Program Design Features Research Articles

Technology ownership, use, and perceptions of web-based program design features for older adults prescribed oral anticancer medication.

Older adults are often prescribed oral anticancer agents (OAAs). Technology-based interventions may offer medication and symptom support. We aimed to evaluate technology ownership, use, and preferred design features of a supportive web-based program using a multimethod design utilizing surveys and semi-structured interviews. Patients were recruited from a National Cancer Institute-designated Comprehensive Cancer Center. Eligibility included those: (1) ≥65years of age; (2) prescribed a Food and Drug Administration-approved OAA; (3) English speaking; (4) able/willing to complete telephone interviews. Interviews were audio-recorded and transcribed verbatim. Cohen's Kappa was used to evaluate inter-rater reliability and calculated at 0.87. Participants (N=30) were predominantly female (70%), White (83.3%), with metastatic disease (90%). The mean age was 74.9years. Ninety percent owned a smartphone, 66.7% owned a tablet, and 90% owned a computer. Nearly 57% reported using smartphones frequently for cancer-related purposes. Four themes with corresponding subthemes were identified: (1) comfort with technology; (2) reasons for technology use for health-related purposes (research of cancer, cancer treatment, and related symptoms/side effects; using the portal to manage health; and appointment and medication reminders); (3) recommended design features for a web-based program (OAA medication-specific information; calendars & medication alarms/reminders; symptom management & symptom trackers; and tutorials and testimonials); and (4) adaptations for older adults (simple navigation; larger font; use of layperson's terms; use of pictures, graphics, and color coding; and voice activation). Older adults use technology for health-related purposes. Specific web-design features and adaptations are needed to enhance usability among older adults.

Workplace genetic testing: which employees are likely to participate, what are their concerns with employer sponsorship, and which design features could reduce barriers and increase participation?

Voluntary genetic testing (GT) leverages low-cost DNA sequencing and other testing methods to provide genetic risk screening for healthy individuals. Given the potential to prevent disease and promote health, some employers now offer GT as an employee benefit (workplace GT, or wGT), but participation remains low. To investigate facilitators and barriers to wGT participation, we conducted one of the first representative surveys of working U.S. adults on this topic (n = 958). We assessed factors that could influence participation, including: sponsoring entity (health provider or employer), program design, and individual demographics. Two-thirds (68%) of respondents indicated willingness to participate in some type of GT, but only half (49%) expressed willingness to participate through their employer. Women were 60% more willing to participate than men, and individuals with previous genetic testing experience were 143% more willing to participate than those without such experience. Across all demographic groups, certain GT program design features tended to increase or decrease willingness to participate. The ability to have one's data deleted from the GT database increased willingness most often (true for 67% of respondents), while selling data to pharmaceutical companies decreased willingness most often (true for 63% of respondents).

International pupil mobility in secondary schools: which variables are most closely associated with the development of intercultural competence?

ABSTRACT Mobility is one of the key actions within the process of internationalising school education to develop interculturally competent pupils. The study at the heart of this paper – Developing Intercultural Competence Through Adolescents’ Mobility (DICTAM) – seeks to explore which programme design features and individual characteristics are most closely associated with the development of intercultural competence. To reach this goal, a longitudinal study (using open-ended questionnaires and the Intercultural Development Inventory) was conducted with 378 pupils from Italian secondary schools who participated in a mobility programme. Overall findings suggest that different individual characteristics and programme design variables might have a different bearing on enhancing intercultural competence. In our sample, the variables duration (longer is better) and gender (female) are the ones which more likely have a positive impact on intercultural growth.

Lessons from the field. Toward evidence‐based parenting support to promote positive parenting in children's sport

