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CHES > Study Group - Implementation > Flashcards

Study Group - Implementation Flashcards

1
Q

What is involved in implementation of health programs?

A
  1. Coordinating logistics to train volunteers & staff
  2. Monitoring progress
  3. Delivering program
  4. Evaluating effectiveness & sustainability of program
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2
Q

What should HES do first when preparing to implement health program? Why?

A

Project or Work Plan b/c a well developed work plan ensures fidelity of implementation

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3
Q

What is a project or work plan?

A
  • Detailed road map for how program goals will be achieved
  • Should be aligned with logic model or strategic plan for program
  • Used to identify needed services so HES can acquire them
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4
Q

What needs to be included in a strong work plan?

A
  1. Goals
  2. Objectives
  3. Activities
  4. Timelines
  5. Evaluation measures
  6. Roles & responsibilities involved in implementing specific aspects of plan
  7. Intervention mapping
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5
Q

Steps of intervention mapping

A
  1. Assessment of problem
  2. Prioritizing determinants of IM
  3. Program Design
  4. Program construction
  5. Program implementation
  6. Program evaluation
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6
Q

What is a part of IM ‘assessment of problem’?

A
  1. Logic model
  2. Ecological model domains
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7
Q

What is included in IM ‘prioritizing determinants of IM’?

A

Ranking priorities based on changeability & level of impact

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8
Q

What is included in IM ‘program design’?

A
  1. Use theory to assist in method selection & strategies
  2. Ensure theories compliment one another & are accurately interpreted/applied
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9
Q

What is included in IM ‘program construction’? How can HES ensure to have high fidelity?

A
  1. Program development
  2. Detailed methods & strategies = high fidelity
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10
Q

What is part of IM ‘program implementation’?

A

Training of staff

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11
Q

What needs to be considered and used in IM ‘program evaluation’?

A
  1. Use logic model as guide
  2. Test for rigor
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12
Q

What are the types of resources needed for implementation of work plan?

A
  1. Personnel
  2. Curriculum & Instructional
  3. Space
  4. Equipment
  5. Financial
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13
Q

What is an MOU/MOA?

A

Document that captures and outlines agreement and principles of that agreement between 2 parties

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14
Q

MOU

A

Memorandum of Understanding

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15
Q

MOA

A

Memorandum of Agreement

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16
Q

What obligations/requirements must HES follow when implementing health programs?

A
  • Guidelines & legal standards for their organization & organization providing funding
  • State & local laws, rules, regulations
  • Funding announcements or solicitations
  • Award notices
  • Guidance documents
  • Any restrictions of how funds can be used
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17
Q

Paperwork Reduction Act (1995)

A

Helps reduce paperwork burden & maximize information collection

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18
Q

Rehabilitation Act (section 508)

A

Federal agencies must make websites, electronic material, & other information technology accessible to people with disabilities

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19
Q

Plain Writing Act (2010)

A

Federal agencies must use “clear communication that public can understand & use”

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20
Q

What is fidelity?

A

Degree of correspondence between program as intended & program is actually implemented in designated order

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21
Q

What should not happen when adapting programs?

A

Substantial modification or elimination of core program elements

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22
Q

What should training staff & volunteers consist of/include?

A
  • Program objectives
  • Intended outcomes
  • Logic model
  • Core elements (program content & steps)
  • Instruction of their role
  • Offer guidance & opportunities to practice their roles
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23
Q

What should be used when training program staff & volunteers?

A

Training manual (AKA Program procedural manual)

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24
Q

What is a training manual used for?

A

Used to communicate step-by-step plans for program

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25
Q

What is included in a training manual/program procedural manual?

A

Provides background info, ideas for facilitation, & parameters of program (supports program fidelity & implementation)

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26
Q

What needs to be considered when providing training?

A
  • Best way to provide instruction based on intended audience
  • Funds & expertise levels of those providing training
  • Cost, content, & required instructional expertise
  • methods to use during training
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27
Q

What are some methods that can be used when providing training?

A
  1. On the job training
  2. One-on-one training
  3. In person group work
  4. Distance learning techniques
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28
Q

What does an action plan for program implementation identify/help HES with?

