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B A S I C L O G I C M O D E L D E V E L O P M E N T
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Developing a Basic Logic
Model For Your Program
Drawing a picture of how your program will achieve results
hether you are a grantseeker developing a proposal for start-up
funds or a
grantee with a program already in operation, developing a logic
model can
strengthen your program. Logic models help identify the
factors that will
impact your program and enable you to anticipate the data and
resources
you will need to achieve success. As you engage in the process
of creating your
program logic model, your organization will systematically
address these important
program planning and evaluation issues:
• Cataloguing of the resources and actions you believe you will
need to reach intended
results.
• Documentation of connections among your available
resources, planned activities and
the results you expect to achieve.
• Description of the results you are aiming for in terms of
specific, measurable, action-
oriented, realistic and timed outcomes.
The exercises in this chapter gather the raw material you need
to draw a basic logic
model that illustrates how and why your program will work and
what it will accomplish.
You can benefit from creating a logic model at any point in the
life of any program.
The logic model development process helps people inside and
outside your
organization understand and improve the purpose and process of
your work.
Chapter 2 is organized into two sections—Program
Implementation, and Program
Results. The best recipe for program success is to complete both
exercises. (Full-size
masters of each exercise and the checklists are provided in the
Forms Appendix at the
back of the guide for you to photocopy and use with stakeholder
groups as you design
your program.)
Exercise 1: Program Results. In a series of three steps, you
describe the results you
plan to achieve with your program.
Exercise 2: Program Resources and Activities by taking you
through three steps
that connect the program’s resources to the actual activities you
plan to do.
Chapter
2
W
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The Mytown Example
Throughout Exercises 1 and 2 we’ll follow an example program
to see how the logic
model steps can be applied. In our example, the folks in
Mytown, USA are striving to
meet the needs of growing numbers of uninsured residents who
are turning to Memorial
Hospital’s Emergency Room for care. Because that care is
expensive and not the best
way to offer care, the community is working to create a free
clinic. Throughout the
chapters, Mytown’s program information will be dropped into
logic model templates for
Program Planning, Implementation, and Evaluation.
Novice Logic modelers may want to have copies of the Basic
Logic Model Template in
front of them and follow along. Those readers with more
experience and familiarity may
want to explore the text and then skip ahead to the completed
Basic Logic Model for the
Mytown Example on page 34.
Demonstrating Progress Towards Change
The Importance of Documenting Progress
According to many funders, grant applications frequently lack
solid descriptions of how
programs will demonstrate their effectiveness. Some grantees
think activities are ends
unto themselves. They report the numbers of participants they
reach or the numbers of
training sessions held as though they were results.
Conducting an activity is not the same as achieving results from
the accomplishment of
that activity. For example, being seen by a doctor is different
from reducing the number
of uninsured emergency room visits. Tracking data like
meetings held or patients
enrolled does monitor your program’s implementation and
performance, but those data
are outputs (activity data), not outcomes (which refer to the
results you expect to achieve
in future years).
“Do the outcomes first” is sage advice. Most logic models lack
specific short- and long-
term outcomes that predict what will be achieved several years
down the road. Specifying
program "milestones" as you design the program builds in ways
to gather the data required
and allows you to periodically assess the program’s progress
toward the goals you
identify. For that reason, Exercise 1 isn’t filled out from left to
right. This exercise
asks you to “do the outcomes first.” We will focus our attention
first on what we
have called “your intended results.”
As you implement your program, outcome measures enhance
program success by
assessing your progress from the beginning and all along the
way. That makes it possible
to notice problems early on. The elements (Outputs, Outcomes,
and Impact) that
comprise your intended results give you an outline of what is
most important to monitor and
gauge to determine the effectiveness of your program. You can
correct and revise based
on your interpretation of the collected data.
Over the past few years,
I have markedly changed
my approach to logic
modeling. I have become
convinced that it makes
a considerable difference
if you do the outcomes
before planning the
activities.
I definitely advocate
doing the outcomes first!
I find that people come
up with much more
effective activities when
they do. Use the motto,
“plan backward,
implement forward.”
Beverly Anderson
Parsons,
WKKF Cluster
Evaluator
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Exercise 1 – Describing Results
Describe the results you desire—Outputs, Outcomes and Impact
If you were running the Mytown Free Clinic, how would you
show that your desired
outcome (a reduction in uninsured emergency care) didn’t result
from a mass exodus of
uninsured residents from Mytown, USA or a sudden increase in
number of employees
offered health insurance coverage by local businesses?
How will you demonstrate that your program contributed to the
change you intend? A well-
crafted logic model can assert it is reasonable to claim that your
program made a substantive
contribution to your intended change. When programs operate in
real communities where
influences and forces are beyond your control, evaluation is
generally more about
documenting a program’s contribution rather than proving
something. Community-based
initiatives operate in complex environments where the scientific
certainty of “proof” is
seldom attainable. This is where logic models can be especially
helpful.
INSTRUCTIONS: Exercise 1 will use the Basic Logic Model
Development
Template. In particular, you will use the information presented
in the gray text boxes
that follow about the Mytown example program to determine
what results are intended
for this program. Example information about outcomes,
impacts, and outputs are
provided. You will fill in the blank Basic Logic Model
Development Template to
illustrate first the outcomes and impacts sought and then the
outputs. You can then
look at the completed template on page 26 to see compare your
interpretation with that
produced by the Mytown folks.
Exercise 1 uses the Basic Logic Model Development Template
RESOURCES ACTIVITIES OUTPUTS SHORT & LONG-
TERM OUTCOMES
IMPACT
In order to accomplish
our set of activities we
will need the
following:
In order to address
our problem or asset
we will conduct the
following activities:
We expect that once
completed or
underway these
activities will produce
the following evidence
of service delivery:
We expect that if
completed or on-
going these activities
will lead to the
following changes in
1-3 then 4-6 years:
We expect that if
completed these
activities will lead to
the following changes
in 7-10 years:
Outcomes and Impacts should be SMART:
• Specific
• Measurable
• Action-oriented
• Realistic
• Timed
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Some logic models number the lists within a column to aid
discussion. Some tabular
logic models use rows to order and show the relationships
among components. Some
logic models, like the outcome and activity examples provided
in Chapter One, use a
box and arrow format to illustrate the "causal linkages"
demonstrating how your
resources, activities, outputs, outcomes, and impact connect to
form chains. These
depictions add to the clarity of your logic model/evaluation
plan. However, for the
most basic of logic models, the inventory approach we illustrate
is sufficient to capture
your thinking about how a program will work. The other
techniques will improve its
utility, but the most important task is to first get the component
parts categorized and
described. Once you have completed the inventory table for
this and Exercise 2 feel
free to experiment with identifying the relationships among the
items across columns.
Short-term outcomes are results you expect to achieve 1 - 3
years after a
program activity is underway.
Short-term outcomes are specific changes in things like
attitudes, behaviors, knowledge,
skills, status, or level of functioning expected to result from
program activities. These
usually are expressed at an individual level among program
participants.
EXAMPLES: Signed Memorandum of Agreement from the local
technical college donating clinic space,
change in participants’ attitudes about the need for a medical
home, increase in number s of scheduled
annual physicals, increased patient follow-up visits, change in
staff’’s awareness of patient scheduling
challenges, increased appropriate referrals from ER’s.
Insert Mytown’s short-term outcomes in the Short & Long term
Outcomes Column of the Basic Logic Model
Development Template.
Long-term outcomes are results you expect to achieve in 4-6
years.
Long-term outcomes are also specific changes in things like
attitudes, behaviors,
knowledge, skills, status, or level of functioning expected to
result from program
activities. These usually build on the progress expected by the
short-term outcomes.
EXAMPLES: The clinic serves as a medical home for 500
uninsured patients. The clinic has sustained
funding sources: patient co-payments ($10/visit) provide 20% of
the Clinic’s operating costs, United Way provides
20%, Memorial Hospital donates 20%, the Medical Society
contributes 20% and an endowment established at
the Community Foundation provides the final 20%. An annual
golf tournament organized by the Kiwanis Club
funds special clinic projects. There has been a 25% reduction
in uninsured emergency care since Mytown Free
Clinic opened five years ago. In the Clinic’s fifth year there is
a 15% reduction in uninsured ER visits. Seventy-
five volunteer administrators and 300 volunteer medical
professionals regularly serve at the clinic each year.
