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Module Seven
By the end of this module, you wil=
l be
able to:
1. Understand the basic framework for developing an
injury prevention program.
2. Identify the proce=
ss of
program evaluation
CLINICAL PREVENTION
AND POPUL=
ATION
HEALTH
Program Development and Evaluation
Ten
Steps for Developing an Injury Prevention Program
•Step One: Gather and Analyze Dat=
a
–The beginning point =
of any
injury prevention program is to examine the data related to morb=
idity
and mortality from injuries. With this information you shou=
ld be
able to make a list of cohort who are most likely to be injured=
and
what types of injuries are most frequent. It can also reveal injuries=
by
severity and by dispositions.
•Example: Injuries on
school playgrounds are common, though they rarely lead to death or permanent disabil=
ity.
Instead, there are many scrapes and bruises and an occasional broken bone. Your de=
cision
to start a prevention program for playground injuries will be based on careful wei=
ghing
of the answers to "How many children are being hurt, how badly and what can b=
e done
to decrease those injuries?" and "Are there other injury =
problems causing, mo=
re
death and disability that we should turn our energy and resources toward'?&q=
uot;
Step Two: Select the Target Injury =
and Population
•Collecting and analyzing data is the fi=
rst
building block of your prevention program. However, do not let it be the only
one. Too often people get stuck in the data phase, postponing prevention
because they use searching, for more data as an excuse to avoid decisions. =
You
may not be able to get all the data you would ideally wish, yet there =
is
enough to give a picture of the injury situation and a clear direction of w=
hat
needs to be done. There comes a point where you must be satisfied that the
data you have is enough to tell you where and how to begin. Then move to St=
ep
Two.
•Selection of a target injury and target
population will help you focus your prevention efforts Keep in mind that a narr=
owly
defined injury prevention goal and target population will make program
planning and evaluation much easier. Example: Imagine the program loosely shaped by t=
he
admonition, "Be careful" as compared to a program molded by the phrase,
"Wear your seat belt."
<=
span
class=3DBB style=3D'position:absolute;left:-3.73%'>•After identifying in=
juries
that cause a significant number of deaths or disability, other fa=
ctors
can help you narrow your choice:
•Severity
–<=
span
style=3D'font-size:64%;color:white;mso-color-index:0'>To what extent do=
the
injuries cause death or severe injury or disability?
•Frequency
<=
/div>
–How often does the
injury occur and to how many people? Data on injuries should be
examined across all age groups. The lives saved and disabilities decr=
eased
must be weighed against the frequency of occurrence.
=
<=
span
class=3DB1B style=3D'position:absolute;left:-3.16%'>–<=
span
style=3D'font-size:64%;color:white;mso-color-index:0'>The most vulnerab=
le
population should be identified. Example: In 1994, bicycle crashes k=
illed
about 800 people in the US. Approximately 175 of these deaths occu=
rred
in children 10 - 15 years old, even though this group only made up
about 9% of the national population
Step Two
•Prevention Method
=
–<=
span
style=3D'font-size:57%;color:yellow'>Is there an effective strategy to =
reduce
frequency and/or severity of the injury? Many injuries still lack effective prevention measures
even though numerous deaths make them obvious targets for preventio=
n.
Example: Bicycle injuries are common among school-age children. The use =
of a
properly fitted helmet can prevent serious head injuries. Pedestrian
injuries cause more deaths in this age group but there are no inexpens=
ive,
readily available strategies which have been shown to reduce the frequency or
severity of these injuries.
–<=
span
style=3D'font-size:57%;color:yellow'>Are there monetary and staff resou=
rces
available? Think about the cost of =
the program. Also co=
nsider
whether program educational materials are already available in-house o=
r if
they could be easily developed. Is there an interested staff person that ca=
n be
trained to address the problem? If the problem is large and the community is
committed, resources can usually be found to address the problem.
=
–Does the community care about the
problem? Consider if the community knows and cares about the problem. While it=
is
possible to educate the community about a serious problem, it will =
be
easier to mobilize people if the community already cares about the injury to=
pic.
