PHN 652 In your role as a public health nurse, what features or strategies would you implement when evaluating an intervention?
PHN 652 In your role as a public health nurse, what features or strategies would you implement when evaluating an intervention?
The features and strategies to implement as a public health nurse (PHN) when evaluating a public health intervention include developing evaluation questions. This will include process evaluation questions that will be used to evaluate how the intervention was implemented and its successes and challenges (Skivington et al., 2021). Outcome evaluation questions will also be developed to assess whether the intervention successfully achieved its goals and assess the intervention’s short- and long-term impact on participants (Skivington et al., 2021). Outcome evaluation is a type of summative study that will examine whether changes occurred in the particular intervention and the level to which changes can be attributed to the intervention.
Conducting a successful evaluation of the public health intervention will need me to identify methods that will be used to obtain appropriate data and evidence. This is because the data collected should align with the evaluation objectives and seek to answer the evaluation research questions (Skivington et al., 2021). Therefore, I will identify methods that I will use to gather qualitative or quantitative data for intervention evaluation. Data availability, reliability, and relevance will be used to determine the data sources for the intervention evaluation. It will also be crucial to decide how much data I will collect for the evaluation (Skivington et al., 2021). The various data sources that I can choose from include surveys, questionnaires, pre- and post-intervention knowledge tests, observations, progress tracking, focus groups, and interviews.
Data collected for evaluation will need to be appropriately managed for future use. Thus, I will identify data management tools consistent with the intervention’s needs. The key features I will look for in the data management tools include backup generation capacity to promote security, data analysis capability, and facilitation of global work or cloud-based functionality (Hamilton & Hopkins, 2019).
Hamilton, J. J., & Hopkins, R. S. (2019). Using technologies for data collection and management. The CDC field epidemiology manual. CDC.
Skivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., … & Moore, L. (2021). A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. bmj, 374. https://doi.org/10.1136/bmj.n2061
Evaluation of intervention is a critical process to ensure the efficiency of the interventions and the safety of the patients or the community. Our role as public health nurse is to identify public health issues, conduct research, determine interventions to address the health issues, implement programs and assess interventions or programs. An impact evaluation is defined as a systematic and empirical investigation of the effects of an intervention (Clarke et. al, 2019). This process assesses to what extent of the outcomes experienced by affected individuals or communities were caused by the intervention in question, and what can be ascribed to other factors such as other interventions, socioeconomic trends, and political or environmental conditions. Assessing the impact of interventions is essential to determining future decisions, identifying areas for improvement, and understanding what happen during the intervention (Clarke et al, 2019). Routine data can be an excellent source of information on a large group of patients with various health conditions across different geographical area (Clarke et al., 2019). This data can be helpful in assessing interventions and making sound healthcare decision.
Clarke, G.M., Conti, S., Wolters, A.T., & Steventon, A. BMJ. (2019). Evaluating the impact of healthcare intervention using routine data. The BMJ, 365. DOI: https://doi.org/10.1136/bmj.l2239
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I agree with you that evaluation of intervention access the efficiency of the interventions and the safety of the dependents. Frequently, intervention is a response reaction when there is a healthcare crisis or a problem interfering with healthcare delivery (Licari et al., 2020). Public health nurses identify public health issues, perform research, and involved in returning normalcy in healthcare settings. Therefore, public health nurses are engaged in assessing the intervention mechanisms. Unfortunately, some intervention routines are expensive and tedious. As a result, public health nurses wish to have successful intervention mechanisms. The evaluation is important in providing the real picture on the proposed information (Janiri et al., 2020). The examination process elaborate the strengths and weaknesses of the preferred intervention routine. An impact evaluation is defined as a systematic and empirical investigation of the effects of an intervention. The intervention should have an impact that will initiate the recovery process. Poor evaluation of the intervention creates room for poor containment of public health issues.
