Monitoring and evaluating transition and sustainability of donor-funded programs: Reflections on the Avahan experience

PurposeIn low and middle-income countries, programs funded and implemented by international donors frequently transition to local funding and management, yet such processes are rarely evaluated. We reflect upon experience evaluating the transition of a large scale HIV/AIDS prevention program in India, known as Avahan, in order to draw lessons about transition evaluation approaches and implementation challenges.ResultsIn terms of conceptualizing the transition theory, the evaluation team identified tensions between the idea of institutionalizing key features of the Avahan program, and ensuring program flexibility to promote sustainability. The transition was planned in three rounds allowing for adaptations to transition intervention and program design during the transition period. The assessment team found it important to track these changes in order to understand which strategies and contextual features supported transition. A mixed methods evaluation was employed, combining semi-structured surveys of transitioning entities (conducted pre and post transition), with longitudinal case studies. Qualitative data helped explain quantitative findings. Measures of transition readiness appeared robust, but we were uncertain of the robustness of institutionalization measures. Finally, challenges to the implementation of such an evaluation are discussed.ConclusionsGiven the scarceness of transition evaluations, the lessons from this evaluation may have widespread relevance.     

Transition from the hospital to the community: small group program.

1. Clients in a psychiatric hospital often experience loss of control over their lives and dissatisfaction with their quality of living. A small group rehabilitation program can counteract the effects of institutionalization and restore a sense of mastery to chronic psychiatric clients. 2. The therapeutic nurse-client relationship provides consistency and stability for clients who must cope with the stress of the mental health system and the transition to a community setting. 3. The program strives to restore individuals' self-confidence and dignity, improve their quality of life, and decrease the frequency and length of hospitalization.     

The operation was a success but the patient died: A critique of “the implementation and evaluation of a problem-solving training program for adolescents”

This critique examines George S. Tellado's account of his evaluation of a problem-solving program for adolescents in a public junior high school in Pennsylvania. The program was apparently successful (i.e., it was shown by the evaluation to improve students' problem-solving capacities), and the evaluation was, for the most part, technically sound, but the program did not survive. This critique suggests that by examining the problem-solving program as an organizational change intervention, several problems can be uncovered regarding the program's design, implementation, evaluation, and institutionalization. In particular, it appears that the school system's staff did not have sufficient ownership of the program to understand it or to wish to carry it on after the program's originator and evaluator were no longer present. This article addresses these problems in detail and recommends techniques from the field of organizational change consultation to increase the likelihood that such programs will live on into the future.     

The Impact of In-Home Services Utilization on the Institutionalization of Older People in Korea

As a result of aging populations, institutionalization of older people is creating an increasing financial burden in many countries. The purpose of the present study was to explore the impact of in-home service utilization on institutionalization. The subjects were newly certified as eligible for long-term care insurance between January and February 2009 in Korea. The follow-up period was 40 months, to April 2012. We used logistic regression models to identify factors influencing the transition to institutional service, adjusting for gender, age, living status, income level, activities of daily living, and chronic disease. The institutionalization rate was estimated to be 17.3% over 40 months. The interval from transitional living to institutionalization was 36 ± 8 months. Risk factors of transition to institutional services are being female, having advanced age, living with friends or cousins, getting dementia, and not using in-home services. We determined that institutionalization is mitigated by use of in-home services. Therefore, supplying appropriate in-home services to current nonusers would help to greatly reduce the rate of institutionalization of older people.     

Development and validation of an instrument to assess institutionalization of health promotion in faith-based organizations

Institutionalization of health promotion interventions occurs when the organization makes changes to support the program as a component of its routine operations. To date there has not been a way to systematically measure institutionalization of health promotion interventions outside of healthcare settings. The purpose of the present study was to develop and evaluate the initial psychometric properties of an instrument to assess institutionalization (i.e., integration) of health activities into faith-based organizations (i.e., churches). This process was informed by previous institutionalization models led by a team of experts and a community-based advisory panel. We recruited African American church leaders (N = 91) to complete a 22-item instrument. An exploratory factor analysis revealed four factors: 1) Organizational Structures (e.g., existing health ministry, health team), 2) Organizational Processes (e.g., records on health activities; instituted health policy), 3) Organizational Resources (e.g., health promotion budget; space for health activities), and 4) Organizational Communication (e.g., health content in church bulletins, discussion of health within sermons) that explained 62.3 % of the variance. The measure, the Faith-Based Organization Health Integration Inventory (FBO-HII), had excellent internal consistency reliability (α = .89) including the subscales (α = .90, .82, .81, and .87). This measure has promising initial psychometric properties for assessing institutionalization of health promotion interventions in faith-based settings.     

