Browsing by Subject "Protocol"

Now showing 1 - 5 of 5
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    Open Access
    Emerging professional practices focusing on reducing inequity in speech-language therapy and audiology: a scoping review protocol
    (2022-04-21) Abrahams, Kristen; Mallick, Rizwana; Hohlfeld, Ameer; Suliaman, Tamzyn; Kathard, Harsha
    Background Human communication is essential for socialising, learning and working. Disabilities and social disadvantage have serious negative consequences on communication which can impact development from early life into adulthood. While speech-language therapists and audiologists (SLT/As) have an important role to play in addressing communication disability and disadvantage, services continue to be inaccessible, unaffordable and unattainable for the majority population. In order to support this large population, it is necessary to reimagine SLT/A practices in line with equity and social inclusion. Recently in the literature, there have been increasing calls for professions to reduce inequities in practice as indicated by the sustainable development goals, human rights and social inclusion approaches increasing in prominence. For the scoping review, equity is understood using the colonial matrix of power to understand how intersections of race, gender, class, disability, geography, heteronormativity and language create the context for inequity. As such, the aim of the scoping review is to address the following question: what are the emerging professional practices in SLT/A focused on reducing inequities? Methods Following the Joanna Briggs Institute guidelines, this scoping review will focus on systematically mapping the documented emerging clinical practices in SLT/A in the literature to identify how the professions are developing equitable practices. The search will include electronic databases and grey literature including PubMed, Scopus, EbscoHost, The Cochrane Library and Dissertation Abstracts International, Education Resource Information Centre from their inception onwards. Published and unpublished literature including all evidence sources will be considered. There should be a clear focus on clinical practice addressing equity in SLT/A. There will be no language limitations for the study. The authors will endeavour translate to have abstracts of articles translated. There will be no time restrictions on date of publication of the literature. Discussion We aim to review the current literature on emerging professional practices in relation to equity in SLT/A to identify emerging trends in clinical practice. It is our goal to provide a synthesis of emerging directions for practice, particularly to inform future practices in the Global South. Systematic review registration Open Science Framework ( osf.io/3a29w ).
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    An evaluation of psychometric properties of caregiver burden outcome measures used in caregivers of children with cerebral palsy: a systematic review protocol
    (BioMed Central, 2016-03-09) Dambi, Jermaine M; Jelsma, Jennifer; Mlambo, Tecla; Chiwaridzo, Matthew; Dangarembizi-Munambah, Nyaradzai; Corten, Lieselotte
    Background: Cerebral palsy (CP) is the most common, life-long paediatric disability. Taking care of a child with CP often results in caregiver burden/strain in the long run. As caregivers play an essential role in the rehabilitation of these children, it is therefore important to routinely screen for health outcomes in informal caregivers. Consequently, a plethora of caregiver burden outcome measures have been developed; however, there is a dearth of evidence of the most psychometrically sound tools. Therefore, the broad objective of this systematic review is to evaluate the psychometrical properties and clinical utility of tools used to measure caregiver burden in caregivers of children with CP. Methods/design: This is a systematic review for the evaluation of the psychometric properties of caregiver burden outcome tools. Two independent and blinded reviewers will search articles on PubMed, Scopus, Web of Science, CINAHL, PsychINFO and Africa-Wide Google Scholar. Information will be analysed using predefined criteria. Thereafter, three independent reviewers will then screen the retrieved articles. The methodological quality of studies on the development and validation of the identified tools will be evaluated using the four point COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Finally, the psychometric properties of the tools which were developed and validated from methodological sound studies will then be analysed using predefined criteria. Discussion: The proposed systematic review will give an extensive review of the psychometrical properties of tools used to measure caregiver burden in caregivers of children with CP. We hope to identify tools that can be used to accurately screen for caregiver burden both in clinical setting and for research purposes.
