Mixed-methods Evaluation Approach Research Articles

Sociotechnical feasibility of natural language processing-driven tools in clinical trial eligibility prescreening for Alzheimer's disease and related dementias.

Alzheimer's disease and related dementias (ADRD) affect over 55 million globally. Current clinical trials suffer from low recruitment rates, a challenge potentially addressable via natural language processing (NLP) technologies for researchers to effectively identify eligible clinical trial participants. This study investigates the sociotechnical feasibility of NLP-driven tools for ADRD research prescreening and analyzes the tools' cognitive complexity's effect on usability to identify cognitive support strategies. A randomized experiment was conducted with 60 clinical research staff using three prescreening tools (Criteria2Query, Informatics for Integrating Biology and the Bedside [i2b2], and Leaf). Cognitive task analysis was employed to analyze the usability of each tool using the Health Information Technology Usability Evaluation Scale. Data analysis involved calculating descriptive statistics, interrater agreement via intraclass correlation coefficient, cognitive complexity, and Generalized Estimating Equations models. Leaf scored highest for usability followed by Criteria2Query and i2b2. Cognitive complexity was found to be affected by age, computer literacy, and number of criteria, but was not significantly associated with usability. Adopting NLP for ADRD prescreening demands careful task delegation, comprehensive training, precise translation of eligibility criteria, and increased research accessibility. The study highlights the relevance of these factors in enhancing NLP-driven tools' usability and efficacy in clinical research prescreening. User-modifiable NLP-driven prescreening tools were favorably received, with system type, evaluation sequence, and user's computer literacy influencing usability more than cognitive complexity. The study emphasizes NLP's potential in improving recruitment for clinical trials, endorsing a mixed-methods approach for future system evaluation and enhancements.

Effects of immersive virtual reality for alleviating anxiety, nausea and vomiting among patients with paediatric cancer receiving their first chemotherapy: protocol for a randomised controlled trial

IntroductionAnxiety, nausea and vomiting are common side effects suffered by paediatric patients receiving chemotherapy. Emerging evidence supports the efficacy of immersive virtual reality (IVR) on improving anxiety and distress symptoms...

Curriculum Evaluation in Online Learning: A Mixed-methods Approach

This paper presents a curriculum evaluation of an online learning program using a mixed-methods approach, which combines quantitative and qualitative methods and tools, and integrates their data and findings. The paper aims to answer the research question: How effective is the online learning program in achieving its intended goals and outcomes, and what are the factors that influence its quality and effectiveness? The paper concludes that the online learning program was effective in achieving its intended goals and outcomes, and that the factors that influenced its quality and effectiveness were the satisfaction, engagement, achievement, and retention of the students who completed the online learning program. The paper also demonstrates the benefits and challenges of using a mixed-methods approach for curriculum evaluation in online learning, and provides valuable insights and feedback for the online learning program and its stakeholders. The paper also acknowledges the limitations and implications of the study, and suggests some recommendations for practice, policy, and future research in the field of online learning and curriculum evaluation.

Vastness of Teachers' Awareness of Students with Special Needs at St. Pamachius Inclusive Secondary School in Hai District, Tanzania