Five companies donate all necessary medical supplies. Grant
funds purchase the computers and software
needed to create electronic patient records. For five years
patient satisfaction ratings have been 90%.
Insert Mytown’s long-term outcomes in the Short & Long Term
Outcomes column of the Basic Logic Model
Development Template.
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Impact refers to the results expected 7-10 years after an activity
is underway —
the future social change your program is working to create
Impacts are the kinds of organizational, community, or system
level changes expected
to result form program activities and which might include
improved conditions,
increased capacity, and/or changes in the policy arena.
EXAMPLES: Specific reduction in inappropriate emergency
room use, increased donations of clinic
supplies to meet identified needs, a stable supply of medical
volunteers, an endowment supporting 35% of
the clinic’s operating funds, 900 patients served/year.
Insert Mytown’s impacts in the Impact Column of the Basic
Logic Model Development Template.
Outputs are data about activities.
They are the direct results of program activities. They are
usually described in terms of
size and scope of the services or products delivered or produced
by the program. They
indicate if a program was delivered to the intended audiences at
the intended “dose.” A
program output, for example might the number of classes
taught, meetings held,
materials distributed, program participation rates, or total
service delivery hours.
EXAMPLES: Number of patients referred to the Free Clinic
from Memorial ER/year, the number of
patients screened/year, the number of qualified patients enrolled
in the Free Clinic/year, the average
number of patient visits/day, the total number of patient
visits/year, the number and specialities of medical
volunteers, the number of volunteer administrators trained, the
number and locations of clinic posters
distributed, the number of potential patients calling for
information/ month.
Insert Mytown’s outputs in the Outputs Column of the Basic
Logic Model Development Template
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Exercise 1 Checklist: Review what you have created using the
checklist below to assess
the quality of your draft.
Progress Toward Results Quality
Criteria
Yes Not
Yet
Comments
Revisions
1. A variety of audiences are taken into
consideration when specifying credible
outputs, outcomes, and impacts.
2. Target participants and/or partners are
described and quantified as outputs
(e.g. 100 teachers from 5 rural high
schools).
3. Events, products, or services listed are
described as outputs in terms of a
treatment or dose (e.g. 30 farmers will
participate in at least 3 sessions of
program, or curriculum will be
distributed to at least 12 agencies).
4. The intensity of the intervention or
treatment is appropriate for the type of
participant targeted (e.g. higher risk
participants warrant higher intensities).
5. The duration of the intervention or
treatment is appropriate for the type of
participant targeted (e.g. higher risk
participants warrant longer duration).
6. Outcomes reflect reasonable,
progressive steps that participants can
make toward longer-term results.
7. Outcomes address awareness, attitudes,
perceptions, knowledge, skills, and/ or
behavior of participants.
EXERCISE 1
Check-list
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8. Outcomes are within the scope of the
program's control or sphere of
reasonable influence.
9. It seems fair or reasonable to hold the
program accountable for the outcomes
specified.
10. The outcomes are specific, measurable,
action-oriented, realistic, and timed.
11. The outcomes are written as change
statements (e.g. things increase,
decrease, or stay the same).
12. The outcomes are achievable within the
funding and reporting periods specified
.
13. The impact, as specified, is not beyond
the scope of the program to achieve.
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Exercise 2—Describing Actions
Linking It All Together
Exercise 2 illustrates exactly how you plan to put your program
theory to work. It leads you
to identify the resources and activities your program will need
to achieve your intended
results. This exercise documents your knowledge of the
community resources you have
available and specific activities your program will implement.
Program rationales in grant proposals are usually strong.
Grantees tend to have a very good
sense of what they want to do. However, they frequently fail to
make specific connections
between their program and related best practice literature and
practitioner wisdom that could
and should support their approach and their work.
To connect actions to program results, this exercise links your
knowledge of what works with
specific descriptions of what your program will do. It requires
you to anticipate what will be
needed to support program activities. The elements that
comprise your program
implementation act as a game plan for the program you propose.
Most logic models list activity items and resources (like
planning meetings, curriculum
purchase or design, training workshops, and service delivery).
Depending on the nature of
your effort, other types of products and processes may be
included. Management-oriented
logic models also include program and evaluation development,
staff and volunteer training,
recruitment of partners and participants, and the publicity
needed to support your work along
the way.
As mentioned earlier, if your program addresses multiple issues
you may find it helpful to go
through the exercises for each issue in turn and then aggregate
them into a larger model that
highlights the relationships among issues.
We recommend referring to a literature review on the problem
your program is designed to
address when you specify program activities. From this explicit
knowledge of what works,
you can more clearly connect the abstract strategies supporting
the program to its concrete
activities.
When Exercise 2 is complete and you are satisfied that you have
an accurate inventory of the
Mytown program's component parts, transfer the information to
the Basic Logic Model
Development Template. Remember you have already filled in
the three columns on the
right with what you have learned about the intended results for
the Mytown program
example.
What activities are planned? Based on what you know about
effective ways to solve
problems or build assets, what specific activities have you
planned?
I would
emphasize that
people may well
change their minds
about the activities
that are the most
useful after having
done the results
work.
Beverly
Anderson
Parsons,
WKKF Cluster
Evaluator
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EXAMPLES: Personnel Committee launches and completes
search for full-time director.
Director is hired and oriented to the board and the community.
Board and staff visit the Anywhere
Free Clinic to learn from its experience and to select documents
to replicate (i.e., policies and
procedures, job descriptions, equipment needs, budgets, funding
strategies, volunteer and patient
records). Board and staff conduct program planning retreat.
Based upon Anywhere’s funding plan,
board secures Free Clinic’s first-year funding. Marketing
Committee creates public relations
campaign in collaboration with Volunteer Committee to secure
volunteers and patients. Facility
Committee creates and completes MOA with technical college
to secure a clinic facility. Quality
Assurance Committee creates evaluation plan in cooperation
with Memorial Hospital’s Emergency
Room staff and the local Chamber of Commerce.
Summarize Mytown’s activities in the Activities column of the
Basic Logic Model Development
Template
What resources are needed? Once you have specified what you
plan to do,
determine the resources you will need to support the solutions
your program proposes.
For some types of programs, it may also be helpful to describe
the influential factors
you are counting on to support your efforts in the community.
EXAMPLES: Medical Society/Memorial Hospital Task Force
for the Uninsured will become a Free
Clinic Board of Directors and secure a 501© (3) status from the
IRS. The Board will recruit 7-10 additional
representatives from drug companies, the local technical school,
Mytown’s United Way, the Chamber of
Commerce, the Community Foundation, the Volunteer Center,
the Nurses Association, etc. During a 6-
month planning period, board committees will be launched;
staff will be recruited/hired/oriented; a site visit
will be conducted; and the Clinic’s first-year’s funding
($150,000/year) will be secured. Committees will
create an MOA with Memorial Hospital and the Medical Society
to secure equipment required: 5 exam
tables, 7 desks, 5 blood pressure cuffs, 5 otoscopes, 5
stethoscopes, 5 PDR’s, 1 set of scales, 10
thermometers, three computers, one first aid emergency kit.
Summarize Mytown’s resources in the Resources column of the
Basic Logic Model Development
Template
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Exercise 2 Checklist: Review what you have created using the
checklist below to assess
the quality of your draft.
Theory into Action
Quality Criteria
Yes Not
Yet
Comments/Revisions
1. Major activities needed to
implement the program are listed.
2. Activities are clearly connected to
the specified program theory.
3. Major resources needed to
implement the program are listed.
4. Resources match the type of
program.
5. All activities have sufficient and
appropriate resources.
Check-list
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Here we include a flowchart that summarizes the steps to
complete your basic logic
model. Keep in mind that you could use this inventory style
template to then further
describe the relationships among the components using
numbered items, rows, or
boxes and arrows as we mentioned earlier.
Flowchart for Exercises 1 & 2—Describing Results, Resources,
and Activities
Exercise 1 Describing Results
Resources Activities Outputs Outcomes Impact
4
Step 1.1
For each of the specific activities you have
planned to do, what short-term and then
long-term outcomes do you expect to
achieve as indicators of the progress made
by your program toward its desired results?
Resources Activities Outputs Outcomes Impact
3
Step 1.2
For each of the specific activities that you
have planned to do, what outputs (service
delivery or implementation targets) do you
hope to reach through the operation of your
program?
