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.     

‘Would you prefer not to?’ Resetting/resistance across literature,culture, and organizations

ABSTRACT

In this paper we put the concepts of reset, aprosdoketon and minor gesture to work in the context of organizational narratives. In particular we engage with two iconic characters of the genre of organizational fiction, Don Draper in the context of Mad Men TV series and the copyist, who is the main character of Bartleby, the Scrivener by Herman Melville. Through a series of textual and performative writings we explore the possibility of setting and resetting organizational narratives/genre. Moreover, we explore what happens when fictional characters from a TV series and a novel (Bartleby and Don Draper) meet us – three scholars working in an array of different fields (literary, methodology, education and organization studies) and how this meeting and interaction shapes our understandings of work, culture, and organizations.     

Fostering CHANGE: Lessons from implementing a multi-country,multi-sector nutrition-sensitive agriculture project

Using agriculture to improve nutrition is an approach growing in popularity, with programs becoming increasingly complex and multisectoral. While there is an active line of research assessing the impacts of such programs, little has been written about the process of successfully implementing them. As such, this paper uses a multisectoral nutrition-sensitive agriculture program implemented in four African countries as a case study to address key challenges in and lessons learned from implementation. We highlight the overall flexibility of nutrition-sensitive agriculture but also the need to adapt certain aspects to the particular context, as well as the opportunities for cross-context learning (and the limits to this). Integrating rigorous evaluation into such complex programs and forging diverse cross-sectoral partnerships offer both rewards and challenges, upon which we reflect. Main lessons learned from the program include the importance of carefully sequencing interventions, retaining flexibility in implementation, allowing for considerable time for cross-sector integration and coordination, and considering community impacts when designing research.     

A multi-level examination of how the organizational context relates to readiness to implement prevention and evidence-based programming in community settings

Prior theoretical and empirical research suggests that multiple aspects of an organization's context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown.Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization's readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization's readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization's morale was also found to be a strong predictor of an organization's readiness. The findings of the current study are discussed in terms of implications for prevention and intervention.     

Working on Womanhood (WOW): A participatory formative evaluation of a community-developed intervention

The well-documented disparities in availability, accessibility, and quality of behavioral health services suggest the need for innovative programs to address the needs of ethnic minority youth. The current study aimed to conduct a participatory, formative evaluation of “Working on Womanhood” (WOW), a community-developed, multifaceted, school-based intervention serving primarily ethnic minority girls living in underserved urban communities. Specifically, the current study aimed to examine the feasibility, acceptability, and initial promise of WOW using community-based participatory research (CBPR) and represented the third phase of a community-academic partnership. Qualitative and quantitative data were collected from 960 WOW participants in 21 urban public schools, as well as WOW counselors, parents, and school staff over the course of one academic year. Results demonstrated evidence of acceptability of WOW and noteworthy improvements for WOW participants in targeted outcomes, including mental health, emotion regulation, and academic engagement. Findings also indicated several challenges to implementation feasibility and acceptability, including screening and enrollment processes and curriculum length. Additionally, we discuss how, consistent with participatory and formative research, findings were used by program implementers to inform program improvements, including modifications to screening processes, timelines, curriculum, and trainings – all in preparation for a rigorous effectiveness evaluation.     

An American Wordless Picturebook in Italian Classrooms: Inspiring Global Connections of People,Places, and Environments

What happens when five teacher candidates and their professor bring a wordless picturebook into Italian classrooms? This article presents a grounded discussion of our immersive experiences from the United States and the minilessons they taught stemming from a piece of children's literature through our study abroad program in Italy. The opening of Italian classroom doors provided reflective observations of the critical and creative thinking processes of more than 200 Italian students (ages 7–16). We (one professor and five early childhood and special education teacher candidates) taught minilessons in five Italian schools during a monthlong study abroad program offered by our university (further described in Author 1, 2017). Although this project was conducted in Italy, we have since used this minilesson successfully in our own classes, and we invite you to adapt our use to fit your teaching.     

Reflections on engaging with an advisory network in the context of a ‘sensitive’ research study

This article surfaces issues about the often-used but widely under-reported practice of working with advisory fora. We critically reflect on our experiences working with an advisory network when co-designing a research study about a ‘sensitive’ subject. We discuss the following: 1) How the network evolved as a matter of ethical and pragmatic choices; 2) Potential issues when discussing sensitive issues ‘outside’ of the participatory or participant context; and 3) Practical and epistemic issues involved in (not) ‘taking’ advice. We suggest that although sensitive research is more conventionally aligned with more ‘radical’ forms of participatory practice, advisory networks can present a useful and sometimes more appropriate form of inclusion and engagement for some advisors and for some types of research study. The article should, therefore, be of interest to a wide range of academic and practice-based health and social care staff and, in particular, those who plan to use advisory fora in their work.     

