Introduction: Parenting programs have been identified as a valuable service provision to promote quality parent-child relationships and attachment styles. The Triple P positive parenting program and the Circle of Security parenting (COS-P) program are evidence-based interventions designed to prevent behavioral and emotional problems in children. However, there is a lack of literature on the experiences of providers delivering these programs in the Canadian context. This study aimed to investigate and characterize these experiences through a mixed-methods approach. Methods: A total of 83 providers participated in the cross-sectional portion of the study, completing readiness measures prior to program implementation. The qualitative descriptive component of the study involved a sub-group of 22 providers in semi-structured focus groups, 12 months after program implementation. Descriptive measures were analyzed using R studio V. 4.2.0, while NVIVO Version 13 was used to manage the thematic analysis of the focus groups. The mixed-methods component involved an explanatory sequential approach, which involved integrating the data via a joint display table. Results: Organizational readiness involving training, supervision, and support were crucial for program delivery. Barriers identified included a lack of support, overwhelming workload, difficulty engaging parents, and program-specific barriers, while facilitators included positive experiences with training, teamwork, confidence, virtual delivery, and managerial support. Discussion: The results suggest that organizational readiness is crucial to the successful delivery of these programs. Providers require training, supervision, and ongoing support to deliver these interventions effectively. Additionally, barriers and facilitators in the delivery of these programs were identified, which can inform future program implementation and improve outcomes. Conclusion: This study provides valuable insights for organizations and providers to effectively deliver parenting programs like Triple P and COS-P by addressing barriers and facilitators of delivery, which can consequently improve parent-child relationships and attachment styles. / Thesis / Master of Public Health (MPH) / Effective delivery of evidence-based parenting programs is essential to promoting positive health outcomes for children and families. Unfortunately, very little research has investigated the experiences of providers delivering these programs. Due to this, our study applied a mixed methods approach that involved 83 providers who completed various readiness measures prior to program implementation, and 22 providers who participated in follow-up focus groups, 12 months after program implementation. The results of our study determined that organizational readiness, which is inclusive of training, supervision, and support, is critical to successful program delivery. Furthermore, we were able to identify barriers and facilitators of program delivery, which can inform future implementation efforts and improve program quality, while promoting positive outcomes for parents and children. This study provides unique insights into the experiences of parenting program providers in Canada and can serve as a tool to inform future program implementation and delivery efforts.

The United States is one of the last countries to transition to the 10th edition of the International Classification of Diseases (ICD-10) coding system. The move from the 35-year-old system, ICD-9, to ICD-10, represents a milestone in the transformation of the 21st century healthcare industry. All covered healthcare entities were mandated to use the ICD-10 system on October 1, 2015, to justify medical necessity, an essential component in determining whether a service is payable or not. Despite the promising outcomes of this shift, more than 70% of healthcare organizations identified concerns related to education efforts, including lack of best practices for the ICD-10 transition. Lack of preparation for the implementation of ICD-10 undermines the clinical, technological, operational, and financial processes of healthcare organizations. This study was an exploration of implementation strategies used to overcome barriers to transition to ICD-10. A single case study was conducted, grounded by the conceptual framework of the technology acceptance model, to learn about ways to mitigate the barriers of this new coding system. Data were gathered from the review of documents, observations, and semistructured interviews with 9 participants of a public healthcare organization in Florida. Data were coded to identify themes. Key themes that emerged from the study included (a) in-depth ICD-10 training, (b) the prevalence of ICD-10 cheat sheets, (c) lack of system readiness, and (d) perception of usefulness of job performance. The results of the study may contribute to social change by identifying successful implementation strategies to mitigate operational disruptions that will allow providers to capture more detailed health information about the severity of patients' conditions.