Community Health Assessment PDF

Community Health: Module II FA Davis Chapters 4 and 5 Dr. M Stout  “I have no special talents. I am only passionately curious” ADD A FOOTER 2 Learning Outcomes 1. Define community health assessment within the context of population health. 2. D...

Community Health: Module II FA Davis Chapters 4 and 5 Dr. M Stout  “I have no special talents. I am only passionately curious” ADD A FOOTER 2 Learning Outcomes 1. Define community health assessment within the context of population health. 2. Describe six approaches to conducting an assessment. 3. Describe assessment frameworks. 4. Use secondary data to identify health characteristics of a community. 5. Describe qualitative and quantitative methods to collect primary data for conducting an assessment. ADD A FOOTER 3 Learning Outcomes (continued) 6. Describe the use of multiple techniques and tools to conduct community assessments. 7. Discuss the usefulness of community assessments. 8. Use an assessment framework to conduct a hypothetical assessment of a community. 9. Analyze primary and secondary data to identify strengths and needs of a community. ADD A FOOTER 4  Community Health Assessment The assessment of community health is a strategic plan that describes the health of a community. The assessment includes these measures: Collection, analyzing, and utilization of data to educate and mobilize communities Recognizing priorities in the community Resources to meet community needs Planning actions to improve health Assessments are a key function of public health. Assessments Development of policies Assurance of intervention In the development of health programs and interventions the goal is to optimize the health of the community or population 5  Skills and competencies that must be present include: Conducting a Community Health indicator selection Health Assessment Appropriate measures for data collection Data evaluation Gaps are recognized and identified Interpretation and utilization of data 6 Community Health Assessment (continued) *Institute of Medicine. (1988). The future of public health. National Assessment Academies Press. Assessment is one of the core public health Policy development functions. It is the first step in the development of health programs and Assurance of interventions aimed at intervention* optimizing the health of a community or population.  What defines a community? A group of individuals who share a common denominator Communities Health of a defined Individuals by: of the community recognize their membership in the community. Community: Three characteristics include – Health status of the community Religious orientation Resources for the community Geographic location Community competence, is the Ethnicity community effectively functioning? Culture  Commitment to the community  Working together by resolving conflict  Interaction of participants  Decision making shared with community  Society/Community relationships  Aware of self and others  Communication effectiveness 8 Conducting a Community Health Assessment Skills or competencies needed to conduct such an assessment include Selecting health indicators Using appropriate methods for collecting data Evaluating data Identifying gaps Interpreting and using data ADD A FOOTER 9 ADD A FOOTER 10  Three characteristics Health status Health of a Selected biostatistics Community related to health and *Goeppinger, J., & Baglioni, A. J. disease Structure (1985). Community competence: A positive approach to needs assessment. American Journal of Community Psychology, 13(5), 507– Demographics of the 523. community as well as the services and resources available in the community Competence Effective community functioning* ADD A FOOTER 11 Effective Community Functioning Select measures of community competence include Commitment to the community Conflict containment and accommodation (working together) Participant interaction Decision making Management of relationships with society ADD A FOOTER 12 Effective Community Functioning (continued) *Goeppinger, J., & Participation (use of Baglioni, A. J. (1985). local services) Community competence: Self-/other awareness A positive approach to Effective needs assessment. communication* American Journal of Community Psychology, 13(5), 507–523. ADD A FOOTER 13 What is the Conducting a Community Health Assessment purpose of a Skills or competencies needed to community conduct such an assessment include Selecting health indicators assessment? Using appropriate methods for collecting To gather information data Identification of areas for Evaluating data action that will result in Identifying gaps improved community health Interpreting and using data Take the first step in health planning Baseline information to assist with the evaluation of health programs 14 Types of Assessments Comprehensive assessment Population-focused assessment Setting-specific assessment Problem- or health issue-based assessment Health impact assessment Rapid needs assessment ADD A FOOTER 15 Assessment Types Comprehensive  Assessment that explores assets, needs not met, and opportunities for improvement. Helpful