Esta pesquisa teve por objetivo a integralidade do cuidado ao portador de transtorno mental na Estratégia Saúde da Família (ESF). Foi realizado um estudo de caso, sendo este desenvolvido a partir de uma adaptação da avaliação proposta de Estrutura, Processo e Resultado de Donabedian (1984), com abordagem qualitativa dos dados. Para coleta de dados foi utilizado: observação e entrevista semi-estruturada. O estudo foi realizado no município de Chapecó- SC, região oeste do Estado de Santa Catarina. Foi selecionada uma Unidade de Saúde da Família da área urbana, com maior tempo de implantação dentre as pesquisadas, com equipe completa de acordo com as propostas e normas do Ministério da Saúde e com maior vulnerabilidade social da área adscrita. Os critérios utilizados para realizar a avaliação estão fundamentados nas respectivas publicações ministeriais: Plano Nacional de Inclusão das Ações de Saúde Mental na Atenção Básica, Manual de Estrutura Física das Unidades Básicas de Saúde: saúde da família, Cadernos de Atenção Básica-Programa de Saúde da Família: a implantação da unidade saúde da família (Caderno I), Guia Prático do Programa de Saúde de Família. A análise dos dados foi dividida em três temas: avaliação da Estrutura, avaliação do Processo e avaliação do Resultado. Na Estrutura, foram observados algumas limitações de área física (salas adaptadas) e de acesso (filas e tempo de espera para consultas médicas e odontológicas) importantes para oferecimento e manutenção da qualidade da assistência aos usuários. No Processo foi possível observar ruídos (na comunicação, na restrição do acesso aos prontuários pelos agentes de saúde, na identificação de situações de risco e na intersetorialidade) e potencialidades no processo de trabalho dos profissionais de saúde (tratamento odontológico na forma completada, a realização de visitas domiciliares, o vínculo e a disponibilidade para a escuta). No Resultado foi observado que o vínculo, a relação entre a equipe e comunidade, o cuidado à família, as visitas domiciliares, o olhar integral do profissional de saúde no exame físico foram relatados como motivos de satisfação dos usuários. E os motivos de insatisfação estiveram ligados ao acesso daqueles usuários que não fazem parte dos programas e sobre a área física. Ao final da pesquisa notou-se que a equipe apresentou um movimento organizacional favorável à integralidade do cuidado a saúde mental. Pois se percebeu, no caso estudado, o compromisso com a organização de uma rede de cuidados a saúde mental, tanto por parte da própria equipe, quanto pela gestão, apesar das limitações encontradas nas dimensões de Estrutura-Processo-Resultado. / This study analyzes the integraity of the system for the care of the patient with mental disorders in the Family Health Strategy (FHS). A case study was undertaken by adaptating the assessment of Structure, Process and Outcome proposed by Donabedian (1984), with a qualitative approach to the data. Observation and semi-structured interviews were drawn on in data collection and then a documental analysis was done. The study was carried out in Chapeco, Western region of the State of Santa Catarina. The oldest Family Health Unit was selected in the most socially vulnerable urban area, with a complete team according to the proposal and rules of the Ministry of Health.The criteria used to make the assessment are based on the respective ministerial publications: The National Plan for Inclusion of Mental Health actions in Basic Care, the manual of the physical structure of the basic units of health: family health, the Basic Care Booklet ? Family Health Program; and the creation of a family health unit (booklet 1), Practical Guide to Family Health Program. The data analysis was divided into three subjects; structure assessment, process assessment and outcome assessment. In the structure assessment, important limitations on the offering and management of the quality of the patient care were observed but, despite those problems, the integraity was not damaged. The process assessment was made from the Analytic Flowchart. This flowchart showed the process used by the interviewer in the health sector in the town, allowing us to observe the problems and potencialities in the health professionals\' work process. The outcome assessment was done by accessing user satisfaction. Through observation, we could obtain an assessment of the care offered and how the user benefits from the service organization to meet their needs. The bond, the relation between team and commnunity, the care for the family, the home visits, the health professional\'s attentive look in the physical examination and the number of users waiting for an appointment were reported as reasons for satisfaction by the users. The assessment in Health, in modern times, contemplates a dynamic and innovative process both to the service organization and to the research. Thus, we could verify the interplay that guides the assessment process, pursuing the transformation and the improvement of policy practices and knowledge in mental health.

