Process evaluation of intervention program for prevention of early sexual activity and alcohol use among Hispanic teenagers

Hispanic teens are a high-risk population for initiation of early sexual activity and alcohol use which in turn has numerous social and health consequences. One strategy to address prevention of these behaviors is to implement a capacity building intervention that promotes parent child communication, encompasses their cultural values and community participation. This study describes the process evaluation of a pilot intervention program amongst Hispanic teens and their families living along the Texas-Mexico border. “Girls Lets Talk” is a small group intervention with 10-14 year old teens and their female adult family members that involves education regarding effects of alcohol use and sexual activity as well as activities for monitoring and refusal skills to prevent risky behaviors. Two waves of the program each consisting of at least seven mother daughter dyads were conducted. During the designing process, community advisory board meetings and focus groups were held to review course materials and ensure they were appropriate to the Mexican American culture. Parent and adolescent surveys were administered at the beginning and end of the intervention to assess for psychosocial outcome variables. All sessions received high mean satisfactory scores (mean of 4.00 or better on a five point scale) for both adult and adolescent participants. Qualitative feedback was obtained via debriefing sessions to evaluate experience as well as alter recruitment strategies. A Wilcoxon Sign Rank analysis of the pre and post intervention surveys was done that showed significant changes in some outcome variables such as intentions and confidence for monitoring behaviors for adults and beliefs regarding sexual activity. “Girls Lets Talk” is a promising example of how a process evaluation plan can help develop a theory based health promotion program using the community based participatory research approach. The intervention may also be effective in altering intentions and enhancing self-efficacy among parents and teens in order to decrease risky behaviors such as early sexual activity and alcohol use.^

Maternal Role & High-Risk Pregnancy Experience with Antepartum Hospitalization

Purpose. The focus of maternal role development, historically, has been on the tasks and processes during pregnancy as they relate to postpartum role transition. The purpose of this study was to investigate how women hospitalized with high-risk pregnancy cognitively construct pregnancy and impending motherhood. ^ Design. The study employed a triangulation design using a convergence model with a dominant focused ethnographic approach. ^ Setting. The antepartum units of two tertiary care centers in a large metropolitan city in southeast Texas. ^ Sample. Data saturation was determined with thirteen (13) primigravid women who had been hospitalized more than 72 hours with preterm labor (PTL) or preterm premature rupture of membranes (PPROM) who subsequently delivered seventeen (17) infants which included 4 sets of twins. ^ Methods. Open-ended, semi-structured interviews and field work were used to explore the development of maternal role in this population. After collecting descriptive data, long individual interviews were conducted and the Prenatal Self Evaluation Questionnaire (PSEQ), an instrument to measure prenatal adaptation to pregnancy, was administered. The interview focused on exploring the woman's experiences of pregnancy and impending motherhood while hospitalized. Interview data and field notes were coded and analyzed using qualitative thematic analytic techniques. The PSEQ was scored and the findings of the qualitative data and PSEQ data were compared. ^ Findings. Thematic analysis of the qualitative data provided an understanding of the cognitive process that occurs as the pregnant woman builds a relationship with the fetus. Thematic analysis resulted in a conceptual model with two complementary components that occur throughout the pregnancy: Establishing a Relationship and Dynamic Equilibrium. Establishing a Relationship includes subthemes of: Courting, Building a Connection, and Engagement. Dynamic equilibrium is the balance between expectations and reality and exists regardless of pregnancy complications. The negotiation of this potential imbalance is triggered by uncertainty, loss of autonomy and control, and isolation and is exacerbated by the high-risk pregnancy and subsequent hospitalization. These triggers can serve as obstacles to maternal role development, but may be mediated by external support from friends and family or health care providers. Support from others may come in the form of anticipatory guidance, presence, or activities that promote self-agency. PSEQ scores were similar to previous reports, but due to the small sample, scores were used primarily for comparison to qualitative data. The qualitative findings were congruent with the PSEQ findings in all of the subscales except in the concern for the well-being of the baby. Interview reports included comments demonstrating significant concern for the well-being of the infant, yet the related subscale did not demonstrate such concern. ^ Conclusions. An understanding of the cognitive process involved in establishing a relationship with the developing fetus related to impending motherhood and the importance of dynamic equilibrium can allow healthcare providers and those who interact with pregnant women to support development of the maternal role and anticipate those barriers that may impede that process. Findings from this study identify those triggers and mediators that influence development of the maternal role and suggest potential intervening strategies for those involved in the care of childbearing families. ^

