Perceptions Of Program Effectiveness Research Articles

Enhancing Health and Empowerment: Assessing the Satisfaction of Underprivileged Rural Women Participating in a Functional Literacy Education Program in Kailali District, Nepal.

Women's empowerment and health literacy are essential for fostering community well-being. Empowering women through education and diverse training plays a crucial role in ensuring their prosperity and overall health. This study investigates the satisfaction and experiences of underprivileged rural mothers participating in a functional literacy education program in the Kailali district, Nepal. We assess participants' perceptions of program effectiveness, examining training content, facilities, and trainers while exploring menstrual hygiene practices and maternal health awareness. Through convenience sampling, 141 underprivileged women from five rural villages near Tikapur were selected from literacy centers run by Mahima Group. Utilizing structured questionnaires and statistical analyses, including descriptive analyses, Spearman's rho correlation, and Pearson's chi-square test, we found that 65.2% of participants expressed high satisfaction levels. Moreover, 96.5% found the program highly effective, with 97.9% reporting improved literacy skills and 96.5% demonstrating increased awareness of menstrual hygiene practices. Additionally, 97.2% agreed that the program enhanced maternal and child health knowledge. Significant correlations were observed among the training course, facilities, trainers, and overall training perception. In line with this, significant associations were found between age groups (p = 0.003) and geographical areas (p = 0.023) with satisfaction levels with the literacy program. These results underscore the satisfaction of participants within the literacy program and its impact on their lives, and advocates for its broader implementation to empower marginalized communities for sustainable development.

Multilevel perceptions of the virtual delivery of the University of California Diabetes Prevention Program on RE-AIM domains due to COVID-19 mandates.

The University of California's Diabetes Prevention Program (UC DPP) Initiative was implemented across all 10 UC campuses in 2018. The COVID-19 pandemic and accompanying mandates required swift changes to program delivery, including pivoting from in-person to virtual delivery (i.e., Zoom). Our goal was to assess multilevel constituent perceptions of the use of a virtual platform to deliver UC DPP due to COVID-19 mandates. We conducted qualitative interviews with 68 UC DPP participants, coordinators, and leaders to examine the use of virtual platform delivery on the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) of UC DPP. Transcripts were analyzed using rapid qualitative analysis and emergent themes were categorized using domains corresponding to RE-AIM framework. Among UC DPP participants (n = 42), virtual delivery primarily impacted perceptions of UC DPP effectiveness and implementation. Some participants perceived program effectiveness to be negatively impacted, given their preference for in-person sessions, which they felt provided more engagement, peer support, and accountability. Implementation challenges included problems with virtual format (e.g., "Zoom fatigue"); however, several benefits were also noted (e.g., increased flexibility, maintenance of DPP connections during campus closures). UC DPP coordinators (n = 18) perceived virtual delivery as positively impacting UC DPP reach, since virtual platforms provided access for some who could not participate in-person, and negatively impacting effectiveness due to reduced engagement and lower peer support. UC leaders (n = 8) perceived that use of the virtual format had a positive impact on reach (e.g., increased availability, accessibility) and negatively impacted effectiveness (e.g., less intensive interactions on a virtual platform). Across constituent levels, the use of a virtual platform had little to no impact on perceptions of adoption and maintenance of UC DPP. Perceptions of the reach, effectiveness, and implementation of UC DPP using a virtual platform varied across constituents, although all groups noted a potential negative impact on overall program effectiveness. Unanticipated program adaptations, including virtual delivery, present potential benefits as well as perceived drawbacks, primarily across the effectiveness domain. Understanding differential constituent perceptions of the impact of virtual delivery can help maximize RE-AIM and inform future UC DPP delivery strategies.

Parental Factors Associated With Intentions to Initiate a Family-Based Pediatric Weight Management Program.

