The adoption of conservation tillage technology can improve the production efficiency of black soils (mollisols), and it has great significance to ensure the sustainable development of agriculture. This paper takes farmers in the black soil region of Jilin Province as the research object, uses 442 survey data of farmers in seven municipal areas in the black soil region of Jilin Province, constructs a logistic-ISM model, first determines the influencing factors of farmers’ adoption of conservation tillage technology, and then analyzes the hierarchical structure of each influencing factor. The results show that: (1) among the eight significant influencing factors of farmers’ adoption of conservation tillage technology, age, whether they know the government’s subsidies for conservation tillage and the number of labor force are the deep-rooted factors; (2) Education level, whether you know that the government is promoting conservation tillage, and the planting area are intermediate level factors; (3) whether they have received the technical services of conservation tillage and whether the cultivated land is scattered is the direct factors. Based on the significance analysis of the influencing factors of farmers’ adoption of conservation tillage technology and the research on the action mechanism of the influencing factors of farmers’ adoption of conservation tillage technology, this paper puts forward policy suggestions to improve the extension system of conservation tillage technology, improve the implementation of land transfer and subsidy policies, strengthen the ability of rural socialized services, and strengthen the publicity of black soils protection. Land is the material basis for human survival and development, and is a valuable non-renewable resource. The black soils distributed in the middle and high latitudes of the world are recognized as the most fertile soil in the world. It has the characteristics of good properties, high fertility and suitable for farming. It is a soil resource worthy of protection and plays an important role in global agricultural production . The MisConservation tillage is an environment-friendly soil tillage model . There iOver the years, the Chinese government’s cultivated land protection policy has achieved some results, but it is not deep enough at the level of farmers. Too macro policies will easily become a mere formality because farmers are the main users and protectors of land, and whether the black soils can be effectively protected depends on the behavior of farmers ,31. SchoNatural condition factors mainly refer to the natural conditions of cultivated land. Cultivated land area, fragmentation degree and slope of cultivated land, whether there is transferred land and so on are the main factors affecting the adoption of farmers’ conservation tillage technology. Bekele et al., analyzed the influencing factors of farmers’ water and soil protection behavior in eastern Ethiopia, and concluded that the cultivated land area and slope are positively correlated with farmers’ protection behavior . Si et aExternal factors mainly include social network, social capital, government policies, government subsidies, technical training and so on. Li et al., and others used the data of 1237 farmers in the Loess Plateau to analyze the regulatory role of government subsidies in soil and water conservation of cultivated land. The results showed that government subsidies can make up for the possible risk losses of farmers, so they can encourage farmers to adopt soil and water conservation farming technology . The resTo sum up, although great progress has been made in the research on the influencing factors of farmers’ new technology adoption and decision making, there are also some deficiencies: on the one hand, in Jilin Province, as an important part of China’s black soil region and an important grain producing area, no scholars have conducted in-depth research on the influencing factors of farmers’ conservation tillage technology adoption; On the other hand, researchers focus on the judgment of significant influencing factors and the analysis of influence degree, or the analysis of farmers’ decision making willingness and behavior of new technology, and lack of in-depth mining of the relationship and hierarchy between various factors.Based on the questionnaire data of farmers in several counties and cities of Jilin Province, this paper uses a logistic model to analyze the influencing factors of farmers’ adoption of conservation tillage technology, and then further analyzes the correlation and hierarchical structure between the influencing factors through an ISM model to explore the internal mechanism affecting the adoption of conservation tillage technology. This is with the aim to better promote conservation tillage technology, improve cultivated land production efficiency and sustainable development of cultivated land, and provide theoretical support and specific suggestions for the release and implementation of relevant government policies.Jilin Province is located in the middle of Northeast China. Affected by the temperate monsoon climate, it is hot and rainy in the summer and cold and rainy in the winter. Herbs grow rapidly in the summer, but decay slowly in the winter. Plant litter accumulates in the soil, forming a fertile humus layer in the black soil region over time. Black soils are also known as isohumisols in Chinese soil taxonomy or mollisols in USA soil taxonomy .2, accounting for 64% of the cultivated land area of the province. Jilin Province is an important grain producing area and has always been China’s main commodity grain export province. The annual grain commodity rate exceeds 80%, the commodity grain provided accounts for 10% of the country and the reserve grain accounts for 20% of the country. For more than 20 consecutive years, the amount of grain transferred out ranks first in the country and has made great contributions to China’s food security.Jilin Province is located in the black soil region of Northeast China, with a black soil cultivated land area of 4.49 million hm2 in 2015 to 1.24 million hm2. There are more and more farmers adopting conservation tillage technology in Jilin Province. They feel good after using conservation tillage technology.Jilin Province has always attached importance to the protection of black land. Conservation tillage has long been vigorously promoted through policy subsidies, technology subsidies and other forms. The main technologies to be promoted include less or no tillage, straw residue coverage, straw crushing, deep ploughing, subsoiling, ridge farming, increased application of organic fertilizer, and soybean rotation. According to the information released by the Ministry of Agriculture and Rural Affairs of China, by the end of 2020, the area of conservation tillage in Jilin Province has increased from 0.3 million hmThe data used in this paper come from a questionnaire survey conducted by the research group in the black soil region of Jilin Province, China from November 2020 to January 2021. Farmers’ samples are selected according to typical sampling methods: firstly, according to the black soil region of conservation tillage, seven counties and cities in Jilin Province are selected, including Changchun City, Siping City, Songyuan City, Jilin City, Liaoyuan City, Tonghua City and Baicheng City. Then, two townships were randomly selected in each county and city. Finally, four natural villages were selected in each township and 8–10 farmers in each village for investigation. A total of 496 questionnaires were distributed. After all the questionnaires were recovered and carefully checked and processed, 54 invalid questionnaires were eliminated, and 442 valid farmers’ data were finally formed. The effective rate of the questionnaire was 89.1%.2 per household and a median of 4 hm2, including their own land and land transferred from others. In terms of formal meaning, these farmers are small-scale and belong to small farmers. In China, the view that the behavior of small farmers advocated by Popkin and Schultz is economic rationality is relatively in the mainstream [It can be learned from the preliminary research that the farmers in the black soil region of Jilin Province are mainly operated by families. Most of the investigated farmers are new types of agricultural operating entities, with an average planting area of about 13 hminstream . Farmersinstream . AccordiThe personal and family characteristics of farmers mainly include the age, gender and education level of the surveyed farmers, whether they have a part-time job, labor force population and the years of planting. With the growth of farmers’ age, their ability to accept new things will be reduced, and they will instinctively resist new technologies. Men are better suited than women to field work, which is a physically demanding job, so men are more likely to use conservation tillage techniques. Farmers with a high level of education will know and pay more attention to conservation tillage, and they will master new technologies faster, so they are more likely to adopt conservation tillage technology. The part-time income of farmers who go out to work will be higher than that of agriculture. Conservation tillage can reduce the input of labor force, give farmers more leisure time to earn money from employment other than farming, so they are more likely to choose conservation tillage. The amount of the labor force population reflects the labor volume of farmers’ families, which may have an impact on the adoption of conservation tillage technology. The longer the planting years, the more fixed the thinking, the lower the acceptance of new things, so it is more impossible to adopt conservation tillage technology. Therefore, this paper assumes that the increase in age and years of planting have a negative impact on the implementation of conservation tillage; the male gender, part-time employment and high education level of farmers have a positive impact on conservation tillage; the impact direction of labor force population is unknown.The characteristics of cultivated land mainly include the planting area, the degree of fragmentation of land, whether the cultivated land has slope land, the types of crops planted, and the adopted fertility measures. The larger the planting area, the more fertile the land is, which is more conducive to the use of agricultural machinery. The more concentrated the cultivated land is, the more conducive it is to large-scale production. Different crops have different requirements for cultivated land, and the input of farmers may be different, so it may affect the adoption of farmers’ conservation tillage technology. This paper assumes that the planting area is large, the land is concentrated, and the cultivated land has no slope, which has a positive effect on farmers’ implementation of conservation tillage, and the