Multi-purpose clinically relevant measures such as the Child and Adolescent Needs and Strengths (CANS; Lyons, 2009) and the Global Appraisal of Individual Needs (GAIN; Dennis et al., 2003) can be useful for improving services at the individual client, program, organization, and system levels. Yet, emerging research suggests that such measures are often not used consistently or effectively (Mellor-Clark, Cross, Macdonald, & Skjulsvik, 2016), and that poor use of these measures can be in part attributed to how they were put into practice (de Jong, 2016). Systematically conducted, empirical research on the effective implementation of such tools is scarce (Boswell, Kraus, Miller, & Lambert, 2015). Thus, the current study examined the factors and processes that contribute to the effective implementation of clinically relevant measures, specifically the CANS and GAIN, in community-based mental health agencies serving children and adolescents. A second objective was to examine the role of staff participation in the implementation process. Three general research questions guided the study, including: (1) How can clinically relevant measures such as the CANS be implemented effectively? (2) What are the perceived consequences of staff participation in adapting and implementing a version of the CANS and how do these consequences come about? and (3) How does the implementation context affect the process and its outcomes? The study employed qualitative, multiple-case study methods. Four child and youth mental health agencies in Ontario participated, including a total of 44 staff with varying roles (e.g., frontline and management). Several cross-case and within case comparisons were made to examine the contribution of staff participation and tool features, such as tool adaptability, to implementation outcomes. Data was analyzed using guidelines developed by Yin (2009), Miles and Huberman (1994), and Thomas (2006). Results suggest that staff participation in the process of putting clinically relevant measures into practice contributes to effective implementation and increased uptake and use of the measures. When staff are engaged in the process, they have reasons and opportunities to interact, talk about the use of the measure, and “co-create fit” between the measure and their work context. This improved fit then facilitates increased staff commitment and ability to use the measure effectively. Agency leaders play a key role in enabling this fit-making process through: encouraging and supporting a participatory approach to implementation, creating implementation structures, following through with planned activities, and being open and responsive to staff feedback. Findings suggest that the implementation context provides incentives or reasons for implementing a measure, affects the initial fit between the measure and staff members’ work, and affects the feasibility of engaging staff in the fit making process. In conclusion, this study is one of the few empirical studies to examine implementation of clinically relevant measures. The findings have important implications for research and practice, which will be discussed.

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no / Purpose – The purpose of this paper is to present results from an evaluation of the experience of a move to independent living for people with mental health needs or a learning disability. The discussion focuses on the shift in organisational culture from providing care within a hostel setting to supporting people in their own tenancies. Design/methodology/approach – The evaluation was underpinned by a participatory action research design. A total of ten co‐researchers with experience of using services or as carers were recruited. Qualitative data was obtained from “before” and “after” interviews with residents, staff and relatives. Findings – Widespread satisfaction was expressed with people's new homes. Many residents were found to be increasingly independent. There was some evidence of concerns regarding the pace and process of change and the introduction of new practices to promote independence. Research limitations/implications – The timing of the evaluation limited the opportunity for comprehensive “before” and “after” data collection. The involvement of co‐researchers required considerable time and support although the experience of those involved was positive. Practical implications – Learning from this evaluation emphasises the importance of support and preparation for staff as well as residents, in moving from hostel to independent living. Social implications – This study highlights the advantages of a participatory design in evaluating a major change in service delivery. Originality/value – This paper raises important issues about organisational change. It contributes to wider debates regarding the implementation of personalisation and recovery‐focused agendas. / © 2013 Emerald. Reproduced in accordance with the publisher's self-archiving policy.

