6-2 Activity: Cultural Implications of Evidence-Based Interventions Handout

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hse 410

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Review the module readings. Select a minority group and create a handout with images and key points on the cultural and ethnic aspects that need to be considered in working with and creating case management interventions for this population. Provide references to support your statements.

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HSE 410 Module Six Activity Guidelines and Rubric Overview: As a case manager, you will likely work with diverse populations. It is very important that you learn about these diverse populations, and continue learning about different groups throughout your career. In this assignment, you will have an opportunity to better understand a minority group. After gaining a better understanding of the minority group, you will also discuss how your understanding of important aspects of this minority group will help you in working with and creating case management interventions with this group. Prompt: Review the module readings. Select a minority group and create a handout with images and key points on the cultural and ethnic aspects that need to be considered in working with and creating case management interventions with this population. Provide references to support your statements. Specifically, the following critical elements must be addressed: • • • • Identifies and describes a minority group Identifies and includes at least two images of the selected minority group that illustrate cultural and ethnic aspects which impact interventions Identifies four key points of the cultural and ethnic aspects of the identified minority group which need to be considered when working with the minority group Summarizes considerations that need to be factored in when working with and creating case management interventions for the identified minority group Guidelines for Submission: Submit your single-page handout as a letter-sized (8 ½ x 11 inches) Microsoft Word document or PDF file. References must be formatted in APA format. Critical Elements Minority Group Identified Cultural and Ethnic Aspects of Minority Group Illustrated Exemplary (100%) Meets “Proficient” criteria and uses substantial details to establish the central issues identified within the minority group Meets “Proficient” criteria and the images provided support details as to why the cultural and ethnic aspects of the minority group are relevant in client care Proficient (85%) Identifies and describes a minority group Needs Improvement (55%) Identifies a minority group but description of the minority group lacks details Not Evident (0%) No minority group is identified Includes images illustrating the cultural or ethnic aspects of the minority group identified Includes some cultural or ethnic aspects of the minority group identified and/or the images are not appropriate for illustrating cultural or ethnic aspects of the minority group identified Does not include images Value 15 25 Cultural and Ethnic Aspects Meets “Proficient” criteria and key points are supported by relevant research Identifies key points of the cultural and ethnic aspects that need to be considered when working with this minority group Summary of Considerations Meets “Proficient” criteria and includes relevant research to support the conclusions Articulation of Response Submission is free of errors related to citations, grammar, spelling, syntax, and organization and is presented in a professional and easy-to-read format Summarizes considerations that need to be factored in when working with and creating case management interventions for the identified minority group Submission has no major errors related to citations, grammar, spelling, syntax, or organization Identifies some key points of the cultural and ethnic aspects that need to be considered when working with this minority group and/or key points lack details Includes a summary of considerations with few details or support No key points included 25 No summary of considerations provided 30 Submission has major errors related to citations, grammar, spelling, syntax, or organization that negatively impact readability and articulation of main ideas Submission has critical errors related to citations, grammar, spelling, syntax, or organization that prevent understanding of ideas Earned Total 5 100% Conducting Program Evaluation with Hispanics in Rural Settings: Ethical Issues and Evaluation Cha... Loi, Claudia X Aguado;McDermott, Robert J American Journal of Health Education; Jul/Aug 2010; 41, 4; ProQuest Central pg. 252 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. A random sample of American Evaluation Association members was surveyed concerning the ethical challenges they encountered in their evaluation work Respondents who indicated that they had faced such challenges differed significantly (in amount and type of evaluation experience, as well as professional discipline) from those who said that they had never encountered an ethical conflict. Ethical problems associated with the reporting of findings by the evaluator were, by far, the most frequently mentioned. Also frequently described were conflicts involving the misinterpretation/misuse of results by stakeholders, contracting with stakeholders, and adherence to disclosure agreements. Aframeworkfor interpreting the study’sfindings, based on