Program Evaluation Research Articles

Implementation and evaluation of a mentorship program in clinical master in family medicine during the COVID-19 pandemic at the Arabian Gulf University: a longitudinal study

BackgroundWe implemented a contextualized innovative mentorship program in the Clinical Master in Family Medicine (CMFM) program established in April 2020 at Arabian Gulf University. In this paper, we describe the process of this program and derive the major challenges faced by trainees and related corrective actions and their outcomes on high-risk trainees for optimal performance.MethodsWe conducted a mixed-method longitudinal study of 80 trainees, analyzing information extracted from the Moodle learning platform about five key performance indicators as well as the contents (quantitative and qualitative) of mentoring meeting reports submitted through a validated online form between 2020 and 2022. We analyzed frequencies and themes of challenges and compared trainees' performance according to time and level of risk.ResultsThe follow-up of all 80 trainees in two cohorts (40 for each cohort) shows that most are female (93.75%) and the mean age is 30.00 ± 2.19 years with a ratio of mentors to mentees of 1 to 5. Meetings are conducted through phone calls, virtually, and face-to-face in 62%, 29%, and 8.3% respectively. The mean number and duration of meetings are 30.88 ± 2.31 and 20.08 ± 9.50 min respectively. Time management is the most reported challenge (41.3%), followed by health, social, and psychological-related issues in 7.6%, 4.6%, and 3% respectively. We extracted four main themes related to trainees, settings of training, e-Portfolio, and the COVID-19 pandemic. The mentorship program captured 12 trainees at high risk for low academic progress (12%) of whom six graduated on time and the remaining had to repeat a few courses the following terms. The performance of the program is stable over time (mean GPA of 3.30 (SE = 0.03), versus 3.34 (SE = 0.05) for cohorts 1 and 2 in the two years respectively, (P = 0.33). However, it is slightly lower among high-risk trainees compared to the remaining (GPA = 3.35 (SE = 0.03) versus 3.14 (SE = 0.08), P = 0.043) though above the minimum of the threshold of 3 out of 4, required for the master's degree.ConclusionThe mentorship program captured the struggling trainees and permitted to implement pertinent corrective actions timely, particularly in the context of a two-year intensive CMFM program during the COVID-19 pandemic.

S87 - Naloxone Distribution in the Emergency Department: Program Evaluation of the University of Washington Harborview Medical Center Emergency Department’s Response to Washington State Bill 5195

S87 - Naloxone Distribution in the Emergency Department: Program Evaluation of the University of Washington Harborview Medical Center Emergency Department’s Response to Washington State Bill 5195

Interspecific hybridization in a large‐river population of Yellowstone Cutthroat Trout: A 20‐year programmatic evaluation

Interspecific hybridization in a large‐river population of Yellowstone Cutthroat Trout: A 20‐year programmatic evaluation

Longitudinal program evaluation of an inter-institutional mentorship network for pediatric rheumatology using a quality improvement framework

BackgroundThe American College of Rheumatology (ACR)/Childhood Arthritis and Rheumatology Research Alliance (CARRA) Mentoring Interest Group (AMIGO) is an inter-institutional mentorship program launched to target mentorship gaps within pediatric rheumatology. Initial program evaluation indicated increased mentorship access. Given the small size of the pediatric rheumatology workforce, maintaining a consistent supply of mentors was a potential threat to the longevity of the network. Our aims were to: (i) describe the sustainability of AMIGO over the period 2011–2018, (ii) highlight ongoing benefits to participants, and (iii) describe challenges in the maintenance of a mentorship network.MethodsA mixed-methods approach centered on a quality improvement framework was used to report on process and outcomes measures associated with AMIGO annual cycles.ResultsUS and Canada Pediatric rheumatology workforce surveys identified 504 possible participants during the time period. As of fall 2018, 331 unique individuals had participated in AMIGO as a mentee, mentor or both for a program response rate of 66% (331/504). Survey of mentees indicated high satisfaction with impact on general career development, research/scholarship and work-life balance. Mentors indicated increased sense of connection to the community and satisfaction with helping mentees despite limited perceived benefit to their academic portfolios. Based on AMIGO’s success, a counterpart program for adult rheumatology, Creating Adult Rheumatology Mentorship in Academia (CARMA), was launched in 2018.ConclusionsDespite the challenges of a limited workforce, AMIGO continues to provide consistent access to mentorship opportunities for the pediatric rheumatology community. This experience can inform approaches to mentorship gaps in other academic subspecialties.

