Program Development Midterm

Program Development Process

1. Assessment

2. Planning

3. Implementation

4. Evaluation

5. Sustainability

Assessment:

define population, needs, context

Planning:

develop goals, objectives, partnerships and resources

Implementation

deliver interventions, while monitoring fidelity and reach

Evaluation

measure outcomes and identify areas for improvement

Sustainability

Secure funding, policy alignment, and capacity to maintain impact

Program Planning cycle:

continuous, with each phase guiding the next. Ongoing evaluation helps improve the program and ensures it continues to meet changing community needs and healthcare trends.

Program Planning cycle steps

Assessment, Planning, Implementation, Evaluation, Sustainability and Dissemination

Social Determinants of Health (SDOH)

economic stability, education, healthcare access, neighborhood/built environment, and social/community context—directly affect whether people can engage in meaningful occupations.

Why should OTs should consider social determinants of health (SDOH) when developing programs?

Addressing barriers like transportation and finances helps create programs that are more accessible, effective, and equitable for everyone.

Economic stability:

income, employment, and housing security shape access to daily occupations.  

Eample - a family living with housing insecurity may struggle to maintain routines that support children’s school participation.

Education access and quality:

: Literacy levels, early education, and vocational training opportunities impact participation across the lifespan

Ex - limited literacy can affect medication management and job performance

Healthcare Access and Quality:

Insurance coverage, availability of providers, and culturally competent care influence whether people have access to the services they need

Neighborhood and built environment:

Safety, transportation, housing quality, and access to green spaces affect opportunities for recreation, work, and community engagement

Social context and community context:

Relationships, discrimination, and civic participation influence occupational choices, sense of belonging, and resilience

Logic model

: a visual tool that shows how a program's resources, activities, and outcomes are connected.

It explains how the program is expected to achieve its goals and helps with planning, accountability, and measuring results.

Parts of Logic Model Inputs

 (resources)

The people, funding, materials, and partnerships that make a program possible

Example: An OT, support staff, and grant funding for a falls prevention program. 

Parts of Logic Model Activities

The interventions or services the program delivers

Parts of Logic Model Outputs

(immediate products)

the direct countable results of an activity

Example: 50 older adults attend balance workshops; 20 homes receive safety modifications.

Parts of Logic Model Outcomes

(changes over time)

The effects of the program.

3 categories

Short term:gains in skills, awareness, knowledge

Immediate: Behavior change or adoption of new strategies

Long term: Broad improvements in health, participation, or systems

PRECEDE:(steps 1-5)

everything you do before a program begins. It helps you understand why a problem exists and what factors influence it.

PRECEDE-PROCEED Model 

1. 1. Social diagnosis:

Analysis of social problems that exist in a community

PRECEDE-PROCEED Model 

2. Epidemiological, behavioral, and environmental assessment:

Look at data to identify health or pariticpation problems

identifying which specific health, behavioral, and environmental factors are contributing to the quality-of-life issues prioritized in Phase 1

PRECEDE-PROCEED Model

3.  Educational and Ecological Assessment:

What are the predisposing factors, reinforcing factors, and enabling factors influencing the health behavior?

PRECEDE-PROCEED Model

4. Administrative and Policy Assessment and intervention Alignment:

What are the implications of the budget, resources available, policies and regulations in place, and other barriers to change.

PRECEDE-PROCEED Model

5. 5. Implementation of program

Launch your program and deliver interventions.

PROCEED (steps 6-9):

guides you through doing the program and checking if it works.

PRECEDE-PROCEED Model

6. Evaluation of Process:

Are you actually doing the things you planned to do?

PRECEDE-PROCEED Model

7. Evaluation of Impact:

Is the intervention having the desired impact on the target population?

PRECEDE-PROCEED Model

8. Evaluation of Outcomes:

Is the intervention leading to the outcome (the desired result) that was envisioned in Phase 1?