Community Statistics  Collection of data about populations living in a community  Looks at assets, unmet needs, and opportunities for improvement  Uses Community Statistics: Health status for the community Health needs of the community Data to assist epidemiological studies 16  Population-Focused Assessment Population definition is a larger group of members who may or may not interact with one another but do share one or more characteristics, characteristics include age, gender, ethnicity, residency and common health issue. Examples of population focused assessment: 1.) Pregnant woman living in a community 2.) Persons aged 64 with diabetes 3) Immigrans from a specific country of origin 17  Setting-Specific Assessments Identification of strengths and weaknesses of policies/programs within a setting. The focus is on the specific setting. Who are the people within the setting? What data is setting specific? Treats the setting as the Community- 18  Problem-Based or Health Issue Assessment Focus is on a specific problem/health issue Data analysis to prioritize who is at most risk Promotes Understanding of: policies, practices and environment Determine who is at Risk Community Assessment/Nursing Process Lets compare steps in the community assessment with steps in the nursing process Assess Collect and analyze data from the community Diagnose Define the problem and determine measurement outcomes needed Intervention Plan the program with community stakeholders Evaluate Determine what worked and what needs to change ADD A FOOTER 20  Rapid Needs Assessment (CASPER Assessments Framework) Assessment that helps establish the extent of an emergent situation and its potential threat Health impact assessment to a community. Assessment of measures put in place Response capacity and additional immediate needs. to protect the community. These Understand immediate needs, determine measures include policies, plans, course of action, identify resources required projects that have included quantitative and qualitative Concepts of Community Assessments techniques. The ability to have Important terms: participants actively involved helps  Needs recognize and understand what  Assets measures will be most beneficial to a community.  Community – based – participatory – research (C B P R) Successful assessments include  There is a shift that takes place from needs to decision makers to help in the assets along with C B P R – meaning that we development of policies, programs focus on maximizing strengths of the and projects. community and not on deficits. HiAs are used to evaluate the impact of policies and projects on health 21 Asset Assessments Three aspects of a community can be seen on an asset map. Focus on the positive aspects of a community Involves constructing a map of assets and capacities Three aspects of a community asset map: People within a community Places within a community Systems within a community 22 Community-Based Participatory Research Engaging our community partners fully in the assessment of the community. Collaborative approach – members should demonstrate interest, knowledge and expertise. All efforts working together to achieve the goal of change to benefit the community. Interest, knowledge, expertise, Achieves Change C B P R – benefits in the following ways: Learning together: Co-learning Contribution equality Research and action balance Culturally competent care within a community Community engagement with the process of change 23  Achieve change that will benefit the C B P R - continued community by improving the health of the community. C B P R works to build capacity, share the vision, ownership, trust, active participation, and mutual benefit. Goals and essential principles Important to evaluate issues of power, fairness, appropriate selection of defined representatives, obtaining consent, community equilibrium, disseminate sensitive data. 24 Assessment Models and Frameworks Benefits Structure is vital along with guidance when an assessment is conducted. Choice of model is dependent on what fits Action Steps in the C H A N G E model: best fits type of assessment being conducted. 1. Assemble the community Types of Models: 2. Create a team Community Health Assessment and Group Evaluation (CHANGE) 3. Community sector review Mobilization for Actions Through Planning 4. Data collection from each sector and Partnership (MAPP) A closer look at assessment models: 5. Data review and establish consensus C H A N G E Model – 6. Data entry  Socioecological basis 7. Data analysis with assignment of  Foundation for conducting a program evaluation. ratings  Start with the end in mind to include the 8. Build an action plan evaluation in the beginning of the assessment process. 25 Community Health Assessment and Group Evaluation (CHANGE) Model *Centers for Disease Control and Prevention. (2021). Community Health This is based on the Assessment and Group socioecological model. Evaluation (CHANGE) tool. The process provides a https://www.cdc.gov/nccd community with the foundation for conducting a php/dnpao/state-local- program evaluation. programs/change-tool/ The idea is to start with the action-steps.html end in mind and include evaluation in the beginning of the assessment process.