There are many types of evaluation and
reasons to evaluate. Program evaluation in public health strives to generate results that have a meaningful impact on the program in question.2 This result is accomplished by beginning with program-specific, focused questions, having engaged stakeholders, and following an established set of guidelines and best practices.
It is critical to identify who needs and will benefit from the evaluation results. Other factors to consider are whether the evaluation process is feasible and will have a direct, tangible impact on the program, and if the results and outcomes are likely to be valid and reliable. The process of public health program evaluation is not necessarily static, but rather can change over the course and life of the program due to changes in environment, resources, and any number of other factors.
Program evaluation plays a vital role in documenting and building the evidence base of public health programs and activities.
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As shown in the table below,3 data informs public health in complementary ways:
Who||Controlled by stakeholders||Controlled by program||Controlled by stakeholders||Controlled by investigator||Controlled by program, state or national standards||Controlled by stakeholders|
Design||Flexible design||No specific design||Tool-based (e.g. Lean, Plan-Do-Study-Act)||Tightly controlled design||Passive, active; census, sample||Flexible design|
Data||Combination of data generated by programs and data collected on a one time basis||Data generated in programs' day to day operations||Process data; day to day operations||Data collected on a one-time basis||Health outcome, demographic, often case definition or question based||Combination of data generated by program and data collected on a one time basis. Analysis is for future expected outcomes; projection|
Time Period||Over a defined period of time||Ongoing||Cyclical||Specific controlled timeframe||Ongoing||In response to a potential project or policy. Must be completed before major decisions are made in order to be effective|
Why||To show how a program is working (either process or outcome)||To inform management and program performance improvement||To achieve measureable rather than anecdotal improvements||To further knowledge, generate evidence based practices or programs||To monitor and inform public health efforts to reduce morbidity and mortality||To determine the impact on health of a potential project or program and provide recommendations to augment positive health impacts and reduce negative health impacts|
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What is the difference between program monitoring and program evaluation?4
|On-going assessment that aims to determine the efficiency of a program||Assessment to determine the effectiveness of a program|
|Decisions based on continuous observations and informal data collection||Decisions based on thorough data collection|
|Short term results||Long term results|
|Conducting internally||Conducted externally|
1. Rossi, Peter H., and Howard E. Freeman. 1993.
Evaluation: a systematic approach. Newbury Park, Calif: Sage Publications.
2. Adapted from Centers for Disease Control and Protection Program Performance and Evaluation Office (PPEO). Introduction to Program Evaluation for Public Health Programs: A Self-Study Guide (CDC). Date accessed: 31 July 2018.
3. Adapted from the Vermont Department of Health. Healthvermont.gov
4. Adapted from Hitchcock, Stacey (2014). Monitoring versus Evaluation: A brief overview of these terms and their application for development actors. New Zealand. Council for International Development.
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