While traditional crime rates are decreasing, cybercrime is on the rise. As a result, the criminal justice system is increasingly dealing with criminals committing cyber-dependent crimes. However, to date there are no effective interventions to prevent recidivism in this type of offenders. Dutch authorities have developed an intervention program, called Hack_Right. Hack_Right is an alternative criminal justice program for young first-offenders of cyber-dependent crimes. In order to prevent recidivism, this program places participants in organizations where they are taught about ethical hacking, complete (technical) assignments and reflect on their offense. In this study, we have evaluated the Hack_Right program and the pilot interventions carried out thus far. By examining the program theory (program evaluation) and implementation of the intervention (process evaluation), the study adds to the scarce literature about cybercrime interventions. During the study, two qualitative research methods have been applied: 1) document analysis and 2) interviews with intervention developers, imposers, implementers and participants. In addition to the observation that the scientific basis for linking specific criminogenic factors to cybercriminals is still fragile, the article concludes that the theoretical base and program integrity of Hack_Right need to be further developed in order to adhere to principles of effective interventions.
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In this article, we describe a study on the impact of an ethics program aimed at strengthening the ethical agency of 15 social workers of three welfare organizations. The goal of the study was to make an inventory of the impact of the program, and to evaluate the relevance of this impact with the help of several stakeholders. The most significant change (MSC) approach was used as a research strategy, though some changes to the approach were made with a view to our research goal. We explain the MSC approach and how we used it in our study design. Further, we describe the research process, answering the question whether our adaptation of the MSC was helpful to inventory the impact of our ethics program and the evaluation of its relevance. The implications of MSC's focus on "most significant" changes and the need for a thorough feedback of the results of the evaluation process in the participating organizations are discussed.
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Objectives: To present the results of the process evaluation of the PLAYgrounds program, using the RE-AIM framework.Design: This study provides information regarding Reach, Adoption, Implementation and Maintenance.Methods: The PLAYgrounds program promotes increasing levels of physical activity in 6–12 years old children and was evaluated using the RE-AIM framework in 4 intervention schools. Data collection consisted of a physical activity questionnaire with children (n = 765, Reach), SOPLAY observations (Implementation and Maintenance), questionnaires on the satisfaction of the implemented elements with teachers (n = 59) and children (n = 730, Implementation) and interviews for increased depth of information. In addition a simple counting of participating schools, describing of non-participating reasons and characteristics of the schools were documented (Adoption).Results: Reach of the target population (i.e. inactive children) was 60.7% (n = 464) and the target population was representative for populations in low-SES neighbourhoods. The PLAYgrounds program was adopted by 4 schools (80%), at which 5 (from 7) program elements were successfully implemented. At 18 monthsfollow-up, 3 of those 5 elements were completely maintained.Conclusions: Adoption, Implementation, and Maintenance proved to be very high. Most likely due to the PLAYgrounds program being a complete intervention package that included financial, material, and staff support. Therefore, it is recommended to retain this high level of support when introducing the PLAYgrounds (or any other intervention) program in schools. In the future it would be recommended to evaluate the PLAYgrounds program on maintenance in schools where the key-person is employed at the school and funding is not available.
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OBJECTIVES: To improve transmural palliative care for acutely admitted older patients, the PalliSupport transmural care pathway was developed. Implementation of this care pathway was challenging. The aim of this study was to improve understanding why the implementation partly failed.DESIGN: A qualitative process evaluation study.SETTING/PARTICIPANTS: 17 professionals who were involved in the PalliSupport program were interviewed.METHODS: Online semi-structured interviews. Thematic analysis to create themes according to the implementation framework of Grol & Wensing.RESULTS: From this study, themes within four levels of implementation emerged: 1) The innovation: challenges in current palliative care, the setting of the pathway and boost for improvement; 2) Individual professional: feeling (un)involved and motivation; 3) Organizational level: project management; 4) Political and economic level: project plan and evaluation.CONCLUSION AND IMPLICATIONS: We learned that the challenges involved in implementing a transmural care pathway in palliative care should not be underestimated. For successful implementation, we emphasize the importance of creating a program that fits the complexity of transmural palliative care. We suggest starting on a small scale and invest in project management. This could help to involve all stakeholders and anticipate current challenges in palliative care. To increase acceptance, create one care pathway that can start and be used in all care settings. Make sure that there is sufficient flexibility in time and room to adjust the project plan, so that a second pilot study can possibly be performed, and choose a scientific evaluation with both rigor and practical usefulness to evaluate effectiveness.
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Background: Quality Improvement (QI) is the key for every healthcare organization. QI programs may help healthcare professionals to develop the needed skills for interprofessional collaboration through interprofessional education. Furthermore, the role of diversity in QI teams is not yet fully understood. This evaluation study aimed to obtain in-depth insights into the expectations and experiences of different stakeholders of a hospital-wide interprofessional QI program. Methods: This qualitative study builds upon 20 semi-structured interviews with participants and two focus groups with the coaches and program advisory board members of this QI program. Data were coded and analyzed using thematic analysis. Results: Three themes emerged from the analysis: “interprofessional education”, “networking” and “motivation: presence with pitfalls”. Working within interprofessional project groups was valuable, because participants with different experiences and skills helped to move the QI project forward. It was simultaneously challenging because IPE was new and revealed problems with hierarchy, communication and planning. Networking was also deemed valuable, but a shared space to keep in contact after finalizing the program was missing. The participants were highly motivated to finish their QI project, but they underestimated the challenges. Conclusions: A hospital-wide QI program must explicitly pay attention to interprofessional collaboration and networking. Leaders of the QI program must cherish the motivation of the participants and make sure that the QI projects are realistic.
