Purpose Increasingly, the value of peer-led programmes to support individuals with co-occurring mental health and substance use disorders (dual diagnosis) is acknowledged. However, there is a lack of validated tools to assess meaningful engagement in these programmes. This study aims to develop and validate the Meaningful Engagement Evaluation Tool (MEET) to measure engagement in dual-diagnosis peer-led support groups systematically. Design/methodology/approach Using a co-designed approach, MEET was developed in collaboration with consumers, peer facilitators and clinicians. The tool consists of two scales – one for consumers and one for facilitators – measuring four key engagement domains: hope and motivation, social connection, recovery strategies and safe space. The study was conducted across six public health service sites, with survey data collected from 410 consumers and 384 facilitators. The quantitative analysis assessed internal consistency, while qualitative responses were thematically analysed. Findings MEET demonstrated strong internal consistency (Cronbach’s alpha = 0.82 for consumers, 0.88 for facilitators). Participants reported high engagement, with qualitative themes highlighting the role of lived experience in fostering connection and recovery. Item responses encountered ceiling effects. Research limitations/implications This study demonstrated that the MEET is a reliable tool for assessing engagement in peer-led dual-diagnosis programmes; however, several limitations were identified. Quantitative data showed ceiling effects, limiting discrimination between high engagement levels. The predominantly mental health-based sample and limited inclusion of alcohol and drug services constrain generalisability. Broader validation, refinement of item wording and enhanced scale sensitivity are needed. Findings highlight MEET’s potential for improving programme evaluation, with future research recommended to optimise measurement precision and test applicability across diverse peer-led settings. Practical implications The MEET provides mental health and alcohol and other drug (AOD) services with a co-designed, reliable tool to evaluate meaningful engagement in peer-led dual-diagnosis programmes, capturing dimensions such as hope, social connection, recovery strategies and safe space. Its use can guide service improvement, highlight the value of lived experience facilitation and strengthen evidence for peer work within integrated care models. By providing structured, participant-centred feedback, MEET supports quality improvement, programme funding justification and alignment with recovery-oriented practice. Future refinements to increase sensitivity will enhance its utility, enabling services to better tailor interventions, demonstrate impact and promote engagement across varied clinical and community settings. Social implications The MEET reinforces the social value of peer-led dual-diagnosis programmes by evidencing their role in fostering inclusion, trust and mutual support among people with lived experience. By capturing participants’ perceptions of hope, connection and safety, it highlights how such programmes reduce stigma, promote empowerment and build recovery capital through shared experiences. Widespread use of MEET can strengthen recognition of peer work as a legitimate and impactful component of mental health and AOD services, supporting policy shifts towards recovery-oriented care. Ultimately, this tool can help embed lived experience perspectives into service design, enhancing social cohesion and equity in health systems. Originality/value The MEET is a reliable and valid measure of engagement in peer-led dual-diagnosis programmes. Future research should further refine MEET and assess its applicability across diverse recovery settings.

Ripple effects mapping (REM), a qualitative participatory approach to intervention evaluation, is gaining recognition as a useful method for elucidating the long-term intended and unintended impacts of complex public health interventions. The present study applied an adapted REM approach to capture systems and community change associated with the Agenda Gap program. This population-level youth mental health promotion intervention is embedded in multi-sectoral partnerships with long-term and relational outcomes post-program that are difficult to elucidate using traditional program evaluation methods. Using transcript and mind map data generated through an REM process with former Agenda Gap youth collaborators and adult allies, reflexive thematic analysis supported the construction of three thematic program outcomes: (1) Reimagining Future Possibilities, (2) Systems Integration: Transforming School Practices, and (3) Progressing From Ripple Effects to Sea Change. Spanning socioecological levels (i.e., individual, family, community, and societal), the outcomes and their associated sub-themes captured the meaningful impacts experienced by Agenda Gap participants, as well as those more distal to the intervention, in the years following implementation. These findings demonstrate the substantive, multi-level impacts of the program and also illustrate how qualitative, participatory approaches, such as REM, can complement other forms of evaluation to reveal outcomes that are typically overlooked. Recommendations and implications for future research and applications of REM are offered.

