Policy, Systems, and Environmental (PSE) Strategies to Support Healthy Eating Behaviors in Early Childhood: A Scoping Review of Existing Evaluation Tools.

BACKGROUND: Policy, Systems, and Environmental (PSE) Policy, Systems, and Environmental (PSE) change strategies aimed at supporting healthy eating behaviors work to enhance optimal nutrition by making healthy foods more available and accessible in the community. PSE change strategies can complement and strengthen knowledge, skills, and behaviors obtained through individual-level nutrition education. OBJECTIVE: This scoping review aimed to (1) identify existing literature evaluating early childhood (i.e., children under five years) PSE change strategies supporting healthy eating behaviors and (2) describe the evaluation tools used to assess the identified PSE change strategies. METHODS: Three databases (PubMed, CINAHL, and Web of Science) were used to systematically search for articles published between 2013 and 2023 written in English and conducted in the United States (US) that evaluated PSE change strategies supporting healthy eating behaviors in young children (i.e., children under the age of five years). Two study members conducted the review, discussing and reconciling discrepancies until a consensus was reached for inter-observer reliability. RESULTS: Findings from this review identified 48 studies evaluating early childhood PSE change strategies supporting healthy eating behaviors, with 36 studies using PSE-focused evaluation tools (n=25) to evaluate these strategies. Most tools (80%) assessed PSE change strategies supporting access and availability of healthy food and beverage options in early childhood education settings. Studies did not evaluate child-level outcomes (i.e., attitudes, preferences, and behaviors) to showcase improvement of early childhood nutrition. Only 60% of the tools reported evidence of validity or reliability. CONCLUSIONS: Most of the studies identified in this scoping review were aimed to evaluate healthy eating PSE change strategies focused on improving access to and availability of healthy foods and beverages in early childhood education settings. Future research is needed to develop and validate PSE-focused evaluation tools assessing child-level healthy eating practices and behaviors.

Impact of a mindfulness-based intervention on well-being and mental health of elementary school children: results from a randomized cluster trial.

Prevention programs, such as mindfulness-based interventions (MBIs), are often implemented in schools to prevent psychological disorders from emerging in children and to support their mental health. This study used a randomized cluster design to evaluate the impact of a MBI, called Mission Méditation, on the well-being and the mental health of elementary school children's. 13 classrooms of an elementary school were randomly allocated to the experimental condition (7 classrooms, n = 127 students) or the waitlist control condition (6 classrooms, n = 104 students). Participants in the experimental condition received a 10-week MBI. Regression analyses revealed significant differences between conditions for inattention. Participants in the MBI condition reported no change in pre- to post-intervention, whereas participants in the control condition reported pre- to post-intervention increases. Results also showed significant differences in perceived competence. Participants in the MBI condition reported a non-significant decrease in perceive competence, whereas participants in the control condition reported significantly higher perceive competence scores from pre- to post-intervention. Results do not indicate that the MBI had a significant impact on participant's well-being and mental health. This suggests that MBIs may not have an added value when compared to other preventive interventions geared towards well-being and mental health promotion in school settings.

Connect-ROD - development and qualitative evaluation of a community-based group intervention to support well-being in patients with a rare or orphan disease.

BACKGROUND: Patients living with various rare or orphan diseases (ROD) experience common psychosocial difficulties. Those need emerge from a combination of factors, such as the large variety of patients and the rarity of resources, as well as concentrated efforts on physical health needs that yielded increases in life expectancy and quality in patients. A gap is therefore rising in the consideration of psychosocial needs of patients, such as coping with the impacts of physical limitations, reducing social isolation and distress. To contribute to address this gap, we developed, pilot-tested and evaluated the acceptability, feasibility, implementation, and short-term effects of Connect-ROD, an online group intervention to support adult patients with a ROD (AP-ROD), which aims to improve coping mechanisms, reinforce sense of control, and support personal goals of AP-ROD. A qualitative study comprising of in-depth pretests, post-test interviews and standardized questionnaires, was conducted with 14 participants in two consecutive intervention groups. RESULTS: The Connect-ROD intervention is strongly anchored in acceptance and commitment therapy as well as community psychology approaches. A pilot test allowed us to improve on the initial structure and to produce a manualized 10-week program delivered online, made up of 2-h sessions comprising formal activities, exchanges and homework. The evaluation showed satisfactory acceptability and accessibility, compliant delivery by facilitators, and promising short-term effects on personal objectives, sense of control, coping mechanisms, symptom management, acceptance of the emotions associated with the disease, distress, self-efficacy, social support and connectedness. The program did not show short-term effects on overall quality of life. CONCLUSION: It is recommended that Connect-ROD is evaluated on a larger scale. It seems promising to support various AP-ROD who live with the complex psychosocial consequences of their disease.