* ADD A FOOTER 26 CHANGE Model Helps a community complete an assessment that not only provides a diagnosis but also ends with the presentation of an action plan. Creates a living document that the community can use to prioritize the health needs of the community. Provides a means for structuring community activities around a common goal. ADD A FOOTER 27 Mobilizing for Action through Planning and Partnerships (MAPP) Vision Achieving improved health and quality of life by the mobilization of partnerships followed by implementation of strategic actions. Six phases of the MAPP model Organization Vision Completion of four assessments Identification of strategic issues Goals in combination with strategies Taking Action 28 Comprehensive Community Health Assessment MAPP and CHANGE are examples of blueprints for conducting a community health assessment. Begin with engaging partners in the process to establish purpose and define the community. Identify existing data sources. ADD A FOOTER 29 Importance of Data Collection Primary Data Data obtained by an assessment team. Secondary Data Data that was previously collected with another purpose in mind. An example: census data. Windshield Survey Type of data collection is primary Provides the “pulse” of the community Observing a community recognizing what is happening in the community, who lives in the community, resources available and other vital aspects of the community. ADD A FOOTER 30 Primary Community Assessment Shoe leather survey (walking) Kinship/Economics/Education/Political/Religious/Associations (KEEPRA) Family life Stable economy Schools and other educational institutions Evidence of political activity Places of Worship Neighborhood Associations 31  Preliminary Observational Data C H A N G E list of sectors: Asking questions to gather good data Surveys conducted for the assessment and inventory of resources: questionnaires on different organizations such as HC institutions and school Quantitative Surveys Qualitative Surveys Numerical data: Categorical data: Depicts numbers, counts, frequencies, Gender etc. Religion Examples include: Marital status  Age Native language  Height Social class  Weight Qualifications  Income Method of treatment  Size of a university  Size of a group 32 Conducting a Survey Vital aspects of a survey: Define the sample Conduction of a sound Choose a sampling approach survey Select a survey method What items will be included in the survey? Evidenced-based tools Secondary Data: Census data Report on crime, national health survey data Health statistics state, local department of public health Aggregate data – does not include individual level data Deidentified data – data that does not include individual identifiers ADD A FOOTER 33 Secondary Data Not Specific to Individuals Examples of data related to the environment: Environmental pollutants Number of vehicles using the roads Information on farmers’ markets, the Food Access Research Atlas, and the Food Desert Locator, an online map Information on organizations within the community such as hospitals, schools, and police departments ADD A FOOTER 34 Primary Community Health Data Collection Determine gaps in the secondary data. Fill the gaps through multiple methods. Inventory of resources Quantitative data: surveys Qualitative data ADD A FOOTER 35 Qualitative Data Focus group An interview with a group of people with similar experiences or backgrounds who meet to discuss a topic of interest Key informant Often represented as a gatekeeper, one who comes closest to representing the community Photo voice Having community members photograph their everyday lives within the context of their communities ADD A FOOTER 36 Additional Survey Tools Community Mapping: Community mapping and Visualization of the community Study concentrations of disease within the Geographic Information community System (G I S) Identification of at-risk populations along with risks Better Understand program implementation G I S: Geographical Information System Computer based program utilized to collect data. This allows storage and retrieval of data along with manipulation of data. Analysis of data: Examine changes/trends/patterns that occur over time ADD A FOOTER 37 Analysis of the Data Making sense of the collected data Examine changes/trends over time. Sociodemographic comparisons include changes from one census data collection period to another. The time period for comparing disease trends varies by the prevalence of disease. Compare with other populations/communities. Are there disparities? Gaps in services? The team identifies the important health issues for the community. ADD A FOOTER 38 Post-Assessment Phase Create, Disseminate, and Develop Now what do we do? an Action Plan Evaluation of the Assessment Process: Include stakeholders in the review of findings of the survey and promote feedback. Seek validation from stakeholders and approach in a collaborative manner to prioritize actions. ADD A FOOTER 39 Questions to review 1.) A community health assessment 2.) A windshield survey is: is: a. A process of collecting, analyzing, and a. Uses secondary data to using data to help a community strive explain demographics of the toward better health. community b. A one-time strategic plan developed b. Gives a good guess at the for a healthier community cost of improving health in a c. Inviting numerous resources into a community community so they will be available for people who want to use them c. Involves a walk-through of the d. Charging the city council with community developing different action plans determined by a committee to help d. Includes conducting focus improve health in a community groups ADD A FOOTER 40 Correct Answers 3 is the correct answer. 