SMILES Program For Children Of Mentally Ill Relatives: Impact Evaluation

The SMILES Program to Help Children Cope with Mentally Ill Relatives

Over the years, there has been a persistently increasing report regarding challenges faced by children living with mentally ill relatives including fathers, mothers, siblings, brothers, and sisters among others. These cases have been of varying consequences to the children, depending on the level of mental illness of the child(ren). It is imperative and substantial that children of tender age do not have sufficient skills of how to adapt to certain circumstances of the environment (Levy, et al., 2017, p. 17). This is evidenced by the fact that, children from such affected families tend to have general issues in their social life as well as cognitive development. Additionally, the relatives of the children who are victims of mental illness have continued undergoing poor medical and mental health care due to the incompetence and ignorance of the involved caretakers (Costello, Taylor, & O’Hara, 2015, p. 449).

In consideration of the preceding insight, the rationale for steering and executing SMILES program (Simplifying mental illness + life-enhancing skills) is to help victimized children from families having mentally affected relatives on how to cope and adjust to the environment in which they live. The SMILES program will be implemented at the youth justice system centere. The youth justice system is a foundation established to foster the empowerment of the young through the provision of necessary support for development, both physically and mentally (Heslin, et al., 2017, p. 407). On the other hand, SMILES was formulated and invented in the late 1990’s by Erica Pitman. In order to achieve effective implementation, the program was undertaken during the school breaks when the children are on holidays (Flood, Minkler, Hennessey, Estrada, & Falbe, 2015, p.668) Particularly, the programme helped in imparting skills and knowledge in children on how to easily adapt and adjust to the challenges they face as a result of coming from families with persons having mental illness. The programme facilitated care acclimatization and positive assimilation of the depression caused by the mentally ill victims from the families (Ward et al., , 2018, p.70). It is important to note that this program was designed specifically for children in the age group of 8-12 and 13-16 years of age.

It is typical that for the effective implementation and execution of any project activities, there must be an efficient coordination of the stakeholders, both internal and external. With such an insight, the stakeholders to be involved in the impact evaluation gram will include the; the organizers (the SMILES support and employees, the youth justice system support and the participants of the event (the children in the age of 12-16 years of age. The program is also expected to attract some members of the health ministry and the community members in which the youth justice system is located (Anwar et al., 2016, p.579)

Stakeholders Involved in the Impact Evaluation of SMILES Program

As it was noted in the preceding section, the program was designed to categorically help the children within the age of 8-12 and 13-16 years with mothers, brothers, sisters, and brothers who are affected by mental illness. The proposed Impact evaluation thence is aimed at examining, analyzing and evaluating the extent to which the smiles programme has impacted on the children coming from families having mentally ill persons (Smith, Rissel, Shilton, & Bauman, 2017, p. 186). Since the program centralized and specialized in helping children whose relatives are affected illnesses like anxiety, bipolar disorder, depression and schizophrenia, the proposed evaluation program formulated specific aims. The aims included but were not limited to the following;

1. Was the SMILES programme efficiently and effectively implemented in the intended community
2. What extent did the SMILES program help in changing the attitude, altitude and social life of the affected children?
3. What were the main barriers/ challenges faced during the implementation of the program
4. What are the possible solutions to the potentially identified barriers and challenges faced during the implementation of the programme?
5. Was the program positively welcomed by the intended population or community

The impact evaluation regarding the implementation of the SMILES program in the youth justice system will be executed using a well-defined designation manner, which is fundamental to the extensive and comprehensive understanding in the effective implementation of the SMILES program in the youth justice system. The study will make use of a non-specific design approach in evaluating the program. This is because the design methods give chance for the incorporation of cross-sectional methods post and multi-observational adjustment during the implementation process. The methods will help in the measurement of the essential elements of the impact evaluation (Smylie et al., 2016, p.143).

A series of other related programs have initially identified the essential elements of impact evaluation, among which the elements include exposure analysis, satisfaction, delivery, and participation. It is, however, important to note that content exposure helps in the determination and measurement of efficacy test regarding the extent to which the program reaches the targeted group or sample as well as the relevance of the program to the group. The participation focuses on the identification and measurement of the satisfaction rate and representativeness of the group. Additionally, the delivery methods are fundamental in the assessment of future dissemination and the fidelity program while the contextual elements identify the processes in which the program engages involved stakeholders as well as the participants of the programme. A holistic understanding of appropriateness and quality of the impact evaluation can be obtained using the all the mention methods (Levy, et al., 2017, p. 17)

The acknowledgment of other evaluation design is also important as it helps in the identification of the strengths and weaknesses of the chosen design and further analyzing the basis why they are not suited for the chosen impact evaluation process. For example, the randomized controlled trials are well-thought to be appropriate for an extensive methodology firmness as it makes use of focus and control groups that are arbitrarily allocated. This method helps in strengthening the external rationality of the impact evaluation finding (Sallnow, Richardson, Murray, & Kellehear, 2016, p. 2011)

Aims of Impact Evaluation

In the same way, the use of quasi-experimental design engages the use of naturally occurring and predetermined groups. Nonetheless, the listed evaluation designs cannot be used in the impact evaluation of the SMILES program due to the fact that they do not appropriately and effectively suit the program (Boone, et al., 2017). There are also related ethical concerns that are associated with the designs which further limits the design method.