Care Navigation and Coordination Program on Reducing Hospital Use for Adults with Complex Health and Psychosocial Needs in South West Sydney, Australia.

Intro: Complex and siloed health and social service systems can be difficult for people to navigate. The fragmented and poorly linked services leads to ineffective communication between care teams, delayed access to services, concerns regarding quality and safety of patient care, as well as patient frustration and disengagement. Description: Planned Care for Better Health (PCBH) is a community-based care navigation and coordination program for people with complex health and psychosocial needs who are at risk of future hospitalisation. It focuses on early identification and holistic care to remove barriers and improve access to healthcare. By including a persons', family and carers in planning, listening to their needs, supporting the person to achieve their goals, and empowering them to make decisions on their own health, PCBH aims to enhance clients' healthcare experience and reduce preventable hospital utilisation. Discussion: Building trusting and collaborative relationships with clients, families, carers, and health service providers requires commitment. Acknowledging and addressing psychosocial needs is critical for enhancing health outcomes. Equipping patients with self-management skills and knowledge to navigate and engage support services may generate lasting effects, even post-program enrolment. Conclusion: PCBH is associated with a notable reduction in unplanned hospitalisations and total bed days. However, reduction in ED presentations is similar between the intervention and comparison cohorts. Future initiatives should focus on a shared vision of integrated care, robust leadership, and participative co-creation with service-level stakeholders. Sustained program establishment, a multidisciplinary care coordinator team, and an early creation of robust evaluation strategy must be considered.

Inclusive Approaches for Measuring Demographics of Underrepresented Populations in STEM and Biomedical Research Training Programs.

As federal strategic plans prioritize increasing diversity within the biomedical workforce, and STEM training and outreach programs seek to recruit and retain students from historically underrepresented populations, there is a need for interrogation of traditional demographic descriptors and careful consideration of best practices for obtaining demographic data. To accelerate this work, equity-focused researchers and leaders from STEM programs convened to examine approaches for measuring demographic variables. Gender, race/ethnicity, disability, and disadvantaged background were prioritized given their focus by federal funding agencies. Categories of sex minority, sexual (orientation) minority, and gender minority (SSGM) should be included in demographic measures collected by STEM programs, consistent with recommendations from White House Executive Orders and federal reports. Our manuscript offers operationalized phrasing for demographic questions and recommendations for use across student-serving programs. Inclusive demographics permit the identification of individuals who are being excluded, marginalized, or improperly aggregated, increasing capacity to address inequities in biomedical research training. As trainees do not enter training programs with equal access, accommodations, or preparation, inclusive demographic measures can welcome trainees and inform a nuanced set of program outcomes that facilitate research on intersectionality to support the recruitment and retention of underrepresented students in biomedical research.

Evaluation of the Cultural, Social and Emotional Wellbeing Program with Aboriginal women in the Boronia Pre-Release Centre for Women: a mixed methods study.

