Program Outcomes Research Articles

Evaluation of one-house one-larvae observer program in controlling dengue hemorrhagic fever in Central Sulawesi

Dengue hemorrhagic fever (DHF) is still a health problem in Poso District. This can be seen from the high number of DHF cases and potential outbreaks from 2017 to 2018. The local government took the initiative to prevent DHF outbreaks in Poso Regency. The Central Sulawesi Provincial Health Office and the Poso Regency Health Office have implemented onehouse one-larvae observer program in the Poso Kota Selatan District area by engaging the local government and community. The implementation of the program and its accomplishments requires evaluation. This study aims to evaluate the one-house one-larvae observer program using input, process, output, and outcome indicators. The research adopts a descriptive-qualitative approach, employing observation and interviews within an evaluation research design. Data analysis was performed using interpretation and triangulation methods. Policy documents are available, and human resources supporting the program are in compliance with the decree. However, the budget for the program is insufficient, while the available infrastructure is sufficient. The process indicators demonstrate satisfactory progress. Based on outputs, there was an increase in achievement against the program target of the number of buildings inspected by house larvae observers over four years. The outcome indicator in the form of the larvae-free rate increased by >90% during one year of program implementation. The implementation of local innovations initiated by the Regency Health Office and stakeholders’ engagement has been proven to increase community participation in programs that impact the achievement of program outputs and outcomes.

Impact of High-Intensity Interval Training (HIIT) on Cardiovascular Health in Middle-Aged Chinese Populations

This paper examines the impact of High-Intensity Interval Training (HIIT) on cardiovascular health among the middle-aged Chinese population, amidst the country’s growing burden of cardiovascular diseases (CVDs). Given the escalating prevalence of CVDs influenced by lifestyle changes, aging, and dietary shifts, there’s a pressing need for efficient and accessible interventions. HIIT, with its brief, intense exercise bursts followed by rest periods, emerges as a potent modality to enhance cardiovascular fitness, manage weight, improve metabolic health, and address psychological stress factors, thereby reducing CVD risk factors. This analysis is grounded in research findings, health statistics, and pilot program outcomes, underscoring HIIT’s viability as a public health strategy. The paper delves into the physiological benefits of HIIT, including improvements in VO2 max, blood pressure regulation, lipid profile enhancement, and insulin sensitivity. It also considers the implementation challenges and strategies for HIIT in China, highlighting the role of technology, healthcare provider collaboration, and tailored community initiatives in promoting widespread HIIT adoption. The conclusions drawn emphasize HIIT’s significant potential in mitigating cardiovascular risk among middle-aged Chinese, advocating for its integration into national health promotion efforts.

Successfully Increasing the Diversity of the Nursing Workforce in Rural South Carolina.

This innovative project was funded by the Health Resources and Services Administration (HRSA) Nursing Workforce Diversity (NWD) grant (2017), with a resultant increase in the diversity of the nursing workforce in the rural Pee Dee Region of South Carolina. The project provided resources to at-risk students (n = 100) and compared participants with a control group (n = 92). The project provided participants mentors, financial assistance, experiential learning, advising, and professional development. The project descriptively compared program outcome benchmarks between groups. The project's multifaceted approach was key to success, providing implications for other programs to increase diversity of the nursing workforce.

Department of Anesthesiology Skilled Peer Support Program Outcomes: Second Victim Perceptions