This formative assessment sought to determine the educators' awareness of special needs students' abilities in promoting inclusive education at St. Pamachius Secondary School. Anchored in Scaffolding theory by the Russian psychologist Lev Vygotsky in 1978, the evaluation employed the convergent design under a mixed methods evaluation approach in which qualitative and quantitative data sets were collected at one point in time, analyzed separately before they were converged in a single study. The targeted population was 439, from which 151 respondents were sampled through stratified random, census and convenient sampling techniques. Data were gathered using questionnaires and interview guides from 123 students, 24 teachers, 1 head of school, and 1 Catholic Diocesan Education secretary. Tools for data collection were validated through research experts from Mwenge Catholic University, and the reliability of the questionnaire was achieved through the Cronbach Alpha technique, where coefficients for students' and teachers' questionnaires were 0.85 and 0.76, respectively. The trustworthiness of the qualitative data was ensured by the triangulation of instruments and peer debriefing methods. Quantitative data were descriptively analyzed in frequencies and percentages and presented in a table. The qualitative data were coded, thematically analyzed and presented in direct quotations. The research findings indicate that both teachers instructing students with special needs and the students themselves exhibit awareness of inclusive education principles. Furthermore, the study highlights positive interactions between teachers instructing both special needs and non-special needs students. Consequently, it can be inferred that teachers and students possess an awareness of effective teaching and learning strategies for both groups, which ultimately contribute to their potential development within the framework of inclusive education at St. Pamachius Secondary School.
 Based on these findings, it is recommended that the Ministry of Education, Science, and Technology enforce mandatory inclusive education courses within teacher training programs. This initiative aims to mandate the integration of inclusive education modules in all teacher training institutions. This mandate ensures that every graduating teacher possesses the essential knowledge and skills for proficiently implementing inclusive education. Such a systemic reform aligns with the overarching objective of advancing inclusive education and comprehensively addressing students' diverse needs.

Teamwork and mental workload in postsurgical pediatric patient handovers: Prospective effect evaluation of an improvement intervention for OR-PICU patient transitions

Postsurgical handover of pediatric patients from operating rooms (OR) to pediatric intensive care units (PICU) is a critical step. This transition is susceptible to errors and inefficiencies particularly if poor multidisciplinary teamwork occurs. Despite wide adoption of standardized handover interventions, comprehensive investigations into joint effects for patient care and provider outcomes are scarce. We aimed to improve OR-PICU handovers quality and sought to evaluate the intervention with particular attention to patient care effects and provider outcomes. A prospective, before-after-study design with an interrupted-series and a multi-source, mixed-methods evaluation approach was established. Drawing upon a participative plan-do-study-act approach, a standardized, checklist-based handover process was designed and implemented. For effect assessments, we observed OR-PICU handovers on site (pre implementation: n = 31, post: n = 30), respectively, with standardized expert observation and provider self-report tools (n = 111, n = 110). Setting was a tertiary Pediatric University Hospital. Supplementary qualitative, semi-structured interviews were conducted, and a general inductive content analysis approach was used to identify key facilitators and barriers on implementation. Improvement efforts focused on stepwise implementation of (1) standardized handover process and (2) a checklist for multi-professional OR-PICU handover communication. We observed significant increases in team and patient setup (pre: 79.3%, post: 98.6%, p < .01), enhanced team engagement (pre: 50%, post: 81.7%, p < .01), and comprehensive information transfer by the anesthesia sub-team (pre: 78.6%, post: 87.3%, p < .01). Expert-rated teamwork outcomes were consistently higher, yet self-reported teamwork did not change over time. Provider perceived stress and disruptions did not change, mental workload tended to decrease over time (pre: M = 3.2, post: 2.9, p = .08). Comprehensiveness of post-operative patient information reported by PICU physician increased significantly: pre: 65.9%, post: 76.2%, p < .05. After implementation, providers acknowledged the importance of standardized handover practices and associated benefits for facilitation of information transfer and comprehensiveness. Among reported barriers were obstacles during implementation as well as insufficient consideration of professionals’ individual workflow after surgery.Conclusion: A multidisciplinary intervention for postsurgical pediatric patient handovers was associated with improved expert-rated teamwork and fewer omissions of key patient information over time. Inconsistent results were obtained for provider-rated mental workload and teamwork outcomes. The findings contribute to a better understanding concerning the interplay of teamwork and provider cognitions in the course of establishing safe patient transitions in pediatric care.What is Known:• Transfer of critically ill children conveys significant challenges for interprofessional communication and teamwork. Prospective research into interventions for safe and efficient handover practices of OR PICU patient transitions is necessary.• Checklists are assumed to facilitate cognitive load among providers in acute clinical environments.What is New:• A standardized, checklist-based handover intervention was associated with improvements in team set-up and information transfer. Provider outcomes such as mental workload and stress did not change over time.• The combination of teamwork and provider assessments allows a more nuanced understanding of implementation barriers and sustainable effects in course of OR-PICU handover interventions.

