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Benchmark Assignment: Evidence-Based Practice Proposal Final Paper

Benchmark Assignment: Evidence-Based Practice Proposal Final Paper

A. Consent/Approval Form for Interviews
A Qualitative Sub-study
Thank you for reading this information sheet related to the interview sub-study. If you are happy and willing to participate, then kindly complete and sign this document. Please fill the boxes (using a tick (√) or a cross (x)) to confirm that you agree with each of the described statements:
Described Statement Please mark the box to confirm
I confirm that I have read and understood the information sheet dated (d/m/y) and have had the opportunity to ask questions.
I understand that my participation is voluntary and that I am free to withdraw at any time without giving any reason and without there being any negative consequences. In addition, should I not wish to answer any particular question or questions, I am free to decline.
I understand that my responses will be kept strictly confidential. I understand that my name will not be linked with the research materials, and will not be identified or identifiable in the report or reports from the research.
I agree for this interview to be tape-recorded. I understand that the audio recording make of this interview will be used for analysis and that the extracts from the interview, which I would not be personally identified, may be used in any conference presentation,

Benchmark Assignment Evidence-Based Practice Proposal Final Paper

Benchmark Assignment Evidence-Based Practice Proposal Final Paper

report or journal article developed as a result of the research. I understand that no other use will be made of the recording without any permission, and that no one outside the research team will be allowed access to the original recording.
I agree that my anonymised data will be kept for future research purposes such as publications related to this study after the completion of the study.
I agree to take part in this interview and will accept the findings of the outcome for the benefit of the study.
Name of Participant: ……………………………… Date: ……………………… Signature: ………………..
Principal Investigator: …………………………….. Date: ………………………. Signature: …………………
To be counter-signed and dated electronically for telephone interviews or in the presence of the participants for face interviews.
Copies: Once this has been signed by all parties, the participant should receive a copy of the signed and dated participation consent form, and the information sheet. A copy of the signed and dated consent form should be placed in the main project file which must be kept in a secure location.

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D. Timeline for the Project
Time in Months
Activity M1 M2 M3 M4 M5 M6 Completion
Develop items for project
Review and revise items with panel of experts
Pre-test of items needed for data collection
Coordination with project administer for conducting research
Prepare project site
Recruit and train study representatives
Data collection using selected tools
Data editing based on findings
Data analysis using statistical approaches
Preparation and submission of final report

E. Methods and Instruments: Questionnaire
Section 1: Personal Information
1- Gender
• Male
• Female
2- Age group
• 18 – 25
• 25- 35
• 35 +
Please respond to the statements in the table below. (Kindly use the following scale; 1- Strongly Agree; 2- Agree; 3- Neutral 4- Disagree 5- Strongly Disagree).
Statement 1 2 3 4 5
I found the MOVE education provided to be well structured
I fully understood the contents discussed during the MOVE program
I realized that time allotted for education sufficient
The education materials used support knowledge retention
I anticipate that the MOVE will be useful for my health

3- How long have you been suffering from obesity?
• Less than 6 months
• 1 year
• 2-3 years
• 5 years +
Section 2
4- What self-care management approaches do you use for your obesity?
5- On Average, how many obesity self-management programs have you attended this year?
• Less than 5
• 5-10
• 10-15
• More than 15
• None
6- When was your last education session?
• Last week
• Last month
• Last quarter
• Before last quarter
7- How often do you benefit from the MOVE sessions you attended?
• Always
• Often
• Sometimes
• Never
8- Considering skills and application, for how long do you remember what you have been trained in?
• Always
• Often
• Sometimes
• Never
9- What are the main barriers for DSME implementation? (Please tick appropriately)
Barriers to MOVE program Tick (√)
Inadequate time allocated for education
Poorly coordinated education sessions that do not encourage active participation
Limited financial resources for MOVE
Lack of interest by the healthcare staff to deliver MOVE
Poor choice of MOVE topics that do encourage learning enthusiasm
Non-Availability of skilled trainer
Poor choice of learning materials that fail to address goals of the MOVE weight loss program

10- Have the MOVE program benefited you? (Please tick (√) as appropriate)
Benefit of the MOVE Tick (√)
Improved my skill
Improved my knowledge
Improved my behaviour


F. Data Collection and Evaluation Tools
Part 1: Measuring Core Outcome Areas
Outcome Area: How MOVE program shift in social norms
o Interview Protocol: Changes in Awareness and Prioritization
o Focus Group: Changes in Attitudes
o Meeting Observation Checklist
o Beliefs about the Importance of a Particular Issue
o Survey: Changes in Prioritization of Specific Issues
Outcome Area: Strengthen Organizational Capacity
o Self-Assessment Tool:
o Assessment
Outcome Area: Strengthened Alliances
Part 2: Tracking Form – Intensity of Integration Assessment
Outcome Area: Strengthened Base of Support
o Tools for Measuring Public Support
o Logs: Increased Public Involvement in an Issue
o Log: Increased Engagement of Stakeholders
o Survey: Increased Public Involvement
Outcome Area: Improved Policies
o Log: Legislative Process Tracking
o Log: Policy Tracking Analysis
o Environmental Assessments: Changes in Physical Environments
Outcome Area: Changes in Impact

Part 3: Tools and Methods for Other Evaluation Designs
Part 4: Evaluation of Strategic Progress
Method: Appreciate Inquiry Approach to Process Evaluation of the Weight-loss Program
Part 5: Measuring Short-Term Incremental Objectives of MOVE program
Part 6: Case Study Documentation of weight-loss Process and Impacts
o Method: Case Studies
o Method: Theory-based Evaluation
o Method: Use of Coding Protocol with Qualitative Data
o Reporting Tool: Alliance for Justice Advocacy Evaluation Tool

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