Most anesthesia providers experience an adverse event during their training or career. Limited evidence suggests skilled peer support programs (SPSPs) reduce initial distress and support adaptive functioning and coping. This study evaluated second victim perceptions of a voluntary SPSP. An SPSP was developed and implemented for all clinical and administrative personnel in the Department of Anesthesiology and Perioperative Medicine in three hospitals and six outpatient surgery centers in December 2017. The program incorporated the Scott Three-Tiered Interventional Model of Second Victim Support. Surveys were offered to clinicians in the department prior to implementation of the SPSP and again 18 months after implementation. Among the subset of respondents who experienced a serious adverse patient event, the authors used multiple logistic regression models that adjusted for role and number of night shifts per month to examine differences in perceived resource availability and post-event support received following implementation of the program. There were 94 surveys (83 complete; 11 partially complete) collected prior to implementation and 84 surveys (67 complete; 17 partially complete) collected after implementation. A total of 25 individuals took the survey at both pre and post (19 complete). After implementation, 62.5% of respondents indicated that institutional support had improved since the occurrence of their serious adverse patient event. Statistical models identified a significant improvement in the probability that a clinician agreed with the statement "I think that the organization learned from the event and took appropriate steps to reduce the chance of it happening again" at post vs. pre (adjusted odds ratio [aOR] 3.9, 95% confidence interval [CI] 1.01-15.1. A statistically significant increase from pre to post in the perceived availability of formal emotional support was identified (aOR 5.2, 95% CI 1.9-22.5). Implementation of a skilled peer support program within a large department of anesthesiology can improve institutional-based emotional support.

Teaching critical thinking in nutritional sciences: a model course and assignments.

Critical thinking is a common and important learning outcome in college curricula. Case-based and problem-based learning can be used to assess and foster critical thinking skills. HNF 250-Contemporary Issues in Human Nutrition is a critical thinking course developed during the redesign of a nutritional sciences major program. Course assignments were designed to assess the course and nutritional sciences major learning outcomes. The nutrition and health claim assignment is scaffolded across the academic semester as three assignments: 1) bibliography assignment; 2) poster presentation; and 3) paper. Course lectures and materials have been designed to prepare students for completion of each assignment. The assignments have been modified over time based on classroom observations and student performance. In 2021, the course learning outcomes were examined by assessing several assignments including the nutrition and health claim poster and paper. Course learning outcome benchmarks using these assessments generally included 80% of students achieving an 80% for each criterion. Results revealed that students were not meeting most of these assessment benchmarks during the 2021 iteration, although benchmark data from other course assessments were more satisfactory. It is possible that the transition from a virtual to an in-person format negatively influenced student performance on these course learning outcomes. This course and the nutrition and health claim assignment example can provide a course design and learning outcome assessment framework for other higher education critical thinking courses.NEW & NOTEWORTHY This paper describes how a scaffolded nutrition and health claim assignment is used to teach critical thinking skills among nutritional sciences students and examine the program's learning outcomes. Further, this course example is to serve as an model for STEM majors on how to incorporate case-based and problem-based learning strategies into an undergraduate course.

An Analysis of Safe Parking Programs: Identifying Program Features and Outcomes of an Emerging Homelessness Intervention

As vehicular homelessness increases in the United States, safe parking programs have proliferated. Yet little research exists on this emerging homelessness intervention. This three-year, mixed-methods study analyzed one of the largest safe parking programs in operation: the Jewish Family Service of San Diego Safe Parking Program (JFS SPP). Through analysis of quantitative data and interviews with 349 clients and 15 staff, this study yielded three major findings. First, JFS SPP has a 40% positive exit rate, with younger clients, women, veterans, and families more likely to exit into housing. Second, JFS SPP is preferred over shelters by persons who have used both services. This preference is especially important for older clients and clients with disabilities for whom safe parking is a safety net. Finally, increasing access to lots and services would benefit all clients, including families, seniors, and individuals with nontraditional schedules. Findings support policy recommendations for safe parking programs.

An Evidence-Based Framework for Medical Student Research Training.

