Effective Recruitment for Parenting Programs Within Ethnic Minority Communities

This article describes the results of a demonstration project which focused on exploring recruitment and retention of ethnic minority families to a parent training program aimed to prevent substance abuse among their children. The Parenting for Drug-Free Children project sought to deliver a curriculum to parents from several ethnic groups in an urban setting. The targeted ethnic communities were African American, Latino, Native American, and Samoan. The project successfully recruited diverse groups of families to participate in a drug prevention program, many of whom had never participated before in a parenting program. The identification of key individuals for recruiting and accessing networks of potential participants proved to be an effective means of recruitment.     

Making Connections: Community Organizing,Empowerment Planning,and Participatory Research in Participatory Evaluation

This article shows the intersections of participatory research, popular education, empowerment planning, and community organizing with participatory evaluation. It argues that a truly successful participatory evaluation involves participants in guiding and even conducting the research, doing a process of self- and program study, creating plans for change, and organizing themselves for implementing these plans. Next, the chapter shows how these elements played out in a participatory evaluation of a community organizing training and technical assistance project in Toledo, Ohio. The first year of the project was facilitated by participatory evaluation that helped identify early successes and problems so participants could make programmatic changes early in the process. The telling of the story also develops practices of participatory evaluation, including planning the evaluation, doing the research and adapting it to changing conditions, uncovering creative tensions, participatory validity checking, and linking the process to planning and action. The chapter concludes with some lessons for participatory evaluation practice.     

Participation in stakeholder-based evaluation: A case study

This paper reports on the evaluation of some of the elements of a multi-component program aimed at improving the accessibility of health and social services for the homeless. The program involved provincial, regional and municipal authorities and more than 20 non-profit and public agencies. In accordance with the overall approach of the program, the principle of stakeholder participation in the evaluation was emphasized by the funding agencies. However, even if the evaluation started under promising conditions, including administrative support, a strong commitment from the involved agencies and experience in formative evaluation within the research team, participation of stakeholders from charitable non-profit agencies met with many difficulties. Using a case study approach, this paper attempts to analyze and discuss how the organizational context of the evaluation, certain stakeholder characteristics and methodological features may have impacted on the evaluation process.     

Male-to-Female Transgender Individuals Building Social Support and Capital From Within a Gender-Focused Network

ABSTRACT

The literature on male-to-female transgender myriad problems such individuals face in their day-to-day lives, including high rates of HIV/AIDS, addiction to drugs, violence, and lack of health care. These problems are exacerbated for ethnic and racial minority MTFs. Support available from their social networks can help MTFs alleviate these problems. This article explores how minority MTFs, specifically in an urban environment, develop supportive social networks defined by their gender and sexual identities. Using principles of community-based participatory research (CBPR), 20 African American and Latina MTFs were recruited at a community-based health care clinic. Their ages ranged from 18 to 53. Data were coded and analyzed following standard procedure for content analysis. The qualitative interviews revealed that participants formed their gender and sexual identities over time, developed gender-focused social networks based in the clinic from which they receive services, and engaged in social capital building and political action. Implications for using CBPR in research with MTFs are discussed.     

Updating the FORECAST formative evaluation approach and some implications for ameliorating theory failure,implementation failure,and evaluation failure

Historically, there has been considerable variability in how formative evaluation has been conceptualized and practiced. FORmative Evaluation Consultation And Systems Technique (FORECAST) is a formative evaluation approach that develops a set of models and processes that can be used across settings and times, while allowing for local adaptations and innovations. FORECAST integrates specific models and tools to improve limitations in program theory, implementation, and evaluation. In the period since its initial use in a federally funded community prevention project in the early 1990s, evaluators have incorporated important formative evaluation innovations into FORECAST, including the integration of feedback loops and proximal outcome evaluation. In addition, FORECAST has been applied in a randomized community research trial. In this article, we describe updates to FORECAST and the implications of FORECAST for ameliorating failures in program theory, implementation, and evaluation.     

A principles-focused evaluation of community mental health short-term case management

Principles-focused evaluations allow evaluators to appraise each principle that guides an organization or program. This study completed a principles-focused evaluation of a new community mental health intervention called Short Term Case Management (STCM) in Toronto, Canada. STCM is a time limited intervention for clients to address unmet needs and personalized goals over 3 months. Findings showcase that a principles-focused evaluation, assessing whether program principles are guiding, useful, inspiring, developmental and/or evaluable (GUIDE), is a practical formative evaluation approach. Specifically, offering an understanding of a novel intervention, including its key components of assessment and planning, support plan implementation and evaluation and care transitions. Findings also highlight that STCM may work best for those clients ready to participate in achieving their own goals. Future research should explore how best to apply the GUIDE framework to complex interventions, including multiple principles, to increase evaluation feasibility and focus.     

