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