Introdução: A Translação do Conhecimento (TC) consiste em uma teoria do conhecimento para a ação que visa à redução das lacunas entre a produção do conhecimento e sua aplicação em boas práticas profissionais e em políticas públicas que promovem melhorias na saúde e nas condições de vida da população. A extensão universitária, articulada ao ensino e à pesquisa, representa uma oportunidade para a TC nas Instituições de Ensino Superior (IES). Contudo, a exiguidade de indicadores de extensão dificulta a avaliação da indissociabilidade dessa tríade acadêmica. Objetivos: 1. Identificar a incorporação dos conteúdos inovadores relacionados à Promoção do Desenvolvimento Infantil (PDI) no ensino, na pesquisa e na extensão, antes e depois de dois anos da participação das IES em projetos de intervenção local (PIL) em municípios paulistas; 2. Elaborar mapas conceituais (MC) para a síntese do processo translacional ocorrido em cursos de graduação de saúde e de educação; 3. Propor indicadores de extensão inovadora; 4. Construir um modelo de avaliação fundamentado no processo de TC. Método: pesquisa exploratória e descritiva, por meio de estudo de casos múltiplos, baseado na triangulação de técnicas qualitativas. Os sujeitos da pesquisa foram sete coordenadores e três professoras de três IES envolvidas nos PIL. Foram coletados dados em duas etapas: I. a) Análise de ementas e planos de ensino de 2009 dos cursos de graduação em Enfermagem, Educação Física, Fisioterapia, Pedagogia, Psicologia e Terapia Ocupacional; b) Entrevistas com informantes-chave sobre o ensino, a pesquisa e a extensão relacionados à PDI; c) Reaplicação das duas fases anteriores com base no ano letivo de 2011; II. Construção de mapas conceituais (MC) para evidenciar a TC em núcleos acadêmicos das IES selecionadas. A análise temática dos documentos e das entrevistas, a síntese cruzada dos casos e o mapeamento conceitual por meio do Cmap Tools®, versão 5.05.01, foram adotados para avaliação dos dados. Desenvolveu-se um esquema analítico com base na ausência ou na presença de oito conteúdos inovadores relacionados à PDI no ensino, na pesquisa e na extensão, a saber: 1. Ausente, 2. Incipiente (apenas no ensino), 3. Regular (no ensino e na pesquisa), 4. Relevante (no ensino e na extensão) e 5. Completa. Resultados: após dois anos de parceria das IES nos projetos, destacaram-se as mudanças ocorridas nos seguintes cursos de graduação: Enfermagem passa de incipiente (75%) para relevante (87,5%) e Psicologia de ausente (87,5%) para relevante (75%) em Centro Universitário Comunitário; no curso de Terapia Ocupacional a classificação ausente (75%) torna-se relevante (75%) e completa (25%) em Universidade Pública Federal; houve a criação de duas disciplinas nos currículos de Pedagogia e Psicologia em Fundação Educacional Privada. Os MC ilustraram o processo de TC ocorrido nas três IES e contribuíram para a elaboração do modelo teórico de Avaliação Translacional de Extensão em Núcleos Acadêmicos (ATENA) composto por 12 indicadores de extensão inovadora. Conclusões: o modelo de ATENA verifica a aplicabilidade das evidências científicas e inovações tecnológicas nas ações de ensino, pesquisa e extensão na interação dos representantes das IES com atores sociais relevantes dos serviços locais e da comunidade a fim de promover a formação profissional, crítica, reflexiva e cidadã. / Introduction: Knowledge Translation (KT) is a theory to action that aims to reduce the gap between knowledge production and application into best practices and public policies in order to improve health and live conditions. Extension in Universities, regardless teaching and research, depicts an opportunity to KT in Higher Education Institutions (HEI). However, there is a lack of extension indicators that complicate evaluation of inextricableness of extension, teaching and research. Objectives: 1. Identifying the incorporation of innovative contents on Early Childhood Promotion (ECP) in teaching, research and extension, before and after two years local intervention-based projects (LIP) at inner state of Sao Paulo, Brazil; 2. Creating concept maps (CM) to synthetize the KT process occurred in Health and Education undergraduate courses; 3. Proposing innovative extension indicators; 4. Building evaluative model with a KT underpinning. Method: it is an exploratory and descriptive research, based on multiple cases study