A growing number of organisations are working to address barriers to accessing veterinary care. There is limited knowledge about how such programmes develop, evolve over time to meet community needs, and how clients and communities are engaged in programme design or evaluation of impacts. Without community-engaged evaluation, programmes cannot determine the effectiveness, potential harms or broader impacts of their services. Three focus groups and four interviews were conducted with a total of 18 accessible veterinary care providers in Canada. Transcripts were qualitatively analysed using a priori and emergent double content coding in NVivo 14. Thirty-three subcodes were identified across five code categories: (1) programme initiation, (2) programme evolution, (3) evaluating success, (4) ideal programme evaluation, and (5) community engagement. Participant's organisations showed large diversity in programme initiation, evolution, evaluation and community participation, reflecting the complexity of access to care and presenting an opportunity for inter-organisational knowledge sharing. Concerns about ethical community engagement, funder reporting requirements, and limited knowledge and resources hinder animal healthcare organisations' ability to effectively engage in community-based evaluation. Potential limitations of this study include small sample size, self-selection bias, limited geographical representation, and power dynamics which can influence responses within interviews and focus groups. This study contributes to the limited literature on the development and evaluation of accessible animal healthcare care programmes in a Canadian context, and from service providers' perspectives.

Creation of a Novel Longitudinal Pediatrics Resident Curricular Program Addressing the Medical and Social Needs of Children with Medical Complexity.

Health care professionals have a special responsibility to recognize and address bias against marginalized groups. A 2-hour seminar explored the role of medicine and nursing in Nazism and the Holocaust, addressing its relevance to implicit and explicit bias in health care today. Program evaluation focused on nurse participants' assessment of objectives, and a pretest/posttest questionnaire measured perceived knowledge gained. Program evaluation indicated that nurses agreed or strongly agreed that all program objectives were met (n = 63). All items of the pretest and posttest questionnaire (n = 38) were statistically significant and showed that the effect of the educational intervention was large. Practice implications of this seminar were encouraging, with nurses noting plans to be more intentional in recognizing and managing implicit biases within patient and colleague interactions. Contemporary relevance of the history of medicine and nursing during Nazism and the Holocaust includes cultivating moral responsibility and effectively addressing implicit and explicit bias, recognizing health care inequities, and preserving human dignity.

This study aims to develop a financial navigation program among patients with breast cancer in China and assess its feasibility, acceptability, and preliminary effects on cost-related health literacy and financial toxicity (FT). The Medical Research Council (MRC) framework were adopted to guide the development of the financial navigation program, providing a structured approach to complex intervention development and evaluation. It consisted of three phases: evidence identification via a scoping review, intervention content modeling through qualitative study analysis, and outcome mapping based on social stress theory. The feasibility, acceptability and primary effectiveness were examined in a single-center, assessor-blinded pilot randomized controlled trial with 26 recruited patients. The financial navigation program consists of needs assessment, cost-related health education, resource/service referral and personalized counseling. The consent rate and a 1-month attrition rate for the feasibility study of the intervention were 55.9% and 7.7%, respectively. Most (91.7%) participants were satisfied with the program and perceived benefits. The intervention significantly improved cost-related health literacy, although no statistically significant between-group difference in FT was observed. The MRC framework serves as a useful scientific basis for developing financial navigation program with a culturally sensitive approach. The financial navigation program was feasible, acceptable, effective in improving cost-related health literacy and has the potential to enhance FT among patients with breast cancer in China. ClinicalTrials.gov Identifier NCT06355440.

A description of the development and initial evaluation of a patient navigator delivered patient portal enrollment program.

BeWell: Implementation and evaluation of an employee psychological wellbeing program in a public health service using the RE-AIM framework

Bridging the gap: Post-release outcome evaluation of the first jail-based telemedicine buprenorphine program.

