Empowerment Evaluation of Programs Involving Youth: Evaluators’ Perceptions

Background: Participatory and collaborative evaluation approaches, including Empowerment Evaluation (EE), are useful for evaluating programs involving youth. Empowerment evaluation involves stakeholders in the evaluation process through a set of structured steps. It is primarily concerned with empowering, illuminating, and building program beneficiaries’ self-determination. Given the emphasis that EE places on inclusivity of stakeholders, it appears to be a good fit for evaluating programs that involve youth. Purpose: To explore the extent to which evaluators use EE to evaluate programs involving youth as well as what factor(s) facilitate and hinder their use of EE in these programs. Setting: The study involved evaluators associated with the Collaborative, Participatory and Empowerment Evaluation and Youth-Focused Evaluation Targeted Interest Groups (TIGs) of the American Evaluation Association (AEA) who are involved in evaluating programs targeted at youth. Intervention: Not applicable. Research Design: We used a two-phase sequential mixed-methods research design. In Phase 1, we surveyed evaluators. In Phase 2, we interviewed a sample of evaluators from Phase 1.  Findings: In Phase 1, 41 (53.9%) respondents indicated not using EE to evaluate programs involving youth, 30 (39.5%) had used EE and 5 (6.6%) were unsure. Of those who used EE, they used it to teach youth program stakeholders about evaluation (n=8, 24.2%), produce more authentic results by engaging youth as experts of their lived experience (n=7, 21.2%) or produce more useful results for stakeholders to use (n=6, 18.2%), as well as other less popular reasons. In Phase 2, 12 interviewees raised five factors that facilitate or hinder the use of EE to evaluate programs involving youth including, evaluator perceptions, type of evaluation experience, evaluator knowledge and professional training, guidelines from organizations and funders, and stakeholders and time. Factors that some interviewees viewed as facilitators others viewed as hinderances.   Keywords: empowerment evaluation, program evaluation, youth-focused evaluation   &nbsp

Patient involvement in resident assessment within the Competence by Design context: a mixed-methods study

Background: Patients can contribute to resident assessment in Competence by Design (CBD). This study explored the extent, nature, as well as the facilitators and hindrances of patient involvement in resident assessment within and across Canadian specialty/sub-specialty/special programs that are transitioning or have transitioned to CBD.     Methods: We used a two-phase sequential explanatory mixed-methods design. In Phase 1, we surveyed program directors (PDs). In Phase 2, we interviewed PDs from Phase 1.Results: In Phase 1, 63 (62.4%) respondents in the CBD preparation stage, do not know if patients will be involved in resident assessment, 21 (20.8%) will involve patients, and 17 (16.8%) will not involve patients. Of those in the field-testing or implementation stages, 24 (72.7%) do not involve patients in resident assessment, five (15.2%) do involve patients, and four (12.1%) do not know if they involve patients. In Phase 2, 12 interviewees raised nine factors that facilitate or hinder patient involvement including, patients’ interests/abilities, guidelines/processes for patient involvement, type of Entrustable Professional Activities, type of patient interactions in programs, and support from healthcare organizations.Conclusion: Patient involvement in resident assessment is limited. We need to engage in discussions on how to support such involvement within CBD

Thinking Beyond Measurement, Description and Judgement: Fourth Generation Evaluation in Family-Centered Pediatric Healthcare Organizations

Background: Although pediatric healthcare organizations have widely implemented the philosophy of family-centered care (FCC), evaluators and health professionals have not explored how to preserve the philosophy of FCC in evaluation processes. Purpose:  To illustrate how fourth generation evaluation, in theory, could facilitate collaboration between evaluators and families and uphold the philosophy of FCC in evaluation. Exploration focuses on describing the ways in which fourth generation evaluation is consistent with FCC and outlining a strategy for implementing it within pediatric healthcare organizations.  Discussion: Current evaluation practices used in healthcare organizations reflect what some describe as the first three generations of evaluation: measurement-, descriptive-, and judgment-oriented evaluation. While these generations encourage evaluators and health professionals to use systematic and rigorous approaches and techniques, they negate opportunities to explore issues that may surface in more flexible evaluation processes and do little to promote FCC in evaluation. Fourth generation evaluation is based on the constructivist paradigm, and its hermeneutic dialectic process moves beyond these generations, as well as the problems associated with them, to reflect the FCC notions of family participation, partnership, collaboration, respect, and joint decision-making. Conclusion: The collaborative and dialogue-oriented environment of pediatric healthcare organizations provides an ideal context for fourth generation evaluation. Although this evaluation approach is consistent with the philosophy of FCC, more research is required to understand the strengths and limitations of using it in these organizations.Keywords: family-centered care; pediatrics; fourth generation evaluation; constructivist paradig

