Assessing a Healthcare Program/Policy Evaluation

Assessment of a Healthcare Program for HIV/AIDS Using the Centres for Disease Control and Prevention (CDC) Program Evaluation Framework

Healthcare programs are one way in which healthcare disparities can be combated. This is especially true in communities that are socio-economically disadvantaged. This paper discusses the evaluation of such a program by making use of the program evaluation framework put forward by the CDC (CDC, 1999). This framework has got six key steps, evaluating the program while keeping in mind the standards for measuring evaluation quality in terms of utility, feasibility, propriety, and accuracy (CDC, 1999). Assessing a Healthcare Program/Policy Evaluation

Step 1: Engaging Stakeholders

Stakeholders to a program are the key players who make the program function. Stakeholders here included local elected leaders, the county public health office, local leaders of churches and mosques, and local hospitals among others. From this assessment, the body that would benefit most from the results and reporting of this program would be the county public health authorities, and by extension the state. This is because the data will be invaluable in their healthcare planning. Assessing a Healthcare Program/Policy Evaluation

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Step 2: Describing the Program

The healthcare program in this evaluation is a HIV/ AIDS Treatment Program for the LGBT community in my county. This program, funded by an anonymous donor for a period of 10 years, offers counselling, testing, free treatment (ARVs), and follow-up to the LGBT community. The realization was that it was crucial to assess the program’s impact hence its effectiveness (Shiramizu et al., 2016). To do this, research was chosen as the best approach to ascertain program efficacy and effectiveness (Glasgow et al., 2003).To date, the total number of people reached by this program is 1,832. These include all those who passed through the program but are no longer attending, and those who are still actively being treated and followed up. About 70% of this number are the targeted LGBT community members. This is because the program managers adopted a policy of not turning away anybody who showed up, even though the target population was LGBT.

Step 3: Focusing the Evaluation Design

The purpose of this evaluation is to gain insight, change practice (if need be), and assess the effects of the program. The users of the findings will be the stakeholders and one of the uses would be public health planning by the county public health authorities as major stakeholders. The method used would be quantitative research which is data-based (CDC, 1999).  Data that is used to conduct this program evaluation is that data collected during the course of the program and data from previous literature on the subject. Assessing a Healthcare Program/Policy Evaluation

Step 4: Gathering Credible Evidence

This assessment is not based on conjecture but on research evidence. Before the program, ARV coverage of the HIV-positive persons from the targeted population was less than 30%. As at now, this figure is at 70%. This is attributable to the outreach and educational activities of the program, and shows how the impact of this program has been immense.

Step 5: Justifying Conclusions

The only unintended consequence was that a number of the general community who needed ARVs were turned off by the fact that the program targeted only LGBTs. This program is meeting and even surpassing its original intent and objectives. More than half of the target LGBT population in the county requiring ARVs has been reached. The initial target was half the population. Also, the program has managed to attract even those community members that are not part of the LGBT community. I would definitely therefore recommend this program model at my place of work, based on this success alone.

Step 6: Ensuring Use and Sharing Lessons Learnt

The findings of this evaluation would be distributed to all stakeholders for action. One of these is the nurse who must be involved at every stage. In fact, two ways in which a nurse advocate would become involved in the program evaluation after a year of implementation are looking at the social determinants of health in the target community and finding out whether the program addressed issues of social justice (equity and access); and ascertaining that the program does not carry out research on persons under the guise of providing free ARVs. This would violate the bioethical principles of autonomy and beneficence, as outlined in the Belmont Report (Williams & Anderson, 2018). Assessing a Healthcare Program/Policy Evaluation

Conclusion

Program evaluation is a systematic process that makes use of a framework. All stakeholders must be involved and the results of tge evaluation must be shared with them all for appropriate action.

References

Centres for Disease Control and Prevention [CDC] (999). Framework for program evaluation in public health. MMWR 1999; 48 (No. RR-11). Retrieved 31 October 2019 from https://www.cdc.gov/eval/framework/

Glasgow, R.E., Lichtenstein, E., & Marcus, A.C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261–1267.

Shiramizu, B., Shambaugh, V., Petrovich, H., Seto, T.B., Ho, T., Mokuau, N., & Hedges, J.R. (2016). Leading by success: Impact of a clinical and translational research infrastructure program to address health inequities. Journal of Racial and Ethnic Health Disparities, 4(5), 983–991. Doi:10.1007/s40615-016-0302-4

Williams, J.K., & Anderson, C.M. (2018). Omics research ethics considerations. Nursing Outlook, 66(4), 386–393. Doi:10.1016/j.outlook.2018.05.003

Assessing a Healthcare Program/Policy Evaluation