Learning Objectives Compare and contrast health promotion and health education programs Discuss Evaluation of Faith Community Nursing Strategies and alternatives Discuss the need for evaluating Faith community Nursing strategies and alternatives Identify methods of evaluating Faith Community Nursing strategies and alternatives
Basic Terminology Evaluation: “ a process of reflection through which the value of certain actions are assessed. The comparison of an object of interest against a standard of acceptability. Standard of Acceptability: Minimum level of performance, effectiveness, benefits.
Faith Community Nursing : Evaluation Is determining the extent to which a strategy or alternative have been carried out and it’s actual effectiveness. (PROCESS EVALUATION).Whether the strategy being used is effective in meeting the goals and objectives To determine the immediate observable effects the strategy or alternative has had on the faith community’s health risks.(IMPACT EVALUATION) Measurable ultimate goal or outcome of the program measured by reduction in morbidity, mortality, ED visits, signs and symptoms or physiological, spiritual indicators. ( long term) (OUTCOME EVALUATION)
Knowledge Check Process Evaluation: Will help us identify whether the number of identified individuals with signs and symptoms of Hypertension did receive blood pressure screening. Impact Evaluation: Blood pressure screening program resulted in identifying individuals with abnormal blood pressures,behavioral change, willing to check blood pressure, referral to PCP, Outcome Evaluation: Controlled BP, decreased morbidity, and mortality etc.
Faith Community Nursing Strategies and Alternatives Are measurable activities and practices that addresses identified diagnoses, issues and strengths within the Faith Community Includes health promotion and restoration of health, spiritual enhancement, prevention of illness, injury and disease, alleviation of suffering and provision of supportive care for those who are dying. Includes health education.
Health EducationHealth education is any combination of learningexperiences designed to help individuals andcommunities improve their health, by increasing theirknowledge or influencing their attitudes. Tells us about health Give information without follow up. Does not include long term planning. Individualistic
Health PromotionHealth promotion is the process of enabling peopleto increase control over, and to improve, their health.It moves beyond a focus on individual behaviortowards a wide range of social and environmentalinterventions. Developing the whole community Targets those in most need Seeks to activate resources Seeks to empower communities to identify their own health priorities Implement strategies needed to overcome identified social challenges.
Health Promotion and Health Education Health promotion programs use elements of health education. Health education is a subset of overall health promotion activity.
Importance of Evaluation Ensures that the strategy/ alternatives/ activity is implemented and operating as planned. Reaching the intended or target audience. Reveals challenges and potential Solutions Assess effectiveness of strategies, activities etc.. Demonstrate productive use of resources Influence decisions about the continuation, refinement or expansion of the program.
Importance Achieving it’s outline objectives Worth the cost Needed and beneficial Making an important contribution to the health of the individuals and the communities we serve. Ensures accountability to the standards of practice for the faith community nurse.
Faith Community Nurses standard of Practice: Competencies Practice 6 : Evaluation: (refer to pg. 33 of Faith Community Nursing Scope and Standards Practice.) The Faith Community Nurse Will: Conduct a wholistic, Systematic, systematic ongoing criterion – based evaluation of the outcomes in relation to the structures and process prescribed by the plan and the indicated timeline. Collaborate with the healthcare consumer and others involved in the care or situation in the evaluative process Evaluates, in partnership with the health care consumer, the effectiveness of the planned strategies in relation to the healthcare consumers responses and attainment of expected outcomes Uses ongoing assessment data to revise the diagnoses, the outcomes, the plan and the plan’s implementation as needed.
Faith Community Nurses standard of Practice: Competencies Practice 6 : Evaluation: (refer to pg. 33 of Faith Community Nursing Scope and Standards Practice.) The Faith Community Nurse Will: Disseminates the results to the healthcare consumer and others involved in the care or situation as appropriate, in accordance with state and federal laws and regulations. Participates in assessing and ensuring the responsible and appropriate use of interventions to minimize unwarranted or unwanted treatment and healthcare consumer suffering. Documents the results of the evaluation including results from the faith or spiritual realm.
Assessment Define the Need: Assessment Wholistic data Collection. Use of appropriate evidence based assessment techniques and instrument. E.g. Faith Community Nursing Health Needs assessment Survey, Focus groups, observation etc. Synthesize data collection to identify patterns and variances and health promotion needs
Diagnosis Derives Diagnoses or issues from the Holistic Assessment Data. Identifies needs and strengths to enhance health and spiritual well being. Prioritize needs and strengths. E.g.. Health education, use of peer/ family support to enhance wellness.
Outcomes Identification (goals setting and objectives) Identifies expected outcomes for a plan individualized to the individual or situation and or tailored to the community. Must be clear and measurable Involves the individual and the faith community in formulating expected outcomes. Derives culturally and spiritually appropriate outcomes from identified needs and diagnoses. Involves a realistic time estimate for attaining expected outcomes. Use Collaboration in developing expected outcomes
Goal and Objectives Goals: Broad statements of what we intended to achieve. Objectives: steps need to achieve our goals. Specific measures we use to determine whether or not we are successful.
Planning Develops a plan that prescribes strategies and alternatives tailored to attain expected outcomes. Integrate evidence based strategies to address the identified diagnosis. Includes strategies for addressing health and wholeness across the life span. Develops an evaluation plan.
