Shek, Daniel T L; Ng, Catalina S M; Law, Moon Y M
2017-02-01
As program implementers' views are seldom included in program evaluation and there are few related studies in different Chinese communities, this study examined the perceptions of the program implementers who implemented the Tier 2 Program of the P.A.T.H.S. Program in Hong Kong. The Tier 2 Program was designed to promote the development of adolescents with greater psychosocial needs. In the community-based P.A.T.H.S. Project, 400 program implementers completed a subjective outcome evaluation form (Form D) for program implementers. Consistent with the previous findings, program implementers generally held positive views towards the program, implementers, and program effectiveness and their views towards these three domains did not differ across grades. In line with the hypotheses, perceived program quality and perceived implementer quality predicted program effectiveness. The present findings provided an alternative perspective showing that the Tier 2 Program was well received by the program implementers and they regarded the program to be beneficial to the program participants.
Weiner, Bryan J; Lewis, Megan A; Linnan, Laura A
2009-04-01
The field of worksite health promotion has moved toward the development and testing of comprehensive programs that target health behaviors with interventions operating at multiple levels of influence. Yet, observational and process evaluation studies indicate that such programs are challenging for worksites to implement effectively. Research has identified several organizational factors that promote or inhibit effective implementation of comprehensive worksite health promotion programs. However, no integrated theory of implementation has emerged from this research. This article describes a theory of the organizational determinants of effective implementation of comprehensive worksite health promotion programs. The model is adapted from theory and research on the implementation of complex innovations in manufacturing, education and health care settings. The article uses the Working Well Trial to illustrate the model's theoretical constructs. Although the article focuses on comprehensive worksite health promotion programs, the conceptual model may also apply to other types of complex health promotion programs. An organization-level theory of the determinants of effective implementation of worksite health promotion programs.
Shek, Daniel T L; Law, Moon Y M
2017-02-01
This study examined the perceptions of the Tier 2 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social programmes) among Chinese secondary school students displaying greater psychosocial needs. Results showed that participants held positive views of program qualities, implementer qualities, as well as the perceived effectiveness of the program. Significant grade differences in terms of various indicators of satisfaction related to program qualities, implementer qualities, and program effectiveness were found. Correlation analyses showed that there were significant inter-relationships amongst program qualities, implementer qualities and program effectiveness. In line with the predictions, both program qualities and implementer qualities were significant predictors of perceived program effectiveness. The present study provides support for the perceived effectiveness of the Tier 2 Program of the Project P.A.T.H.S. in the community-based project context.
The US Air Force suicide prevention program: implications for public health policy.
Knox, Kerry L; Pflanz, Steven; Talcott, Gerald W; Campise, Rick L; Lavigne, Jill E; Bajorska, Alina; Tu, Xin; Caine, Eric D
2010-12-01
We evaluated the effectiveness of the US Air Force Suicide Prevention Program (AFSPP) in reducing suicide, and we measured the extent to which air force installations implemented the program. We determined the AFSPP's impact on suicide rates in the air force by applying an intervention regression model to data from 1981 through 2008, providing 16 years of data before the program's 1997 launch and 11 years of data after launch. Also, we measured implementation of program components at 2 points in time: during a 2004 increase in suicide rates, and 2 years afterward. Suicide rates in the air force were significantly lower after the AFSPP was launched than before, except during 2004. We also determined that the program was being implemented less rigorously in 2004. The AFSPP effectively prevented suicides in the US Air Force. The long-term effectiveness of this program depends upon extensive implementation and effective monitoring of implementation. Suicides can be reduced through a multilayered, overlapping approach that encompasses key prevention domains and tracks implementation of program activities.
Leavy, Breiffni; Kwak, Lydia; Hagströmer, Maria; Franzén, Erika
2017-02-07
If people with progressive neurological diseases are to avail of evidence-based rehabilitation, programs found effective in randomized controlled trials (RCT's) must firstly be adapted and tested in clinical effectiveness studies as a means of strengthening their evidence base. This paper describes the protocol for an effectiveness-implementation trial that will assess the clinical effectiveness of a highly challenging balance training program (the HiBalance program) for people with mild-moderate Parkinson's disease (PD) while simultaneously collecting data concerning the way in which the program is implemented. The HiBalance program is systemically designed to target balance impairments in PD and has been shown effective at improving balance control and gait in a previous RCT. Study aims are to i) determine the effectiveness of the adapted HiBalance program on performance and self-rated outcomes such as balance control, gait and physical activity level ii) conduct a process evaluation of program implementation at the various clinics iii) determine barriers and facilitators to program implementation in these settings. This effectiveness-implementation type 1 hybrid study will use a non-randomized controlled design with consecutive inclusion of people with PD at multiple clinical sites. A mixed method approach will be used to collect clinical effectiveness data and process evaluation data which is both quantitative and qualitative in nature. The consolidated framework for implementation research (CFIR) will be used to guide the planning and collection of data concerning implementation barriers and facilitators. The HiBalance program will be provided by physical therapists as a part of standard rehabilitation care at the clinical sites, while the evaluation of the implementation process will be performed by the research group and funded by research grants. An effectiveness-implementation study design benefits patients by speeding up the process of translating findings from research settings to routine health care. Findings from this study will also be highly relevant for those working with neurological rehabilitation when faced with decisions concerning the translation of training programs from efficacy studies to everyday clinical practice. ClinicalTrials.gov march 2016, NCT02727478 .
Shek, Daniel T. L.; Ma, Cecilia M. S.
2012-01-01
This paper integrates the evaluation findings based on program implementers in nine datasets collected from 2005 to 2009 (244 schools and 7,926 implementers). Using consolidated data with schools as the unit of analysis, results showed that program implementers generally had positive perceptions of the program, themselves, and benefits of the program, with more than four-fifths of the implementers regarding the program as beneficial to the program participants. The subjective outcome evaluation instrument was found to be internally consistent. Multiple regression analyses revealed that perceived qualities of the program and program implementers predicted perceived effectiveness of the program. In conjunction with evaluation findings based on other sources, the present study provides support for the effectiveness of the Tier 1 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in Hong Kong. PMID:22629224
The US Air Force Suicide Prevention Program: Implications for Public Health Policy
Pflanz, Steven; Talcott, Gerald W.; Campise, Rick L.; Lavigne, Jill E.; Bajorska, Alina; Tu, Xin; Caine, Eric D.
2010-01-01
Objectives. We evaluated the effectiveness of the US Air Force Suicide Prevention Program (AFSPP) in reducing suicide, and we measured the extent to which air force installations implemented the program. Methods. We determined the AFSPP's impact on suicide rates in the air force by applying an intervention regression model to data from 1981 through 2008, providing 16 years of data before the program's 1997 launch and 11 years of data after launch. Also, we measured implementation of program components at 2 points in time: during a 2004 increase in suicide rates, and 2 years afterward. Results. Suicide rates in the air force were significantly lower after the AFSPP was launched than before, except during 2004. We also determined that the program was being implemented less rigorously in 2004. Conclusions. The AFSPP effectively prevented suicides in the US Air Force. The long-term effectiveness of this program depends upon extensive implementation and effective monitoring of implementation. Suicides can be reduced through a multilayered, overlapping approach that encompasses key prevention domains and tracks implementation of program activities. PMID:20466973
Blando, James; Ridenour, Marilyn; Hartley, Daniel; Casteel, Carri
2015-01-01
Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings in light of previous studies and experiences and offer suggestions for decreasing WPV in healthcare settings. They conclude that although many of these challenges to effective implementation of workplace violence programs are both within the program itself and relate to broader industry and societal issues, creative innovations can address these issues and improve WPV prevention programs.
Blando, James; Ridenour, Marilyn; Hartley, Daniel; Casteel, Carri
2014-12-04
Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings in light of previous studies and experiences and offer suggestions for decreasing WPV in healthcare settings. They conclude that although many of these challenges to effective implementation of workplace violence programs are both within the program itself and relate to broader industry and societal issues, creative innovations can address these issues and improve WPV prevention programs.
Hill, Laura G; Goates, Scott G; Rosenman, Robert
2010-04-01
To calculate valid estimates of the costs and benefits of substance abuse prevention programs, selection effects must be identified and corrected. A supplemental comparison sample is typically used for this purpose, but in community-based program implementations, such a sample is often not available. We present an evaluation design and analytic approach that can be used in program evaluations of real-world implementations to identify selection effects, which in turn can help inform recruitment strategies, pinpoint possible selection influences on measured program outcomes, and refine estimates of program costs and benefits. We illustrate our approach with data from a multisite implementation of a popular substance abuse prevention program. Our results indicate that the program's participants differed significantly from the population at large.
ERIC Educational Resources Information Center
Gerstner, Jerusha J.; Finney, Sara J.
2013-01-01
Implementation fidelity assessment provides a means of measuring the alignment between the planned program and the implemented program. Unfortunately, the implemented program can differ from the planned program, resulting in ambiguous inferences about the planned program's effectiveness (i.e., it is uncertain if poor results are due to an…
Implementation contexts of a Tuberculosis Control Program in Brazilian prisons
de Oliveira, Luisa Gonçalves Dutra; Natal, Sonia; Camacho, Luiz Antonio Bastos
2015-01-01
OBJECTIVE To analyze the influence from context characteristics in the control of tuberculosis in prisons, and the influence from the program implementation degrees in observed effects. METHODS A multiple case study, with a qualitative approach, conducted in the prison systems of two Brazilian states in 2011 and 2012. Two prisons were analyzed in each state, and a prison hospital was analyzed in one of them. The data were submitted to a content analysis, which was based on external, political-organizational, implementation, and effect dimensions. Contextual factors and the ones in the program organization were correlated. The independent variable was the program implementation degree and the dependent one, the effects from the Tuberculosis Control Program in prisons. RESULTS The context with the highest sociodemographic vulnerability, the highest incidence rate of tuberculosis, and the smallest amount of available resources were associated with the low implementation degree of the program. The results from tuberculosis treatment in the prison system were better where the program had already been partially implemented than in the case with low implementation degree in both cases. CONCLUSIONS The implementation degree and its contexts – external and political-organizational dimensions – simultaneously contribute to the effects that are observed in the control of tuberculosis in analyzed prisons. PMID:26465668
ERIC Educational Resources Information Center
Ip, Sau M. V.; And Others
1994-01-01
Describes quasiexperimental investigation constructed to examine effects of staff implementation of choice program on reduction of challenging behaviors of people with developmental disabilities residing in supported community residences. Results suggest that choice program implementation produced significant decreases in frequency and severity of…
ERIC Educational Resources Information Center
van Nassau, Femke; Singh, Amika S.; Hoekstra, Trynke; van Mechelen, Willem; Brug, Johannes; Chinapaw, Mai J. M.
2016-01-01
This study investigates if and to what extent the Dutch Obesity Intervention in Teenagers (DOiT) program was implemented as intended and how this affected program effectiveness. We collected data at 20 prevocational education schools in the Netherlands. We assessed seven process indicators: recruitment, reach, dosage, fidelity, satisfaction,…
Brady, Teresa J; Murphy, Louise B; O'Colmain, Benita J; Hobson, Reeti Desai
2017-09-01
To evaluate whether implementation factors or fidelity moderate chronic disease self-management education program outcomes. Meta-analysis of 34 Arthritis Self-Management Program and Chronic Disease Self-Management Program studies. Community. N = 10 792. Twelve implementation factors: program delivery fidelity and setting and leader and participant characteristics. Eighteen program outcomes: self-reported health behaviors, physical health status, psychological health status, and health-care utilization. Meta-analysis using pooled effect sizes. Modest to moderate statistically significant differences for 4 of 6 implementation factors; these findings were counterintuitive with better outcomes when leaders and participants were unpaid, leaders had less than minimum training, and implementation did not meet fidelity requirements. Exploratory study findings suggest that these interventions tolerate some variability in implementation factors. Further work is needed to identify key elements where fidelity is essential for intervention effectiveness.
Teachers or Psychologists: Who Should Facilitate Depression Prevention Programs in Schools?
Wahl, Melanie S.; Adelson, Jill L.; Patak, Margarete A.; Pössel, Patrick; Hautzinger, Martin
2014-01-01
The current study evaluates a depression prevention program for adolescents led by psychologists vs. teachers in comparison to a control. The universal school-based prevention program has shown its efficacy in several studies when implemented by psychologists. The current study compares the effects of the program as implemented by teachers versus that implemented by psychologists under real-life conditions. A total of 646 vocational track 8th grade students from Germany participated either in a universal prevention program, led by teachers (n = 207) or psychologists (n = 213), or a teaching-as-usual control condition (n = 226). The design includes baseline, post-intervention, and follow-up (at 6 and 12 months post-intervention). The cognitive-behavioral program includes 10 sessions held in a regular school setting in same-gender groups and is based on the social information-processing model of social competence. Positive intervention effects were found on the change in girls’ depressive symptoms up to 12 months after program delivery when the program was implemented by psychologists. No such effects were found on boys or when program was delivered by teachers. The prevention program can successfully be implemented for girls by psychologists. Further research is needed for explanations of these effects. PMID:24837667
DiStefano, Lindsay J; Frank, Barnett S; Root, Hayley J; Padua, Darin A
Neuromuscular preventive training programs effectively reduce injury and improve performance in youth athletes. However, program effectiveness is directly linked to program compliance, fidelity, and dosage. Preventive training programs are not widely adopted by youth sport coaches. One way to promote widespread dissemination and compliance is to identify implementation strategies that influence program adoption and maintenance. It is unknown how previously published programs have followed the elements of an implementation framework. The objective of this review was to evaluate how elements of the 7 steps of implementation, developed by Padua et al, have been performed in the evidence of lower extremity preventive training programs. A systematic review of the literature from 1996 through September 2016 was conducted using electronic databases. Investigations that documented implementation of a sport team-based neuromuscular preventive training program in youth athletes and measured lower extremity injury rates were included. Clinical review. Level 4. A total of 12 studies met the inclusion criteria and were reviewed. Information regarding the completion of any of the 7 steps within the implementation framework developed by Padua et al was extracted. None of the 12 articles documented completion of all 7 steps. While each study addressed some of the 7 steps, no study addressed maintenance or an exit strategy for youth athletes. Program implementation appears limited in obtaining administrative support, utilizing an interdisciplinary implementation team, and monitoring or promoting fidelity of the intervention. Despite strong evidence supporting the effectiveness of preventive training programs in youth athletes, there is a gap between short-term improvements and long-term implementation strategies. Future interventions should include all 7 steps of the implementation framework to promote transparent dissemination of preventive training programs.
Casillas, Katherine L; Fauchier, Angèle; Derkash, Bridget T; Garrido, Edward F
2016-03-01
In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results. Copyright © 2015 Elsevier Ltd. All rights reserved.
Wolfenden, L; Carruthers, J; Wyse, R; Yoong, S
2014-08-01
School-based programs targeting the prevention of tobacco use are a key strategy for reducing the overall tobacco-related mortality and morbidity in the community. While substantial research investment has resulted in the identification of various effective tobacco prevention interventions in schools, this research investment will not result in public health benefits, unless effectively disseminated and implemented. This rapid review aimed to identify effective implementation or dissemination interventions, targeting the adoption of school-based tobacco prevention programs. A systematic search was conducted to identify published systematic reviews that examined the effectiveness of implementation and dissemination strategies for facilitating the adoption of tobacco policies or programs in schools from 1992 to 2012. The search yielded 1028 results, with one relevant systematic review being identified. The review included two controlled studies examining the implementation and dissemination of tobacco prevention programs and guidelines. The two randomised trials examined the delivery of active face-to-face training to implement a school-based curriculum compared with video-delivered or mail-based training. Improvements in the implementation of the programs were reported for the face-to-face training arm in both trials. Little rigorous evidence exists to guide the implementation and dissemination of tobacco prevention programs in schools. SO WHAT? Few systematic reviews exist to inform the implementation of evidence-based tobacco prevention programs in schools. In the absence of a strong evidence base, health care policymakers and practitioners may need to draw on setting-based frameworks or parallel evidence from other settings to design strategies to facilitate the adoption of tobacco prevention initiatives.
Perrin, Karen M; Burke, Somer Goad; O'Connor, Danielle; Walby, Gary; Shippey, Claire; Pitt, Seraphine; McDermott, Robert J; Forthofer, Melinda S
2006-10-26
Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.
A Framework for Identifying Implementation Issues Affecting Extension Human Sciences Programming
ERIC Educational Resources Information Center
Abell, Ellen; Cummings, Rebekah; Duke, Adrienne M.; Marshall, Jennifer Wells
2015-01-01
Extension programs based on identified needs, relevant theory, and solid research too often fail to realize their objectives. Program implementation is acknowledged to contribute to program effectiveness, yet systematic attention has not been paid to the array of implementation issues that can complicate achieving program goals. We developed the…
Statewide Implementation of Evidence-Based Programs
ERIC Educational Resources Information Center
Fixsen, Dean; Blase, Karen; Metz, Allison; van Dyke, Melissa
2013-01-01
Evidence-based programs will be useful to the extent they produce benefits to individuals on a socially significant scale. It appears the combination of effective programs and effective implementation methods is required to assure consistent uses of programs and reliable benefits to children and families. To date, focus has been placed primarily…
Implementing an Evidence-Based Fall Prevention Intervention in Community Senior Centers.
Li, Fuzhong; Harmer, Peter; Fitzgerald, Kathleen
2016-11-01
To evaluate the impact of implementing an evidence-based fall prevention intervention in community senior centers. We used a single-group design to evaluate the Tai Ji Quan: Moving for Better Balance (TJQMBB) program's adoption, population reach, implementation, effectiveness, and maintenance among 36 senior centers in 4 Oregon counties between 2012 and 2016. The primary outcome measure, as part of the effectiveness evaluation, was number of falls as ascertained by self-report. Trained TJQMBB instructors delivered the program to community-dwelling older adults for 48 weeks, with a 6-month postintervention follow-up. TJQMBB was adopted by 89% of the senior centers approached and reached 90% of the target population. The program resulted in a 49% reduction in the total number of falls and improved physical performance. Participation was well maintained after the program's completion. The average cost-effectiveness ratio for the 48-week program implementation was $917 per fall prevented and $676 per fall prevented for multiple falls. TJQMBB is an effective public health program that can be broadly implemented in community senior centers for primary prevention of falls among community-dwelling older adults.
Perrin, Karen M; Burke, Somer Goad; O'Connor, Danielle; Walby, Gary; Shippey, Claire; Pitt, Seraphine; McDermott, Robert J; Forthofer, Melinda S
2006-01-01
Background and objectives Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. Methods The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. Results This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. Conclusion Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity. PMID:17067388
Evidence Based Bullying Prevention in Turkey: Implementation of the ViSC Social Competence Program
ERIC Educational Resources Information Center
Dogan, Aysun; Keser, Eda; Sen, Zeynep; Yanagida, Takuya; Gradinger, Petra; Strohmeier, Dagmar
2017-01-01
The ViSC program is the first evidence based anti-bullying program implemented in Turkey. A quasi-experimental longitudinal control group design comprising six schools and 26 classes was realized to examine the program effectiveness regarding different forms of perpetration and victimization. The effectiveness of two dosages of…
Kozica, S L; Lombard, C B; Harrison, C L; Teede, H J
2016-11-24
The Healthy Lifestyle Program for women (HeLP-her) is a low-intensity, self-management program which has demonstrated efficacy in preventing excess weight gain in women. However, little is known about the implementation, reach, and sustainability of low-intensity prevention programs in rural settings, where risk for obesity in women is higher than urban settings. We aimed to evaluate a low-intensity healthy lifestyle program delivered to women in a rural setting to inform development of effective community prevention programs. A mixed method hybrid implementation and evaluation study, guided by the RE-AIM framework (addressing the Reach, Effectiveness, Adoption, Implementation, and Maintenance), was undertaken. Data collection tools included anthropometric measures, program checklists, questionnaires, and semi-structured interviews with participants and local stakeholders. The RE-AIM self-audit tool was applied to assess evaluation rigor. Six hundred and forty-nine women from 41 relatively socio-economic disadvantaged communities in Australia participated: mean age 39.6 years (±SD 6.7) and body mass index of 28.8 kg/m 2 (±SD 6.9). A between-group weight difference of -0.92 kg (95% CI -1.67 to -0.16) showed program effectiveness. Reach was broad across 41 towns with 62% of participants reporting influencing some of the health behaviors of their families. Strong implementation fidelity was achieved with good retention rates at 1 year (76%) and high participant satisfaction (82% of participants willing to recommend this program). Over 300 multi-level community partnerships were established supporting high adoption. Stakeholders reported potential capacity to implement and sustain the prevention program in resource poor rural settings, due to the low-intensity design and minimal resources required. Our comprehensive RE-AIM evaluation demonstrates that an evidence-based obesity prevention program can be successfully implemented in real-world settings. The program achieved broad reach, effectiveness, and satisfaction at the community and stakeholder level, revealing potential for program sustainability. The evaluation addressed implementation knowledge gaps to support future obesity prevention program scale-up. Australian and New Zealand Clinical Trial Registry ACTRN 12612000115831 [ http://www.anzctr.org.au/ ].
Baldwin, Constance D; Chandran, Latha; Gusic, Maryellen E
2017-01-01
Multisite and national professional development (PD) programs for educators are challenging to establish. Use of implementation science (IS) frameworks designed to convert evidence-based intervention methods into effective health care practice may help PD developers translate proven educational methods and models into successful, well-run programs. Implementation of the national Educational Scholars Program (ESP) is used to illustrate the value of the IS model. Four adaptable elements of IS are described: (1) replication of an evidence-based model, (2) systematic stages of implementation, (3) management of implementation using three implementation drivers, and (4) demonstration of program success through measures of fidelity to proven models and sustainability. Implementation of the ESP was grounded on five established principles and methods for successful PD. The process was conducted in four IS stages over 10 years: Exploration, Installation, Initial Implementation, and Full Implementation. To ensure effective and efficient processes, attention to IS implementation drivers helped to manage organizational relationships, build competence in faculty and scholars, and address leadership challenges. We describe the ESP's fidelity to evidence-based structures and methods, and offer three examples of sustainability efforts that enabled achievement of targeted program outcomes, including academic productivity, strong networking, and career advancement of scholars. Application of IS frameworks to program implementation may help other PD programs to translate evidence-based methods into interventions with enhanced impact. A PD program can follow systematic developmental stages and be operationalized by practical implementation drivers, thereby creating successful and sustainable interventions that promote the academic vitality of health professions educators.
Implementing a centralized institutional peer tutoring program.
Gaughf, Natalie White; Foster, Penni Smith
2016-01-01
Peer tutoring has been found to be beneficial to both students and peer tutors in health sciences education programs. This article describes the implementation of a centralized, institutional peer tutoring program at the University of Mississippi Medical Center, an academic health science center in the U.S. The Program: This multispecialty peer tutoring program paired students experiencing academic difficulties with peer tutors who showed prior academic success, professionalism and effective communication skills. The program allowed students and peer tutors to coordinate their own tutoring services. Evaluations by both students and peer tutors showed satisfaction with the program. Recommendations for developing and implementing an effective peer tutoring program are presented, including utilization of an online system, consistent program policy with high professionalism expectations, funding, program evaluation and data tracking.
Weaver, Robert G; Moore, Justin B; Turner-McGrievy, Brie; Saunders, Ruth; Beighle, Aaron; Khan, M Mahmud; Chandler, Jessica; Brazendale, Keith; Randell, Allison; Webster, Collin; Beets, Michael W
2017-08-01
The YMCA of USA has adopted Healthy Eating and Physical Activity (HEPA) Standards for its afterschool programs (ASPs). Little is known about strategies YMCA ASPs are implementing to achieve Standards and these strategies' effectiveness. (1) Identify strategies implemented in YMCA ASPs and (2) evaluate the relationship between strategy implementation and meeting Standards. HEPA was measured via accelerometer (moderate-to-vigorous-physical-activity [MVPA]) and direct observation (snacks served) in 20 ASPs. Strategies were identified and mapped onto a capacity building framework ( Strategies To Enhance Practice [STEPs]). Mixed-effects regression estimated increases in HEPA outcomes as implementation increased. Model-implied estimates were calculated for high (i.e., highest implementation score achieved), moderate (median implementation score across programs), and low (lowest implementation score achieved) implementation for both HEPA separately. Programs implemented a variety of strategies identified in STEPs. For every 1-point increase in implementation score 1.45% (95% confidence interval = 0.33% to 2.55%, p ≤ .001) more girls accumulated 30 min/day of MVPA and fruits and/or vegetables were served on 0.11 more days (95% confidence interval = 0.11-0.45, p ≤ .01). Relationships between implementation and other HEPA outcomes did not reach statistical significance. Still regression estimates indicated that desserts are served on 1.94 fewer days (i.e., 0.40 vs. 2.34) in the highest implementing program than the lowest implementing program and water is served 0.73 more days (i.e., 2.37 vs. 1.64). Adopting HEPA Standards at the national level does not lead to changes in routine practice in all programs. Practical strategies that programs could adopt to more fully comply with the HEPA Standards are identified.
Kam, Chi-Ming; Greenberg, Mark T; Walls, Carla T
2003-03-01
In order for empirically validated school-based prevention programs to "go to scale," it is important to understand the processes underlying program dissemination. Data collected in effectiveness trials, especially those measuring the quality of program implementation and administrative support, are valuable in explicating important factors influencing implementation. This study describes findings regarding quality of implementation in a recent effectiveness trial conducted in a high-risk, American urban community. This delinquency prevention trial is a locally owned intervention, which used the Promoting Alternative THinking Skills Curriculum as its major program component. The intervention involved 350 first graders in 6 inner-city public schools. Three schools implemented the intervention and the other 3 were comparison schools from the same school district. Although intervention effects were not found for all the intervention schools, the intervention was effective in improving children's emotional competence and reducing their aggression in schools which effectively supported the intervention. This study, utilizing data from the 3 intervention schools (13 classrooms and 164 students), suggested that 2 factors contributed to the success of the intervention: (a) adequate support from school principals and (b) high degree of classroom implementation by teachers. These findings are discussed in light of the theory-driven models in program evaluation that emphasized the importance of the multiple factors influencing the implementation of school-based interventions.
The Role of the Principal in the Implementation of a Gifted Education Program in a School.
ERIC Educational Resources Information Center
Taylor, C. A.
1987-01-01
The degree to which a principal provides appropriate and sufficient support for implementation of a gifted education program will determine the success of the program. Actions that can facilitate implementation, teacher use, and institutionalization and the effects of various managerial styles are discussed. Components of a gifted program are…
ERIC Educational Resources Information Center
Waruwu, Binahati; Sitompul, Harun; Manullang, Belferik
2016-01-01
The purposes of this study are to find out the significant effect of: (1) EEA on strategy implementation, (2) IEA on strategy implementation, (3) EEA on study program performance, (4) IEA on study program performance, and (5) strategy implementation on study program performance of Vocational High School (VHS) in Nias Archipelago. The population of…
Parent Experience of Implementing Effective Home Programs
ERIC Educational Resources Information Center
Novak, Iona
2011-01-01
The aim of this preliminary study was to describe parent views about implementing effective home programs to inform practice recommendations. Semi-structured interviews were conducted with 10 parents of children with cerebral palsy (2 fathers and 8 mothers) who had participated in a home program by using a partnership-based approach. Transcripts…
Siegel, Michael
2002-01-01
In 2001, nearly one billion dollars will be spent on statewide tobacco control programs, including those in California, Massachusetts, Arizona, and Oregon, funded by cigarette tax revenues, and the program in Florida, funded by the state's settlement with the tobacco industry. With such large expenditures, it is imperative to find out whether these programs are working. This paper reviews the effectiveness of the statewide tobacco control programs in California, Massachusetts, Arizona, Oregon, and Florida. It focuses on two aspects of process evaluation--the funding and implementation of the programs and the tobacco industry's response, and four elements of outcome evaluation--the programs' effects on cigarette consumption, adult and youth smoking prevalence, and protection of the public from secondhand smoke. The paper formulates general lessons learned from these existing programs and generates recommendations to improve and inform the development and implementation of these and future programs.
Gunning, Melissa; Sun, Ping; Sussman, Steve
2009-01-01
One of the important research issues in the emerging area of research on dissemination of prevention programs relates to the type and extent of training needed by program providers to prepare them to implement effective programs with fidelity. The present paper describes the immediate outcomes of a dissemination and implementation trial of Project Toward No Drug Abuse, an evidence-based prevention program for high school students. A total of 65 high schools in 14 school districts across the USA were recruited and randomly assigned to one of three experimental conditions: comprehensive implementation support for teachers, regular workshop training only, or standard care control. The comprehensive intervention was comprised of on-site coaching, web-based support, and technical assistance, in addition to the regular workshop. Students (n=2,983) completed self-report surveys before and immediately after program implementation. Fidelity of implementation was assessed with a classroom observation procedure that focused on program process. Results indicated that relative to the controls, both intervention conditions produced effects on hypothesized program mediators, including greater gains in program-related knowledge; greater reductions in cigarette, marijuana and hard drug use intentions; and more positive changes in drug-related beliefs. There were stronger effects on implementation fidelity in the comprehensive, relative to the regular, training condition. However, seven of the ten immediate student outcome measures showed no significant differences between the two training conditions. The implications of these findings for dissemination research and practice are discussed. PMID:19757052
Rohrbach, Louise Ann; Gunning, Melissa; Sun, Ping; Sussman, Steve
2010-03-01
One of the important research issues in the emerging area of research on dissemination of prevention programs relates to the type and extent of training needed by program providers to prepare them to implement effective programs with fidelity. The present paper describes the immediate outcomes of a dissemination and implementation trial of Project Toward No Drug Abuse, an evidence-based prevention program for high school students. A total of 65 high schools in 14 school districts across the USA were recruited and randomly assigned to one of three experimental conditions: comprehensive implementation support for teachers, regular workshop training only, or standard care control. The comprehensive intervention was comprised of on-site coaching, web-based support, and technical assistance, in addition to the regular workshop. Students (n = 2,983) completed self-report surveys before and immediately after program implementation. Fidelity of implementation was assessed with a classroom observation procedure that focused on program process. Results indicated that relative to the controls, both intervention conditions produced effects on hypothesized program mediators, including greater gains in program-related knowledge; greater reductions in cigarette, marijuana and hard drug use intentions; and more positive changes in drug-related beliefs. There were stronger effects on implementation fidelity in the comprehensive, relative to the regular, training condition. However, seven of the ten immediate student outcome measures showed no significant differences between the two training conditions. The implications of these findings for dissemination research and practice are discussed.
ERIC Educational Resources Information Center
van Lieshout, Sanne; Mevissen, Fraukje; de Waal, Esri; Kok, Gerjo
2017-01-01
Schools are a common setting for adolescents to receive health education, but implementation of these programs with high levels of completeness and fidelity is not self-evident. Programs that are only partially implemented (completeness) or not implemented as instructed (fidelity) are unlikely to be effective. Therefore, it is important to…
Dent, Clyde W.; Skara, Silvana; Sun, Ping; Sussman, Steve
2011-01-01
This paper presents the results of an effectiveness trial of Project Towards No Drug Abuse [TND], in which we compared program delivery by regular classroom teachers and program specialists within the same high schools. Within 18 schools that were randomly assigned to the program or control conditions, health classrooms were assigned to program delivery by teachers or (outside) specialists. Classroom sessions were observed by pairs of observers to assess three domains of implementation fidelity: adherence, classroom process, and perceived student acceptance of the program. Pre- and immediate posttest survey data were collected from 2331 students. Of the four composite indexes of implementation fidelity that were examined, only one (quality of delivery) showed a difference between specialists and teachers, with marginally higher ratings of specialists (p < .10). Both teachers and program specialists achieved effects on three of the five immediate outcome measures, including program-specific knowledge, addiction concern, and social self-control. Students’ posttest ratings of the program overall and the quality of program delivery failed to reveal differences between the teacher- and specialist-led classrooms. These results suggest that motivated, trained classroom teachers can implement evidence-based prevention programs with fidelity and achieve immediate effects. PMID:17180722
2011-01-01
Background Even effective interventions for people with dementia and their caregivers require specific implementation efforts. A pilot study showed that the highly effective community occupational therapy in dementia (COTiD) program was not implemented optimally due to various barriers. To decrease these barriers and make implementation of the program more effective a combined implementation (CI) strategy was developed. In our study we will compare the effectiveness of this CI strategy with the usual educational (ED) strategy. Methods In this cluster randomized, single-blinded, controlled trial, each cluster consists of at least two occupational therapists, a manager, and a physician working at Dutch healthcare organizations that deliver community occupational therapy. Forty-five clusters, stratified by healthcare setting (nursing home, hospital, mental health service), have been allocated randomly to either the intervention group (CI strategy) or the control group (ED strategy). The study population consists of the professionals included in each cluster and community-dwelling people with dementia and their caregivers. The primary outcome measures are the use of community OT, the adherence of OTs to the COTiD program, and the cost effectiveness of implementing the COTiD program in outpatient care. Secondary outcome measures are patient and caregiver outcomes and knowledge of managers, physicians and OTs about the COTiD program. Discussion Implementation research is fairly new in the field of occupational therapy, making this a unique study. This study does not only evaluate the effects of the CI-strategy on professionals, but also the effects of professionals' degree of implementation on client and caregiver outcomes. Clinical trials registration NCT01117285 PMID:21450063
ERIC Educational Resources Information Center
Pagano, Paul Gregory
2009-01-01
Purpose. The purposes of this study were to compare the perceptions of public middle school AVID and Non-AVID teachers regarding (a) their partnership in the AVID program, (b) the effectiveness of AVID program implementation, and (c) the factors that impede or facilitate AVID program implementation. Methodology. A descriptive, ex post facto…
Directions in implementation research methods for behavioral and social science.
Irwin, Molly; Supplee, Lauren H
2012-10-01
There is a growing interest, by researchers, policymakers, and practitioners, in evidence-based policy and practice. As a result, more dollars are being invested in program evaluation in order to establish "what works," and in some cases, funding is specifically tied to those programs found to be effective. However, reproducing positive effects found in research requires more than simply adopting an evidence-based program. Implementation research can provide guidance on which components of an intervention matter most for program impacts and how implementation components can best be implemented. However, while the body of rigorous research on effective practices continues to grow, research on implementation lags behind. To address these issues, the Administration for Children and Families and federal partners convened a roundtable meeting entitled, Improving Implementation Research Methods for Behavioral and Social Science, in the fall of 2010. This special section of the Journal of Behavioral Health Services & Research includes papers from the roundtable and highlights the role implementation science can play in shedding light on the difficult task of taking evidence-based practices to scale.
Laws, R; Hesketh, K D; Ball, K; Cooper, C; Vrljic, K; Campbell, K J
2016-08-08
While there is a growing interest in the field of research translation, there are few published examples of public health interventions that have been effectively scaled up and implemented in the community. This paper provides a case study of the community-wide implementation of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT), an obesity prevention program for parents with infants aged 3-18 months. The study explored key factors influencing the translation of the Program into routine practice and the respective role of policy makers, researchers and implementers. Case studies were conducted of five of the eight prevention areas in Victoria, Australia who implemented the Program. Cases were selected on the basis of having implemented the Program for 6 months or more. Data were collected from January to June 2015 and included 18 individual interviews, one focus group and observation of two meetings. A total of 28 individuals, including research staff (n = 4), policy makers (n = 2) and implementers (n = 22), contributed to the data collected. Thematic analysis was conducted using cross case comparisons and key themes were verified through member checking. Key facilitators of implementation included availability of a pre-packaged evidence based program addressing a community need, along with support and training provided by research staff to local implementers. Partnerships between researchers and policy makers facilitated initial program adoption, while local partnerships supported community implementation. Community partnerships were facilitated by local coordinators through alignment of program goals with existing policies and services. Workforce capacity for program delivery and administration was a challenge, largely overcome by embedding the Program into existing roles. Adapting the Program to fit local circumstance was critical for feasible and sustainable delivery, however balancing this with program fidelity was a critical issue. The lack of ongoing funding to support translation activities was a barrier for researchers continued involvement in community implementation. Policy makers, researchers and practitioners have important and complementary roles to play in supporting the translation of effective research interventions into practice. New avenues need to be explored to strengthen partnerships between researchers and end users to support the integration of effective public health research interventions into practice.
Provost, Sylvie; Pineault, Raynald; Tousignant, Pierre; Hamel, Marjolaine; Da Silva, Roxane Borgès
2011-11-10
The goal of this project is to evaluate the implementation of an integrated and interdisciplinary program for prevention and management of cardiometabolic risk (PCMR). The intervention is based on the Chronic Care Model. The study will evaluate the implementation of the PCMR in 6 of the 12 health and social services centres (CSSS) in Montréal, and the effects of the PCMR on patients and the practice of their primary care physicians up to 40 months following implementation, as well as the sustainability of the program. Objectives are: 1-to evaluate the effects of the PCMR and their persistence on patients registered in the program and the practice of their primary care physicians, by implementation site and degree of exposure to the program; 2-to assess the degree of implementation of PCMR in each CSSS territory and identify related contextual factors; 3-to establish the relationships between the effects observed, the degree of PCMR implementation and the related contextual factors; 4-to assess the impact of the PCMR on strengthening local services networks. The evaluation will use a mixed design that includes two complementary research strategies. The first strategy is similar to a quasi-experimental "before-after" design, based on a quantitative approach; it will look at the program's effects and their variations among the six territories. The effects analysis will use data from a clinical database and from questionnaires completed by participating patients and physicians. Over 3000 patients will be recruited. The second strategy corresponds to a multiple case study approach, where each of the six CSSS constitutes a case. With this strategy, qualitative methods will set out the context of implementation using data from semi-structured interviews with program managers. The quantitative data will be analyzed using linear or multilevel models complemented with an interpretive approach to qualitative data analysis. Our study will identify contextual factors associated with the effectiveness, successful implementation and sustainability of such a program. The contextual information will enable us to extrapolate our results to other contexts with similar conditions. ClinicalTrials.gov: NCT01326130.
Designing, testing, and implementing a sustainable nurse home visiting program: right@home.
Goldfeld, Sharon; Price, Anna; Kemp, Lynn
2018-05-01
Nurse home visiting (NHV) offers a potential platform to both address the factors that limit access to services for families experiencing adversity and provide effective interventions. Currently, the ability to examine program implementation is hampered by a lack of detailed description of actual, rather than expected, program development and delivery in published studies. Home visiting implementation remains a black box in relation to quality and sustainability. However, previous literature would suggest that efforts to both report and improve program implementation are vital for NHV to have population impact and policy sustainability. In this paper, we provide a case study of the design, testing, and implementation of the right@home program, an Australian NHV program and randomized controlled trial. We address existing gaps related to implementation of NHV programs by describing the processes used to develop the program to be trialed, summarizing its effectiveness, and detailing the quality processes and implementation evaluation. The weight of our evidence suggests that NHV can be a powerful and sustainable platform for addressing inequitable outcomes, particularly when the program focuses on parent engagement and partnership, delivers evidence-based strategies shown to improve outcomes, includes fidelity monitoring, and is adapted to and embedded within existing service delivery systems. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.
Rugs, Deborah; Toyinbo, Peter; Patel, Nitin; Powell-Cope, Gail; Hahm, Bridget; Elnitsky, Christine; Besterman-Dahan, Karen; Campbell, Robert; Sutton, Bryce
2013-11-18
Health care workers, such as nurses, nursing aides, orderlies, and attendants, who manually move patients, are consistently listed in the top professions for musculoskeletal injuries (MSIs) by the Bureau of Labor Statistics. These MSIs are typically caused by high-risk patient caregiving activities. In 2008, a safe patient handling (SPH) program was implemented in all 153 Veterans Administration Medical Centers (VAMCs) throughout the United States to reduce patient handling injuries. The goal of the present study is to evaluate the effects associated with the national implementation of a comprehensive SPH program. The primary objectives of the research were to determine the effectiveness of the SPH program in improving direct care nursing outcomes and to provide a context for understanding variations in program results across sites over time. Secondary objectives of the present research were to evaluate the effectiveness of the program in reducing direct and indirect costs associated with patient handling, to explore the potential mediating and moderating mechanisms, and to identify unintended consequences of implementing the program. This 3-year longitudinal study used mixed methods of data collection at 6- to 9-month intervals. The analyses will include data from surveys, administrative databases, individual and focus group interviews, and nonparticipant observations. For this study, a 3-tiered measurement plan was used. For Tier 1, the unit of analysis was the facility, the data source was the facility coordinator or administrative data, and all 153 VAMCs participated. For Tier 2, frontline caregivers and program peer leaders at 17 facilities each completed different surveys. For Tier 3, six facilities completed qualitative site visits, which included individual interviews, focus groups, and nonparticipant observations. Multiple regression models were proposed to test the effects of SPH components on nursing outcomes related to patient handling. Content analysis and constant comparative analysis were proposed for qualitative data analysis to understand the context of implementation and to triangulate quantitative data. All three tiers of data for this study have been collected. We are now in the analyses and writing phase of the project, with the possibility for extraction of additional administrative data. The focus of this paper is to describe the SPH program, its evaluation study design, and its data collection procedures. This study evaluates the effects associated with the national implementation of a comprehensive SPH program that was implemented in all 153 VAMCs throughout the United States to reduce patient handling injuries. To our knowledge, this is the largest evaluation of an SPH program in the United States. A major strength of this observational study design is that all VAMCs implemented the program and were included in Tier 1 of the study; therefore, population sampling bias is not a concern. Although the design lacks a comparison group for testing program effects, this longitudinal field study design allows for capturing program dose-response effects within a naturalistic context. Implementation of the VA-wide SPH program afforded the opportunity for rigorous evaluation in a naturalistic context. Findings will guide VA operations for policy and decision making about resources, and will be useful for health care, in general, outside of the VA, in implementation and impact of an SPH program.
ERIC Educational Resources Information Center
Fernando, Sheara
2010-01-01
The success of an implementation effort depends on the ability for a system to utilize the innovation effectively; the effective usage of an innovation can be determined by monitoring for program integrity and fidelity, and assessing the degree to which the program implementation matches the intended plan (Fixsen, Blase, Horner, & Sugai 2007). The…
ERIC Educational Resources Information Center
Hussey, David L.; Flannery, Daniel J.
2007-01-01
In 2004, Second Step (Committee for Children, 2002), a violence prevention program, was implemented in the Cleveland Heights-University Heights school district for 1,416 K through second grade students. Both process and outcome measures were used to evaluate program impact and examine issues related to the implementation and evaluation of…
ERIC Educational Resources Information Center
Jowers, Keri L.; Bradshaw, Catherine P.; Gately, Sherry
2007-01-01
Public schools are under increased pressure to implement evidence-based substance abuse prevention programs. A number of model programs have been identified, but little research has examined the effectiveness of these programs when "brought to scale" or implemented district-wide. The current paper summarizes the application of the Adelman and…
Nurses' perceptions of nurse residency: identifying barriers to implementation.
Wierzbinski-Cross, Heather; Ward, Kristin; Baumann, Paula
2015-01-01
The purpose of this project was to describe the benefits and components of successful nurse residency programs, as well as gain insight into the perceptions of staff nurses, nurse educators, and nurse leaders regarding value, feasibility, and barriers to implementing nurse residency programs in acute care settings. This study has important implications for implementing an effective residency program.
ERIC Educational Resources Information Center
Fox, Lise; Veguilla, Myrna; Perez Binder, Denise
2014-01-01
The Technical Assistance Center on Social Emotional Intervention for Young Children (TACSEI) Roadmap on "Data Decision-Making and Program-Wide Implementation of the Pyramid Model" provides programs with guidance on how to collect and use data to ensure the implementation of the Pyramid Model with fidelity and decision-making that…
An Effective Model for Improving Global Health Nursing Competence.
Kang, Sun-Joo
2016-01-01
This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students' needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students' reflective journals was examined. Additionally, students' awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre- and post-program implementation. The importance of identifying students' needs regarding global nursing competence when developing appropriate curricula is discussed.
Conte, Kathleen P; Marie Harvey, S; Turner Goins, R
2017-12-01
The need to scale-up effective arthritis self-management programs is pressing as the prevalence of arthritis increases. The CDC Arthritis Program funds state health departments to work with local delivery systems to embed arthritis programs into their day-to-day work. To encourage organizational ownership and sustainability of programs, funding is restricted to offset program start-up costs. The purpose of this study was to identify factors that impacted the success of implementing an evidence-based arthritis self-management program, funded by the CDC Arthritis Program, into the Oregon Extension Service. We interviewed staff and partners involved in implementation who had and had not successfully delivered Walk With Ease (N = 12) to identify barriers and facilitators to scaling-up. Document analysis of administrative records was used to triangulate and expand on findings. Delivery goals defined by the funder were not met in Year 1: only 3 of the expected 28 programs were delivered. Barriers to implementation included insufficient planning for implementation driven by pressure to deliver programs and insufficient resources to support staff time. Facilitators included centralized administration of key implementation activities and staffs' previous experience implementing new programs. The importance of planning and preparing for implementation cannot be overlooked. Funders, however, eager to see deliverables, continue to define implementation goals in terms of program reach, exclusive of capacity-building. Lack of capacity-building can jeopardize staff buy-in, implementation quality, and sustainability. Based on our findings coupled with support from implementation literature, we offer recommendations for future large-scale implementation efforts operating under such funding restrictions.
75 FR 6131 - Proposed Processed Raspberry Promotion, Research, and Information Order
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-08
... promotion, research, and information program for processed raspberries. The proposed program, Processed... be exempt from the assessment. The proposed program would be implemented under the Commodity... implementation of the program prior to it going into effect. In addition, USDA is announcing that the referendum...
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-31
... Deterioration (PSD) Program; Massachusetts; Announcing Delegation Agreement Between EPA and Massachusetts... authority to implement and enforce the Federal Prevention of Significant Deterioration (PSD) program to the MassDEP. Therefore, effective that date, MassDEP is the implementing authority for the PSD program in...
Dariotis, Jacinda K.; Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Gould, Laura Feagans; Greenberg, Mark T.; Mendelson, Tamar
2016-01-01
Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators – students and their classroom teachers – merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings. PMID:28670007
Dariotis, Jacinda K; Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Gould, Laura Feagans; Greenberg, Mark T; Mendelson, Tamar
2017-01-01
Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators - students and their classroom teachers - merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings.
American Pharmacists Association; Bough, Marcie
2011-01-01
To develop an improved risk evaluation and mitigation strategies (REMS) system for maximizing effective and safe patient medication use while minimizing burden on the health care delivery system. 34 stakeholders gathered October 6-7, 2010, in Arlington, VA, for the REMS Stakeholder Meeting, convened by the American Pharmacists Association (APhA). Participants included national health care provider associations, including representatives for physicians, physician assistants, nurses, nurse practitioners, and pharmacists, as well as representatives for patient advocates, drug distributors, community pharmacists (chain and independent), drug manufacturer associations (brand, generic, and biologic organizations), and health information technology, standards, and safety organizations. Staff from the Food and Drug Administration (FDA) Center for Drug Evaluation and Research participated as observers. The meeting built on themes from the APhA's 2009 REMS white paper. The current REMS environment presents many challenges for health care providers due to the growing number of REMS programs and the lack of standardization or similarities among various REMS programs. A standardized REMS process that focuses on maximizing patient safety and minimizing impacts on patient access and provider implementation could offset these challenges. A new process that includes effective provider interventions and standardized tools and systems for implementing REMS programs may improve patient care and overcome some of the communication issues providers and patients currently face. Metrics could be put in place to evaluate the effectiveness of REMS elements. By incorporating REMS program components into existing technologies and data infrastructures, achieving REMS implementation that is workflow neutral and minimizes administrative burden may be possible. An appropriate compensation model could ensure providers have adequate resources for patient care and REMS implementation. Overall, stakeholders should continue to work collaboratively with FDA and manufacturers to improve REMS program design and implementation issues. A workable REMS system will require effective patient interventions, standardized elements that limit barriers to implementation for both patients and providers, standardized yet flexible implementation strategies, use of existing technologies in practice settings, increased opportunities for provider input early in REMS design processes, improved communication strategies and awareness of program requirements, and viable provider compensation models needed to offset costs to implement and comply with REMS program requirements.
Strengthening 4-H Program Communication through Technology
ERIC Educational Resources Information Center
Robideau, Kari; Santl, Karyn
2011-01-01
Advances in technology are transforming how youth and parents interact with programs. The Strengthening 4-H Communication through Technology project was implemented in eight county 4-H programs in Northwest Minnesota. This article outlines the intentional process used to effectively implement technology in program planning. The project includes:…
Gordon, Chloe S; Kervin, Lisa K; Jones, Sandra C; Howard, Steven J
2017-02-02
Alcohol media literacy programs seek to mitigate the potentially harmful effects of alcohol advertising on children's drinking intentions and behaviours through equipping them with skills to challenge media messages. In order for such programs to be effective, the teaching and learning experiences must be tailored to their specific cultural context. Media in the Spotlight is an alcohol media literacy program aimed at 9 to 12 year old Australian children. This study evaluates the process and implementation of the program, outlining the factors that facilitated and inhibited implementation. From this evaluation, a pedagogical framework has been developed for health professionals implementing culturally responsive programs in school settings. Process measures included: semi-structured interviews with teachers before and after the program was implemented (n = 11 interviews), program evaluation questionnaires completed by children (n = 166), lesson observations completed by teachers (n = 35 observations), and reflective journal entries completed by the researcher (n = 44 entries). A thematic analysis approach was used to analyse all of the data sets using NVivo. Inductive coding was used, whereby the findings were derived from the research objectives and multiple readings and interpretations of the data. Five key pedagogical considerations were identified that facilitated implementation. These were: connecting to the students' life worlds to achieve cultural significance; empowering students with real-world skills to ensure relevance; ensuring programs are well structured with strong connections to the school curriculum; creating developmentally appropriate activities while providing a range of assessment opportunities; and including hands-on and interactive activities to promote student engagement. Three potential inhibitors to implementing the alcohol media literacy program in upper-elementary school classrooms were identified. These included topic sensitivities, classroom management challenges, and fitting new programs into already busy school schedules. Overall, the program content and individual lessons were well received by the teachers and students. The lessons learned from the development, implementation and evaluation of this program can provide health professionals with key pedagogical strategies for designing culturally responsive educational programs. Culturally responsive programs are critical for ensuring interventions are effective for their specific context.
Ingabire, Willy; Reine, Petera M; Hedt-Gauthier, Bethany L; Hirschhorn, Lisa R; Kirk, Catherine M; Nahimana, Evrard; Nepomscene Uwiringiyemungu, Jean; Ndayisaba, Aphrodis; Manzi, Anatole
2015-12-01
Implementation lessons: (1) implementation of an effective quality improvement and patient safety program in a rural hospital setting requires collaboration between hospital leadership, Ministry of Health and other stakeholders. (2) Building Quality Improvement (QI) capacity to develop engaged QI teams supported by mentoring can improve quality and patient safety. Copyright © 2015 Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Haycock, Ken; Cavill, Pat
This case study examined: (1) what market research is required for planning for the implementation of "Information Power: Building Partnerships for Learning," the 1998 national guidelines for effective school library media programs; (2) what issues need to be addressed and what target audiences are required to effect change, as well as…
Implementation Processes and Pay for Performance in Healthcare: A Systematic Review.
Kondo, Karli K; Damberg, Cheryl L; Mendelson, Aaron; Motu'apuaka, Makalapua; Freeman, Michele; O'Neil, Maya; Relevo, Rose; Low, Allison; Kansagara, Devan
2016-04-01
Over the last decade, various pay-for-performance (P4P) programs have been implemented to improve quality in health systems, including the VHA. P4P programs are complex, and their effects may vary by design, context, and other implementation processes. We conducted a systematic review and key informant (KI) interviews to better understand the implementation factors that modify the effectiveness of P4P. We searched PubMed, PsycINFO, and CINAHL through April 2014, and reviewed reference lists. We included trials and observational studies of P4P implementation. Two investigators abstracted data and assessed study quality. We interviewed P4P researchers to gain further insight. Among 1363 titles and abstracts, we selected 509 for full-text review, and included 41 primary studies. Of these 41 studies, 33 examined P4P programs in ambulatory settings, 7 targeted hospitals, and 1 study applied to nursing homes. Related to implementation, 13 studies examined program design, 8 examined implementation processes, 6 the outer setting, 18 the inner setting, and 5 provider characteristics. Results suggest the importance of considering underlying payment models and using statistically stringent methods of composite measure development, and ensuring that high-quality care will be maintained after incentive removal. We found no conclusive evidence that provider or practice characteristics relate to P4P effectiveness. Interviews with 14 KIs supported limited evidence that effective P4P program measures should be aligned with organizational goals, that incentive structures should be carefully considered, and that factors such as a strong infrastructure and public reporting may have a large influence. There is limited evidence from which to draw firm conclusions related to P4P implementation. Findings from studies and KI interviews suggest that P4P programs should undergo regular evaluation and should target areas of poor performance. Additionally, measures and incentives should align with organizational priorities, and programs should allow for changes over time in response to data and provider input.
ERIC Educational Resources Information Center
Renville, Gary
1999-01-01
Describes the positive mental, physical, and social growth impacts that the camping experience had on the author, and urges camp program evaluation to plan and implement such changes. Sidebar lists steps of effective evaluation: program goals and objectives, goals of evaluation, implementation of evaluation, data analysis, and findings and…
Beidas, Rinad S.; Paciotti, Breah; Barg, Fran; Branas, Andrea R.; Brown, Justin C.; Glanz, Karen; DeMichele, Angela; DiGiovanni, Laura; Salvatore, Domenick
2014-01-01
Background The primary aims of this hybrid Type 1 effectiveness-implementation trial were to quantitatively assess whether an evidence-based exercise intervention for breast cancer survivors, Strength After Breast Cancer, was safe and effective in a new setting and to qualitatively assess barriers to implementation. Methods A cohort of 84 survivors completed measurements related to limb volume, muscle strength, and body image at baseline, 67 survivors completed measurements 12 months later. Qualitative methods were used to understand barriers to implementation experienced by referring oncology clinicians and physical therapists who delivered the program. Results Similar to the efficacy trial, the revised intervention demonstrated safety with regard to lymphedema, and led to improvements in lymphedema symptoms, muscular strength, and body image. Comparison of effects in the effectiveness trial to effects in the efficacy trial revealed larger strength increases in the efficacy trial than in the effectiveness trial (P < .04), but few other differences were found. Qualitative implementation data suggested significant barriers around intervention characteristics, payment, eligibility criteria, the referral process, the need for champions (ie, advocates), and the need to adapt during implementation of the intervention, which should be considered in future dissemination and implementation efforts. Conclusions This trial successfully demonstrated that a physical therapy led strength training program for breast cancer survivors can be implemented in a community setting while retaining the effectiveness and safety of the clinical trial. However, during the translation process, strategies to reduce barriers to implementation are required. This new program can inform larger scale dissemination and implementation efforts. PMID:25749601
Schutte, Lisette; van den Borne, Marieke; Kok, Gerjo; Meijer, Suzanne; Mevissen, Fraukje Ef
2016-07-12
Full program implementation is crucial for effectiveness but is often overlooked or insufficiently considered during development of behavioral change interventions. For school-based health promotion programs, teachers are key players in program implementation, but teacher support in this phase is mostly limited to technical support and information. To ensure optimal implementation of the Dutch school-based sexual health program Long Live Love, a Web-based coaching website was developed to support teachers in completeness and fidelity of program implementation. The aim of this paper is to provide insight into the process of systematic development of a Web-based coaching intervention to support teachers in their implementation of a school-based sexual health program. The intervention mapping (IM) protocol was applied for the development of a theory- and evidence-based intervention. The IM process begins with (1) a needs assessment, followed by (2) the formulation of change objectives, (3) the selection of theory-based intervention methods and practical applications that take the parameters for effectiveness into consideration, (4) integration of practical applications into an organized program, (5) planning for adoption, implementation, and sustainability of the program, and finally, (6) generating an evaluation plan to measure program effectiveness. Teacher's implementation behavior was characterized by inconsistently selecting parts of the program and not delivering (all) lessons as intended by program developers. Teachers, however, did not perceive this behavior as problematic, revealing the discrepancy between teacher's actual and perceived need for support in delivering Long Live Love lessons with completeness and fidelity. Teachers did, however, acknowledge different difficulties they encountered which could potentially negatively influence the quality of implementation. With the IM protocol, this Web-based coaching intervention was developed based on a concept of unobtrusive coaching, by and for teachers, to bring about change in teachers' implementation behavior. This paper provides an example of a Web-based intervention to bring about behavioral change in a target group of intermediaries who lack intrinsic motivation for coaching and who's perceptions differ from their actual problematic behavior. The IM protocol is a useful tool for guiding the scientific development of interventions and making them compatible with the needs and preferences of the target group.
