Health Program: Implementation

CHSC 433CHSC 433

Module 4/Chapter 7Module 4/Chapter 7L. Michele Issel, PhD

UIC School of Public Health

Comprehensive Model of Program Theory Components

Program Theory

Impact TheoryProcess Theory

Service Utilization Plan(Activities=Interventions)

Organizational Plan(Inputs)

Outputs Longer termOUTCOMES

InitialOUTCOMES

(Impact)

Process Objectives Impact and Outcome Objectives

I. Process Implementation Components

The Organizational Plan

The Service Utilization Plan

Distinguishing inputs from outputs

in the Program Theory

Focus on Process Theory

Program implementation focuses on acquiring and utilizing inputs that have been delineated in the Process Theory.

Attention to documenting the extent of outputs to the Process Theory is process evaluation.

Elements of Organizational Plan

ImmediateHealth Effects

(Impacts)

PhysicalResources

Transporta-tion

ManagerialResources

InformationalResources

HumanResources

OrganizationalPlan

ServicesUtilization Plan

OutputsOutputs

TimeResources

MonetaryResources

Timeline

OperationsManual

OrganizationalChart

Budget

SocialMarketing

Participants

Cueing

InterventionDelivery

MaterialsProduced

Coverage

Units ofService

ServiceCompletion

Organizational Plan

How to garner, configure, and

deploy resources, organize

program activities so that the

intended service is developed and

maintained

A Good Program Manager will …

Have detailed project planning Break project into phases and components Define results and deliverables Have measurable milestones (=objectives) Obtain commitment of stakeholders Gain involvement of contributing teams Have project tracking system (=process evaluation) Accurately measure process and outcomes Review process monitoring data regularly

(continued)

Orient new staff Motivate staff Effectively communicate Provide leadership Create trusting environment Have personnel appraisal system Keep senior management involved Be a role model

Reminder:Need Cultural

Appropriateness Of program staff (cultural competence)

Of program materials

Of social marketing approach and materials

Of intervention strategy

Of evaluation methods

Of stakeholder involvement

Basic Budgeting

Budget is a plan Budget is a communication tool Budget is a way to prioritize Budget is managerial tool to

oversee resources

Service Utilization Plan

How the intended target population

receives the intended amount of

the intended intervention through

interaction with the program’s

service delivery system

Diffusion of Innovation

Consider the diffusion of innovation

curve when estimating interest in a

program that has not been tried

(sold) before

Majority adoption takes time

Diffusion of Innovation Curve

Innovators

Early Adopters

Adopters

Laggards

% Popu

lation

Service Utilization: Intervention Types

Therapy: medical, psychological, pharmacological

Education, training, skills building Coaching, encouragement, contract Monitoring, follow-up Referral, networking, services coordination Transportation, housing, tangibles

Must be appropriate for level of pyramid at which the program is designed

Getting Help

Involve staff in objective setting Involve staff in devising measurement

of objective achievement Involve Board Members, especially

those with expertise Use on-line resources

II. Budgeting Basics

The Operational Budget

Breakeven Analysis

Budget Terminology

Fixed costs do not change with number of participants

Variable costs do change with number of participants

Direct costs are “seen” by participants

Indirect costs are not “seen” by participants

Charge is the amount asked as payment

Cost is what is spent to do the program

Profit is the difference between cost and charge

Using Excel for Budgets

Develop a codebook/mechanism that tracks the survey items with variable names and abbreviated column titles

Think spreadsheet, not database in which can ask “select respondents, if they have characteristic x”

Conventional layout:Row per respondentColumns per variable/itemCell contains respondents response

Using Excel…

Use software creature features (i.e., formating borders, graphics, color cell) to make it a bit more fun to do data entry

Use “insert formulas” in the cell for doing the math, then the answer changes as the data in the cells change ~ let the software do the work.

Create graphics on separate worksheets (the tabs at the bottom of the page) so the graphic does not hide the data.

Break Even Analysis

Simple math that answers the question of at what point will the program costs be matched with program income

Applicable to public health as way to prioritize programs, establish targets in utilization plan and organizational plan.

Break Even Requires Having the Following:

Variable Cost Fixed Cost Charge (income generated)

For detailed information and examples, go the web sites listed under required reading…

Think Program Implementation Across the Pyramid

Direct Health Care

Services____________________

Enabling Services___________________________

Population-Based Services___________________________________

Infrastructure Services