influence direction of the types of crops are unknown.Farming cognition is also one of the important factors in the implementation of conservation tillage. Whether they have received relevant knowledge training, that is, whether the villages and towns where the farmers are located have services of conservation tillage technology is also important. After understanding conservation tillage technology, they are more likely to adopt conservation tillage. Farmers applying organic fertilizer or returning straw to the field are obviously more inclined to adopt new technologies and are more likely to adopt Conservation Tillage Technologies. In addition, whether the following conservation tillage measures are known, such as less tillage and no tillage, straw residue mulching, straw crushing and mulching, deep ploughing or subsoiling, ridge farming, soybean rotation and other measures may be very imported. Farmers may implement some of the above measures based on agricultural experience or training. This paper assumes that after receiving the technical services of conservation tillage, adopting appropriate fertilization measures, and understanding the conservation tillage measures will have a positive impact on the implementation of conservation tillage.External factors mainly refer to the policies and publicity of conservation tillage issued by governments at all levels. Farmers tend to trust the publicity of the government, so it is easier for farmers advocated by the government to adopt conservation tillage technology. Farmers are rational, economic people and will make choices to maximize their own interests. Relevant subsidies will encourage them to implement conservation tillage. Similarly, satisfaction with agricultural machinery services will also increase the possibility of adopting conservation tillage technology. Therefore, this paper assumes that there are conservation tillage subsidies, farmers are satisfied with agricultural machinery services, and have a positive effect on farmers’ implementation of conservation tillage.The dependent variable of this study is whether farmers adopt conservation tillage technology, and the value of farmers adopting conservation tillage is 1; the value assigned to farmers without conservation tillage technology is 0. The independent variables mainly select four types of factors  affecting farmers’ adoption of conservation tillage technology, a total of 16 variables. The details are shown in In this study, the results of whether farmers in the black soil region adopt conservation tillage technology are only adopted and not adopted, which is an obvious binary decision-making problem, that is, the variable value of conservation tillage technology is 1, and the variable value of non-conservation tillage technology is 0. Therefore, this paper uses a logistic regression model to explore which factors will affect farmers’ adoption of conservation tillage technology, and previous studies have also proved the applicability of a logistic regression model in the study of influencing factors ,50,51. TIn Formula (1), The factors affecting farmers’ adoption of conservation tillage technology may have internal relations. It is important to distinguish the relationship levels between factors and find out the core factors. This paper will use an ISM model for further analysis. The significant influencing factors obtained from the results of the logistic model are the constituent elements of the ISM analysis system, so as to realize the linkage application of logistic ism ,53.The interpretive structural model is a method developed by Professor Warfield in 1976 to analyze complex socioeconomic problems. Its basic core idea is to extract the constituent elements of the problem, use the incidence matrix principle in graph theory and computer technology to process the information of the factors and their mutual influence relationship, and finally construct the system into a multi-level hierarchical model with a good structural relationship ,55. ThroAssuming that there are The adjacency matrix of these factors can be obtained. The adjacency matrix reflects the direct relationship between elements, the reachability matrix reflects the indirect relationship between elements, and the reachability matrix between factors can be obtained from Formula (3):In Formula (3), The factors contained in the top layer can be determined according to Formulas (4) and (5):In Formula (4) The data of this study were processed with stata15 software. As shown in Through regression, eight variables are significant influencing factors, including age, education level, whether the government publicity about conservation tillage is known, whether they have received the technical service of conservation tillage, whether the government’s subsidies for conservation tillage are known; while the labor force, planting area and whether cultivated land is scattered have a significant negative impact. These eight significant influencing factors will be further analyzed.According to the steps of the ISM analysis method, the system composition is determined first. In this paper, According to The reachability matrix According to the principle of Formula (5), the following can be obtained by using Matlab R2021a software: The age and education level of farmers has a significant positive impact on the adoption of conservation tillage technology, which is consistent with the expected direction. With the increasing of age, the willingness to protect also increases. The reason may be that the older the farmers are, the more experienced they are, the deeper their feelings for the land and the stronger their awareness of protecting the black land. The higher the education level of farmers, the higher the acceptance of new technologies, the easier it is to learn and adopt new technologies and the more able it is to resist unknown risks . TherefoThe amount of the labor force population has a significant negative impact on the adoption of conservation tillage technology, indicating that the smaller the family labor force population, the more the behavior of protecting black soils will be. In the survey, it is found that with a smaller household labor force, farmers will tend to use agricultural machinery operation and technologies such as less tillage and no tillage to reduce the amount of labor.The gender, whether they have a part-time job and planting years of farmers have no significant impact on the adoption of conservation tillage technology, which is different from the expectation. In the survey, it is not difficult to find that there is not much difference between women and men. They also participate in agricultural work, so it has nothing to do with gender. The black soil region of Jilin Province is relatively cold, and it is basically planted only once a year. Farmers generally choose to go out to work during the slack season in the winter, and most of them are short-term jobs, which do not conflict with the main industry, so it has nothing to do with whether they are part-time or not. The planting years can only reflect the degree of farmers’ mastery of existing technologies, which has no direct impact on the adoption of new technologies, but depends on the cognitive level.Planting area and whether cultivated land is scattered have a significant negative impact on farmers’ adoption of conservation tillage technology. The impact of planting area is inconsistent with expectations. The results show that the larger the sowing area, the weaker the farmers’ willingness to protect. Through in-depth communication with farmers, it was discovered that most of the farmers with a large planting area obtained their land through land transfer. They have no long-term contract right to use the transferred land, and the transfer period is different, so it has a significant negative impact on the enthusiasm of protecting black soils. Fragmented and scattered land will seriously restrict the use of agricultural machinery, and require farmers to rush between different cultivated lands, and farmers’ willingness to adopt conservation tillage technology will also be weakened. Therefore, land dispersion has a significant negative impact on farmers’ adoption of conservation tillage technology.Whether the cultivated land has slopes and the types of crops planted have no significant negative impact on the adoption of conservation tillage technology by farmers. Due to the implementation of China’s policy of returning farmland to forest and grassland, there are few slope lands that are not suitable for farming, and a small slope has little impact on cultivated land. The main crops in Jilin Province are corn and rice. Conservation tillage technology is mainly applicable to dry fields, so it has nothing to do with the crops planted.Whether farmers have received the technical service of conservation tillage has a significant positive impact on farmers’ adoption of conservation tillage technology. This is consistent with the expected judgment. Conservation tillage technology can only be mastered by farmers through the guidance and training of agricultural technology extension personnel. With conservation tillage technology services, farmers will have the ability and peace of mind to adopt conservation tillage technology to protect black soils.Fertilization measures and whether the following conservation tillage measures are known have no significant impact on farmers’ adoption of conservation tillage technology, which is inconsistent with expectations. Farmers are skeptical about fertilizing measures other than chemical fertilizer. Almost all of them use chemical fertilizer to avoid the risk of yield reduction. They are also skeptical about the specific measures of conservation tillage, so their cognition of conservation tillage technology is not deep enough, and they will be more conservative due to risk considerations, so these two factors are not significant.Whether the government publicity about conservation tillage is known and whether the government’s subsidies for conservation tillage are known have a significant positive impact on farmers’ adoption of conservation tillage technology, which is consistent with expectations. The government publicity will strengthen farmers’ awareness of black soils resources, better recognize the significance of protecting black soils, and increase the enthusiasm of adopting conservation tillage to protect black soils . ConservWhether farmers are satisfied with the local agricultural machinery service has no significant impact on farmers’ adoption of conservation tillage technology, which is inconsistent with expectations. From the survey results, farmers are generally satisfied with agricultural machinery services, so this item is not significant.S4, whether they have received the technical service of conservation tillage, and S8, whether cultivated land is scattered; the second layer includes