Formative process evaluation of the REFUGIUM Peerhealth promotion program for refugees: a multimethod case study

Abstract

Objective The objective of this study was to develop and establish a professional program management of the REFUGIUM health awareness program for refugees. Background REFUGIUM provides health promotion for refugees following participatory action research approach with a vulnerable target group. Therefore, the program undergoes constant process changes as well as team member fluctuation. In the period from February until July 2017 program management and implementation were highly time consuming due to lack of effective program management tools. Methods Formative process evaluation was conducted in form of a multi-method case study. Participatory observation was conducted during organisational preparation and conduction of peer facilitator trainings for two generations. At 2 timepoints in total 28 open-ended formative process evaluation questionnaires were distributed to the program staff. Result Program management tools were developed and validated consisting of a framework with steps from A to M. It requires monitoring, documentation, and the involvement of the REFUGIUM team and program coordinator. This includes a formative evaluation questionnaire and 9 categories of the program management tool. The tools were developed by identifying constituent activities, barriers, resources and solutions of each task of the 4 units. For each task the necessary resources (documents, materials) were developed and incorporated systematically in the electronic platform EMIL HAW Flüchtlingsgesundheit 2017 (resources) and materials were stored systematically in university rooms N5.29 and N2.09. Consequently, the steps were organised into a logical sequence. 4 management tools with corresponding detailed instructions for each process step of program management (units 1-4) were developed and 77 ressources were created and uploaded: induction phase for new REFUGIUM Team members (unit 1), peer facilitator training (PFT) (unit 2), didactical peer facilitator training (DPFT) (unit 3), and Applied peer facilitator training (APFT) (unit 4). Lastly the assessment of REFUGIUM programs managerial complexity elements were developed using the MODeST framework (Maylor, 2010, p.38) and an induction phase document for unit 1 was developed. Tools were developed and validated during peer facilitator training of in total 32 refugees, which were trained by peer facilitator trainers and staff of university in 56 training sessions as well as 54 workshops in refugee accommodations and at university in Arabic, Dari/Farsi, English and German. Outlook The study contributes to public health research knowledge regarding the processes and instruments needed to organise and evaluate a health promotion program following a participatory action research approach with a vulnerable group effectively and efficiently. The instruments comprise of the formative evaluation questionnaire and management tools with corresponding resources (instructions, documents, materials), which can be used and adapted in future studies on program management in health promotion programs.