搜索结果：Evaluation and program planning

Strong family networks or kinships are integral for overall health and wellbeing, and it is important for families to have the opportunity to build positive and supportive relationships together. In Australia, culturally safe and appropriate programs have the potential to help Aboriginal families to strengthen connections and improve overall physical, social and emotional health and wellbeing. The Moordidjabiny Moort (Stronger Families) program was a place-based, culturally appropriate, family-determined health and wellbeing program, where families chose, planned, undertook and evaluated an activity with the aim of creating positive outcomes for their family. The program was delivered by the South West Aboriginal Medical Service, an Aboriginal Community Controlled Health Organisation that delivers a range of comprehensive primary healthcare services throughout the South West region of Western Australia. Central to this program was a holistic approach to support families and community by providing culturally responsive, community-led health promotion and prevention programs. However, Aboriginal Community Controlled Health Organisations are often limited due to funding constraints and reporting requirements that often do not cover outcome-based program evaluations. Thus, in addition to examining the impacts of the Moordidjabiny Moort (Stronger Families) program, the evaluation reported here also seeks to provide evidence to advocate for funding for similar programs in the future. Conducted as part of an internal program evaluation and culturally safe research-capacity-building learning experience for staff, the study implemented an evaluation design with embedded participatory action research and Aboriginal Data Sovereignty principles. Evaluation data included family activity grant application information and participant activity reports. Yarning circles and individual yarns were conducted with available program participants and staff and thematically analysed. A program logic model guided the development of outcome measures. The activities provided healing, connection, and improved social and emotional wellbeing, and highlighted the importance of self-determination and cultural ways of working. Findings also show the value of a program logic that connects purposes and outcomes in program planning and evaluation. Added costs, organisation stresses and limited planning lead time are potential barriers to the implementation of this type of program. Both the organisation and the families involved in the project were able to determine how the project would be implemented and therefore ensured the needs and priorities of those involved were identified and met. Allowing families to determine their own outcome measures demonstrates on a small scale the empowering value of applying Aboriginal Data Sovereignty principles. Connecting purpose, planning and evaluation highlighted the value of self-determination, and the application of Aboriginal Data Sovereignty 'governance of data' principles. Comprehensive primary healthcare services that provide a holistic range of services in a culturally sensitive manner are particularly valued by Aboriginal people living in regional, rural and remote areas who would otherwise have been difficult to access. Aligned with the principle of 'data for governance' it is hoped that the learnings from this evaluation will inform funding models to allow Aboriginal Community Controlled Health Organisations greater determination regarding ways to deliver and evaluate programs using the methods and measures they choose.

The 2023 iteration of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimated prevalence, incidence, and health burden for 375 diseases and injuries, including 12 mental disorders. We assess past, current, and emerging trends in the prevalence and burden of mental disorders across sexes and age groups, for 21 regions, 204 countries and territories, and by Socio-demographic Index (SDI) quintile, from 1990 to 2023. Mental disorders included in GBD 2023 were anxiety disorders, major depressive disorder, dysthymia, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, anorexia nervosa, bulimia nervosa, idiopathic developmental intellectual disability, and a residual category of other mental disorders. A literature review identified epidemiological data for each disorder. These were analysed via a Bayesian meta-regression to estimate prevalence by disorder, sex, age, location, and year. Disorder-specific prevalence was multiplied by disability weights representing the severity of health loss associated with each disorder to estimate years lived with disability (YLDs). Deaths due to anorexia nervosa were assessed with a Cause of Death Ensemble modelling strategy to estimate deaths by sex, age, location, and year, and then multiplied by the standard life expectancy at age of death to estimate years of life lost (YLLs). YLDs equalled disability-adjusted life-years (DALYs) for all mental disorders except anorexia nervosa (the only mental disorder considered as an underlying cause of death in GBD), for which DALYs represented the sum of YLDs and YLLs. We presented prevalence, deaths, YLDs, YLLs, and DALYs as counts, age-specific rates per 100 000 population, and age-standardised rates per 100 000 population. We estimated 1·17 billion (95% uncertainty interval 1·06-1·31) prevalent cases of mental disorders globally in 2023, equivalent to an age-standardised prevalence rate of 14 210·7 cases (12 849·5-15 940·1) per 100 000 population. These estimates represented a 95·5% (75·0-121·2) increase in prevalent cases and 24·2% (11·4-41·4) increase in age-standardised prevalence rate between 1990 and 2023. All mental disorders showed increases in prevalent cases between 1990 and 2023, while notable increases were seen in age-standardised prevalence rates for anxiety disorders, major depressive disorder, dysthymia, anorexia nervosa, bulimia nervosa, schizophrenia, and conduct disorder. There were an estimated 171 million (127-228) DALYs due to mental disorders globally across sex and age in 2023, equivalent to an age-standardised DALY rate of 2070·5 DALYs (1519·1-2750·5) per 100 000 population. Mental disorders contributed to 6·1% (4·8-7·6) of all-cause DALYs in 2023, making them the fifth leading cause of global DALYs (up from 12th in 1990). DALYs were almost entirely composed of YLDs. Mental disorders were the leading cause of YLDs in 2023 (up from second in 1990), explaining 17·3% (14·8-20·6) of all-cause global YLDs. Leading causes of mental disorder DALYs were anxiety disorders (ranked 11th among the 304 diseases and injuries at Level 4 of the GBD cause hierarchy), major depressive disorder (15th), and schizophrenia (41st). Globally in 2023, mental disorder age-standardised DALY rates were higher among females (2239·6 [1643·7-3014·1] per 100 000) than among males (1900·2 [1399·8-2510·8] per 100 000), and peaked in the 15-19 years age group (2617·3 [1850·6-3696·8] per 100 000). All locations showed increased mental disorder DALY rates in 2023 compared with 1990, ranging across countries and territories from 1302·4 (952·7-1683·7) per 100 000 in Viet Nam to 3555·8 (2661·9-4715·0) per 100 000 in the Netherlands. Across SDI quintiles, DALY rates ranged from 1853·0 (1352·1-2469·3) per 100 000 for middle SDI to 2184·1 (1606·1-2890·3) per 100 000 for high SDI. A significant health burden was imposed by mental disorders in all countries and territories in 2023, irrespective of the health resources available. In some instances, this burden has increased over time and is unevenly distributed across populations. Stronger surveillance systems, particularly in low-income and middle-income countries, are required. Additionally, we need more coordinated and inclusive policies to reduce the burden through early treatment and prevention, tailored to sex and age differences across locations. Responding to the mental health needs of our global population, especially those most vulnerable, is an obligation, not a choice. Gates Foundation, Queensland Health, and University of Queensland.