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    Government policy interventions to reduce human antimicrobial use: protocol for a systematic review and meta-analysis
    (BioMed Central, 2017-12-13) Rogers Van Katwyk, Susan; Grimshaw, Jeremy M; Mendelson, Marc; Taljaard, Monica; Hoffman, Steven J
    Background: Antimicrobial resistance (AMR) is a recognized threat to global public health. Increasing AMR and a dry pipeline of novel antimicrobial drugs have put AMR in the international spotlight. One strategy to combat AMR is to reduce antimicrobial drug consumption. Governments around the world have been experimenting with different policy interventions, such as regulating where antimicrobials can be sold, restricting the use of last-resort antimicrobials, funding AMR stewardship programs, and launching public awareness campaigns. To inform future action, governments should have access to synthesized data on the effectiveness of large-scale AMR interventions. This planned systematic review will (1) identify and describe previously evaluated government policy interventions to reduce human antimicrobial use and (2) estimate the effectiveness of these different strategies. Methods: An electronic search strategy has been developed in consultation with two research librarians. Seven databases (MEDLINE, CINAHL, EMBASE, CENTRAL, PAIS Index, Web of Science, and PubMed excluding MEDLINE) will be searched, and additional studies will be identified using several gray literature search strategies. To be included, a study must (1) clearly describe the government policy and (2) use a rigorous design to quantitatively measure the impact of the policy on human antibiotic use. The intervention of interest is any policy intervention enacted by a government or government agency in any country to change human antimicrobial use. Two independent reviewers will screen for eligibility using criteria defined a priori. Data will be extracted with Covidence software using a customized extraction form. If sufficient data exists, a meta-analysis by intervention type will be conducted as part of the effectiveness review. However, if there are too few studies or if the interventions are too heterogeneous, data will be tabulated and a narrative synthesis strategy will be used. Discussion: This evidence synthesis is intended for use by policymakers, public health practitioners, and researchers to inform future government policies aiming to address antimicrobial resistance. This review will also identify gaps in the evidence about the effectiveness of different policy interventions to inform future research priorities. Systematic review registration: PROSPERO CRD42017067514.
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    Stepped care to optimize pre-exposure prophylaxis (PrEP) effectiveness in pregnant and postpartum women (SCOPE-PP) in South Africa: a randomized control trial
    (2022-07-07) Joseph Davey, Dvora L.; Dovel, Kathryn; Cleary, Susan; Khadka, Nehaa; Mashele, Nyiko; Silliman, Miriam; Mvududu, Rufaro; Nyemba, Dorothy C.; Coates, Thomas J.; Myer, Landon
    Background HIV incidence among pregnant and postpartum women remains high in South Africa. Pre-exposure prophylaxis (PrEP) use remains suboptimal in this population, particularly during the postpartum period when women’s engagement with routine clinic visits outside PrEP decreases. Key barriers to sustained PrEP use include the need for ongoing contact with the health facility and suboptimal counseling around effective PrEP use. Methods Stepped Care to Optimize PrEP Effectiveness in Pregnant and Postpartum women (SCOPE-PP), is a two-stepped unblinded, individually randomized controlled trial (RCT) that aims to optimize peripartum and postpartum PrEP use by providing a stepped package of evidence-based interventions. We will enroll 650 pregnant women (> 25 weeks pregnant) who access PrEP at a busy antenatal clinic in Cape Town at the time of recruitment and follow them for 15 months. We will enroll and individually randomize pregnant women > 16 years who are not living with HIV who are either on PrEP or interested in starting PrEP during pregnancy. In step 1, we will evaluate the impact of enhanced adherence counselling and biofeedback (using urine tenofovir tests for biofeedback) and rapid PrEP collection (to reduce time required) on PrEP use in early peripartum compared to standard of care (SOC) (n = 325 per arm). The primary outcome is PrEP persistence per urine tenofovir levels and dried blood spots of tenofovir diphosphate (TFV-DP) after 6-months. The second step will enroll and individually randomize participants from Step 1 who discontinue taking PrEP or have poor persistence in Step 1 but want to continue PrEP. Step 2 will test the impact of enhanced counseling and biofeedback plus rapid PrEP collection compared to community PrEP delivery with HIV self-testing on PrEP use (n = up to 325 postpartum women). The primary outcome is PrEP continuation and persistence 6-months following second randomization (~ 9-months postpartum). Finally, we will estimate the cost effectiveness of SCOPE-PP vs. SOC per primary outcomes and disability-adjusted life-years (DALYs) averted in both Step 1 and 2 using micro-costing with trial- and model-based economic evaluation. Discussion This study will provide novel insights into optimal strategies for delivering PrEP to peripartum and postpartum women in this high-incidence setting. Trial registration NCT05322629 : Date of registration: April 12, 2022.
