Program Stakeholders Research Articles

Innovative participatory evaluation methodologies to assess and sustain multilevel impacts of two community-based physical activity programs for women in Colombia

BackgroundCommunity-based physical activity (PA) programs are appealing to women in Latin America and show potential for improving women’s health. This study aimed to engage healthy middle-aged women, breast cancer survivors and local stakeholders participating in two publicly funded community-based PA programs in Bogotá, Colombia (Recreovía and My Body) to assess and visually map the perceived barriers, facilitators, and outcomes to promote programs’ improvement, scaling and sustainability.MethodsWe used two participatory action research methods, the 1) Our Voice citizen science method to capture data and drive local change in built and social environmental facilitators and barriers that influence women’s engagement in community-based PA; and 2) Ripple Effects Mapping to visually map the intended and unintended outcomes of PA programs. We used thematic analysis to classify the results at the individual, social, and community levels.ResultsThe stakeholders engaged in the participatory evaluation included cross-sector actors from the programs (N = 6) and program users (total N = 34) from the two programs (Recreovía N = 16; My Body N = 18). Program users were women with a mean age of 55.7 years (SD = 8.03), 65% lived in low-income neighborhoods. They identified infrastructure as the main feature affecting PA, having both positive (e.g., appropriate facilities) and negative (e.g., poorly built areas for PA) effects. Regarding program improvements, stakeholders advocated for parks’ cleaning, safety, and appropriate use. The most highlighted outcomes were the expansion and strengthening of social bonds and the engagement in collective wellbeing, which leveraged some participants’ leadership skills for PA promotion strategies in their community. The facilitated dialogue among program users and stakeholders fostered the sustainability and expansion of the community-based PA programs, even during the COVID-19 pandemic.ConclusionsThe implementation of both participatory methodologies provided a multidimensional understanding of the programs’ impacts and multisectoral dialogues that fostered efforts to sustain the community-based PA programs.

Formative Evaluation of a Workforce Investment Organization to Provide Scaled Training for Home Health Aides Serving Managed Long-Term Care Plan Clients in New York State

As part of its Medicaid program restructuring, New York State funded 11 Workforce Investment Organizations (WIO) to support training initiatives for the long-term care workforce. Focusing on one WIO, this formative evaluation examined quality improvement training programs delivered to 11,163 Home Health Aides employed by home care agencies serving clients of Managed Long-Term Care plans. Results are presented from a thematic analysis of qualitative interviews with organizational and program stakeholders examining contextual factors influencing program objectives, implementation, barriers and facilitators, and perceived outcomes. Findings suggested that WIO training programs were implemented during a period of shifting organizational strategies alongside value-based payment reforms and challenges to aide recruitment and retention. Stakeholders appraised WIO training programs positively and valued program flexibility and facilitation of communication and collaboration between agencies and plans. However, delivery and implementation challenges existed, and industry-wide structural fragmentation led stakeholders to question the WIO's larger impact.

A novel element of comprehensive program evaluation: Using a domain matrix design

AbstractObjectiveThis brief presents a novel element of program evaluation, termed a domain matrix design, and demonstrates the application of the design element with an example from a collaborative evaluation project focused on the Department of the Air Force's Personal Financial Readiness program.BackgroundUtilizing sound scientific principles and employing a replicable approach to program evaluation, the domain matrix design is an adaptable approach to quantitative data collection for program evaluation that minimizes participant survey burden while maximizing available data.MethodThis goal is primarily achieved through the identification of domains of measurable training outcomes that are pertinent to the evaluation and then the strategic assignment of program participants to survey assessment groups that provide sufficient, but limited, overlap of these domains.ResultsThe proposed approach provides sufficient data on all outcome domains, and analyses can be utilized to examine how each domain is linked to other domains as outlined in the program's logic model, while also minimizing the participant burden and streamlining data collection.ConclusionThis brief serves as an example of bridging evaluation to meet internal program stakeholders' needs with opportunities to contribute to the broader research community, specifically the fields of family science and evaluation. That is, the example project demonstrates how evaluation can meet both the internal needs of program stakeholders (e.g., does this program work for us? what modifications are needed to enhance program effectiveness?) and the external needs of the research community (e.g., broad dissemination of findings to share and compare results).

