Longitudinal 2 Midterm
Well-defined SMART objectives will help focus the strategies of health and wellness initiative. Which of the following is INCORRECT? a. S - specific b. M - measurable c. A - abundant d. R - realistic e. T - time-bound
c. A - abundant **achievable
partners in the public health system to ensure conditions for population health
community, clinical care delivery system, employers and businesses, media, academia, government public health infrastructure
Which of the following descriptions about health & wellness initiatives is INCORRECT? a. they can be very basic or wide reaching b. they are outreach events that are part of a strategically planned community health intervention that can be tailored to address the needs of a specific segment of a community c. HWIs that include education and screening components have been found successful. d. A HWI is a more expensive strategy to provide community outreach and a common vehicle utilized by health educators to increase awareness to a variety of priority populations and communities
d. A HWI is a more expensive strategy to provide community outreach and a common vehicle utilized by health educators to increase health awareness to a variety of priority populations and communities
(T/F) A logic model displays the connections between resources, activities and outcomes, so it cannot be used to explain, track and monitor operations, processes and functions during the course of implementation.
false
T/F - A logic model needs to convey what is meaningful and understandable to its users. In general, a logic model used for communication purpose is more detailed than one used for implementation or evaluation purposes.
false
T/F - a health related intervention will be most effective in improving population health when it targets a specific determinant of health
false
T/F - although a logic model offers the rationale of why a program is likely to succeed, it cannot help program designers discover any gaps in their reasoning or places where their assumptions might be off-track
false
T/F - if the information on a community or target population is unavailable/insufficient in existing data sources, it should not be collected directly from the community stakeholders
false
T/F - the nature of vulnerability among vulnerable populations in health care system is due to a single explanatory factor for the most part
false
T/F - the objectives of a program should be flexible, adaptive, and dynamic over the course of implementing the program
false
T/F - the starting point for establishing a logic model is to estimate how long it will take an existing problem of a community to be solved
false
T/F - "Prevention" is key in managing population health. CDC's 618 initiative conceptualizes types of prevention into three "buckets" based on how many prevention activities are provided.
false *based on where the prevention occurs
T/F - "Participants" in a program refer to those who will receive services offered by the program specifically
false *participation - who we reach - participants, clients, agencies, customers, decision-makers
backbone of public health system
federal agencies, state agencies, local agencies
mission of public health
fulfilling society's interest in assuring conditions in which people can be healthy and the substance of public health as organized community efforts aimed at the prevention of disease and the promotion of health
steps of community needs assessment
identify and engage stakeholders -> define the community -> collect and analyze data -> select priority community health issues -> document and communicate results -> plan improvement strategies -> implement improvement plans -> evaluate progress
types of preventive intervention (CDC 618 initiative)
(3 buckets) -traditional clinical prevention -innovative clinical preventive interventions -total population or community-wide intervention
essential functions wheel
(assessment) monitor health -> diagnose & investigate -> (policy development) inform, educate, empower -> mobilize community partnerships ->develop policies -> (assurance) enforce laws -> link to/provide care ->assure competent workforce -> evaluate
logic model key components
*inputs (what is invested) *outputs (what is done) *outcomes, impact (what results)
type of MedWatch ADE report
-serious ADE - fatal, life-threatening, disabling, initial/prolonged hospitalization, etc. -non-serious ADE
reporting med errors
-FDA Center for Drug Evaluation and Research (CDER) -MedWatch
logic model
-a simplified picture or graphic presentation of a program, initiative, or intervention that is response to a given situation -shows the logic relationship among the resources that are invested, the activities that take place, and the benefits or changes that result -portrays the underlying rationale of the program or initiative -is the core of the program planning, program evaluation, program management, and communication
benefits of a logic model
-develops understanding -helps expose assumptions -helps monitor progress -helps restrain over-promising -facilitates project reporting -promotes communication -serves as an evaluation framework
criteria for MUP
-disparities in health status -inability to pay/lack of affordability -barriers to access -unavailable primary care providers
why pharmacists care about public health
-duty and obligation for reporting -help individual patients with health services they need -help improve the legal, financial, and social environment that you work in
variables used for defining a community
-geographic location or setting -demographics -socioeconomic status -sexual orientation -disease state or disability status -religion
vulnerable populations
-have high risk for health care problems -face significant hardships (financial, educational, and housing) -have a limited ability to understand or give informed consent without the assistance of language services (children, patients with dementia) -lack the skills to communicate effectively in English
How do you prioritize community needs?
