INTRODUCTION: Antimicrobial resistance (AMR) poses a critical global health threat, with millions of deaths attributed to it annually. Antibiotic stewardship to combat AMR is the responsibility of all healthcare professionals. Despite evidence suggesting that it is unnecessary, dentists routinely prescribe prophylactic antibiotics following third molar (3M) surgeries. METHOD: This mixed-methods study examined the behavioural barriers influencing antibiotic prescribing practices within the Division of Oral and Maxillofacial Surgery at the National University Centre for Oral Health Singapore. This study used the capability, opportunity and motivation for behavioural change or COM-B framework to implement interventions targeting the behavioural barriers. RESULTS: Pre- and post-intervention data over 6 months showed a significant reduction in antibiotic prescriptions from 84.45% to 20.89%, following the implementation of COM-B strategies (P<0.001). Qualitative feedback from focus group discussions highlighted a positive shift in clinicians' attitudes towards antibiotic reduction, acknowledging the minimal infection risk associated with non-prescribing practices. Notably, complication rates remained stable throughout the study period, indicating no adverse effects from reduced antibiotic usage. CONCLUSION These findings demonstrated that the COM-B model can be successfully applied to modify deeply ingrained prescription habits, and underscored the effectiveness of a structured behavioural change intervention in enhancing compliance with antibiotic stewardship guidelines. The study advocates continuation of initiatives to sustain this positive trend and mitigate AMR in clinical practice.
Humans ; Molar, Third/surgery* ; Anti-Bacterial Agents/therapeutic use* ; Singapore ; Antimicrobial Stewardship/methods* ; Practice Patterns, Dentists'/statistics & numerical data* ; Antibiotic Prophylaxis ; Female ; Attitude of Health Personnel ; Male ; Tooth Extraction ; Adult ; Focus Groups ; Practice Patterns, Physicians'

focus group interview was conducted with six health professionals. For quantitative research, a self-reported survey was administered. A total of 542 health professionals participated in the survey, and 526 completed the entire questionnaire. Health professionals showed positive attitudes toward precision medicine. About 95–96% of respondents agreed that precision medicine will be effective in treatment and precise diagnosis, and 69.9% reported that they would participate as study subjects. Meanwhile, they expressed concerns regarding educating patients and health professionals in precision medicine and developing research and data sharing infrastructure. Also, they emphasized the importance of developing precision medicine in an equitable way. Despite varying levels of awareness of precision medicine, the health professionals expressed a willingness to engage in precision medicine research, and recommended that health professionals work closely with policymakers to design precision medicine in a way that can be effectively adopted. Health professionals showed had a positive, but cautious, attitude toward precision medicine. The results of this study suggest areas to be addressed before ushering in precision medicine in Korea.]]>
Diagnosis ; Focus Groups ; Health Occupations ; Humans ; Information Dissemination ; Korea ; Methods ; Precision Medicine ; Qualitative Research ; Surveys and Questionnaires

OBJECTIVES: A Womans University College of Medicine faces curriculum reform in 2020. To determine what reforms are needed in the premedical curriculum, a needs assessment was conducted.METHODS: This study utilizes qualitative study method. A focus group interview was conducted with four students who completed premedical courses from November to December 2018. Interviews were conducted in two groups by grade level, and each interview was recorded. After transcribing the recorded contents, four researchers analyzed the data using conventional content analysis.RESULTS: Students chose A Womans University College of Medicine considering their future careers as female medical professionals and other considerations such as scholarships. The students expected diverse experiences, exchanges with students in different departments, and fusion of medicine with other fields during their premedical years. Overall, these expectations were met during the course, but individual needs for customized education, such as liberal arts, were unmet. In general, students' attitudes toward premedical courses were very motivated and they actively used resources provided by the university.CONCLUSION: Qualitative research can provide a better understanding of quantitative data, such as a student survey performed to prepare for curriculum reform. Based on this understanding, the curriculum will be reformed to reflect the educational needs of students, to motivate students and to provide satisfactory education.
Curriculum ; Education ; Education, Medical ; Fellowships and Scholarships ; Female ; Focus Groups ; Humans ; Methods ; Needs Assessment ; Program Evaluation ; Qualitative Research ; Students, Premedical

