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Article
Publication date: 26 March 2024

P. Padma Sri Lekha, E.P. Abdul Azeez and Ronald R. O'Donnell

Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming…

Abstract

Purpose

Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming popular in the Western world, its presence in the global context is not promising. This paper aims to explore the need for IBH in India and address its barriers to implementation and possible solutions.

Design/methodology/approach

We analyzed the case of IBH and its potential implications for India using the current evidence base, authors' reflections and experience of implementing similar programs.

Findings

This paper identifies contextual factors, including increased instances of non-communicable diseases and psychosocial and cultural determinants of health, that necessitate the implementation of IBH programs in India. The key features of different IBH models and their applicability are outlined. The current status of IBH and potential challenges in implementation in India in terms of human resources and other factors are delineated. We also discuss the potential models for implementing IBH in India.

Originality/value

Integrating behavioral health in primary care is considered an effective and sustainable model to promote health and well-being across various target populations. Towards this end, this paper is the first to discuss the contextual factors of IBH in India. It is a significant addition to the knowledge base on IBH and its possible implementation barriers and strategies in low- and middle-income countries.

Details

Journal of Integrated Care, vol. 32 no. 2
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 22 September 2023

Jeffersson Santos, Amanda Acevedo-Morales, Lillian Jones, Tara Bautista, Carolyn Camplain, Chesleigh N. Keene and Julie Baldwin

Advancing behavioral health and primary care integration is a priority for helping clients overcome the complex health challenges impacting healthcare deserts like those in…

Abstract

Purpose

Advancing behavioral health and primary care integration is a priority for helping clients overcome the complex health challenges impacting healthcare deserts like those in Arizona, United States of America (USA). This study aimed to explore the perspectives of people with a substance use disorder (SUD) on accessing integrated primary care (IPC) services in a rural-serving behavioral healthcare organization in Arizona.

Design/methodology/approach

Clients from a behavioral health facility in Arizona (n = 10) diagnosed with SUDs who also accessed IPC participated in a 45-min semi-structured interview.

Findings

The authors identified six overarching themes: (1) importance of IPC for clients being treated for SUDs, (2) client low level of awareness of IPC availability at the facility, (3) strategies to increase awareness of IPC availability at the behavioral health facility, (4) cultural practices providers should consider in care integration, (5) attitudes and perceptions about the experience of accessing IPC and (6) challenges to attending IPC appointments. The authors also identified subthemes for most of the main themes.

Originality/value

This is the first study in rural Arizona to identify valuable insights into the experiences of people with SUDs accessing IPC, providing a foundation for future research in the region on care integration.

Details

Journal of Integrated Care, vol. 32 no. 1
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 26 March 2024

Dilek Şahin, Mehmet Nurullah Kurutkan and Tuba Arslan

Today, e-government (electronic government) applications have extended to the frontiers of health-care delivery. E-Nabız contains personal health records of health services…

Abstract

Purpose

Today, e-government (electronic government) applications have extended to the frontiers of health-care delivery. E-Nabız contains personal health records of health services received, whether public or private. The use of the application by patients and physicians has provided efficiency and cost advantages. The success of e-Nabız depends on the level of technology acceptance of health-care service providers and recipients. While there is a large research literature on the technology acceptance of service recipients in health-care services, there is a limited number of studies on physicians providing services. This study aims to determine the level of influence of trust and privacy variables in addition to performance expectancy, effort expectancy, social influence and facilitating factors in the unified theory of acceptance and use of technology (UTAUT) model on the intention and behavior of using e-Nabız application.

Design/methodology/approach

The population of the study consisted of general practitioners and specialist physicians actively working in any health facility in Turkey. Data were collected cross-sectionally from 236 physicians on a voluntary basis through a questionnaire. The response rate of data collection was calculated as 47.20%. Data were collected cross-sectionally from 236 physicians through a questionnaire. Descriptive statistics, correlation analysis and structural equation modeling were used to analyze the data.

Findings

The study found that performance expectancy, effort expectancy, trust and perceived privacy had a significant effect on physicians’ behavioral intentions to adopt the e-Nabız system. In addition, facilitating conditions and behavioral intention were determinants of usage behavior (p < 0.05). However, no significant relationship was found between social influence and behavioral intention (p > 0.05).

Originality/value

This study confirms that the UTAUT model provides an appropriate framework for predicting factors influencing physicians’ behaviors and intention to use e-Nabız. In addition, the empirical findings show that trust and perceived privacy, which are additionally considered in the model, are also influential.

Details

Journal of Science and Technology Policy Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2053-4620

Keywords

Article
Publication date: 17 July 2023

Kunwar Saraf, Karthik Bajar, Aaditya Jain and Akhilesh Barve

This study aims to determine the barriers hindering the incorporation of blockchain technology (BCT) in two key service industries – hotel and health care – as well as to assess…

Abstract

Purpose

This study aims to determine the barriers hindering the incorporation of blockchain technology (BCT) in two key service industries – hotel and health care – as well as to assess their readiness for implementing BCT after overcoming the barriers.

