Capstone Project Change Proposal Essay Example Paper
In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: Background Clinical problem statement. Purpose of the change proposal in relation to providing patient care in the changing health care system. PICOT question. Literature search strategy employed. Evaluation of the literature. Applicable change or nursing theory utilized. Proposed implementation plan with outcome measures. Discussion of how evidence-based practice was used in creating the intervention plan. Plan for evaluating the proposed nursing intervention. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome. Appendix section, if tables, graphs, surveys, educational materials, etc. are created. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion Capstone Project Change Proposal Essay Example Paper.
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Nearly every single nation on the planet has been affected by Coronavirus illness, also known as COVID-19. Since the first incident was reported in Wuhan province, China, in December 2019, the illness has affected more than one hundred million individuals worldwide. Consequently, nearly two million people have died as a result of the illness. The illness is marked by respiratory problems, like difficulty breathing. Excessive fatigue, high fever, and a dry cough are among the most critical and typical manifestations. Other clinical manifestations include chest discomfort, speech problems, and a struggle to breathe properly. It takes a maximum of fourteen days for a person to get sick after being infected with the virus (Numbers & Assessment, 2020). Individuals may be educated on preventative measures by receiving vaccination information, which has been shown to reduce the chance of contracting Covid-19 infection.
Clinical Problem Statement
Since the first incident of COVID-19 was reported, the rise of the virus and the rapidity with which it has spread have generated widespread concern across the globe. Scientists, physicians, and representatives from various healthcare organizations have kept working tirelessly to come up with solutions that will stop the spreading of covid-19 in the community. Hand washing, the use of masks, social distancing, and contact tracing are examples of preventative measures. Despite the fact that all of the remedies listed above have been shown to be effective in reducing the spread of Covid-19, some individuals continue to fail to take the measures necessary to eliminate the virus from their communities. Covid-19 vaccinations have recently been produced in an attempt to prevent the spread of the illness. Despite the fact that it seems to be a significant step forward in our age of pandemics, the vaccine has been severely hampered by resistance from certain individuals who may not have had sufficient information about it (Adhikari & Cheah, 2021) Capstone Project Change Proposal Essay Example Paper.
Purpose of the Change Proposal
To demonstrate to the people of Legacy Willow Bend, Plano, Texas how far they have gone since the onset of the virus, the change proposal for reducing the spread of covid-19 has been developed. Because of widespread misconceptions regarding the covid-19 immunization, the public has shown strong opposition to the vaccination. Nevertheless, in hopes of preventing the disease from spreading, vaccination of the general public is required in order to prevent future transmission. Specifically, the proposed change seeks to clarify methods for dealing with vaccination resistance by healthcare organizations and care providers in the context of their patients and personnel. A tiered strategy based on evidence-based methods will be used to promote vaccination adoption and manage any reluctance that may exist (Finney Rutten et al., 2021). Prior evidence-based procedures based on vaccines serve as the basis for the development of these initiatives. Among the variables to be addressed are interpersonal, communication, behavioral, and execution strategies that resolve resistance and promote the preventive strategy of vaccination at the individual, social, and organizational levels.
PICOT Question
In Legacy Willow Bend, Plano Texas (P), does knowledge on preventing the spread of Covid-19 through giving vaccination information and sites that help with the vaccination exercise (I), compared to lack of knowledge on Covid-19 vaccination (C), lead to a reduction in the Covid-19 cases (O), over a period of 3 months (T)?
Literature Search Strategy
The database search technique was found to be a successful search strategy, and it was taken into consideration throughout the creation of the literature review. When searching for the most relevant peer-reviewed papers on the Covid-19 disease, I utilized this technique to narrow our search. Medline and Google Scholar are two examples of databases that were used in this study. Furthermore, the most important search terms pertaining to the Covid-19 vaccine hesitancy were widely used to assess the relevant and useful academic literature. At the end of the process, an evaluation of the selected articles was conducted in order to determine their level of applicability to the study subject Capstone Project Change Proposal Essay Example Paper.
