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.     

Evaluation of a classroom movement integration training delivered in a low socioeconomic school district

Movement integration (MI), which involves infusing physical activity (PA) into general education classrooms, is an evidence-based strategy within whole-of-school approaches for helping children meet the national PA guideline of at least 60 min per day. This study evaluated an MI training delivered in a low socioeconomic elementary school that had recently invested in three movement facilitative classrooms (a kinesthetic classroom and two activity labs). We investigated (a) the training’s fidelity in meeting recommended best practices for professional development and (b) school professionals’ perspectives of the training. Eight school professionals participated in the study, including five classroom teachers, two activity lab supervisors, and the principal. The researchers used a video of the training to rate the fidelity of the training to best practice recommendations. Interviews, field notes, and informal conversations with participants were qualitatively analyzed for themes. The training received a total fidelity score of 42%. Qualitative findings highlighted participants’ varied perspectives of the training’s purpose, challenges associated with the training and future recommendations for MI trainings. For MI trainings to be a valuable asset in increasing teachers’ value and effective implementation of MI, trainings need to be designed to be in line with best practice recommendations and teachers’ perceived needs.     

Physical activity and nutrition program for adults with metabolic syndrome: Process evaluation

IntroductionThe Vietnam Physical Activity and Nutrition (VPAN) program aimed to improve physical activity and nutrition for adults aged 50–65 years with Metabolic Syndrome in Vietnam. The VPAN program consisted of a range of resources and strategies, including an information booklet, resistance band, face-to-face education sessions, and walking groups. This process evaluation assessed the participation, fidelity, satisfaction, and reasons for completing and not-completing the VPAN.MethodsData were collected by mixed-methods from a sample of 214 intervention participants. Quantitative data were collected via surveys (n = 163); qualitative data via face-to-face exit interviews with intervention program completers (n = 10) and non-completers (n = 10), and brief post education session discussions.ResultsMost participants (87%–96%) reported the program resources and strategies useful, assisting them to increase their physical activity level and improving their diet. The education sessions were the most preferred strategy (97%) with high attendance (>78% of participants). The main reasons for withdrawal were work commitments and being too busy.ConclusionThe evaluation indicated that the program reached and engaged the majority of participants throughout the six-month intervention. The combination of printed resources and face-to-face intervention components was a suitable approach to support lifestyle behavioural change in the Vietnamese population.     

Emergence of social support networks among breast cancer survivors through a community-based physical activity program in Colombia

Physical activity (PA), social networks, and social support have been associated with decreased mortality and improved quality of life among breast cancer survivors (BCS). This study used social network analysis to understand the social co-benefits of a community-based PA program for BCS in Colombia. Two types of social support networks emerged from the program: friendship (the number of edges increased by 90 %) and PA support (35 % of participants practiced PA together after the program). Using egocentric and socio-centric analysis we show the presence of homophily for friendship and PA support relations and the BCS’s roles in their networks.     

Evaluating sociodemographic data: implications for program planning and development

Sociodemographic data can have broad implications for program planning and development. Yet, such data are often obtained and analyzed in a non-rigorous methodological fashion. Four of these methodological issues are discussed in this paper. Their relevance for program planning and development are clarified, using examples from the utilization, needs assessment, illness behavior, and social functioning literature.     

Generalizability of an adult-validated model for predicting increased physical activity in after-school program children: Effects of treatment formats on fitness indicators

Inappropriately high weight in children is a persistent problem in the United States, and physical activity is often reduced in schools due to academic demands. Effective after-school programs could positively impact both physical activity and overweight/obesity, however previous reviews and meta-analyses have indicated minimal effects. Both 4- and 3-day/week versions of a social cognitive theory-driven physical activity/nutrition after-school program were evaluated against unstructured care to assess effects in children (overall M_age = 10.00 years, SD = .80). For changes over 9 months in body mass index (BMI), effects sizes (Cohen’s d) were .68, .40, and .07 in the 4-day (n = 70), 3-day (n = 70), and unstructured (n = 50) groups, respectively. Similar patterns of effects were found for changes in free-time physical activity and cardiovascular endurance. Incorporating a theory-based prediction model previously supported in teens through older adults, with and without medical disorders and health-risk factors, improvements in exercise-related self-regulation and self-efficacy, and mood, significantly predicted increased free-time physical activity (R² = .48). Effects significantly strengthened to R² = .62 when completion/non-completion of the recommended 300 min/week of physical activity was also accounted for. Change in BMI was inversely related to physical activity change, β=-.14, p < .05. The present evaluation process indicated promising effects, and indicated theory-based targets to foster future program improvements.     

