Module Assignment: HEALTH PROMOTION PROGRAM IMPLEMENTATION AND EVALUATION
Modular Learning Outcomes
Upon successful completion of this module, the student will be able to satisfy the following outcomes:
• Case
o Identify and describe the different levels of evaluating a health promotion/intervention.
• SLP
o Discuss principles, processes, strategies, and concerns of implementing a health promotion program/intervention.
• Discussion
o Determine important issues in identifying and allocating resources for health promotion program/intervention.
Module Overview
Organizing the Community
A community is a locale or domain characterized by the following elements:
• Memberships - A sense of identity and belonging
• Common symbol systems - similar language, rituals, and ceremonies
• Shared values and norms
• Mutual influence - community members have influence and are influenced by each other
• Shared needs and commitment to meeting them
• Shared emotional connection - members share common history, experiences, and mutual support
A community may be defined geographically (for example a neighborhood) but this is not always necessary. Health educators may work with small or large communities.
Community organizing is a process through which communities are helped to identify common problems or goals, mobilize resources, and develop and implement strategies for reaching the goals they have collectively set.
When organizing communities, the following assumptions need to be made:
• Communities of people can develop capacity to deal with their own problems.
• People want to change and can change.
• People should participate in making, adjusting, or controlling the major changes taking place in their community.
• Changes in community living that are self-imposed or self-developed have a meaning and permanence that imposed changes do not have.
• A "holistic approach" can deal successfully with problems with which a "fragmented approach" cannot cope.
There are various methods for organizing and building a community. McKenzie and Smeltzer propose these steps:
There are several models available for guiding community organizers.
One widely-used model is the Planned Approach to Community Health (PATCH). PATCH was designed using the PRECEDE model and was created "to strengthen state and local health departments' capacities to plan, implement, and evaluate community-based health promotion activities targeted toward priority health problems". PATCH also led to the inspiration for PROCEED.
The essential elements of PATCH include community organization with local support, participation, and leadership, community members using local health data to determine the health problems, prioritize the health problems, and set goals and objectives, carrying out interventions, and evaluating the results. PATCH is a team approach in which the people of the community make the decisions (via a consensus process) and do the work, with technical assistance from the state and local health departments and the Centers for Disease Control and Prevention. These team members not only facilitate the necessary work, but also provide financial support for the project.
PROGRAM IMPLEMENTATION
Implementing the Health Promotion/Intervention Program
Program implementation is the process of implementing the program's strategies. It consists of initiating the activities, providing assistance, solving problems, and reporting on progress.
There are some important questions to ask and answer when implementing a program:
• What are the objectives of the program?
• What is the rationale or theoretical basis of the program (i.e., why should it work)?
• What is the content of the program?
• What are the strategies or methods to be used?
• In what context (physical, social, political, etc.) is the program delivered (i.e., selection of organizational location)?
• How will you know if the program has succeeded? (i.e., it is best to consider if you would be able to evaluate your program while you are designing it).
Factors to consider for the implementation process:
• Establish who, what, where, why, how, and when.
• Carefully define your target group or population.
• Perform reality checks. For example, does it seem reasonable to expect that the program can be finished in the available time and with the available resources?
Key processes for program implementation are: establishing effective communication channels, documenting processes, identifying opportunities, and developing contingency plans if obstacles or changes need to be addressed. It is important to monitor all activities on a regular basis to ensure the activities are working towards the initial goals and objectives set for the program.
Three major ways of implementing a program have been suggested: by using a piloting process; by phasing it in, in small segments; or by initiating the total program all at once (not recommended). Borg and Gall suggest a ten-step research and development cycle, of which the last seven steps can be used as an implementation model for health promotion programs: preliminary field-testing, program revisions, main field-testing, operational program revisions, operational field testing, final revisions, dissemination and implementation.
PROGRAM EVALUATION
Evaluation tries to answer the questions:
• What difference has a particular health promotion program made?
• What changes in health status has it produced?
Evaluation involves observing, documenting, and measuring. It compares the actual results of the program with what was expected to happen. Planning for evaluation is an essential part of the initial health promotion program planning process.
Types of Evaluation
There are three different levels of evaluation which can be used to assess the effectiveness of a health promotion program:
• Process evaluation
• Impact evaluation
• Outcome evaluation
These must be done in a logical order - the short-term effects of the health promotion program must be assessed before any long-term benefits can be measured.
Process Evaluation
Process evaluation assesses the health promotion program's quality, the way the program was run, and whether the target group was reached. Process evaluation usually focuses on the following key areas:
• Is the program reaching the target group?
• Are participants satisfied with the program?
• Are the activities of the program being implemented as planned?
• Are the materials and components of the activity of good quality?
Impact Evaluation
Impact evaluation assesses the short-term effects of the program and is concerned with whether the objectives were met. It measures changes in behavior, environment, health knowledge, social participation, lifestyle, or risk factors.
Examples of questions asked:
• What proportion of the target group have heard of the health promotion activities?
