Question

Implementing a health program

Implementing a health program involves many challenges.

Use the South University Online Library, the Internet, and personal interactions with your local health authorities to understand the various facets of implementing public health programs. Based on your research and understanding, respond to the following:

Explain the four categories of information, which provide a useful framework for organizing a community health program.

Describe the importance of assessing program implementation in a public health program.

There are three levels of program implementation. Describe each of them and the significance of each level of program implementation.

The public health pyramid is an overarching framework for public health planning and evaluation. Explain program implementation at the various levels of the public health pyramid.

Answer 1

Many programs and interventions developed to improve conditions in local communities. Communities come together to reduce the level of violence that exists, to work for safe, affordable housing for everyone, or to help more students do well in school, to give just a few examples.

Examples of different types of programs include:

• Direct service interventions (e.g., a program that offers free breakfast to improve nutrition for grade school children)
• Community mobilization efforts (e.g., organizing a boycott of California grapes to improve the economic well-being of farm workers)
• Research initiatives (e.g., an effort to find out whether inequities in health outcomes based on race can be reduced)
• Surveillance systems (e.g., whether early detection of school readiness improves educational outcomes)
• Advocacy work (e.g., a campaign to influence the state legislature to pass legislation regarding tobacco control)
• Social marketing campaigns (e.g., a campaign in the Third World encouraging mothers to breast-feed their babies to reduce infant mortality)
• Infrastructure building projects (e.g., a program to build the capacity of state agencies to support community development initiatives)
• Training programs (e.g., a job training program to reduce unemployment in urban neighborhoods)
• Administrative systems (e.g., an incentive program to improve efficiency of health services)

Statement of need

A statement of need describes the problem, goal, or opportunity that the program addresses; it also begins to imply what the program will do in response. Important features to note regarding a program's need are: the nature of the problem or goal, who is affected, how big it is, and whether (and how) it is changing.

Expectations

Expectations are the program's intended results. They describe what the program has to accomplish to be considered successful. For most programs, the accomplishments exist on a continuum (first, we want to accomplish X... then, we want to do Y...). Therefore, they should be organized by time ranging from specific (and immediate) to broad (and longer-term) consequences. For example, a program's vision, mission, goals, and objectives, all represent varying levels of specificity about a program's expectations.

Activities

Activities are everything the program does to bring about changes. Describing program components and elements permits specific strategies and actions to be listed in logical sequence. This also shows how different program activities, such as education and enforcement, relate to one another. Describing program activities also provides an opportunity to distinguish activities that are the direct responsibility of the program from those that are conducted by related programs or partner organizations. Things outside of the program that may affect its success, such as harsher laws punishing businesses that sell alcohol to minors, can also be noted.

Resources

Resources include the time, talent, equipment, information, money, and other assets available to conduct program activities. Reviewing the resources a program has tells a lot about the amount and intensity of its services. It may also point out situations where there is a mismatch between what the group wants to do and the resources available to carry out these activities. Understanding program costs is a necessity to assess the cost-benefit ratio as part of the evaluation.

To improve how things get done:

• Refine plans for introducing a new practice
• Determine the extent to which plans were implemented
• Improve educational materials
• Enhance cultural competence
• Verify that participants' rights are protected
• Set priorities for staff training
• Make mid-course adjustments
• Clarify communication
• Determine if client satisfaction can be improved
• Compare costs to benefits
• Find out which participants benefit most from the program
• Mobilize community support for the program

• To determine what the effects of the program are:

  • Assess skills development by program participants
  • Compare changes in behavior over time
  • Decide where to allocate new resources
  • Document the level of success in accomplishing objectives
  • Demonstrate that accountability requirements are fulfilled
  • Use information from multiple evaluations to predict the likely effects of similar programs

• To affect participants:

  • Reinforce messages of the program
  • Stimulate dialogue and raise awareness about community issues
  • Broaden consensus among partners about program goals
  • Teach evaluation skills to staff and other stakeholders
  • Gather success stories
  • Support organizational change and improvement