Also keep in mind that some injuries are seasonal and your community mi=
ght
be more interested in a specific injury, such as drowning, at certain times =
of
the year.
Step Two
Step Three: Determine Intervention =
Strategies<=
/span>
•After identifying a target injury, you =
will
want to spend some time considering the many factors that play into=
the
injury's occurrence.
•These factors will help you identify how
the injury might be prevented. The factors can be divided into three main
areas:
– the person,
– the causes of injury and
–the environmental conditions surrounding
the injury event.
•If you consider what happens in each of
these main areas before the injury occurs and what you might do to prev=
ent
those events, you are on your way to selecting an intervention strategy.&=
#13;
– Example: Think about motor vehicle collisions. T=
he
drive may bring such factors as alcohol intoxication, poor vision, fati=
gue
and lack of driving experience. The causes of injury may include brakes, tires and =
speed of travel. The
environmental conditions may include a wet roadway, dark night =
and
poor road signage. Obviously there are many more possible factor=
s.
•Successful interventions will include a=
mix
of passive and active methods. Strategies that are passive happen
automatically and therefore do not require a conscious decision by the individ=
ual.
–An example of this is the protection a =
seat
belt provides in a motor vehicle collision. Active interventions necessitate
"action" on the part of the individual. For example, an indi=
vidual
must fasten a seat belt for it to act as protection in a collision. Those
strategies that require decision making on the part of the <=
span
style=3D'position:absolute;top:48.25%;left:14.04%;width:95.5%;height:3.5%'=
>individual are going=
to be
more difficult because they require someone to make a conscious choice to =
change
their behavior and, often times, repeat this new behavior over and ov=
er
again.
–Example: You may choose to focus on
promotion of bicycle helmets. You may choose to create edu=
cation
materials and have a bicycle rodeo that encourages bicycle safety
(education). As part of the program perhaps you will try to get a <=
/span>law passed to require
bicycle helmet use in your area (legislation). Bicycle helmets themselves c=
ould
be considered a technological solution. These are simply examples of
possible pieces: you do not necessarily need to use all three strategies in your p=
rogram
though the more you use them, the greater success you are likely to ac=
hieve.
Step Three
<=
span
class=3DBB style=3D'position:absolute;left:-3.82%'>•Selection of Strateg=
ies As
you look at the different factors involved in an injury occurre=
nce,
consideration of the following will help you identify the strateg=
ies
you may want to use:
•1. Consider who will implement the
strategy.
<=
span
class=3DB1B style=3D'position:absolute;left:-3.11%'>–<=
span
style=3D'font-size:64%;color:white;mso-color-index:0'>The selection of the
prevention strategy and particular technique chosen to accomplish it may
depend on who in the community will be doing it.
•Example: Given the goal of
improving pedestrian safety, schools are likely to choose
educational techniques such as a pedestrian safety curriculum. City eng=
ineers
might install a walking signal and crosswalk (technology) to improve a dangero=
us
street crossing and police may choose to strictly enforce speed limits in
school zones (legislation).
Step Three
•<=
/span>2. Remember to target your
message.
–You should tailor your interventions to=
the
specific population and need. Example: In Hawaii, bathers must be educated abo=
ut
surf and undertow. Because Hawaii has many Japanese tourists, warning signs need to be in Japane=
se as
well as English. When writing educational material targeted at=
the
elderly, bigger font size will make the piece easier to read.
Adolescents might respond better to a fast paced video than a brochure. =
3;
•3.
The strategy must be acceptable to the target audience.
=
–You will want to be sure that you are
promoting something reasonable and practical for your target audience. The=
re
is no use in promoting something so outlandish that no one would e=
ver
do it. Consider if you wanted to reduce injury in motor vehicle
collisions. One way to do this might be to encourage drivers to wear helme=
ts
in their cars. While individuals who wore helmets might reduce/avoid injury,=
it
is not very practical to think that the public would be amenable to
this idea.
Step Three
Step Four: Develop An =
Implementation Pla=
n
•State
Your Goal - Be Specific!
–The goal should be clearly stated in
measurable terms.