Central Coast Regional Equity Initiative: Co-Creating and Actionizing a New Community-Led Equity Framework

We present a community-led equity framework as a foundation for promoting equity on the Central Coast of California. We discuss the key elements of a participatory, community-led evaluation and planning approach for the Central Coast Regional Equity Initiative, which aims to advocate for social, health, environmental, and economic equity through region-wide cross-sector collaboration, community and research-informed action, and an indigenized and decolonized approach. Through a systematic mixed-methods evaluation and planning approach, including Community Consultations and Strategic Action Planning, we found that our community’s lived experience contributes to a deeper understanding of inequities, and that engagement in cross-sector collaboration empowers our community to bridge data with action organizing. The findings demonstrate that engagement in community-led evaluation and planning contributes to a greater readiness for cross-sector collaborative action and a sense of community ownership of solutions to equity issues, and sets the stage for deeper-rooted, long-term success built on genuine reciprocity and trust. We present our community-led equity framework inviting others to adopt systematic community knowledge-base-building that values community wisdom, identifies power imbalance, promotes trust-building through healthy discomfort, and encourages reflective action.

A training intervention to enhance self-management support competencies among nurses: A non-randomized trial with mixed-methods evaluation

AimTo evaluate the process and outcomes of INTENSS, a training intervention grounded in Self-Determination Theory to enhance nurses’ competencies for self-management support. DesignNon-randomized intervention study with mixed-methods evaluation approach (2019–2020). MethodsThe multifaceted training was implemented in six groups. Cluster-assignment to study arm 1 or arm 2. Arm 1 received a basic training module and arm 2 the basic module with additional video-interaction guidance. Focus groups were held to detect what was helpful in competency enhancement. Intervention effectiveness was determined on trainees’ attitude, motivation, self-efficacy and skills for self-management support (multiple time-points by self-reports and observations). ResultsTrainees (N = 50) indicated the video-interaction guidance, the connectivity within the training group, the constructive feedback from trainers as well as from peers, as helpful for the acquisition of self-management support skills. At 2-month post-training, participants slightly improved in their competencies for the assess (p = .03), agree (p = .02), arrange (p < .01) phase and partnership skills (p < .01). Between the study arms, video-trained participants significantly reduced their use of controlling approaches (p = .03). Observations indicated that trainees mostly used an autonomy-supportive approach, seldom we observed the use of competence supportive, controlling or chaotic approaches. The interviews gave indications that obligatory training in this field needs to be questioned. ConclusionThe outcome evaluation of the INTENNS training indicated most improvement in nurses’ skills for collaborative goal setting and partnership with patients. The mixed-methods evaluation emerges transferable principles to implement the training amongst nurses and, by extension, other healthcare professions. A training intervention involving patient experts can add value to further pave the way towards a true partnership between patients and healthcare professionals. ImpactA training intervention taking into account the complexity of supporting patients towards self-management is available. Important elements for growth are: connectivity within training group, a safe learning climate where ‘failure’ is allowed and video-interaction guidance. Obligatory training participation can be questioned.