Improving the Forensic Documentation of Injuries Through Alternate Light: A Researcher-Practitioner Partnership.

An alternate light source (ALS) is a practitioner-driven technology that can potentially improve the documentation of injuries among victims of interpersonal violence. However, evidence-based guidelines are needed to incorporate and document an ALS skin assessment into a forensic medical examination that accurately reflects the science, context of forensic nursing practice, trauma-informed responses, and potential impact on criminal justice stakeholders. This article introduces the forensic nursing community to a current translation-into-practice project focused on developing and evaluating an ALS implementation program to improve the assessment and documentation of bruises among adult patients with a history of interpersonal violence. Our researcher-practitioner collaboration uses theory-based approaches that consider both the developed program's practice context and stakeholder impact. The goal is to provide evidentiary support for adult victims of violence and a more equitable forensic nursing practice that benefits diverse patient populations.

Ripple effects mapping: capturing the wider impacts of systems change efforts in public health

BackgroundSystems approaches are currently being advocated and implemented to address complex challenges in Public Health. These approaches work by bringing multi-sectoral stakeholders together to develop a collective understanding of the system, and then to identify places where they can leverage change across the system. Systems approaches are unpredictable, where cause-and-effect cannot always be disentangled, and unintended consequences – positive and negative – frequently arise. Evaluating such approaches is difficult and new methods are warranted.MethodsRipple Effects Mapping (REM) is a qualitative method which can capture the wider impacts, and adaptive nature, of a systems approach. Using a case study example from the evaluation of a physical activity-orientated systems approach in Gloucestershire, we: a) introduce the adapted REM method; b) describe how REM was applied in the example; c) explain how REM outputs were analysed; d) provide examples of how REM outputs were used; and e) describe the strengths, limitations, and future uses of REM based on our reflections.ResultsRipple Effects Mapping is a participatory method that requires the active input of programme stakeholders in data gathering workshops. It produces visual outputs (i.e., maps) of the programme activities and impacts, which are mapped along a timeline to understand the temporal dimension of systems change efforts. The REM outputs from our example were created over several iterations, with data collected every 3–4 months, to build a picture of activities and impacts that have continued or ceased. Workshops took place both in person and online. An inductive content analysis was undertaken to describe and quantify the patterns within the REM outputs. Detailed guidance related to the preparation, delivery, and analysis of REM are included in this paper.ConclusionREM may help to advance our understanding and evaluation of complex systems approaches, especially within the field of Public Health. We therefore invite other researchers, practitioners and policymakers to use REM and continuously evolve the method to enhance its application and practical utility.

A multi-component evaluation framework of a state-wide preventive health program: My health for life.

Chronic disease is a growing problem affecting approximately half of all Australian adults. In response to growing calls for action on chronic disease, the My health for life program was created, aimed at improving the health of individuals at high risk of developing preventable chronic disease. The preventive health program is multi-modal, cross-culturally tailored and contains complex social marketing, community engagement, risk assessment and health promotion components. Therefore, a multi-component evaluation framework is essential to understand the effectiveness of the My health for life program. This brief report details the evaluation. The evaluation design uses non-randomised, longitudinal analysis using repeated measures, observational, program goal-based and pretest-posttest design features to assess the program, its specific modalities and its program adaptations. To ensure timely and credible evaluation, different evaluative implementation frameworks and methods are considered. Quantitative and qualitative methods collect an array of program data at differing levels to assess the processes, outcomes and impacts of My health for life. The implemented evaluation framework has allowed measurement of: (i) process impacts including uptake, retention and attrition, participant satisfaction, fidelity and program stakeholder engagement and (ii) outcomes relating to individual participant level changes in health behaviours. SO WHAT?: This evaluation is an example of an integrated evaluation approach in a large successful preventive health program. Findings from the evaluation will ultimately inform the applicability and transferability of the program and inform policy makers, stakeholders and other health professionals in preventive health practice.