This thesis is based on Project Artemis, a critical, girl-centred participatory action research (PAR) project designed as part of an evaluation of Artemis Place, an alternative education program serving “at-risk” girls in Victoria, BC. Nine Artemis Place students between the ages of 15 and 18 worked alongside me as co-researchers to investigate how Artemis Place has affected their lives. Our research also explored girl co-researchers' schooling experiences more broadly and the structural inequities they experience across the multiple contexts of their lives. Our process was rooted in a critical, participatory, collaborative framework, which aimed to investigate, problematize, and address (through social action) the complex forces shaping girls' experiences of marginalization. We used arts-based methods such as photovoice, graffiti walls, journaling and participatory video to cycle through the iterative phases of PAR: exploration/data collection, critical reflection/analysis, and action. We produced a documentary film as our primary research dissemination tool. In this thesis, I undertake my own analysis of our collective research to do a deep reading of girls' resistances to “at-risk” constructions of girlhood, in order to understand their negotiations of the complex forces shaping their daily realities. I complicate the concept of resistance using a hybridized feminist-poststructural (Davies, 2000) and desire-based (Tuck, 2010) framework to explore the ways girls' resistances are produced through flows of desire – creative and productive force – that disrupt, exceed, (re)configure, and/or (re)code “girl” and “risk.” I argue that tracing the “desire flows” (Deleuze & Guattari, 1987) and reconfigurations produced in/through our critical research process, is an important, political move toward sustaining alternative figurations of girlhood. As such, this thesis contributes promising, ethical/affirmative/political possibilities for understanding the complexities of girls' lives and for engaging alongside them in feminist research, praxis, and activism for social justice. / Graduate

Midst contextual themes of new technologies and globalisation, South African organisations are challenged to attract, develop and retain suitable skills in a labour market that will continue to suffer shortages. The HR function of today is required to partner with organisations at a strategic level in response to this challenge. Successful organisations understand that transforming the HR function require regular in-depth analyses of its effectiveness. The study aimed to assess the effectiveness of an HR function operating in a public utility, against current trends in HR transition. Different evaluation methodologies are explored to develop a theoretical evaluation model for the effectiveness of a HR function. The results confirmed that the HR function is not effective in its role as strategic partner, and highlights significant differences in perception between the stakeholders and the HR function regarding its effectiveness. Recommendations were made on future transformation actions for the specific HR function. / Industrial & Organisational Psychology / M.A. (Industrial Psychology)

Trata-se da meta-avaliação de um processo avaliativo desenvolvido por secretários e assessores técnicos municipais de uma região de saúde do estado de São Paulo, com foco nos critérios de utilidade e participação. É uma pesquisa qualitativa, cuja base empírica foi 1) o material produzido em sete oficinas realizadas com os representantes municipais, com vistas à avaliação de um aspecto da linha de cuidados em saúde sob a ótica da integralidade; e 2) as entrevistas semiestruturadas realizadas com os mesmos atores após a finalização do processo avaliativo. Para a avaliação do critério de utilidade, utilizou-se principalmente o referencial de KIRKHART (2000), com o objetivo de ampliar a análise para além do uso instrumental dos achados avaliativos e focá-la na identificação de influências múltiplas exercidas por um fenômeno complexo como um processo avaliativo. A análise do critério participação se deu com base no referencial de COUSINS e WHITMORE (1998), buscando a identificação no material empírico de decisões ou aspectos contextuais que fizeram com que a opção participativa fosse aprofundada ou limitada no processo em foco. O trabalho destaca a importância de explicitar pressupostos que baseiam a metodologia da avaliação/ meta-avaliação escolhida, e a necessidade de se buscar referenciais teóricos de análise compatíveis com a opção realizada, frisando a inexistência de posturas neutras ou estudos totalmente objetivos; e a importância de capacitar avaliadores a acompanharem a demanda dos participantes de um processo participativo com a flexibilidade necessária para conferir-lhe o maior aproveitamento possível. Conclui-se pela viabilidade, com vantagens, da realização de processos participativos locais com gestores na Saúde Pública, destacando a possibilidade de ganhos em formação e o enriquecimento dos processos de negociação em nível do território, de forma coerente à política de construção das regiões de saúde no SUS. / This study aims to meta-evaluate an evaluation process developed by policymakers and technical advisors of a Health Region of Sao Paulo, centering on criteria of utility and participation. It analyzes the feasibility and possible benefits of using a participatory methodology in Public Health evaluations, highlighting aspects that facilitate