Program Stakeholders Research Articles

Drug Story Theater: A Mixed-Methods Study of a Peer-to-Peer Approach to Substance Abuse Education

Objective: Drug Story Theater (DST) is a peer-to-peer intervention that engages teenagers in the early stages of their recovery to develop shows about the seduction of, addiction to, and recovery from drugs and alcohol. Methods: We analyzed anonymous surveys completed by students before and after attending a DST performance, and transcripts of focus group interviews conducted with (1) program developers, (2) stakeholders, (3) performers, and (4) audience members. Results: Students (N = 871) from 5 schools attended one of 2 DST performances. Participants demonstrated increased knowledge on 5 fact-based questions (mean improvement range, 19%- 35%; p < .001 for all), and favorable changes on 10 items addressing perceptions regarding substance use risk (paired t test range, 3.9-9.4; p < .001 for all). Through iterative thematic analysis we developed an alliterative “7P” model spanning 2 domains: (1) Participants (Performers and Peers); and (2) Program (Partnerships, Practicalities, and Prevention). Conclusions: Exposure to a DST performance improved knowledge and risk perceptions about addiction among middle and high school students. It remains to be seen if those changes can have an effect on the prevention of substance use and dependence among vulnerable youth, and whether the active components of DST can be replicated in other school environments.

Providing a safer passage: Perceptions about a neighborhood intervention program for disadvantaged youth.

"Safe Passage" is an after-school intervention program for disadvantaged youth in a medium-sized city in southern California. Led by local law enforcement, as well as the city's recreation and park department, the program's goal is to combine community policing with after-school care and tutoring to support children living in a large apartment complex with the highest rates of gang membership and crime in the city. This is an exploratory study that examines the perspectives of various stakeholders in the intervention program, including the community members, the local police, and Safe Passage staff members. Survey data from the community residents, program staff and law enforcement were collected. Findings indicate that there was some consensus across the various subpopulations on the challenges that have had the largest negative influence on youth in the community. The local police and the community members surveyed were also in agreement that police/community relations were largely positive. All stakeholders surveyed felt generally positive about the intervention program, but the community members were more skeptical of the program's ability to deter their children from trouble. Implications of our findings for the program and for future studies are discussed.

PIN3 Impact of Antimicrobial Stewardship Interventions on Compliance with Surgical Antibiotic Prophylaxis: A Systematic Review

There is paucity of data describing the effectiveness of antimicrobial stewardship in improving compliance with surgical antibiotic prophylaxis. This review evaluated the impact of antimicrobial stewardship interventions on compliance with surgical antibiotic prophylaxis measures, surgical site infection and economic outcome. PubMed, Scopus, Science Direct, and Google Scholar databases were searched to identify eligible studies that reported the impact of antimicrobial stewardship on compliance with surgical antibiotic prophylaxis and/or antibiotic utilization, surgical site infections from 2000 to 2017. Fourteen studies were selected; eight (57%) uncontrolled before-and-after studies, and two each randomized trial, interrupted time series and controlled before-and-after studies. Clinician education, organizational changes and audit and feedback were the most common stewardship interventions. Stewardship interventions improved compliance with antibiotic selection (1% - 90%); timing of first dose (5% - 96%); intra-operative re-dosing (28% - 53%); and total compliance (19% - 44%). Duration of antibiotic prophylaxis had the least improvement (7% - 25%) after stewardship interventions. Generally, studies with low baseline compliance rate showed greater improvements after stewardship interventions. Stewardship interventions reduced antibiotic utilization (20% - 35% Defined Daily Dose/100 procedures), surgical site infections (0.8% - 5.6%), and the costs of antibiotic prophylaxis per procedure ($ 2.5 - $ 345). Participation of stakeholders in antimicrobial stewardship program was vital for the success of the interventions. Low quality evidence shows that stewardship interventions improve compliance with surgical antibiotic prophylaxis measures, and reduced antibiotic utilization, surgical site infections and cost of surgical antibiotic prophylaxis.

