Assignment 2 - 809

After the class that we had the other day I have given a lot more thought to this assignment and rewritten it with fresh perspective. One of the things that really came through during our class was the use of logic models and I think that without a logic model for this evaluation it is difficult to plan which type of evaluation to use. I can clearly see that logic models are the backbone of any evaluation and after discussing this program in terms of a logic model in class it became more clear to me how to proceed with an evaluation.
For the evaluation of the program using exercise to diminish gestational diabetes in Aboriginal women I would go with the Provus discrepancy model. I've chosen this model as I feel that it fits how I would evaluate the program given the limited amount of information I have about it. Of course I would start by identifying the program objectives but also look for underlying objectives which are not stated explicitly. The main objective is to reduce instances of GDM but are there also underlying goals of increasing Aboriginal community health and educating the Aboriginal community about the dangers of GDM and how to avoid its dangerous effects?
The next step is to assess whether or not those goals were met. In order to do this we need to gather data. I think that interviews with secondary stakeholders such as the nurse, physiotherapist and the exercise instructors would be a great place to start so that we can get an overall view of how they think the program went and what they perceived the goals were and whether they were met. Next, I think that interviews would also be great to conduct with the participants but seeing as how they are busy moms now, I think a phone survey would be a lot more convenient for them and you'd get more responses. After gathering the data you need to compare the results with the goals and see if there were any discrepancies between the stated goals and the results. If discrepancies do exist you need to examine why they exist and then move on to making recommendations for change. Do the goals need to change or does the implementation? Finally you need to look at whether this program should proceed in its current form or needs to be redesigned altogether and whether or not it was cost effective.
I feel that this model worked well for this project because it helps to define the program as it evaluates it. After reading the summary of the program I was left with tons of questions regarding who exactly all of the stakeholders were, where the funding really came from, how the program was advertised and implemented, and the actual affect on the mothers after it was done. I think that because the program was an offshoot of another research project it probably wasn't given the kind of planning needed to ensure success and the discrepancy model can provide the clear link of goals to results that needs to be shown if the project is to continue. By redefining the goals and making them clear this program could become strengthened in its implementation.
Another aspect that I feel is important in this evaluation is the cost-benefit analysis. In any kind of program dealing with health care there is a financial aspect that must be addressed. The program must show that it has a positive economic impact in the health care field, or why would anyone give them money to continue?
I hope that by rewriting this I've given you the assignment you're looking for, but I know for sure that I've learned from this assignment by rethinking it and I'm pleased with that outcome.

Ecur 809 Assignment #1

The evaluation that I've chosen to examine is a federal government evaluation of a Health Canada program concerning Hepatitis C. The program began in 1999 and was to finish in 2003/4 and its primary goals were to raise awareness of the disease, educate the public and other stakeholders about prevention, to create treatment programs, to set up community based programs for support of those affected, and to support research into the disease and its effects. It is a formative evaluation in that it was done when the program was ongoing and was not the final summative evaluation but rather the goal was to refine the implementation of the program and to be accountable to stakeholders such as the Canadian public and the treasury. The evaluation was based on a logic model which examined what was planned versus what was actually achieved by examining the components and funding, activities, outputs, and immediate, intermediate and long term outcomes.
Five separate logic models were integrated into one overarching model which used both quantitative and qualitative evaluation. The data collection methods used were interviews and surveys. There was also a review of pertinent documents and published literature pertaining to Hepatitis C in Canada. Case study reports were created based on the findings and used to code the data to strengthen the validity of the findings. Two reports were created, one dealing with the program implementation and progress of the program, including conclusions and recommendations and the other report containing the case study information. Bias was reduced by using multiple sources for the data and the strength of the study was enhanced by the high response rates in the case studies.
There were several things that I noticed about the evaluation that were both good and bad. From a research standpoint I appreciate that they included the technical aspects of the information gathering techniques regarding how the data was sampled and what it was analysed for. However I would have liked to have access to the case studies that were completed and also the interview and survey questions to assess the level of bias within the measurements themselves. Although it is presented in wording that I understand as someone who has taken a research methods course, I wish that the summary of information that was gathered was presented in such a way as to be easy for all of the stakeholders to understand. In the study they found that one of the problems for primary stakeholders, who are afflicted with the disease, was that they had a problem accessing the information regarding Hepatitis C, but they do not present the report in a way that these stakeholders could find the information useful regarding literacy levels and cultural awareness.
Overall I feel that this was a well-done evaluation for what it was intended to do. Although most of the recommendations were to continue to implement the program in the same ways that it was being done already, an evaluation like this is necessary for a program of this length to refocus on the initial goals and to examine how successful the program has been so far. It does no good to examine the program at the end and find that there were several ways that the stakeholders' needs were not being met. Because this was the first program about Hepatitis C in Canada, it made sense to do a midterm evaluation in case the program ran into major areas of difficult and needed to be restructured. As it was the evaluation helped to strengthen the initial goals and assure stakeholders that the program is doing its intended job.

http://www.phac-aspc.gc.ca/hepc/pubs/psrpmideval-ppsrevalinter/index-eng.php#toc