Assessing local capacity for health intervention

Because of their location within the practice realm, participatory, community-based public health coalitions offer many lessons about implementing and sustaining local interventions. This paper presents a case study of capacity assessment at the local level. Capacity evaluation methods are presented, with emphasis on the theoretical framework used to guide the evaluation. The capacity evaluation framework presented herein was theoretically based and designed to generate practical information to facilitate the adoption of a locally tailored youth obesity prevention program, VERB Summer Scorecard (VSS). Using multiple methods, four aspects of community capacity were assessed, including community, knowledge and skills, resources, and power. Within each category, factors that facilitated or impeded program implementation were distinguished. The evaluation protocol was designed to generate information increasing community capacity to sustain a community-based obesity prevention program. Capacity tables were used as a program-planning tool and as a system for sharing implementation and sustainability requirements with potential adopters. This case study also explores how to use capacity assessment results to empower coalitions to serve as catalysts for development of local programs in other communities.     

Community-based behavioral health interventions: Developing strong community partnerships

The popularity of community-based interventions has experienced a revival over the last two decades. The general theme behind this trend is that greater community involvement provides researchers and practitioners with culturally relevant information to make interventions successful. This involvement is usually solicited through the formation of community coalitions and advisory boards. Although the positive influence of community partnerships is well established, strategies for successfully developing and sustaining these partnerships are less clear. To address this gap, this paper presents evaluation findings from The Making Connections Initiative, a national effort emphasizing community-level prevention strategies for improving the mental health of men/boys. Sixteen grantees were tasked with developing a coalition of community organizations to provide input into the development and implementation of a local prevention initiative. An evaluation of the 16 grantees’ planning activities identified four themes related to developing and sustaining successful community partnerships. This article reports on the strategies that were found most successful across grantees. With the increasing popularity of community-based programs, strategies for successfully partnering with local organizations are particularly important. This study adds to the limited research on best practices for forming community partnerships and should serve as a guide for community-based evaluators and program planners.     

Key considerations for logic model development in research partnerships: a Canadian case study

Community-academic partnership research is a fairly new genre of community-based participatory research. It has arisen in part, from recognition of the potential role of alliances in the development and translation of applied knowledge and the elimination of health disparities. This paper reports on the learning process of academic and community members who worked together in developing a logic model for a research program focusing on partnerships with vulnerable populations. The Partners in Community Health Research is a 6-year training program that seeks to combine research, training, and practice through the work of its "learning clusters". As these types of partnerships proliferate, the articulation and exploration of clear models will assist in their implementation. The authors, coming from both academia and community agencies, present a logic model meant to facilitate program management. Key considerations in the model's development are discussed in the context of an ongoing research partnership; namely, the complexity of the research partnership, power and accountability, alignment with health promotion policy, and the iterative nature of program design. Recommendations challenge academics, policy-makers, service providers, and community members to reflect on the elements needed to support and manage research partnerships and the tools necessary to ensure continued collaboration.     

Using formative research to tailor a community intervention focused on the prevention of chronic disease

This case study attempts to illustrate and address in-depth the issues surrounding the collection, analysis, and application of formative research findings to program development and implementation. We provide an in-depth case study of tailoring a program for the residents of Berkshire County, Massachusetts. The formative research process includes collection and analysis of secondary data sources, extensive in-person interviews with community leaders, and in-depth focus groups with members of the population of interest. Findings from the formative research are then applied to tailoring the program materials and presentations and the training of the integrative team of health professionals that offer the program. Distinct components of program are tailored to the realities of the social, cultural, historical, and health and medical contexts in each community while other components of the program are tailored to individual participants. Overall, we believe this case study fully illustrates the utility of formative research in tailoring evidenced-based programs to increase program relevance and positive outcomes while maintaining fidelity to a program’s learning objectives and evaluation. We hope this in-depth account with specific examples proves useful as a guide to others when designing and conducting formative research to tailor health and medical interventions to the audience.     

