Reforming Health Care Delivery Through Payment Change and Transparency: Minnesota's Innovations

Examines Minnesota's healthcare delivery system reforms, with a focus on legislation that included a health improvement program and enhanced coverage for the low-income uninsured. Discusses public and private initiatives, accomplishments, and challenges

The concept and practice of leadership in social work

The starting point for this research was a series of calls for leadership ‘at all levels’, addressed to the social work profession due to evidence of poor performance, low morale and high attrition. The aim of the research was to find out whether there were characteristic features of leadership that were shared by people who were qualified social workers operating within roles of frontline practice, organisational management and identified leadership, that could provide guidance in developing leadership capacity within the profession.The research took the form of a qualitative study, comprising individual and group interviews with a purposive sample of 24 qualified social workers, in roles ranging from frontline practice to national leadership, and 12 other professionals. It identified three characteristic traits of social work leadership, ‘ethically inspired’, ‘empirically informed’, and ‘strategic’ and two characteristic leadership behaviours, ‘collaborating’ and ‘challenging’. It showed that these were combined to produce four characteristic features of social work leadership, which were demonstrated, to a greater or lesser degree, and in varying forms, by participants at different levels.An innovative framework and model of ‘ethical-adaptive’ leadership was developed on the basis of the findings of this research that is distinctive to the social work profession and is applicable to both practitioners and those at different levels of organisational management and identified leadership. As such it has the potential to fulfil the intended purpose of the research and may also be of value to other human service professions

The Determinants of Participation in Land Use-Related Education and Training: A Case Study of the State of Michigan

In recent years, numerous policy makers and educators in Michigan have advocated increasing participation of land use planning officials in land use-related education and training. The Michigan Land Use Leadership Council, commissioned by Governor Granholm, recommended that 60% of planning and zoning officials complete basic land use planning, zoning, and smart growth educational programs by 2010. However, while demographic information has been gathered on planning officials, little empirical research has been conducted on the determinants of participating in land use education and training. This paper uses regression analysis to estimate and interpret a demand function for participation in land use-related education and training. Results indicate willingness to participate in land use-related training is a function of education, perceived benefit, and length in service. These findings have important programmatic and policy implications. Training programs should be geared towards those planning officials who are beginning to serve. Educators should focus on promoting and educating communities and planning officials on the potential benefits of land use-related training.Land Economics/Use, Teaching/Communication/Extension/Profession,

Mindful Evaluation: Cultivating Our Ability to Be Reflexive and Self-Aware

Background: Mindfulness, giving our full attention to what we are doing in the present moment, is perhaps best understood as training for the brain. When we are mindful, we are actively engaged with our thoughts, feelings, and sensations. Purpose: The purpose of this article is to introduce the concept of “mindful evaluation” as a way to cultivate our reflexivity and self-awareness to improve our evaluation practice. Mindful evaluation is an invitation to be more intentional and reflexive about our ontological, epistemological, and methodological assumptions in general as well as for each evaluation we undertake. Setting: Mindfulness has been gaining popularity both with the general public and a variety of professional disciplines thanks in large part to the growing body of research on its efficacy. As disciplines such as healthcare, economics, and education are incorporating the benefits of mindfulness in their work, we explore how we too might use the principles of mindfulness in evaluation and evaluation practice. Intervention: This article did not require an intervention. Research Design: Not applicable Data Collection and Analysis: Not applicable Findings: We present simple steps for incorporating the principles of mindfulness to how we approach evaluation. Keywords: mindfulness; reflective practice; evaluator competence

Food Waste at Lewiston Middle School

In 2017, 30-40% of all food produced in the United States ended up in landfills and contributed to the country’s carbon footprint. At the same time, 13% of US households were food insecure. In Maine, however, that number rises to 15.7% and in the city of Lewiston, ME, it to 25.2%. Enough of the Lewiston population is affected by food insecurity to make the Lewiston School District eligible for the Community Eligibility Provision (CEP), which guarantees free breakfast and lunch to all students, regardless of socioeconomic background. As the only middle school in the district, Lewiston Middle School (LMS) receives this extra funding for all 800 of its seventh and eighth-grade students. Despite the fact that a quarter of the school population experiences food insecurity, we found that the cafeteria sends over 1,000 pounds of food waste a week to a landfill. In order to find potential recovery options for this food waste, and to reduce the school’s carbon footprint, we conducted informal surveys and a waste audit in the LMS cafeteria. This data was used to determine what percentage of the school’s total waste was food and therefore could be diverted from its path to the landfill. We used the EPA Food Recovery Hierarchy guidelines to help inform our recommendations. Based on our findings, we proposed three different methods for Lewiston Middle School to divert their food waste out of the landfill. These methods included establishing a shared table, giving the waste to a local pig farmer, and contracting with a local commercial composting company. We recommend that LMS combine two or all three of these recovery methods to best address food insecurity for its students, increase sustainability at the school, and reduce food waste