A practice-based culminating experience: Writing a HRSA grant application with Texas Organ Sharing Alliance for public education efforts to increase solid organ donation

In November 2010, nearly 110,000 people in the United States were waiting for organs for transplantation. Despite the fact that the organ donor registration rate has doubled in the last year, Texas has the lowest registration rate in the nation. Due to the need for improved registration rates in Texas, this practice-based culminating experience was to write an application for federal funding for the central Texas organ procurement organization, Texas Organ Sharing Alliance. The culminating experience has two levels of significance for public health – (1) to engage in an activity to promote organ donation registration, and (2) to provide professional experience in grant writing. ^ The process began with a literature review. The review was to identify successful intervention activities in motivating organ donation registration that could be used in intervention design for the grant application. Conclusions derived from the literature review included (1) the need to specifically encourage family discussions, (2) religious and community leaders can be leveraged to facilitate organ donation conversations in families, (3) communication content must be culturally sensitive and (4) ethnic disparities in transplantation must be acknowledged and discussed.^ Post the literature review; the experience followed a five step process of developing the grant application. The steps included securing permission to proceed, assembling a project team, creation of a project plan and timeline, writing each element of the grant application including the design of proposed intervention activities, and completion of the federal grant application. ^ After the grant application was written, an evaluation of the grant writing process was conducted. Opportunities for improvement were identified. The first opportunity was the need for better timeline management to allow for review of the application by an independent party, iterative development of the budget proposal, and development of collaborative partnerships. Another improvement opportunity was the management of conflict regarding the design of the intervention that stemmed from marketing versus evidence-based approaches. The most important improvement opportunity was the need to develop a more exhaustive evaluation plan.^ Eight supplementary files are attached to appendices: Feasibility Discussion in Appendix 1, Grant Guidance and Workshop Notes in Appendix 2, Presentation to Texas Organ Sharing Alliance in Appendix 3, Team Recruitment Presentation in Appendix 5, Grant Project Narrative in Appendix 7, Federal Application Form in Appendix 8, and Budget Workbook with Budget Narrative in Appendix 9.^

Use of a modified delphi process for establishing occupational exposure limits in support of health surveillance for space travelers

On-orbit exposures can come from numerous factors related to the space environment as evidenced by almost 50 years of environmental samples collected for water analysis, air analysis, radiation analysis, and physiologic parameters. For astronauts and spaceflight participants the occupational exposures can be very different from those experienced by workers performing similar tasks in workplaces on Earth, because the duration of the exposure could be continuous for very long orbital, and eventually interplanetary, missions. The establishment of long-term exposure standards is vital to controlling the quality of the spacecraft environment over long periods. NASA often needs to update and revise its prior exposure standards (Spacecrafts Maximum Allowable Concentrations (SMACs)). Traditional standards-setting processes are often lengthy, so a more rapid method to review and establish standards would be a substantial advancement in this area. This project investigates use of the Delphi method for this purpose. ^ In order to achieve the objectives of this study a modified Delphi methodology was tested in three trials executed by doctoral students and a panel of experts in disciplines related to occupational safety and health. During each test/trial modifications were made to the methodology. Prior to submission of the Delphi Questionnaire to the panel of experts a pilot study/trial was conducted using five doctoral students with the goals of testing and adjusting the Delphi questionnaire to improve comprehension, work out any procedural issues and evaluate the effectiveness of the questionnaire in drawing the desired responses. The remainder of the study consisted of two trials of the Modified Delphi process using 6 chemicals that currently have the potential of causing occupational exposures to NASA astronauts or spaceflight participants. To assist in setting Occupational Exposure Limits (OEL), the expert panel was established consisting of experts from academia, government and industry. Evidence was collected and used to create close-ended questionnaires which were submitted to the Delphi panel of experts for the establishment of OEL values for three chemicals from the list of six originally selected (trial 1). Once the first Delphi trial was completed, adjustments were made to the Delphi questionnaires and the process above was repeated with the remaining 3 chemicals (trial 2). ^ Results indicate that experience in occupational safety and health and with OEL methodologies can have a positive effect in minimizing the time experts take in completing this process. Based on the results of the questionnaires and comparison of the results with the SMAC already established by NASA, we conclude that use of the Delphi methodology is appropriate for use in the decision-making process for the selection of OELs.^