An impact evaluation of the Scottish take-home naloxone programme

Extension Master Gardener Volunteers (EMGVs) serve as critical educators in promoting research-based gardening practices such as integrated pest management (IPM), sustainable and environmentally responsible pest control methods. Despite the central role EMGVs play in public horticultural education, few studies have evaluated their actual IPM knowledge. This study assessed baseline IPM knowledge among EMGVs nationwide using a 12-question instrument developed through a modified Delphi process. A total of 887 valid responses were analyzed using descriptive statistics, χ 2 tests, and regression modeling. Results revealed that although most respondents self-identified as “somewhat knowledgeable,” objective assessment scores revealed a higher level of competency, with 519 respondents (58.5%) scoring in the “very knowledgeable” range. Higher IPM knowledge scores were significantly associated with more years of education, younger age, male gender, and in-person or longer-format EMGV training programs. However, knowledge gaps were evident in questions related to pesticide classification, biological control, and organic labeling—terminology often misunderstood or conflated by both consumers and volunteers. These findings suggest that although EMGVs are generally well informed about IPM, targeted enhancements to training programs—particularly in areas such as pesticide usage, definitions, and biological controls—may enhance their ability to provide accurate research-based information to consumers. This study establishes a foundation for improved curriculum development and encourages continued research into EMGV competencies across other horticultural topics. This study represents the first national quantitative assessment of EMGV IPM knowledge in the United States and establishes a national baseline for future program evaluation.

Early performance of a decentralised, primary-care hepatitis C programme in Cambodia: a retrospective programme evaluation, 2024

Analysis of the degree of implementation of the HEALTHQUAL program.

This article discusses the importance of effective communication tools in public health, highlighting innovations like Quick Response (QR) codes and QR wallet reference cards (QR cards) for enhancing outreach and education. QR codes are scannable barcodes that link to digital content. QR cards are compact cards, similar to business cards, with codes that lead to relevant health information. To our knowledge, there is little published literature on using QR codes and cards for public health programs and health communication outside of health care clinics and education settings. The North Carolina Department of Health and Human Services, Division of Public Health, Community and Clinical Connections for Prevention and Health Branch has successfully implemented QR codes in various public health programs, particularly in diabetes management and nutrition, physical activity, and obesity initiatives. Key lessons learned include using reputable QR code generators, ensuring visibility and scanability of the codes, testing links before use, providing clear calls to action, and considering dynamic versus static codes based on needs. QR codes can be leveraged in public health practice for program promotion, evaluation sharing, and community resource accessibility. However, limitations such as smartphone dependency among some populations should be acknowledged. In conclusion, while QR codes are a simple tool, they hold significant potential for improving public health communication. Research on QR code use in public health settings could help inform best practices for public health programs and health promotion across different contexts.

The Mandar people in West Sulawesi have a traditional coconut oil, "Lomoq Mandar," which is made from the abundant coconut in the area and is known to have health benefits, such as anti-inflammatory properties and natural moisture. This oil manufacturing business group has great potential in terms of natural resources and market opportunities, but it also faces technical, managerial, and marketing challenges that hinder the sustainable development of the business. This community service program aims to empower the traditional coconut oil manufacturing business group "Lomoq Mandar" in an effort to prevent pressure ulcers in bedridden patients. Pressure ulcers are a serious problem that can be prevented through optimal skin care, including the use of natural moisturizers. The Mandar community has great potential in making Lomoq Mandar, but faces challenges in health and business management aspects. The program is implemented in four stages: first, coordination and needs analysis with partners to understand the challenges at hand; second, the design and implementation of digital promotions through social media to expand market reach; third, training in the use of modern tools and business management to improve production efficiency; and fourth, program evaluation to measure the impact of activities. Results of activities After the intervention, Lomoq Mandar oil production increased from less than 40 bottles to 80 bottles per day, with sales turnover also increasing. The product now has professional packaging and complete legality, and SOP is implemented to ensure quality. Marketing strategies through social media have increased public awareness of the health benefits of the product. This program is in line with the Sustainable Development Goals (SDGs) related to health, hunger alleviation, and economic growth, and has succeeded in improving community welfare and business sustainability.