understanding the subjective commitment of evaluators to the roles of scientist and/or helping . professional, is proposed PROGRAM EVALUATORS AND ETHICAL CHALLENGES A National Survey MICHAEL MORRIS ROBIN COHN University of New Haven A ethical issues in program evaluation have received lthough deal of attention in the relevant a great scholarly literature, empirical studies of the ethical challenges encountered by evaluators are extremely rare. The overwhelming majority of analyses employ an anecdotal database that is sometimes linked to a theory-driven conceptual framework (e.g., Fang and Ellwein 1990; Mariner 1990; Mathison 1991; Perloff and Perloff 1980; Sieber and Sanders 1978; Skaburskis 1987; Smith 1985; Windle and Neigher 1978). In a few investigations, evaluators have been asked to respond to a list of statements representing ethical standards in evaluation (DeBrey 1989; AUTHORS’ NOTE: An earlier version of this article was presented at the 1992 annual meeting of the American Evaluation Association in Seattle. We wish to thank the following individuals for the valuable feedback they provided during the pilot phase of this study: Molly Engle, Joanne Farley, Jennifer Greene, Sandra Mathison, Hallie Preskill, Michael Reed and Rosalie Torres. EVALUATION REVIEW, Vol 17 No 6, December 1993 621-642 @ 1993 Sage Publications, Inc 621 622 McKillip and Garberg 1986; Sheinfeld and Lord 1981 ). In these studies, respondents rate each statement on such dimensions as applicability to their evaluation work, importance, compatibility with other statements, and level of personal agreement. As useful as this research is, it does not directly examine the ethical problems and dilemmas that evaluators experience. The only published study that straightforwardly addresses these conflicts was conducted by Newman and Brown (1992). Each item in their survey instrument described a violation of one of the 30 evaluation standards developed by the Joint Committee on Standards for Educational Evaluation ( 1981 ), with respondents providing ratings of both frequency and seriousness for every violation. The researchers found that experienced evaluators perceived Utility and Feasibility standards to be more frequently violated than Accuracy and Propriety ones; no major differences between the four areas were found on the seriousness dimension. These results are intriguing, but our ability to draw conclusions from them about the personal experiences of evaluators is limited by the study’s methodology. For example, respondents’ generalized perceptions of violation frequencies might not necessarily be highly correlated with their estimates of how often they have encountered those problems in their own evaluation work. Even more important, the structured nature of the Newman and Brown (1992) survey inevitably restricts the domain of the possible responses to those contained in the instrument. Of the 96 evaluation &dquo;pitfalls&dquo; (i.e., violations) described by the Joint Committee (1981), only 30-less than a third-were included in their study. Although pragmatic considerations undoubtedly played a major role in the researchers’ decision to work with just a subset of the violations, the fact remains that selection of a different subset could have generated results significantly different from those actually obtained in their investigation. The issue being raised here, however, goes beyond the number of items chosen for the study. No list of structured items, even one that contained each of the Joint Committee’s 96 pitfalls, is likely to be exhaustive. There is always the possibility that such a list will omit scenarios that would be viewed as ethically problematical by at least some evaluators, As long as it is the researcher who determines the universe of situations to be evaluated by the respondent, this limitation is unavoidable. Against this background, it is noteworthy that no published research on evaluation ethics has employed the open-ended methodology used by Pope and Vetter (1992) in their study of ethical conflicts encountered by members of the American Psychological Association (APA). Respondents in their survey were simply asked to describe briefly &dquo;an incident that you or a 623 colleague have faced in the last year or two that was ethically challenging to you&dquo; (p. 398). With this procedure, it is the respondent’s conceptualization of ethical concerns, not the researcher’s, that serves as the point of departure. If applied to evaluators, it holds the promise of generating a more accurate picture of their experiences with self-defined ethical challenges than other approaches can produce. Consequently, the research described in this article used a respondent-driven methodology to examine the ethical conflicts faced by a large, representative sample of evaluators. METHOD SUBJECTS The population from which the survey sample was randomly drawn consisted of all individuals with United States addresses who were listed in the 1991 American Evaluation Association (AEA) Directory and for whom information concerning highest degree, employment setting, and primary discipline was provided. Of the 2,142 names in the Directory, 1,732 (81%) met these criteria. A questionnaire was sent to 700 of these individuals. The initial mailing generated a response rate of 43.3%, with a follow-up mailing to nonrespondents yielding an additional 22.3%. Thus the overall response rate was 65.6% (N = 459). This rate compares very favorably