In 2012 the Academy of Nutrition and Dietetics (Academy) and the American Society for Enteral and Parenteral Nutrition (ASPEN) published a consensus statement outlining the clinical characteristics recommended for the diagnosis of adult malnutrition, specifically undernutrition. The Academy and ASPEN recognized the need to standardize the approach to identify, diagnose and document malnutrition. There continues to be growing awareness that malnutrition plays a significant role on health outcomes and on the course of treatment for patients. The high prevalence of malnutrition at hospital admission identifies the need for more awareness, recognition and treatment at an earlier stage, such as primary care or an outpatient setting. The primary objective of this study was to assess the effectiveness of a malnutrition education program implemented in the outpatient clinics at James A. Haley Veterans’ Hospital and Clinics in Tampa, FL. The education program involved hands-on Nutrition Focused Physical Exam Workshop training for outpatient dietitians, education to outpatient dietitians regarding policies and procedures for improved identification and documentation of malnutrition, and education to primary care physicians at a formal staff meeting and team meetings and huddles. The Ambulatory Care Nutrition Section Chief recognized the need for further nutrition focused physical exam (NFPE) training for outpatient dietitians and general malnutrition training to outpatient providers. The interventions implemented as part of the malnutrition education program in the outpatient setting at James A. Haley Veterans’ Hospital and Clinics showed statistically significant, desired outcomes as indicated by improvements in outpatient dietitian confidence levels with performing NFPE and statistically significant associations between fiscal year and presence of malnutrition codes to evaluate effectiveness of training for both dietitians and primary care physicians.

The adult and pediatric healthcare providers at a New England medical center attended simulation training for responding to cardiac arrests that incorporated the current American Heart Association (AHA) evidence-based standards. The purpose of this concurrent mixed method program evaluation was to compare the adult code blue and pediatric team training programs to the AHA's standards and identify if the staff learned the necessary skills to care for patients in cardiac arrest. The conceptual models used for the study were Crisis Resource Management and the transfer of learning model. The study sample was 660 adult and 269 pediatric healthcare providers who participated in both programs between 2012 and 2015. The research questions explored how the adult and pediatric programs compared, if they provided staff with necessary skills to care for cardiac arrests using current standards, and the staff perceptions of program effectiveness and barriers encountered. The data were collected using evaluation and observation forms and needs-assessment surveys. A chi square analysis identified differences between the programs on staff preparedness and transfer of knowledge into practice. The coding of the qualitative data identified themes from the participants' perceptions on program design. Results prompted a program and curriculum redesign to include multiple opportunities to allow staff to learn and practice skills for low volume high acuity situations. The study promotes social change by giving healthcare providers opportunities to translate evidence-based training into clinical practice. The ability to function effectively as a team in a crisis improves patient outcome and potentially reduces mortality and morbidity within the institution and community. Simulation education also improves staff confidence in performance of low volume and high acuity situations.

Teacher education programs focus on preparing teachers to instruct students, but they usually do not focus on preparing teachers to manage students’ behavior, which may prevent teachers from providing effective instruction. This project study evaluated a classroom behavior management model, CHAMPS, designed to help teachers manage student behavior so they can focus their time and energy on instruction and student success. Positive Behavior Systems (PBS), used in the field of behavioral management, served as the theoretical foundation for this study. The evaluation design followed Stufflebeam’s (2003) Context, Input, Process, and Product (CIPP) by employing the outcome-based approach, which evaluated the extent to which a program is meeting predetermined outcomes and objectives. The open-ended research questions explored whether the classroom management system accomplished its goal of guiding teachers in making effective decisions about managing behavior. Data were collected from a researcher-created qualitative questionnaire and phone interviews from a purposeful sample of 7 elementary school teachers who attended all 5 CHAMPS training sessions and who implemented CHAMPS strategies in their classrooms. Qualitative data were open coded and reoccurring themes including connections, support, structure, teach, and model were identified and interpreted for meaning. The findings indicated that CHAMPS, as a model for classroom management, successfully guided these participants in making effective decisions about managing students’ behavior. This study may contribute to a greater understanding of effective classroom management strategies and awareness of classroom behavior management issues for teachers, administrators, and district stakeholders.

This study examined the implementation of the State of Georgia's School Instructional Extension Program (SIEP) at one middle school in a rural school district. SIEP was adopted in this district in an effort to improve outcomes for students who demonstrate deficiencies in core-academic subjects. For the past 2 years, SIEP has been used at this study site to address low academic performance in the area of mathematics. However, to date, school leaders have not developed a system to evaluate the efficacy of the program. The purpose of this project study was to conduct a comprehensive program evaluation that addressed the program's strengths and weaknesses in terms of student achievement. Bandura's self-efficacy theory was used as a theoretical framework. The formative component of the evaluation used a concurrent, mixed-methods design to analyze data from program stakeholders through student surveys (n = 36), teacher surveys (n = 8), and a teacher focus group (n = 5). The summative component used 2 years' scores for the mathematics Georgia Criterion-Referenced Competency Test (GCRCT) to conduct 2-way ANOVAs that compared the SIEP students' mean gains scores to the mean gains score of low-performing students who qualified for SIEP but did not participate in the program. Summative findings indicated that the program did not significantly impact students' mathematics GCRCT gains scores. Moreover, formative data revealed suggestions for the program's insignificant impact including lack of teacher preparation time and program schedule time. Implications for positive social change that should follow program reform include: (a) improving student achievement in mathematics, (b) making evidence-based decisions regarding best practices for teachers, and (c) using data to implement effective academic programs.

