Integrated evaluation project

Knowing What Works – Evaluation for Public Health 2019

Assessment: Integrated evaluation project

Due: Sunday 3rd November 2019, submit by 11.59pm

Word count: 2000 words (excluding references and appendices)

Weighting: 45%

Each student will develop and report a detailed evaluation plan for a public health intervention, the scenario for which will be provided. The evaluation plan should use an integrated approach, drawing on mixed methods, and must include economic evaluation.

Scenario

Obesity is associated with an increased risk of a wide range of conditions including diabetes, hypertension, cardiovascular disease and some cancers (NHMRC, 2013), and Australia has one of the highest rates of overweight and obesity among developed nations. Around 63% of Australian adults are obese (28%) or overweight (35%) (AIHW, 2014), costing almost $40 billion (Medibank, 2010). There is evidence that even a small amount of weight loss (e.g. 5% of initial weight) can produce clinically important health benefits (Stevens et al, 2006). Evidence has shown that collaborative care with the active involvement of nurses in clinical management processes is effective for the management of chronic conditions in primary care (Horrocks et al, 2002). As such, a practice nurse-led lifestyle program is believed to provide effective care, continuity and sustainability in the management of chronic conditions such as obesity within Australian primary care.

The proposed program includes key behavioural strategies, including self-monitoring, lapse management and goal setting, delivered in non-judgemental, collaborative and empathetic consultations. The program will be delivered by practice nurses, within general practices in the City of Playford, South Australia. Six fortnightly sessions will provide education on healthy lifestyle and behaviour modification techniques. Topics include: healthy eating, food labelling, increasing physical activity, alcohol and weight, eating habits and emotion, prevention of short-term lapses, and long-term weight maintenance following weight loss. Three follow-up sessions are provided at 6, 9, and 12 months to support weight loss maintenance. Practice nurses receive training and ongoing support and mentoring from an experienced dietitian, who works in the public health team implementing the program, using materials and methods that comply with clinical practice guidelines. The population targeted to be participants of the program are adults, aged 18-75 years, with a Body Mass Index (BMI) ≥ 30.

The goal of the program is to support participants to make a sustained reduction of at least 5% of their body weight, over a two-year time period, with the ultimate goal of reducing weight-related morbidity and mortality in the Australian population.

References

Australian Institute of Health and Welfare. (2014). Australia's Health 2014. Canberra. Available from: https://www.aihw.gov.au/reports-data/health-welfare-overview/australias-health/overview (accessed 21/7/2019)

Horrocks S, Anderson E, Salisbury C. (2002). Systematic review of whether nurse practitioners working in primary care can provide equal care to doctors. British Medical Journal, 324: 819–23. https://doi-org.proxy.library.adelaide.edu.au/10.1136/bmj.324.7341.819

Medibank. (2010). Obesity in Australia: financial impacts & cost benefits of intervention. Canberra. Available from: http://www.medibank.com.au/Client/Documents/Pdfs/Obesity_Report_2010.pdf (accessed 21/7/2019)

Sturgiss, E., Douglas, K., Kathage, R., & Res, S. 2016. A synthesis of selected national Australian guidelines on the general practice management of adult patients who are overweight or obese. AFP. 45(5): 327- 331 https://www.racgp.org.au/afp/2016/may/a-synthesis-of-selected-national-australian-guidelines- on-the-general-practice-management-of-adult-patients-who-are-overweight-or-obese/ Stevens J, Truesdale KP, McClain JE, et al. (2006). The definition of weight maintenance. International Journal of Obesity, 30(3): 391-9. https://doi-org.proxy.library.adelaide.edu.au/10.1038/sj.ijo.0803175

Additional resources and information

The following resources may provide you with helpful background information:

- Nursing in primary care: https://www.apna.asn.au/profession/what-is-primary-health-care- nursing

- Information on obesity (a good starting point): http://www.who.int/mediacentre/factsheets/fs311/en/

- Britt H, Miller GC, Henderson J, Harrison C, Bayram C, Charles J, et al. General practice activity in Australia 2012–13. Sydney: Sydney University Press; 2013.

- General practice in Australia: http://www.racgp.org.au/becomingagp/what-is-a-gp/what-is- general-practice/

- City of Playford: https://www.playford.sa.gov.au/, https://en.wikipedia.org/wiki/City_of_Playford

- GP Plus Health Care services and centres: http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health +services/gp+plus+health+care+services+and+centres

Requirements of report

You should structure your written submission around the steps for evaluation planning outlined by Round et al (2005):

1. Describe the program

- Include setting and location, program goal, target population, objectives, interventions, process and impact indicators

- You need to determine the objectives in relation to which your program will be evaluated; these should be SMART objectives.