Tailored mHealth intervention for improving treatment adherence for people living with HIV in Iran (HamRaah): protocol for a feasibility study and randomised pilot trial with a nested realist evaluation

IntroductionMiddle East and North Africa (MENA) has a rising rate of new HIV infections and AIDS-related mortality. Consistent adherence to antiretroviral therapy (ART) leads to viral suppression, preventing HIV transmission...

Using systems methods to elicit complex program theories

AbstractContextual interventions pose unique challenges for implementation studies and evaluation research. By contextual, we mean programs that are tightly integrated with the social systems they are seeking to influence or transform. This integration challenges foundational assumptions of intervention science and necessitates the development of innovative approaches to monitoring and evaluation. The W3 (‘What Works and Why’) project piloted the use of complex systems theory and methods (CSTM) to develop program theories for peer and community‐led (PCL) programs in HIV and viral hepatitis prevention and health promotion. As a class, these programs have struggled to articulate and theorize their approach to justify their funding and to build an evidence base. CSTM allowed us to articulate detailed program theories based on ‘mental models’ held by program staff and stakeholders. This chapter describes our reflection and adaptation experience as we piloted the CSTM approach in─and as─social research.

The Challenges of Promoting Social Inclusion through Sport: The Experience of a Sport-Based Initiative in Italy

Social inclusion is broadly recognized as a priority to accomplish at an international level. While the influence of sport toward this social mission has been largely debated, literature lacks contributions capturing the challenges of sport when promoting social inclusion. Based in case study methodology, the investigation explores the impact of a multi-stakeholder sport initiative developing social inclusion for socially vulnerable youth and the related challenges of the intervention through in-depth interviews with diverse program stakeholders. The main findings indicated the emergence of four challenges: limited transferability of program outcomes for youth in living conditions of severe vulnerability; drop-out of youth in living conditions of severe vulnerability; limited sustainability of program social workers; lack of sports club management skills. The work highlights some limits of sport-based programs for social inclusion and discusses some implications for practice to maximize the societal impact of such interventions.

Mapping the residency program landscape

When properly structured, library residencies introduce recently graduated Master of Library and/or Information Science (MLIS) professionals to librarianship, allow recent graduates to apply the knowledge and skills learned during their MLIS studies, and infuse host institutions with new, innovative ideas, including the latest technology and theory being taught in library and information science (LIS) programs. Unfortunately, rather than realizing their potential, residencies are often hampered by miscommunication and a lack of organization that cause real harm to the new resident and the current employees by creating a tense, sometimes even hostile, work environment. This can negate the potential benefits of a residency program, leaving the resident unhappy and disillusioned by the library profession. Understanding the current landscape of residency programs is a necessary first step toward evaluating the efficacy of this form of early career employment in retaining an innovative and engaged next generation of library professionals. Using survey research, this study answered the questions: What are the characteristics of residency programs? How is success measured in residency programs? What are some specific best practices that residency programs are currently implementing? The findings from this survey indicate that there is no one-size-fits-all residency program structure, from the mission and goals of the programs to how a program measures its ultimate success, responses were varied. While there are positive trends, like residencies lasting for at least two years, there is still much work to be done. Notably, most programs still only have one resident per cohort and residency cohorts do not overlap leading residents to feel isolated. While we concede there are likely many concerns (including budgetary) that may make two or more residents per cohort or overlapping cohorts unfeasible, it is an issue that should be addressed because many residents themselves have asked for this change. We also detail several suggestions for building and maintaining buy-in among stakeholders in the residency program, a necessary step toward ensuring each resident feels welcome in an institution and is ultimately successful. It is our hope that this research provides residency program coordinators with a roadmap to follow when planning or re-evaluating their residencies.

