PHN 652 What is the importance of evaluating population-based interventions?
PHN 652 What is the importance of evaluating population-based interventions?
A health and family program in Illinois has long valued evidence-based home visiting programs as an effective and efficient strategy for improving the life trajectory of expectant and new families who are at risk for poor health, educational, economic, and social outcomes. The Health Resources & Services Administration (HRSA) Maternal and Child Health, (HRSA, 2021).
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. According to HRSA, (2021), “The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program support pregnant people and parents with young children who live in communities that face greater risks and barriers to achieving positive maternal and child health outcomes. Families choose to participate in home visiting programs, and partner with health, social service, and child development professionals to set and achieve goals that improve their health and well-being. The program aims to improve maternal and child health. Prevent child abuse and neglect. Reduce crime and domestic violence, increase family education, and promote children’s development and readiness for school. The purpose is to connect families to needed community resources and support.
Health Resources & Services Administration, (2021). Maternal & Child Health. Retrieved from: https://mchb.hrsa.gov/programs-impact/programs/home-visiting/maternal-infant-early-childhood-home-visiting-miechv-program
Evaluating population-based interventions is an essential step in over-all process of develop programs and policies to improve the health and well-being of a population. Population-based interventions are widely used to modify the delivery of health and social care. Assessment of these interventions enables healthcare teams to learn and to improve services, and can inform future policy (Clarke et al., 2019). However, it requires a thorough collection of data to properly evaluate the effectiveness of these interventions. Comparing observed outcomes with what is expected if interventions did not happen can help in determining appropriate actions or decision making for population.
Clarke, G.M., Conti, S., Wolters, A.T., & Stevenson, A. (2019). Evaluating the impact of healthcare interventions using routine data. BMJ. DOI: https://doi.org/10.1136/bmj.l2239
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When it comes to population -based interventions the evaluating process is important primarily because it targets the at risk population and looks at preventive measures for the population exposed. Additionally, it focus on an approach that looks at intervening in all possible levels of practice . It’s important to consider evidence based interventions as they can be directed at the entire population within a community, the systems that affect the health of those populations, and the individuals and families within those populations known to be at risk. In the planning and development phase , its important to consider the evaluation phase during the development of evidence-based interventions because these interventions exacerbate health inequalities (Waters, et al.,2006). For these reasons, population -based research investigates numerous determinants of health, including health care services, individuals’ genetics and health behaviors, physical and social environments. Furthermore,when evaluating the development , its important to recognize funding can be a barrier and according to Ariosto, et al. (2018) “Funding agencies have increased their support for population health research in response to rapidly growing chronic illness populations and skyrocketing medical costs .” Which is great and beneficial to the healthcare system as a whole.
Ariosto, D. A., Harper, E. M., Wilson, M. L., Hull, S. C., Nahm, E. S., & Sylvia, M. L. (2018). Population health: a nursing action plan. JAMIA open, 1(1), 7–10. https://doi.org/10.1093/jamiaopen/ooy003
Waters, E., Doyle, J., Jackson, N., Howes, F., Brunton, G., Oakley, A., & Cochrane Collaboration (2006). Evaluating the effectiveness of public health interventions: the role and activities of the Cochrane Collaboration. Journal of epidemiology and community health, 60(4), 285–289. https://doi.org/10.1136/jech.2003.015354
Evaluation can be frightening to many people. Evidence-based interventions need to be evaluated and selected based on the specific issues demonstrated by the target population. So, the process for identifying an intervention includes identifying the population issue and evaluating intervention options. Evaluating during planning and development means determining the value of the work. Determine baselines for behaviors you wish to change, (U.S. Department of Education, n.d.). If you want to know how many changes the program has brought about, you’ll need to know what was happening before the intervention got started. Focus on the impact planning and implementation or work is having on the community. Continue revising and updating action plans. Keep the implementation of the intervention strong and focused on the goals at hand. You have developed and implemented an initiative in the community, and you want to know how well it’s working, (Community Tool Box, 2018). Evaluation provides you with this feedback on what worked and what needs to be revised. Implementation of Interventions is specific to what knowledge, skills, and competencies are addressed in a community to achieve the target outcome. Population-based interventions are specific to target populations and, within an intervention, multiple factors may be defined as targets for that population.
