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Recreational activities are uniquely suited for the implementation of a positive youth development (PYD) approach, as they create space for youths’ physical, psychological, and social development. This may be especially true for vulnerable youth who face additional risk factors such as single parent homes and living in low-income communities. Momentum Bicycle Clubs (MBC), based in Greenville, South Carolina, use noncompetitive recreational bicycling as a mechanism to facilitate group mentoring opportunities for high-risk youth. MBC engage youth with their community while providing opportunities for leadership, building positive relationships, exercise, and learning new skills. This exploratory project’s purpose is to better understand the bicycle as a PYD mechanism through group mentoring by studying MBC program design, processes, and outcomes. Researchers identified three primary themes that indicated the bicycle provided youth opportunities to gain responsibility, confidence, and improved health. Sub themes provided additional context. For example, youth gained responsibility for their bikes and related equipment, as well as their individual and the group’s safety. MBC is an example of using individual specialized recreation equipment as an effective PYD mechanism that allows the program to meet more PYD desired outcomes than traditional programs. The bicycle rides differentiate the program dynamic from other PYD programs as the mentors are also group participants. This allows the mentors to share in the experience and role model behavior, which may foster stronger group identity and cohesiveness. Year-round asset intensive programs of this nature have management challenges, including sufficient resources (e.g., bicycle storage and maintenance), mentors willing to ride bicycles, as well as ensuring youth safety while riding. The resource challenges are met through extensive partnerships with government, nonprofit, and commercial agencies, which has also benefitted the program through a wider variety of mentors, adult role models, internship opportunities for the youth, and community knowledge about MBC. Safe bicycling is accomplished through extensive training, locating the clubs in areas with access to low traffic streets, and a 20-mile paved multiuse path. Lastly, since it is difficult to have meaningful conversations while riding, mentors must build in time before and after rides and at planned stops to facilitate the most meaningful mentor-mentee relationships.

BACKGROUND AND PURPOSE: With an aging population, falls have become an increasing public health concern. While face-to-face exercise programs have demonstrated efficacy in reducing falls, their effectiveness is hampered by low participation and adherence. Digital technologies are a novel and potentially effective method for delivering tailored fall prevention exercise programs to older adults. In addition, they may increase the reach, uptake, and sustainability of fall prevention programs. Therefore, understanding older adults' experiences of using technology-driven methods is essential. This study explored the user experience of StandingTall, a home-based fall prevention program delivered through a tablet computer.METHODS: Fifty participants were recruited using purposive sampling, from a larger randomized controlled trial. Participants were selected to ensure maximum variability with respect to age, gender, experience with technology, and adherence to the program. Participants undertook a one-on-one structured interview. We followed an iterative approach to develop themes.RESULTS AND DISCUSSION: Eight themes were identified. These fall under 2 categories: user experience and program design. Participants found StandingTall enjoyable, and while its flexible delivery facilitated exercise, some participants found the technology challenging. Some participants expressed frustration with technological literacy, but most demonstrated an ability to overcome these challenges, and learn a new skill. Older adults who engaged in a technology-driven fall prevention program found it enjoyable, with the flexibility provided by the online delivery central to this experience. While the overall experience was positive, participants expressed mixed feelings about key design features. The embedded behavior change strategies were not considered motivating by most participants. Furthermore, some older adults associated the program characters with gender-based stereotypes and negative views of aging, which can impact on motivation and preventive behavior.CONCLUSION: This study found digital technologies are an effective and enjoyable method for delivering a fall prevention program. This study highlights that older adults are interested in learning how to engage successfully with novel technologies.

We applied a three-step process, abstracting and analyzing program budgets to examine how Colorectal Cancer Control Program (CRCCP) awardees are structuring their programs and to assess the fidelity of program design to the CRCCP public health model. We reviewed 23 state, one tribal organization, and six university awardee budgets. We assessed resource allocations, staffing structures, and contracted partners and their activities. Awardees allocated 83% of all funds to contracts and personnel. Program managers were the most budgeted personnel type across three measures: number of people, full-time equivalency, and personnel costs. Awardees not only contracted with health care systems and clinics (39% of all contracts) but also contracted other partner types. Contractors were mainly funded to implement evidence-based interventions (25%) and conduct evaluation (24%). Program design varied among awardees in the number of staff (0–22), number of full-time equivalencies (0–5.4), and the number of contracts (1–11) budgeted. State awardees budgeted more resources to contracts, compared with university awardees (57% vs. 31%), while universities budgeted more for total personnel costs (41% vs. 30%). We learned that awardees designed their programs with fidelity to the CRCCP model. Although implementation approaches varied, overall results suggest implementation requires a combination of internal capacities and contracted partners. Budgets provide opportunities to use already existing program data to evaluate program design, partnerships, and planned activities.

The emissions trading scheme (ETS) is considered an effective policy tool for achieving emission reductions. At present, China’s ETS pilots have completed several compliance periods and provided rich experience for a national ETS. Taking advantage of the variations in the regional ETS pilots across regions and sectors and over time, this study used a difference-in-difference-in-differences (DDD) model to examine the effects of ETS pilots and differential program design on industry risk and the impacts of risk on future investment horizon. First, we found that the ETS pilots significantly increase profit variability (total risk) in China’s industry; that is, ETS induces greater uncertainty in the covered sectors. In terms of industry heterogeneity, non-electricity sectors (specifically ferrous metal) engage in higher levels of risk taking. Second, the influence of such program features as the allowance allocation (total amounts and approaches), China Certification Emission Reduction (CCER) trading volumes, and penalties are heterogeneous. Finally, during the period around the treatment, industry risk can significantly encourage longer rather than shorter investment. In particular, the punishment mechanism and benchmarking allocation play a positive role in regulating the risk‒investment relationship.

In this paper, the authors describe one of the signature programs launched through the Marian K. Shaughnessy Nurse Leadership Academy, the post-doctoral system-level executive nursing education program. This program was directly linked to the core focus of the Shaughnessy Nurse Leadership Academy. The program design, speakers, and outcomes are presented along with lessons learned, including the value and power of philanthropy, and the need for flexibility in both scheduling and implementation during a pandemic.