Assessing Determinants of Programmatic Performance of Community Management of Malaria, Pneumonia, and Diarrhea in Children in Africa: Protocol and Data Collection for a Mixed Methods Evaluation of Integrated Community Case Management.

BackgroundIntegrated community case management (iCCM) is a child health program designed to provide integrated community-based care for children with pneumonia, malaria, or diarrhea in hard-to-reach areas of low- and middle-income countries. The foundation of the intervention is service delivery by community health workers (CHWs) who depend on reliable provision of drugs and supplies, consistent supervision, comprehensive training, and community acceptance and participation to perform optimally. The effectiveness of the program may also depend on a number of other elements, including an enabling policy environment, financing mechanisms from the national to the local level, data transmission systems, and appropriate monitoring and evaluation. The extent to which these factors act upon each other to influence the effectiveness and viability of iCCM is both variable and challenging to assess, especially across different implementation contexts.ObjectiveIn this paper, we describe a mixed methods systems-based study protocol to assess the programmatic components of iCCM that are associated with intervention effectiveness and report preliminary results of data collection.MethodsThis protocol uses a mixed qualitative and quantitative study design based on a systems thinking approach within four iCCM programs in Malawi, Democratic Republic of the Congo, and Niger State and Abia State in Nigeria. Routine monitoring data are collected to determine intervention effectiveness, namely testing, treatment, and referral outcomes. Surveys with CHWs, supervisors, and caregivers are performed to collect quantitative data on their demographics, activities, and experiences within the program and how these relate to the areas of intervention effectiveness. Focus group discussions are conducted with these stakeholders as well as local traditional leaders to contextualize these data. Key informant interviews are undertaken with national- and district-level program stakeholders and officers knowledgeable in critical program processes.ResultsWe performed 3836 surveys and 45 focus group discussions of 379 participants with CHWs, supervisors, caregivers, and traditional leaders, as well as 120 key informant interviews with district- and national-level program managers, health officers, and ministry officials. Policy and program documents were additionally collected for review.ConclusionsWe expect that evidence from this study will inform child health programs and practice in low- and middle-income settings as well as future policy development within the iCCM intervention.International Registered Report Identifier (IRRID)DERR1-10.2196/33076

Extending seasonal malaria chemoprevention to five cycles: a pilot study of feasibility and acceptability in Mangodara district, Burkina Faso

BackgroundSeasonal malaria chemoprevention (SMC) involves administering antimalarial drugs at monthly intervals during the high malaria transmission period to children aged 3 to 59 months as recommended by the World Health Organization. Typically, a full SMC course is administered over four monthly cycles from July to October, coinciding with the rainy season. However, an analysis of rainfall patterns suggest that the malaria transmission season is longer and starting as early as June in the south of Burkina Faso, leading to a rise in cases prior to the first cycle. This study assessed the acceptability and feasibility of extending SMC from four to five cycles to coincide with the earlier rainy season in Mangodara health district.MethodsThe mixed-methods study was conducted between July and November 2019. Quantitative data were collected through end-of-cycle and end-of-round household surveys to determine the effect of the additional cycle on the coverage of SMC in Mangodara. The data were then compared with 22 other districts where SMC was implemented by Malaria Consortium. Eight focus group discussions were conducted with caregivers and community distributors and 11 key informant interviews with community, programme and national-level stakeholders. These aimed to determine perceptions of the acceptability and feasibility of extending SMC to five cycles.ResultsThe extension was perceived as acceptable by caregivers, community distributors and stakeholders due to the positive impact on the health of children under five. However, many community distributors expressed concern over the feasibility, mainly due to the clash with farming activities in June. Stakeholders highlighted the need for more evidence on the impact of the additional cycle on parasite resistance prior to scale-up. End-of-cycle survey data showed no difference in coverage between five SMC cycles in Mangodara and four cycles in the 22 comparison districts.ConclusionsThe additional cycle should begin early in the day in order to not coincide with the agricultural activities of community distributors. Continuous sensitisation at community level is critical for the sustainability of SMC and acceptance of an additional cycle, which should actively engage male caregivers. Providing additional support in proportion to the increased workload from a fifth cycle, including timely remuneration, is critical to avoid the demotivation of community distributors. Further studies are required to understand the effectiveness, including cost-effectiveness, of tailoring SMC according to the rainy season. Understanding the impact of an additional cycle on parasite resistance to SPAQ is critical to address key informants’ concerns around the deviation from the current four-cycle policy recommendation.

