Scaling up to a population health intervention: A readiness assessment framework - PowerPoint PPT Presentation

Loading...

PPT – Scaling up to a population health intervention: A readiness assessment framework PowerPoint presentation | free to download - id: 71dc79-OWI4N



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Scaling up to a population health intervention: A readiness assessment framework

Description:

Scaling up to a population health intervention: A readiness assessment framework Duyen Thi Kim Nguyen, MSc (Psychology) Doctoral student (Population & Public Health) – PowerPoint PPT presentation

Number of Views:175
Avg rating:3.0/5.0
Slides: 30
Provided by: Ngu87
Learn more at: http://www.phirnet.ca
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Scaling up to a population health intervention: A readiness assessment framework


1
Scaling up to a population health intervention
A readiness assessment framework
  • Duyen Thi Kim Nguyen, MSc (Psychology)
  • Doctoral student (Population Public Health)
  • Department of Community Health Sciences
  • d.t.nguyen_at_ucalgary.ca
  • PHIRNET Student Webinar

2
Purpose of this webinar
  • To share my study purpose, research questions,
    background, and methods with the PHIRNET
    community
  • To obtain constructive feedback from trainees and
    experts in the field of population health,
    intervention research, evaluation, and scale up
  • To provoke discussions regarding knowledge gaps
    in scaling up and how to advance PHIR methods

3
Purpose of my dissertation
  • To develop a readiness assessment framework to
    assist stakeholders to determine if a health
    intervention is ready to scale up to a
    population-level intervention.

Key terms
ready
intervention
stakeholder
scale up
population-level
health
4
Research Questions
  • How are health interventions initially scaled up
    successfully to population-level interventions?
  • How are health interventions sustained
    successfully as scaled up population-level
    interventions?
  • What are the key elements of successfully scaled
    up population-level interventions ?

Phase 1 Scoping Review
5
Research Questions contd
Phase 2 Case study evaluation (CSE) Case
Stardale Phase 3 Test and refine the framework
  1. What can we learn by piloting the readiness
    assessment framework on an existing
    community-level intervention?

6
Background
  • Canada is a country of perpetual pilot projects
    (Bégin et al., 2009, p. 1185)
  • Not necessary for all interventions to be scaled
    up (e.g., programs treating individuals)
  • Interventions using upstream approaches should be
    considered
  • PHI have potential for great health impact
  • Root causes
  • Reducing inequities and incidence

7
Types and paths of scaling up (Uvin, 1995)
8
Scaling up
  • Mangham Hanson (2010) literature search in June
    2008
  • PubMed scaling up scaling-up
  • 1989-2001 2 citations re. scaling up health
    interventions
  • 2001-2008 51 citations
  • July 2008-Feb 2012 132 citations
  • Scaling up Canada and globally
  • Conference to Advance the State of the Science
    and Practice on Scale-up and Spread of Effective
    Health Programs (2010)

9
Phase 2 CSE -Provide evaluation report
-Greater understanding of Stardales processes,
outcomes, and more
Phase 1 Scoping Review -Develop a Readiness
Assessment Framework -Expert feedback and assess
validity


Phase 3 Test and refine the framework -Assess
its utility practicality (Stardale) -Feedback
assess validity (Experts)
Readiness assessment framework to assist
stakeholders to determine if a health
intervention is ready to scale up to a
population-level intervention
10
Scoping Review 101
  • Systematic review
  • Scoping review
  • Focused question
  • Hypothesis-testing
  • Systematic explicit method
  • I/E Criteria defined a priori
  • Study filters
  • Formal quality assessment
  • Synthesize the data to provide evidence in
    support/rejection of the research hypothesis
  • Broad question
  • Assessing scope breadth
  • Less constrained iterative
  • I/E Criteria defined post hoc
  • Typically no study filters
  • Quality assessment (optional)
  • Examine extent, range, mapping Value of a sys
    review Summarize disseminate Gaps

11
Phase 1 Conceptual Framework
  • Scoping Arksey OMalley (2005) Levac et al,
    (2010)
  • Readiness Assessment Framework
  • Population health approach
  • Reducing health inequities and improving health
    among population groups (aggregate)
  • Focus on broad range of underlying conditions
    (PHAC, 2001)
  • Complex Adaptive Systems
  • a collection of individual agents not always
    predictable interconnected (Plesk Greenhalgh,
    2001, p. 625)
  • Individ properties ? Collect. properties
    (Matheson et al., 2009)