We present a decision analytic framework that uses a mathematical model of Chlamydia trachomatis transmission dynamics in two interacting populations using ordinary differential equations. A public health survey informs model parametrization, and analytical findings guide the computational design of the decision-making process. The potential impact of jail-based screen-treat (S-T) programs on community health outcomes is presented. Numerical experiments are conducted for a case study population to quantify the effect and evaluate the cost-effectiveness of considered interventions. Numerical experiments show the effectiveness of increased jail S-T rates on community cases when resources for a community S-T program stays constant. Although this effect decreases when higher S-T rates are in place, jail-based S-T programs are cost-effective relative to community-based programs. Summary of Contribution: Public health programs have been developed to control community-wide infectious diseases and to reduce prevalence of sexually transmitted diseases (STD). These programs can consist of screening and treatment of diseases and behavioral interventions. Public correctional facilities play an important role in operational execution of these public health programs. However, because of lack of capacity and resources, public health programs using correctional facilities are questioned by policy-makers in terms of their costs and benefits. In this article, we present an analytical framework using a computational epidemiology model for supporting public health policy making. The system represents the dynamics of Chlamydia trachomatis transmission in two interacting populations, with an ordinary differential equations-based simulation model. The theoretical epidemic control conditions are derived and numerically tested, which guide the design of simulation experiments. Then cost-effectiveness of the potential policies is analyzed. We also present an extensive sensitivity analyses on model parameters. This study contributes to the computational epidemiology literature by presenting an analytical framework to guide effective simulation experimentation for policy decision making. The presented methodology can be applied to other complex policy and public health problems.

Designing software for multicore platforms is a significant challenge, as one has to break-down the work into items that can run concurrently. In this chapter we address the design problem from two perspectives: the decomposition and the program structure.

INTRODUCTION Cost studies are increasingly popular given resource constraints. While scholars stress the context-dependent nature of cost, and the importance of theory, cost studies remain context-blind and atheoretical. However, realist economic evaluation (REE) privileges context and the testing/refinement of economic program theory. This preliminary REE serves to test and refine economic program theory for supervision training programs of different durations to better inform future program design/implementation. METHODS Our preliminary REE unpacked how short (half-day) and extended (12-week) supervision training programs in Victoria, Australia produced costs and outcomes. We employed mixed methods: qualitative realist and quantitative cost methods. Economically optimised program models were developed guided by identified cost-sensitive mechanisms and contexts. RESULTS As part of identified context-mechanism-outcome configurations (CMOCs) for both training programs, we found a wider diversity of positive outcomes but greater costs for the extended program (11 outcomes; AU$3,069/learner) compared with the short program (7 outcomes; $385/learner). We identified four shared cost-sensitive mechanisms for both programs (training duration, learner protected time, learner engagement, and facilitator competence), and one shared cost-sensitive context (learners' supervisory experience). We developed two economically optimised program models: (1) short program for experienced supervisors facilitated by senior educators ($406/learner); and (2) extended program for inexperienced supervisors facilitated by junior educators ($2,104/learner). DISCUSSION Our initial economic program theory was somewhat supported, refuted, and refined. Results were partly consistent with previous research, but also extended it through unpacking cost-sensitive mechanisms and contexts. While our preliminary REE fills a pressing gap in the methodology literature, conducting REE was challenging given our desire to integrate economic and realist analyses fully, and remain faithful to realist principles. Attention to training duration and experience levels of the facilitator-learner dyad may help to balance the cost and outcomes of training programs.

Purpose This study aims to problematize how gender is enacted within entrepreneurship education and training (EET). Design/methodology/approach Using a social feminist lens, this study advances principles, a conceptual framework, assessment criteria and illustrative performance metrics to inform gender-sensitive EET programs and courses. Findings are based on a cross-case thematic analysis of two large-scale case studies conducted in Canada and Jordan. Findings The findings bridge social feminist theory and EET studies. The originality of the research rests in its utilization of the principles and conceptual framework to examine EET and to inform the development, design and assessment of gender-sensitive programs and courses. Research limitations/implications The framework and criteria do not differentiate types or levels of EET. The investigators lead the assessment of curricula and co-construction of gender-sensitive course content. Interpreter bias cannot be ruled out. Practical implications The proposed principles, framework, criteria and performance will assist stakeholders in EET program/course design, content, delivery and evaluation. Social implications Aligned with the United Nation Sustain Development Goal 5 (gender equity), the findings demonstrate the value of adapting a critical lens across all elements of EET and responding to biases in participant selection and engagement, program design and curricula. Originality/value To the best of the authors’ knowledge, this is among the first studies to use a social feminist perspective and case study methodology to inform criteria to assess EET.

In recent years, the demand for more culturally competent candidates has risen as employers seek workers highly adaptable to the global marketplace. Study abroad internship programs offer a rich training ground for college students to gain valuable international and intercultural career experience. This study examined the effects of experiential program design on the cultural intelligence of participants in an international internship program. College students from a large Midwestern university were enrolled in an international internship program in Amsterdam, Netherlands; Lima, Peru; or Seoul, South Korea. The program design incorporated principles of Kolb’s Experiential Learning Theory (ELT) to increase student reflection on their experience and engage them in the ELT cycle. Participants were scored on the Cultural Intelligence Scale (CQS) before and after the internship, and pre-test and post-test scores were compared and analyzed. Findings indicated significant growth in participants’ cultural intelligence. The intentional incorporation of experiential learning principles in the design and implementation of internship abroad programs has clear potential to increase participant’ intercultural competence and develop their skills for the 21st century workplace.