Schools offer an influential setting for delivering health promotion interventions. However, the success of these efforts largely depends on how well the implementation context is understood and addressed. While "context" is recognized as a key concept in implementation science, it remains inconsistently defined and applied. Therefore, the aim of this scoping review was to critically examine theoretical approaches used in implementation of school health intervention programs, and to explore how these approaches conceptualize and address context. Ultimately, the goal is to develop a conceptual framework that can support researchers, practitioners, and decision-makers in better understanding and addressing context in school health promotion. This scoping review was conducted following the Joanna Briggs Institute (JBI) guidelines. A search was conducted in Medline and ASSIA on June 18th, 2024. Articles were screened independently by two authors. After data extraction, a reflexive thematic analysis approach was used to analyze data. Our findings reveal that various theoretical approaches including implementation, adaptation, and system frameworks, as well as organizational and actor-network theory, have been utilized to conceptualize and address context in school health promotion. These approaches were applied across different stages of implementation: planning, delivery, and evaluation. However, our results confirm considerable variation in how these theoretical approaches address and define context. These different ways of defining context not only highlight a lack of consensus around its definition but also have significant implications leading to the prioritization of certain aspects of context over others, resulting in a fragmented, incomplete understanding of the social, cultural, economic, and political setting within which interventions are implemented. Using reflexive thematic analysis, we identified two overarching themes. The first theme, dimensions of context, comprises four contextual dimensions: organizational, socio-cultural, economic, and political. The second theme, features of context, captures the dynamic, interconnected, non-linear nature of context, and its spatial and temporal aspects. Together, these dimensions and features are integrated into a visual framework, the Contextual Framework for School Implementation (CFSI). The framework is further supported by practical guiding questions spanning all implementation phases: planning, delivery, and evaluation, emphasizing the importance of considering implementation context from the outset of program development. This review examined how theoretical approaches have been used to understand and address context in school health promotion. It shows that while context is often recognized as important, current ways of describing and applying it are fragmented and incomplete. By integrating the key dimensions and features of context, the proposed framework provides phase-specific questions to guide planning, delivery, and evaluation for understanding how context shapes implementation. The framework may also help explain certain implementation challenges, supporting both researchers and health practitioners in navigating contextual complexity throughout the implementation process, thereby informing context-sensitive health policy and practice. This study was based on a registered protocol ( https://osf.io/azdv4/ ). It is part of the Changemaker project funded by the European Union (GA No 101137359).