Evaluation of the Literature
It was found that the proportion of community members who get a COVID-19 vaccination is closely linked to key pandemic outcome indicators such as incidences, hospitalizations, and fatalities. As a result, vaccination hesitancy has risen to become one of the most pressing public health problems. At its most fundamental level, reluctance to be vaccinated is a personal choice that reflects the reasoning and decision-making processes of the person.
In order to comprehend either the virus itself or the vaccine’s effectiveness, only a small number of people have access to and understanding healthcare and scientific literature. Individuals are therefore compelled to make choices in response to the information they get from friends and family, the media they consume, as well as more general information from recognized colleagues and leaders. In order for people to comprehend the world around them in context and prevent the spread of Covid-19, they need in-depth knowledge about vaccines and how they function Capstone Project Change Proposal Essay Example Paper.
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Applicable Change or Nursing Theory Utilized
In order to better understand and create interventions to combat Coronavirus among the residents of Legacy Willow Bend in Plano, Texas, the theory of Human Caring, by Jean Watson, was used as a framework. The human being, surrounding, health, and nursing principles are central to the nursing practice theory (Pajnkihar et al., 2017). It was used to assist the execution of a change project that sought to increase awareness about COVID-19 infections, as well as understanding vaccination as a preventive measure. In this specific instance, the applicable change was a reduction in the rate of vaccine hesitancy of this particular population. It is essential to remember that people’s health extends beyond the physical body, as it is concerned with the harmony of one’s own self, soul, and mind. The residents of Legacy Willow Bend may find reassurance and accountability in the knowledge that the emphasized initiatives will be followed in order to increase their protection against Covid-19 infection.
Proposed Implementation Plan with Outcome Measures
In order to overcome distrust and establish confidence in the COVID-19 vaccinations, it is essential that the public is engaged. It is more probable that public involvement will have an effect (and will help to create confidence beyond the scope of COVID-19 vaccination programs) if the approach is structured and organized in such a way that community ideals can be converted into policy and practice. It is anticipated that printed pamphlets would be extensively used since they will help the practitioners in understanding the standards for implementing the strategies. In the right environment, healthcare practitioners can develop a solid platform that enables earning public’s trust by creating partnerships that include orchestrating for policy change, offering widely available COVID-19 testing and treatment, paying attention to the needs of the population, and guaranteeing that vaccinations are administered in an equitable manner.
How Evidence-Based Practice was used in Creating the Intervention Plan
It is undeniable that Covid-19 impacts the vast majority of individuals, particularly the most susceptible, who include the elderly and those suffering from underlying medical problems. Poor immunity and other problems result, which may eventually lead to death. As a result, raising public awareness and providing educational opportunities will be critical in assisting with the greater acceptance of receiving a vaccine. With regard to the prevention of Covid-19 via vaccination, nursing interventions function as an interpersonal level strategy Capstone Project Change Proposal Essay Example Paper.
Plan for Evaluating the Proposed Nursing Intervention
When examining the efficacy of the suggested interventions, I will use the process evaluation technique as my primary tool. The approach will be used to develop a logical framework that incorporates the most important elements of the project’s inputs, outputs, and operations throughout its duration (Parrott & Carman, 2019). The efficacy of the intervention in mitigating risks and improving the safety of the residents of Legacy Willow Bend will be evaluated, as will the risk factors that have emerged as a result of the pandemic. In addition, because the approach has a feedback mechanism that includes regular evaluations, time and resources will be more efficiently used for the early identification of the drawback.
Identification of Potential Barriers to Plan Implementation, and a Discussion of How These Could be overcome.
Some members of the community, such as the elderly, lack reading and writing abilities. Therefore the use of pamphlets may substantially reduce the capacity to ask questions and express concerns in an effective manner. The pre-existing conditions present in the community present a major obstacle to the implementation of the interventions recommended to lower the chances of Covid-19 spread in the population. Furthermore, certain members of the population are more likely to continue to refuse vaccinations (Barasteh et al., 2020). This will very certainly raise the likelihood of being infected and, as a result, the horrific consequences of the illness. In order to reduce the likelihood of possible obstacles, the practitioners participating will match the individuals in the project in order to minimize cases of literacy hurdles.
