Expert consensus on best evaluative practices in community-based rehabilitation

Abstract

Purpose: The objective of this study was to generate expert consensus on best evaluative practices for community-based rehabilitation (CBR). This consensus includes key features of the evaluation process and methods, and discussion of whether a shared framework should be used to report findings and, if so, which framework should play this role. Method: A Delphi study with two predefined rounds was conducted. Experts in CBR from a wide range of geographical areas and disciplinary backgrounds were recruited to complete the questionnaires. Both quantitative and qualitative analyses were performed to generate the recommendations for best practices in CBR evaluation. Results: A panel of 42 experts reached consensus on 13 recommendations for best evaluative practices in CBR. In regard to the critical qualities of sound CBR evaluation processes, panellists emphasized that these processes should be inclusive, participatory, empowering and respectful of local cultures and languages. The group agreed that evaluators should consider the use of mixed methods and participatory tools, and should combine indicators from a universal list of CBR indicators with locally generated ones. The group also agreed that a common framework should guide CBR evaluations, and that this framework should be a flexible combination between the CBR Matrix and the CBR Principles. Conclusions: An expert panel reached consensus on key features of best evaluative practices in CBR. Knowledge transfer initiatives are now required to develop guidelines, tools and training opportunities to facilitate CBR program evaluations.

Implications for Rehabilitation

• CBR evaluation processes should strive to be inclusive, participatory, empowering and respectful of local cultures and languages.

• CBR evaluators should strongly consider using mixed methods, participatory tools, a combination of indicators generated with the local community and with others from a bank of CBR indicators.

• CBR evaluations should be situated within a shared, but flexible, framework. This shared framework could combine the CBR Matrix and the CBR Principles.

• Community-based rehabilitation
• evaluation
• expert consensus
• framework
• process
• program evaluation

Acknowledgements

The authors wish to highlight the generosity of all those on the experts panel: Binoy Acharya, Marieke Boersma, Svein Brodtkor, Yinghong Cai, Eva Yin-Han Chung, Huib Cornielje, Israel Cruz, Sunil Deepak, Eduardo García, Solangel Garcia, Brigitte Gautron, Priscille Geiser, Ann Goerdt, Cindy Greer, Geraldine Halls, Gulliver Ishmael, Djenana Jalovcic, Sally Hartley, Jorge Morales, Chapal Khasnabis, Pim Kuipers, Jayanth Kumar, Jay Kumar, Gwynnyth Llewellyn, Sue Lukersmith, Malcolm MacLachlan, Ros Madden, Hasheem Mannan, Stephen Muldoon, Malcolm Peat, Eladio Recabarren, Lieve Sabbe, Pedro Safrao, Rachel Tainsh, Maya Thomas, Sara Varughese, Wim van Brakel, Andrea Vogt, Angela Wangda, David Werner, Mary Wickenden and Victoria Zubiaurre. They also want to thank those who piloted the questionnaires: Shaun Cleaver, Brydne Edwards, Danyelle Garcia, Adalberto Loyola Sánchez, Janet Njelesani, Stéphane Poitras, and Soumana Zamo. Practical support was provided by the Institute for Global Health of the University College London and Université du Québec à Trois-Rivières.

Declaration of interest

This article forms part of the doctoral thesis of the first author. She has been supported financially by the Canadian Institutes of Health Research (Vanier Graduate Scholarship and Michael Smith Foreign Study Supplement), the University of Ottawa (Excellence and Mobility Scholarships), the Canadian Occupational Therapy Foundation (Doctoral Scholarship), and the Ministry of Training and Universities (Ontario Graduate Scholarship).