Examining the link between program implementation and behavior outcomes in the lifestyle education for activity program (LEAP)

Lifestyle Education for Activity Program (LEAP) was a comprehensive, school-based intervention designed to promote physical activity in high school girls. The intervention focused on changes in instructional practices and the school environment to affect personal, social, and environmental factors related to physical activity. Multiple process evaluation tools and an organizational assessment tool were developed to monitor program implementation from a framework called the LEAP essential elements, which characterized complete and acceptable intervention delivery; secular trends were also monitored. Using process data, LEAP intervention schools were categorized into low- and high-implementing groups and compared with control schools on nine essential elements assessed at the organizational level. The Wilcoxon scores test revealed that low- and high-implementing intervention, and control schools differed significantly on two of nine administrator-reported organizational-level components: having a physical activity team and having a faculty-staff health promotion program. A mixed-model analysis of covariance indicated that, compared to control schools, a greater percentage of girls in high-implementing schools reported engaging in vigorous physical activity. Process evaluation can be used to understand the relationship between level of implementation and successful program outcome.     

Comparing rating paradigms for evidence-based program registers in behavioral health: Evidentiary criteria and implications for assessing programs

Decision makers need timely and credible information about the effectiveness of behavioral health interventions. Online evidence-based program registers (EBPRs) have been developed to address this need. However, the methods by which these registers determine programs and practices as being “evidence-based” has not been investigated in detail. This paper examines the evidentiary criteria EBPRs use to rate programs and the implications for how different registers rate the same programs. Although the registers tend to employ a standard Campbellian hierarchy of evidence to assess evaluation results, there is also considerable disagreement among the registers about what constitutes an adequate research design and sufficient data for designating a program as evidence-based. Additionally, differences exist in how registers report findings of “no effect,” which may deprive users of important information. Of all programs on the 15 registers that rate individual programs, 79% appear on only one register. Among a random sample of 100 programs rated by more than one register, 42% were inconsistently rated by the multiple registers to some degree.     

Stand Up for Health: Programme theory for an intervention to reduce sedentary behaviour in contact centres

BackgroundContact centre staff spend up to 95 % of their day seated, which can lead to a range of negative health outcomes. The aim of this study was to develop a programme theory for a complex intervention to reduce sedentary behaviour in contact centres.MethodsThe 6SQuID model was used. A literature review, and focus groups at one contact centre were used to: understand the problem (step 1); identify modifiable factors (step 2); and develop a theory of change (step 3). A workshop shaped a theory of action (step 4), and the programme theory was refined after testing activities over 6 months (step 5). The intervention is currently undergoing further evaluation and feasibility testing in a larger scale stepped wedge randomised controlled study in 11 contact centres (Step 6).ResultsStep 1: Limited opportunity to sit less, and move more at work was identified as the main problem. Step 2: Modifiable factors were identified at four levels of the centre. Step 3: A theory of change was developed around cultural norms and individual behaviour change. Step 4: Actions were developed to ‘activate’ the theory of change. Step 5: Activities were implemented, and adapted over 6 months and the programme theory was refined.ConclusionThe programme theory behind this intervention is robust, evidence based, adaptive and transferable.     

A randomized study of CrossFit Kids for fostering fitness and academic outcomes in middle school students

Within the context of school-based physical education (PE), a strength and conditioning program called CrossFit Kids (CFK) has emerged as a potential intervention for positively impacting students. The purpose of this study was to evaluate through a randomized-controlled trial how academic and health-related fitness outcomes differed for middle school students (age = 12.73; 55.3 % male) who participated in a school-based CFK program (n=72) as compared to a group of students who participated in PE class (n=72). Questionnaire data were collected twice across the 9-month academic year and combined with FitnessGram and grade data.Students in both the intervention and comparison groups increased in health-related fitness outcomes (all p values < .017), and there was a significant treatment group by time interaction on school-reported grades [F(1, 124) = 7.270, p = .008, η_P^2 = .055].Significant gender by time interaction effects were found for the relationship between CFK or PE participation and health-related fitness outcomes, but there were no significant interaction effects by gender on academic outcomes. Because developmental outcomes are conditional and result from the coaction of many factors, the findings suggest that some elements of CFK might be beneficial to build skills yet disadvantageous to academic outcomes.     

Cultural diversity competencies in child and youth care services in Portugal: Development of two measures and a brief training program

Few researchers have examined the training of child care workers in cultural diversity competencies, despite the growing number of ethnic minority children and youth in residential care. The present paper reports two studies. In study 1, we aimed to adapt and develop two measures of cultural diversity competencies—a self-report questionnaire and an objective measure based on a case vignette (n = 51). In study 2, we proposed a brief training program. A quasi-experimental design (n = 30) was used, with cultural competencies being evaluated before and after the training. Results revealed that (1) child care workers tended to over-estimate their self-perceived competence and that (2) the experimental group was more capable of including cultural elements in their definition of strategies and relational aspects of intervention after a brief training than the group that received no training (control). Implications of this study are discussed for further development of cultural diversity competencies in professionals working in residential child care.     