Improving disclosure of medical errors: Including patients and family members in the disclosure process

Over the last decade, adverse events and medical errors have become a main focus of interest for the standards of quality and safety in the U.S. healthcare system (Weinstein & Henderson, 2009). Particularly when a medical error occurs, the disclosure of medical errors and its practices have become a focal point of the healthcare process. Patients and family members who have experienced a medical error might be able to provide knowledge and insight on how to improve the disclose process. However, patient and family member are not typically involved in the disclosure process, thus their experiences go unnoticed. ^ The purpose of this research was to explore how best to include patients and family members in the disclosure process regarding a medical error. The research consisted of 28 qualitative interviews from three stakeholder groups: Hospital Administrators, Clinical Service Providers, and Patients and Family Members. They were asked for their ideas and suggestions on how best to include patients and family members in the disclosure process. Framework Analysis was used to analyze this data and find prevalent themes based on the primary research question. A secondary aim was to index categories created based on the interviews that were collected. Data was used from the Texas Disclosure and Compensation Study with Dr. Eric Thomas as the Principal Investigator. Full acknowledgement of access to this data is given to Dr. Thomas. ^ The themes from the research revealed that each stakeholder group was interested and open to including patients and family members in the disclosure process and that the disclosure process should not be a "one-way" avenue. The themes gave many suggestions regarding how to best include patients and family members in the disclosure process of a medical error. Secondary aims revealed several ways to assess the ideas and suggestion given by the stakeholders. Overall, acceptability of getting the perspective of patients and family members was the most common theme. Comparison of each stakeholder group revealed that including patients and family members would be beneficial to improving hospital disclosure practices. ^ Conclusions included a list of recommendations and measureable appropriate strategies that could provide hospital with key stakeholders insights on how to improve their disclosure process. Sharing patients and family members experience with healthcare providers can encourage a shift in culture where patients are valued and active in participating in hospital practices. To my knowledge, this research is the very first of its kind and moves the disclosure process conversation forward in a patient-family member inclusion direction that will assist in improving disclosure practices. Future research should implement and evaluate the success of the various inclusion strategies.^

Key Factors to Successful Community Development: The Korean Experience

The Saemaul Undong of the Republic of Korea has been world-widely recognized as a successful model of rural community development. The Saemaul Undong was a pure Korean way of community development program which was initiated by the political will of the top national leadership in order to escape from poverty. There are several key factors to the success of the Saemaul Undong. First, the national government's guidance and support for the movement played a very important role in the whole period of the movement. Second, there was a wide range of people's participation in the implementation process. Third, the Saemaul Undong could make a big success by nurturing community leadership which was selected by rural residents themselves. Finally, as a movement for the spiritual reform, the Saemaul Undong imbued the people with the spirits of diligence, the self-reliance, and cooperation.