– It must be specific as to exactly =
what
you plan to do, for whom and in what time period. The more focused a=
nd
specific the goal, the more guidance it will provide for your program implementation and
evaluation measurement.
–The goal of "reducing injury"
does not give good clues as to what to do, for whom, and certainly not how. It =
is a
set-up for failure because seeing a change in death and injury statistics =
may
take years and will be difficult to attribute to your program. Try this instead: "Reduce
childhood death and hospitalization due to head injury by incre=
asing
the wearing of bicycle helmets 30% among children 5 - 12 years in Spokane Coun=
ty
over the next five years". Exactly who, what and how is clear.
Step Four
•Write Objectives
<=
span
class=3DB1B style=3D'position:absolute;left:-3.15%'>–<=
span
style=3D'font-size:71%;color:white;mso-color-index:0'>Objectives tell you =
how
you are going to go about accomplishing your goal. Again, re=
member
that the more focused the program, the more easily it is accomplished.
–Example: Using bicycle helmet=
s for
children again, the following objectives might be some of those utilized =
to
reach the above goal:
–
•Educate parents that=
their
children can be seriously injured from bicycle crashes.
•Educate parents that
bicycle helmets can reduce serious injuries.
•Reduce peer pressure=
so
children will wear helmets.
•Ensure the availabil=
ity of
low-cost helmets.
<=
span
class=3DBB style=3D'position:absolute;left:-4.04%'>•Increase general com=
munity
awareness of the problem of bicycle related head injuries.
•
Step Four
•<=
/span>Develop Program Ideas
•The above objectives are clear, aim at =
the
goal, and are measurable.
–Each objective needs specific actions on
your part to accomplish it. This is where coalition members st=
art to
take part (See Step 5). Programming might include participation in a h=
ealth
fair, hosting a bike rodeo or conducting school assemblies. Think ab=
out
events that occur in the community throughout the year where your program t=
heme
would fit in well.
–For example, a local hospital might hav=
e a
fair in which you could take part.
–
•You will want to choose an implementati=
on
strategy that has already been designed and evaluated for efficacy. Your r=
ole
will be shaping and tailoring this strategy to fit your community's resou=
rces
and needs. For example, you may not have the resources available to do =
all
of the program parts. Instead, you can prioritize and choose the most fitting
pieces for your community. You may decide that you want to narrow the f=
ocus
of the target audience.
– For example, a strategy may be des=
igned
for the general population and you want to really focus on adolescents. This
tailoring will make an intervention strategy work best for you and provides a s=
ense
of ownership.
Step Five: Identify, Select and Commit
Community Agencies to Implement the Program
•<=
/span>Coalition Formation
•A coalition is a loosely organized grou=
p of
individuals that each represent agencies and organizations that work toward=
a
common goal. Each member contributes knowledge, expertise and action
appropriate to their field of interest. Three elements are essential for =
an
effective coalition.
–The lead agency takes responsibility and leadership for the injury
prevention program. Within the lead agency there should be a designated coordinato=
r.
This is preferably a paid position or a percentage of a staff job.
–The coordinator is responsible for planning the goal and objectives for
the project and ensuring that they are accomplished. The coordinator
may draw upon his/her lead agency or a consultant for assistance,
direction and advice. The coordinator plans and leads meetings, serve=
s as
a communications hub for the coalition members, motivates the members to
perform activities and moves the project along toward completion.
–Enthusiastic
and committed members are vital to the project. They are the individuals who will
disseminate information and conduct activities. As the lead =
agency, you will alr=
eady
have developed the program objectives and framework. Lay those out for th=
em,
get them to agree and thus buy-in to the pro-ram, and then move right into=
the
methods - what they will actively do.
Locating Potential Coalition =
Members
•Agencies should have a mission
consistent with that of the program's goal.
–Example: If you are implem=
enting
a bike helmet program, bike shops may not be a good addition to =
your
coalition. Bike shops want to make money. This is not the same =
goal as saving li=
ves.