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    Towards Validation of South African Communicative Development Inventories: An object naming/identification task for South African English and Afrikaans
    (2022) Husselmann, Nicole; Pascoe, Michelle; Southwood, Frenette
    Background: South Africa is a country rich in diversity, with language constituting a large proportion of this diversity as the country has eleven official languages with Afrikaans, isiXhosa and South African English (SAE) being the provincial languages of the Western Cape. Research on language acquisition in South Africa is limited, but vital for the early identification, assessment and management of children who are not developing language in a typical way. A recent project in South Africa has led to the development of Communicative Development Inventories (MB-CDIs) in several of the country's official languages. MB-CDIs are parent-report questionnaires about young children's language acquisition. It is challenging to validate these MB-CDIs in the local context as there are few other language assessments available for comparative purposes. Aims and Objectives: This project aimed to develop a protocol for language assessments that can be used as part of the validation process for the MB-CDIs in South African languages. The objectives were (1) to devise a protocol for an object naming and object identification task for use with six South African languages (Afrikaans, isiXhosa, SAE, Sesotho, Setswana, and Xitsonga); (2) to describe the expressive and receptive language of children acquiring SAE based on assessment with two different tools/approaches (the object naming/identification task and parent-report MB-CDI); and (3) to describe the expressive and receptive language of children acquiring Afrikaans based on assessment with two different tools/approaches (the object naming/identification task and parent-report MB-CDI). Methodology: This study used a mixed-methods, descriptive-linguistic approach. The first objective relied on literature only and no participants were needed. I devised a protocol for a novel object naming/identification task1 which could be used to validate the MB-CDIs in six languages (Afrikaans, isiXhosa, SAE, Sesotho, Setswana, and Xitsonga). For objectives 2 and 3, focusing solely on SAE and Afrikaans, I used the protocol to devise an object naming/identification task to be used with each language, respectively. Participants (toddlercaregiver dyads) were recruited and a pilot study undertaken in which the object naming/identification task was administered to each child participant. I collected parental report data by either administering the MB-CDI in SAE and Afrikaans manually to the adult participants (parents/guardians of the children), or by providing them with a link to the online version of the MB-CDI which they were able to complete in their own time. A total of 35 dyads were included in this study: 17 child and 17 adult participants for SAE and 18 child and 18 adult participants for Afrikaans. Results: SAE: The descriptive statistics suggested variability in the overall scores on both the object naming/identification task and the MB-CDI. Correlations between the 25 items in the object naming/identification task and the same 25 items in the MB-CDI indicated a significant correlation between the two assessments overall (r=0.928; p<0.05) and a significant correlation was indicated for toddlers only (r=0.935; p<0.05) and a significant correlation was indicated for toddlers only (r=0.901; p< 0.01). Correlations between the object naming/identification task and the entire MB-CDI indicated a significant correlation (r=0.901; p< 0.01) for overall vocabulary scores. Internal reliability scores for only the 25 items included in the object naming/identification task and the 25 items in the MB-CDI also indicated a high internal consistency for the language domains (α=0.911). For the gesture domain, a reasonable but lower internal consistency (α=0.673) was found. Internal reliability scores overall indicated a high internal consistency for the language domains (α=0.947). In contrast, the internal consistency indicated for the gesture domain was not satisfactory (α=0.293). Afrikaans: The descriptive statistics indicated variability among scores obtained on the MB-CDI and the object naming/identification task. Correlations between the 25 items included in the object naming/identification task and only the same 25 items included in the MB-CDI, indicated a strong correlation (r=0.906; p< 0.01). No correlation was found for infants only (r=0.692; p< 0.05) and a significant correlation was indicated for toddlers only (r=0.901; p< 0.01). Correlations between the object naming/identification task and the entire MB-CDI indicated a strong correlation for overall vocabulary scores (r=0.909; p< 0.01). Internal reliability scores on only the 25 items included in both assessments indicated a high internal consistency for the language domains (α=0.960). Internal reliability scores between the object naming/identification task and the entire MB-CDI indicated a high internal consistency for the language domains (α=0.950). Similarly, a strong internal consistency was found for the gesture domain (α=0.914). Conclusion: The findings indicate that when correlating the responses to the 25 items included in the object naming/identification task and the MB-CDI only, as well as from the entire vocabulary and gesture sections of the MB-CDI, there is high concurrent validity between the two assessments overall for both SAE and Afrikaans. Focusing on toddlers and infants more specifically, although high concurrent validity was found overall, the findings for both SAE and Afrikaans suggest that there is high concurrent validity for both assessments for toddlers, but no correlation between the assessments for infants. High internal consistency indicated reliability for both assessments for SAE and Afrikaans. The object naming/identification task, which was developed and piloted in this study, has the potential to be used as a measure to validate full MB-CDIs in SAE and Afrikaans. Furthermore, it has the potential to be used as a valid and reliable screening tool in its own right, although further refinement is needed for the infant component of the task. The protocol developed in the first objective of this study can now be applied to other local languages, ultimately contributing to the creation of a valid and reliable set of assessments of young children's early language development in South Africa.