S2 education level, S3 whether the government publicity about conservation tillage is known and S7 planting area; The third layer includes S1 age, S5 whether the government’s subsidies for conservation tillage are known and S6 labor force. Through sorting, the correlation and hierarchy among the influencing factors of farmers’ adoption of conservation tillage technology in the black soil region of Jilin Province, China, are obtained as shown in The results of interpretation structure analysis show that the eight significant influencing factors of farmers’ adoption of conservation tillage technology are divided into three levels: the first layer includes It can be seen from Whether farmers adopt conservation tillage technology can be summarized into the following three paths.Path 1: age → education level, whether the government publicity about conservation tillage is known → whether they have received the technical service of conservation tillage → whether conservation tillage technology is adopted. In this path, age is a deep factor. Since its reform and opening up, China’s economy has developed rapidly, more and more attention has been paid to education, and nine-year compulsory education has been implemented. Therefore, the younger farmers are more likely to receive higher education, and the older farmers have a stronger sense of trust in the government and are more likely to accept the contents of government publicity. The higher the level of education and the wider the government’s publicity on conservation tillage, farmers are more likely to take the initiative to learn conservation tillage technology. The government will also pay more attention to the technical services related to conservation tillage. After learning conservation tillage technology, farmers will have a higher possibility of adopting conservation tillage technology.Path 2: age, whether the government’s subsidies for conservation tillage are known → whether the government publicity about conservation tillage is known → whether they have received the technical service of conservation tillage → whether conservation tillage technology is adopted. In this path, age and whether the government’s subsidies for conservation tillage are known are deep-seated factors. In Jilin Province, the government has subsidies for conservation tillage, but some farmers do not care about government policies, so they do not know the specific subsidies. Subsidies are the simplest and most direct promotion factor. People who know the government’s subsidies for conservation tillage will also pay more attention to the publicity of conservation tillage. As mentioned above, the older the age, the easier it is to accept the content of government publicity. The more extensive the government publicity, the more attention will be paid to the technical services related to conservation tillage, which will eventually affect farmers’ adoption of conservation tillage technology.Path 3: labor force, whether the government’s subsidies for conservation tillage are known → planting area → whether cultivated land is scattered → whether conservation tillage technology is adopted. In this path, the labor force and whether the government’s subsidies for conservation tillage are known are deep-seated factors, The larger the number of working people, the larger the area that can be cultivated. After knowing the government’s subsidies for conservation tillage, farmers will be more willing to contract land and accept the transferred land of other farmers, so as to expand the planting area. The larger the planting area, the higher the possibility of land dispersion, but the scattered land is not conducive to the use of agricultural machinery. The use of agricultural machinery is an important part of conservation tillage, so it will affect the behavior of farmers’ conservation tillage .Based on the data obtained by the research group and by establishing the logistic ISM model, this paper studies the influencing factors of the adoption of conservation tillage technology by 442 farmers in cities or villages in the black soil region of Jilin Province. Through theoretical combing and empirical analysis, we can draw the following conclusions.Age, education level, whether the government publicity about conservation tillage is known, whether they have received the technical service of conservation tillage, whether the government’s subsidies for conservation tillage are known all have a significant positive impact. Additionally, the labor force, planting area and whether cultivated land is scattered have a significant negative impact.Among the eight significant influencing factors of farmers’ adoption of conservation tillage technology, age, whether the government’s subsidies for conservation tillage are known and the labor force are the deep-rooted factors. They affect the following factors, including education level, whether the government publicity about conservation tillage is known and planting area. Whether they have received the technical service of conservation tillage and whether the cultivated land is scattered are the direct factors on the surface.In the context of ensuring China’s food security policy, the government pays more and more attention to the protection of black soils in Jilin Province, a large grain producing province. As the most basic unit of production and management in the black soil region of Jilin Province, the adoption of conservation tillage technology by farmers directly affects the production efficiency of cultivated land in Jilin Province, which is of great significance to ensure China’s food security. Based on the above analysis conclusions, the following policy implications can be obtained:First, improve the extension system of conservation tillage technology. The average education levels of farmers are junior high school, and the age of farmers is about 44, which leads to their low acceptance and understanding of new things. Therefore, when the government publicizes and promotes conservation tillage technology and improves farmers’ skills, it should fully take into account the characteristics of farmers. The government should make use of the slack time to actively organize farmers to participate in the training of conservation tillage technology, and establish demonstration sites for on-site guidance by technology extension personnel, thus reducing constraints due to age and education.Second, improve and implement relevant land policies. On the one hand, the subsidy policy for black soils protection is important. It can be seen from the previous conclusion that whether farmers know that the government’s subsidy for conservation tillage is a deep-seated factor. The grass-roots government should give economic compensation to farmers who use conservation tillage technology to protect black soils and ecology, and should also publicize in place and explain more relevant policies, so that farmers can truly understand relevant policies and improve farmers’ understanding and satisfaction with subsidy policies, and it can encourage more farmers to protect black soils. On the other hand, we should improve the land circulation policy, facilitate farmers to expand the planting area for large-scale management, reduce the dispersion of land contracted by farmers, and then promote mechanized production.Third, strengthen the ability of rural socialized services. The labor force is one of the deep-seated factors. With the development of urbanization, farmers will be more likely to choose to go out to work. The reduction in labor force makes farmers more dependent on agricultural machinery. Therefore, it is necessary to speed up the construction of rural socialized services, which can provide farmers in the black soil region with seed industry services, agricultural machinery services, financial and insurance services that meet the requirements of conservation tillage, and reduce the cost of farmers’ protection of black soils.Fourth, strengthen publicity of black soils protection. Farmers’ insufficient awareness of conservation tillage is one of the important reasons for their weak awareness of black soils protection, so they should increase publicity through TV stations, websites, mobile phones, books and other channels, vfigorously publicize the laws and regulations on conservation tillage, widely publicize the subsidy policy of conservation tillage, and fully mobilize the enthusiasm and initiative of farmers to adopt conservation tillage.


In Canada, stroke survivors have difficulty accessing community-based rehabilitation services because of a lack of resources. VirTele, a personalized remote rehabilitation program combining virtual reality exergames and telerehabilitation, was developed to provide stroke survivors an opportunity to pursue rehabilitation of their chronic upper extremity (UE) deficits at home while receiving ongoing follow-up from a clinician.We aimed to identify the behavioral and motivational techniques used by clinicians during the VirTele intervention, explore the indicators of empowerment among stroke survivors, and investigate the determinants of VirTele use among stroke survivors and clinicians.This multiple case study involved 3 stroke survivors with chronic UE deficits and their respective clinicians (physiotherapists) who participated in the VirTele intervention, a 2-month remote rehabilitation intervention that uses nonimmersive virtual reality exergames and telerehabilitation aimed at improving UE deficits in stroke survivors. Study participants had autonomous access to Jintronix exergames and were asked to use them for 30 minutes, 5 times a week. The VirTele intervention included 1-hour videoconference sessions with a clinician 1 to 3 times a week, during which the clinician engaged in motivational interviewing, supervised the stroke survivors’ use of the exergames, and monitored their use of the affected UE through activities of daily living. Semidirected interviews were conducted with the clinicians and stroke survivors 4 to 5 weeks after the end of the VirTele intervention. All interviews were audiorecorded and transcribed verbatim. An abductive thematic analysis was conducted to generate new ideas through a dynamic interaction between data and theory.Three stroke survivors , with a mean age of 58.8 (SD 19.4) years, and 2 physiotherapists participated in the study. Five major determinants of VirTele use emerged from the qualitative analyses, namely technology performance (usefulness and perception of exergames), effort (ease of use), family support (encouragement), facilitators (considerations of the stroke survivors’ safety as well as trust and understanding of instructions), and challenges (miscommunication and exergame limits). During the VirTele intervention, both clinicians used motivational and behavioral techniques to support autonomy, competence, and connectivity. All these attributes were reflected