Program Implementation Outcomes Research Articles

Development and Validation of an Evaluation Questionnaire for the Healthy Early Life Moments in Singapore (HELMS) Program.

Global fertility rates are declining due to metabolic and mental health challenges in women trying to conceive. The Healthy Early Life Moments in Singapore (HELMS) program aims to address these challenges through mobile health (mHealth)-enabled lifestyle interventions. However, the lack of validated evaluation tools for such programs makes it difficult to assess their feasibility and acceptability. To tackle this, a comprehensive evaluation questionnaire was developed and validated to determine if the HELMS preconception program's implementation outcomes were achieved. The questionnaire development process included a literature review and a two-step validation process: content validation by five content experts and face validation by 20 HELMS participants. Content validation was assessed using the scale content validity index (S-CVI) based on relevance, clarity, simplicity, and ambiguity. Face validation with participants evaluated these criteria and the ease of completing the questionnaire. Internal consistency was assessed using Cronbach's alpha among 49 participants. The questionnaire achieved good S-CVI values for relevance (0.93), clarity (0.91), simplicity (0.94), and ambiguity (0.71). After expert feedback, the revised version scored highly among HELMS participants for relevance (100%), clarity (95%), simplicity (95%), and non-ambiguity (90%). A Cronbach's alpha of 0.93 indicated good internal consistency. The HELMS evaluation questionnaire shows promise for evaluating similar mHealth-based lifestyle intervention programs globally.

Development of the Technical Assistance Engagement Scale: a modified Delphi study

BackgroundTechnical assistance (TA) is a tailored approach to capacity building that is commonly used to support implementation of evidence-based interventions. Despite its widespread applications, measurement tools for assessing critical components of TA are scant. In particular, the field lacks an expert-informed measure for examining relationship quality between TA providers and recipients. TA relationships are central to TA and significantly associated with program implementation outcomes. The current study seeks to address the gap in TA measurement tools by providing a scale for assessing TA relationships.MethodsWe utilized a modified Delphi approach involving two rounds of Delphi surveys and a panel discussion with TA experts to garner feedback and consensus on the domains and items that compose the TA Engagement Scale.ResultsTA experts represented various U.S. organizations and TA roles (e.g., provider, recipient, researcher) with 25 respondents in the first survey and 26 respondents in the second survey. The modified Delphi process resulted in a scale composed of six domains and 22 items relevant and important to TA relationships between providers and recipients.ConclusionThe TA Engagement Scale is a formative evaluation tool intended to offer TA providers the ability to identify strengths and areas for growth in the provider-recipient relationship and to communicate about ongoing needs. As a standard measurement tool, it lends a step toward more systematic collection of TA data, the ability to generate a more coherent body of TA evidence, and enables comparisons of TA relationships across settings.

N019 Implementation of an Integrated Diabetes Management Program Within a Cardiac Care Institution: Pre and Post Program Implementation Results

The epidemic of diabetes continues to flourish in Canada and throughout the world. This epidemic is no where more apparent than in the in-patient hospital setting. Cardiovascular disease remains to be the leading cause of death in individuals with diabetes and occurs two to four fold more often than in nondiabetics (Clinical Practice Guidelines 2008). Within our tertiary cardiac care institution, approximately fifty percent of in-patients are diagnosed with diabetes; ten to fifteen percent are newly diagnosed upon admission to hospital. Patients with a preexisting diagnosis of diabetes experience a 2.7fold increase in risk of in-hospital mortality, while those newly diagnosed have an 18fold increase compared to patients with normoglycemia (Fowler, 2009). A multitude of evidence exists linking high glucose levels with increased resource use and worse clinical outcomes in patients with cardiovascular disease. Diabetes education and management skills are the forefront of managing diabetes. Hospitalization is a unique opportunity for health care providers to provide patients with evidenced based diabetes care. A systematic and integrated diabetes management program was implemented in our acute cardiac institution based on best practice guidelines. This presentation will focus on comparing pre program or baseline data with post program implementation outcomes. Study results will demonstrate the feasibility and effectiveness of a diabetes management program within a tertiary in-patient environment, a paradigm shift from the traditional primary models. Health outcomes depend on patients managing this chronic disease effectively, reducing complications, improving quality of life and decreasing hospital readmissions.