with those obtained in Shadish and Epstein’s (1987) survey of Evaluation Network and Evaluation Research Society members (57%), Rog’s (1990) survey of the AEA membership (55%), and Pope and Vetter’s (1992) survey of the APA membership (51%). Respondents did not differ significantly from nonrespondents (at p < .05 or less) on any dimension for which we had comparative data: highest degree, employment setting, primary discipline, and gender. SURVEY INSTRUMENT The questionnaire consisted of two sections. Section 1 asked respondents if they had ever encountered an ethical problem in their work as a program evaluator to which they had to respond. Those who answered affirmatively were asked to (1) describe the ethical problems they had faced most frequently in their work (as many as three different problems could be described) and (2) describe the single most serious ethical problem they had ever 624 encountered. (If a respondent described only one &dquo;frequent&dquo; problem, and did not answer the question concerning the most serious problem, we treated the one description that was given as the answer to both questions.) It is important to note that this section of the survey contained an introduction instructing respondents to assume that &dquo;the definition of ’ethical’ being used in this study is exactly the same as your definition of that term.&dquo; Section 2 solicited background information, with the primary focus being the extent and nature of the respondent’s evaluation experience.’ Individuals were asked to indicate the number of years they had worked in program evaluation, as well as the approximate number of evaluations they had actually conducted. They were also asked about their level of experience (1 = very little, 5 = a great deal) in five different evaluation areas: evaluability assessment, needs assessment, implementation/process evaluation, outcome/ impact assessment, and cost-benefit analysis. Finally, respondents were asked to estimate what percentage of their evaluations they had conducted as an external evaluator and what percentage they had conducted as an internal evaluator. CONTENT ANALYSIS PROCEDURES The Standards for Program Evaluation (SPE) developed by the Evaluation Research Society Standards Committee (1982) were used to categorize each one of the ethical problems described by respondents. (Recall that a single respondent could generate as many as four different problems: the three most frequent and the one most serious.) More specifically, each problem was assigned as many as three different code numbers drawn from the list of 55 numbered statements contained in the SPE. The total number of codes assigned to any given problem depended on how many ethical issues were raised by that problem. Overall, we assigned an average of 1.84 codes to each problem. In applying the SPE to our data we modified the list in one significant way. Preliminary coding had indicated that five of the SPE statements dealing with data analysis and interpretation (Standards 31 to 35) were so conceptually similar that, in practice, it was not possible to distinguish between them with any confidence for coding purposes. Consequently, we decided to collapse these five standards into one: &dquo;Appropriate analytic procedures should be applied to the data.&dquo; We considered, but decided against, using the standards developed by the Joint Committee on Standards for Educational Evaluation ( 1981 ) to analyze the responses. During the planning phase of the study we actually applied 625 TABLE 1: NOTE: Primary Discipline of Respondents (in percentages) (n 456) = Fgures do not total 100% due to rounding. both sets of standards to pilot data and concluded that the SPE were better suited to the data. The SPE’s modest advantage lay in their organization; subgroups of standards are presented in an order roughly corresponding to the phases of an unfolding evaluation. For many of the ethical problems described by our respondents, the stage of the evaluation in which the conflict was perceived to have occurred appeared to be an important consideration. RESULTS RESPONDENT CHARACTERISTICS Nearly two thirds of the respondents possessed a doctoral degree (59% Ph.D., 7% Ed.D), 28% had a master’s, 4% a bachelor’s, and 3% were &dquo;other.&dquo; Respondents’ primary disciplines are reported in Table 1, where it can be seen that nearly half identified with either education or psychology. The largest subgroup of respondents worked in a college or university setting, with most of the others fairly evenly divided between federal agencies, state agencies, nonprofit organizations, and private business (see Table 2). With respect to gender, 55% of the respondents were male, and 45% were female. EVALUATION EXPERIENCE A small percentage of the respondents (3%) indicated that they had never conducted an evaluation; this subgroup was excluded from all subsequent 626 TABLE 2: NOTE: Employment Settings of Respondents (in percentages) (n 455) = Figures do not total 100% due to rounding. TABLE 3: Respondents’ Evaluation Experience (n = 445) analyses. For the 97% who said that they had done at least one evaluation, experience in the field averaged 11.4 years (SD 7.3), with a range spanning from 1 to 44 years. Another indication of the respondents’ considerable degree of experience can be found in Table 3: 60% had conducted 11I their = evaluations. The nature of respondents’ evaluation activities varied. Overall, their highest level