Beyond professional snail races: Contextualizing corporate communication in Indonesia

This study provides an overview of the current state of corporate communication in some of Indonesia’s largest companies. A cross-cultural survey of senior managers highlights the uniqueness of Indonesia by comparing practitioners’ perceptions with results from two Western countries, namely Austria and Australia. The results reveal the limitations of traditional professionalization theories; embedding corporate communication into the cultural and institutional context has proved to be more instructive. Practitioners in Indonesia employ a comparably critical distance to their own cultural environment. However, at the same time, they are highly adaptive when it comes to the stringently regulated and politicized institutional context of their work. From a normative perspective, we would instead support a self-understanding of professional communicators as societal change agents.     

ANALYZING THE IMPACT OF THE WORLD'S LARGEST PUBLIC WORKS PROJECT ON CRIME

India started the implementation of a rural public works program in 2006, covering all districts of the country within 3 years. The program guarantees 100 days of employment per year at minimum wage to each rural household, with the goal of reducing joblessness and poverty. We exploit the design and implementation of this program to investigate its employment impact on various types of crimes to provide rare evidence on the employment–crime relationship in a developing country context. We find that employment generated by the program has a negative impact on both property crime and violent crime. The same conclusion is reached when we analyze the impact of the program using its staggered rollout structure as the source of identification in a difference-in-difference analysis. Although crime elasticities with respect to employment are small, this finding represents another dimension of the social benefit generated by the program. (JEL K4, E24, H54)     

Food Landscapes: Cooking,Community Service and Art-Making with Teens

ABSTRACT

In this article, we describe Food Landscapes, an interdisciplinary program involving youth who live in an urban community identified as a food desert. Food Landscapes combined socially engaged art-making, cooking, community engagement, and community service to open dialogue with youth about food justice and equity, the meaning of community, and the formation of meaningful relationships between youth and community members who have disabilities. We describe the program and discuss the theory and model bases for the program and lessons learned during program implementation.     

As You Sow,So Shall You Reap?

Foundations’ capacity‐building grant programs strive to bolster performance and outcomes for their nonprofit grantees. Yet with few outcome evaluations of such programs, we have limited understanding of whether these capacity‐building efforts achieve their intended result. This study evaluates fifteen years of data for one foundation's capacity‐building grant program to understand whether targeted capacity building for financial management and development contributes to nonprofit financial growth. The authors examine the management–performance link in this context and inform sector leaders who dedicate resources to capacity‐building programs about the outcomes of these efforts.     

Inspiring Hope,Envisioning Alternatives: The Importance of Peer Role Models in a Mandated Treatment Program for Women

ABSTRACT

This article presents evidence from a program evaluation effort conducted with clients in a mandated treatment setting for drug-involved women charged with felony-level offenses. We present themes from qualitative interviews that stress the importance of identifying with a peer who is further along in recovery as a crucial mechanism for instilling hope and fostering program engagement. We also provide survey data that shows that a client's ability to imagine a life without using drugs, at intake, is a significant predictor of program success. Finally, the Stages of Change Readiness and Treatment Eagerness scale did not show any significant correlations with program success in this population. All women entered this program from very challenging situations, but we conclude that those who enter with the least hope and smallest (or absent) vision of any alternative future are especially vulnerable for a bad outcome. We urge researchers and practitioners to further explore the ways in which connections with peer role models facilitate engagement and successful outcomes; and to systematically evaluate the effect of interventions designed to foster such connections on program outcomes.     

A decision support tool to determine cost-to-benefit of a family-centered in-home program for at-risk adolescents

Family-centered program research has demonstrated its effectiveness in improving adolescent outcomes. However, given current fiscal constraints faced by governmental agencies, a recent report from the Institute of Medicine and National Research Council highlighted the need for cost-benefit analyses to inform decision making by policymakers. Furthermore, performance management tools such as balanced scorecards and dashboards do not generally include cost-benefit analyses. In this paper, we describe the development of an Excel-based decision support tool that can be used to evaluate a selected family-based program for at-risk children and adolescents relative to a comparison program or the status quo. This tool incorporates the use of an efficient, user-friendly interface with results provided in concise tabular and graphical formats that may be interpreted without need for substantial training in economic evaluation. To illustrate, we present an application of this tool to evaluate use of Boys Town’s In-Home Family Services (IHFS) relative to detention and out-of-home placement in New York City. Use of the decision support tool can help mitigate the need for programs to contract experts in economic evaluation, especially when there are financial or time constraints.     