as empowerment indicators in the stroke survivors. Lessons learned from using telerehabilitation combined with exergames are provided, which will be relevant to other researchers and contexts.This multiple case study provides a first glimpse into the impact that motivational interviewing can have on adherence to exergames and changes in behavior in the use of the affected UE in stroke survivors. Lessons learned regarding the supportive role caregivers play and the new responsibilities clinicians have when using the VirTele intervention may inform the use of exergames via telerehabilitation. These lessons will also serve as a model to guide the implementation of similar interventions.RR2-10.2196/14629 In Canada, stroke survivors have difficulty accessing community-based rehabilitation services because of a lack of resources . EvidencTelerehabilitation and virtual reality technologies could play an important role in providing novel rehabilitation approaches to optimize stroke recovery in the chronic phases, as suggested by Canadian stroke guidelines . More spSpace Race, Fish Frenzy, Pop Clap, Apple Picking, and Kitchen Cleanup) performed in a sitting position. The performance of the affected UE  and the duration and number of sessions played can be accessed on the web through a clinician portal within the Jintronix system. Reacts is an internet-based audiovisual platform that can be used through a computer or mobile phone to conduct secure videoconferences and share content . It enables screen sharing (viewing the participant’s computer screen) to supervise in real time the stroke survivors’ performance, provide direct feedback, and adjust difficulty level in collaboration with the stroke survivors, taking into account their preferences and capacities .VirTele, a personalized remote rehabilitation program combining virtual reality exergames and telerehabilitation, was developed to provide stroke survivors an opportunity to pursue rehabilitation of their chronic UE deficits at home while receiving ongoing follow-up from a clinician . More spAn initial study was conducted with a stroke survivor to test the VirTele technology and study protocol during the development phase of the intervention . The resBehavior-modification strategies  have been implemented in exercise promotion interventions to enhance motivation, exercise participation, and maintenance -14. As gEventually, the SDT-informed VirTele intervention may not only help patients and clinicians decide together on the best treatment options but also allow clinicians to identify potential problems once the patient has reintegrated into the community. Thus, this study will also document the experiences of the stroke survivor as well as the clinician when using the VirTele program, which are key aspects for the successful eventual implementation of such interventions.The objectives of this study were as follows:Identify behavioral and motivational techniques used by clinicians during the VirTele intervention.Explore indicators of empowerment among stroke survivors.Investigate the determinants of VirTele use among stroke survivors and clinicians.This study used a multiple case design, which allows extensive data collection with varied methods across different cases . This deThis multiple case study is embedded into a 2-armed randomized clinical trial comparing an experimental group (receiving the VirTele intervention) with a control group (receiving standard care) in Montreal, Quebec, Canada, and registered with ClinicalTrials.gov (NCT03759106) .The qualitative data were collected between June 2019 and August 2020 by the first author , a PhD student under the supervision of DK and JH who had previous experience in qualitative research and stroke rehabilitation research. This multiple case study was reported according to the Standards for Reporting Qualitative Research .This study targeted the stroke survivors who were assigned to the experimental group receiving the VirTele intervention in the context of the 2-armed randomized clinical trial and who had completed the 2-month program. This group of stroke survivors was screened for eligibility before enrollment, and participants were selected based on the inclusion and exclusion criteria described in the published protocol (refer to the Participant Selection and Recruitment Strategy section) . The cliThis study received ethics approval from the research ethics board of the Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal  [The VirTele intervention protocol is illustrated in The Unified Theory of Acceptance and Use of Technology (UTAUT)  was usedThe UTAUT also incorporates 4 moderators—age, sex, experience, and willingness to use—that can influence technology adoption intention and use behavior . In the Triangulation was used for this multiple case study. This involved the use of various methods to collect qualitative data . First, Second, logbooks were used by the clinicians to collect data related to technical difficulties, number of videoconference meetings, complementary activities suggested in addition to the exergames, and motivational strategies used. Third, reflexive notes were used by the researchers to collect VirTele intervention–context-related data . Demographic information about the stroke survivors was also collected. A sample size of 10 stroke survivors and 4 clinicians was targeted to diversify the experiences and enrich the data. However, only data saturation can predict the final sample size .Abductive thematic analysis was conducted. This type of analysis seeks to go beyond inductive and deductive reasoning . By adopQDA Miner   was usedIn each case, the stroke survivors’ and clinicians’ experiences with the VirTele intervention and indicators of SDT variables were developed and examined independently and across the duos (stroke survivors and clinicians) for a within-case comparison. Next, experiences were examined among cases, using a cross-case analysis, to explore differences and similarities regarding the determinants of VirTele use and indicators of SDT variables. Underlying similarities and constant associations were then developed to form more general explanations. The analysis was conducted by 3 members of the research team . The verbatim transcripts were translated from French into English for publication and verified by bilingual team members (DRA and DK).The principles of Lincoln and Guba , includiFive stroke survivors were assigned to the intervention group and completed the VirTele intervention .However, recruitment was halted in mid-March 2020 at the onset of the COVID-19 pandemic in Canada, and all research activities were suspended from March 2020 to October 2020. Of the 5 stroke survivors allocated to the VirTele group, 1 (20%) could not be reached to conduct the interview, and 1 (20%) was excluded because he did not speak French or English fluently. Of the 3 remaining stroke survivors, 2 (67%) were women (participant ID1 and participant ID5), and 1 (33%) was a man (participant ID11); their mean age was 58.8 (SD 19.4) years, and they varied in terms of computer familiarity, Chedoke-McMaster stroke assessment score, time since stroke, and dominance of UE. Two physiotherapists participated in administering the VirTele intervention. Participant ID11 received a 3-month VirTele intervention instead of 2 months, as was the case for participant ID1 and participant ID5, given that it was impossible to retrieve the technology material during the COVID-19 pandemic period. We decided to give this participant the opportunity to benefit from the services offered by this technology for an additional month. For readability, each participant was given a pseudonym: participant ID1 identified as Carolina, participant ID5 identified as Helene, and participant ID11 identified as Jack.A detailed case description of the 3 duos (stroke survivor and respective clinician), collected from the interviews, logbooks, and exergame portal, is provided in Differences and similarities have emerged regarding the determinants of VirTele use between the duos (stroke survivor and clinician).In terms of relative advantages, the clinicians believed that VirTele facilitated access to rehabilitation services and that exergames and follow-up enhanced stroke survivor motivation and compliance to the rehabilitation program. A clinician felt that the feedback (scores of games and clinician feedback) and the follow-up increased stroke survivor empowerment. Neither the clinicians nor the stroke survivors expressed expectations regarding the benefits of the VirTele program, and only apprehensions were reported.The stroke survivors had different perceptions of the exergames (perceived either as an instrument of play or a therapeutic intervention). Helene compared the exergames with “bridge card games” and stated that she liked to win, which motivated her to continue playing during the 2-month intervention. Jack initially showed some apprehension, which diminished with practice, regarding the therapeutic value of the exergames.All stroke survivors demonstrated high adherence to the exergames; however, only Carolina and Helene expressed an intention to use the affected UE in daily activities, which was maintained after the end of the VirTele intervention. Jack had expressed no intention to use the affected UE in daily activities, which was corroborated by the clinicians. Helene experienced no improvement in motor function. She reported no change in her arm function but said that she had begun to use her arm in daily activities.From the clinicians’ perspective, their main role when using VirTele can be summarized in terms of the following tasks: adjust the difficulty level of the exergames, monitor the stroke survivors’ adherence to the exergames and their compliance to carrying out activities of daily living, observe the movements during the exergames, correct postures and movements, and act as coaches to motivate the stroke survivors and encourage and maintain adherence.With regard to demonstrating the exercises through the videoconference technology, without physical contact (hands-on demonstrations), the clinicians reported considerable apprehension, which subsided later because the stroke survivors were able to correctly comprehend the instructions. In addition, the clinicians were able to demonstrate the exercise through clear, concise, and simple instructions, which was challenging at times because of the participants’ loss of attention (not listening to the instructions or sound getting cut off).The clinicians pointed out some limits of the exergames that may influence technology performance, such as limited choice of exergames, which could become repetitive (significant focus on shoulder movements); limited parameters of difficulty; and insufficient rest time between sets of repetitions . This feedback was provided by Jack. According to one of the clinicians, the lack of