Building the capacity of community health volunteers for non-communicable disease prevention in low-income urban communities in Malaysia

Background To address the rising non-communicable diseases (NCDs) in Malaysia, the Better Health Programme Malaysia (BHP MYS) engaged and trained community health volunteers (CHVs) to undertake health promotion activities with poor urban communities in Kuala Lumpur to reduce their NCD risk. This study evaluates the extent that the capacity-building programme achieved the objectives of increasing knowledge and confidence in NCD prevention and adopting personal lifestyle changes. Methods A capacity-building programme was designed to emphasise active learning approaches and blended learning (in-person and digital) and was delivered between January to December 2021 (during the Malaysian Government “Movement Control Orders” in response to the COVID-19 pandemic). Thirty CHVs participated in the capacity-building programme. A mixed methods evaluation approach was used, including quantitative surveys and routine data, focus group discussions, and semi-structured interviews. Findings Community Health Volunteers increased their NCD knowledge (85.2% provided correct answers in post-programme assessment compared to 43.3% at pre-programme assessment), made changes to their dietary and physical activity practices (100%), and adopted new engagement techniques, particularly a digital social influencer role for NCD behaviour change. The most important factors for sustaining participation were individual motivation and a supportive environment. CHVs were satisfied with the blended in-person-digital approach and perceived that the usefulness and applicability of the health information received was the primary benefit across all delivery modes. Cohort-based, active learning approaches and actionable messages can encourage learning retention and facilitate application. Dedicated technical support and ‘job aid’ tools are required for CHVs to perform and sustain NCD prevention roles effectively. Conclusions The capacity-building programme effectively increased CHV capacities to address NCDs in their own lives and communities and was acceptable to CHVs. The findings suggest the value of cohort-based, active learning approaches in building capacity. Expanding on capacity-building and sustaining involvement are important considerations for this cohort and, in general, for health volunteer capacity-building in Malaysia and elsewhere.

Demonstration of Impact Through the Evaluation of the 2020-2021 Africa Cancer Research and Control ECHO

PURPOSE The Africa Cancer Research and Control ECHO is a virtual community of practice and knowledge dissemination platform for cancer professionals. Each year, the steering committee completes an evaluation to elicit feedback and inform continuous program improvement. The 2020-2021 evaluation included for the first time a qualitative component, allowing documentation of concrete utilization of knowledge gained from the Africa Cancer ECHO to advance cancer control efforts. METHODS Participants were invited to complete a survey about satisfaction, knowledge acquisition, knowledge application, and outcomes of the Africa Cancer ECHO. In addition, six steering committee members completed semi-structured interviews with a focus on program outcomes. RESULTS A total of 226 unique people from over 40 organizations participated in the Africa Cancer ECHO during 2020-2021, with 19 sessions hosted on topics across the cancer control continuum. Twenty-two participants representing nine countries and multiple sectors of cancer research and control responded to the survey. They reported participating to gain knowledge (57%), network (21%) and strongly agreed that sessions were relevant and engaging (100%). Reported limitations included obstacles of time (74%), technology (13%) and limited opportunities to engage with partners and participants (50%). Participants applied the knowledge gained in various ways including: adding survivorship to their National Cancer Control Plans (for the first time); adapting training materials to initiate a patient navigation program, partnering to strengthen brachytherapy capacity at the national level and collaboratively conducting a situational analysis of cancer survivorship in the Africa region. CONCLUSION The Africa Cancer ECHO provides a relevant and engaging platform which encourages community and the exchange of socio-culturally adapted best practices in cancer research and control in the African region. The mixed methods evaluation approach has deepened understanding of how knowledge exchanged in the ECHO sessions is utilized and applied. More targeted recruitment and retention, as well as facilitation of collaborations beyond the sessions will further strengthen this community.

Implementation of a Diabetes Self-Management Education and Support Intervention in Rural Guatemala: A Mixed-Methods Evaluation Using the RE-AIM Framework.

