NURS 6720 – Population-Based Public Health Nursing Interventions

 NURS 6720 – Population-Based Public Health Nursing Interventions

WEEK 2 : Community Agency Assessment: Information Gathering

The questions as to whether community policing complement or compete with traditional policing has been posed within security organs since the inception of community policing initiatives. The fundamental reasons behind this concern are not particularly hard to point out.NURS 6720 – Population-Based Public Health Nursing Interventions

Efforts in protection of life and property from internal and external threats demands more than entrenchment of overlapping principles among the various policing initiatives and approaches. In fact, the aftermath of the September 11 terrorist attacks have generated intense desire to develop and enforce proactive policing approaches.

Community policing and Traditional Policing

Despite having come under intense criticisms concerning its principles, mechanisms, and value, a number of indicators as provided in literature’s seem point out that community policing complement traditional policing.

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According to Friedman n (1992), “the principles of community policing have traditionally emphasized the dimensions of proactive policing, problem-solving, and community partnerships and cooperation.” However, the underlying fact is that both community policing and traditional policing share fundamental elements in efforts to deter and prevent crime. This is because they have overlapping concepts.

Each of the crime deterrence and preventive approaches emphasizes the critical role of information gathering. According to Friedman n (1992), “traditional security policies purport increased and enhanced intelligence gathering and analytical capabilities and community policing encourages the identification and analysis of information pertaining to future delinquent behavior.”

In adopting information and intelligence gathering in crime prevention, each adopts proactive approach in crime prevention and management. This means that each values the important ingredient of information gathering as a key construct in creating safe communities.

Furthermore, both community and traditional policing take cognizance of the value of cooperation and information sharing. Whitaker (1980) asserts, “in direct connection with information gathering, each strategy believes effective collaboration will enhance terrorism or crime-related intelligence collection, while also generating improvements within the community itself.”

The attainment of high levels of accuracy in data makes use of flexibility, social capital, trust, and numerous lines of information. In fact, the success of security agencies’ capacity to deter and prevent crime revolves around the close relations and overlapping concepts between community and traditional policing.

The next reason behind the fact that community policing complements traditional policing is that both recognize the need to develop well-structured relationships. “Both policing approaches take keen interests in cooperation that are compatible with standard police practices” (Flynt, & Olin, 2003).

Despite the fact that community policing seems to depart from some traditional approaches in policing such as reactive approaches to crime prevention and management, the fundamental roots in achieving the desired objectives seem to point out that both approaches complement each other, especially in the prevention of new security concerns such as terrorism.

Conclusion

From the above discussions, it is discerned that community policing complements traditional policing and forms the viable path to crime prevention and deterrence. However, this does not mean that it does not compete with traditional policing approaches.

Critics of community policing argue that the effective implementation of community policing demands significant modifications and restructuring of police departments. The underlying fact is that its principles, values and mechanisms all point out the fact that it complements traditional policing approaches.

WEEK 3 : Population Health Nursing in Action

The questions as to whether community policing complement or compete with traditional policing has been posed within security organs since the inception of community policing initiatives. The fundamental reasons behind this concern are not particularly hard to point out.

Efforts in protection of life and property from internal and external threats demands more than entrenchment of overlapping principles among the various policing initiatives and approaches. In fact, the aftermath of the September 11 terrorist attacks have generated intense desire to develop and enforce proactive policing approaches.NURS 6720 – Population-Based Public Health Nursing Interventions

Community policing and Traditional Policing

Despite having come under intense criticisms concerning its principles, mechanisms, and value, a number of indicators as provided in literatures seem point out that community policing complement traditional policing.

According to Friedmann (1992), “the principles of community policing have traditionally emphasized the dimensions of proactive policing, problem-solving, and community partnerships and cooperation.” However, the underlying fact is that both community policing and traditional policing share fundamental elements in efforts to deter and prevent crime. This is because they have overlapping concepts.

Each of the crime deterrence and preventive approaches emphasizes the critical role of information gathering. According to Friedmann (1992), “traditional security policies purport increased and enhanced intelligence gathering and analytical capabilities and community policing encourages the identification and analysis of information pertaining to future delinquent behavior.”

In adopting information and intelligence gathering in crime prevention, each adopts proactive approach in crime prevention and management. This means that each values the important ingredient of information gathering as a key construct in creating safe communities.