A
  • Used to describe how goals & objectives will be achieved
  • Identifies needed resources
  • How responsibilities will be assigned
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29
Q

Who should be involved in developing action plan for program implementation?

A

Members of intended audience (both those who can hinder & help implementation of program)

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30
Q

How does intervention mapping focus on dissemination?

A

Developing implementation plan to achieve supporting adoption, implementation, & maintenance of programs

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31
Q

What are the GENERAL phases of program implementation?

A
  1. Adopt program
  2. Identify & prioritize tasks to complete
  3. Establish management system
  4. Put plans into action
  5. End or sustain program/intervention
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32
Q

What are the components of EFFECTIVE public health programs?

A
  1. Use innovation to develop evidence base
  2. Use limited number of high priority, evidence-based interventions
  3. Use effective program management
  4. Use partnerships & coalitions
  5. Communicate accurate & timely information
  6. Obtain resources & support
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33
Q

Program implementation challenges

A
  1. Lack of funding to implement program as designed (fidelity)
  2. Common settings have primary missions other than prevention
  3. Implementing new programs requires training staff & administration in effective delivery
  4. Kinds of data systems needed to target & monitor prevention programs does not currently exist
  5. Participation in & completion of prevention programs is usually voluntary
  6. Some organizations have more capacity to handle implementation than others
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34
Q

What needs to be done PRIOR to implementation of health program?

A
  • Gain program/intervention buy-in from priority population
  • Identify individuals/organizations responsible for intervention delivery
  • Use implementation plan or project management plan to develop detailed list and relationships of all program activities, components, & tasks
  • Pilot testing & phase in
  • Mass communication to share info & support program objectives & implementation
  • Consider how to end or sustain program
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35
Q

How can HES create environment conducive to learning?

A
  1. Get management or stakeholder support
  2. Identify resources to support implementation
  3. Obtain buy-in from implementation staff
  4. Meet learner’s needs
  5. Target audience
  6. Healthy & positive physical environment (trust & respect, physical aspects in classroom)
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36
Q

How does HES determine baseline data?

A

Review available quantitative & qualitative data from secondary data (national, state, & local resources)

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37
Q

Why is determining baseline data important?

A
  • Provides beginning measure for evaluating changes in behavior, practices, & skills associated with program goals
  • Helps in assessment of knowledge, beliefs, attitudes, values of intended audience
  • Helps in assessing capabilities & skills related to outcomes
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38
Q

How is marking plan used by HES?

A

Identifies audience(s), message(s), & intended communication methods

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39
Q

What should health program marking plan be aligned with?

A

Program goals & objectives

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40
Q

Targeted messages

A

Segmenting/dividing audience into smaller SUBGROUPS with similar characteristics

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41
Q

Tailored Messages

A
  • Specific SUBPOPULATION focusing on their needs & personal (primary) data
  • culturally appropriate, relevant, & applicable
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42
Q

How can HES reach larger audience via tailored messages?

A

Computer tailoring

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43
Q

What are the 4 principles of Marketing? What are they in program planning/implementation?

A
  1. Product - target of intervention
  2. Place - location of program
  3. Price - monetary & other costs associated with program
  4. Promotion - sum of all avenues used to communicate messages about the program
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44
Q

Potential program implementation issues

A
  1. Staffing & training
  2. Intervention content
  3. Program delivery
  4. Intervention participants
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45
Q

What does “Behavior is multifaceted” mean?

A

Multiple strategies are often needed to change behavior

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46
Q

How can HES develop health programs that will be potentially successful in motivating priority population to change their behavior?

A

Consider strategies at various levels of ecological model

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47
Q

RE-AIM

A

Reach Effectiveness Adoption Implementation Maintenance

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48
Q

What is RE-AIM used for?

A

Help with intervention delivery

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49
Q

IM ADAPT meaning? How is it helpful for HES?

A

Intervention Mapping to Adapt

  • helpful in adapting evidence-based interventions
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50
Q

What are IM ADAPT steps?

A
  1. Needs Assessment
  2. Set objectives
  3. Select methods
  4. Design program
  5. Plan implementation
  6. Create evaluation plan
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51
Q

What are the different types of media for HES to consider?