As research becomes an increasingly important component of medical education, there is greater emphasis on incorporating programmatic enhancements to the research experience. This study builds a logic model to summarize research program inputs, outputs, and outcomes from research-oriented medical schools across the country, providing a framework that institutions can use to design and improve their medical student research training programs. Between November 2021 and February 2022, we administered a survey assessing institutional characteristics, research offerings, curriculum, funding, and student scholarly products to the medical schools ranked 1-50 in research in 2021 by US News and World Report. Results were compiled in the form of a logic model. Thirty-seven institutions (72.5%) responded. Common program inputs included personnel such as at least one funded program director (97.3%), while funding for medical student research activities was highly variable (8-72%). There was much less funding for faculty research mentors (2.7%), advisors (18.9%), and teaching faculty (29.7%). Common outputs included a medical student research office or program (97.3%), formal research curricula (83.8%), and services and programs such as research day (91.9%). The most common outcomes tracked were publications (48.6%), presentations/posters (43.2%), student participation (29.7%), and completion of a research requirement(29.7%). Common themes in medical student research training programs may be conceptualized with a logic model that schools can use to develop, evaluate, and iteratively improve their programs. Institutions should consider their desired program outcomes prior to designing inputs (e.g., funding, personnel) and outputs (e.g., curriculum, training). The online version contains supplementary material available at 10.1007/s40670-024-02001-3.

Most Significant Changes Experienced by Organic Agriculture Production Training Beneficiaries in Ifugao, Philippines

The Most Significant Change (MSC) technique was used to explore the impacts of the Organic Agriculture Production (OAP) Training Program of Ifugao State University in Ifugao, Philippines. Beneficiaries were asked about changes that resulted from their participation in the program. Themes were identified from these changes. Bennett’s hierarchy of program outcomes served as basis in determining levels to which collected changes correspond. There were 105 stories in total. These referred to changes economically, socially as well as changes in beneficiaries’ knowledge, attitudes, and skills. Results revealed that the OAP Training Program brought about changes at higher levels that were in line with Bennett’s hierarchy. The OAP Training Program brought impacts to beneficiaries economic and social circumstances as well as knowledge, attitudes, and skills.

A review of restorative justice programmes for First Nations Peoples in Queensland

ABSTRACT This paper reports on the development and implementation of restorative justice policy and practice for First Nations Peoples in Queensland. Using diverse public source materials to produce a summary history and assessment of the Queensland experience, the study found that restorative justice can provide an appropriate response to crime within First Nations communities, but that programmes have had limited application and utilisation to-date. The findings suggest that programmes must involve First Nations Peoples in programme design and delivery, while addressing the systemic disadvantages faced by these communities through a substantial increase in government investment. The study identified the need for increased application of restorative justice and enhanced research on programme outcomes; acknowledging the need to increase attention to victims’ needs and experiences. The paper also recognised the need for more First Nations led research to explore how restorative justice programmes can be enhanced to improve outcomes for First Nations Peoples.

A Scoping Review of Group Nutrition Education and Cooking Programs for People Affected by Cancer

BackgroundGroup nutrition education and cooking programs for people affected by cancer have the potential to address commonly reported unmet needs for dietary information, as well as provide opportunities for practical and social support. ObjectiveTo report the nutrition-related content, delivery methods, and outcomes measured in group nutrition education and cooking programs for people affected by cancer in the published literature, and describe how these programs were developed, implemented, and evaluated. MethodsA scoping review of academic literature is reported using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews guidelines. Key terms such as cancer, nutrition education, and cooking were searched across 4 databases (PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature, and Web of Science) on June 1, 2023, for records published over the past 10 years. Records were independently screened by 2 reviewers. Data extracted included program participants, components, nutrition-related content, delivery methods, outcomes measured, and information about how the program was developed, implemented, and evaluated. ResultsOf 2,254 records identified, 41 articles met eligibility criteria, reporting on 37 programs. Most programs were designed for adult cancer survivors (89%) and conducted after primary treatment (81%). Four programs invited caregivers to attend. Almost all programs (97%) included a nutrition education component, and more than half (59%) included cooking activities, with a predominant focus on recommendations and practical skills for healthy eating. Most programs were delivered byregistered dietitians and/or nutritionists (54%) and included group discussions (57%) and active involvement in cooking activities (57%) in program delivery. The participant outcomes that were measured covered dietary, psychosocial, clinical, and anthropometric domains. Many programs were developed with cancer survivors, dietitians or nutritionists, and researchers. No studies reported on sustainability of program implementation or overall costs. Programs were evaluated using data from surveys, focus groups, interviews, and field notes, with articles typically reporting on participation rates, reasons for nonparticipation, program acceptability, aspects of the nutrition-related programs valued by participants, and suggestions for improvement. ConclusionsFuture research should prioritize assessing the effectiveness of these programs for participants. Future development, implementation, and evaluation of these programs should include family members and friends and assess the sustainability of program delivery, including cost-effectiveness.

