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Challenges and facilitators to building program evaluation capacity among community-based organizations.

We have been collaborating with many community-based organizations (CBOs) to increase their capacity to implement our evidence-based HIV prevention intervention. A frequent issue in these collaborations is how CBOs can evaluate their implementation of the intervention using feasible and sound methods. This study sought to provide the foundation for evaluation recommendations, tools, training, and technical assistance to help CBOs build their evaluation capacity. We conducted a qualitative study of 21 CBOs, 12 funders, and 11 technical assistance providers regarding beliefs and attitudes about evaluation, preferences and requirements for evaluation, evaluation methods that are currently being used at CBOs, and recommendations regarding feasible and effective evaluation that CBOs can use. The themes that arose in the telephone interviews are organized around three major topics: facilitators and barriers to conducting evaluation, evaluation methods that CBOs use, and how to increase CBOs' capacity to conduct evaluations.

Community Health Services↗

A moral imperative to improve the quality of work-life for nurses: building inclusive social capital capacity.

The complexity and incessant change in the corporatised health care workplace has influenced nurses' work choices, morale, quality of work-life and the wellbeing of patients. Thus, there is an urgent moral imperative to improve the quality of work-life for nurses. To this end, it is crucial to re-define progress beyond the sole economic markers of success and profit in the health care workplace. This paper argues for the identification of ethical markers and indicators of organisational success based on bridging and linking social capital which could be used to re-organise health care organisations, hence crafting inclusive moral spaces where nurses can safely work and provide quality care for patients. Social and ethical evaluation is well suited to examine current workplace dilemmas from a psychosocial perspective and provide a framework for best practice in building capacity in effective social relations and family friendly, ethical workplaces.

Attitude of Health Personnel↗

Developing community capacity and improving health in African American communities.

Community-based programs have produced mixed results. Community capacity is thought to be a major determinant of program effectiveness. Thus, enhancing community capacity may increase the beneficial effects of existing programs and enhance future program effectiveness. This highlights the need to focus on understanding the components of capacity and the methods of enhancing capacity. Although we are just beginning to examine and understand key concepts, community capacity is probably influenced by both relatively nonmodifiable characteristics (such as demographic factors, institutional resources, and social structures) and relatively modifiable characteristics (such as knowledge, skills, and the ability and willingness of members and agencies to work collaboratively). In their relationships with community members and agencies, academicians and public health practitioners may help acquire categorical funding to enhance opportunities to build community capacity and their own capacity as well. The relationship between academicians/practitioners and community members/agencies probably is influenced by a host of characteristics which determine the degree to which capacity can be built. This paper discusses: the key components of capacity; the factors that influence building capacity through collaborations; a community health advisor (CHA) model which both builds on sociocultural aspects of African American culture and is consistent with methods for building community capacity; and how modifications to this model allow it to be compatible with categorically funded projects.

Black or African American↗

Developing community capacity and improving health in African American communities.

Community-based programs have produced mixed results. Community capacity is thought to be a major determinant of program effectiveness. Thus, enhancing community capacity may increase the beneficial effects of existing programs and enhance future program effectiveness. This highlights the need to focus on understanding the components of capacity and the methods of enhancing capacity. Although we are just beginning to examine and understand key concepts, community capacity is probably influenced by both relatively nonmodifiable characteristics (such as demographic factors, institutional resources, and social structures) and relatively modifiable characteristics (such as knowledge, skills, and the ability and willingness of members and agencies to work collaboratively). In their relationships with community members and agencies, academicians and public health practitioners may help acquire categorical funding to enhance opportunities to build community capacity and their own capacity as well. The relationship between academicians/practitioners and community members/agencies probably is influenced by a host of characteristics which determine the degree to which capacity can be built. This paper discusses: the key components of capacity; the factors that influence building capacity through collaborations; a community health advisor (CHA) model which both builds on sociocultural aspects of African American culture and is consistent with methods for building community capacity; and how modifications to this model allow it to be compatible with categorically funded projects.

Black or African American↗

Building the analytic capacity of the State Maternal and Child Health workforce--a history of the HRSA/MCHB Academic Partnership.