and qualitative triangulation. Subjects were seven coordinators and three teachers from three HEI that have been participating on LIP. Data were collected in two stages: I. a) Analysis of syllabi and study plans until 2009 related to Nursing, Physical Education, Physiotherapy, Pedagogy, Psychology and Occupational Therapy undergraduate courses; b) Key-informants interviews about teaching, research and extension activities about ECP; c) Reapplication of a and b phases based on 2011 school year; II. Creating CM to evince KT in HEIs academic centers. Thematic analysis of documents and transcripted interviews, cross-case synthesis and concept mapping by Cmap Tools® 5.05.01 were adopted to evaluate data. We have developed an analytical scheme based on absence or presence of eight innovative contents on ECP in teaching, research and extension, namely: 1. Absent, 2. Incipient (only in teaching), 3. Regular (in teaching and research), 4. Relevant (in teaching and extension) and 5. Complete. Results: after two-years HEI and LIP partnership, we have highlighted changes occured in the following undergraduate courses: Nursing that was incipient (75%) and has become relevant (87,5%), Psychology from absent (87,5%) to relevant (75%) in a Community College; Occupational Therapy that was absent (75%) has turned into relevant (75%) and complete (25%) in a Public University; there was a creation of two disciplines focused on ECP in Private College Pedagogy and Psychology curricula. CM have illustrated KT process occurred in HEI and contributed to elaborate a theoretical model of Translational Evaluation on Extension in Academic Centers composed by 12 innovative extension indicators. Conclusions: this model verifies evidence and innovation applicability into teaching, research and extension activities and interaction among HEI faculty and students and local services and community stakeholders in order to achieve a professional, critical, reflexive and citizen formation.

O objetivo deste estudo foi investigar se participantes de Programas de Preparação para a Aposentadoria que se planejam para esta fase da vida e desenvolvem um plano de atividades para este novo período da vida, apresentam índices de qualidade de vida. Determinar dentre os indicadores da qualidade de vida em profissionais, decorrentes de ações prévias de planejamento, quais foram as atividades impactantes vivenciadas nos Programas de Preparação para Aposentadoria, que possam ser mensuradas e avaliadas, referentes aos domínios psicológico, físico, social e meio-ambiente e identificar se os programas empresariais destinados à indivíduos que pretendem desenvolver atividades continuadas depois da obtenção do benefício da aposentadoria, contribuíram para os indicadores da qualidade de vida. O estudo quantitativo pesquisou 51 profissionais que participam do Programa de Preparação para a Aposentadoria denominado \"Tempo Amigo\" de uma empresa metropolitana de transporte público da cidade de São Paulo, no segundo semestre de 2015, incluindo profissionais perto de se aposentarem e também de profissionais já aposentados, que continuam a participar do atual programa. Para este estudo definimos aposentadoria como sendo as pessoas no exercício do benefício obtido conforme as regras do Instituto Nacional do Seguro Social. Utilizamos como instrumentos o Questionários Organização Mundial da Saúde de qualidade de vida suscinto (WHOQOL-Bref) e Questionário Psicossocial: Atividades influenciadoras de Qualidade de Vida, através da visão do trabalho e a construção do futuro (o autoconhecimento e a autoprojeção) em indivíduos que participam do Programa de Preparação para a Aposentadoria. Os resultados evidenciaram que profissionais que participam do Programa de Preparação para a Aposentadoria, planejam sua aposentadoria e preparam um plano de atividades para fazer depois deste momento apresentam indicadores da qualidade de vida nos domínios Psicológico 3,7127, Físico 3,7088, Relações Sociais 3,6153 e do Meio-Ambiente 3,6127, dentro dos padrões razoáveis estabelecidos pela Organização Mundial da Saúde. Os indicadores da qualidade de vida referentes aos domínios geral, psicológico, físico, social e meioambiente foram influenciados pelo planejamento de atividades preparatórias, vivenciadas no Programa de Preparação para a Aposentadoria. Dentre os indicadores da qualidade de vida, identificados no