OBJECTIVE: To assess the effectiveness of the Cultural, Social and Emotional Wellbeing Program for reducing psychological distress and enhancing the social and emotional wellbeing of Aboriginal women preparing for release from prison. STUDY DESIGN: Mixed methods; qualitative study (adapted reflexive thematic analysis of stories of most significant change) and assessment of psychological distress. SETTING, PARTICIPANTS: Aboriginal and Torres Strait Islander women at the Boronia Pre-release Centre for Women, Perth, Western Australia, May and July 2021. INTERVENTION: Cultural, Social and Emotional Wellbeing Program (two days per week for six weeks). The Program involves presentations, workshops, activities, group discussions, and self-reflections designed to enhance social and emotional wellbeing. MAIN OUTCOME MEASURES: Themes and subthemes identified from reflexive thematic analysis of participants' stories of most significant change; change in mean psychological distress, as assessed with the 5-item Kessler Scale (K-5) before and after the Program. RESULTS: Fourteen of 16 invited women completed the Program; ten participated in its evaluation. They reported improved social and emotional wellbeing, reflected as enhanced connections to culture, family, and community. Mean psychological distress was lower after the Program (mean K-5 score, 11.3; 95% confidence interval [CI], 9.0-13.6) than before the Program (9.0; 95% CI, 6.5-11.5; P = 0.047). CONCLUSION: The women who participated in the Program reported personal growth, including acceptance of self and acceptance and pride in culture, reflecting enhanced social and emotional wellbeing through connections to culture and kinship. Our preliminary findings suggest that the Program could improve the resilience of Aboriginal and Torres Strait Islander in contact with the justice system.

Evaluation and Assessment of the ABATE Framework to Enhance Implicit Bias Training for Virtual Interviews in Medical Schools.

Introduction: The influence of implicit biases in virtual interviews must be addressed to ensure equity within the admissions process. ABATE is a mnemonic framework of five specific categories of implicit bias (affinity-based, backdrop-based, appearance-based, technology and media-based, and enunciation-based biases) that should be anticipated and mitigated for faculty, staff, health professionals, and medical students who conduct virtual interviews at medical schools. Methods: A 60-minute workshop was developed to educate medical school admissions interviewers about the ABATE model and strategies to mitigate implicit bias during virtual interviews. Four workshops were held over 1 year totaling 217 individual attendees. The workshops were evaluated using a single-group, pre-post questionnaire designed with the Kirkpatrick evaluation model. Results: Attendees reported that they found the ABATE workshop useful and relevant to improving their ability to minimize implicit bias during virtual interviews. Significant improvements were found in attendee reactions to the utility of implicit bias training (M pre = 2.6, M post = 3.1, p = .002). Significant changes were also reported in attendees' attitudes about interviewing confidence (M pre = 3.0, M post = 3.2, p = .04), bias awareness (M pre = 3.0, M post = 3.4, p = .002), and identifying and applying bias mitigation solutions (M pre = 2.5, M post = 3.0, p = .003). Knowledge specific to backdrop-based biases also significantly increased (M pre = 3.2, M post = 3.4, p = .04). Discussion: The ABATE workshop demonstrates promise in mitigating implicit bias in virtual medical school interviews.

Healthcare workers' perspectives on a prescription phone program to meet the health equity needs of patients in the emergency department: a qualitative study.

OBJECTIVES: People experiencing homelessness and marginalization face considerable barriers to accessing healthcare services. Increased reliance on technology within healthcare has exacerbated these inequities. We evaluated a hospital-based prescription phone program aimed to reduce digital health inequities and improve access to services among marginalized patients in Emergency Departments. We examined the perceived outcomes of the program and the contextual barriers and facilitators affecting outcomes. METHODS: We conducted a constructivist qualitative program evaluation at two urban, academic hospitals in Toronto, Ontario. We interviewed 12 healthcare workers about their perspectives on program implementation and outcomes and analyzed the interview data using reflexive thematic analysis. RESULTS: Our analyses generated five interrelated program outcomes: building trust with patients, facilitating independence in healthcare, bridging sectors of care, enabling equitable care for marginalized populations, and mitigating moral distress among healthcare workers. Participants expressed that phone provision is critical for adequately serving patients who face barriers to accessing health and social services, and for supporting healthcare workers who often lack resources to adequately serve these patients. We identified key contextual enablers and challenges that may influence program outcomes and future implementation efforts. CONCLUSIONS: Our findings suggest that providing phones to marginalized patient populations may address digital and social health inequities; however, building trusting relationships with patients, understanding the unique needs of these populations, and operating within a biopsychosocial model of health are key to program success.