The Maternal and Child Health Bureau of the Health Resources and Services Administration (HRSA) in conjunction with Schools of Public Health has sponsored a variety of graduate education and continuing education initiatives during the last 15 years aimed at enhancing the analytic capacity of the maternal and child health (MCH) workforce. These initiatives are described, with lessons learned as well as recommendations for future efforts provided.

Child↗

Building academic geriatric capacity: an evaluation of the John A. Hartford Foundation Centers of Excellence initiative.

Almost 15 years ago, the John A. Hartford Foundation began its Centers of Excellence (CoE) program. In summer 2002, a quantitative and qualitative evaluation of the CoE program was conducted. The evaluation used previously collected quantitative data from surveys of program directors and graduates of fellowship programs, as well as interviews and surveys of currently funded CoEs. Since its inception, the CoE program has supported 163 geriatrics fellows, of whom 63% entered academic geriatrics. Almost half of these graduating fellows have gone to new academic institutions. CoEs have also supported 222 faculty, including some who were in disciplines other than geriatrics. The vast majority (82%) have remained in academics, and nearly two-thirds are currently in geriatrics. As the priorities and needs of the institutions and geriatrics programs changed, most centers shifted their CoE priorities. These changes predominantly took two forms: a refocus from one activity to another or an expansion of outreach or levels of support. Based upon this formal evaluation, the Hartford-supported CoE program has been successful in strengthening academic geriatrics, particularly in attracting, developing, and retaining geriatrics faculty.

California↗

ITREOH building of regional capacity to monitor recreational water: development of a non-commercial microcystin ELISA and its impact on public health policy.

In 2001, a University of California, Davis-University of the Republic, Montevideo, partnership created a Fogarty ITREOH program to exploit the potential of ELISA to provide a low-cost environmental analysis attractive to economically distressed countries of temperate South America. This paper describes the development and validation of an ELISA method for the determination of Cyanobacteria microcystin toxins in algal blooms, which release hepatotoxic metabolites that can reach toxic levels in rivers, lakes, or coastal estuaries used for recreation or water supplies. The assay made possible the first systematic monitoring of water from the Rio de la Plata at Montevideo over two summers. The project has been integrated into a bi-national effort to monitor the Rio de la Plata.

Bacterial Toxins↗

Participatory supervision model: building health promotion capacity among health officers and the community.

INTRODUCTION: The Thai traditional health supervision model has been developed since 1991. However, many supervisors lack supervisory knowledge and skills. This study aimed to compare and identify the strengths and challenges of two different supervision models, in order to determine their effects on enhancing the health promotion capacity of health officers in two primary care units (PCU) in Chiang Mai Province, northern Thailand. METHODS: The two models were implemented at two PCU in one semi-district, Chiang Mai Province, over a six-month period. The first model involved supervisors from the district level, with the full participation of health officers at the sub-district level. The second model was designed with the addition of community involvement in the supervision process. Before implementing the models, the district supervisors attended a retraining course to enhance their supervisory knowledge and ability. Questionnaires were used to assess health officers' job satisfaction, clients' perceived service quality and care satisfaction. Semi-structured interviews and qualitative observations were used to explore the involvement of health officers and the community, and to determine the strengths and challenges of each supervisory model. RESULTS: Both before and after the intervention, the PCU health officers appeared to have good and comparable job satisfaction levels. Bivariate analysis indicated that after the intervention, both supervisory models appeared effective in terms of clients' perceived service quality and satisfaction with care, among those who utilized the PCU. However, the second model, which allowed the community to participate in the supervision process, achieved better results. The qualitative findings suggested that the involvement of health officers caused a rapid change and improvement after the supervision. The involvement of the community helped the community itself to identify problems and formulate alternatives to meet the community's needs. CONCLUSIONS: This study shows positive outcomes for two forms of participatory supervision in a rural setting. There appear to be additional positive outcomes for the model that involved community participation. To ensure successful implementation, several issues, such as the supervisor's knowledge and ability, health officer workload and supervisory communication skills, need to be improved.

Adult↗