Successful Implementation of Enhanced Recovery After Surgery Program in a Safety-Net Hospital: Barriers and Facilitators

PurposeEnhanced recovery after surgery (ERAS) programs comprise bundles of evidence-based recommendations designed to reduce physiological stress and support early return of function after surgery. In this study, we sought to investigate the barriers and facilitators of successful implementation of ERAS in a major safety-net hospital. DesignOur ERAS program has been designed as a quality improvement pilot project in prospective fashion with a real-time feedback loop. The program is designed to address established culture of safety-net hospitals. MethodsAn extensive multidisciplinary team investigated the barriers to success for three different levels of program stakeholders: providers, patients, and the facility. After a systematic review of these barriers, solutions were offered and implemented in a multidisciplinary care model with special attention to outcomes and continuous feedback. The findings are summarized in a grid format for better understanding and implementation ease. FindingsPatients (N = 198) were enrolled in an ERAS program in a nonrandomized fashion during the pilot period of October 2017 to August 2018. ERAS cohort of patients’ outcomes were then compared with those of 20,328 non-ERAS patients. The ERAS group had less complication with shorter length of stay compared with their non-ERAS counterparts. Furthermore, it has cost less to take care of these patients. Interestingly, this decrease was not achieved by a reciprocal increase in subsequent readmission or reoperation rates. ConclusionsUnique barriers exist when implementing an ERAS protocol in a safety-net hospital. These barriers can be overcome to improve the quality of care at a decreased cost. We have provided a grid to facilitate the implementation process.

Patient and provider perspectives regarding criteria for patient prioritization in two specialized rehabilitation programs

To increase fairness and equity in access to rehabilitation services, a strategy emerging from the literature is patient prioritization. Selecting explicit prioritization criteria is a complex task because it is important to simultaneously consider the objectives of all stakeholders. The of this study was to compare service users’ and service providers’ perspectives regarding patient prioritization criteria in two rehabilitation programs. We conducted a multiple case study in two rehabilitation programs, i.e., a driving evaluation program and a compression garment manufacturing program. We sent a web-based survey asking two groups (patients and providers) to individually produce a set of criteria, then individual answers were coded and combined in a single set of criteria. Stakeholders identified a total of 32 criteria to prioritize patients. Some criteria, such as age, occupation, functional level, pain, absence of caregiver, and time since referral, were considered important by both stakeholders in both programs. Patients and providers tended to have similar opinions about criteria to prioritize patients in waitlists. Taking into consideration the opinions of all stakeholders concerning prioritization criteria is an important part of the decision-making process.

Collective reflections on the first cycle of a collaborative learning platform to strengthen rural primary healthcare in Mpumalanga, South Africa

BackgroundFrontline managers and health service providers are constrained in many contexts from responding to community priorities due to organizational cultures focused on centrally defined outputs and targets. This paper presents an evaluation of the Verbal Autopsy with Participatory Action Research (VAPAR) programme—a collaborative learning platform embedded in the local health system in Mpumalanga, South Africa—for strengthening of rural primary healthcare (PHC) systems. The programme aims to address exclusion from access to health services by generating and acting on research evidence of practical, local relevance.MethodsDrawing on existing links in the provincial and national health systems and applying rapid, participatory evaluation techniques, we evaluated the first action-learning cycle of the VAPAR programme (2017–19). We collected data in three phases: (1) 10 individual interviews with programme stakeholders, including from government departments and parastatals, nongovernmental organizations and local communities; (2) an evaluative/exploratory workshop with provincial and district Department of Health managers; and (3) feedback and discussion of findings during an interactive workshop with national child health experts.ResultsIndividual programme stakeholders described early outcomes relating to effective research and stakeholder engagement, and organization and delivery of services, with potential further contributions to the establishment of an evidence base for local policy and planning, and improved health outcomes. These outcomes were verified with provincial managers. Provincial and national stakeholders identified the potential for VAPAR to support engagement between communities and health authorities for collective planning and implementation of services. Provincial stakeholders proposed that this could be achieved through a two-way integration, with VAPAR stakeholders participating in routine health planning and review activities and frontline health officials being involved in the VAPAR process. Findings were collated into a revised theory of change.ConclusionsThe VAPAR learning platform was regarded as a feasible, acceptable and relevant approach to facilitate cooperative learning and community participation in health systems. The evaluation provides support for a collaborative learning platform within routine health system processes and contributes to the limited evaluative evidence base on embedded health systems research.