AbstractObjectiveThe development of a brief online program to improve prosocial parent behavior at children's sporting events is described. We provide an overview of the collaborative research and development process, the theoretical basis for program content, design features, and evaluation approach used to establish the feasibility of Play Well Triple P in Junior Rugby League.BackgroundParents influence children's experience of sports, impacting their enjoyment and participation, motivation to play, behavior, and performance during sporting events. Parental expectations and behaviors can place pressure on children, decreasing their enjoyment and contributing to their desistance from playing sport. As sport is important for maintaining children's social and psychological well‐being, research is needed to investigate strategies for supporting children to retain positive involvement in sports throughout childhood and adolescence.MethodCodesign principles were applied across four phases of program development—surveying parents of junior players (Phase 1), which informed the development of program content and design (Phase 2), refining the program based on feedback from parents and sports officials (Phase 3), and concluding with a feasibility evaluation of the final program (Phase 4).ResultsParents who participated in Play Well Triple P reported improvements in positive sport parenting behavior, decreases in negative sport parenting behavior, and a high level of satisfaction with the program.Conclusions and implicationsThe codesign framework for the development of a parent program for rugby league produced a promising and well‐accepted sports parenting program that warrants further trialing, and application to other junior sporting contexts.

Understanding the Sociocognitive Determinants Underlying Intentions to Exercise for Postconcussion Symptom Relief: An Application of the Theory of Planned Behavior.

This study investigated individual sociocognitive factors from the theory of planned behavior and their relationship to exercise for postconcussion recovery. Four hundred and fifty-nine Australian adults, two-thirds of whom had no concussion history (66%), completed an online survey of their beliefs and attitudes toward exercise for postconcussion recovery. Secondary questions evaluated program design features that could affect engagement (eg,session frequency). Structured equation modeling found that subjective norms were the strongest significant predictor of intention to participate in exercise for postconcussion recovery. Perceived behavioral control was also a significant predictor of intention to participate but to a lesser extent. Attitude did not predict participation intention. The design features identified as key were personalization and being supervised during the program. This study found that people's intention to participate in a program of exercise postconcussion recovery is shaped by individual psychological factors and identified program design features that could be adjusted for increased engagement. Program success could be maximized through strategies such as supporting individuals to have a stronger sense of control over their participation through the choice of session timing or frequency and harnessing the influence of significant others via supportive messaging from key professionals.

PROTOCOL: Effectiveness of economic development interventions in humanitarian settings in low- and middle-income countries: A mixed-method systematic review.

This is the protocol for a Campbell systematic review. The review will address the following research questions: (1) What are the effects of economic development interventions on the economic outcomes of people in humanitarian settings? What factors explain any observed variations in effect such as setting, programme design features or duration? (2) What are the effects of economic development interventions on the food security, nutrition, the psychosocial and mental health, and the physical health outcomes of populations in humanitarian settings? (3) What are the success factors and barriers that affect the implementation and effectiveness of economic development interventions on populations affected by humanitarian crisis?

"It has to be more than exercise": exploring multiple perspectives to community-based exercise program design for persons with breast cancer.

Connecting persons with cancer to exercise resources and/or supports requires a diverse team of professionals. As such, there is merit to engaging multiple individuals or "partners" along the cancer pathway to explore the relevant features of community-based exercise program (CBEP) design. The purpose of this study was to explore multi-partner perspectives to CBEP design for persons diagnosed with breast cancer (PWBC) to inform the implementation of a CBEP in a local setting. PWBC, health care professionals and qualified exercise professionals participated in one of four 60-min focus group discussions. Rich dialogue about preferred program environments, program delivery teams, and core program practices was encouraged using a semi-structured discussion guide. Focus groups were audio recorded, transcribed verbatim, and analyzed using inductive thematic analysis. Five main themes were identified based on focus group discussions, each pointing to an important feature of CBEP design for PWBC. Themes included the desire for CBEPs to incorporate elements designed to improve cancer literacy, provide opportunities to participate with peers, foster self-efficacy, prioritize program accessibility, and meaningfully integrate CBEPs within a network of supportive cancer care. The collective effect of fostering such elements in CBEPs may serve to increase the uptake and maintenance of exercise among PWBC; ultimately enhancing their overall well-being and quality of life.

A - 166 Predictors of Intention to Participate in Programmed Exercise for Postconcussion Recovery.