Kok, Gerjo; Meijer, Suzanne; Mevissen, Fraukje EF
2016-01-01
Background Full program implementation is crucial for effectiveness but is often overlooked or insufficiently considered during development of behavioral change interventions. For school-based health promotion programs, teachers are key players in program implementation, but teacher support in this phase is mostly limited to technical support and information. To ensure optimal implementation of the Dutch school-based sexual health program Long Live Love, a Web-based coaching website was developed to support teachers in completeness and fidelity of program implementation. Objective The aim of this paper is to provide insight into the process of systematic development of a Web-based coaching intervention to support teachers in their implementation of a school-based sexual health program. Methods The intervention mapping (IM) protocol was applied for the development of a theory- and evidence-based intervention. The IM process begins with (1) a needs assessment, followed by (2) the formulation of change objectives, (3) the selection of theory-based intervention methods and practical applications that take the parameters for effectiveness into consideration, (4) integration of practical applications into an organized program, (5) planning for adoption, implementation, and sustainability of the program, and finally, (6) generating an evaluation plan to measure program effectiveness. Results Teacher’s implementation behavior was characterized by inconsistently selecting parts of the program and not delivering (all) lessons as intended by program developers. Teachers, however, did not perceive this behavior as problematic, revealing the discrepancy between teacher’s actual and perceived need for support in delivering Long Live Love lessons with completeness and fidelity. Teachers did, however, acknowledge different difficulties they encountered which could potentially negatively influence the quality of implementation. With the IM protocol, this Web-based coaching intervention was developed based on a concept of unobtrusive coaching, by and for teachers, to bring about change in teachers’ implementation behavior. Conclusions This paper provides an example of a Web-based intervention to bring about behavioral change in a target group of intermediaries who lack intrinsic motivation for coaching and who’s perceptions differ from their actual problematic behavior. The IM protocol is a useful tool for guiding the scientific development of interventions and making them compatible with the needs and preferences of the target group. PMID:27405241
ERIC Educational Resources Information Center
Austin, Megan J.
2015-01-01
Little is known about the supply side of voucher programs, despite schools' central role in program effectiveness. Using survey and interview data on the Indiana Choice Scholarship Program (ICSP), I analyze schools' participation decisions and early implementation experiences to understand better how schools respond to program regulations. I find…
Stanton, Bonita; Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Mortimer, Arvis; Li, Xiaoming; Marshall, Sharon; Poitier, Maxwell; Adderley, Richard
2015-01-01
More information is needed about factors influencing real-life implementation and program impact of interventions effective in controlled study conditions. Ongoing national implementation of an evidence-based HIV prevention program targeting grade 6 students in The Bahamas offers the opportunity to examine patterns of implementation and relate them to student outcomes. Data were collected from 208 grade 6 teachers, 75 grade 7 teachers and 4,411 grade 6 students followed over two years. Mixed-effects modeling analysis examined the association of teachers’ patterns of implementation with student outcomes. High quality program implementation in grade 6 (high implementation dosage and fidelity) was significantly related to student outcomes six and 18 months post-intervention. Quality of implementation of the booster session in grade 7 was also significantly related to student outcomes in grade 7. Quality of delivery of the brief booster session a year after initial implementation is important in maintaining or resetting the student outcome trajectory. PMID:26093781
Kolovelonis, Athanasios; Goudas, Marios; Theodorakis, Yannis
2016-11-01
The aim of the study was to examine the effectiveness of the smoking prevention program "I do not smoke, I exercise" implemented with elementary and secondary school students. "I do not smoke, I exercise" is a theory-based smoking prevention program that promotes exercise as an alternative of smoking. The program consists of eight sessions implemented weekly. Participants were 338 Greek students (135 elementary and 203 secondary students) who were pre- and posttested in smoking, program, and exercise-related measures. The results showed that the program had significant effects on elementary students' attitudes toward smoking, intention to smoke, subjective norms, attitudes toward the application of the program, and knowledge about the health consequences of smoking. For secondary students, significant effects were found on students' perceived behavioral control and knowledge about the health consequences of smoking, while very few students reported a smoking experience before and after the intervention. Therefore the program "I do not smoke, I exercise" may have positive effects on variables related with smoking behavior. Differences in the program's impact on elementary and secondary students were identified. All these are discussed with reference to the need of implementing smoking prevention programs in schools contexts. © 2016 Society for Public Health Education.
Zijlstra, G A R; Du Moulin, M F M T; van Haastregt, J C M; de Jonge, M; Kempen, G I J M; van der Poel, A
2013-12-01
A cognitive behavioral program reduced concerns about falling and related avoidance behavior among older community-dwelling adults in a randomized controlled trial. In the current study we examined the effects and acceptability of the program after nation-wide implementation into home care organizations in The Netherlands. In a one-group pretest-posttest study with data collection before the start of the program and at 2 and 4 months, the effects and acceptability of the program were assessed in 125 community-dwelling older people. The outcomes of the effect evaluation included concerns about falls, related avoidance behavior, falls, fall-related medical attention, feelings of anxiety, symptoms of depression, and loneliness. Pretest-posttest analyses with the Wilcoxon signed-rank test and the paired t-test showed significant improvements at 4 months for concerns about falls, activity avoidance, number of falls in the past 2 months, feelings of anxiety, and symptoms of depression. No significant differences were shown for the other outcomes. After implementation in home care organizations, the outcomes indicate positive program effects on concerns about falls, avoidance behavior, and falls in community-dwelling older people. Given the similarity in results, i.e. between those of the previously performed randomized controlled trial and those of the current pretest-posttest study, we conclude that the program can be successfully implemented in practice. This article is an adjusted, Dutch version of Zijlstra GA, van Haastregt JC, Du Moulin MF, de Jonge MC, van der Poel A, Kempen GI. Effects of the implementation of an evidenc-based program to manage concerns about falls in older adults. The Gerontologist 2013;53(5):839-849; doi: 10.1093/geront/gns142.
Meng, Karin; Peters, Stefan; Faller, Hermann
2017-06-01
To evaluate the effectiveness of a standardized, patient-oriented, biopsychosocial back school after implementation in inpatient orthopedic rehabilitation. A multi-center, quasi-experimental controlled study of patients with low back pain (n=535) was conducted. Patients in the control group received the traditional back school before implementation of the new program (usual care); patients in the intervention group received the new standardized back school after implementation into routine care. Patients' illness knowledge and conduct of back exercises (primary outcomes) and secondary self-management outcomes and treatment satisfaction were obtained at admission, discharge, and 6 and 12 months after rehabilitation. We found a significant small between-group intervention effect on patients' illness knowledge in medium- to long term (6 months: η 2 =0.015; 12 months: η 2 =0.013). There were trends for effects on conduct of back exercises among men (6 and 12 months: η 2 =0.008 both). Furthermore, significant small effects were observed for treatment satisfaction at discharge and physical activity after 6 months. The standardized back school seems to be more effective in certain outcomes than a usual care program despite heterogeneous program implementation. Further dissemination within orthopedic rehabilitation may be encouraged to foster self-management outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.
Interactive electromagnetic launcher simulation
NASA Astrophysics Data System (ADS)
Young, F. J.; Howland, H. R.; Hughes, W. F.; Fikse, D. A.
1982-01-01
The mathematical model, usage, and documentation of an interactive computer simulation for an electromagnetic launcher is presented. The launcher is modeled as an electrical circuit. Three slight variations of the program permit studies of a launcher with (1) rail skin effects, (2) rail skin effects and approximated storage coil skin effects, or (3) neither of these effects. Usage of the program as currently implemented on the Westinghouse R&D Univac 1106 is described, with a sample session shown. The implementation of the program permits rapid scoping of the effects of parameter changes.
ERIC Educational Resources Information Center
Bost, Dana Nannette
2009-01-01
This is a case study of the implementation of 8 VAC 20-542-530(2), a state policy governing the internship component of Virginia principal preparation programs. The purpose of the study was to examine the implementation of the policy and its effectiveness for changing professional practice in Virginia. States hold the responsibility for…
ERIC Educational Resources Information Center
Black, Sally; Washington, Ericka
2008-01-01
The Olweus Bullying Prevention Program (BPP) is an internationally recognized school-based bullying prevention program. This project sought to evaluate pilot implementation of the program in one urban district using fidelity of implementation, bullying incident density (BID), student surveys, and serious incident reports as process and outcome…
MINDFULNESS GOES TO SCHOOL: THINGS LEARNED (SO FAR) FROM RESEARCH AND REAL-WORLD EXPERIENCES.
Semple, Randye J; Droutman, Vita; Reid, Brittany Ann
2017-01-01
Mindfulness-based curricula are being implemented in K-12 schools across the nation. Many of these programs, although well-considered and implemented, have little or no research support for their effectiveness. Recognizing the paucity of published research in this area, a sampling of school-based programs currently being implemented in the schools is reviewed. The programs reviewed are Inner Explorer, Master Mind and Moment Program, Mindfulness and Mind-Body Skills for Children, Mindful Schools, Resilient Kids, Still Quiet Place, Stress Reduction and Mindfulness Curriculum and Mindful Moment , and Wellness and Resilience Program . We offer a summary of research support for each program and discussion of unpublished, mostly qualitative indicators of feasibility, acceptability, efficacy, and effectiveness. Strengths and limitations of each program are described, along with suggestions for bolstering informative and useful research. We encourage researchers, educators, and mindfulness practitioners to work collaboratively to conduct rigorous program evaluations.
MINDFULNESS GOES TO SCHOOL: THINGS LEARNED (SO FAR) FROM RESEARCH AND REAL-WORLD EXPERIENCES
Semple, Randye J.; Droutman, Vita; Reid, Brittany Ann
2016-01-01
Mindfulness-based curricula are being implemented in K-12 schools across the nation. Many of these programs, although well-considered and implemented, have little or no research support for their effectiveness. Recognizing the paucity of published research in this area, a sampling of school-based programs currently being implemented in the schools is reviewed. The programs reviewed are Inner Explorer, Master Mind and Moment Program, Mindfulness and Mind-Body Skills for Children, Mindful Schools, Resilient Kids, Still Quiet Place, Stress Reduction and Mindfulness Curriculum and Mindful Moment, and Wellness and Resilience Program. We offer a summary of research support for each program and discussion of unpublished, mostly qualitative indicators of feasibility, acceptability, efficacy, and effectiveness. Strengths and limitations of each program are described, along with suggestions for bolstering informative and useful research. We encourage researchers, educators, and mindfulness practitioners to work collaboratively to conduct rigorous program evaluations. PMID:28458403
Effective prevention programs for tobacco use.
Pentz, M A
1999-01-01
Several types of prevention programs have shown effects on delaying or reducing youth tobacco use for periods of 1-5 years or more. These are referred to as evidence-based programs. However, they are not widely used. At the same time, with few exceptions, adolescent tobacco use rates have been stable or have increased in the 1990s. The challenge for prevention is to identify critical components shared by effective prevention programs--that is, components most associated with effect, and then to evaluate factors that are most likely to promote adoption, implementation, and diffusion of effective programs across schools and communities in the United States. Effective tobacco prevention programs focus on counteracting social influences on tobacco use, include either direct training of youth in resistance and assertiveness skills or, for policy and community organization interventions, direct or indirect (through adults) training in community activism, and are mainly theory-based, with an emphasis on three levels of theory: (a) personal (attitudes, normative expectations, and beliefs); (b) social (social or group behavior); and/or (c) environmental (communications and diffusion). Program effects increase with the use of booster sessions, standardized implementor training and support, multiple program components, and multiple levels of theory. Overall, multi-component community programs that have a school program as a basis, with supportive parent, media, and community organization components, have shown the most sustained effects on tobacco use. Positive program adoption by the school or community, extent and quality of program implementation, and existence of credible networks of leaders to promote the program are critical for any effect. Research on predictors of adoption, implementation, and diffusion of evidence-based programs is scanty relative to outcome research. In addition, more research is needed on why multi-component programs appear to be most effective, whether effect is related to existing tobacco policies, whether prevention programs have differential effects on youth with different natural trajectories of tobacco use, and whether prevention programs can be used to recruit smokers into cessation programs.
A multifaceted program for improving quality of care in intensive care units: IATROREF study.
Garrouste-Orgeas, Maite; Soufir, Lilia; Tabah, Alexis; Schwebel, Carole; Vesin, Aurelien; Adrie, Christophe; Thuong, Marie; Timsit, Jean Francois
2012-02-01
To test the effects of three multifaceted safety programs designed to decrease insulin administration errors, anticoagulant prescription and administration errors, and errors leading to accidental removal of endotracheal tubes and central venous catheters, respectively. Medical errors and adverse events are associated with increased mortality in intensive care patients, indicating an urgent need for prevention programs. Multicenter cluster-randomized study. One medical intensive care unit in a university hospital and two medical-surgical intensive care units in community hospitals belonging to the Outcomerea Study Group. Consecutive patients >18 yrs admitted from January 2007 to January 2008 to the intensive care units. We tested three multifaceted safety programs vs. standard care in random order, each over 2.5 months, after a 1.5-month observation period. Incidence rates of medical errors/1000 patient-days in the multifaceted safety program and standard-care groups were compared using adjusted hierarchical models. In 2117 patients with 15,014 patient-days, 8520 medical errors (567.5/1000 patient-days) were reported, including 1438 adverse events (16.9%, 95.8/1000 patient-days). The insulin multifaceted safety program significantly decreased errors during implementation (risk ratio 0.65; 95% confidence interval [CI] 0.52-0.82; p = .0003) and after implementation (risk ratio 0.51; 95% CI 0.35-0.73; p = .0004). A significant Hawthorne effect was found. The accidental tube/catheter removal multifaceted safety program decreased errors significantly during implementation (odds ratio [OR] 0.34; 95% CI 0.15-0.81; p = .01]) and nonsignificantly after implementation (OR 1.65; 95% CI 0.78-3.48). The anticoagulation multifaceted safety program was not significantly effective (OR 0.64; 95% CI 0.26-1.59) but produced a significant Hawthorne effect. A multifaceted program was effective in preventing insulin errors and accidental tube/catheter removal. Significant Hawthorne effects occurred, emphasizing the need for appropriately designed studies before definitively implementing strategies. clinicaltrials.gov Identifier: NCT00461461.
Ohinmaa, Arto; Langille, Jessie-Lee; Jamieson, Stuart; Whitby, Caroline; Veugelers, Paul J
2011-01-01
Comprehensive school health (CSH) is increasingly receiving renewed interest as a strategy to improve health and learning. The present study estimates the costs associated with implementing and maintaining CSH. We reviewed the accounting information of all schools in the Annapolis Valley Health Promoting Schools (AVHPS) program in 2008/2009. We considered support for nutrition and physical activity programs by the public system, grants, donations, fundraising and volunteers. The annual public funding to AVHPS to implement and maintain CSH totaled $344,514, which translates, on average, to $7,830 per school and $22.67 per student. Of the public funding, $140,500 was for CSH, $86,250 for breakfast programs, $28,750 for school food policy programs, and the remainder for other subsidized programs. Grants, donations and fundraising were mostly locally acquired. They totaled $127,235, which translates, on average, to $2,892 per school or $8.37 per student. The value of volunteer support was estimated to be equivalent to the value of grants, donations and fundraising combined. Of all grants, donations, fundraising and volunteers, 20% was directed to physical activity programs and 80% to nutrition programs. The public costs to implement and maintain CSH are modest. They leveraged substantial local funding and in-kind contributions, underlining community support for healthy eating and active living. Where CSH is effective in preventing childhood overweight, it is most likely cost-effective too, as costs for future chronic diseases are mounting. CSH programs that are proven effective and cost-effective have enormous potential for broad implementation and for reducing the public health burden associated with obesity.
ERIC Educational Resources Information Center
Cotter, Katie L.; Bacallao, Martica; Smokowski, Paul R.; Robertson, Caroline I. B.
2013-01-01
Objectives: This study examines the implementation and effectiveness of Parenting Wisely, an Internet-based parenting skills intervention. The study assesses whether parents benefit from Parenting Wisely participation and whether the delivery format influences program effectiveness. Method: This study uses a quasi-experimental design.…
Evaluating the Effectiveness of Student Assistance Programs in Pennsylvania.
ERIC Educational Resources Information Center
Fertman, Carl I.; Fichter, Cele; Schlesinger, Jo; Tarasevich, Susan; Wald, Holly; Zhang, Xiaoyan
2001-01-01
This evaluation of the Pennsylvania Student Assistance Program (SAP) was conducted to determine overall efficacy of SAPs and, more specifically, how SAP is currently implemented. Findings indicate that SAP is being implemented as designed. Recommended is the development of benchmarks and indicators focusing on best SAP practices and effectiveness.…
Handbook on Effective Implementation of School Improvement Grants
ERIC Educational Resources Information Center
Perlman, Carole L., Ed.; Redding, Sam, Ed.
2011-01-01
The purpose of this "Handbook" is to bolster the effective implementation of the intervention models and strategies outlined in the "2010 School Improvement Grant" (SIG) program--section 1003(g) of the Elementary and Secondary Education Act (ESEA)--in order to achieve the program's clear goal--rapid improvement of persistently…
Planning, Implementing, and Maintaining an Effective In-School Suspension Program.
ERIC Educational Resources Information Center
Sullivan, Judy S.
1989-01-01
Notes that many in-school suspension (ISS) programs are used as a temporary controlling technique, rather than a truly rehabilitative measure. Presents 12 steps in planning and implementing, and 10 steps in maintaining, an ISS program that is a positive disciplinary strategy. (NH)
The SBIRT program matrix: a conceptual framework for program implementation and evaluation.
Del Boca, Frances K; McRee, Bonnie; Vendetti, Janice; Damon, Donna
2017-02-01
Screening, Brief Intervention and Referral to Treatment (SBIRT) is a comprehensive, integrated, public health approach to the delivery of services to those at risk for the adverse consequences of alcohol and other drug use, and for those with probable substance use disorders. Research on successful SBIRT implementation has lagged behind studies of efficacy and effectiveness. This paper (1) outlines a conceptual framework, the SBIRT Program Matrix, to guide implementation research and program evaluation and (2) specifies potential implementation outcomes. Overview and narrative description of the SBIRT Program Matrix. The SBIRT Program Matrix has five components, each of which includes multiple elements: SBIRT services; performance sites; provider attributes; patient/client populations; and management structure and activities. Implementation outcomes include program adoption, acceptability, appropriateness, feasibility, fidelity, costs, penetration, sustainability, service provision and grant compliance. The Screening, Brief Intervention and Referral to Treatment Program Matrix provides a template for identifying, classifying and organizing the naturally occurring commonalities and variations within and across SBIRT programs, and for investigating which variables are associated with implementation success and, ultimately, with treatment outcomes and other impacts. © 2017 Society for the Study of Addiction.
The Fundamental Importance of Effective Program Implementation for Successful Character Development
ERIC Educational Resources Information Center
Durlak, Joseph A.
2017-01-01
This article reviews literature that emphasizes how both research findings and practical applications have confirmed the fundamental importance of program implementation in the spread of successful character education interventions. Attention is given to defining implementation, explaining its major elements and why it is so important, discussing…
Goedendorp, Martine M; Kuiper, Daphne; Reijneveld, Sijmen A; Sanderman, Robbert; Steverink, Nardi
2017-06-01
The Self-Management of Well-being (SMW) group intervention for older women was implemented in health and social care. Our aim was to assess whether effects of the SMW intervention were comparable with the original randomized controlled trial (RCT). Furthermore, we investigated threats to effectiveness, such as participant adherence, group reached, and program fidelity. In the implementation study (IMP) 287 and RCT 142 women participated. We compared scores on self-management ability and well-being of the IMP and RCT. For adherence, drop-out rates and session attendance were compared. Regarding reach, we compared participants' baseline characteristics. Professionals completed questions regarding program fidelity. No significant differences were found on effect outcomes and adherence between IMP and RCT (all p≥0.135). Intervention effect sizes were equal (0.47-0.59). IMP participants were significantly less lonely and more likely to be married, but had lower well-being. Most professionals followed the protocol, with only minimal deviations. The effectiveness of the SMW group intervention was reproduced after implementation, with similar participant adherence, minimal changes in the group reached, and high program fidelity. The SMW group intervention can be transferred to health and social care without loss of effectiveness. Implementation at a larger scale is warranted. Copyright © 2017 Elsevier B.V. All rights reserved.
Ruiz-Ramos, Jesus; Frasquet, Juan; Romá, Eva; Poveda-Andres, Jose Luis; Salavert-Leti, Miguel; Castellanos, Alvaro; Ramirez, Paula
2017-06-01
To evaluate the cost-effectiveness of antimicrobial stewardship (AS) program implementation focused on critical care units based on assumptions for the Spanish setting. A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed. Model variables and costs, along with their distributions, were obtained from the literature. The study was performed from the Spanish National Health System (NHS) perspective, including only direct costs. The Incremental Cost-Effectiveness Ratio (ICER) was analysed regarding the ability of the program to reduce multi-drug resistant bacteria. Uncertainty in ICERs was evaluated with probabilistic sensitivity analyses. In the short-term, implementing an AS reduces the consumption of antimicrobials with a net benefit of €71,738. In the long-term, the maintenance of the program involves an additional cost to the system of €107,569. Cost per avoided resistance was €7,342, and cost-per-life-years gained (LYG) was €9,788. Results from the probabilistic sensitivity analysis showed that there was a more than 90% likelihood that an AS would be cost-effective at a level of €8,000 per LYG. Wide variability of economic results obtained from the implementation of this type of AS program and short information on their impact on patient evolution and any resistance avoided. Implementing an AS focusing on critical care patients is a long-term cost-effective tool. Implementation costs are amortized by reducing antimicrobial consumption to prevent infection by multidrug-resistant pathogens.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Schaus, P.S.
This Configuration Management Implementation Plan (CMIP) was developed to assist in managing systems, structures, and components (SSCS), to facilitate the effective control and statusing of changes to SSCS, and to ensure technical consistency between design, performance, and operational requirements. Its purpose is to describe the approach Privatization Infrastructure will take in implementing a configuration management program, to identify the Program`s products that need configuration management control, to determine the rigor of control, and to identify the mechanisms for that control.
76 FR 10089 - Value-Added Producer Grant Program
Federal Register 2010, 2011, 2012, 2013, 2014
2011-02-23
..., business plans, and marketing strategies. The program will also provide working capital for expenses such as implementing an existing viable marketing strategy. The Agency will implement the program to meet... projects that develop mid-tier value marketing chains. DATES: This interim rule is effective March 25, 2011...
Work-site health and fitness programs: Impact on the employee and employer.
Voit, Susan
2001-01-01
Physical fitness and health lifestyle habits have been reported to lower the risk of death from disease, foster healthy muscles, joints and bones, and enhance personal function and mental health. Given these benefits, many employers are implementing health and fitness programs into their workplace with the goals of improving and maintaining the health of their employees and increasing worker productivity. However, research is still being conducted to determine if these programs are an effective means of achieving these goals. OBJECTIVE: The purpose of this paper is to investigate the impact of these programs on employee physical and mental health, employee work performance, and the employer. This paper also investigates the effectiveness of the specific program structures and intervention procedures that were used in the employee health and fitness programs that have been implemented. STUDY DESIGN: This paper analyzed 15 previously conducted studies to investigate the impact and design of employee health and fitness programs. RESULTS: The reviewed literature suggests that the incorporation of an employee health and fitness program can have positive effects for both the employee and the employer. Programs that are structured using a variety of physical fitness programs, health education classes, outreach and one on one counseling with follow up contact have proven to be most beneficial in terms of employee and employer satisfaction. CONCLUSION: The implementation of an employee health and fitness program can have positive lasting effects on both the employee and employer. In addition to implementing programs that offer a variety of choices and one on one counseling, employers would benefit from targeting the at-risk population to ensure that the programs benefit the greatest number of employees possible.
ERIC Educational Resources Information Center
Finn, Peter; McDevitt, Jack
2005-01-01
There has been a growing interest in placing sworn police officers in schools as SROs to improve school safety. The purpose of the National Assessment was to identify what program "models" have been implemented, how programs have been implemented, and what the programs' possible effects may be. To obtain this information, Abt Associates conducted…
Varnell, Gayle; Haas, Barbara; Duke, Gloria; Hudson, Kathy
2008-01-01
Transitioning to an evidence-based practice (EBP) environment is a new and often overwhelming challenge for many organisations. The most effective strategies to implement EBP have yet to be determined. In this study an accelerated development EBP program, which was administered to nurses from five hospitals was evaluated. At each hospital, nurses were selected as an "EBP champion" whose role would be to help facilitate the transition within that organisation. The purpose of this study was to evaluate the effectiveness of an accelerated educational program on the attitudes toward and implementation of EBP among nurses employed in acute-care facilities. Forty-nine nurses from five acute-care facilities participated in an 8-week program to develop into EBP champions. Participants attended a 2-hour class each week conducted by four faculty members of a local university. Pre- and post-test mean scores of the EBP barriers (EBPB) and EBP implementation (EBPI) scales were compared using paired t tests to determine the effect of the accelerated development program. Respondents reported higher scores on both the beliefs and implementation scales at the end of the program. Paired t tests indicated a significant difference in means for both the EBPB (p < .01) and EBPI (p < .01). Nurses who attend an accelerated educational program have the potential to significantly improve beliefs and attitudes about EBP. Administrative support and collaboration between academia and service are essential for successful intervention.
Youth empowerment solutions for violence prevention.
Reischl, Thomas M; Zimmerman, Marc A; Morrel-Samuels, Susan; Franzen, Susan P; Faulk, Monique; Eisman, Andria B; Roberts, Everett
2011-12-01
The limited success of youth violence prevention interventions suggests that effective prevention needs to address causes at multiple levels of analysis and empower youth in developing and implementing prevention programs. In this article, we review published studies of youth violence prevention efforts that engage youth in developing or implementing violence prevention activities. The reviewed studies suggest the promise of youth empowerment strategies and the need for systematic outcome studies of empowerment programs. After reviewing empowerment theory applied to youth violence prevention programs, we present a case study of the Youth Empowerment Solutions (YES) for Peaceful Communities program. YES engages middle-school youth in an after-school and summer program that includes a culturally tailored character development curriculum and empowers the youth to plan and implement community improvement projects with assistance from adult neighborhood advocates. The case study focuses on outcome evaluation results and presents evidence of the YES program effects on community-level outcomes (eg, property improvements, violent crime incidents) and on individual-level outcomes (eg, conflict avoidance, victimization). The literature review and the case study suggest the promise of engaging and empowering youth to plan and implement youth violence prevention programs.
Implementing HIV Testing in Substance Use Treatment Programs: A Systematic Review.
Simeone, Claire A; Seal, Stella M; Savage, Christine
People who use drugs are at increased risk for HIV acquisition, poor engagement in health care, and late screening for HIV with advanced HIV at diagnosis and increased HIV-related morbidity, mortality, and health care costs. This systematic review evaluates current evidence about the effectiveness and feasibility of implementing HIV testing in U.S. substance use treatment programs. The literature search identified 535 articles. Full text review was limited to articles that explicitly addressed strategies to implement HIV testing in substance use programs: 17 met criteria and were included in the review; nine used quantitative, qualitative, or mixed-method designs to describe or quantify HIV testing rates, acceptance by clients and staff, and cost-effectiveness; eight organization surveys described barriers and facilitators to testing implementation. The evidence supported the effectiveness and feasibility of rapid, routine, and streamlined HIV testing in substance use treatment programs. Primary challenges included organizational support and sustainable funding. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
Baillie, Colin P T; Galaviz, Karla I; Emiry, Kevin; Bruner, Mark W; Bruner, Brenda G; Lévesque, Lucie
2017-03-01
Physical activity (PA) programs are a promising strategy to promote positive youth development (PYD). It is not known if published reports provide sufficient information to promote the implementation of effective PYD in indigenous youth. The purpose of this study was to assess the extent to which published literature on PA programs that promote PYD in indigenous youth report on RE-AIM (reach, effectiveness, adoption, implementation, maintenance) indicators. A systematic literature search was conducted to identify articles reporting on PA programs that promote PYD in indigenous youth. The search yielded 8084 articles. A validated 21-item RE-AIM abstraction tool assessing internal and external validity factors was used to extract data from 10 articles meeting eligibility criteria. The most commonly reported dimensions were effectiveness (73 %), adoption (48 %), and maintenance (43 %). Reach (34 %) and implementation (30 %) were less often reported. Published research provides insufficient information to inform real-world implementation of PA programs to promote PYD in indigenous youth.
Ghate, Deborah
2016-01-01
The transfer of knowledge of effective practice, especially into "usual care" settings, remains challenging. This article argues that to close this gap we need to recognize the particular challenges of whole-system improvement. We need to move beyond a limited focus on individual programs and experimental research on their effectiveness. The rapidly developing field of implementation science and practice (ISP) provides a particular lens and a set of important constructs that can helpfully accelerate progress. A review of selected key constructs and distinctive features of ISP, including recognizing invisible system infrastructure, co-construction involving active collaboration between stakeholders, and attention to active implementation, supports for providers beyond education and training. Key aspects of an implementation lens likely to be most helpful in sustaining effectiveness include assisting innovators to identify and accommodate the architecture of existing systems, understand the implementation process as a series of distinct but nonlinear stages, identify implementation outcomes as prerequisites for treatment outcomes, and analyse implementation challenges using frameworks of implementation drivers. In complex adaptive systems, how services are implemented may matter more than their specific content, and how services align and adapt to local context may determine their sustained usefulness. To improve implementation-relevant research, we need better process evaluation and cannot rely on experimental methods that do not capture complex systemic contexts. Deployment of an implementation lens may perhaps help to avoid future "rigor mortis," enabling more productively flexible and integrative approaches to both program design and evaluation.
A Toolkit for Designing and Implementing Effective Title I Schoolwide Programs
ERIC Educational Resources Information Center
New, Wendy Jo; Rhines, Chris; Walter, Fran; Klekotka, Peggie
2005-01-01
This toolkit is designed to provide educational leaders with information, tools, resources, and practical examples to help schools to effectively implement Title I schoolwide programs. It is intended to serve as a useful resource for states, districts, and schools to use, along with other resources and technical support, to create or refine…
Reciprocal Peer Coaching: A Critical Contributor to Implementing Individual Leadership Plans
ERIC Educational Resources Information Center
Goldman, Ellen; Wesner, Marilyn; Karnchanomai, Ornpawee
2013-01-01
Billions of dollars are spent annually on programs to develop organizational leaders, yet the effectiveness of these programs is poorly understood. Scholars advise that value is enhanced by the development of individual leadership plans at program completion, followed by implementation experience with subsequent coaching and reflection. The…
Beyond Strength: Participant Perspectives on the Benefits of an Older Adult Exercise Program
ERIC Educational Resources Information Center
Kohn, Marlana; Belza, Basia; Petrescu-Prahova, Miruna; Miyawaki, Christina E.
2016-01-01
This study examines the expected and experienced benefits among participants in Enhance®Fitness (EF), an evidence-based group physical activity program for older adults. We also describe the implications for program dissemination (reach, implementation, and maintenance) within the RE-AIM (reach, effectiveness, adoption, implementation, and…
40 CFR 258.58 - Implementation of the corrective action program.
Code of Federal Regulations, 2013 CFR
2013-07-01
... (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Ground-Water Monitoring and Corrective...) Establish and implement a corrective action ground-water monitoring program that: (i) At a minimum, meet the requirements of an assessment monitoring program under § 258.55; (ii) Indicate the effectiveness of the...
40 CFR 258.58 - Implementation of the corrective action program.
Code of Federal Regulations, 2012 CFR
2012-07-01
... WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Ground-Water Monitoring and Corrective Action § 258... implement a corrective action ground-water monitoring program that: (i) At a minimum, meet the requirements of an assessment monitoring program under § 258.55; (ii) Indicate the effectiveness of the corrective...
40 CFR 258.58 - Implementation of the corrective action program.
Code of Federal Regulations, 2011 CFR
2011-07-01
... (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Ground-Water Monitoring and Corrective...) Establish and implement a corrective action ground-water monitoring program that: (i) At a minimum, meet the requirements of an assessment monitoring program under § 258.55; (ii) Indicate the effectiveness of the...
40 CFR 258.58 - Implementation of the corrective action program.
Code of Federal Regulations, 2014 CFR
2014-07-01
... (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Ground-Water Monitoring and Corrective...) Establish and implement a corrective action ground-water monitoring program that: (i) At a minimum, meet the requirements of an assessment monitoring program under § 258.55; (ii) Indicate the effectiveness of the...
40 CFR 257.28 - Implementation of the corrective action program.
Code of Federal Regulations, 2012 CFR
2012-07-01
...-Hazardous Waste Disposal Units Ground-Water Monitoring and Corrective Action § 257.28 Implementation of the... ground-water monitoring program that: (i) At a minimum, meets the requirements of an assessment monitoring program under § 257.25; (ii) Indicates the effectiveness of the corrective action remedy; and (iii...
The Community Options Program: An Evaluation of Early Implementation Experience.
ERIC Educational Resources Information Center
Wisconsin State Dept. of Health and Social Services, Madison.
This document contains a preliminary report on the implementation of Wisconsin's Community Options Program (COP), a program designed both to divert persons from entering nursing homes and to deinstitutionalize current nursing home residents who can be effectively served by community-based alternatives. The introduction of this report provides a…
Managing Air Quality - Program Implementation
Describes elements for the set of activities to ensure that control strategies are put into effect and that air quality goals and standards are fulfilled, permitting programs, and additional resources related to implementation under the Clean Air Act.
Implementation of a tobacco-free workplace program at a local mental health authority.
Correa-Fernández, Virmarie; Wilson, William T; Shedrick, Deborah A; Kyburz, Bryce; L Samaha, Hannah; Stacey, Timothy; Williams, Teresa; Lam, Cho Y; Reitzel, Lorraine R
2017-06-01
Tobacco-free workplace policies that incorporate evidence-based practices can increase the reach and effectiveness of tobacco dependence treatment among underserved populations but may be underutilized due to limited knowledge about implementation processes. This paper describes the implementation of a comprehensive tobacco-free workplace program at a behavioral healthcare community center in Texas. The center participated in a tobacco-free workplace program implementation project that provided guidance and resources and allowed center autonomy in implementation. Six employee-based subcommittees guided implementation of program components including consumer and staff surveys, policy development, signage, tobacco use assessments, communication, and nicotine replacement distribution. Timeline development, successes, challenges, lessons learned, and sustainability initiatives are delineated. Concerns about the tobacco-free workplace policy from the center's staff and consumers were gradually replaced by strong support for the initiative. Program success was enabled by consistent support from the center's leadership, publicity of program efforts, and educational campaigns. The center surpassed the program expectations when it adopted a tobacco-free hiring policy, which was not an initial program goal. This center's path to a tobacco-free workplace provides an implementation and sustainability model for other behavioral health community centers and other organizations to become tobacco free.
Selecting, adapting, and sustaining programs in health care systems
Zullig, Leah L; Bosworth, Hayden B
2015-01-01
Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA) Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. PMID:25931825
2014-01-01
Background The HIV/AIDS epidemic continues to disproportionately affect African American communities in the US, particularly those located in urban areas. Despite the fact that HIV is often transmitted from one sexual partner to another, most HIV prevention interventions have focused only on individuals, rather than couples. This five-year study investigates community-based implementation, effectiveness, and sustainability of ‘Eban II,’ an evidence-based risk reduction intervention for African-American heterosexual, serodiscordant couples. Methods/design This hybrid implementation/effectiveness implementation study is guided by organizational change theory as conceptualized in the Texas Christian University Program Change Model (PCM), a model of phased organizational change from exposure to adoption, implementation, and sustainability. The primary implementation aims are to assist 10 community-based organizations (CBOs) to implement and sustain Eban II; specifically, to partner with CBOs to expose providers to the intervention; facilitate its adoption, implementation and sustainment; and to evaluate processes and determinants of implementation, effectiveness, fidelity, and sustainment. The primary effectiveness aim is to evaluate the effect of Eban II on participant (n = 200 couples) outcomes, specifically incidents of protected sex and proportion of condom use. We will also determine the cost-effectiveness of implementation, as measured by implementation costs and potential cost savings. A mixed methods evaluation will examine implementation at the agency level; staff members from the CBOs will complete baseline measures of organizational context and climate, while key stakeholders will be interviewed periodically throughout implementation. Effectiveness of Eban II will be assessed using a randomized delayed enrollment (waitlist) control design to evaluate the impact of treatment on outcomes at posttest and three-month follow-up. Multi-level hierarchical modeling with a multi-level nested structure will be used to evaluate the effects of agency- and couples-level characteristics on couples-level outcomes (e.g., condom use). Discussion This study will produce important information regarding the value of the Eban II program and a theory-guided implementation process and tools designed for use in implementing Eban II and other evidence-based programs in demographically diverse, resource-constrained treatment settings. Trial registration NCT00644163 PMID:24950708
Hamilton, Alison B; Mittman, Brian S; Williams, John K; Liu, Honghu H; Eccles, Alicia M; Hutchinson, Craig S; Wyatt, Gail E
2014-06-20
The HIV/AIDS epidemic continues to disproportionately affect African American communities in the US, particularly those located in urban areas. Despite the fact that HIV is often transmitted from one sexual partner to another, most HIV prevention interventions have focused only on individuals, rather than couples. This five-year study investigates community-based implementation, effectiveness, and sustainability of 'Eban II,' an evidence-based risk reduction intervention for African-American heterosexual, serodiscordant couples. This hybrid implementation/effectiveness implementation study is guided by organizational change theory as conceptualized in the Texas Christian University Program Change Model (PCM), a model of phased organizational change from exposure to adoption, implementation, and sustainability. The primary implementation aims are to assist 10 community-based organizations (CBOs) to implement and sustain Eban II; specifically, to partner with CBOs to expose providers to the intervention; facilitate its adoption, implementation and sustainment; and to evaluate processes and determinants of implementation, effectiveness, fidelity, and sustainment. The primary effectiveness aim is to evaluate the effect of Eban II on participant (n = 200 couples) outcomes, specifically incidents of protected sex and proportion of condom use. We will also determine the cost-effectiveness of implementation, as measured by implementation costs and potential cost savings. A mixed methods evaluation will examine implementation at the agency level; staff members from the CBOs will complete baseline measures of organizational context and climate, while key stakeholders will be interviewed periodically throughout implementation. Effectiveness of Eban II will be assessed using a randomized delayed enrollment (waitlist) control design to evaluate the impact of treatment on outcomes at posttest and three-month follow-up. Multi-level hierarchical modeling with a multi-level nested structure will be used to evaluate the effects of agency- and couples-level characteristics on couples-level outcomes (e.g., condom use). This study will produce important information regarding the value of the Eban II program and a theory-guided implementation process and tools designed for use in implementing Eban II and other evidence-based programs in demographically diverse, resource-constrained treatment settings. NCT00644163.
ERIC Educational Resources Information Center
Liu, Chieh-Hsing; Chang, Fong-Ching; Liao, Li-Ling; Niu, Yu-Zhen; Cheng, Chi-Chia; Shih, Shu-Fang; Chang, Tzu-Chau; Chou, Hsin-Pei
2015-01-01
In 2011, the Taiwan government expanded its support of school-district/university partnership programs that promote the implementation of the evidenced-based Health Promoting Schools (HPS) program. This study examined whether expanding the support for this initiative was effective in advancing HPS implementation, perceived HPS impact and perceived…
Krukowski, Rebecca A; Lensing, Shelly; Love, Sharhonda; Prewitt, T Elaine; Adams, Becky; Cornell, Carol E; Felix, Holly C; West, Delia
2013-02-01
Lay health educators (LHEs) offer great promise for facilitating the translation of evidence-based health promotion programs to underserved areas; yet, there is little guidance on how to train LHEs to implement these programs, particularly in the crucial area of empirically validated obesity interventions. This article describes experiences in recruiting, training, and retaining 20 LHEs who delivered a 12-month evidence-based behavioral lifestyle intervention (based on the Diabetes Prevention Program) in senior centers across a rural state. A mixed method approach was used which incorporated collecting the folllowing: quantitative data on sociodemographic characteristics of LHEs; process data related to training, recruitment, intervention implementation, and retention of LHEs; and a quantitative program evaluation questionnaire, which was supplemented by a qualitative program evaluation questionnaire. Descriptive statistics were calculated for quantitative data, and qualitative data were analyzed using content analysis. The training program was well received, and the LHEs effectively recruited participants and implemented the lifestyle intervention in senior centers following a structured protocol. The methods used in this study produced excellent long-term retention of LHEs and good adherence to intervention protocol, and as such may provide a model that could be effective for others seeking to implement LHE-delivered health promotion programs.
Bierman, K L
1997-08-01
Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program.
Bierman, Karen L.
2012-01-01
Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program. PMID:9338956
An Integrative Suicide Prevention Program for Visitor Charcoal Burning Suicide and Suicide Pact
ERIC Educational Resources Information Center
Wong, Paul W. C.; Liu, Patricia M. Y.; Chan, Wincy S. C.; Law, Y. W.; Law, Steven C. K.; Fu, King-Wa; Li, Hana S. H.; Tso, M. K.; Beautrais, Annette L.; Yip, Paul S. F.
2009-01-01
An integrative suicide prevention program was implemented to tackle an outbreak of visitor charcoal burning suicides in Cheung Chau, an island in Hong Kong, in 2002. This study evaluated the effectiveness of the program. The numbers of visitor suicides reduced from 37 deaths in the 51 months prior to program implementation to 6 deaths in the 42…
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-08
...; Effectiveness of a Community's Implementation of the NFIP Community Assistance Program CAC and CAV Reports... Implementation of the NFIP Community Assistance Program CAC and CAV Reports. Type of information collection...
Richard, Lucie; Torres, Sara; Tremblay, Marie-Claude; Chiocchio, François; Litvak, Éric; Fortin-Pellerin, Laurence; Beaudet, Nicole
2015-06-14
Professional development is a key component of effective public health infrastructures. To be successful, professional development programs in public health and health promotion must adapt to practitioners' complex real-world practice settings while preserving the core components of those programs' models and theoretical bases. An appropriate balance must be struck between implementation fidelity, defined as respecting the core nature of the program that underlies its effects, and adaptability to context to maximize benefit in specific situations. This article presents a professional development pilot program, the Health Promotion Laboratory (HPL), and analyzes how it was adapted to three different settings while preserving its core components. An exploratory analysis was also conducted to identify team and contextual factors that might have been at play in the emergence of implementation profiles in each site. This paper describes the program, its core components and adaptive features, along with three implementation experiences in local public health teams in Quebec, Canada. For each setting, documentary sources were analyzed to trace the implementation of activities, including temporal patterns throughout the project for each program component. Information about teams and their contexts/settings was obtained through documentary analysis and semi-structured interviews with HPL participants, colleagues and managers from each organization. While each team developed a unique pattern of implementing the activities, all the program's core components were implemented. Differences of implementation were observed in terms of numbers and percentages of activities related to different components of the program as well as in the patterns of activities across time. It is plausible that organizational characteristics influencing, for example, work schedule flexibility or learning culture might have played a role in the HPL implementation process. This paper shows how a professional development program model can be adapted to different contexts while preserving its core components. Capturing the heterogeneity of the intervention's exposure, as was done here, will make possible in-depth impact analyses involving, for example, the testing of program-context interactions to identify program outcomes predictors. Such work is essential to advance knowledge on the action mechanisms of professional development programs.
ERIC Educational Resources Information Center
Shek, Daniel T. L.; Sun, Rachel C. F.
2008-01-01
A total of 207 schools (N = 33,693 students) participated in the Secondary 1 Program of Project P.A.T.H.S. in the Full Implementation Phase (2006-07). Participants responded to a Subjective Outcome Evaluation Form (Form A) to assess their views of the program, instructors, and perceived effectiveness after program completion. Utilizing the…
Miller, Alison L; Weston, Lauren E; Perryman, Jamie; Horwitz, Talia; Franzen, Susan; Cochran, Shirley
2014-09-01
Most incarcerated women are mothers. Parenting programs may benefit women, children and families, yet effectively intervening in correctional settings is a challenge. An evidence-based parenting intervention (the Strengthening Families Program) was tailored and implemented with women in a jail setting. Goals were to assess mothers' needs and interests regarding parenting while they were incarcerated, adapt the program to address those needs, and establish intervention delivery and evaluation methods in collaboration with a community-based agency. Women reported wanting to know more about effective communication; how children manage stress; finances; drug and alcohol use; self-care; and stress reduction. They reported high program satisfaction and reported reduced endorsement of corporal punishment after the intervention. Barriers to implementation included unpredictable attendance from session to session due to changing release dates, transfer to other facilities, and jail policies (e.g., lock-down; commissary hours). Implications for sustainable implementation of parenting programs in jail settings are discussed.
Cockpit resource management training at People Express
NASA Technical Reports Server (NTRS)
Bruce, Keith D.; Jensen, Doug
1987-01-01
In January 1986 in a continuing effort to maintain and improve flight safety and solve some Cockpit Resource Management (CRM) problems, People Express implemented a new CRM training program. It is a continuously running program, scheduled over the next three years and includes state-of-the-art full-mission simulation (LOFT), semi-annual seminar workshops and a comprehensive academic program authored by Robert W. Mudge of Cockpit Management Resources Inc. That program is outlined and to maximize its contribution to the workshop's goals, is organized into four topic areas: (1) Program content: the essential elements of resource management training; (2) Training methods: the strengths and weaknesses of current approaches; (3) Implementation: the implementation of CRM training; and (4) Effectiveness: the effectiveness of training. It is confined as much as possible to concise descriptions of the program's basic components. Brief discussions of rationale are included, however no attempt is made to discuss or review popular CRM tenets or the supporting research.
Using a Mixed-Methods RE-AIM Framework to Evaluate Community Health Programs for Older Latinas.
Schwingel, Andiara; Gálvez, Patricia; Linares, Deborah; Sebastião, Emerson
2017-06-01
This study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate a promotora-led community health program designed for Latinas ages 50 and older that sought to improve physical activity, nutrition, and stress management. A mixed-methods evaluation approach was administered at participant and organizational levels with a focus on the efficacy, adoption, implementation, and maintenance components of the RE-AIM theoretical model. The program was shown to be effective at improving participants' eating behaviors, increasing their physical activity levels, and lowering their depressive symptoms. Promotoras felt motivated and sufficiently prepared to deliver the program. Some implementation challenges were reported. More child care opportunities and an increased focus on mental well-being were suggested. The promotora delivery model has promise for program sustainability with both promotoras and participants alike expressing interest in leading future programs.
ERIC Educational Resources Information Center
Thomas, Cheryl Denise
2015-01-01
The purpose of this study was to determine if the implementation of PBIS (Positive Behavioral Intervention Support) program had a positive significant effect in decreasing office discipline referrals in a local elementary school. A sample independent t-Test was used to examine data on the school's average office discipline referrals for two years…
ERIC Educational Resources Information Center
Arthur, Michael W.; Hawkins, J. David; Brown, Eric C.; Briney, John S.; Oesterle, Sabrina; Abbott, Robert D.
2010-01-01
Although advances in prevention science over the past two decades have produced a growing list of tested and effective programs and policies for preventing adolescent delinquency and drug use, widespread dissemination and high-quality implementation of effective programs and policies in communities has not been achieved. The Community Youth…
Translation of an Effective Tai Chi Intervention Into a Community-Based Falls-Prevention Program
Li, Fuzhong; Harmer, Peter; Glasgow, Russell; Mack, Karin A.; Sleet, David; Fisher, K. John; Kohn, Melvin A.; Millet, Lisa M.; Mead, Jennifer; Xu, Junheng; Lin, Mei-Li; Yang, Tingzhong; Sutton, Beth; Tompkins, Yvaughn
2008-01-01
Tai Chi—Moving for Better Balance, a falls-prevention program developed from a randomized controlled trial for community-based use, was evaluated with the RE-AIM framework in 6 community centers. The program had a 100% adoption rate and 87% reach into the target older adult population. All centers implemented the intervention with good fidelity, and participants showed significant improvements in health-related outcome measures. This evidence-based tai chi program is practical to disseminate and can be effectively implemented and maintained in community settings. PMID:18511723
Implementing Implementation Science: An Approach for HIV Prevention, Care and Treatment Programs.
Lambdin, Barrot H; Cheng, Ben; Peter, Trevor; Mbwambo, Jessie; Apollo, Tsitsi; Dunbar, Megan; Udoh, Ifeoma C; Cattamanchi, Adithya; Geng, Elvin H; Volberding, Paul
2015-01-01
Though great progress has been realized over the last decade in extending HIV prevention, care and treatment in some of the least resourced settings of the world, a substantial gap remains between what we know works and what we are actually achieving in HIV programs. To address this, leaders have called for the adoption of an implementation science framework to improve the efficiency and effectiveness of HIV programs. Implementation science (IS) is a multidisciplinary scientific field that seeks generalizable knowledge about the magnitude of, determinants of and strategies to close the gap between evidence and routine practice for health in real-world settings. We propose an IS approach that is iterative in nature and composed of four major components: 1) Identifying Bottlenecks and Gaps, 2) Developing and Implementing Strategies, 3) Measuring Effectiveness and Efficiency, and 4) Utilizing Results. With this framework, IS initiatives draw from a variety of disciplines including qualitative and quantitative methodologies in order to develop new approaches responsive to the complexities of real world program delivery. In order to remain useful for the changing programmatic landscape, IS research should factor in relevant timeframes and engage the multi-sectoral community of stakeholders, including community members, health care teams, program managers, researchers and policy makers, to facilitate the development of programs, practices and polices that lead to a more effective and efficient global AIDS response. The approach presented here is a synthesis of approaches and is a useful model to address IS-related questions for HIV prevention, care and treatment programs. This approach, however, is not a panacea, and we will continue to learn new ways of thinking as we move forward to close the implementation gap.
Implementing Implementation Science: An Approach for HIV Prevention, Care and Treatment Programs
Lambdin, Barrot H.; Cheng, Ben; Peter, Trevor; Mbwambo, Jessie; Apollo, Tsitsi; Dunbar, Megan; Udoh, Ifeoma C.; Cattamanchi, Adithya; Geng, Elvin H.; Volberding, Paul
2015-01-01
Though great progress has been realized over the last decade in extending HIV prevention, care and treatment in some of the least resourced settings of the world, a substantial gap remains between what we know works and what we are actually achieving in HIV programs. To address this, leaders have called for the adoption of an implementation science framework to improve the efficiency and effectiveness of HIV programs. Implementation science (IS) is a multidisciplinary scientific field that seeks generalizable knowledge about the magnitude of, determinants of and strategies to close the gap between evidence and routine practice for health in real-world settings. We propose an IS approach that is iterative in nature and composed of four major components: 1) Identifying Bottlenecks and Gaps, 2) Developing and Implementing Strategies, 3) Measuring Effectiveness and Efficiency, and 4) Utilizing Results. With this framework, IS initiatives draw from a variety of disciplines including qualitative and quantitative methodologies in order to develop new approaches responsive to the complexities of real world program delivery. In order to remain useful for the changing programmatic landscape, IS research should factor in relevant timeframes and engage the multi-sectoral community of stakeholders, including community members, health care teams, program managers, researchers and policy makers, to facilitate the development of programs, practices and polices that lead to a more effective and efficient global AIDS response. The approach presented here is a synthesis of approaches and is a useful model to address IS-related questions for HIV prevention, care and treatment programs. This approach, however, is not a panacea, and we will continue to learn new ways of thinking as we move forward to close the implementation gap. PMID:25986374
ERIC Educational Resources Information Center
LaPointe, Michelle; Stullich, Stephanie
2004-01-01
The Comprehensive School Reform (CSR) program provides financial assistance to help schools develop and implement systematic approaches to schoolwide improvement that are grounded in scientifically based research and effective practices. The goal of the program is to enable all children to meet challenging state academic content and achievement…
ERIC Educational Resources Information Center
Faddis, Bonnie J.; Beam, Margaret; Hahn, Karen J.; Willardson, Marlyn; Sipe, Deborah; Ahrens-Gray, Paul
The Comprehensive School Reform Demonstration (CSRD) Program was established through Public Law 105-78, the 1998 Department of Education Appropriations Act. CSRD provides financial assistance to underachieving schools implementing comprehensive school-reform programs that are based on reliable research and effective practices. It intends to…
Developing, Implementing, and Evaluating a No-Child-Left-Inside Pilot Program
ERIC Educational Resources Information Center
Brand, Jamie C.; Radel, Claudia; Brain, Roslynn; Greene, Jack
2014-01-01
We describe experience with a pilot week-long, No-Child-Left-Inside (NCLI), outdoor program implemented in Cache Valley, Utah, in 2012. Through response analysis of a "pre-then-post" children's survey and a parent-completed demographic survey, we assess program effectiveness in raising children's enthusiasm for nature-related behaviors…
You've Shown the Program Model Is Effective. Now What?
ERIC Educational Resources Information Center
Ellickson, Phyllis L.
2014-01-01
Rigorous tests of theory-based programs require faithful implementation. Otherwise, lack of results might be attributable to faulty program delivery, faulty theory, or both. However, once the evidence indicates the model works and merits broader dissemination, implementation issues do not fade away. How can developers enhance the likelihood that…
Linking Implementation Fidelity to Impacts in an RCT
ERIC Educational Resources Information Center
Unlu, Fatih; Bozzi, Laurie; Layzer, Carolyn; Smith, Arthur; Price, Cristofer; Hurtig, Richard
2013-01-01
In experimental studies, researchers are often interested in secondary research questions that explore important aspects of main findings, such as whether or not program effects vary according to the level of fidelity in which the program has been implemented; or according to the dosage received by individuals participated in the program. In this…
Controlling the Ecotourist in a Wild Dolphin Feeding Program: Is Education the Answer?
ERIC Educational Resources Information Center
Orams, Mark B.; Hill, Greg J. E.
1998-01-01
The effectiveness of an education program for tourists who hand-feed wild dolphins at Tangalooma, Moreton Island in eastern Australia was evaluated. Data were gathered on tourist behavior during feeding sessions before and after the education policy was implemented. After implementation of the education program, inappropriate behaviors such as…
New York State Educational Programs That Work. Sharing Successful Programs, 1990 Edition.
ERIC Educational Resources Information Center
New York State Education Dept., Albany.
Sharing Successful Programs (SSP) is a national dissemination process for validating, sharing, and implementing successful educational programs. It offers effective strategies for educational improvement by sharing validated programs and provides a cost-effective way for school districts to duplicate validated programs in accordance with their…
Kelsey, Meredith; Layzer, Jean
2014-03-01
This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.
Leyvraz, Magali; Aaron, Grant J; Poonawala, Alia; van Liere, Marti J; Schofield, Dominic; Myatt, Mark; Neufeld, Lynnette M
2017-05-01
Background: The efficacy of a number of interventions that include fortified complementary foods (FCFs) or other products to improve infant and young child feeding (IYCF) is well established. Programs that provide such products free or at a subsidized price are implemented in many countries around the world. Demonstrating the impact at scale of these programs has been challenging, and rigorous information on coverage and utilization is lacking. Objective: The objective of this article is to review key findings from 11 coverage surveys of IYCF programs distributing or selling FCFs or micronutrient powders in 5 countries. Methods: Programs were implemented in Ghana, Cote d'Ivoire, India, Bangladesh, and Vietnam. Surveys were implemented at different stages of program implementation between 2013 and 2015. The Fortification Assessment Coverage Toolkit (FACT) was developed to assess 3 levels of coverage (message: awareness of the product; contact: use of the product ≥1 time; and effective: regular use aligned with program-specific goals), as well as barriers and factors that facilitate coverage. Analyses included the coverage estimates, as well as an assessment of equity of coverage between the poor and nonpoor, and between those with poor and adequate child feeding practices. Results: Coverage varied greatly between countries and program models. Message coverage ranged from 29.0% to 99.7%, contact coverage from 22.6% to 94.4%, and effective coverage from 0.8% to 88.3%. Beyond creating awareness, programs that achieved high coverage were those with effective mechanisms in place to overcome barriers for both supply and demand. Conclusions: Variability in coverage was likely due to the program design, delivery model, quality of implementation, and product type. Measuring program coverage and understanding its determinants is essential for program improvement and to estimate the potential for impact of programs at scale. Use of the FACT can help overcome this evidence gap.
