Browsing by Subject "acceptability"

Trust and empowerment are popular management practices, with many big organizations having adopted initiatives involving the two concepts. Despite the popularity of these initiatives, most of them fail. To be able to design effective behavior change interventions we need to know what made the interventions successful or unsuccessful by evaluating them. Traditionally, effectiveness was evaluated but recently knowing why an intervention worked is perceived as essential. By understanding how participants of trust and empowerment initiatives perceive their acceptability, insights can be gained into why the intervention worked as it did. Intervention acceptability refers to how the intervention providers or receivers think or feel about an intervention. This study aims to examine the retrospective intervention acceptability, of an organizational pilot intervention focusing on trust and empowerment, from the perspective of the intervention recipients. To examine how the intervention participants perceive the acceptability of the intervention, the acceptability domains of the Theoretical Framework of Acceptability (TFA) will be used. As the TFA was developed for assessing the acceptability of healthcare interventions, the fit of the framework for assessing the acceptability of an organizational intervention will be evaluated. The study adopts a qualitative research methodology using theory-driven content analysis with a relativist perspective. The data was collected using online semi-structured focus group interviews. The sample included 12 team- or project leaders from different parts of the world. The results show that the intervention has high retrospective acceptability from the perspective of the intervention recipients. The participants mainly used the existing TFA domains in their construction of acceptability, with the addition of including appropriateness as a central domain. It, therefore, seems that the TFA works well for understanding how the participants of a trust and empowerment intervention conducted in an organizational setting, perceive its acceptability. It seems that the intervention is designed to suit the target group well, which increases the likelihood for a successful full-scale intervention when and if the organization decides to roll out the training on a larger scale. This study also provides insights into the applicability of using the TFA in a new context.

Evidence based medicines alongside with age-appropriate dosage forms are essential in enabling appropriate treatment for any patient group. Pediatric pharmacotherapy, however, is lacking age-appropriate dosage forms and research-based evidence regarding the dosing, efficacy, and safety of medicines. Orally administered drugs require manipulation to enable administration and are often used against the indications approved in the marketing authorization and summary of product characteristics (SmPC). This off-label use puts pediatric patients at risk for medicational errors and adverse drug reactions. The aim of this study was to investigate recent trends in oral dosage forms used in pediatric randomized controlled trials (RCTs), with emphasis on age appropriateness. The results could be utilized in developing evidence-based dosage forms, suitable for all pediatric patients aged 0-17 years, and manufacturable in a small scale in a hospital pharmacy. This study was conducted as a systematic review following the PRISMA Statement. The literature search was carried out from Pubmed and Scopus databases and it covered a five-year period of 2015-2020. References from the databases were entered to the Covidence systematic review platform. After removing duplicates 3333 articles were left for screening. Two independent researchers selected the articles first screening by title and abstract, and then by full text review. A qualitative content analysis was conducted on the included articles. Altogether 77 articles met the inclusion criteria. Dosage forms included were tablets (n=37), liquids (n=21), capsules (n=18) and multiparticulates (n=6). Majority of the dosage forms were conventional (n=49) compared to more advanced novel modified release and fixed-dose combination formulations (n=33). Based on our results, orally administered dosage forms used in the recent pediatric RCTs are still limited by poor acceptability, palatability, and the need to manipulate dosage forms to enable administration. These issues are similar to the ones related to the off-label use of medicine that compromise patient safety. Majority of the dosage forms included in our study were tablets, indicating a positive shift towards more safe and acceptable dosage form. Formulations were also evolving towards dispersible, extended-release and fixed-dose combinations that offer additional benefits for pediatric patients. The low number of children < 2 years old included in study populations and the poor acceptability profile reported by most studies limit our conclusions on an ideal age-appropriate dosage form. Further research is needed on unifying the guidelines used in pediatric drug development.

Gestational diabetes mellitus (GDM) is a condition of glucose intolerance with onset or first recognition during pregnancy, and it poses multiple health risks for both the mother and the child. The prevalence of GDM is increasing globally and effective interventions are needed to reduce the associated risks. Mobile health (mHealth) solutions have a great potential in answering this need since they are cost-effective and able to reach large groups of people. mHealth solutions might be especially effective for management of chronic conditions that require patient behavior change. Investigating intervention acceptability has an important part in the process of developing successful interventions. The aim of this thesis is to investigate the prospective acceptability of an mHealth intervention for GDM from the perspective of its potential recipients. The thesis also seeks to find out whether there are any associations between technological experience and perceptions of intervention acceptability as well as ways in which the intervention acceptability could be improved. The thesis utilizes data collected in the first phase of the eMOM GDM study, a research project with the aim of developing an mHealth intervention to support the self-management of GDM. The application acceptability was studied with semi-structured interviews with 10 women currently diagnosed with GDM. Previous technological experience was self-reported by the participants in a background questionnaire. Theory-driven content analysis was used to analyze the interviews. The results show that the intervention has high prospective acceptability from the perspective of the potential participants. For most of the domains of acceptability there is still room for improvement, and several ideas for further improving the intervention’s acceptability are discussed. The results could also indicate a possible relationship between technological experience and mHealth intervention acceptability. This thesis contributes to the development of an intervention by providing insight on the factors influencing intervention acceptability and ideas on how to improve it. The results also provide valuable information for developing future mHealth solutions for GDM. The potential association between technological experience and intervention acceptability are interesting regarding all mHealth intervention development and should be studied further.