1 is the correct answer A community assessment is an A windshield survey shows the ongoing plan of collecting, “pulse of a community.” It is a analyzing, and using data to primary data collection tool that determine what policies should be offers no monetary assessment of prioritized to improve the health of a the community’s needs. community. These priorities change as the community changes ADD A FOOTER 41 https://www.maricopa.gov/4980/Current-CHNA-CHIP-Data-Reports Identify demographics, top 3 health issues, resources, and strategic planning to addreIdentify demographics, top 3 health issues, resources and strategic planning to address the concerns. 42 Chapter 5: Health Program Planning 43 Learning Outcomes 1. Discuss the use of Healthy People 2030 in health program planning. 2. Identify components of different health planning models. 3. Describe the steps in writing community diagnoses. 4. Explain the importance of evidence-based practice in program planning. ADD A FOOTER 44 Learning Outcomes (continued) 5. Describe the process of writing goals, objectives, and activities for a health program. 6. Discuss the different types and values of program evaluation. ADD A FOOTER 45 Health Program Planning for Communities *Centers for Disease Community program planning The process that helps Control and Prevention. communities understand how (2020). About the to move from where they are to where they want to be community guide. This multistep process https://www.thecommunit Generally begins with the yguide.org/about/about- definition of the problem and community-guide development of an evaluation plan Includes a feedback loop with findings from program evaluation used for program improvement* ADD A FOOTER 46 Health Program Planning at All Levels *Centers for Disease Planning occurs at these Control and Prevention. levels: Local or tribal (2018). National public State health performance Federal standards. https://www.cdc.gov/publi Part of strategic planning chealthgateway/nphps/ind for the public’s health happens at the global ex.html level One of the 10 essential public health services* ADD A FOOTER 47 Community Capacity *Fawcett, S. B. (2021). The ability of community Section 3. Our model of members to work together practice: Building capacity to organize their assets and resources to improve the for community and health of the community system change. Building community https://ctb.ku.edu/en/table capacity can -of-contents/overview/mo Increase quality of life del-for-community- Promote long-term change-and- community health improvement/building- Increase community capacity/main resilience* ADD A FOOTER 48 Health Program Planning: Four Steps 1. Performing The nursing process is assessment applied to populations 2. Developing rather than individuals. interventions 3. Implementing interventions 4. Evaluating the effectiveness of interventions ADD A FOOTER 49 Assessment to Program Plan It begins with the assessment phase covered in Chapter 4. Based on the assessment, the collaborative community partners arrive at a community diagnosis. They then decide what action would be most productive to improve the health of the community and begin to plan a program or programs to address the priority health issues identified. Once the plan is in place, they act (implement the plan). The final stages are to evaluate how well the plan addressed the priority issue and, if it works, how best to sustain the program. The program could involve such things as policy change, health education, or the creation of new public health services. Frequently, it means putting in place a program to address the community health diagnosis with the goal of improving health outcomes for the population, reducing the risk of disease, and/or minimizing the impact of disease. Program planning follows the same process for the population level that the nursing process uses with individuals and is similar to the development of a care plan in the nursing process and the evaluation of the effectiveness of the intervention 50 1988 Report: “The Future of Public Health” Public health practice was recognized as focusing on populations and not individuals. Health planning recognized as a local level function. Core public health functions include: Assessment Policy development Service assurances were identified Program planning models: Precede/Proceed MAPP CHANGE Logic Model ADD A FOOTER 51 Healthy People (HP) 2030 and