Aaron, Grant J; Poonawala, Alia; van Liere, Marti J; Schofield, Dominic; Myatt, Mark
2017-01-01
Background: The efficacy of a number of interventions that include fortified complementary foods (FCFs) or other products to improve infant and young child feeding (IYCF) is well established. Programs that provide such products free or at a subsidized price are implemented in many countries around the world. Demonstrating the impact at scale of these programs has been challenging, and rigorous information on coverage and utilization is lacking. Objective: The objective of this article is to review key findings from 11 coverage surveys of IYCF programs distributing or selling FCFs or micronutrient powders in 5 countries. Methods: Programs were implemented in Ghana, Cote d’Ivoire, India, Bangladesh, and Vietnam. Surveys were implemented at different stages of program implementation between 2013 and 2015. The Fortification Assessment Coverage Toolkit (FACT) was developed to assess 3 levels of coverage (message: awareness of the product; contact: use of the product ≥1 time; and effective: regular use aligned with program-specific goals), as well as barriers and factors that facilitate coverage. Analyses included the coverage estimates, as well as an assessment of equity of coverage between the poor and nonpoor, and between those with poor and adequate child feeding practices. Results: Coverage varied greatly between countries and program models. Message coverage ranged from 29.0% to 99.7%, contact coverage from 22.6% to 94.4%, and effective coverage from 0.8% to 88.3%. Beyond creating awareness, programs that achieved high coverage were those with effective mechanisms in place to overcome barriers for both supply and demand. Conclusions: Variability in coverage was likely due to the program design, delivery model, quality of implementation, and product type. Measuring program coverage and understanding its determinants is essential for program improvement and to estimate the potential for impact of programs at scale. Use of the FACT can help overcome this evidence gap. PMID:28404839
ERIC Educational Resources Information Center
Bandy, Tawana; Burkhauser, Mary; Metz, Allison J. R.
2009-01-01
Although many program managers look to data to inform decision-making and manage their programs, high-quality program data may not always be available. Yet such data are necessary for effective program implementation. The use of high-quality data facilitates program management, reduces reliance on anecdotal information, and ensures that data are…
Implementing a Coach-Delivered Dating Violence Prevention Program with High School Athletes.
Jaime, Maria Catrina D; McCauley, Heather L; Tancredi, Daniel J; Decker, Michele R; Silverman, Jay G; O'Connor, Brian; Miller, Elizabeth
2018-05-10
Teen dating violence and sexual violence are severe public health problems. Abusive behaviors within the context of dating or romantic relationships are associated with adverse health outcomes. Promoting positive bystander intervention and increasing knowledge of abusive behaviors are promising strategies for preventing dating and sexual violence. Coaching Boys Into Men (CBIM) is an evidence-based, athletic coach-delivered dating violence prevention program that has been shown to increase positive bystander behaviors and reduce abuse perpetration among high school male athletes. Identifying specific barriers and facilitators based on the coaches' experiences with program delivery combined with the coaches' and athletes' program perceptions may help optimize future CBIM implementation and sustainability. Semi-structured interviews with coaches (n = 36) explored the implementers' perspectives on strategies that worked well and potential barriers to program implementation. Ten focus groups with male athletes (n = 39) assessed their experiences with CBIM and the suitability of having their coaches deliver this program. Coaches described using the CBIM training cards and integrating program delivery during practice. Athletes reported coaches routinely delivering the CBIM program and adding their own personal stories or examples to the discussions. Key facilitators to program implementation include support from the violence prevention advocate, the ease of integrating CBIM into the sports season, and using the program materials. Barriers to implementation included finding sufficient time for the program, dynamics of delivering sensitive program content, and participant constraints. Coaches and athletes alike found the program feasible and acceptable to implement within the sports setting. Both coaches and athletes offered insights on the implementation and the feasibility and acceptability of CBIM within school-based athletic programs. These experiences by implementers and recipients alike can inform future dissemination and implementation efforts of CBIM. Further, by pinpointing where and how coaches were successful in implementing the program and what resonated with athletes, can help better understand how CBIM is effective in promoting athletes to stop violence against women and girls. Coach and athlete reflections on CBIM implementation provide insights for optimizing future program delivery and dissemination.
HIV Pre-exposure Prophylaxis Program Implementation Using Intervention Mapping.
Flash, Charlene A; Frost, Elizabeth L T; Giordano, Thomas P; Amico, K Rivet; Cully, Jeffrey A; Markham, Christine M
2018-04-01
HIV pre-exposure prophylaxis has been proven to be an effective tool in HIV prevention. However, numerous barriers still exist in pre-exposure prophylaxis implementation. The framework of Intervention Mapping was used from August 2016 to October 2017 to describe the process of adoption, implementation, and maintenance of an HIV prevention program from 2012 through 2017 in Houston, Texas, that is nested within a county health system HIV clinic. Using the tasks outlined in the Intervention Mapping framework, potential program implementers were identified, outcomes and performance objectives established, matrices of change objectives created, and methods and practical applications formed. Results include the formation of three matrices that document program outcomes, change agents involved in the process, and the determinants needed to facilitate program adoption, implementation, and maintenance. Key features that facilitated successful program adoption and implementation were obtaining leadership buy-in, leveraging existing resources, systematic evaluation of operations, ongoing education for both clinical and nonclinical staff, and attention to emergent issues during launch. The utilization of Intervention Mapping to delineate the program planning steps can provide a model for pre-exposure prophylaxis implementation in other settings. Copyright © 2018. Published by Elsevier Inc.
Lechtig, Aarón; Gross, Rainer; Vivanco, Oscar Aquino; Gross, Ursula; López de Romaña, Daniel
2006-01-01
Weekly multimicronutrient supplementation was initiated as an appropriate intervention to protect poor urban populations from anemia. To identify the lessons learned from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]) weekly multimicronutrient supplementation program implemented in poor urban populations of Chiclayo, Peru. Data were collected from a 12-week program in which multimicronutrient supplements were provided weekly to women and adolescent girls 12 through 44 years of age and children under 5 years of age. A baseline survey was first conducted. Within the weekly multimicronutrient supplementation program, information was collected on supplement distribution, compliance, biological effectiveness, and cost. Supplementation, fortification, and dietary strategies can be integrated synergistically within a micronutrient intervention program. To ensure high cost-effectiveness of a weekly multimicronutrient supplementation program, the following conditions need to be met: the program should be implemented twice a year for 4 months; the program should be simultaneously implemented at the household (micro), community (meso), and national (macro) levels; there should be governmental participation from health and other sectors; and there should be community and private sector participation. Weekly multimicronutrient supplementation programs are cost effective options in urban areas with populations at low risk of energy deficiency and high risk of micronutrient deficiencies.
Crossing 138: two approaches to churn under the Affordable Care Act.
Ravel, Gabriel; DeSantis, J Angelo
2014-01-01
A predicted side effect of the Medicaid expansion and state-based Exchanges under the Affordable Care Act is churn. Churn is the shifting into and out of eligibility for insurance affordability programs due to income changes. Because the line between Medicaid and Exchange eligibility is fine -138% of the federal poverty level -millions of Americans are expected to gain and lose eligibility. Frequently, this churning undermines continuity of care, raises costs, and frustrates those affected. This article explores two proposed programs to mitigate the effects of churn: the Basic Health Program and the Bridge Program. This article evaluates both programs' ability to mitigate the effects of churn, the likely side effects to states' implementing them, and legal and practical obstacles to their implementation. It concludes that the Bridge Program is the better approach.
ERIC Educational Resources Information Center
Dariotis, Jacinda K.; Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Feagans Gould, Laura; Greenberg, Mark T.; Mendelson, Tamar
2017-01-01
Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators--students and their classroom teachers-merit attention in this…
Mindfulness Goes to School: Things Learned (So Far) from Research and Real-World Experiences
ERIC Educational Resources Information Center
Semple, Randye J.; Droutman, Vita; Reid, Brittany Ann
2017-01-01
Mindfulness-based curricula are being implemented in K-12 schools across the nation. Many of these programs, although well considered and implemented, have little or no research support for their effectiveness. Recognizing the paucity of published research in this area, a sampling of school-based programs currently being implemented in the schools…
Pettigrew, Jonathan; Graham, John W.; Miller-Day, Michelle; Hecht, Michael L.; Krieger, Janice L.; Shin, Young Ju
2014-01-01
Poor implementation quality (IQ) is known to reduce program effects making it important to consider IQ for evaluation and dissemination of prevention programs. However, less is known about the ways specific implementation variables relate to outcomes. In this study, two versions of the keepin’ it REAL, 7th grade drug prevention intervention were implemented in 78 classrooms in 25 schools in rural districts in Pennsylvania and Ohio. IQ was measured through observational coding of 276 videos. IQ variables included adherence to the curriculum, teacher engagement (attentiveness, enthusiasm, seriousness, clarity, positivity), student engagement (attention, participation), and a global rating of teacher delivery quality. Factor analysis showed that teacher engagement, student engagement, and delivery quality formed one factor, which was labeled delivery. A second factor was adherence to the curriculum. Self-report student surveys measured substance use, norms (beliefs about prevalence and acceptability of use), and efficacy (beliefs about one’s ability to refuse substance offers) at two waves (pretest, immediate posttest). Mixed model regression analysis which accounted for missing data and controlled for pretest levels examined implementation quality’s effects on individual level outcomes, statistically controlling for cluster level effects. Results show that when implemented well, students show positive outcomes compared to students receiving a poorly implemented program. Delivery significantly influenced substance use and norms, but not efficacy. Adherence marginally significantly predicted use and significantly predicted norms, but not efficacy. Findings underscore the importance of comprehensively measuring and accounting for IQ, particularly delivery, when evaluating prevention interventions. PMID:24442403
The effectiveness of laser and radar based enforcement programs for deterrence of speeding
DOT National Transportation Integrated Search
1997-02-01
This report documents the results of a study to determine the community-wide effectiveness of laser-based speed enforcement programs relative to radar-based programs. Jurisdiction-wide speeding enforcement programs were implemented and evaluated in t...
Effectiveness of computer ergonomics interventions for an engineering company: a program evaluation.
Goodman, Glenn; Landis, James; George, Christina; McGuire, Sheila; Shorter, Crystal; Sieminski, Michelle; Wilson, Tamika
2005-01-01
Ergonomic principles at the computer workstation may reduce the occurrence of work related injuries commonly associated with intensive computer use. A program implemented in 2001 by an occupational therapist and a physical therapist utilized these preventative measures with education about ergonomics, individualized evaluations of computer workstations, and recommendations for ergonomic and environmental changes. This study examined program outcomes and perceived effectiveness based on review of documents, interviews, and surveys of the employees and the plant manager. The program was deemed successful as shown by 59% of all therapist recommendations and 74% of ergonomic recommendations being implemented by the company, with an 85% satisfaction rate for the ergonomic interventions and an overall employee satisfaction rate of 70%. Eighty-one percent of the physical problems reported by employees were resolved to their satisfaction one year later. Successful implementation of ergonomics programs depend upon effective communication and education of the consumers, and the support, cooperation and collaboration of management and employees.
Haque, Hasibul; Hill, Philip C; Gauld, Robin
2017-01-01
Against a backdrop of changing concepts of aid effectiveness, development effectiveness, health systems strengthening, and increasing emphasis on impact evaluation, this article proposes a theory-driven impact evaluation framework to gauge the effect of aid effectiveness principles on programmatic outcomes of different aid funded programs in the health sector of a particular country. The foundation and step-by-step process of implementing the framework are described. With empirical evidence from the field, the steps involve analysis of context, program designs, implementation mechanisms, outcomes, synthesis, and interpretation of findings through the programs' underlying program theories and interactions with the state context and health system. The framework can be useful for comparatively evaluating different aid interventions both in fragile and non-fragile state contexts.
Johnson, Stacy R; Pas, Elise T; Bradshaw, Catherine P; Ialongo, Nicholas S
2018-05-01
There is growing awareness of the importance of implementation fidelity and the supports, such as coaching, to optimize it. This study examined how coaching activities (i.e., check-ins, needs assessment, modeling, and technical assistance) related directly and indirectly to implementation dosage and quality of the PAX Good Behavior Game, via a mediating pathway through working relationship. Mediation analyses of 138 teachers revealed direct effects of modeling and working relationship on implementation dosage, whereas needs assessment was associated with greater dosage indirectly, by higher ratings of the working relationship. Understanding how coaching activities promote implementation fidelity elements has implications for improving program effectiveness.
Evaluation of programs to improve complementary feeding in infants and young children.
Frongillo, Edward A
2017-10-01
Evaluation of complementary feeding programs is needed to enhance knowledge on what works, to document responsible use of resources, and for advocacy. Evaluation is done during program conceptualization and design, implementation, and determination of effectiveness. This paper explains the role of evaluation in the advancement of complementary feeding programs, presenting concepts and methods and illustrating them through examples. Planning and investments for evaluations should occur from the beginning of the project life cycle. Essential to evaluation is articulation of a program theory on how change would occur and what program actions are required for change. Analysis of program impact pathways makes explicit the dynamic connections in the program theory and accounts for contextual factors that could influence program effectiveness. Evaluating implementation functioning is done through addressing questions about needs, coverage, provision, and utilization using information obtained from process evaluation, operations research, and monitoring. Evaluating effectiveness is done through assessing impact, efficiency, coverage, process, and causality. Plausibility designs ask whether the program seemed to have an effect above and beyond external influences, often using a nonrandomized control group and baseline and end line measures. Probability designs ask whether there was an effect using a randomized control group. Evaluations may not be able to use randomization, particularly for programs implemented at a large scale. Plausibility designs, innovative designs, or innovative combinations of designs sometimes are best able to provide useful information. Further work is needed to develop practical designs for evaluation of large-scale country programs on complementary feeding. © 2017 John Wiley & Sons Ltd.
Implementing Suicide Prevention Programs: Costs and Potential Life Years Saved in Canada.
Vasiliadis, Helen-Maria; Lesage, Alain; Latimer, Eric; Seguin, Monique
2015-09-01
Little is known about the costs and effects of suicide prevention programs at the population level. We aimed to determine (i) the costs associated with a suicide death and using prospective values (ii) the costs and effects of transferring, into a Canadian context, the results of the European Nuremberg Alliance against Depression (NAD) trial with the addition of 4 community-based suicide prevention strategies. These included the training of family physicians in the detection and treatment of depression, population campaigns aimed at increasing awareness about depression, the training of community leaders among first responders and follow-up of individuals who attempted suicide. This study includes a prospective value implementation study design. Using published data and information from interviews with Canadian decision makers, we assessed the costs of a suicide death in the province of Quebec and the costs of potentially implementing the NAD multi-modal suicide prevention programs, and the incremental cost-effectiveness ratio (ICER), from a health care system and societal perspective, associated with the NAD program while considering the friction cost method (FCM) and human capital approach (HCA) (discounted at 3%.) The costs considered included those incurred for the suicide prevention program and direct medical and non-medical costs as well as those related to a police investigation and funeral costs. Indirect costs associated with loss of productivity and short term disability were also considered. Sensitivity analyses were also carried out. Costs presented were in 2010 dollars. The annual total cost of implementing the suicide prevention programs in Quebec reached CAD23,982,293. The most expensive components of the program included the follow-up of individuals who had attempted suicide and psychotherapy for bereaved individuals. These accounted for 39% and 34% of total costs. The ICER associated with the implementation of the programs reached on average CAD3,979 per life year saved. Suicide prevention programs such as the NAD trial are cost-effective and can result in important potential cost-savings due to averted suicide deaths and reduced life years lost. Implementation of suicide prevention programs at the population level in Canada is cost-effective. Community mental health programs aimed at increasing awareness and the treatment of depression and better follow-up of high risk individuals for suicide are associated with a minimal per capita investment. These programs can result in important potential cost-savings due to averted suicide deaths and decreased disability due to depression. Additional research should focus on whether the outcomes of multi-modal suicide programs are specific or synergistic and most effective for which population subgroups. This may help inform how best to invest resources for the highest return.
Miller, Ted R; Zaloshnja, Eduard; Spicer, Rebecca S
2007-05-01
Few studies have evaluated the impact of workplace substance abuse prevention programs on occupational injury, despite this being a justification for these programs. This paper estimates the effectiveness and benefit-cost ratio of a peer-based substance abuse prevention program at a U.S. transportation company, implemented in phases from 1988 to 1990. The program focuses on changing workplace attitudes toward on-the-job substance use in addition to training workers to recognize and intervene with coworkers who have a problem. The program was strengthened by federally mandated random drug and alcohol testing (implemented, respectively, in 1990 and 1994). With time-series analysis, we analyzed the association of monthly injury rates and costs with phased program implementation, controlling for industry injury trend. The combination of the peer-based program and testing was associated with an approximate one-third reduction in injury rate, avoiding an estimated $48 million in employer costs in 1999. That year, the peer-based program cost the company $35 and testing cost another $35 per employee. The program avoided an estimated $1850 in employer injury costs per employee in 1999, corresponding to a benefit-cost ratio of 26:1. The findings suggest that peer-based programs buttressed by random testing can be cost-effective in the workplace.
Kalina, C M
1999-10-30
Managers are challenged to demonstrate all programs as economically essential to the business, generating an appreciable return on investment. Further challenge exists to blend and integrate clinical and business objectives in program development. Disability management programs must be viewed as economically essential to the financial success of the business to assure management support for clinical interventions and return-to-work strategies essential for a successful program. This paper discusses a disability management program integrating clinical and business goals and objectives in return-to-work strategies to effect positive clinical, social-cultural, and business results. Clinical, educational, social, and economic challenges in the development, implementation, and continued management of a disability program at a large corporation with multiple global work sites are defined. Continued discussion addresses the effective clinical interventions and educational strategies utilized successfully within the workplace environment in response to each defined challenge. A multiple disciplinary team approach, clinical and business outcome measures, and quality assurance indicators are discussed as major program components. This article discusses a successful program approach focusing on business process and methodology. These parameters are used to link resources to strategy, developing a product for implementing and managing a program demonstrating economic value added through effective clinical medical case management.
Lee, Yang-Chool; Yi, Eun-Surk; Choi, Won-Ho; Lee, Byung-Mun; Cho, Sung-Bo; Kim, Ji-Youn
2015-01-01
The purpose of this study was to design a repeatable universal rehabilitation program in which patients with hemiplegia can participate voluntarily, complementing physical and occupational therapies to increase voluntary exercise practice rate. Also, this study attempted to identify the relationship between psychological resilience due to the implementation of self-bedside exercise and functional recovery of activity of daily living (ADL). 12 patients with hemiplegia voluntarily participated in 8 weeks of self-bedside exercise 5 times a day and more than 5 days a week. Their program implementation, resilience, activities of daily living (MBI), upper limb motor functions (MFT), and balance ability (BBS) were analyzed and compared before and after the program. Compared to before implementing the program, significant increases were found in resilience, MBI, BBS, and MFT in the affected side after the implementation, and the resilience scores showed statistically positive correlation in MBI and MFT. Also, the change in resilience before and after the program implementation showed a statistically positive correlation. Therefore, it can be concluded that the self-bedside exercise developed in this study had a positive effect on voluntary participation in exercise as well as resilience and ADL. However, many studies which complement the psychological aspects of hemiparetic patients with stroke are still needed. PMID:25830141
Kilbourne, Amy M; Almirall, Daniel; Goodrich, David E; Lai, Zongshan; Abraham, Kristen M; Nord, Kristina M; Bowersox, Nicholas W
2014-12-28
Few implementation strategies have been empirically tested for their effectiveness in improving uptake of evidence-based treatments or programs. This study compared the effectiveness of an immediate versus delayed enhanced implementation strategy (Enhanced Replicating Effective Programs (REP)) for providers at Veterans Health Administration (VA) outpatient facilities (sites) on improved uptake of an outreach program (Re-Engage) among sites not initially responding to a standard implementation strategy. One mental health provider from each U.S. VA site (N = 158) was initially given a REP-based package and training program in Re-Engage. The Re-Engage program involved giving each site provider a list of patients with serious mental illness who had not been seen at their facility for at least a year, requesting that providers contact these patients, assessing patient clinical status, and where appropriate, facilitating appointments to VA health services. At month 6, sites considered non-responsive (N = 89, total of 3,075 patients), defined as providers updating documentation for less than <80% of patients on their list, were randomized to two adaptive implementation interventions: Enhanced REP (provider coaching; N = 40 sites) for 6 months followed by Standard REP for 6 months; versus continued Standard REP (N = 49 sites) for 6 months followed by 6 months of Enhanced REP for sites still not responding. Outcomes included patient-level Re-Engage implementation and utilization. Patients from sites that were randomized to receive Enhanced REP immediately compared to Standard REP were more likely to have a completed contact (adjusted OR = 2.13; 95% CI: 1.09-4.19, P = 0.02). There were no differences in patient-level utilization between Enhanced and Standard REP sites. Enhanced REP was associated with greater Re-Engage program uptake (completed contacts) among sites not responding to a standard implementation strategy. Further research is needed to determine whether national implementation of Facilitation results in tangible changes in patient-level outcomes. ISRCTN21059161.
ERIC Educational Resources Information Center
Harris, Paulette Proctor; Pollingue, Alice B.; Hearrington, Doug; Holmes, Arthur
2014-01-01
New special education teachers often struggle to teach children the mathematics vocabulary necessary to understand and effectively solve math word problems. The authors designed and implemented a pilot program to prepare pre-service teachers majoring in special education to implement the Camelot Learning Math Intervention Program (CLMIP). We met…
ERIC Educational Resources Information Center
Flores, Margaret M.; Kaylor, Maria
2007-01-01
The current exploratory study investigated the effects of a Direct Instruction program implemented with middle school students identified as at-risk for failure in mathematics. Direct Instruction has typically been implemented with students with disabilities in separate special education settings. However, this study examined the extent to which…
[A Matter of Balance: strategy for implementation in Dutch homecare organizations].
de Jonge, M C; van der Poel, A; van Haastregt, J C M; Du Moulin, M F T M; Zijlstra, G A R; Voordouw, I
2013-02-01
The Dutch version of A Matter of Balance (AMB-NL) is a cognitive behavioral group program to reduce fear of falling and related activity avoidance in community-living older persons. This paper presents the strategy for implementation of AMB-NL in Dutch homecare organizations and the outcomes of this implementation. The aim was to implement AMB-NL in at least 50 % of 64 homecare organizations in The Netherlands in 2009 and 2010. The implementation strategy was based on the four phases of the Replicating Effective Interventions: pre-conditions, pre-implementation, implementation, and maintenance and evolution. After preparing the implementation activities, such as identifying implementation barriers, consulting stakeholders, preparing the materials involved in the implementation, and training the facilitators of the program (n = 53), AMB-NL was implemented in 16 of the 64 homecare organizations (25 %). Another five homecare organizations indicated that they would shortly include AMB-NL in their care program. These organizations conducted the intervention 19 times to a total of 178 participants. After the implementation phase another 16 facilitators were trained, and program materials were successfully disseminated. The implementation of AMB-NL was well performed. The targeted aim is not fully reached within the two-year timeframe, but the program is well received by participants, trainers and homecare organizations. Further implementation and maintenance of AMB-NL in primary health care is recommended.
Reynolds, Arthur J; Hayakawa, Momoko; Ou, Suh-Ruu; Mondi, Christina F; Englund, Michelle M; Candee, Allyson J; Smerillo, Nicole E
2017-09-01
We describe the development, implementation, and evaluation of a comprehensive preschool to third grade prevention program for the goals of sustaining services at a large scale. The Midwest Child-Parent Center (CPC) Expansion is a multilevel collaborative school reform model designed to improve school achievement and parental involvement from ages 3 to 9. By increasing the dosage, coordination, and comprehensiveness of services, the program is expected to enhance the transition to school and promote more enduring effects on well-being in multiple domains. We review and evaluate evidence from two longitudinal studies (Midwest CPC, 2012 to present; Chicago Longitudinal Study, 1983 to present) and four implementation examples of how the guiding principles of shared ownership, committed resources, and progress monitoring for improvement can promote effectiveness. The implementation system of partners and further expansion using "Pay for Success" financing shows the feasibility of scaling the program while continuing to improve effectiveness. © 2017 The Authors. Child Development published by Wiley Periodicals, Inc. on behalf of Society for Research in Child Development.
Evaluating the Effectiveness of the Kids Living Fit[TM] Program: A Comparative Study
ERIC Educational Resources Information Center
Speroni, Karen Gabel; Earley, Cynthia; Atherton, Martin
2007-01-01
After-school programs can be implemented by school nurses to facilitate healthy lifestyle choices in children with the goal of decreasing obesity. Kids Living Fit[TM] (KLF), an after-school program designed by community hospital nurses, was implemented in elementary schools and focused on best lifestyle choices regarding foods consumed and…
Fat Bias and Weight-Related Teasing Prevention among Adolescents
ERIC Educational Resources Information Center
Miyairi, Maya
2013-01-01
The purpose of this study was to implement a weight-related teasing prevention program and evaluate the effectiveness of the program among adolescents. One hundred forty-three students in 7th-grade in health classes at the middle school were asked to participate in the study. The weight-related teasing prevention program was implemented as part of…
ERIC Educational Resources Information Center
Rollins, Howard; And Others
The results of a 3-year project that developed a practical program for the wide-scale implementation of behavior modification in urban schools are presented in this paper. The major outcomes of the project were (a) a practical, cost-effective behavior modification program that reduces discipline problems, increases student motivation, and…
ERIC Educational Resources Information Center
Weaver, Robert G.; Moore, Justin B.; Turner-McGrievy, Brie; Saunders, Ruth; Beighle, Aaron; Khan, M. Mahmud; Chandler, Jessica; Brazendale, Keith; Randell, Allison; Webster, Collin; Beets, Michael W.
2017-01-01
Background: The YMCA of USA has adopted Healthy Eating and Physical Activity (HEPA) Standards for its afterschool programs (ASPs). Little is known about strategies YMCA ASPs are implementing to achieve Standards and these strategies' effectiveness. Aims: (1) Identify strategies implemented in YMCA ASPs and (2) evaluate the relationship between…
Eco-School in Kindergartens: The Effects, Interpretation, and Implementation of a Pilot Program
ERIC Educational Resources Information Center
Cincera, Jan; Kroufek, Roman; Simonova, Petra; Broukalova, Lenka; Broukal, Vaclav; Skalík, Jan
2017-01-01
This study presents an analysis of a Czech pilot project in implementing the Eco-School program in kindergartens. The evaluation applied a mixed design that included pre/post testing of children using picture-based questionnaires, and interviews with the teachers responsible for conducting the program. The findings revealed a significant increase…
Rafii, Zahra; Ahmadi, Fazlollah; Nourbakhsh, Sayed Mohamad Kazem; Hajizadeh, Ebrahim
2016-09-01
Introduction: Medical advances have improved life expectancy and survival of patients with thalassemia. However, as getting older, patients with thalassemia experience different complications which impair their quality of life. The aim of this study was to examine the effects of a nurse-implemented orientation program on quality of life in patients with thalassemia. Methods: A convenience sample of 55 patients with thalassemia were recruited in this quasi-experimental study. Patients were randomly allocated to control or experimental groups. A demographic questionnaire, Thalassemia quality of life questionnaire, and 36-item short form health survey were used for data collection before and one month after the intervention. In the intervention group, 1.5-month orientation program including of the three steps of inauguration, implementation, and closure was implemented, while the control group received routine care. The Chi-square, independent t-test and paired-samples t-test were used for data analysis by using SPSS ver.13 software. Results: The intervention and control group did not differ significantly from each other regarding demographic characteristics. Moreover, no significant difference was observed between the two groups regarding the quality of life scores after the implementation of orientation program. Conclusion: Implementing a short-term orientation program was not effective in enhancing the quality of life in patients with thalassemia; hence, developing long-term multimodal strategies may result in better improvement.
Dennis, Sarah; Hetherington, Sharon A; Borodzicz, Jerrad A; Hermiz, Oshana; Zwar, Nicholas A
2015-04-01
Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program. Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically. Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas. Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration when programs are funded and implemented in the community.
ERIC Educational Resources Information Center
Nelson, J. Ron; Martella, Ronald M.; Marchand-Martella, Nancy
2002-01-01
A study evaluated a comprehensive school-wide program based on an effective behavioral support approach for preventing disruptive behaviors implemented in seven elementary schools. The program included a school-wide discipline program, tutoring, conflict resolution, and functional behavioral intervention plans. Schools showed positive effects on…
Effective Summer Programming: What Educators and Policymakers Should Know
ERIC Educational Resources Information Center
McEachin, Andrew; Augustine, Catherine H.; McCombs, Jennifer
2018-01-01
The evidence suggests that many types of summer learning programs have the potential to reduce summer learning losses and perhaps create learning gains. However, implementing a summer program does not guarantee positive effects on students' learning. A key question then is: What factors make a summer learning program effective? This article, drawn…
2013-01-01
Background A multifaceted implementation (MFI) strategy was used to implement an evidence-based occupational therapy program for people with dementia (COTiD program). This strategy was successful in increasing the number of referrals, but not in improving occupational therapists’ (OTs) adherence. Therefore, a process evaluation was conducted to identify factors that influenced the effectiveness of the MFI strategy. Methods A mixed-method approach of qualitative and quantitative research was used to evaluate the implementation process. The MFI strategy as planned and as executed were reported and evaluated based on the framework of Hulscher et al. (2003; 2006). Data on OTs attitudes and expected barriers were collected at baseline from 94 OTs using a 19-item questionnaire. Data on the experiences were collected after finishing the implementation using focus groups with OTs and telephone interviews with physicians and managers. For quantitative data, frequencies and correlations were calculated and qualitative data were analyzed using inductive content analysis. Results The implementation strategy as executed had a stronger focus than planned on increasing OTs promotional skills due to an initial lack of referrals. This resulted in less attention for increasing OTs’ skills in using the COTiD program as initially intended. At baseline, OTs had a positive attitude toward the program, however, 75% did not feel experienced enough and only 14.3% felt competent in using the program. Focus groups and interviews revealed various determinants that influenced implementation. Most managers were positive about the program. However, the degree of operational support of managers for OTs regarding the implementation was not always adequate. Managers stated that a well-defined place for occupational therapy within the dementia care network was lacking although this was perceived necessary for successful implementation. Several physicians perceived psychosocial interventions not to be in their area of expertise or not their responsibility. All professionals perceived inter-professional collaboration to be a facilitator for effective implementation, and general practitioners were perceived as key partners in this collaboration. However, collaboration was not always optimal. OTs indicated that increasing the referral rate was most effective when promoting OT via other disciplines within a physician’s network. Conclusion Our data suggests that a first step in successful implementation should be to make sure that individual and organizational barriers are resolved. In addition, implementation should be network-based and encourage inter-professional collaboration. Initial promotion of COTiD should focus on physicians that have a positive attitude toward non-pharmacological interventions. PMID:24195975
Döpp, Carola M E; Graff, Maud J L; Rikkert, Marcel G M Olde; Nijhuis van der Sanden, Maria W G; Vernooij-Dassen, Myrra J F J
2013-11-07
A multifaceted implementation (MFI) strategy was used to implement an evidence-based occupational therapy program for people with dementia (COTiD program). This strategy was successful in increasing the number of referrals, but not in improving occupational therapists' (OTs) adherence. Therefore, a process evaluation was conducted to identify factors that influenced the effectiveness of the MFI strategy. A mixed-method approach of qualitative and quantitative research was used to evaluate the implementation process. The MFI strategy as planned and as executed were reported and evaluated based on the framework of Hulscher et al. (2003; 2006). Data on OTs attitudes and expected barriers were collected at baseline from 94 OTs using a 19-item questionnaire. Data on the experiences were collected after finishing the implementation using focus groups with OTs and telephone interviews with physicians and managers. For quantitative data, frequencies and correlations were calculated and qualitative data were analyzed using inductive content analysis. The implementation strategy as executed had a stronger focus than planned on increasing OTs promotional skills due to an initial lack of referrals. This resulted in less attention for increasing OTs' skills in using the COTiD program as initially intended. At baseline, OTs had a positive attitude toward the program, however, 75% did not feel experienced enough and only 14.3% felt competent in using the program. Focus groups and interviews revealed various determinants that influenced implementation. Most managers were positive about the program. However, the degree of operational support of managers for OTs regarding the implementation was not always adequate. Managers stated that a well-defined place for occupational therapy within the dementia care network was lacking although this was perceived necessary for successful implementation. Several physicians perceived psychosocial interventions not to be in their area of expertise or not their responsibility. All professionals perceived inter-professional collaboration to be a facilitator for effective implementation, and general practitioners were perceived as key partners in this collaboration. However, collaboration was not always optimal. OTs indicated that increasing the referral rate was most effective when promoting OT via other disciplines within a physician's network. Our data suggests that a first step in successful implementation should be to make sure that individual and organizational barriers are resolved. In addition, implementation should be network-based and encourage inter-professional collaboration. Initial promotion of COTiD should focus on physicians that have a positive attitude toward non-pharmacological interventions.
Monfils, M K
1995-05-01
1. The functions of a continuous quality improvement tool used by Deming--the Plan, Do, Check, Act Cycle--can be applied to the assessment, implementation, and ongoing evaluation of an Employee Assistance Program (EAP). 2. Various methods are available to assess the need for an EAP. As much data as possible should be collected to qualify and quantify the need so that management can make an informed decision and develop measures to determine program effectiveness. 3. Once an EAP is implemented, it should be monitored continually against the effectiveness measures initially developed. Using a continuous quality improvement process, the occupational health nurse and the EAP provider can establish a dynamic relationship that allows for growth beyond the original design and increased effectiveness of service to employees.
Jiang, Xuemei; Zhang, Kebin; Yang, Xiaohui
2017-01-01
Many payment for ecosystem services (PES) programs, such as the Slope Land Conversion Program (SLCP), are passive and require full participation by impacted households. In contrast, this study considers the alternative of “active and incomplete” participation in PES programs, in which participants are not obliged to contract their own land, and have the right to select into the program or not. This type of program has been popular over the last decade in China; however, there have been few studies on the characteristics of willingness to participate and implementation. As such, this paper uses the Choice Experiment (CE) method to explore ways for inducing effective program participation, by analyzing the effects of different regime attributes. The case study used to analyze participation utility was the Jing-Ji Afforestation Program for Ecological and Water Protection (JAPEWP), a typical active-participation forestry PES program, and a key source of water near Beijing in the Miyun Reservoir Catchment (MRC). Analyzing rural household survey data indicated that the program faces a variety of challenges, including long-term maintenance, implementation performance, cost-effectiveness, and monitoring approaches. There are also challenges with one-size-fits-all payment strategies, due to ineffective program participation or imperfect implementation regimes. In response, this study proposes several policies, including providing secure and complete land tenure to the participants, creating more local off-farm employment opportunities, designing performance-based monitoring systems that are integrated with financial incentives, applying differentiated payment strategies, providing capacity building to support forestation activities, and establishing a comprehensive implementation regime that would address these challenges. These policy conclusions provide valuable lessons for other active-participation PES programs as well. PMID:28046106
Li, Hao; Bennett, Michael T; Jiang, Xuemei; Zhang, Kebin; Yang, Xiaohui
2017-01-01
Many payment for ecosystem services (PES) programs, such as the Slope Land Conversion Program (SLCP), are passive and require full participation by impacted households. In contrast, this study considers the alternative of "active and incomplete" participation in PES programs, in which participants are not obliged to contract their own land, and have the right to select into the program or not. This type of program has been popular over the last decade in China; however, there have been few studies on the characteristics of willingness to participate and implementation. As such, this paper uses the Choice Experiment (CE) method to explore ways for inducing effective program participation, by analyzing the effects of different regime attributes. The case study used to analyze participation utility was the Jing-Ji Afforestation Program for Ecological and Water Protection (JAPEWP), a typical active-participation forestry PES program, and a key source of water near Beijing in the Miyun Reservoir Catchment (MRC). Analyzing rural household survey data indicated that the program faces a variety of challenges, including long-term maintenance, implementation performance, cost-effectiveness, and monitoring approaches. There are also challenges with one-size-fits-all payment strategies, due to ineffective program participation or imperfect implementation regimes. In response, this study proposes several policies, including providing secure and complete land tenure to the participants, creating more local off-farm employment opportunities, designing performance-based monitoring systems that are integrated with financial incentives, applying differentiated payment strategies, providing capacity building to support forestation activities, and establishing a comprehensive implementation regime that would address these challenges. These policy conclusions provide valuable lessons for other active-participation PES programs as well.
Godoy Garraza, Lucas; Walrath, Christine; Goldston, David B; Reid, Hailey; McKeon, Richard
2015-11-01
Youth suicide prevention is a major public health priority. Studies documenting the effectiveness of community-based suicide prevention programs in reducing the number of nonlethal suicide attempts have been sparse. To determine whether a reduction in suicide attempts among youths occurs following the implementation of the Garrett Lee Smith Memorial Suicide Prevention Program (hereafter referred to as the GLS program), consistent with the reduction in mortality documented previously. We conducted an observational study of community-based suicide prevention programs for youths across 46 states and 12 tribal communities. The study compared 466 counties implementing the GLS program between 2006 and 2009 with 1161 counties that shared key preintervention characteristics but were not exposed to the GLS program. The unweighted rounded numbers of respondents used in this analysis were 84 000 in the control group and 57 000 in the intervention group. We used propensity score-based techniques to increase comparability (on background characteristics) between counties that implemented the GLS program and counties that did not. We combined information on program activities collected by the GLS national evaluation with information on county characteristics from several secondary sources. The data analysis was performed between April and August 2014. P < .05 was considered statistically significant. Comprehensive, multifaceted suicide prevention programs, including gatekeeper training, education and mental health awareness programs, screening activities, improved community partnerships and linkages to service, programs for suicide survivors, and crisis hotlines. Suicide attempt rates for each county following implementation of the GLS program for youths 16 to 23 years of age at the time the program activities were implemented. We obtained this information from the National Survey on Drug Use and Health administered to a large national probabilistic sample between 2008 and 2011. Counties implementing GLS program activities had significantly lower suicide attempt rates among youths 16 to 23 years of age in the year following implementation of the GLS program than did similar counties that did not implement GLS program activities (4.9 fewer attempts per 1000 youths [95% CI, 1.8-8.0 fewer attempts per 1000 youths]; P = .003). More than 79 000 suicide attempts may have been averted during the period studied following implementation of the GLS program. There was no significant difference in suicide attempt rates among individuals older than 23 years during that same period. There was no evidence of longer-term differences in suicide attempt rates. Comprehensive GLS program activities were associated with a reduction in suicide attempt rates. Sustained suicide prevention programming efforts may be needed to maintain the reduction in suicide attempt rates.
Padek, Margaret; Allen, Peg; Erwin, Paul C; Franco, Melissa; Hammond, Ross A; Heuberger, Benjamin; Kasman, Matt; Luke, Doug A; Mazzucca, Stephanie; Moreland-Russell, Sarah; Brownson, Ross C
2018-03-23
Much of the cancer burden in the USA is preventable, through application of existing knowledge. State-level funders and public health practitioners are in ideal positions to affect programs and policies related to cancer control. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Greater attention to mis-implementation should lead to use of effective interventions and more efficient expenditure of resources, which in the long term, will lead to more positive cancer outcomes. This is a three-phase study that takes a comprehensive approach, leading to the elucidation of tactics for addressing mis-implementation. Phase 1: We assess the extent to which mis-implementation is occurring among state cancer control programs in public health. This initial phase will involve a survey of 800 practitioners representing all states. The programs represented will span the full continuum of cancer control, from primary prevention to survivorship. Phase 2: Using data from phase 1 to identify organizations in which mis-implementation is particularly high or low, the team will conduct eight comparative case studies to get a richer understanding of mis-implementation and to understand contextual differences. These case studies will highlight lessons learned about mis-implementation and identify hypothesized drivers. Phase 3: Agent-based modeling will be used to identify dynamic interactions between individual capacity, organizational capacity, use of evidence, funding, and external factors driving mis-implementation. The team will then translate and disseminate findings from phases 1 to 3 to practitioners and practice-related stakeholders to support the reduction of mis-implementation. This study is innovative and significant because it will (1) be the first to refine and further develop reliable and valid measures of mis-implementation of public health programs; (2) bring together a strong, transdisciplinary team with significant expertise in practice-based research; (3) use agent-based modeling to address cancer control implementation; and (4) use a participatory, evidence-based, stakeholder-driven approach that will identify key leverage points for addressing mis-implementation among state public health programs. This research is expected to provide replicable computational simulation models that can identify leverage points and public health system dynamics to reduce mis-implementation in cancer control and may be of interest to other health areas.
Commuter choice primer : an employer's guide to implementing effective commuter choice programs
DOT National Transportation Integrated Search
2003-01-01
The Commuter Choice Primer is intended to be a concise, user-friendly reference guide for employers and transportation professionals to developing and implementing worksite commuter choice programs. It is available on-line in both HTML and PDF format...
State of the science on implementation research in early child development and future directions.
Aboud, Frances E; Yousafzai, Aisha K; Nores, Milagros
2018-05-01
We summarize the state of the field of implementation research and practice for early child development and propose recommendations. First, conclusions are drawn regarding what is generally known about the implementation of early childhood development programs, based on papers and discussions leading to a published series on the topic. Second, recommendations for short-term activities emphasize the use of newly published guidelines for reporting data collection methods and results for implementation processes; knowledge of the guidelines and a menu of measures allows for planning ahead. Additional recommendations include careful documentation of early-stage implementation, such as adapting a program to a different context and assessing feasibility, as well as the process of sustaining and scaling up a program. Using existing implementation information by building on and improving past programs and translating them into policy are recommended. Longer term goals are to identify implementation characteristics of effective programs and determinants of these characteristics. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals Inc. on behalf of The New York Academy of Sciences.
NASA Astrophysics Data System (ADS)
Pearson, Roxanne N.
In 2010, the President's Council of Advisors on Science and Technology recommended that eight hundred new STEM focused elementary and middle schools be established. Unfortunately, districts may be slow to implement STEM at the elementary level because they do not understand how to do so effectively (Zimny, 2017). School administrators need a framework for decision-making and supervisory feedback related to the process of managing these programs (Zimny, 2017). To support administrators in implementing elementary STEM immersion programs, this project explored three questions: What criteria are common among existing STEM immersion program rubrics? What criteria should be included in a comprehensive rubric for managing elementary STEM immersion programs at the district level? What do district documents show about how elementary STEM immersion programs develop, implement, and evaluate those programs? The team developed a comprehensive STEM program review instrument including criteria for effective elementary STEM curriculum and the professional development and administrative support necessary to implement such curriculum. These criteria were organized into three stages, including the planning and development of elementary STEM immersion programs, the implementation of these programs, and the evaluation of these programs after they had been implemented for a significant period of time. The team synthesized best practice indicators relevant to elementary STEM programs from existing K-12 guides, then validated those indicators against current best practice research and feedback from STEM education experts. District documents from seven elementary STEM immersion programs in Missouri and Colorado were examined using the team's rubric. Scores were higher in the areas of program planning, content alignment, and ongoing refinement of curriculum, and lower in the areas of professional development for professional skills and STEM-specific pedagogy, two-way communication with stakeholders, and data collection for program refinement. Scores were lowest for those schools with inadequate documentation of their program management processes. The team recommended districts institute a more rigorous documentation process for managing innovative programs such as STEM immersion. Communication plans should include procedures for two-way communication with all stakeholders. Data collection and refinement efforts should increase, as should professional development opportunities related to professional skills and STEM-specific pedagogy; this should include administrators.
NASA Astrophysics Data System (ADS)
Boriack, Anna Christine
The purpose of this study is to examine teachers' perceptions of professional development and changes in classroom practice. A proposed conceptual framework for effective professional development that results in changes in classroom practices was developed. Data from two programs that provided professional development to teachers in the areas of technology, mathematics, and science was used to inform the conceptual framework. These two programs were Target Technology in Texas (T3) and Mathematics, Science, and Technology Teacher Preparation Academies (MSTTPA). This dissertation used a multiple article format to explore each program separately, yet the proposed conceptual framework allowed for comparisons to be made between the two programs. The first study investigated teachers' perceptions of technology-related professional development after their districts had received a T3 grant. An online survey was administrated to all teachers to determine their perceptions of technology-related professional development along with technology self-efficacy. Classroom observations were conducted to determine if teachers were implementing technology. The results indicated that teachers did not perceive professional development as being effective and were not implementing technology in their classrooms. Teachers did have high technology self-efficacy and perceived adequate school support, which implies that effective professional development may be a large factor in whether or not teachers implement technology in their classrooms. The second study evaluated participants' perceptions of the effectiveness of mathematics and science professional development offered through a MSTTP academy. Current and former participants completed an online survey which measured their perceptions of academy activities and school environment. Participants also self-reported classroom implementation of technology. Interviews and open-ended survey questions were used to provide further insight into academy activities. The results indicated that academy participants perceived effective academy activities along with a supportive school environment. Additionally, participants reported sometimes implementing technology in their classrooms. These findings suggest that several factors might influence the successful classroom implementation of professional development. The data which supports the conceptual framework shows that effective professional development may play a key role in successful classroom implementation. Future professional development activities should be designed around characteristics for effective professional development to increase the likelihood that classroom implementation might occur.
Ishaak, Fariel; de Vries, Nanne Karel; van der Wolf, Kees
2014-06-11
In this article, the test implementation of a school-oriented drug prevention program "Study without Drugs" is discussed. The aims of this study were to determine the results of the process evaluation and to determine whether the proposed school-oriented drug prevention program during a pilot project was effective for the participating pupils. Sixty second-grade pupils at a junior high school in Paramaribo, Suriname participated in the test implementation. They were divided into two classes. For the process evaluation the students completed a structured questionnaire focusing on content and teaching method after every lesson. Lessons were qualified with a score from 0-10. The process was also evaluated by the teachers through structured interviews. Attention was paid to reach, dose delivered, dose received, fidelity, connection, achieved effects/observed behaviors, areas for improvement, and lesson strengths. The effect evaluation was conducted by using the General Liniair Model (repeated measure). The research (-design) was a pre-experimental design with pre-and post-test. No class or sex differences were detected among the pupils with regard to the assessment of content, methodology, and qualification of the lessons. Post-testing showed that participating pupils obtained an increased knowledge of drugs, their drug-resisting skills were enhanced, and behavior determinants (attitude, subjective norm, self-efficacy, and intention) became more negative towards drugs. From the results of the test implementation can be cautiously concluded that the program "Study without Drugs" may yield positive results when applied in schools). Thus, this pilot program can be considered a step towards the development and implementation of an evidence-based school-oriented program for pupils in Suriname.
2014-01-01
Background In this article, the test implementation of a school-oriented drug prevention program “Study without Drugs” is discussed. The aims of this study were to determine the results of the process evaluation and to determine whether the proposed school-oriented drug prevention program during a pilot project was effective for the participating pupils. Methods Sixty second-grade pupils at a junior high school in Paramaribo, Suriname participated in the test implementation. They were divided into two classes. For the process evaluation the students completed a structured questionnaire focusing on content and teaching method after every lesson. Lessons were qualified with a score from 0–10. The process was also evaluated by the teachers through structured interviews. Attention was paid to reach, dose delivered, dose received, fidelity, connection, achieved effects/observed behaviors, areas for improvement, and lesson strengths. The effect evaluation was conducted by using the General Liniair Model (repeated measure). The research (-design) was a pre-experimental design with pre-and post-test. Results No class or sex differences were detected among the pupils with regard to the assessment of content, methodology, and qualification of the lessons. Post-testing showed that participating pupils obtained an increased knowledge of drugs, their drug-resisting skills were enhanced, and behavior determinants (attitude, subjective norm, self-efficacy, and intention) became more negative towards drugs. Conclusions From the results of the test implementation can be cautiously concluded that the program “Study without Drugs” may yield positive results when applied in schools). Thus, this pilot program can be considered a step towards the development and implementation of an evidence-based school-oriented program for pupils in Suriname. PMID:24920468
ERIC Educational Resources Information Center
Reyes, Maria Regina; Brackett, Marc A.; Rivers, Susan E.; Elbertson, Nicole A.; Salovey, Peter
2012-01-01
This study examined how training, dosage, and implementation quality of a social and emotional learning program, The RULER Approach, were related to students' social and emotional competencies. There were no main effects for any of the variables on student outcomes, but students had more positive outcomes when their teachers (a) attended more…
ERIC Educational Resources Information Center
Srivastava, Meenakshi; de Boer, Anke A.; Pijl, Sip Jan
2015-01-01
Teachers are seen as key players in implementing inclusive education. However, extremely little attention has been paid to teacher preparation, particularly in India. The aim of the current study was to implement a teacher training program and evaluate its effects and appropriateness. This focused on increasing teachers' (a) attitudes, (b)…
Crossroads Cafe Implementation Florida Evaluation.
ERIC Educational Resources Information Center
McLean, Teri
The evaluation reviews the implementation of the "Crossroads Cafe" English language instruction program in Florida, focusing on the program's management, training, and overall effectiveness as measured by its impact on adult English-as-a-Second-Language (ESL) teachers and learners. "Crossroads Cafe" is a series of videotape…
Evaluation Strategies for EWP Programs: A Marketing Perspective.
ERIC Educational Resources Information Center
Turkewych, Christine
1986-01-01
Describes how evaluation strategies can be implemented to increase the effectiveness of English in the Work Place programs. Discusses the design and implementation of the strategy, how to analyze its results and produce a final report, and ways to get the results used. (SED)
ERIC Educational Resources Information Center
Shin, YoungJu; Miller-Day, Michelle; Pettigrew, Jonathan; Hecht, Michael L.; Krieger, Janice L.
2014-01-01
Enhancing the delivery quality of school-based, evidence-based prevention programs is one key to ensuring uniform program effects on student outcomes. Program evaluations often focus on content dosage when implementing prevention curricula, however, less is known about implementation quality of prevention content, especially among teachers who may…
Miller, Alison L.; Weston, Lauren E.; Perryman, Jamie; Horwitz, Talia; Franzen, Susan; Cochran, Shirley
2015-01-01
Most incarcerated women are mothers. Parenting programs may benefit women, children and families, yet effectively intervening in correctional settings is a challenge. An evidence-based parenting intervention (the Strengthening Families Program) was tailored and implemented with women in a jail setting. Goals were to assess mothers' needs and interests regarding parenting while they were incarcerated, adapt the program to address those needs, and establish intervention delivery and evaluation methods in collaboration with a community-based agency. Women reported wanting to know more about effective communication; how children manage stress; finances; drug and alcohol use; self-care; and stress reduction. They reported high program satisfaction and reported reduced endorsement of corporal punishment after the intervention. Barriers to implementation included unpredictable attendance from session to session due to changing release dates, transfer to other facilities, and jail policies (e.g., lock-down; commissary hours). Implications for sustainable implementation of parenting programs in jail settings are discussed. PMID:26612963
Damschroder, Laura J; Reardon, Caitlin M; Sperber, Nina; Robinson, Claire H; Fickel, Jacqueline J; Oddone, Eugene Z
2017-06-01
The Telephone Lifestyle Coaching (TLC) program provided telephone-based coaching for six lifestyle behaviors to 5321 Veterans at 24 Veterans Health Administration (VHA) medical facilities. The purpose of the study was to conduct an evaluation of the TLC program to identify factors associated with successful implementation. A mixed-methods study design was used. Quantitative measures of organizational readiness for implementation and facility complexity were used to purposively select a subset of facilities for in-depth evaluation. Context assessments were conducted using interview transcripts. The Consolidated Framework for Implementation Research (CFIR) was used to guide qualitative data collection and analysis. Factors most strongly correlated with referral rates included having a skilled implementation leader who used effective multi-component strategies to engage primary care clinicians as well as general clinic structures that supported implementation. Evaluation findings pointed to recommendations for local and national leaders to help anticipate and mitigate potential barriers to successful implementation.
Reilly, Rachel; Evans, Katharine; Gomersall, Judith; Gorham, Gillian; Peters, Micah D J; Warren, Steven; O'Shea, Rebekah; Cass, Alan; Brown, Alex
2016-04-06
Indigenous peoples in Australia, New Zealand and Canada carry a greater burden of chronic kidney disease (CKD) than the general populations in each country, and this burden is predicted to increase. Given the human and economic cost of dialysis, understanding how to better manage CKD at earlier stages of disease progression is an important priority for practitioners and policy-makers. A systematic review of mixed evidence was undertaken to examine the evidence relating to the effectivness, cost-effectiveness and acceptability of chronic kidney disease management programs designed for Indigenous people, as well as barriers and enablers of implementation of such programs. Published and unpublished studies reporting quantitative and qualitative data on health sector-led management programs and models of care explicitly designed to manage, slow progression or otherwise improve the lives of Indigenous people with CKD published between 2000 and 2014 were considered for inclusion. Data on clinical effectiveness, ability to self-manage, quality of life, acceptability, cost and cost-benefit, barriers and enablers of implementation were of interest. Quantitative data was summarized in narrative and tabular form and qualitative data was synthesized using the Joanna Briggs Institute meta-aggregation approach. Ten studies were included. Six studies provided evidence of clinical effectiveness of CKD programs designed for Indigenous people, two provided evidence of cost and cost-effectiveness of a CKD program, and two provided qualitative evidence of barriers and enablers of implementation of effective and/or acceptable CKD management programs. Common features of effective and acceptable programs were integration within existing services, nurse-led care, intensive follow-up, provision of culturally-appropriate education, governance structures supporting community ownership, robust clinical systems supporting communication and a central role for Indigenous Health Workers. Given the human cost of dialysis and the growing population of people living with CKD, there is an urgent need to draw lessons from the available evidence from this and other sources, including studies in the broader population, to better serve this population with programs that address the barriers to receiving high-quality care and improve quality of life.
Effect of six sigma program on the number of surgeries cancellation.
Gheysari, Esmat; Yousefi, Hojatollah; Soleymani, Hossain; Mojdeh, Soheila
2016-01-01
Today, the rate of surgeries is increasing, but surgeries are canceled due to various reasons. Unexpected cancellation of surgeries not only results in disorder in the operating room schedule, but also causes stress for patients and their family and increases costs. We determined the number and causes of surgery cancellations and areas for improvement. This outcome evaluation of Six Sigma program was conducted on 850 cases after the implementation of the program and compared to that of 850 cases which received routine care before the program. Cases were selected through easy sampling during the study. Before the implementation, the number of cancellations was recorded daily and their reasons were investigated. Then, Six Sigma program was implemented in accordance with the reasons for each category and necessary steps were taken to prevent the cancellation of surgeries. Data were collected for 3 months using a three-section data collection form. For data analysis, distribution and relative frequency and chi-square test were used. The three categories of patient, physician, and hospital system were identified as the main causes. The highest rate of cancellation was related to ENT surgeries (74.19%). No cancellations were made in orology surgeries. The implementation of the Six Sigma program caused a significant difference in surgery cancellation (P = 0.003); 31 (3.6%) cases of cancellation were reduced to 12 (1.4%) cases. The results showed that Six Sigma program is a pre-surgery care quality improvement program. Patient education and the implementation of the 6 sigma program can be effective in reducing the rate of cancellation of operations.
Meta-analysis of the effectiveness of school substance abuse prevention programs in Spain.
Espada, José P; Gonzálvez, María T; Orgilés, Mireia; Lloret, Daniel; Guillén-Riquelme, Alejandro
2015-01-01
There has been an increase in adolescent substance use that has led to the development and implementation of prevention programs. New evidence is needed in order to improve them and optimize the resources. The aim of this paper is to use a meta-analysis to analyze the effectiveness of school drug prevention programs in Spain. Twenty-one studies that evaluated drug abuse prevention programs in schools, were published between 2002 and 2013, and that met the selection criteria were identified. Preventive program effectiveness was low ( d = 0.16), although it was higher at the follow-up ( d = 0.30). The programs were most effective in changing attitudes ( d = 0.44) towards drugs. The models of health education ( d = 0.48) and social learning ( d = 0.20) were also very effective, especially in combination with oral, written, and audiovisual support material ( d = 0.21) and the implementation of joint programs by health education professionals and faculty members ( d = 0.25). Is possible to determine the need for more rigorous evaluations of interventions to establish useful programs.