Case Study of Applied LIP Approach/Activities in the Philippines The Training Services Enhancement Project for Rural Life Improvement (TSEP-RLI) Experience

TSEP-RLI was a technical cooperation project jointly conducted by GOP thru DA-Agricultural Training Institute (ATI) and GOJ thru JICA aimed at institutionalizing the training program for Rural Life Improvement (RLI) at the (ATI). As expected, farmers, fisherfolk, women, youth and extension agents were provided with efficient and effective training services from ATI leading to the improvement of quality of life in the rural areas through efforts of human resource development. The ATI- Bohol was chosen as the model center where participatory trials and various activities of the project were undertaken for five years. These activities were participatory surveys and data collection of on-farm and off-farm productive activities; planning workshop for RLI; feedbacking of survey results and action plans to the community and the Local Government Units (LGUs), and signing of Memorandum of Agreement between the Project and participating LGUs. The above activities were done to facilitate the planning and development of most effective and necessary rural life improvement activities, to confirm the willingness of the people to support and participate and to formalize the partnership between the Project and the LGUs. Since the concept of rural life covers a vast range of activities, a consensus had been reached that the total aspects of rural life be grasped in three spheres, namely, Production & Livelihood (P/L), Rural Living Condition (RLC) and Community Environment (C/E). The RLI for Ubi (Yam) Growers was one of the pilot activities undertaken in two pilot barangays and the target beneficiaries were members of the Rural Improvement Club (RIC- a group of organized women) with the LGU of the Municipality of Corella as the implementing partner. During the planning workshop, the barangay residents articulated their desire to promote production and processing of ubi (sphere on P/L - as the entry point), lack of nutritious food was one of the identified problem (sphere on RLC- expansion point) and environmental degradation such as deforestation, and soil erosion was another problem articulated by the community people (sphere on C/E- expansion point). Major activities that were undertaken namely, Ubi cooking contest, cooking/processing seminar, training courses on entrepreneurial development, ubi production and storage technology, packaging and product design, human resource development and simplified bookkeeping motivated the beneficiaries as well as developed and enhanced their skills & capabilities while strengthening their associations. Their participation to the 5 ubi festivals and other related activities had brought some impacts on their economic and rural life improvement activities. The seven principles of TSEP-RLI include the participatory process, holistic approach, dialogical approach, bottom -up training needs assessment, demand-driven approach, cost sharing approach and collaborative implementation with other agencies including LGUs and the community.

La Práctica del Desarrollo Local: Veinticinco Años de Experiencia del Instituto de Desarrollo Comunitario de Cuenca en Territorios Rurales