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As a result, increasing face-to-face interaction with the elderly will reduce the demand for printed materials. An emphasis will be placed on people who have various underlying medical problems, and it will be stressed that they should be convinced of the need of receiving the Covid-19 vaccination. In the end, incentives may be added to increase the chances of administering the vaccination Capstone Project Change Proposal Essay Example Paper.
Literature Evaluation Table
Student Name:
Change Topic: The Coronavirus pandemic has an adverse effect on most countries globally, including the U.S. For this reason, measures are required to prevent this epidemic. The Capstone Project focuses on evidence-based strategies for preventing the spread of the COVID-19.
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
|
Islam, M, S et al. (2020). Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: A global analysis. Infect Control Hosp Epidemiol; 15: 1–11. Doi: 10.1017/ice.2020.237
|
Moghadas, S, M et al. (2020). The impact of vaccination on COVID-19 outbreaks in the United States. medRxiv. Preprint. Doi: 10.1101/2020.11.27.20240051
|
Stringhini, S, Wisniak, A, & Piumatti, G et al. (2020). Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland (SEROCoV-POP): A population-based study. Lancet; 396: 313-319. DOI: https://doi.org/10.1016/S0140-6736(20)31304-0 | Folegatti, P, M., Ewer, K, J. & Aley, P, K et al. (2020). Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomized controlled trial. Lancet; 396: 467-478. DOI: https://doi.org/10.1016/S0140-6736(20)31604-4 |
| Article Title and Year Published
|
Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: A global analysis. (2020) | The impact of vaccination on COVID-19 outbreaks in the United States (2020) | Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland (SEROCoV-POP): a population-based study (2020) | Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomized controlled trial (2020) |
| Research Questions (Qualitative)/Hypothesis (Quantitative)
|
What are the transmission dynamics for COVID-19? | What is the effect of a 2-dose COVID-19 vaccination campaign on lowering the hospitalizations, incidence, and COVID-19-related deaths in the U.S.? | The level of anti-SARS-CoV-2 in individuals positively correlates with COVID-19 infection rates.
|
A positive correlation exists between neutralizing antibody responses and antibody levels. |
| Purposes/Aim of Study | The study aims at evaluating the mode of COVID-19 transmission. | This study evaluates the effect of a 2-dose COVID-19 vaccination campaign on lowering the hospitalizations, incidence, and COVID-19-related deaths in the U.S. | The population-based serosurvey aimed to measure the level of anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies in individuals to guide infection rates estimation and epidemic progress monitoring. | The study aimed at evaluating a viral vectored coronavirus vaccine’s safety, reactogenicity, and immunogenicity against SARS-CoV-2. |
| Design (Type of Quantitative, or Type of Qualitative)
|
The authors utilized a qualitative research design in the study. | A qualitative research design was utilized in this study | A quantitative research design was used in this study. | The authors utilized a quantitative research design. |
| Setting/Sample
|
The authors targeted guidelines based on two high-income nations, including Australia and the United Kingdom, and one middle-income country (China). | The sample consisted of healthcare workers and high-risk individuals. | The sample consisted of
2766 participants. |
The sample constituted 1077 participants. |
| Methods: Intervention/Instruments
|
Interventions include putting on surgical masks and N95 respirators by healthcare providers. | The intervention involved vaccinating the targeted population. | The authors used anti-ELISA (Euroimmun; Lübeck, Germany #EI 2606-9601 G) to assess SARS-CoV-2 IgG antibodies. | ChAdOx1 nCoV-19 was administered to 543 participants, while MenACWY was given to 534 participants. |
| Analysis
|
The analysis involved the interpretation of patterns and themes in the guidelines. | The analysis involved assessing vaccine efficacy against disease after 2 doses were administered to the sample population, 21 days apart. | The researchers used a Bayesian logistic regression model to estimate seroprevalence. | The authors used ELISA in data analysis. |