Semiannual Report to Congress on the Effectiveness of the Civil Aviation Security Program.
1987-12-31
This report also provides data on the initiatives being implemented as a result of the review of domestic airport security by the Secretary’s Safety...enforcement support for airline and airport security measures. Finally, the passengers-the ultimate beneficiaries of the security program--pay for...of these airports is required to implement a security program which provides a secure operating environment for these air carriers. Airport security programs
Classroom Teachers' Perceptions of the Implementation and Effects of Full Inclusion.
ERIC Educational Resources Information Center
Sardo-Brown, Deborah; Hinson, Stephanie
1995-01-01
Describes a survey of 51 graduate students/full-time teachers at schools implementing full inclusion programs. Participants expressed their views concerning implementation methods, effects on instructional practices, community reactions, and advantages and disadvantages. Schools need to do a better job of explaining the rationale for full…
ERIC Educational Resources Information Center
Hawken, Leanne S.
2006-01-01
School psychologists are excellent candidates to support school administrations interested in implementing a continuum of effective behavior support. To prevent severe problem behavior, best practice suggests implementing a continuum of effective behavior support which includes primary level prevention procedures, secondary level targeted…
Effects of a work injury prevention program for housekeeping in the hotel industry.
Landers, Merrill; Maguire, Lynn
2004-01-01
The aim of this retrospective study was to determine the effectiveness of a work injury prevention program in the housekeeping department of a hotel. Studies have validated the use of different injury prevention strategies to decrease the incidence of work-related injuries. Few studies, however, have reported the efficacy of an on-site work injury prevention program by a physical therapist. In 1995, implementation of a work injury prevention program by a physical therapist to 50 housekeeping supervisors, 60 house persons and 340 guest room attendants at a large hotel began. This program included a detailed work risk analysis of the work environment, development of job descriptions, identification of injury-related problematic work situations, and implementation of a job specific supervisor-training program. Supervisor, house person and guest room attendant training was also conducted at the end of 1995 and the beginning of 1997. Data of injury reports in 1995, 1996, and 1997 were analyzed to determine the results of the program. There was a reduction in total injury claims, total medical expenses, total lost work time and total restricted duty time. These results demonstrate the cost effectiveness of implementing a work injury prevention program for housekeeping guest room attendants in the hotel industry. Copyright 2004 IOS Press
Program Implementation Approaches to Build and Sustain Health Care Coordination for Type 2 Diabetes.
Fitzgerald, Tania M; Williams, Pam A; Dodge, Julia A; Quinn, Martha; Heminger, Christina L; Moultrie, Rebecca; Taylor, Olivia; Nelson, Belinda W; Lewis, Megan A
2017-03-01
As more people enter the U.S. health care system under the Affordable Care Act (ACA), it is increasingly critical to deliver coordinated, high-quality health care. The ACA supports implementation and sustainability of efficient health care models, given expected limits in available resources. This article highlights implementation strategies to build and sustain care coordination, particularly ones consistent with and reinforced by the ACA. It focuses on disease self-management programs to improve the health of patients with type 2 diabetes, exemplified by grantees of the Alliance to Reduce Disparities in Diabetes. We conducted interviews with grantee program representatives throughout their 5-year programs and conducted a qualitative framework analysis of data to identify key themes related to care coordination. The most promising care coordination strategies that grantee programs described included establishing clinic-community collaborations, embedding community health workers within care management teams, and sharing electronic data. Establishing provider buy-in was crucial for these strategies to be effective. This article adds new insights into strategies promoting effective care coordination. The strategies that grantees implemented throughout the program align with ACA requirements, underscoring their relevance to the changing U.S. health care environment and the likelihood of further support for program sustainability.
Update and expansion of the HIV/AIDS prevention program archive (HAPPA)
Card, Josefina J.; Cunningham, Shayna D.; Newman, Emily N.; Golden, Rachel E.
2017-01-01
Established in 1996 with funding from CDC and NIH, the HIV/AIDS Prevention Program Archive (HAPPA) is now the biggest private sector collection of HIV-related evidence-based behavioral interventions (EBIs). Each EBI in HAPPA has been determined by a distinguished Scientist Expert Panel to have demonstrated efficacy in preventing HIV or its risk-related behaviors in the United States. The multimedia replications kits contain everything that a new site would need to implement an EBI such as a user guide that gives an overview of the program and the evidence of its effectiveness; a facilitator’s manual that gives step-by-step implementation protocols for each session; and session implementation materials referenced in the facilitator's manual such as slides, video clips, participant handouts, activity masters, checklists, and homework assignments for the next session. The program packages also contain evaluation materials such as surveys and questionnaires that were used in the original demonstration of effectiveness and that may be used to re-evaluate the program as implemented in a new setting. Recently, we have expanded HAPPA’s scope to include HIV EBIs developed globally and to include evidence-based structural interventions (effective in modifying the physical, social, cultural, political, economic, legal, and/or policy aspects of the HIV risk environment). This paper describes HAPPA’s procedures for identifying, selecting, acquiring and packaging HIV EBIs. It also provides comprehensive lists of evidence-based HIV behavioral and structural interventions and gives information on how to access EBI program packages for implementation in new settings. PMID:28781971
ERIC Educational Resources Information Center
Finn, Kevin; Campisi, Jay
2015-01-01
This article describes how a Peer-Led Team Learning (PLTL) program was implemented in a first-year, undergraduate Anatomy and Physiology course sequence to examine the student perceptions of the program and determine the effects of PLTL on student performance.
Effectiveness of a "Grass Roots" Statewide Enrichment Program for Gifted Elementary School Children
ERIC Educational Resources Information Center
Golle, Jessika; Zettler, Ingo; Rose, Norman; Trautwein, Ulrich; Hasselhorn, Marcus; Nagengast, Benjamin
2018-01-01
Enrichment programs provide learning opportunities for a broader or deeper examination of curricular or extracurricular topics and are popular in gifted education. Herein, we investigated the effectiveness of a statewide extracurricular enrichment program for gifted elementary school children in Germany. The program implemented a "grass…
Weingarten, Christine; Rabago, Jina; Reynolds, Jasmine; Gates, Kalani; Yanagida, Evie; Baker, Charlene
2018-06-01
Rates of childhood sexual abuse are unacceptably high, with potentially long-lasting consequences for those who have been victimized. Currently, there are a number of sexual violence prevention programs that have been developed to lower rates of victimization, increase awareness, and connect victims with resources. Within this area of research, there has been less focus on effective methods of program dissemination. For example, school-based sexual violence prevention programs have had positive outcomes; however, little is known about how these programs are disseminated. The train-the-trainer model of dissemination utilizes master trainers to equip others to implement programs, thereby allowing more adults to teach and subsequently more children to receive the program. This study used survey data from teachers and other school personnel (n = 127) to analyze the utility of a train-the-trainer model of dissemination for a sexual violence prevention program in the state of Hawai'i. Through responses of people who were trained to implement the program (59.8% of whom did implement), aspects of the training, the program itself, and factors affecting whether a person implemented the program were explored. Results suggest that time spent in training, job position, and time in that position predicted whether a person trained to implement the sexual violence prevention program followed through with teaching the program to students. Additionally, 54.7% of people who did implement the program had at least one student disclose sexual violence to them, indicating the importance of sexual violence prevention programming and dissemination of these programs. Copyright © 2018 Elsevier Ltd. All rights reserved.
Re-examining Responsibilities: Health Educators as Researchers.
ERIC Educational Resources Information Center
Drolet, Judy C.
1991-01-01
Discusses seven areas of responsibility for entry-level health educators which can be demonstrated through research: assessing individual and community needs for health education; planning effective health education programs; implementing programs; evaluating program effectiveness; coordinating service provision; acting as a resource; and…
The role of the case manager in a disease management program.
Huston, Carol J
2002-01-01
Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.
The role of the case manager in a disease management program.
Huston, C J
2001-01-01
Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.
Bergman, Jacqueline J; Briggs, Marilyn M; Beall, Deborah L; Curwood, Sandy; Gray, Pilar; Soiseth, Scott; Taylor, Rodney K; Zidenberg-Cherr, Sheri
2015-01-01
A statewide professional development program was developed and implemented throughout California for school nutrition directors with the goal of creating healthy school environments and regional networks for collaboration and healthy school environment sustainability. Needs of school nutrition directors were identified through a needs assessment questionnaire. Results of the needs assessment questionnaire (n = 256) identified (a) planning cost-effective menus; (b) reducing calories, sodium, saturated fat, and trans fat in menus; and (c) using U.S. Department of Agriculture foods cost-effectively as the most useful topics. Highest rated topics informed the content of the professional development program. A post-professional development questionnaire identified key "insights, inspirations, and strategies" as (a) marketing of school foods program, (b) expansion of salad bars, and (c) collaboration with community partners. A 6-month follow-up questionnaire identified that 86% of participants made progress toward implementing at least one of their five insights, inspirations, and strategies in their school districts. Most common areas that were implemented were marketing and branding (32%), revamping salad bars (18%), and motivating staff (16%). School and Community Actions for Nutrition survey analysis showed a significant increase in the use of marketing methods in school nutrition programs from baseline to 6-month post-program implementation (p = .024). © 2014 Society for Public Health Education.
[Level of implementation of the Program for Safety and Health at Work in Antioquia, Colombia].
Vega-Monsalve, Ninfa Del Carmen
2017-07-13
This study describes the level of implementation of the Program for Safety and Health at Work in companies located in the Department of Antioquia, Colombia, and associated factors. A cross-sectional survey included 73 companies with more than 50 workers each and implementation of the program. A total of 65 interviews were held, in addition to 73 checklists and process reviews. The companies showed suboptimal compliance with the management model for workplace safety and health proposed by the International Labor Organization (ILO). The component with the best development was Organization (87%), and the worst was Policy (67%). Company executives contended that the causes of suboptimal implementation were the limited commitment by area directors and scarce budget resources. Risk management mostly aimed to comply with the legal requirements in order to avoid penalties, plus documenting cases. There was little implementation of effective checks and controls to reduce the sources of work accidents. The study concludes that workers' health management lacks effective strategies.
Ouslander, Joseph G; Bonner, Alice; Herndon, Laurie; Shutes, Jill
2014-03-01
Interventions to Reduce Acute Care Transfers (INTERACT) is a publicly available quality improvement program that focuses on improving the identification, evaluation, and management of acute changes in condition of nursing home residents. Effective implementation has been associated with substantial reductions in hospitalization of nursing home residents. Familiarity with and support of program implementation by medical directors and primary care clinicians in the nursing home setting are essential to effectiveness and sustainability of the program over time. In addition to helping nursing homes prevent unnecessary hospitalizations and their related complications and costs, and thereby continuing to be or becoming attractive partners for hospitals, health care systems, managed care plans, and accountable care organizations, effective INTERACT implementation will assist nursing homes in meeting the new requirement for a robust quality assurance performance improvement program, which is being rolled out by the federal government over the next year. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.
Gould, Laura Feagans; Dariotis, Jacinda K.; Greenberg, Mark T.; Mendelson, Tamar
2015-01-01
As school-based mindfulness and yoga programs gain popularity, the systematic study of fidelity of program implementation (FOI) is critical to provide a more robust understanding of the core components of mindfulness and yoga interventions, their potential to improve specified teacher and student outcomes, and our ability to implement these programs consistently and effectively. This paper reviews the current state of the science with respect to inclusion and reporting of FOI in peer-reviewed studies examining the effects of school-based mindfulness and/or yoga programs targeting students and/or teachers implemented in grades kindergarten through twelve (K-12) in North America. Electronic searches in PsychInfo and Web of Science from their inception through May 2014, in addition to hand searches of relevant review articles, identified 312 publications, 48 of which met inclusion criteria. Findings indicated a relative paucity of rigorous FOI. Fewer than 10% of studies outlined potential core program components or referenced a formal theory of action, and fewer than 20% assessed any aspect of FOI beyond participant dosage. The emerging nature of the evidence base provides a critical window of opportunity to grapple with key issues relevant to FOI of mindfulness-based and yoga programs, including identifying essential elements of these programs that should be faithfully implemented and how we might develop rigorous measures to accurately capture them. Consideration of these questions and suggested next steps are intended to help advance the emerging field of school-based mindfulness and yoga interventions. PMID:27158278
Huang, Li-Hui; Zhang, Luo; Tobe, Ruo-Yan Gai; Qi, Fang-Hua; Sun, Long; Teng, Yue; Ke, Qing-Lin; Mai, Fei; Zhang, Xue-Feng; Zhang, Mei; Yang, Ru-Lan; Tu, Lin; Li, Hong-Hui; Gu, Yan-Qing; Xu, Sai-Nan; Yue, Xiao-Yan; Li, Xiao-Dong; Qi, Bei-Er; Cheng, Xiao-Huan; Tang, Wei; Xu, Ling-Zhong; Han, De-Min
2012-04-17
Neonatal hearing screening (NHS) has been routinely offered as a vital component of early childhood care in developed countries, whereas such a screening program is still at the pilot or preliminary stage as regards its nationwide implementation in developing countries. To provide significant evidence for health policy making in China, this study aims to determine the cost-effectiveness of NHS program implementation in case of eight provinces of China. A cost-effectiveness model was conducted and all neonates annually born from 2007 to 2009 in eight provinces of China were simulated in this model. The model parameters were estimated from the established databases in the general hospitals or maternal and child health hospitals of these eight provinces, supplemented from the published literature. The model estimated changes in program implementation costs, disability-adjusted life years (DALYs), average cost-effectiveness ratio (ACER), and incremental cost-effectiveness ratio (ICER) for universal screening compared to targeted screening in eight provinces. A multivariate sensitivity analysis was performed to determine uncertainty in health effect estimates and cost-effectiveness ratios using a probabilistic modeling technique. Targeted strategy trended to be cost-effective in Guangxi, Jiangxi, Henan, Guangdong, Zhejiang, Hebei, Shandong, and Beijing from the level of 9%, 9%, 8%, 4%, 3%, 7%, 5%, and 2%, respectively; while universal strategy trended to be cost-effective in those provinces from the level of 70%, 70%, 48%, 10%, 8%, 28%, 15%, 4%, respectively. This study showed although there was a huge disparity in the implementation of the NHS program in the surveyed provinces, both universal strategy and targeted strategy showed cost-effectiveness in those relatively developed provinces, while neither of the screening strategy showed cost-effectiveness in those relatively developing provinces. This study also showed that both strategies especially universal strategy achieve a good economic effect in the long term costs. Universal screening might be considered as the prioritized implementation goal especially in those relatively developed provinces of China as it provides the best health and economic effects, while targeted screening might be temporarily more realistic than universal screening in those relatively developing provinces of China.
Torres, Daniel; Gugala, Zbigniew; Lindsey, Ronald W
2015-04-01
Programs seek to expose trainees to research during residency. However, little is known in any formal sense regarding how to do this effectively, or whether these efforts result in more or better-quality research output. The objective of our study was to evaluate a dedicated resident research program in terms of the quantity and quality of resident research peer-reviewed publications. Specifically we asked: (1) Did residents mentored through a dedicated resident research program have more peer-reviewed publications in higher-impact journals with higher citation rates compared with residents who pursued research projects under a less structured approach? (2) Did this effect continue after graduation? In 2006, our department of orthopaedic surgery established a dedicated resident research program, which consisted of a new research policy and a research committee to monitor quality and compliance with this policy. Peer-reviewed publications (determined from PubMed) of residents who graduated 6 years before establishing the dedicated resident research program were compared with publications from an equal period of the research-program-directed residents. The data were assessed using descriptive statistics and regression analysis. Twenty-four residents graduated from 2001 to 2006 (before implementation of the dedicated resident research program); 27 graduated from 2007 to 2012 (after implementation of the dedicated resident research program). There were 74 eligible publications as defined by the study inclusion and exclusion criteria. Residents who trained after implementation of the dedicated resident research program published more papers during residency than did residents who trained before the program was implemented (1.15 versus 0.79 publications per resident; 95% CI [0.05,0.93]; p = 0.047) and the journal impact factor was greater in the group that had the research program (1.25 versus 0.55 per resident; 95% CI [0.2,1.18]; p = 0.005). There were no differences between postresidency publications by trainees who graduated with versus without the research program in the number of publications, citations, and average journal impact factor per resident. A regression analysis showed no difference in citation rates of the residents' published papers before and since implementation of the research program. Currently in the United States, there are no standard policies or requirements that dictate how research should be incorporated in orthopaedic surgery residency training programs. The results of our study suggest that implementation of a dedicated resident research program improves the quantity and to some extent quality of orthopaedic resident research publications, but this effect did not persist after graduation.
ERIC Educational Resources Information Center
Goh, Tan Leng
2014-01-01
Physical inactivity is an increasing problem among children and adolescents. The TAKE 10!® program, which integrates physical activity (PA) into academic subjects, was implemented in one elementary school in Magna, Utah to increase children's daily in-school PA. A three-study approach was used to examine: (a) effects of TAKE 10!® on elementary…
Ladapo, Joseph A.; Elliott, Marc N.; Bogart, Laura M.; Kanouse, David E.; Vestal, Katherine D.; Klein, David J.; Ratner, Jessica A.; Schuster, Mark A.
2015-01-01
Purpose To examine the cost and cost-effectiveness of implementing Talking Parents, Healthy Teens, a worksite-based parenting program designed to help parents address sexual health with their adolescent children. Methods We enrolled 535 parents with adolescent children at 13 worksites in southern California in a randomized trial. Time and wage data from employees involved in implementing the program were used to estimate fixed and variable costs. Cost-effectiveness was determined with nonparametric bootstrap analysis. For the intervention, parents participated in eight weekly one-hour teaching sessions at lunchtime. The program included games, discussions, role plays, and videotaped role plays to help parents learn to communicate with their children about sex-related topics, teach their children assertiveness and decision-making skills, and supervise and interact with their children more effectively. Results Implementing the program cost $543.03 (SD=$289.98) per worksite in fixed costs, and $28.05 per parent (SD=$4.08) in variable costs. At 9 months, this $28.05 investment per parent yielded improvements in number of sexual health topics discussed, condom teaching, and communication quality and openness. The cost-effectiveness was $7.42 per new topic discussed using parental responses and $9.18 using adolescent responses. Other efficacy outcomes also yielded favorable cost-effectiveness ratios. Conclusions Talking Parents, Healthy Teens demonstrated the feasibility and cost-effectiveness of a worksite-based parenting program to promote parent-adolescent communication about sexual health. Its cost is reasonable and unlikely to be a significant barrier to adoption and diffusion for most worksites considering its implementation. PMID:23406890
Implementation of a Mentor-Protege Program by a Major Department of Defense Contractor
1991-06-01
Department of Defense contractors to furnish disadvantaged small business concerns with assistance designed to enhance their capabilities to perform...implementation by analyzing the perceptions of one large DoD contractor and the small disadvantaged business community regarding the Mentor-Protege program...offered by this program would be effective in improving the capabilities of small disadvantaged businesses. There are, however, several barriers present
Jung, Mary E; Bourne, Jessica E; Gainforth, Heather L
2018-01-26
Childhood overweight and obesity is a major public health concern. Community-based interventions have the potential to reach caregivers and children. However, the overall health impact of these programs is rarely comprehensively assessed. This study evaluated a physical activity and healthy eating family program (Healthy Together; HT) using the RE-AIM framework. Ten sites implemented the 5-week program. Thirty-nine staff members and 277 program participants (126 caregivers [M age = 35.6] and 151 children [M age = 13]) participated in the evaluation. Each RE-AIM dimension was assessed independently using a mixed-methods approach. Sources of data included archival records, interviews and surveys. Effectiveness outcome variables were assessed at pre- and post-intervention and 6-month follow-up. Reach: HT participants were almost entirely recruited from existing programs within sites. Effectiveness: Caregivers' nutrition related efficacy beliefs increased following HT (ps < .03). Participation in HT was not associated with significant changes in physical activity or nutrition behaviour or perceived social support (ps > .05). Knowledge surrounding healthy diets and physical activity increased in children and caregivers (ps < .05). Adoption: Thirty-five percent of sites approached to implement HT expressed interest. The 10 sites selected recruited existing staff members to implement HT. Program objectives were met 72.8% of the time and 71 adaptations were made. HT was finance- and time-dependent. Maintenance: Two sites fully implemented HT in the follow-up year and 5 sites incorporated aspects of HT into other programs. Working alongside organizations that develop community programs to conduct comprehensive, arms-length evaluations can systematically highlight areas of success and challenges. Overall HT represents a feasible community-based intervention; however further support is required in order to ensure the program is effective at positively targeting the desired outcomes. As a result of this evaluation, modifications are currently being implemented to HT.
Mager, Diana R; Kazer, Meredith W; Conelius, Jaclyn; Shea, Joyce; Lippman, Doris T; Torosyan, Roben; Nantz, Kathryn
2014-06-03
For many years, an area of research in higher education has been emerging around the development and implementation of fair and effective peer evaluation programs. Recently, a new body of knowledge has developed regarding the development and implementation of fair and effective peer evaluation programs resulting in formative and summative evaluations. The purpose of this article is to describe the development, implementation, and evaluation of a peer review of teaching (PRoT) program for nursing faculty, initiated at one small comprehensive university in the northeastern United States. Pairs of nursing faculty evaluated each other's teaching, syllabi, and course materials after collaborating in a pre-evaluation conference to discuss goals of the classroom visit. Qualitative data gathered in post project focus groups revealed that faculty found their modified PRoT process to be a mutually beneficial experience that was more useful, flexible and collegial, and less stressful than their previous evaluation process.
Evaluating the Implementation of an Olympic Education Program in Greece
NASA Astrophysics Data System (ADS)
Grammatikopoulos, Vasilios; Tsigilis, Nikolaos; Koustelios, Athanasios; Theodorakis, Yannis
2005-11-01
The aim of this study was to develop an instrument for evaluating how an education program has been implemented. Such evaluation can provide insight into the effectiveness of a program. Examined here was the Olympic Education Program used in Greek schools since 2000. In it, students learn the history of the Olympic games and the importance of exercise for health along with the principles and values of sports and volunteerism. The evaluation instrument underlying this study addressed the following six factors: `facilities', `administration', `educational material', `student-teacher relationships', `educational procedures', and `training'. Results indicate that the instrument, while adequate for assessing effectiveness, should be combined with advanced statistical methods.
Korndorffer, James R; Arora, Sonal; Sevdalis, Nick; Paige, John; McClusky, David A; Stefanidis, Dimitris
2013-07-01
The American College of Surgeons/Association of Program Directors in Surgery (ACS/APDS) National Skills Curriculum is a 3-phase program targeting technical and nontechnical skills development. Few data exist regarding the adoption of this curriculum by surgical residencies. This study attempted to determine the rate of uptake and identify implementation enablers/barriers. A web-based survey was developed by an international expert panel of surgical educators (5 surgeons and 1 psychologist). After piloting, the survey was sent to all general surgery program directors via email link. Descriptive statistics were used to determine the residency program characteristics and perceptions of the curriculum. Implementation rates for each phase and module were calculated. Adoption barriers were identified quantitatively and qualitatively using free text responses. Standardized qualitative methodology of emergent theme analysis was used to identify strategies for success and details of support required for implementation. Of the 238 program directors approached, 117 (49%) responded to the survey. Twenty-one percent (25/117) were unaware of the ACS/APDS curriculum. Implementation rates for were 36% for phase I, 19% for phase II, and 16% for phase III. The most common modules adopted were the suturing, knot-tying, and chest tube modules of phase I. Over 50% of respondents identified lack of faculty protected time, limited personnel, significant costs, and resident work-hour restrictions as major obstacles to implementation. Strategies for effective uptake included faculty incentives, adequate funding, administrative support, and dedicated time and resources. Despite the availability of a comprehensive curriculum, its diffusion into general surgery residency programs remains low. Obstacles related to successful implementation include personnel, learner, and administrative issues. Addressing these issues may improve the adoption rate of the curriculum. Copyright © 2013 Mosby, Inc. All rights reserved.
Evaluation of Post-Arrival Programs and Services.
ERIC Educational Resources Information Center
Australian Inst. of Multicultural Affairs, Melbourne (Australia).
This book assesses the effectiveness of recommendations implemented after the release of the Australian government's "Report of the Review of Post-Arrival Programs and Services for Migrants" in 1977. In general, the implementation of the Report's proposals has been of substantial benefit to migrants (both newly arrived and longer…
ERIC Educational Resources Information Center
Reid, Sandy D.
2010-01-01
The purpose of this study was to determine (a) if the reading program adopted by Sally D. Meadows enhanced the achievement of students placed in the Early Intervention Program (EIP); (b) if the students' reading achievement scores increased more after the second year of implementation than they did after the first year of implementation; and (c)…
Results of an independent evaluation of Project ALERT delivered in schools by Cooperative Extension.
St Pierre, Tena L; Osgood, D Wayne; Mincemoyer, Claudia C; Kaltreider, D Lynne; Kauh, Tina J
2005-12-01
Reported are results of an independent effectiveness study of the Project ALERT drug prevention program implemented in eight Pennsylvania middle schools by outside program leaders employed by Cooperative Extension. In this randomized, 2-cohort longitudinal evaluation, 1,649 seventh-grade students completed a pretest and four waves of posttests over the 2-year program and 1-year follow-up. Project ALERT's effectiveness was tested through a 3-level hierarchical linear model. Analyses failed to yield any positive effects for substance use or mediators for use in the adult or teen-assisted delivery of the curriculum. An extensive set of additional analyses detected no differential program effects by student risk level, gender, school, or level of implementation quality. Potential explanations for outcomes relative to Project ALERT's original effectiveness trial are discussed, as well as implications for future research, including the need to conduct independent effectiveness studies of previously validated programs in a variety of contexts.
At What Cost? Examining the Cost Effectiveness of a Universal Social-Emotional Learning Program
ERIC Educational Resources Information Center
Hunter, Leah J.; DiPerna, James C.; Hart, Susan Crandall; Crowley, Max
2018-01-01
Although implementation of universal social-emotional learning programs is becoming more common in schools, few studies have examined the cost-effectiveness of such programs. As such, the purpose of this article is two fold. First, we provide an overview of cost-effectiveness methods for school-based programs, and second, we share results of a…
Developments in Assisting Countries in Implementing the IAEA Additional Protocol
DOE Office of Scientific and Technical Information (OSTI.GOV)
Killinger, Mark H.; Hansen, Linda H.; Cain, Ronald A.
In 2008, the U.S. Department of Energy (DOE) began assisting selected non-nuclear weapon states in planning and preparing for implementation of the International Atomic Energy Agency’s Additional Protocol (AP). Since then, the AP international implementation program has contributed to the substantial progress made by Vietnam, Thailand, Iraq, and Malaysia in preparing for entry-into-force of the AP. An overall engagement plan has been developed with components designed to train government AP implementing agencies, inform policy makers, conduct outreach to industry and universities, make AP reporting software available and useful, and plan a detailed approach for implementing the declaration and complementary accessmore » provisions of the AP. DOE recently began collaborating with Indonesia, which has already entered the AP into force, requiring a second method of engagement somewhat different from that taken with countries that have not entered the AP into force. The AP international implementation program, administered by the International Nuclear Safeguards and Engagement Program, is working more closely with DOE’s International Nonproliferation Export Control Program to ensure countries are aware of and prepared to implement the export/import provisions of the AP. As the AP implementation program matures and helps move countries closer to entry-into-force or improved AP implementation, it is identifying characteristics of a country’s “end-state” that indicate that DOE assistance is no longer required. The U.S. AP Implementation Act and Senate Resolution of Ratification require the Administration to report annually to Congress on measures taken to achieve the adoption of the AP in non-nuclear weapon states. DOE’s AP international implementation program is a significant part of these measures. This paper describes recent developments to increase the scope and effectiveness of the program.« less
Teacher training as a behavior change process: principles and results from a longitudinal study.
Kealey, K A; Peterson, A V; Gaul, M A; Dinh, K T
2000-02-01
For students to realize the benefits of behavior change curricula for disease prevention, programs must be implemented effectively. However, implementation failure is a common problem documented in the literature. In this article, teacher training is conceptualized as a behavior change process with explicit teacher motivation components included to help effect the intended behavior (i.e., implementation). Using this method, the Hutchinson Smoking Prevention Project, a randomized controlled trial in school-based smoking prevention, conducted 65 in-service programs, training nearly 500 teachers (Grades 3-10) from 72 schools. Implementation was monitored by teacher self-report and classroom observations by project staff. The results were favorable. All eligible teachers received training, virtually all trained teachers implemented the research curriculum, and 89% of observed lessons worked as intended. It is concluded that teacher training conceptualized as a behavior change process and including explicit teacher motivation components can promote effective implementation of behavior change curricula in public school classrooms.
Schutte, Lisette; Mevissen, Fraukje E F; Meijer, Suzanne; Paulussen, Theo; van Empelen, Pepijn; Kok, Gerjo
2018-06-18
The quality of implementation is important to ensure the effectiveness of behavioral change interventions in practice. Implementing such programs with completeness and adherence is not an automatic process and may require additional support. In school settings, the support teachers receive during implementation is often limited and appears to fall short when attempting to preserve completeness and adherence in program delivery. With the aim to improve completeness and adherence of teachers' delivery of a sexual health promoting intervention ("Long Live Love" [LLL]) in secondary education, a Web-based e-coach was developed ("lesgevenindeliefde.nl"or"teachinglove.nl"). The effectiveness of the e-coach, as part of a broader implementation strategy, in influencing teachers' implementation was evaluated. This study aimed to report on the effect evaluation to determine the effect of the Web-based e-coach on teacher implementation of a school-based sex education program called LLL and on its determinants. A cluster randomized controlled trial (e-coaching vs waiting list control) was conducted with a baseline assessment (T0) and follow-up (T1) 2 weeks after completing the LLL program. A total of 43 schools with 83 teachers participated in the study. In the follow-up, 38 schools participated, 23 in the e-coaching condition with 41 teachers and 15 in the control condition with 26 teachers. Multilevel regression analysis was used to evaluate the effect of the e-coaching website on implementation behavior, namely, completeness and adherence to LLL implementation, and on its determinants. The e-coaching intervention was not found to have an effect on teachers' implementation behavior; teachers assigned to the experimental e-coaching website did not score higher on completeness (P=.60) or adherence (P=.67) as compared with teachers in the control condition. When comparing the 30 teachers who made actual use of the e-coaching website with the 37 teachers who did not, no significant differences were found either (P≥.54). In addition, there was no effect of e-coaching on the determinants of teacher implementation behavior (t 67-75 ≤0.69; P≥.22). E-coaching was not found to be effective in enhancing completeness of and adherence to LLL by teachers. The lack of effect may be attributed to the intervention content, the limited use, or the study design itself. The e-coaching intervention may not have adequately addressed adherence and completeness of LLL to bring about behavioral change. Furthermore, the e-coaching intervention was not or insufficiently used by teachers. A possible biased sample of motivated, able teachers may have agreed to participate in the study, and a possible "ceiling effect" may have been present because of the high implementation grade. This, however, does not imply that Web-based coaching in itself is an ineffective strategy to promote adherence and completeness of program implementation. A process evaluation is required as follow-up. International Standard Randomised Controlled Trial Number ISRCTN11754581; http://www.isrctn.com/ISRCTN11754581 (Archived by WebCite at http://www.webcitation.org/70C5TUOOh). ©Lisette Schutte, Fraukje E.F. Mevissen, Suzanne Meijer, Theo Paulussen, Pepijn van Empelen, Gerjo Kok. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.06.2018.
van Lieshout, Sanne; Mevissen, Fraukje; de Waal, Esri; Kok, Gerjo
2017-06-01
Schools are a common setting for adolescents to receive health education, but implementation of these programs with high levels of completeness and fidelity is not self-evident. Programs that are only partially implemented (completeness) or not implemented as instructed (fidelity) are unlikely to be effective. Therefore, it is important to identify which determinants affect completeness and fidelity of program implementation. As part of the launch of Long Live Love+ (LLL+), an online school-based sexuality education program for adolescents aged 15-17, we performed a process evaluation among teachers and students to measure the levels of completeness and fidelity, identify factors influencing teachers' implementation, and to evaluate the students' response. Sixteen Biology teachers from nine secondary schools throughout the Netherlands who implemented LLL+ were interviewed and 60 students participated in 13 focus group discussions. Results showed that teachers' completeness ranged between 22-100% (M = 75%). Fidelity was high, but many teachers added elements. Teachers and students enjoyed LLL+, particularly the diversity in the exercises and its interactive character. The most important factors that influenced implementation were time and organizational constraints, lack of awareness on the impact of completeness and fidelity, and student response. These factors should be taken into account when developing school-based prevention programs. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Creating Cooperative Classrooms: Effects of a Two-Year Staff Development Program
ERIC Educational Resources Information Center
Krol, Karen; Sleegers, Peter; Veenman, Simon; Voeten, Marinus
2008-01-01
In this study, the implementation effects of a staff development program on cooperative learning (CL) for Dutch elementary school teachers were studied. A pre-test-post-test non-equivalent control group design was used to investigate program effects on the instructional behaviours of teachers. Based on observations of teacher behaviour during…
The Moderating Effects of School Climate on Bullying Prevention Efforts
ERIC Educational Resources Information Center
Low, Sabina; Van Ryzin, Mark
2014-01-01
Bullying prevention efforts have yielded mixed effects over the last 20 years. Program effectiveness is driven by a number of factors (e.g., program elements and implementation), but there remains a dearth of understanding regarding the role of school climate on the impact of bullying prevention programs. This gap is surprising, given research…
40 CFR 96.24 - Effective date of initial NOX Budget permit.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Effective date of initial NOX Budget... PROGRAMS (CONTINUED) NOX BUDGET TRADING PROGRAM AND CAIR NOX AND SO2 TRADING PROGRAMS FOR STATE IMPLEMENTATION PLANS Permits § 96.24 Effective date of initial NOX Budget permit. The initial NOX Budget permit...
Seguin, Rebecca A.; Chui, Kenneth K. H.; Clark, Valerie; Corbin, Marilyn A.; Goldberg, Jeanne P.; Heidkamp-Young, Eleanor; Lichtenstein, Alice H.; Wiker, Nancy; Nelson, Miriam E.
2015-01-01
Objectives. We describe the national dissemination of an evidence-based community cardiovascular disease prevention program for midlife and older women using the RE-AIM (reach effectiveness adoption implementation maintenance) framework and share key lessons learned during translation. Methods. In a 2010 to 2014 collaboration between the StrongWomen program and the National Extension Association of Family and Consumer Sciences, we assessed reach, adoption, implementation, and maintenance using survey methods, and we assessed effectiveness using a pretest–posttest within-participants design, with weight change as the primary outcome. Results. Overall reach into the population was 15 per 10 000. Of 85 trained leaders, 41 (48%) adopted the program. During the 12-week intervention, weight decreased by 0.5 kilograms, fruit and vegetable intake increased by 2.1 servings per day, and physical activity increased by 1238 metabolic equivalent (MET)-minutes per week (all P < .001). Average fidelity score was 4.7 (out of possible 5). Eleven of 41 adopting leaders (27%) maintained the program. Conclusions. The StrongWomen–Healthy Hearts program can be implemented with high fidelity in a variety of settings while remaining effective. These data provide direction for program modification to improve impact as dissemination continues. PMID:26469644
Effect of six sigma program on the number of surgeries cancellation
Gheysari, Esmat; Yousefi, Hojatollah; Soleymani, Hossain; Mojdeh, Soheila
2016-01-01
Background: Today, the rate of surgeries is increasing, but surgeries are canceled due to various reasons. Unexpected cancellation of surgeries not only results in disorder in the operating room schedule, but also causes stress for patients and their family and increases costs. We determined the number and causes of surgery cancellations and areas for improvement. Materials and Methods: This outcome evaluation of Six Sigma program was conducted on 850 cases after the implementation of the program and compared to that of 850 cases which received routine care before the program. Cases were selected through easy sampling during the study. Before the implementation, the number of cancellations was recorded daily and their reasons were investigated. Then, Six Sigma program was implemented in accordance with the reasons for each category and necessary steps were taken to prevent the cancellation of surgeries. Data were collected for 3 months using a three-section data collection form. For data analysis, distribution and relative frequency and chi-square test were used. Results: The three categories of patient, physician, and hospital system were identified as the main causes. The highest rate of cancellation was related to ENT surgeries (74.19%). No cancellations were made in orology surgeries. The implementation of the Six Sigma program caused a significant difference in surgery cancellation (P = 0.003); 31 (3.6%) cases of cancellation were reduced to 12 (1.4%) cases. Conclusions: The results showed that Six Sigma program is a pre-surgery care quality improvement program. Patient education and the implementation of the 6 sigma program can be effective in reducing the rate of cancellation of operations. PMID:27095994
Ponirou, Paraskevi; Diomidous, Marianna; Mantas, John; Kalokairinou, Athena; Kalouri, Ourania; Kapadochos, Theodoros; Tzavara, Chara
2014-01-01
The education in First Aid through health education programs can help in promoting the health of the population. Meanwhile, the development of alternative forms of education with emphasis on distance learning implemented with e-learning creates an innovative system of knowledge and skills in different population groups. The main purpose of this research proposal is to investigate the effectiveness of the educational program to candidates educators about knowledge and emergency preparedness at school. The study used the Solomon four group design (2 intervention groups and 2 control groups). Statistical analysis showed significant difference within the four groups. Intervention groups had improved significantly their knowledge showing that the program was effective and that they would eventually deal with a threatening situation with right handlings. There were no statistical significant findings regarding other independent variables (p>0,05).The health education program with the implementation of synchronous distance learning succeeded to enhance the knowledge of candidates educators.
Fitting Community Based Newborn Care Package into the health systems of Nepal.
Pradhan, Y V; Upreti, S R; Kc, N P; Thapa, K; Shrestha, P R; Shedain, P R; Dhakwa, J R; Aryal, D R; Aryal, S; Paudel, D C; Paudel, D; Khanal, S; Bhandari, A; Kc, A
2011-10-01
Community-based strategies for delivering effective newborn interventions are an essential step to avert newborn death, in settings where the health facilities are unable to effectively deliver the interventions and reach their population. Effective implementation of community-based interventions as a large scale program and within the existing health system depends on the appropriate design and planning, monitoring and support systems. This article provides an overview of implementation design of Community-Based Newborn Care Package (CB-NCP) program, its setup within the health system, and early results of the implementation from one of the pilot districts. The evaluation of CB-NCP in one of the pilot districts shows significant improvement in antenatal, intrapartum and post natal care. The implementation design of the CB-NCP has six different health system management functions: i) district planning and orientation, ii) training/human resource development, iii) monitoring and evaluation, iv) logistics and supply chain management, v) communication strategy, and vi) pay for performance. The CB-NCP program embraced the existing system of monitoring with some additional components for the pilot phase to test implementation feasibility, and aligns with existing safe motherhood and child health programs. Though CB-NCP interventions are proven independently in different local and global contexts, they are piloted in 10 districts as a "package" within the national health system settings of Nepal.
ERIC Educational Resources Information Center
Alodwan, Talal; Almosa, Mosaab
2018-01-01
The study aimed to assess the effectiveness of a computer program based on Analysis, Design, Development, Implementation and Evaluation (ADDIE) Model on the achievement of Ninth Graders' listening and Reading Comprehension Skills in English. The study sample comprised 70 ninth graders during the second semester of the academic year 2016/2017. The…
The University of North Carolina Medical Center pharmacy resident leadership certificate program.
Lyons, Kayley; Griggs, Danielle; Lebovic, Rachel; Roth, Mary E; South, David A; Hatfield, Chad
2017-03-15
The development and implementation of a certificate program for pharmacy residents are described. University of North Carolina (UNC) Medical Center met the call for increased efforts in the area of pharmacy residency leadership training through the design, implementation, and evaluation of a leadership certificate program. The purpose of the UNC certificate program is to develop leaders who will serve others, improve their communities, and advance the profession. The program is designed to (1) foster self-awareness, social awareness, and altruism, (2) provide transferable and individualized leadership experiences, (3) enrich other residency components through integration of leadership development opportunities, and (4) create role models for departmental leadership. A team of preceptors and residents implemented the certificate program by integrating program components into the existing pharmacy residency infrastructure. The certificate program includes required and flexible components to allow residents to set and achieve their determined leadership development goals. Overall, residents are satisfied with the program and perceive it as worthwhile. During the first 3 years since implementation of the certification initiative, program facilitators improved the feasibility of, participant engagement in, and sustainability of the program. Future directions include an effectiveness evaluation and a "scale-up" to other institutions. The need for a pharmacy residency leadership certificate was met by designing, implementing, and evaluating such a program at UNC. Through its first 3 years, the program was feasible, sustainable, and valued by program participants. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
From Implementation to Outcomes to Impacts: Designing a Comprehensive Program Evaluation
NASA Astrophysics Data System (ADS)
Shebby, S.
2015-12-01
Funders are often interested in learning about the impact of program activities, yet before the impacts are determined, educational evaluations should first examine program implementation and outcomes. Implementation evaluation examines how and the extent to which program activities are delivered as intended, including the extent to which activities reached the targeted participants. Outcome evaluation is comprised of a systematic examination of the effects that a program has on program participants, such as changes in knowledge, attitudes, beliefs, values, and behaviors. In this presentation, presenters will share insights on evaluating the implementation, outcomes, and impacts associated with an online science curriculum for K-2 students. The science curriculum was designed to provide students with access to science concepts and skills in an interactive and innovative environment, and teachers with embedded, aligned, and on-demand professional development. One of the most important—and challenging—steps in this evaluation was to select outcomes that were well-defined, measurable, and aligned to program activities, as well as relevant to program stakeholders. An additional challenge was to measure implementation given limited access to the classroom environment. This presentation will include a discussion of the process evaluators used to select appropriate implementation indicators and outcomes (teacher and student), design an evaluation approach, and craft data collection instruments. Although examples provided are specific to the K-2 science intervention, the best practices discussed are pertinent to all program and event evaluations. Impact evaluation goes beyond implementation and outcome evaluation to inform whether a program is working or not. It requires a comparison group to inform what outcomes would have been in the absence of the intervention. As such, this presentation will also include a discussion of impacts, including how impacts are defined and measured, and some common challenges in evaluating program impact.
Implementation fidelity of Multidimensional Family Therapy in an international trial.
Rowe, Cynthia; Rigter, Henk; Henderson, Craig; Gantner, Andreas; Mos, Kees; Nielsen, Philip; Phan, Olivier
2013-04-01
Implementation fidelity, a critical aspect of clinical trials research that establishes adequate delivery of the treatment as prescribed in treatment manuals and protocols, is also essential to the successful implementation of effective programs into new practice settings. Although infrequently studied in the drug abuse field, stronger implementation fidelity has been linked to better outcomes in practice but appears to be more difficult to achieve with greater distance from model developers. In the INternational CAnnabis Need for Treatment (INCANT) multi-national randomized clinical trial, investigators tested the effectiveness of Multidimensional Family Therapy (MDFT) in comparison to individual psychotherapy (IP) in Brussels, Berlin, Paris, The Hague, and Geneva with 450 adolescents with a cannabis use disorder and their parents. This study reports on the implementation fidelity of MDFT across these five Western European sites in terms of treatment adherence, dose and program differentiation, and discusses possible implications for international implementation efforts. Copyright © 2013 Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Hopson, Laura M.; Holleran Steiker, Lori K.
2010-01-01
Although there is a strong evidence base for effective substance abuse prevention programs for youths, there is a need to facilitate the implementation and evaluation of these programs in real-world settings. This study evaluates the effectiveness of adapted versions of an evidence-based prevention program, keepin' it REAL (kiR), with alternative…
Project S.P.I.C.E.: Special Partnership in Career Education. Guide to Program Implementation.
ERIC Educational Resources Information Center
Emerson, Debby H.; And Others
The implementation guide to Project SPICE (Special Partnership in Career Education) - a curriculum designed to develop and demonstrate effective methods and techniques for providing career education experiences for educable mentally handicapped (EMH) students (ages 11-to-13 years) is provided. A description of the program focuses on program…
School Indoor Air Quality Assessment and Program Implementation.
ERIC Educational Resources Information Center
Prill, R.; Blake, D.; Hales, D.
This paper describes the effectiveness of a three-step indoor air quality (IAQ) program implemented by 156 schools in the states of Washington and Idaho during the 2000-2001 school year. An experienced IAQ/building science specialist conducted walk-through assessments at each school. These assessments documented deficiencies and served as an…
Effectiveness of the Civil Aviation Security Program.
1980-05-22
SECURITY. - CONTINUED TRAINING OF LAW ENFORCEMENT OFFICERS SUPPORTING AIRPORT SECURITY ACTIVITIES. - SECURITY PROGRAMS IMPLEMENTED BY AIR FREIGHT...cooperation by all concerned. (See Exhibit 14) Airport Security - Ongoing activities which contributed significantly to airport security included full...implementation of the revised Federal Aviation Regulations (FAR) Part 107 governing airport security , training of law enforcement officers supporting
Social Media in Diabetes Education: A Viable Option?
ERIC Educational Resources Information Center
Cooper, Julie; Cox, Jill N.; Corbin, Marilyn A.
2012-01-01
As Extension educators are encouraged to implement more cost-effective and efficient means of programming, the use of Web-based social media has become a popular option. Penn State Extension implemented a social media awareness survey among participants in its community-based diabetes education program to determine familiarity with this medium,…
ERIC Educational Resources Information Center
Pennsylvania Department of Education, 2005
2005-01-01
This document was prepared to serve as an aid in the planning, design, implementation, and ongoing evaluation of Alternative Education for Disruptive Youth Programs in Pennsylvania. School Codes and Public Laws are cited for guidance on mandatory issues. The suggestions and implementation strategies provided in this document are not requirements…
Sullivan, Jennifer L.; Adjognon, Omonyêlé L.; Engle, Ryann L.; Shin, Marlena H.; Afable, Melissa K.; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen
2018-01-01
Background: From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. Purpose: The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Methodology: Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. Results: The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. Discussion: This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Implications: Anticipating potential pitfalls of program implementation for future noninstitutional LTSS programs can improve implementation efficiency and program sustainability. Staff at multiple levels in the organization must fully support noninstitutional LTSS programs to address these challenges. PMID:28125459
Sullivan, Jennifer L; Adjognon, Omonyêlé L; Engle, Ryann L; Shin, Marlena H; Afable, Melissa K; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen
From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Anticipating potential pitfalls of program implementation for future noninstitutional LTSS programs can improve implementation efficiency and program sustainability. Staff at multiple levels in the organization must fully support noninstitutional LTSS programs to address these challenges.
Effect of Medicaid Disease Management Programs on Emergency Admissions and Inpatient Costs
Conti, Matthew S
2013-01-01
Objective To determine the impact of state Medicaid diabetes disease management programs on emergency admissions and inpatient costs. Data National InPatient Sample sponsored by the Agency for Healthcare Research and Quality Project for the years from 2000 to 2008 using 18 states. Study Design A difference-in-difference methodology compares costs and number of emergency admissions for Washington, Texas, and Georgia, which implemented disease management programs between 2000 and 2008, to states that did not undergo the transition to managed care (N = 103). Data Extraction Costs and emergency admissions were extracted for diabetic Medicaid enrollees diagnosed in the reform and non-reform states and collapsed into state and year cells. Principal Findings In the three treatment states, the implementation of disease management programs did not have statistically significant impacts on the outcome variables when compared to the control states. Conclusions States that implemented disease management programs did not achieve improvements in costs or the number of emergency of admissions; thus, these programs do not appear to be an effective way to reduce the burden of this chronic disease. PMID:23278435
Effect of Medicaid disease management programs on emergency admissions and inpatient costs.
Conti, Matthew S
2013-08-01
To determine the impact of state Medicaid diabetes disease management programs on emergency admissions and inpatient costs. National InPatient Sample sponsored by the Agency for Healthcare Research and Quality Project for the years from 2000 to 2008 using 18 states. A difference-in-difference methodology compares costs and number of emergency admissions for Washington, Texas, and Georgia, which implemented disease management programs between 2000 and 2008, to states that did not undergo the transition to managed care (N = 103). Costs and emergency admissions were extracted for diabetic Medicaid enrollees diagnosed in the reform and non-reform states and collapsed into state and year cells. In the three treatment states, the implementation of disease management programs did not have statistically significant impacts on the outcome variables when compared to the control states. States that implemented disease management programs did not achieve improvements in costs or the number of emergency of admissions; thus, these programs do not appear to be an effective way to reduce the burden of this chronic disease. © Health Research and Educational Trust.
Special education versus inclusive education: the role of the TEACCH program.
Panerai, Simonetta; Zingale, Marinella; Trubia, Grazia; Finocchiaro, Maria; Zuccarello, Rosa; Ferri, Raffaele; Elia, Maurizio
2009-06-01
Our study aimed at comparing, over a period of 3 years, the effectiveness of three different educational approaches addressed to children with autism and severe mental retardation. The first one was a treatment and education of autistic and related communication handicapped children (TEACCH) program implemented in a residential center; the second was a TEACCH program implemented at home and at mainstream schools, after a specific parent psychoeducational training; the third approach referred to inclusive education in mainstream schools, in which a nonspecific approach was implemented. Each subject was assessed twice, using the Psycho-Educational Profile-Revised (PEP-R) and Vineland Adaptive Behavior Scale (VABS)-survey form. Effectiveness of TEACCH appeared to be confirmed, showing positive outcomes in the natural setting, and revealing its inclusive value.
Owczarzak, Jill; Broaddus, Michelle; Pinkerton, Steven
2016-01-01
Continued debate about the relative value of fidelity versus adaptation, and lack of clarity about the meaning of fidelity, raise concerns about how frontline service providers resolve similar issues in their daily practice. We use SISTA (‘Sisters Informing Sisters on Topics about acquired immune deficiency syndrome’), an evidence-based human immunodeficiency virus (HIV) prevention intervention for African American women, to understand how facilitators and program directors interpret and enact implementation fidelity with the need for adaptation in real-world program delivery. We conducted 22 in-depth, semi-structured interviews with service providers from four agencies implementing SISTA. Facilitators valued their skills as group leaders and ability to emotionally engage participants as more critical to program effectiveness than delivering the intervention with strict fidelity. Consequently, they saw program manuals as guides rather than static texts that should never be changed and, moreover, viewed the prescriptive nature of manuals as undermining their efforts to fully engage with participants. Our findings suggest that greater consideration should be given to understanding the role of facilitators in program effectiveness over and above the question of whether they implement the program with fidelity. Moreover, training curricula should provide facilitators with transferable skills through general facilitator training rather than only program-specific or manual-specific training. PMID:26944867
Designing for Scale: Reflections on Rolling Out Reading Improvement in Kenya and Liberia.
Gove, Amber; Korda Poole, Medina; Piper, Benjamin
2017-03-01
Since 2008, the Ministries of Education in Liberia and Kenya have undertaken transitions from small-scale pilot programs to improve reading outcomes among primary learners to the large-scale implementation of reading interventions. The effects of the pilots on learning outcomes were significant, but questions remained regarding whether such large gains could be sustained at scale. In this article, the authors dissect the Liberian and Kenyan experiences with implementing large-scale reading programs, documenting the critical components and conditions of the program designs that affected the likelihood of successfully transitioning from pilot to scale. They also review the design, deployment, and effectiveness of each pilot program and the scale, design, duration, enabling conditions, and initial effectiveness results of the scaled programs in each country. The implications of these results for the design of both pilot and large-scale reading programs are discussed in light of the experiences of both the Liberian and Kenyan programs. © 2017 Wiley Periodicals, Inc.
Adapting Certified Safe Farm to North Carolina Agriculture: An Implementation Study.
Storm, Julia F; LePrevost, Catherine E; Tutor-Marcom, Robin; Cope, W Gregory
2016-01-01
Certified Safe Farm (CSF) is a multimodal safety and health program developed and assessed through multiple controlled intervention studies in Iowa. Although developed with the intent to be broadly applicable to agriculture, CSF has not been widely implemented outside the midwestern United States. This article describes the CSF implementation process in North Carolina (NC), as piloted on a large-scale in three agriculturally diverse and productive counties of NC, and reports its effectiveness using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. Implementation involved (1) capacity building through safety and health training, (2) adaptation of components of Iowa's CSF model to NC agriculture, (3) marketing and recruitment, and (4) formative evaluation, including an online survey and focus group discussion. From 2009 to 2012, 113 farms participated in at least one component of the CSF intervention, representing a NC farm participation rate of 3.1% in the study area. A major adaptation of NC implementation was the utilization of NC Cooperative Extension as the local driver of implementation in contrast to local AgriSafe clinics in Iowa. The most innovative adaptation to CSF components was the development of a defined economic incentive in the form of a cost-share program. The RE-AIM framework was found to be useful and relevant to the field of agricultural health and safety translational research. This study provides effectiveness measures and implementation alternatives useful for those considering implementing CSF. It informs current efforts to move CSF from research to practice through the National Sustainable Model CSF Program initiative.
Kennedy, Eileen; Fekadu, Habtamu; Ghosh, Shibani; Baral, Kedar; Davis, Dale; Sapkota, Diplav; Webb, Patrick
2016-12-01
Effective governance is essential for effective nutrition program implementation. There are additional challenges in launching multisector plans to enhance nutritional status. The present study compares the challenges and opportunities in Ethiopia and Nepal in designing and implementing a multisector plan for nutrition. A semi-quantitative questionnaire with open-ended questions was used to solicit information from senior national-level policy officials and other key stakeholders. The nature of the major nutrition problems in each country was similar; these include malnutrition (particularly stunting), food insecurity, and micronutrient malnutrition. The main challenges identified included the need for more specificity in the roles of agencies/individuals in program implementation, more effective mechanisms for linking national to subnational officials, methods for creating awareness of the plans, and a dedicated line item in the budgets of each agency. The level of enthusiasm was high in both countries. Respondents in both countries highlighted the need to identify a "champion" at the highest level who would keep the momentum for the respective plans alive. © The Author(s) 2016.
Hallfors, D; Godette, D
2002-08-01
This study examines adoption and implementation of the US Department of Education's new policy, the 'Principles of Effectiveness', from a diffusion of innovations theoretical framework. In this report, we evaluate adoption in relation to Principle 3: the requirement to select research-based programs. Results from a sample of 104 school districts in 12 states indicate that many districts appear to be selecting research-based curricula, but that the quality of implementation is low. Only 19% of the responding district coordinators indicated that schools were implementing a research-based curriculum with fidelity. Common problems included lack of teacher training, lack of requisite materials, use of some but not all of the required lessons and teaching strategies, and failure to deliver lessons to age-appropriate student groups. This study represents the first attempt to assess the quality of implementation of research-based programs as required by the Principles of Effectiveness. We conclude that low levels of funding, inadequate infrastructure, decentralized decision making and lack of program guidance have contributed to the slow progress in improving school-based prevention.