Lewiston Food Policy Audit

The success and development of a sustainable urban and regional food system hinges on the involvement of city planners and policy implementation by local government. Knowledge of where policies are supportive or unsupportive is critical for community activists, such as the Good Food Council of Lewiston Auburn (GFCLA), to direct limited resources toward effective changes. Conducting a food policy audit is one standardized approach for identifying gaps within a food system. In this report, we introduce a food policy audit tool that we adapted for use in Lewiston, Maine. We show results from conducting it in Lewiston and provide recommendations for policy change and future work. The audit tool is composed of 97 “yes” or “no” questions regarding city food policy. To answer these questions, we relied on the knowledge of city government officials and local experts. In interviews where we posed the audit tool questions, we additionally discussed related current policies and programs. We also inquired about the relative need for improving and developing new policies related to each question, and discussed potential challenges associated with implementing these changes. With the help of many invaluable resource persons, we were successful in adapting the audit tool and completing the audit within ten weeks. In examining the collected data, we found that the “yes/no” binary of the tool did not clearly identify gaps in the food system. With the objective of clarifying these results, we developed both a quantitative and qualitative classification scheme, and applied this methodology to analyze the audit tool. The quantitative classification scheme is based off of a numerical “grade” ranging between zero and one, depending on if the policy supports or inhibits the sustainability of the Lewiston food system. To further delineate our data we developed a qualitative classification scheme, applied to questions with grades below one. The qualitative 2 classification ranks the gaps on both their urgency and feasibility for change, which were largely determined via the advice of resource persons and our learned knowledge of the local food policy climate. Our quantitative grading scheme indicates that 22% of the policy enacted is currently supporting a sustainable food system in Lewiston. The remaining 78% is not, allowing for the identification of policies that are detrimental, non-existent, or existing at the federal or state level instead of at the city level. When policies exist at the state or federal level, there is opportunity to ensure food policies are meeting the specific needs of the Lewiston community. We have compiled a list of recommendations ranging from broad to specific next-steps. It is our intention that these future projects be pursued by the GFCLA in partnership with another Bates College ES capstone group and/or through collaboration with other interested individuals and organizations. Recommendations: ● Confirm audit data by referencing the literature of Lewiston policy and code. ● Conduct a literature review to examine strategies for bridging identified gaps in cities similar to Lewiston. ● Consider changing the Lewiston food sovereignty declaration to permit the sale of homegrown vegetables and other goods to friends and family. ● Considering implementing longer contracts for community farm gardens in abandoned lots, as well as “joint use” agreements for gardens between local organizations and schools. 3 ● Conduct an assessment of the feasibility of implementing compost in the Lewiston Public Schools. ● Identify local programs that are already improving the sustainability of the food system and develop a plan to increase city support through advertising campaigns that direct citizens to such existing programs and organizations. ○ Ensure these advertising campaigns reach the New Mainer community. ● Research the pros and cons of establishing agricultural preservation laws in Lewiston. ● Before embarking on advocacy for any suggested changes, conduct interviews with community members who would be impacted by a change in policy. ● Conduct a similar food policy audit in Auburn and find potential areas to collaborate between the cities to increase the sustainability of the Lewiston food system

The Promise of Participatory Evaluation in Family-Centered Rehabilitation Settings: A Qualitative Study

Background: Family-centered service philosophy (FCS) is an important contextual aspect of many pediatric rehabilitation programs. It recognizes the importance of supporting family relationships and the benefits of active family participation in all aspects of programming. Unfortunately, many professionals often overlook FCS philosophy when designing and implementing evaluations. Given the emphasis that participatory evaluation places on collaboration and the engagement of stakeholders, it appears to be theoretically compatible with FCS philosophy.  Purpose: To explore parents’ and staff members’ perceptions of participatory program evaluation, including its congruence with family-centered service (FCS) philosophy, as well as the feasibility and practicality of using participatory program evaluation within pediatric rehabilitation centers.Setting: The study was conducted at two urban pediatric rehabilitation centers in Ontario, Canada.Intervention: Not applicable.Design: Qualitative exploration.Data Collection and Analysis: The study included qualitative interviews, focus groups and a thematic analysis.  Findings: Participants described how participatory evaluation, in congruence with FCS philosophy, would increase the relevance of program evaluations for families, help support program interventions, assist in the development of clinician-parent relationships, and facilitate the empowerment of families. They also described how a lack of time, funding, and training, as well as variations in the priorities and interests of families presented challenges for using participatory evaluation within their centers

Références aux patients dans les référentiels de compétences CanMEDS 2005 et 2015