Analysis and mapping of harm reduction research in the context of injectable drug use: identifying research hotspots, gaps and future directions

BackgroundHarm reduction is a crucial approach in addressing the multifaceted challenges of injectable drug use. This paper presents an analysis and mapping of the existing literature on harm reduction research in the context of injectable drug use. By reviewing a comprehensive set of scholarly articles, this study identifies research hotspots, knowledge gaps, and future directions in the field. The findings provide valuable insights for researchers, policymakers, and practitioners to guide future research efforts and inform evidence-based harm reduction interventions.MethodsData for the study was obtained from the Scopus database, using keywords and phrases related to harm reduction and injectable drug use. Validation methods were employed to verify the accuracy and comprehensiveness of the search strategy. Data analysis involved identifying growth patterns, key contributors, mapping frequent terms, identifying research hotspots, and identifying emerging research directions.ResultsA total of 971 articles were found, with a notable increase from 2015 to 2022. The International Journal of Drug Policy (n = 172, 17.7%) and the Harm Reduction Journal (n = 104, 10.7%) were the most prolific journals, and the United States (n = 558, 57.5%) had the highest number of publications. The Johns Hopkins University (n = 80, 8.5%) was the most prolific institution. Mapping of frequent author keywords revealed the main keywords, including harm reduction, HIV, hepatitis C, and opioid overdose. The highly cited articles cover a broad time span and focus on topics like naloxone distribution, HIV and hepatitis C transmission, while recent articles concentrate on emerging issues such as the impact of the COVID-19 pandemic, fentanyl-related concerns, stigma reduction, and needle and syringe programs. Both sets of articles share a common focus on harm reduction strategies, but recent publications highlight current challenges and developments in the field.ConclusionsThis study provides insights into research landscape on harm reduction in injectable drug use. Research is concentrated in high-income countries, emphasizing the need for more research in low- and middle-income countries. Recent publications focus on emerging challenges like COVID-19 and fentanyl. Research gaps highlight the need for studies in diverse populations, social determinants, program evaluation, and implementation strategies to enhance harm reduction interventions.

Health impact evaluation of Aspirational Districts Program in India: Evidence from National Family Health Survey

The Aspirational District Program (ADP) is a unique initiative of Government of India launched in 2018 that aims to reduce inter-district multidimensional inequality. ADP aims to bring the least developed districts to catch up with the rest of the other districts in the country. The program is comprehensive in its scope as it targets improvement of several key development indicators spanning health and nutrition, education, agriculture and water resources, financial inclusion and skill development and basic infrastructure indicators. Aspirational districts (ADs) are eligible for enhanced funding and priority allocation of various initiatives undertaken by the central and the state governments. Our research estimates the causal impact of ADP on the targeted health and nutrition indicators using a combination of propensity score matching and difference-in-differences (PSM-DID). We use the fourth and fifth rounds of National Family Health Survey (NFHS) data collected in 2015–16 and 2019–21 respectively which serve as the pre and post-treatment data for our analysis. Moreover, we take advantage of the transparent mechanism outlined for the identification of ADs under ADP, which we use for propensity score matching for our PSM-DID. While we observe negative impact of ADP on early initiation of breastfeeding, we believe that the impact is confounded with the effects of Covid-19 since part of NFHS-5 data was collected during the pandemic. However, the negative impact of ADP on early initiation of breastfeeding disappears when we only use pre-covid data (i.e. data for districts from states surveyed before the pandemic). Additionally, using pre-covid data we find a reduction in the prevalence of underweight children younger than 5 years to an extent of 2 to 4 percentage points in ADs as an impact of ADP, which is robust across multiple specification. We do not find evidence of a positive or a negative impact of ADP on any other health and nutrition indicators. Future research efforts should be made towards impact evaluation of all the targeted indicators in order to get a comprehensive unbiased evaluation of ADP.