PlanningI. When and how to monitor program and conduct process evaluationsII. Determine when to conduct impact evaluationIII. Determine when to conduct outcome evaluation or how soon you want to measure outcomes
Implement The Faith Community nurse implements the identified plan Utilize evidence based strategies to implement interventions . Tailor interventions Culturally sensitive interventions Utilize community and faith community resources and systems to implement the plan
PART 3 EVALUATION: Needs to be considered in the planning stages.
The Faith community nurse evaluates progress toward attainment of goals Conducts a wholistic, systematic ongoing criterion – based evaluation of the outcomes in relation to the structures and process prescribed by the plan and the indicated timeline
Uses ongoing assessment data to revise the diagnoses, the outcomes, the plan and the plan’s implementation as needed. Determine Information needed. Use process evaluation during program implementation , impact evaluation at the end of the program and outcome evaluation at follow up. Develop a data collection DesignI. Record KeepingII. Pre-Post (before and after to measure change, Change= impact.III. Post onlyIV. Observational studies/ auditsV. Controlled experiments (complex and time consuming) Determine the Method of Data CollectionStandard and consistent Format.I. InterviewsII. QuestionnairesIII. Counting number of events that occurredIV. SurveysV. Observation./Audits.
Cont.- Whatever method is chosen, a collection form, such as a questionnaire or checklist will be needed so that data is collected in a standard manner and in a common format.
Evaluates, in partnership with the health care consumer, the effectiveness of the planned strategies in relation to the healthcare consumers responses and attainment of expected outcomes Focus your evaluation Identify the purpose of the evaluation. Determine the kind of evaluation; PROCESS, IMPACT, OUTCOME. Consider what questions needs to be answered by the Evaluation. Develop Data collection forms: Must address either, the process, impact and or outcomes of the planned strategies Directly assess attainment of Expected outcomes. Determine who needs to be assessed to determine effectiveness of the planned strategy
Data Collection and Analysis Collect data. Organize and Analyze Data:I. Statistical Analysis: descriptive statistics/ inferential statistics.(mean, graphs, chi square etc).II. Compare Pre-post Changes ( report measured differences in percentages)III. Identify Patterns and themes in self reports.
Interpretation Interpret changes, patterns and themes as either :A. An Impact: ImmediateB. An outcome: may require additional follow-upc. Process: changes made to program design andimplementation as a result of little or no success inachieving goals and objectives
Conclusion Summarize findings. Present to Faith Community Present to Texas Health Fort Worth-Faith Community Nursing Coordinator. Celebrate achievement.
Putting it all together Tracy R N. administered her quarterly needs assessment survey to the FCN congregation. Analysis of data revealed emerging themes for 3 top priority areas in the FCN Community: 48% had no access to a regular dentist and a lack thereof of healthy oral health behaviors. 22% Diagnosed High Blood pressure. 10% were obese. Strategically intervenes : Based on the above data, Tracey RN, in collaboration with the Faith community and their sponsors decided to make oral health promotion a priority in the next quarter. Plan : Oral health promotion programI. Plans method and design of evaluation,.II. Decides on Pre-Post survey questionnaire.III. Goal of the program is adoption of healthy oral behaviors( Objectives:- to enroll at least 80% of the faith community in need of oral health, teach flossing , oral care , distribution of dental and how to acquire supplies and referral, to local dentist, phone reminders.) and to improve oral health of the community.IV. Designed survey questions that addressed access to regular dental supplies, knowledge of how to practice good oral hygiene and frequency and knowledge of local oral care resourcesV. Administered pre survey questions before start of the programVI. Implement Program; includes :a. Distribution of dental suppliesb. Teaching and demonstration of oral carec. referral to oral health care providers and resources.VII. Process evaluation during program implementation to assess whether program is achieving goals andobjectives.Uses survey questions to asses, ease of participation, comprehension, usefulness, barriers etc.VIII. Once program is completed,administer same survey questionnaires for post testing.IX. Analyze Data and determines pre-post changes
Putting it all together Changes reported as percentages PRE POST TEST/BASELINE TEST/FOLLOW UP RAW % TOTAL RAW % TOTAL Pre- post changeDental 10 10/50* 20% 40 40/50*1 80% (80-supply 100 00 20)/ 20*100 =Dental 300%Practice 15 15/50*1 30% 35 35/50*1 70% 133.3% 00 00Resources 5 5/50* 10% 45 45/50*1 90% 800% 100 00
Putting it all together Tracy RN, presented program impact to the faith community 800 700 600 500 400 pre post 300 changes 200 100 0 Dental practices Dental supples Dental Resourcespre 20 30 10post 80 70 90changes 300 133 800
Putting it all together .x. Impact: Data interpreted as: 3-4 times more access to dental supplies 1-2 times improvement in dental practices. 8-9 times more access to regular dentist.XI. Outcome Data collection and analysis repeated at five months to determine sustained oral health behaviors.- Outcomes reported as improvement in oral health in the faith community.
Case study Conduct a needs assessment in your faith community and describe how you will intervene. Describe and design an appropriate Evaluation for the intervention Interpret Findings .