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121 results

Page 1 of 7

  • Assessing hospital antibiotic stewardship program (ASP) implementation: validation of an implementation science-informed survey

  • Jorie Michaela Butler, Ellen Childs, Tamar Barlam, Mari-Lynn Drainoni, Caitlin Reardon, Yue Zhang, Laura Damschroder, Peter Taber, Karl Madaras-Kelly, Matthew Goetz, Shana Burrowes, Eddie Stenehjem, Jincheng Shen, Chong Zhang, Angela Presson, Matthew Howard Samore
  • Journal:
    Antimicrobial Stewardship & Healthcare Epidemiology / Volume 5 / Issue 1 / 2025
    Published online by Cambridge University Press:
    20 June 2025, e133
    • Article
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      • Open access
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  • Objective:

    Antibiotic stewardship programs (ASPs) are crucial to prevent the emergence of antibiotic resistance and to improve outcomes for patients. A validated instrument rooted in a theoretically derived implementation science framework will increase our understanding of ASP implementation and enable comparisons across implementation sites.

    Design:
    Methods:

    Antibiotic stewards (infectious disease pharmacists and physicians) were recruited from Veterans Affairs (VA) hospitals to complete a survey on stewardship implementation. We used the Consolidated Framework for Implementation Research (CFIR) to guide development of an ASP implementation survey assessing 22 potential determinants of implementation across five domains of CFIR. We conducted confirmatory factor analyses (CFA) to assess construct validity of 8 construct measures and evaluated internal consistency.

    Results:

    A total of 150 stewards completed the survey from 110 VA hospitals. CFA for most CFIR constructs exhibited good fit. Internal consistency for CFIR construct subscales (Cronbach’s alpha) ranged from 0.54–0.96, indicating modest to strong internal consistency. Determinants that were rated highly present at the sites (across site means ≥ 4.0 or above) included Self-Efficacy, Engaging, Evidence Strength and Quality and Relative Advantage, indicating stewards found ASP evidence compelling and felt their personal involvement was effective in engendering positive results for the ASP.

    Conclusions:

    Psychometric properties indicate validity of the first CFIR-based survey of determinants for ASP implementation outcomes. Clinical, quality improvement, and research teams can use this survey to identify contextual determinants of ASP implementation and use this information to guide selection of strategies and compare results across multiple sites.

  • Introduction

  • Edited by Mary-Ellen Lynall, University of Cambridge, Peter B. Jones, University of Cambridge, Stephen M. Stahl, University of California, San Diego
  • Book:
    Cambridge Textbook of Neuroscience for Psychiatrists
    Published online:
    08 November 2023
    Print publication:
    16 November 2023, pp 1-3

  • Summary

    In the past 100 years, there has been a revolution in our understanding of the brain. So far, this has done little to disrupt mainstream psychiatric practice. That is set to change. New neuroscience-based treatments are emerging, while evidence from neuroscience and genetics are calling into question traditional diagnostic boundaries. Psychiatrists of the future will need to integrate their understanding of brain imaging, molecular diagnostics, psychological factors and social context to provide neuroscience-informed care plans.

Cambridge Textbook of Neuroscience for Psychiatrists
  • Edited by Mary-Ellen Lynall, Peter B. Jones, Stephen M. Stahl
  • Published online:
    08 November 2023
    Print publication:
    16 November 2023
  • Cambridge Textbook of Neuroscience for Psychiatrists is a 'one stop shop' for what any psychiatrist needs to know about the brain. Understanding the brain and mind requires a vast array of techniques and conceptual approaches. The Editors have assembled a team of basic neuroscientists, geneticists, psychologists, psychiatrists, neurologists, neurosurgeons and endocrinologists who bring you the cutting edge of translational neuroscience that addresses the material most relevant to current or future psychiatric practice. The book showcases what is known, highlights aspects that are less well understood and defines key outstanding questions. A revolution in our understanding of the brain has, so far, done little to disrupt mainstream psychiatric practice. That is set to change. The chapters align with the UK MRCPsych neuroscience syllabus and link to the USA National Neuroscience Curriculum Initiative (NNCI). Highly illustrated and accessible, this book will appeal to psychiatrists, neuroscientists, psychologists, other healthcare students and professionals.

  • The numeric understanding measures: Developing and validating adaptive and nonadaptive numeracy scales

  • Michael C. Silverstein, Pär Bjälkebring, Brittany Shoots-Reinhard, Ellen Peters
  • Journal:
    Judgment and Decision Making / Volume 18 / 2023
    Published online by Cambridge University Press:
    28 June 2023, e19
    • Article
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      • Open access
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  • Numeracy—the ability to understand and use numeric information—is linked to good decision-making. Several problems exist with current numeracy measures, however. Depending on the participant sample, some existing measures are too easy or too hard; also, established measures often contain items well-known to participants. The current article aimed to develop new numeric understanding measures (NUMs) including a 1-item (1-NUM), 4-item (4-NUM), and 4-item adaptive measure (A-NUM). In a calibration study, 2 participant samples (n = 226 and 264 from Amazon’s Mechanical Turk [MTurk]) each responded to half of 84 novel numeracy items. We calibrated items using 2-parameter logistic item response theory (IRT) models. Based on item parameters, we developed the 3 new numeracy measures. In a subsequent validation study, 600 MTurk participants completed the new numeracy measures, the adaptive Berlin Numeracy Test, and the Weller Rasch-Based Numeracy Test, in randomized order. To establish predictive and convergent validities, participants also completed judgment and decision tasks, Raven’s progressive matrices, a vocabulary test, and demographics. Confirmatory factor analyses suggested that the 1-NUM, 4-NUM, and A-NUM load onto the same factor as existing measures. The NUM scales also showed similar association patterns to subjective numeracy and cognitive ability measures as established measures. Finally, they effectively predicted classic numeracy effects. In fact, based on power analyses, the A-NUM and 4-NUM appeared to confer more power to detect effects than existing measures. Thus, using IRT, we developed 3 brief numeracy measures, using novel items and without sacrificing construct scope. The measures can be downloaded as Qualtrics files (https://osf.io/pcegz/).

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