and hinder this undertaking. It is a qualitative research, which empirical basis was 1) the material produced in seven workshops with municipal representatives, aiming the evaluation of an aspect of health care from the perspective of integrity; and 2) semi-structured interviews with the same actors after completion of the evaluation process. KIRKHART´s theoretical framework (2000) was used to evaluate the utility criterion, in order to expand the analysis beyond the instrumental use of the evaluation findings, and focus it in identifying multiple influences exerted by a complex phenomenon as an evaluation process. The evaluation criterion of participation was based on references of COUSINS e WHITMORE (1998), aiming to identify decisions or contextual aspects in the empirical material that made participatory option limited or depth in the focused process. The work highlights the need to seek theoretical frameworks of analysis consistent with the methodological choice carried out in order to enhance the identification of evaluation gains and limitations, and enable evaluators to monitor the demand of participants in the evaluation process with flexibility to reach its best use, even in those cases where there are limitations on the possibilities of participation. The results confirmed the viability, with advantages, of holding local participatory processes with policymakers and managers in Public Health, highlighting the possibility of gains in education and the enrichment of the negotiation process in the territory level, consistent with the policy of building health regions in SUS.

Trata-se da meta-avaliação de um processo avaliativo desenvolvido por secretários e assessores técnicos municipais de uma região de saúde do estado de São Paulo, com foco nos critérios de utilidade e participação. É uma pesquisa qualitativa, cuja base empírica foi 1) o material produzido em sete oficinas realizadas com os representantes municipais, com vistas à avaliação de um aspecto da linha de cuidados em saúde sob a ótica da integralidade; e 2) as entrevistas semiestruturadas realizadas com os mesmos atores após a finalização do processo avaliativo. Para a avaliação do critério de utilidade, utilizou-se principalmente o referencial de KIRKHART (2000), com o objetivo de ampliar a análise para além do uso instrumental dos achados avaliativos e focá-la na identificação de influências múltiplas exercidas por um fenômeno complexo como um processo avaliativo. A análise do critério participação se deu com base no referencial de COUSINS e WHITMORE (1998), buscando a identificação no material empírico de decisões ou aspectos contextuais que fizeram com que a opção participativa fosse aprofundada ou limitada no processo em foco. O trabalho destaca a importância de explicitar pressupostos que baseiam a metodologia da avaliação/ meta-avaliação escolhida, e a necessidade de se buscar referenciais teóricos de análise compatíveis com a opção realizada, frisando a inexistência de posturas neutras ou estudos totalmente objetivos; e a importância de capacitar avaliadores a acompanharem a demanda dos participantes de um processo participativo com a flexibilidade necessária para conferir-lhe o maior aproveitamento possível. Conclui-se pela viabilidade, com vantagens, da realização de processos participativos locais com gestores na Saúde Pública, destacando a possibilidade de ganhos em formação e o enriquecimento dos processos de negociação em nível do território, de forma coerente à política de construção das regiões de saúde no SUS. / This study aims to meta-evaluate an evaluation process developed by policymakers and technical advisors of a Health Region of Sao Paulo, centering on criteria of utility and participation. It analyzes the feasibility and possible benefits of using a participatory methodology in Public Health evaluations, highlighting aspects that facilitate and hinder this undertaking. It is a qualitative research, which empirical basis was 1) the material produced in seven workshops with municipal representatives, aiming the evaluation of an aspect of health care from the perspective of integrity; and 2) semi-structured interviews with the same actors after completion of the evaluation process. KIRKHART´s theoretical framework (2000) was used to evaluate the utility criterion, in order to expand the analysis beyond the instrumental use of the evaluation findings, and focus it in identifying multiple influences exerted by a complex phenomenon as an evaluation process. The evaluation criterion of participation was based on references of COUSINS e WHITMORE (1998), aiming to identify decisions or contextual aspects in the empirical material that made participatory option limited or depth in the focused process. The work highlights the need to seek theoretical frameworks of analysis consistent with the methodological choice carried out in order to enhance the identification of evaluation gains and limitations, and enable evaluators to monitor the demand of participants in the evaluation process with flexibility to reach its best use, even in those cases where there are limitations on the possibilities of participation. The results confirmed the viability, with advantages, of holding local participatory processes with policymakers and managers in Public Health, highlighting the possibility of gains in education and the enrichment of the negotiation process in the territory level, consistent with the policy of building health regions in SUS.