Background: Childhood obesity can be addressed through family-based pediatric weight management; however, treatment enrollment in the United States is low. This study aimed to identify parental factors associated with intentions to initiate a family-based pediatric weight management program. Methods: Cross-sectional survey data were collected from an online panel of US parents with at least one 5- to 11-year-old child identified as likely to have overweight or obesity. Participants viewed a video about a hypothetical family-based pediatric weight management program, rated their 30-day initiation intentions for that program, and answered additional related questionnaires. Results: Participants (n = 158) identified as White/Caucasian (53%) or Black/African American (47%), were primarily female (61.4%) and married/cohabitating (81.6%) with children who were predominantly girls (53.2%) and, on average, 9-year-olds. Higher parents' perception of program effectiveness predicted initiation intentions (p < 0.001), while concern for their child's weight and parent depression and anxiety levels did not. Higher initiation intentions and perceived program effectiveness were reported by Black/African American participants (p < 0.01) and those with at least a bachelor's degree (p < 0.01) compared to White/Caucasian participants and those without a bachelor's degree, respectively. Initiation intentions were higher for those with greater financial security (p = 0.020) and fewer than three children in the home (p = 0.026). Participants endorsed initiation barriers of time constraints (25%), possible lack of enjoyment for the child (16.9%), and lack of family support (15%). Conclusions: Future program enrollment efforts may need to focus on strategies to increase perceived program effectiveness, although further research is needed that measures actual enrollment in real-world contexts.

Lifestyle change program engagement in real-world clinical practice: a mixed-methods analysis.

Participant engagement in structured lifestyle change programs (LCPs) is essential for adopting behaviors that promote weight loss; however, the challenges to, and facilitators that promote, engagement with such programs are not well understood. We conducted a mixed-methods study among real-world LCP participants to assess factors associated with program engagement and to examine the reasons for withdrawal. Using electronic health records (EHR), we identified LCP eligible participants between 2010 and 2017. Multivariable logistic regression was used to assess associations between program engagement and baseline characteristics. Semi-structured interviews with LCP participants were conducted and thematically analyzed to examine reasons for withdrawal. A total of 1,813 LCP participants were included. The median number of sessions attended was 10 of 21-25 sessions. Highest LCP engagement was associated with factors potentially related to self-efficacy/motivation, such as older age, higher baseline weight, prior healthcare utilization and an absence of a history of smoking or depression. Engagement was also negatively associated with being Non-Hispanic Black versus White. The qualitative analysis of the interviews revealed four general themes pertaining to participants' withdrawal: competing priorities, perceived program effectiveness, characteristics of the program, and facilitator-related factors. Taken together, results from this mixed-methods study suggest that motivation and self-efficacy are important for program engagement; future LCP enhancements should incorporate flexible formats that may help participants manage competing priorities and maximize personal and cultural relevance for all racial/ethnic groups, especially those who have not benefitted fully. Furthermore, participants should be encouraged to set realistic goals to manage expectations.

Comprehensive INGO Accountability to Strengthen Perceived Program Effectiveness: A Logical Thing?

The accountability of international nongovernmental organizations (INGOs) has come under closer public and academic scrutiny. Critics call for a more comprehensive approach to accountability—one that addresses a wider set of stakeholders, and beneficiaries in particular. There is an increase in empirical evidence suggesting that comprehensive accountability has positive implications for the organizational performance. This article develops a framework for comprehensive INGO accountability and tests its implications on program effectiveness. The framework describes three accountability meta-logics: the resource logic, outcome assessment logic, and discursive logic. Applying partial least squares structural equation modeling, the impact of these meta-logics on perceived program effectiveness as well as their drivers is tested. The analysis is based on a unique data set from an international survey among 201 INGO leaders from 21 countries. The findings suggest that comprehensive accountability indeed strengthens the perceived program effectiveness. The study emphasizes the managerial argument that implementing comprehensive accountability, not only is the “right thing” to do, but also has the strategic advantage of strengthening perceived mission achievement.

