scholarly journals Evaluating Large-Scale Integrated Care Projects: The Development of a Protocol for a Mixed Methods Realist Evaluation Study in Belgium

2020 ◽  
Vol 20 (3) ◽  
Author(s):  
Geert Goderis ◽  
Elien Colman ◽  
Lucia Alvarez Irusta ◽  
Ann Van Hecke ◽  
Benoit Pétré ◽  
...  
2019 ◽  
Vol 27 (3) ◽  
pp. 204-214 ◽  
Author(s):  
Tom Grimwood

Purpose The purpose of this paper is to discuss the methodological challenges to evaluating one of the 50 vanguard sites of the new care model (NCM) programme for integrated care in England, and make the case for a modified realist approach to this kind of evaluation. Design/methodology/approach The paper considers three challenges to evaluating the NCM in this particular vanguard: complexity, strategy and rhetoric. It reflects on how the realist approach negotiates these philosophical challenges to delivering integrated care, in order to provide contextualised accounts of who a programme works for, in what context, and why. Findings The paper argues that, in the case of this particular vanguard site, the tangible benefit of the realist approach was not in providing a firm epistemological basis for evaluation, but rather in drawing out and articulating the ontological rhetoric of such large-scale transformation programmes. By understanding the work of the NCM less as an objective “system”, and more as a dynamic form of persuasion, aimed at securing the “adherence of minds” (Perelman and Olbrechts-Tyteca, 2008, p. 8) in multiple audiences, the paper suggests that realist evaluation can be used to address both the systematic issues and localised successes the NCMs encountered. Originality/value The paper identifies a number of aspects of new models of integrated care for evaluators to consider. It offers ways of negotiating the challenges to conventional outcome-focused evaluation, by drawing attention to the need for contextualised, time-situated and audience-sensitive value of NCMs.


2019 ◽  
Vol 27 (3) ◽  
pp. 215-231 ◽  
Author(s):  
Liset Grooten ◽  
Cristina-Adriana Alexandru ◽  
Tamara Alhambra-Borrás ◽  
Stuart Anderson ◽  
Francesca Avolio ◽  
...  

Purpose To ensure that more people will benefit from integrated care initiatives, scaling-up of successful initiatives is the way forward. However, new challenges present themselves as knowledge on how to achieve successful large-scale implementation is scarce. The EU-funded project SCIROCCO uses a step-based scaling-up strategy to explore what to scale-up, and how to scale-up integrated care initiatives by matching the complementary strengths and weaknesses of five European regions involved in integrated care. The purpose of this paper is to describe a multi-method evaluation protocol designed to understand what factors influence the implementation of the SCIROCCO strategy to support the scaling-up of integrated care. Design/methodology/approach The first part of the protocol focuses on the assessment of the implementation fidelity of the SCIROCCO step-based strategy. The objective is to gain insight in whether the step-based strategy is implemented as it was designed to explore what works and does not work when implementing the scaling-up strategy. The second part concerns a realist evaluation to examine what it is about the SCIROCCO’s strategy that works for whom, why, how and in which circumstances when scaling-up integrated care. Findings The intended study will provide valuable information on the implementation of the scaling-up strategy which will help to explain for what specific reasons the implementation succeeds and will facilitate further improvement of project outcomes. Originality/value The expected insights could be useful to guide the development, implementation and evaluation of future scaling-up strategies to advance the change towards more sustainable health and care systems.


2019 ◽  
Vol 18 (4) ◽  
pp. 228-230
Author(s):  
Paul Linsley

AbstractThis paper examines an increasingly used methodology developed by Pawson and Tilley [1] that they termed, ‘Realistic Evaluation’. The paper provides an overview of methodology as well as exploring its underpinning philosophy, that of critical realism. The paper suggests that Realistic Evaluation provides a useful means of exploring the health and social sciences through the use of mixed methods and concludes with how a researcher might go about constructing a Realist Evaluation study.


2018 ◽  
Vol 10 (1) ◽  
pp. 283-295
Author(s):  
Katrin Niglas ◽  
◽  
Meril Ümarik ◽  
Maarja Tinn ◽  
Ivor Goodson ◽  
...  

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Nishigaki ◽  
C Koga ◽  
M Hanazato ◽  
K Kondo

