Technical Assistance Providers Research Articles

ATA2020 Session Summaries (Abstracts)

ATA2020 Session Summaries (Abstracts)

"On a Positive Path": School Superintendents' Perceptions of and Experiences With Local School Wellness Policy Implementation and Evaluation.

Renewed federal requirements for local school wellness policies highlighted the continued importance of supporting school districts as they implement and evaluate wellness initiatives. Superintendents-as school district leaders-play a critical role in wellness policy implementation and evaluation; however, to our knowledge, no studies examine their perspectives or experiences with the most recent federal rule or wellness initiatives more broadly. This study qualitatively examined superintendents' perspectives, experiences, and recommendations with wellness policy implementation and evaluation. Focus groups (n = 39) and follow-up interviews (n = 14 of the focus group participants) were conducted with superintendents from March to July 2017. Coders organized and coded transcript data using Atlas.ti, Version 8 to facilitate thematic analysis. Superintendents had overall positive perceptions of wellness policies and reported that implementation improved over time. Most described wellness approaches beyond typical wellness policy domains, including social-emotional learning and staff wellness. Evaluation of wellness policies was noted to be a challenge, and superintendents requested more tools and resources, as well as opportunities to learn from "best practices." Increased local and state accountability were recommended to facilitate motivation for other superintendents to engage with wellness. This study adds to the literature on a critical stakeholder in the school wellness field. Advocates and technical assistance providers can apply superintendents' recommendations to engage more district leaders in these initiatives.

Optimization of Masjid-Based Zakat Management: A Graduation Empowerment Approach

Research related to optimizing zakat management has been widely discussed, as well as masjid-based objects, but research related to optimizing zakat at masjid focusing on the application of graduation empowerment is still rarely found. This research initiated the concept of graduation empowerment in the Masjid-based zakat Management. Thus, the mustahik around the masjid can be managed systematically so that the graduation process into muzkki can be measured and effective. This article is a conceptual study through a literature review of selected articles that examine best practices both in microfinance and in social funds for the poor. Empowerment of graduations at the Masjid can be done effectively through: 1) The masjid has baitul maal and baitul tamwil (BMT) as divisions that manage the social funds of Masjid worshipers; 2) BMT builds a mustahik and muzakki database as a basis for making maps of community empowerment; 3) BMT designs graduation empowerment for mustahik through holistic intermediation; 4) professional managers; 5) partnerships with technical assistance providers; 6) program and reporting transparency
 Keywords: Optimization, Masjid-Based, Zakat Management, Graduation empowerment, BMT

Workforce development strategies: a model for preparing the workforce to support transformational systems in child welfare

ABSTRACTCalls for transformational systems change that lead to improved outcomes for children in child welfare can only be answered by preparing an effective workforce and building an agency climate that is ready for change. The National Child Welfare Workforce Institute developed a comprehensive model for public, private, and tribal child welfare agencies to improve the health of their workforce. This paper describes the application of the model in one state agency. Through leadership development, a distributive teaming approach, and implementation of an evidence-supported practice model, they were able to significantly improve the organizational climate of their agency. The article discusses practice implications and recommendations for child welfare agencies and technical assistance providers for fostering positive organizational health and ultimately improving outcomes for families.

Understanding the Role of Academic Partners as Technical Assistance Providers: Results from an Exploratory Study to Address Precarious Work.

Universities may be well poised to support knowledge, skill, and capacity-building efforts to foster the development of multi-level interventions to address complex problems. Researchers at the University of Illinois at Chicago (UIC) engaged organizations interested in developing policy- and systems-level initiatives to address the drivers of precarious work in a six-meeting Action Learning (AL) process, in which the researchers served as technical assistance (TA) providers focused on facilitating learning and promoting critical thinking among participants. This exploratory qualitative study examined the role, facilitators, challenges, and impacts of university facilitation in this context. A total of 22 individuals participated in this study, including UIC TA providers, content expert TA providers from labor-focused organizations, and TA recipients from health-focused organizations. Results from interviews and a focus group highlight the utility of a university connecting organizations from different disciplines that do not traditionally work together, and suggest that the TA provided by UIC helped participants think concretely about precarious work and ways in which their organizations might work collaboratively to bring about sustainable change. Findings from this study suggest that university facilitation using an AL approach may be effective in increasing knowledge to action.