• Has there been a change in behavior (e.g., more people exercising)?
Outcome Evaluation
Outcome evaluation assesses whether the health promotion program has been effective in the long term and whether its overall goal has been met.
Examples of questions asked:
• Has there been an increase in breast feeding?
• How much has the death rate from lung cancer been reduced?
Evaluation Methods
Quantitative evaluation methods involve systematically measuring changes and effects using numbers and statistics (e.g., the percent of people who have stopped smoking). Quantitative methods allow the size of any changes to be measured and comparisons to be made between particular groups.
Qualitative evaluation methods focus on describing people's experience and feelings about the program. There are many qualitative evaluation tools, for example focus groups and in-depth interviews. Qualitative evaluation is useful in understanding why particular effects occurred as a result of the health promotion program (e.g., why people started to exercise more).
The most comprehensive health promotion evaluations use a combination of both methods.
Purposes of Evaluation
• To determine achievement of objectives related to improved health status
• To improve program implementation
• To provide accountability to those who funded the program, community, and other stakeholders
• To increase community support for initiatives
• To contribute to the scientific base for public health interventions
• To inform policy decisions
Results from evaluations conducted early in the planning process can assist in improving the program. Early data should be analyzed quickly to make necessary adjustments. It is also good to establish early who will conduct the evaluation, and whether it will it be internal or external. Internal evaluators are close to program, already on staff, and thus may be biased when assessing the program. However, costs are usually higher for external evaluation and may be more objective, though evaluators are not as familiar with the program. An evaluation is best done by someone who is experienced in evaluation.
Potential Problems in Evaluation
• If the planners failed to build evaluation into program planning
• Adequate procedures cost time and resources
• Changes sometimes come slowly
• Some changes do not last
• It is sometimes difficult to distinguish between cause and effect
Experimental and Control Groups
One of the most rigorous ways of assessing whether a program worked is to compare the results with a population group that was not exposed to the program. The group that participated in the program is known as the experimental group. The control group should be as similar as possible to the experimental group. If participants cannot be randomly assigned to an experimental or control group, a nonequivalent control group may be used. This, however, needs to be taken into account when analyzing the data.
Module SLP: HEALTH PROMOTION PROGRAM IMPLEMENTATION AND EVALUATION
Building on the information you collected so far, please provide a discussion on the following:
1. How you would go about implementing your health promotion program/intervention.
2. How you would involve the community.
3. Identify and discuss the resources you will need to implement your health promotion program//intervention.
Discuss how you would evaluate your health promotion/intervention program. What would your process, impact, and outcome evaluation consist of? What evaluation methods would you use? What problems are you likely to encounter in the evaluation process?
SLP Assignment Expectations
Make sure that all assignment questions are specifically answered, that your answers are clear, and your paper is well organized. Please provide enough depth, while paying attention to grammar, spelling, and punctuation. Your paper needs to be about 3 pages long.
Your assignment will not be graded until you have submitted an Originality Report with a Similarity Index (SI) score <15% (excluding direct quotes, quoted assignment instructions, and references). Papers not meeting this requirement by the end of the session will receive a score of 0 (grade of F). Papers with a lower SI score may be returned for revisions. For example, if one paragraph accounting for only 10% of a paper is cut and pasted, the paper could be returned for revision, despite the low SI score. Please use the report and your SI score as a guide to improve the originality of your work.
Reflections on Course Concepts
Given the readings and assignments in the course:
o Identify and briefly discuss two concepts in this course that you believe will be most applicable to the professional discipline you will enter upon completion of your degree program.
o What is the importance of these concepts to the professional discipline?
o How will you use these concepts in your future career?
Optional: Offer feedback on how the course and/or facilitation of the course can be improved.
Reflection is a mental process that challenges you to use critical thinking to examine the course information, analyze it carefully, make connections with previous knowledge and experience, and draw conclusions based on the resulting ideas. A well-cultivated critical thinker raises vital questions and problems, formulating them clearly and precisely; gathers and assesses relevant information, using abstract ideas to interpret it effectively; comes to well-reasoned conclusions and solutions, testing them against relevant criteria and standards; thinks open-mindedly within alternative systems of thought, recognizing and assessing, as need be, their assumptions, implications, and practical consequences; and communicates effectively with others in figuring out solutions to complex problems. (Paul & Elder, 2008)
In order to earn maximum credit, the comment should be more than your opinion, and more than a quick "off the top of your head" response. Be sure to support your statements, cite sources properly, cite within the text of your comments, and list your reference(s). The response must be a minimum of 250 words.
Paul, R. & Elder, L. (February 2008). The miniature guide to critical thinking concepts and tools. Foundation for Critical Thinking Press
Format your assignment according to the following formatting requirements:
1. The answer should be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides.
2. The response also includes a cover page containing the title of the assignment, the student's name, the course title, and the date. The cover page is not included in the required page length.
3. Also include a reference page. The Citations and references should follow APA format. The reference page is not included in the required page length.
Attachment:- Module-Background.rar