Theory-based evaluation studies have long been promoted as increasing stakeholder knowledge of the program and improving decision-making (Bickman, 1987; Chen, 2004; Suchman, 1967; Weiss, 1998), but such advocacy has little empirical research support. This paper helps to redress this deficiency by reporting on an empirical study which investigated the relationship between the use of program theory as the basis for an evaluation study and the nature of the evaluation information generated and its utility. The investigation followed three program evaluation studies through their term and focused on the extent of theory use and the nature and influence of the information from each evaluation. A model of factors which it has been suggested influence the use of program evaluation information was developed and investigated (Alkin, 1985; Cousins & Leithwood, 1986, 1993; Cummings, 1997; Leviton & Hughes, 1981; Hudson-Mabbs, 1993; Pawson & Tilley, 1997; Preskill & Torres, 1997). Structural equation modeling was used to test and further explore the model, while qualitative data were used to gain further insight into the study findings. The investigation was not able to confirm that a greater use of program theory in an evaluation study improves the usefulness of evaluation findings. The study does, however, identify interactions between program theory and other predictor variables, such as the characteristics of the evaluation study, related to increased information use. It also provides further evidence regarding the importance of stakeholder involvement in an evaluation study on the extent to which they use and are influenced by evaluation information. Furthermore, this research provides insight into perceptions developed by many evaluators through experience and practice, such as the vulnerability of an evaluation study to contextual factors which typically are outside the control of the evaluation team.

Little is known about the effectiveness of district plans in protecting built heritage, which is a matter of national importance under New Zealand's Resource Management Act 1991 (RMAct). This is despite the fact that the RMAct directs planning agencies to evaluate the effectiveness of plan provisions. This lack of evaluation is not unique to New Zealand or merely symptomatic of heritage planning. Instead, it is a shortcoming in planning theory and practice internationally; a well recognised impediment being that planning lacks a suitable evaluation approach. This thesis aims to address this deficiency by proposing a methodology for evaluating plan effectiveness and applying it to the built heritage provisions of two district plans. The methodology adopted has been shaped by the theory-based and realist evaluation approaches, as developed in the field of programme evaluation. Both approaches share a common ontology regarding claims of causality, which stresses 'knowledge in context'. Thus, a central endeavour of the research is not only to identify the environmental outcomes arising from plan implementation, but also to understand how and why the implementation context promoted or inhibited the achievement of plan goals. In so doing, the causal and implementation theories underpinning the plans' heritage provisions are exposed, modelled and tested. The findings reveal that plan implementation failed to prevent the loss of built heritage values in many instances. While the plans' causal theory was largely sound, key aspects of the implementation theory were not realised during the development control process. Plan quality was a significant factor, as was the commitment and capacity of developers to comply with the plans. The institutional fixation on consent processing speed rather than environmental outcomes was a further impediment. Overall, the theory-based approach provided a useful framework for determining plan effectiveness and holds promise for evaluating plan issues other than built heritage.

Regular physical activity can help prevent chronic conditions and it is positively linked to health-related quality of life (United States Department of Health and Human Services [USDHHS], 2000). Unfortunately, many older adults do not engage in leisure time activity (USDHHS, 2000); making it important to design and test physical activity interventions for this population. The purpose of this dissertation was to review the external validity of theory-based physical activity interventions and to examine the efficacy of a mail-based physical activity intervention. The review included 54 theory-based interventions and overall the studies focused on internal rather than external validity. The hypotheses of the experimental study were that the psychological mediators and physical activity participation would significantly increase among the treatment group as compared to the control group, and that the changes in the mediators would be related to the changes in activity levels. The intervention included 4 weekly stage-matched packages targeting population specific physical activity beliefs (Antikainen et al., 2009) and weekly phone calls to reassess stages of change. Physical activity participation, stages of change, and theory of planned behavior constructs were assessed at baseline and follow-up. Differences in activity levels and theory-based constructs were assessed with repeated measures mixed analysis of variance. Stage of change progression was examined with chi-square analysis. Measured variable path analysis was used to determine associations between the theory constructs, stages of change, and physical activity participation. The participants were 55 older adults, ages 54 to 96 years. Most of the participants were female, Black, and reported low levels of education and income. The treatment group reported statistically significantly greater physical activity after the intervention than the control group that reported lower levels of activity at follow-up. Although not statistically significant, there was a trend in SOC progression after the intervention in the treatment group. Finally, the integrated model was found to have a good fit at follow-up and perceived behavioral control emerged as a significant predictor of physical activity. This research provides important information for the design of physical activity interventions based upon the integrated framework for translation to community-based organizations.