Building Grantee Capacity as a Core Strategy to Improve Local Food Systems

Greater Twin Cities United Way (GTCUW), Minnesota’s largest nongovernmental social services funder, connects local people and resources to change systems that limit our potential. Hunger and food insecurity require a spectrum of holistic responses that address emergency and root causes, while advancing long-term solutions for individuals, families, communities, and systems. To that end, GTCUW launched Full Lives, an innovative grantmaking strategy fostering a healthy and equitable community food system where all residents can thrive. This two-year, US$1.5 million effort employs a place-based approach to community and economic development to reduce food insecurity by improving food access, food affordability, and food justice for a low-income Minneapolis neighborhood facing systemic food security issues. Full Lives grantees focus on diverse aspects of the local supply chain that strengthen North Minneapolis’s local food system. Full Lives further augments this effort through grantee learning focused on increased organizational capacity and strengthened connections among grantee organizations, with a cross-cutting theme of commu­nity development. GTCUW partners with local technical assistance providers to implement flexible, innova­tive, responsive, and targeted capacity-building strategies and services. This strategic investment generates cross-agency collaboration, active networking, organizational development, and enhanced food systems tech­nical expertise. A robust evaluation—including qualitative and quantitative elements—reveals successes, chal­lenges, and lessons learned from the design and execution of these capacity-building strategies. Practice and measurement of this grantee capacity-building investment suggests strategies and considerations for partner­ship development, incorporation of grantee and community voice in planning, and delivery of ongoing educational activities for grantees. GTCUW would like to thank the General Mills Foundation for its generous support in making this work possible.

Applying Theory of Change to a Structural Change Initiative: Evaluation of Model Communities in a Diverse County.

Structural change approaches, also called policy, systems, and environmental change approaches, have been increasingly promoted and adopted by public ealth agencies in the past decade. These interventions require attention to multilevel, complex and contextual influences on individual and community health outcomes, requiring a sound theoretical framework that links the many processes and outcomes over time. The Model Communities program of Cook County, Illinois Communities Putting Prevention to Work program employed a theory of change (ToC) framework to inform the evaluations' design and execution. The main objective of this study was to apply findings from the longitudinal multiple case study evaluation to develop an adapted ToC. We conducted 97 key informant interviews across three waves, with a focus on Model Communities program participants', Communities Putting Prevention to Work staff, and technical assistance providers' experiences over time. Four analysts organized and coded the data using qualitative software; exploratory functions and data matrices were employed throughout three waves of analysis. Adaptations to the ToC included the addition of a construct, "change readiness," as well as refinements to constructs: organizational capacity (human capital, technical assistance, informal and formal leadership), local partnerships, and the importance of sustainability. The findings offer a data-informed theoretical framework that may be considered for use in evaluations of structural change interventions in complex and diverse counties.

MyVA Access: An Evaluation of Changes in Access for a System-Wide Program Implemented in the Veterans Health Administration.

The current study evaluates changes in access as a result of the MyVA Access program-a system-wide effort to improve patient access in the Veterans Health Administration. Data on 20 different measures were collected, and changes were analyzed using t tests and Chow tests. Additionally, organizational health-how able a system is to create health care practice change-was evaluated for a sample of medical centers (n = 36) via phone interviews and surveys conducted with facility staff and technical assistance providers. An organizational health variable was created and correlated with the access measures. Results showed that, nationally, average wait times for urgent consults, new patient wait times for mental health and specialty care, and slot utilization for primary and specialty care patients improved. Patient satisfaction measures also improved, and patient complaints decreased. Better organizational health was associated with improvements in patient access.

Conditional Causal Mediation Analysis of Factors Associated With Cover Crop Adoption in Iowa, USA

AbstractThe Iowa Nutrient Reduction Strategy is a statewide effort that aims to encourage voluntary adoption of conservation practices by farmers to reduce the loss of nitrogen and phosphorus that contribute to water quality impairments in the Upper Midwest and drive hypoxic conditions in the Gulf of Mexico. This work is an analysis of the first 2 years (2015–2016) of a 5‐year survey of Iowa farmers. We employ causal mediation analysis to examine the direct and indirect effects of key explanatory variables (e.g., information sources, nutrient management influences, involvement in watershed management activities, and conservation technical assistance) and two causally ordered mediators (farmers' awareness of and attitudes toward the Nutrient Reduction Strategy) on cover crop use. Results showed that participation in watershed activities and receipt of cost share or technical assistance had positive direct effects on cover crop use, while low levels of perceived nutrient loss mitigation self‐efficacy had a negative direct effect. Information and influence of public sector soil and water conservation entities had positive indirect effects on cover crop use through awareness and attitudes, while influence of private sector agribusiness entities had negative indirect effects through those mediators. These results suggest that current strategies such as engaging farmers in watershed management activities and public sector cost share and technical assistance are increasing adoption of cover crops, but the data also point to a need to increase engagement with private sector actors to help them improve their effectiveness as conservation technical assistance providers.

