Health Program: Implementation

1
Health Program Implementation

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

2
Comprehensive Model of Program Theory Components
3
I. Process Implementation Components

• The Organizational Plan
• The Service Utilization Plan
• Distinguishing inputs from outputs in the Program
  Theory

4
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.

5
Elements of Organizational Plan
6
Organizational Plan

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

7
A Good Program Manager will

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

8
(continued)

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

9
ReminderNeed Cultural Appropriateness

• Of program staff (cultural competence)
• Of program materials
• Of social marketing approach and materials
• Of intervention strategy
• Of evaluation methods
• Of stakeholder involvement

10
Basic Budgeting

• Budget is a plan
• Budget is a communication tool
• Budget is a way to prioritize
• Budget is managerial tool to oversee resources

11
Service Utilization Plan

• How the intended target population receives the
  intended amount of the intended intervention
  through interaction with the programs service
  delivery system

12
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

13
Diffusion of Innovation Curve
Laggards

Popula tion
Adopters
Early Adopters
Innovators
Time
14
Service Utilization Intervention Types

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

15
Getting Help

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

16
II. Budgeting Basics

• The Operational Budget
• Breakeven Analysis

17
Budget Terminology

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

18
Using Excel for Budgets

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

19
Using Excel

• Use software creature features (i.e., formating
  borders, graphics, color cell) to make it a bit
  more fun to do data entry
• 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.
• Create graphics on separate worksheets (the tabs
  at the bottom of the page) so the graphic does
  not hide the data.

20
Break Even Analysis

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

21
Break Even Requires Having the Following

• Variable Cost
• Fixed Cost
• Charge (income generated)
• For detailed information and examples, go the web
  sites listed under required reading

22
Think Program Implementation Across the Pyramid