Health Program: Implementation CHSC 433 Module 4/Chapter 7 L. Michele Issel, PhD UIC School of Public Health

Comprehensive Model of Program Theory Components

I. Process Implementation Components l The Organizational Plan l The Service Utilization Plan l Distinguishing inputs from outputs in the Program Theory

Focus on Process Theory Program implementation focuses on acquiring and utilizing inputs that have been delineated in the Process Theory. Attention to documenting the extent of outputs to the Process Theory is process evaluation.

Elements of Organizational Plan

Organizational Plan How to garner, configure, and deploy resources, organize program activities so that the intended service is developed and maintained

A Good Program Manager will … l Have detailed project planning l Break project into phases and components l Define results and deliverables l Have measurable milestones (=objectives) l Obtain commitment of stakeholders l Gain involvement of contributing teams l Have project tracking system (=process evaluation) l Accurately measure process and outcomes l Review process monitoring data regularly

(continued) l Orient new staff l Motivate staff l Effectively communicate l Provide leadership l Create trusting environment l Have personnel appraisal system l Keep senior management involved l Be a role model

Reminder: Need Cultural Appropriateness l Of program staff (cultural competence) l Of program materials l Of social marketing approach and materials l Of intervention strategy l Of evaluation methods l Of stakeholder involvement

Basic Budgeting l Budget is a plan l Budget is a communication tool l Budget is a way to prioritize l Budget is managerial tool to oversee resources

Service Utilization Plan How the intended target population receives the intended amount of the intended intervention through interaction with the program’s service delivery system

Diffusion of Innovation Consider the diffusion of innovation curve when estimating interest in a program that has not been tried (sold) before Majority adoption takes time

Diffusion of Innovation Curve Innovators Early Adopters Adopters Laggards % Popu la tion

Service Utilization: Intervention Types l Therapy: medical, psychological, pharmacological l Education, training, skills building l Coaching, encouragement, contract l Monitoring, follow-up l Referral, networking, services coordination l Transportation, housing, tangibles Must be appropriate for level of pyramid at which the program is designed

Getting Help l Involve staff in objective setting l Involve staff in devising measurement of objective achievement l Involve Board Members, especially those with expertise l Use on-line resources

II. Budgeting Basics l The Operational Budget l Breakeven Analysis

Budget Terminology l Fixed costs do not change with number of participants l Variable costs do change with number of participants l Direct costs are “seen” by participants l Indirect costs are not “seen” by participants l Charge is the amount asked as payment l Cost is what is spent to do the program l Profit is the difference between cost and charge

Using Excel for Budgets l Develop a codebook/mechanism that tracks the survey items with variable names and abbreviated column titles l Think spreadsheet, not database in which can ask “select respondents, if they have characteristic x” l Conventional layout: Row per respondent Columns per variable/item Cell contains respondents response

Using Excel… l Use software creature features (i.e., formating borders, graphics, color cell) to make it a bit more fun to do data entry l Use “insert formulas” in the cell for doing the math, then the answer changes as the data in the cells change ~ let the software do the work. l Create graphics on separate worksheets (the tabs at the bottom of the page) so the graphic does not hide the data.

Break Even Analysis l Simple math that answers the question of at what point will the program costs be matched with program income l Applicable to public health as way to prioritize programs, establish targets in utilization plan and organizational plan.

Break Even Requires Having the Following: l Variable Cost l Fixed Cost l Charge (income generated) l For detailed information and examples, go the web sites listed under required reading…

Think Program Implementation Across the Pyramid