Digital health interventions show promise for promoting behavior change, but how they incorporate action planning strategies is underreported. This oversight limits understanding of how to implement behavior change techniques. iSIPsmarter is a digital health intervention aimed at reducing sugar-sweetened beverage (SSB) consumption among Appalachian adults. This study aimed to examine the digital action planning process in the iSIPsmarter intervention, specifically by (1) assessing the frequency of action plan engagement, (2) evaluating participants' perceived difficulty implementing their action plans and examining progress toward achieving SSB reduction and weight goals, and (3) exploring the selection of barriers and strategies. The digital action planning process is embedded within 5 of iSIPsmarter's 6 behavioral content modules (Cores) and paired with self-monitoring of SSB intake via SMS text messaging and weight via a cellular-enabled scale. Participants first self-select program goals for SSB intake (in ounces) and weight (loss or maintenance). Then, in Cores 2-6, they complete action plans using personalized tracking feedback, recommendations, and goal progress updates. Participants identify barriers and strategies using preprogrammed or write-in responses. Summary statistics described the aims. Participants (n=119) were predominately White (Caucasian), female, aged between 18 and 44 years, college-educated, and from rural counties. On average, participants completed 4.5 (SD 1.1) of 5 possible SSB action plans, with 80% (95/119) completing all 5. Across all Cores, perceived difficulty implementing action plans and achieving goals remained relatively stable, with an average of 48% rating the tasks as impossible or hard, 29% as neither hard nor easy, and 24% as easy or very easy. Nearly half achieved their self-selected weekly SSB goals, and one-third made progress toward them. At Core 6, 57% (54/95) of participants met their self-selected SSB program goal, while 46% (44/95) met the recommended SSB intake of less than 8 ounces per day. Of 119 participants, 53 (45%) modified their SSB barriers, and 63 (53%) selected new strategies during action planning. Top reported SSB barriers included (1) caffeine, (2) taste, and (3) habit. Among those with a program weight loss goal (n=94), the average weight loss was -1.3% (SD 2.6) at the 9-week follow-up, with 61% (57/94) achieving their goal. By 6 months, weight loss increased to -2.1% (SD 5.6), with 54% (49/90) achieving their goal. Of those completing weight action plans, 62% (69/112) modified their barriers. Top weight barriers included (1) sweets, (2) portion sizes, and (3) eating healthy foods. Findings underscore the value of digital action planning as a central behavior change technique within a nutrition-focused digital intervention. High action plan completion and consistent strategy adaptation suggest that structured, digitally personalized goal setting and action planning processes can effectively support behavior change, particularly among underserved populations with limited access to preventative care.

'Encompass' is a participatory group-based intervention originating from low- and middle-income countries, co-developed with parents and professionals to enhance the well-being, health literacy and empowerment of caregivers of young children with complex neurodisability. We aimed to assess the feasibility and acceptability of (a) intervention delivery in two socially deprived UK urban areas and (b) evaluation methods including data collection on programme outcomes and costs. We conducted a mixed-methods pilot and feasibility study with caregivers of children under 5 years with complex neurodisability. Feasibility of intervention delivery was assessed based on recruitment rates, group attendance, fidelity checklists and qualitative interviews with caregivers and facilitators. The suitability of evaluation methods was explored through follow-up rates, questionnaire completeness and caregiver feedback on outcome measures. Data relating to implementation at organisational and system levels were explored through interviews with facilitators and key partners. Results were compared to predefined traffic light criteria (green, amber and red) to determine whether a larger scale evaluation was warranted. Eight caregivers participated in the programme. Fidelity of delivery and follow-up questionnaire completion met green criteria, while recruitment and attendance met amber criteria, indicating that minor adaptations are required before scaling up. Qualitative findings demonstrated high acceptability of the programme among caregivers and facilitators, particularly valuing the co-facilitation model, participatory approach and peer support. Flexible delivery, including online participation and communication support, enhanced accessibility for families with diverse needs. Capturing programme delivery costs was feasible and provided preliminary estimates to inform future economic evaluation. Our findings provide proof of principle that 'Encompass' can feasibly and acceptably be delivered and evaluated with caregivers of children with complex neurodisability in an ethnically diverse UK community health setting. The findings support progression to a larger scale evaluation, with refinements to recruitment strategies and delivery logistics. Caregivers with lived experience were central to developing the 'Encompass' programme and this study. Four local mothers of children with complex neurodisability contributed to planning, recruitment and sense-checking the findings. ClinicalTrials.gov identifier: NCT06310681.