Ladapo, Joseph A; Elliott, Marc N; Bogart, Laura M; Kanouse, David E; Vestal, Katherine D; Klein, David J; Ratner, Jessica A; Schuster, Mark A
2013-11-01
To examine the cost and cost-effectiveness of implementing Talking Parents, Healthy Teens, a worksite-based parenting program designed to help parents address sexual health with their adolescent children. We enrolled 535 parents with adolescent children at 13 worksites in southern California in a randomized trial. We used time and wage data from employees involved in implementing the program to estimate fixed and variable costs. We determined cost-effectiveness with nonparametric bootstrap analysis. For the intervention, parents participated in eight weekly 1-hour teaching sessions at lunchtime. The program included games, discussions, role plays, and videotaped role plays to help parents learn to communicate with their children about sex-related topics, teach their children assertiveness and decision-making skills, and supervise and interact with their children more effectively. Implementing the program cost $543.03 (standard deviation, $289.98) per worksite in fixed costs, and $28.05 per parent (standard deviation, $4.08) in variable costs. At 9 months, this $28.05 investment per parent yielded improvements in number of sexual health topics discussed, condom teaching, and communication quality and openness. The cost-effectiveness was $7.42 per new topic discussed using parental responses and $9.18 using adolescent responses. Other efficacy outcomes also yielded favorable cost-effectiveness ratios. Talking Parents, Healthy Teens demonstrated the feasibility and cost-effectiveness of a worksite-based parenting program to promote parent-adolescent communication about sexual health. Its cost is reasonable and is unlikely to be a significant barrier to adoption and diffusion for most worksites considering its implementation. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Finlon, Kristy J; Izard, Carroll E; Seidenfeld, Adina; Johnson, Stacy R; Cavadel, Elizabeth Woodburn; Ewing, E Stephanie Krauthamer; Morgan, Judith K
2015-11-01
Effectiveness studies of preschool social-emotional programs are needed in low-income, diverse populations to help promote the well-being of at-risk children. Following an initial program efficacy study 2 years prior, 248 culturally diverse Head Start preschool children participated in the current effectiveness trial and received either the Emotion-Based Prevention Program (EBP) or the I Can Problem Solve (ICPS) intervention. Pre- and postdata collection included direct child assessment, teacher report, parent interview, and independent observations. Teachers implementing the EBP intervention demonstrated good and consistent fidelity to the program. Overall, children in EBP classrooms gained more emotion knowledge and displayed greater decreases in negative emotion expressions and internalizing behaviors across the implementation period as compared to children in ICPS classrooms. In addition, cumulative risk, parental depressive symptoms, and classroom climate significantly moderated treatment effects. For children experiencing more stress or less support, EBP produced more successful outcomes than did ICPS. These results provide evidence of EBP sustainability and program effectiveness, as did previous findings that demonstrated EBP improvements in emotion knowledge, regulation skills, and behavior problems replicated under unsupervised program conditions.
The Effects of a Developmentally Appropriate Music and Movement Program on Motor Performance
ERIC Educational Resources Information Center
Zachopoulou, E.; Tsapakidou, A.; Derri, V.
2004-01-01
Basic motor skills development is achieved through the implementation of different types of physical education programs. The purpose of this study was to investigate and to compare the effect of a developmentally appropriate music and movement program and of a developmentally appropriate physical education program on the development of jumping and…
Cahalin, Lawrence P; Kaminsky, Leonard; Lavie, Carl J; Briggs, Paige; Cahalin, Brendan L; Myers, Jonathan; Forman, Daniel E; Patel, Mahesh J; Pinkstaff, Sherry O; Arena, Ross
2015-01-01
The development and implementation of worksite health and wellness programs (WHWPs) in the United States (US) hold promise as a means to improve population health and reverse current trends in non-communicable disease incidence and prevalence. However, WHWPs face organizational, economic, systematic, legal, and logistical challenges which have combined to impact program availability and expansion. Even so, there is a burgeoning body of evidence indicating WHWPs can significantly improve the health profile of participating employees in a cost effective manner. This foundation of scientific knowledge justifies further research inquiry to elucidate optimal WHWP models. It is clear that the development, implementation and operation of WHWPs require a strong commitment from organizational leadership, a pervasive culture of health and availability of necessary resources and infrastructure. Since organizations vary significantly, there is a need to have flexibility in creating a customized, effective health and wellness program. Furthermore, several key legal issues must be addressed to facilitate employer and employee needs and responsibilities; the US Affordable Care Act will play a major role moving forward. The purposes of this review are to: 1) examine currently available health and wellness program models and considerations for the future; 2) highlight key legal issues associated with WHWP development and implementation; and 3) identify challenges and solutions for the development and implementation of as well as adherence to WHWPs. Copyright © 2015 Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Caulkins, Jonathan P.; Rydell, C. Peter; Everingham, Susan S.; Chiesa, James; Bushway, Shawn
This book describes an analysis of the cost-effectiveness of model school-based drug prevention programs at reducing cocaine consumption. It compares prevention's cost-effectiveness with that of several enforcement programs and with that of treating heavy cocaine users. It also assesses the cost of nationwide implementation of model prevention…
Tsuruta, S; Misztal, I; Strandén, I
2001-05-01
Utility of the preconditioned conjugate gradient algorithm with a diagonal preconditioner for solving mixed-model equations in animal breeding applications was evaluated with 16 test problems. The problems included single- and multiple-trait analyses, with data on beef, dairy, and swine ranging from small examples to national data sets. Multiple-trait models considered low and high genetic correlations. Convergence was based on relative differences between left- and right-hand sides. The ordering of equations was fixed effects followed by random effects, with no special ordering within random effects. The preconditioned conjugate gradient program implemented with double precision converged for all models. However, when implemented in single precision, the preconditioned conjugate gradient algorithm did not converge for seven large models. The preconditioned conjugate gradient and successive overrelaxation algorithms were subsequently compared for 13 of the test problems. The preconditioned conjugate gradient algorithm was easy to implement with the iteration on data for general models. However, successive overrelaxation requires specific programming for each set of models. On average, the preconditioned conjugate gradient algorithm converged in three times fewer rounds of iteration than successive overrelaxation. With straightforward implementations, programs using the preconditioned conjugate gradient algorithm may be two or more times faster than those using successive overrelaxation. However, programs using the preconditioned conjugate gradient algorithm would use more memory than would comparable implementations using successive overrelaxation. Extensive optimization of either algorithm can influence rankings. The preconditioned conjugate gradient implemented with iteration on data, a diagonal preconditioner, and in double precision may be the algorithm of choice for solving mixed-model equations when sufficient memory is available and ease of implementation is essential.
Kropp, Frankie; Lewis, Daniel; Winhusen, Theresa
2017-01-01
Research has consistently found contingency management (CM) to be an effective tool in increasing desired patient behaviors in substance use disorder (SUD) treatment. Despite the strong evidence for the effectiveness of this intervention, practical issues and the cost of implementing CM in treatment programs have been significant barriers to adoption. To evaluate the impact of a CM program designed and implemented by university-affiliated methadone clinic staff to increase patient group attendance. The CM program consisted of a weekly raffle for patients attending clinician-led group counseling and/or in-clinic Methadone Anonymous (MA) groups in which slips with patient ID#s were entered and one ID slip was drawn per week with a fee credit for a dose of methadone ($15) as the prize. The CM program continued for 12 months. Group attendance was tracked before, during, and after CM implementation as part of ongoing clinic service utilization monitoring. Following the implementation of CM, attendance at any clinician-led or MA groups increased significantly from baseline to month 1 (X 2 =5.78, p<0.05) but this increase was not sustained beyond month 6. Analysis of attendance by type of group revealed that clinician-led group attendance did not increase significantly but there was a significant increase in in-clinic MA group attendance from baseline to month 1 (X 2 =20.27, p<0.001), which was sustained through the 12-month implementation period (X 2 =11.21, p<0.001) and through 3 months post-implementation (X 2 =14.73; p<0.001). A low-cost, simple CM intervention implemented by clinic staff was associated with significant increases in the target behavior of increasing group attendance. Copyright © 2016 Elsevier Inc. All rights reserved.
Nápoles, Anna María; Santoyo-Olsson, Jasmine; Ortiz, Carmen; Gregorich, Steven; Lee, Howard E.; Duron, Ysabel; Graves, Kristi; Luce, Judith A.; McGuire, Peggy; Díaz-Méndez, Marynieves; Stewart, Anita L.
2014-01-01
Background Latinas with breast cancer suffer symptom and psychosocial health disparities. Effective interventions have not been developed for or tested in this population. Purpose We describe community-based participatory research methods used to develop and implement the Nuevo Amanecer program, a culturally tailored, peer-delivered cognitive-behavioral stress management intervention for low-income Spanish-speaking Latinas with breast cancer, and unique considerations in implementing a randomized controlled trial to test the program in community settings. Methods We applied an implementation science framework to delineate the methodological phases used to develop and implement the Nuevo Amanecer program and trial, emphasizing community engagement processes. Results In phase 1, we established project infrastructure: academic and community Co-Principal Investigators, community partners, community advisory board, steering committee, and funding. In phase 2, we identified three program inputs: formative research, a community best practices model, and an evidence-based intervention tested in non-Latinas. In phase 3, we created the new program by integrating and adapting intervention components from the three sources, making adaptations to accommodate low-literacy, Spanish language, cultural factors, community context, and population needs. In phase 4, we built community capacity for the program and trial by training field staff (recruiters and interventionists embedded in community sites), compensating field staff, and creating a system for identifying potential participants. In phase 5, we implemented and monitored the program and trial. Engaging community partners in all phases has resulted in a new, culturally tailored program that is suitable for newly diagnosed Latinas with breast cancer and a trial that is acceptable and supported by community and clinical partners. Lessons Learned Engagement of community-based organizations and cancer survivors as research partners and hiring recruiters and interventionists from the community were critical to successful implementation in community settings. Having culturally and linguistically competent research staff with excellent interpersonal skills facilitated implementation. Facilitating and maintaining excellent communication among community partners was imperative to troubleshoot implementation issues. Randomization was challenging due to community concerns about assigning women to a control group. Patient privacy regulations and the need for extensive outreach to establish relationships between community partners and clinical sites hampered initial recruitment. Limitations These were resource-intensive processes to develop and implement the program that need to be compared to less intensive alternatives. Conclusions Engaging community members in design and implementation of community-based programs and trials enhances cultural appropriateness and congruence with the community context. If the randomized trial demonstrates that the intervention is effective, it will fill a gap in evidence-based programs to address ethnic disparities in quality of life among Spanish-speaking Latinas with breast cancer. PMID:24577971
Effects of an Integrated Health Care Program for Children
Kim, Ok Hyun; Park, Jin Kyung
2017-01-01
[Purpose] This study examined the effects of an integrated health care program in elementary school students. [Methods] The integrated program comprised exercises (3–4 times/week) and six sessions on nutritional and psychological education. Anthropometric measurements were recorded before the intervention. Additionally, physical fitness, dietary habits, nutrition knowledge, and psychological changes were assessed before and after the program. [Results] In total, 29% of the subjects were overweight and obese before the intervention (32% boys and 26% girls). There was a significant increase in flexibility, endurance, and cardiovascular endurance after the implementation of the program. Additionally, as a result of the program, participants showed improvement in nutrition knowledge and dietary habits. After the training, children tended to exhibit increased self–efficacy and lower stress, but the findings were not statistically significant. [Conclusion] Implementation of an integrated health care program for the prevention and treatment of obesity could have a positive impact on children’s health. It is hoped that continued research on the long-term effects of such programs is conducted along with the development of various programs. PMID:28712260
2013-01-01
Background Numerous worksite health promotion program (WHPPs) have been implemented the past years to improve employees’ health and lifestyle (i.e., physical activity, nutrition, smoking, alcohol use and relaxation). Research primarily focused on the effectiveness of these WHPPs. Whereas process evaluations provide essential information necessary to improve large scale implementation across other settings. Therefore, this review aims to: (1) further our understanding of the quality of process evaluations alongside effect evaluations for WHPPs, (2) identify barriers/facilitators affecting implementation, and (3) explore the relationship between effectiveness and the implementation process. Methods Pubmed, EMBASE, PsycINFO, and Cochrane (controlled trials) were searched from 2000 to July 2012 for peer-reviewed (randomized) controlled trials published in English reporting on both the effectiveness and the implementation process of a WHPP focusing on physical activity, smoking cessation, alcohol use, healthy diet and/or relaxation at work, targeting employees aged 18-65 years. Results Of the 307 effect evaluations identified, twenty-two (7.2%) published an additional process evaluation and were included in this review. The results showed that eight of those studies based their process evaluation on a theoretical framework. The methodological quality of nine process evaluations was good. The most frequently reported process components were dose delivered and dose received. Over 50 different implementation barriers/facilitators were identified. The most frequently reported facilitator was strong management support. Lack of resources was the most frequently reported barrier. Seven studies examined the link between implementation and effectiveness. In general a positive association was found between fidelity, dose and the primary outcome of the program. Conclusions Process evaluations are not systematically performed alongside effectiveness studies for WHPPs. The quality of the process evaluations is mostly poor to average, resulting in a lack of systematically measured barriers/facilitators. The narrow focus on implementation makes it difficult to explore the relationship between effectiveness and implementation. Furthermore, the operationalisation of process components varied between studies, indicating a need for consensus about defining and operationalising process components. PMID:24341605
Cost effectiveness of the MDOT preventive maintenance program.
DOT National Transportation Integrated Search
2013-04-01
The Michigan Department of Transportations (MDOT) pavement preservation program dates back to 1992. MDOTs pavement preservation strategy is primarily implemented through its capital preventive maintenance (CPM) program, in which preventive main...
Leadbeater, Bonnie J; Gladstone, Emilie J; Sukhawathanakul, Paweena
2015-09-01
Substantial research illuminates many factors effecting the implementation of evidence-based mental health promotion programs in schools; however, research on how schools plan for sustaining their investments in these programs is limited. In this qualitative study, we elicited descriptions of opportunities and challenges for sustainability. We interviewed 24 individuals from schools involved in a longitudinal, qualitative research project that followed uptake and implementation of the evidence-based WITS Programs across 2 years (Leadbeater et al. 2012). WITS stands for Walk away, Ignore, Talk it out and Seek help and the online WITS Programs focus on preventing peer victimization ( www.witsprograms.ca ). Our findings suggest that sustainability planning in schools is not merely a next step following high quality implementation, but rather involves multiple ongoing processes that need to be anticipated and supported by school leadership and program champions and developers in order to realize investments in evidence-based programs.
Berkel, Cady; Mauricio, Anne M; Sandler, Irwin N; Wolchik, Sharlene A; Gallo, Carlos G; Brown, C Hendricks
2017-12-14
This study tests a theoretical cascade model in which multiple dimensions of facilitator delivery predict indicators of participant responsiveness, which in turn lead to improvements in targeted program outcomes. An effectiveness trial of the 10-session New Beginnings Program for divorcing families was implemented in partnership with four county-level family courts. This study included 366 families assigned to the intervention condition who attended at least one session. Independent observers provided ratings of program delivery (i.e., fidelity to the curriculum and process quality). Facilitators reported on parent attendance and parents' competence in home practice of program skills. At pretest and posttest, children reported on parenting and parents reported child mental health. We hypothesized effects of quality on attendance, fidelity and attendance on home practice, and home practice on improvements in parenting and child mental health. Structural Equation Modeling with mediation and moderation analyses were used to test these associations. Results indicated quality was significantly associated with attendance, and attendance moderated the effect of fidelity on home practice. Home practice was a significant mediator of the links between fidelity and improvements in parent-child relationship quality and child externalizing and internalizing problems. Findings provide support for fidelity to the curriculum, process quality, attendance, and home practice as valid predictors of program outcomes for mothers and fathers. Future directions for assessing implementation in community settings are discussed.
Sustainability of the good behaviour game in Dutch primary schools.
Dijkman, Marieke A M; Harting, Janneke; van Tol, Lenneke; van der Wal, Marcel F
2017-02-01
Sustainability of health promotion programs is essential to maintain their positive effects. However, few studies have examined the extent of program sustainability and the factors influencing it. We examined these issues through the Good Behaviour Game (GBG), a classroom-based program in primary schools with beneficial behavioural and health-related effects that was implemented in 2008. GBG coordinators of 17 participating schools were invited in the study 2 years after the initial program implementation. Sustainability was measured using a 20-item checklist comprised of four dimensions of routinization including: memory, adaptation, values and rules. A semi-structured interview was then completed with 16 of the GBG coordinators to discuss the checklist scores and to probe in more depth the current level of sustainability. Based on the checklist scores, sustainability of the GBG was considered ‘high’ in five schools, ‘medium’ in another five and ‘weak’ in six. Factors influencing sustainability identified by GBG coordinators were organizational strength, strong leadership, program championship and the perceived modifiability and effectiveness of the GBG. Also, different factors were related to different dimensions of routinization. The combination of a sustainability checklist and an interview about influential factors may help to further clarify the sustainability construct and reveal which implementation sites, routinization dimensions and influential factors should be explored to further facilitate the sustaining of programs with proven effectiveness.
Foundations for Effective School Library Media Programs.
ERIC Educational Resources Information Center
Haycock, Ken, Ed.
This collection of 38 articles, reprinted from "Emergency Librarian," addresses critical elements of school library media program development and implementation, organized by seven areas: foundations; the school context; role clarification; information literacy; collaborative program planning and teaching; program development; and…
Local Climate and Energy Program Model Design Guide: Enhancing Value and Creating Lasting Programs
Created for local climate and clean energy program implementers, learn how programs create and deliver value to target audiences and partners, how to raise revenue, and how they can operate cost effectively.
Performance and prospects of payments for ecosystem services programs: evidence from China.
Yang, Wu; Liu, Wei; Viña, Andrés; Luo, Junyan; He, Guangming; Ouyang, Zhiyun; Zhang, Hemin; Liu, Jianguo
2013-09-30
Systematic evaluation of the environmental and socioeconomic effects of Payments for Ecosystem Services (PES) programs is crucial for guiding policy design and implementation. We evaluated the performance of the Natural Forest Conservation Program (NFCP), a national PES program of China, in the Wolong Nature Reserve for giant pandas. The environmental effects of the NFCP were evaluated through a historical trend (1965-2001) analysis of forest cover to estimate a counter-factual (i.e., without-PES) forest cover baseline for 2007. The socioeconomic effects of the NFCP were evaluated using data collected through household interviews carried out before and after NFCP implementation in 2001. Our results suggest that the NFCP was not only significantly associated with increases in forest cover, but also had both positive (e.g., labor reduction for fuelwood collection) and negative (e.g., economic losses due to crop raiding by wildlife) effects on local households. Results from this study emphasize the importance of integrating local conditions and understanding underlying mechanisms to enhance the performance of PES programs. Our findings are useful for the design and implementation of successful conservation policies not only in our study area but also in similar places around the world. Copyright © 2013 Elsevier Ltd. All rights reserved.
Effects of a Mathematics Cognitive Acceleration Program on Student Achievement and Motivation
ERIC Educational Resources Information Center
Finau, Teukava; Treagust, David F.; Won, Mihye; Chandrasegaran, A. L.
2018-01-01
This paper presents the effects of a cognitive acceleration program in mathematics classes on Tongan students' achievements, motivation and self-regulation. Cognitive Acceleration in Mathematics Education (CAME) is a program developed at King's College and implemented worldwide with the aim of improving students' thinking skills, mathematics…
Brown, C Hendricks; Mohr, David C; Gallo, Carlos G; Mader, Christopher; Palinkas, Lawrence; Wingood, Gina; Prado, Guillermo; Kellam, Sheppard G; Pantin, Hilda; Poduska, Jeanne; Gibbons, Robert; McManus, John; Ogihara, Mitsunori; Valente, Thomas; Wulczyn, Fred; Czaja, Sara; Sutcliffe, Geoff; Villamar, Juan; Jacobs, Christopher
2013-06-01
African Americans and Hispanics in the United States have much higher rates of HIV than non-minorities. There is now strong evidence that a range of behavioral interventions are efficacious in reducing sexual risk behavior in these populations. Although a handful of these programs are just beginning to be disseminated widely, we still have not implemented effective programs to a level that would reduce the population incidence of HIV for minorities. We proposed that innovative approaches involving computational technologies be explored for their use in both developing new interventions and in supporting wide-scale implementation of effective behavioral interventions. Mobile technologies have a place in both of these activities. First, mobile technologies can be used in sensing contexts and interacting to the unique preferences and needs of individuals at times where intervention to reduce risk would be most impactful. Second, mobile technologies can be used to improve the delivery of interventions by facilitators and their agencies. Systems science methods including social network analysis, agent-based models, computational linguistics, intelligent data analysis, and systems and software engineering all have strategic roles that can bring about advances in HIV prevention in minority communities. Using an existing mobile technology for depression and 3 effective HIV prevention programs, we illustrated how 8 areas in the intervention/implementation process can use innovative computational approaches to advance intervention adoption, fidelity, and sustainability.
Applying Resource Based Relative Value Scales (RBRVS) to the Champus Program
1990-12-01
fee for the related service .[Ref. 6:p. 7] F. EFFECTS OF RBRVS When a Medicare fee schedule is fully implemented, several Important...reimbursement rates increase would be attracted to CHAMPUS. In analyzing the impact of a resource based fee schedule on the Medicare program, the PPRC...procedures performed by physicians into components of work, training costs, and practice costs. The Medicare program is planning to implement a fee
NASA software specification and evaluation system: Software verification/validation techniques
NASA Technical Reports Server (NTRS)
1977-01-01
NASA software requirement specifications were used in the development of a system for validating and verifying computer programs. The software specification and evaluation system (SSES) provides for the effective and efficient specification, implementation, and testing of computer software programs. The system as implemented will produce structured FORTRAN or ANSI FORTRAN programs, but the principles upon which SSES is designed allow it to be easily adapted to other high order languages.
Is Stacking Intervention Components Cost-Effective? An Analysis of the Incredible Years Program
ERIC Educational Resources Information Center
Foster, E. Michael; Olchowski, Allison E.; Webster-Stratton, Carolyn H.
2007-01-01
The cost-effectiveness of delivering stacked multiple intervention components for children is compared to implementing single intervention by analyzing the Incredible Years Series program. The result suggests multiple intervention components are more cost-effective than single intervention components.
Medicaid prior-authorization programs and the use of cyclooxygenase-2 inhibitors.
Fischer, Michael A; Schneeweiss, Sebastian; Avorn, Jerry; Solomon, Daniel H
2004-11-18
Over the past five years, selective cyclooxygenase-2 inhibitors (coxibs) have accounted for a growing proportion of prescriptions for nonsteroidal antiinflammatory drugs (NSAIDs). To control these expenses, many state Medicaid programs have implemented prior-authorization requirements before coxibs can be prescribed. We evaluated the effect of such programs on the use of coxibs by Medicaid beneficiaries. We surveyed state Medicaid agencies to determine whether prescription of coxibs required prior authorization and, if so, the criteria for authorization. For each program, we compared these criteria with evidence-based recommendations for prescribing of coxibs. Using data for all filled prescriptions in 50 state Medicaid programs from 1999 through the end of 2003, we calculated the proportion of defined daily doses of NSAIDs accounted for by coxibs. Time-series analyses were used to measure the changes in prescription patterns after the implementation of each prior-authorization program. By 2001, coxibs accounted for half of all NSAID doses covered by Medicaid. This proportion varied widely according to the state in 2003, from a low of 11 percent to a high of 70 percent of all NSAID doses. Twenty-two states implemented prior-authorization programs for coxibs during the study period. Overall, the implementation of such programs reduced the proportion of NSAID doses made up by coxibs by 15.0 percent (95 percent confidence interval, 10.9 to 19.2 percent), corresponding to a decrease of 10.28 dollars (95 percent confidence interval, 7.56 dollars to 13.00 dollars) in spending per NSAID prescription. The effect of such programs was not influenced by the degree to which a prior-authorization program incorporated evidence-based prescribing recommendations. The use of coxibs and spending on NSAIDs varies widely by state and declined substantially after the implementation of prior-authorization programs. Determining whether these reductions are clinically appropriate will have important implications for the development of rational drug-reimbursement policies. Copyright 2004 Massachusetts Medical Society.
Tol, Wietse; Jordans, Mark; Zangana, Goran Sabir; Amin, Ahmed Mohammed; Bolton, Paul; Bass, Judith; Bonilla-Escobar, Fransisco Javier; Thornicroft, Graham
2014-01-01
The burden of mental health problems in (post)conflict low- and middle-income countries (LMIC) is substantial. Despite growing evidence for the effectiveness of selected mental health programs in conflict-affected LMIC and growing policy support, actual uptake and implementation have been slow. A key direction for future research, and a new frontier within science and practice, is Dissemination and Implementation (DI) which directly addresses the movement of evidence-based, effective health care approaches from experimental settings into routine use. This paper outlines some key implementation challenges, and strategies to address these, while implementing evidence-based treatments in conflict-affected LMIC based on the authors’ collective experiences. Dissemination and implementation evaluation and research in conflict settings is an essential new research direction. Future DI work in LMIC should include: 1) defining concepts and developing measurement tools, 2) the measurement of DI outcomes for all programming, and 3) the systematic evaluation of specific implementation strategies. PMID:28316559
Schoeny, Michael; Risser, Heather; Johnson, Tricia
2016-01-01
Introduction Up to 20% of children demonstrate behavior problems that interfere with relationship development and academic achievement. Parent participation in behavioral parent training programs has been shown to decrease child problem behaviors and promote positive parent-child relationships. However, attendance and parent involvement in face-to-face parent training remain low. Testing the implementation, efficacy, and cost of alternative delivery models is needed to (a) increase the reach and sustainability of parent training interventions and (b) address the barriers to parent participation and implementation of such programs, specifically in primary health care settings. The purpose of this paper is to describe the study protocol evaluating the implementation, efficacy, and cost-effectiveness of delivering the tablet-based ezParent program in pediatric primary care sites. Methods The implementation of the ezParent in four pediatric primary care sites will be evaluated using a descriptive design and cost-effectiveness analysis. The efficacy of the ezParent will be tested using a randomized controlled trial design with 312 parents of 2 to 5 year old children from pediatric primary care settings. Data on parenting and child behavior outcomes will be obtained from all participants at baseline, and 3, 6, and 12 months post baseline. Discussion Integrating and evaluating the implementation of the ezParent in pediatric primary care is an innovative opportunity to promote positive parenting with potential for universal access to the preschool population and for low cost by building on existing infrastructure in pediatric primary care. PMID:27592122
Coulon, Sandra M; Wilson, Dawn K; Griffin, Sarah; St George, Sara M; Alia, Kassandra A; Trumpeter, Nevelyn N; Wandersman, Abraham K; Forthofer, Melinda; Robinson, Shamika; Gadson, Barney
2012-12-01
Evaluating programs targeting physical activity may help to reduce disparate rates of obesity among African Americans. We report formative process evaluation methods and implementation dose, fidelity, and reach in the Positive Action for Today's Health trial. We applied evaluation methods based on an ecological framework in 2 community-based police-patrolled walking programs targeting access and safety in underserved African American communities. One program also targeted social connectedness and motivation to walk using a social marketing approach. Process data were systematically collected from baseline to 12 months. Adequate implementation dose was achieved, with fidelity achieved but less stable in both programs. Monthly walkers increased to 424 in the walking-plus-social marketing program, indicating expanding program reach, in contrast to no increase in the walking-only program. Increased reach was correlated with peer-led Pride Strides (r = .92; P < .001), a key social marketing component, and program social interaction was the primary reason for which walkers reported participating. Formative process evaluation demonstrated that the walking programs were effectively implemented and that social marketing increased walking and perceived social connectedness in African American communities.
A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus.
Ulfsdotter, Malin; Lindberg, Lene; Månsdotter, Anna
2015-01-01
There are few health economic evaluations of parenting programs with quality-adjusted life-years (QALYs) as the outcome measure. The objective of this study was, therefore, to conduct a cost-effectiveness analysis of the universal parenting program All Children in Focus (ABC). The goals were to estimate the costs of program implementation, investigate the health effects of the program, and examine its cost-effectiveness. A cost-effectiveness analysis was conducted. Costs included setup costs and operating costs. A parent proxy Visual Analog Scale was used to measure QALYs in children, whereas the General Health Questionnaire-12 was used for parents. A societal perspective was adopted, and the incremental cost-effectiveness ratio was calculated. To account for uncertainty in the estimate, the probability of cost-effectiveness was investigated, and sensitivity analyses were used to account for the uncertainty in cost data. The cost was € 326.3 per parent, of which € 53.7 represented setup costs under the assumption that group leaders on average run 10 groups, and € 272.6 was the operating costs. For health effects, the QALY gain was 0.0042 per child and 0.0027 per parent. These gains resulted in an incremental cost-effectiveness ratio for the base case of € 47 290 per gained QALY. The sensitivity analyses resulted in ratios from € 41 739 to € 55 072. With the common Swedish threshold value of € 55 000 per QALY, the probability of the ABC program being cost-effective was 50.8 percent. Our analysis of the ABC program demonstrates cost-effectiveness ratios below or just above the QALY threshold in Sweden. However, due to great uncertainty about the data, the health economic rationale for implementation should be further studied considering a longer time perspective, effects on siblings, and validated measuring techniques, before full scale implementation.
A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus
Ulfsdotter, Malin
2015-01-01
Objective There are few health economic evaluations of parenting programs with quality-adjusted life-years (QALYs) as the outcome measure. The objective of this study was, therefore, to conduct a cost-effectiveness analysis of the universal parenting program All Children in Focus (ABC). The goals were to estimate the costs of program implementation, investigate the health effects of the program, and examine its cost-effectiveness. Methods A cost-effectiveness analysis was conducted. Costs included setup costs and operating costs. A parent proxy Visual Analog Scale was used to measure QALYs in children, whereas the General Health Questionnaire-12 was used for parents. A societal perspective was adopted, and the incremental cost-effectiveness ratio was calculated. To account for uncertainty in the estimate, the probability of cost-effectiveness was investigated, and sensitivity analyses were used to account for the uncertainty in cost data. Results The cost was €326.3 per parent, of which €53.7 represented setup costs under the assumption that group leaders on average run 10 groups, and €272.6 was the operating costs. For health effects, the QALY gain was 0.0042 per child and 0.0027 per parent. These gains resulted in an incremental cost-effectiveness ratio for the base case of €47 290 per gained QALY. The sensitivity analyses resulted in ratios from €41 739 to €55 072. With the common Swedish threshold value of €55 000 per QALY, the probability of the ABC program being cost-effective was 50.8 percent. Conclusion Our analysis of the ABC program demonstrates cost-effectiveness ratios below or just above the QALY threshold in Sweden. However, due to great uncertainty about the data, the health economic rationale for implementation should be further studied considering a longer time perspective, effects on siblings, and validated measuring techniques, before full scale implementation. PMID:26681349
Jacobs, Sara R; Weiner, Bryan J; Reeve, Bryce B; Hofmann, David A; Christian, Michael; Weinberger, Morris
2015-01-22
The failure rates for implementing complex innovations in healthcare organizations are high. Estimates range from 30% to 90% depending on the scope of the organizational change involved, the definition of failure, and the criteria to judge it. The innovation implementation framework offers a promising approach to examine the organizational factors that determine effective implementation. To date, the utility of this framework in a healthcare setting has been limited to qualitative studies and/or group level analyses. Therefore, the goal of this study was to quantitatively examine this framework among individual participants in the National Cancer Institute's Community Clinical Oncology Program using structural equation modeling. We examined the innovation implementation framework using structural equation modeling (SEM) among 481 physician participants in the National Cancer Institute's Community Clinical Oncology Program (CCOP). The data sources included the CCOP Annual Progress Reports, surveys of CCOP physician participants and administrators, and the American Medical Association Physician Masterfile. Overall the final model fit well. Our results demonstrated that not only did perceptions of implementation climate have a statistically significant direct effect on implementation effectiveness, but physicians' perceptions of implementation climate also mediated the relationship between organizational implementation policies and practices (IPP) and enrollment (p <0.05). In addition, physician factors such as CCOP PI status, age, radiological oncologists, and non-oncologist specialists significantly influenced enrollment as well as CCOP organizational size and structure, which had indirect effects on implementation effectiveness through IPP and implementation climate. Overall, our results quantitatively confirmed the main relationship postulated in the innovation implementation framework between IPP, implementation climate, and implementation effectiveness among individual physicians. This finding is important, as although the model has been discussed within healthcare organizations before, the studies have been predominately qualitative in nature and/or at the organizational level. In addition, our findings have practical applications. Managers looking to increase implementation effectiveness of an innovation should focus on creating an environment that physicians perceive as encouraging implementation. In addition, managers should consider instituting specific organizational IPP aimed at increasing positive perceptions of implementation climate. For example, IPP should include specific expectations, support, and rewards for innovation use.
Sanchez, Michael A.; Rimer, Barbara K.; Samet, Jonathan M.; Glasgow, Russell E.
2014-01-01
Implementation Science is a set of tools, principles and methodologies that can be used to bring scientific evidence into action, improve health care quality and delivery and improve public health. As the burden of cancer increases in low- and middle-income countries, it is important to plan cancer control programs that are both evidence-based and delivered in ways that are feasible, cost-effective, contextually appropriate and sustainable. This review presents a framework for using implementation science for cancer control planning and implementation and discusses potential areas of focus for research and programs in low and middle-income countries interested in integrating research into practice and policy. PMID:25178984
Information needs for natural fire management planning
Parsons, David; Bancroft, Larry; Nichols, Thomas; Stohlgren, Thomas
1985-01-01
The development and implementation of an effective natural fire management program require a clear definition of goals and objectives, an ever-expanding information base, and effective program evaluation. Examples are given from Sequoia and Kings Canyon National Parks.
A 3-Month Jump-Landing Training Program: A Feasibility Study Using the RE-AIM Framework
Aerts, Inne; Cumps, Elke; Verhagen, Evert; Mathieu, Niels; Van Schuerbeeck, Sander; Meeusen, Romain
2013-01-01
Context: Evaluating the translatability and feasibility of an intervention program has become as important as determining the effectiveness of the intervention. Objective: To evaluate the applicability of a 3-month jump-landing training program in basketball players, using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Design: Randomized controlled trial. Setting: National and regional basketball teams. Patients or Other Participants: Twenty-four teams of the second highest national division and regional basketball divisions in Flanders, Belgium, were randomly assigned (1:1) to a control group and intervention group. A total of 243 athletes (control group = 129, intervention group = 114), ages 15 to 41 years, volunteered. Intervention(s): All exercises in the intervention program followed a progressive development, emphasizing lower extremity alignment during jump-landing activities. Main Outcome Measure(s): The results of the process evaluation of the intervention program were based on the 5 dimensions of the RE-AIM framework. The injury incidence density, hazard ratios, and 95% confidence intervals were determined. Results: The participation rate of the total sample was 100% (reach). The hazard ratio was different between the intervention group and the control group (0.40 [95% confidence interval = 0.16, 0.99]; effectiveness). Of the 12 teams in the intervention group, 8 teams (66.7%) agreed to participate in the study (adoption). Eight of the participating coaches (66.7%) felt positively about the intervention program and stated that they had implemented the training sessions of the program as intended (implementation). All coaches except 1 (87.5%) intended to continue the intervention program the next season (maintenance). Conclusions: Compliance of the coaches in this coach-supervised jump-landing training program was high. In addition, the program was effective in preventing lower extremity injuries. PMID:23675788
A 3-month jump-landing training program: a feasibility study using the RE-AIM framework.
Aerts, Inne; Cumps, Elke; Verhagen, Evert; Mathieu, Niels; Van Schuerbeeck, Sander; Meeusen, Romain
2013-01-01
Evaluating the translatability and feasibility of an intervention program has become as important as determining the effectiveness of the intervention. To evaluate the applicability of a 3-month jump-landing training program in basketball players, using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Randomized controlled trial. National and regional basketball teams. Twenty-four teams of the second highest national division and regional basketball divisions in Flanders, Belgium, were randomly assigned (1:1) to a control group and intervention group. A total of 243 athletes (control group = 129, intervention group = 114), ages 15 to 41 years, volunteered. All exercises in the intervention program followed a progressive development, emphasizing lower extremity alignment during jump-landing activities. The results of the process evaluation of the intervention program were based on the 5 dimensions of the RE-AIM framework. The injury incidence density, hazard ratios, and 95% confidence intervals were determined. The participation rate of the total sample was 100% (reach). The hazard ratio was different between the intervention group and the control group (0.40 [95% confidence interval = 0.16, 0.99]; effectiveness). Of the 12 teams in the intervention group, 8 teams (66.7%) agreed to participate in the study (adoption). Eight of the participating coaches (66.7%) felt positively about the intervention program and stated that they had implemented the training sessions of the program as intended (implementation). All coaches except 1 (87.5%) intended to continue the intervention program the next season (maintenance). Compliance of the coaches in this coach-supervised jump-landing training program was high. In addition, the program was effective in preventing lower extremity injuries.
Separate and Not Equal: The Implementation of Structured English Immersion in Arizona's Classrooms
ERIC Educational Resources Information Center
Lillie, Karen E.; Markos, Amy; Arias, M. Beatriz; Wiley, Terrence G.
2012-01-01
Background/Context: Over the last ten years, a convergence of laws and decrees has impacted the development and implementation of Arizona's current program for English language learners (ELLs): the four-hour Structured English Immersion (SEI) model. Arizona's new model, while being touted by some as the most effective program for ELLs (Clark,…
ERIC Educational Resources Information Center
Gates, Susan M.; Hamilton, Laura S.; Martorell, Paco; Burkhauser, Susan; Heaton, Paul; Pierson, Ashley; Baird, Matthew; Vuollo, Mirka; Li, Jennifer J.; Lavery, Diana Catherine; Harvey, Melody; Gu, Kun
2014-01-01
New Leaders is dedicated to promoting student achievement by developing outstanding school leaders to serve in urban schools. RAND Corporation researchers conducted a formative and summative external evaluation of the New Leaders program, its theory of action, and its implementation from 2006 through 2013. This document presents technical…
ERIC Educational Resources Information Center
Tucker, Joy C.
2015-01-01
This study provides evidence that systematic management of change can facilitate the implementation of first-year experience programming that leads to improved results in retention and student success for community college students. The study includes four major themes: (a) first-year experience, (b) change management, (c) change leadership, and…
Evaluation in the Seventies: What We Have Learned About Program Development and Implementation.
ERIC Educational Resources Information Center
Holley, Freda M.
This paper, generated by the Austin, Texas, Independent School District's Office of Research and Evaluation, offers a set of working hypotheses about what a school district must do in the implementation of programs to improve the cost/effectiveness ratio of educational innovations. The author draws on three years of the Austin school district's…
The Effects of Implementation Fidelity in the "Towards No Drug Abuse" Dissemination Trial
ERIC Educational Resources Information Center
Little, Melissa A.; Sussman, Steven; Sun, Ping; Rohrbach, Louise A.
2013-01-01
Purpose: The current study aims to examine the influence of contextual and provider-level factors on the implementation fidelity of a research-based substance abuse prevention program. Also, it aims to investigate whether two provider-level factors, self-efficacy and beliefs about the value of the program, statistically moderate and mediate the…
ERIC Educational Resources Information Center
Calderon, Margarita Espino; Minaya-Rowe, Liliana
This book provides school administrators, teachers, and parents with the basic knowledge necessary for planning and implementing effective two-way bilingual programs. It offers essential elements to help students gain literacy in two languages, increase cross-cultural understanding, and meet high levels of achievement in all core academic areas.…
Preventing Alcohol and Other Drug Problems through Drug Education. Policy Bulletin No. 3.
ERIC Educational Resources Information Center
Bailey, William J.
Public schools have a responsibility to educate students about drug abuse, and states have a responsibility to assist schools in their efforts. Properly designed and implemented drug education programs are the most cost-effective means of preventing alcohol and other drug problems. Poorly designed and implemented programs, on the other hand, can…
ERIC Educational Resources Information Center
Self-Brown, Shannon; Valente, Jessica R.; Wild, Robert C.; Whitaker, Daniel J.; Galanter, Rachel; Dorsey, Shannon; Stanley, Jenelle
2012-01-01
Benchmarking is a program evaluation approach that can be used to study whether the outcomes of parents/children who participate in an evidence-based program in the community approximate the outcomes found in randomized trials. This paper presents a case illustration using benchmarking methodology to examine a community implementation of…
ERIC Educational Resources Information Center
Pastchal-Temple, Andrea Sheree
2012-01-01
Many school districts are using research-based strategies to increase student achievement. The "No Child Left Behind Act" of 2001 was created and implemented to assist all students becoming proficient in reading and mathematics by 2014. One strategy many school districts implemented includes an after-school program. One school district…
ERIC Educational Resources Information Center
Supanakorn-Davila, Supawan; Bolliger, Doris U.
2012-01-01
Online training has become popular in the professional development of government employees in Thailand. One large government agency developed an online program to provide training to its employees across the country using two systems: an Internet and Intranet-based system. With the new program implemented, the evaluation of the instructional…
An Evaluation of an Implementation of the Reading Recovery Program.
ERIC Educational Resources Information Center
Denton, Carolyn A.
The effectiveness of the Reading Recovery Program, a literacy intervention for at-risk first-grade students, as it was implemented in 1995-96 in a small rural school district in Texas was studied. Reading Recovery consists of daily individual literacy tutoring sessions taught by a specially trained teacher, and emphasizes active engagement of the…
ERIC Educational Resources Information Center
Sellami, Nadia; Shaked, Shanna; Laski, Frank A.; Eagan, Kevin M.; Sanders, Erin R.
2017-01-01
Learning assistant (LA) programs have been implemented at a range of institutions, usually as part of a comprehensive curricular transformation accompanied by a pedagogical switch to active learning. While this shift in pedagogy has led to increased student learning gains, the positive effect of LAs has not yet been distinguished from that of…
Weiss, Daniel; Lillefjell, Monica; Magnus, Eva
2016-02-11
Health promotion, with a focus on multidimensional upstream factors and an ecological, life-course approach, is establishing itself as the guiding philosophy for addressing public health. Action at the political and programmatic level on the Social Determinants of Health has proven effective for promoting and building public health at all levels but has been particularly evident at the national and international levels - due in large part to available documents and guidelines. Although research and experience establish that health promotion is most effective when settings-based, the development of health promoting policies and programs at the local level is still difficult. This study intended to investigate available knowledge on the development and implementation of health promoting policies and programs at the local level and identify factors most important for facilitating capacity building and outcome achievement. We used a scoping review in order to review the current literature on local policy development and program implementation. Keywords were chosen based on results of a previous literature review. A total of 53 articles were divided into two categories: policy and implementation. Critical analysis was conducted for each article and a summary assembled. Data was charted with specific focus on the aims of the study, data acquisition, key theories/concepts/frameworks used, outcome measures, results, and conclusions. The articles included in this study primarily focused on discussing factors that facilitate the development of health promoting policy and the implementation of health promotion programs. Most significant facilitators included: collaborative decision-making, agreement of objectives and goals, local planning and action, effective leadership, building and maintaining trust, availability of resources, a dynamic approach, a realistic time-frame, and trained and knowledgeable staff. Within each of these important facilitating factors, various elements supporting implementation were discussed and highlighted in this study. Our results indicate that clear and consistent facilitators exist for supporting health promoting policy development and program implementation at the local level. These results offer a starting point for local action on the Social Determinants of Health and have the potential to contribute to the development of a framework for improving action at the local level.
Heckman, James; Moon, Seong Hyeok; Pinto, Rodrigo; Savelyev, Peter; Yavitz, Adam
2012-01-01
Social experiments are powerful sources of information about the effectiveness of interventions. In practice, initial randomization plans are almost always compromised. Multiple hypotheses are frequently tested. “Significant” effects are often reported with p-values that do not account for preliminary screening from a large candidate pool of possible effects. This paper develops tools for analyzing data from experiments as they are actually implemented. We apply these tools to analyze the influential HighScope Perry Preschool Program. The Perry program was a social experiment that provided preschool education and home visits to disadvantaged children during their preschool years. It was evaluated by the method of random assignment. Both treatments and controls have been followed from age 3 through age 40. Previous analyses of the Perry data assume that the planned randomization protocol was implemented. In fact, as in many social experiments, the intended randomization protocol was compromised. Accounting for compromised randomization, multiple-hypothesis testing, and small sample sizes, we find statistically significant and economically important program effects for both males and females. We also examine the representativeness of the Perry study. PMID:23255883
Voegler-Lee, Mary Ellen; Kupersmidt, Janis B.; Field, Samuel; Willoughby, Michael T.
2017-01-01
Recent years have seen increasing numbers of classroom-based interventions designed to enhance the school readiness of at-risk preschoolers. Even the most comprehensive, well-designed programs can suffer from limited effectiveness due to low-frequency implementation by teachers. The current study presents findings from the Building Bridges project (BB), an integrated program targeting school readiness in Head Start and low-income child care centers. Previous studies have reported the role of teacher-level and program-level characteristics in predicting teacher implementation of an intervention. The present study examines the role of student characteristics—language and math ability, social skills, and behavioral functioning—in predicting implementation exposure. These associations were examined in the context of program type (Head Start, child care) and intervention condition (consultation, no consultation). 88 classrooms (41 Head Start, 47 child care) participated in the BB intervention. Implementation exposure was predicted by several distinct student characteristics. Teachers whose students exhibited poorer language skills implemented significantly more BB activities, a finding that was consistent across program types and intervention conditions. A marginally significant trend was identified for oppositional behavior when interacted with intervention group in that teachers whose students demonstrated higher rates of oppositional behavior implemented fewer intervention activities when they did not have a consultant. Teachers in child care centers with a BB consultant had higher rates of implementation than did teachers in all other groups. These findings provide important information regarding the student-level characteristics that should be evaluated in order to optimize implementation of an intervention. PMID:22615022
2013-01-01
Background Improving quality in children’s mental health and social service settings will require implementation strategies capable of moving effective treatments and other innovations (e.g., assessment tools) into routine care. It is likely that efforts to identify, develop, and refine implementation strategies will be more successful if they are informed by relevant stakeholders and are responsive to the strengths and limitations of the contexts and implementation processes identified in usual care settings. This study will describe: the types of implementation strategies used; how organizational leaders make decisions about what to implement and how to approach the implementation process; organizational stakeholders’ perceptions of different implementation strategies; and the potential influence of organizational culture and climate on implementation strategy selection, implementation decision-making, and stakeholders’ perceptions of implementation strategies. Methods/design This study is a mixed methods multiple case study of seven children’s social service organizations in one Midwestern city in the United States that compose the control group of a larger randomized controlled trial. Qualitative data will include semi-structured interviews with organizational leaders (e.g., CEOs/directors, clinical directors, program managers) and a review of documents (e.g., implementation and quality improvement plans, program manuals, etc.) that will shed light on implementation decision-making and specific implementation strategies that are used to implement new programs and practices. Additionally, focus groups with clinicians will explore their perceptions of a range of implementation strategies. This qualitative work will inform the development of a Web-based survey that will assess the perceived effectiveness, relative importance, acceptability, feasibility, and appropriateness of implementation strategies from the perspective of both clinicians and organizational leaders. Finally, the Organizational Social Context measure will be used to assess organizational culture and climate. Qualitative, quantitative, and mixed methods data will be analyzed and interpreted at the case level as well as across cases in order to highlight meaningful similarities, differences, and site-specific experiences. Discussion This study is designed to inform efforts to develop more effective implementation strategies by fully describing the implementation experiences of a sample of community-based organizations that provide mental health services to youth in one Midwestern city. PMID:23961701
Harshbarger, Camilla; Simmons, Gretchen; Coelho, Helen; Sloop, Kira; Collins, Charles
2006-08-01
The Centers for Disease Control and Prevention (CDC), through its Diffusion of Effective Behavioral Interventions (DEBI) program, trained over 260 agencies on VOICES/VOCES between August 2003 and April 2005. ORC Macro conducted interviews with agency staff 3 months after receiving VOICES/VOCES training. This article discusses the diffusion of VOICES/VOCES; agencies' adoption, adaptation, and implementation of this intervention; and needs for ongoing proactive technical assistance (TA) for agencies to successfully integrate behavioral interventions into their programs. The vastmajority of agencies implemented VOICES/VOCES with fidelity to the core elements, and agencies successfully adapted the intervention to make it more appealing to target populations. TA is needed for interventions to be successfully adapted and implemented with fidelity to the core elements, and to ensure program sustainability. More effective interventions of short duration and minimum complexity to easily match with existing resources and conditions of agency capacity among HIV prevention providers in the community are needed.
A "Common Factors" Approach to Developing Culturally Tailored HIV Prevention Interventions.
Owczarzak, Jill; Phillips, Sarah D; Filippova, Olga; Alpatova, Polina; Mazhnaya, Alyona; Zub, Tatyana; Aleksanyan, Ruzanna
2016-06-01
The current dominant model of HIV prevention intervention dissemination involves packaging interventions developed in one context, training providers to implement that specific intervention, and evaluating the extent to which providers implement it with fidelity. Research shows that providers rarely implement these programs with fidelity due to perceived incompatibility, resource constraints, and preference for locally generated solutions. In this study, we used the concept of "common factors," or broad constructs shared by most evidence-based HIV prevention interventions, to train service providers to develop their own programs. We recruited eight Ukrainian HIV prevention organizations from regions with HIV epidemics concentrated among people who inject drugs. We trained staff to identify HIV risk behaviors and determinants, construct behavior change logic models, and develop and manualize an intervention. We systematically reviewed each manual to assess intervention format and content and determine whether the program met intervention criteria as taught during training. All agencies developed programs that reflected common factors of effective behavior change HIV prevention interventions. Each agency's program targeted a unique population that reflected local HIV epidemiology. All programs incorporated diverse pedagogical strategies that focused on skill-building, goal-setting, communication, and empowerment. Agencies struggled to limit information dissemination and the overall scope and length of their programs. We conclude that training service providers to develop their own programs based on common elements of effective behavior change interventions can potentially transform existing processes of program development, implementation, and capacity building. Expanding this model will require committed training and support resources. © 2015 Society for Public Health Education.
The Effects of a Contingency Contracting Program on the Nocturnal Enuresis of Three Children
ERIC Educational Resources Information Center
Stover, Anthony C.; Dunlap, Glen; Neff, Bryon
2008-01-01
Objective: This study was conducted to evaluate the effects of a contingency contracting program to eliminate nocturnal enuresis of three children ages 5 to 12. Methods: The program was implemented by the children's primary caregivers, two of whom were foster parents and the third a case worker in the foster care system. The program was a package…
ERIC Educational Resources Information Center
Ehresman, Norman D.; And Others
The major objective of the research project was to develop and implement an inservice education program designed to improve teaching effectiveness of vocational teachers of disadvantaged students in vocational programs. In addition, the authors sought to determine the effects of the inservice program on teachers and their students and to develop a…
ERIC Educational Resources Information Center
Giannotta, Fabrizia; Weichold, Karina
2016-01-01
Background: Life skills programs are effective tools to combat youth substance use. However there is a lack of studies concerning their effectiveness in Europe. Objective: This study investigated the 1 year follow up effects and the program implementation of a life skills school-based intervention (IPSY: Information + Psychosocial…
ERIC Educational Resources Information Center
Lenihan, Dawn; McCobb, Emily; Diurba, Amanda; Linder, Deborah; Freeman, Lisa
2016-01-01
Reading assistance dogs can be incorporated into reading programs to increase a child's desire and ability to read. However, more data is needed to demonstrate the effectiveness of such programs. A 5-week reading assistance dog program was implemented to assess feasibility and effectiveness. Participants included 18 children entering the 2nd grade…
Hopson, Laura M.; Holleran Steiker, Lori K.
2010-01-01
Although there is a strong evidence base for effective substance abuse prevention programs for youth, there is a need to facilitate the implementation and evaluation of these programs in real world settings. This study evaluates the effectiveness of adapted versions of an evidence-based prevention program, keepin’ it REAL (kiR), with alternative school students. Programs are often adapted when used in schools and other community settings for a variety of reasons. The kiR adaptations, developed during an earlier phase of this study, were created to make the curriculum more appropriate for alternative high school youth. The adaptations were evaluated using a quasi-experimental design in which questionnaires were administered at pretest, posttest, and follow-up, and focus groups were conducted at posttest. MANOVA analyses indicate significantly reduced intentions to accept alcohol and, for younger participants, reduced alcohol use. Focus group data support the need for age appropriate prevention content. The authors discuss implications for practitioners implementing prevention programs in schools. PMID:20622971
ERIC Educational Resources Information Center
IUME Briefs, 1992
1992-01-01
Some programs for helping at-risk youth achieve excellent results, while others do not. One reason for program success can be proper management. Mentoring is a promising strategy for helping at-risk youth. Planners who want to create effective mentoring programs should look at the implementation experiences of other youth programs. Evaluations…
Titler, Marita G; Visovatti, Moira A; Shuman, Clayton; Ellis, Katrina R; Banerjee, Tanima; Dockham, Bonnie; Yakusheva, Olga; Northouse, Laurel
2017-11-01
This study examined the effectiveness, feasibility, and satisfaction with implementation of the FOCUS program in two US Cancer Support Community affiliates in Ohio and California as well as the cost to deliver the program. FOCUS is an evidence-based psychoeducational intervention for dyads (cancer patients and caregivers). A pre-post-intervention design was employed. Eleven, five-session Focus programs were delivered by licensed professionals in a small group format (three-four dyads/group) to 36 patient-caregiver dyads. An Implementation Training Manual, a FOCUS Intervention Protocol Manual, and weekly conference calls were used to foster implementation. Participants completed questionnaires prior to and following completion of each five-session FOCUS program to measure primary (emotional distress, quality of life) and secondary outcomes (benefits of illness, self-efficacy, and dyadic communication). Enrollment and retention rates and fidelity to FOCUS were used to measure feasibility. Cost estimates were based on time and median hourly wages. Repeated analysis of variance was used to analyze the effect of FOCUS on outcomes for dyads. Descriptive statistics were used to examine feasibility, satisfaction, and cost estimates. FOCUS had positive effects on QOL (p = .014), emotional (p = .012), and functional (p = .049) well-being, emotional distress (p = .002), benefits of illness (p = .013), and self-efficacy (p = .001). Intervention fidelity was 85% with enrollment and retention rates of 71.4 and 90%, respectively. Participants were highly satisfied. Cost for oversight and delivery of the five-session FOCUS program was $168.00 per dyad. FOCUS is an economic and effective intervention to decrease distress and improve the quality of life for dyads.
Zarrett, Nicole; Skiles, Brittany; Wilson, Dawn K; McClintock, Lauren
2012-08-01
Minimal effects found across youth physical activity (PA) interventions, and increased attention to circumstances that impede adequate delivery of program components, has highlighted the importance of learning from staff what is needed to foster staff comprehension and engagement for developing, adopting, and successfully implementing PA-based youth interventions. The purpose of this study is to address this knowledge gap by conducting a qualitative assessment of school staff perspectives on the positive aspects and challenges of implementing the 17-week ACT program, an after-school intervention that integrated motivational and behavioral components to promote PA in underserved adolescents. Interviews were conducted with one school staff member from each participating school for all four trial cohorts (N=12). Transcripts were coded by independent coders (r=.84) and content analyses of themes was performed using QSR NVivo. Themes were organized into five meta-themes: (1) Logistics; (2) Essential Elements; (3) Staff and Child Challenges; (4) Staff Comprehension, Value, and Enjoyment; (5) Spill-Over Effects. Findings indicate that staff can be successful at understanding, valuing, and reaching fidelity in implementing climate-based mediation components. The insight gained from this study lays the foundation for understanding the components needed for establishing well-implemented, effective, and generalizable interventions for increasing youth PA. Copyright © 2012 Elsevier Ltd. All rights reserved.
NASA Technical Reports Server (NTRS)
Duarte, Luis Alberto; Kross, Denny (Technical Monitor)
2001-01-01
The US civil aerospace program has been a great contributor to the creation and implementation of techniques and methods to identify, analyze, and confront risk. NASA has accomplished mission success in many instances, but also has had many failures. Anomalies have kept the Agency from achieving success on other occasions, as well. While NASA has mastered ways to prevent risks, and to quickly and effectively react and recover from anomalies or failures, it was not until few years ago that a comprehensive Risk Management process started being implemented in some of its programs and projects. A Continuous Risk Management (CRM) cycle process was developed and has been promoted and used successfully in programs and projects across the Agency.
Lavery, Lawrence A; Wunderlich, Robert P; Tredwell, Jeffrey L
2005-10-01
To demonstrate the effectiveness of a diabetic foot disease management program in a managed care organization. We implemented a lower extremity disease management program consisting of screening and treatment protocols for diabetic members in a managed care organization. Screening consisted of evaluation of neuropathy, peripheral vascular disease, deformities, foot pressures, and history of lower extremity pathology. We stratified patients into low and high-risk groups, and implemented preventive or acute care protocols. Utilization was tracked for 28 months and compared to 12 months of historic data prior to implementation of the disease management program. After we implemented the disease management program, the incidence of amputations decreased 47.4% from 12.89 per 1000 diabetics per year to 6.18 (p<0.05). The number of foot-related hospital admissions decreased 37.8% from 22.86 per 1000 members per year to 14.23 (37.8%). The average inpatient length-of-stay (LOS) was reduced 21.7% from 4.75 to 3.72 days (p<0.05). In addition, there was a 69.8% reduction in the number of skilled nursing facility (SNF) admissions per 1000 members per year (Table 1) and a 38.2% reduction in the average SNF LOS from 8.72 to 6.52 days (p<0.05). A population-based screening and treatment program for the diabetic foot can dramatically reduce hospitalizations and clinical outcomes.