A
  1. Paid media
  2. Earned media
  3. Social media
  4. Digital media
52
Q

Gantt Chart

A

Visual representation of all tasks needed to be completed before, during, & after program

53
Q

What does Gantt Chart allow HES to do?

A

Plan tasks needed to successfully deliver program & monitor progress of all tasks

54
Q

Program Evaluation & Review Technique (PERT)

A

Visually shows relationships between tasks and allows HES to track progress

55
Q

Critical Path Method (CPM)

A
  1. Graphically shows timelines & relationships to tasks
  2. Ability to show components that are most important in adhering to timeline
56
Q

Fishbone Diagram

A

Represent sequential events & major factors that produce given outcome

  • AKA Cause & effect diagrams *
57
Q

Control Charts

A

Shows average & whether variable is within acceptable parameters

58
Q

Histograms

A

Simple bar graph showing frequency of value for one variable

59
Q

Scatter Diagrams

A

Bar graph to identify major source of problem

60
Q

Flowcharts

A

Sequence of activities from start to outcome

61
Q

What does meeting with stakeholders regularly allow for?

A
  • Monitoring progress
  • Receive feedback
  • Report progress (who gets the reports? What is preferred method?)
62
Q

What can be used to help track whether activities are producing desired outcomes & if outputs lead to expected short-term outfomes?

A

Logic model

63
Q

How can keeping track of outcomes & indicators related to program objectives help HES?

A
  • Assess preliminary data regarding program successes, unintended outcomes, & opportunity to refine as needed
  • Preliminary analysis captures descriptive data important to stakeholders, funders, & program staff
  • Better understanding why intervention succeeded or failed to achieve expected results
64
Q

When modifying action plan, what does HES need to know?

A
  1. Who to involve
  2. Know when & from who approvals are needed
  3. When modifications may be needed through evaluation of process & monitoring fidelity of implementation
65
Q

What should HES focus on when adapting a program?

A

Maintaining fidelity of ORIGINAL intervention

66
Q

What does program adaptation allow HES to do?

A

Create common ground between delivery of intervention & characteristics of group using program/intervention

67
Q

Steps of Program Adaptation

A
  1. Assess community
  2. Understand possible interventions
  3. Select intervention
  4. Consult with experts
  5. Consult with stakeholders
  6. Decide on needed adaptations
  7. Adapt original program
  8. Train staff
  9. Test adapted materials
  10. Implement adapted program
  11. Evaluate adapted program
68
Q

What can be used to measure fidelity?

A
  • Activity logs
  • Document reviews
  • Observations
  • Reports
  • Surveys
  • Gantt charts
  • Logic models
  • Interviews
69
Q

What is multiplicity?

A

of activities (can be at different levels)

70
Q

What is dose?

A

program units delivered via program activities

  • How many program components were delivered as part of intervention?
71
Q

How is dose tracked?

A

Process evaluation & program monitoring

72
Q

Core functions of human resource management

A

PADS

  1. Planning
  2. Acquisition
  3. Development
  4. Sanctions
73
Q

How should curriculum & instructional resources, space, or equipment & supplies be monitored?

A

Based on volume, frequency of use, & relationship to program/project plan

74
Q

How can HES ensure resources are used properly?

A

Project plans & Project management principles

75
Q

What does financial management do within human resource management?

A
  1. Development & use of system processes that ensure fiscal accountability
  2. Approach to accounting operations
  3. Reporting & regular reviews or audits
76
Q

What can be used to collect data on sustainability elements/domains?

A
  • Surveys
  • Interviews
  • Focus groups
  • Program documents
77
Q

What types of data should be collected on sustainability of program/intervention?

A
  • Leadership/political support
  • Funding stability
  • Collaboration/partnerships
  • Organizational capacity
  • Program evaluation
  • Program adoption
  • Communication
  • Strategic planning/vision
78
Q

What guides should be created to aid in stability of program/intervention throughout program/program monitoring?

A
  1. Implementation guide
  2. Train-the-trainer model
  3. Document lesion
79
Q

When should intervention/program sustainability be considered?

