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OBJECTIVES: Program evaluation is an essential function for public health professionals that is necessary to acquire funding for public health programs and support evidenced-based practice, but coverage of program evaluation principles and methodology within the master of public health (MPH) curriculum is inconsistent and may not adequately prepare students to conduct program evaluation activities postgraduation, especially on culturally responsive program evaluation. We examined the effectiveness of an online training course on program evaluation topics. METHODS: In July 2021, we recruited current and recently graduated MPH students from accredited US universities to measure the effectiveness of a 1-hour online training course in program evaluation. We distributed pre- and postsurveys to eligible participants. We assessed program evaluation skills on a 4-point Likert scale to determine improvements in knowledge (from 4 = extremely knowledgeable to 1 = not knowledgeable), attitudes (from 4 = strongly agree to 1 = strongly disagree), and self-efficacy (from 4 = strongly agree to 1 = strongly disagree). RESULTS: Among 80 MPH students who completed the survey, respondents indicated mean (SD) increases from presurvey to postsurvey in knowledge (from 2.13 [0.66] to 3.24 [0.54]) and attitudes (from 3.61 [0.51] to 3.84 [0.30]) toward program evaluation and in self-efficacy in conducting program evaluation (from 2.92 [0.71] to 3.44 [0.52]). CONCLUSION: The course may be an effective approach for training public health professionals about program evaluation. Our results provide a basis for revising the way program evaluation is taught and practical recommendations for integrating program evaluation competencies within public health curricula, such as by incorporating a self-paced training course for continuing education.

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PURPOSE: Undertaking evaluations of public health interventions can be problematic, particularly where there are multiple stakeholders and high degrees of complexity. This is especially true with regards to the evaluation of community interventions that can include multiple actors with differing priorities, budgets and resources. Using the example of a place-based community wellbeing project, this paper discusses the practical application of 'Outcome Harvesting' as a methodology for retrospective, responsive and collaborative evaluation in public health research. RESULTS: Our example shows that Outcome Harvesting can be effectively applied to the evaluation of community development initiatives and is likely to have potential in evaluating public health interventions more generally. Our case study also found it was well suited to retrospective evaluation, although the earlier the work can begin the more beneficial it is in understanding the project and in gathering sufficient data. CONCLUSION: Outcome Harvesting shows promise for evaluating community development initiatives, allowing evaluators to work closely with key stakeholders to arrive at a mutually agreed and verifiable set of outcomes. However, challenges remain with regards to engaging a broad range of participants and with ensuring adequate time and resources are available to evaluate initiatives effectively.

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This article presents the findings from the first 3 years of the evaluation of Healthy Families NZ, a systems-change intervention to prevent chronic diseases in 10 communities. The initiative, which builds on existing prevention activities, aims to strengthen the health prevention system through evidence-driven action to enable people to make good food choices, be physically active, smoke-free and free from alcohol-related harm. Key investment areas are a dedicated systems thinking and acting health promotion workforce, and activating leaders who can influence transformational change. The evaluation to date has found the initiative is being implemented with integrity. Evidence indicates a shift towards greater action on prevention, and the prevention system being strengthened. Maori ownership has been enabled, and prioritizing equity has led teams to utilize methods that amplify diverse local perspectives. There is progress on developing a flexible workforce through adaptive learning, flexible resources, professional development and a responsive National team. There is also progress in activating local leadership and empowering local teams. The initiative design has explicitly taken into account the context of complexity within which it is being implemented. It has evolved to focus on action that can accelerate sharing information and practices within communities, and between policy and decision-makers. Healthy Families NZ and its evaluation have been refunded to 2022. This provides an important opportunity to gather further insight into effective ways to strengthen the community agency and trust needed to promote and deliver evidence-based action on prevention.

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OBJECTIVES: Stakeholder co-production in design of public health programmes may reduce the 'implementation gap' but can be time-consuming and costly. Prototyping, iterative refining relevant to delivery context, offers a potential solution. This evaluation explored implementation and lessons learnt for a 12-week referral-based weight-management programme, 'Momenta', along with feasibility of an iterative prototyping evaluation framework. DESIGN: Mixed methods evaluation: Qualitative implementation exploration with referrers and service users; preliminary analysis of anonymised quantitative service data (12 and 52 weeks). SETTING: Two leisure centres in Northumberland, North East England. PARTICIPANTS: Individual interviews with referring professionals (n=5) and focus groups with service users (n=13). Individuals (n=182) referred by healthcare professionals (quantitative data). INTERVENTIONS: Three 12-week programme iterations: Momenta (n=59), Momenta-Fitness membership (n=58) and Fitness membership only (n=65). PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome: Qualitative themes developed through stakeholder-engagement. Secondary outcomes included preliminary exploration of recruitment, uptake, retention, and changes in weight, body mass index, waist circumference and psychological well-being. RESULTS: Service users reported positive experiences of Momenta. Implementation gaps were revealed around the referral process and practitioner knowledge. Prototyping enabled iterative refinements such as broadening inclusion criteria. Uptake and 12-week retention were higher for Momenta (84.7%, 45.8%) and Momenta-Fitness (93.1%, 60.3%) versus Fitness only (75.4%, 24.6%). Exploration of other preliminary outcomes (completers only) suggested potential for within-group weight loss and increased psychological well-being for Momenta and Momenta-Fitness at 12 weeks. 52 week follow-up data were limited (32%, 33% and 6% retention for those who started Momenta, Momenta-Fitness and Fitness, respectively) but suggested potential weight loss maintenance for Momenta-Fitness. CONCLUSIONS: Identification of issues within the referral process enabled real-time iterative refinement, while lessons learnt may be of value for local implementation of 'off-the-shelf' weight management packages more generally. Our preliminary data for completers suggest Momenta may have potential for weight loss, particularly when offered with a fitness membership.