Participatory research methodologies and the use of interactive communication technologies (ICTs) such as email are increasingly seen by many researchers, including feminists, as offering ways to enhance women’s inclusion, participation and empowerment. However, from critical and poststructuralist perspectives, some researchers suggest the need for greater caution about claims that participatory methodologies and certain communication technologies automatically enhance inclusion and empowerment. These researchers argue that issues of power, agenda and voice in the research context require greater attention (LeCompte, 1995). The major argument made in this thesis is that feminist researchers need to adopt a more critical and rigorous yet pragmatic approach to evaluating women’s empowerment, inclusion and participation, and that this approach needs to include an analysis of diversity and difference, macro and micro contexts, power-knowledge relations, and the contradictory effects of participation. The outcomes of this study suggest that this approach can create new knowledge and understanding that will enable the development of more effective strategies for women’s empowerment and inclusion. To explore and support this argument, findings are presented from a detailed evaluation and critique of a major feminist action research project that involved women in rural, regional and remote Queensland, Australia and elsewhere, a university research team and several government and industry partners. The project made extensive use of ICTs, including email and the Internet, and aimed to be empowering and inclusive. Given the many contradictory discourses of empowerment that currently circulate, empowerment is seen as a problematic concept. The multiple meanings and discourses of empowerment are therefore identified and considered in the analysis. With the increasing importance of communication technologies in rural community development, this study also evaluates the effectiveness of ICTs as a medium for empowering rural women. The ‘politics of difference’ (Young, 1990) that underpins attempts to include a diversity of rural women in feminist research projects presents many challenges to feminist praxis. Chapters 1 and 2 propose that, in evaluating such projects, researchers need to take diversity and difference into account to avoid reproducing stereotyped images of rural women, and to identify those who are included and excluded. This is because of the complex nature of the identity ‘rural woman’, the multiple barriers to women’s participation, and the diverse needs, agendas and ideologies of participants and stakeholders. The concept of seriality (Young, 1994) is used in this study to avoid reproducing ‘rural women’ and feminist researchers as women with a singular identity. Chapters 1 and 2 argue that a comprehensive and critical analysis of these complex issues requires an eclectic, transdisciplinary approach, and that this can be fruitfully achieved by using a combination of two feminist frameworks of theory and epistemology: praxis feminism and feminist poststructuralism. While there are commonalities between these frameworks, the feminist poststructuralist framework takes a much more cautious and critical approach to claims for empowerment than praxis feminism. The praxis feminist framework draws on feminist theories that view power as social, cooperative and enabling. Women’s diverse needs, values, issues and experiences are taken into account, and the analysis aims to gives voice to women. The purpose of this is to better understand the processes that meet women’s diverse needs and could be empowering and inclusive for women (or otherwise). In contrast, the feminist poststructuralist framework uses Foucault’s (1980) analytic of power as positive and strategic, exercised in all our interactions, and intimately connected to knowledge. The power-knowledge relations, and the multiple and shifting discourses and subject positions that were taken up in various research contexts are identified and analysed. The purpose of this is to highlight the contradictions and dangers inherent in feminist practices of empowerment that often go unnoticed. To achieve its practical and critical aims, this study uses two different, but complementary, research methodologies: participatory feminist evaluation and feminist deconstructive ethnography, and multiple research methods, which are outlined in Chapter 3. This eclectic approach is argued to provide maximum flexibility and creativity in the research process, and to enable the complexity and richness of the data to be represented and understood from a diversity of perspectives. Triangulation of the multiple methods and sources of data is employed to increase the validity and rigour of the