profissionais, decorrentes de ações prévias de planejamento vivenciados através do Programa de Preparação para a Aposentadoria provido pela empresa, observamos que as atividades preparatórias que impactaram foram as referentes à saúde, à produtividade, ao potencial, à construção do futuro e às finanças. O programa empresarial de preparação para a aposentadoria destinado à indivíduos que pretendem desenvolver atividades continuadas, depois de obtido o benefício da aposentadoria, contribuiu para os indicadores da qualidade de vida. programas e projetos de saúde / The objective of this study was to investigate whether people participating in a Retirement Preparation Program, planning this phase of life and deploy a plan of activities for their new time, have indicative in quality of life. Determine among quality of life indicatives, due to planning previous actions, which were important activities experienced in Retirement Preparation Plan, that can be measured and evaluated to psychological, physical, social and environment domains and identify wheather programs directed to individuals which intend deploy on going activities after getting retirement benefit, contributed to quality of life indicative. A quantitative study researched 51 professionals participants Retirement Preparation Program nominated Tempo Amigo, in a metropolitan public transportation company in São Paulo City, in second semester of 2015, including professionals close to retirement and professionals already retired, which continued participating current program. To this study retirement was defined as people exercising the benefit obtained under Instituto Nacional do Seguro Social\'s rules. WHOQOL-Bref and Psychosocial: activities influencing quality of life, throughout work vision and building the future (self-consciousness and selfprojection) questionnaires were applied at individuals participating in Retirement Preparation Program. The rusults showed that professionals participating in Retirement Preparaion Program, planning their retirement and preparing a plan of activities to do after this moment presented quality of life indicatives at domains Psychological 3.7127, Physical 3.7088, Social Relationships 3.6153 and Environment 3.6127, inside razonable standards stablished by Worldwide Health Organization. The quality of life indicatives due to domains general, physicological, physic, social and environment were impacted by planning preparatories activities, experienced in Retirement Preparation Program. Among the quality of life indicatives identifyed in professional due to previous planning actions experimented in Retirement Preparation Program provided by company, it was observed that the preparatories activities which impacted were due to healthy, productivity, potential, building the future and finance. The retirement corporative preparation program directed to individuals which intend to deploy on going activities, after obtained retirement benefit, contributed to quality of life indicatives

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The Primary Health Care (PHC) is shown as a strategic space for the exercise of management and evaluation in health. In this scenario, the coordination of care is considered one of its four key attributes. This is understood by the ability to ensure continuity of care in the service network and the identification of issues that are addressed in other levels of the network. In this sense, this research aims to evaluate the PHC quality in the municipalities of the 4ªCRS / RS by checking the coordination of care, by applying the PCATool (Brazil) at the top-level health professionals and service users health, ≥ 18 years and whose access was not the first. This is a quantitative approach to research with cross-sectional design. Data collection was carried out from February to August 2015, the PHC services in the municipalities of the 4th CRS / RS / BR. The study population included 1,071 adults and 203 professionals working in PHC. Data collection was conducted through interviews by applying the research protocol (demographic questionnaire and PCATool-Brazil version Adult and Professional) and was held in a computerized manner. Data were collected using Epi Info 7.0 program and automatically extracted for notebooks. The analysis was performed using the Statistical Package for Social Sciences (SPSS) version 19.0 for