Human-centered design practitioners should not overlook the value of systematic and standardized documentation and measurement inherent in global health and should consider ways to link design insights and solution development processes to traditional global health outcome and impact measures., Key Messages Integrating human-centered design (HCD) and global health requires new approaches to managing measurement across multidisciplinary project teams that: Optimize the rigor of public health monitoring and evaluationIntroduce appropriate measurement into creative HCD approaches without compromising the types of learning that HCD can uniquely provideTensions can emerge in the ways that HCD and global health approach measurement, but these can be addressed by appreciating the value of iterative learning, combining measurement approaches, and increasing transparency and documentation.To be relevant and effective in HCD-influenced health programming, global health practitioners and evaluators should adapt the timing and approach of traditional measurement approaches, integrate metrics that reflect user experience and desires, and use methods that facilitate adaptation and learning as well as assess performance and impact., Monitoring and evaluation (M&E), a new frontier for human-centered design (HCD), is still largely unexplored. In global health, M&E is considered essential to good practice, and evidence and data are critical tools in program design, performance monitoring, impact evaluation, and adaptation and learning. As HCD is increasingly integrated into global health practice, designers and global health practitioners are learning as they go how to integrate measurement into design and adapt traditional M&E approaches to design-influenced global health projects. This article illustrates some of the tensions inherent in the way global health and HCD practitioners approach measurement, using several cases to illustrate the ways in which tensions can be managed. Using framing introduced by the MeasureD project, which aimed to audit measurement practices in HCD (called social design in the MeasureD project), we explore 3 recent examples of design-influenced global health interventions: 1 focusing on products, 1 on behavior change, and 1 on service improvement, to extract learning about how teams used measurement, for what purpose, and to what effect. In comparing these examples and recent experience, we report on the steps being taken toward greater alignment in the use of measurement to advance human-centered global health programming.

Background Visual art has been increasingly incorporated into medical education and has been shown to enhance important competencies, such as empathy. However, limited evidence on effective visual art program design and evaluation processes remain. This systematic review examines the format, content, and espoused outcomes of visual art-based training programs in undergraduate medical education. Methods A comprehensive literature search of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and ProQuestERIC on undergraduate medical education and visual arts retrieved 1703 articles published from 2014 to 2020. After reviewing inclusion and exclusion criteria, 23 articles were chosen for full review and synthesis. Results Program format and content varied, ranging from 1-day specific competency focused programs to well-structured comprehensive 6-12-week programs. 6 areas of program foci were identified: observation skills, empathy, tolerance to uncertainty, cultural sensitivity, team building and collaboration, and wellness and resiliency. Although several programs used validated measures to assess skills acquisition, they seldom addressed long-term outcomes. Conclusions Our findings indicate that visual art-based education hold a promise to enhance important competencies in medical education, particularly empathy. Clinical observation, in particular, had the strongest evidence of its effectiveness compared to the other competencies. Future programs incorporating visual arts will benefit from a longitudinal (greater than 6 weeks) program which incorporates guided artworks, reflection exercises, and a group discussion to provide a stronger foundation for the development of core competencies. We propose using validated scales to measure outcomes in future studies and follow-up with participants to better assess Kirkpatrick Level 3 and 4 outcomes.

OBJECTIVES This study examines 14 independent and diverse health care interventions funded under the second round of Health Care Innovation Awards by CMS to determine if any organizational, model, or implementation features were strongly associated with the programs' estimated impacts on total expenditures, hospitalizations, or emergency department visits. STUDY DESIGN We estimated program impacts using awardee-specific difference-in-differences models based on Medicare and Medicaid enrollment and claims data for treatment and matched comparison groups from 2012 to 2018. METHODS We used 2 analytic approaches to identify program features associated with favorable impacts. The first method identified program characteristics that were common among programs that had estimated reductions in costs and service use and uncommon among those that did not. The second approach compared median impacts among awardees with a given distinguishing feature with median impacts among awardees that lacked the characteristic. RESULTS Of the 23 program features examined, 7 were associated with favorable estimated impacts: 3 intervention components (behavioral health, telehealth, and health information technology) and 4 program design and organizational characteristics (having prior experience implementing similar programs, targeting patients with substantial nonmedical needs in addition to medical problems, being focused on individual patient care rather than transforming provider practice, and using nonclinical staff as frontline providers of the intervention). CONCLUSIONS Innovative health care service delivery models with 2 or more of these 7 identified features were more likely than programs without them to reduce Medicare and Medicaid beneficiaries' needs for costly health care services.

As the demand for science communication proficiency is growing and post-secondary science communication courses and programs are launched or redesigned, it is paramount to understand who takes these courses and why. Based on a convergent mixed methods approach, this article explores the characteristics and self-reported motivations of students enrolled in an online science communication course at Université Laval, Canada, from 2009 to 2018. Results show that the typical science communication student is a woman with a career-orientated motivation pattern, mostly seeing science communication skills as an asset for a career in communication, science, or health. Be it career-driven, interest-driven, or online education-driven, motivation pattern differences emerge depending on the students’ gender or field of study. Those patterns offer new paths of research, such as exploring the impact of science communication program design or of advertising strategies on enrollment.

In the midst of the Spring 2020 initial surge of the COVID-19 pandemic in New York, members of the Psychiatry Department of Weill Cornell Medicine/NewYork-Presbyterian Hospital rapidly created and implemented a brief, behavioral skills-based intervention program, "CopeNYP", to address the immediate mental health needs of the employees of the hospital and medical school. We describe the development, implementation and evolution of this telehealth-delivered program staffed primarily by in-house clinical psychologists, postdoctoral fellows, pre-doctoral interns and counselors who were redeployed or volunteered their time to provide urgent support for employees. We discuss the challenges and lessons learned in providing brief, skills-based psychological interventions for employees subjected to chronic stress. As the impact of the pandemic became prolonged, employees faced compounding stressors including social isolation, fear of infection, grief and loss, and sequelae of COVID-19-related illness combined with work-related demands. Our goal is to present our program design, implementation, and utilization as a blueprint for other institutions that would like to develop an evidence-based clinician-staffed psychological intervention program to support ongoing employee mental health needs.