Beyond From its inception in the 1970s, Healthy People has sought not only to assess health status but also to project improved status with outcome measurement. The intent of the new HP 2030 is to continue to guide efforts to plan, implement, and evaluate health promotion and disease prevention interventions for the nation. ADD A FOOTER 52 MAPIT Implementing HP Using MAPIT (Mobilize, Assess, Plan, Intervene, and Track progress) Healthy People is based on a simple but powerful model that helps to: Establish national health objectives. Provide data and tools to enable states, cities, communities, and individuals across the country to combine their efforts to achieve them. Use the MAPIT framework to help: Mobilize partners. Assess the needs of a community. Create and implement a plan to reach HP objectives. Track a community’s progress.12 ADD A FOOTER 53 Program Planning Models PRECEDE/PROCEED model MAPP model CHANGE model Logic model ADD A FOOTER 54 Program Planning: Precede-Proceed Model Precede Proceed Predisposing, Reinforcing and Focus on the efforts to modify social Enabling factors and Causes in environment with the goal of healthy Educational Diagnosis and lifestyle. Evaluation. Policy, Regulation, Organizational  Starts with a comprehensive Constructs in Education, and assessment Environmental  Provides guidance regarding Served as the basis for other health administrative and organizational program planning and assessment concerns models like M A P P and C H A N G E.  Design is the end of this process with the implementation and evaluation of the new process 55  Precede-Proceed Model If you were a contractor setting out to build a wood-frame house, you wouldn’t just pick up whatever wood you found lying around and begin. You’d consult first with the owner, and start with an idea of the house the owners wanted – its size, its shape, its features. You’d want a picture of the finished house, and a floor plan as well, with some notes on measurements and materials. You’d plan the construction with the owners, and set out a process for getting it done. And you’d do all this before you ever picked up a tool, because otherwise the process would be hit-or-miss: The owners wouldn’t get the house they wanted, and your time would be wasted. 56 Precede-Proceed Model The same is true if you’re developing an intervention to address a health or community issue. It makes no sense to pick an issue at random, and to use whatever service happens to be available to try to address it. You have to consult with the community You need to understand and analyze community information Include your own and others’ observations Fully understanding the context of the issue to create an intervention that will actually bring about the changes the community wants and needs. 57 Precede 4 Phases PRECEDE has four phases, which we’ll explore in greater detail later in the section: Phase 1: Identifying the ultimate desired result. Phase 2: Identifying and setting priorities among health or community issues and their behavioral and environmental determinants that stand in the way of achieving that result, or conditions that have to be attained to achieve that result; and identifying the behaviors, lifestyles, and/or environmental factors that affect those issues or conditions. Phase 3: Identifying the predisposing, enabling, and reinforcing factors that can affect the behaviors, attitudes, and environmental factors given priority in Phase 2. Phase 4: Identifying the administrative and policy factors that influence what can be implemented. 58 Proceed 4 Phases PROCEED has four phases that cover the actual implementation of the intervention and the careful evaluation of it, working back to the original starting point – the ultimate desired outcome of the process. Phase 5: Implementation – the design and actual conducting of the intervention. Phase 6: Process evaluation. Are you actually doing the things you planned to do? Phase 7: Impact evaluation. Is the intervention having the desired impact on the target population? Phase 8: Outcome evaluation. Is the intervention leading to the outcome (the desired result) that was envisioned in Phase 1? 59 MAPP Tool Mobilizing for Action through Planning and Partnerships (MAPP) tool, which was launched in 2001. The MAPP tool includes the full scope of health planning including assessing, diagnosing, developing an intervention, implementing the intervention, and evaluating the effectiveness of the intervention. By contrast: CHANGE focuses on assessment and diagnosis with evaluation built in as the goal (see Table 4-2). Communities and PHDs have used MAPP across the country because it includes an action phase, providing a comprehensive approach to improving the health of a community. The focus of the first five phases of MAPP is the process involved in working with the community on strategic planning and conducting four separate assessments. 