| Key Findings
|
The study findings indicate various SARS-CoV-2 transmission modes, including being spread through aerosols and droplets and human to human via contact or through everyday interactions. | The study revealed that vaccination effectively reduced the risk of contracting the COVID -19 among the targeted population by 4.6%. However, the efficacy rate varied depending on one’s age. The highest relative decline was reported in older adults aged 65 years and above. | The study findings indicated that young children aged between 5 and 9 years and older people above 65 had a substantially lower seroprevalence than the other age groups. Therefore, these populations were less likely to be infected with COVID-19. | The study findings indicated a strong correlation between the correlation between neutralizing antibody responses and antibody levels. |
| Recommendations
|
It is recommendable to introduce preventive measures to all individuals at risk of contracting the Corona Virus. | Vaccination is recommendable in preventing individuals from contracting the Corona Virus. | COVID-19 prevention campaign should concentrate more on other age groups than on children aged between 5 and 9 years and older people above 65 years since their prevalence for contracting the virus is relatively low than other ages. | The ChAdOx1 nCoV-19 should be used in preventing COVID-19. |
| Explanation of How the Article Supports EBP/Capstone Project
|
This article supports the Capstone Project since it proposes various COVID-19 prevention measures, including wearing surgical masks and N95 respirators. | This article supports the Capstone Project since it indicates the efficacy of vaccination in preventing COVID-19, especially among elderly individuals aged 65 and above. | This article supports the Capstone Project since it points out the age groups that the prevention initiatives should target, thereby lowering the COVID-19 infection incidence and related deaths. | This article supports the Capstone Project since it reveals the efficacy of ChAdOx1 nCoV-19 in preventing the Corona Virus. |
| Criteria | Article 5 | Article 6 | Article 7 | Article 8 |
| Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
|
Ramasamy, M & Minassian, A, M. (2020). Safety and immunogenicity of ChAdOx1 nCoV-19 (AZD1222) vaccine administered in a prime-boost regimen in older adults (COV002): A phase 2/3 single-blind, randomized controlled trial. Lancet; 396 (10267): 1979-1993.
https://doi.org/10.1016/S0140-6736(20)32466-1
|
Barrett, J, R & Belij-Rammerstorfer, S. (2021). Phase 1/2 trial of SARS-CoV-2 vaccine ChAdOx1 nCoV-19 with a booster dose induces multifunctional antibody responses.
Nature Medicine; 27: 279–288. https://www.nature.com/articles/s41591-020-01179-4 |
Bartsch, S, M et al. (2020). Vaccine Efficacy Needed for a COVID-19 Coronavirus Vaccine to Prevent or Stop an Epidemic as the Sole Intervention. Am J Prev Med; 59(4): 493–503. Doi: 10.1016/j.amepre.2020.06.011 | Logunov, D, Y., Dolzhikova, I, V & Zubkova, O, V et al. (2020). Safety and immunogenicity of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine in two formulations: two open, non-randomized phase 1/2 studies from Russia. Lancet; 396: 887-897. DOI: https://doi.org/10.1016/S0140-6736(20)31866-3. |
| Article Title and Year Published
|
Safety and immunogenicity of ChAdOx1 nCoV-19 (AZD1222) vaccine administered in young and older adults. (2020). | Phase 1/2 trial of SARS-CoV-2 vaccine ChAdOx1 nCoV-19 with a booster dose induces multifunctional antibody responses. (2021). | Vaccine Efficacy Needed for a COVID-19 Coronavirus Vaccine to Prevent or Stop an Epidemic as the Sole Intervention. (2020). | Safety and immunogenicity of a rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine in two formulations: two open, non-randomized phase 1/2 studies from Russia. (2020). |
| Research Questions (Qualitative)/Hypothesis (Quantitative)
|
The study hypothesizes that a positive correlation exists between the safety and immunogenicity of ChAdOx1 nCoV-19 (AZD1222) against antibodies’ response in young and older adults aged 70 years and above. | There is no correlation between preexisting immunity to the ChAdOx1 vector and reactogenicity upon being administered with the second dose of the vaccine. | What is the required vaccine efficacy for the Coronavirus vaccine to either stop or prevent an epidemic as the sole intervention? | A positive correlation exists between the vaccine administration and the T-cell response. |
