Public Health Planning Exam 3: Key Terms & Definitions

4 P's of marketing

Product

Price

Place

Promotion

What we're offering people for product

Commodity (Tangible good or service)

Idea

Attitude

Behavior

Service

Product Must Be

Solution to a problem

Unique

Cognizant of the competition

Deigned in terms of the user's beliefs, practices, and values

The cost of adopting the product (price)

Money

Time

Pleasure

Loss of self esteem

Embarrassment

Others

Place or Channels

Where tangible products are purchased

Where service is provided

Media aspect

Where people will act

Media aspect

Delivery of message

Frame of mind

Important Considerations for place

Available

Easy to find and use

Appropriate

Timely

Place where decisions are made

Healthcare settings

Family/friends

Advertising reminders

Promotion

Creation of educational messages that are memorable and persuasive

Message design elements for promotion

Type of appeal

Tone

Spokesperson

consumer orientation

Understand consumers' perceptions:

Benefits

Barriers

Self-efficacy

Social norms

Program Implementation Defined

the act of converting planning, goals, and objectives into action through administrative structure, management activities, policies, procedures, and regulations, and organizational actions of new programs

Setting up, managing, and executing a project

Program diffusion - adoption, implementation, sustainability

Efforts involved per phase of program development

Effort needed for needs assessment

about half

Effort needed for program development

little

effort needed for program implementation and process evaluation

a lot

effort needed for outcome evaluation

Most effort needed

effort needed for termination; impact evaluation

Least effort needed

Grant Chart

Program Evaluation and Review Technique

Pilot Testing

trying the program out with a small group from the priority population to identify any problems

Pilot Testing questions

1. Were strategies implemented as planned?

2. Did the intervention strategies work as planned?

3. Adequacy of resources

4. Evaluation of pilot activities

Phasing in

limiting the number of people who are exposed then gradually increasing the numbers.

Phasing in questions

1. Especially if there is a large target population

2. Can phase in by location, program offering, and number of participants.

Total Program

All in priority population exposed at the same time.

Pilot advantages

Opportunity to test program

Close control of program

Pilot disadvantages

Very few involved

Not meeting all needs

Hard to generalize about results

Phased-in advantages

easier to cope with workload

gradual investment

Phased-in Disadvantages

fewer people involved

Total program advantages

more people involved evaluation more meaningful with larger group

Total program disadvantages

big commitment

no chance to test program

Safety and Medical Concerns

Most programs are to improve health, thus do not put participants in danger.

Informed consent (waiver of liability or release of liability) do not protect planners from being sued

Medical clearance signed by a physician

Ensure safety & health

Ensure safety & health

Program Location; appropriate security

Building codes met and facilities free from any hazards

Qualified instructors

Plan in case of emergency

Informed Consent

Explain nature of program

Inform participants of risk and discomfort

Explain expected benefits

Inform of alternative programs

Indicate that they are free to discontinue participation at any time.

Allow participants to ask questions

Reducing liability

Key to avoiding liability

Aware of legal liabilities

Qualified instructors

Good judgement

Medical clearance

Limit work to expertise

Safe environment

Insurance

Negligence

Failing to act in a prudent (reasonable) manner

Omission

Commission

Purpose of the logic model

To determine if objectives were met

To improve program implementation

To provide accountability to stakeholders

To increase public support for initiatives

To contribute to the scientific base

To inform policy decision

Two critical purposes of program evaluation

assessing & improving implementation quality

determining program effectiveness

The logic model

A picture of your program: what you are putting into the program, what you are doing, and what you are trying to achieve

Clarifies the strategy underlying your program

Builds common understanding, especially about the relationship between actions and results

Communicates what your program is (and is not) about

Forms a basis for evaluation

Inputs

The inputs dedicated to our consumed by the program.

Can include non-physical investments, such as staff time

Activities

The actions that the program takes to achieve desired outcomes.

Each activity should begin with an action verb to demonstrate that it is something your organization is doing.