Testing implementation support for evidence-based programs in community settings: a replication cluster-randomized trial of Getting To Outcomes\xae

BackgroundCommunity organizations can have difficulty implementing evidence-based prevention programs. More research is needed on implementation support interventions designed to help these organizations implement programs with quality.MethodsPreparing to Run Effective Programs (PREP) is a randomized controlled trial testing Getting To Outcomes (GTO), a 2-year implementation support intervention. It compares 15 Boys and Girls Club sites implementing CHOICE (control group), a five-session evidence-based alcohol and drug prevention program, with 14 similar sites implementing CHOICE supported by GTO (intervention group). PREP replicates a previous GTO study that had the same design, but featured a teen pregnancy prevention program instead. All sites received typical CHOICE training. Fourteen intervention sites received GTO manuals, training, and onsite technical assistance to help practitioners complete implementation best practices specified by GTO (i.e., GTO steps). During the first year, technical assistance providers helped the intervention group adopt, plan, and deliver CHOICE. Then, this group was trained on evaluation and quality improvement steps of GTO using feedback reports summarizing their own data, which yielded revised plans for subsequent implementation of CHOICE. This paper presents results regarding GTO’s impact on CHOICE fidelity (adherence, quality of delivery, dosage) and the proximal outcomes of the youth participants (aged 10–14)—attitudes and intentions regarding cigarettes, alcohol, and marijuana use. Fidelity was assessed at all sites by observer ratings and attendance logs. Proximal outcomes were assessed via survey at baseline, 3, and 6 months.ResultsAfter 1 year, fidelity and proximal outcomes were similar between Intervention and control groups. After 2 years (which included GTO quality improvement activities that took place between years 1 and 2), intervention sites had higher ratings of CHOICE adherence and quality of delivery (dosage remained similar). Proximal outcomes did not differ between groups in either year, although there was universally high endorsement of prosocial responses to those outcomes from the start.ConclusionsFindings suggest that systematic implementation support provided by GTO can help community organizations achieve better fidelity. Findings replicate the implementation results from a previous GTO study using the same design, but with a different evidence-based program and different fidelity measures. Although proximal outcomes did not change, in large part due to ceiling effects, the implementation findings suggest GTO can support a variety of programs.Trial registrationThis project is registered at ClinicalTrials.gov with number NCT02135991. The trial was first registered on May 12, 2014.

Concentration despite competition: The organizational ecology of technical assistance providers

When international organizations expand and proliferate, why do they fail to spread more evenly in their policy sphere? To answer this question, this article builds on organizational ecology theory, which was recently introduced into the study of international organizations. However, rather than studying each population separately, as previous studies have done, this article investigates how distinct populations with overlapping niches shape each other’s evolution. It argues that when inter-population competition occurs, the first population to occupy its niche at a high density limits the long-term development of other populations. This is the case even if emerging populations may temporarily enjoy a higher growth rate. The argument is illustrated by a study of the relations between four populations of technical assistance providers in the field of intellectual property. By doing so, the article brings for the first time inter-population relations in the study of international organizations and provides an explanation for the persistent concentration of international organizations in specific areas of the governance space.

Identifying opportunities to improve piped water continuity and water system monitoring in Honduras, Nicaragua, and Panama: Evidence from Bayesian networks and regression analysis

Many piped water systems in rural areas of Latin America and the Caribbean provide discontinuous service. In response to service delivery challenges, governments developed the Rural Water and Sanitation Information System to monitor water service levels, infrastructure conditions, water committees, and technical assistance providers. Collected data are combined into metrics to represent water service sustainability. There is little analysis of these data to identify service delivery and system improvement opportunities and the sustainability metrics are unvalidated. Multivariable regression and Bayesian networks were used to analyze variables associated with the availability of 24-h water services using data from 5560 community-based piped water systems in Honduras, Nicaragua, and Panama. The regression models were compared to the sustainability metric. In Honduras and Nicaragua, the proportion of systems providing 24-h service spanned 71 percentage points between sub-national regions. Good condition infrastructure and year-round water source availability were associated with the availability of 24-h service. The availability of support for system rehabilitation in Honduras and for preventative maintenance in Nicaragua were associated with the availability of 24-h services. The Bayesian networks predicted that good condition infrastructure and year-round water source availability were more influential on the availability of 24-h service than management variables such as the availability of external technical support and funds to rehabilitate the system. In each country, insufficient household water tariffs were collected for 90% or more of systems to cover infrastructure, operations, and maintenance costs. The r-squared values for the regression models ranged from 0.22 (Nicaragua) to 0.49 (Honduras) as compared to 0.05 (Nicaragua) to 0.03 (Honduras) for the sustainability metric – suggesting that regression models are better at predicting higher service levels. Rural water service operators, technical assistance providers, local and national governments, and external support agencies could make better use of monitoring data by using interdisciplinary systems approaches to identify improvement opportunities to allocate technical and financial resources to systems with low service levels.