Design/methodology/approach

The barriers of this study are determined through two phases: a review of prior literature and obtaining expert opinions, which are then analyzed to identify specific barriers that are impeding the incorporation of BCT. Moreover, to generate a blockchain implementation reluctance index (BIRI), this study presents an interval-valued intuitionistic fuzzy set (IVIFS) that uses graph theory and matrix approach (GTMA). The permanent function in the GTMA approach is computed using the PERMAN algorithm. Finally, to compare the readiness of the hotel and health-care industries to adopt BCT, the BIRI values are plotted and evaluated.

Findings

The barriers identified by this study are listed under five major headings, namely, financial, operational, behavioral, technical and legal. This study revealed that the operational and technical barriers of BCT are critically hindering its widespread integration in hotel and health-care industries. Furthermore, on comparing the BIRI values of both industries, the result suggested that the hotel industry needs to work more on these barriers to effectively incorporate BCT. Besides the comparison, the BIRI values clearly indicate that both industries have to put a lot of effort into the mitigation of the barriers found by this study to successfully integrate BCT.

Research limitations/implications

The experts’ opinions are used to evaluate the identified barriers, which raises the chance that the opinions are prejudiced based on the experts’ perspectives and ideologies. The sensitivity of decision-maker loads toward preference outcomes is not analyzed in this manuscript. Therefore, any recent sensitivity analysis may be considered a prospective field for future research. This study applies a multicriteria decision-making (MCDM) approach, IVIFS–GTMA, which limits the evaluation of the influence caused by individual barriers on the integration of BCT in the hotel and health-care industries. Henceforth, in future investigations, alternative MCDM methods may be used to analyze individual barriers.

Practical implications

According to the findings, if the hotel or health-care industry aims to incorporate BCT in its supply chain operations, it is recommended to emphasize more on the operational barriers along with the technical and behavioral barriers. The barriers mentioned in this manuscript can be used as guidance for developers in their development activities, such as scalability concerns, establishment costs, the 51% attack and the inefficient nature of BCT. Furthermore, they may address the potential users’ negative perceptions about security, privacy, trust and risk avoidance through creatively developed blockchain solutions to promote BCT implementation.

Originality/value

To the best of the author’s knowledge, this is the first study that identifies barriers toward BCT incorporation in the major service industries, i.e. hotel and health care. Moreover, this is the first study that compares the preparedness of the hotel and health-care industries to determine the industry that requires more work to implement BCT.

Book part
Publication date: 7 February 2024

Anne M. Hewitt

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public…

Abstract

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

Article
Publication date: 30 April 2024

Pimtong Tavitiyaman, Tin-Sing Vincent Law, Yuk-Fai Ben Fong and Tommy K.C. Ng

This study aims to explore the influence of health-care service quality on customers’ perceived value, satisfaction, effectiveness and behavioural intention concerning district…

Abstract

Purpose

This study aims to explore the influence of health-care service quality on customers’ perceived value, satisfaction, effectiveness and behavioural intention concerning district health centres (DHCs) in Hong Kong. This research also intends to assess customers’ perception of the subsidy scheme and its influence on the relationships amongst the aforementioned constructs.

Design/methodology/approach

The convenience and snowball sampling approaches were adopted, and the self-administered questionnaire was sent to 309 customers of DHCs.

Findings

Service quality attributes in terms of staffing and procedures positively increased customers’ perceived value and staffing, procedures and operations. Physical facilities positively promoted customers’ satisfaction, consequently improving DHCs’ effectiveness and behavioural intention. However, core treatments and services of DHCs did not impact customers’ perceived value and satisfaction. Furthermore, customers receiving subsidies exhibited a more positive perception than those without subsidies.

Practical implications

Health-care organisations are advised to strategically allocate resources (staffing, facilities and procedures and operations management) to optimise overall performance outcomes. DHC operators could reinforce the core services of DHCs and health-care voucher subsidies to local citizens so as to enhance the effectiveness of DHCs and behavioural intention of customers.

Originality/value

This study integrates the input–process–output approach in measuring the effectiveness of and customers’ behavioural intention towards newly established DHCs.

Details

International Journal of Quality and Service Sciences, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1756-669X

Keywords

Book part
Publication date: 7 February 2024

Clair Reynolds Kueny, Alex Price and Casey Canfield

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower…

Abstract

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

Details

Research and Theory to Foster Change in the Face of Grand Health Care Challenges
Type: Book
ISBN: 978-1-83797-655-3

Keywords

Article
Publication date: 15 February 2024

Sevenpri Candra, Edith Frederica, Hanifa Amalia Putri and Ooi Kok Loang

This study aims to analyze the effects of performance expectancy, effort expectancy, social influence and facilitating conditions on the behavioral intention of using mobile…

Abstract

Purpose

This study aims to analyze the effects of performance expectancy, effort expectancy, social influence and facilitating conditions on the behavioral intention of using mobile health applications, especially during and after the COVID-19 pandemic.