diversification in the difficulty parameters may induce a ceiling effect in terms of difficulty, which can be demotivating for the stroke survivor.Helene and Carolina reported a problem with the avatar in some of the games . The clinicians believe that the avatar issues were related to not following recalibration instructions before starting the game, an important phase that allows the Kinect camera (Microsoft Corporation) to capture both arms and recalibrate the degrees of movement in each limb, enabling better control over the avatar.With regard to effort, the clinicians as well as the stroke survivors encountered technological issues , which caused some frustration among the stroke survivors. The issues were managed either by the research team or the clinician (telephone support) or by the stroke survivors themselves or with the help of a family member .All of the clinicians and stroke survivors, except Helene, found the technology intuitive and user friendly. Helene needed the help of a family member to turn on and use the VirTele intervention.Positive feedback from friends and family, after seeing or hearing about the system, encouraged the stroke survivors to start or continue using the VirTele intervention. The clinicians also played an important role in supporting  and encouraging the stroke survivors to adhere to the exergames and use the affected UE in daily activities. This may have contributed to their empowerment. Further details regarding stroke survivor empowerment are provided in According to the clinicians, 3 main factors facilitated their use of the VirTele intervention: the stroke survivors’ safety , the capacity of the participants to comprehend their instructions through the technology, and the trust relationship established with the stroke survivors (through shared decision-making), regarding which the clinicians were apprehensive before the intervention.The main challenge encountered by a clinician with Jack was that the stroke survivor had been diagnosed with aphasia. This led to miscommunication between the clinician and Jack, as well as frustration for the latter. Thus, the clinician encountered difficulty in carrying out the motivational interviews and customizing the intervention according to Jack’s needs because these were not well understood. Furthermore, challenges related to lack of comfort in using the technology (unfamiliarity with computers) and limited access to the internet were problems that both Helene and Jack had to deal with.In the clinicians’ interviews, some meaning units, reflecting different recommendations related to the use of the VirTele program, were assembled. They are presented as a bulleted list in Lessons learned from clinicians’ recommendationsBoth stroke survivors and clinicians are receptive to using the technology, despite technological limitations.The caregiver has a supportive role in using the technology, particularly among stroke survivors who are not familiar with IT.The clinicians’ transition into the new roles and responsibilities may be facilitated by considerations of the stroke survivors’ safety, capacity to understand the instructions, and trust.Aphasia may lead to frustration among stroke survivors when interacting with clinicians, but it does not affect technology use.The use of telerehabilitation combined with exergames may empower stroke survivors, through autonomy, competence, and connectivity, and increase frequency of use of the affected upper extremity in activities of daily living during and after the end of the VirTele intervention.The objectives of this multiple case study were to (1) identify behavioral and motivational techniques used by clinicians during the VirTele intervention, (2) explore indicators of empowerment among stroke survivors, and (3) investigate the determinants of VirTele use among stroke survivors and clinicians.The clinicians used numerous motivational interviewing strategies that helped to create supportive psychological needs environments. The stroke survivors demonstrated empowerment at different levels in term of autonomy, competence, and connectivity. This is likely to result in better management of self-care, more independence from clinicians, and increased motivation to pursue a rehabilitation program . In factJack did not express any intention to use his UE in daily activities after the end of the VirTele program, although he used his UE in self-directed exercises during the VirTele program as per the clinician’s recommendations and instructions. Jack may have been externally motivated, which means that he wanted to change only for external reasons, not because he wanted to; for example, he performed an exercise because the clinician asked him to, or he used the exergames because he knew that he was being monitored. In addition, Jack’s indicators of empowerment were less developed at the connectivity and competence levels, which can be explained by the miscommunication challenge that he faced (because of his aphasia diagnosis). In fact, Jack’s clinician pointed out that Jack’s needs were not well understood. This made it difficult to customize the program and provide adequate support for competence and left little space for a sense of connectivity and belonginess. Therefore, the lack of participant empowerment in terms of autonomy, competence, and connectivity may reflect externally regulated motivation, rather than internal motivation, which often involves short-term changes .Helene also demonstrated external motivation because she stated that she continued to use the exergames to win, not to exercise her UE, because she did not perceive any significant change with her UE. However, external motivation can be internalized and accepted to lead to effective changes . At the Furthermore, recommendations reported by the clinicians reflecting what they learned from using VirTele were also provided, although these data were supplementary to, and not the original focus of, the study . These rAmong the main determinants that were identified from the UTAUT, performance stood out as being meaningful in the 3 cases. In fact, the clinicians as well as the stroke survivors perceived relative advantages of the VirTele intervention compared with standard therapy (facilitating access to therapy and enhancing motivation) and felt comfortable interacting with each other.The main role of the clinician during the VirTele intervention was to monitor the use of the affected UE by the stroke survivor through self-directed exergames and activities of daily living, which aims to enhance the stroke survivor’s autonomy to continue using their affected UE after the end of the intervention. This is particularly relevant in the chronic stage of stroke because not all stroke survivors have access to rehabilitation services after discharge . The VirThe limits of the exergames, as pointed out by the clinicians and stroke survivors, may have reduced the technology performance with regard to attaining the individual stroke survivors’ goals. However, it did not seem to affect the behavioral intention and use behavior regarding the technology among the clinicians and stroke survivors. Furthermore, family members ended up playing a supportive role  during the VirTele program, particularly with Helene who was not familiar with computers.Communication difficulties, such as those resulting from Jack’s aphasia diagnosis, were considered the main challenge to motivational interviewing administration, which led to frustration for Jack, but did not affect technology use among the stroke survivors. Furthermore, 3 factors were identified by the clinicians as facilitators of technology use including trust, considerations for the participants’ safety, and their capacity to comprehend the clinician’s instructions. In addition to these factors, the previous experiences of the clinicians in motivational interviewing and their ease of use of the VirTele intervention may have facilitated the transition to their new roles and responsibilities in the VirTele context. This also suggests that the VirTele intervention may be easily transferred into actual clinical practice to offer stroke survivors opportunities for practice and to change their unhealthy behaviors.This study’s results corroborate the findings in the study by Caughlin et al , which cIn a previous study, Sit et al  found thMoreover, the determinants of VirTele use, identified through this study, are in part consistent with the determinants reported by other studies deploying telerehabilitation  and virtParticipants’ expectations regarding the VirTele intervention before the start of the study were not documented. Therefore, it was not clear whether the intervention met the participants’ expectations, which could affect technology acceptability and their compliance to the rehabilitation program. Future studies could investigate expectations before the start of the intervention to better capture end user expectations of similar interventions. Furthermore, given the small sample size, the results of this study should be interpreted with caution.In conclusion, the factors predicting intention to use the VirTele intervention and use behavior among stroke survivors and clinicians include technology performance, effort, social influence, contextual facilitators, and challenges. The empowerment attained by stroke survivors is promising for the future deployment of such an intervention to encourage the use of the affected UE in activities of daily living and achieve impactful long-term improvement. The lessons learned from this study regarding the resilience of stroke survivors and adaptability of clinicians with respect to technology limitations, role of the caregiver, new responsibilities of clinicians during the VirTele intervention, impact of aphasia diagnosis, and empowerment of stroke survivors may help to guide the implementation of similar interventions. However, further studies in different contexts are needed to better understand the factors affecting intention to use such technologies and use behavior.


