Lecture 3: Community Engaged Program Planning, Community Partnerships, & Program Evaluation

1. assessment --> data collection

2. diagnosis --> identifying strengths & problems

3. planning --> program development

4. implementation

5. evaluation - program outcomes

what are the steps in the nursing care management process for population health nursing?

community program planning

the process that helps communities understand how to move from where they are to where they would like to be

health program planning

a multistep process that generally begins with the definition of the problem and development of an evaluation plan; findings from program evaluation being used for program improvement

improve aggregate health

what do health program planning models aim to do?

1. PRECEDE-PROCEED model

2. logic model

3. CHANGE

what are various models that are considered health program planning models?

PRECEDE-PROCEED model

health program planning model that gives insight into how to develop an educational program that will positively change health behavior

logic model

health program planning model that provides the underlying theory that drives program design; guides a team in the careful planning of a well-thought-out program; moves like a chain of reasoning from the planned work to the intended results in five steps

1. resources

2. activities

3. outputs

4. outcomes

5. impact

what are the 5 components of the logic model?

community capacity

refers to the ability of community members to work together to organize their assets and resources to improve the health of the community

community organizing

involves bringing people together to get things done and helping people to act jointly in the best interest of their community

social justice

idea that emphasizes how everyone should have access to basic health services, economic security, adequate housing and food, education, and a lack of discrimination

data collection

what occurs during the assessment step of the nursing care management process for population health nursing?

community diagnosis

a summary statement resulting from the community assessment and the analysis of the data collected

-existing, emerging, & potential health threats

-strengths or competencies

what should a community diagnosis reflect?

1. potential/adverse situation or "readiness" (problem)

2. the population

3. what problem is related to (characteristics of population)

4. how problem is demonstrated

what are the 4 components of a community diagnosis?

1. risk of (specific problem in community)

2. among (specific group or population)

3. related to (strengths and weaknesses in community)

4. as evidenced by (data supporting risk)

what is included in the community diagnosis format related to each component of the diagnosis?

develop measurable process and outcome objectives to assess progress

what is involved in the planning step of the nursing care management process for population health nursing?

1. involvement of community = partner

2. skill & time to do an assessment

3. shared conclusions w/ partners of needed interventions

4. program planning, interventions, & evaluation

what are the 4 important, key components of health program planning?

1. identify primary health issues in community

2. develop process & outcome objectives

3. select effective interventions

4. implement interventions

5. evaluate interventions

what are the steps to health program planning?

1. magnitude of problem

2. seriousness of consequences

3. feasibility of correcting problem

what should be considered in problem prioritization?

-need community awareness of problem

-need community motivation to solve problem

what is the relationship between problem prioritization and community involvement?

-availability of expertise

-speed problem can be resolved

-nurse's/team's ability to influence problem solution

what are some characteristics that play a role in the effectiveness of problem prioritization?

goals

broad statements of desired outcomes

objectives

precise statements indicating the means of achieving desired outcomes

1. process objectives

2. outcome objectives

what are the 2 types of objectives?

process objectives

type of objective that includes steps in the process to achieve goals; short-term, detailed objectives you set to reach the desired action

outcome objectives

type of objective that includes steps in the outcomes to achieve goal; long-term, specific, overarching objectives

-process: by January 2014, identify and hire 3 community health workers

-outcome: by January 2015, increase percentage of population with BP at or below 120/80

what is an example of a process objective vs an outcome objective?

SMART format --> specific, measurable, achievable, realistic, time sensitive

what format should objectives be in?

interventions

actions the public health nurses take on behalf of individuals, families, systems, and communities to improve or protect health status

diagnoses, goals, & objectives

interventions that are chosen to help meet objectives should be directly linked to what?

supported by current literature on interventions that work (EBP)

what should interventions be supported by if they are being used in health program planning?

1. primary

2. secondary

3. tertiary

what are the 3 levels of prevention?

primary prevention

level of prevention that involves interventions conducted to prevent development of disease or injury in those who are currently healthy; happens before disease has developed

-proper hand washing

-vaccinations

-alter environment to prevent falls

-teaching patients to ↑ exercise

what are some examples of primary prevention?

secondary prevention

level of prevention that involves interventions aimed at early detection and initiation of treatment for disease, thus reducing disease-associated morbidity and mortality

-teaching a kid how to use an epi pen

-screenings (ex: mammograms, colonoscopies)

-pre-diabetes interventions

what are some examples of secondary prevention?

tertiary prevention

level of prevention that involves the prevention of disability and premature death and, when indicated, the initiation of rehabilitation for those diagnosed with disease

-rehabilitation

-regular foot care & blood sugar monitoring in patients with diabetes

what are some examples of tertiary prevention?

public health nursing interventions wheel

model that illustrates how public health nurses can improve the health of the individuals, families, communities, and systems

1. determine intervention focus (target audience)

2. determine prevention level (primary, secondary, tertiary)

3. validate practicality of planned intervention

before choosing an intervention, what should be done?

-may be short or long term

-has 5 stages

what are some characteristics of the "implementation" step of the nursing care management process for population health nursing?

1. community accepts program

2. specify tasks & estimate needed resources

3. develop specific plans

4. establish mechanism for program management

5. put plan in action

what are the 5 stages of program implementation?

program evaluation

the systematic collection of information about the activities, outputs, and outcomes to enhance a program and its effectiveness

-important final assessment

-starts w/ goals & objectives

-appraisal of effects of interventions

what are some basic characteristics of program evaluation?

1. formative evaluation

2. process evaluation

3. summative evaluation

what are the 3 types of program evaluation?

formative evaluation/process evaluation

type of program evaluation that occurs during the development of a program, while the activities are forming and being implemented for the first time; concerned with the delivery of the program and organizational context (structures and procedures)

formative/process evaluation = monitors process objectives

what is the relationship between formative evaluation/process evaluation and process objectives?

ongoing feedback on performance of the program

what does formative evaluation/process evaluation provide?

summative evaluation

type of program evaluation that occurs at the end of the program and is the evaluation of the objectives and the goal; judging the worth of the program at the end of the activities and discovering whether the program achieved the intended change

cost and cost-benefit

what does summative evaluation often consider?

summative evaluation = monitors outcome objectives

what is the relationship between summative evaluation and outcome objectives?