Marques, Cristiano Corrêa de Azevedo; Carvalheiro, José da Rocha
2017-01-01
to assess the performance of the diagnostic network in the implementation process of the Program for Viral Hepatitis Prevention and Control in São Paulo State, Brazil, from 1997 to 2012. evaluation study based on documentary research and structured interviews, combined with a historical series analysis of indicators developed to assess the implementation process of the program, using data from the Department of the Brazilian National Health System. from 1997 to 2012, the serology, biopsy and molecular biology diagnostic networks showed an increase in the coefficients of coverage of 7.4, 7.3, and 62.0 times, respectively, with an increase in cases detection and treatment access. despite the effective implementation of the diagnostic network, there is a need to review the search strategy for new cases, and access to liver biopsy, still insufficient to the program demand.
Manca, Donna Patricia; Aubrey-Bassler, Kris; Kandola, Kami; Aguilar, Carolina; Campbell-Scherer, Denise; Sopcak, Nicolette; O'Brien, Mary Ann; Meaney, Christopher; Faria, Vee; Baxter, Julia; Moineddin, Rahim; Salvalaggio, Ginetta; Green, Lee; Cave, Andrew; Grunfeld, Eva
2014-10-08
The objectives of this paper are to describe the planned implementation and evaluation of the Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER 2) program which originated from the BETTER trial. The pragmatic trial, informed by the Chronic Care Model, demonstrated the effectiveness of an approach to Chronic Disease Prevention and Screening (CDPS) involving the use of a new role, the prevention practitioner. The desired goals of the program are improved clinical outcomes, reduction in the burden of chronic disease, and improved sustainability of the health-care system through improved CDPS in primary care. The BETTER 2 program aims to expand the implementation of the intervention used in the original BETTER trial into communities across Canada (Alberta, Ontario, Newfoundland and Labrador, the Northwest Territories and Nova Scotia). This proactive approach provides at-risk patients with an intervention from the prevention practitioner, a health-care professional. Using the BETTER toolkit, the prevention practitioner determines which CDPS actions the patient is eligible to receive, and through shared decision-making and motivational interviewing, develops a unique and individualized 'prevention prescription' with the patient. This intervention is 1) personalized; 2) addressing multiple conditions; 3) integrated through linkages to local, regional, or national resources; and 4) longitudinal by assessing patients over time. The BETTER 2 program brings together primary care providers, policy/decision makers and researchers to work towards improving CDPS in primary care. The target patient population is adults aged 40-65. The reach, effectiveness, adoption, implementation, maintain (RE-AIM) framework will inform the evaluation of the program through qualitative and quantitative methods. A composite index will be used to quantitatively assess the effectiveness of the prevention practitioner intervention. The CDPS actions comprising the composite index include the following: process measures, referral/treatment measures, and target/change outcome measures related to cardiovascular disease, diabetes, cancer and associated lifestyle factors. The BETTER 2 program is a collaborative approach grounded in practice and built from existing work (i.e., integration not creation). The program evaluation is designed to provide an understanding of issues impacting the implementation of an effective approach for CDPS within primary care that may be adapted to become sustainable in the non-research setting.
ERIC Educational Resources Information Center
Baytop, Chanza M.
2006-01-01
A study implements meta-analytic methods to synthesize the findings and analyze the effects of interventions, including secondary teen pregnancy prevention programs, on educational achievement among unwed African American teen mothers. Results indicate that secondary teen pregnancy prevention programs and other interventions for adolescent mothers…
ERIC Educational Resources Information Center
Elias, Maurice J.
This article urges a reexamination of the concept of dissemination of health-related prevention programs. The article discusses factors that serve as sustaining conditions for dissemination of prevention programs including: (1) the nature of preventive intervention and parameters of effective community-based prevention praxis; (2) aspects of the…
English as a Second Language: Implementing Effective Adult Education Programs.
ERIC Educational Resources Information Center
California State Dept. of Education, Sacramento. Adult, Alternative, and Continuation Education Div.
The manual is designed to assist California educators and public in understanding the various aspects of an effective English-as-a-Second-Language (ESL) program for adults. It provides theory-based and practical guidelines for conceptualizing, planning, designing, managing, and evaluating such programs. Chapters address these topics: the adult ESL…
Grant Funding to Implement PREPaRE Training in Your School District
ERIC Educational Resources Information Center
Paige, Leslie Z.
2010-01-01
Implementing an effective crisis management program in a school district has associated costs. The most precious resource in a school system is time. Time is necessary for acquiring and practicing new skills, and for developing and implementing strategies to introduce and expand the change throughout a school or district. Implementing an effective…
Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs
Freeman, Richard K.; Krasna, Mark J.
2015-01-01
Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed. PMID:26380186
Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs.
Osarogiagbon, Raymond U; Freeman, Richard K; Krasna, Mark J
2015-08-01
Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed.
[Pay for performance (P4P). Long-term effects and perspectives].
Schrappe, M; Gültekin, N
2011-02-01
After 10 years of experience and research, a wide array of results on evaluation and long-term effects of pay for performance (P4P) programs have been published. These data do not only give insight into most of the problems of implementation, but also into aspects which, in part, may attenuate the high expectations at the beginning of the discussion. P4P programs exhibit a ceiling effect, some improvements are reversed after incentives are cancelled, and improvements show opportunity costs as absent improvements for indicators, which are not object to financial incentives (in some cases for the same disease). These observations can be explained by the hypothesis that P4P programs have characteristics of fee-for-service reimbursement, if symmetric information is available for insurance and provider. P4P programs are local instruments. While integration of healthcare is considered as an important issue, they should be combined with programs and incentives which foster further vertical and horizontal integration. For Germany, further research in the implementation and effects of P4P programs is necessary.
Hoekstra, Femke; van Offenbeek, Marjolein A G; Dekker, Rienk; Hettinga, Florentina J; Hoekstra, Trynke; van der Woude, Lucas H V; van der Schans, Cees P
2017-12-01
Although the importance of evaluating implementation fidelity is acknowledged, little is known about heterogeneity in fidelity over time. This study aims to generate insight into the heterogeneity in implementation fidelity trajectories of a health promotion program in multidisciplinary settings and the relationship with changes in patients' health behavior. This study used longitudinal data from the nationwide implementation of an evidence-informed physical activity promotion program in Dutch rehabilitation care. Fidelity scores were calculated based on annual surveys filled in by involved professionals (n = ± 70). Higher fidelity scores indicate a more complete implementation of the program's core components. A hierarchical cluster analysis was conducted on the implementation fidelity scores of 17 organizations at three different time points. Quantitative and qualitative data were used to explore organizational and professional differences between identified trajectories. Regression analyses were conducted to determine differences in patient outcomes. Three trajectories were identified as the following: 'stable high fidelity' (n = 9), 'moderate and improving fidelity' (n = 6), and 'unstable fidelity' (n = 2). The stable high fidelity organizations were generally smaller, started earlier, and implemented the program in a more structured way compared to moderate and improving fidelity organizations. At the implementation period's start and end, support from physicians and physiotherapists, professionals' appreciation, and program compatibility were rated more positively by professionals working in stable high fidelity organizations as compared to the moderate and improving fidelity organizations (p < .05). Qualitative data showed that the stable high fidelity organizations had often an explicit vision and strategy about the implementation of the program. Intriguingly, the trajectories were not associated with patients' self-reported physical activity outcomes (adjusted model β = - 651.6, t(613) = - 1032, p = .303). Differences in organizational-level implementation fidelity trajectories did not result in outcome differences at patient-level. This suggests that an effective implementation fidelity trajectory is contingent on the local organization's conditions. More specifically, achieving stable high implementation fidelity required the management of tensions: realizing a localized change vision, while safeguarding the program's standardized core components and engaging the scarce physicians throughout the process. When scaling up evidence-informed health promotion programs, we propose to tailor the management of implementation tensions to local organizations' starting position, size, and circumstances. The Netherlands National Trial Register NTR3961 . Registered 18 April 2013.
Goncy, Elizabeth A; Sutherland, Kevin S; Farrell, Albert D; Sullivan, Terri N; Doyle, Sarah T
2015-04-01
Although there is evidence that school-based prevention programs can produce positive effects on students' academic and behavioral functioning, the ability of teachers to sustain high-quality implementation remains an open and vexing question. Because teachers are often the intervention agents in school-based prevention programs, assessing both their adherence to program procedures and their competence in program delivery is critical for ensuring student responsiveness to prevention programs, which in turn may impact their efficacy. The current study assessed treatment fidelity of implementation of the Olweus' Bullying Prevention Program (OBPP) in two urban middle schools. Trained observers completed 280 observations of teachers' delivery of the class meeting component of the OBPP and rated teachers' instructional and procedural adherence and competence of delivery and students' responsiveness. Analyses using multilevel modeling indicated that competence of delivery was significantly related to student responsiveness above and beyond teacher instructional behavior adherence, such that class meetings conducted with higher instructional adherence and procedural competence resulted in higher student responsiveness to the program after controlling for the clustered nature of teachers, and several observation-level and teacher-level covariates. This study highlights the need for strategies to increase teacher use of effective instructional practices and competence with program procedures to enhance the efficacy of prevention programming in schools.
Song, Hee-Jung; Gittelsohn, Joel; Kim, MiYong; Suratkar, Sonali; Sharma, Sangita; Anliker, Jean
2011-05-01
Based on substantial formative research, the authors developed and implemented a year-long corner store-based program in East Baltimore focusing on Korean American (KA) stores. To understand acceptability of the intervention by storeowners, the authors examined the motivating factors for program participation, barriers to program implementation, perceived effectiveness of intervention materials, and perceptions about the program. Data collection methods included in-depth interviews with seven corner store owners, field notes by interventionists, and a follow-up survey. Stores varied considerably in terms of owners' perceptions about the program, supportive atmosphere, and acceptability of intervention strategies. The storeowners who showed strong or moderate support for the program were more likely to sustain the stocking of promoted foods such as cooking spray and baked or low-fat chips after the program was completed as compared to less supportive stores. The level of support and active participation of storeowners can greatly influence the success of corner store-based nutrition interventions.
Factors Influencing Implementation of a Preschool-Based Physical Activity Intervention
ERIC Educational Resources Information Center
Lau, Erica Y.; Saunders, Ruth P.; Beets, Michael W.; Cai, Bo; Pate, Russell R.
2017-01-01
Examining factors that influence implementation of key program components that underlie an intervention's success provides important information to inform the development of effective dissemination strategies. We examined direct and indirect effects of preschool capacity, quality of prevention support system and teacher characteristics on…
Process Evaluation of an Effective Church-Based Diet Intervention: Body & Soul
ERIC Educational Resources Information Center
Campbell, Marci Kramish; Resnicow, Ken; Carr, Carol; Wang, Terry; Williams, Alexis
2007-01-01
Body & Soul has demonstrated effectiveness as a dietary intervention among African American church members. The process evaluation assessed relationships between program exposure and implementation factors and study outcomes and characterized factors important for adoption, implementation, and maintenance. Data sources included participant surveys…
2012-01-01
Introduction Improving access to sterile injection equipment is a key component in community-based infectious disease prevention. Implementation of syringe access programs has sometimes been complicated by community opposition and police interference. Case description In 2006, the Delaware legislature authorized a pilot syringe exchange program (SEP). A program designed to prevent, monitor, and respond to possible policing and community barriers before they had a chance to effect program implementation and operation. A program designed to prevent, monitor, and respond to these barriers was planned and implemented by a multidisciplinary team of legal practitioners and public health professionals. Discussion We report on an integrated intervention to address structural barriers to syringe exchange program utilization. This intervention employs community, police and client education combined with systematic surveillance of and rapid response to police interference to preempt the kinds of structural barriers to implementation observed elsewhere. The intervention addresses community concerns and stresses the benefits of syringe exchange programs to officer occupational safety. Conclusions A cohesive effort combining collaboration with and educational outreach to police and community members based on the needs and concerns of these groups as well as SEP clients and potential clients helped establish a supportive street environment for the SEP. Police-driven structural barriers to implementation of public health programs targeting populations engaged in drug use and other illicit behavior can be addressed by up-stream planning, prevention, monitoring and intervention strategies. More research is needed to inform the tailoring of interventions to address police-driven barriers to HIV prevention services, especially among marginalized populations. PMID:22591836
Implementing the CDC’s Colorectal Cancer Screening Demonstration Program: Wisdom From the Field
Rohan, Elizabeth A.; Boehm, Jennifer E.; DeGroff, Amy; Glover-Kudon, Rebecca; Preissle, Judith
2017-01-01
BACKGROUND Colorectal cancer, as the second leading cause of cancer-related deaths among men and women in the United States, represents an important area for public health intervention. Although colorectal cancer screening can prevent cancer and detect disease early when treatment is most effective, few organized public health screening programs have been implemented and evaluated. From 2005 to 2009, the Centers for Disease Control and Prevention funded 5 sites to participate in the Colorectal Cancer Screening Demonstration Program (CRCSDP), which was designed to reach medically underserved populations. METHODS The authors conducted a longitudinal, multiple case study to analyze program implementation processes. Qualitative methods included interviews with 100 stakeholders, 125 observations, and review of 19 documents. Data were analyzed within and across cases. RESULTS Several themes related to CRCSDP implementation emerged from the cross-case analysis: the complexity of colorectal cancer screening, the need for teamwork and collaboration, integration of the program into existing systems, the ability of programs to use wisdom at the local level, and the influence of social norms. Although these themes were explored independently from 1 another, interaction across themes was evident. CONCLUSIONS Colorectal cancer screening is clinically complex, and its screening methods are not well accepted by the general public; both of these circumstances have implications for program implementation. Using patient navigation, engaging in transdisciplinary teamwork, assimilating new programs into existing clinical settings, and deferring to local-level wisdom together helped to address complexity and enhance program implementation. In addition, public health efforts must confront negative social norms around colorectal cancer screening. PMID:23868482
Highfield, Linda; Hartman, Marieke A.; Bartholomew, L. Kay; Balihe, Philomene; Ausborn, Valerie A.
2015-01-01
Breast cancer mortality disparities continue, particularly for uninsured and minority women. A number of effective evidence-based interventions (EBIs) exist for addressing barriers to mammography screening; however, their uptake and use in community has been limited. Few cancer-specific studies have evaluated adapted EBIs in new contexts, and fewer still have considered implementation. This study sought to (1) evaluate the effectiveness of an adapted mammography EBI in improving appointment keeping in African American women and (2) describe processes of implementation in a new practice setting. We used the type 1 hybrid design to test effectiveness and implementation using a quasi-experimental design. Logistic regression and intent-to-treat analysis were used to evaluate mammography appointment attendance. The no-show rate was 44% (comparison) versus 19% (intervention). The adjusted odds of a woman in the intervention group attending her appointment were 3.88 (p < 0.001). The adjusted odds of a woman attending her appointment in the intent-to-treat analysis were 2.31 (p < 0.05). Adapted EBI effectiveness was 3.88 (adjusted OR) versus 2.10 (OR) for the original program, indicating enhanced program effect. A number of implementation barriers and facilitators were identified. Our findings support previous studies noting that sequentially measuring EBI efficacy and effectiveness, followed by implementation, may be missing important contextual information. PMID:26504790
Owczarzak, Jill; Broaddus, Michelle; Pinkerton, Steven
2016-04-01
Continued debate about the relative value of fidelity versus adaptation, and lack of clarity about the meaning of fidelity, raise concerns about how frontline service providers resolve similar issues in their daily practice. We use SISTA ('Sisters Informing Sisters on Topics about acquired immune deficiency syndrome'), an evidence-based human immunodeficiency virus (HIV) prevention intervention for African American women, to understand how facilitators and program directors interpret and enact implementation fidelity with the need for adaptation in real-world program delivery. We conducted 22 in-depth, semi-structured interviews with service providers from four agencies implementing SISTA. Facilitators valued their skills as group leaders and ability to emotionally engage participants as more critical to program effectiveness than delivering the intervention with strict fidelity. Consequently, they saw program manuals as guides rather than static texts that should never be changed and, moreover, viewed the prescriptive nature of manuals as undermining their efforts to fully engage with participants. Our findings suggest that greater consideration should be given to understanding the role of facilitators in program effectiveness over and above the question of whether they implement the program with fidelity. Moreover, training curricula should provide facilitators with transferable skills through general facilitator training rather than only program-specific or manual-specific training. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
RACER: Effective Race Detection Using AspectJ
NASA Technical Reports Server (NTRS)
Bodden, Eric; Havelund, Klaus
2008-01-01
The limits of coding with joint constraints on detected and undetected error rates Programming errors occur frequently in large software systems, and even more so if these systems are concurrent. In the past, researchers have developed specialized programs to aid programmers detecting concurrent programming errors such as deadlocks, livelocks, starvation and data races. In this work we propose a language extension to the aspect-oriented programming language AspectJ, in the form of three new built-in pointcuts, lock(), unlock() and may be Shared(), which allow programmers to monitor program events where locks are granted or handed back, and where values are accessed that may be shared amongst multiple Java threads. We decide thread-locality using a static thread-local objects analysis developed by others. Using the three new primitive pointcuts, researchers can directly implement efficient monitoring algorithms to detect concurrent programming errors online. As an example, we expose a new algorithm which we call RACER, an adoption of the well-known ERASER algorithm to the memory model of Java. We implemented the new pointcuts as an extension to the Aspect Bench Compiler, implemented the RACER algorithm using this language extension and then applied the algorithm to the NASA K9 Rover Executive. Our experiments proved our implementation very effective. In the Rover Executive RACER finds 70 data races. Only one of these races was previously known.We further applied the algorithm to two other multi-threaded programs written by Computer Science researchers, in which we found races as well.
A workplace modified duty program for employees in an oncology center.
Soteriades, Elpidoforos S
2017-01-01
Workplace modified duty programs may provide reasonable accommodations to employees who have partial temporary job disability and could work on duty accommodations until they fully recover. However, little is known about the implementation barriers and effectiveness of such programs. This study is aimed at evaluating the implementation of a modified duty program for employees in an oncology center. A modified duty program for employees working at the Bank of Cyprus Oncology Center, a non profit organization with 200 employees located in the Republic of Cyprus was evaluated based on the health records of the occupational medicine department. Employees' participation in the program was 3%. A total of 12 employees participated (6 each year). The participants were all women and the mean participation period was 21.6 days (range 10 - 65 days). The two most frequent reasons for a modified duty assignment were pregnancy and back pain. Employees were assigned either on limited duties or on a combination of limited duties and reduced work hours. Employees reported being very satisfied with their participation based on a follow-up narrative oral assessment. The small participation rate does not allow for advanced statistical analyses. Further studies from larger organizations are urgently needed to evaluate the effectiveness of modified duty programs. The development of a legal framework for such modified duty programs in Cyprus as well as internationally may promote their implementation in order to facilitate the effective management of temporary partial job disability for the benefit of both employees and businesses.
Cervical cancer screening in Bulgaria--past and present experience.
Valerianova, Zdravka; Panayotova, Yulia; Amati, Camilla; Baili, Paolo
2010-01-01
In Bulgaria the previously (1970-1985) existing population based cervical cancer screening was replaced in the early 1990s with an opportunistic model due to political and socioeconomic reasons. As a result, in the last 20 years, cervical cancer incidence and mortality rates steady increased. The objective of the EUROCHIP project in Bulgaria was to evaluate the readiness of the health system as well as health providers' attitudes to implementation in the country of a population based screening program for cervical cancer. Using a structured questionnaire, a convenience sample of medical specialists representing different actors involved in cervical cancer prevention, treatment, financing and policy were interviewed. The majority of interviewed practitioners worried that organization and implementation of an effective population-based cervical cancer screening program is not possible in the current unstable health system. A nostalgic attitude to the cervical cancer screening, performed in the past and pessimistic view on the capability of the current health system to cope are strong. As main barriers to implementation of an effective program were pointed financial and organizational ones. Motivation for gynecologists to perform smear test should include better information, organization and payment. Medical specialists in Bulgaria are aware of the alarming rates of cervical cancer incidence and mortality in the country. However, due to the insufficient communication and interaction between policy makers and front-line health care staff, they do not have enough information on the ongoing programs. Absence of health policy regarding screening is considered as main barrier for implementation of an effective screening program.
Development and implementation of a writing program to improve resident authorship rates.
Clemmons, Amber Bradley; Hoge, Stephanie C; Cribb, Ashley; Manasco, Kalen B
2015-09-01
The development, implementation, and evaluation of a writing program with a formalized writing project as a component of postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residencies are described. The writing program at Georgia Regents Medical Center/University of Georgia College of Pharmacy, a collaborative and jointly funded program, was initiated in the 2010-11 residency year. The goals of the program are to teach residents to communicate effectively, apply leadership skills, employ project management skills, and provide medication- and practice- related education and training. The program combines both writing experiences and mentorship. At the beginning of the residency year, trainees are presented with opportunities to participate in both research projects and writing projects. Specifically, opportunities within the writing program include involvement in review articles, case reports, drug information rounds, book chapters, letters to the editor, and high-quality medication-use evaluations for potential publication. The writing project is highly encouraged, and completion of a manuscript to be submitted for publication is expected by graduation. Nine papers were published by 8 of 18 PGY1 and PGY2 residents in the four years before program implementation. A total of 23 publications were published by 18 (72%) of the 25 PGY1 and PGY2 residents in the four years after implementation of the writing program. Implementation of a formal writing program increased the overall publication rate of residents. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Terezhalmy, G T; Gitto, C A
1998-10-01
The current climate in society regarding infectious diseases in general, and herpes, hepatitis, and HIV infections in particular, dictates that today's dental practices must use effective infection control techniques. The Occupational Safety and Health Administration continues to inspect, cite, and fine health care facilities. More states are implementing regulations concerning the operation of health care facilities. Patients are becoming more sophisticated in their scrutinizing of the dental and medical professions' approach to asepsis. Media coverage of exposure incidents is becoming more intense. All these factors leave dentists no choice; they must implement appropriate infection control techniques. The life-time cost of effective infection control is far less than one malpractice settlement. Implementation of an effective infection control program to promote dental asepsis can be cost-effective. In addition, it can be a practice builder.
Trip, Simona; Bora, Carmen; Sipos-Gug, Sebastian; Tocai, Ioana; Gradinger, Petra; Yanagida, Takuya; Strohmeier, Dagmar
2015-10-01
The effectiveness of a class-based antibullying prevention program on cognitions, emotions, and behaviors was investigated. The program consists of a cognitive-behavioral (Rational Emotive Behavioral Education; REBE) and a behavioral (Viennese Social Competence; ViSC) component. The REBE program is based on rational emotive behavioral theory and contains 9 student lessons. The ViSC program is based on social learning theory and comprises 10 student lessons. The order of the programs was experimentally manipulated. The REBE-ViSC program was implemented in 5 schools (14 classes), the ViSC-REBE program was implemented in 3 schools (9 classes), and 3 schools (11 classes) served as an untreated control group. Data were collected during 1 school year at pretest, midpoint, and posttest. Emotions (overt and internalizing anger), cognitions (learning and entitlement), and behaviors (bullying perpetration and bullying victimization) were measured with self-assessments. To examine the effectiveness of the REBE-ViSC/ViSC-REBE program, multilevel growth models were applied (time points at Level 1, individuals at Level 2, and classes at Level 3). The analyses revealed that the program effects differed depending on the order of the programs. The REBE-ViSC condition was more effective in changing negative emotions than the ViSC-REBE condition; both experimental conditions were effective in reducing dysfunctional cognitions, whereas no behavioral change was found in the 2 experimental groups when compared with the control group. To improve program effectiveness regarding behavioral changes, a multilevel whole-school approach including a teacher component is recommended. (c) 2015 APA, all rights reserved).
NASA Astrophysics Data System (ADS)
Yin, Runsheng; Yin, Guiping
2010-03-01
China has undertaken several major programs of terrestrial ecosystem restoration (ERPs) in recent years, including the Natural Forest Protection Program (NFPP) and the Sloping Land Conversion Program (SLCP). There have been reports on the implementation of these programs, their preliminary impacts, and the problems encountered in carrying them out; a great deal has been learned from these studies. Nonetheless, China’s ERPs are not limited to the NFPP and the SLCP. Because a complete documentation and a timely update of these major efforts are still missing from the literature, it is difficult to gauge the scope of these programs and the scale of their impacts. In addition, a more thorough and critical analysis of both the general ERP policy and the specific technical measures used in implementing the ERPs remains urgently needed. The purpose of this article is to tackle these tasks. Overall, with the huge government investments in the ERPs, tremendous progress has been made in implementing them. To complete them successfully and to fundamentally improve the targeted ecosystems, however, it is essential for China to have a more balanced and comprehensive approach to ecological restoration. This approach must include: adopting better planning and management practices; strengthening the governance of program implementation; emphasizing the active engagement of local people; establishing an independent, competent monitoring network; and conducting adequate assessments of program effectiveness and impact.
Schulz, Claudia; Lindlbauer, Ivonne; Rapp, Kilian; Becker, Clemens; König, Hans-Helmut
2017-06-01
Femoral fractures are frequently consequences of falls in nursing homes and are associated with considerable costs and unfavorable outcomes such as immobility and mortality. The purpose of this study was to examine the long-term effectiveness of a multifactorial fall and fracture prevention program in nursing homes in terms of reducing femoral fractures. Retrospective cohort study. Nursing homes. Health insurance claims data for 2005-2013 including 85,148 insurants of a sickness fund (Allgemeine Ortskrankenkasse Bayern), aged 65 years or older and living in 802 nursing homes in Bavaria, Germany. The fall prevention program was implemented stepwise in 4 time-lagged waves in almost 1,000 nursing homes in Bavaria, Germany, and was financially supported by a Bavarian statutory health insurance for the initial period of 3 years after implementation. The components of Bavarian Fall and Fracture Prevention Program were related to the staff (education), to the residents (progressive strength and balance training, medication, hip protectors), and suggested environmental adaptations as well as fall documentation and feedback on fall statistics. Data were used to create an unbalanced panel data set with observations per resident and quarterly period. We designed each wave to have 9 quarters (2.25 years) before implementation and 15 quarters (3.75 years) as follow-up period, respectively. Time trend-adjusted logistic generalized estimating equations were used to examine the impact of implementation of the fall prevention program on the likelihood of femoral fractures, controlling for resident and nursing home characteristics. The analysis took into account that the fall prevention program was implemented in 4 time-lagged waves. The implementation of the fall prevention program was not associated with a significant reduction in femoral fractures. Only a transient reduction of femoral fractures in the first wave was observed. Patient characteristics were positively associated with the likelihood of femoral fractures (P < .001); women compared to men [odds ratio (OR) = 0.877], age category 2 (OR = 1.486) and 3 (OR = 1.973) compared to category 1, care level 1 compared to 2 (OR = 0.897) and 3 (OR = 0.426), and a prior fracture (OR = 2.230) significantly increased the likelihood of a femoral fracture. There was no evidence for the long-term effectiveness of the fall prevention program in nursing homes. The restriction of the transient reduction to the first implementation wave may be explainable by a higher motivation of nursing homes starting first with the fall prevention program. Efforts should be directed to further identify factors that determine the long-term effectiveness of fall prevention programs in nursing homes. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Levin, Henry M.; Catlin, Doran; Elson, Alex
2010-01-01
Many educators and researchers have proposed reforms for dealing with the ongoing adolescent literacy crisis. Progress in strengthening young people's literacy now depends on schools a) choosing appropriate programs and b) implementing them consistently and effectively. Yet the history of school reform is littered with reforms that were adopted…
ERIC Educational Resources Information Center
Forman, Stephanie
2016-01-01
Dual language immersion program models represent a potentially effective way to serve growing numbers of English language learners (ELLs) in schools and districts. However, local challenges, such as interpersonal conflict, can impact the process of implementing dual language policies and programs, limiting the extent to which they are able to meet…
Implementation of a School-Based Fluoride Tablet Program in a Rural Community.
ERIC Educational Resources Information Center
Eriksen, Michael; And Others
A segment of a 3-year dental research project involving 2,000 school children aged 5-13 conducted in a rural Pennsylvania county, this study presents 1 component in a 3-pronged attempt to determine the effectiveness of a school-based dental health delivery system. The implementation procedures of this program are described as involving:…
NASA Astrophysics Data System (ADS)
Rhee, Hyang-yon; Choi, Kyunghee
2014-05-01
The purposes of this study were (1) to develop a science and technology (ST) ethics education program for prospective science teachers, (2) to examine the effect of the program on the perceptions of the participants, in terms of their ethics and education concerns, and (3) to evaluate the impact of the program design. The program utilized problem-based learning (PBL) which was performed as an iterative process during two cycles. A total of 23 and 29 prospective teachers in each cycle performed team activities. A PBL-based ST ethics education program for the science classroom setting was effective in enhancing participants' perceptions of ethics and education in ST. These perceptions motivated prospective science teachers to develop and implement ST ethics education in their future classrooms. The change in the prospective teachers' perceptions of ethical issues and the need for ethics education was greater when the topic was controversial.
Defence R&D Canada's autonomous intelligent systems program
NASA Astrophysics Data System (ADS)
Digney, Bruce L.; Hubbard, Paul; Gagnon, Eric; Lauzon, Marc; Rabbath, Camille; Beckman, Blake; Collier, Jack A.; Penzes, Steven G.; Broten, Gregory S.; Monckton, Simon P.; Trentini, Michael; Kim, Bumsoo; Farell, Philip; Hopkin, Dave
2004-09-01
The Defence Research and Development Canada's (DRDC has been given strategic direction to pursue research to increase the independence and effectiveness of military vehicles and systems. This has led to the creation of the Autonomous Intelligent Systems (AIS) prgram and is notionally divide into air, land and marine vehicle systems as well as command, control and decision support systems. This paper presents an overarching description of AIS research issues, challenges and directions as well as a nominal path that vehicle intelligence will take. The AIS program requires a very close coordination between research and implementation on real vehicles. This paper briefly discusses the symbiotic relationship between intelligence algorithms and implementation mechanisms. Also presented are representative work from two vehicle specific research program programs. Work from the Autonomous Air Systems program discusses the development of effective cooperate control for multiple air vehicle. The Autonomous Land Systems program discusses its developments in platform and ground vehicle intelligence.
Self-Brown, Shannon R; C Osborne, Melissa; Rostad, Whitney; Feil, Ed
2017-11-01
Implementation of evidence-based parenting programs is critical for parents at-risk for child maltreatment perpetration; however, widespread use of effective programs is limited in both child welfare and prevention settings. This exploratory study sought to examine whether a technology-mediated approach to SafeCare ® delivery can feasibly assist newly trained providers in achieving successful implementation outcomes. Thirty-one providers working in child welfare or high-risk prevention settings were randomized to either SafeCare Implementation with Technology-Assistance (SC-TA) or SafeCare Implementation as Usual (SC-IU). SC-TA providers used a web-based program during session that provided video-based psychoeducation and modeling directly to parents and overall session guidance to providers. Implementation outcome data were collected from providers for six months. Data strongly supported the feasibility of SC-TA. Further, data indicated that SC-TA providers spent significantly less time on several activities in preparation, during, and in follow-up to SafeCare sessions compared to SC-IU providers. No differences were found between the groups with regard to SafeCare fidelity and certification status. Findings suggest that technology can augment implementation by reducing the time and training burden associated with implementing new evidence-based practices for at-risk families.
Wells, Kenneth B; Jones, Loretta; Chung, Bowen; Dixon, Elizabeth L; Tang, Lingqi; Gilmore, Jim; Sherbourne, Cathy; Ngo, Victoria K; Ong, Michael K; Stockdale, Susan; Ramos, Esmeralda; Belin, Thomas R; Miranda, Jeanne
2013-10-01
Depression contributes to disability and there are ethnic/racial disparities in access and outcomes of care. Quality improvement (QI) programs for depression in primary care improve outcomes relative to usual care, but health, social and other community-based service sectors also support clients in under-resourced communities. Little is known about effects on client outcomes of strategies to implement depression QI across diverse sectors. To compare the effectiveness of Community Engagement and Planning (CEP) and Resources for Services (RS) to implement depression QI on clients' mental health-related quality of life (HRQL) and services use. Matched programs from health, social and other service sectors were randomized to community engagement and planning (promoting inter-agency collaboration) or resources for services (individual program technical assistance plus outreach) to implement depression QI toolkits in Hollywood-Metro and South Los Angeles. From 93 randomized programs, 4,440 clients were screened and of 1,322 depressed by the 8-item Patient Health Questionnaire (PHQ-8) and providing contact information, 1,246 enrolled and 1,018 in 90 programs completed baseline or 6-month follow-up. Self-reported mental HRQL and probable depression (primary), physical activity, employment, homelessness risk factors (secondary) and services use. CEP was more effective than RS at improving mental HRQL, increasing physical activity and reducing homelessness risk factors, rate of behavioral health hospitalization and medication visits among specialty care users (i.e. psychiatrists, mental health providers) while increasing depression visits among users of primary care/public health for depression and users of faith-based and park programs (each p < 0.05). Employment, use of antidepressants, and total contacts were not significantly affected (each p > 0.05). Community engagement to build a collaborative approach to implementing depression QI across diverse programs was more effective than resources for services for individual programs in improving mental HRQL, physical activity and homelessness risk factors, and shifted utilization away from hospitalizations and specialty medication visits toward primary care and other sectors, offering an expanded health-home model to address multiple disparities for depressed safety-net clients.
28 CFR Appendix A to Part 41 - Leadership and Coordination of Nondiscrimination Laws
Code of Federal Regulations, 2011 CFR
2011-07-01
... Nondiscrimination Laws A Appendix A to Part 41 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF... effective implementation of various laws prohibiting discriminatory practices in Federal programs and.... Coordination of Nondiscrimination Provisions. 1-201. The Attorney General shall coordinate the implementation...
Ament, Stephanie M C; Gillissen, Freek; Moser, Albine; Maessen, José M C; Dirksen, Carmen D; von Meyenfeldt, Maarten F; van der Weijden, Trudy
2017-12-01
Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological levels of the health care system and demands continuous effort in the postimplementation phase. © 2017 John Wiley & Sons, Ltd.
Caldwell, Linda L; Younker, Anita S; Wegner, Lisa; Patrick, Megan E; Vergnani, Tania; Smith, Edward A; Flisher, Alan J
2008-01-01
As the push for evidence-based programming gathers momentum, many human services programs and interventions are under increased scrutiny to justify their effectiveness across different conditions and populations. Government agencies and the public want to be assured that their resources are being put to good use on programs that are effective and efficient (Guskey, 2000). Thus, programs are increasingly based on theory and evaluated through randomized control trials using longitudinal data. Despite this progress, hypothesized outcomes are often not detected and/or their effect sizes are small (Gingiss, Roberts-Gray, Boerm, 2006). Moreover, findings may go against intuition or "gut feelings" on the part of project staff. Given the need to understand how program implementation issues relate to outcomes, this study focuses on whether process measures that focus on program implementation and fidelity can shed light on associated outcomes. In particular, we linked the process evaluation of the HealthWise motivation lesson with outcomes across four waves of data collection. We hypothesized that HealthWise would increase learners' intrinsic and identified forms of motivation, and decrease amotivation and extrinsic motivation. We did not hypothesize a direction of effects on introjected motivation due to its conceptual ambiguity. Data came from youth in four intervention schools (n = 902, 41.1%) and five control schools (n = 1291, 58.9%) who were participating in a multi-cohort, longitudinal study. The schools were in a township near Cape Town, South Africa. For each cohort, baseline data are collected on learners as they begin Grade 8. We currently have four waves of data collected on the first cohort, which is the focus of this paper. The mean age of the sample at Wave 3 was 15.0 years (SD = .86) and 51% of students were female. Results suggested that there was evidence of an overall program effect of the curriculum on amotivation regardless of fidelity of implementation. Compared to the control schools, all treatment school learners reported lower levels of amotivation in Wave 4 compared to Wave 3, as hypothesized. Using process evaluation data to monitor implementation fidelity, however, we also conclude that the school with better trained teachers who also reported higher levels of program fidelity had better outcomes than the other schools. We discuss the implications of linking process data with outcome data and associated methodological challenges in linking these data.
Outcomes Assessment in Dental Hygiene Programs.
ERIC Educational Resources Information Center
Grimes, Ellen B.
1999-01-01
A survey of 22 dental-hygiene-program directors found that programs routinely and effectively assess student outcomes and use the information for program improvements and to demonstrate accountability. Both policy and faculty/administrative support were deemed important to implementation. Time constraints were a major barrier. Outcomes-assessment…
Implementation of the Hammersmith Infant Neurological Exam in a High-Risk Infant Follow-Up Program
Maitre, Nathalie L; Chorna, Olena; Romeo, Domenico M; Guzzetta, Andrea
2017-01-01
Background High-Risk Infant Follow-Up (HRIF) programs provide early identification and referral for treatment of neurodevelopmental delays and impairments. In these programs, a standardized neurological exam is a critical component of evaluation for clinical and research purposes. Implementation To address primary challenges of provider educational diversity and standardized documentation, we designed an approach to training and implementation of the Hammersmith Infant Neurological Exam (HINE) with pre-course materials, a workshop model and adaptation of the electronic medical record. Conclusions Provider completion and documentation of a neurologic exam were evaluated before and after HINE training. Standardized training and implementation of the HINE in a large HRIF is feasible and effective and allows for quantitative evaluation of neurological findings and developmental trajectories. PMID:27765470
Usability evaluation of user interface of thesis title review system
NASA Astrophysics Data System (ADS)
Tri, Y.; Erna, A.; Gellysa, U.
2018-03-01
Presentation of programs with user interface that can be accessed online through the website of course greatly provide user benefits. User can easily access the program they need. There are usability values that serve as a benchmark for the success of a user accessible program, ie efficiency, effectiveness, and convenience. These usability values also determine the development of the program for the better use. Therefore, on the review title thesis program that will be implemented in STT Dumai was measured usability evaluation. It aims to see which sides are not yet perfect and need to be improved to improve the performance and utilization of the program. Usability evaluation was measured by using smartPLS software. Database used was the result of respondent questionnaires that include questions about the experience when they used program. The result of a review of thesis title program implemented in STT Dumai has an efficiency value of 22.615, the effectiveness of 20.612, and satisfaction of 33.177.
ERIC Educational Resources Information Center
Pereira, Ana Isabel; Marques, Teresa; Russo, Vanessa; Barros, Luísa; Barrett, P.
2014-01-01
The FRIENDS for Life program is a cognitive-behavioral group program that targets anxiety in children. The main purpose of this study was to analyze the effectiveness of the Portuguese version of the FRIENDS for Life Program, which was implemented in schools to reduce anxiety problems in a group of highly anxious children. The study used a…
Ecological and socioeconomic effects of China's policies for ecosystem services.
Liu, Jianguo; Li, Shuxin; Ouyang, Zhiyun; Tam, Christine; Chen, Xiaodong
2008-07-15
To address devastating environmental crises and to improve human well-being, China has been implementing a number of national policies on payments for ecosystem services. Two of them, the Natural Forest Conservation Program (NFCP) and the Grain to Green Program (GTGP), are among the biggest programs in the world because of their ambitious goals, massive scales, huge payments, and potentially enormous impacts. The NFCP conserves natural forests through logging bans and afforestation with incentives to forest enterprises, whereas the GTGP converts cropland on steep slopes to forest and grassland by providing farmers with grain and cash subsidies. Overall ecological effects are beneficial, and socioeconomic effects are mostly positive. Whereas there are time lags in ecological effects, socioeconomic effects are more immediate. Both the NFCP and the GTGP also have global implications because they increase vegetative cover, enhance carbon sequestration, and reduce dust to other countries by controlling soil erosion. The future impacts of these programs may be even bigger. Extended payments for the GTGP have recently been approved by the central government for up to 8 years. The NFCP is likely to follow suit and receive renewed payments. To make these programs more effective, we recommend systematic planning, diversified funding, effective compensation, integrated research, and comprehensive monitoring. Effective implementation of these programs can also provide important experiences and lessons for other ecosystem service payment programs in China and many other parts of the world.
The Effect of the MassHealth Hospital Pay-for-Performance Program on Quality
Ryan, Andrew M; Blustein, Jan
2011-01-01
Objective To test the effect of Massachusetts Medicaid's (MassHealth) hospital-based pay-for-performance (P4P) program, implemented in 2008, on quality of care for pneumonia and surgical infection prevention (SIP). Data Hospital Compare process of care quality data from 2004 to 2009 for acute care hospitals in Massachusetts (N = 62) and other states (N = 3,676) and American Hospital Association data on hospital characteristics from 2005. Study Design Panel data models with hospital fixed effects and hospital-specific trends are estimated to test the effect of P4P on composite quality for pneumonia and SIP. This base model is extended to control for the completeness of measure reporting. Further sensitivity checks include estimation with propensity-score matched control hospitals, excluding hospitals in other P4P programs, varying the time period during which the program was assumed to have an effect, and testing the program effect across hospital characteristics. Principal Findings Estimates from our preferred specification, including hospital fixed effects, trends, and the control for measure completeness, indicate small and nonsignificant program effects for pneumonia (−0.67 percentage points, p>.10) and SIP (−0.12 percentage points, p>.10). Sensitivity checks indicate a similar pattern of findings across specifications. Conclusions Despite offering substantial financial incentives, the MassHealth P4P program did not improve quality in the first years of implementation. PMID:21210796
An Approach for Dynamic Optimization of Prevention Program Implementation in Stochastic Environments
NASA Astrophysics Data System (ADS)
Kang, Yuncheol; Prabhu, Vittal
The science of preventing youth problems has significantly advanced in developing evidence-based prevention program (EBP) by using randomized clinical trials. Effective EBP can reduce delinquency, aggression, violence, bullying and substance abuse among youth. Unfortunately the outcomes of EBP implemented in natural settings usually tend to be lower than in clinical trials, which has motivated the need to study EBP implementations. In this paper we propose to model EBP implementations in natural settings as stochastic dynamic processes. Specifically, we propose Markov Decision Process (MDP) for modeling and dynamic optimization of such EBP implementations. We illustrate these concepts using simple numerical examples and discuss potential challenges in using such approaches in practice.
Campbell, Sandra; McCalman, Janya; Redman-MacLaren, Michelle; Canuto, Karla; Vine, Kristina; Sewter, Jenny; McDonald, Malcolm
2018-03-24
A healthy start predicts better health in later life. Many remote-living Aboriginal and Torres Strait Islander Australian families lack access to consistent, culturally-safe health services. This paper presents a study of implementation of the Baby One Program (BOP). The BOP was designed as a family-centred, Indigenous Healthworker-led, home-visiting model of care focused on promoting family health to give children the best start to life. It was developed by Aboriginal community-controlled Apunipima Cape York Health Council and delivered in Queensland Cape York remote communities. We aimed to determine how the BOP was implemented, enablers, strategies used and formative implementation outcomes. The qualitative approach utilised theoretical and purposive sampling to explore people's experiences of a program implementation process. Data were generated from semi-structured interviews with four family members enrolled in the BOP and 24 Apunipima staff members. In addition, twenty community members, including two program users, participated in a men's community focus group. The findings are presented according to themes arising from the data. The BOP was rolled out in nine remote Cape York communities between July 2014 and December 2015 and there was high uptake. Indigenous Healthworkers were supported by midwives and maternal and child health nurses to deliver health education to 161 eligible families. The key to effective implementation of family-centred care appeared to be the relationships formed between health practitioners, especially Indigenous Healthworkers, and families. The data revealed the following themes: challenging environments for new families and valuing cultural ways, resourcing program delivery, working towards a team approach, negotiating the cultural interface, engaging families, exchanging knowledge through 'yarning', strengthening the workforce, and seeing health changes in families. Healthworker education and training, and knowledge exchange between Healthworkers, midwives and nurses was critical to program effectiveness. The program continues to grow despite substantial logistic, financial and practical challenges. This study describes an evolving process and explores how health providers connect with families and how the program responds to family and cultural issues. Program development is ongoing; strengthened by more community-level involvement, embedded strategies for ongoing self-evaluation and continuous quality improvements that are responsive to family needs.
Developing an active implementation model for a chronic disease management program.
Smidth, Margrethe; Christensen, Morten Bondo; Olesen, Frede; Vedsted, Peter
2013-04-01
Introduction and diffusion of new disease management programs in healthcare is usually slow, but active theory-driven implementation seems to outperform other implementation strategies. However, we have only scarce evidence on the feasibility and real effect of such strategies in complex primary care settings where municipalities, general practitioners and hospitals should work together. The Central Denmark Region recently implemented a disease management program for chronic obstructive pulmonary disease (COPD) which presented an opportunity to test an active implementation model against the usual implementation model. The aim of the present paper is to describe the development of an active implementation model using the Medical Research Council's model for complex interventions and the Chronic Care Model. We used the Medical Research Council's five-stage model for developing complex interventions to design an implementation model for a disease management program for COPD. First, literature on implementing change in general practice was scrutinised and empirical knowledge was assessed for suitability. In phase I, the intervention was developed; and in phases II and III, it was tested in a block- and cluster-randomised study. In phase IV, we evaluated the feasibility for others to use our active implementation model. The Chronic Care Model was identified as a model for designing efficient implementation elements. These elements were combined into a multifaceted intervention, and a timeline for the trial in a randomised study was decided upon in accordance with the five stages in the Medical Research Council's model; this was captured in a PaTPlot, which allowed us to focus on the structure and the timing of the intervention. The implementation strategies identified as efficient were use of the Breakthrough Series, academic detailing, provision of patient material and meetings between providers. The active implementation model was tested in a randomised trial (results reported elsewhere). The combination of the theoretical model for complex interventions and the Chronic Care Model and the chosen specific implementation strategies proved feasible for a practice-based active implementation model for a chronic-disease-management-program for COPD. Using the Medical Research Council's model added transparency to the design phase which further facilitated the process of implementing the program. http://www.clinicaltrials.gov/(NCT01228708).
Glasgow, Russell E.; Christiansen, Steve; Smith, K. Sabina; Stevens, Victor J.; Toobert, Deborah J.
2009-01-01
Computer-tailored behavior change programs offer the potential for reaching large populations at a much lower cost than individual or group-based programs. However, few of these programs to date appear to integrate behavioral theory with user choice, or combine different electronic modalities. We describe the development of an integrated CD-ROM and interactive voice response dietary change intervention that combines behavioral problem-solving theory with a high degree of user choice. The program, WISE CHOICES, is being evaluated as part of an ongoing trial. This paper describes the program development, emphasizing how user preferences are accommodated, and presents implementation and user satisfaction data. The program was successfully implemented; the linkages among the central database, the CD-ROM and the automated telephone components were robust, and participants liked the program almost as well as a counselor-delivered dietary change condition. Multi-modality programs that emphasize the strengths of each approach appear to be feasible. Future research is needed to determine the program impact and cost-effectiveness compared with counselor-delivered intervention. PMID:18711204
NASA Astrophysics Data System (ADS)
Dass, Pradeep Maxwell
1997-11-01
A formative evaluation of the implementation of the Iowa Chautauqua model of professional development in Collier County, Florida, was conducted during 1995-97, focusing on implementation issues and teacher enhancement. Major findings are as follows: Implementation issues. (1) Development of a shared vision through collaborative interaction between teachers, school administrators, and district administrators is critical to successful program implementation. (2) When a new program is implemented on a district-wide basis, the success of implementation depends upon how well the program matches local goals and needs and how ready the district and teachers are to make changes necessary for implementing the tenets of the program. (3) Development of proper understanding of desired pedagogical approaches requires modeling of these approaches in program activities, with explicit attention drawn to the modeling. (4) Successful implementation of desired pedagogical approaches in the classroom is critically influenced by the support and continual feedback teachers receive from district administrators, building administrators, and their peers. (5) Unwavering commitment of district and school administrators is essential for encouraging more teachers to participate in the program, leading to district-wide implementation without making it mandatory. Teacher Enhancement. (1) Participants developed leadership skills in mentorship, teamwork, presenting at professional meetings, and assuming responsibility within the program. (2) Participants learned to focus more on student questions and concerns, value prior conceptions of students, and develop instructional activities accordingly. They grew in their understanding and use of the constructivist pedagogy. (3) Participants attitude toward teaching in general and science in particular improved markedly, leading to new excitement and enthusiasm toward their profession. (4) Participants became more confident about teaching science. Elementary teachers reported spending more time on science activities and integrating science topics more with other curricular areas. (5) Participants collaborated more with their peers, administrators, and local community resources in improving instructional activities, providing more meaningful learning experiences for their students. (6) Participants integrated more technological resources than they did formerly, helping students explore avenues otherwise inaccessible. This investigation reveals that teacher enhancement is closely related to changed practice, which is critically influenced by implementation issues at broader levels.
Hundert, J
1982-01-01
In contrast to previous studies where teachers were instructed how to implement behavior modification programs designed by an experimenter, teachers in the present experiment were taught how to write as well as implement behavior modification programs. The generalized effects of two training conditions on teacher and pupil behaviors were assessed by a multiple baseline design where, following baseline, two teachers of multi-handicapped deaf children were taught to set objectives and measure pupil performance (measurement training), Later, through a training manual, they learned a general problem-solving approach to writing behavior modification programs (programming training). After both training conditions, experimenter feedback was given for teachers' application of training to a target behavior for one pupil and generalization was measured across target behaviors for the same pupil and across pupils. It was found that measurement training had little general effect on either teacher behavior or pupil behavior. However, after programming training, teachers increased their program writing and correct use of behavior modification procedures and generalized this training across pupils and target behaviors. Along with these effects, there was improvement in pupil behaviors. Possible explanation for generalized effects of teacher training were considered.
Air quality management in Mexico.
Fernández-Bremauntz, Adrián
2008-01-01
Several significant program and policy measures have been implemented in Mexico over the past 15 yr to improve air quality. This article provides an overview of air quality management strategies in Mexico, including (1) policy initiatives such as vehicle use restrictions, air quality standards, vehicle emissions, and fuel quality standards, and (2) supporting programs including establishment of a national emission inventory, an air pollution episodes program, and the implementation of exposure and health effects studies. Trends in air pollution episodes and ambient air pollutant concentrations are described.
Busum, Kristin Van; Mattke, Soeren
2013-11-01
In this commentary, we argue that financial incentives are only one of many key components that employers should consider when designing and implementing a workplace wellness program. Strategies such as social encouragement and providing token rewards may also be effective in improving awareness and engagement. Should employers choose to utilize financial incentives, they should tailor them to the goals for the program as well as the targeted behaviors and health outcomes.
McLean, Kendra; Day, Lesley; Dalton, Andrew
2015-03-26
Falls among older people are of growing concern globally. Implementing cost-effective strategies for their prevention is of utmost importance given the ageing population and associated potential for increased costs of fall-related injury over the next decades. The purpose of this study was to undertake a cost-utility analysis and secondary cost-effectiveness analysis from a healthcare system perspective, of a group-based exercise program compared to routine care for falls prevention in an older community-dwelling population. A decision analysis using a decision tree model was based on the results of a previously published randomised controlled trial with a community-dwelling population aged over 70. Measures of falls, fall-related injuries and resource use were directly obtained from trial data and supplemented by literature-based utility measures. A sub-group analysis was performed of women only. Cost estimates are reported in 2010 British Pound Sterling (GBP). The ICER of GBP£51,483 per QALY for the base case analysis was well above the accepted cost-effectiveness threshold of GBP£20,000 to £30,000 per QALY, but in a sensitivity analysis with minimised program implementation the incremental cost reached GBP£25,678 per QALY. The ICER value at 95% confidence in the base case analysis was GBP£99,664 per QALY and GBP£50,549 per QALY in the lower cost analysis. Males had a 44% lower injury rate if they fell, compared to females resulting in a more favourable ICER for the women only analysis. For women only the ICER was GBP£22,986 per QALY in the base case and was below the cost-effectiveness threshold for all other variations of program implementation. The ICER value at 95% confidence was GBP£48,212 in the women only base case analysis and GBP£23,645 in the lower cost analysis. The base case incremental cost per fall averted was GBP£652 (GBP£616 for women only). A threshold analysis indicates that this exercise program cannot realistically break even. The results suggest that this exercise program is cost-effective for women only. There is no evidence to support its cost-effectiveness in a group of mixed gender unless the costs of program implementation are minimal. Conservative assumptions may have underestimated the true cost-effectiveness of the program.
A policy analysis of the implementation of a Reproductive Health Vouchers Program in Kenya.
Abuya, Timothy; Njuki, Rebecca; Warren, Charlotte E; Okal, Jerry; Obare, Francis; Kanya, Lucy; Askew, Ian; Bellows, Ben
2012-07-23
Innovative financing strategies such as those that integrate supply and demand elements like the output-based approach (OBA) have been implemented to reduce financial barriers to maternal health services. The Kenyan government with support from the German Development Bank (KfW) implemented an OBA voucher program to subsidize priority reproductive health services. Little evidence exists on the experience of implementing such programs in different settings. We describe the implementation process of the Kenyan OBA program and draw implications for scale up. Policy analysis using document review and qualitative data from 10 in-depth interviews with facility in-charges and 18 with service providers from the contracted facilities, local administration, health and field managers in Kitui, Kiambu and Kisumu districts as well as Korogocho and Viwandani slums in Nairobi. The OBA implementation process was designed in phases providing an opportunity for learning and adapting the lessons to local settings; the design consisted of five components: a defined benefit package, contracting and quality assurance; marketing and distribution of vouchers and claims processing and reimbursement. Key implementation challenges included limited feedback to providers on the outcomes of quality assurance and accreditation and budgetary constraints that limited effective marketing leading to inadequate information to clients on the benefit package. Claims processing and reimbursement was sophisticated but required adherence to time consuming procedures and in some cases private providers complained of low reimbursement rates for services provided. OBA voucher schemes can be implemented successfully in similar settings. For effective scale up, strong partnership will be required between the public and private entities. The government's role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize existing platforms to scale up such strategies.
A Policy Analysis of the implementation of a Reproductive Health Vouchers Program in Kenya
2012-01-01
Background Innovative financing strategies such as those that integrate supply and demand elements like the output-based approach (OBA) have been implemented to reduce financial barriers to maternal health services. The Kenyan government with support from the German Development Bank (KfW) implemented an OBA voucher program to subsidize priority reproductive health services. Little evidence exists on the experience of implementing such programs in different settings. We describe the implementation process of the Kenyan OBA program and draw implications for scale up. Methods Policy analysis using document review and qualitative data from 10 in-depth interviews with facility in-charges and 18 with service providers from the contracted facilities, local administration, health and field managers in Kitui, Kiambu and Kisumu districts as well as Korogocho and Viwandani slums in Nairobi. Results The OBA implementation process was designed in phases providing an opportunity for learning and adapting the lessons to local settings; the design consisted of five components: a defined benefit package, contracting and quality assurance; marketing and distribution of vouchers and claims processing and reimbursement. Key implementation challenges included limited feedback to providers on the outcomes of quality assurance and accreditation and budgetary constraints that limited effective marketing leading to inadequate information to clients on the benefit package. Claims processing and reimbursement was sophisticated but required adherence to time consuming procedures and in some cases private providers complained of low reimbursement rates for services provided. Conclusions OBA voucher schemes can be implemented successfully in similar settings. For effective scale up, strong partnership will be required between the public and private entities. The government’s role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize existing platforms to scale up such strategies. PMID:22823923
Jones, Damon E; Feinberg, Mark E; Hostetler, Michelle L
2014-06-01
The transition to parenthood involves many stressors that can have implications for the couple relationship as well as the developmental environment of the child. Scholars and policymakers have recognized the potential for interventions that can help couples navigate these stressors to improve parenting and coparenting strategies. Such evidence-based programs are scarcely available, however, and little is known about the resources necessary to carry out these programs. This study examines the costs and resources necessary to implement Family Foundations, a program that addresses the multifaceted issues facing first-time parents through a series of pre- and post-natal classes. Costs were determined using a 6-step analytic process and are based on the first implementation of the program carried out through a five-year demonstration project. This assessment demonstrates how overall costs change across years as new cohorts of families are introduced, and how cost breakdowns differ by category as needs shift from training group leaders to sustaining program services. Information from this cost analysis helps clarify how the program could be made more efficient in subsequent implementations. We also consider how results may be used in future research examining economic benefits of participation in the program. Copyright © 2014 Elsevier Ltd. All rights reserved.