| Purposes/Aim of Study | The study evaluates the efficacy of the ChAdOx1 nCoV-19 (AZD1222) vaccine in young and older adults. | The study’s primary purpose was to evaluate the efficacy of ChAdOx1 nCoV-19 dose in inducing multifunctional antibody responses. | The study aims at assessing the required vaccine efficacy for the Coronavirus vaccine to either stop or prevent an epidemic as the sole intervention. | The study aims at evaluating the safety and immunogenicity of two formulations (frozen and lyophilized) of the prime-boost COVID-19 vaccine. |
| Design (Type of Quantitative, or Type of Qualitative)
|
A quantitative research design was used in this study. | The authors utilized a quantitative research design. | A qualitative research design was used. | The authors utilized quantitative research design. |
| Setting/Sample
|
The study was conducted at two U.K. clinical research facilities. 560 participants were enrolled on the study. | The study involved 52 participants between 18 and 55 years. | U.S. citizens who are at a high risk of contracting the Coronavirus. | 76 participants were enrolled on the two studies. |
| Methods: Intervention/Instruments
|
Two-dose regimes, including ChAdOx1 nCoV-19 and MenACWY were assigned to the participants. | ChAdOx1 nCoV-19 prime-boost was administered to people who had received the first dose. | The authors developed a computational model of the U.S. population to stimulate the spread of COVID-19 and the efficacy of the vaccination. | The participants were given either one dose of rAd26-S or one dose of rAd5-S and the safety of each was evaluated after 28 days. |
| Analysis
|
Safety results were presented as frequencies, while immunological results were presented as medians and IQR. | Medians with IQRs or geometric means were used to present study findings. | Simulation experiments results were analyzed using sequence analysis. | GraphPad Prism 8 was used to do all statistical calculations, while spearman’s test was used to do correlational analysis. |
| Key Findings
|
The study findings indicated that the ChAdOx1 nCoV-19 vaccine is safe and well-tolerated. The vaccine’s reactogenicity profile is lower in older adults than in younger adults. | The findings indicate that the ChAdOx1 nCoV-19 second dose enhances both the functionality and titer of the antibody response. Additionally, the findings indicate a lowers reactogenic in a booster dose than the first dose. | The study findings indicated that a Coronavirus vaccine should have an efficacy of at least 60% to prevent the epidemic. | The study findings indicated the safety and tolerability of the vaccine. |
| Recommendations
|
ChAdOx1 nCoV-19 vaccine should be administered against SARS-CoV-2 in older adults due to its efficacy in this population and a lower reactogenicity profile. | A two-dose regimen of ChAdOx1 nCov-19 should be administered to individuals at a higher risk of contracting the virus due to its efficacy in enhancing the functionality of the antibodies and a lower reactogenic in a booster than in the first dose. | COVID-19 vaccines with more than 60% efficacy can be used to prevent the epidemic among Americans. | The rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine should be used in protecting individuals from SARS-CoV-2 infection. |
| Explanation of How the Article Supports EBP/Capstone
|
This article supports the Capstone Project since it reveals the efficacy and safety of ChAdOx1 nCoV-19 vaccine in preventing COVID-19 in older adults. Capstone Project Change Proposal Essay Example Paper | This article supports the Capstone Project since its findings indicate the efficacy of A two-dose regimen of ChAdOx1 nCoV-19 in preventing the Corona Virus. | This article supports the Capstone Project since it indicates that the Coronavirus vaccine must have an efficacy of at least 60% to prevent the epidemic as a sole prevention strategy. | This article supports the Capstone Project since it reveals the efficacy of The rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine in protecting individuals against the Coronavirus. |
References
Barrett, J, R & Belij-Rammerstorfer, S. (2021). Phase 1/2 trial of SARS-CoV-2 vaccine ChAdOx1 nCoV-19 with a booster dose induces multifunctional antibody responses.