Background: Patient involvement in postgraduate medical education (PGME) can help residents improve their communication, professionalism, and collaboration. The CanMEDS Framework defines such competencies for physicians and informs teaching and assessment activities in PGME. However, it is unclear how patients are referenced in the CanMEDS Framework and if these references encourage the active involvement of patients in PGME. To inform how patients are referenced in the revisions of the CanMEDS Framework, scheduled for publication in 2025, our aim was to determine how patients are referenced in each the 2005 and 2015 CanMEDS Frameworks. Methods: We used document analysis to examine how the term ‘patient(s)’ is referenced in the 2005 and 2015 CanMEDS Frameworks. Results: Several 2005 and 2015 CanMEDS Roles include patients in the descriptions but do not reference them in the competencies. Others do not reference patients in the descriptions or competencies, potentially detracting from the importance of involving patients. As it stands, the 2015 Health Advocate is the only Role that describes and references patients working with physicians as partners in care, facilitating potential opportunities for patient involvement in PGME.  Conclusion: There are inconsistencies in how patients are described and referenced as potential partners in PGME throughout past and present CanMEDS Frameworks. Understanding these inconsistencies can inform the revision of CanMEDS that is scheduled for publication in 2025.Contexte : La participation des patients dans la formation médicale postdoctorale (FMPD) peut aider les résidents à améliorer leur professionnalisme et leurs compétences en matière de communication et de collaboration. Le référentiel CanMEDS définit les compétences des médecins et oriente les activités d’enseignement et d’évaluation dans la formation médicale postdoctorale. Cependant, la manière dont les patients sont décrits dans le référentiel CanMEDS n’est pas claire et il n’est pas certain que cette description encourage la participation active des patients dans la FMPD. Pour éclairer la description des patients dans les révisions du référentiel CanMEDS, dont la publication est prévue en 2025, notre objectif était d’examiner comment ils sont présentés dans les référentiels CanMEDS de 2005 et 2015. Méthodes : Nous avons utilisé l’analyse de documents pour examiner les références au terme « patient(s) » dans les référentiels CanMEDS 2005 et 2015. Résultats : Dans les référentiels CanMEDS de 2005 et 2015, les patients sont mentionnés dans la description de certains rôles, mais ils ne le sont pas dans la description des compétences qui y sont associées. Dans d’autres cas, ni la description du rôle ni celle des compétences correspondantes ne font référence aux patients, ce qui peut minimiser l’importance de la participation de ces derniers. Actuellement, le rôle de promoteur de la santé dans le référentiel de 2015 est le seul qui comprend une description et une référence aux patients comme travaillant avec le médecin à titre de partenaires de soins, et qui favorise ainsi la possibilité de faire participer les patients dans la FMPD.  Conclusion : Les référentiels CanMEDS passés et présents contiennent des incohérences quant à la description des patients comme partenaires potentiels dans la FMPD. La compréhension de ces incohérences peut éclairer la révision de CanMEDS, dont la publication est prévue en 2025

Empowerment Evaluation of Programs Involving Youth

Background: Participatory and collaborative evaluation approaches, including Empowerment Evaluation (EE), are useful for evaluating programs involving youth. Empowerment evaluation involves stakeholders in the evaluation process through a set of structured steps. It is primarily concerned with empowering, illuminating, and building program beneficiaries’ self-determination. Given the emphasis that EE places on inclusivity of stakeholders, it appears to be a good fit for evaluating programs that involve youth. Purpose: To explore the extent to which evaluators use EE to evaluate programs involving youth as well as what factor(s) facilitate and hinder their use of EE in these programs. Setting: The study involved evaluators associated with the Collaborative, Participatory and Empowerment Evaluation and Youth-Focused Evaluation Targeted Interest Groups (TIGs) of the American Evaluation Association (AEA) who are involved in evaluating programs targeted at youth. Intervention: Not applicable. Research Design: We used a two-phase sequential mixed-methods research design. In Phase 1, we surveyed evaluators. In Phase 2, we interviewed a sample of evaluators from Phase 1.  Findings: In Phase 1, 41 (53.9%) respondents indicated not using EE to evaluate programs involving youth, 30 (39.5%) had used EE and 5 (6.6%) were unsure. Of those who used EE, they used it to teach youth program stakeholders about evaluation (n=8, 24.2%), produce more authentic results by engaging youth as experts of their lived experience (n=7, 21.2%) or produce more useful results for stakeholders to use (n=6, 18.2%), as well as other less popular reasons. In Phase 2, 12 interviewees raised five factors that facilitate or hinder the use of EE to evaluate programs involving youth including, evaluator perceptions, type of evaluation experience, evaluator knowledge and professional training, guidelines from organizations and funders, and stakeholders and time. Factors that some interviewees viewed as facilitators others viewed as hinderances.   Keywords: empowerment evaluation, program evaluation, youth-focused evaluation  

Spontaneous Chelation-Driven Reduction of the Neptunyl Cation in Aqueous Solution.

Octadentate hydroxypyridinone (HOPO) and catecholamide (CAM) siderophore analogues are known to be efficacious chelators of the actinide cations, and these ligands are also capable of facilitating both activation and reduction of actinyl species. Utilizing X-ray absorption near edge structure (XANES) and extended X-ray absorption fine structure (EXAFS) spectroscopies, as well as cyclic voltammetry measurements, herein, we elucidate chelation-based mechanisms for driving reactivity and initiating redox processes in a family of neptunyl-HOPO and CAM complexes. Based on the selected chelator, the ability to control the oxidation state of neptunium and the speed of reduction and concurrent oxo group activation was demonstrated. Most notably, reduction kinetics for the NpV O2 +/ /NpIV redox couple upon chelation by the ligands 3,4,3-LI(1,2-HOPO) and 3,4,3-LI(CAM)2 (1,2-HOPO)2 was observed to be faster than ever reported, and in fact quicker than we could measure using either X-ray absorption spectroscopy or electrochemical techniques