analysis. Assessing how well feminist projects that use ICTs have met the aim of including a diversity of women requires an analysis of a wide range of complex social, economic, cultural, technological, contextual and methodological issues related to women’s participation. Analysing these issues also requires giving voice to a diversity of participants’ and stakeholders’ assessments and meanings of ‘diversity’ and ‘inclusion’. The results of this analysis, set out in Chapter 4, suggest that differences in perceptions of diversity and inclusion are strongly related to participants’ and stakeholders’ political and ideological beliefs and values, and their degree of commitment to social justice issues. The evaluation found that a limited diversity of women participated in the project, and identified many barriers to their participation. Feminists argue that women-only activities are often more empowering than mixed gender activities. The evaluation findings detailed in Chapter 5 suggest that the project’s women-centred activities, particularly the workshops and online groups, were very successful in meeting the multiple needs of most participants. However, contradictory or undesirable effects of the project’s activities were also identified. This analysis demonstrates the need to consider the various groups of participants and their diverse needs in assessing how well feminist methods and activities have met women’s needs or are empowering. Chapter 6 identifies various forms and features of empowerment and disempowerment and categorises them as social, technological, political and psychological. A model is developed that illustrates the interrelationships between these four forms of empowerment. Technological empowerment is identified as a new under-theorised form of empowerment that is seen as increasingly important as ICTs become more central to women’s networking and participation. However, the findings suggest that the extent to which participants want to be empowered needs to be respected. While many participants were found to have experienced the four forms of empowerment, their participation was also shown to have had various disempowering effects. The project’s online group welink (women’s electronic link), which linked rural and urban women, including government policy-makers, was assessed as the most empowering project activity. The discourse analysis and deconstructions, undertaken in Chapter 6, identify competing and contradictory discourses of new communication technologies and feminist participatory action research. The various discourses taken up by the researchers and participants were shown to have both empowering and disempowering effects. The analysis demonstrates the intersection between empowerment and disempowerment and the shifting subject positions that were taken up, depending on the research context. It was argued that the discourses of feminist action research operated as a ‘regime of truth’ (Foucault, 1980) that regulated and constrained the discourses and practices of this form of research. An analysis of a highly contentious welink discussion challenges feminist assumptions that giving voice to women will lead to empowerment, and suggests that silence can, in some circumstances, be empowering. This analysis highlights the intersection of voice and silence, the limitations of the gendered discourse of care and connection, and how this discourse, and other factors, regulated the use of more critical discourses. Critical reflections on the study are made in Chapter 7. They include the suggestion that an ‘impossible burden’ was placed on the project’s feminist researchers who used an egalitarian feminist discourse that produced expectations of ‘equal relations’ between participants and researchers. However, these relations had to be established in the context of a university-based project that involved senior academic, government and industry staff. Drawing on the new knowledge and understandings developed, this study proposes several principles and strategies for feminist participatory action research projects that seek the inclusion and empowerment of rural women and use ICTs. They include the suggestion that feminists need an awareness of the limits to the politics of difference discourse when power-knowledge relations are ignored. A further principle is that there is value in adopting a Foucauldian analytic of power, since this enables a better understanding of the complex, multifaceted and dynamic nature of power-knowledge relations in the research context. This approach also provides an awareness of how processes that attempt to empower will inevitably produce disempowerment at certain moments. Principles and strategies for undertaking participatory feminist evaluations are also suggested.

