Planning
budget categories
personnel: percentage of FTE (.5 fte=half time) travel equipment supplies (hard to itemize, office supplies) communication printing and duplication consultants miscellaneous/other
SMART objective
Specific Measurable Achievable/attainable Relevant/realistic Time-bound
ethical principles for research
-no harm -beneficence -autonomy -justice -fidelity
ethical principles
-produce benefits -prevent harms -distributive justice -procedural justice, transparency -autonomy -universal human rights -confidentiality -protecting subgroups -trust
Integrated Planning and Evaluation Model
1) Assessment (P-P phase 1: social and phase 2: epi) 2) Identification of Determinants and Precursors (P-P phase 3: behavioral and environmental assessment; and phase 4: educational and ecological assessment) 3) Intervention Selection and Development (P-P phase 5: administrative and policy assessment) 4) Implementation (P-P phase 6: implementation) 5) Monitoring and Evaluation (P-P phases 7-9)
evidence-based
a program is judged to be evidence-based if evaluation research shows (usually) positive results; the evaluation is peer-reviewed; results can be attributed to the program; the program is endorsed by a federal agency or respected research organization
predisposing
antecedents to behavioral change 3 types: cognitive, emotional, and demographic factors that make a person more likely to adopt or change a behavior ex: knowledge, attitudes, skills, efficacy; these are the focus of many individually-based theoretical constructs (TPB, TTM, HBM) and can often be influenced by education and communication
enabling
antecedents to behavioral or environmental change these are conditions of the environment that facilitate the performance of an action by individuals or organizations examples: availability/accessibility of resources, transportation, policies, skills that can be developed these can be influenced by community organization, capacity-building interventions
impact evaluation
assesses change in PRE factors and determinants
criteria for data used
available/accessible; valid; consistent (methods unchanged over time); periodic collection; sensitive (can detect change over time)
changeability
behavioral determinants are more changeable when: -still in developmental stages -not deeply rooted in culture -changeable by social action and/or policy -documented evidence of changeability -compelling theory for changeability environmental: -interactive with behavior -changeably by social action and/or policy -documented evidence of changeability -compelling theory for changeability -public and/or political support
capacity assessment
capacity may include: -readiness -resources/strengths -other dimensions -competence at the individual, organizational, or community levels
outcomes
changes resulting from the program (short-term) changes in... awareness, knowledge, attitudes, perceptions, behavioral intentions, skills, etc. (medium-term) changes in... behavior, decision-making, policies, social action (long-term) changes in...conditions, social (well-being), health status, economic, environmental
outcome evaluation
design an "optimal" rather than "ideal" evaluation, considering many factors: -prioritized questions -stakeholder priorities -ethical considerations -available resources -size of project -number of participants -capacity
epi assessment
determine the importance of the health/social issue; describe the distribution of the issue; helps to determine the magnitude and distribution of the problem, and provide rationale for program priorities measures occurrence (mortality, morbidity, incidence, prevalence) measures impact: YPLL, DALY, QALY, YLD, death
outcome evaluation
determines effet on health and QOL indicators
social assessment
determines people's perceptions of their needs and quality of life; considers resources, capacity, and readiness to change find common ground between community's perceived needs, actual needs, and resources -identify stakeholders -assess quality of life and sociocultural concerns -document needs -decide on priorities and targets -assess resources available
conceptual model
diagram of proposed causal linkages and relationships between concepts related to a particular health problem can be used to guide the development of an intervention each proposed relationship must have a good reason for being in the model (data or a hypothesis); only show the relationships that will be tested does not have to include all variables but helps organize determinants and precursors
prioritization
different strategies for prioritization multi-voting technique strategy grids nominal group technique Hanlon method Prioritization matrix
outputs
direct results/products of program activities # of participants, clients served, materials produced, clinics adopting, materials distributed, people attending meetings, patients enrolled, coalitions formed, curricula developed, policies created/adopted, database established
activities
events or actions undertaken as part of the program develop, train, teach, deliver serves, develop products, network with others, build partnerships, assess, facilitate, launch, work with the media
risk factors
factors that increase the likelihood of a negative outcome
promotive factors
factors that increase the likelihood of a positive outcome
protective factors
factors that insulate individuals or groups from negative influences
process evaluation
focuses on the extent to which an intervention reached the intended participants and is carried out as planned (fidelity)
reinforcing
follow a behavior (change) and provide incentive for maintenance or repetition of the change positive or negative feedback of behavior or environmental change; examples: social support, peer approval, rewards and punishment
goal vs objective
goal: broad statement of what will change and who will be affected objective: identifies how much of a program's goal(s) will be achieved in concrete, measurable terms who will change by how much, by when, and how will it be measured; should be SMART; indicators are measures to show the results of your program