Programmed exercise has been proposed for postconcussion recovery, but willingness to engage in such programs has not been explored. This study investigated sociocognitive factors from the Theory of Planned Behavior (TPB) and their relationship to exercise intention for postconcussion recovery (intention). Four hundred and fifty-nine adults completed an online survey (Age = 18-72years, 34% concussion history). All participants received information about mTBI, postconcussion symptoms, and programmed exercise. The measures assessed TPB constructs including intention, and evaluated program design features that could affect engagement (e.g., session frequency). Structured equation modelling found that intention was significantly predicted (p < 0.05) by subjective norms (strongest predictor) and perceived behavioral control (weaker predictor). Attitudes did not significantly predict intention. The model accounted for approximately half of the variance in exercise intention (R2 = 0.506). The addition of moderators (habitual exercise, concussion history) did not have any effect. Key program design features were personalization and supervision. People's intention to undertake programmed exercise for postconcussion recovery is shaped by individual psychological factors, especially subjective norms and perceived behavioral control. This could be considered in the program design (e.g., building program connections with significant others; fostering a sense of control through personalization/session timetabling). Further research is needed to establish the effect of such additions on engagement with programmed exercise for postconcussion recovery.

Value-Based Payment for Clinicians Treating Cardiovascular Disease: A Policy Statement From the American Heart Association.

Clinician payment is transitioning from fee-for-service to value-based payment, with reimbursement tied to health care quality and cost. However, the overarching goals of value-based payment-to improve health care quality, lower costs, or both-have been largely unmet. This policy statement reviews the current state of value-based payment and provides recommended best practices for future design and implementation. The policy statement is divided into sections that detail different aspects of value-based payment: (1) key program design features (patient population, quality measurement, cost measurement, and risk adjustment), (2) the role of equity during design and evaluation, (3) adjustment of payment, and (4) program implementation and evaluation. Each section introduces the topic, describes important considerations, and lists examples from existing programs. Each section includes recommended best practices for future program design. The policy statement highlights 4 key themes for successful value-based payment. First, programs should carefully weigh the incentives between lowering cost and improving quality of care and ensure that there is adequate focus on quality of care. Second, the expansion of value-based payment should be a tool for improving equity, which is central to quality of care and should be a focal point of program design and evaluation. Third, value-based payment should continue to move away from fee for service toward more flexible funding that allows clinicians to focus resources on the interventions that best help patients. Last, successful programs should find ways to channel clinicians' intrinsic motivation to improve their performance and the care for their patients. These principles should guide the future development of clinician value-based payment models.

Do Community College “Promise” Programs With Low-Bar Merit Criteria Improve High School Performance?

Objective/Research Question: Community college “Promise” programs have proliferated recently, particularly in areas with many low-income, academically struggling students. Many Promise programs restrict eligibility by high school performance but set eligibility thresholds quite low. As such they function as “low-bar” merit scholarships, and merit scholarships are often believed to incentivize improved academic performance. But do such “low-bar” merit scholarships boost high school attendance and grades? Methods: We investigate impacts of one such program, the Milwaukee Area Technical College Promise, on high school students in Milwaukee Public Schools, exploiting program design features to identify treatment effects through a differences-in-differences strategy. Results: The program appears to have marginally improved high school grades while slightly lowering attendance. These effects cancel each other out in terms of meeting combined GPA and attendance eligibility thresholds. Estimated positive impacts on GPA were statistically significant but very small for males, Black students, free lunch eligible students, special education students and current English language learners, while impacts on attendance were negative for most subgroups. The positive GPA effect was restricted to the program’s second year. Conclusions: We do not find strong evidence that low-bar scholarships are effective at improving academic performance. Policymakers should reconsider conventional wisdom underlying inclusion of merit criteria in broad-based scholarships.

Impact of social protection on gender equality in low- and middle-income countries: A systematic review of reviews.

Impact of social protection on gender equality in low- and middle-income countries: A systematic review of reviews.

Interrelated analysis of interaction, sequential patterns and academic achievement in online learning

This study aimed to examine the behaviour of learners across a whole system and in various courses to reveal the interrelation between learners' system interaction, age, programme features and course design. We obtained data from the system logs of 1,634 learners enrolled in distance learning programmes. We performed hierarchical clustering analysis to describe system interactions; then, we carried out a sequential pattern analysis to examine navigational behaviours by clusters. The results showed that the system interactions (e.g., content, live lesson, assignment, exam, discussion) across the whole system differ by age and programme. The behaviour profiles of the learners changed when different course designs were presented. Learners who interacted more with any component (e.g., live lesson or content) according to their needs were more successful than those with limited interaction and assessment-oriented (those with limited interactions outside of the assignment). In an information and communication technology course, learners whose system interactions were sufficient to receive rewards were more likely to succeed. The sequential pattern analysis showed that the assessment-oriented cluster interacted with the assignment in the midterm weeks; the award-oriented cluster interacted with the content or completed their assignment and received an award. Consequently, it is difficult to determine or generalise the intervention unless the system, programme and course design features are standard. Implications for practice or policy: Course designers can use the assessment activities or motivation factors such as awards to increase students' system interactions. Course designers should not determine or generalise interventions unless the system, programme and course design are standard. Researchers should not only focus on data but also consider the contextual characteristics of data.

