Community-based Evaluation Research Articles

Local knowledge, uses, and conservation status of the African golden cat Caracal aurata in central Cameroon

ABSTRACT The African golden cat Caracal aurata is one of Africa’s least known felids, and little is understood about local people’s knowledge and uses of this cat. Questionnaires were completed with 454 people from 15 villages near Mpem et Djim National Park and the Council Forest of Yoko to assess local knowledge, uses, and perceived conservation status of this felid. Only 35% of respondents recognized the species, and older people were more likely to do so. Locals stated that the golden cat population is currently low, that the species is considered a totemic animal, a sign of power and grandeur, and that their pelts are an ornamental asset. Hunting with guns and snares was stated to be the greatest threat to golden cats. Locals urged restricting hunting to protect the species, and both chicken and pig farming were suggested as alternatives to hunting. Our study is the first community-based evaluation of the golden cat in Cameroon.

E-Eval: Learnings from a Community-Based Evaluation Capacity Building Initiative

Evaluation capacity building (ECB) initiatives are important for supporting social-serving organizations in using evaluation to demonstrate and improve the effectiveness of their programs. In this practice note, the authors present their experience developing and implementing E-Eval, a responsive community-based course for building evaluation capacity in Alberta’s mentoring sector. In order to support others in taking a similar approach to building evaluation capacity in the social-serving sector, they describe how the concept of E-Eval emerged, outline its design and implementation processes, and discuss their learnings and their relevance for other professionals implementing or researching community-based ECB.

Community-Based Evaluation When Localizing Sustainable Development Goals

The purpose of this practice note is to demonstrate how a community-based approach to evaluation can be used to support the evaluations of the United Nation’s Sustainable Development Goals in local community settings. The authors argue that using a community-based evaluation approach that is stakeholder-driven, participatory, and action-oriented is one mechanism to address this challenge. They illustrate the utility of such an evaluation approach by identifying their key learnings through a national capacity-building project.

A Place-Based Feminist Approach to Decolonizing Energy Planning: Developing a Community-Based Evaluation Tool for Molokaʻi

A Place-Based Feminist Approach to Decolonizing Energy Planning: Developing a Community-Based Evaluation Tool for Molokaʻi

Food insecurity and its consequences in indigenous children and youth in Canada.

Food insecurity (FI) is at a crisis level in some Indigenous communities and impacts many of the half million First Nations Inuit and Métis (FNIM) children across Canada, particularly in isolated northern communities. This can lead to malnutrition and can have significant impacts on the physical, intellectual, emotional and social development of a child, often with lasting effects across the life course. This is a narrative review article with extensive search of the medical literature with input from the FNIM National organizations. The primary cause of FI is an imbalance between the high price of food relative to household income, where poverty is a driving factor. The cost and lack of availability to healthy foods has resulted in a transition to unhealthy market foods. Food security programs need to be prioritized, multi-faceted and multi-tiered within a framework of food sovereignty. Translational science, research, to practice is also important. The use of successful Indigenous based models of FI, towards food sovereignty using self-determination, Indigenous Knowledge, strength-based models, and ancestral sustainability are critical. Continued community-based evaluation of FI towards sustainable healthy food programs are important for communities to initiate track, evaluate, and grow robust community-based programs to counter-balance FI. Continued scientific research in the fields of FI, food sovereignty, and their relationship to co-occurring conditions related to healthy eating and beverage consumption are vastly important to the health of Indigenous Peoples. These are all part of many Indigenous connection to the earth, through food source, the maintenance of health through ancestral ways of living, set in the premise of looking forward multiple generations towards the continued resiliency through food, diet, relationship, and sovereignty. Food Security is a human right and needs to be urgently addressed for Indigenous children in Canada.

Procedural and participatory ethics: community-based evaluation in practice

This article argues that it can be beneficial for institution-based, procedural ethics review of evaluation design in the planning stage to be followed by community-based oversight of ethical issues in the field. Deferring to an institutional review board (IRB) for ethical assessment when a project is underway can be impractical for community-based projects that are designed to be responsive to local needs and interests, especially when community leaders expect to have a meaningful say in determining what is the right thing to do. This article discusses a 2-year project in New Zealand, where community leaders and the project funder formed a project steering group to, among other things, provide ethical oversight. Ethical issues that arose during the project and the steering group’s role in considering the most suitable response are discussed and linked to literature about participatory ethics.