prioritization matrix
good for when health problems are considered against a large number of criteria or when an agency is restarted to focusing on only one issue 1) create a matrix by listing all issues down the y axis and all the criteria across the x axis 2) rate each health issue against each criterion 3) weight the criteria 4) calculate priority scores
behavioral and environmental assessment
identification of determinants (IPEM) systematic analysis of factors in the immediate social/physical environment that could be linked to the behavior or directly related to the outcomes 1) create an inventory of environmental factors 2) rate the importance 3) rate the changeability 4) prioritize environmental targets based on importance and changeability 5) develop objectives
causal factors
identified in P-P phase 4, Ecological and Educational Assessment predisposing, enabling, and reinforcing
prioritizing precursors
importance: consider prevalence, immediacy (how urgent? proximity to behavioral or environmental determinant) and necessity changeability: consider results of previous attempts; hierarchy of changeability (knowledge, beliefs, skills)
matching, mapping, pooling, and patching
in administrative and policy assessment phase -match the ecological levels to program components -map specific interventions based on theory and prior research to specific PRE factors -pool prior interventions and community-preferred interventions that might have less evidence to support them -patch those interventions to fill gaps in evidence-based best practices
indicators
measures used to demonstrate change in a situation, or progress of a program secondary or primary data should be valid, reliable, precise, and relevant
PRECEDE-PROCEED
population-based and ecological approach to planning Predisposing, Reinforcing, and Enabling Constructs in Educational/environmental Diagnosis and Evaluation (PRECEDE) Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (PROCEED) 9 phases: 1) social assessment 2) epi assessment 3) behavioral and environmental assessment 4) educational and ecological assessment 5) administrative and policy assessment 6) implementation 7) process evaluation 8) impact evaluation 9) outcome evaluation
unintended consequences
program may: -exacerbate the problem -identify another problem -raise people's expectations -create turf battles -displace problems rather than solve them -have a spillover effet -have positive contagion to non-participants
intervention selection
program should align with stakeholder goals, identified determinants/precursors, and appropriate SEF levels program should be efficient, effective, feasible, and ethical look through systematic reviews or EBI registries to find interventions if there are no interventions, develop your own using theory, prevention principles, and EBIs with similar populations and issues
pros and cons about EBIs
pros: -internal validity -cost effective (rather than having to create a new one) -can increase buy-in from stakeholders (often face resistance from stakeholders in trying something new) -shown to be effective in populations studied cons: -may not be generalizable -they are effective under well-funded controlled conditions -it is assumed they were implemented with fidelity
inputs
resources (new and existing) that go into a program staff, volunteers, time, money, research base, materials, equipment, technology, partners
needs assessment
review of health and social issues facing a population social, epi, capacity, and strengths/assets
strategy grid
shifts emphasis towards addressing problems that will yield the greatest results; particularly useful when agencies are limited in capacity and want to focus on areas to have the greatest impact 1) select criteria; pick 2 broad criteria (e.g, importance, need, feasibility, impact, cost 2) create a grid with 4 quadrants 3) label the quadrants 4) categorize the competing projects or activities into the boxes and prioritize which quadrant to choose (e.g., high need and high feasibility)
common criteria for prioritizing health issues
size (# of people affected) seriousness (degree to which it leads to death, disability, and impaired QOL) trends equity feasibility value (importance to community) consequences of inaction (risks associated with exacerbation of problem) social determinant/root cause (whether or not a problem is a root cause that impact more than one health issue)
logic model
systematic presentation of: -resources you plan to invest -activities you plan to implement -products you plan to create -short and long-term changes or results you hope to achieve identifies critical elements in a program; makes explicit the assumptions underlying an intervention -guides the evaluation -helps match evaluation to the program -helps us know what and when to measure inputs (process eval) activities (process eval) outputs (process and outcome) short-term outcomes (outcome) long-term outcomes (outcome)
precursors
the causal factors factors of highest priority behavioral and environmental determinants that 1) are necessary to initiate, facilitate, and sustain change; and 2) become the immediate targets of a program/intervention find these in literature and theory
program sustainability
think about how to maintain benefits; institutionalize a program within an organization, capacity building in the community 8 sustainability domains: -funding stability -political support -partnerships -program adaptation -program evaluation -communications -public health impacts -strategic planning
multi-voting technique
used when narrowing down a long list of health problems to a top few Round 1: each participant votes for their highest priority items 2: update list, and participants can vote a number of times equal to half the number of health problems on the list 3: continue until narrowed down