Windows. scores were the Attention Coordination attribute. Please note that the ethical aspects of research involving human beings were respected, according to the National Health Council Resolution 422/12. The results revealed by this study show that the Warning Coordination attribute was evaluated as satisfactory, that is, obtained a Top rated in dimensions Integration and Care Information System, both in the adult version and the professional version. In the adult version scores in dimension Care Integration were: the Basic Health Units (BHU) 6.66 (6.28 to 7.03), in the Family Health Strategy (ESF) 6.34 (5.94 -6.73) and in mixed UBS 6.87 (6.30 to 7.43); the scores in the dimension Information System were: the UBS 7.22 (7.02 to 7.41), the ESF 7.09 (6.88 to 7.29) and in mixed UBS 7.26 (6.94 -7.57). In the professional version scores in dimension Care Integration were: the UBS 6.34 (5.79 to 6.88), the ESF 6.41 (6.01 to 6.80) and in mixed UBS 6.74 ( 6.24 to 7.23); the scores in the dimension Information System were: the UBS 8.84 (8.22 to 9.45), the ESF 8.77 (8.40 to 9.13) and in mixed UBS 8.54 (8.03 -9.04). The results presented in this study have important implications for the evaluated services and also for public policy attention to health of the 32 municipalities that make up the two health regions studied. In addition to strengthening the development of evaluation studies in order to improve the quality of PHC and coordination of care. / A Atenção Primária à Saúde (APS) mostra-se como um espaço estratégico para o exercício da gestão e avaliação em saúde. Neste cenário, a coordenação da atenção é considerada um dentre os seus quatro atributos essenciais. Esta é compreendida pela capacidade de garantir a continuidade da atenção na rede de serviços, bem como a identificação de problemas que são abordados em outros níveis da rede. Nesse sentido, a presente pesquisa tem como objetivo avaliar a qualidade da APS nos municípios que integram a 4ªCRS/RS por meio da verificação da coordenação da atenção, mediante a aplicação do PCATool (Brasil) aos profissionais de saúde de nível superior e usuários dos serviços de saúde, ≥ 18 anos e cujo o acesso não fosse o primeiro. Trata-se de uma pesquisa de abordagem quantitativa com delineamento transversal. A coleta de dados foi desenvolvida de fevereiro a agosto de 2015, nos serviços de APS nos municípios da 4ª CRS/RS/BR. A população do estudo contemplou 1.071 usuários adultos e 203 profissionais atuantes na APS. A coleta dos dados foi realizada por meio de entrevista mediante aplicação do protocolo de pesquisa (questionário sócio demográfico e PCATool-Brasil versão Adulto e Profissional) e foi realizada de maneira informatizada. Os dados foram coletados no Programa Epi Info 7.0 e extraídos automaticamente para notebooks. A análise foi realizada no Programa Statistical Package for the Social Sciences (SPSS®), versão 19.0 for Windows. Foram construídos escores do atributo Coordenação da Atenção. Salienta-se que foram respeitados os aspectos éticos das pesquisas com seres humanos, seguindo a Resolução 422/12 do Conselho Nacional de Saúde. Os resultados revelados pelo presente estudo mostram que o atributo Coordenação da Atenção foi avaliado como satisfatório, ou seja, obteve uma alta avaliação nas dimensões Integração de Cuidados e Sistema de Informações, tanto na versão adulto quanto na versão profissional. Na versão adulto os escores na dimensão Integração de Cuidados foram de: nas Unidades Básicas de Saúde (UBS) 6,66 (6,28-7,03), nas Estratégias de Saúde da Família (ESF) 6,34 (5,94-6,73) e nas UBS mistas 6,87 (6,30-7,43); os escores na dimensão Sistema de Informação foram de: nas UBS 7,22 (7,02-7,41), nas ESF 7,09 (6,88-7,29) e nas UBS mistas 7,26 (6,94-7,57). Na versão profissional os escores na dimensão Integração de Cuidados foram de: nas UBS 6,34 (5,79-6,88), nas ESF 6,41 (6,01-6,80) e nas UBS mistas 6,74 (6,24-7,23); os escores na dimensão Sistema de Informação foram de: nas UBS 8,84 (8,22-9,45), nas ESF 8,77 (8,40-9,13) e nas UBS mistas 8,54 (8,03-9,04). Os resultados apresentados neste estudo trazem importantes implicações para os serviços avaliados e também para as políticas públicas de atenção a saúde dos 32 municípios que compõe as duas regiões de saúde estudadas. Além de reforçar o desenvolvimento de estudos avaliativos a fim de melhorar a qualidade da APS e da coordenação da atenção.