Exploring Tourists’ Knowledge, Perceptions and Willingness to Pay on Biodiversity Conservation: Insights from Kinabalu Park, Borneo

The richness of biodiversity and ecotourism development in Malaysia has contributed to economic growth and human well-being. In this context, Kinabalu Park, Borneo, offers the uniqueness of biodiversity as the main attraction to local and foreign tourists. However, the economic value of biodiversity is difficult to quantify due to the non-existent market for these resources. This study explored the tourists’ knowledge and perception regarding the biodiversity issues and estimated the Willingness to Pay (WTP) for Kinabalu Park’s biodiversity conservation using the Contingent Valuation Method (CVM). A total of 250 questionnaires with five bid prices were distributed to local (RM3, RM6, RM9, RM12, and RM15) and international tourists (RM15, RM30, RM45, RM60, and RM75). This study reported that more than half of the respondents are willing to pay for the conservation of biodiversity. Most local and international tourists are willing to pay RM5 and RM84.05 per person, respectively. The Principle Component Analysis (PCA) in Factor Analysis showed that the “environmental” factor had the highest eigenvalue compared to the “social” factor. This finding shows that tourism has a very significant environmental attitude and preferences towards the conservation of biodiversity. The financial planning management can help the stakeholders in biodiversity conservation programs at Kinabalu Park for better governance in the future.

Lessons from a community vaccination programme to control a meningococcal disease serogroup W outbreak in remote South Australia, 2017.

ProblemFrom December 2016 to February 2017, two cases of invasive meningococcal disease and one case of meningococcal conjunctivitis, all serogroup W, occurred in Aboriginal children in the Ceduna region of South Australia. The clustering of cases in time and place met the threshold for a community outbreak.ContextThe Ceduna region is a remote part of South Australia, with more than 25% of the population identifying as Aboriginal or Torres Strait Islander.ActionAs part of the outbreak response, a community-wide meningococcal vaccination programme against serogroups A, C, W and Y was implemented in a collaboration among different agencies of the South Australia Department for Health and Well-being, Aboriginal health and community services providers, and other local service providers and government agencies. The programme comprised an outbreak vaccination schedule, targeting all people aged 3 2 months residing in the cases’ places of residence or in towns with close links.OutcomeBetween March and June 2017, 3383 persons were vaccinated, achieving an estimated coverage of 71–85% of the target population, with 31% (n = 1034) of those vaccinated identifying as Aboriginal or Torres Strait Islander. No local cases of serogroup W occurred during the vaccination programme, but two further cases were notified by the end of 2018.DiscussionThe participation of a large number of local and non-health-sector stakeholders in programme planning and implementation, a clear response management structure and high community acceptability were identified as key factors that contributed to the programme achieving high vaccination coverage. The need to develop standard operating procedures for community-based outbreak response interventions to ease logistical challenges was considered an important lesson learnt.

Engaging Opportunity Youth and Cross-System Stakeholders in Program Development, Implementation and Evaluation: Challenges, Successes and Lessons Learned