60 CHANGE Model The CDC based the CHANGE tool on the socioecological model to help communities build an action plan based on identified assets and areas for improvement. The stated purpose of the CHANGE tool is “to enable local stakeholders and community team members to survey and identify community strengths and areas for improvement regarding current policy, systems, and environmental change strategies. The process provides a community with the foundation for conducting a program evaluation. The idea is to start with the end in mind and include evaluation in the beginning of the assessment process. This tool includes a set of Microsoft Office Excel spreadsheets that communities can use to manage the data they collect. The tool provides a guide to doing a community assessment and helps with prioritizing areas for improvement. 61 Classic Example In general, behaviors, lifestyles, and environmental factors are what an intervention sets out to change. The changes in these areas in turn affect the crucial issues, and lead to the achievement of the final outcome: improvement of overall QOL for the community. A classic example of community change through behavior change is that of reducing the incidence of lung cancer and heart disease in a community by convincing smokers to change their behavior – i.e. quit. Fewer smokers mean less secondhand smoke, less time lost from work because of smoke breaks and smoking-related illnesses, fewer low-birth-weight babies, fewer children with asthma and other respiratory ailments, and lower health insurance costs. Altogether, changing smokers’ behavior adds up to an improvement in the overall quality of life for the community 62 What do these do: Identify primary health issues in your community. Community Health Assessment and Group Evaluation (CHANGE) MAPP (Mobilizing for Action Through Planning and Partnerships) County health rankings National Public Health Performance Standards When we looked at the Maricopa County Programs-often they are compared to National Standards-where we rank on health issues. 63 Logic Model: Driving design – Moving in logical order Five steps Resources Activities Outputs Outcomes Impact Gives a visual of the steps taken at the end The concept of a logic model is it logically moves like a chain of reasoning from the planned work to the intended results in five steps, starting with input and resources to program activities to outputs to outcomes to impact. The model is read from left to right. 64 The Basic Logic Model St Louis Project: Protecting vulnerable populations in the event of a disaster. 66 Logic Model https://whatworks.org.nz/logic-mode l/ ADD A FOOTER 67 Health Program planning – Key aspects Active Community involvement Social justice Skill and investment of time to complete a Society is based on the constructs of human rights competent assessment and equity Shared conclusions with partners of needed Those who have plenty share what they have with interventions those in need Program planning – interventions – evaluation Everyone should have access to basic health services, economic security, appropriate housing Social justice: human rights and equality and food, education that is satisfactory, decrease in Community Organizing discrimination based on race and religion Assisting in helping others work as a team for the Community Diagnosis best interest of the community Representation of the last stage of the community  Community organization happens in poorer assessment process, it also includes the first phase communities that are disenfranchised, uniting of health program planning numbers to gain the power and influence for social Clear and concise statement of the health problem justice. and the reasons/theories for the problems  Nurses listen, facilitate, and develop community Assist the community teams in creating a program leadership skills. with the necessary components 68  Program Goals A broad statement of the impact expected by implementing a program A statement of outcome rather than activity Usually only a few goals for a program No actual outcome measurements included in the goals Should be realistic and reachable Objectives Clarify the goal. Design an outcome measurement. Keep the program focused on the intended intervention. Include who will achieve what, by how much, and by when. Utilize S.M.A.R.T. objectives. ADD A FOOTER 70 National Perspective The 2012 IOM report strongly advocated for increased funding of public health and population-level interventions. Public health nurses (PHNs) today embrace this population focus with their community-based assessments, health planning, population-based program designs and interventions, program evaluation, and policy development. Both PHNs and nurses working in other settings need skills related to engaging community partners in these program efforts and how to make successful programs sustainable. Identifying the areas of community organizing, coalition building, collaborating, social marketing, and policy development The Intervention Wheel Practice Model Includes all of these perspectives are useful in health planning and program design, implementation, and evaluation. 