La présente étude vise à vérifier si la forme de maltraitance subie par l’enfant modère les effets d’un programme d’entrainement aux habiletés parentales (PEHP) sur la probabilité de fermeture du dossier de l’enfant et la probabilité que l’enfant fasse l’objet d’un nouveau signalement fondé aux services de protection de la jeunesse (PJ). L’étude porte sur 736 enfants ayant eu un dossier actif aux services de PJ de Montréal entre 2007 et 2015. Le groupe expérimental est composé de tous les enfants dont le parent a participé au PEHP Incredible Years (n=368). Un groupe contrôle a été apparié au groupe expérimental sur la base d’un score de propension. Des régressions de Cox ont révélé qu’à partir du moment où les parents ont participé au PEHP, la probabilité de fermeture du dossier des enfants suivis pour des motifs de négligence augmente davantage que celle des enfants suivis pour des motifs de mauvais traitements psychologiques. La participation au PEHP n’a pas d’effet sur la récurrence de la maltraitance signalée, et ce, peu importe la forme de mauvais traitements subis. Les résultats démontrent que la participation des parents à un PEHP permet d’augmenter la probabilité de fermeture du dossier de leur enfant, et donc, de diminuer les durées de prise en charge en PJ. / Abstract: The study examines whether the form of maltreatment experienced by the child moderates the effects of a parent training program (PTP) on the probability that the child’s case will be closed and that the child will be the subject of a new founded report to child protective services (CPS). This study involved 736 children on whom the Montreal CPS agency had an active file between 2007 and 2015. The experimental group was composed of all children with a parent who participated in the PTP Incredible Years (n=368). A control group was matched with the experimental group based on a propensity score. Cox regression revealed that once parents have participated in the PTP, the probability that their children’s cases will be closed increases more for children being followed because of neglect than for those being followed because of emotional maltreatment. Participating in the PTP has no effect on the recurrence of reported maltreatment, regardless of what form of maltreatment the child has been subjected to. Results show that a parent’s participating in a PTP increases the probability that his or her child’s CPS case will be closed and hence reduces the length of time that the child must receive protective services.

This study analyzes the satisfaction of doctoral students in the joint doctoral program in Christian higher education between Dallas Theological Seminary (DTS) and the University of North Texas (UNT). The study focuses on the 18 students who have been identified as advanced participants in or graduates from the joint program from its inception in 1997 through its 10-year mark in 2007. Fourteen of the 18 eligible students agreed to participate in this study for a 77.8 % response rate. The doctoral students completed a survey that was created using a study of Garrett in 2006 of doctoral students at Historically Black Colleges and Universities and of McLaughlin in 2002 of graduate students in Christian education at DTS. The purpose of this study was to determine to what extent the joint doctoral program in higher education between both institutions meets the expectations of the students and prepares them for the range of careers that they then pursue. The study offers a number of findings surrounding the five research questions and offers several conclusions and recommendations for further research. The study concluded that the surveyed participants were immensely satisfied with their education experience thus assuming that the joint program does meet expectations and prepare students for future careers.