ABSTRACT Opportunity youth (OY; i.e., youth ages 16–24 who are neither working nor in school) are a population who is difficult to engage and retain in educational programs, particularly in community college career and technical education (CTE) programs. OY are an important population to community colleges, as CTE programs culminating in industry-recognized credentials and employment constitute an important on-ramp to the workforce for young adults. The Manufacturing Training Program is a vocational training program offered at a local community college in Phoenix, Arizona that was informed by input from youth and service providers to support OY in obtaining the necessary technical skills/credential for entry-level employment in manufacturing. Researchers conducted a qualitative study using in-depth interviews with 32 program stakeholders and beneficiaries (i.e., 14 staff and 18 youth). Data were coded and analyzed using content analysis to identify major themes for each stakeholder and beneficiary group interviewed as well as working hypotheses to guide future CTE program development. Findings suggest that there are both challenges and successes related to recruiting, retaining and employing OY. Recruitment challenges include lack of information about and disinterest in manufacturing, whereas successes include leveraging family members in recruiting youth. Retention challenges include meeting OYs’ basic needs, whereas successes include providing quality case management. Employment challenges include limited employer participation whereas successes include developing an effective process to connect employers with trained youth. Findings and lessons learned on recruitment, retention, and employment challenges and successes offer direction for community colleges to develop and strengthen CTE programs for OY.

A mobile phone application for malaria case-based reporting to advance malaria surveillance in Myanmar: a mixed methods evaluation

BackgroundTo achieve malaria elimination in the Greater Mekong Subregion, including Myanmar, it is necessary to ensure all malaria cases are detected, treated, and reported in a timely manner. Mobile phone-based applications for malaria reporting, case management, and surveillance implemented at a community-level may overcome reporting limitations associated with current paper-based reporting (PBR), but their effectiveness in this context is unknown.MethodsA mixed methods evaluation study was undertaken to determine the effectiveness of a national Malaria Case-Based Reporting (MCBR) mobile phone application in improving malaria case reporting compared to the existing PBR reporting system in Myanmar. Methods included secondary analysis of malaria case report data, questionnaires, focus group discussions and field observations of community volunteers, interviews and direct observations of malaria programme stakeholders, and cost analysis. Using a combination of these approaches the following areas were investigated: data quality and completeness, data access and usage, capacity for timely reporting, the acceptability, functionality, and ease of use of the application and facilitators and barriers to its use, and the relative cost of MCBR compared to the PBR system.ResultsCompared to PBR, MCBR enabled more accurate and complete data to be reported in a much timelier manner, with 63% of MCBR users reporting they transmit rapid diagnostic test outcomes within 24 h, compared to 0% of PBR users. MCBR was favoured by integrated community malaria volunteers and their supervisors because of its efficiency. However, several technical and operational challenges associated with internet coverage, data transmission, and e-literacy were identified and stakeholders reported not being confident to rely solely on MCBR data for programmatic decision-making.ConclusionsImplementation of MCBR provided timely and accurate data for malaria surveillance. Findings from this evaluation study will enable the optimization of an application-based reporting system for malaria monitoring and surveillance in the Greater Mekong Subregion and advance systems to track progress towards, and certify, the achievement of malaria elimination targets.

Scale-up of antiretroviral treatment access among people living with HIV in Rivers State, Nigeria, 2019--2020.

The aim of this study was to describe and evaluate the impact of the programme intervention of the Rivers State Antiretroviral Treatment (ART) Surge, a collaboration between the US President's Emergency Plan for AIDS Relief (PEPFAR) and the State Ministry of Health, to increase HIV case-finding and ART access in Rivers State, the state with the largest ART gap among people living with HIV (PWH) in Nigeria. During April 2019-September 2020, the intervention included six specific strategies: using local government area-level ART gap analysis to guide case-finding; expanding targeted community testing; tailoring comprehensive key population HIV services; engaging HIV treatment programme stakeholders; synchronizing team efforts; and using near real-time data for programme action. Weekly reported facility and community data on tests conducted, PWH diagnosed, and PWH initiated on ART were aggregated. The total number of PWH maintained on ART was reported quarterly. During May 2019-September 2020, the weekly number of newly diagnosed PWH initiated on ART supported by PEPFAR in Rivers State increased from 82 to 1723. During October 2019-September 2020, the monthly number of people screened for HIV testing eligibility in the community increased from 44 000 to 360 000. During April 2019-September 2020, the total number of PWH on ART supported by PEPFAR statewide increased by 3.8 times, from 26 041 to 99 733. The strategies applied by HIV program stakeholders contributed to scale-up of PWH identification and ART linkage within the Rivers State ART Surge. Continued gains through time indicate the importance of the application of a quality improvement approach to maintain programme flexibility and effectiveness.