An initiative to coordinate early learning programs across a major city in the Midwestern United States was undertaken in 2013. The opinions of teachers regarding effects on instruction and children were not included in the development and implementation of the program. This omission is important because multiple scholars have pointed to the benefits and need of including stakeholders' perspectives in program development. The purpose of this study was to explore preschool teachers' experiences and perspectives of this initiative using a qualitative bounded instrumental case study design. Fullan's theory of educational change served as the framework of this study. Nine preschool teachers, who worked full-time in the Head Start-RTL initiative, volunteered to participate in individual semistructured interviews. Data were analyzed using open coding and thematic analysis. The findings revealed 3 themes: programs and services, initiative administration and processes, and initiative resources. Within each theme, participants identified benefits, challenges, and ideas for improvement, including increased administrative and financial support, streamlined processes, and freedom to individualize curriculum to meet the needs of a diverse student body. It is recommended that teachers' perspectives and their experiences with this initiative be used in planning and implementing changes needed to improve the current program. These endeavors by school district personnel may contribute to positive social change by reducing duplicated administration demands on preschool teachers, who, in turn, could devote more time to instruction and interaction with young children, resulting in improved quality of preschool services and positive outcomes for preschool children and their families.

Brazil has an active agrarian reform policy program, publicly organized by the federal government and publicly administered at the state level by the National Institute for Colonization and Agrarian Reform. The objective of the agrarian reform policy program is to retitle unproductive and underproductive rural lands to increase agricultural production and land use. Previous agrarian reform researchers have examined quantities of land redistributed, rural technology developments, and the impact of social movements on land redistribution, but a knowledge gap remains regarding the correlation of agricultural production yields in rural municipalities before and after policy program participation. The State of Ceará has undertaken continuous land redistribution efforts between 1975 and 2006. For this longitudinal study, an agricultural production yield t-test analysis was conducted for the Brazilian State of Ceará with the marked time-series data collection for 1990, 1996, 2000, and 2006. The research and evaluation of the agrarian reform policy program used publicly available, secondary data from the Government of Brazil's Brazilian Institute of Geography and Statistics and the National Institute of Colonization and Agrarian Reform. The correlated analysis was organized by group: municipalities with a high-rate of agrarian reform participation and municipalities with a no-rate level of agrarian reform participation. By marking the point of program participation at 1996, the time-series t test identified marked agricultural production increases as correlated to agrarian reform policy program participation. The results can be used to justify agrarian reform programs, to promote further rural infrastructure development, and to support poverty alleviation efforts.

Calls continually are made to provide economic assessments of research program achievements and efficiency. Yet little effort has been given to develop an assessment framework that would focus on the research discovery itself, treating the research manager as a producer and the research technology as a knowledge production function. The present dissertation develops such a framework and uses it, with a variety of analytical approaches, to evaluate a two-phase international aquacultural research program consisting of 55 distinct studies. A Bayesian knowledge measure is developed for this purpose, allowing close examination of each of two knowledge creation pathways ��� the extent of new findings (mean surprise) and the extent of uncertainty reduction (precision). Factors affecting each of these two pathways are estimated in decomposed form, their total effects on knowledge achievement then combined to form an aggregate knowledge production function. Team workload, education level, and scientist travel distance strongly affect knowledge creation as postulated, although exhibiting varying effect magnitudes and significances across the two program phases. A research study's analytical approach significantly affects its knowledge acquisition pathways, accounting partially for the newness of its scientific discoveries. Survey studies tend, in contrast, to have greater potential for new findings, but yield greater uncertainty than do experimental studies. In each of the two program phases, fish market trading and water quality are, in my output-elasticities-based approach, respectively the least productive topic area and research-outcome dimension. Asian researchers appear ��� compared to their colleagues in South America and Africa ��� to achieve the highest predictive precision but the least mean surprise, probably because of the greater maturity of their projects. In both program phases, estimated output elasticities imply increasing knowledge returns to scale, although the elasticities decline from 3.52 in Phase I to 1.07 in Phase II. The dual cost function approach provides indirect insight into the program manager���s investment decisions and to the returns to knowledge output, complementing the primal approach. In my cost-based approach, knowledge cost elasticities are below unity, estimated at 0.49 in Phase II and 0.37 in Phase I, consistent with the increasing returns to scale found in the output-elasticities-based approach. Given the increasing returns to scale estimated with both approaches, the aquacultural program appears to have a substantial incentive to enlarge its knowledge investments. Also consistent with duality, the least-output-productive fish-trade topic area, water-quality outcome, and Asian research are found in my cost analysis to be the most cost-consuming. The technical efficiencies of the aquacultural program's individual studies are also examined, relative to both one another and to their own potentially best practices. The examination is conducted using, successively, the Farrell input technical efficiency measure and the directional sum-distance measure. Results are consistent across these two efficiency instruments, confirming the conclusions about output and cost elasticities in the previous chapters and providing a completeness to the overall research evaluation. / Graduation date: 2013 / Access restricted to the OSU Community at author's request from Dec. 27, 2012 - Dec. 27, 2014