A Participant-Informed Model for Preventing Teen Pregnancy in a Rural Latino Community

Recognizing the need for health prevention efforts that are tailored to the needs of Latinos in rural communities, the researchers utilized focus groups to ascertain the perspectives of Latino children and their parents who participated in a teen pregnancy prevention program. This article presents a Latino-driven conceptual design of an evidence-informed comprehensive, community-based, and culturally sensitive teen-pregnancy prevention program. The new model, called the Family-Festival Prevention Model, (1) used culturally relevant and experiential learning activities, (2) promoted community connections, (3) incorporated strategies that engaged fathers, and (4) engaged important faith-based and community stakeholders to involve the whole community in prevention efforts.     

Adoption Competent Clinical Practice: Defining Its Meaning and Development

The need for adoption competent mental health services has been well documented. However, the term “adoption-competent” has lacked a standardized, broadly accepted definition. This article reports findings from two related studies. The first examines how adoption competencies are demonstrated in practice by clinicians participating in an evidence-informed adoption competency training program. The second is an online survey designed to determine whether members of adoption kinship networks agree with a definition of an adoption competent mental health professional developed by experts. Both studies contribute to our understanding of what constitutes “adoption competent” clinical practice.     

Field Note—Developing Suicide Risk Assessment Training for Hospital Social Workers: An Academic–Community Partnership

This article describes 1 large urban pediatric hospital's partnership with a university to provide suicide assessment and management training within its social work department. Social work administrators conducted a department-wide needs assessment and implemented a 2-session suicide assessment training program and evaluation. Respondents (97.8%) indicated that the training was either helpful or very helpful in 8 suicide assessment skill-based domains. All attendees reported positive changes in perceived competence in 6 of 8 skill-based domains. A brief and time-efficient in-service training can be instrumental in augmenting hospital social worker competence in suicide risk assessment practice. This model of training program development, implementation, and evaluation is feasible, evidence-informed, and may be replicated.     

Partnering for Mental Health Promotion: Implementing Evidence Based Mental Health Services Within a Maternal and Child Home Health Visiting Program

This article details the clinical foundations of a social work focused community-based participatory research project promoting women’s mental health during and around the time of pregnancy. Specifically, we discuss the theoretical, empirical and organizational implementation of an enhanced engagement model of mental health service delivery that integrates evidenced based practices into the structure and services of an existing non-profit maternal and child health home visiting agency. The model is grounded in literature addressing barriers to accessing mental health care among minority women living in low-income communities. We discuss informing the intervention through direct consumer involvement, as well the rationale supporting the inclusion of Interpersonal Psychotherapy and Cognitive Behavioral Therapy into the design and implementation of the model which emphasizes adequate training of staff with varying levels of mental health experience. Finally, we describe typical client situations and responses reflected by the Enhanced Engagement model and discuss future implications of this approach as a way to offer meaningful intervention to women and families who may not have access or eligibility to utilize specialty mental health services.     

Teaching Clinical Social Work Skills Entirely Online: A Case Example

While numerous disciplines have eagerly embraced innovative educational technology, many social work educators have not been among early adopters. Social work's focus on the human connection and hands‐on practice skills can seem antithetical to technology‐mediated education. Nevertheless, social work programs are implementing distance learning and Internet‐mediated courses, and some schools are offering entire social work courses online. Leading the way in this regard is the Florida State University College of Social Work, which has developed and implemented the first CSWE‐accredited, entirely online Master of Social Work program. The purpose of this paper is to describe the development, design, and implementation of one skills‐based clinical course in this program, with the goal of sharing information in a way that will further the discussion of the risks and benefits of online education as well as provide guidance for educators who may be interested in developing a skills‐based online course in the future.     

