Analyzing free-text survey responses: An accessible strategy for developing patient-centered programs and program evaluation

Despite widespread availability of yoga in the Veterans Health Administration (VA), it remains unclear how to best evaluate yoga programs. This is particularly problematic for programs aimed at veterans with mental health concerns, as evaluation typically focuses narrowly upon mental health symptom severity, even though program participants may have other health-related priorities. We analyzed responses to free-text questions on 237 surveys completed by veterans with mental health concerns enrolled in a yoga program at six VA clinics in Louisiana to characterize veteran participants’ experiences with yoga. Qualitative analysis resulted in 15 domains reflecting veterans’ individual health-related values and priorities. We use results to illustrate the potential for analysis of free-text responses to reveal valuable insights into patient experiences, demonstrating how these data can inform patient-centered program evaluation. The approach we present is more accessible to those responsible for decision-making about local programs than conventional methods of analyzing qualitive evaluation data.     

Responding to Adolescent Violence in the Home – A Community Mental Health Approach

Family violence perpetrated by adults is increasingly understood as a health issue, and we argue that this pertains even more strongly to violence by adolescents. The co-dependence of the parent–child bond, lack of maturity in the adolescent, and often related issues of disability or mental illness make these young people both complex and also vulnerable. This research paper reviews the current literature relating to adolescent violence in the home, identifies known best practice, and evaluates the importance of taking a family-focused, therapeutic approach to adolescent family violence, in place of a punitive one. It describes the use of a co-design workshop to unpack gaps in service provision and develop a potential family focused model of care to address the needs both of young people who use violence, and their families. The findings indicate that an inclusive family approach is a key element in addressing adolescent violence in the home across a spectrum of behaviours and mental health care needs. The use of a coordinated, family-inclusive response through mental health care services is recommended to address the complexity of this issue, as well as to provide support both to adolescents and to their families and carers.     

Navigating infant feeding supports after migration: Perspectives of Arabic and Chinese mothers and health professionals in Australia

Optimal feeding practices can establish lifelong, transgenerational and global health benefits. Migration and cultural factors impact infant feeding practices and the support mothers receive for optimal infant feeding. This qualitative study explored support for infant feeding among Arabic and Chinese speaking migrant mothers in Australia.Semi-structured focus groups were conducted in language with 24 Arabic and 22 Chinese-Mandarin speaking migrant mothers with children under five years of age. Individual interviews were conducted in English with 20 health professionals working with Arabic or Chinese speaking migrant families. Data were thematically analysed using the framework method.Traditional family networks and trusted bi-cultural doctors were influential infant feeding supports for mothers. Health professionals perceived maternal and child health services to be poorly understood, and some mothers who accessed services felt they were not always culturally sensitive. Mothers sought additional information and support through online sources and peers. Both mothers and health professionals recognised the challenges of managing conflicting infant feeding advice and seeking best-practice support.The findings of this study highlight opportunities for health professionals to better support migrant mothers’ infant feeding practices, for example through engaging families and working with doctors. There is a need for greater cultural sensitivity within maternal and child health services and culturally relevant programs to support healthy infant feeding practices among migrant communities.     

The impact of planning for COVID-19 on private practising midwives in Australia

ProblemThe COVID-19 pandemic response has required planning for the safe provision of care. In Australia, privately practising midwives are an important group to consider as they often struggle for acceptance by the health system.BackgroundThere are around 200 Endorsed Midwives eligible to practice privately in Australia (privately practising midwives) who provide provide the full continuum of midwifery care.AimTo explore the experience of PPMs in relation to the response to planning for the COVID-19 pandemic.MethodsAn online survey was distributed through social media and personal networks to privately practising midwives in Australia in April 2020.ResultsOne hundred and three privately practising midwives responded to the survey. The majority (82%) felt very, or well informed, though nearly half indicated they would value specifically tailored information especially from professional bodies. One third (35%) felt prepared regarding PPE but many lacked masks, gowns and gloves, hand sanitiser and disinfectant. Sixty four percent acquired PPE through social media community sharing sites, online orders, hardware stores or made masks. Sixty-eight percent of those with collaborative arrangements with local hospitals reported a lack of support and were unable to support women who needed transfer to hospital. The majority (93%) reported an increase in the number of enquiries relating to homebirth.ConclusionPrivately practising midwives were resourceful, sought out information and were prepared. Support from the hospital sector was not always present. Lessons need to be learned especially in terms of integration, support, education and being included as part of the broader health system.     