Association between casino resort employee department and responsible gambling program perceptions: a three-year follow-up study

ABSTRACT This study presents results from a third wave of data collection of a longitudinal project investigating implementation of an RG program, GameSense, at MGM Resorts International (MGM), and how casino employees perceive responsible gambling (RG) efforts. Survey data at three time periods – Year 1 (baseline, N = 2,192), Year 2 (one-year follow-up, N = 852) and Year 3 (two-year follow-up, N = 1,114) – measured MGM employees’ (1) perceptions of RG program effectiveness, (2) gambling misconceptions, and (3) perceived company support. We conducted a one-way MANCOVA on Year 3 data, with gambling industry tenure as the covariate, and a two-way MANCOVA to examine the interaction and main effects of department of employment and time period. In Year 3, Front of House Casino employees were more likely than their colleagues to perceive RG programs as effective, suggesting they can play a valuable role in refining internal program content and delivery. In investigating year-over-year changes, both perceived program effectiveness and perceived company support were lower in Year 3 than in Years 1 and 2. GameSense is designed to be part of company culture, and fluctuations in year-over-year findings suggest RG cultural change should be viewed as a long-term goal, not necessarily achieved immediately after initial program launch.

Examining the Preliminary Effectiveness and Acceptability of a Web-Based Training Program for Australian Secondary School Teachers: Pilot Study of the BEAM (Building Educators' Skills in Adolescent Mental Health) Program.

BackgroundSecondary schools are increasingly supporting adolescents’ mental health and well-being, yet many teachers report that they lack the skills and confidence to do so. Building Educators’ skills in Adolescent Mental Health (BEAM) is a web-based training program developed to improve secondary school teachers’ knowledge and confidence in caring for students’ mental health.ObjectiveThis pilot study examined the preliminary effectiveness and acceptability of the BEAM program for improving mental health knowledge, attitudes, confidence, helping behaviors, and psychological distress among secondary school teachers.MethodsA single-arm pilot trial was conducted from July to December 2019 among secondary school teachers located in New South Wales, Australia, who were employed in leadership positions responsible for managing student well-being (ie, Year Advisors). Participants had access to the BEAM program for 6 weeks. Self-report surveys, delivered at baseline, postintervention (6-weeks post baseline) and 3-month follow-up (19 weeks post baseline) were used to measure changes in training outcomes. Acceptability was assessed by program use, barriers, satisfaction, and participants’ perceptions of program effectiveness.ResultsA total of 70 secondary school teachers took part (mean age 36.5 years, SD 9.41 years, range 24-60 years). Significant improvements in confidence were reported at postintervention and 3-month follow-up. Significant improvements in helping behaviors were reported at 3-month follow-up only. There was also a significant reduction in psychological distress at postintervention. Participants agreed that the program content was easy to understand and relevant, but program completion was challenged by lack of time, competing priorities, and forgetfulness.ConclusionsFindings indicated that a web-based training program may be beneficial for improving secondary school teachers’ abilities to care for students’ mental health; however, program modifications are required to increase training completions.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12619000821190, Universal Trial Number U1111-1232-7680; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377529

"A Piece of Sanity in the Midst of Insane Times": Girls on the Run Programming to Promote Physical Activity and Psychosocial Well-Being During the COVID-19 Pandemic.

Afterschool programs have the potential to promote social, emotional, and physical health outcomes among youth participants. The positive youth development (PYD) framework argues that acquiring desirable attitudes and behaviors occurs when skill-building opportunities are explicitly provided within a safe and supportive climate guided by caring, competent, and compassionate instructors. Girls on the Run (GOTR) is a PYD program that uses running, motor skills, and other physical activities as a platform for promoting positive psychosocial outcomes and life skills learning among elementary- and middle school-aged girls. The onset of the COVID-19 pandemic challenged GOTR to modify lessons, coach training, and program delivery (in-person, virtual, or hybrid) to accommodate public health guidelines. The purpose of this study was to assess caregivers' and coaches' perceptions of program effectiveness in light of these changes. Following the Fall 2020 season, caregivers (n = 1,617) and coaches (n = 991) from 1,077 teams and 39 councils completed an online survey about program experiences. Both stakeholder groups positively rated program impact regardless of delivery mode, although in-person mode was rated higher for satisfaction with the end-of-season event. Thematic analysis of open-ended responses revealed that caregivers and coaches identified increased physical activity opportunities and life skills learning as well as improved social, psychological, and emotional development as a result of participating. Both stakeholders noted GOTR provided a sense of normalcy during this time of great need. Findings using mixed methods provide evidence of program effectiveness and recommendations for youth programming during challenging times.