Resources Activities Outputs Outcomes Impact
5
Step 1.3
For each of the specific activities you have
planned to do, what impact do you expect to
achieve in your community?
Exercise 2 Describing Resources and Activities
Resources Activities Outputs Outcomes Impact
2
Step 2.1
Knowing what you know about what works to
solve problems or build assets as specified in
the theory of change for your program, what
specific activities have you planned to do?
Resources Activities Outputs Outcomes Impact
1
Step 2.2
What resources are available to your
program to support the specific activities you
have planned to do (for some programs, it
may also be important to state those
influential factors you are counting on to
support your work)?
T H E O R Y - O F C H A N G E
Logic Model Development Program Implementation Template –
Exercise 1 & 2
RESOURCES ACTIVITIES OUTPUTS SHORT & LONG-
TERM OUTCOMES
IMPACT
In order to accomplish our set of
activities we will need the
following:
In order to address our problem or
asset we will accomplish the
following activities:
We expect that once accomplished
these activities will produce the
following evidence or service
delivery:
We expect that if accomplished
these activities will lead to the
following changes in 1-3 then 4-6
years:
We expect that if accomplished
these activities will lead to the
following changes in 7-10 years:
• IRS 501(c)(3) status
• Diverse, dedicated
board of directors
representing
potential partners
• Endorsement from
Memorial Hospital,
Mytown Medical
Society, and United
Way
• Donated clinic
facility
• Job descriptions for
board and staff
• First year’s funding
($150,000)
• Clinic equipment
• Board & staff
orientation process
• Clinic budget
• Launch/complete
search for executive
director
• Board & staff conduct
Anywhere Free Clinic
site visit
• Board & staff conduct
planning retreat
• Design and implement
funding strategy
• Design and implement
volunteer recruitment
and training
• Secure facility for clinic
• Create an evaluation
plan
• Design and implement
PR campaign
• # of patients referred
from ER to the
clinic/year
• # of qualified patients
enrolled in the
clinic/year
• # of patient visits/year
• # of medical
volunteers
serving/year
• # of patient fliers
distributed
• # of calls/month
seeking info about
clinic
• Memorandum of
Agreement for free
clinic space
• Change in patient
attitude about need
for medical home
• Change in # of
scheduled annual
physicals/follow-ups
• Increased # of
ER/physician referrals
• Decreased volume of
unreimbursed
emergencies treated
in Memorial ER
• Patient co-payments
supply 20% of clinic
operating costs
• 25% reduction in # of
uninsured ER
visits/year
• 300 medical
volunteers serving
regularly each year
• Clinic is a United Way
Agency
• Clinic endowment
established
• 90% patient
satisfaction for 5
years.
• 900 patients
served/year
T H E O R Y - O F C H A N G E
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Prevalence of Internet addiction among adolescents
The adolescence phase is the period when one is transiting from
childhood to early adulthood. During this period, individuals
tend to experience emotional crises which are accompanied by
mood changes, anxiety, frustration, and fear of failures.
Adolescents are fascinated with the technology and are the
leading Internet users among all the demographics. Lack of
emotional intelligence among adolescents make them prone to
risky behaviors and often indulge in addictive practices.8 This
includes practices such as excessive Internet use to cope up
with frustrations associated with this age group. The prevalence
of Internet addiction is, therefore high among adolescents as
compared to adults.
Interventions initiated to solve the issue of cyber addiction in
adolescents
Cyber addiction has been recognized as a psychological disorder
by the World Health Organization (WHO).9 Different countries
including the United States have also recognized Internet
addiction as a public health concern. Cyber addiction has been
strongly associated with impulsiveness and aggressive
behaviours among adolescents. Adolescents addicted to Internet
use tend to become violent and withdrawn from social
activities. Additionally, the high number of obesity and diabetes
among adolescents in the United States has been positively
associated with physical inactivity as most youths spend their
spare time on online activities. Therefore, several preventive
interventions have been initiated to help alleviate adolescents
from cyber addiction-related consequences.
One of the widespread intervention initiatives to curb cyber
addiction is basic education about the consequences of
excessive use of the Internet. Educators use expert’s factual
information on adverse dangers of Internet addiction and how to
control Internet use. The effects of Internet use have been
incorporated in the media education in primary and secondary
schools.10
Intervention plan and needed resources
Since Internet addiction has become a serious problem among
adolescents between the ages of 10-19 years, implementing
effective intervention programs is critical for better outcomes.
Three interventions will be appropriate including
psychotherapy, reality therapy, and the reSTART program.
Various psychological intervention plans have been proposed to
cut down the cyber addiction among adolescents. Some of the
widely proposed psychological interventions include
psychotherapies such as community-based treatment, vocational
rehabilitation, cognitive-behavioural therapy and problem-
solving therapy. Psychotherapeutic interventions follow two
models; moderate and controlled use of the Internet.11 The
moderate model intervention indicates that addicted individual
to stay offline for an increasing amount of time than there are
online. For instance, parents can control the time that their
children spend on online activities. If the adolescent resumes
Internet activities immediately after school until bedtime, the
parent can limit it to 2 to 3 hours after school.
Other intervention plans include setting schedules that disrupt
patterns of Internet use among adolescents. Educators and other
concerned parties can schedule activities that engage
adolescents physically and make them avoid any engagement
with Internet applications. These disruptive activities include
outdoor sports and activities. Also, adolescents are encouraged
to abstain from Internet applications that they cannot control.
For instance, the adolescent can be stopped from navigating
online games which have been found to be highly addictive.
Additionally, support groups can be used to reduce Internet
addiction among adolescents. Research shows that most people
use the Internet as a compensation to lack of social
support.Psychotherapy
Psychotherapeutic interventions have been proved by many
scholars to be effective in addressing Internet addiction. In this
intervention plan for cyber addition, no specific form of
psychological intervention exists as the universal or standard
for treatment. The intervention can be implemented in the form
of two contexts including controlled use and total abstinence.
Because of the numerous benefits of the Internet in the daily
lives of adolescents, it can be challenging to implement the
total abstinence model to individuals suffering from Internet
addiction. As such, the guiding principle in this intervention
program will be controlled and moderate use of the Internet. In
the abstinence model, the addict stays away from using a
specific Internet application such as games and chat rooms and
utilizes other applications in moderation. The abstinence model
will be used to individuals who have tried and failed to
moderate their Internet application.
Therapeutic intervention entails cognitive restructuring
concerning the Internet applications that the adolescents use
often. Several techniques will be used to achieve this goal. The
first approach will be helping those affected practice the
opposite. Here, the therapists together with parents and teachers
discover the Internet usage pattern of the adolescent and disrupt
them by proposing new schedules. For instance, if the addict
goes online after school and remains online until the time to
sleep, the parent can suggest for dinner, doing homework then
go back to the computer. The strategy will disrupt the addict’s
Internet usage pattern, therefore preventing him or her from
excessive use.
The second strategy will comprise helping the adolescents to set
specific and achievable goals concerning the amount of time
spent on the Internet. The third approach will include the use of
support groups where the addicts will receive sufficient social
support from family and friends. Most Internet addicts tend to
use the Internet to compensate for the lack of social support,
therefore providing such enhancements can play a critical role
in curing the addiction. To successfully implement the
therapeutic interventions, there must be cooperation between
parents, teachers, and counselors of the addict adolescents.
While the parent tries to execute the strategies at home, teachers
should also do the same at school.
Additionally, reality therapy will also play a crucial role in
addressing cyber addiction among adolescents. Reality therapy
focuses on problem-solving as well as making appropriate
choices to attain specific goals.12 The primary purpose of this
approach is to address issues, rebuild connections and to focus
on a better future. Here, the therapist asks the addicts what they
want and how their present behaviors are playing a role in
achieving the set goals. As such, the therapist and client can
both explore the appropriate solutions to problems facing the
client as well as make those solutions a reality. In this case, the
counselors in schools will act as therapists to help the
adolescents identify their problems and come up with
appropriate solutions that make the set targets a reality.
The parents and teachers will also play a significant role in this
approach. Because they also tend to interact with these
adolescents at home and school respectively. Lastly, the
reSTART Program will also form part of the psychotherapeutic
interventions where therapists will try to restore the behaviors
the behaviors of the addicts as well as come up with solutions to
their problems to make their lives better. Moreover, the
resources needed for successful implementation of this
intervention include therapists and financial resources to the
facilitation of the therapists and marketing of the program.