Custom Epoch Estimation for Surveys

The paper provides a method for generating epoch estimates for time series survey data, allowing for different periods of time (or even point estimates) according to user demand. The method uses a modified kriging estimator, which suppresses the contribution of sampling error variability in order to guarantee that custom epoch estimates have an interpolation property. For the veteran population variable of the American Community Survey, we utilize a simple Brownian Motion model of the population process and derive the modified kriging estimator for this case. The tuning parameters of this population model can be calibrated to the data via simple formulas. We illustrate the application of this method to the generation of point estimates of veteran population, an important objective for Veterans Affairs.     

高维大数据基因网络中的社区发现——以NC方法为例

从大量基因中识别出致病基因是大数据下的一个十分重要的高维统计问题。基因间网络结构的存在使得对于致病基因的识别已从单个基因识别扩展到基因模块识别。从基因网络中挖掘出基因模块就是所谓的社区发现（或节点聚类）问题。绝大多数社区发现方法仅利用网络结构信息,而忽略节点本身的信息。Newman和Clauset于2016年提出了一个将二者有机结合的基于统计推断的社区发现方法（简称为NC方法）。本文以NC方法为案例,介绍统计方法在实际基因网络中的应用和取得的成果,并从统计学角度提出了改进措施。通过对NC方法的分析可以看出对于以基因网络为代表的非结构化数据,统计思想和原理在数据分析中仍然处于核心地位。而相应的统计方法则需要针对数据的特点及关心的问题进行相应的调整和优化。     

The importance of systems thinking,context, and inclusion when studying the feasibility of expanding the FoodShare (SNAP) outreach program to rural communities of Northern Wisconsin

Evaluators often neglect to question whether a program has been appropriately designed for a new context prior to a feasibility study’s commencement. In this paper, we document the results of a case study that closely examined context when determining the feasibility of implementing a FoodShare outreach program in rural northern Wisconsin. Using community-based participatory mixed methods, we examine how stakeholder engagement led to both study refinement and a more comprehensive understanding of community food security based on contextual factors and systems thinking. Lessons learned when conducting feasibility studies from this perspective are provided to improve evaluation practice.     

Using theory of change as a framework for examining community context and philanthropic impact

As part of the process of examining their theory of change (TOC) and reflecting on grant making activity, one Midwestern foundation employed a multipronged strategy to assess 209 community-based mental health grants across seven years of funding. This article details the evaluation approach, which comprised these areas of the TOC: grantees’ use of evidence-based interventions, cultural competency, quality improvement, community collaboration, and use of integrated care. Inductive analyses identified grantees’ use of innovative practices, trauma-informed care, and use of validated instruments. In an iterative exercise spanning multiple years, the foundation and researchers found ways to gather information about community capacity and impact while simultaneously minimizing grantee data collection/reporting burden. Findings revealed that community agencies were improving in their uptake of evidence-based interventions and use of validated instruments. Community grantee use of trauma informed care also improved over the study period. Grantee desire to collaborate and coordinate services within the community was also strong. The research also revealed that in multiple domains (such as technology and non-profit operating costs) grantees needed support in building agency capacity. These findings shed light on which aspects of the foundation’s TOC were being addressed through funding, and which areas of the community needed additional support.     

Using a community-created multisite evaluation to promote evaluation use across a sector

Multisite evaluation has been cited as a strategy for building knowledge about a program's success and enhancing evaluation capacity and evaluation use. Even so, the extent to which data from these efforts are made available to individual project participants varies. This article describes a community-created multisite evaluation that was designed to overcome this limitation. Based on the negotiated centralized evaluation model and implemented within the context of a community of practice, the EvalFest community-created multisite evaluation has used shared measures to collect data from 30,000 participants from partner sites across the community over three years. This article describes the design characteristics of the community-created multisite approach, and presents results related to partners’ evaluation use that demonstrate the early success of this method. We conclude by considering how this strategy might be applied to other sectors.