Evaluation of community-based AIDS education and risk reduction projects in ethnic and racial minority communities: A survey of projects funded by the U.S. public health service

The purpose of this study was to describe proposed program evaluation methods used to determine effectiveness of selected federally funded AIDS education and risk reduction interventions focused on ethnic and racial minority populations. Funding for AIDS prevention programs has grown significantly since 1985, when the first allocation of $11 million was earmarked for general AIDS prevention and education. In 1987, funds specifically targeting minority populations were set aside from AIDS prevention and education programs. Nine agencies/divisions within the Department of Health and Human Services (DHHS) were identified as having funded AIDS prevention and education projects targeted toward ethnic and racial minority populations. The grants and contracts reviewed for this study were limited to those programs receiving Federal funding through DHHS. Few programs provided information within the broader context of sex education and drug education. The modification of needle-sharing behavior among IV drug users and unprotected sex with an IV drug user were the two most frequent risk factors targeted. All 63 programs used at least one formative evaluation method. The most frequently used formative techniques were monitoring achievement of project objectives and counting the number of people participating in program activities. Forty programs counted the amount of AIDS literature distributed. Thirty-three programs conducted a baseline assessment of AIDS knowledge, and 33 programs conducted a baseline assessment of risk behaviors for HIV infection. Results from this study support the National Academy of Sciences recommendation that while summative evaluation will ultimately be valuable, it would be premature to begin developing outcome evaluation strategies at the present time. It is incumbent upon program planners and evaluators to ensure that premature program evaluations are not made in an effort to eliminate direct federal funding of minority community-based strategies to stop the spread of HIV infection.     

Ngarraanga Giinganay (‘thinking peacefully’): Co-design and pilot study of a culturally-grounded mindfulness-based stress reduction program with older First Nations Australians

First Nations ‘survivors’ are ageing in increasing numbers. Life-course stress and depression are of concern for older First Nations Australians, yet there are limited psychosocial interventions. This study aimed to co-design a culturally-grounded mindfulness-based program (‘Ngarraanga Giinganay’) and evaluate acceptability/feasibility with an Aboriginal community on Gumbaynggirr Country. An expert Working Group guided program development, with Aboriginal and non-Aboriginal clinicians/consultants. A workshop, collaborative yarning group with older Aboriginal people (n = 9), and further consultation contributed to the design/refinement of the 8-session group-based program, ensuring content aligned with therapeutic principles of mindfulness and cultural understandings of the Gumbaynggirr community. A single-group pilot study was conducted (n = 7, 62−81 years), co-facilitated by an Aboriginal clinician and Elder. Outcomes were qualitative (understandings of mindfulness, program acceptability, benefits to health/wellbeing). Pilot results demonstrated feasibility, acceptability and preliminary effectiveness. The program enhanced understandings of mindfulness and participants highlighted benefits such as helping anxiety, relaxation, focusing on the moment and connection to Country/land. Trends were seen for reducing depression, anxiety and stress symptoms, and blood pressure. This study provides insight into partnering with underrepresented populations through ageing research, highlighting the effectiveness of this co-design approach. Ngarraanga Giinganay has considerable potential for supporting health and wellbeing of First Nations peoples.     

Ethnic Minority Social Work Mental Helath Training Programs:

This article reports on the critical mental health issues and concerns of ethnic minority groups of color. Accomplishments are summarized from National Institute of Mental Health ethnic minority social work clinical training programs. Goals and proposals are suggested for addressing ethnic minority mental health needs. Personnel and curriculum recommendations are offered to enhance the effectiveness of social work mental health interventions.     

Developing a program for social work with Latino populations: a case study

ABSTRACT

This paper presents a case study of the development of a program in a large U.S. School of Social Work to train social work students to work with Latina/o populations entitled ‘Latino/a Initiatives for Service, Training, and Assessment’ (LISTA). Using a case study methodology, this work fills a current gap in the literature as it examines the programmatic and curricular dynamics associated with such an effort. The methods section details LISTA’s planning process and early implementation. This includes the demographic, theoretical, and professional context of the program along with the stages of curricular development. The results section examines LISTA’s current curriculum, including three courses, field placements and study abroad program, as well as its assessment processes. It further examines issues and challenges related to developing a new curricular emphasis in a graduate program, including funding, recruitment, and securing field placements. The discussion section provides a set of recommendations, including the institutionalization of mechanisms for community feedback and the recruitment of ethnic minority students and faculty. LISTA serves as a potential model for recruiting and training social workers to serve diverse ethnic minority populations.     