Factors Related to the Institutionalization of Older Aged Individuals Using Home- and Community-Based Care Services: Data From the South Korea Long-Term Care Insurance Program, 2008–2013

South Korea introduced a public long-term care insurance (LTCI) program in response to its rapidly aging population. This study analyzed the association between living arrangement and caregiver type with institutionalization in LTCI grade 1 (very severe limitations), 2 (severe limitations), and 3 (moderate limitations) beneficiaries using data from the LTCI cohort, 2008 to 2013. The dependent variable was alteration status from home to institutional care within 1 year of receiving home service. Independent variables were living arrangement and primary caregiver type. The analysis was conducted using the generalized estimating equation model. Higher likelihoods of institutionalization were found in individuals living with a non-family member compared to individuals living with their spouses. Individuals without a caregiver or with a paid caregiver were also more likely to experience institutionalization than individuals with a spouse primary caregiver. Our findings underscore the importance of monitoring identified vulnerable groups of individuals to attain LTCI sustainability and enhance elderly quality of life.     

Institutions and juvenile delinquency in historical perspective

This paper is an empirical historical study of institutionalization of juvenile delinquents. Estimates of institutionalization rates from 1820 to 1970 are presented. Rates have increased throughout this period, most rapidly in the second half of the 19th century and again during recent decades of the 20th century. Theories that have attempted to explain institutionalization are reviewed. However, the commonly accepted theories do not seem to comprehensively account for the observed pattern of institutional growth. A different perspective is offered, one that seems to fit the totality of data better than previous theories. The evidence suggests that institutionalization for juvenile delinquency has increased as a function of a changing vouth labor market—first the separation of work from family life, followed by a long-term decline in demand for young workers. As a dilemma in social planning related to juvenile delinquency, the findings suggest a need for providing con- structive social and economic alternatives to the declining youth labor market.     

直接甲烷化用于城市煤气的生产

通过对国内外甲烷化现状、水平和发展趋势的分析,叙述了耐硫甲烷化工业性试验的成功情况,提出了直接甲烷化用于城市煤气生产方案。     

Understanding knowledge transfer in an ergonomics intervention at a poultry processing plant

This case study reviews the knowledge transfer (KT) process of implementing a knife sharpening and steeling program into a poultry processing plant via a participatory ergonomics intervention. This ergonomics intervention required stakeholder participation at the company level to move a 'train-the-trainer' program, developed in Québec, Canada, into action on the plant's deboning line. Communications and exchanges with key stakeholders, as well as changes in steeling and production behaviours were recorded. The intervention was assumed to be at least partially successful because positive changes in work operations occurred. Ergonomic-related changes such as those documented have been cited in the academic literature as beneficial to worker health. However, several components cited in literature that are associated with a successful participatory ergonomics intervention were not attained during the project. A Dynamic Knowledge Transfer Model was used to identify KT issues that impacted on the success of train-the-trainer program. A debriefing analysis reveals that a failure to consider key participatory ergonomics factors necessary for success were related to capacity deficits in the knowledge dissemination strategy.     

An opera house for the “Paris of South America”: pathways to the institutionalization of high culture

Who has the power to institutionalize culture? How is it that cultural forms become legitimated and appropriated by certain groups? And what are the organizational forms that guarantee the continuity of the interlocks among classifications, etiquette, and resources in the long run? This article explores these questions by observing the struggle over the institutionalization of opera as high culture during the late nineteenth century and early twentieth century in Buenos Aires, a region of the world understudied by cultural sociologists. It contends that to answer these questions we need to observe the contested dynamics though which the process of institutionalization happens. It also shows how this contestation affects, in the long-term, the processes of evaluation and legitimation of the classification upheld, and the consequences it has in terms of audience stratification. In the Discussion section, I present a novel framework for the study of pathways to high culture institutionalization that highlights how the role of the state and competing stakeholders can introduce variable relationships among the elites, the arts, and social closure.     

学术批评:青年研究亟待填补的洼地

学术批评是青年研究学术积累、学术提炼、学术提升的重要途径,应该始终伴随青年研究、青年学学科建设和发展的全过程。但当下学术批评常常处于低语甚至失语状态,成为青年研究领域的一块学术洼地。造成这种状态的原因主要包括对"问题导向"理解片面、学术焦点尚未聚集、学术视野狭窄、批评武器匮乏、"好人主义"盛行等。提升青年研究学术水平,促进青年学学科建设,需要形成和完善学术反思机制,使学术批评常态化和制度化。     

The use of concept mapping for scale development and validation in evaluation

Evaluators often make key decisions about what content to include when designing new scales. However, without clear conceptual grounding, there is a risk these decisions may compromise the scale's validity. Techniques such as concept mapping are available to evaluators for the specification of conceptual frameworks, but have not been used as a fully integrated part of scale development. As part of a multi-site evaluation of family support programs, we integrated concept mapping with traditional scale-development processes to strengthen the creation of a scale for inclusion in an evaluation instrument. Using concept mapping, we engaged staff and managers in the development of a framework of intended benefits of program participation and used the information to systematically select the scale's content. The psychometric characteristics of the scale were then formally assessed using a sample of program participants. The implications of the approach for supporting construct validity, inclusion of staff and managers, and theory-driven evaluation are discussed.     