Jones, Damon E.; Feinberg, Mark E.; Hostetler, Michelle
2014-01-01
The transition to parenthood involves many stressors that can have implications for the couple relationship as well as the developmental environment of the child. Scholars and policymakers have recognized the potential for interventions that can help couples navigate these stressors to improve parenting and coparenting strategies. Such evidence-based programs are scarcely available, however, and little is known about the resources necessary to carry out these programs. This study examines the costs and resources necessary to implement Family Foundations, a program that addresses the multifaceted issues facing first-time parents through a series of pre- and post-natal classes. Costs were determined using a 6-step analytic process and are based on the first implementation of the program carried out through a five-year demonstration project. This assessment demonstrates how overall costs change across years as new cohorts of families are introduced, and how cost breakdowns differ by category as needs shift from training group leaders to sustaining program services. Information from this cost analysis helps clarify how the program could be made more efficient in subsequent implementations. We also consider how results may be used in future research examining economic benefits of participation in the program. PMID:24603052
Wilson, Dawn K.; Griffin, Sarah; St. George, Sara M.; Alia, Kassandra A.; Trumpeter, Nevelyn N.; Wandersman, Abraham K.; Forthofer, Melinda; Robinson, Shamika; Gadson, Barney
2012-01-01
Objectives. Evaluating programs targeting physical activity may help to reduce disparate rates of obesity among African Americans. We report formative process evaluation methods and implementation dose, fidelity, and reach in the Positive Action for Today’s Health trial. Methods: We applied evaluation methods based on an ecological framework in 2 community-based police-patrolled walking programs targeting access and safety in underserved African American communities. One program also targeted social connectedness and motivation to walk using a social marketing approach. Process data were systematically collected from baseline to 12 months. Results: Adequate implementation dose was achieved, with fidelity achieved but less stable in both programs. Monthly walkers increased to 424 in the walking-plus-social marketing program, indicating expanding program reach, in contrast to no increase in the walking-only program. Increased reach was correlated with peer-led Pride Strides (r = .92; P < .001), a key social marketing component, and program social interaction was the primary reason for which walkers reported participating. Conclusions: Formative process evaluation demonstrated that the walking programs were effectively implemented and that social marketing increased walking and perceived social connectedness in African American communities. PMID:23078486
Moore, Justin B.; Carson, Russell L.; Webster, Collin A.; Singletary, Camelia R.; Castelli, Darla M.; Pate, Russell R.; Beets, Michael W.; Beighle, Aaron
2018-01-01
Comprehensive school physical activity programs (CSPAPs) have been endorsed as a promising strategy to increase youth physical activity (PA) in school settings. A CSPAP is a five-component approach, which includes opportunities before, during, and after school for PA. Extensive resources are available to public health practitioners and school officials regarding what should be implemented, but little guidance and few resources are available regarding how to effectively implement a CSPAP. Implementation science provides a number of conceptual frameworks that can guide implementation of a CSPAP, but few published studies have employed an implementation science framework to a CSPAP. Therefore, we developed Be a Champion! (BAC), which represents a synthesis of implementation science strategies, modified for application to CSPAPs implementation in schools while allowing for local tailoring of the approach. This article describes BAC while providing examples from the implementation of a CSPAP in three rural elementary schools. PMID:29354631
Implementing an anti-smoking program in rural-remote communities: challenges and strategies.
Tall, Julie A; Brew, Bronwyn K; Saurman, Emily; Jones, Therese C
2015-01-01
Rural-remote communities report higher smoking rates and poorer health outcomes than that of metropolitan areas. While anti-smoking programs are an important measure for addressing smoking and improving health, little is known of the challenges faced by primary healthcare staff implementing those programs in the rural-remote setting. The aim of this study was to explore the challenges and strategies of implementing an anti-smoking program by primary healthcare staff in rural-remote Australia. Guided by a phenomenological approach, semi-structured interviews and focus groups were conducted with health service managers, case managers and general practitioners involved in program implementation in Australian rural-remote communities between 2008 and 2010. Program implementation was reported to be challenged by limited primary and mental healthcare resources and client access to services; limited collaboration between health services; the difficulty of accessing staff training; high levels of community distress and disadvantage; the normalisation of smoking and its deleterious impact on smoking abstinence among program clients; and low morale among health staff. Strategies identified to overcome challenges included appointing tobacco-dedicated staff; improving health service collaboration, access and flexibility; providing subsidised pharmacotherapies and boosting staff morale. Findings may assist health services to better tailor anti-smoking programs for the rural-remote setting, where smoking rates are particularly high. Catering for the unique challenges of the rural-remote setting is necessary if anti-smoking programs are to be efficacious, cost-effective and capable of improving rural-remote health outcomes.
Nevada Underserved Science Education Program
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nicole Rourke; Jason Marcks
2004-07-06
Nevada Underserved Science Education Program (NUSEP) is a project to examine the effect of implementing new and innovative Earth and space science education curriculum in Nevada schools. The project provided professional development opportunities and educational materials for teachers participating in the program.
Aggressive driving enforcement : evaluation of two demonstration programs
DOT National Transportation Integrated Search
2004-03-24
This report presents the results of a study conducted to assess the effects of two programs that were implemented to reduce the incidence of aggressive driving. The programs were conducted by the Marion County Traffic Safety Partnership (a consortium...
Project Career REACH: Marketing Strategies for Effective Guidance Programs.
ERIC Educational Resources Information Center
Bollendorf, Marsha; And Others
1990-01-01
Outlines the practical marketing strategies used to implement Project Career REACH, a career development program for high school freshmen. Marketing basics for guidance programs are discussed, including mission analysis, market analysis, resource analysis, strategic planning, and evaluation. (TE)
75 FR 16562 - High-Speed Intercity Passenger Rail (HSIPR) Program
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-01
...), passenger traffic and services (marketing, ticketing, station, and on- board services), and general... retention, ``green'' environmental outcomes, potential energy savings, and effects on community livability. Program Management Approach--A phased program implementation strategy including a preliminary description...
Aggressive driving enforcement : evaluations of two demonstration programs
DOT National Transportation Integrated Search
2004-03-01
This report presents the results of a study conducted to assess the effects of two programs that were implemented to reduce the incidence of aggressive driving. The programs were conducted by the Marion County Traffic Safety Partnership (a consortium...
Knowles, Valerie; Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Jones, Giavana; Harris, Carole; Kaljee, Linda; Li, Xiaoming; Koci, Veronica; Chen, Xinguang; Marshall, Sharon; Stanton, Bonita
2012-01-01
Using data from the preparatory phase prior to national implementation of an effective HIV prevention program (Focus on Youth in the Caribbean; FOYC) in all Bahamian government sixth-grade classes, we describe (1) actual FOYC implementation, (2) factors that influenced implementation, and (3) the relationship of implementation with intervention outcome. Six elementary schools (with 17 grade six classrooms) were selected to participate in the preparatory phase. The 17 teachers were invited to attend a training workshop, coordinate administration of questionnaires to the students, teach the 10 sessions of FOYC and complete self-assessment checklists. A total of 395 students submitted baseline and 311 students submitted year-end questionnaires. Thirteen teachers initiated FOYC; five completed all 10 sessions. Implementation of FOYC was not related to teacher FOYC workshop experience but did cluster by school. There were significant positive correlations between improved student knowledge of HIV/AIDS, protective health skills, perceived parental monitoring and reduced risk behaviours with the number of FOYC sessions delivered. Implementation was impeded by logistics issues, structural issues with the measures, and comfort-level issues, most of which can be addressed for national implementation. Degree of FOYC implementation is correlated with positive student outcomes.
School-based sleep education program improves sleep and academic performance of school-age children.
Gruber, Reut; Somerville, Gail; Bergmame, Lana; Fontil, Laura; Paquin, Soukaina
2016-05-01
The objective of this study was to develop and evaluate the effectiveness of a school-based sleep education program aimed at improving the sleep and academic performance of school-age children. Using a community-based participatory research approach, we created a school-based sleep education program, "Sleep for Success"™ (SFS), composed of four distinct modules that addressed the children, their family and community, the school staff, and decision makers within the school setting. Implementation was carried out in three elementary schools. Seventy-one students participated in the evaluation of the program. The effectiveness of the SFS program was evaluated using non-randomized controlled before-and-after study groups (intervention and control) assessed over two time points (pre- and post-program implementation). Before (baseline) and after implementation, sleep and academic performance were measured using actigraphy and report card marks, respectively. In the intervention group, true sleep was extended by 18.2 min per night, sleep efficiency improved by 2.3%, and sleep latency was shortened by 2.3 min, and report card grades in mathematics and English improved significantly. No changes were noted in the control group. Participation in the sleep education program was associated with significant improvements in children's sleep and academic performance. Copyright © 2016 Elsevier B.V. All rights reserved.
ERIC Educational Resources Information Center
Fauth, Rebecca C.; Leventhal, Tama; Brooks-Gunn, Jeanne
2008-01-01
This study explored program effects on adults' well-being seven years following the implementation of a court-ordered neighborhood mobility program. Low-income black and Latino adults residing in poor, segregated neighborhoods in Yonkers, New York were randomly selected to relocate to publicly funded town-houses in middle-class neighborhoods…
The Effects of the Elevate Math Summer Program on Math Achievement and Algebra Readiness
ERIC Educational Resources Information Center
Snipes, Jason; Huang, Chun-Wei; Jaquet, Karina; Finkelstein, Neal
2016-01-01
To raise math success rates in middle school, many schools and districts have implemented summer math programs designed to improve student preparation for algebra content in grade 8. However, little is known about the effectiveness of these programs. While students who participate typically experience learning gains, there is little rigorous…
ERIC Educational Resources Information Center
Myers, Marion
2012-01-01
This quantitative, non-experimental, correlational study investigated the effects of the Accelerated Reader (AR) program on reading achievement in elementary school students. The study also examined the perceptions of teachers and administrators about the effectiveness of the AR program. This study took place in three elementary schools located in…
Modeling an Effective Program for Latina/o College Student Success
ERIC Educational Resources Information Center
Gonzalez, Kenneth P.; Meling, Vanessa S.
2017-01-01
This article presents a case study of the design, implementation, and results of a program developed to increase Latina/o student success at a Hispanic-Serving Institution. A team of university faculty, staff, and administrator researchers drew from four sources of evidence to design and examine the effects of the program, including: (a)…
Policy to Practice: A Look at National and State Implementation of School Resource Officer Programs
ERIC Educational Resources Information Center
Cray, Martha; Weiler, Spencer C.
2011-01-01
In response to questions related to school safety, in the 1990s the school resource officer (SRO) program gained prominence as an effective intervention strategy. Despite the widespread utilization of SROs in America's public schools, there exists a lack of meaningful research related to practices and effectiveness of SRO programs. A school…
Prevalence and Implementation of IAQ Programs in U.S. Schools
Moglia, Dena; Smith, Alisa; MacIntosh, David L.; Somers, Jennifer L.
2006-01-01
In this study, we determined the extent to which U.S. schools are implementing indoor air quality (IAQ) programs. We administered a questionnaire on IAQ programs and practices to a representative sample of schools. Participants were asked to provide information on the use, administration, implementation, challenges, and benefits of the IAQ program in their school. We developed an IAQ Practice Index to determine the level of activity directed toward IAQ in schools. The index was computed based on responses to specific survey questions and was normalized to a range of 0 to 100. Each question was weighted qualitatively according to its contribution to strong IAQ management practices. Forty-two percent of schools in the United States have an IAQ management program, and there has been sustained growth from 1998 through 2002 in the number of schools that have such programs. Nearly half of those schools use the U.S. Environmental Protection Agency’s IAQ Tools for Schools program. The IAQ Practice Index scores varied widely for schools with an IAQ management program, suggesting that having a program is not equivalent to implementing effective IAQ policies and procedures. Respondents indicated that their IAQ programs led to improved workplace satisfaction, fewer asthma attacks, fewer visits to the school nurse, and lower absenteeism. When actively supported by the school administration, an IAQ program appears to be a valuable factor in improving the learning environment for U.S. schoolchildren. PMID:16393672
Prevalence and implementation of IAQ programs in U.S. schools.
Moglia, Dena; Smith, Alisa; MacIntosh, David L; Somers, Jennifer L
2006-01-01
In this study, we determined the extent to which U.S. schools are implementing indoor air quality (IAQ) programs. We administered a questionnaire on IAQ programs and practices to a representative sample of schools. Participants were asked to provide information on the use, administration, implementation, challenges, and benefits of the IAQ program in their school. We developed an IAQ Practice Index to determine the level of activity directed toward IAQ in schools. The index was computed based on responses to specific survey questions and was normalized to a range of 0 to 100. Each question was weighted qualitatively according to its contribution to strong IAQ management practices. Forty-two percent of schools in the United States have an IAQ management program, and there has been sustained growth from 1998 through 2002 in the number of schools that have such programs. Nearly half of those schools use the U.S. Environmental Protection Agency's IAQ Tools for Schools program. The IAQ Practice Index scores varied widely for schools with an IAQ management program, suggesting that having a program is not equivalent to implementing effective IAQ policies and procedures. Respondents indicated that their IAQ programs led to improved workplace satisfaction, fewer asthma attacks, fewer visits to the school nurse, and lower absenteeism. When actively supported by the school administration, an IAQ program appears to be a valuable factor in improving the learning environment for U.S. schoolchildren.
Viester, Laura; Verhagen, Evert A L M; Bongers, Paulien M; van der Beek, Allard J
2014-11-01
To evaluate the process of a health promotion program, aiming to improve physical activity levels and diet among construction workers. The process evaluation was conducted after the RE-AIM framework for the evaluation of the public health impact of health promotion interventions. Effectiveness was assessed on motivational stage-of-change, self-efficacy, and decisional balance for physical activity and dietary behavior. The external validity of the trial was satisfactory with representative reach of workers and adoption of workplace units in the participating construction company. The extent to which the program was implemented as intended was modest. The intervention was effective on participants' progress through stages of behavior change. Based on the RE-AIM dimensions, it is concluded that for construction workers, the program is feasible and potentially effective, but adjustments are required before widespread implementation.
DeJoy, David M.; Vandenberg, Robert J.; Corso, Phaedra; Padilla, Heather; Zuercher, Heather
2016-01-01
Objective To evaluate the effectiveness of the Fuel Your Life program, an adaptation of the Diabetes Prevention Program, utilizing implementation strategies commonly used in worksite programs – telephone coaching, small group coaching and self-study. Methods The primary outcomes of BMI and weight were examined in a randomized control trial conducted with city/county employees. Results Although the majority of participants in all three groups lost some weight, the phone group lost significantly more weight (4.9 lbs.), followed by the small groups (3.4 lbs.) and the self-study (2.7 lbs.). Of the total participants, 28.3% of the phone group, 20.6% of the small group and 15.7 of the self-study group lost 5% or more of their body weight. Conclusions Fuel Your Life (DPP) can be effectively disseminated using different implementation strategies that are tailored to the workplace. PMID:27820761
Vossius, Corinna; Lotto, Editha; Lyanga, Sara; Mduma, Estomih; Msemo, Georgina; Perlman, Jeffrey; Ersdal, Hege L
2014-01-01
The Helping Babies Breathe" (HBB) program is an evidence-based curriculum in basic neonatal care and resuscitation, utilizing simulation-based training to educate large numbers of birth attendants in low-resource countries. We analyzed its cost-effectiveness at a faith-based Haydom Lutheran Hospital (HLH) in rural Tanzania. Data about early neonatal mortality and fresh stillbirth rates were drawn from a linked observational study during one year before and one year after full implementation of the HBB program. Cost data were provided by the Tanzanian Ministry of Health and Social Welfare (MOHSW), the research department at HLH, and the manufacturer of the training material Lærdal Global Health. Costs per life saved were USD 233, while they were USD 4.21 per life year gained. Costs for maintaining the program were USD 80 per life saved and USD 1.44 per life year gained. Costs per disease adjusted life year (DALY) averted ranged from International Dollars (ID; a virtual valuta corrected for purchasing power world-wide) 12 to 23, according to how DALYs were calculated. The HBB program is a low-cost intervention. Implementation in a very rural faith-based hospital like HLH has been highly cost-effective. To facilitate further global implementation of HBB a cost-effectiveness analysis including government owned institutions, urban hospitals and district facilities is desirable for a more diverse analysis to explore cost-driving factors and predictors of enhanced cost-effectiveness.
Vossius, Corinna; Lotto, Editha; Lyanga, Sara; Mduma, Estomih; Msemo, Georgina; Perlman, Jeffrey; Ersdal, Hege L.
2014-01-01
Objective The Helping Babies Breathe” (HBB) program is an evidence-based curriculum in basic neonatal care and resuscitation, utilizing simulation-based training to educate large numbers of birth attendants in low-resource countries. We analyzed its cost-effectiveness at a faith-based Haydom Lutheran Hospital (HLH) in rural Tanzania. Methods Data about early neonatal mortality and fresh stillbirth rates were drawn from a linked observational study during one year before and one year after full implementation of the HBB program. Cost data were provided by the Tanzanian Ministry of Health and Social Welfare (MOHSW), the research department at HLH, and the manufacturer of the training material Lærdal Global Health. Findings Costs per life saved were USD 233, while they were USD 4.21 per life year gained. Costs for maintaining the program were USD 80 per life saved and USD 1.44 per life year gained. Costs per disease adjusted life year (DALY) averted ranged from International Dollars (ID; a virtual valuta corrected for purchasing power world-wide) 12 to 23, according to how DALYs were calculated. Conclusion The HBB program is a low-cost intervention. Implementation in a very rural faith-based hospital like HLH has been highly cost-effective. To facilitate further global implementation of HBB a cost-effectiveness analysis including government owned institutions, urban hospitals and district facilities is desirable for a more diverse analysis to explore cost-driving factors and predictors of enhanced cost-effectiveness. PMID:25006802
Olmedilla-Zafra, Aurelio; Rubio, Victor J; Ortega, Enrique; García-Mas, Alexandre
2017-03-01
Several attempts to reduce the incidence of sport injuries using psychosocial interventions produced fruitful, although inconclusive results. This paper presents the effectiveness and implementation issues of a pilot 3-month stress-management and muscle relaxation program aimed at reducing sport injury incidence. Pre-post treatment-non treatment group comparison. The program was administered by a trained psychologist on a once-a-week, 1-h session basis. Seventy-four male soccer players from four National Youth league teams voluntarily participated. Teams were randomly assigned to either treatment/non-treatment group. Injury protocol, Self-monitoring cards, Athletes' satisfaction and commitment survey, Coaches' interview. Group main effect and Time-Group interaction effect were both statistically significant, F(1,60) = 8.30, p = 0.005, η 2 p = 0.121, with the average number of injuries larger in the post-treatment phase of non-treatment group (p = 0.005, η 2 p = 0.077). There was a significant decrease in the average number of injuries for the intervention group before and after implementing the program (p < 0.001, η 2 p = 0.309). A controlled implementation of a psychosocial program was effective in reducing youth soccer sport injuries, with a high level of satisfaction and commitment from the athletes, as well as high acceptance from the coaches. Copyright © 2016 Elsevier Ltd. All rights reserved.
Thinking Broadly: Financing Strategies for Youth Programs
ERIC Educational Resources Information Center
Deich, Sharon G.; Hayes, Cheryl D.
2007-01-01
This publication is part of a series of tools and resources on financing and sustaining youth programming. These tools and resources are intended to help policymakers, program developers, and community leaders develop innovative strategies for implementing, financing, and sustaining effective programs and policies. This strategy brief presents a…
48 CFR 313.301 - Government-wide commercial purchase card.
Code of Federal Regulations, 2011 CFR
2011-10-01
..., Appendix B, “Improving the Management of Government Charge Card Programs;” GSA's SmartPay Program guidance; and HHS Purchase Card program standards. (2) The OPDIVs, through their designated Agency/Organization... training requirements to ensure effective implementation of the HHS purchase card program. (3) OPDIVs shall...
Management Training for Directors.
ERIC Educational Resources Information Center
Yaptinchay, Karen
1998-01-01
Describes a management program for Head Start directors called the Head Start-Johnson & Johnson Management Fellows program that focuses on issues and problems encountered by directors in implementing and operating programs at the local level. Notes that the management program represents a response to increasing need for cost-effective and…
Nadeem, Erum; Weiss, Dara; Olin, S. Serene; Hoagwood, Kimberly E.; Horwitz, Sarah M.
2016-01-01
Learning collaboratives (LCs) are used widely to promote implementation of evidence-based practices (EBPs). However, there has been limited research on the effectiveness of LCs and models vary widely in their structure, focus and components. The goal of the present study was to develop and field test a theory-based LC model to augment a state-led, evidence-based training program for clinicians providing mental health services to children. Analysis of implementation outcomes contrasted LC sites to matched comparison sites that participated in the clinical training program alone. Results suggested that clinicians from sites participating in the LC were more highly engaged in the state-led clinical training program and were more likely to complete program requirements. PMID:27167744
Nadeem, Erum; Weiss, Dara; Olin, S Serene; Hoagwood, Kimberly E; Horwitz, Sarah M
2016-11-01
Learning collaboratives (LCs) are used widely to promote implementation of evidence-based practices. However, there has been limited research on the effectiveness of LCs and models vary widely in their structure, focus and components. The goal of the present study was to develop and field test a theory-based LC model to augment a state-led, evidence-based training program for clinicians providing mental health services to children. Analysis of implementation outcomes contrasted LC sites to matched comparison sites that participated in the clinical training program alone. Results suggested that clinicians from sites participating in the LC were more highly engaged in the state-led clinical training program and were more likely to complete program requirements.
ERIC Educational Resources Information Center
Young, Rufus, Jr.
The Effective Schools Program in St. Louis, Missouri, public schools expanded the concept of effective schools developed in Project SHAL (1980-1984). The following five characteristics are considered effective school factors: (1) strong administrative leadership (2) high teacher expectations; (3) positive school climate; (4) total school…
Evaluation of the Accelerated Reader Program in Chesapeake, VA, Public Schools
ERIC Educational Resources Information Center
Chase, Elaine; Goodin, Penny; Nichols, W. Randolph
2010-01-01
The Accelerated Reader program from Renaissance Learning Inc. is a popular program implemented in elementary and middle schools across the country that encourages students to read and monitors their progress in the program. Despite its widespread use and popularity, there have been some questions about the program's effectiveness at increasing…
Transfer of training through a science education professional development program
NASA Astrophysics Data System (ADS)
Sowards, Alan Bosworth
Educational research substantiates that effective professional development models must be developed in order for reform-based teaching strategies to be implemented in classrooms. This study examined the effectiveness of an established reform-based science education professional development program, Project LIFE. The study investigated what impact Project LIFE had on participants implementation of reform-based instruction in their classroom three years after participation in the science inservice program. Participants in the case studies described use of reform-based instruction and program factors that influenced transfer of training to their classrooms. Subjects of the study were 5th--10th grade teachers who participated in the 1997--98 Project LIFE professional development program. The study employed a mixed design including both qualitative and quantitative methodology. The qualitative data was collected from multiple sources which included: an open-ended survey, classroom observations, structured interviews, and artifacts. Three purposeful selection of teachers for case studies were made with teacher approval and authorization from building principals. Interview responses from the three case studies were further analyzed qualitatively using the microcomputer software NUD*IST. Tables and figures generated from NUD*IST graphically represented the case study teachers response and case comparison to six established categories: (1) continued implementation of reform-based instruction, (2) use of reform-based instruction, (3) program factors supporting transfer of training, (4) professional development, (5) goals of Project LIFE, and (6) critical issues in science education. Paired t-tests were used to analysis the quantitative data collected from the Survey of Attitudes Toward Science and Science Teaching. The study concluded the 1997--98 Project LIFE participants continued to implement reform-based instruction in their classrooms three years later. According to the teachers the program factors having the most influence on transferring training to their classroom were the positive responses from students; reflections with other teachers regarding instructional activities and strategies; modeling of activities and strategies they received from Project LIFE staff while participating in the program; and teachers commitment to reform-based instruction. These findings are important in enhancing national science reform goals. In order for teachers to be able to implement science-reform-based instruction in their classrooms they must experience effective professional development models. Designers of professional development programs must understand which factors in staff development programs most contribute to transfer of training.
Students helping students: vertical peer mentoring to enhance the medical school experience.
Andre, Christine; Deerin, Jessica; Leykum, Luci
2017-05-02
Effective mentoring is an important component of medical student professional development. We provide a description of the mentoring program at our institution. Our institution UTHSCSA implemented a student-advising program (Veritas) with clinical faculty mentors and senior students (MiMs). The MiMs provided vertical peer mentoring to more junior students as an adjunct to faculty advising. The MiMs lead small group discussions that foster camaraderie, share academic and career information and promote professional identity. An optional MiM elective more intensively develops mentorship and leadership skills through a formal curriculum. The authors used annual survey data of all students as well as student mentors to evaluate program effectiveness. Overall, student perception of the program improved each year across multiple domains, including feeling more prepared, supported and satisfied with their overall experience in medical school. Student mentors also found the process rewarding and helpful to their future careers as physicians. The authors suggest implementing a vertical peer-mentoring program can be an effective adjunct to faculty mentoring.
Workplace Lactation Programs in Small WIC Service Sites: A Potential Model.
Angeletti, Michelle A; Llossas, Jose R
2018-03-01
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has an opportunity to protect, promote, and support breastfeeding by implementing and modeling workplace lactation programs in small WIC agencies that may have barriers regarding the lack of both human and financial resources. The goal of this article was to describe effective strategies for agency administrators in small WIC service sites so that they can reduce barriers, successfully implement workplace lactation policies and programs, and model successful strategies for other small employers. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Man-rated flight software for the F-8 DFBW program
NASA Technical Reports Server (NTRS)
Bairnsfather, R. R.
1976-01-01
The design, implementation, and verification of the flight control software used in the F-8 DFBW program are discussed. Since the DFBW utilizes an Apollo computer and hardware, the procedures, controls, and basic management techniques employed are based on those developed for the Apollo software system. Program assembly control, simulator configuration control, erasable-memory load generation, change procedures and anomaly reporting are discussed. The primary verification tools are described, as well as the program test plans and their implementation on the various simulators. Failure effects analysis and the creation of special failure generating software for testing purposes are described.
A university-sponsored home health nursing program in Karachi, Pakistan.
Smego, Raymond A; Khan, Mohammad Aslam; Khowaja, Khurshid; Rafique, Rozina; Datoo, Farida
2005-11-01
This article describes a university-sponsored home health nursing program in a large urban center in Pakistan and details the essential elements needed in implementing such a program in a developing country. Compared to in-hospital treatment, home healthcare reduced hospital stay from 12.8 days to 3.9 days, and resulted in a net savings of Pakistani rupees (PRs) 5,374,135 (USD 89,569). A cost-effective home treatment program in a resource-limited country can be successfully implemented by using the hospital pharmacy as the central point for the preparation and distribution of medications and specialty nursing services.
ERIC Educational Resources Information Center
Grant, Robert Luther
2017-01-01
Data breaches due to social engineering attacks and employee negligence are on the rise. The only known defense against social engineering attacks and employee negligence is information security awareness and training. However, implementation of awareness and training programs within organizations are lagging in priority. This research used the…
ERIC Educational Resources Information Center
Li, Jennifer; Steele, Jennifer; Slater, Robert; Bacon, Michael; Miller, Trey
2016-01-01
Many educators and policy makers look to two-way dual language immersion as one of the most promising options to close achievement gaps for English learners. However, the programs' effectiveness depends on the quality of their implementation. This article reports on a large-scale study of the implementation of dual language immersion across a…
Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-25
..., revisions to the State of Iowa's State Implementation Plan (SIP), Title V program, and Clean Air Act (CAA..., subject to the requirements of sections 111(d) and 129 of the CAA, do not exist in the State; and... changes to the Title V program, pursuant to section 500 of the CAA. DATES: This rule is effective December...
Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam
2014-05-01
While the ultimate goal of simulation training is to enhance learning, cost-effectiveness is a critical factor. Research that compares simulation training in terms of educational- and cost-effectiveness will lead to better-informed curricular decisions. Using previously published data we conducted a cost-effectiveness analysis of three simulation-based programs. Medical students (n = 15 per group) practiced in one of three 2-h intravenous catheterization skills training programs: low-fidelity (virtual reality), high-fidelity (mannequin), or progressive (consisting of virtual reality, task trainer, and mannequin simulator). One week later, all performed a transfer test on a hybrid simulation (standardized patient with a task trainer). We used a net benefit regression model to identify the most cost-effective training program via paired comparisons. We also created a cost-effectiveness acceptability curve to visually represent the probability that one program is more cost-effective when compared to its comparator at various 'willingness-to-pay' values. We conducted separate analyses for implementation and total costs. The results showed that the progressive program had the highest total cost (p < 0.001) whereas the high-fidelity program had the highest implementation cost (p < 0.001). While the most cost-effective program depended on the decision makers' willingness-to-pay value, the progressive training program was generally most educationally- and cost-effective. Our analyses suggest that a progressive program that strategically combines simulation modalities provides a cost-effective solution. More generally, we have introduced how a cost-effectiveness analysis may be applied to simulation training; a method that medical educators may use to investment decisions (e.g., purchasing cost-effective and educationally sound simulators).
Process Evaluation of Making HEPA Policy Practice: A Group Randomized Trial.
Weaver, Robert G; Moore, Justin B; Huberty, Jennifer; Freedman, Darcy; Turner-McGrievy, Brie; Beighle, Aaron; Ward, Diane; Pate, Russell; Saunders, Ruth; Brazendale, Keith; Chandler, Jessica; Ajja, Rahma; Kyryliuk, Becky; Beets, Michael W
2016-09-01
This study examines the link between implementation of Strategies to Enhance Practice (STEPs) and outcomes. Twenty after-school programs (ASPs) participated in an intervention to increase children's accumulation of 30 minutes/day of moderate to vigorous physical activity (MVPA) and quality of snacks served during program time. Outcomes were measured via accelerometer (MVPA) and direct observation (snacks). STEPs implementation data were collected via document review and direct observation. Based on implementation data, ASPs were divided into high/low implementers. Differences between high/low implementers' change in percentage of boys accumulating 30 minutes/day of MVPA were observed. There was no difference between high/low implementers for girls. Days fruits and/or vegetables and water were served increased in the high/low implementation groups, while desserts and sugar-sweetened beverages decreased. Effect sizes (ES) for the difference in changes between the high and low group ranged from low (ES = 0.16) to high (ES = 0.97). Higher levels of implementation led to increased MVPA for boys, whereas girls MVPA benefited from the intervention regardless of high/low implementation. ESs of the difference between high/low implementers indicate that increased implementation of STEPs increases days healthier snacks are served. Programs in the high-implementation group implemented a variety of STEPs strategies, suggesting local adoption/adaptation is key to implementation. © 2016 Society for Public Health Education.
Looking Forward: The Promise of Widespread Implementation of Parent Training Programs
Forgatch, Marion S.; Patterson, Gerald R.; Gewirtz, Abigail H.
2013-01-01
Over the past quarter century a body of parent training programs has been developed and validated as effective in reducing child behavior problems, but few of these have made their way into routine practice. This article describes the long and winding road of implementation as applied to children's mental health. Adopting Rogers' (1995) diffusion framework and Fixsen and colleagues' implementation framework (Fixsen, Naoom, Blase, Friedman, & Wallace, 2005), we review more than a decade of research on the implementation of Parent Management Training – Oregon Model (PMTO®). Data from US and international PMTO implementations are used to illustrate the payoffs and the challenges of making empirically supported interventions routine practice in the community. Technological advances that break down barriers to communication across distances, the availability of efficacious programs suitable for implementation, and the urgent need for high quality mental health care provide strong rationales for prioritizing attention to implementation. Over the next quarter of a century, the challenge is to reduce the prevalence of children's psychopathology by creating science-based delivery systems to reach families in need, everywhere. PMID:24443650
Steps toward a Technology for the Diffusion of Innovations.
ERIC Educational Resources Information Center
Stolz, Stephanie B.
Research-based technologies for solving problems currently exist but are not being widely implemented. Although user variables, program effectiveness, and political considerations have been documented as correlates of implementation, general non-implementation of the technology still exists, due to a lack of methods. A technology of dissemination…
Mihalic, Sharon F; Fagan, Abigail A; Argamaso, Susanne
2008-01-18
Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured. This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST) drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness. Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers), ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence). Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage). Student behavior and use of interactive teaching techniques (quality of delivery) were positively related. No variables were related to student participation (student responsiveness). Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that organizations should consider to ensure fidelity, such as selecting programs with features that minimize complexity while maximizing flexibility. Time constraints in the classroom should be considered when choosing a program. Student behavior also influences program delivery, so schools should train teachers in the use of classroom management skills. This project involved comprehensive program monitoring and technical assistance that likely facilitated the identification and resolution of problems and contributed to the overall high quality of implementation. Schools should recognize the importance of training and technical assistance to ensure quality program delivery.
Alternative Education: Evaluation and Implementation of EBCE.
ERIC Educational Resources Information Center
Shively, Joe E.; Sanders, Jack
Increasing student disenchantment with traditional schooling prompted the development of an alternative educational program: Experience-Based Career Education (EBCE). During three years of development, evaluation provided student, parent, and employer data on program impact and effectiveness. Stakeholders' involvement in program development and…
Marketing Education Program Management Guide.
ERIC Educational Resources Information Center
Blair, Betty; And Others
This guide was designed for use by marketing education teacher-coordinators and administrators in implementing marketing education programs. The document includes the following: an overall picture of administrative responsibilities related to high quality programs, guidelines and forms needed to deliver effective instruction, resources and…
Dusenbury, Linda; Brannigan, Rosalind; Hansen, William B; Walsh, John; Falco, Mathea
2005-06-01
As prevention programs become disseminated, the most serious threat to effectiveness is maintaining the quality of implementation intended by the developers. This paper proposes a methodology for measuring quality of implementation in school settings and presents data from a pilot study designed to test several of the proposed components. These methods included assessments of adherence, quality of process, the positive or negative valence of adaptations, teachers' attitudes and teachers' understanding of program content. This study was conducted with 11 teachers who had varying degrees of experience who taught Life Skills Training. Observation and interview data were collected during visits to schools. Results suggest that quality of implementation can be measured through observation and interview. Teachers varied in adherence and quality of program delivery. All teachers made adaptations to the program. Experienced teachers were more likely to adhere to the curriculum, deliver it in a way that was more interactive and engaging to students, communicate the goals and objectives better, and make positive adaptations. The field can use these findings as the basis for exploring strategies for measuring and improving quality of implementation.
Stenehjem, Edward; Hersh, Adam L; Buckel, Whitney R; Jones, Peter; Sheng, Xiaoming; Evans, R Scott; Burke, John P; Lopansri, Bert K; Srivastava, Rajendu; Greene, Tom; Pavia, Andrew T
2018-02-23
Studies on the implementation of antibiotic stewardship programs (ASPs) in small hospitals are limited. Accreditation organizations now require all hospitals to have ASPs. The objective of this cluster-randomized intervention was to assess the effectiveness of implementing ASPs in Intermountain Healthcare's 15 small hospitals. Each hospital was randomized to 1 of 3 ASPs of escalating intensity. Program 1 hospitals were provided basic antibiotic stewardship education and tools, access to an infectious disease hotline, and antibiotic utilization data. Program 2 hospitals received those interventions plus advanced education, audit and feedback for select antibiotics, and locally controlled antibiotic restrictions. Program 3 hospitals received program 2 interventions plus audit and feedback on the majority of antibiotics, and an infectious diseases-trained clinician approved restricted antibiotics and reviewed microbiology results. Changes in total and broad-spectrum antibiotic use within programs (intervention versus baseline) and the difference between programs in the magnitude of change in antibiotic use (eg, program 3 vs 1) were evaluated with mixed models. Program 3 hospitals showed reductions in total (rate ratio, 0.89; confidence interval, .80-.99) and broad-spectrum (0.76; .63-.91) antibiotic use when the intervention period was compared with the baseline period. Program 1 and 2 hospitals did not experience a reduction in antibiotic use. Comparison of the magnitude of effects between programs showed a similar trend favoring program 3, but this was not statistically significant. Only the most intensive ASP intervention was associated with reduction in total and broad-spectrum antibiotic use when compared with baseline. NCT03245879.
The Cost and Threshold Analysis of Retention in Care (RiC): A Multi-Site National HIV Care Program.
Maulsby, Catherine; Jain, Kriti M; Weir, Brian W; Enobun, Blessing; Riordan, Maura; Charles, Vignetta E; Holtgrave, David R
2017-03-01
Persons diagnosed with HIV but not retained in HIV medical care accounted for the majority of HIV transmissions in 2009 in the United States (US). There is an urgent need to implement and disseminate HIV retention in care programs; however little is known about the costs associated with implementing retention in care programs. We assessed the costs and cost-saving thresholds for seven Retention in Care (RiC) programs implemented in the US using standard methods recommended by the US Panel on Cost-effectiveness in Health and Medicine. Data were gathered from accounting and program implementation records, entered into a standardized RiC economic analysis spreadsheet, and standardized to a 12 month time frame. Total program costs for from the societal perspective ranged from $47,919 to $423,913 per year or $146 to $2,752 per participant. Cost-saving thresholds ranged from 0.13 HIV transmissions averted to 1.18 HIV transmission averted per year. We estimated that these cost-saving thresholds could be achieved through 1 to 16 additional person-years of viral suppression. Across a range of program models, retention in care interventions had highly achievable cost-saving thresholds, suggesting that retention in care programs are a judicious use of resources.
Creating Dedicated Local and State Revenue Sources for Youth Programs
ERIC Educational Resources Information Center
Sherman, Rachel H.; Deich, Sharon G.; Langford, Barbara Hanson
2007-01-01
This publication is part of a series of tools and resources on financing and sustaining youth programming. These tools and resources are intended to assist policy makers, program developers and community leaders in developing innovative strategies for implementing, financing and sustaining effective programs and policies. This brief highlights six…
A Guide to Successful Public Private Partnerships for Youth Programs
ERIC Educational Resources Information Center
Relave, Nanette; Deich, Sharon
2007-01-01
This publication is part of a series of tools and resources on financing and sustaining youth programming. These tools and resources are intended to help policymakers, program developers, and community leaders develop innovative strategies for implementing, financing, and sustaining effective programs and policies. This guide provides practical…
ERIC Educational Resources Information Center
Steward, Jennifer M.
2017-01-01
Sexual violence on college campuses is a pervasive problem with the potential for extensive physical and psychological health consequences. Institutions have begun implementing prevention programs; however, more research is needed to understand whether these programs are effective. Bystander intervention programs have increased in popularity…
Utilizing a State Level Volunteer Recognition Program at the County Level
ERIC Educational Resources Information Center
McCall, Fran Korthaus; Culp, Ken, III
2013-01-01
Volunteer recognition is an important component of Extension programs. Most land-grant universities have implemented a state volunteer recognition program. Extension professionals, however, are too overburdened with meetings, programs, and activities to effectively recognize volunteers locally. Utilizing a state model is an efficient means of…
31 CFR 1024.210 - Anti-money laundering programs for mutual funds.
Code of Federal Regulations, 2011 CFR
2011-07-01
... mutual funds. 1024.210 Section 1024.210 Money and Finance: Treasury Regulations Relating to Money and... FUNDS Programs § 1024.210 Anti-money laundering programs for mutual funds. (a) Effective July 24, 2002, each mutual fund shall develop and implement a written anti-money laundering program reasonably...
Home-Start between Childhood and Maturity: A Programme Evaluation.
ERIC Educational Resources Information Center
Terpstra, Linda; van Dijke, Anke
A crucial question for evaluating nationally or internationally implemented programs is whether local adaptations detract from program quality and effectiveness. An evaluation examined the program successes and challenges encountered in the first 5 years of Home-Start in the Netherlands, a home-based family support program for families with young…
ERIC Educational Resources Information Center
Rank, Bryan D.; Retallick, Michael S.
2017-01-01
Faculty in agricultural teacher education programs are responsible for preparing future teachers to lead effective school-based agricultural education programs. However, agriculture teachers are having difficulty implementing supervised agricultural experience (SAE), even though they value it conceptually as a program component. In an effort to…
Designing and Implementing Effective In-School Alternatives to Suspension.
ERIC Educational Resources Information Center
Mizell, M. Hayes
Because of widespread disillusion with suspension as a discipline procedure, school officials are developing inschool alternative programs. Institution of such a program must begin with reflection about how current disciplinary programs are succeeding or failing. The primary purposes of the program must include helping the child and identifying…
Code of Federal Regulations, 2012 CFR
2012-01-01
... take action by promoting rigorous enforcement measures and effective substance abuse prevention programs. During National Impaired Driving Prevention Month, we recommit to preventing tragedy before it... efforts, implement more effective legislation, and support successful, evidence-based prevention programs...
Superfund Reform 1995. Principles for a new Superfund program
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bresnick, W.
1995-11-01
Superfund Reform `95 is a broad coalition of small and large businesses and local governments. Superfund Reform `95 believes now is the time for a new law to be drafted based on the principles and programmatic elements described below. Superfund Reform `95 believes that the program they are proposing will generate efficiencies and cost savings that will permit it to be implemented without the need to increase the total amount of taxes currently being levied to support the Superfund. The current federal Superfund program is badly broken and in need of major restructuring. The existing Superfund program must be replacedmore » by a new program in which the benefits justify its cost and which is equitable, cost-effective, and limited in size and scope so that it is targeted to address real, current, and significant risks to human health and environment posed by the past disposal of hazardous substances. The size of the federal National Priorities List (NPL) should be capped so that the remedial response program is phased out over time. Retroactive liability should be repealed and the remedy selection process significantly reformed. States should be given the opportunity to be delegated implementation of the reformed federal Superfund program at NPL sites as well as provided with incentives to implement their own similarly reformed programs in a fair and cost-effective manner.« less
Langdon, Sarah E; Golden, Shannon L; Arnold, Elizabeth Mayfield; Maynor, Rhonda F; Bryant, Alfred; Freeman, V Kay; Bell, Ronny A
2016-05-01
Background American Indian (AI) youth have the highest rates of suicide among racial/ethnic minority groups in the United States. Community-based strategies are essential to address this issue, and community-based participatory research (CBPR) offers a model to engage AI communities in mental health promotion programming. Objectives This article describes successes and challenges of a CBPR, mixed-method project, The Lumbee Rite of Passage (LROP), an academic-community partnership to develop and implement a suicide prevention program for Lumbee AI youth in North Carolina. Method LROP was conducted in two phases to (1) understand knowledge and perceptions of existing mental health resources and (2) develop, implement, and evaluate a cultural enrichment program as a means of suicide prevention. Discussion/Results LROP implemented an effective community-academic partnership by (1) identifying and understanding community contexts, (2) maintaining equitable partnerships, and (3) implementing a culturally tailored research design targeting multilevel changes to support mental health. Strategies formed from the partnership alleviated challenges in each of these key CBPR concept areas. Conclusions LROP highlights how a CBPR approach contributes to positive outcomes and identifies opportunities for future collaboration in a tribal community. Using culturally appropriate CBPR strategies is critical to achieving sustainable, effective programs to improve mental health of AI youth. © 2016 Society for Public Health Education.
Wolff, Shelly
2008-01-01
Financially speaking, an effective, comprehensive, properly executed health and productivity (H&P) program can drive significant business results. Unfortunately, many companies are not getting the same return on their investments in H&P programs as their peers. This article defines program effectiveness and describes the specific activities of employers that have implemented successful H&P strategies leading to improved health, increased productivity and lower benefit costs-and, in turn, higher levels of performance, returns to shareholders and market premium.
Program Alternatives - 36 CFR § 800.14
implementation of a particular agency program or the resolution of adverse effects from complex projects or and the potential effects from the undertakings must be foreseeable and likely to be minimal or not undertakings, effects, historic properties, or treatment options. Standard treatments carry the ACHP's explicit
Longitudinal impact of the Cyber Friendly Schools program on adolescents' cyberbullying behavior.
Cross, Donna; Shaw, Thérèse; Hadwen, Kate; Cardoso, Patricia; Slee, Phillip; Roberts, Clare; Thomas, Laura; Barnes, Amy
2016-01-01
Cyberbullying is a major public health problem associated with serious mental, social, and academic consequences for young people. To date, few programs addressing cyberbullying have been developed and empirically tested. The Cyber Friendly Schools (CFS) group-randomized controlled trial measured the longitudinal impact of a whole-school online cyberbullying prevention and intervention program, developed in partnership with young people. Non-government secondary schools in Perth, Western Australia, (N = 35; 3,000+ students) were randomized to an intervention (n = 19) or usual practice control group (n = 16 schools). Students completed online questionnaires in 2010, 2011, and at 1-year follow-up in 2012, measuring their cyberbullying experiences during the previous school term. The intervention group received the program in Grades 8 and 9 (aged 13-14 years). Program effects were tested using two-part growth models. The program was associated with significantly greater declines in the odds of involvement in cyber-victimization and perpetration from pre- to the first post-test, but no other differences were evident between the study conditions. However, teachers implemented only one third of the program content. More work is needed to build teacher capacity and self-efficacy to effectively implement cyberbullying programs. Whole-school cyberbullying interventions implemented in conjunction with other bullying prevention programs may reduce cyber-victimization more than traditional school-based bullying prevention programs alone. Aggr. Behav. 42:166-180, 2016. © 2015 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Crowley, D Max; Greenberg, Mark T; Feinberg, Mark E; Spoth, Richard L; Redmond, Cleve R
2012-02-01
A substantial challenge in improving public health is how to facilitate the local adoption of evidence-based interventions (EBIs). To do so, an important step is to build local stakeholders' knowledge and decision-making skills regarding the adoption and implementation of EBIs. One EBI delivery system, called PROSPER (PROmoting School-community-university Partnerships to Enhance Resilience), has effectively mobilized community prevention efforts, implemented prevention programming with quality, and consequently decreased youth substance abuse. While these results are encouraging, another objective is to increase local stakeholder knowledge of best practices for adoption, implementation and evaluation of EBIs. Using a mixed methods approach, we assessed local stakeholder knowledge of these best practices over 5 years, in 28 intervention and control communities. Results indicated that the PROSPER partnership model led to significant increases in expert knowledge regarding the selection, implementation, and evaluation of evidence-based interventions. Findings illustrate the limited programming knowledge possessed by members of local prevention efforts, the difficulty of complete knowledge transfer, and highlight one method for cultivating that knowledge.
Design and implementation of population-based specialty care programs.
Botts, Sheila R; Gee, Michael T; Chang, Christopher C; Young, Iris; Saito, Logan; Lyman, Alfred E
2017-09-15
The development, implementation, and scaling of 3 population-based specialty care programs in a large integrated healthcare system are reviewed, and the role of clinical pharmacy services in ensuring safe, effective, and affordable care is highlighted. The Kaiser Permanente (KP) integrated healthcare delivery model allows for rapid development and expansion of innovative population management programs involving pharmacy services. Clinical pharmacists have assumed integral roles in improving the safety and effectiveness of high-complexity, high-cost care for specialty populations. These roles require an appropriate practice scope and are supported by an advanced electronic health record with disease registries and electronic surveillance tools for care-gap identification. The 3 specialty population programs described were implemented to address variation or unrecognized gaps in care for at-risk specialty populations. The Home Phototherapy Program has leveraged internal partnerships with clinical pharmacists to improve access to cost-effective nonpharmacologic interventions for psoriasis and other skin disorders. The Multiple Sclerosis Care Program has incorporated clinical pharmacists into neurology care in order to apply clinical guidelines in a systematic manner. The KP SureNet program has used clinical pharmacists and data analytics to identify opportunities to prevent drug-related adverse outcomes and ensure timely follow-up. Specialty care programs improve quality, cost outcomes, and the patient experience by appropriating resources to provide systematic and targeted care to high-risk patients. KP leverages an integration of people, processes, and technology to develop and scale population-based specialty care. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Misso, Marie L; Ilic, Dragan; Haines, Terry P; Hutchinson, Alison M; East, Christine E; Teede, Helena J
2016-01-14
Health professionals need to be integrated more effectively in clinical research to ensure that research addresses clinical needs and provides practical solutions at the coal face of care. In light of limited evidence on how best to achieve this, evaluation of strategies to introduce, adapt and sustain evidence-based practices across different populations and settings is required. This project aims to address this gap through the co-design, development, implementation, evaluation, refinement and ultimately scale-up of a clinical research engagement and leadership capacity building program in a clinical setting with little to no co-ordinated approach to clinical research engagement and education. The protocol is based on principles of research capacity building and on a six-step framework, which have previously led to successful implementation and long-term sustainability. A mixed methods study design will be used. Methods will include: (1) a review of the literature about strategies that engage health professionals in research through capacity building and/or education in research methods; (2) a review of existing local research education and support elements; (3) a needs assessment in the local clinical setting, including an online cross-sectional survey and semi-structured interviews; (4) co-design and development of an educational and support program; (5) implementation of the program in the clinical environment; and (6) pre- and post-implementation evaluation and ultimately program scale-up. The evaluation focuses on research activity and knowledge, attitudes and preferences about clinical research, evidence-based practice and leadership and post implementation, about their satisfaction with the program. The investigators will evaluate the feasibility and effect of the program according to capacity building measures and will revise where appropriate prior to scale-up. It is anticipated that this clinical research engagement and leadership capacity building program will enable and enhance clinically relevant research to be led and conducted by health professionals in the health setting. This approach will also encourage identification of areas of clinical uncertainty and need that can be addressed through clinical research within the health setting.
Implementing newborn mock codes.
Blakely, Teresa Gail
2007-01-01
This article describes the implementation of a newborn mock code program. Although the Neonatal Resuscitation Program (NRP) is one of the most widely used health education programs in the world and is required for most hospital providers who attend deliveries, research tells us that retention of NRP skills deteriorates rapidly after completion of the course. NRP requires coordination and cooperation among all providers; however, a lack of leadership and teamwork during resuscitation (often associated with a lack of confidence) has been noted. Implementation of newborn mock code scenarios can encourage teamwork, communication, skills building, and increased confidence levels of providers. Mock codes can help providers become strong team members and team leaders by helping them be better prepared for serious situations in the delivery room. Implementation of newborn mock codes can be effectively accomplished with appropriate planning and consideration for adult learning behaviors.
Subramanian, Sujha; Tangka, Florence K L; Hoover, Sonja; Nadel, Marion; Smith, Robert; Atkin, Wendy; Patnick, Julietta
2016-01-01
Worldwide, colorectal cancer is the fourth leading cause of death from cancer and the incidence is projected to increase. Many countries are exploring the introduction of organized screening programs, but there is limited information on the resources required and guidance for cost-effective implementation. To facilitate the generating of the economics evidence base for program implementation, we collected and analyzed detailed program cost data from 5 European members of the International Colorectal Cancer Screening Network. The cost per person screened estimates, often used to compare across programs as an overall measure, varied significantly across the programs. In addition, there were substantial differences in the programmatic and clinical cost incurred, even when the same type of screening test was used. Based on these findings, several recommendations are provided to enhance the underlying methodology and validity of the comparative economic assessments. The recommendations include the need for detailed activity-based cost information, the use of a comprehensive set of effectiveness measures to adequately capture differences between programs, and the incorporation of data from multiple programs in cost-effectiveness models to increase generalizability. Economic evaluation of real-world colorectal cancer-screening programs is essential to derive valuable insights to improve program operations and ensure optimal use of available resources.
Walker, Sarah Cusworth; Bumbarger, Brian K; Phillippi, Stephen W
2015-10-01
Evidence-based programs (EBPs) are an increasingly visible aspect of the treatment landscape in juvenile justice. Research demonstrates that such programs yield positive returns on investment and are replacing more expensive, less effective options. However, programs are unlikely to produce expected benefits when they are not well-matched to community needs, not sustained and do not reach sufficient reach and scale. We argue that achieving these benchmarks for successful implementation will require states and county governments to invest in data-driven decision infrastructure in order to respond in a rigorous and flexible way to shifting political and funding climates. We conceptualize this infrastructure as diagnostic capacity and evaluative capacity: Diagnostic capacity is defined as the process of selecting appropriate programing and evaluative capacity is defined as the ability to monitor and evaluate progress. Policy analyses of Washington State, Pennsylvania and Louisiana's program implementation successes are used to illustrate the benefits of diagnostic and evaluate capacity as a critical element of EBP implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.
Hartzler, Bryan; Peavy, K Michelle; Jackson, T Ron; Carney, Molly
2016-01-22
Pragmatic trials of empirically-supported behavior therapies may inform clinical and policy decisions concerning therapy sustainment. This retrospective trial design paper describes and discusses pragmatic features of a hybrid type III implementation/effectiveness trial of a contingency management (CM) intervention at an opioid treatment program. Prior reporting (Hartzler et al., J Subst Abuse Treat 46:429-438, 2014; Hartzler, Subst Abuse Treat Prev Policy 10:30, 2015) notes success in recruiting program staff for voluntary participation, durable impacts of CM training on staff-level outcomes, provisional setting implementation of the intervention, documentation of clinical effectiveness, and post-trial sustainment of CM. Six pragmatic design features, and both scientific and practical bases for their inclusion in the trial, are presented: (1) a collaborative intervention design process, (2) voluntary recruitment of program staff for therapy training and implementation, (3) serial training outcome assessments, with quasi-experimental staff randomization to either single or multiple baseline assessment conditions, (4) designation of a 90-day period immediately after training in which the setting implemented the intervention on a provisional basis, (5) inclusive patient eligibility for receipt of the CM intervention, and (6) designation of two staff as local implementation leaders to oversee clinical/administrative issues in provisional implementation. Each pragmatic trial design feature is argued to have contributed to sustainment of CM. Contributions implicate the building of setting proprietorship for the CM intervention, culling of internal staff expertise in its delivery, iterative use of assessment methods that limited setting burden, documentation of setting-specific clinical effectiveness, expanded penetration of CM among staff during provisional implementation, and promotion of setting self-reliance in the oversight of sustainable implementation procedures. It is hoped this discussion offers ideas for how to impact local clinical and policy decisions via effective behavior therapy dissemination.
A Prevention Program for Preschool C.O.A.s: Design and Early Effects.
ERIC Educational Resources Information Center
Zucker, Robert A.; And Others
This report addresses three levels of questions about the effectiveness of the Michigan State University Multiple Risk Outreach Program (MROP). The MROP was designed to recruit families from this high-risk population and test the implementation of an intervention protocol in a population-based program for 3- to 6-year-olds and their families. This…
The Effects of the "Welcome Schools" Program in Madrid, Spain: An Ethnographic Analysis
ERIC Educational Resources Information Center
del Olmo, Margarita
2010-01-01
The aim of this paper is to share the conclusions of a recent ethnographic study carried out in Madrid from 2005 to 2008 to analyze the effects of a program implemented by the Community of Madrid, Spain, to address diversity in schools. The Program was given an English name--"Welcome Schools"--and was aimed at preparing children recently…
NASA Technical Reports Server (NTRS)
Sadler, S. G.
1972-01-01
A mathematical model and computer program was implemented to study the main rotor free wake geometry effects on helicopter rotor blade air loads and response in steady maneuvers. Volume 1 (NASA CR-2110) contains the theoretical formulation and analysis of results. Volume 2 contains the computer program listing.
Going to Scale: A Nonrandomized Nationwide Trial of the KiVa Antibullying Program for Grades 1-9
ERIC Educational Resources Information Center
Karna, Antti; Voeten, Marinus; Little, Todd D.; Poskiparta, Elisa; Alanen, Erkki; Salmivalli, Christina
2011-01-01
Objective: The effects of school-based antibullying programs have typically been examined on small samples, with number of schools ranging from 1 to 78 (Farrington & Ttofi, 2009). This study investigated the effectiveness of the KiVa antibullying program in the beginning of its nationwide implementation in Finland. Method: At each time point,…
Does team training work? Principles for health care.
Salas, Eduardo; DiazGranados, Deborah; Weaver, Sallie J; King, Heidi
2008-11-01
Teamwork is integral to a working environment conducive to patient safety and care. Team training is one methodology designed to equip team members with the competencies necessary for optimizing teamwork. There is evidence of team training's effectiveness in highly complex and dynamic work environments, such as aviation and health care. However, most quantitative evaluations of training do not offer any insight into the actual reasons why, how, and when team training is effective. To address this gap in understanding, and to provide guidance for members of the health care community interested in implementing team training programs, this article presents both quantitative results and a specific qualitative review and content analysis of team training implemented in health care. Based on this review, we offer eight evidence-based principles for effective planning, implementation, and evaluation of team training programs specific to health care.