Using a participatory evaluation design to create an online data collection and monitoring system for New Mexico's Community Health Councils

We present the collaborative development of a web-based data collection and monitoring plan for thirty-two county councils within New Mexico's health council system. The monitoring plan, a key component in our multiyear participatory statewide evaluation process, was co-developed with the end users: representatives of the health councils. Guided by the Institute of Medicine's Community, Health Improvement Process framework, we first developed a logic model that delineated processes and intermediate systems-level outcomes in council development, planning, and community action. Through the online system, health councils reported data on intermediate outcomes, including policy changes and funds leveraged. The system captured data that were common across the health council system, yet was also flexible so that councils could report their unique accomplishments at the county level. A main benefit of the online system was that it provided the ability to assess intermediate, outcomes across the health council system. Developing the system was not without challenges, including creating processes to ensure participation across a large rural state; creating shared understanding of intermediate outcomes and indicators; and overcoming technological issues. Even through the challenges, however, the benefits of committing to using participatory processes far outweighed the challenges.     

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.     

Ethnic Minority Curriculum in Baccalaureate Social Work Programs

A survey of 87 accredited baccalaureate social work programs assessed ethnic minority content in the curriculum. Respondents described specialized courses, those with a "primary focus" (75-100% of course time) on ethnic minority curriculum, in three major topical areas: (1) curriculum content, (2) resources (e.g., textbooks, guest speakers, case studies), and (3) future implications. The majority of respondents (68%) participate in programs with these specialized courses, and indicate that curriculum content is broad in scope. They perceive resources as being readily available, current program curricula as adequate, and a strong momentum for future growth.     

Capacity-building needs of minority health nonprofits

This article reports on the results of a statewide assessment of the capacity-building needs of organizations that provide health services to ethnic minority groups in Ohio. The research addressed gaps in knowledge about the specific needs of these organizations for improved effectiveness and long-term sustainability. A telephone survey of 659 organizations, supplemented by focus groups with 37 participants in the state's largest cities, indicated substantial need and interest in capacity-building technical assistance in areas such as revenue-generating activities, marketing and public relations, information technology training, program evaluation, and board leadership development. The limited ability of these organizations to pay for the needed assistance creates challenges for planning approaches to meet these vital needs.     

Using MSD prevention for cultural change in mining: Queensland Government/Anglo Coal Industry partnership

Queensland Mining has a strong focus on safety performance, but risk management of health, including Musculoskeletal Disorders (MSDs) continues to have a lower priority. The reliance on individual screening of workers and lower level approaches such as manual handling training is part of the coal mining 'culture'. Initiatives such as the New South Wales and Queensland Mining joint project to develop good practice guidance for mining has allowed for a more consistent message on participatory ergonomics and prevention of MSD. An evidence based practice approach, including the introduction of participatory ergonomics and safe design principles, was proposed to Anglo American Coal operations in Queensland. The project consisted of a skills analysis of current health personnel, design of a facilitated participatory ergonomics training program, site visits to identify good practice and champions, and a graduated mentoring program for health personnel. Early results demonstrate a number of sites are benefiting from site taskforces with a focus on positive performance outcomes.     

Process evaluation of the ‘Singapore Physical Activity and Nutrition Study’

IntroductionThe Singapore Physical Activity and Nutrition Study (SPANS) aimed to improve the physical activity (PA) and nutrition behaviours of Singaporean women aged 50 years and over. The SPANS program consisted of PA classes, nutrition workshops, telephone dietary counselling, health booklets, a health calendar and program ambassadors. This study aimed to assess and understand the implementation of the program strategies and gain insight into process evaluation components to inform future programs.MethodsThe evaluation was guided by a process evaluation framework and collected data via questionnaires (n = 209), program ambassador documentation and exit interviews with program completers (n = 13) and non-completers (n = 12).ResultsIn total, 295 participants completed the program (response rate = 84 %). Participants reported high levels of satisfaction with the overall program (99.5 %) and program activities (96.7 %), and also rated program ambassadors highly. Participation rates were highest for telephone dietary counselling sessions. The main reason for not attending program activities was having a ‘busy schedule’ (n = 158). Participants cited a need for improved recreational centre facilities and increased flexibility around program delivery.ConclusionsThe process evaluation showed that the program strategies were implemented as planned and were deemed suitable for supporting behaviour change among Singaporean women aged 50 years and over. The program reached and involved the majority of participants throughout the six months. The combination of practical educational resources and supportive program ambassadors were key strategies that facilitated positive PA and dietary behaviours. However, there needs to be some flexibility in the delivery of programs. The findings of this research may inform other programs in the region.     

