Our overall goal was to enhance the usability and interactivity of the RE-AIM website (re-aim.org) and improve resources to support the application of the RE-AIM framework within the context of dissemination & implementation (D&I) research and practice.

We applied a mixed-methods approach to obtain user feedback from 24 D&I researchers and practitioners. Usability (System Usability Scale) and interactivity (Interactivity Scale) were assessed through validated surveys, at baseline and after two iterative rounds of website modifications (Phase 1 and Phase 2). We also conducted qualitative assessments at each phase.

Qualitative baseline and Phase 1 findings indicated a need to simplify organization, enhance information accessibility, provide concrete guidance on applying RE-AIM, and clarify contextual factors related to RE-AIM constructs. After streamlining website and homepage organization, Phase 2 qualitative results suggested improved user navigation experience; users also requested greater interactivity. Modifications included: new interactive planning tool and a video introduction of contextual factors influencing RE-AIM outcomes. Significant improvements were found in the SUS score from baseline to Phase 1(64.2[SD18.7] to 80.8 [SD 12.1] (p < .05) and remained higher in Phase 2(77.1[SD 15] (p = 0.08). Interactivity also improved from baseline to Phase 2(3.5[SD1.2] to 41[0.9], though not statistically significant.

User-centered feedback on online resources, as exemplified by this use case example of enhancements to the RE-AIM website, are important in bridging the gap between research and practice, and the revised website should be more accessible and useful to users.

People with hoarding behaviours often struggle to engage in treatment. This study aimed to explore the experiences of a sample of people who identify as engaging in hoarding behaviours and who are seeking support. Exploring motivation to seek help, the barriers those who hoard face in accessing support and what facilitates accepting help, can aid understanding of how best to intervene.

Eight individuals who self-identified as seeking help in relation to hoarding behaviours were recruited via social media and support groups. Interviews were conducted by telephone or video call, before being transcribed and analysed using interpretative phenomenological analysis.

Participants described complex help-seeking narratives and reported continued ambivalence about addressing their hoarding behaviours. The four group experiential themes identified were Wrestling with identity; Who can I trust?; Services don’t fit; and Being overlooked: ‘they’re too busy looking at the thing, not the person’. Difficulties trusting others and services were identified; services were experienced as rejecting and many participants sought help for problems other than their hoarding. Problems accessing appropriate help for hoarding were predominant in the narratives, although participants who had accessed peer support described this as valuable.

There are both internal (e.g. fear of judgement; feeling overwhelmed) and external (e.g. service gaps) barriers that make finding useful help for hoarding behaviours very difficult. Services may facilitate those seeking help by taking a compassionate and person-centred approach to hoarding problems.

Central line-associated bloodstream infection (CLABSI) is a national target for mandatory reporting and a Centers for Medicare and Medicaid Services target for value-based purchasing. Differences in chart review versus claims-based metrics used by national agencies and groups raise concerns about the validity of these measures.

Evaluate consistency and reasons for discordance among chart review and claims-based CLABSI events.

We conducted 2 multicenter retrospective cohort studies within 6 academic institutions. A total of 150 consecutive patients were identified with CLABSI on the basis of National Healthcare Safety Network (NHSN) criteria (NHSN cohort), and an additional 150 consecutive patients were identified with CLABSI on the basis of claims codes (claims cohort). Ail events had full-text medical record reviews and were identified as concordant or discordant with the other metric.

In the NHSN cohort, there were 152 CLABSIs among 150 patients, and 73.0% of these cases were discordant with claims data. Common reasons for the lack of associated claims codes included coding omission and lack of physician documentation of bacteremia cause. In the claims cohort, there were 150 CLABSIs among 150 patients, and 65.3% of these cases were discordant with NHSN criteria. Common reasons for the lack of NHSN reporting were identification of non-CLABSI with bacteremia meeting Centers for Disease Control and Prevention (CDC) criteria for an alternative infection source.

Substantial discordance between NHSN and claims-based CLABSI indicators persists. Compared with standardized CDC chart review criteria, claims data often had both coding omissions and misclassification of non-CLABSI infections as CLABSI. Additionally, claims did not identify any additional CLABSIs for CDC reporting. NHSN criteria are a more consistent interhospital standard for CLABSI reporting.

The Texas Department of State Health Services (DSHS) implemented an active mortality surveillance system to enumerate and characterize hurricane-related deaths during Hurricane Ike in 2008. This surveillance system used established guidelines and case definitions to categorize deaths as directly, indirectly, and possibly related to Hurricane Ike.

The objective of this study was to evaluate Texas DSHS' active mortality surveillance system using US Centers for Disease Control and Prevention's (CDC) surveillance system evaluation guidelines.

Using CDC's Updated Guidelines for Surveillance System Evaluation, the active mortality surveillance system of the Texas DSHS was evaluated. Data from the active mortality surveillance system were compared with Texas vital statistics data for the same time period to estimate the completeness of reported disaster-related deaths.

From September 8 through October 13, 2008, medical examiners (MEs) and Justices of the Peace (JPs) in 44 affected counties reported deaths daily by using a one-page, standardized mortality form. The active mortality surveillance system identified 74 hurricane-related deaths, whereas a review of vital statistics data revealed only four deaths that were hurricane-related. The average time of reporting a death by active mortality surveillance and vital statistics was 14 days and 16 days, respectively.

Texas's active mortality surveillance system successfully identified hurricane-related deaths. Evaluation of the active mortality surveillance system suggested that it is necessary to collect detailed and representative mortality data during a hurricane because vital statistics do not capture sufficient information to identify whether deaths are hurricane-related. The results from this evaluation will help improve active mortality surveillance during hurricanes which, in turn, will enhance preparedness and response plans and identify public health interventions to reduce future hurricane-related mortality rates.

Choudhary E, Zane DF, Beasley C, Jones R, Rey A, Noe RS, Martin C, Wolkin AF, Bayleyegn TM. Evaluation of active mortality surveillance system data for monitoring hurricane-related deaths, Texas, 2008. Prehosp Disaster Med. 2012;27(4):1-6.