Process Evaluation in Action: Lessons Learned from Alabama REACH 2010

The CDC-funded Alabama Racial and Ethnic Approaches to Community Health (REACH 2010) project is designed to reduce and eliminate disparities in breast and cervical cancer between African American and white women in six rural and three urban counties in Alabama. In this manuscript, we report on the development, implementation, results, and lessons learned from a process evaluation plan initiated during the Phase I planning period of the Alabama REACH 2010 program. The process evaluation plan for Alabama REACH 2010 focused on four main areas of activity that coincided with program objectives: assessing coalition development, building community capacity, conducting a needs assessment, and developing a community action plan. Process evaluation findings indicated that progress made by Alabama REACH 2010 was due, in part, to evaluative feedback. We conclude that process evaluation can be a powerful tool for monitoring and measuring the administrative aspect of a complex, community-based health intervention

Planning and implementation of a participatory evaluation strategy: A viable approach in the evaluation of community-based participatory programs addressing cancer disparities

Community-based participatory research (CBPR) has been posited as a promising methodology to address health concerns at the community level, including cancer disparities. However, the major criticism to this approach is the lack of scientific grounded evaluation methods to assess development and implementation of this type of research. This paper describes the process of development and implementation of a participatory evaluation framework within a CBPR program to reduce breast, cervical, and colorectal cancer disparities between African Americans and whites in Alabama and Mississippi as well as lessons learned. The participatory process involved community partners and academicians in a fluid process to identify common ground activities and outcomes. The logic model, a lay friendly approach, was used as the template and clearly outlined the steps to be taken in the evaluation process without sacrificing the rigorousness of the evaluation process. We have learned three major lessons in this process: (1) the importance of constant and open dialogue among partners; (2) flexibility to make changes in the evaluation plan and implementation; and (3) importance of evaluators playing the role of facilitators between the community and academicians. Despite the challenges, we offer a viable approach to evaluation of CBPR programs focusing on cancer disparities.Participatory evaluation Cancer disparities Community-based participatory research Logic model

Community Health Advisors As Research Partners - An Evaluation of the Training and Activities

The feasibility of training large numbers of community health advisors as research partners (CHARPs) was evaluated using talking circles data and cancer activity questionnaires and logs. The talking circles data indicated that the CHARPs (n = 108) valued their training and believed they learned necessary research partner skills. A review of contacts (n = 7,956) provided evidence that CRARPs (n = 883) could work as a team to deliver a variety of services over time to the community The findings suggested that implementing a large scale intervention with CHARPs has the potential to increase the dissemination of cancer information and to reduce cancer disparities

The Deep South Network for Cancer Control - Building a Community Infrastructure to Reduce Cancer Health Disparities

Given the recent advances in cancer treatment, cancer disparity between whites and African-Americans continues as an unacceptable health problem. African-Americans face a considerable disparity with regard to cancer incidence, survival, and mortality when compared with the majority white population. On the basis of prior research findings, the Deep South Network (DSN) chose to address cancer disparities by using the Community Health Advisor (CHA) model, the Empowerment Theory developed by Paulo Freire, and the Community Development Theory to build a community and coalition infrastructure. The CHA model and empowerment theory were used to develop a motivated volunteer, grassroots community infrastructure of Community Health Advisors as Research Partners (CHARPs), while the coalition-building model was used to build partnerships within communities and at a statewide level. With 883 volunteers trained as CHARPs spreading cancer awareness messages, both African-Americans and whites showed an increase in breast and cervical cancer screening utilization in Mississippi and Alabama. In Mississippi, taking into account the increase for the state as a whole, the proportion that might be attributable to the CHARP intervention was 23% of the increase in pap smears and 117% of the increase in mammograms. The DSN has been effective in raising cancer awareness, improving both education and outreach to its target populations, and increasing the use of cancer screening services. The National Cancer Institute has funded the Network for an additional 5 years. The goal of eliminating cancer health disparities will be pursued in the targeted rural and urban counties in Mississippi and Alabama using Community-Based Participatory Research

A critical examination of gender, race, and sexuality in introductory clinical psychology textbooks

Clinical psychology is a field that aims to understand behavior and to use this understanding to aid individuals and society in a multitude of ways. Many psychologists use their training to help patients who seek help with emotional, behavioral, or other types of mental health issues. Because psychologists can have a significant impact on individual's lives and society as a whole, analysis of the training psychologists receive is critical to ensure that appropriate material is being integrated into that training. The present study is an examination of the five top selling introductory psychology textbooks as of 2008. These textbooks are used in upper level undergraduate and beginning graduate classrooms. The study's aim was to examine the content of these textbooks for information related to gender, race, and sexuality. The findings suggest that although the field of psychology has continued to report that multicultural sensitivity is essential to effective treatment of diverse individuals, introductory psychology textbooks do not have sufficient and accurate information in any of these areas. All of the books examined were authored by males, contained a higher proportion of photographs of white males than white females and ethnic minority males and females, contained traditionally gendered descriptions of males and females, reported little information on sexuality or race, had no information on possible reasons for reported sex differences, and contained gendered examples of psychopathology. The significance of these findings and suggestions for improving the multicultural content of psychology textbooks are discussed. (Published By University of Alabama Libraries

Beyond fig leaves and scarlet letters: women voicing themselves in diaries and blogs

This project explores the reasons that women write in diaries and blogs and the ways that they reckon with audience and identity through private writing in public spaces. It observes that women write to work through difficult experiences, to give substance to the tasks of impermanence that fill their days and lives, to forge connections with other women related to issues of mutual interest and concern, and to assert themselves as subjects of their own making in the face of competing social constructions of who they should be. The importance of this subject matter lies in the ways that writing is a source of strength to individuals who have been silenced or otherwise isolated through the circumstances of their lives. I have chosen to look at the value of writing for women, but the principles that I set forth are applicable to other groups of people, particularly those who have experienced marginalization or loss of some kind. The research traces the history of the diary and its significance for women, the evolution of the diary's function as it has moved online, the relationship between the diary and identity formation for its writer, and finally, the relationships between writers and their audiences, particularly with the diary in its incarnation as the blog. I develop the metaphors of fig leaves and scarlet letters to represent the ways in which women negotiate the dynamics of truth, identity, and audience in textual practice and assert that emerging technologies such as the blog allow for women to move beyond the silences that these images symbolize, create communities, and give voice to their lives. (Published By University of Alabama Libraries

Planning and implementation of a participatory evaluation strategy: A viable approach in the evaluation of community-based participatory programs addressing cancer disparities

Community-based participatory research (CBPR) has been posited as a promising methodology to address health concerns at the community level, including cancer disparities. However, the major criticism to this approach is the lack of scientific grounded evaluation methods to assess development and implementation of this type of research. This paper describes the process of development and implementation of a participatory evaluation framework within a CBPR program to reduce breast, cervical, and colorectal cancer disparities between African Americans and whites in Alabama and Mississippi as well as lessons learned. The participatory process involved community partners and academicians in a fluid process to identify common ground activities and outcomes. The logic model, a lay friendly approach, was used as the template and clearly outlined the steps to be taken in the evaluation process without sacrificing the rigorousness of the evaluation process. We have learned three major lessons in this process: (1) the importance of constant and open dialogue among partners; (2) flexibility to make changes in the evaluation plan and implementation; and (3) importance of evaluators playing the role of facilitators between the community and academicians. Despite the challenges, we offer a viable approach to evaluation of CBPR programs focusing on cancer disparitie