Exploring the connections between programmatic assessment and program evaluation within competency-based medical education programs.

Programmatic assessment and program evaluation are both important within competency-based medical education (CBME) programs. Given this importance, there is value in evaluating programmatic assessment as well as using the information collected in programmatic assessment for the evaluation of CBME programs. In order to help facilitate these two activities, this paper distinguishes between programmatic assessment and program evaluation as well as highlights the connections between them.

Patients' and parents' perspectives of and experiences with assessing nursing students' paediatric clinical practice.

Purpose: To explore patients' and parents' involvement in the formative assessment of undergraduate nursing students' paediatric clinical practice.

Methods: We conducted semi-structured interviews with paediatric patients between 14 to 18 years old and parents who received care from a nursing student while admitted to a paediatric tertiary care hospital in Canada. We analysed the data using qualitative content analysis as well as Lincoln and Guba's criteria for establishing trustworthiness.

Effectiveness of permanent supportive housing and income assistance interventions for homeless individuals in high-income countries: a systematic review.

Background: Permanent supportive housing and income assistance are valuable interventions for homeless individuals. Homelessness can reduce physical and social wellbeing, presenting public health risks for infectious diseases, disability, and death. We did a systematic review, meta-analysis, and narrative synthesis to investigate the effectiveness and cost-effectiveness of permanent supportive housing and income interventions on the health and social wellbeing of individuals who are homeless in high-income countries.

"It's not just injecting drugs": Supervised consumption sites and the social determinants of health.

Background: People who inject drugs are highly vulnerable to social determinants of health (SDOH) inequities, such as homelessness, food insecurity, lack of social support, and poor access to healthcare. Supervised consumption sites (SCSs) have been developed to reduce harms associated with injection drug use but their social impacts remain largely unknown. This study explored service users' experiences with SCSs and how their service use affected their SDOH.

Establishing need and population priorities to improve the health of homeless and vulnerably housed women, youth, and men: A Delphi consensus study.

Background: Homelessness is one of the most disabling and precarious living conditions. The objective of this Delphi consensus study was to identify priority needs and at-risk population subgroups among homeless and vulnerably housed people to guide the development of a more responsive and person-centred clinical practice guideline.

Methods: We used a literature review and expert working group to produce an initial list of needs and at-risk subgroups of homeless and vulnerably housed populations.

Service use and recovery among currently and formerly homeless adults with mental illness.

Background: A range of health and social services exist to address the many life adversities experienced by people with mental illness. However, the effects of services on their recovery in the context of ongoing homelessness and poverty have been minimally examined.

Aims: This qualitative study sought to better understand the role of health and social services in the recovery processes of people with mental illness and histories of homelessness.

The Association of Residential Instability and Hospitalizations among Homeless and Vulnerably Housed Individuals: Results from a Prospective Cohort Study.

The present study examined the association of residential instability with hospitalizations among homeless and vulnerably housed individuals over a 4-year time period. Survey data were linked to administrative records on hospitalizations. Specifically, we used data from the Health and Housing in Transition study, a prospective cohort study that tracked the health and housing status of homeless and vulnerably housed individuals in Canada.

Examining the Relationships between Cumulative Childhood Adversity and the Risk of Criminal Justice Involvement and Victimization among Homeless Adults with Mental Illnesses after Receiving Housing First Intervention.

Objectives: Exposure to adverse childhood experiences (ACEs) is associated with increased risk of criminal justice involvement and repeated victimization among homeless individuals. This study aimed to (1) examine whether the relationship between cumulative ACE score and odds of experiencing criminal justice involvement and victimization remains significant over time after receiving the Housing First (HF) intervention and (2) investigate the moderating effect of cumulative ACE score on the effectiveness of the HF intervention on the likelihood of experiencing these outcomes among homeless individuals with mental illnesses.

Methods: We used longitudinal data over the 2-year follow-up period from the At Home/ demonstration project that provided HF versus treatment as usual (TAU) to homeless adults with mental illness in five Canadian cities (N = 1,888).

Surviving versus living life: Capabilities and service use among adults with mental health problems and histories of homelessness.

The capabilities approach is a framework that can be applied to marginalised populations, including people with mental health problems and histories of homelessness, to measure well-being. Although a range of health and social services exist to address the many challenges associated with mental health problems and homelessness, the extent to which these services impact capabilities is unknown. This qualitative study explored the perspectives of people with mental health problems and histories of homelessness to understand how they perceived their service use as affecting their capabilities.

A randomized controlled trial of the effectiveness of Housing First in a small Canadian City.

Background: The paper presents two-year findings from a study investigating the effectiveness of Housing First (HF) with assertive community treatment (ACT) in helping individuals with serious mental illness, who are homeless or precariously housed and living in a small city, to become stably housed.

Methods: The research design was a parallel group non-blinded RCT with participants randomly assigned after the baseline interview to receive HF with ACT (N = 100) or treatment as usual (TAU; N = 101). Participants were interviewed every 3 months over 21/24 months to investigate changes on a range of housing and psychosocial outcomes.

Lessons learned from piloting a pain assessment program for high frequency emergency department users.

Background and aims Chronic pain (CP) management presents a challenge for the healthcare system as many individuals experiencing CP cannot access appropriate services. Consequently, individuals may visit emergency departments (EDs) to address their CP, even though this setting is not the most appropriate. CP was identified as a common factor amongst patients with repeat ED use at a hospital in Ottawa, Canada.