The conceptualization and measurement of quality of life: implications for program planning and evaluation in the field of intellectual disabilities

The concept of quality of life (QOL) is increasingly being used in the field of intellectual disabilities as a conceptual and measurement framework for program planning and evaluation. This article describes the development of a QOL conceptual and measurement framework, and summarizes how this framework is currently being used both nationally and internationally to assess and report personal QOL-related outcomes, to guide quality improvement strategies, and to evaluate the effectiveness of those strategies. Implications of such use are discussed, including those related to understanding mental models, developing internal data systems, supporting organization change, and building on current public policies. The article concludes with reference to the evolving nature of the QOL concept and the impact of this on model development and transdisciplinary research.     

Recentralization of Tokyo: Contradiction and Political Struggle for Regional Policy in Japan

Tokyo, the capital city of Japan, has always been a center of national economic growth, and hence a focal point of political struggle between local and national government. There exist two kinds of political forces; the former desires strong concentration of economic activities in Tokyo based on market rationality and economic efficiency, and the latter counters the former claiming more decentralization based on the balanced national economic structure. This paper reviews the development of urban and regional policy in Japan over the last 20 years and examines how such political forces have played out. After the decade‐long sluggish economic performance and the challenge of inter‐urban competition by Asian mega‐cities, Tokyo Metropolitan Government formulated an aggressive promotional policy under the leadership of the then Governor Ishihara. He tactically created a political consensus to give locational favor to the central part of Tokyo at the expense of other regions. It was partially challenged by the election of the then Prime Minister Shinzo Abe who insisted the need to revitalize the regions that were economically lagging. Despite his words, however, the centralization of Tokyo continued. This paper argues that the regional revitalization policy under the Abe administration was political rhetoric rather than reality, and Japan's economic fortune may still depend on the performance of Tokyo in the global economy under the neoliberal policy orientation.     

Development and psychometric testing of the childhood obesity perceptions (COP) survey among African American caregivers: A tool for obesity prevention program planning

Currently, public health practitioners are analyzing the role that caregivers play in childhood obesity efforts. Assessing African American caregiver’s perceptions of childhood obesity in rural communities is an important prevention effort. This article’s objective is to describe the development and psychometric testing of a survey tool to assess childhood obesity perceptions among African American caregivers in a rural setting, which can be used for obesity prevention program development or evaluation. The Childhood Obesity Perceptions (COP) survey was developed to reflect the multidimensional nature of childhood obesity including risk factors, health complications, weight status, built environment, and obesity prevention strategies. A 97-item survey was pretested and piloted with the priority population. After pretesting and piloting, the survey was reduced to 59-items and administered to 135 African American caregivers. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was conducted to test how well the survey items represented the number of Social Cognitive Theory constructs. Twenty items were removed from the original 59-item survey and acceptable internal consistency of the six factors (α = 0.70–0.85) was documented for all scales in the final COP instrument. CFA resulted in a less than adequate fit; however, a multivariate Lagrange multiplier test identified modifications to improve the model fit. The COP survey represents a promising approach as a potentially comprehensive assessment for implementation or evaluation of childhood obesity programs.     

Computer systems in addiction treatment programs: Availability and implications for program evaluation

Addiction treatment programs have been slow to adopt computerized information systems. Little systematic data exist on programs' technological infrastructures and use of electronic databases to store and analyze client information. Likewise, there is little information available on counselors' access to and use of the Internet for learning about new treatment techniques. Drawing upon data obtained in 2002–2003 from nationally-representative samples of publicly- and privately-funded addiction treatment centers and their counselors, this article describes the current state of the field in terms of data system availability and Internet usage. The availability of client-level databases is variable but continues to evolve. Programs maintaining electronic client data appear to be at an advantage for implementing outcomes monitoring activities. While counselors' access to computers is high, their use of the Internet and the NIDA website is low. The implications of these findings, and directions for future research, are discussed.     

Time matters: the potential and pitfalls of using mixed methods approaches in longitudinal program evaluation

While social programs are often assessed using short-term impact studies, longitudinal designs allow evaluators to capture change over time, identify longer-term outcomes, adapt instruments, and better understand participants in transition. A mixed methods design can be critical in understanding these dynamics; yet there is a lack of literature exploring the practical considerations of planning and conducting qualitative and quantitative data collection and analysis within longitudinal studies. This paper examines two different mixed methods frameworks used in a 5-year evaluation of three youth entrepreneurship programs in East Africa. We show how the evaluation team dealt with unique challenges across methods and over time, and how the design ultimately facilitated a richer understanding of program impacts and processes. Considerations for conducting this type of study are explored, related to the impact of longevity on analysis and research staff. Successfully using a longitudinal mixed methods approach requires researchers to be strategic and reflexive, and work in close collaboration.     