Community-based Evaluation of the Relationship Between Hoarding Symptoms and Interconnectedness with Items

Community-based Evaluation of the Relationship Between Hoarding Symptoms and Interconnectedness with Items

Xenobiotic-induced ribosomal stress compromises dysbiotic gut barrier aging: A one health perspective

Upon exposure to internal or environmental insults, ribosomes stand sentinel. In particular, stress-driven dysregulation of ribosomal homeostasis is a potent trigger of adverse outcomes in mammalians. The present study assessed whether the ribosomal insult affects the aging process via the regulation of sentinel organs such as the gut. Analyses of the human aging dataset demonstrated that elevated features of ribosomal stress are inversely linked to barrier maintenance biomarkers during the aging process. Ribosome-insulted worms displayed reduced lifespan, which was associated with the disruption of gut barriers. Mechanistically, ribosomal stress-activated Sek-1/p38 signaling, a central platform of ribosomal stress responses, counteracted the gut barrier deterioration through the maintenance of the gut barrier, which was consistent with the results in a murine insult model. However, since the gut-protective p38 signaling was attenuated with aging, the ribosomal stress-induced distress was exacerbated in the gut epithelia and mucosa of the aged animals, subsequently leading to increased bacterial exposure. Moreover, the bacterial community-based evaluation predicted concomitant increases in the abundance of mucosal sugar utilizers and mucin metabolic enzymes in response to ribosomal insult in the aged host. All of the present evidence on ribosomal insulting against the gut barrier integrity from worms to mammals provides new insights into organelle-associated translational modulation of biological longevity in a one health perspective.

Abstract 15644: Health-Related Quality of Life in Survivors of Cardiac Arrest: A Community-Based, Age-Stratified Analysis

Introduction: Health-related quality of life (HRQoL) is affected after out-of-hospital cardiac arrest (OHCA), but HRQoL scores in OHCA survivors are largely reported as a homogenous group. We performed a community-based evaluation of HRQoL scores in OHCA survivors and report the results stratified by age. Methods: We captured all residents of Multnomah Co., OR, and Ventura Co., CA who survived an OHCA during 2015-2021. We consented 197 survivors into our study and asked survivors to complete the Short-Form-36 Health Survey Version 1 (SF-36) to assess HRQoL at the time of the interview. The median time from OHCA to SF-36 interview date was 10 months. Scores for the 8 health domains of the SF-36 were calculated, and we used an independent sample t-test to compare the continuous scores of OHCA survivors to age-and-sex-standardized scores in the general population. Results: Of the 185 adult survivors who completed the SF-36 interview data (94% of those consented), the mean (SD) age was 60 (15) years and 58% were male. Overall, survivors had lower physical (p=0.0002) and emotional (p=0.01) health scores and lower social function (p=0.05) compared to the general population. We observed several age-domain interactions and split our sample into 3 age categories to explore HRQoL by age. Younger individuals (age 18-44, n=23) had similar HRQoL compared to the same ages in the general population. Older individuals (age 65+, n=78) also experienced similar HRQoL but reported better general health compared to the general population. Middle-aged survivors (age 45-64, n=84) reported lower physical function (p=0.05), physical problems (p=0.0009), emotional health (p=0.04), and social function (p=0.05) scores compared to the general population (Figure). Conclusion: HRQoL scores in survivors of OHCA were affected by age and were observed to be lowest in the middle-age subgroup. Targeted interventions in middle-aged survivors may have the greatest impact on improved HRQoL following OHCA.

Dosing for Personalized Prophylaxis in Hemophilia A Highly Varies on the Underlying Population Pharmacokinetic Models.

Model-informed personalized prophylaxis with factor VIII (FVIII) replacement therapy aimed at higher trough levels is becoming indispensable for patients with severe hemophilia A. This study aimed to identify the most suitable population pharmacokinetic (PK) models for personalized prophylaxis using various FVIII products and 2 clinical assays and to implement the most suitable one in open-access software. Twelve published population PK models were systematically compared to predict the time above target (TaT) for a reference dosing occasion. External validation was performed using a 5-point PK data from 39 adult patients with hemophilia A with FVIII measured by chromogenic substrate (CSA) and 1-stage assays (OSAs) using NONMEM under 3 different conditions: a priori (with all FVIII samples blinded), a posteriori (with 1 trough sample), and general model fit (with all FVIII samples including the reference dosing occasion provided). On average, the baseline covariate models overpredicted TaT (a priori; bias -3.8 hours to 49.6 hours). When additionally including 1 previous trough FVIII sample before the reference dosing occasion (a posteriori), only 50% of the models improved in bias (-1.0 hours to 36.5 hours) and imprecision (22.4 hours and 60.7 hours). Using all the time points (general model fit), the models accurately predicted (individual TaT less than ±12 hours compared with the reference) 62%-90% and 33%-74% of the patients using CSA and OSA data, respectively. Across all scenarios, predictions using CSA data were more accurate than those using the OSA data. One model performed best across the population (bias: -3.8 hours a priori, -1.0 hours a posteriori , and 0.6 hours general model fit ) and acceptably predicted 44% (a priori) to 90% ( general model fit ) of the patients. To allow the community-based evaluation of patient-individual FVIII dosing, this model was implemented in the open-access model-informed precision dosing software "TDMx."

