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The National Center for Complementary and Integrated Health, National Institutes of Health, U.S. Department of Health and Human Services, has highlighted a need for research to better understand the usage of complementary and alternative medicine practices. The purpose of this study was to investigate the flow of complementary and alternative medicine information among yoga practitioners. The study consisted of 51 yoga practitioners from 7 yoga studio locations. This mixed-methods study used interviews, surveys, and field notes to collect data. Content and social network analyses provided supporting evidence for Rogers' diffusion of innovations theory and Granovetter's strength of weak ties theory. Key findings included a preference for face-to-face communications, students having both strong and weak relationship ties to directors and instructors, and yoga being the top recommended practice. The study suggested that yoga practitioners related to complementary and alternative medicine information through the lens of their friends and relatives, sought information from trusted sources, and used this information to determine which practices were right for them to pursue.

Introduction : Une utilisation non-optimale du fauteuil roulant manuel (FRM) peut avoir des répercussions sur différents aspects de la vie des enfants et jeunes qui utilisent cette aide à la mobilité. Malgré la disponibilité et l'efficacité du Wheelchair Skills Program (WSP), l'entraînement des habiletés en FRM est parfois inadéquat ou absent en pratique. Pour combler cette lacune entre les connaissances et la pratique, ce mémoire vise à identifier les besoins et les enjeux concernant l’évaluation et l’entraînement des habiletés en FRM en réadaptation pédiatrique. Méthodes: Guidé par le cadre Knowledge to Action, une étude à devis mixte séquentiel explicatif a été conduite dans un centre de réadaptation pédiatrique et ses écoles affiliées. La phase quantitative comprenait une enquête en ligne auprès d'ergothérapeutes et un questionnaire papier auprès d’usagers pédiatriques et de leurs parents. La phase qualitative comprenait des groupes de discussion avec les ergothérapeutes. L’analyse a utilisé des statistiques descriptives et une méthode déductive basée sur le Consolidated Framework for Implementation Research. Résultats : Les résultats du sondage aux ergothérapeutes (n=35) montrent une divergence entre l’importance perçue à l’égard de l’évaluation et l’entraînement des habiletés en FRM (94% jugent important) et leur prévalence dans la pratique. Peu d’ergothérapeutes utilisent des outils standardisés et forment principalement les enfants aux habiletés de base (c.-à.-d., d’intérieur) et les parents à l'entretien du FRM. Les réponses du questionnaire aux usagers corroborent ces résultats alors que les enfants et parents décrivent des difficultés à l’utilisation du FRM dans la communauté, en plus de rapporter des chutes. Les résultats des groupes de discussion révèlent des barrières à l’utilisation du WSP qui expliquent les lacunes observées dans la pratique. Conclusion : Pour surmonter les barrières à l’utilisation du WSP en réadaptation pédiatrique, des adaptations au WSP et la production d'outils pour le transfert de connaissances (TC) ont été proposées avec la création de nouvelles connaissances par la recherche. / Introduction : Suboptimal manual wheelchair use can have repercussions on different aspects of the lives of children and adolescents who use this mobility aid. Despite the availability and effectiveness of the Wheelchair Skill Program (WSP), manual wheelchair skills training is often inadequate or absent in clinical practice among occupational therapists (OTs). To bridge this evidence-practice gap, this thesis aims to identify and understand the needs and challenges regarding manual wheelchair skills testing and training practices in pediatric rehabilitation. Methods: Guided by the Knowledge to Action Framework, an explanatory sequential mixed methods design was employed. The quantitative phase involved an online survey with OTs working in a pediatric rehabilitation center and its affiliated schools and a paper survey with pediatric manual wheelchair users and their parents. The qualitative phase involved focus groups with the OTs. Data were analyzed using descriptive statistics and a deductive analysis based on the Consolidated Framework for Implementation Research. Results: According to the OT survey results (n=35), there is a discrepancy between the perceived importance of wheelchair skills testing and training (94% consider it important) and their prevalence in practice. Of the training provided, children are primarily trained indoor skills, while parents are primarily educated about wheelchair maintenance. Standardized, evidence-based tools are rarely used. The child survey results corroborate these findings as the children and parent described difficulties with many community and advanced wheelchair skills, as well as falls experienced in these situations. The focus group findings identified barriers to using the WSP which explained the gaps observed in practice. Conclusion: To address the identified barriers, recommendations of WSP adaptations and knowledge translation (KT) tools production were proposed with creation of new knowledge. Findings from this thesis establish a first step towards bridging the evidence-practice gap in manual wheelchair skills testing and training.