Demonstrating the benefit of a cellulitis-specific patient reported outcome measure (CELLUPROM©) as part of the National Cellulitis Improvement Programme in Wales

PurposeDespite a known risk of cellulitis recurrence, the management of the wider impact and risk factors has been neglected. The innovative National Cellulitis Improvement Programme (NCIP) addresses this by providing evidence-based and individualised care to improve patient reported outcomes and reduce the risk of recurrence. The aim of this paper is to examine the longer-term impact of cellulitis and to identify a suitable and clinically relevant Patient Reported Outcome Measure (PROM).MethodsA review of existing cellulitis-specific PROMs was undertaken, alongside literature detailing the patient-focused impact of cellulitis, to identify a suitable PROM for clinical use. A group of expert therapists and patient representatives (n = 14) shared their individual and collective experiences over a series of events to discuss and debate the impact of cellulitis and review available PROMs. CELLUPROM© is introduced with anonymised PROM data and case study information reported to establish the impact of CELLUPROM© within usual NCIP care.ResultsNo cellulitis-specific PROMs were identified. Literature focused on the signs and symptoms of an acute episode of cellulitis, with outcome measures primarily used to evidence the impact of an intervention. An enduring physical, social and emotional impact of cellulitis was identified in this study, providing the basis for the new cellulitis-specific PROM (CELLUPROM©), which has been implemented with good effect in clinical care.ConclusionThis study has highlighted the lasting impact of cellulitis. Using CELLUPROM© within the risk-reduction NCIP has helped develop Value-Based Healthcare and support programme evaluation.

Developing pre-licensure interprofessional and stroke care competencies through skills-based simulations

ABSTRACT Interprofessional collaboration (IPC) in stroke care is accepted as best practice and necessary given the multi-system challenges and array of professionals involved. Our two-part stroke team simulations offer an intentional interprofessional educational experience (IPE) embedded in pre-licensure occupational therapy, physical therapy, pharmacy, medicine, nursing and speech-language pathology curricula. This six-year mixed method program evaluation aimed to determine if simulation delivery differences necessitated by COVID-19 impacted students’ IPC perception, ratings, and reported learning. Following both simulations, the Interprofessional Collaborative Competency Assessment Scale (ICCAS) and free-text self-reported learning was voluntarily and anonymously collected. A factorial ANOVA using the ICCAS interprofessional competency factors compared scores across delivery methods. Content and category analysis was done for free-text responses. Overall, delivery formats did not affect positive changes in pre-post ICCAS scores. However, pre and post ICCAS scores were significantly different for interprofessional competencies of roles/responsibilities and collaborative patient/family centered approach. Analysis of over 10,000 written response to four open-ended questions revealed the simulation designs evoked better understanding of others’ and own scope of practice, how roles and shared leadership change based on context and client need, and the value of each team member’s expertise. Virtual-experience-only students noted preference for an in-person stroke clinic simulation opportunity.