Health promoting school (HPS) interventions have the potential to improve adolescent health and well-being, but evidence regarding implementation and system-level impact in real-world school settings remains limited. "My Life - I Decide" (My Life) is a systems-oriented HPS intervention developed to strengthen positive mental and physical health, school well-being, and health-promoting school practices among 10th-grade students in Denmark. This study aims to describe the intervention, study design, and evaluation framework of the "My Life" intervention and its pragmatic controlled trial, including effectiveness, process, and system-level evaluations. The intervention is informed by the World Health Organization HPS framework and combines curriculum-based health education, action-oriented teaching, life-psychological approaches, and education outside the classroom. The intervention includes four phases: (1) preparation through cross-sectoral collaboration between health and education sectors; (2) planning and local adaptation; (3) delivery of a health education program; and (4) anchoring of health-promoting practices at the school level. Effectiveness is evaluated using a pragmatic controlled waiting-list trial design. Four intervention schools (11 classes) were matched with 4 control schools (15 classes), including approximately 416 students aged 15-17 years. Primary outcomes include social and emotional competences, self-efficacy, mental well-being, health literacy, school connectedness, and student interpersonal relations. Student survey data are collected at baseline, postintervention, and follow-up, and effectiveness will be analyzed using multilevel mixed models. System-level impacts are assessed using a mixed-methods design, including school staff surveys, interviews with school and municipal stakeholders, and student focus groups. A realist-informed multimethod process evaluation examines implementation fidelity, acceptability, contextual factors, and mechanisms of impact across intervention schools. Data sources include observations, interviews, student registration, and postsession surveys completed by health consultants after each teaching session. The study will generate quantitative and qualitative data on student outcomes, implementation processes, intersectoral collaboration, and development of health-promoting practices within schools. Findings from the effectiveness, process, and system-level evaluations will be triangulated to test and refine the initial program theory of the intervention. Recruitment of schools and student enrollment have been completed, and baseline data collection commenced in September 2025. Follow-up assessments are being conducted according to the study timeline. Qualitative data collection for the process and system-level evaluations were completed in June 2026. The "My Life" study will contribute knowledge on the implementation and evaluation of complex HPS interventions in real-world educational settings. The findings may inform future HPS initiatives and provide methodological insights into combining effectiveness, process, and system-level evaluations in adolescent health promotion research.

Family planning (FP) is a critical component of reproductive health, enabling individuals to plan the number and timing of children through various contraceptive methods.We outline the conceptual framework and country case study methodology used by the Exemplars in Family Planning (EFP) project. This was based on the wider Exemplars in Global Health programme, which uses mixed-methods to examine determinants of FP progress in countries that exceed expectations for health outcomes. The EFP project integrates findings from case studies on six such countries, including quantitative analyses of trends and drivers of modern contraceptive prevalence, systematic reviews, policy, programme and financing assessments, and qualitative data collection with policymakers, providers and community actors. Data triangulation across these methods, complemented by consortium input and country workshops, enabled robust validation of findings and identification of cross-cutting themes. This approach produced a nuanced understanding of FP progress by capturing interactions between government programmes (demand and supply), service delivery mechanisms, subnational contexts and individual determinants. Quantitative decomposition and trend analyses quantified the contributions of population characteristics, behavioural factors and interventions, while qualitative and stakeholder data contextualised these findings within local sociocultural, health system and policy environments.This multicountry, mixed-methods analysis led by local researchers and supported by a global consortium enhanced methodological rigour, contextualised findings and enabled cross-country learning on FP progress. It identified key cross-cutting drivers and offers evidence-informed guidance to improve contraceptive uptake and demand satisified, while highlighting the need for context-specific interventions and further longitudinal, multicountry research.

Program evaluation is critical in ensuring the effectiveness of both sport programs and organizations. Despite its importance, many sport organizations lack sufficient knowledge and resources (e.g., funding) to carry out evaluation, reflecting a broader trend referred to as low capacity for evaluation. To address evaluation capacity gaps, organizations can connect with and learn from "evaluation champions" within their respective sectors. Evaluation champions are individuals or organizations that actively promote and exemplify best evaluation practices, provide training and support, and mentor peers in program evaluation. However, little research profiles evaluation champions in sport, limiting sport knowledge users' accessibility to potential knowledge exchange and collaboration opportunities to enhance evaluation capacity. Therefore, this reflective case narrative describes an evaluation champion in the sport sector with a specific emphasis on the impact of its evaluation practices, priorities, and approaches. Recommendations and lessons learned from the organization are shared to provide insight to other sport organizations that engage in evaluation. Findings add to the ongoing work in Canada to support sport organizations in increasing their capacities for effective program evaluation.

University is a pivotal life-course transition in which academic, social and geographic changes intersect with heightened risk for mental disorders and maladaptive behaviors. Health Mode On (HMO) and its longitudinal expansion Health Mode On Plus (HMO+), funded by the Italian Ministry of University and Research (MUR) competitive PRO-BEN 1 and PRO-BEN 2 calls, couple harmonized surveillance with a stepped, integrated model of prevention and care aligned with the World Mental Health-International College Student (WMH-ICS) framework to address fragmentation of campus provision and unmet need. HMO implements a cross-sectional, census-style online survey paired with the implementation of an integrated counseling pathway and a Virtual Academy for staff and student mentors. HMO+ adds 12-month re-contact, objective lifestyle sub-studies, and a strengthened shared digital platform that supports first-contact intake, triage, and orientation to the most appropriate service. Within this framework, students with an anxiety risk profile may be offered participation in an embedded two-arm randomized evaluation of digital cognitive-behavioral therapy (e-CBT) versus counseling-as-usual. The consortium spans five universities, four higher artistic and musical education (AFAM) institutes and one Scuola Superiore Universitaria, in coordination with University Sports Centres (CUS). Primary outcomes are 12-month and lifetime DSM-5 disorder status derived from validated WMH-ICS/CIDI-based modules (mood; anxiety; trauma- and stressor-related; obsessive-compulsive and related; eating; attention-deficit/hyperactivity; and substance use disorders), and safety outcomes (suicidal ideation, planning and non-suicidal self-injury). Secondary outcomes include psychological distress, role impairment, days-out-of-role, sleep, physical activity (accelerometry in subsamples), dietary habits, nicotine and cannabis use, behavioral addictions (e.g., gaming, gambling, internet addiction), social connectedness, academic engagement and service access. Analyses will estimate weighted prevalence and impairment with multilevel models; longitudinal change with mixed-effects models and GEE; and naturalistic program effects using difference-in-differences with propensity-score methods. Ethics approvals will be obtained at the coordinating and partner institutions. GDPR-compliant governance and results' FAIR-oriented sharing are planned, alongside open-access publications, institutional dashboards and policy briefs.