The Doctorate in Clinical Laboratory Sciences: A New Curriculum to Enhance the Connection of the Laboratory to Health Care Providers

This report discusses the need for a Doctorate in Clinical Laboratory Sciences program and describes a curriculum to train Doctorate in Clinical Laboratory Sciences students. The Doctorate in Clinical Laboratory Sciences program was developed to help reduce diagnostic errors in patient care by enhancing connections between the clinical laboratory and health care providers. Data are presented from program implementation in 2016 to 2017 academic year to 2019 to 2020 regarding the faculty and student demographics, program statistics (eg, admissions and attrition rates), and effectiveness. Perceptions of program effectiveness were obtained via surveys from 28 faculty physicians who supervised Doctorate in Clinical Laboratory Sciences students during clinical service rotations. Another survey assessed the preferred type of practice after graduation of 33 students. Over the 4-year period, the program had a 50% rate of admission and a 21.8% attrition rate. As of December 2020, 15 students graduated from the program. The majority (69%-82%) of physician faculty who completed the survey agreed that Doctorate in Clinical Laboratory Sciences students contributed positively at clinical rounds. Approximately two-thirds of students reported a preference to lead a Diagnostic Management Team or serve as an advanced practice provider in a Diagnostic Management Team with leadership provided by an MD/DO or PhD. This report provides useful information for other institutions that may want to establish similar Doctorate in Clinical Laboratory Sciences programs. Early data suggest that our program effectively trains doctoral-level advanced practice medical laboratory scientists, who may play an important role in improving patient safety by reducing diagnostic errors and providing value-based, optimal patient care.

Association between employee department and responsible gambling program perceptions: extension and follow-up study

PurposeThis study investigates how employees perceive responsible gambling (RG) programs, which are part of a corporate social responsibility (CSR) framework for minimizing negative impacts associated with problematic gambling. Casino employees have different levels of interaction with gamblers, which could affect employees' opinions about RG.Design/methodology/approachSurveys at two time periods – baseline (N = 2,192) and one-year follow-up (N = 852) to a new RG program – asked employees at MGM Resorts International (MGM) about their (1) perceptions of program effectiveness, (2) gambling behaviors and beliefs and (3) perceived level of employer support. Two one-way MANCOVAs, with years employed in the gambling industry as the covariate, extended results from a prior study. An additional two-way MANCOVA examined contact-level and year-over-year differences.FindingsEmployees who have high contact with gamblers, such as those in security or casino dealer positions, viewed RG programs as less effective than employees who have low contact with gamblers, such as those in culinary or corporate positions.Practical implicationsEmployees are vital to harm reduction CSR strategies and MGM should work toward a program with varied RG training content and delivery, depending on the likelihood of employee interaction with active gamblers.Originality/valueRG programs are key CSR initiatives for hospitality organizations with gambling licenses. Employees play an interactive role in delivering these programs, so their perceptions and understanding help assess program value. This is the first study to examine employee perceptions of a newly-implemented RG program with baseline and follow-up data.

Improving Diversity and Inclusion in the Post–Coronavirus Disease 2019 Era Through a Radiation Oncology Intensive Shadowing Experience (RISE)