12
Search Parameter Topic Search terms
Population All populations ---
Intervention Addressing 1 economical, social, or physical condition(s), with the aim of improving social, physical, or psychological well-being on a population level practice, program, strateg, intervention, pilot project, polic, well-being, well being, health (health next polic) prevent innovation -e.g., ((school or community) near2 program) ((school or community) near2 intervention)
Comparison --- ---
Outcome Attempt to intervention scale up scaling up, scaling-up, scale up, scale-up, scaled up, scaled-up, implementation, universal, coverage, expand, national, population improv, spread, replication, integrat, mobil, aggregat divers, increas, variet -e.g., (scal near2 up),
Study Design All designs included ---
13
1) Database PubMed, Medline, EMBASE, Global
Health, Canadian Health Research Collection,
CINAHL, PsycINFO, Social Services Abstract,
Social Work Abstract, Cochrane Database of
Systematic Reviews, ERIC, EconLit, WHO Library
and Information Networks for Knowledge Database
(WHOLIS) 2) Grey literature - Scopus, select
conferences regarding scale up (e.g., Conference
to advance the state of the science and practice
on scale-up and spread of effective health
programs) and scale up studies and evaluations of
organizations, companies, and government
initiatives (e.g., ExpandNet) 3) Authors will be
contacted for clarification, data, or further
studies 4) Experts and research teams identified
during the review process will be contacted for
information regarding their knowledge of ongoing
or unpublished studies or other consultation 5)
Bibliography list of identified relevant
publications Select journals
14
Quality Assessment Tools
  • Downs Black (1998) Checklist
  • Randomized non-randomized studies
  • Scores fro overall study quality, quality of
    reporting, power, internal validly (bias
    confounding), and external validity
  • Critical Appraisal Skills Programme (CASP)
    appraisal checklist (Public Health Resource Unit,
    England, 2006)
  • 10 questions regarding rigour, credibility, and
    relevance
  • Quality in Qualitative Evaluation (Spencer et al,
    2003)
  • Focus on qualitative evaluation research
  • Search on the Cochrane Qualitative Research
    Methods Group

15
Search Topic Data to extract
Population All populations Check all that apply for initial intervention age group youth (age 13-17) child (age gt13, adults (age 18 to 64), seniors (age 65), all age group Check all that apply for scale up intervention age group youth (age 13-187 child (age gt13), adults (age 18 to 64), seniors (age 65), all age group Describe demographics of inital intervention group Describe demographics of intended scale up intervention Size of people targeted in the intial intervention Size of people targeted in the scaled up intervention
Intervention 1 ESP cond(s), with aim of improving SPP well-being on population level Location of intervention Check all that apply for conditions addressed, and please specify (social, economical, or physical) Check all that apply, and please specify (social well-bing, physical well-being, psychological well-being) Contextual factors of the intervention and the political, social, and environmental context in which scaling up occurred
Outcome Attempt to intervention scale up Level of attempted scale up (international, national, regional, provincial, other) level of achieved scale up (international, national, regional, provincial, other) type of scale up and describe (quantitative, functional, political, organizational) Processes/Factors regarding initial scale up (e.g., planning, implementation, monitoring) Processes/Factors regarding sustained scale up (e.g., monitoring, evaluation, planning, implementation) Funding/Money-related Was scaling up achieved, why or why not, and how Was scaling up guided by a theory/framework? Which one? Unintended outcomes
Study design All designs Study design used Issues/limitations with study design Confounding
Other Miscellaneous Date of extraction, name of reviewer, reference id, first author, title of article
16
Categorization for organization analysis
Characteristics of Stardale
Health outcome(s)
Research Questions
Population characteristics
Complexity
NVivo 9
Theory behind the intervention
Underlying condition(s)
Context
17
(No Transcript)
18
Expert feedback
  • Experts (academic, practice)
  • Population health
  • Intervention research
  • Scaling up
  • Surveys and/or semi-structured interviews
  • Face validity
  • Content validity (main domains present)
  • Feedback re. strengths, weaknesses, gaps

19
Phase 2 Case Study Evaluation
20
Stardale Honouring the girls stories
  • Non-profit organization and registered charity
  • Honouring the Girls Stories (est. 2005) in
    Calgary, AB
  • Provides life skills, literacy education, and
    advocacy to urban Aboriginal female youths (10-17
    years)
  • Organized activities afterschool (e.g., arts,
    tutoring, sporting events, dance, acting,
    modeling)
  • 2/wk from Sept-June 600p-800p with supports
    all year-round

21
Participatory Approach
  • Doing research with, not on the participant
    (Minkler Wallerstein, 2003)
  • Participatory research design implementation
    (Merriam, 2009), developing sense of ownership,
    create meaning, and increase likelihood of using
    the results (Patton, 2002)
  • Principles Flexible design, building theory
    based on participants perspectives, simplicity,
    agreed topics, analysis reflects the detail and
    diversity, share results with participants for
    informed conclusion (Rothe, 2000)

22
Aboriginal Research/Evaluations
  • Tri-council guidelines re. Research involving the
    First Nations, Inuit and Métis peoples of Canada
    (Gov of Canada, 2011)
  • Aboriginal advisory committee
  • Key components (Johnston, 2008)
  • Unique way of knowing
  • Explaining in relevance to Aboriginal culture
  • In-person, verbal communication
  • Acknowledge Aboriginal core values
  • Time