Les guides de pratique sont généralement définis comme des guides élaborés par une méthode systématique pour aider les praticiens et les patients à prendre des décisions concernant les soins de santé appropriés. Utilisés pour améliorer les pratiques, orienter les soins et diminuer les coûts, ils jouent un rôle de plus en plus central dans le système de santé et des services sociaux. Toutefois, ceux-ci présentent de nombreux défis, que ce soit au niveau de la qualité de leur contenu ou de leur utilisation par les intervenants. Afin de brosser un portrait de la situation des guides de pratique dans le domaine de la psychoéducation, deux études ont été réalisées. La première a pour objectif d’approfondir notre compréhension de la qualité des guides de pratique de l’Ordre des psychoéducateurs et psychoéducatrices du Québec (OPPQ). Celle- ci est constituée de deux volets : une évaluation quantitative de la qualité de ces guides avec la grille AGREE II et une évaluation qualitative de leur qualité à partir de la perception des psychoéducateurs concernant de tels guides, leur définition, leurs objectifs et leurs caractéristiques. Les résultats indiquent que les guides en psychoéducation offrent des informations claires et simples d’utilisation. Toutefois, ils présentent également des lacunes importantes dans plusieurs aspects : la rigueur d’élaboration, la participation des groupes concernés, l’applicabilité et l’indépendance éditoriale. De plus, d’autres critères spécifiques à la psychoéducation dont l’intégration des modèles théoriques, la sensibilisation des clients et des collègues, la précision des cadres légaux, sont nécessaires. Ces résultats permettent d’ores et déjà d’émettre des recommandations pour l’évaluation des guides de pratique en psychoéducation, l’amélioration de la qualité des guides actuels de l’OPPQ et assurer la qualité des guides futurs de l’OPPQ. La deuxième étude vise à mieux comprendre les facteurs personnels et environnementaux favorisant l’utilisation des guides par les psychoéducateurs. Nous avons effectué une recherche à devis mixte constituée de deux volets : 1- évaluation quantitative des facteurs influençant l’utilisation des guides de pratique à partir des réponses de 386 psychoéducateurs au questionnaire d’utilisation des connaissances (QUC ; en ligne) et 2- évaluation qualitative des mêmes facteurs à partir de la perception de 18 psychoéducateurs rencontrés individuellement, en ligne, après leur participation au premier volet. Il ressort des deux analyses qu’il est difficile d’isoler un facteur unique déterminant l’utilisation des guides de pratique. Celle-ci est plutôtexpliquée par un ensemble de facteurs en relation dynamique et complexe. L’analyse de régression logistique semble faire ressortir le rôle central des variables mesurant les opinions des intervenants sur les connaissances issues de la recherche. De plus, les résultats qualitatifs obtenus mettent de l’avant un ensemble d’autres éléments personnels et environnementaux, notamment le rôle de la formation dans l’utilisation des guides. Une meilleure connaissance de ces variables peut offrir des pistes pour favoriser l’utilisation des guides, notamment des recommandations pour la formation des psychoéducateurs. Les résultats des deux études permettent de dégager des recommandations complémentaires autant pour l’amélioration de l’utilisation des guides en psychoéducation que pour le développement de futurs outils de transfert de connaissances. En particulier, ils permettent d’identifier les caractéristiques principales pour développer des outils informatiques d’aide à la décision qui répondent spécifiquement aux besoins des psychoéducateurs. Ce point est d’autant plus important, étant donné l’augmentation importante de ces outils dans le domaine psychosocial dans les dernières années. / Practice guidelines are typically defined as guides developed using a systematic method to assist practitioners and patients in making informed health care decisions. They are used to improve practices, direct patient care and reduce costs, and are playing an increasingly pivotal role in the health care and social services system. The guidelines have many shortcomings, however, both in terms of quality and use by practitioners. Two studies were conducted to provide a picture of the current situation regarding practice guidelines in psychoeducation. The purpose of the first study was to gain a deeper understanding of the quality of the practice guidelines developed by the Ordre des psychoéducateurs et psychoéducatrices du Québec (OPPQ) [Quebec order of psychoeducators]. The study consisted of two parts: a quantitative assessment of the quality of the guidelines using AGREE II; and a qualitative assessment of their quality based on psychoeducators' perceptions of them, as well as their definition, objectives and characteristics. The results indicate that the psychoeducation guidelines provide clear, easy-to-follow information. However, they also have significant shortcomings, in several respects: thoroughness of guideline development, stakeholder involvement, applicability and editorial independence. Additional criteria specific to psychoeducation are also needed, including the integration of theoretical models, client and colleague awareness, and the detailed definition of legal frameworks. Based on these results, recommendations can already be made for assessing psychoeducational practice guidelines, improving the quality of the current OPPQ guidelines and ensuring the quality of OPPQ guidelines in the future. The second study was designed to better understand the personal and environmental factors that promote guideline use by psychoeducators. We conducted a mixed-methods study that had two components: (1) a quantitative assessment of the factors influencing the use of practice guidelines, based on the responses of 386 psychoeducators to a level of knowledge use survey (KUS; online); and (2) a qualitative assessment of these same factors, based on the perceptions of 18 psychoeducators met individually, online, following