Research Area 3

Using a Systems Approach to Catalyze Behavioral Change


Optimizing Antibiotic Use With Persuasive Interventions

Journal Paper (2020 Journal of Medical Systems)

Conference Presentation (2020 Healthcare Symposium)

Collaborators: Dr. Jeff Niederdeppe, Dr. Ole Vielemeyer, A/P Brandyn Lau, Michelle Demetres, Dr. Hessam Sadatsafavi

Challenge: A rise in antimicrobial resistance seen especially since 2000 is in part caused by indiscriminate antimicrobial use. Persuasive interventions have been successful in optimizing antimicrobial use but findings in this area have been mixed.

Research Question: What are the evidence-based strategies in using persuasive interventions to optimize antibiotic use in healthcare?

Research Technique: Narrative review

Findings: Make patient, family, or provider education an integral component of the multimodal intervention.

Implications for Practice: Implement a combination of persuasive interventions from both groups: audit and feedback, academic detailing, or patient, family, or provider education; and meeting or reminders.


Improving Hand Hygiene in Healthcare - An Evidence-based Approach

Journal Paper (2016 American Journal of Infection Control)

Conference Presentation (2015 Healthcare Design Conference)

Collaborators: Dr. Rana Zadeh, Dr. Ole Vielemeyer, Ella Franklin

Challenge: Hand hygiene in health care facilities is a key component to reduce pathogen transmission and infections. However, most interventions have not been sustainable.

Research Question: What are the published evidence-based hand hygiene interventions that led to improved hand hygiene compliance?

Research Technique: Narrative review

Findings: Interventions were categorized as improving awareness with education, facility design, and planning, unit-level protocols and procedures, hospital-wide programs, and multimodal interventions.

Implications for Practice: To create hospital-wide programs that engage end-users, policymakers should draw expertise from interdisciplinary fields. Before implementing the various components of multimodal interventions, practitioners should identify and examine difficulties unique to their organizations.


Improving Hand Hygiene in Healthcare - A Social Science Approach

Journal Paper (2017 American Journal of Infection Control)

Conference Presentation (2019 Healthcare Symposium)

Challenge: Hand hygiene research is designed and conducted by health care practitioners who may lack formal training in research methods, particularly in the area of social science research.

Research Question: What are the common threats to construct validity pertaining to hand hygiene research? What are the practical limitations in current research designs? How can construct validity be improved in future research?

Research Technique: Narrative review

Findings: The following concepts in construct validity can potentially improve future research: Hawthorne effect, self-reporting, experimenter effect, evaluation apprehension, hypothesis guessing, timing, restricted range, and mono-operation bias.

Implications for Practice: Researchers should consult with staff from the hospital’s ethics review board to ensure that research will be conducted in accordance with ethical guidelines.


Improving Hand Hygiene in Healthcare - A Management Approach

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Conference Poster (2017 Healthcare Symposium)

Collaborator: Dr. Rana Zadeh

Challenge: There is often a lack of organizational consensus when it comes to infection control efforts.

Research Question: What are the current management approaches on hand hygiene and the current management’s view on the influence of facility design, operations, and management on hand hygiene?

Research Techniques: Contextual inquiry and thematic analysis

Findings: It is important to understand the unique workflow and processes of every unit. Collaborations between departments may allow staff to decide on locations that may be more visible and/or accessible.

Implications for Practice: To sustain hand hygiene interventions, stakeholders, e.g., management, architects, designers, infection control manager should engage in dialogues to create a coordinated plan of action.