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Background: Many community-dwelling older adults experience limitations in (instrumental) activities of daily living, resulting in the need for homecare services. Whereas services should ideally aim at maintaining independence, homecare staff often take over activities, thereby undermining older adults’ self-care skills and jeopardizing their ability to continue living at home. Reablement is an innovative care approach aimed at optimizing independence. The reablement training program ‘Stay Active at Home’ for homecare staff was designed to support the implementation of reablement in the delivery of homecare services. This study evaluated the implementation, mechanisms of impact and context of the program. Methods: We conducted a process evaluation alongside a 12-month cluster randomized controlled trial, using an embedded mixed-methods design. One hundred fifty-four homecare staff members (23 nurses, 34 nurse assistants, 8 nurse aides and 89 domestic workers) from five working areas received the program. Data on the implementation (reach, dose, fidelity, adaptations and acceptability), possible mechanisms of impact (homecare staff's knowledge, attitude, skills and support) and context were collected using logbooks, registration forms, checklists, log data and focus group interviews with homecare staff (n = 23) and program trainers (n=4). Results: The program was largely implemented as intended. Homecare staff's average compliance to the program meetings was 73.4%; staff members accepted the program, and particularly valued its practical elements and team approach. They experienced positive changes in their knowledge, attitude and skills about reablement, and perceived social and organizational support from colleagues and team managers to implement reablement. However, the extent to which homecare staff implemented reablement in practice, varied. Perceived facilitators included digital care plans, the organization’s lump sum funding and newly referred clients. Perceived barriers included resistance to change from clients or their social network, complex care situations, time pressure and staff shortages. Conclusions: The program was feasible to implement in the Dutch homecare setting, and was perceived as useful in daily practice. Nevertheless, integrating reablement into homecare staff's working practices remained challenging due to various personal and contextual factors. Future implementation of the program may benefit from minor program adaptations and a more stimulating work environment.
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Some patients in psychiatric treatment are considered extremely difficult to treat because of the disruptive nature of their relationships with treatment staff. In this paper, we describe and evaluate a specialist inpatient treatment program for these patients. Data were collected from medical records and daily reports of patients (n = 108). Pretest-posttest measurements were used to evaluate the treatment. The main treatment method consists of the provision of safety, structure, and cooperation. Treatment results show statistically significant changes from admittance to discharge. The collaborative and consistent manner in which nurses approach the patients is crucial for quality of care.
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Kick-Start College is a three-day pre-academic program (summer school) for prospective first year students of Inholland Rotterdam, University of Applied Sciences. The aim is to integrate students academically and socially, which could make the transition to higher education easier and eventually lead to lower dropout rates of students. Research has been conducted on both student experiences with the program as well as effects of the program. Method: pretest-posttest with academic-, social-, professional- and university integration1, self-esteem, motivation, evaluation.
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Background: The support of people with profound intellectual and multiple disabilities (PIMD) rarely focused onmotor activity, which might have negative consequences for the quality of life of these people. Evidence-based motor activity programs that present individually tailored and structural motor activity for these people are, regretfully, lacking. This study developed such a program for these people and evaluated the implementationprocess.Methods: The motor activity program is developed in accordance with the theoretical premises of the educational program and consists of four methodological steps in which the content is individually filled with: motor activitystructurally embedded within the activities of daily living, and 3–5 motor activities aimed at a specific goal, which is evaluated. Program delivery consisted of a manual, explanation to the teams, and coaching of one contact personper participant (n = 9). Process evaluation included the delivered fidelity, dose, reach, and adaptations made during the program. In addition, mechanisms of impact and the influence of contextual factors were evaluated. Data collection included researcher logbooks, individual program content, and staff reports.Results: The intended fidelity, dose, and reach were not obtained in most participants. Content has been made explicit for seven participants, but only in one participant all critical steps in implementation were performed asintended, though later in time. In three participants, previously offered motor activities were described within the weekly program, but without all activities having a clear link with the goal set. It is showed that the core elementsof the program were affected with the conceived implementation plan. The time schedule, critical elements in implementation and program content were influenced by a lack of conditions such as professionals’ motivationand responsibility, methodical working, interdisciplinarity and continuity in staff.Conclusions: The results suggest that the implementation might be improved in case more attention is paid to the organizational conditions and implementation structure. The findings led to substantial changes in the implementation strategy. This study underlines the importance of process evaluation prior to testing foreffectiveness.
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This paper reports on the effects of an e-cycling incentive program in the province of North-Brabant, The Netherlands, in which commuters could earn monetary incentives when using their e-bike. The study used a longitudinal design allowing to observe behaviour change and mode shifts. The program appeared to be highly effective in stimulating e-bike use, as one month after the start of the program, the share of commute trips made by e-bike increased from 0% to 68%, with an increase up to 73% after half a year of participating. The environmental, congestion and health benefits of this shift are however mixed. Half of the e-bike trips substitute car trips, with positive effects on environment, congestion and health. The other half substitutes conventional cycling trips, implying fever health benefits. Our analyses further suggest that distance is an important factor for adopting e-cycling, where e-bike has a larger acceptable distance than a conventional bike. Nevertheless, we observed that the likelihood to use the e-bike decreased as commuting distance increased. Multivariate analyses suggest that a shift to e-cycling is affected by age, gender, physical condition, car ownership and household composition. Our study did find support for the hypothesis that having a strong car-commuting habit decreases the probability of mode shift to a new mode alternative. In contrast, multimodality may increase the likelihood of e-bike use as a result of openness to other travel options and a more deliberate mode choice. Lastly, dissatisfaction with the current travel mode positively influences mode shift towards the e-bike. Our results imply that stimulating e-cycling may be a promising way of stimulating physical activity, but that it will be most effective if targeted at specific groups who are not currently engaging in active travel.
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