Download - Health Promoters Program_HealthEduc series-1
Understanding the roadmap for
Effective Health Programs When Health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes
useless, and intelligence cannot be applied” Herophilus of Chalcedon 335-280 BC
Presented by: Dr. Bimbola Idowu
• Objectives
• About African American Health Program
• Define effective health program
• Components of an effective health program
Outline
At the end of this presentation health promoters will be able to:• Explain an effective health program
• Identify core components of an effective health program
• List building models for your program
• Describe steps in at least one of the models
Objectives
The African American Health Program (AAHP) was created in 1999 and is funded by the Montgomery County Department of Health and Human Services and administered by BETAH Associates, Inc.
AAHP History
Our Mission
• To eliminate health disparities and improve the number and quality of years of life for African Americans and people of African descent in Montgomery County, MD
• AAHP serves Montgomery County residents of all socio-economic statuses
Our Goals1. To raise awareness in the Montgomery
County community about key health disparities.
2. To integrate African American health concerns into existing services and programs.
3. To monitor health status data for African Americans in Montgomery County.
4. To implement and evaluate strategies to achieve specific health objectives.
AAHP Strategy: Toward Health Equity
To bring together community partners and resources in a collaborative and efficient
manner to support the goals of the African American Health Program.
AAHP Health Disparity Areas
► Infant Mortality ► HIV/AIDS ► Cardiovascular ► Cancer ► Diabetes
► Oral Health
What is an effective Program?
Effective Program can simply be described as a planned program based on evidence (research) with clear and systemic strategies for implementation
Importance of having an effective Program
Use of programs especially for outreach have emerged as a major strategy to:facilitate education
prevention
information dissemination
capacity building in addressing health related issues
Program Model“A chart or visual diagram that provides representation ofhow program activities/services are linked to desired changes in the target population” Card & Akers, 2009
Components of an effective Program (1 of 2)
Program model Problem statement; formal theories of behavior
change – what is the problem; need or gap
Target population – who will benefit from this intervention
Goals and objectives – what does the intervention aim to achieve among the target population
Components of an effective Program (2 of 2)
Program model Program activities; resources – what will
the intervention do; cultural sensitivity
Linkages to desired results – how the intervention will have its intended results
Monitoring and Evaluation
Problem (1 of 2)
What is the Problem?Need
e.g.- heart attacks as cause of death among young African immigrants
Gap –addresses missing link between need & servicese.g. no culturally designed brochures for African
immigrants
Problem (1 of 2)
Write the problem statement?Content
vision, affected target, evidence of scope of problem
Probable cause of the problem, gap
Ideas on how to address it
Indicators that show that the problem has been addressed
Target Who will benefit from this intervention?
Age, gender, race/ethnicity, culture
How do you identify the group of interest?General observation
comments from members of the community; news
Data – to justify your observationSources: local health department; community
health departments in case of studies by academic staff
Community needs assessment
Goals & Objective (1 of 2)
GoalVery important pieceGuides program planning and designCommunicates to stakeholdersEnables evaluation
Success is dependent upon realistic goals
Goals & Objective (1 of 2)
GoalCharacteristics
Describe the overall purpose of the program
Describe broad outcomes and concepts (what we want to accomplish)
Expressed in general terms
Goals & Objective (1 of 2)
Objectives
Specifically state how the goals will be achieved
Are measurable: Define what you want to see
Encourage a consistent focus on program functions
Objectives are not Tasks
Objectives (1 of 2)
Characteristics SMART Specific: Be precise about what you are going to
achieve Measurable: Quantify the objectives Appropriate: Align with the needs of the target
audience Realistic: Do you have the resources to make the
objective happen? Time-Specific: State when you will achieve the
objective
Goals & Objectives (1 of 2)
Goal
Objective 1
Objective 3
Objective 2
Tool
Objective
Verb Metric Population Object Baseline Measure
Goal Measure Timeframe
Breakdownregister Percent
age
Young African
immigrants in zip code
Healthy heart class 0% 2% December
2011
By December 2011, at least 2% of young African immigrants in zip code 20904 will register for healthy heart class
apply Percentage
Healthy heart class
members
Young African
immigrants that apply for class
-- 3% Annually
On an annual basis, at least 3% of members that apply to the healthy heart class will be young African Immigrants
Program Activities (1 of )
2 planning models Theory Logic model
Outcome approach model
Monitoring and Evaluation
Theory Logic Model (1 of 3)
What is a theory?Lay man’s view
Guess, a hunch
Scientist’s viewA fact based framework for describing a
phenomenonProvides a roadmap for understanding human
behavior, emotions, attitudesDescribes a behavior and makes predictions about
the future
Source: http://psychology.about.com/od/tindex/f/theory.htm
Theory Logic Model (2 of 3)
Examples:The Health Belief Model
Information- Motivation Behavior Model
AIDS Risk Reduction Model
Theory of Reasoned action
Social Learning/ Cognitive Theory
Theory Logic Model (3 of 3)
Assumptions Inputs Activities Outputs Outcomes Impact
Outcome Logic Model
Inputs Activities Outputs Outcomes Impact
Monitoring and Evaluation
MonitoringBuilt into the Input phaseGathers descriptive data on operation of programAnswers of interest are:
What services are delivered?
What resources are used in the delivery?
Who is served – characteristics?
Do participants & staff like the program?Describing “what is” without any attached
judgment
Evaluation (1 of 3)
Process Who, what, where, when, how questions?
More comparative than monitoring
Assesses “what is” vs. “what was intended/planned”
It helps discover what staff is doing? Which participants are attending?
Tools: Data collection Sign-in sheet Designed form for staff and participant satisfaction
questionnaire Various points
Evaluation (2 of 3)
OutcomeFocus is on program effectiveness
Short term, intermediate & long term outcomes
QuestionsDid the program make a difference in
participants?Under what circumstances was the program most
effective?What aspects of the program were responsible
for the changes?
Evaluation (3 of 3)
OutcomeLong term and impact outcomes very
tedious, takes time, moneyComparison is not only with the
participants but also with a comparative group
Large sample size for identified differences to be significant
Data collection at beginning, specified intervals and at the end
Challenges & Barriers Peculiar to every phase of the Program ModelInternal
Is it well articulated for others to understand & buy-in?
Is it worth my agency investment?Change in agency leadershipHow many stakeholders would be brought on board
ExternalGovernment policy change in direction
Environmental – natural disasters, community priorities
References Card, J.J. & Akers, D.D. (2009). How to plan, implement and
evaluate your HIV Prevention Program. Sociometrics Press Fisher, D., Chinman, M. et al. (2006) Getting to outcomes with
developmental assets: ten steps to measuring success in Youth programs and communities www.rand.org/pubs/technical_reports
Fowler, C.J.C (2008). Achieving outcomes through best process program design and evaluation. MAPHTC training handout
Nagle, B. (2009). SMART: Developing effective goals and objectives. national.spacegrant.org/.../presentations/.../SpaceGrantPresentationMarch09.ppt
W.K. Kellogg Foundation Evaluation Handbook/ Logic Model Development Guide CD
What is a theory? http://psychology.about.com/od/tindex/f/theory.htm