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A pumped storage power plant produces significant noise such that adjacent areas were deemed uninhabitable for the local population. In recent years, the population in the area has increased, and the noise levels are now causing significant distress to the local population. The company operating the power plant and a citizens' initiative have both commissioned noise measurements. The measurements showed that the continuous pump noise was audible over many kilometers. The A-weighted sound-pressure level of 50 dBA at the next residential area underestimates the perceived noise, given the clear tonal nature in the low frequency range. Interviews of the exposed population, together with detailed "annoyance diaries" by a sample of the residents, proved their high level of annoyance. Their reported observations on distress and sleep disturbances coincide with the time course of the pumping operation. The pumping noise leads to annoyance in a large area, and to considerable nuisance in a smaller one. For the most exposed homes, long-term exposure might be considered a health hazard due to stress and disturbances in sleep quality. Therefore, the operator committed to developing a technical noise control plan. This case shows that a scientific approach within a complex environmental noise problem can foster an agreement about noise protection measures. However, this can only be successful if all involved parties participate in the process. Pilot studies are underway to test the impact of damping material layers on the pipes, the housing of the pipes, and the kind of air vessel solutions between the pumps and the pipes. Int J Occup Med Environ Health. 2019;32(3):401-11.

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PURPOSE: Current evidence-based research suggests that early evaluation, comprehensive care plans, and appropriate referrals for childhood and adolescent behavioral and development needs is critical for successful family-centered outcomes. The overall purpose of this study was to conduct an assessment of a state public health program that offers diagnostic evaluation and coordination for children with behavioral and developmental disorders in the state of Virginia (Child Development Center programs, or CDC). A secondary purpose was to provide translational policy and advocacy targets based on key findings. DESIGN AND METHOD: The evaluation of the scope of services of the CDC programs was done using qualitative interviews with a focus group interview (n = 23), interviews from representatives from individual centers ( n = 5 centers), and descriptive quantitative data elements for the fiscal year 2015. RESULTS: After conducting the state public health evaluation, several translational health policy priorities emerged, including: (a) the need for integrated data standards, (b) Lack of developmental pediatric workforce, particularly in rural sectors of the state, and (c) Need for enhanced program support for care coordination. CONCLUSION: Academic nurse and public health partnerships can aid in translation from research to policy among vulnerable populations and assist in communication to key stakeholders and legislators for iterative action and reassessment.

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We report on the implementation experience of carrying out data collection and other activities for a public health evaluation study on whether U.S. President's Emergency Plan for AIDS Relief (PEPFAR) investment improved utilization of health services and health system strengthening in Uganda. The retrospective study period focused on the PEPFAR scale-up, from mid-2005 through mid-2011, a period of expansion of PEPFAR programing and health services. We visited 315 health care facilities in Uganda in 2011 and 2012 to collect routine health management information system data forms, as well as to conduct interviews with health system leaders. An earlier phase of this research project collected data from all 112 health district headquarters, reported elsewhere. This article describes the lessons learned from collecting data from health care facilities, project management, useful technologies, and mistakes. We used several new technologies to facilitate data collection, including portable document scanners, smartphones, and web-based data collection, along with older but reliable technologies such as car batteries for power, folding tables to create space, and letters of introduction from appropriate authorities to create entrée. Research in limited-resource settings requires an approach that values the skills and talents of local people, institutions and government agencies, and a tolerance for the unexpected. The development of personal relationships was key to the success of the project. We observed that capacity building activities were repaid many fold, especially in data management and technology.

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OBJECTIVES: To review the methods currently used to synthesize evidence in public health evaluations and demonstrate the availability of more sophisticated approaches. STUDY DESIGN AND SETTING: A systematic review of National Institute for Health and Care Excellence (NICE) public health appraisals published between 2006 and 2012 was performed to assess the methods used for the synthesis of effectiveness evidence. The ability of new developments in evidence synthesis methodology to address the challenges and opportunities present in a public health context is demonstrated. RESULTS: Nine (23%) of the 39 NICE appraisals included in the review performed pairwise meta-analyses as part of the effectiveness review with one of these also including a network meta-analysis. Of the remainder, 29 (74.4%) presented narrative summaries of the evidence only, and 1 (2.6%) appraisal did not present any review of effectiveness and/or cost-effectiveness evidence. Heterogeneity of outcomes, methods, and interventions were the main reasons given for not pooling the data. Exploration of quantitative synthesis methods shows that pairwise meta-analyses can be extended to incorporate individual participant data (when it is available), extend the number of interventions being compared using a network meta-analysis, and adjust for both subject- and summary-level covariates. All these can contribute to ensuring the analysis answers directly the policy-relevant questions. CONCLUSION: More sophisticated methods in evidence synthesis should be considered to make evaluations in public health more useful for decision makers.

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