A common evaluation purpose is to determine whether a policy or program was implemented as intended: referred to as formative evaluation, process evaluation, or evaluating program improvement. A well-designed formative evaluation is important in: detecting program drift; providing timely feedback to program staff to make cost-saving mid-course corrections; reassuring the sponsor that quality assurance measures are implemented to protect investments; and interpreting impact/outcome evaluation. A formative evaluation should not just gather data on deviations from an anticipated course of action, but provide recommendations for improvement. Current methods for program improvement vary in their ability to solicit targeted recommendations. Root cause analysis (RCA) is a well-established, robust methodology used in a variety of disciplines. RCA has been primarily used by evaluators operating from a theory-driven orientation to evaluate the merit and worth of a program or policy. Surprisingly, a review of the literature suggests that RCA's utility as a program improvement tool has remained largely unrecognised in evaluation. This article illustrates the application of RCA in evaluating program improvement. The conditions under which RCA might be preferred over other formative evaluation methods are discussed.

The purpose of this review was to identify knowledge gaps within the literature regarding the impact of opioid use disorder, specific to immigrants in the United States, by addressing the following questions: 1) What is presented in the literature about the impact of opioid use disorder (OUD) and the opioid epidemic on immigrants in the United States?; and 2) What role does culture play in the opioid use disorder experiences of immigrants in the United States? Nineteen research articles were uncovered that addressed immigrants in the U.S. and opioid use disorder. The following themes prevailed: 1) OUD comparisons, 2) OUD comorbidities, 3) disparate OUD treatment engagement, and 4) the role of country of origin. Limited review findings support the need for future research on the topic of opioid misuse among immigrants in the United States. The authors elaborated on additional issues that influence OUD rates and warrant further exploration. Matters related to the potential positive roles of religion and faith leaders, cultural perceptions and expectations about gender roles, immigration status, ethnically diverse needs among sub-groups of immigrants, the role of geographic location within the U.S., and the implications of COVID-19 on OUD among immigrants need to be addressed to alleviate the deleterious impact of opioid misuse among immigrants.