PERFORMANCE EVALUATION OF THE TRANS METRO DELI PROGRAM IN IMPROVING PUBLIC TRANSPORTATION SERVICES IN MEDAN CITY

This study aims to determine and describe the Performance Evaluation of the Trans Metro Deli Program in Improving Public Transportation Services in Medan City. At the beginning of its operation, Trans Metro Deli received good views from the public because it could be enjoyed for free. However, the implementation of the Trans Metro Deli program, which has been almost 3 years, has not fully addressed the problems in the field, so it is necessary to evaluate the performance of the Trans Metro Deli program. The purpose of this study was to identify and describe in detail performance evaluation of the Trans Metro Deli Program by looking at Helmut Wollman's evaluation indicators: Effectiveness, Efficiency and Equity. This research use descriptive qualitative approach. Based on the research results, performance evaluation of the Trans Metro Deli program was carried out using three evaluation indicators: First, effectiveness is running well but is hampered by the problem of illegal parking which has not been resolved. Second, efficiency needs to be considered to increase the number of human resources in the technology department. Third, Equity is not yet optimal, this can be seen from the 217 bus stops, only 60 of them were made permanent while the rest were damaged. Therefore, it is very necessary to improve the transportation facilities and infrastructure in Medan that are able to meet the needs of all levels of society, especially for the disabled and the elderly.

Evaluation of a Virtual Tai Chi Program for Older Veterans at Risk of Loneliness or Physical Deconditioning: A Quality Improvement Project.

This Quality Improvement project evaluated the implementation of a virtual Tai Chi program for older Veterans (OVs) at risk of loneliness and/or physical deconditioning. A 12-week Tai Chi course was conducted virtually at three Veterans Affairs sites using VA Video Connect (VVC). Changes in physical function based on the 30-Second Chair Stand (30CST) and loneliness based on the De Jong Gierveld Loneliness Scale (DJGS) were measured, as were the OVs' satisfaction and adherence. Of 109 OVs who enrolled, 74 completed the program with a mean attendance rate of 84%. Completers demonstrated a statistically significant improvement in the 30CST, and those who were moderately or severely lonely at baseline saw a statistically significant improvement in the DJGS. Course evaluations were generally very positive. Results suggest that a virtual Tai Chi program is an effective and very satisfying intervention for OVs at risk of loneliness or physical deconditioning.

Impact of integrated child development scheme on nutritional and health status of children

The Indian government’s centerpiece initiative, the Integrated Child Development Scheme (ICDS) project, aims to improve the overall growth, wellness, and nutrition of children under six years old and pregnant and breastfeeding mothers’ nutritional and physical well-being. KanyaKumari (KK) district, located in the southern state of Tamil Nadu, has also benefited from this program. Using a questionnaire survey method, valid data were collected from 120 participants, and interviews were subsequently conducted with 52 individuals to gain deeper insights into the research topic. SPSS statistical software was utilized. The program under assessment, the ICDS, targets children under six and pregnant and lactating mothers, offering services like nutrition, healthcare, and early childhood education to improve their health and Nutritional Status (NS). The indicators being assessed include nutritional and Health Status (HS) (e.g., malnutrition, immunization rates) to decrease malnutrition and improve overall health outcomes. The findings of this study indicate that the prevalence of child malnutrition has decreased, suggesting that the ICDS has been effective in improving the NHC. The novelty of this research lies in its specific focus on the KK district, its evaluation of a government program’s impact, and its emphasis on child welfare and development. The study’s insights on integrated child development programs can inform policymakers, healthcare providers, and community groups globally, aiding efforts to improve child health and nutrition implications. The ICDS has had a positive impact on the NHC in the KK district. However, continuous efforts are required to overcome challenges and ensure the sustained success of the program in the district.

Evaluation of a Remote Patient Monitoring Program During the COVID-19 Pandemic: Retrospective Case Study With a Mixed Methods Explanatory Sequential Design.

Community health center (CHC) patients experience a disproportionately high prevalence of chronic conditions and barriers to accessing technologies that might support the management of these conditions. One such technology includes tools used for remote patient monitoring (RPM), the use of which surged during the COVID-19 pandemic. The aim of this study was to assess how a CHC implemented an RPM program during the COVID-19 pandemic. This retrospective case study used a mixed methods explanatory sequential design to evaluate a CHC's implementation of a suite of RPM tools during the COVID-19 pandemic. Analyses used electronic health record-extracted health outcomes data and semistructured interviews with the CHC's staff and patients participating in the RPM program. The CHC enrolled 147 patients in a hypertension RPM program. After 6 months of RPM use, mean systolic blood pressure (BP) was 13.4 mm Hg lower and mean diastolic BP 6.4 mm Hg lower, corresponding with an increase in hypertension control (BP<140/90 mm Hg) from 33.3% of patients to 81.5%. Considerable effort was dedicated to standing up the program, reinforced by organizational prioritization of chronic disease management, and by a clinician who championed program implementation. Noted barriers to implementation of the RPM program were limited initial training, lack of sustained support, and complexities related to the RPM device technology. While RPM technology holds promise for addressing chronic disease management, successful RPM program requires substantial investment in implementation support and technical assistance.