Community Tool Box, (2018)., Measuring success: Evaluating comprehensive community initiatives. Retrieved from: https://ctb.ku.edu/en/table-of-contents/evaluate/evaluate-community-initiatives/measure-success/main
U.S. Department of Education., (n.d.). How to select an evidence-based intervention. Retrieved from: https://implementationscience.uconn.edu/wp-content/uploads/sites/1115/2014/12/PRIME_quickguide_edvidence-based_intervention.pdf#:~
Population-based interventions are health services provided to the population at large or to a subset of the population (race, culture, geography) to promote the overall health of the population (Office of the Surgeon General, 2004). The Office of the Surgeon General (2004) also identified that population health interventions are aimed at preventing disease, premature deaths, disability, and injuries and that some methods to accomplish these goals include public education programs, community projects and media interventions or be a combination of these approaches.
A population-based intervention is effective when it includes measures such as assessment, health promotion, disease prevention, monitoring of services, and evaluation (Office of the Surgeon General, 2004). To find out the effects of interventions on the population, an impact evaluation of the interventions is necessary. An impact evaluation assess to what extent the outcomes experienced by affected populations were caused by the interventions in question (Clark et al., 2019). Evaluation can be conducted during the development or implementation of an intervention (formative evaluation) or conducted after the intervention’s completion or at the end of the program cycle (summative evaluation). it is important to consider evaluation during the planning and development phase because it allows for fine tunning or analyzing the intervention before it is implemented.
Clarke, G. M., Conti, S., Wolters, A. T., & Steventon, A. (2019). Evaluating the impact of healthcare interventions using routine data. BMJ (Clinical research ed.), 365,12239
Office of the Surgeon General. (2004). 12 Population-based Approaches to Promote Bone Health.
Public and private resources are being dedicated to community-based health improvement programs. But evaluation of these programs typically rely on data about process and a pre-post study design without a comparison community. To better evaluate health improvement programs, funders should provide guidance and expertise in measurement, data collection, and analytic strategies at the beginning of program implementation. An evaluation team should be employed to provide guidance and expertise in measurement, data collection, and analytic strategies at the beginning of program implementation. Early entry of such a team allows for the identification of control communities, gathering of necessary pre-implementation of data, and formative evaluations that lead to a summative evaluation (Fry et al., 2018). The evaluation of population-based interventions is necessary because it helps to improve the outcomes and to measure the results of the implementation.
It is necessary for evaluation in planning and developing evidence-based. An evaluation plan outlines the evaluation approach, including the focus of the evaluation, evaluation design, evaluation research questions, data collection methods, evaluation activities, stakeholders that should be engaged, timeline, performance measures, key milestones, and cost. It is important to establish an evaluation plan before the program starts to make sure that the evaluation research questions, measure, and methods align with the evaluation’s goals (Evaluation Planning, n.d.) Evaluations help determine what works well and what could be improved in a program initiative.
Evaluation Planning. (n.d.). Retrieved from https://www.ruralhealthinfo.org/toolkits/rural-toolkit/4/evaluation-planning
Fry, C. E., J, L., Al., E., DL, D., T, B., GC, K., . . . CJ, R. (2018, January 01). Evaluating Community-Based Health Improvement Programs: Health Affairs Journal. Retrieved from https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1125
Healthcare professionals implement population-based interventions at all levels of practice; individual, community, and system levels. In essence, the interventions benefit an entire population at risk of a disease or infection. Healthcare providers evaluate population-based interventions before implementation in a broader population (Clarke et al., 2019). The rationale for evaluating the interventions is to measure their efficiency. Caregivers evaluate two groups of people from the population of interest; the intervention group and the control group. They collect and analyze clinically significant data to determine which interventions work well by achieving set goals and which interventions require improvement for high degree achievement of goals (Clarke et al., 2019). In addition, evaluating population-based interventions helps nurses to assess the extent to which an intervention causes the observed outcomes of the population of interest. This assessment is necessary because other factors such as political and environmental conditions and socioeconomic trends can influence population outcomes.