The reSTART program
The reSTART program is an Internet addiction recovery
program based in Fall City, Washington. This integrated
program operates on an inpatient basis and helps teenagers
addicted to the Internet shun the habit.13 The program uses a
strategy referred to as technology detoxification to help their
clients recover from cyber addiction. Technology detoxification
is defined as no Internet or technology use for a period of one
and half to three months (45 to 90 days). Out of the total
number of individuals who were taken through the 45 to 90 days
of no technology, almost three quarters (74%) showed
significant improvement from cyber addiction. Of these
individuals 21% showed little improvement while only 5%
showed signs of deteriorating. These results were regarded as
preliminary because of a small sample studied and lacked a
control group. These limitations notwithstanding, there is
indication that most of the improvements demonstrated are as a
result of the program.
The reSTART program also helps with recovery from alcohol
and drug abuse. Some of the therapies used include cognitive
behavioral therapy, acceptance and commitment therapy,
experiential adventure-based therapy, brain enhancing
interventions, and mindfulness-based relapse prevention. Other
therapeutic interventions employed by the reSTART program
include psycho-educational groups (incorporating interventions
such as addiction education, life visioning, social and life skills,
communication and assertiveness training, and life balance
plan). The program also uses individualized treatments
for co-occurring disorders, aftercare treatments (which can
monitor technology use, enhance group work, and continuing
psychotherapy). Monitoring of technology use, ongoing
psychotherapy and group work), and ongoing care (outpatient
treatment) in a personalized, all-inclusive approach among other
interventions.14
The program is designed in such a way that it weans patients
away from the Internet via a combination of social skills and
traditional talk therapies. Some of the techniques used include
valuable lessons in communication skills. Patients are also
assigned tasks such as feeding goats, performing home
maintenance, and raising chickens as a way of reorienting them
with the life away from the Internet. The first Internet addict to
be enrolled in the program was a 19-year old young man from
Iowa who confessed that he was addicted to an online game.
The reSTART program seems to be expensive (costing roughly
$14,500 for the entire program) but experts have expressed
optimism that it can be helpful. According to Stuart Fischoff, a
psychologist and senior editor at the Journal of Media
Psychology with no affiliation to the program, the program has
given rise to very positive results. He observed that the aim is
to make the patient experience satisfaction from something that
does not need connection to the Internet. Thus, giving to
patients someone who appreciates them, needs them, and does
not judge them but gives them a chance to forget about the
Internet and reach out to the real world.15
Comparison with the existing programs
Currently, several intervention approaches to Internet addiction
have been integrated, for instance, cognitive behavioral therapy,
family therapy, community therapy among others.16 The
similarity between these therapies and psychotherapy
approaches is that all of them require face-to-face interactions
between the therapist and clients. They are also aimed at
changing behaviors and lifestyles through dropping the old and
bad ones then adopting the new one that can make life better.
Also, all of these therapies need cooperation among the
therapist, client, and other relevant individuals such as parents
and teachers for successful outcomes.
Moreover, the programs intends to improve on the existing
programs through ensuring cooperation between parents,
teachers, and the addicts to achieve the desired results. Most
past and previous intervention programs only focuses on the
relationship between the therapist and client; however, other
individuals such as teachers and parents also play a vital role in
changing behaviors of addicts. Therefore, this program will
focus on creating healthy relationships to attain its targets.
Challenges with implementation
In essence, implementation of any program usually faces
various challenges that can adversely impact the outcomes. In
this program, one of the problems that would likely to surface
include failure of the addicts to cooperate with the therapists.
Since most adolescents cannot live without the Internet, they
would probably not to collaborate with the therapists through
the intervention program. They might give false information
about their Internet-related problems, therefore jeopardizing the
work of the therapists as well as outcomes. Another challenge
will relate to the failure of parents and teachers to cooperate
with the therapists.
As noted earlier, parents and teachers will play a vital role in
the success of this program; therefore their failure to cooperate
can adversely impact the outcomes. The third potential
challenge will relate to finances where the therapists might lack
sufficient money to reach the addicts as well as create
awareness about the program.
Evaluation plan
Evaluating a program is usually not an easy task. Moreover, to
assess the effectiveness and success of the proposed
intervention program, several measurable outcomes will be
used. Firstly, the participation and involvement of the addicts,
parents, and teachers rate will indicate the effectiveness and
success of the program. For instance, a high number of addicts,
parents, and teachers who will involve in the program will
signify its success. However, a low turnout will mean that the
awareness as well as the implementation of the program was
ineffective. Another element that will be used to evaluate the
plan includes the behaviors of the addicts. Three weeks
following the implementation of the program, the behaviors of
addicts will be assessed to determine any changes. Positive
behavioral changes will indicate the effectiveness and success
of the program. The adolescents are expected to demonstrate a
positive change by reducing their dependence on the usage of
the Internet and adopt other alternatives.
Challenges with evaluation
The primary challenge that will be faced during the evaluation
plan will be relate to locating all the addicts that would have
gone through the program. Some of the participants might not
be present during evaluation, therefore, leading to assumptions
that might not reflect the actual impact of the program. Another
challenge would be finding the right measurement to assess the
effectiveness of the program. Finding an appropriate measure or
scale to determine the success of any program is usually
difficult.
Approaches to treating adolescent Internet addicts
Under this category of efforts applied for deterrence of cyber
addiction, motivational interviewing is commonly used. This is
a client-centered but directive technique used in intrinsic
impulse to change enhancement which works by exploring and
solving patient uncertainty.17 This technique was developed to
help addicts shun behaviors which may lead to addiction and
learn new behavioral and live skills.
Some of the methods used here include open-ended questions,
affirmation, reflective listening, as well as summarization to
enable patients talk about their concerns about change.18 One
shortcoming about the motivational interviewing technique is
that presently, there are no studies addressing its efficiency in
treating Internet addiction, although it has been seen to be
effective in treating other addictions.
Interventions by family members and the community is the
other psychological approach widely used to treat adolescents
with the Internet addiction problem.19 Family training and
community reinforcement can be a useful technique in
improving the enthusiasm of an Internet addict to reduce the
time spent on the Internet.20 This strategy to treat people with
Internet addiction can be very effective if used properly since it
involves people who are very close to the addict. One limitation
of the strategy is that it can fail if communication between the
patient and family members or the community is poor.
Through reality therapy, individuals can be encouraged to
choose to enhance their lives by promising to change their
behavior on Internet use. This incorporates meetings to show
those addicted that addiction is a choice and train them how to
manage time.21 This is done by introducing alternative
activities which help to keep the affected person busy and keep
them off the problematic behavior.
An overall shortcoming of the above efforts is that they have
not been applied in large scale. Further, some of the methods do
not have scholarly research to support their application and
efficacy. It is also unfortunate that no specific studies have
been done to target intervention measures to save the American
adolescents from Internet addiction. These efforts need to be
backed through policy by the government and their use
embraced to save adolescents from cyber addiction.
Addressing the issue of cyber addiction would greatly
contribute to the issue of better services in the health care
places.22 By addressing this issue, improved means and
increased access to prevention and treatment services can be
developed. Health care reform and parity laws are providing
good opportunities and incentives to address cyber addiction
and other related disorders more effectively. The reforms give
new opportunities to create better practices that are full of
evidence in addressing health and other social problems which
are associated with cyber addiction.
Logic models are used to "present and share your understanding
of the relationships among the resources you have to operate
your program, the activities you plan, and the changes or results
you hope to achieve. You will be presenting your problem to a
foundation or coalition and proposing ways it can be addressed.
A logic is a great way to show the connections between the
different sections of your presentation/project.
Instructions: Create a logic model for the topic Cyber
Addiction: Its Prevalence and Contributing Factors among U.S.
Adolescents using the paper attached.
The logic model should include the following sections:
· Inputs: Identify the resources needed to implement the
intervention.
· Activities: Identify actions that will be used to achieve the
intended results.
· Outputs: Identify the direct results of intervention activities.
Here you will link the activities you propose to your affected
population. What did your activity actually produce?
· Outcomes: Identify the change that occurs between the inputs
and the outputs. The immediate changes that occurred in
participants.