Physical activity (PA) is essential for health and wellbeing, yet participation among women from culturally and linguistically diverse (CALD) backgrounds remains low due to complex, multi-level barriers. Co-design is increasingly recognised as a means of developing culturally relevant and sustainable interventions, but its application within local government-led PA programmes is limited. Guided by the socioecological model (SEM), this study examined how co-design can be operationalised within a local government context to plan and deliver PA opportunities, alongside an exploratory analysis of short-term outcomes. A mixed-method participatory design was conducted across four phases: planning, co-creation, implementation and evaluation. SEM informed identification of barriers and enablers during workshops, while co-design principles guided collaborative strategy development. Data collection included co-design workshops (n = 76 women), pre- and post-intervention surveys (baseline n = 42; follow-up n = 21), a staff focus group and interviews with women (n = 3). Quantitative data were analysed using paired t-tests; qualitative data were thematically analysed to examine co-design processes and participant experiences. Co-design resulted in the development and implementation of culturally relevant programmes including group-based exercise, women's football, netball and water safety, incorporating features such as childcare, safety and opportunities for social connection. Quantitative findings indicated modest increases in PA (+34 min/week, p = 0.25), and improved physical health (p = 0.02). Qualitative findings highlighted outcomes associated with enhanced social connections and sense of empowerment, and the importance of iterative programme adaptation. Integrating SEM and co-design offers a robust framework for addressing multi-level barriers and supporting inclusive PA programmes within local government practice and strengthening community capacity and equity in health. SO WHAT?: These findings provide actionable evidence for local governments seeking to implement inclusive, culturally responsive PA initiatives, positioning co-design as a scalable approach to addressing participation inequities among women from CALD backgrounds.

Mass drug administration (MDA) is a key strategy for controlling schistosomiasis and soil-transmitted helminthiasis in low-resource settings. Assessing its long-term sustainability is important for maintaining and expanding disease control achievements. This study examined the sustainability capacity of Rwanda's MDA program using the Program Sustainability Assessment Tool (PSAT). A mixed-methods approach was used. Twenty-one key informants, including government officials, donors, and local stakeholders, participated in qualitative interviews, and 16 of them also completed the PSAT quantitative survey. Qualitative data were thematically analyzed, while quantitative findings from the survey were used to calculate domain-specific and overall sustainability scores. The overall Rwanda MDA program sustainability score was 3.75 out of 5. Partnerships scored the highest at 4.1, with qualitative data emphasizing strong collaboration among government agencies, international organizations, and community stakeholders. Political support and program evaluation both received a score of 3.9, with qualitative data emphasizing good policy alignment, but some issues with data accuracy. Funding stability was the weakest domain, scoring 3.3, and qualitative data highlighted reliance on external donors. Strategic planning scored 3.5, with qualitative data highlighting limited development of long-term financial strategies and the absence of a dedicated sustainability plan. This assessment revealed a moderate sustainability capacity for the MDA program, characterized by strong political support, active partnerships, and promising adaptations, including the expansion of treatment coverage to adults. However, dependence on donor funding, staffing shortages, and data management issues continue to pose a risk to the program's sustainability. Improving domestic resource allocation, investing in human resources, and strengthening data systems could enhance the program's capacity for sustainability.

