Health Program Context PDF

Health as a Concept • WHO definition (1947) – Absence of illness and presence of well-being • Health viewed as holistic – Physical, mental, developmental social, and financial aspects – “Health problems” may affect one domain while the others remain healthy • Health viewed as political – Health po...

Health as a Concept • WHO definition (1947) – Absence of illness and presence of well-being • Health viewed as holistic – Physical, mental, developmental social, and financial aspects – “Health problems” may affect one domain while the others remain healthy • Health viewed as political – Health policy around access to care – Implications for program planning Outcome- vs. Utilization-Focused Evaluations Focus Purpose Audience Method Outcome Show program effect Funders, researchers, other external audience Research methods; usually external evaluators Utilization Get stakeholders to use evaluation findings for decisions regarding program improvements and future program development Program people (internal audience), funders Research methods, participatory Standards Established by the Joint Commission on Standards for Educational Evaluation Standard Description Utility To ensure that the evaluation will meet the content needs of those involved Feasibility To ensure that the evaluation will be realistic, prudent, diplomatic, and frugal Propriety To ensure that the evaluation will be conducted in a legal and unbiased way Accuracy To ensure that the evaluation will communicate appropriate and accurate information Adapted from the American Evaluation Association (2002) The Program Life Cycle: Assessment, Implementation, and Evaluation Program Stage Community Assessment Program Implementation Program Evaluation Pilot Generic information about the health problem & target audience Few participants; strict guidelines & protocols Rigorous impact evaluation & process monitoring Model Greater information about the target audience Realistic number of participants; use previously set procedures Outcome & impact assessment; rigorous process monitoring Prototype Very specific information about the target audience & local variations in the health problem Some flexibility and adaptation to local needs; realistic enrollment Outcome & impact assessment; rigorous process monitoring The Program Life Cycle, Continued Program Stage Community Assessment Program Implementation Program Evaluation Organizationally Institutionalized More attention to assessment of organizational resources for program sustainability Use standard operating procedures; organization specific Outcome & impact assessment based on objectives; routine process monitoring Professionally institutionalized Rarely any detail, more assessment of competitors and professional norms Standards for professional practice; may involve certification Use professionally set standards or benchmarks of outcome & impact assessment Healthy People 2010 Objectives in 28 Focus Areas • Access to quality health services • Arthritis, osteoporosis, and chronic back conditions • Cancer • Chronic kidney disease • Diabetes • Disability and secondary conditions • Educational and • Immunization and infectious disease • Injury and violence prevention • Maternal, infant, and child health • Medical product safety • Mental health and mental disorders • Nutrition and overweight • Occupational safety and