Public Health Program Evaluation

Public Health Program Evaluation

At each level of the public health pyramid, identify at least two factors that can affect the acquisition of informed consent from those involved in providing evaluation data about health.

At the population-based level, the issue of informed consent becomes blurred with the implementation of health policy because the passage of health policies always implies consent. Because population-based services are so closely linked to health policy, the processes at the infrastructure level are critical in determining the nature and scope of health programs at this level of the pyramid. However, the growing body of evaluations of population-based health services, often couched as health policy studies, can lead to meta-evaluations and evidence-based practice for population-based services.

At the infrastructure level of the public health pyramid, sensemaking occurs within individuals. Still, the collective processes by which organizations and policymakers achieve a shared understanding and interpretation of evaluation findings lead to policy decisions regarding health programs. Policy adoption and program implementation are two possible evaluation uses (McClintock & Colosi, 1998). Decision makers, who are part of the infrastructure, may need to reconcile differences between organizational process improvement and evaluating perspectives and recommendations. Procedures for dealing with ethical issues and IRB and HIPAA procedures must emanate from the infrastructure level and be applied consistently throughout the pyramid levels.

What practical strategies might prevent the misuse of evaluations described in this chapter?

Given the pressures to sustain programs and meet funding mandates, evaluation results may be misused. Misuse can occur in many ways but is generally understood to consist of manipulating the evaluation in ways that distort the findings or compromise the integrity of the evaluation. Misuse can occur at any point during the evaluation process, beginning with an inappropriately chosen design that biases findings and extends to interference with data collection and the outright alteration of the evaluation findings (Stevens & Dial, 1994). One way to minimize the potential for misuse is to involve program stakeholders and educate them about the evaluation and its appropriate use. In addition, sharing with the stakeholders and program staff members the standards to which evaluators are held by their professional organization may help them realize that evaluating is not just a funding or sustainability issue but also an ethical issue.

References

McClintock, C., & Colosi, L.A. (1998). Evaluation of welfare reform: A framework for addressing the urgent and the important. Evaluation Review, 22(5), 668-694.

Stevens, C.J., & Dial M. (1994, Winter). What constitutes misuse? New Directions for Program Evaluation, 64, 3-14.

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Chapters 16

Public Health Program Evaluation

Answer each of the following questions:

1. At each level of the public health pyramid, identify at least two factors that can affect the acquisition of informed consent from those involved in providing evaluation data about a health program.
2. What practical strategies might prevent the misuse of evaluations described in this chapter?
3. In what ways might evidence-based practice (of any of the health disciplines) benefit from a meta-evaluation of programs to address a given health problem?