The present dissertation is inserted in the research line Management and Labor of the research group Labor, Health, Education and Nursing of the Department of Nursing at UFSM. It comprehends as object of research the participatory evaluation in health, and as main objective, to recognize the perception of nurses acting in primary health care in municipality of the central region of Rio Grande do Sul state, on the role of participatory evaluation as a tool of qualification of management and subsidiary in the taking of decisions in such level of attention to health. This research aims at contributing to the implementation of the policy of institutionalization of the evaluation in primary health care, and, at the same time, recognizing perceptions of the nurses on such topic, showing them the fact that there is an evaluation policy, and that it can be a tool of qualification of their professional performance. The theoretical framework adopted is based on the evaluation in health, taking as reference the participatory evaluation in health. The methodology brings the qualitative approach, and the attainment of information needed in order to achieve the objective of study was the semistructured interview, and for the analysis of such it was utilized the analysis of content. The research subjects are nurses of the primary health care units, chosen by sortition after the exclusion of those who did not fit in the research criterion, and that agreed in participating in the study. The research was submitted to the appraisal of the Committee of Ethics in Research, being accredited with the CAAE (Certificate of Appraisal) number 0166.0.243.000- 11. The discourses of the research subjects led to four categories: the concept of evaluation in health, the evaluation in health and management, evaluative methodologies, and participatory evaluation in health. The research findings allow us to infer that the answerers are not clear about evaluation, yet, they consider it an important tool for the qualification of primary health care, as well as they consider important the inclusion of health workers and users in the evaluative process, in addition to making evident the inexistence of formal and systematic evaluative practices. There must be a concern, on the part of the manager, in the sense of realizing and motivating evaluative practices, and there is the necessity to be triggered actions in the sense of evaluating in a methodical and systematical form the actions developed, only few informal evaluations that do not impact on their labor process. The perception regarding the importance of participatory evaluation in health led us to the conclusion that the introduction of evaluative practices in health would have, in the professionals, allies for their evolution. / A presente dissertação de mestrado está inserida na linha de pesquisa Gestão e Trabalho do Grupo de Pesquisa, Trabalho, Saúde, Educação e Enfermagem do Departamento de Enfermagem da Universidade Federal de Santa Maria - UFSM. Tem como objeto de pesquisa a avaliação participativa em saúde, e como objetivo geral conhecer a percepção dos enfermeiros que atuam na Atenção Básica em município da região central do Rio Grande do Sul, quanto ao papel da avaliação participativa como instrumento de qualificação da gestão e subsidiário na tomada de decisões nesse nível de atenção à saúde. Esta pesquisa tem em vista contribuir para a implantação da política de institucionalização da avaliação na Atenção Básica, na medida em que, ao mesmo tempo em que busca conhecer percepções dos enfermeiros sobre o tema, coloca-os diante do fato de que existe uma política de avaliação, e que esta pode ser um instrumento na qualificação de sua atuação profissional. O arcabouço teórico utilizado fundamenta-se na avaliação em saúde, tomando como referencia a avaliação participativa em saúde. A metodologia utilizada traz a abordagem qualitativa e a obtenção dos dados indispensáveis para que seja alcançado o objetivo do estudo foi a entrevista semi-estruturada e para análise deste foi utilizada a análise de conteúdo. Os sujeitos das pesquisas são enfermeiros das unidades básicas de saúde, escolhidos por sorteio após a exclusão daqueles que não se enquadravam nos critérios da pesquisa e que concordaram em participar do estudo. A pesquisa foi submetida à apreciação do Comitê de Ética em Pesquisa, tenso sido aprovado como o número CAAE (Certificado de Apresentação para Apreciação Ética): 0166.0.243.000-11. Os discursos dos sujeitos da pesquisa deram origem a quatro categorias: o conceito de avaliação em saúde, a avaliação em saúde e a gestão, metodologias avaliativas, e avaliação participativa em saúde. Os achados dessa pesquisa permitem inferir que os respondentes não tem clareza sobre avaliação, contudo a consideram uma ferramenta importante para a qualificação da atenção básica, bem como consideram importante a inclusão de trabalhadores em saúde e usuários no processo avaliativo, além de evidenciar a inexistência de práticas avaliativas formais e sistemáticas. Deve haver preocupação por parte do gestor no sentido de realizar ou incentivar práticas avaliativas, e há necessidade serem desencadeadas ações no sentido de avaliar de forma metódica e sistemática as ações desenvolvidas, apenas algumas avaliações informais que não tem impacto sobre seu processo de trabalho. A percepção a respeito da importância da avaliação participativa em saúde nos leva a conclusão de que a introdução de práticas avaliativas em saúde teria nos profissionais parceiros para sua evolução.