Depression and anxiety in the perinatal period affect many women and have multiple negative impacts on the mother and baby. The Integrated Infant Mental Health approach embeds a Behavioral Health Consultant (IMH-BHC) who has specialized training in Infant Mental Health into OB/GYN clinics. This manuscript reports a quasi-experimental comparison of two groups of women through pregnancy and the first year postpartum, receiving integrated IMH care versus standard OB care. We hypothesized integrated IMH care patients would show less anxiety and depression across pregnancy and postpartum than comparison patients. Using a quasi-experimental design, we compared integrated IMH care patients with standard OB care patients to evaluate the primary outcomes of depression and anxiety symptoms from pregnancy through 12 months postpartum across ten obstetric clinics (seven treatment clinics and three comparison clinics) between 2018 and 2021. Data collection included questionnaires in-person, then over the phone during the COVID-19 pandemic. Regression analysis, using fixed effects models to accommodate differences between clinics, compared changes in number of symptoms over time between treatment and comparison groups. Logistic regression was used for comparing number of participants above clinical cutoffs for anxiety and depression symptoms in late pregnancy and at 12-months postpartum. Piecewise linear modeling was used to examine trajectories of symptoms of anxiety and depression. During pregnancy, depression scores for the intervention group (n = 90) remained constant whereas depression in the comparison group (n = 68) increased across the later stage of pregnancy. The slope of change for depression scores across the postpartum year was not significantly different in the two groups. Anxiety symptom trajectories did not differ significantly by group membership during pregnancy or in the postpartum period. The intervention group was less likely to be married, to own their homes, or to have completed schooling beyond high school. More participants in the intervention group identified as Black or non-White. Propensity score weighting achieved equivalence in demographics between intervention and comparison groups. Our findings suggest possible benefits of the integrated IMH model for maternal wellness, most notably for depression symptoms during late pregnancy in a sample of women with high comorbid risk. Supporting at-risk dyads through programs like integrated IMH care represents a much-needed intervention that may make a meaningful difference in the lives of families.

The aim of the study is to assess the competency test certification (CTC) program for mechanical engineering techniques in Vocational High Schools (VHS) by combining the CSE-UCLA program evaluation model with the Assessment Evaluability And Performance Monitoring (AEPM) in order to determine the program's effectiveness level in detail. This program evaluation research use a mixed-methods approach, with a quantitative approach to evaluate the accuracy of the data collected during the research period and a qualitative approach using the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) analysis. System assessment, program planning, implementation of the program, program improvement, program certification, and performance monitoring are the six evaluation components that make up the program evaluation design used in this study, which combines the CSE-UCLA model with the AEPM. The head of the machining program, the head of the workshop, the productive machining teachers, the vice principal in charge of curriculum, the vice principal in charge of industrial relations, the vice principal in charge of facilities and infrastructure, and the principal are the subjects of this research. Five sample vocational high schools in the Special Capital Region of Jakarta Province area were given questionnaires as part of the data collection process. The technique for determining all subjects uses the Purposive Sampling technique. With an average of all program dimension components, the research results indicate the level of effectiveness of the machining competency test certification program's performance. (1). Good is the category rating for the system assessment (2). Category grade for program planning: Good (3). Satisfactory rating for program implementation (4). Fair, (5) is the program improvement category score. Category score for program certification: Fair (6). tracking the Fair performance category score. An approach to show the effectiveness of the statements and questions in the competency test certification for the mechanical engineering machining program is to apply program evaluation using a combination of the CSE-UCLA model and Assessment Evaluability and Performance Monitoring (AEPM).