Upon resettlement, refugees face many challenges, including limited knowledge of available food and food insecurity, that increase their risks of diet-related diseases. Nutrition education may help them better navigate the challenges of their new food environments and help them live healthier lives. This review assesses the evidence on nutrition education delivery strategies and outcomes among refugees in the United States and other high-income countries using Levac review guidelines. Multiple electronic databases were searched using combinations of the following terms: nutrition, food, cooking, or gardening; education, workshop, curriculum, class, literacy, or program; and refugee. The quality of the peer-reviewed papers was assessed using the Medical Education Research Study Quality Instrument (MERSQI) scoring method. A total of 1930 studies were identified, and 17 met the inclusion criteria. The mean MERSQI score of the peer-reviewed studies was 9.02 (SD, 3.3; range, 1-14). The key nutrition education delivery strategies included conducting a needs assessment and providing client-centered education, a collaborative approach in program design, and hands-on activities such as cooking and store visits. A refugee's literacy level, cultural, and language barriers are common challenges to nutrition education delivery. Because there is limited evidence regarding the efficacy of programs regarding changes in refugees' nutrition knowledge and diet-related behaviors, future research should include rigorously designed studies and the development and implementation of standardized assessment and training tools. The adoption of a context-specific and flexible model is important for effective nutrition education delivery among the refugee population.

This is a design and development carried out to develop a web-based evaluation model in teacher professional programs. The subject of this research were participants in the professional teacher program in 2021. In addition, experts in the field of technology and evaluation are also the subject of this research to assess the feasibility of the developed model. The data collection technique used in this study is a questionnaire technique. Data analysis was carried out by descriptive quantitative analysis. Proof of the validity and reliability of internal consistency using the Gregory method. The results show that a web-based evaluation model has been developed by measuring four program components, namely context, input, process, and product. The results of the expert assessment indicate that this model is feasible and meets content validity. The developed model is also reliable based on internal consistency and meets the aspects of practicality and effectiveness based on user ratings. Keywords: Web-based evaluation, teacher professional program

Hypertension is the leading single preventable risk factor for death worldwide, and most of the disease burden attributed to hypertension weighs on low-and middle-income countries. Effective large-scale public health hypertension control programs are needed to control hypertension globally. National programs can follow six important steps to launch a successful national-scale hypertension control program: establish an administrative structure and survey current resources, select a standard hypertension treatment protocol, ensure supply of medication and blood pressure devices, train health care workers to measure blood pressure and control hypertension, implement an information system for monitoring patients and the program overall, and enroll and monitor patients with phased program expansion. Resolve to Save Lives, an initiative of global public health organization Vital Strategies, and its partners organized these six key steps and materials into a structured, stepwise guide to establish best practices in hypertension program design, launch, maintenance, and scale-up.

Nutrition education through school-based garden programs is a promising intervention to promote youth health and development. Gardeneers is a Chicago-based nonprofit, leading garden programming across area schools. To better understanding their impact on youth health, Gardeneers aimed to define their model more clearly. Using a collective case study design, this mixed-method, formative program evaluation focused on describing program implementation variation across schools. General program design included nutrition education through hands-on garden-based learning. Stakeholder engagement was a strength for some schools and a challenge for others. Sustainability was an ongoing challenge for all schools, particularly funding. Priority student outcomes also varied between schools. Adaptability is core to Gardeneers' approach-the challenge lies in replicable program design and manageable growth, but the strength lies in the ability to meet specific school and student needs. Using these findings, Gardeneers refined their program model and identified program improvements opportunities.

India experiences a substantial burden of cervical cancer and accounts for nearly one third of cervical cancer deaths worldwide. While human papillomavirus (HPV) vaccines have been introduced subnationally in some states, HPV has not yet been rolled out nationally. Given the target age group, schools are the most common delivery channel for HPV vaccines, but this fails to account for local girls who never attended or no longer attend school. We conducted a qualitative, design-informed, community-based study conducted in Uttar Pradesh, India. We assessed facilitators and barriers among out-of-school girls and proposed program characteristics to inform the design of pro-equity HPV vaccine delivery programs for out-of-school girls. Programs should improve parental knowledge of the risk of cervical cancer, engage vaccinated girls as vaccine champions, utilize varied media options for low-literacy populations, and ensure that HPV vaccine services are accessible and flexible to accommodate out-of-school girls. In areas with poor or irregular school attendance among adolescent girls, HPV vaccine coverage will remain suboptimal until programs can effectively address their needs and reach this priority population. Our findings present a meaningful opportunity for program planners to purposefully design HPV vaccination programs according to these parameters, rather than modifying existing programs to include HPV vaccine. Adolescent girls, their parents, and other community members should be involved in program design to ensure that the program can effectively meet the needs of adolescent girls who are not in school.

Short message service (SMS), or text-based, health interventions offer a promising opportunity to deliver health education and have been shown to improve diet and exercise. However, few are theory-based or target low-income parents. This pilot study, informed by the Theory of Planned Behavior (TPB), primarily sought to determine if health education delivered via SMS was feasible and acceptable to low-income parents of young children. Using a one-group, pre- to post-test study design to assess a 12-week SMS-based health education program, parents enrolled in a health-related program at an early childhood development center for low-income families were sent three text messages per week that corresponded to a weekly diet or physical activity-related theme. Surveys assessed pre-post changes in TPB constructs and collected program feedback. Among the 119 eligible parents invited to participate, 109 were sent all text messages for the duration of the study. Participants were mostly Black (98.9%), 25–39 years old (83.9%), female (93.8%), and in single-parent households (63.8%). More than half (n = 59) completed the pre-survey, answered a bi-directional program text, or completed the post-survey. Twelve participants completed both the pre- and post-survey and at least one bi-directional text. Post-survey results revealed that most participants liked the program design and enjoyed their experience with the program. SMS-based interventions can simplify delivery of health information to low-income parents of young children. Although engagement was low, retention was high, and feedback was largely positive.

Community engagement experiences in STEM fields are typically project-based, which introduces components and considerations not explicitly addressed by models commonly used in community-engaged learning more broadly. This paper is a narrative on how we reflected on current models, developed a new one designed for project-based community engagement experiences, and where we see it being useful into the future. While existing models can be useful for STEM-based project teams, project-based engagement raises further questions and presents additional features, such as the existence of the dual value generators of both the project deliverable and project process. We concentrated on providing a macroscopic view of project-based community engagement to organize aspects of a program and maximize positive features while managing resources. The visual model has been developed to facilitate reflection on program design, development, operation, and assessment. It can facilitate intentional consideration, definition, and organization of stakeholders, project deliverables, project process, resources input, and value produced. We foresee several potential uses for this model as a conceptual framework and practical tool for community engagement experiences and programs.