· Impact: Identify the longer term or systematic change that will
occur as a result.
*Examples of logic models:
http://cyberuse.com/logic-model-template.html
http://toolkit.pellinstitute.org/evaluation-guide/plan-
budget/using-a-logic-model/

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B A S I C L O G I C M O D E L D E V E L O P M E N T Pr.docx

  • 1. B A S I C L O G I C M O D E L D E V E L O P M E N T Produced by The W. K. Kellogg Foundation 53535353 Developing a Basic Logic Model For Your Program Drawing a picture of how your program will achieve results hether you are a grantseeker developing a proposal for start-up funds or a grantee with a program already in operation, developing a logic model can strengthen your program. Logic models help identify the factors that will impact your program and enable you to anticipate the data and resources you will need to achieve success. As you engage in the process of creating your program logic model, your organization will systematically address these important program planning and evaluation issues: • Cataloguing of the resources and actions you believe you will need to reach intended results. • Documentation of connections among your available resources, planned activities and the results you expect to achieve.
  • 2. • Description of the results you are aiming for in terms of specific, measurable, action- oriented, realistic and timed outcomes. The exercises in this chapter gather the raw material you need to draw a basic logic model that illustrates how and why your program will work and what it will accomplish. You can benefit from creating a logic model at any point in the life of any program. The logic model development process helps people inside and outside your organization understand and improve the purpose and process of your work. Chapter 2 is organized into two sections—Program Implementation, and Program Results. The best recipe for program success is to complete both exercises. (Full-size masters of each exercise and the checklists are provided in the Forms Appendix at the back of the guide for you to photocopy and use with stakeholder groups as you design your program.) Exercise 1: Program Results. In a series of three steps, you describe the results you plan to achieve with your program. Exercise 2: Program Resources and Activities by taking you through three steps that connect the program’s resources to the actual activities you plan to do. Chapter
  • 3. 2 W B A S I C L O G I C M O D E L D E V E L O P M E N T Produced by The W. K. Kellogg Foundation 54545454 The Mytown Example Throughout Exercises 1 and 2 we’ll follow an example program to see how the logic model steps can be applied. In our example, the folks in Mytown, USA are striving to meet the needs of growing numbers of uninsured residents who are turning to Memorial Hospital’s Emergency Room for care. Because that care is expensive and not the best way to offer care, the community is working to create a free clinic. Throughout the chapters, Mytown’s program information will be dropped into logic model templates for Program Planning, Implementation, and Evaluation. Novice Logic modelers may want to have copies of the Basic Logic Model Template in front of them and follow along. Those readers with more experience and familiarity may want to explore the text and then skip ahead to the completed Basic Logic Model for the Mytown Example on page 34. Demonstrating Progress Towards Change
  • 4. The Importance of Documenting Progress According to many funders, grant applications frequently lack solid descriptions of how programs will demonstrate their effectiveness. Some grantees think activities are ends unto themselves. They report the numbers of participants they reach or the numbers of training sessions held as though they were results. Conducting an activity is not the same as achieving results from the accomplishment of that activity. For example, being seen by a doctor is different from reducing the number of uninsured emergency room visits. Tracking data like meetings held or patients enrolled does monitor your program’s implementation and performance, but those data are outputs (activity data), not outcomes (which refer to the results you expect to achieve in future years). “Do the outcomes first” is sage advice. Most logic models lack specific short- and long- term outcomes that predict what will be achieved several years down the road. Specifying program "milestones" as you design the program builds in ways to gather the data required and allows you to periodically assess the program’s progress toward the goals you identify. For that reason, Exercise 1 isn’t filled out from left to right. This exercise asks you to “do the outcomes first.” We will focus our attention first on what we have called “your intended results.”
  • 5. As you implement your program, outcome measures enhance program success by assessing your progress from the beginning and all along the way. That makes it possible to notice problems early on. The elements (Outputs, Outcomes, and Impact) that comprise your intended results give you an outline of what is most important to monitor and gauge to determine the effectiveness of your program. You can correct and revise based on your interpretation of the collected data. Over the past few years, I have markedly changed my approach to logic modeling. I have become convinced that it makes a considerable difference if you do the outcomes before planning the activities. I definitely advocate doing the outcomes first! I find that people come up with much more effective activities when they do. Use the motto, “plan backward, implement forward.” Beverly Anderson Parsons, WKKF Cluster Evaluator
  • 6. B A S I C L O G I C M O D E L D E V E L O P M E N T Produced by The W. K. Kellogg Foundation 55555555 Exercise 1 – Describing Results Describe the results you desire—Outputs, Outcomes and Impact If you were running the Mytown Free Clinic, how would you show that your desired outcome (a reduction in uninsured emergency care) didn’t result from a mass exodus of uninsured residents from Mytown, USA or a sudden increase in number of employees offered health insurance coverage by local businesses? How will you demonstrate that your program contributed to the change you intend? A well- crafted logic model can assert it is reasonable to claim that your program made a substantive contribution to your intended change. When programs operate in real communities where influences and forces are beyond your control, evaluation is generally more about documenting a program’s contribution rather than proving something. Community-based initiatives operate in complex environments where the scientific certainty of “proof” is seldom attainable. This is where logic models can be especially helpful. INSTRUCTIONS: Exercise 1 will use the Basic Logic Model Development Template. In particular, you will use the information presented in the gray text boxes
  • 7. that follow about the Mytown example program to determine what results are intended for this program. Example information about outcomes, impacts, and outputs are provided. You will fill in the blank Basic Logic Model Development Template to illustrate first the outcomes and impacts sought and then the outputs. You can then look at the completed template on page 26 to see compare your interpretation with that produced by the Mytown folks. Exercise 1 uses the Basic Logic Model Development Template RESOURCES ACTIVITIES OUTPUTS SHORT & LONG- TERM OUTCOMES IMPACT In order to accomplish our set of activities we will need the following: In order to address our problem or asset we will conduct the following activities: We expect that once completed or underway these activities will produce the following evidence of service delivery:
  • 8. We expect that if completed or on- going these activities will lead to the following changes in 1-3 then 4-6 years: We expect that if completed these activities will lead to the following changes in 7-10 years: Outcomes and Impacts should be SMART: • Specific • Measurable • Action-oriented • Realistic • Timed B A S I C L O G I C M O D E L D E V E L O P M E N T Produced by The W. K. Kellogg Foundation 56565656 Some logic models number the lists within a column to aid discussion. Some tabular logic models use rows to order and show the relationships among components. Some logic models, like the outcome and activity examples provided
  • 9. in Chapter One, use a box and arrow format to illustrate the "causal linkages" demonstrating how your resources, activities, outputs, outcomes, and impact connect to form chains. These depictions add to the clarity of your logic model/evaluation plan. However, for the most basic of logic models, the inventory approach we illustrate is sufficient to capture your thinking about how a program will work. The other techniques will improve its utility, but the most important task is to first get the component parts categorized and described. Once you have completed the inventory table for this and Exercise 2 feel free to experiment with identifying the relationships among the items across columns. Short-term outcomes are results you expect to achieve 1 - 3 years after a program activity is underway. Short-term outcomes are specific changes in things like attitudes, behaviors, knowledge, skills, status, or level of functioning expected to result from program activities. These usually are expressed at an individual level among program participants. EXAMPLES: Signed Memorandum of Agreement from the local technical college donating clinic space, change in participants’ attitudes about the need for a medical home, increase in number s of scheduled annual physicals, increased patient follow-up visits, change in staff’’s awareness of patient scheduling challenges, increased appropriate referrals from ER’s.
  • 10. Insert Mytown’s short-term outcomes in the Short & Long term Outcomes Column of the Basic Logic Model Development Template. Long-term outcomes are results you expect to achieve in 4-6 years. Long-term outcomes are also specific changes in things like attitudes, behaviors, knowledge, skills, status, or level of functioning expected to result from program activities. These usually build on the progress expected by the short-term outcomes. EXAMPLES: The clinic serves as a medical home for 500 uninsured patients. The clinic has sustained funding sources: patient co-payments ($10/visit) provide 20% of the Clinic’s operating costs, United Way provides 20%, Memorial Hospital donates 20%, the Medical Society contributes 20% and an endowment established at the Community Foundation provides the final 20%. An annual golf tournament organized by the Kiwanis Club funds special clinic projects. There has been a 25% reduction in uninsured emergency care since Mytown Free Clinic opened five years ago. In the Clinic’s fifth year there is a 15% reduction in uninsured ER visits. Seventy- five volunteer administrators and 300 volunteer medical professionals regularly serve at the clinic each year. Five companies donate all necessary medical supplies. Grant funds purchase the computers and software needed to create electronic patient records. For five years patient satisfaction ratings have been 90%. Insert Mytown’s long-term outcomes in the Short & Long Term Outcomes column of the Basic Logic Model Development Template.
