Comparing evaluation activities across multiple theories of practice.

This article compares and contrasts the evaluation activities described in Practical Participatory Evaluation (Cousins & Whitmore, 1998), Values-engaged Evaluation (Greene, 2005), and Emergent Realist Evaluation (Mark, Henry, & Julnes, 1998). Using the logic models developed to depict each of the three evaluation theories (Hansen, Alkin, & Wallace, 2013) as a starting point, both quantitative and qualitative analysis techniques are employed to discuss the similarities and differences across the practice prescriptions. The approaches are then described according to Miller's (2010) standards for empirical examinations of evaluation theory. Specifically, I offer speculation about their operational specificity and feasibility in practice. I argue that none of the models is completely specific, or wholly unique, and they all present challenges of adaptation into the field. However, the models each offer varying degrees of guidance and unique elements through their prescriptions.

When does a conceptual framework become a theory? Reflections from an accidental theorist.

In this short paper I reflect on the application of a program logic modeling approach to visualizing evaluation theory as it relates to practical participatory evaluation (PPE). The work of Hansen, Alkin and associates presented in this volume is well-thought out, carefully done, rigorous, and important. I found that their application of the approach resonated well with my understanding of PPE with a few notable exceptions. Specifically, the essence of the partnership aspect of the approach was underemphasized as was stakeholders' role in augmenting the credibility of evaluation findings and PPEs contribution to conceptual use. I then reminisce about the development and evolution of the participatory evaluation framework that we have been working with for so many years. I raise the point that we think of it as a theoretical framework to bound inquiry, not as an evaluation theory per se, which raises an interesting question: when does a theoretical framework become a theory?

Effectiveness of social skills training for reduction of self-perceived stigma in leprosy patients in rural India--a preliminary study.

OBJECTIVES: To assess the effectiveness of social skills training in leprosy patients to raise self-esteem and reduce self-perceived stigma. DESIGN: Five leprosy patients were given 10 day-long group-sessions of social skills training over 3 weeks. Training involved: identification of the emotions and concerns of patients when interacting socially; analysis of positive and negative social interactions and non-verbal and verbal skills training. Role-plays, videos and live models were used. Self-esteem and a reduction in self-perceived stigma were assessed qualitatively before and after training using semi-structured interviews. Assessment of change was scored under the indicators: self-perception, family, wider community and job. Patients were assessed for displaying new ways of interacting with people and changes in expectations for the future. RESULTS: Qualitative analysis of the interviews before and after training suggested that social skills training could raise the self-esteem of leprosy patients and combat self-perceived stigma. Increase in self-esteem, as evident through the verbal interactions with the interviewers and behavioural changes in the community, were noted in the majority of patients. CONCLUSION: Social skills training along with counseling may be able to increase the self-esteem of leprosy patients, and so be a useful part of leprosy rehabilitation schemes to try and combat the stigma of leprosy.

Tele-education on leprosy: evaluation of an educational strategy.

The purpose of this research was to evaluate educational strategies applied to a tele-education leprosy course. The curriculum was for members of the Brazilian Family Health Team and was made available through the Sao Paulo Telehealth Portal. The course educational strategy was based on a constructivist learning model where interactivity was emphasized. Authors assessed motivational aspects of the course using the WebMAC Professional tool. Forty-eight healthcare professionals answered the evaluation questionnaire. Adequate internal consistency was achieved (Cronbach's alpha = 0.79). More than 95% of queried items received good evaluations. Multidimensional analysis according to motivational groups of questions (STIMULATING, MEANINGFUL, ORGANIZED, EASY-TO-USE) showed high agreement. According to WebMAC's criteria, it was considered an "awesome course." The tele-educational strategies implemented for leprosy disclosed high motivational scores.

Gains and losses of structured information collection in the evaluation of 'rehabilitation in the community' programmes: ten lessons learnt during actual evaluations.

