Hi all,
Please see attached my intervention.
Hi Kadia,
PAS sounds like a comprehensive educational intervention! I think we had a similar problem to address with our gap: changing the behaviour of physicians. It sounds to me like your intervention is voluntary for pediatricians, i.e. they will only sign up for the workshop if they're interested in the topic. I don't have any real-life experience in implementation science interventions, but I could imagine that a voluntary educational intervention might not have the intended effect of closing the gap, especially as the incentives that are provided seem to be of interest primarily to those who are interested in the topic in the first place (while those who have other priorities than ACE screening or those with time constraints will not care too much if they are not part of the active website or the community of advocates). Furthermore, I was wondering whether you plan on a follow-up intervention or a feedback to physicians, so they will be exposed to the issue more than just once?
I'm looking forward to a discussion in class!
Christine
I agree, this sounds very convincing Kadia. I really like your use of the COM-B model.
I would think a lot about the opportunity level. It's going to be very important to operationalize which patients should be screened and at which types of visits. In adult medicine, there are things that are asked about or measured at almost all visits now (like weight and medication list update / reconciliation). However, few things can make it onto that list...for instance, while it is important to ask about alcohol or illicit drug use, most clinicians probably ask about that when they have a new patient, the clinical situation might be linked, or if they're doing a 'well child' check up. On top of what type of clinic visit, how often? Is it enough to document once for each patient that an ACE questionnaire was completed, or once a year, or every visit.
If you're going to track performance and give incentives, these questions become really important.
Great work on really thinking out your intervention! I think there is great baseline work in this assignment here with just minor adjustments in the details needed to strengthen this intervention. I think Christine and Kevin already touched on the main issue regarding incentives. It seems like only those pediatricians who are interested in ACEs would be the ones participating. What are some other ways to get providers to attend these training sessions? Can you offer them support such as a social worker hotline etc? Is there some way you can assist these providers into easily incorporating ACEs screening into their practice? Maybe someone to come by and assist with this? Just a few fine tuning things but overall I think there is some great groundwork that you set for this intervention.