Elizabeth Meggetto, Fiona Kent, Bernadette Ward and Helen Keleher
Healthcare systems are increasing in complexity, and to ensure people can use the system effectively, health organizations are increasingly interested in how to take an…
Abstract
Purpose
Healthcare systems are increasing in complexity, and to ensure people can use the system effectively, health organizations are increasingly interested in how to take an organizational health literacy (OHL) approach. OHL is a relatively new concept, and there is little evidence about how to successfully implement organizational health literacy interventions and frameworks. This study, a literature review, aims to explore the operationalization of OHL.
Design/methodology/approach
A realist literature review, using a systems lens, was undertaken to examine how and why the operationalization of OHL contributed to changes in OHL and why interventions were more effective in some contexts than others. Initial scoping was followed by a formal literature search of Medline, CINAHL plus, Web of Science, Scopus, Embase and PsychINFO for original peer-reviewed publications evaluating OHL interventions until March, 2018.
Findings
The search strategy yielded 174 publications; 17 of these were included in the review. Accreditation, policy drivers, executive leadership and cultures of quality improvement provided the context for effective OHL interventions. The dominant mechanisms influencing implementation of OHL interventions included staff knowledge of OHL, internal health literacy expertise, shared responsibility and a systematic approach to implementation.
Research limitations/implications
This study outlines what contexts and mechanisms are required to achieve particular outcomes in OHL operationalization. The context in which OHL implementation occurs is critical, as is the sequence of implementation.
Originality/value
Health services seeking to implement OHL need to understand these mechanisms so they can successfully operationalize OHL. This study advances the concept of OHL operationalization by contributing to the theory underpinning successful implementation of OHL.
Details
Keywords
Ioan Mihangel Charnley-Parry, Elias Keller, Ivan Sebalo, John Whitton, Linden J. Ball, Beth Helen Richardson and John E. Marsh
Nuclear energy is a contested topic, requiring trade-offs in energy independence, ethicality and uncertainty. Anthropogenic climate change complicates these decisions further…
Abstract
Purpose
Nuclear energy is a contested topic, requiring trade-offs in energy independence, ethicality and uncertainty. Anthropogenic climate change complicates these decisions further, with nuclear energy competing with other low-carbon and sustainable energy sources. Decisions about nuclear energy’s role, as part of a sustainable energy system, must be made in cooperation with all stakeholders. However, it is unclear how the public is involved in these decisions in the UK. This study aims to address this gap, exploring the degree to which public participation has occurred in the UK.
Design/methodology/approach
This paper conducted a scoping review of public participation in UK nuclear energy decision-making in the context of sustainable energy transitions, where the government retains and promotes nuclear energy as part of a sustainable energy system. Following a systematic literary search, this paper reviewed 28 academic and grey literature documents.
Findings
Public participation has primarily been conducted as consultations rather than active participation. There is limited evidence that consultations have meaningfully contributed to politically and socially responsible (i.e. individuals and groups working together for community benefit) decision-making, with public opinion on nuclear energy’s role being divided and is influenced by how it is framed.
Originality/value
Social aspects of nuclear energy development have historically received less attention than environmental and economic elements; the role of engagement and participation is relatively rare. Modern literature reviews in this context are largely absent, a gap this paper originally contribute to. This paper suggest ways in which how effective, inclusive engagement process could contribute to a fairer, responsible decision-making process and energy system in the UK.
Details
Keywords
Helen Lockett, Geoffrey Waghorn, Rob Kydd and David Chant
The purpose of this paper is to explore the predictive validity of two measures of fidelity to the individual placement and support (IPS) approach to supported employment.
Abstract
Purpose
The purpose of this paper is to explore the predictive validity of two measures of fidelity to the individual placement and support (IPS) approach to supported employment.
Design/methodology/approach
A systematic review and meta-analysis was conducted of IPS programs. In total, 30 studies provided information characterizing 69 cohorts and 8,392 participants. Predictive validity was assessed by a precision and negative prediction analysis and by multivariate analysis of deviance.
Findings
Fidelity scores on the IPS-15 scale of 60 or less accurately predicted poor outcomes, defined as 43 percent or less of participants commencing employment, in 100 percent of cohorts. Among cohorts with IPS-15 fidelity scores of 61-75, 63 percent attained good employment outcomes defined as 44 percent or more commencing employment. A similar pattern emerged from the precision analysis of the smaller sample of IPS-25 cohorts. Multivariate analysis of deviance for studies using the IPS-15 scale examined six cohort characteristics. Following adjustment for fidelity score, only fidelity score (χ2=15.31, df=1, p<0.001) and author group (χ2=35.01, df=17, p=0.01) representing an aspect of cohort heterogeneity, remained associated with commencing employment.
Research limitations/implications
This study provides evidence of moderate, yet important, predictive validity of the IPS-15 scale across diverse international and research contexts. The smaller sample of IPS-25 studies limited the analysis that could be conducted.
Practical implications
Program implementation leaders are encouraged to first focus on attaining good fidelity, then supplement fidelity monitoring with tracking the percentage of new clients who obtain a competitive job employment over a pre-defined period of time.
Originality/value
The evidence indicates that good fidelity may be necessary but not sufficient for good competitive employment outcomes.
Details
Keywords
Karen Block, Lisa Gibbs, Susie Macfarlane and Mardie Townsend
The purpose of this paper is to present emergent findings from an evaluation of the Stephanie Alexander Kitchen Garden (SAKG) Program showing that the program promoted…
Abstract
Purpose
The purpose of this paper is to present emergent findings from an evaluation of the Stephanie Alexander Kitchen Garden (SAKG) Program showing that the program promoted appreciation of cultural diversity and inclusion of culturally diverse groups.
Design/methodology/approach
The findings reported here are from the qualitative component of a mixed-method, nonrandomized, pre- and post-comparison evaluation study. Focus groups and interviews were held with school principals, teachers, program specialist staff, parents, volunteers and children at the program schools.
Findings
In a culturally diverse school, the program enhanced the school’s capacity to engage and include children and families from migrant backgrounds. In less diverse settings, the program provided opportunities for schools to teach children about cultural diversity.
Research limitations/implications
Assessing the program’s impact on multicultural education was not a specific objective of this study, rather these findings emerged as an unanticipated outcome during interviews and focus groups that explored participants’ views on important changes to schools associated with the program. Thus, the quantitative component of the evaluation did not assess the extent of this program impact and further research is recommended.
Practical implications
The program may have particular value in culturally diverse schools, providing benefits in terms of engagement of children and families and potentially, in the longer term, associated improvements in learning outcomes.
Social implications
These findings suggest that the program can help to promote social equity and inclusion for culturally diverse groups.
Originality/value
This paper highlights critical equity implications associated with school-based programs’ capacity to include culturally and linguistically diverse groups.