Alleviation of Poverty Through Panchayat Raj Institutions: A Critical Study of Challenges and Prospects in Karnataka, India

Purpose: The purpose of this paper is to: Analyse the role of Panchayat Raj Institutions (PRIs) in alleviating poverty in Karnataka, India. Identify the challenges faced by PRIs in implementing poverty alleviation programs. Explore potential solutions to overcome these challenges and improve program effectiveness. Provide recommendations for strengthening the role of PRIs in poverty alleviation efforts. Theoretical reference: This paper draws on several theoretical frameworks, including: heories of poverty alleviation, focusing on the role of local governance and community participation. Theories of decentralization and the devolution of power to local governments. Theories of social justice and equity, emphasizing the need to address the root causes of poverty. Theories of sustainable development, highlighting the importance of integrating economic, social, and environmental considerations. Method: This research is primarily a doctrinal study, relying on a variety of primary and secondary sources: Primary Sources: Statutory enactments: Constitution of India, 1950, Central Government Schemes implemented by PRIs, The Karnataka Gram Swaraj and Panchayat Raj Act, 1993. Policy documents: National Rural Development Policy, Karnataka State Rural Development Policy, Poverty alleviation scheme guidelines. Secondary Sources: Statistical analysis: Government reports and data sets, Research reports and surveys, Research publications: Peer-reviewed articles and books on poverty alleviation, local governance, and development. Case studies: Examples of successful poverty alleviation programs implemented by PRIs. Results: This research identified several key challenges faced by PRIs in implementing poverty alleviation programs in Karnataka: Corruption: Misuse of funds and resources hinders the effectiveness of programs and prevents benefits from reaching the intended beneficiaries. Caste: Deep-rooted social inequalities limit access to resources and opportunities for marginalized communities. Lack of awareness: Many people remain unaware of available schemes and benefits, leading to underutilization of resources. Limited capacity: PRIs often lack the necessary skills and resources to effectively plan, implement, and monitor programs. Lack of coordination: Poor coordination between different levels of government and stakeholders can lead to delays, duplication of efforts, and inefficient resource allocation. Despite these challenges, the research also identified several promising practices and potential solutions: Transparency and accountability: Initiatives like social audits and public hearings can improve transparency and hold PRI officials accountable for program outcomes. Community participation: Engaging communities in program design and decision-making can ensure programs are relevant and address local needs. Capacity building: Training programs can equip PRI officials with the necessary skills and knowledge to manage programs effectively. Technology and innovation: Utilizing technology can enhance program efficiency, data management, and communication with beneficiaries. Partnerships: Collaborations with NGOs, civil society organizations, and private sector can contribute resources, expertise, and innovation. Conclusion: PRIs play a crucial role in alleviating poverty in India. While they face numerous challenges, there are also promising solutions and opportunities for improvement. By investing in capacity building, promoting transparency, fostering community participation, and embracing technology and innovation, PRIs can be empowered to become more effective agents of poverty alleviation in Karnataka and beyond. Implications of research: This research has several key implications for policy and practice: The need for strengthened capacity building for PRI officials to improve program planning, implementation, and monitoring. The importance of enhancing transparency and accountability in the allocation and use of resources for poverty alleviation programs. The necessity for increased community participation in program design and decision-making to ensure programs are responsive to local needs and priorities. The need for better coordination between central, state, and local governments to ensure effective implementation of poverty alleviation programs. Originality/value: This research contributes to the existing body of knowledge on poverty alleviation by: Providing a detailed analysis of the role of PRIs in Karnataka, India, a context that is often overlooked in research. Identifying unique challenges faced by PRIs in implementing poverty alleviation programs. Offering practical recommendations for strengthening the role of PRIs and improving program effectiveness. Contributing to the understanding of how local governance can be leveraged to achieve sustainable poverty alleviation.

