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 Step 2: Describe the Program

Since your proposed program or improved intervention is still within the design or implementation phase, it has yet to be marketed to the MCH field as an innovative practice. A robust evaluation demonstrating the effectiveness of the program can help garner interest in the innovation as well as increase uptake of the program by other MCH colleagues across states. Before diving into your evaluation efforts (whether process or outcome-oriented), it is vital to communicate the most salient details of your proposed innovation, specifically the target, need, outcomes, activities, outputs, resouces/inputs and relationship of activities and outcomes.

Each element is listed and described below; the bullets represent ideas for each of these elements from our example, The Parent Child Assistance Program (Washington State), an AMCHP Innovation Station Best Practice and award winner at AMCHP’s 2013 Annual Conference. PCAP (the Parent Child Assistance Program) is a three year advocacy/case management model for women who are at-risk for substance abuse during pregnancy as well as their families.

Program Elements and Examples

Target → Which MCH population domain(s) will be affected/served by your innovation (primary population focus)? Which stakeholders will be instrumental in implementing/sustaining the innovative practice or helping to create the infrastructure for your program to reach your targeted MCH audiences?

  • PCAP touches four MCH population domains: Women, Infants, Children, CYSHCN (Primary)
  • Other social service providers (key stakeholders in PCAP)

Need → What is the primary focus of your innovation for those target populations? What problems are you aiming to alleviate through your innovative practice? (Examples are chronic diseases, access to healthcare and support services, data and assessment, care coordination, birth outcomes, preventive services, screenings, health education/promotion, and disparities).

  • PCAP assists substance‐abusing pregnant and parenting mothers in obtaining alcohol and drug treatment, staying in recovery, and resolving myriad complex problems related to their substance abuse  (Primary Focus)
  • Problems to Alleviate: Access to healthcare and community resources related to ATOD treatment and recovery; prevent the future births of alcohol and drug‐affected children; instable housing; lack of employment or instability in employment status; future incarceration of mothers

Outcomes → What do you anticipate will change (or has changed on a small scale) because of your innovation? Are there specific Title V National Performance Measures (NPMs) that could be affected by your program? Consider the effects not only on your target audiences but also those other key stakeholders you have identified.

  • Programmatic outcomes: alcohol/drug treatment; abstinence from alcohol/drugs; family planning & subsequent birth; health & well‐ being of target child; family connection with services; and stability indicators: education, source of income, employment.
  • Specific Title V NPMs affected (directly or indirectly): NPM #14 →A) Percent of women who smoke during pregnancy and B) Percent of children who live in households where someone smokes; NPM #15 → Percent of children 0 through 17 years who are adequately insured

Activities → What are some of the overarching tasks that need to be carried out by program staff in order to generate changes?

  • Recruitment of paraprofessional case managers that align with desired criteria: successfully overcome difficult personal, family, or community life circumstances similar to those experienced by PCAP clients
  • Identification and recruitment of women to be served by PCAP: substance-abusing pregnant and/or parenting mothers
  • Home visitation by case managers
       Motivational interviewing, goal setting, incremental recognition/ acknowledgement of performance achievement, verbal and         emotional encouragement and continuous engagement, role modeling by case managers
  • Coordination and connection of families to needed services offered by other community providers

Outputs → What specific metrics or products will your activities yield?

  • Number of case managers hired, employed, retained
  • Number of women identified, enrolled, and participating in PCAP
  • Number of home visits by case managers
  • Needs assessments from clients
  • Inventory of personal goals and necessary steps developed by clients
  • Care coordination and referrals to other community providers

Resources/Inputs → What will your program need to conduct and sustain the activities? These resources can include personnel, funding, tools, policies etc. that help ensure your program activities are effectively implemented.

  • Personnel → Director of host agencies, case managers, community providers
  • Funding → main (WA state legislature line item) and other funding partnerships
  • County Site Host Agencies
  • Academic Partners & Institutes from University of Washington system

Relationship of Activities and Outcomes → How do you illustrate the ways your activities will impact or alter specific anticipated outcomes? What is the correlation between the two?

  • PCAP program evaluation is based on a quasi-experimental multiple measure pre-/post-test design
       Results from self-reported client Intake inventory form to Exit inventory form 
               - Assesses their relationship with assigned case manager
  • Rates of treatment and abstinence from ATOD immediately following the program and after follow-up period

Visualizing Your Program: Logic Models an Key Driver Diagrams

You can describe your program components, specifically the relationship between the activities and outcomes, through visual depictions known as logic models or key driver diagrams (which are being used in the MCH field in conjunction with quality improvement). These graphics can be tailored according to your stakeholders, e.g. broad for elected officials, family leaders, advocates, or more detailed, e.g. Title V/program staff, consultants, or partner organization staff.