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'welcome to the world': Process evaluation of a paramedic home safety intervention

机译：“欢迎来到世界”：护理人员家庭安全干预措施的过程评估

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Background. The specialty of emergency medical services (EMS) has been challenged to take up community prevention activities as a part of its service mission. Though outcome evaluations of these activities have been published, there are no reports of programs' process evaluations. Orange County EMS initiated, in 1998, the "Welcome to the World" (WTTW) program, a home safety screening program for families with newborns. Objective. We sought to perform a process evaluation of the WTTW program. Methods. By reviewing programmatic data andrecords, conducting key informant interviews andfocus groups, andanalyzing print materials, we conducted a retrospective process evaluation encompassing recruitment, reach, context, and, to a lesser extent, "dose delivered," "dose received," andfidelity. Results. The program evaluation found that recruitment was less than optimal with a minority of participants from lower socioeconomic backgrounds. The WTTW program reached about 4 of all possible participants in the community. Context presented significant impediments for the program. The demographics of the community changed dramatically during the program, with a large influx of Spanish-speaking immigrants. Additionally, the county suffered an economic downturn during the interval, resulting in deep budget cuts. Dose delivered anddose received, while not fully evaluated, showed that the home survey andprint materials were generally well received andutilized by participants. Fidelity was measured by interview andfocus group andrevealed general adherence to the intent of the program. Conclusions. Our process evaluation indicates the importance of good organization andmanagement, with attention to careful program monitoring to facilitate continuous program improvement andincrease fidelity to plans. We suggest that, in the future, process evaluation be built into the development of any of EMS-initiated community activity, from the dawn of an idea through every phase of the program. Careful attention to recruitment, reach, dose, andfidelity will provide leaders with crucial information to judge the reasons for the success or failure of the program andto identify needed modifications to ensure the future success andfacilitate replication.
机译：背景。紧急医疗服务（EMS）的专业已受到挑战，以开展社区预防活动作为其服务任务的一部分。尽管已经发布了对这些活动的结果评估，但是没有关于程序过程评估的报告。橙县EMS在1998年启动了“欢迎来到世界”（WTTW）计划，这是一项针对新生儿家庭的家庭安全检查计划。目的。我们试图对WTTW计划进行过程评估。方法。通过审查程序性数据和记录，进行关键的信息提供者访谈和焦点小组以及分析印刷材料，我们进行了回顾性过程评估，包括招募，覆盖范围，背景以及（在较小程度上）“已交付的剂量”，“已接受的剂量”和保真度。结果。该计划评估发现，在社会经济背景较低的少数参与者中，招募并不理想。 WTTW计划覆盖了社区中所有可能的参与者中的4个。上下文为该程序带来了重大障碍。在该计划期间，社区人口发生了巨大变化，大量涌入了讲西班牙语的移民。此外，在此期间，该县经历了经济衰退，导致预算大幅削减。交付的剂量和收到的剂量虽然未得到充分评估，但表明参加者普遍接受并充分利用了家庭调查和印刷材料。保真度是通过访谈和焦点小组评估的，并表明了对计划意图的普遍遵守。结论。我们的过程评估表明了良好组织和管理的重要性，同时注意对程序进行仔细的监视，以促进程序的不断改进和增强对计划的忠诚度。我们建议，从构思之初到计划的每个阶段，将来都应将过程评估纳入任何EMS发起的社区活动的开发中。对招聘，覆盖范围，剂量和忠诚度的认真关注将为领导者提供重要信息，以判断该计划成功或失败的原因，并确定需要进行的修改，以确保将来的成功并促进复制。

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