“Program evaluation, as a concept and process of weighing, interpreting, and subsequently making judgments about data collected from multiple components of programming” (Billings & Halstead). While the Canterbury District Health Board as cited by Fineout-Overholt & Johnston (2007), states that “evaluation is assessment of both processes and outcomes of a program or implementation. ” Irrespective of the fact that evaluation is the final step of Evidence Base Practice process, it should be an ongoing process, necessary all through the stages of EBP, to ensure that quality of plans and process.
Evaluation of the evidence, implementation process and it’s effectiveness, before the dissemination to stakeholders, is an imperative. Hence, to ensure a comprehensive evaluation, certain factors have to be considered in the methodology and variables as it applies to the evidence sought in the project, it’s application and purpose, in order to yield the desired outcome for dissemination.
These factors include; reasons for the evaluation, having a time frame, choosing the appropriate time to evaluate, who the evaluators will be and having an evaluation design or framework. It is also important to select an evaluation instrument, consider the data collection process, it’s analysis, manner in which results are reported, how they will be used and the costs of evaluation. In consideration of my choice of Evidence Base Practice project, which is using diet and exercise to control glycaemia and reduce complications in type 2 diabetes patients.
The implementation logistics involved the use of strategic methods, such as health education of participants by nurses, dietitians, using power point presentations, healthcare model, leaflets, fliers, display of diet foods, measurements of weight and blood sugars, how to calculate food calories and the invitation of diet and exercise companies, to help motivate the patient’s participation in the project. “Consistent collection of data is crucial to a solidly documented program evaluation report,” (Gard, Flannigan & Cluskey, 2004).
To achieve a reliable and valid evaluation of data collected, to generate evidence, a post structured questionnaire was developed in the following context: What is their attitude to health, wellbeing and the having to deal with type 2 diabetes, pre and post program. Effectiveness and usefulness of the methods adopted in the implementation process, Pre and post perception about diet and exercise, as a necessary intervention and it’s effectiveness in glycaemic control and prevention of diabetes complications.
How motivated were they with the noted weight reduction, glycaemic control, provided incentives and cooperation received from diet and exercise companies and researchers. What role does culture, beliefs and socioeconomic factors, play in their choice of foods and it’s risk factors towards developing type 2 diabetes. Their overall impression of both positive and negative impact of the program.
In addition, to evaluate the staffs participant experience, a meeting was organized in sessions to ensure everyone’s input, also using a separate questionnaire, asking the following questions: How helpful, was the methods and program aids used in the process. Pre and post participation rate, taking into consideration, gender as a factor. Adequacy of project funds, resources and it’s effect on implementation their whole impression, attitude, perception about rating of the EBP choice and project processes.
In evaluating the above implementation methods employed, using above questionnaires, in a survey, patients attitude is expected to increase positively towards health and wellbeing, as reflected in their commitment to their scheduled appointments and care as opposed to their noncompliant attitude before the program. This in turn will encourage a positive staffs attitude, morale and perception of an evidence base practice process.
Further evaluation of patients and staffs perception on cultural influence, adequacy of project , materials and resources, will reveal a positive change in patients cultural beliefs about food types and their effects on glycemic control, compared to previously held beliefs by the Black Americans and Hispanics participants. While the nurses, doctors and dietitians will find, that culture and social economic factors has a huge role to play in the predisposition of minorities to type 2 diabetes.
In conclusion, the overall impression and rating by patients and staffs participant of the process according to evaluation survey, showed that the program will be a success because in addition to already existing evidence that diet and exercise can effectively reduce glycaemia and diabetic complications, as obtained from systemic reviews, interventions used were all appropriate for the process.
Demonstrating strengths that motivated staffs and patients participation to yield the needed evidence and limitations, that will prompt further studies, thereby continuing evidence base practice process. Supporting this is Menix ( 2007) that “evaluating various concepts, models, processes, and research findings provide evidence to design program outcome and best practices” (p. 207).
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References
Fineout-Overholt, E., & Johnston, L. (2007). Evaluation: an essential step to the EBP process. Worldviews On Evidence-Based Nursing, 4(1), 54-59.
Gard C, Flannigan P, Cluskey M. Program evaluation: an ongoing systematic process. Nursing Education Perspectives [serial online]. July 2004;25(4):176-179. Available from: CINAHL Plus with Full Text, Ipswich, MA
Menix K. Evaluation of learning and program effectiveness. Journal Of Continuing Education In Nursing [serial online]. September 2007;38(5):201. Available from: CINAHL Plus with Full Text, Ipswich, MA.