Design/methodology/approach

A survey was developed using an online survey platform and distributed to Indonesian consumers for three weeks, and 149 usable responses were obtained. The principal component analysis, linear regression and analysis of variance tests were performed to test the validity and reliability of the measurement model and the hypothesized relationships among constructs.

Findings

Surprisingly, unlike previous studies on IT adoption, the findings show that social influence has no significant impact on behavioral intention. Facilitating conditions have a very weak to almost no significant impact on behavioral intention to use mobile health applications.

Research limitations/implications

This research is conducted during pandemic COVID-19 where using mobile health apps is a must. In the future this research can be expanded as comparison study after the pandemic COVID-19 stated.

Practical implications

The result implies that digital technologies adoption intention is strongly affected by performance expectancy and effort expectancy, with performance expectancy as the most significant predictor. Nonetheless, the interaction of performance expectancy, effort expectancy, social influence and facilitating conditions influences behavioral intention significantly. Therefore, social influence and facilitating conditions are still important even with very insignificant effects.

Originality/value

To improve consumers’ behavioral intention to use mobile health applications, application providers should promote mobile health applications as useful telemedicine tools by primarily focusing on the application performance and usage experience.

Details

Journal of Science and Technology Policy Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2053-4620

Keywords

Open Access
Article
Publication date: 6 March 2024

Annie Williams, Hannah Bayfield, Martin Elliott, Jennifer Lyttleton-Smith, Honor Young, Rhiannon Evans and Sara Long

Using a mixed methodology comprising interviews, case file analysis and descriptive statistics, this study aims to examine the experiences of all 43 young people in Wales subject…

Abstract

Purpose

Using a mixed methodology comprising interviews, case file analysis and descriptive statistics, this study aims to examine the experiences of all 43 young people in Wales subject to secure accommodation orders between 1st April 2016 and 31st March 2018.

Design/methodology/approach

Children in the UK aged 10–17 years who are deemed to be at a significant level of risk to themselves or others may be subject to a secure accommodation order, leading to time spent in a secure children’s home (SCH) on welfare grounds. Following a rise in the number of children in Wales referred to SCHs for welfare reasons, this paper describes these young people’s journeys into, through and out of SCHs, giving insight into their experiences and highlighting areas for policy and practice improvements.

Findings

Findings indicate that improvements in mental health support and placement availability are key in improving the experiences of this particularly vulnerable group of young people throughout their childhood.

Practical implications

Other practical implications of the study’s findings, such as improvements in secure transport arrangements, are also discussed.

Originality/value

While the findings are limited by the reliance on self-report methods and the size of the study, namely, the small number of young people with experience of SCHs who were able to participate, the findings build on the existing knowledge base around children’s residential accommodation and provide new insights into how best to support these children.

Details

Journal of Children's Services, vol. 19 no. 1
Type: Research Article
ISSN: 1746-6660

Keywords

Article
Publication date: 7 December 2023

Panos Vostanis, Sajida Hassan, Syeda Zeenat Fatima and Michelle O'Reilly

Children in majority world countries (MWC) have high rates of unmet mental health needs, with limited access to specialist resources. Integration of child mental health in…

Abstract

Purpose

Children in majority world countries (MWC) have high rates of unmet mental health needs, with limited access to specialist resources. Integration of child mental health in existing psychosocial care can improve provision. Through a Train-the-Trainer (ToT) cascade approach, this study aimed to provide a framework for such integration in resource-constrained communities in Karachi, Pakistan and to establish hindering and enabling factors.

Design/methodology/approach

Eight practitioners attended a child mental health ToT program, including training on a five-domain service transformation framework. Trainers co-designed and implemented interventions that integrated child mental health knowledge and skills on each domain. These were attended by 136 end-users (youth, parents, teachers, managers), of whom a sub-sample of 47 stakeholders, as well as the trainers, attended focus groups on their experiences. Data were analysed through a thematic codebook.

Findings

Established themes reflected common ingredients across all domains/interventions that were deemed important for child mental health care integration. These included child-centric approaches, positive parenting, community mobilization and systemic changes.

Originality/value

Integrated child mental health care informed by the Train-of-Trainer approach can be a useful model for resource-constrained MWC contexts. Integrated interventions should be co-produced with communities.

Details

Journal of Integrated Care, vol. 32 no. 2
Type: Research Article
ISSN: 1476-9018

Keywords

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