A

From the beginning or program planning

80
Q

Accountability

A
  1. Being answerable for actions taken
  2. Successful/failure of program
81
Q

Responsibility

A

Being charged with ensuring that things are done within specific parameters

82
Q

Types of Accountability

A
  1. Efficiency
  2. Fiscal
  3. Legal
  4. Coverage
  5. Service delivery
  6. Impact
83
Q

Phases of Implementation

A
  1. Encourage target population to take interest in program
  2. Conducting resource & task inventory
  3. Program planning
  4. Putting plans into action
  5. Using evaluation to decide whether to terminate or continue program
84
Q

Steps for Initiating Plan of Action

A
  1. Community Organization
  2. Pretesting
  3. Diversity training
  4. Effective leadership
85
Q

What is community organization?

A

Consultations & cooperation with respected individuals & organizations in community

86
Q

Why is pretesting done/performed?

A

To acquire information about prevalent attitudes & health-related behaviors

87
Q

What is diversity training?

A

Adjusting health communication message to various constituents in the community

88
Q

Effective leadership

A

Strong sense of organization & discipline within health education program

89
Q

Steps of Community Organizing Process

A
  1. Recognize the issue
  2. Entering community
  3. Establishing priorities & goals
  4. Selecting strategies for problem solving
  5. Implementing the plan
  6. Evaluating progress
  7. Maintaining achievements
90
Q

How can HES recognize the issue/problem within a community?

A
  • Needs assessment
  • Evaluation of primary & secondary data
91
Q

How can HES establish goals & priorities via community organizing process?

A

Utilize SMART technique for establishing goals & objectives

92
Q

How can HES select best strategy for problem solving via Community Organizing Process?

A

Establish tailored messages

93
Q

What are ways HES can implement the program?

A
  1. Phase-in
  2. Total implementation
94
Q

How can evaluation of program be completed via community organizing process?

A

Using established indicators

95
Q

How can HES ensure maintaining achievements identified in community organizing process?

A

Continuing or discontinuing elements of program based on evaluation

96
Q

What are things HES need to use/consider when providing training for implementation using social cognitive theory?

A
  1. Address more than 1 element of reciprocal determinism
  2. Engineer environment
  3. Address individual skill building
  4. Clarify values
  5. Understand need to provide great deal of practice
  6. Practice repetition
  7. Observational learning
  8. Verbal persuasion
  9. Learning in increments
  10. Provide skill training to foster mastery in behavior
  11. Capitalize previous experience
  12. Provide models of similar situations
  13. Use testimonials
  14. Foster self awareness of physical & emotional responses
  15. Use all venues to regulate & foster self control
  16. Encourage use of journaling
97
Q

Training Strategies implementing Transtheoretical Model

A
  1. Increase awareness
  2. Make risks personal
  3. Emphasize self-efficacy
  4. Aid in development of definitive plans
  5. Establish short term goals
  6. Give specific resources
  7. Give feedback & positive reinforcement
  8. Aid in problem solving
  9. Give opportunities for social support
    10 Aid in establishing coping strategies
  10. Provide reminders of benefits
  11. Describe pros & cons of change for individual (consequences & rewards)
  12. Establish self awareness of behaviors that are problematic
  13. Utilize empathy/family interventions
98
Q

Health Belief Model

A
  • Likelihood of action determined by perceived gains in something they value
  • Independent influence on behavior based on PERCEIVED THREAT & EXPECTED GAINS

severity + susceptibility = threat
benefits - barriers = adopting behavior

99
Q

What are cues to action?

A

Internal symptoms or external events/reminders from credible sources that encourage behavior (part of health belief model)

100
Q

How does level of self-efficacy aid/hinder behavior change?

A

People won’t try new behavior if they are not confident they can succeed

100
Q

What are the constructs of Social Cognitive Theory (SCT)?

A
  1. Knowledge
  2. Outcome expectations
  3. Goal formation
  4. Perceived self-efficacy
  5. Socio-economic factors
101
Q

What are the types of knowledge considered with SCT?

A

Content & Procedural knowledge

102
Q

Content knowledge

A
103
Q

Procedural knowledge

A
104
Q

Perceived Self-Efficacy is _______________.

