Evaluation of capacity-building program of district health managers in India: a contextualized theoretical framework

Performance of local health services managers at district level is crucial to ensure that health services are of good quality and cater to the health needs of the population in the area. In many low- and middle-income countries, health services managers are poorly equipped with public health management capacities needed for planning and managing their local health system. In the south Indian Tumkur district, a consortium of five non-governmental organizations partnered with the state government to organize a capacity-building program for health managers. The program consisted of a mix of periodic contact classes, mentoring and assignments and was spread over 30 months. In this paper, we develop a theoretical framework in the form of a refined program theory to understand how such a capacity-building program could bring about organizational change. A well-formulated program theory enables an understanding of how interventions could bring about improvements and an evaluation of the intervention. In the refined program theory of the intervention, we identified various factors at individual, institutional, and environmental levels that could interact with the hypothesized mechanisms of organizational change, such as staff's perceived self-efficacy and commitment to their organizations. Based on this program theory, we formulated context-mechanism-outcome configurations that can be used to evaluate the intervention and, more specifically, to understand what worked, for whom and under what conditions. We discuss the application of program theory development in conducting a realist evaluation. Realist evaluation embraces principles of systems thinking by providing a method for understanding how elements of the system interact with one another in producing a given outcome.

Why Psychology Needs to Stop Striving for Novelty and How to Move Towards Theory-Driven Research

Psychological science is maturing and therefore transitioning from explorative to theory-driven research. While explorative research seeks to find something "new," theory-driven research seeks to elaborate on already known and hence predictable effects. A consequence of these differences is that the quality of explorative and theory-driven research needs to be judged by distinct criterions that optimally support their respective development. Especially, theory-driven research needs to be judged by its methodological rigor. A focus on innovativeness, which is typical for explorative research, will instead incentivize bad research practices (e.g., imprecise theorizing, ignoring previous research, parallel theories). To support the advancement of psychology, we must drop the innovation requirement for theory-driven research and instead require the strongest methods, which are marked by high internal and external validity. Precise theorizing needs to substitute novelty. Theories are advanced by requiring explicit, testable assumptions, and an explicit preference for one theory over another. These explicit and potentially wrong assumptions should not be silenced within the peer-review process, but instead be scrutinized in new publications. Importantly, these changes in scientific conduct need to be supported by senior researchers, especially, in their roles as editors, reviewers, and in the hiring process. An important obstacle to further theory-driven research is to measure scientific merit using researchers' number of publications, which favors theoretically shallow and imprecise writing. Additionally, it makes publications the central target of scientific misconduct even though they are the main source of information for the scientific community and the public. To advance the field, researchers should be judged by their contribution to the scientific community (e.g., exchange with and support of colleagues, and mentoring). Another step to advance psychology is to clearly differentiate between measurement model and theory, and not to overgeneralize based on few stimuli, incidences, or studies. We will use ideas from the theory of science to underline the changes necessary within the field of psychology to overcome this existential replication crisis.

COVID-19 and team-based healthcare: The essentiality of theory-driven research

There is evidence to suggest enhanced teamness, heightened interprofessional values and practices, and even the potential for dilution of occupational status hierarchies within healthcare practice and delivery during the time of COVID-19. It is essential that we study these emergent changes using the lens of multilevel theory to better understand these recent developments and their current and future implications for interprofessional practice, education, and policy. Within this article, we first offer a brief overview of secondary data to highlight these COVID-19-specific shifts to provide context and perspective. We then outline prominent micro, meso, and macro-level theories, and propose accompanying rudimentary hypotheses and related general research questions to help guide, and ideally accelerate IPE and IPCP research related to this crisis. Our goal is to not only spotlight key areas for future research during and post COVID-19 but also provide a "starter kit" to encourage more theory-driven research (and theory-expansion) in the IPE and IPCP fields.

An evolutionary perspective for the exposome

The exposome was proposed following the realization that most human diseases have an environmental rather than a genetic (hereditary) origin. Non-communicable diseases are, in fact, the consequence of multiple exposures that activate a sequence of stages in a multistage process that already starts in early life. This attracted attention to both the multiplicity (in fact, potentially the totality) of exposures humans are exposed to since conception and to the life-long perspective of disease causation. In this paper, we examine an extension of the exposome concept that incorporates a Darwinian approach based on the concept of phenotypic plasticity. One of the theses is that interpreting exposome science as "precision environmental research" is only a partial interpretation, largely focused on chemical exposures, while a broadening of the perspective is needed, also in light of the planetary crisis. Such broadening involves the incorporation of basic concepts from evolutionary biology and medicine, including the ability of organisms to adapt to rapidly changing environments. We refer in particular to cancer and "Darwinian carcinogenesis."

The future of neuropsychology is digital, theory-driven, and Bayesian: a paradigmatic study of cognitive flexibility

Introduction

This study explores the transformative potential of digital, theory-driven, and Bayesian paradigms in neuropsychology by combining digital technologies, a commitment to evaluating theoretical frameworks, and Bayesian statistics. The study also examines theories of executive function and cognitive flexibility in a large sample of neurotypical individuals (N = 489).

Methods

We developed an internet-based Wisconsin Card-Sorting Task (iWCST) optimized for online assessment of perseveration errors (PE). Predictions of the percentage of PE, PE (%), in non-repetitive versus repetitive situations were derived from the established supervisory attention system (SAS) theory, non-repetitive PE (%) < repetitive PE (%), and the novel goal-directed instrumental control (GIC) theory, non-repetitive PE (%) > repetitive PE (%).

Results

Bayesian t-tests revealed the presence of a robust error suppression effect (ESE) indicating that PE are less likely in repetitive situations than in non-repetitive situations, contradicting SAS theory with posterior model probability p < 0.001 and confirming GIC theory with posterior model probability p > 0.999. We conclude that repetitive situations support cognitive set switching in the iWCST by facilitating the retrieval of goal-directed, instrumental memory that associates stimulus features, actions, and outcomes, thereby generating the ESE in neurotypical individuals. We also report exploratory data analyses, including a Bayesian network analysis of relationships between iWCST measures.

Discussion

Overall, this study serves as a paradigmatic model for combining digital technologies, theory-driven research, and Bayesian statistics in neuropsychology. It also provides insight into how this integrative, innovative approach can advance the understanding of executive function and cognitive flexibility and inform future research and clinical applications.