Compliance under control: Insights from an incentive-based conservation program in rural Bolivia

Conditionality is often considered a key feature of Payments for Ecosystem Services (PES) and other incentive-based conservation programs. Critical components of conditionality – monitoring and sanctions for noncompliance – have received relatively little attention. We identified five groups of potential drivers of compliance based on the concepts of material costs and benefits; social pressure; environmental values and beliefs; trust, fairness and reciprocity; and household characteristics. We analysed data on 1823 monitoring visits from an incentive-based watershed conservation program in rural Bolivia. Drivers informed by material costs and benefits were significantly associated with compliance. Specifically, three program design features were associated with higher likelihood of compliance: less restrictive contracts, larger areas under contract, and having been previously monitored for compliance. Other drivers, including sensitivity to social pressure, environmental values/beliefs, trust, fairness and reciprocity, and household demographic and economic characteristics, were not consistently associated with compliance rates. These results suggest that conservation professionals and policy makers have a large amount of control over compliance in PES, and that clear communication with participants about program objectives and conditions and meaningful and repeated monitoring are key elements of successful and effective PES.

Ohio's Dual Eligible Population: Effects of Program Design and Implementation on Care Management

MyCare Ohio is a prospective blended managed care payment model program tasked to provide comprehensive and coordinated care to Ohio residents who are dully eligible for Medicare and Medicaid. To understand the administration and day-to-day implementation of care management within MyCare Ohio, n=75 interviews with a total of n=331 personnel from Area Agencies on Aging, Managed Care Plans, and service providers were conducted. Interviews were audio recorded, transcribed, and checked for accuracy. Data were analyzed by iterative reviews and deductive coding in Dedoose. Respondents provided insights on how care management activities are affected by program design features (e.g., ability to opt-out of the Medicare component), transitions between acute and long-term care settings, documentation systems and data-sharing, and high numbers of beneficiaries with behavioral health diagnoses. Implications for practice and policy will be discussed.

More evidence on the impact of government social protection in sub‐Saharan Africa: Ghana, Malawi, and Zimbabwe

SummaryMotivationGovernments in sub‐Saharan Africa (SSA) have rapidly expanded cash transfer programmes as part of their social protection strategy over the last decade. Currently 46 countries have a state‐sponsored social protection programme, compared to just 25 countries in 2005, with the most common type of programme being cash transfers, representing 51% of all social protection spending in the region.PurposeWe present evidence on the overall impacts of state‐sponsored cash transfer programmes in SSA, using data from three impact evaluations of government programmes. All three programmes were a key component of the poverty reduction strategy of the respective governments at the time of the evaluations.Methods and approachWe show impacts across nine broad domains including both protection, production and human development, using baseline and follow‐up household surveys on Treatment and Control groups. We relate the pattern of impacts to programme design parameters to further understand the constraints faced by ultra‐poor rural households.FindingsAll three programmes have strong effects on their primary objective—food security or food consumption, as well as on secondary objectives that include livelihood strengthening and children’s well‐being. The largest and most consistent impacts occur in Malawi, where transfer values are in line with international best practice and payments were made regularly during the study period. All programmes show a positive income multiplier, with the multiplier largest in Malawi at 2.94.Policy implicationsThe overall results across three national programmes add to the growing evidence from Africa that government unconditional cash transfers have important positive effects on households, that these effects are not limited to just food security, and that programme design features influence the pattern and size of impacts. Results in this article are based on programmes that pass both criteria of implementation feasibility and political acceptability, and thus provide a more accurate reflection of what real‐world cash transfer programmes can achieve in SSA.

