Lecture 6: Evaluation Flashcards

1
Q

What is evaluation? And what does it involve?

A
  • A process that critically examines a program
  • It involves systematically collecting and analyzing information about activities, characteristics, and outcomes.
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2
Q

Why evaluate?

A

To determine the effect(s) of a program
- Is it succesfull in preventing and/ or reducing the health problem?

Accountability
- Is the money spend wisely?

Development
- To improve its effectiveness, implementation on larger scale and/ or inform programming decisions

Ethical aspects
- Unwanted side effects

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3
Q

Evaluation is often omitted, why? And what are known reasons?

A

Evaluation is often the last consideration in planning and implementing an intervention

Known reasons are:
- Money (evaluation is expensive)
- Threat (it can be threatening for employees in terms of unexpected outcome/ the intervention might not be effective)
- Time constraints
- Already proven effective
- Intervention is still developing

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4
Q

What is included in an evaluation plan?

A
  1. Relevant evaluation/ research question
  2. Appropriate design and methods
  3. A program/ intervention
  4. Outcomes
  5. Involvement of stakeholders
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5
Q

What types of evaluation exist?

A
  1. Effect evaluation
  2. Process evaluation
  3. Economic evaluation
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6
Q
  1. What question is answered in effect evaluation?
  2. What does it examine and what does it provide an answer to?
A

“How succesfull is the program/ intervention in preventing and/ or reducing the health problem?”

  • It examines the effects (outcomes) of the program
  • It provides an answer to the primary (research) question
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7
Q

The effect evaluation / program outcomes can be described for..

A
  • Health
  • Quality of Life
  • Behavior
  • Environment
  • Etc.
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8
Q

What question is answered in process evaluation?

A

“Why is the program (not) succesful in preventing and/ or reducing the health problem?”

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9
Q

What is the purpose of process evaluation? And what does it examine?

(4 imporant aspects are examined)

A

To understand processes in order to strengthen or improve the programme being evaluated

Examines:
1. The delivery and content of a programme
2. The quality of its implementation
3. Barriers and facilitators of implementation
4. The organizational context (Staff, procedures, inputs and so on)

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10
Q

What question is answered in economic evaluation?

A

“Is the (preventive) health intervention cost-effective in preventing and/ or reducing the health program?”

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11
Q

Economic evaluation includes a comparison of..

A

.. the costs and outcomes of (preventive) health interventions

  • Intervention costs
  • Treatment costs (e.g., hospital, extra visit GP)
  • Societal costs (e.g., absenteeism)
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12
Q

Basic evaluation questions refer to…

7 items

A
  1. Reach, integrity, acceptability
  2. Observed change
  3. Internal validity
  4. Effect explanation
  5. Cost-beneft assessment
  6. Applicability
  7. Generalizability
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13
Q

What does RE-AIM stand for?

A

Reach
Effectiveness
Adoption
Implementation
Maintenance

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14
Q

What is the RE-AIM framework used for?

A

To evaluate the impact of health promotion programs

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15
Q

What is meant by Reach in the RE-AIM framework?

A
  • The percent and representiveness of individuals willing to participate in a program
  • Explores characteristics of study participants
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16
Q

What is meant by Effectiveness in the RE-AIM framework?

A
  • The impact of the intervention on targeted outcomes (e.g., health promotion outcomes, intermediate outcomes, health outcomes)
17
Q

What is meant by Adoption in the RE-AIM Framework?

A
  • The percent and representiveness of settings and intervention staff that agree to deliver a program
  • Examines facilitators and barriers for adoption
18
Q

What is meant by Implementation in the RE-AIM framework?

A
  • The consistency and skill with which various program elements are delivered by various staff
19
Q

What is meant by Maintenance in the RE-AIM framework?

A
  • The extend to which individual participants maintain behavior change long term and at the setting level
  • The degree to which the program is sustained over time within the organizations delivering it
20
Q

What is GRADE used for?

A

Rating quality of evidence and strength of recommendations

21
Q

What does GRADE stand for?

A

Grading of
Recommendations
Assessment
Development
and
Evaluation

22
Q

What is quality of evidence? and what levels are there?

A

Quality of evidence reflects the extend of our confidence that the estimates of the effect are correct

Levels:
- High
- Moderate
- Low
- Very low

23
Q

What factors lower quality of evidence?

5 factors

A
  • Study limitations (bias)
  • Inconsistency of results
  • Indirectness of evidence
  • Publication bias
  • Imprecision
24
Q

What factors increase quality of evidence?

2 factors

A
  • Large magnitude effect
  • Dose-response gradient
25
Q

Quality of evidence from high to low

9 in total

A
  1. Meta-analysis of RCT’s
  2. Systematic review of RCT’s
  3. RCT
  4. Non-RCT
  5. Pre-post comparison
  6. Correlational studies
  7. Expert committee reports
  8. Case studies
  9. Anecdotes