  • 11. B A S I C L O G I C M O D E L D E V E L O P M E N T Produced by The W. K. Kellogg Foundation 57575757 Impact refers to the results expected 7-10 years after an activity is underway — the future social change your program is working to create Impacts are the kinds of organizational, community, or system level changes expected to result form program activities and which might include improved conditions, increased capacity, and/or changes in the policy arena. EXAMPLES: Specific reduction in inappropriate emergency room use, increased donations of clinic supplies to meet identified needs, a stable supply of medical volunteers, an endowment supporting 35% of the clinic’s operating funds, 900 patients served/year. Insert Mytown’s impacts in the Impact Column of the Basic Logic Model Development Template. Outputs are data about activities. They are the direct results of program activities. They are usually described in terms of size and scope of the services or products delivered or produced by the program. They indicate if a program was delivered to the intended audiences at the intended “dose.” A
  • 12. program output, for example might the number of classes taught, meetings held, materials distributed, program participation rates, or total service delivery hours. EXAMPLES: Number of patients referred to the Free Clinic from Memorial ER/year, the number of patients screened/year, the number of qualified patients enrolled in the Free Clinic/year, the average number of patient visits/day, the total number of patient visits/year, the number and specialities of medical volunteers, the number of volunteer administrators trained, the number and locations of clinic posters distributed, the number of potential patients calling for information/ month. Insert Mytown’s outputs in the Outputs Column of the Basic Logic Model Development Template B A S I C L O G I C M O D E L D E V E L O P M E N T Produced by The W. K. Kellogg Foundation 58585858 Exercise 1 Checklist: Review what you have created using the checklist below to assess the quality of your draft.
  • 13. Progress Toward Results Quality Criteria Yes Not Yet Comments Revisions 1. A variety of audiences are taken into consideration when specifying credible outputs, outcomes, and impacts. 2. Target participants and/or partners are described and quantified as outputs (e.g. 100 teachers from 5 rural high schools). 3. Events, products, or services listed are described as outputs in terms of a treatment or dose (e.g. 30 farmers will participate in at least 3 sessions of program, or curriculum will be distributed to at least 12 agencies). 4. The intensity of the intervention or treatment is appropriate for the type of participant targeted (e.g. higher risk participants warrant higher intensities). 5. The duration of the intervention or treatment is appropriate for the type of
  • 14. participant targeted (e.g. higher risk participants warrant longer duration). 6. Outcomes reflect reasonable, progressive steps that participants can make toward longer-term results. 7. Outcomes address awareness, attitudes, perceptions, knowledge, skills, and/ or behavior of participants. EXERCISE 1 Check-list B A S I C L O G I C M O D E L D E V E L O P M E N T Produced by The W. K. Kellogg Foundation 59595959 8. Outcomes are within the scope of the program's control or sphere of reasonable influence. 9. It seems fair or reasonable to hold the program accountable for the outcomes specified.
  • 15. 10. The outcomes are specific, measurable, action-oriented, realistic, and timed. 11. The outcomes are written as change statements (e.g. things increase, decrease, or stay the same). 12. The outcomes are achievable within the funding and reporting periods specified . 13. The impact, as specified, is not beyond the scope of the program to achieve. B A S I C L O G I C M O D E L D E V E L O P M E N T Produced by The W. K. Kellogg Foundation 60606060 Exercise 2—Describing Actions Linking It All Together Exercise 2 illustrates exactly how you plan to put your program
  • 16. theory to work. It leads you to identify the resources and activities your program will need to achieve your intended results. This exercise documents your knowledge of the community resources you have available and specific activities your program will implement. Program rationales in grant proposals are usually strong. Grantees tend to have a very good sense of what they want to do. However, they frequently fail to make specific connections between their program and related best practice literature and practitioner wisdom that could and should support their approach and their work. To connect actions to program results, this exercise links your knowledge of what works with specific descriptions of what your program will do. It requires you to anticipate what will be needed to support program activities. The elements that comprise your program implementation act as a game plan for the program you propose. Most logic models list activity items and resources (like planning meetings, curriculum purchase or design, training workshops, and service delivery). Depending on the nature of your effort, other types of products and processes may be included. Management-oriented logic models also include program and evaluation development, staff and volunteer training, recruitment of partners and participants, and the publicity needed to support your work along the way. As mentioned earlier, if your program addresses multiple issues
  • 17. you may find it helpful to go through the exercises for each issue in turn and then aggregate them into a larger model that highlights the relationships among issues. We recommend referring to a literature review on the problem your program is designed to address when you specify program activities. From this explicit knowledge of what works, you can more clearly connect the abstract strategies supporting the program to its concrete activities. When Exercise 2 is complete and you are satisfied that you have an accurate inventory of the Mytown program's component parts, transfer the information to the Basic Logic Model Development Template. Remember you have already filled in the three columns on the right with what you have learned about the intended results for the Mytown program example. What activities are planned? Based on what you know about effective ways to solve problems or build assets, what specific activities have you planned? I would emphasize that people may well change their minds about the activities that are the most useful after having
  • 18. done the results work. Beverly Anderson Parsons, WKKF Cluster Evaluator B A S I C L O G I C M O D E L D E V E L O P M E N T Produced by The W. K. Kellogg Foundation 61616161 EXAMPLES: Personnel Committee launches and completes search for full-time director. Director is hired and oriented to the board and the community. Board and staff visit the Anywhere Free Clinic to learn from its experience and to select documents to replicate (i.e., policies and procedures, job descriptions, equipment needs, budgets, funding strategies, volunteer and patient records). Board and staff conduct program planning retreat. Based upon Anywhere’s funding plan, board secures Free Clinic’s first-year funding. Marketing Committee creates public relations campaign in collaboration with Volunteer Committee to secure volunteers and patients. Facility Committee creates and completes MOA with technical college to secure a clinic facility. Quality Assurance Committee creates evaluation plan in cooperation with Memorial Hospital’s Emergency Room staff and the local Chamber of Commerce.
  • 19. Summarize Mytown’s activities in the Activities column of the Basic Logic Model Development Template What resources are needed? Once you have specified what you plan to do, determine the resources you will need to support the solutions your program proposes. For some types of programs, it may also be helpful to describe the influential factors you are counting on to support your efforts in the community. EXAMPLES: Medical Society/Memorial Hospital Task Force for the Uninsured will become a Free Clinic Board of Directors and secure a 501© (3) status from the IRS. The Board will recruit 7-10 additional representatives from drug companies, the local technical school, Mytown’s United Way, the Chamber of Commerce, the Community Foundation, the Volunteer Center, the Nurses Association, etc. During a 6- month planning period, board committees will be launched; staff will be recruited/hired/oriented; a site visit will be conducted; and the Clinic’s first-year’s funding ($150,000/year) will be secured. Committees will create an MOA with Memorial Hospital and the Medical Society to secure equipment required: 5 exam tables, 7 desks, 5 blood pressure cuffs, 5 otoscopes, 5 stethoscopes, 5 PDR’s, 1 set of scales, 10 thermometers, three computers, one first aid emergency kit. Summarize Mytown’s resources in the Resources column of the Basic Logic Model Development Template
  • 20. B A S I C L O G I C M O D E L D E V E L O P M E N T Produced by The W. K. Kellogg Foundation 62626262 Exercise 2 Checklist: Review what you have created using the checklist below to assess the quality of your draft. Theory into Action Quality Criteria Yes Not Yet Comments/Revisions 1. Major activities needed to implement the program are listed. 2. Activities are clearly connected to
  • 21. the specified program theory. 3. Major resources needed to implement the program are listed. 4. Resources match the type of program. 5. All activities have sufficient and appropriate resources. Check-list B A S I C L O G I C M O D E L D E V E L O P M E N T Produced by The W. K. Kellogg Foundation 63636363
  • 22. Here we include a flowchart that summarizes the steps to complete your basic logic model. Keep in mind that you could use this inventory style template to then further describe the relationships among the components using numbered items, rows, or boxes and arrows as we mentioned earlier. Flowchart for Exercises 1 & 2—Describing Results, Resources, and Activities Exercise 1 Describing Results Resources Activities Outputs Outcomes Impact 4 Step 1.1 For each of the specific activities you have planned to do, what short-term and then long-term outcomes do you expect to achieve as indicators of the progress made by your program toward its desired results? Resources Activities Outputs Outcomes Impact 3 Step 1.2 For each of the specific activities that you have planned to do, what outputs (service delivery or implementation targets) do you hope to reach through the operation of your program?