[LEARNING MODEL DEVELOPMENT IN ENVIRONMENTAL-BASED TRAINING FOR TEACHERS OF SOCIAL SCIENCE PROGRAMS IN MADRASAH ALIYAH]. The fundamental problem in this research, is that learning in the Madrasah Aliyah Social Science program which starts from planning to evaluation has not been based on the environment or contextual, therefore this research uses a type of development research with development methods to produce certain products and test the effectiveness of the products being analyzed. qualitatively and qualitatively descriptive. The conclusion of this study resulted in two products, namely the development of a training learning model in the form of an environment-based training learning program design which was validated by experts, obtaining an average score of 94% and an environment-based learning guide with a blended learning pattern, an average score of 98%. The conclusion of the research stages of developing an environment-based training learning model, obtained an average score of 89.91% accompanied by environmental-based learning guide products obtained an average score of 88.25%, while the teacher's ability to prepare HOTS questions as an evaluation tool and is an integral part in this environment-based learning, the average score is 89.53%. Thusthe product of this model development is very feasible to be a system product at the Education and TrainingCenter for Technical Education and Religious Personnel

This review highlights a commonality of implementation barriers across geographically dispersed GeneXpert interventions for TB testing. This indicates the importance of using implementation frameworks to report findings that can improve public health outcomes across low- and middle-income countries., Key Messages In low- and middle-income countries (LMICs) that have a higher burden of TB, the necessity for improved and rapid diagnostic testing, such as Xpert MTB/RIF that detects both TB and rifampicin resistance, has been limited by resource-related implementation challenges.Identifying and responding to the implementation-related barriers and enablers in Xpert testing programs across LMICs can help improve public health outcomes, which in this review were negatively impacted by barriers that were identified.We found that across the studies included in the review, an integrated and coordinated approach was required for implementing Xpert TB models of care into different health settings, but in LMICs, this approach can be associated with a lack of integration and coordination.When deciding on a particular implementation approach, the existing context of a health setting and the expertise and needs of key stakeholders (for example, clinicians, laboratories, and government) should be considered.Reporting of Xpert programs against an implementation science framework can increase learning across geographically diverse settings and thereby support improvement in program design., Introduction: Current evidence indicates that the impact of GeneXpert for diagnosing TB in low- and middle-income countries (LMICs) has not demonstrated equivalent outcomes when compared to Xpert evaluations in upper-middle-income countries. Challenges associated with implementation are possible contributing factors preventing this innovative diagnostic technology from achieving more significant public health outcomes. This review aimed to assess the use of implementation science frameworks when reporting the enablers and barriers for the implementation of GeneXpert for diagnosing TB in LMICs. Methods: We conducted a qualitative systematic review of the peer-reviewed literature using PubMed, Medline, and Scopus. Eligible articles were those published between January 2010 and March 2020 that identified enablers and barriers to GeneXpert implementation, as well as the implementation approach delivered in an LMIC. Results: Eleven studies were included in the review. Implementation barriers were found to be relatively consistent across studies and included patient-level factors, human resources, material resources, service implementation, service coordination, and technical operations. Few studies (n=5) identified enabling factors in the implementation of Xpert for TB testing. Identified enablers included strategies such as active case finding, expanding diagnostic algorithms, and daily transport of samples. The public health impact of Xpert TB testing interventions was commonly influenced by implementation barriers (n=4). Of the 11 studies, only 3 reported against an implementation framework. Conclusion: This review identified a commonality in implementation barriers and enablers that influenced the overall public health impact of GeneXpert. With greater transparency of these barriers and enablers, program planners can promote a more collaborative approach and adapt interventions. It is recommended that program planners use implementation science frameworks when conducting research and publishing. This will build an evidence base focused on implementation and thereby support programs to address implementation barriers and include enabling factors in program design.

The essential factor in achieving a good learning process is discipline in the lecture process. Students and lecturers are encouraged to be disciplined and active participants in the lecture process, allowing the Lecturer's principal duty of transforming and disseminating science and technology to become more concentrated. Furthermore, to eliminate overlapping lecture schedules, lecture hours, and lecture venues that do not meet needs, it is easier for stakeholders to monitor and regulate lecturers' and students' lecture attendance so that quick and accurate decision-making can be done. To establish discipline in school utilizing biometric identification technology (fingerprints) and Radio Frequency Identification (RFID) technology, developing application software to make it easier to manage work schedules is required. The Work Scheduling program is an online application built with the PHP programming language, MySQL database, and fingerprint and RFID identification support devices that are expected to be effective and efficient tools in the process of scheduling lectures and recording lecture attendance of students and lecturers, making it easier to publish lecture schedules.

Academic programs in the medical/health humanities have proliferated widely in recent years, and the professional, academic, and cultural drivers of this growth promise sustained new program development. In this article, we present the results of a survey sent to representatives of one hundred twenty-four baccalaureate and ten graduate programs in the medical/health humanities to assess the experiences and needs of existing programs. Survey results confirm the interest in and need for a descriptive toolkit as opposed to a prescriptive manual; indicate what data and materials are most needed to support the successful development of new academic programs in the field; and identify areas for future research. Recognizing a need for program development resources, the Health Humanities Consortium (HHC) has initiated the creation of a comprehensive online toolkit. We discuss survey results and the toolkit in relation to the drivers of new program growth. Finally, we describe resources now available through the HHC’s new online program toolkit, including existing programs; sample syllabi; sample curricula templates; program rationale; proposal templates; and graduation data.

Tuberculosis is an important public health problem in the Eastern Mediterranean Region. It is crucial for each country to develop a national tuberculosis surveillance system. WHO has developed a standardized tuberculosis surveillance system through which two important indicators for tuberculosis control, a cure rate and a case detection rate, can be collected. The number of countries that have adopted the WHO tuberculosis surveillance system has been increasing in the Region. At the moment, 13 countries have reported a cure rate, which is the most important indicator for national tuberculosis control programmes. It is hoped that more countries will adopt this system.