- Objectives may relate to clinical data beyond weight (e.g., HbA1c, blood sugar, lipids, waist circumference, blood pressure, smoking, alcohol consumption, etc)

2. Evaluation preview

- Include how you will engage stakeholders, the purpose of evaluation, and the key evaluation questions

- For the purposes of this assessment, you do not need to consider resources required to conduct the evaluation (e.g., budget, expertise) – you can assume your evaluation team has sufficient resources.

3. Focus the evaluation design

- Your design should include two components:

1. An evaluation planning process grid to outline how you will evaluate performance against your program objectives, using at least two different methods/data sources. The grid can be included as an appendix to your report.

2. A proposed health economic evaluation, to inform decision-making about future funding of the program. This should include the study perspective, an appropriate time horizon, health care resources (including averted costs), health outcomes (commonly used in economic evaluation), and sensitivity analysis.

4. Collect data

- You will not actually collect data, but you should consider how you will sample and recruit participants, and what data collection methods and instruments you will use, for both components of your evaluation design.

- Include sample survey, interview or focus group questions in your appendices.

5. Analyse and interpret data

- You will not analyse data, but you can consider the type of analysis that may be appropriate for the data you propose collecting.

- You should consider how the findings of different evaluation methods could be integrated and used to inform each other.

6. Disseminate lessons learnt

- Include what reports will be prepared, and for whom.

You should cite any sources and references used to inform your plan. You can use Vancouver, Harvard, or APA referencing styles, but please be consistent and accurate. Referencing Guides are available here: http://libguides.adelaide.edu.au/referencing.

Submit your paper via Turnitin, on MyUni. Extensions should be requested from the Course Coordinator by Friday 1st November. Late submissions, without an extension, will attract a penalty of 5% per day.

Assessment rubric

High Distinction Distinction Credit Pass Fail

Description of the program (including background, details of program, and objectives)

A very clear and thorough description of the program

A clear and mostly thorough description of the program

A good description of the program, but missing some details

A basic description of the program, with few details or under developed objectives

Any description of the program is missing, incomplete, or not clear

Evaluation preview (including stakeholder engagement, and key questions)

A very clear and thorough evaluation preview

A clear and mostly thorough evaluation preview

A good evaluation preview, but missing some details

A basic evaluation preview, with just sufficient detail included

Any evaluation preview is missing, incomplete, or not clear

Evaluation design – planning process grid (including at least two methods/ data sources)

A very clear and thorough evaluation design

A clear and mostly thorough evaluation design

A good evaluation design, but missing some details

A basic evaluation design, with just sufficient detail included

The evaluation design is missing, incomplete, or not clear

Evaluation design – health economic evaluation

A very clear and thorough evaluation design

A clear and mostly thorough evaluation design

A good evaluation design, but missing some details

A basic evaluation design, with just sufficient detail included

The evaluation design is missing, incomplete, or not clear

Data collection plan (including sampling, recruitment, methods, and sample questions)

A very clear and thorough data collection plan

A clear and mostly thorough data collection plan

A good data collection plan, but missing some details

A basic data collection plan, with just sufficient detail included

The data collection plan is missing, incomplete, or not clear

Data analysis plan (including integration across methods)

A very clear and thorough data analysis plan

A clear and mostly thorough data analysis plan

A good data analysis plan, but missing some details

A basic data analysis plan, with just sufficient detail included

The data analysis plan is missing, incomplete, or not clear

Dissemination plan

A very clear and thorough dissemination plan

A clear and mostly thorough dissemination plan

A good dissemination plan, but missing some details

A basic dissemination plan, with just sufficient detail included

The dissemination plan is missing, incomplete, or unclear

Quality of evaluation plan

Clearly demonstrates understanding, originality, and independent thought; uses evidence effectively

Good level of understanding, originality, and independent thought; uses evidence to support arguments

Well-reasoned evaluation plan, demonstrating understanding and originality, and based on broad evidence

Sound evaluation plan, demonstrating some understanding

Very little evidence of understanding; evaluation plan overall is lacking details or not clear

Expression and presentation

Highly developed skills in expression and presentation. Referencing is well done, with no mistakes.

Well-developed skills in expression and presentation is mostly well done, with only occasional mistakes

Good skills in expression and presentation. Referencing is mostly well done, with some mistakes

Adequate skills in expression and presentation. An attempt to provide references

Rudimentary skills in expression and presentation. Inaccurate and inconsistent referencing

General description

Outstanding or exceptional work in terms of understanding, interpretation and presentation

A very high standard of work which demonstrates originality and insight

Clear understanding and presentation and degree of originality and insight

Satisfies the minimum requirements

Fails to satisfy the minimum requirements

Mark out of 45:

Grade:

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