The process of evaluating a capacity-building support initiative for HIV positive South Africans

This paper describes the process of evaluating a capacity-building initiative involving HIV positive South Africans. The evaluation was conducted within a participatory evaluation framework, which aims at empowering participants through social action. The rationale is that an understanding and acceptance of evaluation results promotes commitment to act. Forty four members of the Kudu Support Group and 23 non-members participated in the evaluation. Methods included in-depth interviews, a survey, repeated measures of the General Health Questionnaire-28 (GHQ-28), a SWOT analysis, interviews with health workers, field notes, and participatory observation. The capacity-building initiative resulted in empowerment through paid employment for support group members, the establishment of a vegetable garden, increased skills and efficacy, access to resources and networks, a perceived reduction of stigma, perceived improvement of social relations, and improved scores on the GHQ-28. Lessons that emerge out of this study are the importance of integrating evaluation as a part of ongoing activities throughout the research project; to ensure that methods and results are understandable and useful to for the participants; that the evaluator has an in-depth understanding of the project and context; and to introduce frequent and simple internal evaluation tools to guide efforts to improve community-based groups’ functioning and activities.     

Participatory evaluation of a community–academic partnership to inform capacity-building and sustainability

The Tampa Bay Community Cancer Network (TBCCN) was formed as a partnership comprised of committed community based organizations (grassroots, service, health care organizations) and a National Cancer Institute designated cancer center working together to reduce cancer health disparities. Adhering to principles of community-based participatory research, TBCCN's primary aims are to develop and sustain outreach, training, and research programs that aim to reach medically underserved, multicultural and multilingual populations within the Tampa Bay tri-county area.Using a participatory evaluation approach, we recently evaluated the partnerships’ priorities for cancer education and outreach; perspectives on the partnerships’ adherence to CBPR principles; and suggestions for sustaining TBCCN and its efforts. The purpose of this paper is to describe implementation and outcomes of this participatory evaluation of a community/academic partnership, and to illustrate the application of evaluation findings for partnership capacity-building and sustainability. Our evaluation provides evidence for partners’ perceived benefits and realized expectations of the partnership and illustrates the value of ongoing and continued partnership assessment to directly inform program activities and build community capacity and sustainability.     

Process evaluation of a diversity training program: the value of a mixed method strategy

Patients’ health and health needs are influenced by categories of difference like sex, gender, ethnic origin and socioeconomic status (SES). To enhance awareness of this diversity among patients and to provide holistic care for them, health professionals should first be aware of the relation between dimensions of diversity and patients’ health and health demands. This paper presents a formative process evaluation of a diversity sensitivity training programme for healthcare professionals. The training was implemented in three healthcare settings (mental healthcare, nursing home and hospital care). Mixed methods were used to monitor the implementation of the training and its effects after three years. Findings demonstrate that the training stimulated participants’ awareness, knowledge and critical attitudes towards diversity. Their motivation and willingness to take action regarding diversity was also enhanced. Yet these developments were less apparent among nursing home participants who felt less satisfied and did not develop a critical perspective on this issue. Qualitative data were helpful to explain differences between the settings. By means of the combination of quantitative and qualitative data, we can conclude that individual learning was not enough to guarantee a sensitive approach to diversity at the organizational level.     

Towards an assessment for organizational participatory research health partnerships: A systematic mixed studies review with framework synthesis

Within the health sciences, organizational participatory research (OPR) is defined as a blend of research and action, in which academic researchers partner with health organization members. OPR is based on a sound partnership between all stakeholders to improve organizational practices. However, little research on the evaluation of OPR health partnership exists. This systematic mixed studies review sought to produce a new theoretical model that structures the evaluation of the OPR processes and related outcomes of OPR health partnerships. Six bibliographic databases were searched together with grey literature sources for OPR health partnership evaluation questionnaires. Six questionnaires were included, from which a pool of 95 OPR health partnership evaluation items were derived. The included questionnaires were appraised for the quality of their origin, development and measurement properties. A framework synthesis was performed using an existing OPR framework by organizing questionnaire items in a matrix using a hybrid thematic analysis. This led to our proposed Organizational Participatory Research Evaluation Model (OPREM) that includes three axes, Trust, Collective Learning and Sustainability (with specific dimensions) and 95 items. This model provides information to help stakeholders comprehensively structure the evaluation of their partnerships and subsequent improvement; thus, potentially helping to improve health organization practices.