La investigación tiene como objetivo principal analizar la experiencia de la Asociación Instituto de Desarrollo Comunitario de Cuenca, en la práctica del desarrollo local en los territorios rurales de esta provincia. La necesidad de estimular a la población para que ésta forme parte de su propio desarrollo, pone de manifiesto la existencia de determinadas instituciones externas que a través de procesos como la facilitación, movilizan y crean capacidades en las personas y las empujan hacia la participación. Este es el caso del IDC de Cuenca que nace en 1985 como entidad privada —declarada de utilidad pública y sin ánimo de lucro—, con la voluntad de sus fundadores de trabajar en el desarrollo local de las zonas deprimidas de Cuenca. La labor desarrollada en estos más de 25 años tiene como centro la promoción de la persona como ser individual y como parte de su comunidad. Para la elaboración de la Tesis, se ha utilizado la metodología del caso de estudio centrado en el análisis de la experiencia del IDC respecto de las cuatro investigaciones realizadas centradas en el proceso de facilitación, las herramientas de formación e información, y la dinamización del tejido asociativo como resultado del proceso. La labor del IDC en la provincia de Cuenca se ha desarrollado a través de la ejecución de proyectos. Éstos se han llevado a cabo por medio de procesos de facilitación donde la creación de grupos de trabajo ha permitido mejorar la estructuración social de las zonas rurales. Los grupos de trabajo son creados y apoyados por el IDC a través de la utilización de las herramientas de información y formación, que deben estar adaptadas a las necesidades de los individuos y en este caso cuentan con una metodología de aplicación propia. La creación de diferentes entidades —asociaciones, cooperativas, clubes, etc.—, ha sido uno de los resultados del trabajo desarrollado por el IDC a través de los procesos de facilitación que han mejorado la estructuración de la sociedad rural. Pese a la complejidad tanto de los procesos de desarrollo como de la evaluación final de dichos procesos, la creación de grupos capaces de alcanzar determinados objetivos propuestos en su comunidad potenciando sus propios recursos, son el ejemplo de la dinamización social que se lleva produciendo en la provincia de Cuenca desde hace más de 25 años. The research's main objective is to analyze the experience of the Asociación Instituto de Desarrollo Comunitario de Cuenca, in the practice of local development in rural areas of this province. The need to encourage more people to take part of their own development, reveals the existence of certain external institutions which through processes such as facilitation, mobilize and create capacities in people to foster their participation. This is the case of the IDC of Cuenca that was born in 1985 as a private entity —declared of public utility and as non profit entity— with the intention, as stated by its founders, of working in the local development of the disadvantaged areas of Cuenca. The work carried out in these more than 25 years focused on promoting the person as an individual and as part of their community. In this research, the methodology of the case study has been used in the analysis of the experience of the IDC in four investigations carried out regarding the process of facilitation, training and information tools, and the improvement of social involvement as a result of the development process. The work of the IDC in the province of Cuenca has been developed through the implementation of projects. They have been carried out through processes of facilitation, where the creation of working groups has improved the social structuring of rural areas. The working groups are created and supported by the IDC through the use of tools of information and training, which must be adapted to the individual needs in each case, and even count with their own implementation methodology. The creation of different entities —associations, cooperatives, clubs, etc.— has been one of the results of the work carried out by the IDC through processes of facilitation which have improved the structure of rural society. Despite the complexity of development processes and the final assessment of these processes, the creation of groups able to reach certain objectives proposed in their community promoting its own resources, is an example of the social involvement that has been taking place in the province of Cuenca for more than 25 years.

Work in progress - Exploiting videoconferencing possibilities to promote the European convergence process

This paper introduces the experience of using videoconferencing and recording as a mechanism to support courses which need to be promoted or discontinued within the framework of the European convergence process. Our objective is to make these courses accessible as live streaming during the lessons as well as recorded lectures and associated documents available to the students as soon as the lesson has finished. The technology used has been developed in our university and it is all open source. Although this is a technical project the key is the human factor involved. The people managing the virtual sessions are students of the courses being recorded. However, they lack technical knowledge, so we had to train them in audiovisuals and enhance the usability of the videoconferencing tool and platform. The validation process is being carried out in five real scenarios at our university. During the whole period we are evaluating technical and pedagogical issues of this experience for both students and teachers to guide the future development of the service. Depending on the final results, the service of lectures recording will be available as educational resource for all of the teaching staff of our university.

Usability Planner: A Tool to Support the Process of Selecting Usability Methods

There is increasing pressure on developers to produce usable systems, which requires the use of appropriate methods to support user centred design during development. There is currently no consistent advice on which methods are appropriate in which circumstances, so the selection of methods relies on individual experience and expertise. Considerable effort is required to collate information from various sources and to understand the applicability of each method in a particular situation. Usability Planner is a tool aimed to support the selection of the most appropriate methods depending on project and organizational constraints. Many of the rules employed are derived from ISO standards, complemented with rules from the authors’ experience.