IntroductionTo address the global diabetes epidemic, lifestyle counseling on diet, physical activity, and weight loss is essential. This study assessed the implementation of a diabetes self-management education and support (DSMES) intervention using a mixed-methods evaluation framework.MethodsWe implemented a culturally adapted, home-based DSMES intervention in rural Indigenous Maya towns in Guatemala from 2018 through 2020. We used a pretest–posttest design and a mixed-methods evaluation approach guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Quantitative data included baseline characteristics, implementation metrics, effectiveness outcomes, and costs. Qualitative data consisted of semistructured interviews with 3 groups of stakeholders.ResultsOf 738 participants screened, 627 participants were enrolled, and 478 participants completed the study. Adjusted mean change in glycated hemoglobin A1c was −0.4% (95% CI, −0.6% to −0.3%; P < .001), change in systolic blood pressure was −5.0 mm Hg (95% CI, −6.4 to −3.7 mm Hg; P < .001), change in diastolic blood pressure was −2.6 mm Hg (95% CI, −3.4 to −1.9 mm Hg; P < .001), and change in body mass index was 0.5 (95% CI, 0.3 to 0.6; P < .001). We observed improvements in diabetes knowledge, distress, and most self-care activities. Key implementation factors included 1) recruitment barriers for men, 2) importance of patient-centered care, 3) role of research staff in catalyzing health worker involvement, 4) tradeoffs between home and telephone visits, and 5) sustainability challenges.ConclusionA community health worker–led DSMES intervention was successfully implemented in the public health system in rural Guatemala and resulted in significant improvements in most clinical and psychometric outcomes. Scaling up sustainable DSMES in health systems in rural settings requires careful consideration of local barriers and facilitators.

Cracks in the wall of a car-oriented local mobility system – Results of an urban living lab

This paper focuses on evaluating the effects of an Urban Living Lab (ULL), which aims to promote the sustainable transition of a local mobility system through civic engagement within a multi-actor cooperation network. For this purpose, an approach is presented on how to measure and evaluate the impacts of a ULL on different levels. Therefore, a framework integrating the transition management approach and the multi-level perspective is developed and used for a mixed-methods evaluation approach of a ULL in a small rural town. The empirical results provide some evidence that after one year, the ULL activities cause some ‘cracks in the wall’ of the currently car-use dominated local mobility system: A significant decrease in the perceived social support of a local transport policy prioritizing car user needs is observed, as well as a significant decrease in the perceived social support for policy measures aiming to upgrade the existing car use infrastructure. Furthermore, citizens now perceive a higher local descriptive norm in favour of walking and cycling. However, ULL activities are not associated with a significant reduction of personal car use. Implications of the evaluation results for the further development of this specific local ULL as well as ULLs in general are discussed. Moreover, lines of psychological research aimed at supporting a better understanding of effective ULLs are described.

The Outcomes of Interprofessional Experiential Learning for Underrepresented Racial/Ethnic Minority Students to Address Latino Childhood Obesity

Addressing Latino childhood obesity requires effective health promotion programs and culturally resonant health professionals. The current profiles of public health professionals and registered dietitians point to the need to increase the number of Latino students trained in community-based participatory research and engagement of underserved populations. To address this workforce gap, the Center for Latino Community Health, Evaluation, and Leadership Training developed the Sanos y Fuertes: Healthy &amp; Strong Graduate Research Fellowship to provide Latino graduate students with research training, professional development, and mentorship. Five cohorts of seven graduate students participated in a yearlong experiential learning program. Graduate research fellows received monthly research and professional development training from faculty, staff, and community health workers. Furthermore, fellows engaged in mentored research through the development and implementation of a Latino childhood obesity prevention curriculum and intervention. A mixed-method evaluation approach was used to assess the effectiveness of the program. Fellows completed baseline, posttraining, and follow-up assessments. Assessment surveys measured training experiences (e.g., research methods, community engagement), confidence (e.g., research methods, health education), and knowledge and skills (e.g., community health program skills). The training resulted in significant increases in skills and confidence between pre- and postassessments that were sustained at follow-up. Based on these findings, we recommend that student training programs include research as experiential learning with multidisciplinary, interprofessional teams and that community-based, community-engaged, or translational research teams include community health workers as integral members for research with marginalized, underserved populations.

Evaluating Community-Facing Virtual Modalities to Support Complex Neurological Populations During the COVID-19 Pandemic: Protocol for a Mixed Methods Study.