Healthcare providers consider evaluating population-based interventions at the planning and development stages to identify change influences such as possible implementation barriers, unexpected changes by populations of interest, and providers’ buy-in (Stojanovic et al., 2020). These factors influence decision-making and inform future policies. Therefore, early identification enables nurses to develop possibly-effective solutions to address the change barriers for successful population-based interventions’ implementation. Early evaluation of interventions also provides insights into the target populations’ society, cultural and environmental contexts (Stojanovic et al., 2020). In addition, healthcare providers also consider early evaluation of the interventions to prevent financial pressures and limited resources during the implementation stage. The rationale is that the planning stage enables nurses to rectify any issues and prevent adverse effects on an entire population. Indeed, the evaluation of population-based interventions is beneficial in promoting population health and well-being.
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
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
As Public health nurses after developing programs and interventions to improve the health of an affected community, there’s need to evaluate to know how effective the choices are. Population-based intervention also known as public heath interventions are actions that public health nurses take on behalf of individuals/families, communities, and systems, to improve or protect health status.
According to Astell-Burt, Rowbotham & Hawe (2018) population-based interventions are vital for they are delivered by people and organizations that operate outside the health sector (e.g urban planning and environmental agencies and help keep people healthy and out of hospital through public policy, regulatory initiatives, single strategy projects and multi-component programs that can benefit entire populations.
Ctb.ku.edu (2022) states that over the past years, there has been a growing trend towards the better use of evaluation to understand and improve practice. The systematic use of evaluation has solved many problems and helped countless community-based organizations do what they do better (Ctb.ku.edu, 2022).
Astell-Burt, T., Rowbotham, S., & Hawe, P. (2018). Communicating the benefits of population health interventions: The health effects can be on par with those of medication. SSM – population health, 6, 54–62. https://doi.org/10.1016/j.ssmph.2018.06.002
Ctb.ku.edu (A Framework for Program Evaluation: A Gateway to Tools. Retrieved from https://ctb.ku.edu/en/table-of-contents/evaluate/evaluation/framework-for-evaluation/main
Evaluation is critical to population-based programs locally and worldwide, as donors, governments, and public health departments strive to improve the performance of the interventions and validate the programs. It is essential to evaluate population-based interventions since it informs future decisions concerning program improvement and further rollout. Evaluations help determine the interventions that worked well and measures that can be taken to improve the population health program or interventions (Clarke et al., 2019). Additionally, it enables the public health nurse to compare the observed outcomes with what was expected if the population-based intervention had not been implemented.
Evaluation helps to establish if the public health interventions were delivered within the appropriate setting and if they reached the targeted number of individuals. It helps to identify if the population-based interventions linked primary care with community support resources and their effectiveness in improving primary care delivery. Furthermore, evaluation findings can be used to demonstrate the impact of the population-based interventions to the program’s donors or funders Clarke et al., 2019). The findings are also used to seek support for continuing the interventions. They also help obtain information on the interventions that can be shared with other public health officials to improve population health.
It is crucial to consider evaluation during the planning and development of evidence-based interventions since it offers a systematic approach to studying the interventions to understand how well they will achieve the goals. An evaluation plan defines the evaluation approach, including the purpose of the evaluation, design, evaluation research questions, and data collection methods (Stojanovic et al., 2020). Moreover, it is essential to consider an evaluation plan before the interventions begin to ensure the research questions, approaches, and methods align with the evaluation’s goals. It also helps to understand the impact the interventions will have, for which population, and in what conditions.
Clarke, G. M., Conti, S., Wolters, A. T., & Steventon, A. (2019). Evaluating the impact of healthcare interventions using routine data. bmj, 365. https://doi.org/10.1136/bmj.l2239
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, 8, 106. https://doi.org/10.3389/fpubh.2020.00106