Despite the importance of quality improvement in advancing patient care and safety, there is limited literature describing structured, practical, and co-designed quality improvement education. This study aimed to (1) describe how learner co-design was operationalized within Kern's 6-step curriculum development framework to develop a quality improvement workshop for medical students and resident physicians, (2) evaluate preworkshop and postworkshop changes in learners' self-reported understanding of and confidence in quality improvement, and (3) explore participants' attitudes toward quality improvement and their perceptions of the workshop's relevance to future practice. Using Kern's 6-step curriculum development model, informed by Kolb's Experiential Learning Theory, we co-designed a 1-day quality improvement workshop with medical students and resident physicians. To address objective 1, the workshop development process was guided by a literature review and a targeted needs assessment. To address objective 2, we used a mixed methods pre-post educational evaluation design. The workshop incorporated expert-led lectures, small-group project design exercises, and peer presentations addressing audit methodology, ethical considerations, and practical implementation. Preworkshop and postworkshop surveys assessed changes in participants' self-reported understanding of quality improvement concepts, confidence, and attitudes using 10-point Likert scales. Quantitative data were analyzed using the Wilcoxon matched-pairs signed-rank and Fisher exact tests. Semistructured interviews explored participants' experiences and helped to explain their quantitative responses. Interview transcripts were analyzed using thematic analysis. Findings from the literature review and targeted needs assessment identified gaps in practical quality improvement education related to project design, implementation, and ethical considerations, which informed workshop co-design. In total, 31 learners attended the workshop, and 77.4% (24/31) completed preworkshop and postworkshop surveys. There was a significant improvement in participants' understanding of the Plan-Do-Study-Act cycle (preworkshop median score 2.0, IQR 1.0-2.8 vs postworkshop median score 4.0, IQR 4.0-5.0; P<.001). Confidence in engaging in quality improvement projects improved significantly (preworkshop median score 4.5, IQR 2.3-7.0 vs postworkshop median score 7.5, IQR 6.3-8.0; P=.004). Self-reported knowledge of additional methodologies, including Six Sigma, Lean, and root cause analysis, also improved significantly. Participants rated the workshop highly (median score 9.5 out of 10). Qualitative findings indicated that participants perceived improved capability in project planning, greater ethical awareness, and stronger motivation to apply learning in clinical practice. These findings reflect self-reported learning experiences rather than objectively verified skill development. Learner co-design was successfully integrated within Kern's curriculum development framework to develop a practical quality improvement workshop informed by identified learner needs. Participation in the workshop was associated with improved self-reported understanding, confidence, and positive perceptions of relevance and usefulness. Future research should examine longer-term outcomes and evaluate adaptation across broader educational settings.

Rural communities face persistent healthcare barriers related to workforce shortages, geographic isolation, transportation limitations and constrained emergency response capacity. Nurse-led mobile clinics may support healthcare access, continuity of care, and disaster preparedness in underserved settings. This study examined the Texas A&M University (TAMU) nurse-led mobile clinic model with respect to rural service delivery, health equity, operational considerations, and disaster preparedness. A mixed-methods descriptive program evaluation was conducted using programmatic operational data, survey responses, and preparedness-planning records. The TAMU mobile clinic serves six rural counties through primary, preventive, and behavioral healthcare delivery using in-person care, telehealth, and home visits. Disaster preparedness activities were integrated through the annual Disaster Day interprofessional simulation involving approximately 600-700 learners. A 2025 Central Texas flooding event served as a case study to evaluate operational preparedness and system readiness. Mobile clinic operations supported healthcare access, continuity of care, and community engagement in rural settings. Interprofessional education simulation findings demonstrated perceived gains in teamwork, triage, communication, and rapid decision-making. During the 2025 flooding event, activation protocols were initiated; however, deployment was not authorized, highlighting system-level constraints related to administrative approval pathways despite operational readiness and workforce preparedness. Nurse-led mobile clinics may serve as an adaptable infrastructure for improving rural healthcare access, supporting continuity of care, and strengthening disaster preparedness. Findings further emphasize that clinical preparedness alone is insufficient without coordinated administrative processes, interoperable systems, and governance structures capable of supporting rapid emergency deployment.

A program evaluation will be conducted to assess the achievement of African American males at predominantly white institutions (PWIs) by examining how effectively, efficiently, and equitably the Education Opportunity Fund program supports job placement, graduation, and semester-to-semester progress. Since no comprehensive evaluation of the Education Opportunity Fund has been conducted, this plan will provide valuable insights to help practitioners fund, improve, and set meaningful goals for programs serving economically disadvantaged college students in New Jersey. An Education Opportunity Fund Program Planning & Development logic model serves as the main evaluation approach, with a survey as the qualitative and quantitative data collection method to gather information on mentorship, academic counseling, leadership, and/or extracurricular opportunities from Education Opportunity Fund program staff, students, and others. The primary goal of the Education Opportunity Fund is to structure a sustainable cohort model for first-generation students over time within the United States of America. The need for equity and access is important for African American male students who come from educationally and economically disadvantaged backgrounds. This program evaluation plan assesses the support services Education Opportunity Fund offers, including academic tutoring, professional development opportunities, and a 5-week first-year orientation, and whether these resources translate into intergenerational success for the target population.