Observation of Malaria Treatment with Dihydroartemisinin-Piperaquine Combination at Primary Health Care

Dihydroartemisinin-Piperaquine (DHP) combination is the first-line treatment for uncomplicated malaria in Indonesia and has been used since 2010. This study was conducted to determine the efficacy of DHP combination for uncomplicated malaria treatment in a community-based evaluation. Recruitment was done by active or passive case detection. All uncomplicated malaria patients were treated with DHP once a day, for 3 days, administered orally (as is done in primary health care). Patients were followed up until day 28 post-treatment. The primary end point was a 28-day cure rate. In this study, 484 subjects were screened through active and passive cases detection. A total of 45 subjects infected by P. vivax and 2 subjects infected by P. falciparum agreed to participate through written informed consent. There was no difference between clinical malaria and asymptomatic malaria in all analyzed characteristics. One patient had a D3 parasite density greater than 25% D0, although no parasites were found on the following day (D4). This study found 46 patients (97.9%) who had adequate clinical and parasitological responses. No adverse event was reported during the follow up of this study. DHP was effective, safe, and well tolerated in the treatment of uncomplicated malaria at primary health care.

Antibiotic Exposure Aggravates Bacteroides-Linked Uremic Toxicity in the Gut-Kidney Axis.

Epidemiological and experimental evidence has implicated a potent link between antibiotic exposure and susceptibility to various diseases. Clinically, antibiotic treatment during platinum chemotherapy is associated with poor prognosis in patients with malignancy. In the present study, mucosal antibiotic exposure was assessed for its impact on renal distress as a sequela of platinum-based chemotherapy. Clinical transcriptome dataset-based evaluations demonstrated that levels of dysbiosis-responsive genes were elevated during renal distress, indicating pathological communications between gut and kidney. Experimentally, mucosal exposure to streptomycin aggravated platinum-induced renal tubular lesions in a mouse model. Moreover, antibiotic-induced dysbiosis increased susceptibility to gut mucosal inflammation, epithelial disruption, and bacterial exposure in response to cisplatin treatment. Further investigation of the luminal microbes indicated that antibiotic-induced dysbiosis promoted the dominance of Bacteroides species. Moreover, the functional assessment of dysbiotic microbiota predicted tryptophan metabolic pathways. In particular, dysbiosis-responsive Bacteroides acidifaciens was associated with the production of the uremic toxin indoxyl sulfate and renal injuries. The results of this study including bacterial community-based evaluations provide new predictive insights into the interorgan communications and interventions against dysbiosis-associated disorders.

A community-based evaluation of disability resources and inclusion practices in rural Botswana

BackgroundCommunity-based approaches to enhance the inclusion of persons with disabilities have proven effective; however, not much is known about cultural and contextual factors that influence the capacity of policy implementation and inclusion practices in rural Botswana. ObjectiveThe study evaluated local disability education and health resources in rural Botswana to develop a deeper understanding of cultural and contextual factors impacting inclusion practices. MethodResearchers used socio-demographic and qualitative research methods to conduct a comprehensive community-based needs assessment. Sampling techniques included maximum variation and snowball sampling. Thirty-two individuals participated in the study. Data were collected between June and August of 2019 through participant observation, in-depth interviews, and focus group discussions. An inductive thematic analysis was conducted by examining participants’ attitudes, perceptions, and experiences of community members with disabilities. ResultsFour primary themes emerged identifying factors that affect people living with disabilities in the rural community: (1) culture of vulnerability, (2) determinants of disability, (3) educational resources for persons with disabilities, and (4) effective systems integration. Findings suggested that while policies associated with disability at the government level are in place, disparities among rural communities’ hindered local responses to managing the needs of persons with disabilities. ConclusionsSocial, environmental, and physical barriers prevent the full implementation of policies that advocate for the rights of persons with disabilities in Botswana's rural settings. Increasing awareness of cultural and contextual factors may help community stakeholders facilitate inclusive practices in Botswana.