The Development and Implementation of a Minority Recruitment Plan: Process,Strategy and Results

Abstract

The authors identify and discuss the planning process and results of a three-year minority recruitment effort. The recruitment principles and framework used to influence decisions are explained. The recruitment and retention effort consisted of six phases: Gauging the environment, preinitiation, program planning and development, implementation, evaluation, and institutionalization. Each phase is discussed along with the tasks and strategies which proved to be effective.     

Maboo wirriya,be healthy: Community-directed development of an evidence-based diabetes prevention program for young Aboriginal people in a remote Australian town

Supporting healthy lifestyle behaviours is a key aspect of preventing type 2 diabetes which disproportionately affects disadvantaged groups from a younger age. Formative participatory research was undertaken to design a program for young Aboriginal people in a remote town in North West Australia with a high level of health needs and relatively few prevention initiatives. Focus groups and advisory discussions with Aboriginal community members were used to determine the nature of the program. The need for a comprehensive program was consistently expressed and limited healthy lifestyle knowledge and difficulties with healthy eating influenced by food environments were noted to be important. With guidance from the Derby Aboriginal Health Service, findings were integrated with previous international research evidence to develop a program tailored to local Aboriginal people aged 15–25 years and refine it after piloting. This 8-session program, ‘Maboo wirriya, be healthy’ involved an education component consistent with the US Diabetes Prevention Program and practical activities including group exercise. Changes to program structure and documentation were made after piloting for future use. The community-directed approach used in this study is vital to ensure relevance of localised chronic disease prevention programs in a range of settings.     

The Colorado Sex Offender Risk Scale

This study documents the development of an adult sex offender risk assessment tool. A sample of 494 sex offenders were followed for an average of 30 months. A risk scale was developed based upon criminal and therapeutic outcomes. The final risk scale included prior juvenile felony convictions, prior adult felony convictions, failure of the first or second grade, not being employed, victim being intoxicated, the perpetrator reporting not being sexually aroused during the crime, possession of a weapon during the crime, denial in therapy, sexual deviance in therapy, and motivation in therapy. The risk scale provided significant relative risk ratios against program failure at 12 and 30 months. Overall, those scoring high on the risk tool were 372% as likely to fail as those scoring low.     

The Effects of Early Institutionalization on the Discrimination of Facial Expressions of Emotion in Young Children

The current study examined the effects of institutionalization on the discrimination of facial expressions of emotion in three groups of 42‐month‐old children. One group consisted of children abandoned at birth who were randomly assigned to Care‐as‐Usual (institutional care) following a baseline assessment. Another group consisted of children abandoned at birth who were randomly assigned to high‐quality foster care following a baseline assessment. A third group consisted of never‐institutionalized children who were reared by their biological parents. All children were familiarized to happy, sad, fearful, and neutral facial expressions and tested on their ability to discriminate familiar versus novel facial expressions. Contrary to our prediction, all three groups of children were equally capable of discriminating among the different expressions. Furthermore, in contrast to findings at 13–30 months of age, these same children showed familiarity rather than novelty preferences toward different expressions. There were also asymmetries in children’s discrimination of facial expressions depending on which facial expression served as the familiar versus novel stimulus. Collectively, early institutionalization appears not to impact the development of the ability to discriminate facial expressions of emotion, at least when preferential looking serves as the dependent measure. These findings are discussed in the context of the myriad domains that are affected by early institutionalization.     

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.     

Structures,Challenges, and Successes of Volunteer Programs Co‐managed by Nonprofit and Public Organizations

This article presents a mixed‐methods, multicase study and comparison of volunteer programs in US national parks that have evolved, in response to growth and fiscal pressures, to be co‐managed by national park staff and their nonprofit support partners. Findings detail why and how the expanded partnerships were formed; how they operate; challenges they face; ways in which they adhere to, stretch, and depart from theories of nonprofit management, collaboration, and program institutionalization; and the significant—even exponential—volunteer program growth that resulted in each case. These nonprofit?public volunteer program partnerships—at Acadia, Arches and ­Canyonlands, Cuyahoga Valley, Golden Gate, the National Mall, and Yosemite national park sites—employ many standard forms of interorganizational relations, even though in these cases the nonprofits give money to the government organization instead of the reverse. Their volunteer program and management structures also share similar elements because of coercive, normative, and mimetic pressures. At the same time, each volunteer program partnership is a distinct blend of collaboration and management practices because of the unique natural features, climate, needs, adjacent populations, and personalities of leaders at each site. The cases employ innovative strategies to substantially increase the number of staff who lead volunteer programs. Recommendations are offered for nonprofit management research and practice, and findings are instructive for organizations that utilize volunteers either as a single entity or as part of a collaboration.     

A longitudinal evaluation of a system of care for children and adolescents with a severe emotional disturbance

A longitudinal program evaluation of the Vermont system of care for children and adolescents with a severe emotional disturbance that focuses on movement between residential placements and compares actual system functioning to service system philosophy and values. A person level longitudinal database is used to generate a system level program evaluation based on mathematical modeling theory. The methodology demonstrated in this paper can be useful to program evaluators in a number of different fields.