of involvement was in impact assessment (M = 4.15) and process evaluation (3.93). There was a modest amount of participation in needs assessment (2.93), and a low level of involvement in cost-benefit analysis (2.02) and evaluability assessment (1.87). Both external and internal evaluators were well represented among the respondents (see Table 4). At the extremes, those who had done external evaluations exclusively accounted for 23% of the sample, whereas purely internal evaluators comprised 18%. or more EXPERIENCE WITH ETHICAL CHALLENGES Nearly two thirds of the respondents (65%) said that they had encountered ethical problems in their evaluation work, whereas the remainder (35%) said 627 TABLE 4: External Evaluation Experience (n 429) = that they had not. These two groups, hereafter referred to as the &dquo;challenged group&dquo; and the &dquo;unchallenged group,&dquo; differed significantly from one another on several dimensions. The challenged group averaged more years of evaluation experience than the unchallenged group (12.6 vs. 8.9, t[434] = 5.09, p < .001) and had also conducted a greater number of evaluations (scale Ms: 2.96 vs. 2.12, t[443] = 6.95, p < .001 ). The challenged group had also devoted a greater percentage of its time to external evaluation than had the unchallenged group (Ms: 55% vs. 45%, t[426] = 2.58, p < .01). Because years of experience and number of evaluations conducted were highly correlated in our sample (r = .60, p < .001), we examined the relationship of each of these variables to membership in the challenged group while holding the other one constant. We found that the significant relationship of number of evaluations conducted to challenged group membership held for all three levels of years tested (1 to 6 years: t[141]= 3.81, p < .001; 7 to 14 years: t[ 139] = 1.70, p < .05; and 15 to 44 years: t[ 150] = 2.30, p < .05; all tests one-tailed). In contrast, none of the relationships between years of evaluation experience and challenged group membership were significant at the .05 level when the number of evaluations conducted was held constant. Chi-square analysis revealed that being in the challenged group was related to one’s highest degree (X2 = 9.89, df = 4, p < .05) and primary discipline (x2 = 20.9, df = 5, p < .001 ). The percentage of respondents in the challenged group for each degree subsample is given in parentheses: Ph.D. (70%), master’s (63%), Ed.D. (55%), bachelor’s (50%), and other (36%). The corresponding figures for discipline are evaluation (88%), sociology (87%), research/statistics (69%), psychology (62%), other (61%), and education (56%). It is noteworthy that, in terms of both degree and discipline, involvement in the field of education was associated with a relatively low probability of being in the challenged group. This finding is supported by more refined analysis. For example, master’s-level respondents who identified education as their primary discipline were significantly less likely than master’s-level respondents in other fields to be in the challenged group (46% vs. 68%, X2 = 628 < .05). For those with Ph.D.s the relationship approached significance (61 % vs. 73%, X2 3.46, df = 1, p < .07). 3.96, df = 1, p = NATURE OF ETHICAL CHALLENGES This and all remaining sections of the Results focuses on the 290 respondents who comprised the challenged group. In describing the ethical conflicts they most frequently encountered, these individuals generated 555 different problem descriptions. In answering the question about the single most serious conflict they had ever encountered, they produced 263 descriptions. Table 5 presents, for both types of problems, the 10 SPE codes that we assigned most often to the respondents’ answers. It is important to note that the unit of analysis for the results reported in the &dquo;Most Frequent Problems&dquo; column of Table 5 is the respondent, not the individual problems he or she described. Thus each number in that column refers to the percentage of the challenged group who mentioned a given issue at least once when describing the ethical problems they had most frequently encountered. (The unit-of-analysis distinction is not relevant to the &dquo;Most Serious Problem&dquo; column because only one serious problem could be generated by each respondent.) Inspection of Table 5 reveals that the five codes assigned most often in the most Frequent Problems&dquo; column are the same, and in the same rank order, as those appearing in the &dquo;Most Serious Problem&dquo; column. Thus there is a great deal of commonality in the issues underlying respondents’ most frequent and most serious ethical challenges. To develop a more detailed understanding of the conflicts associated with the codes that were most often assigned, we performed a follow-up content analysis of problems that had been assigned any of the four top-ranked codes (40, 51, 2, 47). The results of this analysis are presented in Tables 6 through 9. A review of these results indicates that, where the reporting of evaluation findings is concerned (Code 40), the major ethical conflict faced by respondents was feeling pressured by stakeholders (usually the primary client) to distort the facts (Table 6). The problem of how to respond when one stumbles upon information in an evaluation that is morally or legally volatile is also worthy of note. Although this was an uncommon occurrence, with only 14% of the Code 40 group saying that they had encountered it frequently, it was a component of the conflicts described by nearly one quarter of the Code 40 respondents to the &dquo;most serious problem&dquo; question. In terms of what can go wrong after evaluation findings are presented (Code 51), the results show a fairly wide variety of possibilities (Table 7). 