Measuring Outcomes of Health Promotion

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Measuring Outcomes of Health Promotion

• What is evaluation
• Why do we care?
• How do we do it?
• When do we do it??

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CNO Standard of Practice knowledge application

• Indicators
• evaluating/describing the outcome of specific
  interventions and modifying the plan/approach
• analyzing and interpreting unusual client
• responses and
• evaluating theoretical and research-based
  approaches for application to practice.

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Evaluation Definition

• Systematic, continuous evaluation in terms of
• Process
• Outcomes
• Compare actual outcomes to stated/desired outcomes

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Purpose of Evaluation

• A system for determining the value of
  pre-determined objectives.
• A collection of the methods and skills necessary
  to determine whether a service is
• needed,
• likely to be used,
• conducted as planned, and helpful.

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CHAPTER 12  
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Process

• Select health protection-health promotion area of
  interest.
• Identify most effective intervention for defined
  area.
• Tailor intervention to client.
• Identify potential factors that may influence
  outcomes.
• Client characteristics
• Demographic factors
• Family characteristics
• Select outcomes to measure effects of
  intervention
•         Short term
•         Intermediate
•         Long term

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Deciding Which Health Outcomes to Measure

• Factors
• What are the goals to be attained?
• What is the purpose and type of intervention?
• What ability is there to access the information
  needed to measure the process/results of
  care//interventions?

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Outcomes classification in health care.

• Client focused
• Diagnostic/Holistic
• Provider focused
• Health care provider/Family

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Potential Evaluation Questions for Health
Promotion Action

• Assessment/Planning
• Strategies
• Evaluation Issues

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Issues regarding health promotion concept and
design

• Is the strategy responding to peoples needs or
  is the strategy determining their needs?
• Does it address the health challenges or reducing
  inequities, increasing prevention, enhancing
  coping?
• Is it middle class in orientation and assumptions
  will it widen the gap and increase inequities?
• Does it include both individual behaviour changes
  and social and political changes through
  collective forms of action?
• Is it focused on lifestyles or does it include
  living and working conditions?

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Issues (cont)

• Is it adapted to local needs and possibilities?
• Are goals and objectives clear and measurable?
• Are the new health promotion concepts adequately
  incorporated and integrated?
• What are the underlying change models?
• Are there goals and indicators at both the
  individual and environmental levels?

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Issues regarding health promotion processes

• What methods are being used to document health
  promotion processes and activities?
• What difficulties were encountered in
  implementation? Why? How were they overcome?
• Are interventions directed at both strengthening
  factors that sustain health and reducing factors
  that cause, or cause vulnerability to ill health?
• Are interventions directed at both the individual
  level and the social, physical and policy
  environmental levels? 

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Issues regarding health promotion impact

• What targets for activities designed to foster
  implementation of the strategy were achieved?
• What targets for mechanisms for bringing about
  improvements in health were achieved?
• What health improvement targets have been
  achieved?

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Challenges in Measuring Health Outcomes

• Separating the contribution of nursing from other
  health care providers
• Sensitivity of measures of outcomes
• Holistic-focused outcomes
• Measurement of community or organizational
  focused outcomes

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Directions for Nursing Practice in Achieving
Health Outcomes

• Outcomes movement has caused nursing to focus on
  the value of their practice time to delineate
  its contribution to health outcomes

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Types of Evaluation

• Process
• Outcome

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Desired/stated outcomes

• Possibilities
• Attained
• Process of attaining
• Not achieved not likely to be achieved

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What can interfere/go wrong? Pitfalls

• Can occur at any point in the nursing process
• Assessment
• Diagnostic reasoning
• Planning/Interventions
• Evaluation