiety Disorders ; Surveys and Questionnaires
Language	English
Publishing date	2024-04-01
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1118536-3
ISSN	1099-1611 ; 1057-9249
ISSN (online)	1099-1611
ISSN	1057-9249
DOI	10.1002/pon.6334
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Article ; Online: Healthcare professionals' experiences of caring for women with false-positive screening test results in the National Health Service Breast Screening Programme.

Long, Hannah A / Brooks, Joanna M / Maxwell, Anthony J / Peters, Sarah / Harvie, Michelle / French, David P

Health expectations : an international journal of public participation in health care and health policy

2024 Volume 27, Issue 2, Page(s) e14023

Abstract: Background: Understanding healthcare professionals' (HCPs) experiences of caring for women with false-positive screening test results in the National Health Service Breast Screening Programme (NHSBSP) is important for reducing the impact of such results. ...

Abstract	Background: Understanding healthcare professionals' (HCPs) experiences of caring for women with false-positive screening test results in the National Health Service Breast Screening Programme (NHSBSP) is important for reducing the impact of such results. Methods: Interviews were undertaken with 12 HCPs from a single NHSBSP unit, including advanced radiographer practitioners, breast radiographers, breast radiologists, clinical nurse specialists (CNSs), and a radiology healthcare assistant. Data were analysed thematically using Template Analysis. Results: Two themes were produced: (1) Gauging and navigating women's anxiety during screening assessment was an inevitable and necessary task for all participants. CNSs were perceived as particularly adept at this, while breast radiographers reported a lack of adequate formal training. (2) Controlling the delivery of information to women (including amount, type and timing of information). HCPs reported various communication strategies to facilitate women's information processing and retention during a distressing time. Conclusions: Women's anxiety could be reduced through dedicated CNS support, but this should not replace support from other HCPs. Breast radiographers may benefit from more training to emotionally support recalled women. While HCPs emphasised taking a patient-centred communication approach, the use of other strategies (e.g., standardised scripts) and the constraints of the 'one-stop shop' model pose challenges to such an approach. Patient and public contribution: During the study design, two Patient and Public Involvement members (women with false-positive-breast screening test results) were consulted to gain an understanding of patient perspectives and experiences of being recalled specifically in the NHSBSP. Their feedback informed the formulations of the research aim, objectives and the direction of the interview guide.
MeSH term(s)	Female ; Humans ; State Medicine ; Mammography/psychology ; Health Personnel ; Allied Health Personnel ; Delivery of Health Care ; Breast Neoplasms/diagnosis ; Qualitative Research
Language	English
Publishing date	2024-03-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2119434-8
ISSN	1369-7625 ; 1369-6513
ISSN (online)	1369-7625
ISSN	1369-6513
DOI	10.1111/hex.14023
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Article ; Online: Efficacy of bolus-dose epinephrine to manage hypotension in the prehospital setting.

Weant, Kyle A / French, David M

The American journal of emergency medicine

2021 Volume 50, Page(s) 71–75

Abstract: Purpose: Hypotension in the Emergency Department (ED) and the prehospital setting has been associated with significant morbidity and mortality. Limited literature exists exploring the utilization of intravenous (IV) bolus-dose epinephrine (BDE) by ... ...

Abstract	Purpose: Hypotension in the Emergency Department (ED) and the prehospital setting has been associated with significant morbidity and mortality. Limited literature exists exploring the utilization of intravenous (IV) bolus-dose epinephrine (BDE) by Emergency Medical Services (EMS). Methods: A retrospective review evaluated patients transported to an academic medical center who had received IV BDE by a single urban EMS system from 2016 to 2020. The primary outcome was to assess the influence IV BDE had on systolic blood pressure (SBP). Secondary objectives were to assess changes in heart rate (HR), the impact of dose variability on SBP, and the incidence of severe hypertension (SBP > 220 mmHg). Results: A total of 55 patients who received 96 administrations of IV BDE were included in the analysis. The most common individual dose was 10 μg (76.0%) and 45.5% received multiple doses. The median weight-based dose of BDE was 0.14 μg/kg. A significant increase in SBP (median 14.0 mmHg) was noted among all patients following BDE administration compared with baseline (p < 0.001). No significant difference was found in HR following BDE compared with baseline (p = 0.375). Those that received a BDE dose >10 μg were noted to have a significantly greater rise in SBP than those that received 10 μg (30.0 mmHg vs. 11.0 mmHg; p = 0.022). Similarly, patients that received a dose ≥0.2 μg/kg had a significantly greater increase in SBP compared with those that received <0.2 μg/kg (30.0 mmHg vs. 10.0 mmHg; p = 0.048). There were no incidences of severe hypertension following therapy. Conclusion: The utilization of IV BDE in the prehospital setting for acute hypotension resulted in a significant rise in SBP. A dose-response relationship was noted both in terms of a flat-based dose and a weight-based dose, with higher doses yielding a greater change in SBP. Additional investigations are necessary to further explore the most appropriate dose of this agent in this setting and its influence, if any, on clinical outcomes.
MeSH term(s)	Emergency Medical Services ; Epinephrine/administration & dosage ; Female ; Humans ; Hypotension/drug therapy ; Male ; Middle Aged ; Retrospective Studies ; Sympathomimetics/administration & dosage
Chemical Substances	Sympathomimetics ; Epinephrine (YKH834O4BH)
Language	English
Publishing date	2021-07-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2021.07.006
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Article ; Online: Experiences of online group support for engaging and supporting participants in the National Health Service Digital Diabetes Prevention Programme: A qualitative interview study.

Cheung, Wang Chun / Miles, Lisa M / Hawkes, Rhiannon E / French, David P

Journal of health services research & policy

2023 Volume 29, Issue 2, Page(s) 100–110

Abstract: Objectives: The National Health Service Digital Diabetes Prevention Programme is a nine-month behavioural intervention for adults in England at risk of type 2 diabetes. This qualitative study aimed to explore how service users engaged with the group ... ...

Abstract	Objectives: The National Health Service Digital Diabetes Prevention Programme is a nine-month behavioural intervention for adults in England at risk of type 2 diabetes. This qualitative study aimed to explore how service users engaged with the group support available within the programme. Methods: The majority of participants ( Results: The majority of participants valued the format of closed group chats, which provided an interactive platform to offer and receive support during their behaviour change journey. However, engagement with group chats reduced over time, and some participants did not find them useful when there was a lack of common interests within the group. Health coaches helped to promote engagement and build rapport among participants within the group chats. Participants reported mixed experiences of discussion forums. Conclusions: Programme developers should consider how to optimise online group support to help service users make behavioural changes, in terms of format, participant composition and use of health coach moderators. Further research is required to better understand who might benefit most from 'group chat' or 'discussion forum' support. Health coach moderation of online support groups is likely to facilitate engagement.
MeSH term(s)	Adult ; Humans ; Diabetes Mellitus, Type 2/prevention & control ; State Medicine ; Qualitative Research ; Health Personnel ; Behavior Therapy
Language	English
Publishing date	2023-12-14
Publishing country	England
Document type	Journal Article
ZDB-ID	1330668-6
ISSN	1758-1060 ; 1355-8196
ISSN (online)	1758-1060
ISSN	1355-8196
DOI	10.1177/13558196231212846
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