Youth athletes’ talent identification and development has become a serious concern around the globe. However, empirical evidence regarding youth sports policies and practices is limited. Emphasizing the talent development needs of youth volleyball players, in this study, the authors evaluated the practices and challenges of a youth volleyball development program in Amhara Regional State, Ethiopia. This study addressed this concern by drawing upon Stufflebeam’s context, input, process, product (CIPP) model to explore a youth volleyball development program across the training sites located in Amhara Regional State, Ethiopia. With the help of this model, this study evaluated the prevailing contexts, allocated inputs, program implementation processes, and products. To this end, this study used multiple case studies involving ten youth project sites. The study participants included samples of participants (n = 179), consisting of youth volleyball players (n = 167), their coaches (n = 8), regional volleyball administrators, and regional educational office physical education coordinators (n = 4). The study participants identified some benefits from participating in the youth volleyball program, which included increased physical activity and health, enhanced positive interpersonal relationships, and knowledge of how to cope with challenges. However, they reported several challenges attributable to contextual constraints which included a lack of the necessary facilities and resources, lack of concern and convenient settings, poor implementation practices, and minimal outcomes. The findings suggest that the challenges of youth volleyball development in Ethiopia are complex and emanate from the context, input, process, and products. Accordingly, when addressing the issues of youth volleyball, it is necessary to develop systems, processes, methods, and tools that recognize all these concerns. Youth sports programs include those organized sports offered in many schools, clubs, and communities . These sA youth volleyball program focuses on developing all-around skills and abilities while helping players to become good team members with a passion for the game . Young vPrevious research examined the personal factors of success for youth volleyball players, focusing on a quantitative analysis of early sports activities and their demographic, anthropometric, and physiological responses. However, few scholars have studied youth volleyball participation and identified conditions under which particular outcomes are likely to occur. Hence, there is a need for a conceptual framework and empirical evidence that identifies the contexts, inputs, and processes through which youth volleyball participation produces positive outcomes ,10.What are the contextual factors in the program environment that are likely to influence the success of youth volleyball development in Amhara Regional State, Ethiopia?How is the program developed and practiced within the existing local and national contexts?What is the current practice of youth volleyball development across the different project sites or centers in Amhara Regional State, Ethiopia?What are the major challenges of the youth volleyball development program in Amhara Regional State, Ethiopia?In Ethiopia, minimal research has been directed toward addressing aspects of youth volleyball from a broader perspective, including its policies and practices . So far,This study used multiple case studies , involviThis study used a qualitative study approach because it helps to understand whether the studied youth volleyball program provides a climate that promotes sport-based youth development. In terms of framework, the CIPP evaluation model was used to holistically evaluate the youth volleyball development program. The practice of using a CIPP evaluation model as a framework for the study of youth sports program is similar to the practice of other studies conducted in sports sciences and sports management studies ,19,20,21There are 40 volleyball project sites in Amhara Regional State, which have been delivering youth volleyball trainings to both males and females. The development of volleyball programs is a process in which volleyball players are transferred, hired, or join the volleyball programs run by different sports academies and volleyball clubs based on their performance at the end of the season in which they engaged in the competition. Through this process, the most skilful or talented volleyball players in each volleyball program are selected and promoted or joined to the sports academy and hired from different volleyball clubs in developed countries. However, in the context of our country, Ethiopia, the concerned bodies and the public do not give special attention like this to other sports disciplines.The researchers selected the CIPP Model as a comprehensive framework that can capture the entire program components from the end users and the program owner’s perspectives . The modAs shown in The study participants included samples of participants (n = 179), comprising youth volleyball coaches , youth volleyball players (n = 167), and Amhara region volleyball administrators. The administrators  included federation committees (n = 1), youth sports office experts in Amhara Regional State (n = 1), and zonal volleyball committee members (n = 1), and the regional education expert assigned for the management of youth sports program (n = 1). While the administrators were at the regional and zonal levels, office experts, and coaches were selected purposively depending on their roles in the programs. The youth volleyball players were selected by using a simple random sampling method. Following the Stufflebeam  CIPP modIn this study, the authors used document analysis as one of the primary tools of data collection in which documents are interpreted by the authors to provide initial evidence-base information about youth volleyball programs in Amhara Regional State, Ethiopia. The types of documents used included public records, comprising official, ongoing records of the National Sports Commission, and its corresponding Amhara Regional State sports office activities. In the young volleyball players’ questionnaire, we included two open-ended question items that allow young participants to answer in open-text format so that they responded to the questions based on their complete knowledge, feeling, and understanding of the youth volleyball program. It means that the responses are not limited to a set of options. The purpose of the interview, in this qualitative inquiry, was to create a conversation that invites the key informants to tell stories, accounts, reports, and descriptions about their perspectives, insights, experiences, feelings, and emotions about the research questions . In eachIn this study, FGD was used with youth volleyball coaches who have rich experience in coaching young athletes. The purpose of the FGD, in this qualitative inquiry, was to gain an in-depth understanding of the youth volleyball program in Amhara Regional State based on the views and perspectives of the youth coaches’ participants. In the focus group, we prepared semi-structured discussion points to enable a focused discussion among the youth coaches’ participants. In terms of the number of FGD participants, we involved eight youth coach participants, and this was acceptable as most focus groups in sports and exercise sciences research contain between four and ten participants . The FGDThe first author prepared field notes following each field observation. The field notes were qualitative notes recorded by the first author during or after his observation of a specific project site he was studying. The notes are intended to be read as evidence that gives meaning and helps in the understanding of the overall program feature found in each site as a specific case. Each field note describes the physical setting, the social environment, and the way in which youth volleyball players and their coaches interacted, and the participants and their roles in the setting.The first author was involved in a one-on-one interview with coaches. He also managed the FGDs with youth volleyball players. Each FGD consisted of 10 youth player participants. The data collection was handled by the first author in each sampled training site and he analyzed and interpreted the results by using thematic analysis. The authors used the federal and regional state program manuals as information sources about the program structure and implementation plans. These included the number of participants in each project site and the overall training duration, implementation, and follow-ups. Also, we used the Ethiopian national sports policy. These documents served as the source of evidence to evaluate the context and input related to the volleyball program studied.To explore the setting and the coaching climate of the youth volleyball program studied, direct observations of training sessions and the entire sporting facilities were conducted (n = 10). The principal author was present at each project site to take observational field notes. The observer aimed to keep an open mindset during observation. Hence observations were unstructured, with field notes written down to document as much information as possible. The field notes included information about the project sites and how the coaching was organized and implemented.Also, individual face-to-face interviews were used with the program administrators to explore their perception of the training context and the surrounding factors associated with the implementation of the program. Each interview lasted between 20 and 30 min. All interviews were held in person by the first author in a private room in the program setting. Due to this experience, a self-reflective stance was adopted during interviewing, with a general openness and curiosity about the interviewees’ experiences was established. Interview topics covered different aspects of the evaluated program, including the perceptions of the interviewee on the training session, the resulting effectiveness and impacts of the program, and the facilitating and hindering contextual factors. In addition, the interviewees reflected on the program implementation mechanisms and processes. Moreover, a focus group was created comprising the coaches involved in the program, lasting for about 90 min, with an audio recording. The first author facilitated the discussion. The study participants discussed their perceptions regarding the youth volleyball program, it’s supposed effectiveness and impact, facilitating or hindering contextual factors, and suggestions for a better future.Ethical approval was provided by the Bahir Dar University Sports Academy Research Committee, and youth volleyball players and their parents provided written informed consent before participation. Each study participant was approached after gaining permission from the gatekeeper at the research site.In this study, the authors used thematic analysis that finds themes in the text by analyzing the meaning of words and phrases . We usedThen the sub-themes in each theme were coded by using inductive coding, also known as open coding. The inductive coding started from scratch, and we created codes based on the qualitative data itself. In our analysis, all the sub-themes and their attributes arise directly from the study participants’ responses. The inductive coding was an iterative process, which means it was thorough and relevant to the production of a more complete, unbiased look at the sub-themes throughout our data . The indWe took all the data from the research dataset and categorized the themes. We organized the themes or codes based on the conceptual framework and how an effective youth development program may be understood