Stakeholder perspectives: Utilizing empowerment evaluation and thematic content analysis to evaluate a community-based preconception care program

BACKGROUND: The life course perspective promotes interventions during the preconception period as being more effective than those implemented during pregnancy in terms of improving birth outcomes. A participatory evaluation of a community-based preconception care program was conducted to determine the most important program components as targets for program improvement. METHODS: This two-phased empowerment evaluation (EE) included all stakeholder groups (23 program participants, 4 program facilitators, 8 program planners and implementers). Five EE sessions were held. Each stakeholder group determined the purpose of the program from their perspective, identified the five program components most important in terms of achieving that purpose, and set goals to improve each component. The top five overall program components were determined based on the rank score of each component identified in the five sessions. Observation notes were taken throughout the process. Thematic content analysis was conducted on all tables from EE sessions and observation notes. RESULTS: The top five program components overall were: physical activity, nutrition, knowing self-worth, in-class interaction/communication, and recognizing/handling stress. Thematic content analysis identified social support, education, classroom environment, and mental health as important aspects of the program. In terms of program improvement, change to a healthy lifestyle, education, communication, participant-driven curriculum, and strategies/tools to promote healthy habits emerged as important themes. CONCLUSION: There were similarities across groups, but different stakeholder groups prioritized different program components and emerging themes varied. Including all stakeholders in program evaluation allows for various stakeholder perspectives to be considered as the program is modified and improved for continuation.