Dissemination and implementation science in program evaluation: A telemental health clinical consultation case example

Increased attention has been placed on evaluating the extent to which clinical programs that support the behavioral health needs of youth have effective processes and result in improved patient outcomes. Several theoretical frameworks from dissemination and implementation (D&I) science have been put forth to guide the evaluation of behavioral health program implemented in the context of real-world settings. Although a strong rationale for the integration of D&I science in program evaluation exists, few examples exist available to guide the evaluator in integrating D&I science in the planning and execution of evaluation activities.This paper seeks to inform program evaluation efforts by outlining two D&I frameworks and describing their integration in program evaluation design. Specifically, this paper seeks to support evaluation efforts by illustrating the use of these frameworks via a case example of a telemental health consultation program in pediatric primary care designed to improve access to behavioral health care for children and adolescents in rural settings. Lessons learned from this effort, as well as recommendations regarding the future evaluation of programs using D&I science to support behavioral health care in community-based settings are discussed.     

Washington State's adoption of a child welfare practice model: An illustration of the Getting To Outcomes implementation framework

Despite a great need for evidence-informed practices in child welfare, very few child welfare systems have implemented evidence-based case management models state-wide. While the literature on implementation from the perspective of model developers and researchers is steadily increasing, there has been little attention to the process of implementation originating from the reverse direction, by community organizations themselves, or with regard to going-to-scale implementation in child welfare. The Getting to Outcomes (GTO) model, which was originally created to help organizations choose and implement prevention programs, is a promising guide for child welfare systems seeking to initiate system-wide implementation of evidence-based practices. The GTO framework provides a step-by-step guide for surveying a system, building motivation, training, and evaluation. This article will illustrate the state-wide implementation of Solution-Based Casework (SBC), an evidence-based model of case management, by Washington State's Children's Administration, following the GTO framework. Despite some barriers and obstacles, the GTO model proved to be feasible and to aide in the implementation of SBC. Implications for the GTO model as a framework for empowering community organizations to choose and implement relevant evidence-based practices will be discussed.     

Instructional Design: Bridge to Competence

Competency-based education emphasizes precision and rigor in instructional development. Social work educators surveyed reported differential success in implementing key instructional development elements. They reported success in specifying instructional objectives and developing related assessment procedures. They faced frequent obstacles in the systematic design of instruction; that is, in building bridges to competence for the learner. A theoretical framework is proposed to guide instructional design strategies. Three interrelated constructs are developed: learning task characteristics, learning environment characteristics, and learner characteristics. Approaches for operationalizing each construct are identified. Design strategies emerge from matching learner and learning environment characteristics to optimize performance on differentiated learning tasks.     

国家示范校中职“双师型”教师培养途径的研究——以广西玉林农业学校为例

立足国家示范校建设需要,针对中职“双师型”教师培养中存在的问题,从学校与教师两个层面设计“双师型”教师的培养途径,即在学校发展层面实施“双师型教师培养五大工程”,在教师发展层面实施“双师型教师培养四个主动方案”,为提升教师的教学、实践、科研等综合素质提供一个切实的举措,最终实现学校发展与教师自身发展的双赢。     

Evaluation of a cross-cultural training program for Pakistani educators: Lessons learned and implications for program planning

In this paper, we share the results of a summative evaluation of PEILI, a US-based adult professional development/training program for secondary school Pakistani teachers. The evaluation was guided by the theories of cultural competence (American Psychological Association, 2003, Bamberger, 1999, Wadsworth, 2001) and established frameworks for the evaluation of professional development/training and instructional design (Bennett, 1975, Guskey, 2002, King, 2014, Kirkpatrick, 1967). The explicit and implicit stakeholder assumptions about the connections between program resources, activities, outputs, and outcomes are described. Participant knowledge and skills were measured via scores on a pre/posttest of professional knowledge, and a standards-based performance assessment rubric. In addition to measuring short-term program outcomes, we also sought to incorporate theory-driven thinking into the evaluation design. Hence, we examined participant self-efficacy and access to social capital, two evidenced-based determinants or “levers” that theoretically explain the transformative space between an intervention and its outcomes (Chen, 2012). Data about program determinants were collected and analyzed through a pre/posttest of self-efficacy and social network analysis. Key evaluation findings include participant acquisition of new instructional skills, increased self-efficacy, and the formation of a nascent professional support network. Lessons learned and implications for the design and evaluation of cross-cultural teacher professional development programs are discussed.     