ABSTRAIT: OBJECTIFS: Les personnes sans abri et marginalisées font face à des obstacles considérables pour accéder aux services de santé. Le recours accru à la technologie dans les soins de santé a exacerbé ces inégalités. Nous avons évalué un programme de téléphones d'ordonnance en milieu hospitalier visant à réduire les inégalités en santé numérique et à améliorer l'accès aux services chez les patients marginalisés des services d'urgence. Nous avons examiné les résultats perçus du programme et les obstacles contextuels et facilitateurs qui influent sur les résultats. MéTHODES: Nous avons mené une évaluation qualitative constructiviste de programmes dans deux hôpitaux universitaires urbains de Toronto, en Ontario. Nous avons interviewé 12 travailleurs de la santé au sujet de leurs points de vue sur la mise en œuvre et les résultats du programme et analysé les données des entrevues au moyen d'une analyse thématique réflexive. RéSULTATS: Nos analyses ont généré cinq résultats de programme interdépendants : établir la confiance avec les patients, faciliter l'indépendance dans les soins de santé, rapprocher les secteurs de soins, permettre des soins équitables pour les populations marginalisées et atténuer la détresse morale chez les travailleurs de la santé. Les participants ont indiqué que la fourniture de services téléphoniques est essentielle pour servir adéquatement les patients qui font face à des obstacles à l'accès aux services de santé et aux services sociaux, et pour soutenir les travailleurs de la santé qui manquent souvent de ressources pour servir adéquatement ces patients. Nous avons cerné les principaux catalyseurs contextuels et les défis qui pourraient influer sur les résultats du programme et les efforts de mise en œuvre futurs. CONCLUSION: Nos résultats suggèrent que la fourniture de téléphones aux populations de patients marginalisés peut remédier aux inégalités numériques et sociales en matière de santé; cependant, établir des relations de confiance avec les patients, comprendre les besoins uniques de ces populations, La réussite du programme repose sur le fait de fonctionner dans un modèle biopsychosocial de la santé.

Asynchronous online training increased knowledge, confidence, and intent to screen and treat substance use disorders among primary care clinicians practicing in Texas.

INTRODUCTION: Despite increasing prevalence of substance use disorders (SUD), few patients are diagnosed and treated in primary care settings. This study evaluated changes in knowledge, confidence, and intention to implement screening and brief intervention (SBI) and SUD treatment after clinicians participated in an asynchronous online education course. METHODS: A self-selected sample of primary care clinicians in Texas participated in online SBI and SUD education March 2021-July 2023. Baseline and post-training surveys evaluated changes in knowledge, confidence, and intent to implement SBI and SUD treatment. Changes were compared using paired t-tests. Multivariable linear regression examined factors potentially associated with confidence and intention to implement changes. Clinician feedback regarding the course was included. RESULTS: Of 613 respondents, 50.9% were practicing family medicine clinicians. Knowledge of adolescent screening tools increased from 21.9% to 75.7% (p < 0.001). Knowledge about the number of drinks that define excessive drinking among non-pregnant women increased from 24.5% at baseline to 64.9% (p < 0.001). Clinicians reported lowest confidence in providing opioid use disorder pharmacotherapy, which improved after program participation. Intent to implement SBI and medication for alcohol, nicotine and opioid use disorders increased (p < 0.001) after training. No factors were associated with change in confidence or intention to implement in multivariable models (p > 0.05). Satisfaction was high and nearly 60% reported intention to change their clinical practice because of the program. CONCLUSION: Knowledge, confidence, and intent to implement SBI and SUD treatment increased after completing the online course. Clinician satisfaction was high and demonstrated improved intention to implement SBI and SUD treatment.

"Dementia Doesn't Mean That Life Doesn't Have More Wonderful Things Ahead": A Qualitative Study Evaluating a Canadian Dementia Support Services Program.