2014-01-01
Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945
Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel Fgj; Hendriks, Erik Jm; Kremers, Stef Pj; van Peppen, Roland Ps; Rutten, Steven Tj; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob Ab
2014-01-15
Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process.
School-based smoking prevention: the teacher training process.
Tortu, S; Botvin, G J
1989-03-01
Effective in-service teacher training must be regarded as a critical aspect of the implementation of any innovative school-based smoking prevention curriculum. Inadequate training or lack of training often leads to implementation failure, which, in turn, may be interpreted as program failure. To be effective, teacher training must include a presentation of the theory underlying the program, a demonstration of the skills to be learned, an opportunity to practice the new skills being taught, feedback, and coaching for application. Training activities must include a training workshop and ongoing consultation during the teacher's first experience with classroom implementation. Adequate preparation before the beginning of training will help to ensure that the necessary components are combined in a meaningful training sequence.
Harris, Alex H S; Bowe, Thomas; Hagedorn, Hildi; Nevedal, Andrea; Finlay, Andrea K; Gidwani, Risha; Rosen, Craig; Kay, Chad; Christopher, Melissa
2016-09-15
Active consideration of effective medications to treat alcohol use disorder (AUD) is a consensus standard of care, yet knowledge and use of these medications are very low across diverse settings. This study evaluated the overall effectiveness a multifaceted academic detailing program to address this persistent quality problem in the US Veterans Health Administration (VHA), as well as the context and process factors that explained variation in effectiveness across sites. An interrupted time series design, analyzed with mixed-effects segmented logistic regression, was used to evaluate changes in level and rate of change in the monthly percent of patients with a clinically documented AUD who received naltrexone, acamprosate, disulfiram, or topiramate. Using data from a 20 month post-implementation period, intervention sites (n = 37) were compared to their own 16 month pre-implementation performance and separately to the rest of VHA. From immediately pre-intervention to the end of the observation period, the percent of patients in the intervention sites with AUD who received medication increased over 3.4 % in absolute terms and 68 % in relative terms (i.e., 4.9-8.3 %). This change was significant compared to the pre-implementation period in the intervention sites and secular trends in control sites. Sites with lower pre-implementation adoption, more person hours of detailing, but fewer people detailed, had larger immediate increases in medication receipt after implementation. The average number of detailing encounters per person was associated with steeper increases in slope over time. This study found empirical support for a multifaceted quality improvement strategy aimed at increasing access to and utilization of pharmacotherapy for AUD. Future studies should focus on determining how to enhance the programs effects, especially in non-responsive locations.
Truong, Hoai-An; Taylor, Catherine R; DiPietro, Natalie A
2012-02-10
To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs. The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes. Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated. The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists' contributions to public health.
Strategic Human Resources Management of Employer Cooperative Education Programs.
ERIC Educational Resources Information Center
Nielsen, Richard P.; Porter, Ralph C.
1982-01-01
This article discusses effective strategic planning and management of employer cooperative education programs. It examines types of planning, the need for such programs, and implementation strategies. Several case studies are considered: Dayton-Hudson, IBM, AT&T, Delta Airlines, and Rockwell International. (CT)
Adams, Megan A; Elmunzer, B Joseph; Scheiman, James M
2014-04-01
In 2001, the University of Michigan Health System (UMHS) implemented a novel medical error disclosure program. This study analyzes the effect of this program on gastroenterology (GI)-related claims and costs. This was a review of claims in the UMHS Risk Management Database (1990-2010), naming a gastroenterologist. Claims were classified according to pre-determined categories. Claims data, including incident date, date of resolution, and total liability dollars, were reviewed. Mean total liability incurred per claim in the pre- and post-implementation eras was compared. Patient encounter data from the Division of Gastroenterology was also reviewed in order to benchmark claims data with changes in clinical volume. There were 238,911 GI encounters in the pre-implementation era and 411,944 in the post-implementation era. A total of 66 encounters resulted in claims: 38 in the pre-implementation era and 28 in the post-implementation era. Of the total number of claims, 15.2% alleged delay in diagnosis/misdiagnosis, 42.4% related to a procedure, and 42.4% involved improper management, treatment, or monitoring. The reduction in the proportion of encounters resulting in claims was statistically significant (P=0.001), as was the reduction in time to claim resolution (1,000 vs. 460 days) (P<0.0001). There was also a reduction in the mean total liability per claim ($167,309 pre vs. $81,107 post, 95% confidence interval: 33682.5-300936.2 pre vs. 1687.8-160526.7 post). Implementation of a novel medical error disclosure program, promoting transparency and quality improvement, not only decreased the number of GI-related claims per patient encounter, but also dramatically shortened the time to claim resolution.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zhou, Nan; Zheng, Nina; Fridley, David
2012-02-28
Appliance energy efficiency standards and labeling (S&L) programs have been important policy tools for regulating the efficiency of energy-using products for over 40 years and continue to expand in terms of geographic and product coverage. The most common S&L programs include mandatory minimum energy performance standards (MEPS) that seek to push the market for efficient products, and energy information and endorsement labels that seek to pull the market. This study seeks to review and compare some of the earliest and most well-developed S&L programs in three countries and one region: the U.S. MEPS and ENERGY STAR, Australia MEPS and Energymore » Label, European Union MEPS and Ecodesign requirements and Energy Label and Japanese Top Runner programs. For each program, key elements of S&L programs are evaluated and comparative analyses across the programs undertaken to identify best practice examples of individual elements as well as cross-cutting factors for success and lessons learned in international S&L program development and implementation. The international review and comparative analysis identified several overarching themes and highlighted some common factors behind successful program elements. First, standard-setting and programmatic implementation can benefit significantly from a legal framework that stipulates a specific timeline or schedule for standard-setting and revision, product coverage and legal sanctions for non-compliance. Second, the different MEPS programs revealed similarities in targeting efficiency gains that are technically feasible and economically justified as the principle for choosing a standard level, in many cases at a level that no product on the current market could reach. Third, detailed survey data such as the U.S. Residential Energy Consumption Survey (RECS) and rigorous analyses provide a strong foundation for standard-setting while incorporating the participation of different groups of stakeholders further strengthen the process. Fourth, sufficient program resources for program implementation and evaluation are critical to the effectiveness of standards and labeling programs and cost-sharing between national and local governments can help ensure adequate resources and uniform implementation. Lastly, check-testing and punitive measures are important forms of enforcement while the cancellation of registration or product sales-based fines have also proven effective in reducing non-compliance. The international comparative analysis also revealed the differing degree to which the level of government decentralization has influenced S&L programs and while no single country has best practices in all elements of standards and labeling development and implementation, national examples of best practices for specific elements do exist. For example, the U.S. has exemplified the use of rigorous analyses for standard-setting and robust data source with the RECS database while Japan's Top Runner standard-setting principle has motivated manufacturers to exceed targets. In terms of standards implementation and enforcement, Australia has demonstrated success with enforcement given its long history of check-testing and enforcement initiatives while mandatory information-sharing between EU jurisdictions on compliance results is another important enforcement mechanism. These examples show that it is important to evaluate not only the drivers of different paths of standards and labeling development, but also the country-specific context for best practice examples in order to understand how and why certain elements of specific S&L programs have been effective.« less
Understanding Real-World Implementation Quality and “Active Ingredients” of PBIS
Molloy, Lauren E.; Moore, Julia E.; Trail, Jessica; Van Epps, John James; Hopfer, Suellen
2014-01-01
Programs delivered in the “real world” often look substantially different from what was originally intended by program developers. Depending on which components of a program are being trimmed or altered, such modifications may seriously undermine the effectiveness of a program. In the present study, these issues are explored within a widely used school-based, non-curricular intervention, Positive Behavioral Intervention and Supports. The present study takes advantage of a uniquely large dataset to gain a better understanding of the “real-world” implementation quality of PBIS, and to take a first step toward identifying the components of PBIS that “matter most” for student outcomes. Data from 27,689 students and 166 public primary and secondary schools across seven states included school and student demographics, indices of PBIS implementation quality, and reports of problem behaviors for any student who received an office discipline referral (ODR) during the 2007-2008 school year. Results of the present study identify three key components of PBIS that many schools are failing to implement properly, three program components that were most related to lower rates of problem behavior (i.e., three “active ingredients” of PBIS), and several school characteristics that help to account for differences across schools in the quality of PBIS implementation. Overall, findings highlight the importance of assessing implementation quality in “real-world” settings, and the need to continue improving understanding of how and why programs work. Findings are discussed in terms of their implications for policy. PMID:23408283
Understanding real-world implementation quality and "active ingredients" of PBIS.
Molloy, Lauren E; Moore, Julia E; Trail, Jessica; Van Epps, John James; Hopfer, Suellen
2013-12-01
Programs delivered in the "real world" often look substantially different from what was originally intended by program developers. Depending on which components of a program are being trimmed or altered, such modifications may seriously undermine the effectiveness of a program. In the present study, these issues are explored within a widely used school-based, non-curricular intervention, Positive Behavioral Intervention and Supports. The present study takes advantage of a uniquely large dataset to gain a better understanding of the "real-world" implementation quality of PBIS and to take a first step toward identifying the components of PBIS that "matter most" for student outcomes. Data from 27,689 students and 166 public primary and secondary schools across seven states included school and student demographics, indices of PBIS implementation quality, and reports of problem behaviors for any student who received an office discipline referral during the 2007-2008 school year. Results of the present study identify three key components of PBIS that many schools are failing to implement properly, three program components that were most related to lower rates of problem behavior (i.e., three "active ingredients" of PBIS), and several school characteristics that help to account for differences across schools in the quality of PBIS implementation. Overall, findings highlight the importance of assessing implementation quality in "real-world" settings, and the need to continue improving understanding of how and why programs work. Findings are discussed in terms of their implications for policy.
23 CFR 1345.5 - Requirements for a grant.
Code of Federal Regulations, 2011 CFR
2011-04-01
... must adopt and implement effective programs to reduce highway deaths and injuries resulting from... strategy that the State intends to use to deliver each message to its target audience. (5) To demonstrate...) Child passenger protection education program. (1) A State must provide an effective system for educating...
23 CFR 1345.5 - Requirements for a grant.
Code of Federal Regulations, 2012 CFR
2012-04-01
... must adopt and implement effective programs to reduce highway deaths and injuries resulting from... strategy that the State intends to use to deliver each message to its target audience. (5) To demonstrate...) Child passenger protection education program. (1) A State must provide an effective system for educating...
A Qualitative Evaluation of the Students of Service (SOS) Program for Sexual Abstinence in Louisiana
ERIC Educational Resources Information Center
Yoo, Seunghyun; Johnson, Carolyn C.; Rice, Janet; Manuel, Powlin
2004-01-01
Abstinence-only programs for preventing teen pregnancy are the only options in some states but are the programs of choice in others. Effectiveness data, however, are lacking. The SOS Adolescent Family Life Program (SOS), an abstinence-only teen pregnancy prevention program, was implemented in south central Louisiana. Peer mentoring with an…
ERIC Educational Resources Information Center
Washburn, Lisa T.; Traywick, LaVona; Copeland, Lauren; Vincent, Jessica
2017-01-01
We present findings from a pilot implementation of the Extension Wellness Ambassador Program, a health-focused master volunteer program, and briefly describe the program approach and purpose. Program participants received 40 hr of training and completed assessments of self-efficacy, physical activity, and functional fitness at baseline and 3-month…
ERIC Educational Resources Information Center
Lewis, Morgan V.; Kosine, Natalie R.
2008-01-01
This publication provides background to inform the implementation of Programs of Study (POS) as required by grantees of funds authorized under the Carl D. Perkins Career and Technical Education Improvement Act of 2006. The report is a review of the evidence on the effectiveness of previous similar initiatives and an examination of the implications…
Chen, Yong; Wu, Dan; Zhang, Wenyi; Chen, Zeliang; Chang, Guohui; Tian, Shuguang; Yang, Ruifu; Liu, Chao
2015-10-01
To investigate the Western Area Surge (WAS) program in the Ebola outbreak of Sierra Leone, and to analyze its implementing effect. The subject of this study was 3,813 laboratory confirmed Ebola hemorrhagic fever (EHF) cases reported in Sierra Leone from November 19, 2014 through January 27, 2015, a period before and after the implementation of the WAS program. To analyze and make conclusions according to the working experience of China Mobile Laboratory Reponses Team in the fight of Ebola outbreak, using WHO published EHF case definition to make diagnosis and compare the number of bed numbers, confirmed EHF cases, samples tested, and positive rates before and after implementation of WAS program. From the implementation of WAS program on 17th December 2014 to half a month later, the total numbers of Ebola holding and treatment centers increased from 640 to 960, six additional laboratories were established. On January, 2015, another two laboratories from America and The Netherlands were established. The numbers of samples tested one month before and after WAS program were 7,891 and 9,783, respectively, with an increase of 24.0 percent, while the positive rate of Ebola virus decreased from 22.2% (1,752/7,891) to 11.0% (1,077/9,783). The positive rate of blood samples decreased from 39.6% (248/626) in the month before WAS program to 27.4% (131/478) (χ2=17.93, P<0.001) in the mother after WAS program, the positive rate of blood samples 22.7% (103/454) to 10% (62/609) (χ2=31.03, P<0.001), accordingly. After 3 weeks of WAS program, in addition to Western Area, another four hotspots in Sierra Leone had also reported a significant decrease of the numbers of confirmed EVD cases. Forty-two days after implementation of WAS program, the daily number of laboratory confirmed EHF cases decreased from 63 to 10. WAS program played a vital role in controlling the EHF outbreak rapidly in Sierra Leone. It could also provide guidance for the control similar large infectious diseases outbreak in the future.
McMahon, Shannon A; Brenner, Stephan; Lohmann, Julia; Makwero, Christopher; Torbica, Aleksandra; Mathanga, Don P; Muula, Adamson S; De Allegri, Manuela
2016-08-19
Gaps remain in understanding how performance-based incentive (PBI) programs affect quality of care and service quantity, whether programs are cost effective and how programs could be tailored to meet client and provider needs while remaining operationally viable. In 2014, Malawi's Ministry of Health launched the Service Delivery Integration-PBI (SSDI-PBI) program. The program is unique in that no portion of performance bonuses are paid to individual health workers, and it shifts responsibility for infrastructure and equipment procurement from facility staff to implementing partners. This protocol outlines an approach that analyzes processes and outcomes, considers expected and unexpected consequences of the program and frames the program's outputs relative to its costs. Findings from this evaluation will inform the intended future scale-up of PBI in Malawi. This study employs a prospective controlled before-and-after triangulation design to assess effects of the PBI program by analyzing quantitative and qualitative data from intervention and control facilities. Guided by a theoretical framework, the evaluation consists of four main components: service provision, health worker motivation, implementation processes and costing. Quality and access outcomes are assessed along four dimensions: (1) structural elements (related to equipment, drugs, staff); (2) process elements (providers' compliance with standards); (3) outputs (service utilization); (4) experiential elements (experiences of service delivery). The costing component includes costs related to start-up, ongoing management, and the cost of incentives themselves. The cost analysis considers costs incurred within the Ministry of Health, funders, and the implementing agency. The evaluation relies on primary data (including interviews and surveys) and secondary data (including costing and health management information system data). Through the lens of a PBI program, we illustrate how complex interventions can be evaluated via not only primary, mixed-methods data collection, but also through a wealth of secondary data from program implementers (including monitoring, evaluation and financial data), and the health system (including service utilization and service readiness data). We also highlight the importance of crafting a theory and using theory to inform the nature of data collected. Finally, we highlight the need to be responsive to stakeholders in order to enhance a study's relevance.
Genetic Parallel Programming: design and implementation.
Cheang, Sin Man; Leung, Kwong Sak; Lee, Kin Hong
2006-01-01
This paper presents a novel Genetic Parallel Programming (GPP) paradigm for evolving parallel programs running on a Multi-Arithmetic-Logic-Unit (Multi-ALU) Processor (MAP). The MAP is a Multiple Instruction-streams, Multiple Data-streams (MIMD), general-purpose register machine that can be implemented on modern Very Large-Scale Integrated Circuits (VLSIs) in order to evaluate genetic programs at high speed. For human programmers, writing parallel programs is more difficult than writing sequential programs. However, experimental results show that GPP evolves parallel programs with less computational effort than that of their sequential counterparts. It creates a new approach to evolving a feasible problem solution in parallel program form and then serializes it into a sequential program if required. The effectiveness and efficiency of GPP are investigated using a suite of 14 well-studied benchmark problems. Experimental results show that GPP speeds up evolution substantially.
Burch, M R; Reiss, M; Bailey, J S
1985-01-01
A facility-wide recreation program was designed and implemented in order to increase staff and client participation in daily leisure activities at an intermediate care facility for severely and profoundly mentally retarded adults. The baseline phase of the study consisted of having recreational materials available during scheduled recreation periods. The treatment was a package program consisting of (1) providing the staff with preplanned materials and activities, (2) assigning staff to specific roles, and (3) monitoring staff and providing feedback by supervisors. The treatment was implemented on the two living units of the Liberty Intermediate Care Facility. Treatment effects were similar on both units. Client participation increased from a baseline average of less than 10% to nearly 50% and staff participation increased from less than 10% to an average of 60% during program implementation.
Robbins, Michael S.; Alonso, Elizabeth; Horigian, Viviana E.; Bachrach, Ken; Burlew, Kathy; Carrión, Ibis S.; Hodgkins, Candace C.; Miller, Michael; Schindler, Eric; VanDeMark, Nancy; Henderson, Craig; Szapocznik, José
2010-01-01
This paper describes the development and implementation of a trial of Brief Strategic Family Therapy (BSFT), an evidence-based drug intervention for adolescents, in eight community substance abuse treatment programs. Researchers and treatment programs collaborated closely to identify and overcome challenges, many of them related to achieving results that were both scientifically rigorous and applicable to the widest possible variety of adolescent substance abuse treatment programs. To meet these challenges, the collaborative team drew on lessons and practices from efficacy, effectiveness, and implementation research. PMID:22002455
Cultural Awareness in Nuclear Security Programs: A Critical Link
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nasser, Al-Sharif Nasser bin; Auda, Jasmine; Bachner, Katherine
Nuclear security programs that offer training and capacity building opportunities to practitioners working in nuclear facilities play a central role in strengthening the global nuclear security architecture. There is often a significant divide, however, between both the development of these programs and their implementation, and between the programs’ intended and actual outcomes. This article argues that this disconnect can often be attributed to an absence of cultural awareness and an inability for internationally-designed programs to effectively resonate with local audiences. Furthermore, the importance of the role of cultural awareness in implementing nuclear security programs will be assessed, and its applicationsmore » in the Jordanian context will be presented.« less
Cultural Awareness in Nuclear Security Programs: A Critical Link
Nasser, Al-Sharif Nasser bin; Auda, Jasmine; Bachner, Katherine
2016-11-20
Nuclear security programs that offer training and capacity building opportunities to practitioners working in nuclear facilities play a central role in strengthening the global nuclear security architecture. There is often a significant divide, however, between both the development of these programs and their implementation, and between the programs’ intended and actual outcomes. This article argues that this disconnect can often be attributed to an absence of cultural awareness and an inability for internationally-designed programs to effectively resonate with local audiences. Furthermore, the importance of the role of cultural awareness in implementing nuclear security programs will be assessed, and its applicationsmore » in the Jordanian context will be presented.« less
Frattaroli, Shannon; McDonald, Eileen M; Tran, Nhan T; Trump, Alison R; OʼBrocki, Raymond C; Gielen, Andrea C
2012-01-01
Smoke alarm canvassing is recognized as an empirically based, effective intervention for increasing access to and the presence of smoke alarms in homes. We sought to inform the implementation of an intervention designed to enhance an existing fire department smoke alarm canvassing program through an empirically grounded, participatory process. We conducted a series of focus groups with fire union leaders and firefighters involved with the canvassing program in 1 US city, shared the results with the participants, and presented the resulting recommendations to fire department leadership. This research occurred in Baltimore, Maryland. Focus group participants included firefighters who participate in the Fire Department's smoke alarm canvassing program and representatives from the local firefighters' union. The focus groups sought to capture firefighters' experiences with and opinions about the canvassing program and how to improve it as well as challenges to canvassing work. We conducted 10 focus groups with 65 participants. Firefighters' perspectives on the canvassing program and their recommendations for improving it were expressed through 3 categories of themes concerning program management, canvassing challenges, and attitudes about the program and the community. We also discuss the process of presenting these findings and recommendations to the participants and the fire department leadership, and describe how implementation of some of the recommendations has progressed. Both the process and outcomes of this formative work inform how to develop and implement community-based public health interventions in real-world settings through academic-community partnerships. The findings also have implications for how canvassing programs are being implemented.
Financial factors and the implementation of medications for treating opioid use disorders.
Knudsen, Hannah K; Roman, Paul M
2012-12-01
Despite the established effectiveness of pharmacotherapies for treating opioid use disorders, implementation of medications for addiction treatment (MAT) by specialty treatment programs is limited. This research examined relationships between organizational factors and the program-level implementation of MAT, with attention paid to specific sources of funding, organizational structure, and workforce resources. Face-to-face structured interviews were conducted in 2008 to 2009 with administrators of 154 community-based treatment programs affiliated with the National Institute on Drug Abuse's Clinical Trials Network; none of these programs exclusively dispensed methadone without offering other levels of care. Implementation of MAT was measured by summing the percentages of opioid patients receiving buprenorphine maintenance, methadone maintenance, and tablet naltrexone. Financial factors included the percentages of revenues received from Medicaid, private insurance, criminal justice, the Federal block grant, state government, and county government. Organizational structure and workforce characteristics were also measured. Implementation of MAT for opioid use disorders was low. Greater reliance on Medicaid was positively associated with implementation after controlling for organizational structure and workforce measures, whereas the association for reliance on criminal justice revenues was negative. The implementation of MAT for opioid use disorders by specialty addiction treatment programs may be facilitated by Medicaid but may be impeded by reliance on funding from the criminal justice system. These findings point to the need for additional research that considers the impact of organizational dependence on different types of funding on patterns of addiction treatment practice.
NASA Technical Reports Server (NTRS)
Rocker, JoAnne; Roncaglia, George J.; Heimerl, Lynn N.; Nelson, Michael L.
2002-01-01
Interoperability and data-exchange are critical for the survival of government information management programs. E-government initiatives are transforming the way the government interacts with the public. More information is to be made available through web-enabled technologies. Programs such as the NASA's Scientific and Technical Information (STI) Program Office are tasked to find more effective ways to disseminate information to the public. The NASA STI Program is an agency-wide program charged with gathering, organizing, storing, and disseminating NASA-produced information for research and public use. The program is investigating the use of a new protocol called the Open Archives Initiative (OAI) as a means to improve data interoperability and data collection. OAI promotes the use of the OAI harvesting protocol as a simple way for data sharing among repositories. In two separate initiatives, the STI Program is implementing OAI In collaboration with the Air Force, Department of Energy, and Old Dominion University, the NASA STI Program has funded research on implementing the OAI to exchange data between the three organizations. The second initiative is the deployment of OAI for the NASA technical report server (TRS) environment. The NASA TRS environment is comprised of distributed technical report servers with a centralized search interface. This paper focuses on the implementation of OAI to promote interoperability among diverse data repositories.
Helfrich, Christian D; Kohn, Marlana J; Stapleton, Austin; Allen, Claire L; Hammerback, Kristen Elizabeth; Chan, K C Gary; Parrish, Amanda T; Ryan, Daron E; Weiner, Bryan J; Harris, Jeffrey R; Hannon, Peggy A
2018-01-01
Organizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time. We analyzed two waves of readiness-to-change survey data collected as part of a three-arm, randomized controlled trial to implement evidence-based health promotion practices in small worksites in low-wage industries. We measured five readiness factors: context (favorable broader conditions); change valence (valuing health promotion); information assessment (demands and resources to implement health promotion); change commitment (an intention to implement health promotion); and change efficacy (a belief in shared ability to implement health promotion). We expected commitment and efficacy to increase at intervention sites along with their self-reported effort to implement health promotion practices, termed wellness-program effort. We compared means between baseline and 15 months, and between intervention and control sites. We used linear regression to test whether intervention and control sites differed in their change-readiness scores over time. Only context and change commitment met reliability thresholds. Change commitment declined significantly for both control (-0.39) and interventions sites (-0.29) from baseline to 15 months, while context did not change for either. Only wellness program effort at 15 months, but not at baseline, differed significantly between control and intervention sites (1.20 controls, 2.02 intervention). Regression analyses resulted in two significant differences between intervention and control sites in changes from baseline to 15 months: (1) intervention sites exhibited significantly smaller change in context scores relative to control sites over time and (2) intervention sites exhibited significantly higher changes in wellness program effort relative to control sites. Contrary to our hypothesis, change commitment declined significantly at both Healthlinks and control sites, even as wellness-program effort increased significantly at HealthLinks sites. Regression to the mean may explain the decline in change commitment. Future research needs to assess whether baseline commitment is an independent predictor of wellness-program effort or an effect modifier of the HealthLinks intervention.
ERIC Educational Resources Information Center
Aughinbaugh, Lorine A.; And Others
Four products were developed during the second year of the Extended Opportunity Programs and Services (EOPS) cost effectiveness study for California community colleges. This project report presents: (1) a revised cost analysis form for state-level reporting of institutional program effectiveness data and per-student costs by EOPS program category…
Davidson, Clare; Neighbors, Charles; Hall, Gerod; Hogue, Aaron; Cho, Richard; Kutner, Bryan; Morgenstern, Jon
2014-11-01
Housing First is a supportive housing model for persons with histories of chronic homelessness that emphasizes client-centered services, provides immediate housing, and does not require treatment for mental illness or substance abuse as a condition of participation. Previous studies of Housing First have found reduced governmental costs and improved personal well-being among participants. However, variations in real-world program implementation require better understanding of the relationship between implementation and outcomes. This study investigated the effects of Housing First implementation on housing and substance use outcomes. Study participants were 358 individuals with histories of chronic homelessness and problematic substance use. Clients were housed in nine scatter-site Housing First programs in New York City. Program fidelity was judged across a set of core Housing First components. Client interviews at baseline and 12 months were used to assess substance use. Clients in programs with greater fidelity to consumer participation components of Housing First were more likely to be retained in housing and were less likely to report using stimulants or opiates at follow-up. Consistently implemented Housing First principles related to consumer participation were associated with superior housing and substance use outcomes among chronically homeless individuals with a history of substance use problems. The study findings suggest that program implementation is central to understanding the potential of Housing First to help clients achieve positive housing and substance use outcomes.
A feasibility study to assess the effectiveness of safe dates for teen mothers.
Herrman, Judith W; Waterhouse, Julie K
2014-01-01
To determine the effectiveness of the adapted Safe Dates curriculum as an intervention for pregnant and/or parenting teens to prevent teen dating violence (TDV). This pre-/posttest, single-sample study provided a means to assess the effectiveness of an adapted Safe Dates curriculum for teen mothers. The adapted Safe Dates curriculum was implemented in three schools designed for the unique needs of teens who are pregnant and/or parenting. The final sample of 41 teen participants, with a mean age of 16.27, completed 80% of the curriculum and two of the three assessments. Most of the teens were pregnant during participation in the curriculum, and six had infants between age 1 and 3 months. The teen mothers completed the pretest, participated in the 10-session adapted Safe Dates curriculum, and completed the posttest at the end of the program and 1 month after program completion. The pre/posttest was adapted from the Safe Dates curriculum-specific evaluation instrument. Senior, undergraduate nursing students were trained in and implemented the curriculum. Participation in the adapted Safe Dates program yielded significant differences in the areas of responses to anger, gender stereotyping, awareness of resources for perpetrators and victims, and psychological violence perpetration. This adapted program may be effective in changing selected outcomes. The implementation of a larger scale, experimental/control group study may demonstrate the program's efficacy at reducing the incidence of TDV among teen mothers. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
Cost and Cost-Effectiveness of Students for Nutrition and eXercise (SNaX).
Ladapo, Joseph A; Bogart, Laura M; Klein, David J; Cowgill, Burton O; Uyeda, Kimberly; Binkle, David G; Stevens, Elizabeth R; Schuster, Mark A
2016-04-01
To examine the cost and cost-effectiveness of implementing Students for Nutrition and eXercise (SNaX), a 5-week middle school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Five intervention and 5 control middle schools (mean enrollment, 1520 students) from the Los Angeles Unified School District participated in a randomized controlled trial of SNaX. Acquisition costs for materials and time and wage data for employees involved in implementing the program were used to estimate fixed and variable costs. Cost-effectiveness was determined using the ratio of variable costs to program efficacy outcomes. The costs of implementing the program over 5 weeks were $5433.26 per school in fixed costs and $2.11 per student in variable costs, equaling a total cost of $8637.17 per school, or $0.23 per student per day. This investment yielded significant increases in the proportion of students served fruit and lunch and a significant decrease in the proportion of students buying snacks. The cost-effectiveness of the program, per student over 5 weeks, was $1.20 per additional fruit served during meals, $8.43 per additional full-priced lunch served, $2.11 per additional reduced-price/free lunch served, and $1.69 per reduction in snacks sold. SNaX demonstrated the feasibility and cost-effectiveness of a middle school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Its cost is modest and unlikely to be a significant barrier to adoption for many schools considering its implementation. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Cost and Cost-effectiveness of Students for Nutrition and Exercise (SNaX)
Ladapo, Joseph A.; Bogart, Laura M.; Klein, David J.; Cowgill, Burton O.; Uyeda, Kimberly; Binkle, David G.; Stevens, Elizabeth R.; Schuster, Mark A.
2015-01-01
Objective To examine the cost and cost-effectiveness of implementing Students for Nutrition and eXercise (SNaX), a 5-week middle-school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Methods Five intervention and five control middle schools (mean enrollment = 1,520 students) from the Los Angeles Unified School District participated in a randomized controlled trial of SNaX. Acquisition costs for materials and time and wage data for employees involved in implementing the program were used to estimate fixed and variable costs. Cost-effectiveness was determined using the ratio of variable costs to program efficacy outcomes. Results The costs of implementing the program over 5 weeks were $5,433.26 per school in fixed costs and $2.11 per student in variable costs, equaling a total cost of $8,637.17 per school, or $0.23 per student per day. This investment yielded significant increases in the proportion of students served fruit and lunch and a significant decrease in the proportion of students buying snacks. The cost-effectiveness of the program, per student over 5 weeks, was $1.20 per additional fruit served during meals, $8.43 per additional full-priced lunch served, $2.11 per additional reduced-price/free lunch served, and $1.69 per reduction in snacks sold. Conclusions SNaX demonstrated the feasibility and cost-effectiveness of a middle-school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education. Its cost is modest and unlikely to be a significant barrier to adoption for many schools considering its implementation. PMID:26427719
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-29
... well-implemented experimental or quasi-experimental studies that demonstrate the program has a sizeable... study or well- designed and well-implemented quasi-experimental study that supports the effectiveness of... moderate evidence: (1) At least one well-designed and well-implemented experimental or quasi-experimental...
ERIC Educational Resources Information Center
Sy, Angela; Glanz, Karen
2008-01-01
Background: The effectiveness of school-based tobacco use prevention programs depends on proper implementation. This study examined factors associated with teachers' implementation of a smoking prevention curriculum in a cluster randomized trial called Project SPLASH (Smoking Prevention Launch Among Students in Hawaii). Methods: A process…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-22
... Promulgation of Air Quality Implementation Plans; Rhode Island; Regional Haze AGENCY: Environmental Protection... Implementation Plan (SIP) that addresses regional haze for the first planning period from 2008 through 2018. The... geographic area (also referred to as the ``regional haze program''). DATES: Effective Date: This rule is...
ERIC Educational Resources Information Center
Lafasakis, Michael; Sturmey, Peter
2007-01-01
Behavioral skills training was used to teach 3 parents to implement discrete-trial teaching with their children with developmental disabilities. Parents learned to implement discrete-trial training, their skills generalized to novel programs, and the children's correct responding increased, suggesting that behavioral skills training is an…
Yu, Qing; Zhao, Geng-Ming; Hong, Xian-Lin; Lutz, Eric A; Guo, Jia-Gang
2013-11-28
Schistosomiasis japonica remains a significant public-health problem in China. This study evaluated cost-effectiveness of a comprehensive schistosomiasis control program (2003-2006). The comprehensive control program was implemented in Zhangjia and Jianwu (cases); while standard interventions continued in Koutou and Xiajia (controls). Incurred costs were documented and the schistosomiasis comprehensive impact index (SCI) and cost-effectiveness ratio (Comprehensive Control Program Cost/SCI) were applied. In 2003, prevalence of Schistosoma japonicum infection was 11.3% (Zhangjia), 6.7% (Jianwu), 6.5% (Koutou), and 8.0% (Xiajia). In 2006, the comprehensive control program in Zhangjia and Jianwu reduced infection to 1.6% and 0.6%, respectively; while Koutou and Xiajia had a schistosomiasis prevalence of 3.2% and 13.0%, respectively. The year-by-year SCIs in Zhangjia were 0.28, 105.25, and 47.58, with an overall increase in cost-effectiveness ratio of 374.9%-544.8%. The SCIs in Jianwu were 16.21, 52.95, and 149.58, with increase in cost-effectiveness of 226.7%-1,149.4%. Investment in Koutou and Xiajia remained static (US$10,000 unit cost). The comprehensive control program implemented in the two case villages reduced median prevalence of schistosomiasis 8.5-fold. Further, the cost effectiveness ratio demonstrated that the comprehensive control program was 170% (Zhangjia) and 922.7% (Jianwu) more cost-effective. This work clearly shows the improvements in both cost and disease prevention effectiveness that a comprehensive control program-approach has on schistosomiasis infection prevalence.
Yu, Qing; Zhao, Geng-Ming; Hong, Xian-Lin; Lutz, Eric A.; Guo, Jia-Gang
2013-01-01
Schistosomiasis japonica remains a significant public-health problem in China. This study evaluated cost-effectiveness of a comprehensive schistosomiasis control program (2003–2006). The comprehensive control program was implemented in Zhangjia and Jianwu (cases); while standard interventions continued in Koutou and Xiajia (controls). Incurred costs were documented and the schistosomiasis comprehensive impact index (SCI) and cost-effectiveness ratio (Comprehensive Control Program Cost/SCI) were applied. In 2003, prevalence of Schistosoma japonicum infection was 11.3% (Zhangjia), 6.7% (Jianwu), 6.5% (Koutou), and 8.0% (Xiajia). In 2006, the comprehensive control program in Zhangjia and Jianwu reduced infection to 1.6% and 0.6%, respectively; while Koutou and Xiajia had a schistosomiasis prevalence of 3.2% and 13.0%, respectively. The year-by-year SCIs in Zhangjia were 0.28, 105.25, and 47.58, with an overall increase in cost-effectiveness ratio of 374.9%–544.8%. The SCIs in Jianwu were 16.21, 52.95, and 149.58, with increase in cost-effectiveness of 226.7%–1,149.4%. Investment in Koutou and Xiajia remained static (US$10,000 unit cost). The comprehensive control program implemented in the two case villages reduced median prevalence of schistosomiasis 8.5-fold. Further, the cost effectiveness ratio demonstrated that the comprehensive control program was 170% (Zhangjia) and 922.7% (Jianwu) more cost-effective. This work clearly shows the improvements in both cost and disease prevention effectiveness that a comprehensive control program-approach has on schistosomiasis infection prevalence. PMID:24287861
Effects of an emotional intelligence program in variables related to the prevention of violence
Garaigordobil, Maite; Peña-Sarrionandia, Ainize
2015-01-01
In recent decades, numerous studies have shown a significant increase in violence during childhood and adolescence. These data suggest the importance of implementing programs to prevent and reduce violent behavior. The study aimed to design a program of emotional intelligence (EI) for adolescents and to assess its effects on variables related to violence prevention. The possible differential effect of the program on both genders was also examined. The sample comprised 148 adolescents aged from 13 to 16 years. The study used an experimental design with repeated pretest–posttest measures and control groups. To measure the variables, four assessment instruments were administered before and after the program, as well as in the follow-up phase (1 year after the conclusion of the intervention). The program consisted of 20 one-hour sessions. The pretest–posttest ANCOVAs showed that the program significantly increased: (1) EI (attention, clarity, emotional repair); (2) assertive cognitive social interaction strategies; (3) internal control of anger; and (4) the cognitive ability to analyze negative feelings. In the follow-up phase, the positive effects of the intervention were generally maintained and, moreover, the use of aggressive strategies as an interpersonal conflict-resolution technique was significantly reduced. Regarding the effect of the program on both genders, the change was very similar, but the boys increased assertive social interaction strategies, attention, and emotional clarity significantly more than the girls. The importance of implementing programs to promote socio-emotional development and prevent violence is discussed. PMID:26082743
Effects of an emotional intelligence program in variables related to the prevention of violence.
Garaigordobil, Maite; Peña-Sarrionandia, Ainize
2015-01-01
In recent decades, numerous studies have shown a significant increase in violence during childhood and adolescence. These data suggest the importance of implementing programs to prevent and reduce violent behavior. The study aimed to design a program of emotional intelligence (EI) for adolescents and to assess its effects on variables related to violence prevention. The possible differential effect of the program on both genders was also examined. The sample comprised 148 adolescents aged from 13 to 16 years. The study used an experimental design with repeated pretest-posttest measures and control groups. To measure the variables, four assessment instruments were administered before and after the program, as well as in the follow-up phase (1 year after the conclusion of the intervention). The program consisted of 20 one-hour sessions. The pretest-posttest ANCOVAs showed that the program significantly increased: (1) EI (attention, clarity, emotional repair); (2) assertive cognitive social interaction strategies; (3) internal control of anger; and (4) the cognitive ability to analyze negative feelings. In the follow-up phase, the positive effects of the intervention were generally maintained and, moreover, the use of aggressive strategies as an interpersonal conflict-resolution technique was significantly reduced. Regarding the effect of the program on both genders, the change was very similar, but the boys increased assertive social interaction strategies, attention, and emotional clarity significantly more than the girls. The importance of implementing programs to promote socio-emotional development and prevent violence is discussed.
2013-01-01
Background The concepts and standard practices of implementation, largely originating in developed countries, cannot necessarily be simply transferred into diverse cultural contexts. There has been relative inattention in the implementation science literature paid to the implementation of interventions targeting minority Indigenous populations within developed countries. This suggests that the implementation literature may be bypassing population groups within developed countries who suffer some of the greatest disadvantage. Within the context of Aboriginal Australian health improvement, this study considers the impact of political and cultural issues by examining the transfer and implementation of the Family Wellbeing program across 56 places over a 20-year period. Methods A theoretical model of program transfer was developed using constructivist-grounded theory methods. Data were generated by conducting in-depth interviews with 18 Aboriginal and non-Aboriginal research respondents who had been active in transferring the program. Data were categorised into higher order abstract concepts and the core impetus for and process of program transfer were identified. Results Organizations transferred the program by using it as a vehicle for supporting inside-out empowerment. The impetus to support inside-out empowerment referred to support for Aboriginal people's participation, responsibility for and control of their own affairs, and the associated ripple effects to family members, organizations, communities, and ultimately reconciliation with Australian society at large. Program transfer occurred through a multi-levelled process of embracing relatedness which included relatedness with self, others, and structural conditions; all three were necessary at both individual and organizational levels. Conclusions Similar to international implementation models, the model of supporting inside-out empowerment by embracing relatedness involved individuals, organizations, and interpersonal and inter-organizational networks. However, the model suggests that for minority Indigenous populations within developed countries, implementation approaches may require greater attention to the empowering nature of the intervention and its implementation, and multiple levels of relatedness by individuals and organizations with self, others, and the structural conditions. Key elements of the theoretical model provide a useful blueprint to inform the transfer of other empowerment programs to minority Indigenous and other disadvantaged populations on a case-by-case basis. PMID:24171867
McCalman, Janya R
2013-10-31
The concepts and standard practices of implementation, largely originating in developed countries, cannot necessarily be simply transferred into diverse cultural contexts. There has been relative inattention in the implementation science literature paid to the implementation of interventions targeting minority Indigenous populations within developed countries. This suggests that the implementation literature may be bypassing population groups within developed countries who suffer some of the greatest disadvantage. Within the context of Aboriginal Australian health improvement, this study considers the impact of political and cultural issues by examining the transfer and implementation of the Family Wellbeing program across 56 places over a 20-year period. A theoretical model of program transfer was developed using constructivist-grounded theory methods. Data were generated by conducting in-depth interviews with 18 Aboriginal and non-Aboriginal research respondents who had been active in transferring the program. Data were categorised into higher order abstract concepts and the core impetus for and process of program transfer were identified. Organizations transferred the program by using it as a vehicle for supporting inside-out empowerment. The impetus to support inside-out empowerment referred to support for Aboriginal people's participation, responsibility for and control of their own affairs, and the associated ripple effects to family members, organizations, communities, and ultimately reconciliation with Australian society at large. Program transfer occurred through a multi-levelled process of embracing relatedness which included relatedness with self, others, and structural conditions; all three were necessary at both individual and organizational levels. Similar to international implementation models, the model of supporting inside-out empowerment by embracing relatedness involved individuals, organizations, and interpersonal and inter-organizational networks. However, the model suggests that for minority Indigenous populations within developed countries, implementation approaches may require greater attention to the empowering nature of the intervention and its implementation, and multiple levels of relatedness by individuals and organizations with self, others, and the structural conditions. Key elements of the theoretical model provide a useful blueprint to inform the transfer of other empowerment programs to minority Indigenous and other disadvantaged populations on a case-by-case basis.
Developing an active implementation model for a chronic disease management program
Smidth, Margrethe; Christensen, Morten Bondo; Olesen, Frede; Vedsted, Peter
2013-01-01
Background Introduction and diffusion of new disease management programs in healthcare is usually slow, but active theory-driven implementation seems to outperform other implementation strategies. However, we have only scarce evidence on the feasibility and real effect of such strategies in complex primary care settings where municipalities, general practitioners and hospitals should work together. The Central Denmark Region recently implemented a disease management program for chronic obstructive pulmonary disease (COPD) which presented an opportunity to test an active implementation model against the usual implementation model. The aim of the present paper is to describe the development of an active implementation model using the Medical Research Council’s model for complex interventions and the Chronic Care Model. Methods We used the Medical Research Council’s five-stage model for developing complex interventions to design an implementation model for a disease management program for COPD. First, literature on implementing change in general practice was scrutinised and empirical knowledge was assessed for suitability. In phase I, the intervention was developed; and in phases II and III, it was tested in a block- and cluster-randomised study. In phase IV, we evaluated the feasibility for others to use our active implementation model. Results The Chronic Care Model was identified as a model for designing efficient implementation elements. These elements were combined into a multifaceted intervention, and a timeline for the trial in a randomised study was decided upon in accordance with the five stages in the Medical Research Council’s model; this was captured in a PaTPlot, which allowed us to focus on the structure and the timing of the intervention. The implementation strategies identified as efficient were use of the Breakthrough Series, academic detailing, provision of patient material and meetings between providers. The active implementation model was tested in a randomised trial (results reported elsewhere). Conclusion The combination of the theoretical model for complex interventions and the Chronic Care Model and the chosen specific implementation strategies proved feasible for a practice-based active implementation model for a chronic-disease-management-program for COPD. Using the Medical Research Council’s model added transparency to the design phase which further facilitated the process of implementing the program. Trial registration: http://www.clinicaltrials.gov/(NCT01228708). PMID:23882169
The Effectiveness of LEAD Program Elements.
ERIC Educational Resources Information Center
Carver, Fred D.
This paper describes the Leadership Enhancement and Development (LEAD) preparation program implemented in Gwinnett County School District, Georgia, and designed to prepare participants for assistant principalships in the school district. Those selected for the program completed year-long coursework and a 12-week internship. This report presents…
Toward More Effective Drug Prevention Programs.
ERIC Educational Resources Information Center
Ellickson, Phyllis L.; Robyn, Abby E.
This report discusses guidelines for developing drug prevention programs. It reflects knowledge acquired in developing and implementing Project ALERT, an adolescent drug prevention program currently being evaluated with more than 6,500 students in California and Oregon schools. The guidelines discussed are based on information about the…
Drugs and Gender: A Women's Recovery Program.
ERIC Educational Resources Information Center
Levers, Lisa Lopez; Hawes, Anderson R.
1990-01-01
Describes a drug treatment program designed and implemented for women which takes into account gender differences. Claims by paying attention to the actual life worlds and needs of women, the program effectively modified the service delivery system to accommodate these women and facilitate their treatment. (ABL)
Report #12-P-0843, September 21, 2012. EPA effectively established and adhered to competitive criteria that resulted in the selection of job training proposals that addressed the broad goals of the Environmental Job Training program.
Interviewing Key Informants: Strategic Planning for a Global Public Health Management Program
ERIC Educational Resources Information Center
Kun, Karen E.; Kassim, Anisa; Howze, Elizabeth; MacDonald, Goldie
2013-01-01
The Centers for Disease Control and Prevention's Sustainable Management Development Program (SMDP) partners with low- and middle-resource countries to develop management capacity so that effective global public health programs can be implemented and better health outcomes can be achieved. The program's impact however, was variable. Hence, there…
Finding Funding: A Guide to Federal Sources for Youth Programs. Finding Funding Series
ERIC Educational Resources Information Center
Dobbins-Harper, Dionne; Bhat, Soumya
2007-01-01
This publication is part of a series of tools and resources on financing and sustaining youth programming. These tools and resources are intended to help policymakers, program developers, and community leaders develop innovative strategies for implementing, financing, and sustaining effective programs and policies. This guide outlines strategies…
Positioning the Co-op Program for Maximum Marketing Effectiveness.
ERIC Educational Resources Information Center
Harris, Ronald R.
1983-01-01
Examines the concept of positioning, which is the way that individuals perceive and are made aware of a program and believe in its benefit to them and its application to cooperative education programs. Includes a five-step plan for assessing the position of cooperative programs and six ways to implement a positioning strategy. (JOW)
Implementing Intervention Movement Programs for Kindergarten Children
ERIC Educational Resources Information Center
Deli, Eleni; Bakle, Iliana; Zachopoulou, Evridiki
2006-01-01
The reported study aimed to identify the effects of two 10-week intervention programs on fundamental locomotor skill performance in kindergarten children. Seventy-five children with mean age 5.4 plus or minus 0.5 years participated. Experimental Group A followed a movement program, experimental Group B followed a music and movement program, and…
Models for Integrating Human Services into the School.
ERIC Educational Resources Information Center
Dolan, Lawrence J.
This report examines five models of school-based integrated human service programs to evaluate the effects of the programs in light of the growing support for and implementation of these programs. The study examined the following programs: (1) school-based health clinics in Baltimore (Maryland); (2) Success for All (an elementary school-level…
Evaluation of a Behavior Management Training Program for Nursing Home Caregivers.
ERIC Educational Resources Information Center
Marsiske, Michael; And Others
This study examined the effectiveness of a new skills training program designed to increase nurse aides' knowledge of behavior management. The training program, designed as five 90-minute group learning modules, was implemented in two Western Pennsylvania nursing homes over a 5-month period. Topics covered within the training program included…
Laur, Celia; Keller, Heather H
2015-01-01
Prospective use of knowledge translation and implementation science frameworks can increase the likelihood of meaningful improvements in health care practices. An example of this creation and application of knowledge is the series of studies conducted by and with the Canadian Malnutrition Task Force (CMTF). Following a cohort study and synthesis of evidence regarding best practice for identification, treatment, and prevention of malnutrition in hospitals, CMTF created an evidence-informed, consensus-based pathway for nutritional care in hospitals. The purpose of this paper is to detail the steps taken in this research program, through four studies, as an example of the knowledge-to-action (KTA) process. The KTA process includes knowledge creation and action cycles. The steps of the action cycle within this program of research are iterative, and up to this point have been informed by three studies, with a fourth underway. The first study identified the magnitude of the malnutrition problem upon admission to hospital and how it is undetected and undertreated (study 1). Knowledge creation resulted in an evidence-based pathway established to address care gaps (study 2) and the development of monitoring tools (study 3). The study was then adapted to local context: focus groups validated face validate the evidence-based pathway; during the final phase, study site implementation teams will continue to adapt the pathway (studies 2 and 4). Barriers to implementation were also assessed; focus groups and interviews were conducted to inform the pathway implementation (studies 1, 2, and 4). In the next step, specific interventions were selected, tailored, and implemented. In the final study in this research program, plan-do-study-act cycles will be used to make changes and to implement the pathway (study 4). To monitor knowledge use and to evaluate outcomes, audits, staff surveys, patient outcomes, etc will be used to record process evaluations (studies 3 and 4). Finally, a sustainability plan will be incorporated into the final study of the program (study 4) to sustain knowledge use. Use of frameworks can increase the likelihood of meaningful and sustainable improvements in health care practice. The example of this program of research demonstrates how existing evidence has been used to identify, create, and adapt knowledge, and how multidisciplinary teams have been used to effect changes in the hospital setting. Effective implementation is essential in nutritional health care, and this multidisciplinary program of research provides an example of how the KTA process can facilitate implementation and promote sustainability.
Considerations for Community-Based mHealth Initiatives: Insights From Three Beacon Communities
2013-01-01
Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs. PMID:24128406
Munsawaengsub, Chokchai; Yimklib, Somkid; Nanthamongkolchai, Sutham; Apinanthavech, Suporn
2009-12-01
To study the effect of promoting self-esteem by participatory learning program on emotional intelligence among early adolescents. The quasi-experimental study was conducted in grade 9 students from two schools in Bangbuathong district, Nonthaburi province. Each experimental and comparative group consisted of 34 students with the lowest score of emotional intelligence. The instruments were questionnaires, Program to Develop Emotional Intelligence and Handbook of Emotional Intelligence Development. The experimental group attended 8 participatory learning activities in 4 weeks to Develop Emotional Intelligence while the comparative group received the handbook for self study. Assessment the effectiveness of program was done by pre-test and post-test immediately and 4 weeks apart concerning the emotional intelligence. Implementation and evaluation was done during May 24-August 12, 2005. Data were analyzed by frequency, percentage, mean, standard deviation, Chi-square, independent sample t-test and paired sample t-test. Before program implementation, both groups had no statistical difference in mean score of emotional intelligence. After intervention, the experimental group had higher mean score of emotional intelligence both immediately and 4 weeks later with statistical significant (p = 0.001 and < 0.001). At 4 weeks after experiment, the mean score in experimental group was higher than the mean score at immediate after experiment with statistical significance (p < 0.001). The program to promote self-esteem by participatory learning process could enhance the emotional intelligence in early-adolescent. This program could be modified and implemented for early adolescent in the community.
Singla, Daisy R; Kumbakumba, Elias
2015-12-01
A randomised cluster effectiveness trial of a parenting intervention in rural Uganda found benefits to child development among children 12-36 months, relevant parenting practices related to stimulation, hygiene and diet, and prevented the worsening of mothers' depressive symptoms. An examination of underlying implementation processes allows researchers and program developers to determine whether the program was implemented as intended and highlight barriers and facilitators that may influence replication and scale-up. The objectives of this study were to describe and critically examine (a) perceived barriers and facilitators related to implementation processes of intervention content, training and supervision and delivery from the perspectives of delivery agents and supervisors; (b) perceived barriers and facilitators related to enactment of practices from the perspective of intervention mothers participating in the parenting program; and c) whether the program was implemented as intended. Semi-structured interviews were conducted at midline with peer delivery agents (n = 12) and intervention mothers (n = 31) and at endline with supervisors (n = 4). Content analysis was used to analyze qualitative data in terms of barriers and facilitators of intervention content, training and supervision, delivery and enactment. Additionally, mothers' recall and enactment of practices were coded and analyzed statistically. Monitoring of group sessions and home visits were examined to reveal whether the program was implemented as intended. Among the program's five key messages, 'love and respect' targeting maternal psychological well-being was the most practiced by mothers, easiest to implement by delivery agents, and mothers reported the most internal facilitators for this message. A detailed manual and structured monitoring forms were perceived to facilitate training, intervention delivery, and supervision. Interactive and active strategies based on social-cognitive learning theory were reported as facilitators to intervention delivery. Only program attendance, but not barriers, facilitators or message recall, was significantly positively related to message enactment. Monitoring of group sessions and home visits showed that the program was largely implemented as intended. This implementation assessment revealed a number of important barriers and facilitators from the perspectives of delivery agents, supervisors and program participants. The methods and results are useful to examining and informing the content, delivery, and scaling up of the current program as well as future mother-child interventions in LMIC settings. Copyright © 2015 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Mallory-Knight, Gwendolyn
2013-01-01
Implementing effective reading instruction is critical for schools. This study examined the effects of the Corrective Reading (CR) program on junior high students with learning disabilities (LD) and students with learning disabilities and attention deficit/hyperactivity disorder (LD/ADHD). The research questions were: What differences exist…
Eliopoulos, Charlotte
2013-01-01
A growing number of nursing homes are implementing culture change programming to create a more homelike environment in which residents and direct care staff are empowered with greater participation in care activities. Although nursing homes that have adopted culture change practices have brought about positive transformation in their settings that have improved quality of care and life, as well as increased resident and staff satisfaction, they represent a minority of all nursing homes. Nursing homes that serve primarily a Medicaid population without supplemental sources of funding have been limited in the resources to support such change processes. The purpose of this project was to gain insight into effective strategies to provide culture change and quality improvement programming to low-performing, under-resourced nursing homes that represent the population of nursing homes least likely to have implemented this programming. Factors that interfered with transformation were identified and insights were gained into factors that need to be considered before transformational processes can be initiated. Effective educational strategies and processes that facilitate change in these types of nursing homes were identified. Despite limitations to the study, there was evidence that the experiences and findings can be of value to other low-performing, under-resourced nursing homes. Ongoing clinical work and research are needed to refine the implementation process and increase the ability to help these settings utilize resources and implement high quality cost effective care to nursing home residents. Copyright © 2013 Mosby, Inc. All rights reserved.
Implementation of HIV and Tuberculosis Diagnostics: The Importance of Context
Dominique, Joyelle K.; Ortiz-Osorno, Alberto A.; Fitzgibbon, Joseph; Gnanashanmugam, Devasena; Gilpin, Christopher; Tucker, Timothy; Peel, Sheila; Peter, Trevor; Kim, Peter; Smith, Steven
2015-01-01
Background. Novel diagnostics have been widely applied across human immunodeficiency virus (HIV) and tuberculosis prevention and treatment programs. To achieve the greatest impact, HIV and tuberculosis diagnostic programs must carefully plan and implement within the context of a specific healthcare system and the laboratory capacity. Methods. A workshop was convened in Cape Town in September 2014. Participants included experts from laboratory and clinical practices, officials from ministries of health, and representatives from industry. Results. The article summarizes best practices, challenges, and lessons learned from implementation experiences across sub-Saharan Africa for (1) building laboratory programs within the context of a healthcare system; (2) utilizing experience of clinicians and healthcare partners in planning and implementing the right diagnostic; and (3) evaluating the effects of new diagnostics on the healthcare system and on patient health outcomes. Conclusions. The successful implementation of HIV and tuberculosis diagnostics in resource-limited settings relies on careful consideration of each specific context. PMID:26409272
Effective Management and Operation of Graduate Programs in Colleges of Pharmacy
ERIC Educational Resources Information Center
Farnsworth, Norman R.
1977-01-01
Management strategy and policy adapted at the University of Illinois at the Medical Center are described in terms of: faculty teaching vs. research time; faculty effectiveness and productivity; committee meetings; morale; departmental funds for research; expectations from graduate students; student recruitment; and program implementation. (LBH)
Effective Teacher Retention Bonuses: Evidence From Tennessee
ERIC Educational Resources Information Center
Springer, Matthew G.; Swain, Walker A.; Rodriguez, Luis A.
2016-01-01
We report findings from a quasi-experimental evaluation of the recently implemented US$5,000 retention bonus program for effective teachers in Tennessee's Priority Schools. We estimate the impact of the program on teacher retention using a fuzzy regression discontinuity design by exploiting a discontinuity in the probability of treatment…