  • 23. Resources Activities Outputs Outcomes Impact 5 Step 1.3 For each of the specific activities you have planned to do, what impact do you expect to achieve in your community? Exercise 2 Describing Resources and Activities Resources Activities Outputs Outcomes Impact 2 Step 2.1 Knowing what you know about what works to solve problems or build assets as specified in the theory of change for your program, what specific activities have you planned to do? Resources Activities Outputs Outcomes Impact 1 Step 2.2 What resources are available to your program to support the specific activities you have planned to do (for some programs, it may also be important to state those influential factors you are counting on to support your work)?
  • 24. T H E O R Y - O F C H A N G E Logic Model Development Program Implementation Template – Exercise 1 & 2 RESOURCES ACTIVITIES OUTPUTS SHORT & LONG- TERM OUTCOMES IMPACT In order to accomplish our set of activities we will need the following: In order to address our problem or asset we will accomplish the following activities: We expect that once accomplished these activities will produce the following evidence or service delivery: We expect that if accomplished these activities will lead to the following changes in 1-3 then 4-6 years: We expect that if accomplished these activities will lead to the following changes in 7-10 years: • IRS 501(c)(3) status
  • 25. • Diverse, dedicated board of directors representing potential partners • Endorsement from Memorial Hospital, Mytown Medical Society, and United Way • Donated clinic facility • Job descriptions for board and staff • First year’s funding ($150,000) • Clinic equipment • Board & staff orientation process • Clinic budget • Launch/complete search for executive director • Board & staff conduct Anywhere Free Clinic site visit • Board & staff conduct
  • 26. planning retreat • Design and implement funding strategy • Design and implement volunteer recruitment and training • Secure facility for clinic • Create an evaluation plan • Design and implement PR campaign • # of patients referred from ER to the clinic/year • # of qualified patients enrolled in the clinic/year • # of patient visits/year • # of medical volunteers serving/year • # of patient fliers distributed • # of calls/month seeking info about
  • 27. clinic • Memorandum of Agreement for free clinic space • Change in patient attitude about need for medical home • Change in # of scheduled annual physicals/follow-ups • Increased # of ER/physician referrals • Decreased volume of unreimbursed emergencies treated in Memorial ER • Patient co-payments supply 20% of clinic operating costs • 25% reduction in # of uninsured ER visits/year • 300 medical volunteers serving regularly each year • Clinic is a United Way
  • 28. Agency • Clinic endowment established • 90% patient satisfaction for 5 years. • 900 patients served/year T H E O R Y - O F C H A N G E 64 Produced by The W. K. Kellogg Foundation Prevalence of Internet addiction among adolescents The adolescence phase is the period when one is transiting from childhood to early adulthood. During this period, individuals tend to experience emotional crises which are accompanied by mood changes, anxiety, frustration, and fear of failures. Adolescents are fascinated with the technology and are the leading Internet users among all the demographics. Lack of emotional intelligence among adolescents make them prone to risky behaviors and often indulge in addictive practices.8 This includes practices such as excessive Internet use to cope up with frustrations associated with this age group. The prevalence of Internet addiction is, therefore high among adolescents as compared to adults. Interventions initiated to solve the issue of cyber addiction in adolescents Cyber addiction has been recognized as a psychological disorder
  • 29. by the World Health Organization (WHO).9 Different countries including the United States have also recognized Internet addiction as a public health concern. Cyber addiction has been strongly associated with impulsiveness and aggressive behaviours among adolescents. Adolescents addicted to Internet use tend to become violent and withdrawn from social activities. Additionally, the high number of obesity and diabetes among adolescents in the United States has been positively associated with physical inactivity as most youths spend their spare time on online activities. Therefore, several preventive interventions have been initiated to help alleviate adolescents from cyber addiction-related consequences. One of the widespread intervention initiatives to curb cyber addiction is basic education about the consequences of excessive use of the Internet. Educators use expert’s factual information on adverse dangers of Internet addiction and how to control Internet use. The effects of Internet use have been incorporated in the media education in primary and secondary schools.10 Intervention plan and needed resources Since Internet addiction has become a serious problem among adolescents between the ages of 10-19 years, implementing effective intervention programs is critical for better outcomes. Three interventions will be appropriate including psychotherapy, reality therapy, and the reSTART program. Various psychological intervention plans have been proposed to cut down the cyber addiction among adolescents. Some of the widely proposed psychological interventions include psychotherapies such as community-based treatment, vocational rehabilitation, cognitive-behavioural therapy and problem- solving therapy. Psychotherapeutic interventions follow two models; moderate and controlled use of the Internet.11 The moderate model intervention indicates that addicted individual to stay offline for an increasing amount of time than there are online. For instance, parents can control the time that their children spend on online activities. If the adolescent resumes
  • 30. Internet activities immediately after school until bedtime, the parent can limit it to 2 to 3 hours after school. Other intervention plans include setting schedules that disrupt patterns of Internet use among adolescents. Educators and other concerned parties can schedule activities that engage adolescents physically and make them avoid any engagement with Internet applications. These disruptive activities include outdoor sports and activities. Also, adolescents are encouraged to abstain from Internet applications that they cannot control. For instance, the adolescent can be stopped from navigating online games which have been found to be highly addictive. Additionally, support groups can be used to reduce Internet addiction among adolescents. Research shows that most people use the Internet as a compensation to lack of social support.Psychotherapy Psychotherapeutic interventions have been proved by many scholars to be effective in addressing Internet addiction. In this intervention plan for cyber addition, no specific form of psychological intervention exists as the universal or standard for treatment. The intervention can be implemented in the form of two contexts including controlled use and total abstinence. Because of the numerous benefits of the Internet in the daily lives of adolescents, it can be challenging to implement the total abstinence model to individuals suffering from Internet addiction. As such, the guiding principle in this intervention program will be controlled and moderate use of the Internet. In the abstinence model, the addict stays away from using a specific Internet application such as games and chat rooms and utilizes other applications in moderation. The abstinence model will be used to individuals who have tried and failed to moderate their Internet application. Therapeutic intervention entails cognitive restructuring concerning the Internet applications that the adolescents use often. Several techniques will be used to achieve this goal. The first approach will be helping those affected practice the opposite. Here, the therapists together with parents and teachers
  • 31. discover the Internet usage pattern of the adolescent and disrupt them by proposing new schedules. For instance, if the addict goes online after school and remains online until the time to sleep, the parent can suggest for dinner, doing homework then go back to the computer. The strategy will disrupt the addict’s Internet usage pattern, therefore preventing him or her from excessive use. The second strategy will comprise helping the adolescents to set specific and achievable goals concerning the amount of time spent on the Internet. The third approach will include the use of support groups where the addicts will receive sufficient social support from family and friends. Most Internet addicts tend to use the Internet to compensate for the lack of social support, therefore providing such enhancements can play a critical role in curing the addiction. To successfully implement the therapeutic interventions, there must be cooperation between parents, teachers, and counselors of the addict adolescents. While the parent tries to execute the strategies at home, teachers should also do the same at school. Additionally, reality therapy will also play a crucial role in addressing cyber addiction among adolescents. Reality therapy focuses on problem-solving as well as making appropriate choices to attain specific goals.12 The primary purpose of this approach is to address issues, rebuild connections and to focus on a better future. Here, the therapist asks the addicts what they want and how their present behaviors are playing a role in achieving the set goals. As such, the therapist and client can both explore the appropriate solutions to problems facing the client as well as make those solutions a reality. In this case, the counselors in schools will act as therapists to help the adolescents identify their problems and come up with appropriate solutions that make the set targets a reality. The parents and teachers will also play a significant role in this approach. Because they also tend to interact with these adolescents at home and school respectively. Lastly, the reSTART Program will also form part of the psychotherapeutic