Why Programs Fail: Lessons for Improving Public Service Quality from a Mixed-Methods Evaluation of an Unsuccessful Teacher Training Program in Nepal

Abstract This study demonstrates rigorously that an at-scale government training program for secondary teachers in Nepal had little or no impact on student learning. It then documents five sets of weaknesses related to training uptake, training-session management, teacher subject knowledge, teacher adoption of new classroom practices, and student knowledge of earlier-grade curriculum content, each of which plausibly explains some, but not all, of the program's failure. While weaknesses in trainer and teacher motivation may have contributed to the program's disappointing performance, the study argues that time, resource, and capacity constraints of both trainers and teachers, and a mismatch between policy design and student learning needs, also limited program success. These results highlight the need to broaden common accountability-focused conceptions of how to improve public service quality.

Triple-drug therapy with ivermectin, diethylcarbamazine and albendazole for the acceleration of lymphatic filariasis elimination in Kenya: Programmatic implementation and results of the first impact assessment.

The World Health Organization (WHO) endorsed the use of triple-drug mass drug administration (MDA) regimen with ivermectin, diethylcarbamazine (DEC) and albendazole (commonly abbreviated as IDA) to accelerate the elimination of lymphatic filariasis (LF) as a public health problem in settings where onchocerciasis is not co-endemic. The National Programme for Elimination of LF (NPELF) in Kenya was among the first adopters of the IDA-MDA and two annual rounds were provided in 2018 and 2019 to the residents of Lamu County and Jomvu sub-County in the coast region. This study documented the feasibility of successfully delivering the two rounds of IDA-MDA. An operational research study was undertaken to determine efficient sampling strategies, indicators, and the appropriate population groups that could be used for the monitoring and evaluation of LF programs using IDA-MDA for the elimination of the disease as a public health problem. Two cross-sectional surveys were conducted at baseline in 2018 before IDA-MDA and an impact assessment 17 months after the second round of IDA-MDA. The reported epidemiological treatment coverage was at least 80% in all implementation units during each round of IDA-MDA. Blood samples were tested for filarial antigenemia using commercial Filariasis Test Strips (FTS) and any individual found to be positive was tested again at night for the presence of microfilariae in finger prick blood smears using microscopy. The overall prevalence of circulating filarial antigen (CFA) was relatively low at the baseline survey with Jomvu having 1.39% (95% CI: 0.91, 2.11) and Lamu having 0.48% (95% CI: 0.21, 1.13). Significant reduction in CFA prevalence was observed during the impact assessment after the two annual rounds of mass treatment. The overall relative reduction (%) in CFA prevalence following the two rounds of MDA with IDA was significant in both Jomvu (52.45%, Z = -2.46, P < 0.02) and Lamu (52.71%, Z = -1.97, P < 0.05). Heterogeneity, however, was observed in the CFA prevalence reduction between random and purposive clusters, as well as between adult and child populations. The results of the impact assessment survey offered strong evidence that it was safe to stop the IDA-MDA in the two EUs because transmission appears to have been interrupted. It is also important to implement a post-treatment surveillance system which would enable efficient detection of any recrudescence of LF transmission at a sub-evaluation unit level. Our findings show that IDA-MDA may be considered for acceleration of LF elimination in other settings where onchocerciasis is not co-endemic.

