Knowing What Works Evaluation For Public Health 2019

Knowing What Works Evaluation For Public Health 2019assessment Inte

Develop a detailed evaluation plan for a practice nurse-led lifestyle program targeting weight loss in primary care settings in the City of Playford, South Australia. The plan should use an integrated approach, combining mixed methods and including economic evaluation. The evaluation should assess the program’s effectiveness in supporting at least 5% weight loss over two years among adults with BMI ≥30, and measure outcomes beyond weight (e.g., blood glucose, blood pressure). The plan must describe the program, stakeholder engagement, evaluation questions, design, data collection, analysis, and dissemination strategies, following structured steps for evaluation planning.

Paper For Above instruction

The rising prevalence of obesity among Australian adults poses a significant public health challenge, contributing to increased morbidity, mortality, and substantial economic costs. Addressing this epidemic requires effective interventions, and primary care settings are critical leverage points for implementing sustainable weight management programs. This paper outlines a comprehensive evaluation plan for a nurse-led lifestyle program aimed at supporting weight loss among adults in the City of Playford, South Australia. The evaluation approach integrates mixed methods and health economic analysis, aligned with best practices in public health program evaluation.

Program Description

The program is designed to facilitate sustained weight loss of at least 5% over two years, targeting adults aged 18-75 with a BMI ≥30 attending two local general practices: GP Plus Health Care Centre Elizabeth and Unihealth Playford GP Super Clinic. The intervention incorporates six fortnightly behavioral sessions involving education on healthy eating, physical activity, alcohol management, and emotion regulation, coupled with three follow-up sessions at 6, 9, and 12 months. Trained practice nurses, mentored by dietitians, deliver the program empathetically, employing behavioral strategies such as self-monitoring, goal-setting, and lapse management. The overarching goal is to reduce weight-related health risks and associated healthcare burdens.

Evaluation Preview

The evaluation aims to determine whether the program achieves its objectives and elucidates the pathways of impact. Stakeholder engagement includes practice nurses, patients, dietitians, healthcare administrators, and policymakers. Key evaluation questions focus on process fidelity, participant outcomes, and economic costs and benefits. The purpose is to inform decision-makers about the program's scalability, sustainability, and cost-effectiveness, guiding resource allocation and policy. The evaluation adopts a participatory approach, incorporating qualitative insights into participant experiences and quantitative measures of clinical outcomes.

Evaluation Design

1. Evaluation Planning Process Grid

The evaluation process grid maps objectives to key questions, data needs, collection methods, responsible personnel, and timing. For example:

  • Objective 1: Increase in physical activity levels — Key question: Did participants increase physical activity? Data: Self-reported activity logs, accelerometry. Collection: Surveys and device data at baseline, mid-point, and follow-up. Responsible: Research assistants. Timing: Baseline, 6 months, 12 months.
  • Objective 2: Achieve ≥5% weight loss — Key question: What proportion of participants reach targeted weight loss? Data: Body weight measurements, BMI calculations. Collection: Clinical assessments during scheduled visits. Responsible: Practice nurses. Timing: Baseline, 12, 24 months.

2. Health Economic Evaluation

The economic analysis adopts a societal perspective over a two-year horizon, assessing costs and health outcomes associated with the intervention. Costs include program delivery, participant time, and healthcare resource utilization. Benefits encompass averted costs due to prevented comorbidities (e.g., diabetes, hypertension), improvements in quality-adjusted life years (QALYs), and productivity gains. The model will employ a decision-analytic framework, incorporating sensitivity analyses to address uncertainty and scenario variations.

Data Collection Methods and Sample Questions

Data will be collected through structured questionnaires, clinical assessments, and administrative data extraction. Sample survey questions include:

  • "On average, how many days per week did you engage in 30 minutes or more of moderate physical activity in the past month?"
  • "What barriers did you encounter in maintaining your dietary changes?"

Clinical data will include blood pressure, HbA1c, lipid profiles, waist circumference, and weight. Recruitment will be via practice registries, with participant consent secured during routine visits.

Data Analysis and Integration

Quantitative data will be analyzed using longitudinal statistical models to assess changes over time, adjusting for confounders. Qualitative data from interviews and focus groups will be thematically analyzed to contextualize quantitative findings. The integration of methods will follow a convergent design, comparing qualitative insights with quantitative outcomes to provide a comprehensive evaluation of program impact, fidelity, and acceptability.

Dissemination of Lessons Learned

Findings will be disseminated via detailed reports to stakeholders, policy briefs for health authorities, peer-reviewed publications, and presentations at conferences. Tailored summaries will address clinicians, policymakers, and patient advocacy groups to facilitate knowledge translation and inform future program scaling and policy development.

Conclusion

This evaluation plan offers a structured, stakeholder-engaged, and methodologically rigorous approach to assess the effectiveness and value of the nurse-led weight management program. By integrating mixed methods and economic evaluation, it aims to generate actionable insights that can optimize resource utilization and improve health outcomes in Australian primary care settings.

References

  • Australian Institute of Health and Welfare. (2014). Australia's Health 2014. AIHW.
  • 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(7341), 819–823.
  • Medibank. (2010). Obesity in Australia: financial impacts & cost benefits of intervention. Medibank.
  • NHMRC. (2013). Evidence on the effectiveness of behavioural interventions for obesity. National Health and Medical Research Council.
  • Round, J., et al. (2005). Six Steps for Evaluation Planning. Victorian Department of Health and Human Services.
  • 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).
  • Stevens, J., Truesdale, KP., McClain, JE., et al. (2006). The definition of weight maintenance. International Journal of Obesity, 30(3), 391-399.
  • Britt, H., et al. (2013). General practice activity in Australia 2012–13. Sydney University Press.
  • City of Playford. (2019). Community health initiatives. City of Playford.
  • Australian Government Department of Health. (2018). National Strategic Framework for Chronic Conditions.

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