Background: Community support programs can improve quality of life for people living with dementia and their care partners. Important to the successful implementation of such programs is close engagement with end-users to gain a better understanding of their needs. This study describes the perspectives of people living with dementia, care partners, and health-care providers on the First Link® dementia support program provided by the Alzheimer Society of British Columbia (ASBC). Methods: Following a large-scale survey (N=1,164), semi-structured interviews were conducted with participants to explore in greater detail the different needs and themes that emerged from the first phase of the study. The interviews explored: 1) experiences with the program; 2) future planning; 3) meaning of independence; and 4) impact of the program on emotional and physical well-being. Results: A total of 48 participants were interviewed in this study. Knowledge and education were key factors that helped participants manage the impact of dementia. Learning about dementia, the experiences of others, strategies on how to manage symptoms, what to plan for in the future, and how to access different services in the community, was tied to increased feelings of confidence and comfort, and decreased stress. Participants also provided suggestions for improvement of the First Link® dementia program such as further embedding the program into the patient journey, providing more services in remote areas, providing education for health-care providers, and increasing awareness of the program. Conclusion: By emphasizing the lived experiences and needs of those living with dementia and their caregivers, this work will inform future research-based program evaluations globally and, in turn, improve the existing services to support people living with-and impacted by-dementia.

Healthy Me, Healthy Planet: Evaluation of a pilot planetary health library program.

ISSUE ADDRESSED: The Healthy Me, Healthy Planet program was an evidence-informed pilot program conducted by a local libraries to promote the health co-benefits of action on climate change. BACKGROUND: An impact evaluation of the Healthy Me, Healthy Planet program was conducted using a mixed methods research design including pre-, during, and post-program surveys and online focus groups. METHODS: The evaluation included 136 participants aged 18+ years who were able to understand and communicate in English or simplified Chinese language. Descriptive analyses of the survey data were integrated with thematic analyses of focus group (N = 2) data to generate key themes. RESULTS: Key impacts included individual and organisational capacity building, personal and social well-being, and pro-environmental knowledge, attitudes, and behaviour. Impacts on program participants included increased confidence, motivation, positive feelings, and personal well-being after taking part in the Healthy Me, Healthy Planet program. Participants reported enhanced social connections, mental well-being, and environmental benefits such as engaging within the community on environmental issues and feeling inspired to make sustainable lifestyle changes. CONCLUSION: Libraries play a key role in promoting the health of people and planet in the community because they are a trusted, safe, and supportive community setting, a curator of credible and reliable evidence-based information on health and planetary topics and a local and free provider for skills and literacy development. SO WHAT: The evaluation of the pilot suggests that participants improved their capacity to practice sustainable living and it is recommended that this program be expanded to other library settings to enhance community connection and support local planetary health initiatives.

Simulation based education in paediatric resuscitation.

There is increasing use of clinical Simulation Based Education (SBE) in healthcare due to an increased focus on patient safety, the call for a new training model not based solely on apprenticeship, a desire for standardised educational opportunities that are available on-demand, and a need to practice and hone skills in a controlled environment. SBE programs should be evaluated against Kirkpatrick level 3 or 4 criteria to ensure they improve patient or staff outcomes in the real world. SBE programs have been shown to improve outcomes in neonatology - reductions in hypoxic ischaemic encephalopathy, in brachial plexus injury, rates of school age cerebral palsy, reductions in 24hr mortality and improvements in first pass intubation rates. In paediatrics SBE programs have shown improvements in paediatric cardiac arrest survival, PICU survival, reduced PICU admissions, reduced PICU length of stay and reduced time to critical operations. SBE can improve the non-technical tasks of teamwork, leadership and communication (within the team and with patients and carers). Simulation is a useful tool in Quality and Safety and is used to identify latent safety issues that can be addressed by future programs. In high stakes assessment simulation can be a mode of assessment, however, care needs to be taken to ensure the tool is validated carefully.

Enhanced Timeliness and Co-Administration of Meningitis B Vaccination in Children: Impact of Funding in Valencian Community, Spain.

Public funding of vaccines may enhance vaccination rates, co-administration, and timeliness. The impacts of including the serogroup B meningococcus vaccine (MenB) into the national immunisation schedule on vaccination rates, co-administration rates, and timeliness were assessed using a population-based pre-funding (2022) and post-funding (2023) study design. MenB vaccination rates improved after funding and were in line with previously funded vaccines. Co-administration rates also increased significantly. Timely administration increased, protecting children at an early age. Public funding has a positive impact on vaccine accessibility and early protection. Consistent population characteristics highlight the role of funding.

