Public Health: What It Is and How It Works, 2^nd Edition

PUBLIC HEALTH PRACTICE EXERCISE 2

• Objectives
• Directions
• Scenario
• Health Problem
• Intervention Strategy
• Work Plan
• Evaluation Strategy

Objectives

With the completion of this exercise, learners will be able to:

define a health problem, its determinants and contributing factors in a manner that facilitates development of an appropriate intervention

develop process impact and outcome objectives for the defined health problem

identify resources necessary to address the problem, and

develop a program work plan and evaluation strategy

Review the attached materials and undertake the planning process described below with your group. Additional information related to program planning and management can be found in Chapter 7 of the text. Each group will follow the general approach described below.

Directions

First, identify, obtain and review background materials on your group’s assigned health problem, as well as any relevant materials from Exercise 1. The Community Tool Box web site may also provide you with some useful insights and information. The Healthy People 2010 Toolkit may be another useful resource.

Next, meet as a group to complete the tasks identified described below. These call for your group to develop an appropriate intervention by formulating a problem statement, analyzing the problem for its determinants and contributing factors, establishing outcome, impact and process objectives, developing a work plan and budget, and designing an evaluation strategy. Each group should complete and submit the equivalent of Exhibits 1 through 5, as described below, PLUS an Executive Summary of their proposal (not to exceed one page). Develop the Executive Summary in a format suitable for submission to the Health Committee of the Chicago City Council. The completed exhibits (or equivalents) are judged based on how well each group develops the problem statement, desired outcome objective, problem analysis, objective setting, work plan and evaluation plan. The Executive Summary is judged on how effectively the arguments for your proposal are communicated. You may develop your Executive Summary in any way that you choose, but it should summarize the problem (why is this important?), the approach (what will be accomplished?) and how progress and success are tracked. The Health Committee will recommend 3 programs for funding!

You are part of a citywide planning group that has proposed priorities for the city's Health Improvement Plan at the request of the Mayor. The priority setting process has progressed well and priorities have been defined. To that end, the Mayor and City Council assured an appropriation of $1,000,000 for the next fiscal year to begin an intervention program for "Health Problem X." The general goal is to reduce mortality and morbidity due to Health Problem X in the City of Chicago. All of the available resources are directed toward this goal. EACH GROUP WILL SELECT THE HEALTH PROBLEM THAT THEY WILL ADDRESS.

State the Health Problem and the Desired Outcome Objective

It is possible that the members of your group may determine that they lack the necessary information to complete their task. In that case, determine the questions that you would ask and the data and information that should be collected in order to:

Characterize the current state of the art for control of Health Problem X

Develop a carefully designed problem statement that includes the magnitude and extent of the problem, the population at risk and pertinent trends

Determine the resources available to address the problem and any additional resources that might be needed, and

Develop a desired outcome objective for the health problem

Then, record your problem statement and desired outcome objective in a format similar to Exhibit 1

General Format for Exhibit 1

Develop an Intervention Strategy

After discussing and completing the following activities, record the group's ideas in a format similar to that of Exhibits 2 and 3.

Analyze Health Problem X in terms of the factors most amenable to intervention

Identify the two most important determinants, and for each, two major contributing factors

Upon completion, this logic model should describe potential pathways through which mortality from Injury X can be reduced. Record your 2 determinants and their contributing factors in a format similar to Exhibit 2. (Refer back to Figure 2-4 on page 51 of the textbook for a description and illustration of this approach.)

Develop an intervention strategy that addresses one or both determinants for the health problem. To do so, select one determinant and its associated contributing factors for which to develop an impact objective and at least 2 process objectives. Consider the state of the art and available resources in developing your objectives. Record your impact objective on Exhibit 2 and the 2 process objectives on Exhibit 3.

Examine the projected impact objective and the associated process objectives. On the basis of these objectives, evaluate the desired outcome objective and modify it as needed to develop the expected outcome objective. Record the expected outcome objective on Exhibit 2.

General Format for Exhibit 2

General Format for Exhibit 3

Develop a Work Plan

After discussing and completing the following activity, develop a summary of the work plan to achieve each process objective in a format similar to Exhibit 4. For each of the process objectives identified above, specify the actual tasks (activities) that are performed by program personnel to achieve the objective, such that:

The tasks are in logical sequence and will lead to the achievement of the process objective

The person(s) (by organizational title) responsible for each task is (are) identified

Necessary deadlines are specified

The budget of $1,000,000 is not exceeded

General Format for Exhibit 4

Develop an Evaluation Strategy

After discussing the issues below, prepare a summary report of the evaluation plan as part of your report. Ask "What is the evidence that this intervention approach will really work?" and "How will we know that this valid approach is really working in this situation?"

Describe how you evaluate each of the following: activities, process objectives, impact objective, and outcome objective. For each evaluation process include information on items to be measured or counted, sources of information, and periodicity of monitoring.

Assume that you achieve all of your process objectives and that your outcome objective is (a) 80 percent achieved and (b) 40 percent achieved. Discuss the appropriate actions based on these evaluation scenarios.

General Format for Exhibit 5