The Australian law is deemed responsible for all the human related research studies in relation to ethical responsibilities. It clearly defines the rights and limitation of the participants as well as that of the researchers. The rules, rights, and responsibilities are based on the principle of fair treatment. The ethical responsibilities of the study help in ensuring recommendable practices among the involved parties in the impact evaluation processes. It also fosters the consideration of the likely risks and benefits of fair treatment of the engaged parties or so, while considering the integrity of the participants. The reflection of ethical responsibilities such as respect for one another, confidentiality of some information gathered from the field, maintenance of justice among participants and research merits helps in the promotion of an appropriate structure for molding a convenient impact and evaluation environment. It, therefore, facilitates ethical quality, reciprocal responsibility, and trust during the study process (Anwar et al., 2016, p.579)

Keeping in mind the study will engage human participants, it becomes imperative and significant to maintain ethical practices. The approval of ethical responsibility will be approved and attained by the in-charge authorities, specifically the community in which the program is being conducted. A well-defined consent forms will be administered to the study participants through a plain written statement. The forms will comprehensively explain the details of the study to be conducted while highlighting the rights an responsibilities of respective stakeholder/ participants.

The possible/ probable risk, likely to arise during the impact evaluation will be highlighted and given to the study participants in regard to the confrontational nature of the issues that will be deliberated so as to have a clear understanding of the consequences of the study. This will help in the mitigation of the anticipated risks by the participants (Heslin, et al., 2017, p. 407). Additionally, the study participants will also be told the remedies of being involved in the study, for example, explaining how getting engaged in the study will be beneficial to them.

Design and Methods used in Impact Evaluation

Just like any other research study, the impact evaluation process makes use of well-defined data collection methods while applying the most appropriate and applicable framework. This involves the selection of a sampling method, data collection instruments, analysis and reporting as it cab be evidenced in the subsequent sections.

The collection of sample participants will be done internally while considering the participation zeal among the study population. It is typical that in an organization/ project, there exist stakeholders with varying interest and participation. With this insight, the sampling method will consider the more active and interested persons. The roles played by different individuals towards the achievement of simplifying mental illness, and life enhancement skills’ program will also be a significant factor to consider when selecting the sample participants (Gaughran et al., 2017, p.413). In regard to the evaluation objectives, the sample will be selected that best fits the data collection methods. In other words, the study will make use of purposeful sampling method to ensure the most convenient and appropriate sample population is selected for the study.

For purposes of reliably and dependably collecting the impact evaluation data, suitable instruments have been shortlisted in consideration to the SMILES aims and objectives. The data collection will also engage the integration and triangulation of the sources of information/ raw data to enhance the robustness of the study findings. Exposure and participation will be measured using a pre-post survey. The survey will be done through the use of both close ended and open-ended questions in a plane written/ typed form (Ward et al., , 2018, p.70)

Additionally, the study will make use of online platforms as a way of increasing/ widening the response rate of the study from a comprehensive context. An analysis of the demographic information regarding the participants will be done to assist in understanding the background of the impact evaluation study these will include but not limited to age, sex, and culture among others (White, Burns, Giglia, & Scott, 2016, p. 350). The demographic study will further facilitate the understanding of the distribution of children facing the prevalent issue of mental illness environment. The study will make use of focus groups in determining the extent to which the program impacts on the targeted community. The use of focus groups acts as control groups in determining study the influence of the study. A unified time interval assessment will be conducted by the educators to analyze and evaluate the program context and fidelity. It will be accompanied by the use of checklists and attendance of the participants. The identification of challenges, barriers and pitfalls will further be attained through the discussions among focus groups in the impact evaluation process (Moore, et al., 2015, p.350).

Ethical Responsibilities towards Study Participants

The data analysis stage will engage the identification and summarization of the compiled raw data and themes while making use of relevant and applicable statistical tools of analysis. The analysis will also involve the use of the descriptive method to interpret the qualitative data. In other words, the data analysis will engage both quantitative and qualitative analysis. It will assist in striking a balance between objectivity and subjectivity of the data collected. Different research scholars have recommended different analysis method as being the most reliable and dependable. It is, however, important to note that the mode of analysis is solely determined by the study mode. Thence, since the impact evaluation process will gather both statistical and descriptive data, it makes it imperative to use both/ mixed method (Ward et al., , 2018, p.70).

The study will follow a well-defined procedure, right from the initiation to the dissemination of the evaluation impact. This will be done as follows.