their participation in the first component. The two analyses revealed that it is difficult to isolate one single factor that determines the use of practice guidelines. Whether guidelines are followed is instead explained by a set of factors in a dynamic and complex relationship. It does appear that personal and environmental variables influence this use. The logistic regression analysis, highlight the central role of variables measuring the opinions of professionals on the knowledge resultingfrom the research. In addition, the qualitative results obtained highlight a series of other personal and environmental elements, and especially the role of training in practice guideline use. Greater knowledge of these variables may suggest ways to increase guideline use in the future, and especially recommendations for psychoeducator training. Based on the results of the two studies, complementary recommendations can be formulated for improving psychoeducational guideline use and for developing future knowledge transfer tools. Most notably, the findings point to the main characteristics required to develop computer-based decision support tools that meet the specific needs of psychoeducators. This is especially important given the significant increase in the use of these tools in the psychosocial field in recent years.

The South African context, in particular, is characterized by a definite need for the facilitation of the development of the youth in a more positive trajectory. Family structures are not always robust enough to support the positive development of the youth, owing to the demands made on single–parent families, amongst other reasons. Community structures may also be less supportive of the development of the youth, because of the impact of the changes associated with the transitional phase of the country during the past sixteen years (Meehan, Peirson & Fridjhon, 2007). Furthermore, young people under the age of 15 years comprise almost a third of the total South African population (Statistics South Africa, 2009), and in the future, they will have to be prepared for an adulthood faced with previously unknown challenges (United Nations Population Fund). The importance of the development of the youth, in order to enable them to contribute to their country in future, is acknowledged by the South African Governement (National Youth Commission website). This study was conducted within the parameters of the newly developing positive youth development (PYD) paradigm. The empirical level of this paradigm is well represented in the literature, indicating that the content areas, or the “what” of PYD, have been well elucidated. However, there is a lack of theory, especially with regard to models describing developmental change (Larson et al., 2004), and evaluation of interventions aiming at the facilitation of PYD. In order to contribute to the answering of the questions regarding the “how” of development, this study had the following main aims: a) the compilation of a theoretical model, describing developmental change in the youth; b) the operationalization of this model for intervention purposes; and c) the evaluation of a programme and the model on which it is based. The study is reported on in an article format, and comprises a total of three articles. The first article focuses on the process of the compilation of a theoretical model by means of: a) the construction of a comprehensive meta–theoretical matrix, b) the integration of theory that features in the PYD literature, and c) the expansion of the latter with theory from other compatible sub–disciplines in psychology. The resultant Positive Youth Development Intervention (PYDI) model provides a process–related description of developmental change ? and is one of the first models to do so. The second article describes the operationalization of the PYDI model, by means of an indication of the relevant constructs, phenomena and processes to be facilitated. Although recent research points to a relation between PYD and self–regulation, there has been no model, describing the role of self–regulation in the facilitation of the positive development of the youth. This study adapted a model from an educational context (Heckhausen & Gollwitzer, 1987 (as cited in Boekaerts & Niemivirta, 2005)), in order to describe the regular self–regulatory processes constituting the bi–directional interactions between the youth and their primary life contexts, as proposed by developmental systems theory (Lerner, 1998), the meta–theory to PYD (King et al., 2005). A further specifc contribution is that the presentation aspects of the programme material, aimed at facilitating the integration thereof, are addressed on a theoretical level. The third article describes the evaluation of the PYDI model and programme, with young adolescents in a school in a rural area as participants. A mixed–methods study, which has been shown to render much richer information than a quantitative study alone, was applied. Although the quantitative data did not prove the success of the programme, the qualitative data suggested that some aspects of self–regulation had indeed been facilitated successfully. A second follow–up assessment, conducted seventeen months later, indicated that certain skills had only become internalized by that time, suggesting that the implementation and evaluation of such a programme should be expanded over an extended time–frame. This study has contributed to the level of theory of PYD, by indicating, a) the lacunae, and b) that theory in compatible sub–disciplinary paradigms could be used in order to devise workable models for PYD. Furthermore, the process–related nature of the PYDI model and programme, owing to its adaptability to different needs, may be adapted and extended to be applicable to the needs of the diverse South African population. Recommendations regarding future application and research, especially within the South African context, have also been put forward in the study. / Thesis (Ph.D. (Psychology))--North-West University, Potchefstroom Campus, 2011.