PURPOSE: The purpose of this study was to define and clarify the concept of political competence for nurses.METHODS: A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical stage of the study, literature on nursing, politics, and other discipline were reviewed. In the fieldwork stage, individual in-depth interviews and focus groups interviews were conducted with politically seasoned experts or activists who had an understanding of the concept of political competence for extensive descriptions in nursing and field of health care.RESULTS: The concept of political competence was represented in four dimensions as political knowledge, political efficacy, political interaction, and political activity. In the political knowledge dimension, there were three attributes, namely, political knowledge, political information and systematic analysis ability. The political efficacy dimension had three attributes of internal political efficacy, external political efficacy, and self-pride of nursing profession. The political interaction dimension had three attributes of organizations and community service, networking, and persuasive power. The political activity dimension had six attributes of political leadership, political expression, assertive behavior, political advocacy, political participation, and policy intervention.CONCLUSION: This concept development might provide a basic understanding of developing a measurement tool and for constructing a theory promoting nurses' political competence.
Concept Formation ; Delivery of Health Care ; Focus Groups ; Leadership ; Mental Competency ; Methods ; Nursing ; Politics ; Professional Competence ; Seasons ; Social Welfare

OBJECTIVES: Occupational injuries are known to be the main adverse outcome of occupational accidents. The purpose of the current study was to identify control strategies to reduce the severity of occupational injuries in the mining industry using Bayesian network (BN) analysis. METHODS: The BN structure was created using a focus group technique. Data on 425 mining accidents was collected, and the required information was extracted. The expectation-maximization algorithm was used to estimate the conditional probability tables. Belief updating was used to determine which factors had the greatest effect on severity of accidents. RESULTS: Based on sensitivity analyses of the BN, training, type of accident, and activity type of workers were the most important factors influencing the severity of accidents. Of individual factors, workers’ experience had the strongest influence on the severity of accidents. CONCLUSIONS: Among the examined factors, safety training was the most important factor influencing the severity of accidents. Organizations may be able to reduce the severity of occupational injuries by holding safety training courses prepared based on the activity type of workers.
Accidents, Occupational ; Bayes Theorem ; Focus Groups ; Mining ; Occupational Injuries

OBJECTIVES: Snacks contribute to the diet quality in youth, which is often poor. Although the US Department of Agriculture (USDA) has guidelines for healthy snacks, this is lost in translation when youth are choosing snacks. To develop a userfriendly app to help identify healthy snacks based on the US Department of Agriculture guidelines and evaluate the app's feasibility, usability, satisfaction, and acceptability. METHODS: The ‘Snackability’ app was developed following the ADDIE (analysis, design, development, implementation, and evaluation) model. The app was pilot tested for 2 weeks among college-age students (18–24 years) using questionnaires and focus groups. Based on the feedback received, the app was improved, and pilot-tested again. RESULTS: The app had a simple score (−1 to 11) and feedback (the higher the score, the healthier the snack is). The 1st pilot test among 12 students showed that the app's feasibility and usability were >50% (p < 0.05). Participants reported that the app was a good way to help individuals select and consume healthy snacks and suggested improving the search process and including average score reports, a ‘consumed history’ tab, gamification, notifications, and the option to add snacks not found. These were incorporated into the 2nd version of the app, which was pilot tested among 8 students. Feasibility, usability, and acceptability of the 2nd version were >50% (p < 0.05). Additional suggestions were to include images for serving size, snack alternatives, and barcode scanning, which were incorporated into the 3rd version. CONCLUSIONS: Snackability app was feasible, usable, satisfactory, and acceptable, and several features were improved as suggested by participants.
Adolescent ; Agriculture ; Diet ; Focus Groups ; Humans ; Serving Size ; Smartphone ; Snacks ; United States Department of Agriculture

OBJECTIVES: The aim of this study is to demonstrate how an integrated information system of mother and toddler cohorts can be developed as a basis of the continuum of care approach that subsequently can be used as the basis of early detection of risk factors of maternal mortality. METHODS: This research was carried out qualitatively. The data was collected through three techniques: in-depth interviews, focus group discussion, and document studies at six public health centers located in four sub-districts of Surabaya, Indonesia. This research was conducted from 2016 to 2018. RESULTS: The data collected from this research has become a basis input data requirement analysis for an integrated mother and toddler cohort information system. The system accommodates all the variables in each period of pre-marriage, pregnancy, labor, infancy and toddlerhood. The system facilitates healthcare workers to retrieve data and information related to mother and toddler health status. CONCLUSIONS: The availability of various pieces of information enables the health status of mothers and toddlers to be monitored thoroughly throughout their long-life cycle. This continuum of care approach is beneficial in the early detection and management of risk factors of maternal mortality, such as pregnancy complications as well as childbirth and postpartum complications.
Cohort Studies ; Continuity of Patient Care ; Delivery of Health Care ; Focus Groups ; Humans ; Indonesia ; Information Systems ; Maternal Mortality ; Maternal-Child Health Services ; Mothers ; Parturition ; Postpartum Period ; Pregnancy ; Pregnancy Complications ; Public Health ; Risk Factors