Lessons From the Social Innovation Fund

Tiered evidence initiatives are an important federal strategy to incentivize and accelerate the use of rigorous evidence in planning, implementing, and assessing social service investments. The Social Innovation Fund (SIF), a program of the Corporation for National and Community Service, adopted a public–private partnership approach to tiered evidence. What was learned from implementing this ambitious program? How can large funding initiatives promote evaluation capacity in smaller organizations and evidence building in a sector broadly, increasing knowledge about how to address important social problems? And what can evaluators and evaluation technical assistance providers not working within a tiered evidence framework learn from the SIF? We provide an overview of the SIF model and describe how the fund operationalized “evidence building.” Materials developed to support SIF grantees represent practical, best practice strategies for successfully completing rigorous, relevant evaluations. Key lessons from overseeing over 130 evaluations—and their utility for other local evaluators—are discussed.

Patient Portal Use and Experience Among Older Adults: Systematic Review.

BackgroundThe older adult population (65 years or older) in the United States is growing, and it is important for communities to consider ways to support the aging population. Patient portals and electronic personal health records (ePHRs) are technologies that could better serve populations with the highest health care needs, such as older adults.ObjectiveThe aim of this study was to assess the existing research landscape related to patient portal and ePHR use and experience among older adults and to understand the benefits and barriers to older adults’ use and adoption of patient portals and ePHRs.MethodsWe searched six pertinent bibliographic databases for papers, published from 2006 to 2016 and written in English, that focused on adults 60 years or older and their use of or experience with patient portals or ePHRs. We adapted preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to review papers based on exclusion and inclusion criteria. We then applied thematic analysis to identify key themes around use, experience, and adoption.ResultsWe retrieved 199 papers after an initial screening and removal of duplicate papers. Then we applied an inclusion and exclusion criteria, resulting in a final set of 17 papers that focused on 15 separate projects. The majority of papers described studies involving qualitative research, including interviews and focus groups. They looked at the experience and use of ePHRs and patient portals. Overall, we found 2 main barriers to use: (1) privacy and security and (2) access to and ability to use technology and the Internet. We found 2 facilitators: (1) technical assistance and (2) family and provider advice. We also reported on older adults’ experience, including satisfaction with the system and improvement of the quality of their health care. Several studies captured features that older adults wanted from these systems such as further assistance managing health-related tasks and contextual health advice and tips.ConclusionsMore research is needed to better understand the patient portal experience among older adults from initial use to adoption. There are also opportunities to explore the role of design in addressing barriers and supporting facilitators to patient portal and ePHR use. Finally, the future use of these systems by older adults should be anticipated and considered in the design process.

Reflection for meaning and action as an engine for professional development across multiple early childhood teacher education contexts

ABSTRACTDrawing from sociocultural theories of learning and literature on reflection in educational contexts, this article describes reflective practices as a meaning-making and action engine to support early childhood education practitioners’ professional knowledge, skills, and dispositions. We argue that the process of reflection requires a differential approach to account for various contexts of professional learning for early childhood practitioners: preservice, in-service, and technical assistance providers/leadership. In order to conceptualize these ideals, we present a new conceptual framework of reflective practices in early childhood professional learning and provide practice examples where we as teacher educators implemented reflective practices with practitioners at different levels in the continuum of early childhood education: preservice teacher candidates, in-service teachers and technical assistance providers supporting child care directors and staff in state quality improvement initiatives.

Examining the Highs and Lows of the Collaborative Relationship Between Technical Assistance Providers and Prevention Implementers.

The PROSPER model uses a three-tiered community partnership, university researcher, and Cooperative Extension-based technical assistance system to support the delivery of evidence-based interventions in communities. This study examines the trajectory and predictors of the collaborative relationship between technical assistance providers and community teams across the three phases of organization, implementation, and sustainability. Members of 14 PROmoting School-university-community Partnerships to Enhance Resilience (PROSPER) community teams and directors of local agencies rated communities' levels of readiness and adolescent substance use norms. Technical assistance providers rated their collaborative relationship with their teams at 14 occasions across 4.5years. Results from mixed models show that levels of collaboration were stable until the sustainability phase, when they increased significantly. Team differences in change were significant during the implementation phase. Community readiness predicted levels of the collaborative relationship over time: high community readiness was associated with a high level of collaboration during organization, but a decline in collaboration during implementation. These results provide a more nuanced understanding of the relationship between technical assistance provision and community prevention teams and lead to recommendations to improve dissemination models to achieve a greater public health impact.