Although bike shops are an important piece in a helmet program, it may be disrupt=
ive to
have them in a planning role with the coalition. It may be better to ask for their
cooperation later and tell them how they can help.
•Members who represent an agency have=
the
buy-in and back-up of their agency both to accomplish tasks =
and
for credibility of the program. Individuals may not have this kind of =
support.
•Consider all aspects of the injury
problem and all the interventions you may employ to insure that you h=
ave
the mix of professions and disciplines that will facilitate your goals.
•Non-traditional agencies and groups
should be considered.
– Example: Insurance compani=
es are
beginning to play a role in injury prevention. Those offering au=
to
insurance may be very interested in joining traffic safety efforts.
•Think about what resources you will =
need
and make sure you include members who can help supply those
resources.
•Remember that it is not the quantity=
of
coalition members that is important, but the quality. A few energetic p=
eople
can accomplish a great deal!
Step Six: Develop an Action Plan
•While the goal and objectives should be=
developed by the
coordinator, activities to accomplish the objectives are the
responsibility of the coalition members.
•Developing a an action plan will formal=
ize
each members' commitment to specific activities and =
how they will
contribute.
• Duties can be selected and assigned
based on the activities.
•Coalition members must be able to choos=
e =
activities which the=
y are
accustomed to doing and have the resources and skills to accomplish.=
Educatio=
nal
Strategies
•Many programs rely heavily on education=
as
a technique. The most effective educational efforts couple personal interacti=
on
with printed educational materials and a media campaign. The more wa=
ys
and places a person sees and hears the injury prevention message, the
more likely it will produce an effect.
•
•<=
/span>Printed Materials
=
–Printed materials such as posters,
brochures, flyers, curriculums or guides will help in education.&#=
13;
–
•<=
/span>Media
–Public information through the media can
act as an effective complement to your other strategies and
allows you to get your message out to man people.
–
•<=
/span>Personal Interaction
=
–Personal interaction is the most effect=
ive
educational tool and must be used in addition to printed materials and media
messages. Assembly programs in schools, presentations at meetings, and
counseling by health care providers are ways to relay a pers=
onal
message to many people.
Legislat=
ive
Strategies
•Legislation is very effective once enac=
ted
but requires extensive planning and usually long-term work is re=
quired
to influence the legislative process. The following specific =
tools are helpful: &=
#13;
•
–A packet designed for legislators that
clearly presents the facts, costs and sides of the injury issue =
and
the legislation being proposed as an intervention. Ideas about how this legis=
lation
could be enforced should be included.
–Convincing data. Often the economic
argument is more persuasive than death statistics. <=
span
style=3D'font-size:57%;color:white;mso-color-index:0'>Example: At the major trauma =
center
in the state of Washington, 63% of the cost of motorcycle injuries is paid =
for
by public funds. This was an influential fact in the passage of the 1989
legislation requiring motorcycle helmets.
–One or more legislators who will sponsor
the bill. They can work to influence other legislators and will appear before the
media to reach the public.
–Close contact with a legislative staff
person and the services of an organizational lobbyist such as tha=
t of a
state medical association can be invaluable.
–Grass roots involvement. Legislators ne=
ed
to hear that their constituents want the bill. A coalition can
brainstorm for organizations and individuals to contact. Every person on a coalitio=
n must
contact their own stakeholders to explain the legislation and enco=
urage
letters and telephone calls to legislators. This is a final =
step but must be done
quickly and efficiently as the bill comes before the legislature.
•=
Technolo=
gical
Strategies
•There are two vital steps to technological strategies.&=
#13;
• One step is to develop and produce=
the
technological method and the second is to market it. Development and
production of the technological device certainly may be beyond the capabili=
ties
of your community coalition. However, a community-based program can be
extremely effective in distribution of the item and promotion of i=
ts
use once it has been developed.
–Example: Life jackets are now
attractive and comfortable to wear. The boating public needs to know=
that
and be educated about the importance of buying and using life jackets.
Creating a demand can also result in lowering the cost which would be an addition=
al
benefit to the public.
–
•Incorporating a coupon discount plan in=
to
your prevention program may increase the program's success. You can work
with a manufacturer or distributor to negotiate a discount.