There are many populations poorly served by the current Canadian approach to health and illness care. These populations include members of ethnic minority groups, those with poor socio-economic status, those who are homeless, working in the sex trade or affected by mental illness. One way of potentially improving the health of communities or populations is through policy. In addition, a deeper understanding of the health needs of underserved populations could facilitate expeditious solutions mindful of resource challenges. In spite of copious research, health inequities and disparities persist. My hypothesis was that the conscious use of specific lenses to examine policies or interview data was a useful device to both better visualize and understand actions related to policy development and community member input. Thus, this thesis research was comprised of two major components. The first was an exploration of two policies of an academic tertiary health care centre through the lenses of feminist, critical social and systems theory. The objective was to determine if viewing policy development using different lenses might influence thinking about issues related to underserved populations. The second component used the same three lenses to conduct a grounded theory analysis of eleven photo-elicitation and six photo-voice interviews with North End Halifax Community members. The focus of these interviews was on contributions to health found in the community of North End Halifax. The results clearly show that examination of policies through the three theoretical lenses serves to highlight hidden assumptions and to broaden the view and comprehension of implications and potential impacts of policies. A better way to formulate policies is one step towards achievement of improved health outcomes. The use of three lenses in the grounded theory analysis significantly enhanced the depth of interview analysis: the feminist lens accentuated the concept of caring and relationships and the extent of the White-middle-class male perspective; the critical social lens crystallized the power disparities at play; and the systems lens stressed the need to examine root causes. The conscious use of specific lenses could facilitate a more comprehensive and comprehended view of the health needs of underserved populations.

No description available.

Thesis (DPhil (Sociology and Social Anthropology))--Stellenbosch University, 2008. / The aim of the study was to design an alcohol abuse prevention program for the workplace that was based on a sound program theory. Ultimately the study aimed to indicate an approach to the improvement of social service programs by the incorporation of program theory in the design, implementation and evaluation of social service programs. In the first phase of the study the program theory was developed. Literature studies on the prevention of alcohol abuse and on program evaluation were done. This was followed by a survey in the workplace to determine alcohol consumption and abuse, factors contributing to alcohol consumption, workplace factors contributing to abuse and attitudes towards the responsible consumption of alcohol. The survey was complemented by focus group discussions. Eight hundred and fifteen respondents completed the survey. The most important findings were that 46% of respondents indicated that they drink alcohol, nine percent could be classified as alcohol dependent according to the Michigan Alcoholism Screening Test (Selzer, 1971) and 24% of men and 15 % of women drank at risky levels. The most important factors contributing to alcohol consumption were social problems, social drinking and dependence. Workplace factors contributing to alcohol consumption were the lack of control, availability of alcohol, social pressure to drink and the quality of work. The program theory was formulated from the results of the literature study, the survey and the focus group discussions. The all-inclusive program theory was that life skills training will lead to a reduction in frustration and therefore a reduction in the abuse of alcohol, within a positive work environment. In the following phase the program was implemented and evaluated. The program consisted of life skills training, supervisor training and the revision of the alcohol policy. Quantitative and qualitative methods were used to test the program theory and evaluate the program. The life skills program was tested by means of an experimental design. The experimental groups showed an improvement in psychosocial functioning, but the differences were not statistically significant. The intervention had no significant effect on the consumption of alcohol. Respondents’ knowledge about the moderate drinking of alcohol improved significantly, but attitudes towards moderate drinking were not affected. Supervisor training was done to improve relationships at work and to lower frustration. Supervisors improved their knowledge of managing a troubled employee significantly and felt more comfortable in managing troubled employees after the training. The substance abuse policy of the workplace was revised successfully. The study contributes significantly to the methodological improvement of substance abuse prevention programs in the workplace and illustrates the importance of program theory in the design and evaluation of social programs. The study also illustrates how a process of formative evaluation can be used to improve social programs. More specifically the value of a systematic process of program development and program evaluation has been demonstrated, including that an in depth problem analysis has been done, an intensive and collaborative process of theory development has been undertaken and a rigorist evaluation design (with quantitative and qualitative components) has been applied.

