IVP Final Flashcards
PH Definition of Surveillance
the ongoing and systematic collection, analysis, and interpretation of health data needed to plan, implement, and evaluate public health programs
How do you ID the strengths/weaknesses of data?
Examine data variables
Consider which variable the different data sources have in common/differ
Determine how they compare to the ideal data source
Begin with 3 data sources that universally exist in all states and centralized locations and upon which a population-based surveillance system could be based.
Example: the definition of injury/different types of data may differ across three local data sources:
Death certificate files by a state health dept
hospital discharge data
MV crash data collected by highway patrol
What are the benefits of linking data?
No single data source has all the info you need for an IVP program
Can show effects of changes in legislation
Can help target an intervention by determining who is at risk
Improved data quality
Increased data comprehensiveness
Expansion of the usefulness of data sources.
It’s an effective strategy for generation of info without the expense/delays of gathering new data
Highlights the significance of missing information and can improve quality of data used for linkage and analysis
How do you disseminate injury surveillance data?
- Convene data committee to develop dissemination plan
- Most effective to disseminate data back to the providers of it as well as the target audience so that it can be appropriately analyzed and used
- Make sure data is useful to other groups, not just disseminated through research papers and grant proposals
- Disclose imperfections
Ex: disseminate child abuse data to community and practitioners through social workers and healthcare workers
What are the benefits of program evaluation?
Essential tool for program management
Informs current decision making by ID-ing implementation problems
Can help program directors make adjustments
Can help enhance the judgment/political will of decision-makers, especially if cost/benefits are included
It’s a way to justify program costs and fulfill demands for accountability, esp. to funding sources
Provides documentation to facilitate efficient replication at a later date, helping to advance knowledge for the field and guide future program development
What are the 4 steps to program evaluation?
Formative Eval, Process Eval, Impact Eval, Outcome Eval
The 3 E’s of injury prevention
Education, Engineering, Enforcement
Define the police power
capacity of the states to regulate behavior and enforce order within their territory for the betterment of health, safety, morals, and general welfare.
Two enumerated powers of federal government
Regulate interstate commerce/ tax and spend
Berger’s 6 conditions for attempting to implement new legislation
- Be thoroughly convinced that the bill addresses a strikingly important issue
- Have evidence that the bill’s actions are effective
- Have support from judges/police re:enforcement
- Have economics estimates that excessive costs not involved
- Have legal counsel confirm constitutionality and compatibility with existing law.
- Broad-based support of constituents
Name some state players
State health depts
state and territorial injury prevention directors assoc.
state highway safety offices
state fire marshal
State OAG
Federal players
National Highway Traffic Safety Administration
Consumer product safety commission
DHHS
National Inst. of Occupational Safety & health
MAternal & child health bureau
NIH
What is the upstream approach?
preventing public health problems at the source to alleviate/prevent downstream effects
Importance of agency-centered prevention
the goal of agency-centered injury prevention efforts is to develop and implement a prevention strategy that can bring about meaningful reductions in morbidity and mortality and an enhancement in life quality
the 3 aspects of developing an injury prevention initiative
- Getting on the agenda
- Starting with a lead agency
- Focusing on the factors most critical to a successful injury prevention program
what does it mean to get on the agenda mean?
incorporating injury prevention into state agency plans or block grants
state plan addressing integration within routine services of other state/local agencies
getting a broad base of support outside the state health agency
importance of having a lead agency in injury prevention initiative
can serve as a community or statewide focal point for injury prevention expertise, offering assistance and resources
SMART Goals
Specific Measurable Achievable Realistic Time-bound
critical factors to successful injury prevention programs
a systems approach, funding, collaboration
systems approach
a model (like socio-ecological framework) that helps in understanding how events are interrelated, connected in patterns, and organized into a totality, rather than being fragmented
5 main purposes for an injury surveillance system
- understand the injury problem
- track progress and monitor trends
- describe injury patterns
- make an assessment
- generate hypotheses
10 step plan for an injury surveillance system
- define objectives
- form a data committee
- ID existing data sources
- determine strengths/limitations of each data source
- conduct preliminary data analysis
- reevaluate objectives based on steps 3-5
- consider linking info from existing data sources
- perform validation studies to evaluate
- develop a dissemination plan for sharing
- tie surveillance to action and funding
State data sources
vital statistics
medical examiner/coroner reports
trauma registries
EMS data
hospital discharge data
national violent death reporting system
national data sources
WISQARS
Fatality Analysis Reporting System (FARS)
Consumer Product Safety Commission (CPSC)
National Vital Statistics System
National Electronic Injury Surveillance System (NEISS)
Overarching goal of program evaluation
To increase the comfort level of practitioners in using evaluation on a consistent basis in the programs they plan and implement and in the materials and policies they develop.
15 Step framework for program evaluation
- develop SMART goals/objectives
- define a set of activities that can be implemented to accomplish objectives/goals
- List questions to be answered for various evalutions
- ID resources needed and compare to what you have
- Set realistic priorities for eval given resources/time
- ID specific individual responsible for oversight
- Select methods appropriate for Eval Questions
- ID potential data sources and develop specific data collection forms/protocols
- Develp an eval schedule
- Conduct formative eval of Materials
- Collect baseline data
- Analyze and interpret data
- Use findings to provide feedback to improve the program
- Communicate findings in a timely manner
- Continue the eval process
Constraints on Program Eval
Limited resources
Unrealistic expactations
Sample size/comparison
Measures
Time
4 Kinds of Program Evaluations
- Formative Evaluations
- Process Evaluations
- Impact Evaluations
- Outcome Evaluations
Formative Evaluations
Used to develop targeted educational materials/refine program design:
pre and post-testing and focus groups
especially useful when program being developed, when a program ID’d without an obvious solution, or when a successful program is being introduced to a new pop/setting
Process Evaluation
Determines whether an IPP is being implemented as designed and whether it is reaching the target population
Tracks your activities (activity inventory), how much educational material did you create, distribute, etc.
Impact Evaluation
Evaluates Progress, Knowledge, Power
*use intermediate indicators to demonstrate program effectiveness
Outcome Evaluation
Evaluate injury rates/program sustainability
*use intermediate indicators to demonstrate program effectiveness
Intermediate Indicators in program evaluation
Proxy/surrogate indicators used to demonstrate program effectiveness instead of waiting around for morbidity/mortality
Measures KAB: knowledge, attitudes, behavior
Main opportunities and barriers with injury prevention
funding limitations
organizational difficulties - infrastructure, no organizational template, leaders without core competencies/credentials,
turf battles
limited scientific support - poor surveillance, gaps in data/info, lack of access
limited distribution of the information
Economic/political constraints - better than one size fits all approach; manufacturers be held accountable
Importance of political arena - communicating with lawmakers, using survivors, etc.
What are the five main purposes for an injury surveillance system?
- To understand the injury problem well enough to design programs that are correctly targeted to injury causation, specific risk factors, populations at greatest risk, geographic location, and temporal issues
- To track progress and monitor trends in the magnitude and distribution of injury morbidity and mortality you and identify new and emerging hazards in a timely fashion
- To describe injury patterns that justify the need for prevention program
- To make an assessment of the global impact of the program
- To generate hypotheses and develop a database for future prevention efforts with the sample size large enough to be useful for research