Implementing a Community-Based Collaborative Project During the COVID-19 Pandemic: A Process Evaluation

In-Home Supportive Services (IHSS) caregivers are critical linchpins in our long-term care system, but little research exists to examine the strategies for enhancing their role working in the homes of persons living with dementia (PLWD). The aim of the IHSS+ Alzheimer’s Disease and Related Dementias Training Project (IHSS+ ADRD Training Project) is to implement a competency-based dementia training program for 600 IHSS caregivers and their consumers; and evaluate the training program’s impact on caregiving, long-term services and supports, and health systems. This project is a partnership between the University of California, San Francisco, Institute for Health & Aging; Center for Caregiver Advancement, a nonprofit organization founded by home care workers; and Alameda Alliance for Health, a non-profit managed care plan created by and for residents of Alameda County, California. The research design and funding of the project was established just prior to the COVID-19 pandemic. As the pandemic evolved, the IHSS+ ADRD Training Project underwent many revisions and pivoted to remote strategies to ensure progress could be made toward the aims. This poster describes a process evaluation of how various challenges were addressed and subsequent changes were made to the methodology. Using a community-based participatory research and program evaluation hybrid model, this project remained nimble, configuring an online dementia training program and evaluation methods that accommodated safety needs of community partners. Benefits and limitations of implementing the IHSS+ ADRD Training Project, using remote strategies, to ensure IHSS caregivers and their consumers could continue receiving education and support, are highlighted.

The challenges of assessing sample representativeness within community-based evaluations of parenting programmes delivered in England and Ireland.

The findings from evaluations of parenting programmes can help inform policy and practice decisions, including how best to allocate scarce resources designed to support families. However, studies often fail to consider the extent to which the findings can be generalised to other settings or populations. One, yet unexplored solution, is to compare study findings and large-scale data sets including publicly available population data. The aims of this study were to assess the feasibility of assessing sample representativeness using publicly available data and to identify the challenges involved in considering the generalisability of study findings. Sociodemographic data from two community-based evaluations of parenting programmes conducted in England and Ireland between 2015 and 2018 were used in the study (N=395 parent-infant dyads). The results indicated some differences between the trial samples and the wider population. However, it is difficult to reach definitive conclusions about these findings due to the limitations associated with using the comparative data sets. Our study revealed three key challenges, including: (1) how best to define and conceptualise representativeness; (2) the availability of comparative data sets; and (3) the quality of the available data. Our study suggests that there is a need for up-to-date, good-quality comparative data sets to allow for the assessment of representativeness. Further work is required to identify parameters for making claims about representativeness, specifically regarding the acceptable level of difference between the target population and the study sample. This is the first study to explore the feasibility of using publicly available population data in two jurisdictions, for the purpose of making judgements about the representativeness of the findings from parent programmes. It is hoped that our results will encourage further investigation around the reporting of trial external validity to enable effective decision-making at policy and practice level.

Opportunity Reboot: A Community-Based Evaluation Focused on Opportunity Youth.

The number of young people living in the margins of society reflects one of the most pressing social inequities of our time. Opportunity youth often face many complex challenges perpetrated by a range of systemic issues. These trajectories can be positively disrupted by surrounding youth with a cohesive web of relational and instrumental supports and spaces where their strengths and potential are seen. Opportunity Reboot, a technical assistance and program enhancement model, was developed to leverage the existing capacity and strengths of community programs to more effectively create pathways to school, career, and life success for opportunity youth. The impact of Opportunity Reboot was tested using a single-group, non-experimental design and a quasi-experimental design with propensity score matching. Findings established associations between opportunity youths' experiences of three core Opportunity Reboot features and growth in select positive identity, social-emotional competencies, and skills for systems navigation outcomes. Opportunity Reboot youth were also more likely, on average, than comparison youth to be employed in the four quarters after endline data collection; this finding was even stronger when comparing youth of color in the Opportunity Reboot and comparison groups. This evaluation strengthens the evidence that program enhancement models like Opportunity Reboot hold promise for positively disrupting the lives of opportunity youth.

Invited Perspective: Oil and Gas Development and Adverse Birth Outcomes: What More Do We Need to Know?