Furthermore, both community and traditional policing take cognizance of the value of cooperation and information sharing. Whitaker (1980) asserts, “in direct connection with information gathering, each strategy believes effective collaboration will enhance terrorism or crime-related intelligence collection, while also generating improvements within the community itself.”

The attainment of high levels of accuracy in data makes use of flexibility, social capital, trust, and numerous lines of information. In fact, the success of security agencies’ capacity to deter and prevent crime revolves around the close relations and overlapping concepts between community and traditional policing.

The next reason behind the fact that community policing complements traditional policing is that both recognize the need to develop well-structured relationships. “Both policing approaches take keen interests in cooperation that are compatible with standard police practices” (Flynt, & Olin, 2003).

Despite the fact that community policing seems to depart from some traditional approaches in policing such as reactive approaches to crime prevention and management, the fundamental roots in achieving the desired objectives seem to point out that both approaches complement each other, especially in the prevention of new security concerns such as terrorism.

Conclusion

From the above discussions, it is discerned that community policing complements traditional policing and forms the viable path to crime prevention and deterrence. However, this does not mean that it does not compete with traditional policing approaches.

Critics of community policing argue that the effective implementation of community policing demands significant modifications and restructuring of police departments. The underlying fact is that its principles, values and mechanisms all point out the fact that it complements traditional policing approaches.NURS 6720 – Population-Based Public Health Nursing Interventions

WEEK 4 :Planning a Public Health Program

Armed with the identification of a health issue – African American infant mortality – and strengthened by the community partnerships that she had formed, the PHN in our case scenario moved forward with her key stakeholders in the next phase of the nursing process: Planning. While the long-term goal of this program was to decrease infant mortality rates in Hamilton County, OH, the PHN recognized that the longest journey begins with the first step: setting smaller, more realistic, and achievable intermediate and short-term goals. For example, reviewing the current public health literature revealed an evidence-based strategy. Community health fairs could be used to promote the health of a community through dissemination of information and building bridges between residents and the health care community.

The process for planning a public health program begins with the big picture – the health issue or problem that you have identified. It is an analysis of the big picture issue that provides the framework for developing the plan – from the long-term goal down to intermediate and short-term goals, and then to more specific objectives and strategies that support achievement at each level. Traditionally, long term goals are those that take more than a year to realize. They are very broad and reflect significant outcomes at the population level. Intermediate goals are those that typically are capable of being achieved in three to six months. Finally, short term goals are those that can be achieved more easily in less than three months. These goals reflect the more immediate impact of a health promotion program.

This week, you will start to develop your course project, focusing on details associated with your selected issue of interest and starting the development of your logic model to use as a tool to develop the public health program plan.

Learning Objectives

Students will:

• Analyze health issues that can be addressed through public health programs
• Analyze populations impacted by health issues
• Create logic models*
• Develop short, medium, and long-term outcomes for intervention plans*
• Create practicum project goals
• Justify practicum projects
• Define methods for implementing practicum projects
• Develop practicum project evaluation plans

*The Assignments related to these Learning Objectives are introduced this week and submitted in Week 5.

Discussion: Planning a Public Health Program

As described in this week’s introduction, the planning of a program starts at the highest level- the topic or issue. The early weeks of this course have provided the opportunity to choose a health issue to carry through the steps of the public health program planning process. For this Discussion, you will share a summary of the topic/issue you plan to focus on and the population(s) impacted.

To Prepare:

• Review this week’s Learning Resources.
• Review the handout “Planning a Public Health Intervention”
• Consider your initial thoughts on a public health program you would want to initiate based on health issues you have discussed with your agency Preceptor.
• Review the literature and relevant websites describing different aspects of the issue.

By Day 3

Post a summary of the health issue of interest that you will target through the program you plan. In addition, post a description of the population impacted by this health issue – include incidence and prevalence rates, geographic and demographic distribution, etc.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days by providing feedback to colleagues with an insight or suggestion based on your agency experience.

WEEK 9 : Program Evaluation Design

Outcomes-based evaluation involves systematically gathering and analyzing data to assess program outcomes, benefits or changes and their effectiveness in meeting objectives. Outcome-based evaluation is ideal for short-term, intermediate term and long-term evaluations. Outcome-based evaluation measures how and whether a program has affected people’s lives.NURS 6720 – Population-Based Public Health Nursing Interventions

Outcome-based evaluation has certain basic components, which include inputs, activities/processes, outputs and outcomes. Inputs consist of resources used to implement a program. Program activities or processes include initiatives taken to meet the objectives.