•
•The coalition may also want to raise fu=
nds
to buy the prevention item, such as bike helmets or smoke detectors. A bulk
purchase such as this often makes the item less expensive which means t=
hat
you can sell the item to the public for a nominal charge
Step Seven: Orient and Train Agencies/Individua=
ls
Implementing the Intervention Plan
•The orientation and training of those
implementing the program helps to insure that they understand their role.
=
;
– It is also helpful for the coaliti=
on
members to have an overall understanding of the scope of the pro=
gram,
how it addresses the need for injury prevention and fits into the larger pict=
ure -
at least a picture as large as your state's efforts for injury prevention.
– Although knowledge of the philosop=
hy of
injury prevention is not necessary for community people, it=
can
be helpful because everyone working on the program in effect an ambassa=
dor
for injury prevention. They will interact with others and represent the progra=
m so
the better understanding they have, the more they may influence others. As=
the
project continues and grows, new members will need to be trained as well.&=
#13;
•This step also implies open and two-way
communication between those working on the program.
<=
/div>
– As people begin their tasks they m=
ust
know what is expected of them and how to go about their
activities.
–They can bring feedback to the group as=
to
the workability of the methods, effectiveness of the tools and reaction from
the community. They can contribute ideas and suggestions for changes.
Step Eight: Implement the Program
•Start
- don't plan forever.
–The initial enthusiasm of coalition mem=
bers
will be lost if you have too many meetings before activities begin.
– Plans can be changed and tailored =
even
as the program is being implemented. In fact, this is ideal because is wi=
ll
allows your program to be flexible and responsive to obstacles.
–
•Remember
that not everything can be done the first year.
–Save activities that need more planning=
for
the second and subsequent years.
–First do the activities that are easiest
and most likely to succeed.
Step Nine: Monitor and Support the =
Program
•Stay in touch with everyone involved with the =
program to insure th=
at all
parts of the project are running smoothly.
•The coordinator shou=
ld
give encouragement, listen to problems and offer suggestions.
<=
/span>•Meetings can provide=
much
of this communication and are a mechanism to involve <=
span
style=3D'font-size:88%;color:white;mso-color-index:0'>the entire group in
success stories and problem areas.
Step Nine
<=
span
class=3DBB style=3D'position:absolute;left:-3.83%'>•Once the program is
underway, most decisions should be made by the coalition.
<=
span
class=3DBB style=3D'position:absolute;left:-3.76%'>•Group decision-making
enhances cohesiveness and promotes a sense of ownership and =
responsibility.
=
;
–However, individual
communication from the coordinator to a coalition member may be
necessary to give technical expertise or deal quickly with a decision involving o=
nly
that member.
= ;
= ;
Step Nine
•Track activities. A reporting form=
can
be d=
istributed
for each agency to return as an activity is completed. This is a valuable source for numbers such as how man=
y people were reached by the activit=
y, number of brochures handed out, ho=
urs spent, etc. This information will =
be important for later program
evaluation.
Step Nine
•Be flexible . The ideal program as mapped out on paper must be able to chang=
e according to the reality of
implementation. The coordinator and coalition must be sensitive to the need for a change=
and then enact a method more suited to=
the actual situation.
Step Nine
•Be aware of group dynamics. A coal=
ition
is m=
ade up
of people with different backgrounds, viewpoints and expertise. Group process is rewarding but can=
be quite challenging
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Step Ten: Evaluate and Revise the =
=
Program
•You will want to know if your program is
helping you reach your stated goal. Evaluation will =
supply this informat=
ion.
•Evaluation must be planned at the begin=
ning
of your program and be ongoing in order to be a =
useful tool. It will=
allow
you to report the effect of your program and provides accountability to=
funding sources and =
the
community.
• Good program management also makes=
evaluation a necessi=
ty.
Step Ten
•Program evaluation&#=
13;
<=
span
class=3DBB style=3D'position:absolute;left:-3.7%'>•Even if you are
implementing a program that has already been developed and evaluated, you s=
till
n=
eed to
evaluate your program to monitor its progress and measure its success in your particular community.