The objective of this thesis is to develop an easy-to-use and computationally economical numerical tool to investigate the flow field in the Pulsed Pressure Chemical Vapour Deposition (PP-CVD) reactor. The PP-CVD process is a novel thin film deposition technique with some advantages over traditional CVD methods. The numerical modelling of the PP-CVD flow field is carried out using the Quiet Direct Simulation (QDS) method, which is a flux-based kinetic-theory approach. Two approaches are considered for the flux reconstruction, which are the true directional manner and the directional splitting method. Both the true directional and the directional decoupled QDS codes are validated against various numerical methods which include EFM, direct simulation, Riemann solver and the Godunov method. Both two dimensional and axisymmetric test problems are considered. Simulations are conducted to investigate the PP-CVD reactor flow field at 1 Pa and 1 kPa reactor base pressures. A droplet flash evaporation model is presented to model the evaporation and transport of the liquid droplets injected. The solution of the droplet flash evaporation model is used as the inlet conditions for the QDS gas phase solver. The droplet model is found to be able to provide pressure rise in the reactor at the predicted rate. A series of parametric studies are conducted for the PP-CVD process. The numerical study confirms the hypothesis that the flow field uniformity is insensitive to the reactor geometry. However, a sufficient distance from the injection inlet is required to allow the injected precursor solution to diffuse uniformly before reaching the substrate. It is also recommended that placement of the substrate at the reactor’s centre axis should be avoided.

Despite indications that colorectal cancer (CRC) screening strategies can decrease mortality and morbidity, screening rates among veterans remains to be low. In the Veterans Affairs (VA), the performance measure for CRC screening is lower than the national standard. This quality improvement (QI) project evaluated the effect of a team-based approach, effective electronic information structures, and the provision of education to nurses and patients in increasing CRC screening rate in primary care from 77% to 85%. CRC screening data were retrospectively collected prior to the start of the project and then compared to screening data 3 months after project implementation. The t test showed a statistically significant increase (p = .009) in CRC screening post intervention. Descriptive analysis was performed to evaluate the knowledge and proficiency of nurses with regard to CRC screening by using pre- and posttest questionnaires. The findings showed that emphasizing the importance of CRC screening among team members as well as appropriately dividing the work was effective in contributing to an increase in CRC screening in primary care. This project contributes to positive social change by increasing the nurses' confidence and proficiency in promoting health and disease prevention among the veterans; decreasing patient suffering; and improving collaboration between providers, nurses, and other departments in the VA primary care.