A visual management tool for program planning,project management and evaluation in paediatric health care

This article describes the development and implementation of a custom-designed Excel-based visual management tool. The tool’s purpose was to support program planning and evaluation by our resource support team within a paediatric health care setting. Our aims in developing it were to 1) establish a streamlined process and supporting tools to efficiently plan and prioritize program directions and activities; 2) track progress; and 3) evaluate and report on our performance, outputs and outcomes. A collaborative approach based on the ADKAR (Awareness, Desire, Knowledge, Ability, Reinforcement) change management model and the LEADS (Lead self, Engage others, Achieve results, Develop coalitions, Systems transformation) leadership framework was used to guide the design and implementation processes. Team members reported high perceived effectiveness and efficiency with respect to the tool’s utility in supporting its proposed aims. A graded approach to building knowledge and skills in using the tool, to individual responsibility for data entry, and to accountability by team members facilitated its successful implementation. Administrative support is important for sustainability and continual improvement of the tool to address changing team needs over time.     

Managing and Adapting Practice: A System for Applying Evidence in Clinical Care with Youth and Families

Concerns about the gap between service quality in mental health systems and the growing literature on scientifically tested treatment approaches has led to multiple policy and practice initiatives calling for greater use of empirically supported interventions (ESIs) in children’s mental health systems. Despite the demonstrated efficacy of these approaches, some concerns remain about the current suitability of ESIs as a single strategy for improving service system quality. Issues raised include (a) the appropriateness of some interventions for individualized care or adaptation in response to emergent events, and (b) the ability for ESIs collectively to yield a comprehensive service array for youth and families. The current paper thus outlines one strategy to complement and extend that work, through a system for organizing and coordinating currently available ESIs as well as for building and adjusting individualized, evidence-informed plans when needed, using dedicated tools to inform treatment design, adaptation, and evaluation in real time. A case example is presented, and implications for treatment and research are discussed.     

Zero effects in substance abuse programs. Avoiding false positives and false negatives in the evaluation of community-based programs

The evaluation of community-based programs poses special design and analysis problems. The present article focuses on two major types of errors that can occur in such evaluations: false positive--incorrectly declaring a program to be effective--and false negatives--incorrectly declaring a program to be ineffective. The evaluation of a national demonstration of community-based programs to reduce substance abuse, Fighting Back, is used to illustrate several approaches to reduce the probability of errors. Both those errors that are affected by the design and those by analytic approaches are considered. Ways to assess multiple outcomes and to match the complexity of the program with design and analytic strategies are proposed. Community trials are complex interventions, and, although they can provide very useful information, their outcomes have to be understood in terms of the constructs they test and the contexts within which they are carried out.     

Grounding Online Prevention Interventions in Theory: Guidelines from a Review of Selected Theories and Research

ABSTRACT

Literature suggests that grounding online interventions in theory improves their success. This article reviews 10 theories selected from the fields of psychotherapy, social work, health promotion, gaming, and innovation dissemination that can be used for grounding the design, development, implementation, and evaluation of online interventions. Selected studies are reviewed to illustrate how these theories have been used in online human service interventions. After this review, an integrated theoretical approach for grounding online interventions is proposed along with guidelines suggested by the review.     

A Model Program for Increasing Treatment Access for African American Women Who Use Crack Cocaine and Are at Risk of Contracting HIV

ABSTRACT

In the United States, the threat of HIV/AIDS to African-American women's health has become the focus of much concern. This article describes a federally funded community-based program that provides services to African-American women at risk for HIV/AIDS in Nashville, TN. This program provides a culturally relevant set of interventions specific to crack cocaine users aimed at reducing substance use and HIV/AIDS risk behaviors. The model is important to the continued development of culturally relevant interventions that are vital to stemming the disproportionate rates of HIV/AIDS within the African-American community by ensuring treatment access to all populations.