Resident Match During the COVID Pandemic: How Have Neurology Programs Adapted? - A Survey.

We aimed to evaluate the perceived effectiveness of interventions implemented by Canadian neurology residency programs for the 2020-2021 iteration of the Canadian Resident Matching Service (CaRMS). A cross-sectional survey was distributed to Canadian neurology residency programs and final-year Canadian medical students who applied to at least one neurology program during the 2020-2021 match cycle. The surveys evaluated pre-interview and interview period interventions implemented by Canadian neurology residency programs and accessed by medical students. Thirty-five medical students and 13 out of 15 institutions in Canada with neurology residency programs responded to the survey. Multiple adaptations were implemented, including social media advertisement, web-based platforms, pre-interview information sessions, and teaching sessions, with all surveyed programs implementing at least two virtual interventions. We found that all interventions were perceived as adequate by a majority (>60%) of medical students, with pre-interview period virtual information sessions perceived as effective by the largest proportion of respondents. All Canadian neurology residency programs held virtual interviews for the 2020-2021 cycle, and most programs utilized the same interview structure as prior years. There was discordance between residency program stakeholders and medical students on the most helpful interview period modality. Medical students found the hospital tours and information sessions most valuable, whereas program stakeholders perceived the virtual socials and interviews as most helpful. The COVID-19 pandemic has led to innovative adaptations implemented by Canadian neurology residency programs, which were seen as effective by both medical students and program stakeholders.

Foreign Language for Future Diplomats: What Integrated Education Approach Is Better?

The current study deals with the Foreign Language Training for university students seeking the Master Degree in International Relations. The research focuses on the efficient organization of Foreign Language for Specific Purposes (FLSP), including ESP, course regarding the professional competence: meeting specific needs of the program stakeholders, designing it for adult learners of intermediate or advanced levels, etc. The aim of the course participants’ training is to apply a foreign language in professional work situations. The learners are expected to get new knowledge and experience through integrated education that includes more than one subject and tends to be more effective. This article offers the theoretical and practical support for FLSP practitioners researching, designing courses and providing materials for learners of the Master programs in International Relations and related professional areas. The support includes problem-based training to develop students’ professional competence. The training focuses on the insights from designing an FLSP course for such students, the analysis of their future job responsibilities, the stakeholders’ needs, as well as the FLSP literature on integrated education approaches review, the Master study programs and Qualification Requirements.

Translating Theory into Practice: Evaluating a Prevention Program for LGBTQ+ Youth and Young Adults

Currently, sexual and gender minority youth live in a heteronormative society that does not provide consistent access to preventative social support services or safe spaces essential for healthy adolescent developmental experiences. This contextual circumstance is a catalyst for having unrecognized preventative risks and needs that are comprehensive to sexual and gender minority youth which further increases the likelihood for this distinct population to become justice involved. This study took place with the Lambert House: LGBTQ+ Youth Community Center, the only social service agency in Seattle, WA dedicated exclusively to LGBTQ+ youth and young adults. Data analyzed for this qualitative study includes: review of program documents, field observation notes, and semi-structured interviews. The aim of the study was to: 1) develop an innovative theoretical and methodological strategy to assess fluid programs and their potential to be effective, 2) determine what program theory is driving the program structure and content based on the program stakeholders and participants points of view, and 3) assess how well the final blueprint of the local program theory model aligns with principles of evidence-based practice.