WIPAKO® Winterthur interprofessional training concept "communication and cooperation in health professions": concept, development process and implementation.

Objective: The positioning and training of communicative and social competencies to improve interprofessional cooperation is and will be a challenge for educational institutions. The aim of this project was to reorient the interprofessional training elements of bachelor programs in terms of both content and structure, to improve the legally required practical relevance and to aim for a sustainable anchoring through the targeted design of the development process. WIPAKO® facilitates the acquisition of communicative and social competencies as a prerequisite for cooperation between the health and medical professions.Methodology: Once suitable process structures had been created, an interprofessional committee of experts defined the training elements (competencies, content, learning and teaching methods, learning objective review and evaluation) in an iterative consensus process based on various framework models and on the involvement of the various stakeholders in the individual study programs.Results: A training concept focusing on communicative and social competencies for interprofessional cooperation is available. The consistent interprofessional development of the concept promoted joint responsibility for training in the sense of an organizational development process.Conclusion: The outlined procedure for the conceptualization and implementation of a corresponding framework model and the framework model itself provide the basis for the empirical examination of competence acquisition and the sustainable anchoring of interprofessional training elements. This will provide suggestions for other educational institutions facing similar challenges.

Socio-economic drivers of drug-resistant tuberculosis in Africa: a scoping review

BackgroundDrug-resistant TB (DR-TB) remains a public health concern due to the high morbidity and mortality rates from the disease. The DR-TB is a multifaceted illness with expensive treatment regimens, toxic medications and most often the long duration of treatment constitutes a substantial financial burden on both infected patients and the health system. Despite significant research advances in the diagnosis and treatment, there is a paucity of synthesized evidence on how socio-economic factors are associated with DR-TB. This review aims to address this gap by synthesizing available evidence and data on the common socio-economic drivers of DR-TB infection in Africa.MethodsA systematic search was conducted on PUBMED and Google Scholar databases from January 2011 to January 2020 using Joanna Briggs Institute’s scoping review approach. An updated search was conducted on 21 September 2020. The eligibility criteria only included systematic reviews and studies with quantitative research methods (cross-sectional, case-control, cohort, and randomized-control trials). Studies conducted in Africa and focusing on socio-economic factors influencing DR-TB burden in African countries were also considered. Data was extracted from all the studies that met the eligibility criteria based on the study’s objectives.ResultsOut of the 154 articles that were retrieved for review, 20 abstracts of these articles met all the eligibility criteria. Of the 20 articles, 17 quantitative and 3 reviews. Two additional articles were found eligible, following the updated search. The following themes were identified as major findings: Social and economic drivers associated with DR-TB. Substance abuse of which, stigma and discrimination were the prominent social drivers. Economic drivers included poverty, financial constraints because of job loss, loss of productive time during hospital admission and treatment costs.ConclusionThis review has highlighted which socio-economic factors contribute to DR- TB This is relevant to assist DR-TB management program and TB stakeholders in different settings to address identified socio-economic gaps and to reduce its negative impact on the programmatic management of DR TB. Therefore, redirecting strategies with more focus on socio-economic empowerment of DR-TB patients could be one of the innovative solutions to reduce the spread and eliminate DR-TB in Africa.

"Eternally restarting" or "a branch line of continuity"? Exploring consequences of external shocks on community health systems in Haiti.