The South African context, in particular, is characterized by a definite need for the facilitation of the development of the youth in a more positive trajectory. Family structures are not always robust enough to support the positive development of the youth, owing to the demands made on single–parent families, amongst other reasons. Community structures may also be less supportive of the development of the youth, because of the impact of the changes associated with the transitional phase of the country during the past sixteen years (Meehan, Peirson & Fridjhon, 2007). Furthermore, young people under the age of 15 years comprise almost a third of the total South African population (Statistics South Africa, 2009), and in the future, they will have to be prepared for an adulthood faced with previously unknown challenges (United Nations Population Fund). The importance of the development of the youth, in order to enable them to contribute to their country in future, is acknowledged by the South African Governement (National Youth Commission website). This study was conducted within the parameters of the newly developing positive youth development (PYD) paradigm. The empirical level of this paradigm is well represented in the literature, indicating that the content areas, or the “what” of PYD, have been well elucidated. However, there is a lack of theory, especially with regard to models describing developmental change (Larson et al., 2004), and evaluation of interventions aiming at the facilitation of PYD. In order to contribute to the answering of the questions regarding the “how” of development, this study had the following main aims: a) the compilation of a theoretical model, describing developmental change in the youth; b) the operationalization of this model for intervention purposes; and c) the evaluation of a programme and the model on which it is based. The study is reported on in an article format, and comprises a total of three articles. The first article focuses on the process of the compilation of a theoretical model by means of: a) the construction of a comprehensive meta–theoretical matrix, b) the integration of theory that features in the PYD literature, and c) the expansion of the latter with theory from other compatible sub–disciplines in psychology. The resultant Positive Youth Development Intervention (PYDI) model provides a process–related description of developmental change ? and is one of the first models to do so. The second article describes the operationalization of the PYDI model, by means of an indication of the relevant constructs, phenomena and processes to be facilitated. Although recent research points to a relation between PYD and self–regulation, there has been no model, describing the role of self–regulation in the facilitation of the positive development of the youth. This study adapted a model from an educational context (Heckhausen & Gollwitzer, 1987 (as cited in Boekaerts & Niemivirta, 2005)), in order to describe the regular self–regulatory processes constituting the bi–directional interactions between the youth and their primary life contexts, as proposed by developmental systems theory (Lerner, 1998), the meta–theory to PYD (King et al., 2005). A further specifc contribution is that the presentation aspects of the programme material, aimed at facilitating the integration thereof, are addressed on a theoretical level. The third article describes the evaluation of the PYDI model and programme, with young adolescents in a school in a rural area as participants. A mixed–methods study, which has been shown to render much richer information than a quantitative study alone, was applied. Although the quantitative data did not prove the success of the programme, the qualitative data suggested that some aspects of self–regulation had indeed been facilitated successfully. A second follow–up assessment, conducted seventeen months later, indicated that certain skills had only become internalized by that time, suggesting that the implementation and evaluation of such a programme should be expanded over an extended time–frame. This study has contributed to the level of theory of PYD, by indicating, a) the lacunae, and b) that theory in compatible sub–disciplinary paradigms could be used in order to devise workable models for PYD. Furthermore, the process–related nature of the PYDI model and programme, owing to its adaptability to different needs, may be adapted and extended to be applicable to the needs of the diverse South African population. Recommendations regarding future application and research, especially within the South African context, have also been put forward in the study. / Thesis (Ph.D. (Psychology))--North-West University, Potchefstroom Campus, 2011.

No description available.