School-based sexual health education interventions to prevent STI/HIV in sub-Saharan Africa: a systematic review and meta-analysis

This is the final version of the article. Available from BioMed Central via the DOI in this record.BACKGROUND: School-based sexual health education has the potential to provide an inclusive and comprehensive approach to promoting sexual health among young people. We reviewed evaluations of school-based sexual health education interventions in sub-Saharan Africa to assess effectiveness in reducing sexually transmitted infections and promoting condom use. METHODS: We searched ten electronic databases, hand-searched key journals, and reference lists of included articles for potential studies. Data were extracted on outcomes, intervention characteristics, methods and study characteristics indicative of methodological quality. Where possible, data were synthesized using random effect meta-analysis. Intervention features found predominantly in effective interventions were noted. RESULTS: The initial search retrieved 21634 potentially relevant citations. Of these, 51 papers reporting on 31 interventions were included. No evaluation reported statistically significant effects on the incidence or prevalence of Human Immunodeficiency Virus and Herpes Simplex Virus 2 infections. However, intervention participants reported statistically significant greater condom use in both randomised controlled trials and non-randomised trials for short (less than 6 months) follow-up periods (OR = 1.62, 95 % CI = 1.03-2.55 and OR = 2.88, 95 % CI = 1.41-5.90 respectively). For intermediate (6-10 months) and long-term (more than 10 months) follow-up periods, the effect was statistically significant (OR = 1.40, 95 % CI = 1.16-1.68) and marginally significant (OR = 1.22, 95 % CI = 0.99-1.50) among the randomised trials respectively. Only 12 of the 31 interventions reported implementation details, out of which seven reported on fidelity. CONCLUSION: School-based sexual health education has the potential to promote condom use among young people in sub-Saharan Africa. However, further work is needed to develop and evaluate interventions that have measurable effects on sexually transmitted infections.This work presents independent research funded by the UK National Institute for Health Research (NIHR), School for Public Health research and the NIHR Collaboration for Leadership in Applied Health Research and Care of the South West Peninsula (PenCLAHRC). The views expressed in this paper are those of the authors and not necessarily those of NIHR, the University of Exeter or the UK Department of Health

Doctors' understanding of individualisation of drug treatments: a qualitative interview study

addresses: University of Exeter Medical School, Institute of Health Services Research, Exeter, UK.notes: PMCID: PMC3657639To explore doctors' understanding of individualisation of drug treatments, and identify the methods used to achieve individualisation

Individualisation of drug treatments for patients with long-term conditions: a review of concepts.

Journal ArticleOBJECTIVES: Patients and policy makers advocate that drug treatments should be individualised. However, the term is used in a variety of ways. We set out to identify the range of related terminology and concepts in the general field of individualisation, map out the relationships between these concepts and explore how patients' perspectives are considered. DESIGN: We consulted members of an established patient and public involvement group about their experience of medicine taking for long-term conditions and their ideas about individualisation. We then conducted a scoping review of the literature to explore how terms surrounding individualisation of drug treatment are used and defined in the literature, and to explore the extent to which patients' perspectives are represented, with a view to informing future recommendations as to how individualisation can be operationalised. METHODS: We identified relevant literature using a range of search strategies. Two researchers independently extracted definitions of terms using a template. Inductive and deductive methods were used to explore the data. RESULTS: Definitions were categorised according to the following themes: medical management; pharmacogenetics, the patient's perspective; interactions between the healthcare provider and patient and management of long-term conditions. CONCLUSIONS: Within the literature reviewed, the involvement of patients in the ongoing management of drug treatment was largely absent. We propose the use of a new term 'mutually agreed tailoring' (MAT). This describes the ongoing pharmacological management of conditions that incorporates patients' specific needs, experiences and existing strategies for using their medications, and the professionals' clinical judgement. This usually includes patients monitoring their symptoms and, with the support of the professional, making appropriate product, dose or timing adjustments as necessary. Our previous work suggests that many patients and doctors are successfully practising MAT, so we suggest that a formal description may facilitate wider utilisation of strategies that will improve patient outcomes.NIHR - CLAHR