This paper describes a half-year in-service Language Teacher Education (LTE) program, targeting the trainee teachers who work in Chinese private English institutes. This is to better prepare them at the outset of their career. Primarily intending to build the trainee teachers’ professionalism and raise their awareness, an overall illustration of adopted training courses and choice of activities are introduced in this paper. Focusing on integrating instructional knowledge from ESL and English language teaching, the LTE program schedule will allow majority of readers to implement during their daily teaching and research activities. Principles underpinning this program design are illustrated one by one. A course like this may not foster all teachers to become professionals at once, but to be a reflective practitioner can be a reachable goal, as accumulation of professional expertise is based on teachers’ capability of understanding how to reflect on teaching.

If conservation depends on people, then community partnerships are the lynchpin to conservation success. The contribution of local knowledge, intellectual capital and volunteer labour not only saves project managers invaluable time and money, it fosters ownership and longevity into conservation initiatives well beyond their projected timeframe. Island communities are socially and culturally diverse and driven by a range of motivations. Hence, if we are to deliver conservation programs at scale, we need to better understand and embed these drivers into program design. We present four contemporary case studies on major populated islands in Australia where community collaborations are building the collective impact needed to underpin conservation success. They contain key learnings about community involvement, to help guide managers with future island planning and avoid some pitfalls.

This article summarizes issues in defining character education (CE) that are relevant to program development and evaluation. No authoritative definition exists for CE, but several features seem prominent. These include a focus on enhancing civic, moral, self-regulatory, and/or intellectual virtues; and (at least implicitly) prioritizing the shaping of participant identity over teaching skills. Within these broad parameters, programs vary widely in their targets and interventions. They can also vary in terms of emphasizing the same or individualized elements of character across students. The discussion finishes with a summary of elements of a CE program, and a call for well-planned evaluations.

The establishment of genomics in health care systems has been occurring for the past decade. It is recognised that implementing genomics within a health service is challenging without a system-wide approach. Globally, as clinical genomics implementation programs have matured there is a growing body of information around program design and outcomes. Program structures vary depending on local ecosystems including the health system, politics and funding availability, however, lessons from other programs are important to the design of programs in different jurisdictions. Here we describe an adaptive approach to the implementation of genomics into a publicly funded health care system servicing a population of 5.1 million people. The adaptive approach enabled flexibility to facilitate substantial changes during the program in response to learnings and external factors. We report the benefits and challenges experienced by the program, particularly in relation to the engagement of people and services, and the design of both individual projects and the program as a whole.

Kliktrip is an Online Travel Agent (OTA) that has trip & activities facilities and was established in 2018 in Bandung. Kliktrip sales are still experiencing a decline due to low public awareness of Kliktrip which is seen through the number of downloads on mobile apps and Instagram followers. Kliktrip sales are still experiencing a decline and public awareness of Kliktrip is still low because Kliktrip has not implemented 7 out of 8 marketing communication mix optimally. Therefore, research was conducted to design an effective marketing communication program for Kliktrip by using benchmarking and Analytical Hierarchy Process (AHP) methods. Based on the results of AHP data processing, it can be seen that the selected benchmark partner is Explorer.id with a total priority vector value of 0.44 and benchmark results with Explorer.id concluded that Kliktrip needs to increases the value of SEO, page views, and unique visitors on the website, creates a Tiktok’s account, webisode, and video podcasting, collaborates with cross-promotion, makes contests (giveaways), increase the number of downloads and reviewers on mobile apps, implementing mobile billboards and cause-related marketing, increasing customer service operational time, participating in exhibitions, and collaborating with influencers.

Background Demanding working conditions in medical practice pressurise the well-being of physicians across all career stages, likely harming patients and healthcare systems. Structural solutions to harmful working conditions are necessary as well as interventions to support physicians in contemporary practice. We report on developing and piloting a team-based program for physicians to improve their working conditions and well-being. Approach Program development steps involved: a preparatory phase, needs assessment, and program design. The program consisted of (1) a feedback tool addressing working conditions and well-being, and an intervention including (2a) a facilitated team dialogue and (2b) a team training on communication and collaborative job crafting. In the program’s pilot, 377 physicians from 48 teams in 14 Dutch hospitals used the feedback tool. Four teams participated in the team dialogue. Two teams performed the team training. Evaluation Physicians indicated that the program was a useful format to gain insight into their working conditions and well-being, and possibly to improve their well-being collaboratively. Reflection We provide seven critical reflections on developing and piloting our program, accompanied by recommendations for developing well-being interventions. Our development approach, program components, and recommendations may support physicians and other healthcare professionals in demanding work environments.

Advances in the management of chronic diseases, combined with an aging population, have escalated the prevalence of people with life-limiting conditions and demand for palliative care. In Australia, this has prompted calls for change in policy frameworks, service systems and funding models that underpin care. The complex social, cultural and policy transformation required to enact these changes has been problematic. This paper reports on qualitative research into a unique, Australian Community Palliative Care program reflecting these aspirational changes. The research examined the program design and its implementation through the perspectives of program staff and volunteers.

Check It is a novel, bundled, community-based seek, test, and treat Chlamydia trachomatis (Ct) screening program for 15- to 24-year-old Black men in New Orleans who have sex with women. The program design addressed barriers and facilitators to Ct screening/treatment by enlisting trusted community partners, incorporating participant input, providing free index/partner expedited treatment, developing relatable marketing materials and an educational Web site, encouraging peer referral, and providing a modest monetary incentive.Areas of high poverty were identified using census data; ethnographic/key informant interviews identified sites in those areas where the target population congregated. Black youth informed Web site design and social marketing. Content was inspirational/educational/amusing and endorsed recruitment and brand awareness. A community advisory board, participant interviews, community partner feedback, and recruitment staff involvement in the process evaluation helped refine the program in an ongoing manner.During formative stages, 41 key informant/community advisory board members informed program refinement. Community partners provided venue locations (n = 65) and participant referrals. Between May 22, 2017, and February 28, 2020, 1890 men were enrolled (acceptance rate, 96.0%) with Ct infection rate of 10.2%. Overall study treatment was provided to 86.1% (71.4%-90.9%) of participants who tested positive and 28.5% (14.5%-41.5%) of their partners. Findings from in-depth interviews with participants (n = 43) led to increased treatment uptake.C. trachomatis community screening of young Black men was successful through collaboration with trusted community partners, by tailoring implements/marketing with participant input, reducing barriers to treatment, and providing modest monetary incentives. The Check It program can serve as a roadmap for reducing health disparities in this population.