PurposeIn response to the coronavirus disease 2019 pandemic, current Association of American Medical Colleges guidelines discourage away rotations, posing significant challenges for attracting students to radiation oncology (RO). This is particularly concerning for medical students underrepresented in medicine (UIM) due to the potential of widening existing disparities in applicant and workforce composition. To proactively address this, we created a Radiation Oncology Intensive Shadowing Experience (RISE) to expose UIM students to the field of RO. Methods and MaterialsKey stakeholders within the residency program, including both UIM faculty and residents with experience in health disparities and medical education, designed a 1-week virtual RISE intended for fourth year UIM students recruited through established national organizations serving UIM medical students. A 1-week disease-specific curriculum was developed using 4 components: (1) foundational exposure to RO, (2) didactic teaching, (3) mentorship opportunities, and (4) a capstone experience. Mentorship was continuously weaved through the experience by attendings, peer resident mentors, and a UIM resident panel to optimize exposure. ResultsRISE was successfully initiated at 2 academic medical centers with 12 UIM students enrolled through August. Anonymized pre- and postclerkship surveys were developed for students, residents, and faculty involved in RISE to evaluate participants’ satisfaction, resident and attending time burden, and perceptions of program effectiveness. ConclusionsWe created a unique virtual RO shadowing experience for UIM students to address a critical gap in exposure to RO, heightened by the coronavirus disease 2019 pandemic, with the goal of improving diversity, equity, and inclusion in our field.

Effects of Intervention Characteristics on Willingness to Initiate a Weight Gain Prevention Program.

To determine characteristics of weight gain prevention programs that facilitate engagement. Randomized factorial experiment (5 × 2). Recruited nationally online. Adults aged 18 to 75 with body mass index ≥25 who decline a behavioral weight loss intervention (n = 498). Participants were randomly presented with one of 10 possible descriptions of hypothetical, free weight gain prevention programs that were all low dose and technology-based but differed in regard to 5 behavior change targets (self-weighing only; diet only; physical activity only; combined diet, physical activity, and self-weighing; or choice between diet, physical activity, and self-weighing targets) crossed with 2 financial incentive conditions (presence or absence of incentives for self-monitoring). Participants reported willingness to join the programs, perceived program effectiveness, and reasons for declining enrollment. Logistic regression and linear regression to test effects of program characteristics offered on willingness to initiate programs and programs' perceived effectiveness, respectively. Content analyses for open-ended text responses. Participants offered the self-weighing-only programs were more willing to initiate than those offered the programs targeting all 3 behaviors combined (50% vs 36%; odds ratio [OR] = 1.79; 95% confidence interval [CI], 1.01-3.13). Participants offered the programs with financial incentives were more willing to initiate (50% vs 33%; OR = 2.08; 95% CI, 1.44-2.99) and anticipated greater intervention effectiveness (β = .34, P = .02) than those offered no financial incentives. Reasons for declining to initiate included specific program features, behavior targets, social aspects, and benefits. Targeting self-weighing and providing financial incentives for self-monitoring may result in greater uptake of weight gain prevention programs. https://osf.io/b9zfh, June 19, 2018.

Teachers’ Perceptions of Sustainability of the Social Emotional Learning Program in Latvia: A Focus Group Study

Abstract The aim of this study was to provide an initial evaluation of the sustainability of the first Social Emotional Learning (hereafter SEL) program in Latvia, which to date is still the only SEL program in our country. Initiated during the 2012/13 academic year, this program has already been implemented in 41 Latvian schools. In order to address the teachersí perceptions of program effectiveness and sustainability seven focus groups were organized. Thematic analysis of the focus group discussions pointed to various benefits of the program, including a general dissemination of SEL principles, and teachersí reflections on the importance of their own active role in the process of social and emotional learning. The value of the support of the school administration for program sustainability was also noted. The views expressed by the teachers were aligned with previous studies, indicating the importance of external support, the teachersí own understanding of SEL principles, and the willingness to be actively engaged in facilitating quality maintenance of the program.

Evaluation of a community-based positive youth development program in Hong Kong: views of program implementers

AbstractUsing a subjective outcome evaluation method, the current study investigated program implementers’ perceptions of the Tier 1 Program of the community-based P.A.T.H.S. Project in Hong Kong. After completion of the program, 599 program implementers completed a valid and reliable scale (i.e. Form B) to give their ratings on program content, their own performance, and perceived program effectiveness. As expected, most program implementers perceived the program in a favorable way by giving very positive ratings on the three aspects measured in Form B. Grade differences on the ratings were observed, with implementers teaching the senior curriculum held more positive views on program effectiveness than did those teaching the junior curriculum. Similar to previous findings, perceived program content and perceived worker performance predicted program effectiveness. Findings of the present study provide further evidence for the success of the Tier 1 Program of the community-based P.A.T.H.S. Project in Hong Kong.

