Evolution of a multilevel framework for health program evaluation
Evolution of a multilevel framework for health program evaluation
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DOI：
10.1071/ah15117
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发表时间：
2017-01-01
影响因子：
1.8
通讯作者：
Fildes, Dave
中科院分区：
文献类型：
--
作者：
Masso, Malcolm;Quinsey, Karen;Fildes, Dave
一个构思良好的评估框架增加了对方案目标和目的的理解，有助于确定成果，并可在方案制定期间用作规划工具。在这里，我们描述的起源和发展的评价框架，认识到，执行是由它发生的设置，所涉及的个人和执行完成的过程的影响。该框架包括一个评价层次，重点是消费者、提供者和护理提供系统的成果，并根据六个领域进行结构化：方案交付、影响、可持续性、能力建设、普遍性和传播。评价框架的这些组成部分符合一个矩阵结构，矩阵内的单元由相关的评价工具支持。该框架的制定受到了各利益攸关方的反馈、评价人员的现有知识以及关于健康促进和实施科学的文献的影响。多年来，该框架已经成熟，通用性足以适用于各种各样的情况，但又足够具体，侧重于数据收集、数据分析和结果的介绍。医疗保健评估通常调查在不受控制的真实的世界环境中实施复杂的创新。这给评价人员和那些想委托进行评价的人带来了许多挑战。在这里，我们描述了一个评估框架的起源和发展，该框架分为三个层次和六个领域。该框架经受住了时间的考验，并被用来评估在提供健康和老年护理方面的各种创新。该框架的新方面包括水平、能力建设和可持续性等概念，对从业人员有何影响？评价框架的结构简单，但很全面，适合在广泛的环境中使用。该框架还可用于评估和规划卫生服务创新的实施。
A well-conceived evaluation framework increases understanding of a program's goals and objectives, facilitates the identification of outcomes and can be used as a planning tool during program development. Herein we describe the origins and development of an evaluation framework that recognises that implementation is influenced by the setting in which it takes place, the individuals involved and the processes by which implementation is accomplished. The framework includes an evaluation hierarchy that focuses on outcomes for consumers, providers and the care delivery system, and is structured according to six domains: program delivery, impact, sustainability, capacity building, generalisability and dissemination. These components of the evaluation framework fit into a matrix structure, and cells within the matrix are supported by relevant evaluation tools. The development of the framework has been influenced by feedback from various stakeholders, existing knowledge of the evaluators and the literature on health promotion and implementation science. Over the years, the framework has matured and is generic enough to be useful in a wide variety of circumstances, yet specific enough to focus data collection, data analysis and the presentation of findings.What is known about the topic? Evaluation in healthcare typically investigates the implementation of complex innovations in uncontrolled real world' settings. This presents many challenges for evaluators and those wanting to commission evaluations.What does this paper add? Herein we describe the origins and development of an evaluation framework that is structured in terms of three levels and six domains. The framework has stood the test of time and been used to evaluate a variety of innovations in the delivery of health and aged care. Novel aspects of the framework include the concepts of levels, capacity building and sustainability.What are the implications for practitioners? The structure of the evaluation framework is simple, yet comprehensive, and is suitable for use in a wide range of settings. The framework can also be used to both evaluate and plan the implementation of innovations in health service delivery.