Culture and language promotion in Thailand: implications for the Thai Lao minority of introducing multilingual signage

This article examines the introduction of multilingual Thai/Thai Lao/English signage in commercial areas of the Faculty of Humanities and Social Sciences at Khon Kaen University, the principal tertiary university for the 19 million citizens of Northeast Thailand, the majority of whom are of the minority ‘Thai Lao’ ethnicity, an ideological construction that is presented in some detail. This introduction of signage followed a previous study to introduce officially sanctioned multilingual direction-giving signage, including the main faculty sign, in three prominent areas of the Faculty. The survey employed a complex methodology to survey the opinions of 300 students together with observation of students and interviews with members of the faculty. The research type is therefore a mixed-methodology investigation of identity and language policy planning, cultural promotion, glocalization, Gal and Irvine’s semiotic ideology structuration process, the (urban) linguistic landscape and Bourdieu’s theories of social reality. The study found high levels of support for the signage from the student body, members of the faculty and the stallholders themselves.     

An E-learning outreach program for public schools: Findings and lessons learned based on a pilot program in Makati City and Cabuyao City,Laguna, Philippines

The E-Learning Outreach Program (ELOP) is a multisectoral, collaborative, and commitment-driven action research that focuses on providing relevant and useful computer and Internet literacy short courses for public elementary students. This study presents the critical action plans of setting up a pilot e-Learning station in Hen. Pio del Pilar Elementary School in Makati City and in Pulo Elementary School in Cabuyao City, Laguna, Philippines. The school’s computer laboratory was converted to an E-Learning station with additional devices and technical support from De La Salle University (DLSU). The study aims to account for a process-based heuristic approach in laying down the different phases of the program, specifically to: (1) coordinate and orient parents, pupils, teachers and school administrators, (2) set-up an e-Learning environment (3) design and write course modules (4) assess learning skills and experience of pupils, and (5) evaluate the program based on research team’s observation and results of the focus group discussion (FGD) with teachers and student-participants. In Pulo Elementary School, a pretest and posttests were conducted with results showing that the program has improved participants’ e-Learning knowledge and skills except for advance skills in hardware utilization. The participants also showed a strong positive attitude towards the ELOP.     

Transition from the Lactational Amenorrhea Method to other modern family planning methods in rural Bangladesh: Barrier analysis and implications for behavior change communication program intervention design

The timely transition from Lactational Amenorrhea Method (LAM)² to another modern family planning method contributes to healthy spacing of pregnancies by increasing the adoption of family planning during the first year postpartum. Yet, literature suggests challenges in completing a timely LAM transition. To guide program implementation in Bangladesh, this study identified factors influencing women's transition decisions.Eighty postpartum women, comprising 40 who transitioned from LAM³ and 40 who did not,⁴ participated. Half of each group participated in in-depth interviews to explore the decision-making process. All participants responded to a “Barrier Analysis” questionnaire to identify differences in eight behavioral determinants.More than half of transitioners switched to another modern method before or within the same month that LAM ended. Of the 18 transitioners who delayed,⁵ 15 waited for menses to return. For non-transitioners, key barriers included waiting for menses to return, misconceptions on return to fertility, and perceived lack of familial support. The LAM transition can help women prevent unintended pregnancy during the first year postpartum. Increased emphasis on counseling women about the risk of pregnancy, and misconceptions about personal fertility patterns are critical for facilitating the transition. Strategies should also include interventions that train health workers and improve social support.     

The development of anti-cancer programs in Canada for the geriatric population: an integrated nursing and medical approach

Cancer control in Canada refers to the development of comprehensive programs utilising modern techniques, tools and approaches that actively prevent, cure or manage cancer. The scope of such programs is quite vast. They range from prevention, early detection and screening, comprehensive treatment both curative and palliative to comprehensive palliative care. Cancer is a disease associated with the aging population, and as the population ages the incidence of cancer would be expected to rise as well. This in itself poses a great challenge. In addition, the aging population demographics with the projected rise in the numbers of senior citizens, especially the over 80 group in the next decade, poses its own creative challenges to health planners. In Canada, health care is centrally administered, and controlled by the provincial governments of Canada, under the Canada Health Act. The challenge of developing comprehensive programs for the geriatric population requires changes in the care models and care pathways. The patient-centred models that have been adapted require a multidisciplinary approach to the clientele and their families that integrates cancer therapy and geriatric care and realities. This requires changes in the nursing and medical approach, as well as education in the subtleties of the two intersecting medical realities.