A 30-Year Radiation Safety Prospectus Describing Organizational Drivers, Program Activities, and Outcomes.

In 1992, the University of Texas Health Science Center at Houston (UTHealth) Radiation Safety Program began assembling data on a monthly basis that described various program drivers and associated activities. A summary of the data was assembled on an annual basis and shared with the professional health physics community at the 10-y and 20-y intervals. With the inclusion of 1991 data points, three decades (1991 to 2020) of data have now been collected and summarized into an updated program prospectus. The prospectus models a commercial enterprise prospectus provided to potential investors and displays various program indicator parameters. The consistent formatting of the data affords an easily digestible and succinct snapshot of program activities and trends. Various program stakeholder's feedback regarding this data continues to be well received. Additionally, UTHealth provides increasing support for UT Physicians clinics throughout the greater Houston, Texas area. The prospectus allows succinct description of the drivers of the program, revealed interesting trends, and has identified training needs for both existing personnel and academic programs that support the radiation protection sciences.

An Ecological Approach to Evaluating Collaborative Practice in NSF Sponsored Partnership Projects: The SPARC Model.

From co-authored publications to sponsored projects involving multiple partner institutions, collaborative practice is an expected part of work in the academy. As evaluators of a National Science Foundation (NSF) Alliances for Graduate Education and the Professoriate (AGEP) grant awarded to four university partners in a large southern state, the authors recognized the increasing value of collaborative practice in the design, implementation, evaluation, and dissemination of findings in the partnership over time. When planning a program among partnering institutions, stakeholders may underestimate the need for, and value of, collaborative practice in facilitating partnership functioning. This method paper outlines an evaluative model to increase the use of collaborative practice in funded academic partnership programs. The model highlights collaborative practice across multiple stakeholder groups in the academic ecology: Sponsors of funded programs (S), Program partners and participants (P), Assessment and evaluation professionals (A), academic researchers (R), and the national and global Community (C). The SPARC model emphasizes evidence-based benefits of collaborative practice across multiple outcome domains. Tools and frameworks for evaluating collaborative practice take a view of optimizing partnership operational performance in achieving stated goals. Collaborative practice can also be an integral element of program activities that support the academic success and scholarly productivity, psychosocial adjustment, and physical and psychological well-being of stakeholders participating in the program. Given the goal of our alliance to promote diversification of the professoriate, the model highlights the use of collaborative practice in supporting stakeholders from groups historically underrepresented in STEM fields across these outcome domains. Using data from a mixed-methods program evaluation of our AGEP alliance over 4 years, the authors provide concrete examples of collaborative practice and their measurement. Results discuss important themes regarding collaborative practice that emerged in each stakeholder group. Authors operationalize the SPARC model with a checklist to assist program stakeholders in designing for and assessing collaborative practice in support of project goals in funded academic partnership projects, emphasizing the contributions of collaborative practice in promoting diversification of the professoriate.

Empowerment Evaluation: A Practical Strategy for Promoting Stakeholder Inclusion and Process Ownership

Empowerment Evaluation is an evolving approach based in empowerment theory, self-determination theory, and evaluation capacity building theory. This strategy prioritizes a wrap-around approach that situates program stakeholders at the center of evaluation activities and collaborators in the development of many key processes. By adopting an empowerment evaluation approach, all stakeholders are subjected to an immersive learning experience which culminates in pride in ownership over the initiatives. In this article, we introduce the underlying principles of the three-step empowerment evaluation framework (Fetterman, Empowerment evaluation (pp. 20–42). SAGE Publications, Inc., 2015) and provide examples that can guide evaluation capacity building for programs and organizations. We illustrate how evaluators can assist programs and organizations in developing a mission, taking stock of their current status, and planning for the future. We provide a case example of an empowerment evaluation of an autism services collaborative using the three-step framework. Implications for evaluators of counseling and mental health programs are discussed.