BackgroundThe COVID-19 pandemic and concomitant governmental responses have created the need for innovative and collaborative approaches to deliver services, especially for populations that have been inequitably affected. In Alberta, Canada, two novel approaches were created in Spring 2020 to remotely support patients with complex neurological conditions and rehabilitation needs. The first approach is a telehealth service that provides wayfinding and self-management advice to Albertans with physical concerns related to existing neurological or musculoskeletal conditions or post-COVID-19 recovery needs. The second approach is a webinar series aimed at supporting self-management and social connectedness of individuals living with spinal cord injury.ObjectiveThe study aims to evaluate the short- and long-term impacts and sustainability of two virtual modalities (telehealth initiative called Rehabilitation Advice Line [RAL] and webinar series called Alberta Spinal Cord Injury Community Interactive Learning Seminars [AB-SCILS]) aimed at advancing self-management, connectedness, and rehabilitation needs during the COVID-19 pandemic and beyond.MethodsWe will use a mixed-methods evaluation approach. Evaluation of the approaches will include one-on-one semistructured interviews and surveys. The evaluation of the telehealth initiative will include secondary data analyses and analysis of call data using artificial intelligence. The evaluation of the webinar series will include analysis of poll questions collected during the webinars and YouTube analytics data.ResultsThe proposed study describes unique pandemic virtual modalities and our approaches to evaluating them to ensure effectiveness and sustainability. Implementing and evaluating these virtual modalities synchronously allows for the building of knowledge on the complementarity of these methods. At the time of submission, we have completed qualitative and quantitative data collection for the telehealth evaluation. For the webinar series, so far, we have distributed the evaluation survey following three webinars and have conducted five attendee interviews.ConclusionsUnderstanding the impact and sustainability of the proposed telehealth modalities is important. The results of the evaluation will provide data that can be actioned and serve to improve other telehealth modalities in the future, since health systems need this information to make decisions on resource allocation, especially in an uncertain pandemic climate. Evaluating the RAL and AB-SCILS to ensure their effectiveness demonstrates that Alberta Health Services and the health system care about ensuring the best practice even after a shift to primarily virtual care.International Registered Report Identifier (IRRID)DERR1-10.2196/28267

Using IPEC pedagogy to transform the future rural advanced practice nursing workforce

Objective: The number of primary care providers has not kept pace with the increasing number of underserved rural populations placing unprecedented demands on the healthcare system and the gap is expected to widen with shortages projected to increase across the United States. Given the urgent need to grow and expand the number of trained diverse primary care providers in rural communities, an innovative sustainable program was implemented to recruit and train diverse rural advanced practice nurses. Building on the successful rural medical and rural pharmacy educational programs at the UIC Health Sciences Campus in Rockford, a rural nursing program with interprofessional curriculum was designed and refined to enable nursing students along with two other professions to develop appreciation, insight, and knowledge of rural healthcare and health disparities in a variety of rural settings as part of an interprofessional team.Methods: A mixed-methods program evaluation approach utilized both quantitative and qualitative data to evaluate program satisfaction and inform ongoing program refinement.Results: Students indicated positive responses to this interprofessional course of study. Continued development and refinement of the curriculum is planned to train the future rural healthcare workforce.Conclusions: Students from three health sciences colleges benefitted from the IPEC program with confirmed satisfaction in interprofessional rural education and collaborative practice. The addition of a rural nursing program merits continuation with modification and expansion to prepare the future rural interprofessional healthcare workforce.