This paper reports on a mixed-methods study of the Total Reading Approach for Children Plus (TRAC+) program, with a particular focus on its mobile learning element, where tablets and an app called Aan Khmer (Read Khmer) were introduced into Cambodian schools to assist ‘struggling students’ in Grades 1 to 3 learn early reading. This paper focuses primarily on survey and interview data collected in 2017 from relevant staff members, namely school directors, literacy coaches, teachers and librarians, about this intervention program. 73 school directors participated in the survey and following this, 68 staff members were interviewed, including 15 of the school directors surveyed. Findings indicate that staff members were positive about the program, including the app, and observed improvements in the children’s reading. However, several implementation challenges were noted, which echo challenges reported in the literature on carrying out technology-based interventions. This paper offers insights into the importance of alignment between program design and user readiness, which may inform other technology-based programs intended to raise literacy standards in low- and middle-income countries (LMICs).

This paper describes the design and piloting of a Character Strengths Development (CSD) curriculum for Glasswing International’s after-school program. The CSD curriculum was designed to be implemented in El Salvador, Honduras, and Guatemala, countries that make up the Central American Northern Triangle (NTCA) and have extremely high rates of violence and criminality. Development of the CSD curriculum included 3 stages: a consultativeprocess with youth, review of relevant literature and design of the curriculum, and piloting of the methodology. Students’ perspectives were engaged throughout the development process to ensure the curriculum was relevant to the lives of youth living in violent communities. The curriculum is the first to be built on the Virtues in Action framework in NTCA countries. Lessons learned are shared for CSD program design and implementation in other contexts with high levels of violence.

Institutions of higher education play an important role in training citizens who can thoughtfully and critically make decisions that impact the sustainability of our planet. While researchers have ...

Since at least Richard Ingersoll's (2003) discussion of teachers treated as “tall children,” teacher management and teacher preparation have been explicitly tied to education reform and school choi...

The study of positive youth development (PYD) requires theory-based methodological considerations pertinent to measurement, research and program design, and data analysis. We outline the appropriate steps that researchers and program evaluators must enact to address these methodological foci in their respective attempts to describe, explain, and optimize the course of positive development among diverse youth around the world. We focus on longitudinal (developmental) research designed to evaluate programs promoting PYD in low- and middle-income countries (LMICs), where life challenges are shaped by multiple adverse situations associated with racism, poverty, gender inequalities, political inequities, and the absence of adequate health and medical resources. Using the Compassion International Study of PYD as a sample case, we suggest how researchers and practitioners might collaborate to enact rigorous, theory-based research aimed at promoting PYD among youth living in LMICs and worldwide.

This essay discusses the EdD Program design and qualitative research course sequence at Drexel University, a private, non-profit institution. This large program admits up to 140 EdD students annually with approximately 100 attending fully online and 40 attending hybrid offerings at the main campus and at a satellite program in Washington, DC. The essay features a qualitative course observation activity designed by Janesick (2011) to be used face-to-face and details how the activity has been adapted for virtual delivery at East Coast University. As a literature review revealed a paucity of published works on teaching observation qualitatively, the authors seek to contribute to the knowledge base with particular emphasis on faculty teaching in an online program. Based upon the East Coast University faculty’s use of this observation activity, students develop increased understanding of the roles of perception and perspective in qualitative observation.

Objectives This scoping review explores the extent to which undergraduate medical education have incorporated complementary and alternative medicine in their curricula and evaluates the teaching, delivery and assessment approaches used. Methods ERIC, Ovid Medline and Pubmed databases were searched with keywords related to "complementary and alternative medicine" and "undergraduate medical education" for relevant articles published until August 2020. Data extraction included the presence/absence of complementary and alternative medicine integration, program duration, instructor background, and assessment methods. Results Of 1146 citations, 26 met the inclusion criteria. Complementary and alternative medicine teaching in undergraduate medical education was widely inconsistent and not well aligned with clearly identified aims and objectives. Various complementary and alternative medicine disciplines were taught, demonstrated or observed, and several programs included teaching on evidence-based medicine. Educational outcomes mainly assessed student satisfaction and learning through self-evaluation and rarely assessed for effectiveness with regards to changing clinical practice or impacts on patient outcomes. Conclusions Inconsistencies in complementary and alternative medicine teaching and assessment in undergraduate medical education reflect the lack of defined graduate competencies. An evidence-based medicine component of an educational program is a potential solution to overcoming breadth and content challenges. Curriculum developers would be better guided with research that determines if complementary and alternative medicine program design, content and assessment influence clinical practice and/or patient outcomes.

We assess the role of race in loans made through the Paycheck Protection Program (PPP). The PPP program, created by the U.S. government as a response to the Covid-19 pandemic, provides loans to small businesses so they can keep employees on their payroll. We argue that the historical record and PPP program design choices made it likely that many Black-owned businesses received smaller PPP loans than White-owned businesses. Using newly released data on the PPP program, we find that Black-owned businesses received loans that were approximately 50% lower than observationally similar White-owned businesses. The effect is marginally smaller in areas with more bank competition and disappeared over time as changes to the PPP program were implemented allowing for entry by fintechs and other non-traditional lenders. Plain English Summary We find that Black-owned businesses received loans through the Paycheck Protection Program that were approximately 50 percent lower than White-owned businesses with similar characteristics. However, this difference in loan size shrank over time as more non-bank lenders such as fintechs were allowed to participate in the program and began approving PPP loans. Loan size differences were also slightly smaller in zip codes containing a larger number of bank branches. These results are consistent with prior research which shows lending discrimination by commercial banks against Black borrowers. It is also consistent with studies showing that greater access to and competition among banks and other lenders can reduce discrimination. In light of these results we recommend that policy makers account for existing racial inequalities within banking or other systems in their program design to produce more equitable outcomes.