  • 32. interventions where therapists will try to restore the behaviors the behaviors of the addicts as well as come up with solutions to their problems to make their lives better. Moreover, the resources needed for successful implementation of this intervention include therapists and financial resources to the facilitation of the therapists and marketing of the program. The reSTART program The reSTART program is an Internet addiction recovery program based in Fall City, Washington. This integrated program operates on an inpatient basis and helps teenagers addicted to the Internet shun the habit.13 The program uses a strategy referred to as technology detoxification to help their clients recover from cyber addiction. Technology detoxification is defined as no Internet or technology use for a period of one and half to three months (45 to 90 days). Out of the total number of individuals who were taken through the 45 to 90 days of no technology, almost three quarters (74%) showed significant improvement from cyber addiction. Of these individuals 21% showed little improvement while only 5% showed signs of deteriorating. These results were regarded as preliminary because of a small sample studied and lacked a control group. These limitations notwithstanding, there is indication that most of the improvements demonstrated are as a result of the program. The reSTART program also helps with recovery from alcohol and drug abuse. Some of the therapies used include cognitive behavioral therapy, acceptance and commitment therapy, experiential adventure-based therapy, brain enhancing interventions, and mindfulness-based relapse prevention. Other therapeutic interventions employed by the reSTART program include psycho-educational groups (incorporating interventions such as addiction education, life visioning, social and life skills, communication and assertiveness training, and life balance plan). The program also uses individualized treatments for co-occurring disorders, aftercare treatments (which can monitor technology use, enhance group work, and continuing
  • 33. psychotherapy). Monitoring of technology use, ongoing psychotherapy and group work), and ongoing care (outpatient treatment) in a personalized, all-inclusive approach among other interventions.14 The program is designed in such a way that it weans patients away from the Internet via a combination of social skills and traditional talk therapies. Some of the techniques used include valuable lessons in communication skills. Patients are also assigned tasks such as feeding goats, performing home maintenance, and raising chickens as a way of reorienting them with the life away from the Internet. The first Internet addict to be enrolled in the program was a 19-year old young man from Iowa who confessed that he was addicted to an online game. The reSTART program seems to be expensive (costing roughly $14,500 for the entire program) but experts have expressed optimism that it can be helpful. According to Stuart Fischoff, a psychologist and senior editor at the Journal of Media Psychology with no affiliation to the program, the program has given rise to very positive results. He observed that the aim is to make the patient experience satisfaction from something that does not need connection to the Internet. Thus, giving to patients someone who appreciates them, needs them, and does not judge them but gives them a chance to forget about the Internet and reach out to the real world.15 Comparison with the existing programs Currently, several intervention approaches to Internet addiction have been integrated, for instance, cognitive behavioral therapy, family therapy, community therapy among others.16 The similarity between these therapies and psychotherapy approaches is that all of them require face-to-face interactions between the therapist and clients. They are also aimed at changing behaviors and lifestyles through dropping the old and bad ones then adopting the new one that can make life better. Also, all of these therapies need cooperation among the therapist, client, and other relevant individuals such as parents and teachers for successful outcomes.
  • 34. Moreover, the programs intends to improve on the existing programs through ensuring cooperation between parents, teachers, and the addicts to achieve the desired results. Most past and previous intervention programs only focuses on the relationship between the therapist and client; however, other individuals such as teachers and parents also play a vital role in changing behaviors of addicts. Therefore, this program will focus on creating healthy relationships to attain its targets. Challenges with implementation In essence, implementation of any program usually faces various challenges that can adversely impact the outcomes. In this program, one of the problems that would likely to surface include failure of the addicts to cooperate with the therapists. Since most adolescents cannot live without the Internet, they would probably not to collaborate with the therapists through the intervention program. They might give false information about their Internet-related problems, therefore jeopardizing the work of the therapists as well as outcomes. Another challenge will relate to the failure of parents and teachers to cooperate with the therapists. As noted earlier, parents and teachers will play a vital role in the success of this program; therefore their failure to cooperate can adversely impact the outcomes. The third potential challenge will relate to finances where the therapists might lack sufficient money to reach the addicts as well as create awareness about the program. Evaluation plan Evaluating a program is usually not an easy task. Moreover, to assess the effectiveness and success of the proposed intervention program, several measurable outcomes will be used. Firstly, the participation and involvement of the addicts, parents, and teachers rate will indicate the effectiveness and success of the program. For instance, a high number of addicts, parents, and teachers who will involve in the program will signify its success. However, a low turnout will mean that the awareness as well as the implementation of the program was
  • 35. ineffective. Another element that will be used to evaluate the plan includes the behaviors of the addicts. Three weeks following the implementation of the program, the behaviors of addicts will be assessed to determine any changes. Positive behavioral changes will indicate the effectiveness and success of the program. The adolescents are expected to demonstrate a positive change by reducing their dependence on the usage of the Internet and adopt other alternatives. Challenges with evaluation The primary challenge that will be faced during the evaluation plan will be relate to locating all the addicts that would have gone through the program. Some of the participants might not be present during evaluation, therefore, leading to assumptions that might not reflect the actual impact of the program. Another challenge would be finding the right measurement to assess the effectiveness of the program. Finding an appropriate measure or scale to determine the success of any program is usually difficult. Approaches to treating adolescent Internet addicts Under this category of efforts applied for deterrence of cyber addiction, motivational interviewing is commonly used. This is a client-centered but directive technique used in intrinsic impulse to change enhancement which works by exploring and solving patient uncertainty.17 This technique was developed to help addicts shun behaviors which may lead to addiction and learn new behavioral and live skills. Some of the methods used here include open-ended questions, affirmation, reflective listening, as well as summarization to enable patients talk about their concerns about change.18 One shortcoming about the motivational interviewing technique is that presently, there are no studies addressing its efficiency in treating Internet addiction, although it has been seen to be effective in treating other addictions. Interventions by family members and the community is the other psychological approach widely used to treat adolescents with the Internet addiction problem.19 Family training and
  • 36. community reinforcement can be a useful technique in improving the enthusiasm of an Internet addict to reduce the time spent on the Internet.20 This strategy to treat people with Internet addiction can be very effective if used properly since it involves people who are very close to the addict. One limitation of the strategy is that it can fail if communication between the patient and family members or the community is poor. Through reality therapy, individuals can be encouraged to choose to enhance their lives by promising to change their behavior on Internet use. This incorporates meetings to show those addicted that addiction is a choice and train them how to manage time.21 This is done by introducing alternative activities which help to keep the affected person busy and keep them off the problematic behavior. An overall shortcoming of the above efforts is that they have not been applied in large scale. Further, some of the methods do not have scholarly research to support their application and efficacy. It is also unfortunate that no specific studies have been done to target intervention measures to save the American adolescents from Internet addiction. These efforts need to be backed through policy by the government and their use embraced to save adolescents from cyber addiction. Addressing the issue of cyber addiction would greatly contribute to the issue of better services in the health care places.22 By addressing this issue, improved means and increased access to prevention and treatment services can be developed. Health care reform and parity laws are providing good opportunities and incentives to address cyber addiction and other related disorders more effectively. The reforms give new opportunities to create better practices that are full of evidence in addressing health and other social problems which are associated with cyber addiction. Logic models are used to "present and share your understanding of the relationships among the resources you have to operate your program, the activities you plan, and the changes or results
  • 37. you hope to achieve. You will be presenting your problem to a foundation or coalition and proposing ways it can be addressed. A logic is a great way to show the connections between the different sections of your presentation/project. Instructions: Create a logic model for the topic Cyber Addiction: Its Prevalence and Contributing Factors among U.S. Adolescents using the paper attached. The logic model should include the following sections: · Inputs: Identify the resources needed to implement the intervention. · Activities: Identify actions that will be used to achieve the intended results. · Outputs: Identify the direct results of intervention activities. Here you will link the activities you propose to your affected population. What did your activity actually produce? · Outcomes: Identify the change that occurs between the inputs and the outputs. The immediate changes that occurred in participants. · Impact: Identify the longer term or systematic change that will occur as a result. *Examples of logic models: http://cyberuse.com/logic-model-template.html http://toolkit.pellinstitute.org/evaluation-guide/plan- budget/using-a-logic-model/