-identify needs from data you collected -set up criteria for prioritization -choose prioritized needs and justify your choices
expanded simple logic model
-inputs: program investments -outputs: activities (what we do), participation (who we reach) -outcomes, impacts: short-term, medium term, long-term
opportunities for pharmacists to impact MUP
-interprofessional collaborations -patient care and education -improve patient's access to healthcare providers -scientific research, policy, and advocacy
MUP and healthcare system
-none of limited health coverage -limited access to providers -reduced system's culture competency -reduced quality of care
common causes of med errors
-poor communication -ambiguities in product names, directions for use, medical abbreviations or writing -poor procedures or techniques -patient misuse because of poor understanding of the directions for use of the product
logic model - inputs
-resources that go into program -what you need to deliver the program - money, knowledge, training, time, personnel, equipment
public health data sources
-surveillance systems -population-based sources: censuses, vital registration systems, household surveys -institution-based sources: resource records (number of hospitals), service records (number of immunization provided), individual records (hospital charts)
core functions of public health
-system - assessment (knowing what needs to be done), policy development (being part of the solution), assurance (making sure it happens) - community -family/individual
logic model - outputs
-the activities the program undertakes and/or the products the program creates -the activities and/or products that reach target participants/populations -outputs lead to outcomes
logic model - outcomes
-the changes or benefits for individuals, families, groups, business, organizations, and communities -outcomes occur along a path from short-term achievements to longer-term achievements (impact) -outcomes help us answer the question of "what differences are we making?"
HHS Action Plan to reduce MUP
-transform healthcare -strengthen the nation's health and human services infrastructure and workforce -advance health, safety, and well-being of the American people -advance scientific knowledge and innovation -increase efficiency, transparency, and accountability of HHS programs
standards for effective evaluation
-utility - serve the info needs of intended users -feasibility - be realistic, prudent, diplomatic and frugal -propriety - behave legally, ethically, and with due regard for the welfare of those involved and those affected -accuracy - reveal and convey technically accurate information
T/F - The fundamental difference between outputs and outcomes is that outcomes refer to "what difference is being made by what we do"
true
definition of community
a group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings
Which of the following statements regarding inputs, outputs, and outcomes of a logic model is INCORRECT? a. "What we do" belongs to "outputs" b. "Who we reach" belongs to "outcomes" c. "What we invest" belongs to "inputs"
b. "who we reach" belongs to outcomes **participants/outputs
There are three core elements in the basic form of a logic model. Which of the following presents those elements in the right order? a. inputs, outputs, outcomes b. inputs, outcomes, outputs c. outputs, outcomes, inputs d. outcome, outputs, inputs
a. inputs, outputs, outcomes
Which of the following statements regarding success of a health & wellness initiative is INCORRECT? a. keep its objective(s) general b. it can pack many health messages, but it is important to keep the messages simple c. know your audience d. align health messages with the initiative
a. keep its objective(s) general
Adverse Drug Events (ADE)
an injury resulting from medical intervention related to a drug. this includes med errors, ADRs, allergic reactions, and overdoses. -can happen anywhere - in hospitals, long-term care settings, and outpatient settings
medication error
any preventable event that may cause or lead to inappropriate medication use or patient harm while the med is in the control of the health care professional, patient or consumer
medically underserved areas and populations
areas or populations designated by HRSA as having too few primary care providers, high infant mortality, high poverty of a high elderly population
logic model - external factors
aspects external to the program that influence the way the program operates and are influenced by the program
Which of the following interventions extends care from the clinical setting to the community according to CDC's 618 initiative? a. total population or community-wide intervention b. an innovative clinical preventive intervention c. a traditional clinical intervention
b. an innovative clinical preventive intervention
Which of the following statements in the context of logic model is INCORRECT? a. "program" means an educational program consisting a series of organized learning activities and resources aiming to help people make improvements in their lives b. "quantitative data" are data in a narrative or text format c. "Performance measurement" is the ongoing monitoring and reporting of accomplishments, particularly progress towards pre-established goals d. "inputs" refer to resources that go into a program including staff time, materials, money, equipment, facilities, volunteer time
b. quantitative data are data in a narrative or text format
Other than inputs, outputs, and outcomes, a complete logic model includes additional 3 components. Which of the following is NOT among those 3 components? a. situation b. assumptions c. internal factors d. external factors
c. internal factors
Which of the descriptions about "outcomes" in program evaluation is CORRECT? a. outcomes cannot be unintended b. outcomes fall into two categories from immediate (initial; short-term) to intermediate (medium-term) outcomes c.outcomes are often synonymous with "impacts"
c. outcomes are often synonymous with "impacts"
Frieden's "Health Impact Pyramid" suggests that interventions may have a greater impact on population health if the interventions address (or the interventions are): a. long-lasting protective interventions b. counseling and education c. socioeconomic factors d. clinical interventions
c. socioeconomic factors
An intervention can be strategically designed to address priority needs of a target population at different levels. Which of the following levels of intervention addresses issues at the individual level instead of population level? a. primary b. secondary c. tertiary
c. tertiary
Which of the following is NOT considered as part of "outputs" in a logic model? a. workshops b. providing counseling c. customers or clients d. changing behavior e. training
d. changing behavior
Many strategies can be used to design an intervention that can address prioritized needs of a target population effectively. Which of the following is NOT a "strategic question to consider" usually? a. what has been successful in the past? b. what is feasible to be implemented in our situation and circumstances? c. what does the research suggest is most effective? d. how far is the place the intervention will be held?
d. how far is the place the intervention will be held?