Moving to Genuine: Credible Cultural Competence and Stakeholder Believability

Background: Cultural competency is becoming an increasingly important concept in evaluation. The developing discussions tend to revolve around how to become culturally competent, why it is important, and how to know when it is attained. More problematically, cultural competency seems bound by dimensions of race, even though culture represents a broader scope of characteristics. Purpose: We review the current usage of cultural competence to point out its limitations and we suggest alternative ideas that can better facilitate communication about this essential topic. We look beyond the evaluation field to learn how cultural competence is handled in other disciplines. Particularly seeking to support communication between evaluation clients and evaluators, we offer strategies to engage in a dialogue about cultural issues. Setting: Not applicable. Intervention: Not applicable. Research Design: Analytic essay. Data Collection and Analysis: Not applicable. Findings: Cultural competence, as a term, is inherently limiting in its connotations, implications, and ability to bring about change. Cultural humility may be a more appropriate term. Regardless of the semantics, the basic need to communicate about the topic remains. Asking for cultural competency, or humility, as we suggest, in Requests for Proposals may be one way to start the conversation. Positioning statements and focused interview questions also may serve to generate discussion between client and evaluator. Keywords: cultural competence, cultural humility, evaluator competence, diversity, client communicatio

Forms and Functions of Participatory Evaluation in International Development: A Review of the Empirical and Theoretical Literature

Background: Since the late 1970s participatory approaches have been widely promoted to evaluate international development programs. However, there is no universal agreement of what is meant by participatory evaluation.  For some evaluators, participatory evaluations involve the extensive participation of all stakeholder groups (from donor to non-recipients) in every phase of the evaluation (from design to dissemination). For others, the participation of donors in the design constitutes a participatory evaluation approach. Participatory evaluation approaches are best considered on a continuum. In other words, there are many gradations to participation and evaluations should be classified accordingly.  Purpose: The lack of shared meaning of participatory evaluation approaches also impedes serious discussion on their use including their merits and demerits, suggestions for their improvement, and their overall effectiveness. The purpose of this article is to present an examination of the literature on participatory evaluation approaches to highlight commonalities and differences. Setting: Not applicable Intervention: Not applicable. Research Design: Not applicable. Data Collection and Analysis: Desk review. Findings: This article clearly demonstrates how broadly participatory evaluation is conceptualized and practiced and underscores the clear need for specification and precision when discussing what is meant by participatory evaluation. Recommendations for how evaluators should describe participatory evaluations are provided. Keywords: participatory evaluation; collaborative evaluation; empowerment evaluation; stakeholder-based evaluatio

Evaluation of an Internet-Based, Psychosexual Intervention for Couples Following Treatment for Breast Cancer: A Phase 1 Trial

Despite the well-established evidence that many breast cancer survivors encounter some degree of difficulty regarding their sexuality, support for women and couples experiencing sexual difficulties as a result of breast cancer is lacking. The purpose of this dissertation was to develop and evaluate an online psychosexual intervention for couples experiencing sexual difficulties following breast cancer. The feasibility, acceptability, and preliminary impact of the intervention were evaluated using a single-arm, mixed-methods design, with participants completing questionnaires concerning sexual functioning, marital quality, and psychological adjustment at baseline, post-treatment, and three-month follow-up, along with satisfaction surveys and post-treatment interviews Participants subjective experiences were triangulated with the quantitative data as a form of cross-verification, and to capture a more nuanced understanding of couples experiences with this intervention and its delivery, along with its benefits. A sample of 14 couples (N = 28) received a 6-session psychosexual intervention delivered via videoconferencing (eTherapy). The intervention was found to be feasible and acceptable, as demonstrated by high retention, treatment adherence, and satisfaction. There was also evidence to suggest that the intervention was effective at improving sexual functioning and satisfaction, although decreasing effect sizes at 3-month follow-up point towards a progressive loss of gains on a number of measures over time. The use of eTherapy was widely accepted by participants, who highlighted several advantages of this modality. Overall, the results support the effectiveness of this eTherapy psychosexual intervention for couples affected by breast cancer. Emerging considerations for researchers and clinicians involved in the evaluation and implementation of psychosexual interventions, as well as in the provision of eTherapy, are also introduced

Street-level practice and the co-production of third sector-led employability services

Policymakers have promised a personalised approach to improving the employability of disadvantaged groups. The evidence suggests that contracted-out activation programmes in the UK and some other welfare states have instead sometimes delivered a standardised ‘work-first’ model. An alternative approach is exemplified in local employability services targeting lone parents in Scotland, led by third sector–public sector partnerships. Our research on these services suggests a link between programme governance (defined by flexible funding and collaborative partnership working) and effective street-level practice (where caseworkers and users co-produce services to empower parents). The article concludes by identifying lessons for the coproduction of future employability services