Feasibility of paying people who use drugs cash to distribute naloxone within their networks

IntroductionImmediate access to naloxone is needed to prevent fatal opioid-related overdoses in the presence of fentanyl analogs saturating the opioid supply. Peer models engage impacted populations who are not accessing naloxone through standard venues, yet compensating peers who utilize syringe service programs with cash stipends to distribute naloxone within networks of people who use drugs is not well described.MethodsAs part of the HEALing Communities Study, syringe service program-based interventions were developed in Holyoke and Gloucester, MA, which paid people who use drugs (“peers”) cash to distribute naloxone. Early program outcomes were evaluated for the time each program was funded within the HCS study period.ResultsDuring 22 study-months of observation, peers in two communities distributed 1104 naloxone kits. The total cost of peer compensation for program delivery was $10,510. The rate of peer-distributed naloxone per 100 K population reached 109 kits/mo and 222 kits/mo in the two communities. Participating peers addressed gaps in harm reduction outreach and distributed naloxone and other harm reduction equipment to individuals who were not syringe service program participants, expanding organizational reach. Being compensated with unrestricted cash stipends supported dignity and acknowledged peers’ work in overdose prevention.ConclusionThe underutilization of compensated peer models is often attributed to funding and organizational barriers. These programs demonstrate that providing cash stipends to peers is feasible and expanded naloxone distribution at two existing syringe service programs. Providing cash stipends for peers who engage in secondary naloxone distribution offers promise in delivering naloxone to people not accessing syringe services.

Characteristics and Outcomes of Postgraduate Midwifery Fellowships: A Mixed Methods Study.

Postgraduate fellowships are growing in midwifery and yet are poorly understood by the profession. These fellowships are optional for midwives interested in developing advanced skills, transitioning to specialty practice, or entering or re-entering professional practice. The purpose of this study was to explore the characteristics and outcomes of US postgraduate midwifery fellowships as described by midwifery fellowship program directors. Postgraduate midwifery fellowship programs in the United States were identified through an environmental scan and snowball sampling. Directors of these fellowship programs were invited to complete a survey and an open-ended interview to determine their program's characteristics and outcomes. Quantitative data were summarized, and thematic analysis was used to explore the qualitative data. An environmental scan and snowball sampling identified 17 postgraduate midwifery fellowship programs. Thirteen fellowship program directors completed a survey (76.5%), and 11 completed an interview (64.7%). The findings identified program characteristics, including location, structure, funding, and educational offerings, of midwifery fellowship programs. The thematic analysis revealed the emergence of 3 themes highlighting the creation of support for midwives in transition, including new graduates and practicing midwives returning to practice after a hiatus or shifting to specialty practice: (1) stepping stones, (2) empowered and equipped, and (3) innovative future. Community birth practice was defined as specialty practice by these directors. The results of this study inform the profession of the availability of fellowships and the development of future high-quality midwifery fellowships. Postgraduate midwifery fellowships should not be required for entry to practice but have a place in the work-study opportunities available to US midwives.

Evaluation Capacity Building Through Community-University Partnership

Evaluation is essential to achieving program outcomes, especially when stakeholders engage with evaluation and make use of the findings. Both of these activities require evaluation capacity that might not be present in community-based organizations. In this paper, we describe how community-university partnership models can support evaluation capacity building (ECB). The basic framework for our ECB initiative was a semester-long, master's-level university course in which 5–6 community partners worked with small groups of 3–4 students to design an evaluation plan. We used mixed-methods to assess (1) if organizations implemented the evaluation plans developed in the course; (2) how organizations used the findings; and (3) what evaluation skills participants continued to use after the course ended. We found that organizations that implemented their evaluation plans gained intended outcomes of ECB, such as improving practice and communicating with stakeholders. These results suggest that community-university partnerships for developing ECB can be effective.