1. Submitting the study aims and objectives of the project’s sponsors in order to lobby for funds
2. Submission of application for the ethical approval from the responsible authorities prior to the kick-off of the project
3. Invitation of the project participants to participate in the impact evaluation study
4. Admission of the pre-program survey to the potential participants of the study wit in a period of 2 weeks
5. Observation of all the sessions from week two to week six of the study by the educator, accompanied by the end of session discussion.
6. Administering the post program, the survey will be conducted in the seventh week.
7. Conducting of the focus group will be done on the seventh to eight weeks. This will be done in relation to the number of participants available for the study
8. On the 9^thweek, the tallying and analysis of data using statistical tools will be undertaken
9. Five months after the impact evaluation of the SMILES program, a post-survey will be undertaken to ensure the effectiveness of the programme.
10. Re-evaluation of the study to identify the gaps in the findings of the study
11. Use of strategies identified as most recommendable from the dissemination section to disseminate the final reports/ findings.

As a way of ensuring maximum and optimistic realization of the impact evaluation study findings, the communication of the carefully analyzed findings, as well as the recommendations, will be undertaken using reactive and proactive channels. This will be made in association with the specified age group of 12 to 16 yeas as initially highlighted by the study age group target. The dissemination will also involve the engagement of the relevant stakeholders when addressing the identified gaps in the impact evaluation study (Ward et al., , 2018, p.70).

Documentation of the report compiled from the impact evaluation will be made using a format of 1:3:25. The final document will be sent to the important stakeholders of the project, including schools catering to children having mentally ill relatives in their homes. Additionally, the report will also be established in public journals to improve and strengthen on the evidence-based practices regarding the program.

References

Costello, M., Taylor, J., & O’Hara, L. (2015). Impact evaluation of a health promotion-focused organisational development strategy on a health service’s capacity to deliver comprehensive primary health care. Australian journal of primary health, 21(4), 444-449.

Flood, J., Minkler, M., Hennessey Lavery, S., Estrada, J., & Falbe, J. (2015). The collective impact model and its potential for health promotion: overview and case study of a healthy retail initiative in San Francisco. Health Education & Behavior, 42(5), 654-668.

Smith, B. J., Rissel, C., Shilton, T., & Bauman, A. (2017). Advancing evaluation practice in health promotion. Health Promotion Journal of Australia, 27(3), 184-186.

Smylie, J., Kirst, M., McShane, K., Firestone, M., Wolfe, S., & O’Campo, P. (2016). Understanding the role of Indigenous community participation in Indigenous prenatal and infant-toddler health promotion programs in Canada: A realist review. Social Science & Medicine, 150, 128-143.

Levy, D. T., Cummings, K. M., Villanti, A. C., Niaura, R., Abrams, D. B., Fong, G. T., & Borland, R. (2017). A framework for evaluating the public health impact of e?cigarettes and other vaporized nicotine products. Addiction, 112(1), 8-17.

Boone, P., Eble, A., Elbourne, D., Frost, C., Jayanty, C., Lakshminarayana, R., … & Reddy, P. (2017). Community health promotion and medical provision for neonatal health—CHAMPION cluster randomised trial in Nagarkurnool district, Telangana (formerly Andhra Pradesh), India. PLoS medicine, 14(7), e1002324.

Sallnow, L., Richardson, H., Murray, S. A., & Kellehear, A. (2016). The impact of a new public health approach to end-of-life care: A systematic review. Palliative medicine, 30(3), 200-211.

Anwar-McHenry, J., Donovan, R. J., Nicholas, A., Kerrigan, S., Francas, S., & Phan, T. (2016). Implementing a Mentally Healthy Schools Framework based on the population wide Act-Belong-Commit mental health promotion campaign: A process evaluation. Health Education, 116(6), 561-579.

Heslin, M., Patel, A., Stahl, D., Gardner-Sood, P., Mushore, M., Smith, S., … & Ohlsen, R. (2017). Randomised controlled trial to improve health and reduce substance use in established psychosis (IMPaCT): cost-effectiveness of integrated psychosocial health promotion. BMC psychiatry, 17(1), 407.

Gaughran, F., Stahl, D., Ismail, K., Greenwood, K., Atakan, Z., Gardner-Sood, P., … & Lowe, P. (2017). Randomised control trial of the effectiveness of an integrated psychosocial health promotion intervention aimed at improving health and reducing substance use in established psychosis (IMPaCT). BMC psychiatry, 17(1), 413.

Moore, G. F., Audrey, S., Barker, M., Bond, L., Bonell, C., Hardeman, W., … & Baird, J. (2015). Process evaluation of complex interventions: Medical Research Council guidance. bmj, 350, h1258.

White, B. K., Burns, S. K., Giglia, R. C., & Scott, J. A. (2016). Designing evaluation plans for health promotion mHealth interventions: a case study of the Milk Man mobile app. Health Promotion Journal of Australia, 27(3), 198-203.

Ward, M., Schulz, A. J., Israel, B. A., Rice, K., Martenies, S. E., & Markarian, E. (2018). A conceptual framework for evaluating health equity promotion within community-based participatory research partnerships. Evaluation and program planning, 70, 25-34.

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