Developing an empirically-based adaptation an training model for intervention scale up of classroom pivotal response teaching: A protocol paper

Abstract Background There is a great need to identify implementation strategies to successfully scale-up public health interventions in order to achieve their intended population impact. The Out-of-school Nutrition and Physical Activity group-randomized trial previously demonstrated improvements in children’s vigorous physical activity and the healthfulness of foods and beverages consumed. This implementation study aimed to assess the effects and costs of two training models to scale-up this evidence-based intervention. Methods A 3-arm group-randomized trial was conducted to compare effectiveness of in-person and online training models for scaling up the intervention compared to controls. One-third of sites were randomized to the in-person train-the-trainer model: local YMCA facilitators attended a training session and then conducted three learning collaborative meetings and technical assistance. One-third were assigned to the online model, consisting of self-paced monthly learning modules, videos, quizzes, and facilitated discussion boards. Remaining sites served as controls. Fifty-three afterschool sites from three YMCA Associations in different regions of the country completed baseline and follow-up observations using a validated tool of afterschool nutrition and physical activity practices. We used multivariable regression models, accounting for clustering of observations, to assess intervention effects on an aggregate afterschool practice primary outcome, and conducted secondary analyses of nine intervention goals (e.g. serving water). Cost data were collected to determine the resources to implement each training model. Results Changes in the primary outcome indicate that, on average, sites in the in-person arm achieved 0.44 additional goals compared to controls (95%CI 0.02, 0.86, p = 0.04). Increases in the number of additional goals achieved in sites in the online arm were not significantly greater than control sites (+ 0.28, 95% CI -0.18, 0.73, p = 0.24). Goal-specific improvements were observed for increasing water offered in the in-person arm and fruits and vegetables offered in the online arm. The cost per person trained was $678 for the in-person training model and $336 for the on-line training model. Conclusions This pilot trial presents promising findings on implementation strategies for scale-up. It validated the in-person training model as an effective approach. The less expensive online training may be a useful option for geographically disbursed sites where in-person training is challenging. Trial registration Although this study does not report the results of a health care intervention on human subjects, it is a randomized trial and was therefore retrospectively registered in ClinicalTrials.gov on July 4, 2019 in accordance with the BMC guidelines to ensure the complete publication of all results (NCT04009304).

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Provider perspectives and reach of an evidence-based intervention in community services for toddlers

Autism ◽

10.1177/13623613211065535 ◽

2022 ◽

pp. 136236132110655

Author(s):

Sarah R Rieth ◽

Kelsey S Dickson ◽

Jordan Ko ◽

Rachel Haine-Schlagel ◽

Kim Gaines ◽

...

Keyword(s):