from the structural, implementation, and outcomes perspectives ,29.This study used a qualitative dataset with a focus on exploring the context, input, process, and product, and the challenges surrounding the development and implementation of the youth volleyball program in the Amhara Regional State, Ethiopia. The focus here is to present the views and perspectives of youth athletes, their coaches, and the program administrators in their own words within the specific program contexts across different locations. For this, the authors took a qualitative research stance and the CIPP evaluation model to the study of youth volleyball program. The CIPP model suggests a specific approach to a youth sports program evaluation, comprising context, input, process, and product . Guided by the conceptual model, the results of the study are organized into four major themes, and each theme has 2–4 sub-themes that emerged from the empirical data collected for this study. The visual map presented in The first-level code describes the major themes that the evaluation of this study focused on investigating .The second-level code specifies the sub-theme under each major theme. The attributes or features of each sub-theme are described in detail under each sub-theme.This hierarchical framing supports the organization of codes based on the conceptual framework. It also allowed us to be able to generate a level of detail in a set of data.In this study, context evaluation was used to give a rational reason for the youth volleyball program. This evaluation was conducted based on evidence in the following areas: policy needs and interests, institutional arrangements, talent development environment, and partnership. The Ethiopian national sports development policy declares the need to increase the pool of excellent athletes, thereby expanding the country’s potential to meet its aspiring target to excel in international sporting events . In addiAccording to the memorandum of understanding document, the youth volleyball program, as well as others, was designed to contribute to the ongoing sports development of the country by creating a healthy and dynamic youth sports system. The youth volleyball development program was targeted to promote youth volleyball players into senior volleyball players. Accordingly, 30% of the youth volleyball players who completed the age-appropriate training with better performance will go to the national sports academies and the other 68% will be transferred to various clubs . In addiThe central concern of any youth sports program is the practice of an effective talent development program as planned in the program document. In this regard, the reviewed documents indicated that the volleyball talent development program consisted of 10 months of youth volleyball training, lasting from September to June. This range of months corresponds with the school activities in one academic year. As indicated in Many of the study participants, particularly youth volleyball players and their coaches, felt that the federal government and the regional state did not give equal attention to volleyball when compared with football and athletics. Most of the study participants perceived that the regional government did not focus on the overall development of volleyball for young people and for the success of the program. Based on this, they recommended that the National and Regional Volleyball Federation and the media should endorse a strong support for the development of youth volleyball. In particular, they should create a comfortable environment, providing the required support, and continually engage in monitoring and evaluating the program.The problems of volleyball programs in Amhara Regional State, as per the perspectives of different study participant groups, primarily included problems of ownership, coordination, support, and follow-ups. As one of the interviewed officials said, “the owner of the program is the school office, but 90% is owned by the sports commission.” One of the interviewees noted that switching the ownership from the sports commission to the office of education brings several advantages. To effectively implement the youth volleyball development program, youth participants must have access to a court, a net, several volleyballs, and a pair of poles for attaching the net to the playing surface. Sporting resources, such as sporting suits, training facilities and equipment, as well as essential first aid kits, are key resources both for training and competitions. However, the study participants of this study reported that these facilities and equipment did not appear in enough quality and quantity. It was clear from the first author’s observation that most of the program sites included in this study had playing courts, which did not have leveled areas that are free from any obstruction. Although there has been a national initiative for sports-development programs across thirteen sporting events, the situation in the project sites does not back up that with evidence. Instead, implementing a youth volleyball development program in the sites studied, as some participants highlighted, compromises the quality of youth volleyball when we consider the limited facilities, resources, and materials present under existing conditions.In the sampled 10 youth volleyball project sites found in Amhara Regional State, the young volleyball players were school-age children found in selected high schools. In each high school, student–athlete samples were selected by using a stratified sampling method with the strata being gender. The questionnaire survey was distributed to 167 student–athletes from the 10 high schools studied, and all of them responded to it. As shown in The youth volleyball players have been selected to participate in the youth volleyball program in their respective high schools based on their interest and previous experience in playing volleyball at the lower grade levels. As the FGD participant coaches stated, the assigned coach (PE teacher) in each high school hosting the volleyball program has the knowledge of the youth volleyball players’ experience, so selection or screening them was not difficult.There were several problems/challenges identified by the sampled participant youth players, coaches, and program administrators. These problems/challenges are primarily family-related problems: lack of facilities and resources for the training, lack of attention by the program coordinators, and others. Here, it is important to note that almost all the study participants also believed that they faced several problems, particularly the absence of follow-up and support and the lack of training facilities and equipment.Another concern involved the fact that sports media did not have a focus of attention on volleyball, particularly youth volleyball. Most of the interviewed participants and FGD discussants commonly agreed that sports media is an important tool for communication and creating awareness among the community members, and it needed to include programs addressing youth volleyball both at the regional and federal levels. The region also identified other issues such as coaches’ salaries, trainers and trainers’ sports equipment, various materials needed for the training, proper selection of training sites, and above all, raising awareness of the importance of the program for youth families and the local community.Process evaluation includes mainly examining the implementation of a sport-based youth development program. Sports development often supports the assumption that young athletes’ multidimensional development may vary depending on how their sport training activities are designed and implemented, the extent of their participation or engagement in the youth sport development process, and the kind of positive relationship established between the youth volleyball players and their coaches. As can be seen in In all sampled project sites, youth volleyball players usually received 2 h of volleyball training per day and a total of 6 h per week. The weekly program was scheduled 3 times per week, including Monday, Wednesday, and Friday . The assigned youth coaches were selected on those days for training based on convenience to reduce the number of days students went to school for learning and volleyball program activities. The volleyball program activity made the training more suitable for the youth volleyball players because it did not clash with their study time so that their formal education remains unaffected due to the volleyball training. In terms of training hours, each session usually took two hours with breaks in between activities. However, most of the coach FGD discussants and some youth volleyball players perceived that these expectations were not strictly followed as there were missed training programs for several reasons related to lack of coaches’ interest and unexpected meeting schedules, large numbers of absentee youth players, and others. It was noted that when the program is mainly under the ownership of the office of education, management of these issues is relatively easier. For example, monitoring youth volleyball players who may miss the scheduled program may not be a problem. Not understanding that the number of shortcuts students take to avoid training will decrease during the project at school (Interviewee 1).The coach participants in this study pointed out that the rate of attendance of youth volleyball players was not as expected. Most of them reported that attrition was a serious issue. According to one of the key interviewees (Interviewee 2), the regional state has taken measures to maintain the sustainability of the youth volleyball program throughout the region. These include developing and implementing a strategic plan to ensure that U-13 to U-15 to U-17 players remain constant. Hence, there is a holistic view of the youth volleyball talent development plan from the beginning to the end.As the FGD participants coaches reported, there were different components, including physical fitness, technical skills, tactical skills, and sporting behavior. In terms of each training session, there were warm-up activities such as general conditioning aerobics and some stretching exercises, followed by the main work, comprising the technical and tactical skills needed, and concluding activities, such as jogging and upper body stretching exercises. Almost all the FGD participant coaches agreed that their training mostly focused on physical fitness and technical skills more than the other activities. In regard to their coaching approach, the responses collected from the youth volleyball players’ open-ended questions showed a prevalence of a coach-centered approach to coaching in youth volleyball training settings. Empirical evidence in the literature in this field supports this claim . Based oWe also explored youth volleyball players and coaches’ perceptions