OBJECTIVES: Mobile health (m-Health) technologies may provide an appropriate follow-up support service for patient groups with post-treatment conditions. While previous studies have introduced m-Health methods for patient care, a smart system that may provide follow-up communication and decision support remains limited to the management of a few specific types of diseases. This paper introduces an m-Health solution in the current climate of increased demand for electronic information exchange. METHODS: Adopting a novel design science research approach, we developed an innovative solution model for post-treatment follow-up decision support interaction for use by patients and physicians and then evaluated it by using convergent interviewing and focus group methods. RESULTS: The cloud-based solution was positively evaluated as supporting physicians and service providers in providing post-treatment follow-up services. Our framework provides a model as an artifact for extending care service systems to inform better follow-up interaction and decision-making. CONCLUSIONS: The study confirmed the perceived value and utility of the proposed Clinical Decision Support artifact indicating that it is promising and has potential to contribute and facilitate appropriate interactions and support for healthcare professionals for future follow-up operationalization. While the prototype was developed and tested in a developing country context, where the availability of doctors is limited for public healthcare, it was anticipated that the prototype would be user-friendly, easy to use, and suitable for post-treatment follow-up through mobility in remote locations.
Artifacts ; Climate ; Decision Support Systems, Clinical ; Delivery of Health Care ; Developing Countries ; Focus Groups ; Follow-Up Studies ; Humans ; Patient Care ; Telemedicine

BACKGROUND: Physical activity levels are low among adolescents in Morocco; however, the influences on physical activity behavior of adolescents have not yet been explored in a qualitative study. Here, we explored potential social-ecological barriers and facilitators of physical activity in Moroccan adolescents with the goal of developing a successful intervention program aimed at improving their physical activity level. METHODS: For this study, we conducted 17 focus group discussions (100 participants, composed of 56 adolescents, 26 parents, and 18 teachers from two middle schools in Taza city, Morocco). Discussions during focus groups were facilitated by a semi-structured interview guide. Guide questions were underpinned by the social-ecological model as a theoretical framework. Data analysis was carried out by two coders using thematic analysis. RESULTS: We found that barriers and facilitators of physical activity in adolescents are organized into six themes that belong to different levels of the social-ecological model. Three themes belonged to the intrapersonal level (perceived motivating and limiting factors, physical activity awareness, and time constraints), two themes were classified into the interpersonal/cultural level (social support and gender and cultural norms), and one theme belonged to the environmental level (access to opportunities). Most of the themes were at the individual level, with each theme including both barriers and facilitators. CONCLUSIONS Adolescent participation in physical activity can be facilitated or hampered by many factors. Results from the focus group discussions showed that these factors belonged to different levels of the social-ecological model, but most were at the individual level. Our findings have several implications. First, they may offer suggestions for a tailored intervention program aimed at improving adolescent physical activity. Second, they can improve quantitative research by enriching the battery of questions of physical activity instruments (e.g., a question related to physical disability). Third, the proposed thematic map can contribute to understanding interactions and causal pathways in the social-ecological model.
Adolescent ; Adolescent Behavior ; psychology ; Exercise ; psychology ; Female ; Focus Groups ; Humans ; Male ; Morocco ; Parents ; psychology ; Qualitative Research ; Risk Factors ; School Teachers ; psychology ; Social Environment ; Students ; psychology

OBJECTIVES: Occupational injuries are known to be the main adverse outcome of occupational accidents. The purpose of the current study was to identify control strategies to reduce the severity of occupational injuries in the mining industry using Bayesian network (BN) analysis.METHODS: The BN structure was created using a focus group technique. Data on 425 mining accidents was collected, and the required information was extracted. The expectation-maximization algorithm was used to estimate the conditional probability tables. Belief updating was used to determine which factors had the greatest effect on severity of accidents.RESULTS: Based on sensitivity analyses of the BN, training, type of accident, and activity type of workers were the most important factors influencing the severity of accidents. Of individual factors, workers' experience had the strongest influence on the severity of accidents.CONCLUSIONS: Among the examined factors, safety training was the most important factor influencing the severity of accidents. Organizations may be able to reduce the severity of occupational injuries by holding safety training courses prepared based on the activity type of workers.
Accidents, Occupational ; Bayes Theorem ; Focus Groups ; Mining ; Occupational Injuries