BackgroundCommunity health systems (CHS) are integral in promoting well-being in humanitarian settings, like Haiti, a country plagued by disruptive socio-political and environmental shocks over the past two decades. Haiti’s community health workers (CHWs) as critical intermediaries have persisted throughout these contextual shocks. This study explores how shocks influence CHS functionality and resilience in Haiti.MethodsWe applied an inductive and deductive qualitative approach to understand the lived experience of CHS actors. A desk review of peer-review and grey literature searched 393 and identified 25 relevant documents on community health policies, guidelines, and strategies implemented over the last fifteen years in Haiti. In-depth interviews with policy and program stakeholders (n = 12), CHWs (n = 24), and CHW supervisors and community health auxiliary nurses (n = 15) were conducted.ResultsVarious shocks – political transitions, natural disasters, and disease outbreaks – describe Haiti’s protracted complex humanitarian setting and reveal distinct influences on CHS functionality (challenges and enablers), resilience, and mediating factors (eg, policy, financing, governance, parallel systems). Consequences of civil unrest and lockdowns (political transitions), internal displacement and infrastructural damage (natural disasters), and livelihood depletion and food insecurity (natural disasters and disease outbreaks) affect CHS functioning. CHW resilience is rooted in their generalized scope of work, intrinsic motivation, history in the community, trusting relationships, self-regulatory capacity, and adaptability. Mental health and safety among CHS actors and communities they serve pose challenges to CHS functionality and resilience, while reinforcing collaborations that promote CHW coverage and support and sustain CHS. Participants recommended government support for CHWs, collaborations stewarded by the government and complemented by partners, sub-national autonomy, and integration of disaster preparedness for all CHWs.ConclusionsPolitical transitions, natural disasters, and disease outbreaks in Haiti continue to profoundly influence CHS functioning, despite mitigating policy and programming efforts. This study documents the relevance of CHS in maintaining primary health care for a country in protracted crises and suggests that propositions of CHW resilience can be explored in complex humanitarian settings globally.

Evaluation plan of the 6for6 research skills program for rural and remote physicians

Overwhelming issues and barriers often prevent rural and remote physicians (RRPs) from pursuing the many socially accountable research questions they encounter on a daily basis. Although research training programs can empower RRPs to rise to these challenges, there is a lack of evidence on how they should be developed and refined. At Memorial University, a faculty development program (FDP) called 6for6 has been helping RRPs surmount their research quagmires and engage in scholarship since 2014. After an initial three-year (2014-17) pilot, we prepared a detailed plan to evaluate the 6for6 research FDP for RRPs and inform future years of delivery. Using a modified Delphi method and participatory action model a group of program team members, stakeholders and evaluation experts developed an evaluation plan including a logic model and an evaluation matrix addressing five key themes. To our knowledge, this is the first evaluation plan for a research-focused FDP targeting RRPs. While this plan was developed specifically for the 6for6 FDP, our approach to its development may be useful to any institution interested in evaluating an FDP with limited resources.

Essentials of Neonatal-Perinatal Medicine fellowship: an overview.

Neonatal-Perinatal Medicine (NPM) fellowship programs have undergone constant evolution since their first appearance in the 1960s. This article is the first in a seven-part series (Table1) that critically evaluates the essentials of neonatology fellowship clinical and research education, performance assessment, and administrative support necessary to support NPM fellowship programs. This overview article will provide background on the history of NPM fellowship programs and provide a framework for the article series. Table 1 Essentials of NPM fellowship article series. Essentials of NPM fellowship Part 1: Overview of NPM fellowship Description of the evolution of NPM Fellowship Part 2: Clinical education and experience Strengths, weaknesses, opportunities, and threats of clinical education in NPM fellowship Part 3: Scholarship opportunities and threats Scholarship requirements during NPM fellowship Part 4: Innovations in medical education Critical analysis of current educational practices and andragogical innovations in NPM fellowship Part 5: Evaluation of competence and proficiency using milestones Assessment of NPM fellows during training using competency-based medical education principles Part 6: Program administration Administrative infrastructure and stakeholders necessary to run a NPM fellowship program Part 7: Careers in NPM Career preparation and opportunities for NPM fellowship graduates.