The objective of the study was to analyse the viewing habits and patterns of Ramadan television programs among university students in the United Arab Emirates, with a focus on the impact of technological advancements on their consumption of media content. Employing a descriptive survey methodology, it utilized an electronic questionnaire that included a purposive non-probability sample of 151 university students in the UAE. The study yielded the following results: 1. A decline in traditional television viewing in favor of digital platforms such as “Shahid” and “Watch It,” with 58% of students spending less than two hours watching, while 30% do not watch at all. 2. Stable viewing rates during Ramadan and outside of it, with 70% continuing to watch television during the holy month. 3. An increase in viewing hours during Ramadan, where the percentage of those watching for less than an hour rose to 46% compared to 28% outside of Ramadan. 4. The preferred viewing times were between 9 PM and midnight (46%), followed by periods before and after iftar. 5. The favored channels were predominantly Emirati, such as Abu Dhabi, Sama Dubai, Dubai, and Emirates. 6. Dramatic series topped the list of the most viewed programs (45%), followed by heritage programs (18%). 7. Motivations for viewing included acquiring knowledge (37.1%), passing time (21.9%), and alleviating boredom (15.9%). 8. The challenges faced by students included family visits (37.7%), community events (21.9%), and scheduling conflicts with university lectures (18.5%). 9. The evaluation of television programs was moderate for 42.4% due to repetition, whereas 31.1% regarded them as strong, and 14.6% considered them very strong. 10. The most favored television program among the sample was “Al-Sharah,” followed by “Awlad Badia Al-Atawila,” with entertainment value and the subject matter being the prominent reasons for preference.

Background: Conventional evaluation approaches are often designed for predictable, linear systems and fail to capture the non-linear dynamics of complex community health interventions. Health projects in mining-affected communities are typically fragmented, with limited coordination or responsiveness to socio-ecological realities. This study applied complexity theory, community-oriented primary care (COPC) principles, and used a transdisciplinary approach to assess a health and wellness project in such a setting. Aim: To describe and reflect on the methodology of a complexity-informed assessment of the coherence and contextual alignment of a health and wellness project in mining-affected communities. Setting: Health and wellness projects funded by the Sishen Iron Ore Company Community Development Trust (SIOC-CDT) and implemented across five municipalities in the Northern Cape and Limpopo provinces, South Africa. Methods: A complexity-informed, mixed-methods design was used. Data were gathered through document review, field observation, and 12 key informant interviews with implementing agents, health officials and traditional healers. Community-oriented primary care principles and complexity theory guided iterative analysis and were supported by digital tools. Results: The study identified fragmented implementation, limited household engagement and weak data systems. Despite widespread activity, the lack of integration and adaptive strategy limited systemic effectiveness. However, transdisciplinary engagement, adaptive iteration and co-production of knowledge and reflection facilitated institutional learning and practical proposals for change that are integrated and context sensitive, responding to complexities. Conclusion: Sustainable health system change in complex settings requires integrated, reflexive and locally grounded approaches that move beyond project-based interventions. Contribution: This study demonstrated how complexity theory, transdisciplinarity, and community-oriented primary care principles offer a viable methodological framework for adaptive evaluation and systemic learning in community health and development, contributing to the journal’s focus on primary care and community health systems in dynamic contexts.

To critically appraise Sidari etal.'s pilot evaluation of the Strong Foundations programme - a 6-week pre-treatment, family-centred intervention that reconceptualises the waitlist as an active window for support, and to assess whether scalable caregiver interventions can improve clinical outcomes and treatment engagement. Critical synthesis of the pilot study's design, implementation, and outcomes. The programme delivered structured psychoeducation to parents alongside specialist medical oversight for adolescents during the pre-treatment period. We summarise reported process and clinical indicators, assess methodological strengths and limitations, and explore adaptations such as digital delivery, peer co-facilitation and primary care integration within stepped-care frameworks. Participating parents reported increased caregiving confidence and understanding of treatment pathways. Adolescents demonstrated preliminary improvements in BMI, affective symptoms and eating-disorder psychopathology. Strengths included focus on an overlooked treatment interval and integrated medical support; limitations included small sample size, absence of a control condition, selection bias, and brief follow-up. Proposed adaptations may increase scalability while preserving family-centred elements. Reframing waitlists as active therapeutic intervals via brief, caregiver-focused interventions are promising for improving early outcomes, uptake and retention. Larger, controlled trials of condensed and digitally enabled formats are needed to establish effectiveness, cost-effectiveness, implementation feasibility and generalisability.