Disability and its determinants among individuals with onchocerciasis in Southeast Nigeria: a cross-sectional study.

Introductionalthough onchocerciasis is rarely a life-threatening disease, it causes chronic morbidity which ultimately leads to disability due to late detection and treatment of the infected people. Disability in Onchocerciasis results in activity limitation and social exclusion of the affected individuals through stigma. This study aimed at assessing the level of disability and its determinants among persons with onchocerciasis.Methodsmulti-stage sampling technique was used to recruit 340 respondents from the randomly selected wards. Disability was assessed using WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) tool. Chi-square test and multivariate analysis using binary logistic regression were used to determine factors associated with disability. The level of statistical significance was determined by a p-value of < 0.05.Resultsthe highest proportion (35.6%) of the respondents was 55 years and above with a mean age of 46.8±17.5. About three-quarters (76.2%) of them had some form of disability and the disability domains mainly affected were participation in community activities (61.8%) and getting along with other people (54.1%) while the least affected were self-care (26.2%) and life activities including domestic responsibilities (45.0%). The Predictor of disability included being ≥48 years old, (AOR=0.2; 95%CI: 0.1-0.4).Conclusionmost people with onchocerciasis experience some form of disability and the major determinant for disability is being in the older age group. Thus, there is a need for stakeholders in the onchocerciasis control program to formulate and implement disability screening programs in the communities for early detection of onchocerciasis-associated disability, especially among the older age group.

Partnerships to expand worksite wellness programs - A qualitative analysis of state and local health department perspectives.

Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the U. S. Because the central mission of state and local health departments (HDs) is to protect, promote, and improve population health, these agencies are well-positioned to address risk behaviors for chronic disease. HD-employer partnerships could enhance worksite wellness programming, but few studies have explored this topic. Building upon previously published findings, the purpose of this qualitative study was to describe the context and environment for HDs’ delivery of worksite wellness programs, including interest, barriers, facilitators, and decision-making processes. We conducted 12 interviews with directors of state chronic disease programs, 21 interviews with local directors, and three focus groups with local staff. We performed a thematic analysis of the data. Key themes include the following: (1) worksite wellness programs delivered by HDs were diverse in topic and scope and delivered both internally (at the HD for their agency) and externally (for other employers); (2) decisions made about chronic disease prevention were largely driven by funding priorities, with federal, state, and local entities playing roles in the decision-making process; and (3) HDs expressed potential interest in worksite wellness program delivery, dependent upon staff capacity, available funding, and employer buy-in. Our results suggest that funding should be increased for and reallocated towards chronic disease prevention, including worksite wellness. To overcome HD barriers to program delivery, key funders and stakeholders should prioritize and communicate the importance of worksite wellness.

Readiness of the Science Education Study Program in the Implementation of the ‘Merdeka Belajar - Kampus Merdeka’ (MBKM) Curriculum

The purpose of this research is the readiness of the science education study program to implement the MBKM curriculum, which is explained through the characteristics of cooperation, lecturer competence, student perception and participation, and analysis of stakeholder needs. The research method uses case study qualitative analysis, and the subjects are teachers, students, and stakeholders in the science education study program. One of the results obtained is the characteristics of the cooperation carried out by the achievement of the graduates. The competencies possessed by lecturers as facilitators in the implementation of MBKM. There is a biased understanding of students' perceptions and involvement in the implementation of MBKM. The stakeholders involved in the preparation of this curriculum have conformity with the needs of the curriculum structure. Furthermore, these results can be used as the basis for the readiness of the Science Study Program in implementing MBKM.