Janiri, D., Doucet, G. E., Pompili, M., Sani, G., Luna, B., Brent, D. A., & Frangou, S. (2020). Risk and protective factors for childhood suicidality: a US population-based study. The Lancet Psychiatry, 7(4), 317-326. https://doi.org/10.1016/S2215-0366(20)30049-3
Licari, M. K., Alvares, G. A., Varcin, K., Evans, K. L., Cleary, D., Reid, S. L., … & Whitehouse, A. J. (2020). Prevalence of motor difficulties in autism spectrum disorder: Analysis of a population‐based cohort. Autism Research, 13(2), 298-306. https://doi.org/10.1002/aur.2230
Evaluation of population-based interventions refers to the investigation of the impact of the implemented intervention on the affected population. Public health nurses conduct evaluations to determine the extent to which the intervention caused the health outcomes and the contribution of environmental, social, and political factors (Clarke et al., 2019). The aim of evaluating population-based interventions is to identify strengths and improvement gaps to achieve positive and lasting health behavior change impact on the target population. Evaluation involves the comparison of expected outcomes and goals with observed results.
Features and strategies that I would consider in evaluating interventions as a public health nurse include formulation of evaluation questions, determination of evaluation data, and shared decision-making. Evaluation questions align with the implementation purpose, goals, and objectives of the health improvement initiative and what shareholders need to learn (Clarke et al., 2019). These questions guide public health nurses through the evaluation process to measure the successful implementation of population-based interventions. The evaluation process helps nurses find answers about the impact of healthcare interventions.
Nurses can collect measurable patient outcome data to compare with clear objectives. Measurable data include medical records, rate of health utilization, and the adoption rate of implemented intervention. In essence, public health nurses can conduct a before-and-after study to assess observed results and expected outcomes. I can facilitate unbiased comparison to improve the internal and external validity of the evaluation, thus enhancing the generalization of the evaluation results. The rationale is that evaluation validity ensures an evaluation is measuring what it is claiming to measure without accounting for confounding factors (Matheson et al., 2018). The evaluation of public health interventions in the real world is complex and poses methodological challenges (Stojanovic et al., 2020). Therefore, it is crucial to make shared decisions by involving shareholders and interdisciplinary team members in planning and evaluating population-based interventions. These strategies are effective in conducting an effective evaluation of interventions.
Clarke, G. M., Conti, S., Wolters, A. T., & Steventon, A. (2019). Evaluating the impact of healthcare interventions using routine data. BMJ, 365. doi: https://doi.org/10.1136/bmj.l2239
Matheson, A., Walton, M., Gray, R., Lindberg, K., Shanthakumar, M., Fyfe, C., … & Borman, B. (2018). Evaluating a community-based public health intervention using a complex systems approach. Journal of Public Health, 40(3), 606-613. doi.org/10.1093/pubmed/fdx117
Stojanovic, J., Wübbeler, M., Geis, S., Reviriego, E., Gutiérrez-Ibarluzea, I., & Lenoir-Wijnkoop, I. (2020). Evaluating public health interventions: a neglected area in health technology assessment. Frontiers In Public Health, 106. doi: 10.3389/fpubh.2020.00106.
and knowledge about the entire population with personal, clinical understandings of the health and illness experiences of individuals and families within the population, particularly vulnerable individuals, and families in Los Angeles County. When evaluating a particular intervention the strategies would depend on the health topic, trends, and risk factors of population groups (Centers for Disease and Control ,2022).For example, there is a need to address physical activity, nutrition, and health weight in the community I would Conduct community-wide campaigns; improve access to outdoor recreational facilities; participate in community coalitions or partnerships to address obesity; enhance access to places for physical activity combined with informational outreach activities (Frieden, 2014). This will take working with communities or specific population groups within the community to develop public policy and targeted health promotion and disease prevention activities.
Centers for Disease and Control (2022). Public Health strategies to improve the health of Individuals with disability. https://www.cdc.gov/ncbddd/disabilityandhealth/documents/foa_1603_2015_publichealthstrategies.pdf
Frieden T. R. (2014). Six components necessary for effective public health program implementation. American journal of public health, 104(1), 17–22. https://doi.org/10.2105/AJPH.2013.301608
Public Health Nursing is an important aspect in nursing and the continuous development of public health nursing will improve health care as a every changing experience. As identified (Parris et al 2016) for public health programs to survive, it is imperative that Public Health nurses define their services and provide evidence supporting the effectiveness of the interventions they offer, for this to be accomplished, a standardized nursing language must be implemented. I think this a important aspect to be addressed based on the needs of the public health nurses to continue to care needed for interventions moving forward.