Early Intervention ◽

Young Children ◽

Child Outcomes ◽

Scale Up ◽

Training Model ◽

Evidence Based ◽

Community Settings ◽

Training Study ◽

Project Impact ◽

Daily Routines

Best-practice recommendations for young children at high likelihood of autism include active involvement of caregivers in intervention. However, the use of evidence-based parent-mediated interventions in community practice remains limited. Preliminary evidence suggests that Project ImPACT for Toddlers demonstrates positive parent and child outcomes in community settings. Project ImPACT for Toddlers was adapted specifically for toddlers and teaches parents of young children strategies to build their child’s social, communication, and play skills in daily routines. This study reports implementation outcomes from the initial community rollout of Project ImPACT for Toddlers and examines the system-wide intervention reach, with the goal of informing continued community sustainment and scale-up. Participants include 38 community providers who participated in a Project ImPACT for Toddlers’ training study who completed an implementation survey and semi-structured interviews after approximately 3 months of community implementation. Participants perceived the training model as acceptable and appropriate, and identified several strengths of the approach. Interview themes also supported the feasibility, acceptability, and utility of the intervention in community settings. Quantitative findings complemented the thematic results from interviews. Intervention reach data indicate an increasing number of agencies delivering and families receiving Project ImPACT for Toddlers. Efforts to scale-up evidence-based interventions in early intervention should continue to build upon the model of the Bond, Regulate, Interact, Develop, Guide, and Engage Collaborative. Lay abstract Expert recommendations for toddlers who are likely to develop autism include caregivers being actively involved in the services children receive. However, many services available in the community may not follow these recommendations. Evidence suggests that an intervention named Project ImPACT for Toddlers demonstrates positive parent and child outcomes for families in the community. Project ImPACT for Toddlers was designed specifically for toddlers by a group of parents, clinicians, researchers, and funders. It teaches parents of young children strategies to support their child’s development in daily routines. This study reports the perspectives of early intervention providers who learned to use Project ImPACT for Toddlers on whether the intervention was a good fit for their practice and easy to use. The study also examines how many agencies are using Project ImPACT for Toddlers and how many families have received the intervention in the community. The goal of the study is to inform the continued use of Project ImPACT for Toddlers in the community and support offering the intervention in other regions. Participants include 38 community providers who participated in a training study of Project ImPACT for Toddlers and completed a survey and semi-structured interview after approximately 3 months of using Project ImPACT for Toddlers with families. Participants perceived the training model as acceptable and appropriate, and identified the group-based model of training, comprehensive materials, and agency support as strengths of the approach. Survey findings complemented the results from the interviews. Data indicate an increasing number of agencies and families accessing Project ImPACT for Toddlers. Efforts to expand evidence-based intervention in early intervention should continue to build upon the model used for Project ImPACT for Toddlers.

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Implementing a Two-Tiered Model of Optometry Training in Mozambique as an Eye Health Development Strategy

Global Journal of Health Science ◽

10.5539/gjhs.v11n9p13 ◽

2019 ◽

Vol 11 (9) ◽

pp. 13

Author(s):

Diane van Staden ◽

James Loughman ◽

Kovin Naidoo

Keyword(s):

Development Strategy ◽

Scale Up ◽

Training Model ◽

World Health Organisation ◽

World Health ◽

Comparative Approach ◽

Situational Analysis ◽

Eye Health ◽

Health Strategy

BACKGROUND: The global burden of vision impairment has been acknowledged by the World Health Organisation as a public health challenge. In order to scale up the production of eye health personnel in developing countries, a tiered model of optometry training was explored in Mozambique. OBJECTIVES: The Mozambique case study was evaluated to assess the feasibility of a tiered model of optometry training as a developmental eye health strategy. METHODS: A qualitative, case study approach was used. Semi-structured key informant interviews were conducted and project documents were reviewed in the data collection phase. Data underwent a process of content analysis, using a constant comparative approach across sources, and was analysed thematically using inductive reasoning. RESULTS: Three key themes which emerged were Rationale for a training model, Implementation considerations and Development practice considerations. Results demonstrated that while tiered models of training may have developmental rationale, awareness of the profession and its place in addressing health needs, intensive consultation with local stakeholders and a thorough situational analysis are required for this strategy to be feasible. CONCLUSIONS: A tiered model of training appears to have theoretical basis as a developmental eye health strategy. However, local applicability and legislative alignment is required in order for these training initiatives to be sustainably implemented.

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The Feasibility of Recruiting and Training Lay Leaders During Real-World Program Delivery and Scale-up: The Case of Walk With Ease

Health Promotion Practice ◽

10.1177/1524839919840004 ◽

2019 ◽

Vol 22 (1) ◽

pp. 91-101 ◽

Cited By ~ 2

Author(s):

Kathleen P. Conte ◽

Fabian Held ◽

Olivia Pipitone ◽

Sally Bowman

Keyword(s):