The objective of this study was to describe the development, implementation, and longitudinal evaluation of a structured, tiered mentorship program within a general surgery residency. This was a single-institution descriptive study using anonymous annual resident surveys conducted from 2024 through 2026. The study was conducted within the General Surgery Residency Program at a tertiary academic training center in Charlotte, North Carolina. General surgery residents participating in a formal mentorship program were surveyed annually. Approximately 32 residents were included each year, with an overall response rate of approximately 70%. Faculty mentorship engagement remained consistently high across all survey years (80%, 92%, and 83%). Most residents reported defined career interests (100%, 86%, and 94%) and access to career mentors (80%, 65%, and 83%). Satisfaction with the mentorship program remained high and stable, with mean satisfaction scores ranging from approximately 3.9 to 4.0. Mentorship was consistently regarded as highly important to surgical training, and most residents reported that the program positively impacted both residency training and career planning. A structured, tiered mentorship program in general surgery residency is feasible, sustainable, and highly valued by trainees. Integration of peer, faculty, career, and alumni mentorship may provide longitudinal support throughout residency training and professional development.

Robust, timely, and decision-oriented surveillance, monitoring, and evaluation (SM&E) systems are fundamental to malaria control and elimination. National household surveys such as the Demographic and Health Surveys (DHS), Malaria Indicator Surveys (MIS), and Multiple Indicator Cluster Surveys (MICS) have historically provided high quality, comparable estimates of malaria burden and intervention coverage. However, substantial recent reductions in global malaria financing have led many endemic countries to delay, scale back, or cancel these surveys, resulting in widening evidence gaps. This perspective paper discusses how malaria programs can adapt by employing a broader set of SM&E approaches. We summarized the use-cases and key considerations of several alternative methodologies, including routine health facility surveillance, first antenatal care visit (ANC1) surveillance, sentinel surveillance systems, Lot Quality Assurance Sampling (LQAS), and targeted cross-sectional surveys, and described how these approaches can reduce reliance on large-scale surveys. While each method has its strengths and limitations, their usefulness depends on the primary SM&E objective, as well as assessing feasibility and data quality, and accounting for transmission setting and representativeness. Routine surveillance remains the central platform for malaria SM&E and should be strengthened to provide quality, continuous, geographically granular insights. Alternative methodologies can add value by validating trends, capturing asymptomatic or non-care seeking infections, or enabling rapid classification against program thresholds where timely decisions are required. To support transparent and context-appropriate method selection, a multidisciplinary taskforce under the Roll Back Malaria Partnership's (RBM) SM&E Working Group developed the SM&E Decision-Support Tool. This tool translates expert consensus and a targeted evidence review into a practical decision tree that aligns methodological options with stated objectives, data availability, and implementation context. It is designed to guide SM&E planning discussions rather than replace feasibility assessments. In conclusion, malaria programs should invest in strengthening routine surveillance systems while adopting a broader, fit-for-purpose portfolio of complementary methodologies tailored to specific decision needs. Further comparative work on costs, feasibility, data quality, and precision levels across settings is needed. Building a stronger evidence base for method selection will help ensure that SM&E strategies remain transparent, appropriate, and sustainable under resource constraints.

Physician burnout and retention are critical challenges in Family Medicine (FM). Professional Identity Formation (PIF) in family physicians (FP) fosters resilience and job satisfaction but is often overlooked in residency training, particularly in predominantly hospital-based programs where residents are disconnected from the primary care community. This qualitative study explored FP PIF in a predominantly hospital-based FM residency program in Singapore and identified factors influencing its development. Individual in-depth semi-structured interviews were conducted with FM residents and post-residency FPs selected through maximum variation purposive sampling. Data was collected and analysed iteratively using Braun and Clarke's reflexive thematic analysis. Cruess et&#xa0;al.'s conceptual model for PIF was used as a sensitising framework, alongside Lankveld et&#xa0;al.'s framework describing psychological processes underlying identity formation. Thirteen participants were interviewed. Three themes were constructed. First, FP PIF wasunderpinned by four psychological 'senses' of competence, connectedness, appreciation, and career trajectory. Second, reflection and socialization drove development of these senses by enabling meaning-making, learning and belonging within the FM community of practice (CoP). Third, residency program features both enabled and/or constrained PIF; while some components scaffolded PIF, more intentional support was needed. PIF is a dynamic, context-dependent psychological process shaped by reflective practice, social participation, and program structure. Intentional support through curriculum design and faculty practices may strengthen PIF. These findings extend existing PIF frameworks and have implications for curriculum design, faculty development, program evaluation, and future research on fostering PIF in hospital-based residency training. This study provides new resident-centered insights on family physician professional identity formation (PIF) in a predominantly hospital-based Family Medicine (FM) residency context.Family physician PIF is formed through developing senses of competence, connectedness, appreciation, and career trajectory, driven by reflection and socialization.FM residency programs can enhance family physician PIF through supportive program features together with faculty development. Program features supportive of PIF include longitudinal clerkships, preceptor roles and structured reflections. Faculty development should be directed at equipping preceptors with the knowledge and skills to facilitate reflection and socialization around PIF.