FDA Adverse Event Reporting System (FAERS)
database that contains information on adverse event and med error reports submitted to FDA
public health approach
define the problem -> identify risk and protective factors -> develop and test prevention strategies -> assure widespread adoption
Health Professional Shortage Areas (HPSAs)
designated by HRSA as having shortages of primary medical care, dental or mental health providers and may be geographic (county of service area), population or facilities
social determinants of health
economic stability, neighborhood and physical environment, education, food, community and social context, health care system
framework for program evaluation in public health (CDC)
engage stakeholders -> describe the program ->focus evaluation design -> gather credible evidence -> justify conclusions ->ensure use and share lessons -> repeat
patient safety in pharmacy
medication errors, drug-drug interactions, ADEs, physical harm (substances, equipment), environmental safety (clean work place, lighting, etc.)
pharmacist role in medication use system
prescribing -> transcribing -> dispensing -> administering -> monitoring
public health vs population health
public health - general populations; disease prevention, health promotion; environment, human behavior and lifestyle, and medical care; focus on the health of communities population health - certain populations; measurement of health outcomes and patterns of determinants; environment, human behavior and lifestyle, and medical care; focus on integrate healthcare systems, agencies and organizations to improve health outcomes of communities
public health vs medicine
public health - populations; disease prevention, health promotion; environment, human behavior and lifestyle, and medical care; integrated with social and public policy disciplines medicine - individuals; disease diagnosis, treatment, and care; medical care; adjunct with social sciences
logic model - assumptions
the beliefs or ideas about the problem or situation; the way the program with operate; what the program expects to achieve; how the participants learn and behave; the resources and staff, the knowledge base, etc.
logic model - situation
the originating problem, or issue
determinants of health
the range of personal, social, economic, and environmental factors that influence health status
(T/F) A logic model is not an evaluation model per se but does help in evaluation, because it helps determine when and what to evaluate so that evaluation resources are used effectively and efficiently.
true
(T/F) Planning a course of action, such as managing a program or charting a course of policy, generally implies some sort of logic model.
true
T/F - In a logic model, lines and directional arrows are used to depict the linkages between inputs, outputs, and outcomes. They represent a "theory of action."
true
T/F - In the context of program evaluation, a logic model is a graphic representation (and a way of thinking) of a program showing the intended relationships between investments and results.
true
T/F - Some interventions may be promising but do not yet have a body of data to qualify them as "evidence-based." This does not mean that such interventions may not be beneficial. By implementing similar interventions in your community and measuring their success, you could contribute to building that evidence base.
true
T/F - When running programs (or interventions), logic models help us plan, implement, evaluate, and communicate more effectively. Before developing a logic model, one should have already engaged in strategic planning and/or spent time understanding the situation and setting priorities.
true
T/F - When your logic model shows that the outcomes you want don't connect to the activities that you are doing, it means that you either need to change your activities to achieve the outcomes you want, or change the expected outcomes to relate better to the activities you are doing.
true
T/F - a logic model is a visual tool that provides descriptions of what a program aims to achieve and how it is expected to work
true
T/F - a successful program should have detailed activities specified before the implementation, and the activities must be maintained without alteration to ensure program effectiveness
true
T/F - after prioritizing needs of a target population or community, a program should be developed with specific changes the program anticipates to achieve in mind
true
T/F - all resources needed to deliver a program, such as trained staff, implementation guides, curricula, expertise, clear roles and responsibilities, funding, permission to implement, are considered as "inputs" in a logic model
true
T/F - an evaluation plan for a program that is to be implemented requires "anticipated outcomes" as one of the essential components in order to assess whether the program achieves its goals
true
T/F - in a logic model, the outcome measures should match the objectives and goals of the program of interest
true
T/F - in order to prioritize health needs of a community or target population, a set of criteria should be determined to guide the prioritization process
true
T/F - individual behavior, access to health services, and state level policy are all being considered as part of determinants of health by Healthy People 2020
true
T/F - there are multiple implementation strategies you can take to address the identified priority needs, but the overarching dichotomy is between a practice (a way of doing things) and an intervention (a program or an initiative)
true
T/F - to make an impact at the population level, the strategy of an intervention should get at the root of the identified need.
true
T/F - vulnerability status of the population should be examined as a multi-dimensional concept - that is, attributes of vulnerability come from both individual and community level risks
true
T/F: it is common that both geographic boundary and population characteristics can be used to define a "community"
true