This study reports and evaluates child outcome measures at a non-profit autism treatment program providing applied behavior analysis (ABA) based services to children age 3 to 8. To accomplish this, a review was conducted of available outcome data for a 1 year period. Several categories of outcome measures have been reported in the autism treatment literature (post-intervention educational placement, cognitive status, developmental and achievement status and/or progress, autism symptom reduction, and diagnostic reclassification). This study found that the program relied on 2 sources of data to evaluate child outcome: Hawaii Early Learning Profile® and program goal mastery. Children are making progress as indicated by these measures. The findings are discussed in relation to broader outcome recommendations.

Submitted by Haroudo Xavier Filho (haroudo.xavierfo@ufpe.br) on 2016-04-20T13:59:49Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissert. Navarro- digital.pdf: 3882779 bytes, checksum: 77b13189bd896f010f248c48052b1529 (MD5) / Made available in DSpace on 2016-04-20T13:59:49Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissert. Navarro- digital.pdf: 3882779 bytes, checksum: 77b13189bd896f010f248c48052b1529 (MD5) Previous issue date: 2015-07-03 / CAPES / O Programa Nacional de Alimentação Escolar tem caráter intersetorial, estimula a participação social e incentiva às economias locais, sendo considerado uma prática de promoção da saúde. No sertão pernambucano, o município de Tabira se destacou na gestão do Programa de Alimentação Escolar (PAE) em 2012. Para compreender os processos relacionados à continuidade das ações inovadoras realizadas, este estudo buscou analisar evidências de sustentabilidade das ações bem-sucedidas do PAE de Tabira. A pesquisa teve abordagem qualitativa com estratégia de estudo de caso. Foi realizado um grupo focal e entrevistas semiestruturadas com 12 informantes-chave. Os dados foram submetidos à análise de conteúdo, com a técnica de análise temática. Foi utilizado o software NVivo® 10 para Windows como primeiro tratamento dos dados. Os resultados apontam que os processos relacionados à implementação das inovações estão relacionados à sua sustentabilidade. A gestão atual continua cumprindo com o objetivo do programa de atender às necessidades nutricionais dos alunos no período em que estão na escola, porém não continuou as atividades educativas em alimentação saudável desenvolvidas na gestão anterior, ou seja, houve uma sustentabilidade parcial do programa. Fatores dos contextos organizacional e sociopolítico favoráveis à sustentabilidade foram a institucionalização do programa, o uso eficiente dos recursos financeiros, a forma centralizada de gestão, a alta participação comunitária no programa e o uso dos recursos da região a favor do programa. Como desfavoráveis foram destacados: fragilidade da articulação intersetorial e capacitação e qualificação profissional deficientes. A forte disputa política local se configura, numa perspectiva, como um fator positivo para a sustentabilidade do programa, mas negativo em alguns aspectos. O PAE de Tabira mostrou a possibilidade de operacionalizar ações de promoção da saúde, mesmo com restrição de recursos naturais e financeiros. Experiências como esta precisam ser mais visualizadas pela comunidade acadêmica e formuladores de políticas. / The Brazilian School Feeding Program is intersectoral, encourages social participation, local economies and is considered as a practice of health promotion. In the Northeast Region, the city of Tabira has done an excellent management of its school feeding program in 2012. To understand the processes related to the continuity of the innovative actions carried out, this study analyzed the evidences of sustainability of the ongoing innovations in Tabira. The research used a qualitative approach with case study strategy. A focus group and semi-structured interviews with 12 key actors were realized. The data were processed with content analysis and thematic analysis. NVivo® software for Windows 10 was used for the first analysis of the data. The results show that the processes that led to the implementation of the innovations are related to their sustainability. The management of Tabiras’s school feeding program may be considered sustainable in part, because it is still complying with the main program's goal, that is satisfying the students nutritional needs during their school time, but did not continues the educational activities on healthy eating developed in the previous administration. Positive organizational and socio-political factors were: the program institutionalization, the efficient use of financial resources, centralized management, high community participation and the use of local resources. Negative factors were: low inter-sectoral coordination and training and poor professional qualification. The strong political engagement at the local level showed both a positive and a negative impact. This study shows that it is possible to operationalize health promotion, even with restriction of financial and natural resources. Experiences like this should be more considered and discussed within the the academic community and among policy makers.