Exploring the content of epilepsy fellowship program websites: an analysis of information available to applicants.

BACKGROUND: Program websites are essential resources in the process of residency and fellowship application. We evaluated the information furnished on these resources by Epilepsy fellowship programs. The extent of information provided was compared across geographic zones, academic affiliation, and national ranking. METHODS: A list of Epilepsy fellowship programs was derived from the Fellowship and Residency Electronic Interactive Database (FREIDA). Links to program websites were obtained directly from FREIDA or using Google's search engine. Online data was categorized to reflect program information, education, recruitment, compensation, epilepsy center-specific information, and social media presence. Data points under each category were collected to develop a standardized scoring system. The frequency of criterion present was compared across geographic zones, academic affiliation, and national ranking using parametric and non-parametric statistical tests. Significance was determined at a p-value ≤ 0.05 for all cases. The study utilized IBM SPSS version 28 and Python 3.11.3. RESULTS: We analyzed 80 Epilepsy fellowship programs. The most reported feature was the program director's name and email (100.0%). The least reported features included board pass rates (1.3%), preparatory boot camp (8.8%), and post-fellowship placements (11.3%). Programs were found to be well-represented on X (88.8%), Facebook (81.3%), and Instagram (71.3%). Most (85.0%) of the programs were searchable through Google. The scores for program information, education, recruitment, compensation, epilepsy center-specific information, and social media visibility did not significantly vary based on location, academic affiliation, or rank status. CONCLUSIONS: Our results demonstrate that despite an online presence, there is much room for improvement in the content available to the applicant. To improve the Match process and attract a roster of well-informed fellows, Epilepsy fellowship programs should furnish program websites with up-to-date information relevant to program information, education, recruitment, compensation, and epilepsy center-specific information.

A Pilot Evaluation of the Respect You Curriculum.

BACKGROUND: The objective of this study is to evaluate the Respect YOU program's impact on students' eating expectancies, body image satisfaction levels, self-efficacy, and knowledge. A total of 444 (intervention cohort n = 348, control cohort n = 96) underclassmen enrolled in health or physical education courses from 7 high schools in the Midwest participated in the study. METHODS: A repeated measure research design was utilized to assess students' eating expectancies, body image satisfaction levels, self-efficacy, and knowledge. More specifically, paired t-tests were conducted to compare outcome measurements to evaluate the efficacy of the intervention. RESULTS: Among the students who received the intervention (n = 348), there was a statistically significant change in scores for eating expectancies (Z = -14.403, p < .001), body image satisfaction levels (Z = -14.114, p < .001), social media self-efficacy (Z = 14.868, p < .001), and knowledge scales (Z = -16.100, p < .001) at post-intervention and compared to the control group. CONCLUSIONS: Results indicate that the Respect YOU program was effective in improving body image scores, eating expectancies, self-esteem, and knowledge-related outcomes among students post-intervention. These results can be used to further develop educational programming to address body image concerns and disordered eating among adolescents.

Evaluating competency-based medical education: a systematized review of current practices.

BACKGROUND: Few published articles provide a comprehensive overview of the available evidence on the topic of evaluating competency-based medical education (CBME) curricula. The purpose of this review is therefore to synthesize the available evidence on the evaluation practices for competency-based curricula employed in schools and programs for undergraduate and postgraduate health professionals. METHOD: This systematized review was conducted following the systematic reviews approach with minor modifications to synthesize the findings of published studies that examined the evaluation of CBME undergraduate and postgraduate programs for health professionals. RESULTS: Thirty-eight articles met the inclusion criteria and reported evaluation practices in CBME curricula from various countries and regions worldwide, such as Canada, China, Turkey, and West Africa. 57% of the evaluated programs were at the postgraduate level, and 71% were in the field of medicine. The results revealed variation in reporting evaluation practices, with numerous studies failing to clarify evaluations' objectives, approaches, tools, and standards as well as how evaluations were reported and communicated. It was noted that questionnaires were the primary tool employed for evaluating programs, often combined with interviews or focus groups. Furthermore, the utilized evaluation standards considered the well-known competencies framework, specialized association guidelines, and accreditation criteria. CONCLUSION: This review calls attention to the importance of ensuring that reports of evaluation experiences include certain essential elements of evaluation to better inform theory and practice.