Piloting and Evaluating an Automated Text-Messaging System in the Veterans Health Administration

Background: The Veterans Health Administration (VA) strives to increase access and patient-centered care. “Annie” is VA’s first national automated text messaging system aimed to give patients a self-management tool to take charge of their health and become more engaged in their own care. We examined early patient/provider experiences with Annie as part of a limited field test and subsequently examined if the texting system would improve outcomes. Objective: To understand early experiences using Annie and subsequently pilot and evaluate automated text messages to improve Veteran self-management and adherence to medications and appointments. Methods: We conducted a national two-phase study in VA. In Phase 1, five sites conducted limited field testing and engaged 43 respondents (23 patients, 20 providers). Respondents completed surveys and qualitative interviews focused on provider adoption, integration into clinic workflow, patient ease of use, perceptions of program effectiveness, and barriers to use. In Phase 2, seven sites implemented Annie. Four intervention sites received a toolkit of materials and facilitation calls intended to enhance Annie implementation. An additional three sites received Annie without implementation support and two matched comparison sites did not receive Annie. A mixed-methods evaluation is underway, and includes pre and post patient and provider surveys and interviews, medical chart abstraction, and process measure analysis. Results: Analysis of Phase 1 data revealed that all participating Veterans felt positive about their ability to receive a text message. All but one Veteran used a smart phone and had been using a cell phone for four years or more, with 83% sending and receiving text messages several times a day. Sixty-seven percent of Veterans agreed that Annie was easy to use, 11% felt they needed to learn a lot to use Annie, 46% felt Annie helped them take better care of their health and become more connected with their clinical team, and 91% would recommend Annie to another Veteran. Among providers, 67% agreed leadership and management would support Annie implementation and 60% would recommend Annie to another provider. Analysis of Phase 1 interviews revealed five lessons to support implementation: 1) the importance of identifying a resource person who is able to bridge technology and clinical issues; 2) promoting the evidence, innovation, and patient empowerment associated with Annie to providers; 3) focusing early Annie enrollment efforts on patients comfortable with technology and who do not need intensive follow up; 4) advertising the adaptability of Annie texting protocols; and 5) the value of Annie as a health coaching tool. In Phase 2 of Annie implementation we are collecting data on patient and provider experiences with Annie, including usability, clinical workflow fit, and clinical benefits such as improved medication adherence and fewer missed labs and visits. Conclusions: Technologies develop rapidly and hold the allure of efficiently doing things that were once cumbersome or not possible to do in a busy clinical setting. The Annie automated text-messaging system may be able to help in this regard by offering support through self-management, coaching, and education outside of clinical encounters. Findings will inform iterative development of Annie and its national rollout. [iproc 2017;3(1):e55]

Factors Related to Injury Prevention Programming by Missouri School Nurses.

Schools often offer injury prevention (IP) programs, but little is known about the types of programs provided or how school nurses decide which to choose. Nurses in the Missouri School Health Services Staffing Survey Database were sent a survey in spring, 2011, to describe school-based IP efforts being offered. A multivariate linear regression was conducted to delineate factors associated with offering IP programs. In total, 522 school nurses participated (33% response rate). The highest priority for selecting an IP program was perceived program effectiveness (92.3% agreement, n = 482). Determinants of offering IP programs included being asked to identify a speaker, being a high school, receiving funding in the last year, prioritizing evidence-based programs, perceiving that administrators support professional development, and knowing how to address patterns of injuries. School nurses should be competent in planning, implementing, and evaluating IP programs, and additional training may be required to accomplish this.