Universities are becoming more accountable for their own funding and for establishing their own societal relevance. As Governments respond to the demands of industry and commerce to fit graduates for the workplace, universities are being asked to provide students with the knowledge and skills for learning and working in an ever-changing workplace. There is a strong implication here that the traditional theory-based learning associated with higher education needs to be augmented (and complemented) by an experiential component that enables students to develop a 'feel' for the workplace and 'an instinct' for what they are likely to be doing when they are working. Demands for such a change are not only coming from industry: students are asking that their university programs be made more 'relevant' to the reality of work rather than merely for the next step in the higher education ladder which requires the 'skills of research'. Recently there has been a strong move throughout the western world towards 'cooperative education' or 'work-integrated education'. Local initiatives at individual institutions are beginning to emphasise the importance of universities developing more symbiotic relationships with the industries in which their graduates are likely to be employed. In Australia, Griffith University has, for example, set up through its Griffith Institute of Higher Education (GIHE) The Griffith Graduate Project, which is attempting to develop an institution-wide policy in this area so that a concerted and coordinated response can be made. As convenor of a Griffith University workplace-based experiential course in the School of Criminology and Criminal Justice, I find this study has provided an opportunity to examine the key determinants of success for a workplace-based course and to consider in detail the teaching and learning processes involved. The aim was to examine the fine-grained processes underlying the construction of new knowledge as students accommodate to the demands placed upon them. The methodology adopted was based on an interpretive constructivist paradigm and addressed a number of questions that considered the roles of the different stakeholders in a specific workplace-based course, the formal and informal expectations held of them, and the role-conflicts these stakeholders tended to experience. This meant that the basic process followed was inductive rather than deductive, worked from the specific to the general and required a methodology that did the same. Because the nature of the work in criminal justice agencies often must deal with feelings and emotion, it was assumed that the students' emotional responses could affect their learning so the methodology allowed for the subjective interpretations and responses (both appropriate and inappropriate) made by all stakeholders and the data was collected as verbatim reports of both factual reports and feeling responses. These were then analysed according to the students' own reports of learning and key principles of procedure for the design and implementation of such courses across the career spectrum were extracted. The values and approaches of action research were central to the responsive case study methodology that was developed. The study found that at its best, the course was conducted according to principles that enabled the student to experience an intuitive 'felt reality' while still making decisions on a strong cognitive base. The acquisition of knowledge appeared to depend on transactions that occurred between teacher and learner, supervisor and student in the workplace milieu. The thesis concludes with a number of recommendations and implications for developing best practice in the field. Ways in which the findings may be incorporated into university policy are also considered, as are the implications for change in the design, conduct and teaching of university professional studies courses.

abstract: Cardiovascular disease (CVD) is the leading cause of mortality in the U.S. While physical activity can reduce CVD risk, most adults do not engage in adequate physical activity to maintain or improve health. Older adults are less likely to participate in physical activity and experience a greater burden of CVD compared to younger adults. Despite knowledge of motivators and barriers to physical activity, the challenge to reduce cardiovascular risk in the older adult population remains unmet. Older adults face unique and complex barriers to physical activity, including limited social contextual resources and behavioral change processes. Interventions to enhance wellness motivation have demonstrated potential in promoting health behavior change among older adults. The purpose of this study was to examine the feasibility of the Yoga for HEART (Health Empowerment and Realizing Transformation) Intervention to increase motivation for physical activity and improve cardiovascular health in older adults. A pilot randomized controlled trial design was used. The Intervention group received Yoga for HEART, a 12-week program to foster motivation for health behavior change. The Control group received a 12-week group yoga program that did not contain theory-based components. The intervention was based on Wellness Motivation Theory, conceptualizing health behavior change as dynamic process of intention formation and goal-directed behavior leading to the development of new and positive health patterns. Critical inputs (i.e., empowering education, motivational support, social network support) were designed to promote social contextual resources and behavioral change processes to increase motivation for physical activity and improve cardiovascular health. Specific Aims were to: (a) examine intervention acceptability, demand, and fidelity, and (b) evaluate intervention efficacy in promoting physical activity and improving cardiovascular health through increased social contextual resources and behavioral change processes. Participants in the Intervention group realized a significant reduction in body mass index (BMI) from baseline to 12 weeks when compared to participants in the Control group. Intervention group participants demonstrated improvement in theoretical mechanisms (i.e., self-knowledge, motivation appraisal, self-regulation, environmental resources) and intended outcomes (i.e., body composition) when compared to Control group participants. Findings from this study support the feasibility of the Yoga for HEART Intervention in older adults. / Dissertation/Thesis / Doctoral Dissertation Nursing and Healthcare Innovation 2018