Create/Promote:

Develop opportunities and enrich enviroments to enhance participation for communities and populations

Ex - Campus wide stress management workshops

focuses on universal well-being and prevention before impairment occurs. 

Establish/Restore:

Build or restore skills, habits, or functions for individuals or groups with performance deficits

Ex - Hand function training post stroke 

begins when a disruption or loss in occupational performance has already occurred. 

Steps of Program Implementation

1. Translate the program design and logic model into an actionable plan

2. Use structured frameworks such as PRECEDE-PROCEED and RE-AIM

3. Begin with a pilot or phased rollout

4. Conduct readiness assessments before launch

Translate the program design and logic model into an actionable plan:

Create a step-by-step plan based on your logic model.

Assign specific tasks, make sure each task supports the program goals, and use measurable outcomes to track progress and keep everyone accountable.

 Use structured frameworks such as PRECEDE–PROCEED and RE-AIM:

PRECEDE-PROCEED and RE-AIM are evidence-based frameworks that help plan, implement, evaluate, and improve programs using data and dmeasurable outcomes.

Begin with a pilot or phased rollout:

Test the program with a small group first to find problems, gather feedback, and make improvements before expanding to a larger population.

Conduct readiness assessments before launch:

Make sure the staff, partners, and facilities have the people, skills, time, and resources needed to successfully run the program

Types of Evaluation

Formatiive

Process

Outcome

Impact

Formative:

is done before a program begins to identify problems, gather feedback, and improve the program before full implementation.

Process:

checks whether the program is being delivered as planned, if it is reaching the target population, and identifies any problems that need to be fixed.

Outcome:

measures the program's long-term success by determining whether it improved health, participation, or quality of life over time.

Impact:

measures the program's short-term effects by determining whether participants' knowledge, attitudes, or behaviors have improved.

Continuous Quality Improvement (CQI):

allows occupational therapists to use data as a guide for ongoing program refinement.

Rather than viewing evaluation as the final step, CQI reframes it as an ongoing cycle.

Involves evaluation, re-evaluation, adjustment, reflection

CQI

Track - Focus on 2–3 core measures that reflect program goals (e.g., participation rates, satisfaction scores, functional outcomes). Don’t collect data you won’t use.

Ask for stories not just numbers - Combine surveys with brief open-ended questions or interviews. Participants’ stories often reveal barriers or strengths that data alone can’t show.

Review, Revise, Reflect - Hold short monthly reflection meetings to identify one improvement to test; small, frequent changes build lasting quality.

Close the feedback loop - Always communicate results back to participants or partners (“You said”, “We did”). Transparency builds trust and engagement.

CQI Evaluation:

Collecting outcome and quality data to determine how well the program is achieving its intended goals.

CQI Re-evaluation:

Reassessing outcomes to determine whether revisions led to meaningful improvement

CQI Adjustment:

Making intentional, data-informed changes to program structure, dosage, or processes

CQI Reflection:

Interpreting patterns, trends, and implementation factors that influence program performance.

What do sustainable prevention programs rely on?

Intentional planning rather than temporary funding alone

Occupational therapists enhance sustainability by:

• Embedding programs into existing services

• Demonstrating value through outcome and participation data

• Building partnerships with stakeholders and community organizations

• Scaling programs gradually rather than expanding prematurely

Sustainability planning ensures....

that preventive services remain available beyond initial funding periods.

Needs identification

Recognizing gaps in health, wellness, or participation through data, observation, and community input.

Theoretical grounding

Using occupational science, practice models, and evidence-based approaches to ensure research-informed programs.

Stakeholder engagement

Involving clients, families, community members, and partners to ensure collaborative and sustainable programs.

Innovation and responsiveness

Staying attentive to healthcare trends, policy shifts, and payment models to ensure service viability.