Invited Perspective: Oil and Gas Development and Adverse Birth Outcomes: What More Do We Need to Know?

Patterns and Predictors of Different Youth Responses to Attachment-Based Parent Intervention

ABSTRACT Objective Few studies have evaluated attachment-based parent interventions for pre-teens and teens, and in particular, differential adolescent trajectories of response. This study examined distinct patterns, and multi-level predictors, of intervention response among youth with serious behavioral and mental health problems whose parents participated in Connect, an attachment- and trauma-informed parent program. Method Participants included 682 parents (M age = 42.83, 86% mothers) and 487 youth (M age = 13.95, 53% female, 28.1% ethnic minority) enrolled in a community-based evaluation of Connect. Parents and youth reported on youth externalizing and internalizing problems (EXT and INT) at six time points from baseline through 18-months post-intervention. Demographic and youth and family level predictors were assessed at baseline. Results Growth mixture modeling revealed three distinct trajectory classes in both the parent and youth models based on different patterns of co-occurring EXT and INT and degree of improvement over time. Youth with severe EXT showed the largest and fastest improvement, and, interestingly, were characterized by higher callous-unemotional traits and risk-taking at program entry. Youth with comorbid EXT/INT demonstrated a partial or moderate response to intervention in the parent and youth model, respectively, and were characterized by more attachment anxiety at baseline. Most youth showed relatively moderate/low levels of EXT/INT at baseline which gradually improved. Caregiver strain also predicted trajectory classes. Conclusions These results have significance for tailoring and personalizing interventions for high-risk youth and provide new understanding regarding the profiles of subgroups of youth who show different responses to an attachment-based parent intervention.

A Latent Class Analysis of Prevention Approaches Used to Reduce Community-Level Prescription Drug Misuse in Adolescents and Young Adults.

The Substance Abuse and Mental Health Services Administration's Strategic Prevention Framework Partnerships for Success (PFS) program supports community-based organizations (CBOs) across the United States in implementing evidence-based prevention interventions to reduce substance use in adolescents and young adults. Little attention has been paid to how CBOs combine interventions to create comprehensive community-specific prevention approaches, or whether different approaches achieve similar community-level effects on prescription drug misuse (PDM). We used PFS evaluation data to address these gaps. Over 200 CBOs reported their prevention intervention characteristics, including strategy type (e.g., prevention education, environmental strategies) and number of unique interventions. Evaluation staff coded whether each intervention was an evidence-based program, practice, or policy (EBPPP). Latent Class Analysis of seven characteristics (use of each of five strategy types, use of one or more EBPPP, and number of interventions implemented) identified six prevention approach profiles: High Implementation EBPPP, Media Campaigns, Environmental EBPPP, High Implementation Non-EBPPP, Prevention Education, and Other Information Dissemination. All approaches except Media Campaigns and Other Information Dissemination were associated with significant reductions in community-level PDM. These approaches may need to be paired with other, more direct, prevention activities to effectively reduce PDM at the community level. However, similar rates of change in PDM across all 6 prevention approaches suggests only weak evidence favoring use of the other four approaches. Community-based evaluations that account for variability in implemented prevention approaches may provide a more nuanced understanding of community-level effects. Additional work is needed to help CBOs identify the most appropriate approach to use based on their target communities' characteristics and resources.

3137 fetuses in 33 years: What we have learned from the Wisconsin stillbirth service program.

The Wisconsin Stillbirth Service Program (WiSSP) provided expert review by a dysmorphologist for community-acquired data on 3137 fetal deaths between 1983 and 2017. Intrinsic fetal causes were consistently identified in about 25% while placental and maternal causes were recognized with increasing frequency as attention was shifted from a primarily fetal to a multifocal approach. Identification of causes increased from 40% to 78% and in about half of cases results of the review altered recurrence risk and/or future pregnancy management. Banked data from WiSSP formed the basis of 24 publications, more than half of which have a genetic counselor and/or summer premedical student intern as an author. The earlier publications emphasized validation of the concept of community-based evaluation with central review, the utility of various parts of the WiSSP protocol, the similarity of second-trimester miscarriages <20 weeks to later stillbirths with respect to causes identified and recurrence risks, and the potential for results of etiologic evaluation to influence future prenatal care. The most important recurrent theme, however, was the interaction of intrinsic fetal, placental, and maternal factors in contributing to fetal demise. This implies that, at least in developed nations with available obstetric care, reduction in stillbirth will require careful attention to the myriad of factors contributing to fetal, placental, and maternal well-being.