•There are two parts =
to
program evaluation:
–<=
span
style=3D'font-size:86%;color:white;mso-color-index:0'> process evaluation and
–<=
span
style=3D'font-size:86%;color:white;mso-color-index:0'>
outcome evaluation.
Step Ten
•Process
evaluation - Are you =
doing
what you said
you would do?
•Process evaluation involves quantiti=
es.
Every method or activity to accomplish the objectives =
should be quantif=
iable
and counted. This is where reports on activities from coaliti=
on members becomes v=
ital.
–Example: Number of school assembly
programs done, number of posters distributed, number of <=
/span>physicians counse=
ling
patients, etc. Weak spots of implementation can be found and improved=
.
Step Ten
•Outcome evaluation measures the final
outcome you are aiming toward - usually a reduction in injury. You should h=
ave
access to a data surveillance system which will give you baseline figures
before your program begins. You can then track data for changes. Howeve=
r, a
warning is in order - the numbers are so small for each injury problem
that a change for a year can only be considered a facetious
"blip". You must watch for a gradual decline over at least a five=
year
period and even then you must be very cautious about attributing su=
ch a
decline to your program. Be aware of what else has gone on in the commu=
nity
which may have influenced the decrease in death and injury.
•A mid-program evaluation is also valuab=
le
because it can alert you to revisions that are needed in the program to
make sure that you are moving toward your goal. Example: Helmet users could be
counted at the beginning of activities for the biking season and at =
the
end for each of the five years of tile program. A steady increase should be s=
een.
If not, revisions in activities need to be made.
Step Ten
•Experimental
Research
•Experimental research refers to the usa=
ge
of scientific research methods and design which conform to the experimental model to
measure the effectiveness of new programs. This is best left to academic
settings where there are adequate evaluative resources. If you are developing a pro-ram=
from
scratch with strategies and interventions never before tried, you must
evaluate it for its effectiveness. If you are not equipped to conduct s=
uch research, contact yo=
ur
local university, teaching hospital, or regional injury prevention center for he=
lp.
Supporti=
ng
Activities
•The importance of the media is often
overlooked in community-based health programs. Yet it is a powerful
tool to use in raising public awareness about your injury problem =
and
its solutions. The most effective way to Utilize the media is to have them
join in a partnership with you on your prevention program. They may not join the coalition per se=
but
would sponsor the program. For example, a =
newspaper could take=
on
the prevention effort as an editorial agenda item. Editorials would be publis=
hed
periodically. The public affairs division of your local radio or
television station could sponsor the program through their own work in commu=
nity
relations. They, like most organizations, want their name on the efforts=
.
Working with the Media
•Public Service Announcements (PSA's) - =
TV
and Radio
–A PSA can capture attention and be used=
as
a complement to other public education efforts; by itself <=
span
style=3D'position:absolute;top:36.0%;left:14.04%;width:94.38%;height:5.25%=
'>a PSA is ineffective=
. A
station might film a PSA (at no charge to you) or would certainly air one t=
he
coalition has made (these are very expensive unless the filming is donated).
Remember, a PSA is not bought and paid air time, it is a service provided=
by
the media, so PSA's are usually aired at odd hours. A television PSA shoul=
d be
no more than 30 seconds in length.
–An effective radio spot should read for
10-15 seconds. Stations usually want the copy rather than pre-recorded
announcements.
Programm=
ing
•A news story, talk show, or specific
program can be an excellent vehicle for publicity.
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–However, before approaching a station, =
do
your homework. If you think your prevention program is worthy of news
coverage, be able to explain why it is important. If you are able to detail some "angles&qu=
ot;
for coverage, outline possible visuals for TV, and offer to help arrang=
e the
interviews and details required for reporting a story you will increase the cha=
nces
for coverage.
–Keep in mind that while filming a news
report may take several hours or even days, coverage is often limit=
ed
to one or two minutes of air time.
–Also remember you need to demonstrate
exciting and different aspects of your program in order to receive
more than just coverage at the "kick-off".