Analysis of the Stunting Program in Kubu Raya Regency through the Use of Evidence Theory

Stunting is a condition of growth failure in children under five due to chronic malnutrition, especially in the First 1,000 Days of Life (HPK). As a form of government responsibility related to efforts to accelerate stunting reduction, the government issued Presidential Regulation (Perpres) Number 72 of 2021 concerning Acceleration of Stunting Reduction. In the 2020-2024 RPJMN, the government targets the stunting prevalence rate in Indonesia to decrease to 14%. Therefore, districts/cities, especially those that are priority districts, must make convergence efforts in accelerating stunting reduction. Kubu Raya Regency is one of the areas in West Kalimantan that has a high percentage of stunting. The use of evidence plays a very important role in the policy-making process, especially in the policy of the Stunting Reduction Acceleration program which is a priority program at this time in accordance with Kubu Raya Regent Regulation Number 59 of 2019. The research method used is descriptive qualitative using data collection techniques in the form of observation, interviews and documentation. Data analysis used in this research with the concept of Evidence Based Policy, which includes several indicators, namely program assessment, budget development, implementation oversight, outcome monitoring and target evaluation. The results of this study show that the use of evidence in the implementation of Kubu Raya Regent Regulation Number 59 of 2019 concerning the Stunting Reduction Acceleration Movement provides significant changes and runs effectively with several new activities and innovations that adjust to the needs.

AN OVER VIEW ON EVALUATION OF TRAINING PROGRAM

This paper begins with an introduction highlighting the significance of training programs and the crucial role of effective evaluation in optimizing outcomes. The purpose of training program evaluation is then explored, focusing on identifying goals, aligning objectives with organizational aims, and understanding the impact on individual and organizational performance. The article delves into various types of training program evaluation, including formative, summative, process, and outcome evaluations, along with their respective methods. Key metrics and indicators, both quantitative and qualitative, are discussed, covering completion rates, performance improvement, cost-effectiveness, participant feedback, skill transfer, and changes in organizational culture. The challenges associated with training program evaluation are addressed, such as a lack of clear objectives, difficulty in measuring intangible outcomes, limited resources, and resistance to change. The abstract concludes by highlighting future trends, emphasizing technology integration, ROI measurement, and personalized learning. It wraps up with a recap of the importance of training program evaluation and an encouraging call for organizations to adopt effective practices for continuous improvement. Keywords: Training Program, Evaluation, Optimization, Formative and Summative valuation, Metrics and Indicators

Exploring the Adoption and Effectiveness of Results-based Management in the Non-profit Sector in Zambia

Purpose: This paper examined the adoption and effective of results-based management in the Non-profit organisation in Zambia. The adoption of RBM in the non-profit sector globally has been the subject of increasing attention in the literature. Limited research has been conducted on the adoption and effectiveness of Results-Based Management (RBM) in the non-profit sector within the Zambian context. Methodology: The study adopted a phenomenological qualitative research design. The study was done in Lusaka and involved two Non-Governmental Organisations (NGO): World Vision and Care International Zambia. The study had a sample size of 20 sampled using purposive sampling technique. The study adopted thematic approach to data analysis. Findings: The findings revealed a positive impact on resource utilisation and efficiency within two NGOs; World Vision and Care International Zambia. Both Organisations report improved efficiency in resource allocation, emphasizing strategic planning and focused activities contributing to program outcomes. While acknowledging overall gains, challenges in optimizing specific resources such as technology and training were recognized. Continuous training and capacity-building emerged as crucial, emphasizing the human resource aspect of RBM success. Integration of financial data with programmatic outcomes and the need for a more comprehensive evaluation of long-term program sustainability were identified. Transparent resource utilization, equitable distribution, and effective communication with stakeholders were deemed essential for achieving consistent results. The study highlights RBM's complex impact on resource management, guiding Organisations toward more purposeful allocation and fostering a culture of continuous improvement.

Competency-based postgraduate training: Mentoring and monitoring using entrustable professional activities with descriptive rubrics for objectivity- A step beyond Dreyfus.

