Home Health Evaluation of health promotion and disease prevention programs : improving population health through evidence-based practice
Social Networks and Interpersonal Violence Outcome Results
The average social network size of 6.48 at baseline was significantly increased by a mean of 2.34 (p = .002) at the end of the intervention with no significant subsequent change at the 10-week follow-up (p = .470). Results of a repeated measures ANOVA and post hoc analyses showed the number of instances of interpersonal violence significantly decreased during and after the FDP, F(1.21, 19.42) = 7.84, p = .008. A description of the outcome results is presented in the article.
Process Evaluation Results
Facilitator feedback documented the number of individuals exposed to the core measures and intervention program procedures. The PEM was used to monitor the delivery of the 20 FDP sessions and the administration of the pre-test-post-test outcome measures. The PEM examined a total of 23 FDP Procedures. As shown in Table 5.16, in Column A, 31 individuals participated in the FDP. An Exposure Rate (C) was calculated by dividing the number of participants exposed to each procedure (B) by the number eligible of participants (A). The Implementation Index (E) for each procedure was calculated by dividing the Exposure Rate (C) by the Performance Standard (D) established prior to program implementation. A Performance Standard (D) of 100% was set for Procedure 1, baseline outcome measures (P1).
Given the reality of program delivery and follow-up in community settings where attrition is typically observed, a Performance Standard of 95% exposure was set for Procedures 2 to 23 (P2... P23). The overall PII was 0.98 (greater than the recommended rate PII > 0.90). The PII provided specific evidence that direct service personnel can be trained to use the FDP and can deliver it to a group of adults with developmental disabilities. Participants continued to engage at high rates in the program over a 10-week period. While most programs delivered over an extended period of time tend to see participation rates decrease, this was not observed by the FDP.
This evaluation confirmed that an abuse-prevention program for adults with developmental disabilities can be successfully delivered to them by facilitators at community service agencies with minimal training. The FDP Implementation Index (PII = 0.98) documented that the intervention was delivered with a very high degree of fidelity to our planning model; participants of the program attended all 20 sessions. A Comprehensiveness Program Implementation Index (PII = 0.96), not presented in this case study, confirmed that facilitators were able to deliver the FDP content as intended, as it is significantly greater than the recommended PII > 0.90. The comprehensiveness results show that the facilitators followed the FDP Manual to deliver the program with fidelity.
The process and outcome evaluation results from the FDP Formative Evaluation were encouraging. While some variation in Implementation Indexes existed, the results from the FDP PEM were similar across the five sites. Clients engaged in the FDP at high rates at all locations, and all of the facilitators were able to deliver FDP content. These results help to document the acceptability of the program by the participants and how well facilitators delivered the content. They represent empirical building
Program Implementation Index (PII)= (EE)/Pn = 22.62/23 = 0.98
blocks for future research to conduct an efficacy evaluation with a much larger number of sites and participants using an experimental design. The results and insight from a well-planned efficacy evaluation that builds on the literature would provide the type and quality of evidence needed to begin to define the feasibility, impact, and cost of tailored programs such as the FDP for people with developmental disabilities. This study illustrated how process evaluations can be applied to programs for people with developmental disabilities.
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