Assessment of work performed by paired students: a pedagogical experience

“Teamwork” is one of the abilities most valued by employers. In [16] we describe the process of adapting to the ECTS methodologies (for ongoing assessment), a course in computer programming for students in a technical degree (Marine Engineering, UPM) not specifically dedicated to computing. As a further step in this process we have emphasized cooperative learning. For this, the students were paired and the work of each pair was evaluated via surprise tests taken and graded jointly, and constituting a substantial part of the final grade. Here we document this experience, discussing methodological aspects, describing indicators for measuring the impact of these methodologies on the educational experience, and reporting on the students’ opinion of it.

Student Reciprocal Peer Teaching as a Method for Active Learning: An Experience in an Electrotechnical Laboratory

Active learning is one of the most efficient mechanisms for learning, according to the psychology of learning. When students act as teachers for other students, the communication is more fluent and knowledge is transferred easier than in a traditional classroom. This teaching method is referred to in the literature as reciprocal peer teaching. In this study, the method is applied to laboratory sessions of a higher education institution course, and the students who act as teachers are referred to as ‘‘laboratory monitors.’’ A particular way to select the monitors and its impact in the final marks is proposed. A total of 181 students participated in the experiment, experiences with laboratory monitors are discussed, and methods for motivating and training laboratory monitors and regular students are proposed. The types of laboratory sessions that can be led by classmates are discussed. This work is related to the changes in teaching methods in the Spanish higher education system, prompted by the Bologna Process for the construction of the European Higher Education Area

Information as a Key Tool for Rural Development. 25 Years of Experience in Spain

The lack of useful information has become a major obstacle that hinders the participation of the members of the community in the development process because they can not accurately perceive how their individual and/or collective action can influence their environment, and because of the lack of elements that support the decision-making processes. This article addresses these issues from the work carried out by the Association Instituto de Desarrollo Comunitario de Cuenca (IDC Cuenca) in the rural areas of this province of Spain for 25 years. The results show how the application of methodologies for the transmission of information tailored to each group of recipients in some aspects, enhances the participation of individuals.

On track for solar grade silicon through a siemens process-type laboratory reactor: operating conditions and energy savings

Polysilicon cost impacts significantly on the photovoltaics (PV) cost and on the energy payback time. Nowadays, the besetting production process is the so called Siemens process, polysilicon deposition by chemical vapor deposition (CVD) from Trichlorosilane. Polysilicon purification level for PV is to a certain extent less demanding that for microelectronics. At the Instituto de Energía Solar (IES) research on this subject is performed through a Siemens process-type laboratory reactor. Through the laboratory CVD prototype at the IES laboratories, valuable information about the phenomena involved in the polysilicon deposition process and the operating conditions is obtained. Polysilicon deposition by CVD is a complex process due to the big number of parameters involved. A study on the influence of temperature and inlet gas mixture composition on the polysilicon deposition growth rate, based on experimental experience, is shown. Moreover, CVD process accounts for the largest contribution to the energy consumption of the polysilicon production. In addition, radiation phenomenon is the major responsible for low energetic efficiency of the whole process. This work presents a model of radiation heat loss, and the theoretical calculations are confirmed experimentally through a prototype reactor at our disposal, yielding a valuable know-how for energy consumption reduction at industrial Siemens reactors.

Providing 3D video services: the challenge from 2D to 3DTV quality of experience

Recently, three-dimensional (3D) video has decisively burst onto the entertainment industry scene, and has arrived in households even before the standardization process has been completed. 3D television (3DTV) adoption and deployment can be seen as a major leap in television history, similar to previous transitions from black and white (B&W) to color, from analog to digital television (TV), and from standard definition to high definition. In this paper, we analyze current 3D video technology trends in order to define a taxonomy of the availability and possible introduction of 3D-based services. We also propose an audiovisual network services architecture which provides a smooth transition from two-dimensional (2D) to 3DTV in an Internet Protocol (IP)-based scenario. Based on subjective assessment tests, we also analyze those factors which will influence the quality of experience in those 3D video services, focusing on effects of both coding and transmission errors. In addition, examples of the application of the architecture and results of assessment tests are provided.