Understanding the implementation of the Grow! parenting program: Findings from a mixed methods pilot study

Evaluating the implementation of parenting interventions is critical to program diffusion and quality across populations and settings, and to enhancing treatment outcomes. This article presents implementation findings from a pilot study of Grow!, a universal parenting program targeting parents of five to eight years olds that aims to improve child outcomes through strengthened parenting. Grow! was implemented at two community sites in central Pennsylvania by trained facilitators. Implementation data was gathered from facilitators and participants using mixed methods, including surveys, observation checklists, semi-structured interviews, and focus group discussions. These data were analyzed and integrated to explore, within the context of Proctor et al.'s (2011) implementation outcome framework, four implementation outcomes (i.e., acceptability, appropriateness, fidelity, and feasibility). Overall, these findings demonstrate that Grow! can be, and was, implemented effectively in a community setting. Moreover, they demonstrate how the Proctor et al. (2011) framework can be operationalized and applied specifically to hybrid effectiveness-implementation design studies.     

Racial Identity,School Racial Climate,and School Intrinsic Motivation Among African American Youth: The Importance of Person–Context Congruence

Researchers have been concerned with whether strong racial identification promotes or inhibits achievement motivation among African American youth, but current literatures have paid little attention to the role of youths' contexts. In this study, we outline a racial identity–context congruence framework that predicts positive benefits of a strong, positive racial identity when the context is congruent with youths' beliefs. To test this framework, we examined school racial climate as a moderator in the relationships of three racial identity variables (centrality, private regard, and public regard) with intrinsic motivation for attending school in a sample of 11th graders. Overall, results support the congruence perspective and also demonstrate how feelings of belonging at school mediate the relationship between racial identity–racial climate congruence and school intrinsic motivation.     

Participatory research to promote physical activity at congregate-meal sites

The purpose of this study was to determine the feasibility and effectiveness of an on-site physical activity (PA) program offered with congregate meals. Study 1 surveyed meal-site users on their likelihood to participate. Study 2 used meal-site-manager interviews and site visits to determine organizational feasibility. Study 3, a controlled pilot study, randomized meal sites to a 12-week group-based social-cognitive (GBSC) intervention or a standard-care control. Studies 1 and 2 indicated that most meal-site users would participate in an on-site PA program, and meal sites had well-suited physical resources and strong organizational support for this type of program. In Study 3, GBSC participants increased their weekly PA over those in the control condition (p < .05, ES = .79). Results indicated that changes in task cohesion might have mediated intervention effectiveness. These studies demonstrate that a PA program offered in this venue is feasible, is effective in promoting PA, and could have a strong public health impact.     

Lessons from a project to create performance measures for public health

This paper uses a specific example to illustrate complications that arise in formulating and implementing performance measures. The context of this demonstration is a Centers for Disease Control and Prevention (CDC)-funded project to explore the feasibility of performance measures developed at the national level for local sexually transmitted disease (STD) prevention and control programs. Grantees provided local data and reported on their experience in eliciting the data and using the results for program development. The experience of this project suggests that measures can be made operationally feasible and programmatically useful only if terminologies are subjected to extensive definition and clarification activities. These activities must include development of common language, mapping of workflows, and clarification of spheres of influence. Finally, performance measures must be used with some caution, as they often unintentionally capture extraneous program elements.     

Research integrity,image manipulation,and anonymizing photographs in visual social science research

Undocumented alterations to research images, defined in this piece as image manipulation, may represent a case of research misconduct. What constitutes image manipulation, particularly when images of human participants used in research need to be adjusted for protection of participant confidentiality? In this article, conceptual clarifications of the definition of image manipulation, image management, and research integrity are developed and adapted to the context of visual social research. Using these definitions, a series of recommendations for notifying human participants of image management techniques via the informed consent processes and a set of guidelines for managing images of identifiable human participants in research in visual studies research are developed.     

Experiences of health service providers establishing an Aboriginal-Mainstream partnership to improve maternity care for Aboriginal and Torres Strait Islander families in an urban setting

Australian policy encourages multiagency partnerships between hospitals and Aboriginal Community Controlled Health Organisations to improve the health of Aboriginal and Torres Strait Islander people. Service planners remain unsure about how to implement such partnerships in maternity care, and there is a lack of appropriate tools designed to gauge the state of such partnerships for the Australian Indigenous context. In 2013, two Aboriginal health services and a major tertiary hospital partnered to deliver best practice maternity care to Indigenous families in Brisbane, Australia. A participatory action research approach underpinned this study. Semi-structured qualitative interviews and focus groups were conducted with 21 of the partnership staff. All interviewees emphasized the partnership’s commitment to improving long-term health and wellbeing for Indigenous families. Strategic planners were more likely to report a positive partnership than staff involved in service delivery who had diverse views. This highlights the challenges of change management when conducting such a significant service redesign in this cross-cultural context. We detail changes made within the partnership in response to the findings and provide suggestions for future development of an evaluation tool to review the state of Aboriginal-Mainstream Partnerships.