SBAR Communication: (situation, background, assessment, recommendation):

A communication tool that ensures clarity, brevity, and precision, presents ideas in a structured, decision-ready format for program creation

Situation:

State the current issue that requires attention

Background:

Provide relevant evidence

Assessment:

Analyze why it matters and what it means

Recommendation:

Propose a solution or next step

Benefits of Using SBAR in OT Program Development

Organizes needs assessment data into a clear, structured format.

Improves credibility when communicating with administrators and stakeholders.

Supports concise, effective advocacy when time is limited.

Strengthens interprofessional communication by using a

standardized format recognized across healthcare disciplines.

Program fidelity

Executive Summary:

1-2 page overview of a program proposal that highlights its purpose, rationale, and expected impact.

It allows busy administrators, funders, and policymakers to quickly understand the program without reading the full proposal.

What is the purpose of an executive summary?

Translate a detailed program plan into a concise, decision-ready overview.

communicate a program's goals, outcomes, and value effectively to administrators and other decision-makers who approve funding and resources.

Executive Summary includes:

Problem statement

Supporting evidence

Proposed Program

Anticipated outcomes

Request for support

Executive Summary

Problem statement Q

What issue or gap is the program designed to address?

Executive Summary

Supporting evidence Q

What data, needs assessment, or contextual information support this issue?

Executive Summary

Proposed Program Q

What is the intervention or service model you are recommending?

Executive Summary

Anticipated outcomes Q

What short-term and long-term benefits are expected for the target population?

Executive Summary

Request for support Q

What resources, funding, or partnerships are needed to move forward?

Elevator pitch

30-60 second verbal summary of a program idea designed to quickly capture the interest of administrators, funders, or community partners.

It clearly explains the problem, the proposed solution, and the program's value, encouraging the listener to learn more.

Elevator pitch includes:

Hook

Problem

Solution

Impact

Elevator pitch

Hook:

Start with a powerful statement or fact that grabs attention

Elevator pitch

Problem

Identify the key issue or need

Elevator pitch

Solution:

Present the OT program or service you are proposing

Elevator pitch

Impact:

Explain the positive outcomes or benefits

Budgets and Proposals:

show how the program will be carried out and supported

Budget:

outlines the costs and resources needed to run a program, including staffing, equipment, supplies, training, and evaluation.

A brief proposal states the total funding requested, while a full proposal provides a detailed breakdown of how the funds will be used

Proposal

is a comprehensive plan that includes the needs assessment, goals, logic model, timeline, evaluation plan, and budget.

Unlike an SBAR, executive summary, or elevator pitch, the proposal provides the detailed information that leaders and funders use to make final funding and approval decisions.

Program fidelity

means delivering the program as it was designed while making only necessary changes for the client or setting.

Keep the core parts the same (goals, strategies, outcomes) but adapt flexible parts like session time, format, or environment.

Purpose of Program Evaluation

Assess effectiveness: determines if program is meeting goals such as improving participation, reducing risk factors, enhancing quality of life

Guides decision making: Evaluate findings, inform program adjustments, resource allocation, and sustainablity strategies 

Support advocacy and accountability: Showing measurable outcomes helps occupational therapists demonstrate the program's value and gain support from funders, policymakers, and the public.

RE-AIM Framework:

Use this when your program is being implemented in multiple sites or when measuring community reach and long-term adoption is key.

Reach

Effectiveness

Adoption

Implementation

Maintenance

Plan-Do-Study-Act Cycle

quick tool to test small changes based on real time feedback, use this when you need to pilot, adjust, or continuously improve your program during active implementation

Program Expenses

Fixed Costs

Variable Costs

Direct Costs

Indirect Costs

Fixed Costs:

Expenses that stay the same regardless of how many people participate (e.g., rent, salaries, insurance).

Variable Costs:

Expenses that change based on the number of participants or services provided (e.g., supplies, snacks, printing materials).

Direct Costs:

Expenses directly related to delivering the program (e.g., therapist salaries, treatment materials, equipment).

Indirect Costs:

Expenses that support the program but are not directly tied to service delivery (e.g., administrative staff, utilities, office space, accounting services).