A Survey of the Bachelor of Physical Education (BPEd) Program's Awareness, Acceptability and Alignment with the University's Vision, Mission, Goals and Objectives

Every organization's vision, mission, goals, and objectives dictate its existence and direction (VMGO). Each state, university, and institution has its own VMGO, which will direct the system's strategic plans, initiatives, and activities, as well as its operations. The study determined the awareness level, acceptance, and consistency of the university's vision and mission, goals of the college, and the BPEd program objectives among students, faculty, and stakeholders. The descriptive research method was used. Students enrolled in the Bachelor of Physical Education program, faculty, and other stakeholders were the respondents of the study, with a total of 80 out of 218 respondents. A survey questionnaire was used in gathering the data. The analyzed and summarized data were then organized into a series of tables in accordance with the study's objectives. Frequency counts, percentages, and averages were utilized as descriptive statistics. The study over all revealed that stakeholders are fully aware and accept VGMO’s key statements. It is also revealed from their response that the statements of the VGMO and the program activities are very much congruent. Hence, VMGO’s statements’ dissemination campaign and strategies are effective. This indicates further sustainability for growth and development.

Formation of the ecosystem of the educational program based on social networking sites technology

The paper investigates the problem of transforming existing approaches to the formation of new effective links between universities and all stakeholders, which becomes the basis for creating competitive educational programs. The purpose of the study is to determine the prerequisites for the formation of an ecosystem and substantiate the concept of interaction between key stakeholders of the educational program based on partnership, network communications and digital transformation. Based on results of the SWOT analysis of the acting master’s educational programs, where the authors work, the feasibility of forming information and communication space of educational program as an ecosystem with the use of all opportunities provided by digital technologies is proved, in particular: the reasons for the inefficiency of existing communication channels within university educational programs are discovered; opportunities and limitations of social networking technology in the deployment of the educational program SMART platform are revealed; the concept of such a virtual space is proposed; benefits of the platform for key stakeholders in the educational program are substantially analyzed. SMART platform architectonics of the educational program is elaborated that describes deciding components of the platform considering the needs of key stakeholders of the educational program and SMART principles of ecosystem formation. The request of members of the educational community for the formation of an open learning space solves the following tasks: 1) students receive direct access to all educational materials, relevant information on cooperation with companies and participation in research projects; 2) expanding the boundaries of educational products, the use of new tools and forms of educational work, the involvement of business experts in the educational process; 3) direct access of employers to program students as potential employees, which minimizes transaction costs for finding personnel with a high level of practical competence, attracting young talents, introducing modern training content in accordance with professional standards. Such collaboration will be able to ensure the relevance of scientific research, enhance its practical significance and facilitate the transfer of innovative technologies into the business environment.

Results-Based Financing for Health: A Case Study of Knowledge and Perceptions Among Stakeholders in a Donor-Funded Program in Zambia.

In 2015, the Zambian government and the Swedish International Development Cooperation Agency (Sida) signed an agreement in which Sida committed to funding a program for Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH). The program includes a results-based financing (RBF) model that aims to reward Zambian districts for improved district-wide results on relevant indicators with additional funding. We aimed to describe stakeholders' knowledge of the RBF model and perceptions of the incentive structure during the first 18 months of the program's implementation. This study illuminates the possible pitfalls of implementing an RBF scheme without giving attention to all necessary steps of the process. A qualitative case study was used and included a review of documents, in-depth interviews, and observations. From February-April 2017, we conducted 37 in-depth interviews, representing the views of 12 development partner agencies, government departments, and health facility staff throughout Zambia. We used a qualitative framework analysis. Findings show that the Zambian government and Sida had different perceptions on what levels of the health system RBF will incentivize and that most districts and hospital administrators interviewed were unaware of the indicators that the RBF was part of the RMNCAH program at all. The lack of knowledge about the RBF scheme among respondents suggests the possibility that the model did not ultimately have the necessary preconditions to create an effective incentive structure. These results demonstrate the need for improved communication between stakeholders and the importance of sufficiently planning an RBF model before implementation.