Co-creating physical activity interventions: a mixed methods evaluation approach

BackgroundCo-creation strategies, such as cooperative planning, are promising as a means to ensure that physical activity interventions address real-world problems and are tailored to the target group. This has already been validated in diverse settings. However, questions targeting the transferability of cooperative planning to new settings and the key factors influencing its success or failure remain unclear. At the same time, co-creation processes are complex, and evaluation can be challenging. Following calls for detailed reporting, this paper describes the programme activities, the underlying logic, and methodological design of a study that aims to evaluate the transfer of cooperative planning to new settings and to explore the associated key determinants.MethodsCooperative planning was utilized as a strategy to target physical activity promotion in three real-world German settings in the nursing care and automotive mechatronics sectors. This involved researchers working alongside stakeholders from practice and policy to conjointly develop new interventions to promote physical activity in physically demanding jobs. A pragmatic approach is used to evaluate both the transferability and key determinants of this strategy. We developed a logic model for this co-creation process that describes the underlying assumptions and guides the evaluation. The evaluation outcomes of this study include planning meetings, newly developed interventions, and the determinants that are likely to affect cooperative planning. Quantitative and qualitative data will be collected using questionnaires, documents, and interviews. The quantitative data will be analysed descriptively, while the qualitative data will mainly be analysed using qualitative content analysis, split by settings. Subsequently, data triangulation will be used to integrate the quantitative and qualitative findings, which will then be compared across all three settings.DiscussionThe study findings will contribute to a better understanding of co-creation strategies, their transferability, and key determinants. The practical implications can include a checklist for assessing key determinants and a guideline for transferring cooperative planning into new settings to benefit more people. Ultimately, this study will help to advance co-creation strategies and may be relevant for researchers, practitioners, and policy-makers targeting physical activity promotion in various contexts.Trial registration: Open Science Framework: https://osf.io/r6xnt/ (retrospectively registered).

Building the future geriatrics workforce through transformative interprofessional education and community-engaged experiential learning

Abstract The number of older Americans, ages 65 years and above, is projected to more than double from 46 million in 2014 to 98 million by 2060.1 Despite these projections, the number of health professionals trained to address the needs of this population is declining and a shortage has been projected across the country by 2025.2-4 To address this health workforce gap, the Institute of Medicine report, Retooling for an Aging America5 calls for enhanced geriatric training across health professions, and a growing body of evidence supports the value of interprofessional education (IPE) and collaborative practice. To respond to the urgent need for a better geriatric trained workforce, we developed an interprofessional course, “Scholars and Leaders in Interprofessional Geriatrics (SLIG)”, designed to enable health science students from different professions to acquire knowledge, understanding, and appreciation of integrated ethical geriatric care, in a variety of healthcare settings (i.e., community care, house calls, post-acute rehabilitation care, and hospice), as part of an interprofessional (IP) team. The learning activities include experiential and didactic learning for six weeks. Course learning objectives are aimed at enabling students to: apply patient- and family-centered approaches for addressing health disparities among older adults; define transitional care and explain the factors affecting effective care transitions and strategies for addressing the needs of older adults at various levels of care; and describe the four Interprofessional Education Collaborative (IPEC) competencies5 and apply these to IP team work in a geriatric care setting. Together, these learning objectives address the continuum of care of older adults, including the trajectory of illness, at different levels including transitions of care. Our mixed-methods program evaluation approach utilized the IPECC-Set 38 6,7 self-efficacy tool in a post-program evaluation survey. The IPECC-SET 38 tool assessed students’ self-efficacy in interprofessional collaborative practice. The tool was developed and validated6,7 by the co-authors and colleagues. A program evaluation survey was administered to all students. The data demonstrated that the participating students consider the course to be beneficial, with 100% of students (n = 30) reporting program learning goals were met and that the program addressed all four IPEC domains. We are encouraged by the overwhelmingly positive response by our students to this IPE course and we plan to continue to contribute to developing the future geriatric IP workforce.

Fatherhood Education with Latino Fathers: A Mixed-Method Evaluation

ABSTRACT As fatherhood education programs become more common and as the United States becomes increasingly diverse, efforts are needed to ensure that programs reach underrepresented groups. Using a mixed-method evaluation approach, this study examined the programmatic impacts and experiences of Latino fathers (n = 156) who participated in fatherhood education programs. Quantitative analyses indicated that participants showed improvements in father-child relations, decreases in partner conflict, and more positive perceptions of employability from pretest to posttest. Qualitative analyses revealed that the programs were largely positively received, with participants reporting greater knowledge of several targeted concepts. Overall, findings suggest that Latino fathers derive perceived benefits from participation in fatherhood education programs. Practical implications are discussed.