Nature Medicine; 27: 279–288. https://www.nature.com/articles/s41591-020-01179-4
Bartsch, S, M et al. (2020). Vaccine Efficacy Needed for a COVID-19 Coronavirus Vaccine to Prevent or Stop an Epidemic as the Sole Intervention. Am J Prev Med; 59(4): 493–503. Doi: 10.1016/j.amepre.2020.06.011
Folegatti, P, M., Ewer, K, J. & Aley, P, K et al. (2020). Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomized controlled trial. Lancet; 396: 467-478. DOI: https://doi.org/10.1016/S0140-6736(20)31604-4
Islam, M, S et al. (2020). Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: A global analysis. Infect Control Hosp Epidemiol; 15: 1–11. Doi: 10.1017/ice.2020.237
Logunov, D, Y., Dolzhikova, I, V & Zubkova, O, V et al. (2020). Safety and immunogenicity of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine in two formulations: two open, non-randomized phase 1/2 studies from Russia. Lancet; 396: 887-897. DOI: https://doi.org/10.1016/S0140-6736(20)31866-3.
Moghadas, S, M et al. (2020). The impact of vaccination on COVID-19 outbreaks in the United States. medRxiv. Doi: 10.1101/2020.11.27.20240051
Ramasamy, M & Minassian, A, M. (2020). Safety and immunogenicity of ChAdOx1 nCoV-19 (AZD1222) vaccine administered in a prime-boost regimen in older adults (COV002): A phase 2/3 single-blind, randomized controlled trial. Lancet; 396 (10267): 1979-1993.
https://doi.org/10.1016/S0140-6736(20)32466-1
Stringhini, S, Wisniak, A, & Piumatti, G et al. (2020). Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland (SEROCoV-POP): A population-based study. Lancet; 396: 313-319. DOI: https://doi.org/10.1016/S0140-6736(20)31304-0
Adhikari, B., & Cheah, P. Y. (2021). Vaccine hesitancy in the COVID-19 era. The Lancet Infectious Diseases, 21(8), 1086. https://doi.org/10.1016/s1473-3099(21)00390-x
Barasteh, S., Azimi, A. V., Khademi, F., Goharinezhad, S., & Rassouli, M. (2020). Covid-19 and nursing home residents: The potential role of geriatric nurses in a special crisis. Nursing Practice Today. http://eprints.iums.ac.ir/23287/
Finney Rutten, L. J., Zhu, X., Leppin, A. L., Ridgeway, J. L., Swift, M. D., Griffin, J. M., St Sauver, J. L., Virk, A., & Jacobson, R. M. (2021). Evidence-Based Strategies for Clinical Organizations to Address COVID-19 Vaccine Hesitancy. Mayo Clinic Proceedings, 96(3), 699–707. https://doi.org/10.1016/j.mayocp.2020.12.024
NUMBERS, S. I., & ASSESSMENT, W. R. (2020). Coronavirus disease 2019 (COVID-19). Americas, 10(2), 1. http://mail.health.gov.pg/covid19/PNGSR23PCOVID-19(2020-05-31).pdf
Pajnkihar, M., McKenna, H. P., Štiglic, G., & Vrbnjak, D. (2017). Fit for practice: Analysis and evaluation of Watson’s theory of human caring. Nursing science quarterly, 30(3), 243- 252.
Parrott, A., & Carman, J. (2019). Scaling Up Programs: Reflections on the Importance of Process Evaluation. Canadian Journal of Program Evaluation, 34(1). https://doi.org/10.3138/cjpe.43216
Capstone Project Change Proposal Essay Example Paper