Abstract Introduction Older adult's depression is a public health problem. In recent years, exposure to local greenspace is beneficial to mental health via increased physical activity in people. However, few studies approach the relationship between greenspace and depression while simultaneously considering the frequency, time, and the number of types of physical activity, and large-scale surveys targeting the older adults. Methods Cross-sectional data conducted in 2016 by the Japan Gerontological Evaluation Study was used. The analysis included older adults aged 65 and over who did not require care or assistance, and a total of 126,878 people in 881 School districts. The explanatory variable is the percentage of the greenspace of the area, and the greenspace data used is data created from satellite photographs acquired by observation satellites of the Japan Aerospace Exploration Agency. The objective variable was depression (Geriatric Depression Scale 5 points or more). The analysis method was a multi-level logistic regression analysis. Physical activity was the number of sports-related hobbies, the frequency of participation in sports meetings, and walking time in daily life. Other factors such as personal attributes, population density of residential areas, and local climate were also considered. Results Depression in the survey was 20.4%. The abundance of greenspace was still associated with depression, considering all physical activity. The odds ratio of depression in areas with more greenspace was 0.92 (95% CI 0.87 - 0.98) compared to areas with less greenspace. Conclusions It became clear that areas with many greenspace were still associated with low depression, even considering the frequency, time and number of physical activities. It is conceivable that the healing effect of seeing greenspace, the reduction of air pollution and noise, etc. are related to the lack of depression without going through physical activity. Key messages In Japan, older adults are less depressed when there are many local greenspace. It became clear that areas with many greenspace were still associated with low depression, even considering physical activities.


2019 ◽  
Vol 4 (01) ◽  
pp. 1-19
Author(s):  
Ferdinan Ferdinan ◽  
Nurhayati Nurhayati

  AbstrakPenelitian ini adalah penelitian evaluasi dengan menggunakan jenis penelitian kombinasi (mixed methods). Pendekatan penelitian, yaitu: pendekatan studi kasus. Sumber data penelitian ini terdiri atas Rektor, Wakil Rektor I, Ketua Lembaga Penjaminan Mutu, Ketua Unit Penjaminan Mutu Fakultas, dan Kasubdit SDM Universitas dan yang menjadi responden yaitu 32 Ketua Prodi dan 70 Ketua Tingkat. Teknik pengumpulan data yaitu wawancara, studi dokumentasi, dan lembar observasi. Penilaian untuk setiap aspek evaluasi dikategorikan menjadi tiga tingkatan: tinggi, sedang, dan rendah.  Pengambilan keputusan dikategorikan menjadi tiga tingkatan: tercapai, kurang tercapai, dan tidak tercapai. Penelitian evaluasi ini memberikan beberapa kesimpulan,  yaitu gambaran pelaksanaan pembelajaran di Unismuh Makassar pada tahapan proses (transactions) menunjukkan bahwa: 1) penguasaan dosen dalam menyusun dan menyiapkan administrasi perkuliahan dari 7 subaspek  yang dievaluasi  terdapat 6 subaspek  telah memenuhi kriteria objektif dan 1 subaspek yang kurang tercapai yaitu kemampuan dosen dalam menyusun buku ajar, 2)) penguasaan dosen dalam pelaksanaan perkuliahan menunjukkan bahwa dari 15 subaspek yang dievaluasi 13 subaspek sudah tercapai sesuai standar objektif dan 2 subaspek yang belum terpenuhi yaitu dosen tidak memberikan sanksi kepada mahasiswa yang terlambat 30 menit dalam mengikuti perkuliahan dan dosen belum menyampaikan materi kuliah dengan berbasis IT, 3) interaksi dosen dengan mahasiswa dalam perkuliahan, dari 4 subaspek yang dievaluasi semuanya telah memenuhi standar objektif, dan 4) kemampuan dosen dalam melakukan evaluasi hasil perkuliahan  menunjukkan bahwa dari 12 subaspek yang dievaluasi terdapat  10 subaspek sudah tercapai sesuai standar objektif dan 2 subaspek kurang terpenuhi. Kata Kunci: Evaluasi, Mutu Pembelajaran dan TransactionsAbstract                This study is an evaluation study using mixed methods. Research approach, namely: case study approach. The data sources of this study consisted of the Chancellor, Deputy Chancellor I, Chairperson of the Quality Assurance Agency, Chair of the Faculty Quality Assurance Unit, and the Head of Sub-directorate of Human Resources of the University and respondents, namely 32 Chairmen of Study Programs and 70 Chairmen. Data collection techniques are interviews, documentation studies, and observation sheets. Assessments for each aspect of evaluation are categorized into three levels: high, medium, and low. Decision making is categorized into three levels: achieved, less achieved, and not achieved. This evaluation study provides several conclusions, namely the description of the implementation of learning in Unismuh Makassar at the stages of transactions shows that: 1) the mastery of lecturers in preparing and preparing lecture administration from 7 sub-aspects evaluated, there are 6 sub-aspects that meet objective criteria and 1 sub-aspect is lacking achieved, namely the ability of lecturers in preparing textbooks, 2)) mastery of lecturers in lecturing shows that out of 15 sub-aspects evaluated 13 sub-aspects have been achieved according to objective standards and 2 sub-aspects that have not been fulfilled, namely lecturers do not sanction students who are 30 minutes late in attending lectures and lecturers have not delivered IT-based lecture material, 3) lecturer and student interaction in lectures, of the 4 sub-aspects evaluated all met objective standards, and 4) lecturers' ability to evaluate lecture results showed that from 12 sub the evaluated aspects have 10 sub-aspects that have been achieved according to objective standards and 2 sub-aspects have not been fulfilled.Keywords: Evaluation, Learning Quality and Transaction


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