Trust in the programme: An exploration of trust dynamics within rural group-based support programmes

Publicly-funded programmes of business support are important vehicles for rural development, and over the last two decades, group-based models of business support have become popular, in which dedicated advisors work with small firms in groups, rather than one-to-one mentoring. A fundamental goal of such programmes is to foster enhanced inter-firm knowledge exchange and learning, and improved firm resilience and innovation, through the development of collective trust amongst participants,. Although many studies have investigated the evolution of trust, including in a rural context, to date most research has focused either on the macro-institutional level, or the micro-personal level, with relatively little exploration of how meso-level collective trust may be encouraged amongst groups of participants in rural business support programmes. This paper addresses the gap by exploring the development of collective trust within two group-based rural business support programmes in Northern Ireland. The study reveals that programme design features and the interpersonal style of advisors combined to shape clients' trust in the programmes and their sponsoring institutions, as well as influencing the degrees of goodwill and camaraderie within the client groups themselves.

First step and last resort: One-Euro-Jobs after the reform

AbstractJob creation programmes aim at increasing the employability of hard-to-place unemployed, and eventually integrating them into employment. Yet, previous evaluation studies have been pessimistic about their efficacy. For One-Euro-Jobs, a job creation programme for welfare benefit recipients in Germany, previous evaluations found unfavourable effects particularly for easier-to-place participants. Thus, in 2012 the legislator reformed the programme in order to target the hard-to-place more accurately. This study is the first post-reform evaluation of One-Euro-Jobs. We find that, although the programme is indeed better targeted than before, One-Euro-Jobs decrease participants’ employment chances within three years after programme entry. These outcomes are worse than those found for pre-reform participants. We cannot conclude with certainty whether the reform decreased the programme’s efficacy, but we identify channels through which the reform and other contemporaneous changes may have done so. These channels include changes in programme design features, changes in business-cycle conditions, and prolonged lock-in effects due to “programme careers”. To substantiate the latter explanation, we also provide novel evidence that One-Euro-Jobs seem to initiate programme careers.

Inclusionary housing in the United States: dynamics of local policy and outcomes in diverse markets

Inclusionary housing (IH) ties the creation of affordable, below market-rate units with new development, and it is known to help address the affordable housing crisis and build inclusive communities. Yet, the absence of a national IH database limits our understanding of the prevalence, practice, and production of inclusionary housing in the U.S., and it creates barriers for further investigation and development of this affordable housing strategy. This study draws a national census of IH programs in the U.S. Through a comprehensive data collection between 2018 and 2019, a total of 1,019 local IH programs are documented in 734 local jurisdictions of 31 states and the District of Columbia. This study summarizes program design nationwide and features distinct patterns in California, Massachusetts, and New Jersey, where state laws largely impact program adoption and production. A subset of 258 programs reported producing about 110,000 inclusionary units, and 123 programs have collected close to $1.8 billion in fees for affordable housing development.

PROTOCOL: Impact of social protection on gender equality in low- and middle-income countries: A systematic review of reviews.

This is the protocol for a Campbell review. The review aims to systematically collect, appraise, map and synthesise the evidence from systematic reviews on the differential gender impacts of social protection programmes in Low- and Middle-Income Countries (LMICs). Therefore, it will answer the following questions: (1)What is known from systematic reviews on the gender-differentiated impacts of social protection programmes in LMICs? (2)What is known from systematic reviews about the factors that determine these gender-differentiated impacts? (3)What is known from existing systematic reviews about design and implementation features of social protection programmes and their association with gender outcomes?

An Essential but Overlooked Workforce: Elevating the Need to Investigate the Career Development of Paraeducators

Recent research documents the positive impact that paraprofessionals have on student learning. Given these strengths, states and districts across the country have developed programs to attract and prepare paraprofessionals to become certified teachers. Despite increased interest in expanding pathways for the paraeducator workforce, research has also consistently revealed that paraeducators encounter obstacles along the career development continuum from recruitment, preparation, placement, and induction. Given the professionalization challenges paraeducators face, this special issue introduction highlights paraeducator research studies that describe innovative program design features, draw from and build on paraeducators’ funds of knowledge and community cultural wealth, and identify organizational structures in schools essential to supporting paraeducators’ development. We conclude with a recommended set of three core commitments for program designers, researchers, policy makers, or community and school district leaders dedicated to ensuring equitable paraeducator professional pathways in the educator workforce.