Educational supervision plays a critical role in enhancing teaching quality, supporting professional development, and improving student learning outcomes. In the Gambia, educational supervision is an important component of school improvement efforts, aimed at ensuring adherence to curriculum standards, promoting effective instructional practices, and strengthening school management. Despite ongoing reforms in the education sector, concerns remain regarding the effectiveness, consistency, and impact of supervision practices across schools. This mini-research study examines educational supervision practices in Gambian schools, focusing on their implementation, effectiveness, challenges, and contributions to teaching and learning quality. The study adopted a qualitative research design based on the review and analysis of secondary data, including government education reports, policy documents, and scholarly literature on educational supervision and school improvement. Relevant sources were systematically reviewed to identify recurring patterns, strengths, and challenges associated with supervision practices in Gambian schools. The findings indicate that educational supervision contributes positively to teacher support, instructional improvement, and school accountability. However, challenges such as limited supervisory resources, insufficient training, high supervisor-to-school ratios, and logistical constraints reduce the effectiveness of supervision activities. Variations in supervision quality between urban and rural schools were also identified. The study concludes that educational supervision remains a valuable mechanism for improving educational quality in The Gambia. Strengthening supervisor capacity, increasing resource allocation, and enhancing monitoring systems can improve the effectiveness of supervision practices and support sustainable school improvement.

Veterans' nursing homes face significant challenges in delivering effective recreational therapy (RT) programs due to complex organizational factors and unique veteran care needs. Limited research has systematically examined organizational determinants from leadership perspectives, despite leaders' critical roles in resource allocation and program implementation. This study examined organizational factors influencing recreational therapy program effectiveness in a veterans' nursing home through comprehensive analysis of leadership perspectives using a mixed-methods approach. A cross-sectional survey was administered to 19 leadership personnel at NYSVETS Home @ Oxford. The 28-question survey assessed RT program effectiveness across five well-being domains, organizational strengths and weaknesses, participation barriers, and leadership involvement patterns. Analysis included descriptive statistics, correlation analysis, and systematic thematic coding of 192 qualitative responses. Leadership rated overall RT program effectiveness highly (78.9%, 95% CI: 60.6-97.3%), with Physical well-being showing the highest impact (3.75&#x2009;&#xb1;&#x2009;0.62, 95% CI: 3.36-4.14) and no significant differences across domains (&#x3c7;&#xb2;&#x2009;=&#x2009;0.563, p&#x2009;=&#x2009;0.967, Kendall's W&#x2009;=&#x2009;0.007). Organizational strengths significantly outweighed weaknesses (U&#x2009;=&#x2009;24.0, p&#x2009;=&#x2009;0.010, effect size r&#x2009;=&#x2009;0.741), with activity variety (89.5%) as the primary asset and resource limitations (52.6%) as the key deficit. Strong positive correlations emerged between engaged veterans and dedicated staff (r&#x2009;=&#x2009;0.782, 95% CI: [0.508, 0.912]). Leadership demonstrated strong mission-vision alignment (76.5%) but involvement intensity showed no significant association with effectiveness (r&#x2009;=&#x2009;0.335, 95% CI: [-0.214, 0.723], p&#x2009;=&#x2009;0.223). A Resource Adequacy Index of 29.7% indicated critical capacity limitations. Qualitative analysis validated quantitative findings, with Social Interaction (40 mentions) and Physical Health (36 mentions) themes supporting effectiveness priorities while revealing veteran-specific challenges including generational preferences for individualized programming. This study provides comprehensive evidence for organizational factors influencing RT effectiveness, demonstrating both program strengths and critical improvement areas. The organizational priority matrix and resource allocation analysis provide evidence-based tools for strategic planning and quality improvement initiatives, informing policy development and practical guidance for healthcare administrators.

Childhood malnutrition among children under five remains a major public health challenge in developing countries, including Nigeria, posing significant long-term health and developmental risks. This study examined the prevalence, related risk factors, and effectiveness of nutritional interventions for children between 0 and 5 years in the Ilorin South Local Government Area of Kwara State, Nigeria. A multi-phase sampling method was employed to select a total of 200 caregiver-child pairs. The study used body measurements and standard questionnaires to assess nutritional status and program participation. Results showed that 13.5% of children were underweight, while 7.5% were overweight and 1.5% were obese. Nutritional deficiencies were significantly associated with economic status, maternal education level, and healthcare access. Evaluation of interventions revealed that the Growth Monitoring and Promotion (GMP) program achieved the highest engagement (60% participation), whereas the Maternal Newborn Child Health Week (MNCHWC) and Accelerating Nutrition Results in Nigeria (ANRiN) programs showed lower levels of participation and perceived effectiveness. In addition, the nutritional counselling and services provided as part of the programs were observed to be the most impactful component for reducing malnutrition among the studied population. Statistically significant correlations were also found between caregivers' composite socio-demographic index and children's nutritional status (p&#x202f;<&#x202f;0.05). To optimize national health outcomes, Nigeria must reform its nutritional framework by strengthening underperforming regional programs and prioritizing community-centred education to ensure more equitable and effective service delivery.