of their experiences in the sampled volleyball project sites at Amhara Regional State. As per the evidence collected for this study, the sampled youth players believed that their experiences in the volleyball program provided them with many benefits, including the development of life skills . In addition, these youth volleyball players believed that through their participation in the volleyball program, they also learned important values, such as teamwork, perseverance, honesty, and respect. In support of these, almost all the FGD participant coaches indicated that the young players’ participation in the volleyball projects was positive for their development, although many stated several challenges that hinder the attainment of far better outcomes. Some even believed that the players’ experience in the volleyball program was a wise use of their leisure time and contributed very positively toward their personal development. However, youth volleyball participants reported that their training was not measured by competition. In fact, “it is a good opportunity for almost all young people to participate in the competition, because the competition is part of the youth development program” (Coach Participant 3). Hence, conducting regular competitions between project sites at different times and creating a budget to recruit the best ones will benefit the region and the country. Furthermore, some coach participants suggest that the regional volleyball federation as well as the Federal Volleyball Federation should strengthen its monitoring and support schemes. Seen from the program coordinator’s side, the high school principals involved in FGD indicated that they were supportive of the practice of youth volleyball programs in their respective high schools, and they also recognized their importance for positive youth development. Furthermore, the principals mentioned that they encourage participation for all students and work to create a sporting environment that is in accordance with the program mission. However, this was not supported by the program implementers; that is, youth volleyball players and their coaches, who strongly argued that the follow-up and support of the program coordinators both at the high school as well as the woreda, zone, and regional levels were unsatisfactory. Youth volleyball players and their coaches involved in this study reported that they had a positive relationship between them. Most of the youth players agreed that their coaches understood them and are willing to help. However, as some participant youths commented, their coaches did not have the commitment and proximity to them in matters related to training and development. Though a clear evidence file was not documented due to lack of data at the regional, zonal, and district/woreda levels, the sports office experts reported that the program contributed far less than was expected by the program planners. As they pointed out, those who transferred into clubs and those who joined the sports academies in volleyball sports each year are very few in number. As one FGD participant coach stated currently, the program does not seem to matter for those who are in charge of its implementation. In addition, another regional sports office expert commented that a strong monitoring and evaluation mechanism should be in place for better quality implementation of the program. As some study participants noted, the youth volleyball program appears to be a cost-effective investment of an increased use of local resources for positive youth development purposes, particularly in densely populated areas and in remote locations where few volleyball playing facilities exist. Overall, the youth volleyball program studied was effective in terms of an athlete-centered focus that emphasizes the positive youth development of each individual player. However, in terms of practice, study participants reported several problems that hinder the success of the program to produce its expected results.The relevance of the youth volleyball program for the development of volleyball in the regional state and country at large is undisputed. The different study participants commonly agreed that youth volleyball is important for the individual youth athlete, the region, and the country. In particular, the youth athlete participants viewed their participation in the volleyball program as a means of developing their sports performance. Most of them witnessed that participation in the volleyball program helped them to be healthy. Some study participants pointed to the relevance of the youth volleyball program for the development of talented youth volleyball players and improvement of the community attitude toward sports. Coaches also confirmed this fact. As most of them noted, a large number of young people came to participate in youth volleyball in their respective training sites. Sports have the potential to promote multiple outcomes in youths’ development. For example, sports participation contributes to the holistic development of youth ,35, surpA sports policy consists of a set of materials for guiding the implementation of sports for development programs, procedures, intellectual dispositions, and ways of reasoning . Indeed,The talent-development environment refers to aspects of the physical, social, emotional, and cultural milieu, where athletic potentials are developed . A holisFamily-related problems involved parents’ lack of awareness and lack of support, leading to disagreements with parents. The positive role of family during the youth athletes’ developmental years has been highlighted in the literature. For example, studies on elite youth athletes indicated that social support rendered by family, coaches, other athletes/peers, and support staff has a positive influence on players’ talent development. The finding of this study concerning the role of the family in the development of volleyball players’ talent is consistent with the findings reported in the literature on this field .These problems are similar to the problems stated in other youth sports studies reported in Ethiopia. For example, a study reported similar problems faced by the youth athletes and their coaches in the sport of taekwondo in Addis Ababa, Ethiopia , in youtYouth volleyball players, including the sample participants in the current study, spend many training hours under the guidance of youth volleyball coaches in deliberate practice . The houThree process features are identified by the study participants as important explanations of the youth volleyball development program, including opportunities to belong, positive social norms, and supportive relationships, among others . It is aThe interpersonal dynamics between the coach and the youth athlete are central to the youth athlete coaching process in any sport . The intAmong the various intentions stated in the strategic planning document, both at the national and regional state levels, the youth sports program anticipates attaining not only sporting excellence but also positive youth behavior outcomes . The youYouth development outcomes are likely to occur when youths’ strengths are aligned with and supported by the resources of the environments in which they live . The aliTo continue enhancing the level of play in our volleyball, we need to develop more multi-skilled young volleyball players. This is only possible, if we are focusing on player development as opposed to team success in terms of winning . ScholarOverall, youth volleyball is one of the relevant mechanisms to promote youth development processes and outcomes. However, the quality of the program components and the contextual factors associated with the program implementation, and the collective efforts of various stakeholder groups needs special attention . The youThis study aimed to holistically explore the youth development program at Amhara Regional State, Ethiopia, by using the CIPP model. Based on the analysis of the collected data, it becomes clear that the youth volleyball program has several benefits for the players in increasing physical activity and health, positive interpersonal relationships, and emotional, cognitive, and behavioral competencies. The results of this study also indicate the presence of several challenges, including a lack of the necessary facilities and resources, lack of concern and settings, poor implementation practices, and minimal outcomes. In addition, the results indicate that the challenges of youth volleyball development in Ethiopia are complex and spread across the context, input, process, and products. Hence, when addressing the issues of youth volleyball, it is necessary to develop systems, processes, methods, and tools that recognize all these concerns. For young volleyball players to train smarter and perform better, coaches and program organizers need to understand the developmental needs of youth volleyball players and have a strategic intervention to empower them.This study is helpful to increase insights about the youth volleyball development program from a broader perspective. Together, the findings of this study provide support for the value and contribution of youth volleyball programs and highlight several key areas for program designers to consider in future designs. For example, it is critical to prepare youth volleyball coaches through professional development and further training opportunities. Additionally, program designers should consider strengthening families’ participation in youth volleyball development programs.This study was not free from limitations. Given that this study used a qualitative methodology, the authors did not establish a rigorous causal relationship between the different evaluation dimensions. Creating a transtheoretical quantitative model comprising variables representing the four domains of the CIPP model would be an important area of future research. One of the limitations of this study is that the sample included only youths aged 15 to 17. Future research should examine sport-based development programs across the other developmental periods , as different age groups may be affected differently by the sports programs. Another potential limitation of this study is the absence of data collected from parents/guardians about youth volleyball development in the sports context. However, many studies show the significance of parental/guardian support for the effectiveness and impactfulness of a youth sports program. Hence, future research should include parental/guardians’ perceptions in studying a youth sports development program. Another limitation of this study is that it focuses exclusively on the effects of the youth development program within the sports setting leaving aside the school setting, thus ignoring the potential influences of other school-based programs and relationships. Future research may address this interconnection between the sports and school contexts.