Outputs

The measurable product of a program's activates

Should be the direct, physical result of activities. Should be measurable and/or tangible

Outputs examples

Number of communications materials printed (posters, flyers)

Number of staff trained

Educational materials developed for target population

Outcomes

The benefits to clients, communities, systems, or organizations

Usually related to changes in knowledge, attitudes, beliefs, behaviors, or health outcomes of the populations of focus for the program. Should be measurable

Outcomes examples

Increased knowledge of the topic (short-term outcome)

Increased delivery of health care service (intermediate outcome)

Increased utilization of health care services (long-term outcome)

How logic models help with evaluation

Provides the program description that guides our evaluation process

Helps us match evaluation to the program

Helps us know what and when to measure

Are you interested in process and/or outcomes?

Helps us focus on key, important information

Prioritize: Where will we spend our limited evaluation resources?

What do we really need know?

Process Evaluation

Examines whether program activities are being implemented as intended

Impact/Outcome Evaluation

Measures program short term and long-term effects in the population.

Reason for process evaluation

when expected outcomes are not observed, process evaluation can suggest reason

when outcomes are positive, process evaluation may help understand which components are especially important

when an activity is newly implemented, and it is too early to expect changes in outcomes

when an outcome evaluation is not feasible due to resource constraints

5 common process evaluation measures

reach

quality of implementation

appropriateness

satisfaction

barriers

reach

Degree to which intended audience participates in intervention

reach questions

What percent of target population were aware of the intervention?

What was the percent of persons attending influenza vaccination clinic that do not usually get vaccinated?

What percent of mothers were contacted by peer-to-peer counselors?

Quality of implementation

Was activity implemented properly, according to standards or protocol

Quality of implementation questions

Was the curriculum implemented per guidelines?

Were protocols followed?

Was the training standardized?

Fidelity: What % of the intervention was implemented (100%, 70%, 30% ??)

Appropriateness

Interventions or messages that are delivered may only be effective if judged appropriate by target population.

Appropriateness questions

Did messages "speak" to target audience?

Culturally appropriate?

Reading level appropriate?

Age appropriate?

Addressed the target concern of the population?

Satisfaction

The extent to which staff are satisfied with training.

Satisfaction questions

Are staff satisfied with the intervention?

Are target population participants satisfied with the intervention?

Barriers

This attempts to understand why something didn't happen, and may identify key environmental variables

Barriers questions

Reasons not attending a clinic or intervention

Reasons for low fidelity

quantitative

survey participants

survey providers of the intervention

qualitative

focus groups

observation of intervention implementation

Impact and Outcome Evaluation purpose

assess objectives

assess goals

requires a comparison group to judge success

what can be evaluated---almost anything

Direct service interventions

Community mobilization efforts

Research initiatives

Surveillance systems

Policies

Outbreak investigations

Laboratory diagnostics

Communication campaigns

Infrastructure-building projects

Training and educational services

Administrative systems

Impact Evaluation

focuses on short term/intermediate endpoints

knowledge

attitudes

behaviors-short term

behavioral intent

skills

awareness

Outcome Evaluation

focuses on long term endpoints

morbidity

mortality

disability

behaviors-long term

Purpose of control/comparison group

To judge success

phases of implementation

1. adoption of the program part of marketing

2. Identifying and prioritizing the task to be completed

3. establishing a system of management

4. putting the plans into action

5. ending or sustaining a program

Identifying and prioritizing the task to be completed (Phase 2)

many tasks need to be completed when implementing a program (eg. reserving space, ordering equipment, hiring staff)

task needs to be identified and prioritized

planning timetables and timelines can help with this process

establishing a system of management (Phase 3)

Establishing a system of management

management

the efficient, satisfactory management of a health promotion program is vital to its long-term success.

Key personnel

delegation of responsibilities

Advisory Boards

putting the plans into action (Phase 4)

putting plans into action

pilot testing

phasing in

total program

ending or sustaining a program (Phase 5)

ending or sustaining a program

how long to run a program

ending a program

sustainability of a program

management

the process of achieving results through controlling human, financial, and technical resources

Key personnel

credentials

ending a program

goals and objectives met?

Are resources available?

need to re-focus?

sustainability of a program

work to institutionalize

advocating for the program

partnering with others

revisiting and revising the rationale

other sources of funding