Course Learning Outcomes for Unit VIII Upon completion of this unit, students should be able to:

Course Learning Outcomes for Unit VIII Upon completion of this unit, students should be able to:

3. Recognize effective organization and promotion of health programming for community health on a global scale. 3.1. Assess the steps for organizing a community health program. 3.2. Identify steps needed to effectively evaluate the community health program.

Reading Assignment Chapter 15: Systems Thinking and Leadership in Community and Public Health

Unit Lesson In this unit, we will discuss systems thinking and community health programming. Community organizing is a process that involves the engagement of individuals, groups, and organizations. Program planning is not required in community organizing; however, it is often times used. Program planning is a process where a health intervention is planned to meet the needs within a population. Antiviolence campaigns and stress management courses are examples of program planning (McKenzie, Pinger, & Kotecki, 2012). When deciding which community health interventions to create, the Centers for Disease Control and Prevention (CDC) uses Guide to Community Preventive Services (Community Guide). The Community Guide is considered credible because it is based off the scientific systematic review process. The guide answers many questions that are critical to community health on subjects such as

 interventions that have worked/did not work,

 populations in which the intervention worked/did not work,

 cost of the intervention,

 benefits/risks of the intervention, and

 future research recommendations (Centers for Disease Control and Prevention, 2015). Community health programs are intricate and are a key factor in disease prevention, improving health, and increasing quality of life. Health status and behaviors are determined by personal, environmental, policy, and organizational influences. Community health programming is targeted at reaching the goals of Healthy People 2010. Community health programs are generally held within healthcare settings; however, other settings are becoming more popular. Programs are being held at schools, worksites, religious organizations, and within communities (Healthy People 2020, 2015). There are instances where healthcare organizations are collaborating with schools to offer health programs. For instance, nutrition and exercise programs are being offered at an increased rate. Employers see the value of employee health. Therefore, many employers offer incentives to employees who take part in employee wellness programs. It is not far fetched to hear about employers checking cholesterol, blood pressure, quality of life, weight, BMI, and sometimes glucose. The rationale is that healthy employees are less likely to call in sick with health-related conditions. Community health professionals must identify their health issue, and then create specific and measurable goals and objectives. Evidence-based interventions should be used to achieve the goals and objectives. It is


Leadership in Public Health

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always a good idea to consider partnerships. The partnerships can be between the government, business, hospitals, schools, community, and other volunteer organizations. The goal behind partnership is to combine services and money and to combine information (U.S. Department of Health and Human Services, 2015). The steps to planning a health program are (1) assessing needs, (2) setting goals and objectives, (3) developing an intervention, (4) implementing the intervention, and (5) evaluating the results. Assessing the needs involves collecting and analyzing information to help develop an understanding of the community issues. Once the issue has been defined, the goals and objectives need to be set. The goals should include information on who may be affected and what will change because of the intervention. The next step is creating an intervention. The intervention occurs when the activity or educational program that will help meet the objectives of the health program are implemented. The final step is evaluation, which involves determining if the interventional program was effective (McKenzie et al., 2012). One example of a community health program is an adolescent health program that targets improving parenting skills. It is suggested that parenting interventions can affect adolescent behaviors and health outcomes; therefore, the intervention targets caregivers’ parenting skills. The interventions for an adolescent parenting program target caregivers and adolescents individually and collectively. The interventions can be delivered in one-on-one or group sessions. The health education focuses on awareness, skill-building, communication, monitoring of behavior, and more specific information (U.S. Department of Health and Human Services, 2015). After an intervention is created and used, it is important that the program be evaluated. Evaluation determines the effectiveness of the program. Evaluation is a process used to understand what the health program does well, what it does not do well, and areas of improvement. The results are used to improve the quality of the program and determine future planning. Evaluations can help improve program design. It is always important to assess and evaluate programs to ensure they are effective and to identify areas of improvement (Centers for Disease Control and Prevention, n.d.). Formative and summative are the two main evaluations types. The first type of formative evaluation is the needs assessment. The needs assessment identifies the target population, the need for the intervention, and how to meet the need. The second type of formative evaluation is the process evaluation. This type of evaluation measures effort and outputs of program. It examines implementation and can be done one time or continuously. Outcome evaluation is the first type of summative evaluation. Outcome evaluation measures the changes and effects of the campaign. It also determines the extent that the program is achieving short-term or medium- term changes and outcomes. The impact evaluation is the second type of summative evaluation, and it measures long-term results. The impacts are the effects that it has on the population, community, school, or environment (Centers for Disease Control and Prevention, n.d.). There are six steps to starting an evaluation (Centers for Disease Control and Prevention, n.d.):

1. Engage stakeholders: The stakeholders should have an interest in your topic/issue and the evaluation. It is imperative that stakeholders are involved in the creation of the evaluation or they are kept informed.

2. Identify program elements to monitor: This step involves determining what is worth monitoring.

You will determine which parts of the program you have information for and if the appropriate data can get collected. This step involves ongoing efforts to track the necessary variables and shows if the program is being conducted as intended.

3. Select the key evaluation questions: This step involves answering basic evaluation questions. What

are you evaluating? What parts of the program will you consider, and what are the standards that the program should reach in order for it to be considered successful?

4. Determine how the information will be gathered: This step involves determining how to gather the

information and data. Which data collection methods will you use? What sources will you use to collect information? During this step, you will also want to make sure you selected the correct research design and methods. For instance, are you going to collect information by using a survey? If so, what type of survey will you distribute (internet, face-to-face, telephone)?

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5. Determine a data analysis and reporting plan: This step involves determining how the data will be analyzed. What statistical software will you use? What types of statistical tests will you run on the data? How will you interpret and summarize the results? Will you disseminate (share or disperse) the information you received?

6. Ensure use and share lessons learned: This step involves using and sharing the information you

obtained. It involves making informed decisions based on the information you received. According to Sharma, Branscum, and Atri (2014), systems thinking is an approach to problem solving that pursues a deeper understanding of relationships and behaviors. Systems thinking is a type of evaluation method that differs from the conventional methods listed above. There are many approaches to system thinking, such as

 dynamic thinking, which focuses on behaviors that lead to problems;

 effect thinking, which visualizes changes in the system, including attitudes and behaviors;

 forest thinking, which focuses on understanding relationships and when changes occurs;

 operational thinking, which focuses on cause and effect; and

 loop thinking, which views cause and effect as an ongoing event (Sharma et al., 2014). Health programming and evaluation are essential for community health. It is vital that interventions and programs are planned and evaluated appropriately.

References Centers for Disease Control and Prevention. (n.d.). Building our understanding: Key concepts of evaluation.

What is it and how do you do it? Retrieved from

Healthy People. (2015). Educational and community-based programs. Retrieved from programs

McKenzie, J. F., Pinger, R. R., & Kotecki, J. E. (2012). An introduction to community health (7th ed.).

Sudbury, MA: Jones & Barlett. Sharma, M., Branscum, P. W., & Atri, A. (2014). Introduction to community and public health.

San Francisco, CA: Jossey-Bass. U.S. Department of Health and Human Services. (2015). What is the community guide? Retrieved from

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