There currently exists a challenge in higher education to improve undergraduate education. The development and more adequate preparation of future faculty, who are current graduate students, is one of several options identified as a viable strategy to address this challenge. This dissertation explored the quality of motivation as a factor affecting the preparation or socialization of future faculty at two top-tier universities. The quality of motivation is believed salient to preparation and socialization. This study focused on the motivation types of teaching-focused future faculty preparation program (FFPP) completers, their programmatic experiences, and various personal and social factors, such as gender, program, and academic discipline, as reason for motivation type. This mixed methods research study was based on the tenets of self-determination theory and revealed quantitatively, through inferential statistics, that a significant difference exists in the motivation type of participants based on gender, program, and academic discipline. Qualitative findings, from focus group interviews, were that FFPP design characteristics included elements to satisfy the innate psychological need for competence but fell short in meeting the need for relatedness. The findings offer insights into aspects that affect the quality of motivation in program participants. They also suggest that in order to more adequately prepare and socialize future faculty, consideration must be given to the importance of satisfying innate psychological needs in an effort to enhance the quality of participant motivation. Both findings support the importance of relatedness in affecting the quality of motivation. The findings of this study support the notion that certain demographic or contextual factors, as well as the satisfaction of innate psychological needs are critical to motivation quality, internalization, behavior, and socialization. The results of this study will contribute to program developers' awareness of motivation quality and its effect on behavior to enhance the design of teaching-focused future faculty preparation programs and socialization. Through the use of motivation quality, this study serves as a catalyst for the more adequate preparation of future faculty to improve undergraduate education.

The purpose of this study was to propose and evaluate a procedure for revising an existing self-administered survey that is in need of item revision and/or scale reduction while maximizing validity and reliability. The procedure was demonstrated using the Client Evaluation of Self and Treatment (CEST; Joe, Broome, Rowan-Szal, & Simpson, 2002), a self-administered survey used in drug and alcohol treatment agencies. The procedure included confirmatory and exploratory factor analyses of a large dataset of completed CEST surveys, a readability analysis, and cognitive interviewing of two different groups of respondents to determine what problems they might have with CEST items. The cognitive interviewing revealed a number of issues that led to confusion among respondents, including items with two distinct concepts embedded, items containing absolutes and vague qualifiers, misinterpreted items, and terms and phrases respondents had difficulty understanding. The CEST was also judged to be long and potentially burdensome to respondents. Based on the results of this evaluation, a new survey—the Brief Assessment of Self in Context (BASIC)—also intended for use by substance abuse treatment providers, was constructed. First, factor analyses of the CEST and advice from an expert panel were used to determine which scales to retain. Next, quantitative analyses and cognitive interviewing helped determine which CEST items to retain and which to revise. Readability, sound item writing principles, and response format and scale requirements were also used to determine which items to include in the initial draft of the BASIC and guided item construction when needed. After the panel of experts provided feedback on the first revision, a final draft was prepared. Another round of cognitive interviewing was followed by administration of the final draft of the survey to a representative sample. The results indicated that the BASIC’s items are clear, unambiguous, and easy to interact with and understand, and that the instrument is an improvement over the CEST. In brief, the procedure demonstrated in this study produced a psychometrically sound instrument composed of items that are easy for respondents to access. / text

Objective: This thesis aimed to advance the study of sustainability through the exploratory use of a conceptual framework for the investigation of a collaborative project. Methods: A qualitative case study design, utilizing document analysis and key informant interviews, was used to conduct a three-year follow-up of a collaborative mental health project. The study design and directed content analysis were informed by the Scheirer and Dearing (2011) conceptual framework. Results: The sustained outcomes identified by the six participating agencies included: institutionalized project components, maintained client benefits, continued collaboration and sustained attention to the issue. The sustainability of project components was associated with complex interactions between the innovation, organization, and community factors investigated. Conclusions: The study illustrated the importance of evaluating multiple aspects of sustainability to fully capture a project’s long-term effect. Complex systems theory was proposed to describe the interactions observed and as a direction for further development of the conceptual framework.