Standardizing Fidelity to Evidence-Based Practice in the Early Psychosis Intervention Network.

OBJECTIVE: This study investigated variations in the measurement of fidelity to coordinated specialty care (CSC) within the Early Psychosis Intervention Network (EPINET), a learning health system that consists of 101 CSC programs within eight hubs. The study investigated the degree to which five fidelity scales could be mapped onto a standard scale. METHODS: The investigators identified six fidelity scales in use by EPINET participants; examined their item content, scoring, and data sources; and mapped five scales onto the First Episode Psychosis Services Fidelity Scale (FEPS-FS), which is the most widely used scale. RESULTS: Mapping five fidelity scales onto the FEPS-FS showed that the percentage of FEPS-FS components successfully mapped ranged from 42% to 81%. CONCLUSIONS: Mapping five scales onto one that uses dichotomous scoring identified the degree of variation in measures and reduced the amount and quality of usable fidelity data. Identifying variations in fidelity measurement is a core function of a learning health system.

Evaluation of a Conference on Cancer-Related Financial and Legal Issues: A Potential Resource to Counter Financial Toxicity.

This study describes the conception, development, and growth of the Triage Cancer Conference hosted by Triage Cancer, a national nonprofit organization providing free legal and financial education to the cancer community. We conducted a retrospective analysis of post-conference participant surveys. Descriptive statistics were calculated for participant demographics, and acceptability, feasibility, and appropriateness were evaluated. From 2016-2021, 1239 participants attended the conference and completed post-conference surveys. Participants included social workers (33%), nurses (30%), and cancer patients/survivors (21%), with representation from over 48 states. Among those who reported race, 16% were Black, and 7% were Hispanic. For acceptability, more than 90% of participants felt that the conference content, instructors, and format were suitable and useful. For feasibility, more than 90% of participants felt that the material was useful, with 93-96% reporting that they were likely to share the information and 98% reporting that they would attend another triage cancer event. Appropriateness was also high, with >80-90% reporting that the sessions met the pre-defined objectives. Triage Cancer fills an important gap in mitigating financial toxicity, and formal evaluation of these programs allows us to build evidence of the role and impact of these existing resources. Future research should focus on adding validated patient-reported outcomes, longer-term follow-up, and ensuring inclusion and evaluation of outcome metrics among vulnerable populations.

Designing an evaluation tool for evaluating training programs of medical students in clinical skill training center from consumers' perspective.

INTRODUCTION: The Clinical Skill Training Center (CSTC) is the first environment where third year medical students learn clinical skills after passing basic science. Consumer- based evaluation is one of the ways to improve this center with the consumer. This study was conducted with the aim of preparing a consumer-oriented evaluation tool for CSTC among medical students. METHOD: The study was mixed method. The first phase was qualitative and for providing an evaluation tool. The second phase was for evaluating the tool. At the first phase, after literature review in the Divergent phase, a complete list of problems in the field of CSTC in medicine schools was prepared. In the convergent step, the prepared list was compared with the standards of clinical education and values of scriven. In the second phase it was evaluated by the scientific and authority committee. Validity has been measured by determining CVR and CVI: Index. The face and content validity of the tool was obtained through the approval of a group of specialists. RESULTS: The findings of the research were in the form of 4 questionnaires: clinical instructors, pre-clinical medical students, and interns. All items were designed as a 5-point Likert. The main areas of evaluation included the objectives and content of training courses, implementation of operations, facilities and equipment, and the environment and indoor space. In order to examine the long-term effects, a special evaluation form was designed for intern. CONCLUSION: The tool for consumer evaluation was designed with good reliability and trustworthiness and suitable for use in the CSTC, and its use can improve the effectiveness of clinical education activities.