71 Behind Public Health Models Behind the public health models lie some assumptions about the prevention of illness and promotion of health, and, by extension, about other community issues as well. Since the health-promoting behaviors and activities that individuals engage in are almost always voluntary, carrying out health promotion has to involve those whose behavior or actions you want to change. All models should be a participatory process, involving all stakeholders – those affected by the issue or condition in question – from the beginning. Health is, by its very nature, a community issue. It is influenced by community attitudes, shaped by the community environment (physical, social, political, and economic), and colored by community history. 72 Behind Public Health Models Health is an integral part of a larger context, probably most clearly defined as quality of life, and it’s within that context that it must be considered. It is only one of many factors that make life better or worse for individuals and the community as a whole. It therefore influences, and is influenced by, much more than seems directly connected to it. Finally, health is more than physical well-being, or than the absence of disease, illness, or injury. It is a constellation of factors – economic, social, political, ecological, and physical – that add up to healthy, high-quality lives for individuals and communities. This broad perspective on health extends to other community issues. We can define the health of a community as its fitness in many areas, of which citizens’ physical health is only one. Indications of a communities health include how well it is. 73 Why public health programs are vital In the latter half of the 20th Century, as medical advances eliminated many infectious diseases, the leading causes of disability and death in the developed world changed to chronic conditions – Heart disease, stroke, cancer, diabetes. The focus of health maintenance, therefore, shifted from the treatment of disease to the prevention of these conditions, and, more recently, to the active promotion of behaviors and attitudes Proper diet, exercise, and reduction of stress, for instance – that in themselves do much to maintain health and improve the length and quality of life. But there are other issues facing the nation now as well-can you name a few that you have been witnessing in your clinical experiences? 74 Health Program Planning in Communities Community program planning: Health program planning: 4 steps Process to help communities move forward Assessment Utilization of a multi-step approach: Development of interventions Define the problem and develop a plan to Implementation of interventions evaluate the problem. Evaluating the effectiveness of interventions Feedback regarding programs and program Community Capacity: evaluation with the goal of program Ability of community members to work improvement. together to organize their assets and Health program planning occurs at all resources in order to improve the health of the levels: community. Local Community capacity can directly influence quality of life State Promote long term community health Federal Increase of community resilience 75 Program Planning continued… Aspects to consider: Objectives Specific diagnosis for a community State concisely and clearly Summary statement – statement stems from assessment and data analysis Measurable outcomes; realistic and reachable Communities are different and therefore have different Remain focused on the intended intervention needs Action-oriented, time-limited, and measurable Problem is identified Include who, what, when – who will achieve Relationships within the population what, by how much and when will this Indicators of the problem conclude Program goals and objectives Goal: broad statement that outlines the expected impact by program implementation Evidence-based practice (E B P) includes literature review, population based-approaches, Goal: understanding of the outcome with a few goals evaluations. listed Goal: not the place for measurements Exploration of theory and rationale for programs Goals should be realistic and attainable 76 S M A R T Objectives 77 Process, Behavioral, Community Level Objectives For example, the group might adopt a comprehensive plan for improving neighborhood housing. In this case, adoption of the plan itself is the objective. For example, a neighborhood improvement group might develop an objective for having an increased amount of home repair taking place (the behavior) and fewer houses with broken or boarded-up windows (the result) For example, the same neighborhood group might have an objective of increasing the percentage of people living in the community with adequate housing as a community-level outcome objective. 78 Goals and Objecitves Lets say we are working on a goal for an Adolescent substance use and prevention initiative What would the objectives be? A goal is an outcome you want to achieve, while an objective is a specific and measurable action that can be reached in a short amount of time, often related to a goal. ADD A FOOTER 79 Cultural Context The team always must consider the culture, ethnicity, and language of the community. Cultural competency may take on a central role. Integrating cultural components into a program is essential. ADD A FOOTER 80 Cultural Considerations Culture must always be considered which includes ethnicity and language of the community. Cultural competence is essential when working with communities. Cultural components must be implemented into the program being developed. 