A
  1. Perception based
  2. Task specific
  3. Context specific
  4. skill oriented
  5. Resilient self-efficacy
105
Q

How can an individual increase self-efficacy? What does each step mean?

A
  1. Physiological state -
  2. Verbal persuasion
  3. Vicarious experience
  4. Enactive attainment
106
Q

What are the 5 stages of Change according to transtheoretical model (TTM)? What occurs in each of the steps?

A
  1. Precontemplation - No intention of taking action in next 6+ months
  2. Contemplation - Thinking about pros/cons of behavior change
  3. Preparation - Intend to adopt behavior in next month
  4. Action - Modifications of lifestyle behavior change has occurred in last 6 months
  5. Maintenance - Sustaining behavior for 6+ months
107
Q

Theory of Reasoned Action (TRA)

A

Suggests personal beliefs about health behaviors & social influences equally & independently shape a person’s intent to act

108
Q

What are the constructs of TRA?

A
  1. BELIEFS + EVALUATION = ATTITUDE towards behavior
  2. Subjective norm
  3. Behavioral intent
109
Q

How to measure behavioral intent via TRA?

A
  • Target
  • Action
  • Time
  • Context
110
Q

Theory of Planned Behavior (TPB)

A
  • similar to TRA (addition of perceived behavioral control
111
Q

What is perceived behavioral control according to TPB?

A
  • Extent individual/group perceives they have control over the outcome
  • Strength or influence of external factors affects adoption of health-protective behavior
112
Q

ARCS motivational model

A

Compilation of guidelines from many motivational theories

113
Q

What are the causes of motivation according to ARCS motivational model?

A

Extrinsic or Intrinisic

114
Q

What does ARCS motivational model provide learners?

A

Ability to acquire new knowledge & skills with enough time & effort

115
Q

What are the motivational categories of ARCS motivational model? What falls under each stage?

A
  1. Attention - Capture learner’s interest & maintain their attention
  2. Relevance - Know learner’s needs & provide opportunities to match activities to motives
  3. Confidence - build positive expectations & provide methods for successful mastery of knowledge & skill
  4. Satisfaction - Provide reinforcement to learners’ success & encourage use of new knowledge & skills
116
Q

Bloom’s Taxonomy

A
  • Helps classify learning objectives that are developed
  • Focuses on concept that instruction needs to possess higher-ordered objectives felt to be intellectually demanding
  • Helps determine spectrum of training needs
  • Considers whether training needs require simple, complicated, or complex learning
117
Q

Classifications of Bloom’s Taxonomy

A
  1. Knowledge
  2. Comprehension
  3. Application
  4. Analysis
  5. Synthesis
  6. Evaluation
118
Q

Tasks of Bloom’s Taxonomy

A
  1. Remember
  2. Understand
  3. Apply
  4. Analyze
  5. Evaluation
  6. Create
119
Q

Methods for Health Education Program Implementation

A
  1. Pilot testing
  2. Phase-in
  3. Total implementation
120
Q

Maslow’s Hierarchy of Needs (from most important first)

A
  1. Physiological needs (air, food, water)
  2. Safety needs (security, employment, health)
  3. Love & belonging (friendship, family, intimacy)
  4. Esteem (respect, self-esteem, status)
  5. Self-actualization (desire to become most that you can be)
  • must receive needs from previous level to look for next level needs *
121
Q

Steps to ensure implementation is consistent

A
  1. Build support for the plan
  2. Develop plan for implementation
  3. Train those guiding implementation
  4. Carry out pilot programs
  5. Assess each step of implementation
  6. Promote the plan
122
Q

How can Physiological state affect self-efficacy? How to improve to increase self-efficacy?

A

Emotions affect physiology

  • Use of can vs can’t
  • Reduce anxiety/stress
  • Focus on positive things
  • ## Control moods naturally
123
Q

How can social (verbal) persuasion affect self-efficacy?

A

Occurs as result of other’s comments about our behaviors & abilities

124
Q

How can we help others’ improve their self-efficacy?

A

Instruct, correct, encourage, & support

125
Q

What is vicarious experience?

A

Participating in behavior after watching others do it

126
Q

What is enactive attainment?

A

Engaging in activity/behavior & interpreting the results

CHES (18 decks)

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