Background At Sri Balaji Vidyapeeth, a competency-based learning and training (CoBaLT©) model for postgraduate (PG) curriculum, within the regulatory norms, was implemented in 2016 after adequate faculty development programmes. This focused on well-defined outcomes. Methods A review of the outcomes was undertaken in 2018 as part of internal quality assurance receiving feedback from all stakeholders, viz. students, alumni and faculty. Recent publications were also reviewed. A major problem identified was lack of clarity in definition of levels leading to subjectivity in assessment while grading. It was also noted that the process needed to be aligned with the programme outcomes. Further refinements were, therefore, made to align and objectivize formative assessment using entrustable professional activities (EPA) with the aid of descriptive rubrics of sub-competencies and milestones. Addition of detailed rubrics for objectivity takes assessment a step beyond the Dreyfus model, aligning overall to the programme outcomes. Results Achievement of appropriate grades in EPAs by individual candidates ensures entrustability in professional activities by the time of completion of the PG programme. The modification was found more transparent and objective with reference to grading by the teachers and more conducive to reflections by the residents on their performance and how to improve it. Conclusions The use of descriptive rubrics along with EPAs brings transparency and plays a key role as an objective assessment tool, which can lend direction to individual resident learning and entrustability. This is an important component of outcome-based education.

ARE CHANGE IN METS DURING CARDIAC REHAB RELATED TO CHANGE IN PEAK VO2 AND 6MWD?

https://youtu.be/x7wTd1TmxrA BACKGROUND Change in metabolic equivalents of task (METs) during exercise training is often used as a program outcome in cardiac rehabilitation (CR). The purpose of this study is to assess the correlation between the change in estimated exercise training METs during a CR program and the change in six-minute walk distance (6MWD) and change in peak oxygen uptake (VO2). METHODS This is a secondary analysis of data from the iATTEND trial- a randomized controlled trial that compared facility based CR versus hybrid CR. Subjects included in this analysis had a history of myocardial infraction, coronary revascularization, heart failure, or valve surgery and completed ≥12 sessions of CR. METs during exercise training were estimated using ACSM treadmill equations from the average of the second, third and fourth sessions of CR and the final three sessions of CR. 6MWD and peak VO2 was derived from a symptom limited graded exercise treadmill test with gas exchange were collected at baseline before starting CR and within 14 days of completing CR. Pearson correlation coefficient was determined between change in estimated exercise training METs and both change in 6MWD and in peak VO2. RESULTS The final cohort was n=237 (age=59±12 years; 35% women; 57% non-white race). The correlation between change in estimated exercise training METs and 6MWD was r=0.257, r=0.245, and r=0.235 among patients who completed ≥12 sessions of CR, ≥24 sessions of CR, and 36 sessions of CR, respectively. The correlation between change in estimated exercise training METs and peak VO2 was r=0.121, r=0.100, and r=0.136 among patients who completed ≥12 sessions of CR, ≥24 sessions of CR, and 36 sessions of CR, respectively. CONCLUSIONS Although change in estimated exercise training METs during a CR program, change in 6MWD, and change in peak VO2 have each been used to describe change in exercise tolerance for program outcomes, the association between these variables is low (r= <0.3). This finding was independent regardless of the number of sessions completed. Further research is needed to better understand the relationship between the various methods of assessing change in exercise tolerance and program outcomes in CR.

Evaluation Model for Online Nursing Education (EM-ONE): Update to the Billings' Framework.

Distance education has progressed and transformed significantly since Billings first created a framework to assess practices and outcomes in web-based courses 20 years ago. This article presents the Evaluation Model for Online Nursing Education (EM-ONE), designed to reflect current best practices and provide recommendations for online nursing education. Four databases were searched to source evidence for online educational practices that resulted in positive learner and programmatic outcomes. Essential components of modern distance education include: (1) curriculum and instruction tailored to the online community of learners; (2) preparation and support for both learners and faculty; and (3) effective user experiences in the online learning environment. Effective distance education practices ultimately prepare graduates who are competent for nursing practice. Retention and satisfaction of online learners are other key considerations for positive outcomes in distance-based programs. [J Nurs Educ. 2024;63(2):93-101.].