Family-based Intervention for Legal System-involved Girls: A Mixed Methods Evaluation.

The increased proportion of juvenile court-involved girls has spurred interest to implement and evaluate services to reduce girls' system involvement. The purpose of this study was to examine the effectiveness of a family-based intervention by using a dominant sequential mixed methods evaluation approach. First, we examined quantitative data using a quasi-experimental design to determine whether the family-based intervention reduced recidivism among court-involved girls. Propensity score matching (PSM) was used to construct statistically equivalent groups to compare one-year recidivism outcomes for girls who received the court-run family-based intervention (n=181) to a group of girls on probation who did not receive the intervention (n=803). Qualitative interviews (n=39) were conducted to contextualize the quantitative findings and highlighted the circumstances that family-focused interventions for court-involved girls. Girls who received the program had slightly lower recidivism rates following the intervention. The qualitative findings contextualized the quasi-experimental results by providing an explanation as to the girls' family circumstances and insights into the mechanisms of the intervention. Results highlighted the importance of family-focused interventions for juvenile justice-involved girls. These findings have practical and policy implications for the use interventions-beyond the individual level-with adjudicated girls and offer suggestions for ways to improve their effectiveness using a community psychology lens. In addition, this paper includes a discussion of evaluating of juvenile court programming from a community psychology perspective including strengths, challenges, and considerations for future work in this area.

Unintended consequences of programmatic changes to infant and young child feeding practices in Bangladesh.

BRAC, an international development organization, implemented a home‐fortification programme from 2014 to 2018 in Bangladesh. This study aimed to understand the unintended consequences of programmatic changes that occurred during the implementation of the programme on the prevalence of good infant and young child feeding (IYCF) practices and other associated factors. We used pooled data from eight cross‐sectional surveys and data from a series of qualitative investigations carried out as part of a mixed‐methods evaluation approach. A total of 6,479 caregivers of children aged 6 to 23 months participated in the surveys. The prevalence of good IYCF practices increased from baseline (42.1%) to midline (45.3%), but it decreased at the endline survey (31.9%). Qualitative investigations identified several reasons for low IYCF practices at the programme level, such as the withdrawal of community health worker (CHW) incentives for promoting IYCF, providing incentives for the home‐fortification of micronutrient powder (MNP) and changing the focus from IYCF promotion to MNP promotion. A multivariable generalized estimating equation model for pooled data revealed that caregivers were 28% (adjusted risk ratio [ARR]: 0.72, 95% CI [0.67, 0.78]) less likely to maintain good IYCF practices during the period when CHWs were not incentivized to promote IYCF compared to the period when CHWs were incentivized to promote it. The prevalence of good IYCF practices decreased from both baseline and midline to the endline survey due to the unintended consequences of the programmatic changes. An integrated intervention strategy to promote the home‐fortification of MNP and IYCF could be helpful to avoid unintended negative consequences of programmatic changes.

Scaling-up Packages of Interventions for cardiovascular disease prevention in Europe and Sub-Saharan Africa (SPICES) - implementation evaluation at operational level

Abstract SPICES focuses on the primary prevention of CVDs in vulnerable populations in Europe and Sub-Saharan Africa by raising awareness regarding CVD and its risk factors and by supporting lifestyle behaviour change in primary care and community settings. It is an implementation project employing a mixed methods evaluation approach. The RE-AIM QuEST and CFIR frameworks are used to guide the evaluation of impact on lifestyle and actual CVD risk and describe implementation barriers and explain how implementation context may influence translation to different settings. The presentation will focus on how these frameworks were used in practice and across settings.