23
Case Study Approach
  • Case study method ideal when addressing why
    and how questions lack of control over events
    contemporary phenomenon (Keen Packwood, 1995
    Yin, 2009)
  • CSE Framework (Yin, 1992 2009)
  • Develop understanding of the program combine
    with literature
  • Define units of analysis Create timeline
  • Define measures, protocols, procedures
  • Data collection, analysis, and synthesis Compose
    a report
  • Reflection Myself and Stardale stakeholders
    (i.e., staff)

24
Phase 3 Test and refine the framework
  • Research Question
  • What can we learn by piloting the readiness
    assessment framework on an existing
    community-level intervention?
  • Pilot by Stardale staff and stakeholders
  • Semi-structure interview for framework feedback
  • Practicality
  • Function
  • Comprehension
  • Feedback re. strengths, weaknesses, gaps

25
Establishing Validity
  • Experts (different from study 1)
  • Population health
  • Intervention research
  • Scaling up
  • Semi-structured interviews
  • Face validity
  • Content validity (main domains present)
  • Feedback re. strengths, weaknesses, gaps

26
Phase 2 Case Study Evaluation -Greater
understanding of a community-level intervention,
Stardale
Phase 1 Scoping Review -Develop a Readiness
Assessment Framework -Expert feedback and assess
validity


Phase 3 Test and refine the framework -Assess
its utility and practicality (Stardale) -Feedback
assess validity (Experts)
Readiness assessment framework to assist
stakeholders to determine if a health
intervention is ready to scale up to a
population-level intervention
27
Select References
Arksey, H. OMalley, L. (2005). Scoping
studies towards a methodological framework.
International Journal of Social Research
Methodology, 8(1)19-32. Edwards, N. (2010).
Scaling-up health innovations and interventions
in public health a brief review of the
current state-of-the-science. Draft Paper
Commissioned for the Conference to Advance
the State of the Science and Practice on Scale-up
and Spread of Effective Health Programs.
Available from http//ihiscaleupconference1
0.blogspot.com/2010/06/june-25-introductory-call.h
tml Johnston, A. L. K. (2008). Aboriginal ways of
knowing Aboriginal-led evaluation. The
Canadian Journal of Program Evaluation, 23(1),
1-6. Levac, D., Colquhoun, H., OBrien, K. K.
(2010). Scoping studies Advancing the
methodology. Implementation Science 569.
Available from http//www.implementationsci
ence.com/content/5/1/69 Mangham, L. J. Hanson,
K. (2010). Scaling up in international health
What are the key issues? Health Policy and
Planning, 25(2) 85-96. doi10.1093/heapol/czp066
Matheson, A., Dew, K., Cumming, J. (2009).
Complexity, evaluation and the effectiveness
of community-based interventions to reduce
health inequalities. Health Promotion
Journal of Australia, 20(3) 221-226. Uvin, P.
(1995). Fighting hunger at the grassroots Paths
to scaling up. World Development, 23(6)
927-939. Yin, R. K. (2009). Case study research.
California Sage.
28
Helpful Resources re. PHIR Methods
Literature reviews Bambra, C. (2011). Real world
reviews A beginners guide to undertaking
systematic reviews of public health
policy interventions. J Epidemiol Community
Health, 65, 14-19. Grant, M. J. Booth, A.
(2009). A typology of reviews an analysis of 14
review types and associated methodologies.
Health Information and Libraries Journal, 26,
91-108. Jackson, N. Waters, E. (2005). Criteria
for the systematic review of health promotion and
public health interventions. Health
Promotion International, 20, 367-74. Riaz, M.,
Sulayman, M., Salleh, N., Mendes, E. (2010).
Experiences conducting systematic reviews
from novices perspective. Avail from
http//www.cs.auckland.ac.nz/norsaremah/EASE2010.
pdf Evaluation research Hawe, P., Degeling, D.,
Hall, J. (1990). Evaluation health promotion A
health workers guide. Australia
Elsevier. Weiss, C. H. (1998). Evaluation, 2nd
ed. New Jersey Prentice Hall. Qualitative
research Denzin, N. K. Lincoln, Y. S. (Eds).
(2011). The SAGE handbook of qualitative
research. Thousand Oaks SAGE. Merriam,
S.B. (2009). Qualitative research A guide to
design and implementation. San Francisco
Jossey-Bass. Stake, R. E. (2010). Qualitative
research Studying how things work. New York
Guilford Press.
29
Thank You!
  • Funding for my dissertation has been provided by
    the CIHR Population Health Intervention Research
    Centre PhD Scholarship.
  • Funding for my internship at the WHO has been
    provided by the CIHR Population Health
    Intervention Research Network Internship
    Scholarship.
  • Supervisors Drs. Lynn McIntyre Lindsay McLaren
  • Supervisory committee and members of PHIRC at UofC
About PowerShow.com