Spare or transform? Agency frames in transition intermediaries

Climate emergency is widely acknowledged. However, our institutions are struggling to find new intervention types to accelerate the transition. This paper analyses this struggle by combining agency theories and discursive approaches to study transition intermediaries, i.e, organizations seeking to foster the transition activities of others. The internal meaning structures of intermediaries are described as interlocking shared action frames, i.e., beliefs and meanings underpining their activities. These frames are characterized through the definition of pairs of contrasting frame elements along eleven framing dimensions. This conceptualization allows for a semi-quantitative mapping of internal structures. The method is developped and illustrated with the in-depth case study of a Swiss regional utility department running an energy efficiency programme. Analysing a series of exploratory workshops, we find that established frames revolve around technology-oriented, managerial approaches to the transition, ultimately narrowing the range of imaginable interventions. While these are well-studied shortcomings of energy efficiency centred approaches, further observations suggest that these frames underpin the perception of intervention impacts, helping keep staff and recipients involved. To strike a balance between energy saving targets and transformative ambitions, this paper suggests revising programme evaluation logics and reframing technological solutions as responses, rather than substitutes, to practice changes.

Improving primary care access for rural women Veterans: the Boost Team.

To improve healthcare access for rural cisgender women and gender diverse Veterans, we created the "Boost Team," a clinician-driven telehealth outreach service to connect this population to Veterans Health Administration (VHA) services. Between 9/2021 and 2/2022, we conducted a needs assessment in the Veterans Integrated Service Network (VISN) 21 and used those data to develop an outreach intervention. We piloted a clinician-led outreach intervention in 3/2022, and formally deployed an outreach team in 9/2022. The needs assessment uncovered opportunities to educate Veterans, staff, and clinicians about available VHA women's health services, and a need for easily-accessible gender-sensitive services. During the pilot, 58% (7/12) rural cisgender women Veterans were successfully contacted, all reported positive experiences with the intervention. The formal outreach team launched in 9/2022 and consists of a nurse practitioner (NP), scheduler, Peer Support Specialist, and medical director. From 9/2022 to 12/2022 the Boost NP called 110 rural cisgender women and gender diverse Veterans and spoke to 65 (59%) of them. Common care needs identified and addressed included care coordination, new referrals, medication management, and diagnostics. Data from Boost show that clinician-led outreach can engage rural cisgender women and gender diverse Veterans in VHA services, there is a desire for more gender-sensitive services, and there is a need for systems-level improvements to allow for improved care coordination and decreased leakage outside of VHA. Using robust strategies grounded in implementation sciences, we will continue conducting a program evaluation to study the impact of Boost and scale and expand the program.

Qualitative evaluation of a multidisciplinary master of cancer sciences: impacts on graduates and influencing curricular factors

BackgroundEvaluations of continuing professional development programs typically focus on short-term knowledge and skill acquisition. There is a need for more comprehensive program evaluation methods that assess a broader range of impacts and can elicit how and why these outcomes occurred. We conducted a qualitative study to investigate the impacts of a multidisciplinary, online health professional postgraduate degree and to gain insights into the factors that led to these impacts.MethodsParticipants were graduates of the University of Melbourne’s Master of Cancer Sciences who could participate in an online interview. Semi-structured, qualitative interviews were conducted exploring a broad range of impacts, including changes in professional practice and career trajectory since graduation, and how the degree influenced these impacts. Data were analysed inductively.ResultsFifteen participants (female: 80%, 31–50 years old: 67%) from a range of professions were interviewed. A number of major themes were uncovered. Impacts on career trajectory included expanded career horizons (e.g. increased role diversity and complexity), and increased confidence in their professional identity. Impacts on professional practice included individual improvements in patient care and research, as well as changes in organisational practice. Factors identified as leading to these impacts were: (i) active, interactive and interprofessional learning; (ii) networking, informal mentoring, and role-modelling; and (iii) support at multiple levels.ConclusionThis study provides preliminary evidence of the positive impact of a Master of Cancer Sciences on graduate career trajectory and professional practice. In addition, the inductive methodology enabled identification of the curricular features (both planned and emergent) that influenced these impacts, facilitating potential transferability of learnings to other teaching programs.