Sustainability of rural water systems: quantitative analysis of Nicaragua’s monitoring data

The sustainability of rural water supply services (WSS) remains one of the core challenges of the rural water sector in Nicaragua. The data available through the Central American Rural Water and Sanitation Information System in Nicaragua (SIASAR, in Spanish) is utilized to investigate the factors that drive the sustained functionality and quality of rural WSS systems over time. This report uses data from 6,863 communities, 4,792 water systems, 2,585 service providers, and 154 technical assistance (TA) providers contained in the SIASAR dataset. Statistical and econometric analysis provide evidence to support the hypothesis – widespread among rural WSS practitioners – that ‘soft’ measures in the provision of WSS are effective in fostering sustainability or ‘functionality’ of those systems. Such ‘soft’ measures include management capacity building of WSS community boards in charge of WSS oversight; demand-responsive approaches for developing, operating, managing, maintaining, rural water infrastructure; cost recovery mechanisms; community participation in the management of WSS systems; and the sustained provision of post-construction TA by local authorities. These measures are found as important determinants of the sustainability of WSS and its investments, and therefore are recommended to be included and institutionalized in rural WSS sector development policies.

Relating extension education to the adoption of sustainable forest management practices

Family forest lands represent a vitally important economic, environmental, and social resource in the U.S. A study of family forest owners was conducted in Virginia in 2007 to determine the relationship between attendance at Extension Service educational programs and the adoption of sustainable forest management practices. A mail survey was conducted to 3435 randomly selected forest owners, with a usable response rate of 32%. Participation in educational programs was shown to be significantly related to higher levels of adoption for all seven categories of sustainable forest management practices studied. For example, in the woodland management category, participants in workshops offered through the Virginia Forest Landowner Education Program (VFLEP) adopted one or more specific practices at a rate of 94%, significantly greater than 83% for forest owners who attended other general educational programs, which in turn was significantly higher than the 75% adoption rate for forest owners who did not attend any educational programs. Two key indicators of sustainable forest management are the preparation and use of a forest management plan, and the use of professional technical assistance providers. For both of these categories participants in the VFLEP adopted at significantly higher rates, 41% and 73%, respectively.

Land, Life, and Security: An Interview with Edgardo Garcia, Secretary General of the Association of Farm Workers in Nicaragua.

This is an interview with Edgardo Garcia, Secretary General of the Association of Farm Workers in Nicaragua and Oscar Berríos from the Nicaraguan National Engineering University. The interview was conducted in Nicaragua in October 2013. Garcia and Berríos address the importance of organizing among formal workers and informal workers, and the shared conditions of both in Nicaragua. They highlight the history and context of the agricultural workers who began organizing during the national armed revolutionary war, the role of government to create conditions for healthy and safe work, and the need for workers to organize and advocate for themselves. Finally, they highlight the importance of solidarity among workers and the need for alliances with unions and technical assistance providers around the world.

Lessons Learned From Dissemination of Evidence-Based Interventions for HIV Prevention.

In 1999, IOM issued a report that recommended that the Centers for Disease Control and Prevention should disseminate evidence-based HIV prevention interventions (EBIs) to be implemented by health departments, community-based organizations, drug treatment centers, and clinics. Based on these recommendations, the Diffusion of Effective Behavioral Interventions Project was initiated in 2000 and began disseminating interventions into public health practice. For 15 years, the Centers for Disease Control and Prevention has disseminated 29 EBIs to more than 11,300 agencies. Lessons were identified during the 15 years of implementation regarding successful methods of dissemination of EBIs. Lessons around selecting interventions for dissemination, developing a dissemination infrastructure including a resource website (https://effectiveinterventions.cdc.gov), and engagement with stakeholders are discussed. A continuous development approach ensured that intervention implementation materials, instructions, and technical assistance were all tailored to the needs of end users, focus populations, and agency capacities. Six follow-up studies demonstrated that adopters of EBIs were able to obtain comparable outcomes to those of the original efficacy research. The Diffusion of Effective Behavioral Interventions Project may offer guidance for other large, national, evidence-based public health dissemination projects.