Real World ◽

Qualitative Interviews ◽

Scale Up ◽

Training Model ◽

Scaling Up ◽

Lay Leaders ◽

Limited Resources ◽

Program Delivery ◽

Leader Training ◽

Lay Leader

Introduction. To maximize limited resources, many health promotion programs are designed to be delivered by volunteer lay leaders. But this model poses challenges to implementation in real-world settings and barriers to successfully scaling-up programs. This study examines the current lay leader training model for Walk With Ease, a Centers for Disease Control and Prevention–funded evidence-based arthritis program delivered at-scale. Method. Recruited volunteers ( n = 106) opted into free online or in-person training and agreed to deliver one Walk With Ease program within the following year—only 49%, however, did. Using logistic regression models and qualitative interviews, we explored predictors of volunteer delivery. Results. Volunteers had higher odds of delivering programs if they trained online (odds ratio [OR] = 9.04, 95% confidence interval [CI: 2.30, 48.36]), previously taught health programs (OR = 15.52, 95% CI [3.51, 103.55]) or trained in the second year of implementation (OR = 27.08, 95% CI [2.63, 415.78]). Qualitative findings underscored that successful volunteers were readied by their previous health education experience. Conclusions. While online training modes appear effective to prepare experienced volunteers, lay leaders required additional support. This calls into question whether lay-led delivery models are suitable for scaling-up programs with limited resources. Given the many lay-led health interventions for chronic disease self-management, investing in common training and infrastructures for lay leader development could advance the quality and sustainability of real-world program delivery.

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APPRENTICESHIP SKILLS DEVELOPMENT WITHIN THE INFORMAL SECTOR OF THE GHANAIAN ECONOMY: THE CASE OF SUNYANI MAGAZINE

UDS International Journal of Development ◽

10.47740/564.udsijd6i ◽

2021 ◽

Vol 8 (1) ◽

pp. 559-572

Author(s):

V. Korang

Keyword(s):

Socioeconomic Development ◽

New Ventures ◽

Scale Up ◽

Training Model ◽

Local Economy ◽

Government Support ◽

Skills Development ◽

Industrial Zone ◽

Cross Sectional Survey ◽

Cross Sectional

Apprenticeship training is one of the several means of developing the skills and competencies of the workforce in every economy. The small and micro-scale engineering enterprises since their inception, have been contributing towards the development of the country. This is particularly so in the manufacturing and engineering sectors where local tools, equipment and machinery are produced and serviced. The Sunyani magazine has become an emerging informal industrial zone where technical skills development is offered to individuals across different areas of engineering. This paper examined the nature of apprenticeship skills development and the associated challenges in an informal industrial zone through a cross-sectional survey. The findings suggest that on-the-job training model without pre- or post-training exams or test characterised the training of apprentices. During the skills development process of the apprentices, the master craftsmen examine the progress of the apprentices to ensure they are progressing and to determine when apprentices have acquired the needed skills to be considered certified. Despite the benefits offered to the local economy, lack of funding for new ventures, lack of government support, tools and equipment constrain the capacity of the informal industrial zone to scale-up its training capacity with the potential of being of greater benefits to the socioeconomic development of the country.

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NiAl precipitation in Fe-12w/o Cr-5w/o Ni-4w/o Al

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010007480x ◽

1983 ◽

Vol 41 ◽

pp. 202-203

Author(s):

L.E. Murr ◽

J.S. Dunning ◽

S. Shankar

Keyword(s):

Solid Solution ◽

Stainless Steel ◽

Stainless Steels ◽

Alloy Composition ◽

Chromium Content ◽

Scale Up ◽

Optical Metallography ◽

Property Evaluation ◽

310 Stainless Steel ◽

Microstructural Studies

Aluminum additions to conventional 18Cr-8Ni austenitic stainless steel compositions impart excellent resistance to high sulfur environments. However, problems are typically encountered with aluminum additions above about 1% due to embrittlement caused by aluminum in solid solution and the precipitation of NiAl. Consequently, little use has been made of aluminum alloy additions to stainless steels for use in sulfur or H2S environments in the chemical industry, energy conversion or generation, and mineral processing, for example.A research program at the Albany Research Center has concentrated on the development of a wrought alloy composition with as low a chromium content as possible, with the idea of developing a low-chromium substitute for 310 stainless steel (25Cr-20Ni) which is often used in high-sulfur environments. On the basis of workability and microstructural studies involving optical metallography on 100g button ingots soaked at 700°C and air-cooled, a low-alloy composition Fe-12Cr-5Ni-4Al (in wt %) was selected for scale up and property evaluation.

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