Newspaper
and Newsletter Articles
•The newspaper is a powerful tool in pub=
lic
communication. A news article can convey more information than brief TV and r=
adio
c=
overage.
You can either write a press release and mail it to newspapers or talk w=
ith a
reporter about covering your story. The same applies to
newsletters. There are hundreds of newsletters that would be appropriate=
for
information on your prevention program. Most newsletter edit=
ors
want articles but would rather have one arrive on their desk already written th=
at
allows them editorial liberty to fit it into their upcoming issue.
•"Victim Story"
•The victim story is an interview or art=
icle
with an injured child or the family and is a great way to receive covera=
ge.
It humanizes the injury problem and gives your program a personal dimens=
ion.
It is also the most likely to receive attention from the media. A "victi=
m =
story" is
particularly effective in smaller local newspapers. Families are often very glad =
to
give interviews as it allows them to tell others how to avoid injury.=
Evaluati=
on of
Programs
•Remember that there are two ways an inj=
ury-prevention program c=
an be
successful.
–The obvious way is if it reduces injuri=
es
and injury-related deaths.
– The other way is if it shows that a
particular intervention does not work.
– A program is truly worthwhile if it
implements a promising intervention and, through evaluation, shows <=
/span>that the interventio=
n does
not<=
/i> reduce injuries. Su=
ch a result would be of g=
reat
value to the injury prevention community: it would save you and other prog=
rams
=
from
wasting further resources and time on that
particular intervention.
particular intervention.
DEMONSTRATING YOUR PROGRAMS WORTH
•Evaluation is the process of deter=
mining
whether
programs—or certain aspects of programs—are appropriate, adequate, effective, and efficient and, if n=
ot,
how to m=
ake
them so. In addition, evaluation shows if programs have unexpected benefits or create unexpected prob=
lems.
Why Evaluate Injury-Prevention =
Programs?
•To learn whether proposed program mater=
ials
are suitable for the people who are to receive them.
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•To learn whether program plans are feas=
ible
before they are put into effect.
•To have an early warning system for
problems that could become serious if unattended.
<=
/div>
•To monitor whether programs are produci=
ng
the desired results.
•To learn whether programs have any
unexpected benefits or problems.
•To enable managers to
improve service.
•To monitor progress =
toward
the program’s goals.
• To produce dat=
a on
which to base future programs.
•To demonstrate the effectiveness of the
program to the target population, to the public, to others who want to conduct
similar programs, and to those who fund the program.
•
![](3D"slide0039_image002.gif")
Four Categories of Information =
Produced by Evaluation
Data about aspects of program that need =
improvement and about which staff is unaware. This is the type of information staff most expects when evaluation begins.
4. New information.
Indicates program needs
Indicates program needs
improvement.
Data about aspects of program that work =
well, but staff does not know
about them.
All evaluation uncovers some pleasant surprises, but program staff rarely expects them.
3. New information.
Indicates program is working well.
Indicates program is working well.
Data about aspects of program that need =
improvement, that staff knows about and hopes will not be found out. Staff <=
/span>=
is unlikely to mention these aspects to =
the evaluator.
2. Information staff knows already.
Indicates program needs
Indicates program needs
improvement.
Data about aspects of program that work =
well, that program staff knows about, and that should be publicized whenever <=
/span>possible.
<=
/div>
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=
1..Information
staff knows already.
Indicates program is working well.
Indicates program is working well.
=
; &n=
bsp;
Description
=
;
Characteristics
![](3D"slide0040_image003.gif")
Steps
Involved in Any Evaluation
•1. Write a statement defining the
objective(s) of the
•
evaluation.
•2. Define the target population.
=
;
•3. Write down the type of informatio=
n to
be collected.
•4. Choose suitable
methods for collecting the &=
#13;
•
information.
•5. Design and test instruments
appropriate to the
•
chosen methods for collecting the information.
•6. Collect raw information.
=
•7. Process the raw
information.
•8. Analyze the
processed information.
•9. Write an evaluation report descri=
bing
the
•
evaluation’s results.