As identified by (Parris et al 2016) A standardized nursing language improves understanding and communication, it can expand nursing knowledge, enhance health information systems, facilitate cost evaluation of nursing services, improve nursing education, and increase comparability when measuring phenomena across individual or across different settings. This gives rise to the thoughts that with education, cost effective actions, and communication that a standardize nursing standard needs to be established to have effective results within an intervention.
We need to be able to identify the use of interventions that will help determine how it will be effective in a public health nurse setting to promote and conduct productivity.
Parris, KM., Place, PJ., Orellana E., Calder J., (2016). Use of nursing diagnoses and interventions in public health nursing practice (Journal Article-care plan, forms)
Public health decision makers, funders, practitioners, and the public are increasingly interested in evidence to underpin public health decision making. Research relevant to public health is not isolated to evidence of the effectiveness of interventions, however interventions need to be researched and evaluated for effectiveness, economic, ethical, and accountability reasons (Waters et al., 2006). One of the keys to managing public health programs is to evaluate the programs’ effectiveness. Limited and unstable funding, lack of automatic means to track and improve performance, workforce limitations, and insufficient political commitment can cause public health programs to fail. Implementation can succeed and be sustained if organizations and coalitions effectively address 6 key areas: innovation, a rigorously established technical package, management, partnership, communication and political community (Frieden, 2014).
In my role as a public health nurse some strategies to implement when evaluating an intervention are to prepare carefully. Successful intervention planning requires collaborative thinking, careful research on the target population as well as interventions that have failed or succeeded in the past. Get feedback from key stakeholders of the problem and ultimate intervention (Intervention Strategies in Public Health (WI 18), 2018).
Frieden, T. R. (2014, January). Six components necessary for effective public health program implementation. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3910052/
Intervention Strategies in Public Health (WI 18). (2018, February 02). Retrieved from https://populationhealthexchange.org/learning-opportunities/winter-institute/intervention-strategies/
Waters, E., Doyle, J., Jackson, N., Howes, F., Brunton, G., Oakley, A., & Cochrane Collaboration. (2006, April). Evaluating the effectiveness of public health interventions: The role and activities of the Cochrane Collaboration. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2566164/
When programs conduct strong, practical evaluations on a routine basis, the findings can both meet accountability mandates as well as improve program effectiveness. As a public health nurse evaluating interventions increases their usefulness and impact on the community, (CDC.gov.,2017). When evaluating interventions as a public health nurse, although program evaluation has always been a respected component of public health practice, the ability to conduct meaningful program evaluations has been constrained by wide differences in expertise, resources of programs, and commitment to evaluation. The strategies I would consider using existing data sources, if possible (e.g., census, existing surveys, surveillance), and if not available then factor in the burden needed to collect each indicator before requiring collection, (CDC.gov., 2017).
Good evaluation requires a combination of skills that are rarely found in one person. Seek additional evaluation expertise in programs within the health department, through external partners (e.g., universities, organizations, companies), from peer programs in other states and localities, and through technical assistance, (CDC.gov., 2017). As the leader of the evaluation team, clearly set and defined responsibilities in their respective roles. As the lead public health nurse, it’s important to be responsible for evaluation activities, including planning and budgeting for evaluation, developing program objectives, addressing data collection needs, reporting findings, and working with consultants. Ultimately being responsible for engaging stakeholders, consultants, and other collaborators who bring the skills and interests needed to plan and conduct the evaluation.
As the leader of the evaluation, I would set guidelines, and incorporate evaluation into all program activities. Understanding both the potential benefits and risks of evaluation. Educates program personnel in designing and conducting the evaluation as well. Evaluating the implementation of the program, the effectiveness, (is it achieving its goals), efficiency, (appropriate use of resources), is it cost-effective, and does the program is attributed to the program’s goal and objective, (Stanhope & Lancaster, 2019).
Centers for Disease Control and Prevention, (2017). Program Performance and Evaluation Office: A Framework for Program Evaluation. Retrieved from: https://www.cdc.gov/evaluation/framework/index.htm
Stanhope, M. & Lancaster, J. (2019). Public health nursing: Population-centered health care in the community (10th ed.)