Processes of Change in an Asthma Self-Care Intervention

The final version of this paper has been published in Qualitative Health Research, Vol. 23 (10), October 2013 by SAGE Publications Ltd, All rights reserved. © It is available at: http://qhr.sagepub.com/content/23/10/1419.longIn this article, we present a qualitative exploration of the psychological and communication processes that occur within an intervention to improve self-care for people with asthma. In the context of a primary-care-based trial of the intervention, we collected data at three time points for 21 patients, comprising 2 audiotaped consultations (nurse and patient together) and individual semistructured interviews 3 months after the second consultation. Using framework analysis, we identified both psychological processes (illness understanding, affective response to asthma, and reasoned motivation) and patientGÇôprovider interactions (active patient involvement and individual tailoring). We use these findings to extend and refine the pre-existing theoretical model of behavior change underpinning the intervention, in particular with relation to patientGÇôprovider interaction processes. We conclude that it is important for developers and providers of asthma self-care interventions to attend to the style of delivery as well as the behavior change techniques involved

MATRIX KAPPA: A PROPOSAL FOR A CARD SORT STATISTIC FOR IS SURVEY INSTRUMENT DEVELOPMENT

The card sort is a key scale development tool that is frequently used in IS survey instrument development. Cohen\u27s Kappa is a recommended measure of inter-rater agreement in this process, however one of its underlying statistical assumptions is violated when it is used in open card sorts. To address this issue, Matrix Kappa is proposed as a complement to other card sort analysis techniques, reframing constructs in terms of item relationships and representing inter-rater agreement in terms of matrices. Matrix Kappa has the benefit of meeting Cohen’s Kappa assumptions for open card sorts and can be used to differentiate both open and closed card sort results that Cohen’s Kappa cannot

The CIO Position at the Crossroads: Two Institutional Views of a Management Innovation

The term Chief Information Officer (CIO) was first coined in 1981 and has been implemented in many firms across a range of industries. Two competing institutional theory views are proposed, one leading to the institutionalization and one leading to the extinguishment of the CIO position. A pilot test was conducted examining Security and Exchange Commission filings where instances of adoption, reduction in status and abandonment were identified

National AI Strategic Plans for the Public versus Private Sectors: A Cross-Cultural Configurational Analysis

We use a fuzzy set Qualitative Comparative Analysis (fsQCA) approach to analyze the national Artificial Intelligence (AI) strategic plans of 34 countries. Applying Hofstede\u27s four-dimension cultural model, we find that countries develop their national AI strategic plans around public and private sector policies in a manner that is consistent with their national cultures and, if they only place emphasis on one, it will generally be on industry. We also find that the most critical differentiators between detailed versus limited plan development are task/people orientation and individualism/collectivism, where high collectivism and high task orientation are linked to more detailed national AI plans and policies

Centralization and Decentralization Decisions: Multiple Contingencies for IT Governance in the Public Sector

There is often a tension in organizations between the centralization and decentralization of IT governance, as demonstrated by Sambamurthy and Zmud’s (1999) landmark paper on IT governance and contingencies. Allocation of decision rights over IT resources and capabilities is a complex governance decision, with results that vary considerably over organizations. In this paper, we conduct a conceptual replication of the well-established Centralized-Decentralized-Federal classification scheme for IT governance. Using data from the National Association of State CIOs and the Center for Digital Government, we empirically validate the three original underlying IT governance components of IT infrastructure management, IT use management and project management. We next apply a configurational approach to assess the level of centralization/decentralization of IT governance and to link them to states\u27 digital performance. Finally, we test the original theoretically derived IT governance constructs against the empirically derived ones to confirm existing and find emergent IT governance forms and their links with high and low performance. The results support the existing research but identify additional contingencies regarding the different domains of the studies (public versus private sector) and the evolution of IT architecture since the original study that have led to greater centralization over time

Richness of IT Use Operationalization: A Conceptual Replication

Use of information technology (IT) remains a key concern for organizations. This article presents a conceptual replication of Burton-Jones and Straub’s (2006) study, exploring the effect of IT Use operationalization richness – lean and rich – on Performance. We used 352 valid responses from Amazon MTurk through an online survey. Consistent with the original study, the hypothesis was tested by using the Structural Equation Modeling technique. Our results – which indicated support for the same hypothesis in the original study – suggest that the richer the IT use operationalization, the higher the individual Performance