Despite the availability of cure for hepatitis C virus (HCV), people experiencing homelessness (PEH) are challenged with initiating and completing HCV treatment. The design of culturally sensitive HCV treatment programs is lacking. The objective was to employ community-based participatory research methods to understand perceptions of HCV-positive PEH, and providers, on the design and delivery of a culturally sensitive, nurse-led community health worker (RN/CHW) HCV initiation and completion program. Four focus group sessions were conducted with HCV-positive PEH ( n = 30) as well as homeless service providers (HSP; n = 7) in Skid Row, Los Angeles. An iterative, thematic approach provided the themes of essentials of successful participant engagement and retention: Role of nurse-Led CHW in promoting: (a) tangible and emotional support; (b) cognitive and behavioral support; and (c) financial and structural resources. The goal of this study is to provide the groundwork for future research of HCV program design to support HCV cure among homeless populations.

The failure of the de-radicalization program in prisons is evidenced by the high recidivation of terrorism convicts who have launched their actions again. This failure was due to the lack of coordination between stakeholders, namely the Director-General of Social Affairs (Dirjenpas) and the BNPT. Government Science sees that there have been sectoral egos between institutions. This study aims to examine the implementation of deradicalization in prisons and to skin sectoral egos in its implementation. This research methodology uses qualitative descriptive, namely the translation through words, by conducting interviews from September to October 2020. The results show that there is a reluctance of the Director-General of Social Affairs to use the concept of deradicalization and prefers to use the concept of guidance owned by the Director-General of Social Affairs itself. This reluctance was based on the negative stigma of using deradicalization and the feeling that BNPT had never coordinated to coordinate deradicalization. The sectoral ego is the result of not being carefully defined by radicalism and terrorism. Each state institution and the general public have their own definitions, resulting in differences in concept resulting in differences in program design and implementation.

Integrated conservation approaches (ICAs) are employed by governments, communities, and nongovernmental organizations worldwide seeking to achieve outcomes with dual benefits for biodiversity conservation and poverty alleviation. Although ICAs are frequently implemented concurrently, interactions among ICAs and the synergies or trade-offs that result are rarely considered during program design, implementation, and evaluation. In support of more deliberate and effective use of ICAs, we examined interactions among four well-known strategies: biosphere reserves (BRs), voluntary protected areas (VPAs), payments for ecosystem services (PES), and community forest management (CFM). Through a comparative case study, we analyzed interactions among spatially or temporally clustered ICAs implemented on communally held and managed lands in three ecologically and socioeconomically distinct regions of Mexico. Our research methods combined policy analysis with data gathered through participant observation and semistructured interviews (n = 78) and focus groups (n = 5) with government officials, implementers, and participants involved in ICAs in 28 communities. Despite the significant differences among the regions in which they were implemented, we found that key actors at each level of involvement generally perceived interactions among ICAs as synergistic. The PES programs were perceived to strengthen protected areas by reducing forest cover loss in and around BRs, fostering proconservation attitudes, and incentivizing the establishment of VPAs. Communities that invested PES income in CFM were motivated to conserve forests beyond the duration of PES programs, and CFM in buffer zones was perceived to strengthen BRs by maintaining forest cover and generating income for communities. We also identified key social and environmental factors that can influence these interaction effects among ICAs. Based on these findings, we recommend further study of ICA interactions and intentionally complementary policy design to maximize positive environmental and social outcomes.Las estrategias de conservación integrada (ECI) son empleadas en todo el mundo por los gobiernos, comunidades y organizaciones no gubernamentales que buscan alcanzar resultados con beneficios tanto para la conservación como para la mitigación de la pobreza. A pesar de que múltiples ECI suelen implementarse simultáneamente, es raro que se tomen en cuenta las posibles interacciones positivas (sinergías) o negativas (trade-offs) durante el diseño, la implementación y la evaluación de estos programas. En búsqueda de un uso más deliberado y efectivo de las ECI, examinamos las interacciones entre cuatro estrategias conocidas: reservas de la biósfera (RB), áreas protegidas voluntarias (APV), pagos por servicios ambientales (PSA) y el manejo comunitario de los bosques (MCB). Mediante un estudio de caso comparativo analizamos las interacciones entre las ECI agrupadas espacial o temporalmente implementadas en tierras con administración y propiedad comunal en tres regiones con diferencias ecológicas y socioeconómicas en México. Nuestros métodos de investigación combinaron el análisis de políticas con datos recopilados mediante la observación participativa, entrevistas semiestructuradas (n = 78) y grupos focales (n = 5) con funcionarios del gobierno, implementadores y participantes involucrados en las ECI de 28 comunidades. A pesar de las diferencias significativas entre las regiones en las que se implementaron estas ECI, descubrimos que los actores clave en cada nivel de participación percibieron de manera generalizada las interacciones entre las ECI como sinérgicas. Los programas de PSA fueron percibidos como algo que fortalece a las áreas protegidas mediante la reducción de la pérdida de la cobertura forestal dentro y fuera de las RB, el fomento de las actitudes a favor de la conservación y el estímulo al establecimiento de las APV. Las comunidades que invirtieron los ingresos por PSA en el MCB expresaron su motivación para conservar los bosques más allá de la duración de los programas de PSA y el MCB en zonas de amortiguamiento fue percibido como un factor de fortalecimiento de las RB mediante el mantenimiento de la cobertura forestal y la generación de ingresos para las comunidades. También identificamos los factores sociales y ambientales importantes que pueden influir sobre estos efectos de interacción entre las ECI. Con base en estos hallazgos, recomendamos un estudio más profundo de las interacciones entre las ECI y un diseño de políticas intencionalmente complementario para maximizar los resultados sociales y ambientales positivos.