PURPOSE: Previously we have explored definitions of community-based rehabilitation (CBR) and proposed a way of classifying rehabilitation programmes by describing their essential characteristics. As the next step, we proposed two flow charts that guide the evaluator through a characterization of the programme and then indicate the information that should be collected. The present paper describes the application of this methodology in five actual evaluations of programmes aiming at socio-economic rehabilitation of persons affected by leprosy. METHOD: We compared the information as required by the flow charts to the information presented in the evaluation reports and asked: "Does this methodology adequately describe and reveal all relevant aspects of the rehabilitation programme?" RESULTS: Use of the flow charts led to discussion between evaluators and programme staff about how each would characterize the programme; this was a valuable step in the evaluation process and provided insight to the staff into their current practices and aspirations. The rehabilitation services as such were always well-described in the evaluation reports. More attention could have been given to the programme environment and provider-client relationships. More or more explicit attention than required by the flow charts could be given to linkages with other rehabilitation programmes and community organizations; questions of organizational capacity; systems to maintain and increase the quality of services; and conditions and constraints imposed by donor organizations. In order to show their effectiveness, rehabilitation programmes need to develop simple information systems which show progress of clients towards the rehabilitation goals defined for them, with them or by them. Impact can be demonstrated by an assessment one year after ending the intervention. This should include assessments of clients' psychological and social status. CONCLUSIONS: The original theoretical framework has proven its value in evaluation practice. The flow charts accommodate a variety of programmes and address the specific aims, contexts and developmental stages of the programmes evaluated. Taking the lessons learnt here into account will further improve the usefulness and practical relevance of the methodology we proposed.

Lot quality assurance sampling (LQAS) for monitoring a leprosy elimination program.

In a statistical sense, prevalences of leprosy in different geographical areas can be called very low or rare. Conventional survey methods to monitor leprosy control programs, therefore, need large sample sizes, are expensive, and are time-consuming. Further, with the lowering of prevalence to the near-desired target level, 1 case per 10,000 population at national or subnational levels, the program administrator's concern will be shifted to smaller areas, e.g., districts, for assessment and, if needed, for necessary interventions. In this paper, Lot Quality Assurance Sampling (LQAS), a quality control tool in industry, is proposed to identify districts/regions having a prevalence of leprosy at or above a certain target level, e.g., 1 in 10,000. This technique can also be considered for identifying districts/regions at or below the target level of 1 per 10,000, i.e., areas where the elimination level is attained. For simulating various situations and strategies, a hypothetical computerized population of 10 million persons was created. This population mimics the actual population in terms of the empirical information on rural/urban distributions and the distribution of households by size for the state of Tamil Nadu, India. Various levels with respect to leprosy prevalence are created using this population. The distribution of the number of cases in the population was expected to follow the Poisson process, and this was also confirmed by examination. Sample sizes and corresponding critical values were computed using Poisson approximation. Initially, villages/towns are selected from the population and from each selected village/town households are selected using systematic sampling. Households instead of individuals are used as sampling units. This sampling procedure was simulated 1000 times in the computer from the base population. The results in four different prevalence situations meet the required limits of Type I error of 5% and 90% Power. It is concluded that after validation under field conditions, this method can be considered for a rapid assessment of the leprosy situation.

Summary report of Workshop on Leprosy in the Caribbean: steps to elimination

Under the auspices of the Caribbean Epidemiology Centre (CAREC/PAHO) and with funding from Aide Aux Lepreux Emmaus Suisse (ALES) a three day workshop was organised on the above subject for member countries of CAREC that have several new leprosy cases per year. Participants included Antigua & Barbuda, Barbados, Dominica, Grenada, Guyana, Jamaica, Saint Lucia, St. Vincent & the Grenadines, Suriname, Trinidad & Tobago and the Turks & Caicos Islands ... The range of expertise available to the meeting included epidemiology, dermatology, physicians involved in the primary health care system, senior public health nurses and leprosy control officers (AU)