![](3D"slide0041_image004.gif")
STAGES =
OF
EVALUATION
<=
span
class=3DBB style=3D'position:absolute;left:-3.73%'>•Evaluation has four =
stages
that are begun in this order: formative, process, impact, and outc=
ome.
P=
lanning
for each stage begins while an injury prevention program is
being developed, and no stage is truly complete until the program is
over.
–<=
span
style=3D'font-size:86%;color:white;mso-color-index:0'>Stage 1: Formative Evaluation
–<=
span
style=3D'font-size:86%;color:white;mso-color-index:0'>Stage 2: Process Evaluation
–<=
span
style=3D'font-size:86%;color:white;mso-color-index:0'>Stage 3: Impact Evaluation
<=
/span>
–<=
span
style=3D'font-size:86%;color:white;mso-color-index:0'>Stage 4: Outcome Evaluation
![](3D"slide0042_image005.gif")
Form=
ative
Evaluation
•Formative evaluation is a way of making
sure program plans, procedures, activities, materials, and modifications will w=
ork as
planned.
• Begin formative evaluation as soon=
as
the idea for a program is conceived.
•Conduct further formative evaluation
whenever an existing program is being adapted for use with a different target population or=
in a
new location or setting.
• A program’s success under on=
e set
of circumstances is not a guarantee of success under other circumstances.&#=
13;
• For evaluation purposes, an adapted
program is a new program. Another occasion for formative evaluation is <=
/span>when an operating pr=
ogram
develops problems but the reason is unclear or the solution not obvio=
us.
![](3D"slide0043_image006.gif")
Process
Evaluation
•The purpose of process evaluation is to
learn whether the program is serving the target population as planned=
and whether the numb=
er of
people being served is more or less than expected.
<=
/div>
•Begin process evaluation as soon as the
program goes into operation. At this stage, you are not looking for =
results. You are mer=
ely
trying to learn whether you are connecting with people in your target
population as planned and whether they are connecting with you.
<=
/span>
• Essentially, process evaluation in=
volves
counting all contacts with the people you are trying to reach and al=
l events related to th=
ose
contacts.
![](3D"slide0044_image007.gif")
Impact
Evaluation
•The purpose of impact evaluation is to
measure whatever changes the program creates in the target
population’s knowledge, attitudes, beliefs, or behavior=
s.
•Collect baseline information for impact
evaluation immediately before, or just as, the program goes into
operation.
• Gather information on changes brou=
ght
about by the program as soon as program personnel have completed th=
eir
first encounter with an individual or group from the target
population.
– For example, the first encounter m=
ight
be with a person who responded to a newspaper advertisement announcing the
availability of low-cost smoke detectors for people with low incomes=
. Or
your first encounter might be with a group of people in a class on how to
install a child’s car seat. Impact evaluation gives you intermedi=
ate
results of the program (e.g., how much people’s knowledge or
attitudes about restraining children in car seats have changed).=
![](3D"slide0045_image008.gif")
Outc=
ome
Evaluation
•For ongoing programs (e.g., a series of
safety classes taught each year to all third graders in your area), conduct outcome eval=
uation
at specified intervals (e.g., every year, every 3 years, or every 5
years).
•For one-time programs (e.g., distributi=
on
of a limited number of free smoke detectors to people with low incomes), conduct ou=
tcome
evaluation after the program is finished.
–The purpose is to learn how well the
program succeeded in achieving its ultimate goal (i.e., decreasing injury-re=
lated
morbidity and mortality).
–Such decreases are difficult to measure,
however, because the rates of morbidity and death due to unintentional injuri=
es are
low.
– Measuring changes in events that o=
ccur
infrequently takes a long time (usually years) and requires a large =
number of study
participants.
CDC Evaluation Resources
•Explore the following links for fu=
rther information about evaluation or
assistance in
conducting an evaluation project.
<=
span
style=3D'font-size:75%;color:white;mso-color-index:0'>• =
http://www.cdc.gov/eval/resources.htm#manuals
<=
span
style=3D'font-size:75%;visibility:hidden'>•
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