0 8 11 s o d #3a 0 15 1;) T5 jg m 0 E w ’D 0 .0 0 c a as 2 § 0 0 0 .5 m -rz 0 0 c m c 0 0 w 0 ’6 c a (a a as 0 L ,a10m c 0 cc 60 3 0 8 8 m -5 âi f= m ’5 2 S0co ’0 0 c8 8 .5 Y co ’c m 0m 1;) a as 6 c( ’n J iii m H c t-oZ 629 630 TABLE 6: Challenges in Presenting Findings (in percentages) NOTE: Percentages are not based on the challenged group as a whole but only on that segment of the challenged group whose problem descriptions were assigned Code 40. a. Percentages in this column total more than 100% because it is possible for one respondent to be represented in as many as three different categories. Within a category, however, a respondent is never counted more than once. When describing their most frequent problems in this area, nearly a third of the Code 51 group mentioned suppression or nonuse of the final report. The use of findings by stakeholders to punish someone (including the evaluator) was encountered about as often as straightforward distortion or misinterpretation. Because nearly 20% of the Code 51 respondents described the misuse they witnessed in a nonspecific fashion, the relative magnitudes of the percentages reported in Table 7 might have differed if more detailed information had been available concerning the circumstances underlying the answers coded as &dquo;unspecified misuse.&dquo; The ethical problems encountered during the entry/contracting stage of the evaluation (Code 2, Table 8) are dominated by what we label the &dquo;stacked deck&dquo; phenomenon: The evaluator believes that the primary client is not sincerely committed to obtaining accurate information about the program in question but only wants the research done to buttress decisions already made, such as seeking additional support, terminating the program, firing someone, and so on. The majority of Code 2 respondents to the &dquo;most frequent problems&dquo; question cited this issue, and it also was a defining characteristic of over half of the conflicts described by Code 2 respondents to the &dquo;most serious problem&dquo; item. Finally, disclosure problems (Code 47) tended to involve either confidentiality or ownership/dissemination issues (Table 9). Whereas the specific 631 TABLE 7: Challenges of Misinterpretation and Misuse (in percentages) NOTE: Percentages are not based on the challenged group as a whole but only on that segment of the challenged group whose problem descriptions were assigned Code 51. a. Percentages in this column total more than 100% because it is possible for one respondent to be represented in as many as three different categories. Within a category, however, a respondent is never counted more than once. b. Figures do not total 100% due to rounding. TABLE 8: Challenges in Contracting With Stakeholders (in percentages) NOTE: Percentages are not based on the challenged group as a whole but only on that segment of the challenged group whose problem descriptions were assigned Code 2. a. Percentages in this column total more than 100% because it is possible for one respondent to be represented in as many as three different categories. Within a category, however, a respondent is never counted more than once. 632 TABLE 9: Challenges in Adhering to Disclosure Agreements (in percentages) NOTE: Percentages are not based on the challenged group as a whole but only on that segment of the challenged group whose problem descriptions were assigned Code 47. a. Percentages in this column total more than 100% because it is possible for one respondent to be represented in as many as three different categories. Within a category, however, a respondent is never counted more than once. forms of these conflicts were cited about equally often in response to the frequency question, the list of serious challenges was led by concerns over unintentional, inadvertent violations of individual confidentiality. Nearly half of allCode 47 respondents to the &dquo;most serious problem&dquo; question described such a conflict. SUBGROUP COMPARISONS For respondents in the challenged group, it is appropriate to ask whether the different types of conflicts they reported are related to their background characteristics. To this end we focused on the eight SPE codes in Table 5 that appeared in the lists of both the most frequent and most serious problems. Table 10 summarizes the results of this analysis. As can be seen, the greatest number of significant relationships involved Code 40, conflicts in presenting findings. Respondents who experienced frequent problems in this area averaged more years of experience (13.8 vs. 10.9, t[281] = 3.35, p < .001), had conducted more evaluations (4.1 vs. 3.8, t[288] = 2.50, p < .05), and had emphasized process evaluation to a greater than those who had extent in their work (4.1 vs. 3.8, t[286] = 2.71, p
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Case Management Interventions with Hispanics in Rural Settings
Cultural and Ethnic considerations:
1. Ethical consideration- Establishing trust, informed
consent, and language consideration (Morris & Cohn,
1993).
2. The presentation of practitioner as a figure of
authority.
3. Follow-up care in...


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