Background: Ballad Health participates in the Centers for Medicare and Medicaid Services’ (CMS) Accountable Health Communities (AHC) model. The AHC model is evaluating if universal screening, referral, and navigation services for health-related social needs (HRSN) can improve outcomes and reduce unnecessary utilization and costs of health care services. To ensure the evaluation of the model has sufficient statistical power, navigation services are expected to be provided to a minimum number of individuals. The purpose of this study is to analyze the characteristics of Ballad Health’s AHC navigation services that could be modified to improve opt-in rates. Methods: The primary outcome measure was identified as whether a beneficiary contacted via telephone opted-in or –out of the navigation program. Andersen’s Behavioral Model for Health Service Use was used as the conceptual framework for selecting covariates of interest. Enabling factors were of primary interest because alternate interventions may be designed around them. Data was pulled for the time period of November 17, 2018 through February 14, 2019. Where possible, covariates were associated with data from CMS’ AHC Data Template v3.1 to accommodate replication for all AHC bridge organizations, though additional internally-collected data, which may not be available for all bridge organizations, were needed for some variables. Chi-squared tests were performed for each covariate. Results: No statistical differences were found for the primary covariates of interest. Opt-in rates by Navigator were lowest for Navigator 5 and highest for Navigator 4 (67.53% and 88.24%). Opt-in rates by weekday of decision were lowest on Thursdays and highest on Wednesdays (64.91% and 77.42%). Opt-in rates based on time of day were lowest between 8:00am and 9:59am, and highest between 12:00pm and 1:59pm (62.50% and 100%). Opt-in rates were lowest when the decision was made six days after the screening and highest when made the same day (53.57% and 83.33%). Opt-in rates were lowest when there were five weekdays between screening and navigation decision, and highest when there were three weekdays between the screening and decision (60% and 90%). Other non-process covariates of interest that were statistically significant for opt-in rates were the presence of either food, safety, or utility needs. Conclusions: Several groups had higher opt-in rates that were not statistically significant; small sample sizes may have impacted the significance of these differences. For example, opt-in rates were higher when made the same day as the screening than when made one day after (83.33% and 74.79%). However, only 18 beneficiary decisions were made on the same day, while 119 were made one day after. Increasing the number of same-day phone call attempts may be a method to improve opt-in rates. Importantly, date and time data for contact attempts before a beneficiary decides to opt-in or opt-out were unavailable as of the time of the analysis. These data are captured and will be added to the analysis when available, which could provide more insight into whether a beneficiary is more likely to opt-in or opt-out.

In 2008, Indiana launched a statewide child care quality rating and improvement system, called the Paths to Quality. To assist providers in improving the quality of their programs, professional development, coaching, and teacher support are provided. Yet the approach, format, and quality of coaching vary. This represents a potential disconnect between high-quality coaching, high-quality child care services, and positive child outcomes. The purpose of this study was to investigate stakeholder views on the strengths and needs of the early childhood coaches with respect to the current coaching system. To meet this goal, the focus group and dyadic interview data were collected with technical assistance administrators, early childhood coaches, and early childhood providers. Data were collected through audio recording and transcription of each data collection session. Results were analyzed by thematic analysis using the long-table approach. Five steps of familiarization, identifying, categorizing, labeling, and summarizing were used for interpretation of the results. The results showed that coaches have a passion for their profession and are very dedicated to helping support early childhood providers and teachers in their growth. On the other hand, the results also show the serious need for change in the coaching approaches and coaching model that is offered across the agency. There is a need for new complex formal training on coaching practices for both early childhood coaches and specialists and technical assistance administrators. Support for coaches needs to be established with an emphasis on an ongoing system of supports and follow up. Additionally, more specific areas of supports and its structure are presented in this study.