Pathways Into Homelessness Among LGBTQ2S Adults.

This article examines entries into homelessness among adults who identify as LGBTQ2S (lesbian, gay, bisexual, transgender, queer, two-spirit). Twenty LGBTQ2S adults who were currently or formerly homeless participated in one qualitative interview. The interview protocol included questions on the participants' history of homelessness, causes of homelessness, and relationship of their gender and/or sexual identity to their homelessness.

Ego-centered relative neighborhood deprivation and reported dietary habits among youth.

Dietary habits are important precursors of childhood obesity. Youths' dietary habits may be constrained by the experience of deprivation due to social (e.g.

Perceptions of Housing and Shelter among People with Histories of Unstable Housing in three Cities in Canada: A Qualitative Study.

Housing is a key social determinant of health that contributes to the well-documented relationship between socioeconomic status and health. This study explored how individuals with histories of unstable and precarious housing perceive their housing or shelter situations, and the impact of these settings on their health and well-being. Participants were recruited from the Health and Housing in Transition study (HHiT), a longitudinal, multi-city study that tracked the health and housing status of people with unstable housing histories over a 5-year period.

Poverty and Serious Mental Illness: Toward Action on a Seemingly Intractable Problem.

This paper examines the issue of poverty among people with serious mental illness (SMI), positioning it as a key issue to be confronted by community mental health systems and practitioners. The paper reviews three perspectives on poverty, considering how each sheds light on poverty among people with SMI, and their implications for action: (a) monetary resources, (b) basic needs, and (c) capabilities. The paper argues that community mental health programs and systems are currently unable to address poverty as they are overly focused on individual-level interventions that, on their own, cannot raise people out of poverty.

A Review of the Literature on LGBTQ Adults Who Experience Homelessness.

Little is known about lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults who experience homelessness. The current review critically analyzes the scant literature on LGBTQ adults who experience homelessness, with a particular focus on: (1) pathways into homelessness; (2) support needs; (3) targeted programming; and (4) exits out of homelessness. A total of 143 articles were identified, and 16 articles met the criteria of appropriate age range, article quality, and relevance of topic.

The Involvement of Adolescents With Chronic Health Conditions in Medical Education: An Exploratory Qualitative Study.

Objectives: In this study, we explored the involvement of adolescents with chronic health conditions in medical education. We focused specifically on adolescents' desired level of involvement in the education of medical students and residents, strategies for involving them in it, and topics on which they would feel comfortable educating these learners.

Methods: We used a community-based participatory research approach and qualitative one-on-one semistructured interviews.

On the evaluation of social innovations and social enterprises: Recognizing and integrating two solitudes in the empirical knowledge base.

Social innovation (SI) is billed as a new way to address complex social problems. Interest in SI has intensified rapidly in the last decade, making it an important area of practice for evaluators, but a difficult one to navigate. Learning from developments in SI and evaluation approaches applied in SI contexts is challenging because of 'fuzzy' concepts and silos of activity and knowledge within SI communities.

When is a randomised controlled trial health equity relevant? Development and validation of a conceptual framework.

Background: Randomised controlled trials can provide evidence relevant to assessing the equity impact of an intervention, but such information is often poorly reported. We describe a conceptual framework to identify health equity-relevant randomised trials with the aim of improving the design and reporting of such trials.

Methods: An interdisciplinary and international research team engaged in an iterative consensus building process to develop and refine the conceptual framework via face-to-face meetings, teleconferences and email correspondence, including findings from a validation exercise whereby two independent reviewers used the emerging framework to classify a sample of randomised trials.

Costs of services for homeless people with mental illness in 5 Canadian cities: a large prospective follow-up study.

Background: Limited evidence on the costs of homelessness in Canada is available. We estimated the average annual costs, in total and by cost category, that homeless people with mental illness engender from the perspective of society. We also identified individual characteristics associated with higher costs.

Has the new Kirkpatrick generation built a better hammer for our evaluation toolbox?

Although Kirkpatrick's original outcome-focused model is widely used to evaluate medical education programs, it is subject to criticism. To combat this criticism and address the complexities of learning environments, the New World Kirkpatrick Model has emerged. This brief article describes key aspects of the New World Kirkpatrick Model for program evaluation.

Neglect, educational success, and young people in out-of-home care: Cross-sectional and longitudinal analyses.

Maltreated young persons in out-of-home care often have poor educational outcomes, heightening their risk of long-term psychosocial disadvantage (Forsman, Brännström, Vinnerljung, & Hjern, 2016). In their systematic reviews, Romano, Babchishin, Marquis, and Fréchette (2014) and O'Higgins, Sebba, and Gardner (in press) found evidence that neglect was more often linked with low academic achievement, whereas abuse was more likely to be associated with behavioral difficulties. In large samples of young persons in out-of-home care in Ontario, Canada, who had experienced mainly neglect, we investigated risk and protective factors as predictors of educational success.

Housing First for Adults with Problematic Substance Use.

Objectives: This study explores the two-year housing- and non-housing-related outcomes for adults who are homeless with problematic substance use who received scattered-site housing and intensive case management services from a Housing First program in Ottawa, Canada, in comparison with a group of adults who are homeless with problematic substance use who had access to standard care in the community.

Methods: Housing First clients (n = 89) and members of a comparison group (n = 89) completed structured interviews at baseline and were followed for two years.

Results: Housing First clients moved into housing more quickly, reported a greater proportion of time housed, were more likely to spend the final six months housed, and had longer housing tenure at 24 months.