81 Adolescent substance use and prevention initiative Objectives developed for an adolescent substance use prevention initiative By the year 2024, the use of tobacco among 12-17 year olds will be reduced by 40%. By the year 2024, the use of alcohol among 12-17 year olds will be reduced by 50%. By the year 2024, the use of marijuana among 12-17 year olds will be reduced by 70%. By the year 2024, the use of cocaine among 12-17 year olds will be reduced by 80%. ADD A FOOTER 82 Program Planning Community-specific diagnosis Summary statement Summary stems from the assessment and analysis of data. Each community is different. Summary states the problem. Population Relationship to the population How the problem is demonstrated (indicators) ADD A FOOTER 83 Program Planning (continued) Evidence-based practice (EBP) Literature review Population-based approaches Evaluation Examine the theory and rationale for other programs ADD A FOOTER 84 Program Implementation and Evaluation Implementation Program Evaluation Resources needed identified Systematic collection of information about How will this information be delivered? activities, outputs, and outcomes with the goal of enhancing program effectiveness. Mechanism for delivery The evaluation provides feedback regarding: Five Stages of Program Implementation  Activities – were they implemented as Acceptance of the program from the designed community  Cost-effectiveness of the program Tasks to be completed and resources needed  Interventions and program theories were in Specific plan for activities of the program alignment Program management  Timeline was appropriate for this project Putting the plan into action  Is the program able to be expanded and duplicated elsewhere 85 Program Evaluation The systematic collection of information about activities, outputs, and outcomes to enhance a program and its effectiveness ADD A FOOTER 86 Program Evaluation (continued) Analysis provides useful feedback related to whether Activities were implemented as they were designed. The program was cost-effective. The intervention and program theories were correct. The timeline was appropriate. The program should be expanded or duplicated in another location. ADD A FOOTER 87 9 Steps to Program Evaluation 1.) Who will participate? Select and evaluate team 2.) Development of questions. 3.) Creation of budget. 4.)Decide on Internal and external evaluation. 5.) Determine how will data be collected? 6.) Collect data. 7.) Analyze and interpret data dindings. 8.) Findings must be communicated to stakeholders. 9.) Utilization of evidence for the program or to improve the program. 88 Formative Evaluation Ongoing feedback about Allows for changing the performance of the The way outcomes are program occurs during the collected for development of the measurements program, while the Parts of the program to activities are forming and better meet the being implemented for the program goals and first time. objectives ADD A FOOTER 89 Process Evaluation Investigates the process of delivering the program or technology Looks at alternative delivery procedures Includes detailed information on How the program actually worked (program operations) Any changes made to the program How those changes have impacted the program ADD A FOOTER 90 Summative Evaluation *W. K. Kellogg Foundation. Occurs at the end of the program (2017). The step-by-step Offers an evaluation of the guide to evaluation: How objectives and the goal: to become savvy Assessment of the outcome evaluation consumers. and impact of the benefits Author. on program participants Evaluation of the causal https://wkkf.issuelab.org/r relationship and the esource/the-step-by-step- theoretical understanding of guide-to-evaluation-how- the planned intervention to-become-savvy- Examination of program cost, looking at cost- evaluation-consumers- effectiveness and cost 4.html benefit* ADD A FOOTER 91 Formative vs Summative Evaluations 92 Question?: True or False: Program goals are always measurable. ADD A FOOTER 93 Answer: False. Reasoning: No actual outcome measurements are included in the goals. ADD A FOOTER 94 Question? Formative Evaluation occurs when? 1) At the end of the program 2) During the development of a program, while the activities are forming and being implemented for the first time. 3)) Prior o the beginning of the program to help identify outcome measures 4) At the end of the program to determine if the program was effective 95 Answer: 2 is the correct answer Formative evaluation provides ongoing feedback on the performance of the program during its development, while the activities are forming and being implemented for the first time. ADD A FOOTER 96 Community Tool Box Examples https://ctb.ku.edu/en/table-of-contents/overview/models -for-community-health-and-development/logic-model-de velopment/example ADD A FOOTER 97