Unleashing leadership potential in unprecedented times: Lessons learned from an evaluation of a virtual cohort-based adaptive leadership program for public health executives

ObjectivesThis paper presents the evaluation results from the Adaptive Leadership Academy (ALA), a pilot program aimed at developing executive-level leaders in public and community health. Study designMixed methods study. MethodsThe evaluation followed the Kirkpatrick Model to assess program participants’ satisfaction with the training, knowledge and skill gain, and behavior change. Data were collected beginning in December 2021 through August 2022 from 20 program participants via online surveys and key informant interviews. ResultsThe findings indicated that ALA helped participants improve their leadership knowledge, skills, and capabilities. In particular, the study highlighted the effectiveness of cohort-based leadership development programs using adaptive leadership as the foundation for the curriculum. Participants found the cohort-based model and synchronous components particularly useful in creating a supportive environment in which to be vulnerable and grow. ConclusionsOverall, the evaluation provided evidence that the ALA pilot enhanced leadership knowledge, skills, and capabilities. The findings support the use of adaptive leadership as a framework for leadership development programs in the public health sector.

Emotional preparedness for human body donor dissection in premedical education: A pilot program evaluation.

Dissection of bodies provided by donors continues to be utilized as a critical part of medical education. It also represents a rite of passage that socializes students to prepare them for the stress that comes with working in a clinical environment as a medical professional. Just as proper guidance in acquiring technical skills is critical in anatomy education, there is an important need for proper emotional guidance throughout the human dissection process. A pilot curriculum was developed by an interdisciplinary faculty team to emotionally prepare students for their first visit to the anatomy laboratory. Students were first-year foundation premedical students who had expressed an interest in visiting the laboratory. Pre- and post-visit surveys were conducted to explore students' emotional responses to a first visit to the anatomy laboratory and their utilization of coping strategies. The survey findings show an overwhelming favorable feeling in anticipation of the human gross anatomy laboratory visit. About 20% of the students experienced anxiety at the anticipation of the laboratory visit, but only 5.3% experienced anxiety during the visit. The decrease in the number of students experiencing anxiety may be attributed to the interventions introduced before and during the visit. Talking with a close friend was the main coping strategy utilized by 63% of students experiencing fear or anxiety during and after the laboratory visit. The findings from this program evaluation provide a better understanding of student emotional preparedness and utilization of coping strategies, which may help prepare and guide future students for the dissection experience.

Assistance for Micro Businesses of Canang Sari Traders in Penatih Dangin Puri Village, East Denpasar

Microenterprises are businesses run by people categorized as poor or near poor. They are family-owned, using local resources and simple technology. Micro-enterprises include unbanked people, a group that is difficult to get access to banking even though this group has the potential to develop business. Canang Sari is the simplest form of offerings in the form of janur made rectangular decorated with various types of flowers that are offered as an effort to get closer to God in prayer. Based on observations, there is a group of canang traders called the Canang Sari Wangi group located in Banjar Laplap Putih, Penatih Dangin Puri Village, East Denpasar who really need help to overcome the problems they face. This Canang Sari Wangi trader group has 5 members who have been established since 2020. The problems faced by this group of Canang Sari Wangi traders are difficult to get access to banking, lack of knowledge for business development due to fluctuations in demand, very fierce competition, high operational costs, lack of understanding of creative marketing and the absence of careful and thorough administration of financial reports. The approach taken is to further coordinate with members of the Canang Sari Wangi Group so as to obtain the main needs for increasing productivity, namely by providing assistance to facilitate access to banking, entrepreneurship assistance, improve creative marketing skills and make business bookkeeping. The output target to be achieved is an increase in the ability of partners to access banking, through creative marketing partners are able to increase group income by 30% and all members of the Canang Sari Wangi group are able to make simple group bookkeeping. The method of implementing this activity is preceded by collecting information from partner conditions, designing activities to be carried out, followed by program socialization, conducting training, mentoring and evaluation.