Exploring Self-Efficacy in Education Leadership Programs

Despite attention given to principal preparation program reform, little research exists explaining how candidates develop self-efficacy or how preparation programs contribute to self-efficacy development. Researchers used a mixed-methods study to examine principals’ perceptions of program effectiveness, determine underlying constructs related to self-efficacy, explore how those factors functioned, and suggest ways to design program experiences promoting self-efficacy. Results suggest that program experiences should create opportunities for relationship building, authentic leadership experiences working with others, and persevering to build self-efficacy. Faculty can support efficacy development through creating instructional opportunities where students gain mastery of leading others in school improvement strategies, requiring internships of substantial length for relationship development, and designing rigorous coursework and program challenges with supportive structures to teach perseverance.

Evaluation of programs for adolescents with greater psychosocial needs: community-based Project P.A.T.H.S. in Hong Kong.

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.

A qualitative exploration of a family self-help mental health program in El Salvador.

BackgroundThere is a significant gap in our knowledge regarding community-based self-help groups and their benefits for persons living with mental conditions and their family caregivers in low and middle income countries. This study describes a such a program in El Salvador and explores participants’ perceptions of program effectiveness and benefits.Case descriptionThe Family Education, Support and Empowerment Program is a multi-component program in the capital that is facilitated by nonprofit professionals but carried out primarily by volunteers. A focus group methodology to build evaluation and research capacity in the organization was used. The study consisted of a questionnaire completed by participants individually, followed by two focus group sessions with the same ten people.ResultsThe study found perceptions of multiple benefits across social, functional, and economic dimensions and a variety of achievements at organizational and national levels.DiscussionThis study identified a family self-help program in El Salvador as a potentially highly beneficial program for its participants. This appears to be the first study to explore benefits across micro, mezzo and macro social levels and to include discussion of more diverse potential benefits such as individual and organizational social capital, leadership, and advocacy. These factors should be explored in future quantitative studies to help determine the relative importance and usefulness of such programs in meeting World Health Organization goals for access to mental health treatment and quality community-based services.Electronic supplementary materialThe online version of this article (doi:10.1186/s13033-016-0058-6) contains supplementary material, which is available to authorized users.

Improving Resident Performance Through a Simulated Rapid Response Team: A Pilot Study.

The Joint Commission requires hospitals to develop systems in which a team of clinicians can rapidly recognize and respond to changes in a patient's condition. The rapid response team (RRT) concept has been widely adopted as the solution to this mandate. The role of house staff in RRTs and the impact on resident education has been controversial. At Christiana Care Health System, eligible residents in their second through final years lead the RRTs. To evaluate the use of a team-based, interdisciplinary RRT training program for educating and training first-year residents in an effort to improve global RRT performance before residents start their second year. This pilot study was administered in 3 phases. Phase 1 provided residents with classroom-based didactic sessions using case-based RRT scenarios. Multiple choice examinations were administered, as well as a confidence survey based on a Likert scale before and after phase 1 of the program. Phase 2 involved experiential training in which residents engaged as mentored participants in actual RRT calls. A qualitative survey was used to measure perceived program effectiveness after phase 2. In phase 3, led by senior residents, simulated RRTs using medical mannequins were conducted. Participants were divided into 5 teams, in which each resident would rotate in the roles of leader, nurse, and respiratory therapist. This phase measured resident performance with regard to medical decision making, data gathering, and team behaviors during the simulated RRT scenarios. Performance was scored by an attending and a senior resident. A total of 18 residents were eligible (N=18) for participation. The average multiple choice test score improved by 20% after didactic training. The average confidence survey score before training was 3.44 out of 5 (69%) and after training was 4.13 (83%), indicating a 14% improvement. High-quality team behaviors correlated with medical decision making (0.92) more closely than did high-quality data gathering (0.11). This difference narrowed during high-pressure scenarios (0.84 and 0.72, respectively). Our data suggest that resident training using a team-based, interdisciplinary RRT training program may improve resident education, interdisciplinary team-based dynamics, and global RRT performance. In turn, data gathering and medical decision making may be enhanced, which may result in better patient outcomes during RRT scenarios.