Outputs reflect units of service provided, such as the number of people served to meet program objectives. Outcome-based evaluation also focuses on outcomes to show actual results, benefits, change or impacts. Outcome targets depict outcome goals desired from the implemented program while outcome indicators are observable and measurable achievements toward the target.

Indicators show any progress made so far. Before conducting an outcome-based evaluation, it is necessary to conduct pilot tests with one or two programs to improve the instrument.

Outcome-based evaluation has specific steps required to accomplish a program evaluation. Sridharan and Nakaima (2010) have identified ten steps to show the need for integrating theory-driven evaluation and other methods of evaluation, as well as to improve evaluation designs and methods.

Program Evaluation

The first step involves identification of primary outcomes intended for examination. It is imperative to identify the program mission and intended impacts. It helps to avoid justification of unnecessary activities. The second step requires the evaluator to choose the most important outcomes for evaluation, and they should be prioritized based on time and other available resources.

The third step requires the evaluator to identify observable measures or indicators for every outcome. This is the most important stage in outcome-based evaluation. The fourth step involves defining target goals of the evaluation. This should reflect the potential number of participants needed to achieve specific outcomes.

In the fifth step, the program evaluator must identify information required to demonstrate indicators, for instance, the number of participants in a given program. The sixth step involves identification of methods for collecting required information efficiently and realistically.

The approaches may include observation, documentation review, focus groups, interviews, questionnaires and case studies among others. Finally, outcome-based evaluation requires the evaluator to analyze and report the findings.NURS 6720 – Population-Based Public Health Nursing Interventions

Strengths and Limitations

Outcome-based evaluation is the most common method of identifying success of a program. It focuses on the results of the intended objectives. This method is robust because it can evaluate a program on short-term, intermediate and long-term basis. It identifies clear program outcomes at the initial stages with the aim of constructing ways of obtaining results.

Integrity

Outcome-based evaluation is robust and supported with scientific principles used in designing research methods. Although it is not a formal research method, evaluators can achieve high-levels of integrity with outcome-based evaluation by ensuring that study instruments are valid and reliable.

Reliability and validity

Outcome-based evaluation could achieve high standards of reliability and validity if the instruments are reliable and valid. However, if the evaluator fails to ensure reliability and validity of the instrument, then the method may lack effectiveness. Low response rates, design method and collection of detailed data could be significant sources of weaknesses.

Overall, the strength of outcome-based evaluation is in ownership. It is a tool designed by an organization to serve its management processes and projects, and therefore there is a great deal of ownership over the process, which enhances how findings will be utilized to fulfill different purposes.

There are different designs that can be used to evaluate programs. Given that each program is unique, it is important to choose an evaluation that aligns with:

• Program goals
• Evaluation research questions
• Purpose of the evaluation
• Available resources

Your evaluation should be designed to answer the identified evaluation research questions.

To evaluate the effect that a program has on participants’ health outcomes, behaviors, and knowledge, there are three different potential designs:

• Experimental design: Used to determine if a program or intervention is more effective than the current process. Involves randomly assigning participants to a treatment or control group. This type of design is often considered to be the gold standard against which other research designs are judged, as it offers a powerful technique for evaluating cause and effect. Fully experimental designs are unusual in evaluation research for rural community health programs, but may be feasible.
• Quasi-experimental design: Does not have a random assignment component, but may involve comparing a treatment group to a similar group that is not participating in the program. Quasi-experimental methods are used to estimate the effect of a treatment, policy, or intervention when controlled experiments are not feasible.
• Non-experimental design: Does not involve a comparison group. Non-experimental designs may include pre- and post-intervention studies with no control or comparison group, case study approaches, and post-intervention-only approaches, among others. The key feature of a non-experimental design is the lack of a control group. While non-experimental evaluation studies are likely to produce actionable findings regarding program outcomes, best practices, and performance improvement, they cannot control for extraneous factors that could influence outcomes, such as community contextual factors or selection bias. NURS 6720 – Population-Based Public Health Nursing Interventions

Other frameworks that have been used to evaluate rural initiatives or programs include:

• Process Evaluation: Process evaluation is a systematic, focused plan for collecting data to determine whether the program model is implemented as originally intended and, if not, how operations differ from those initially planned. It seeks to answer the question, “What services are actually being delivered and to whom?” This framework also gathers information on stakeholders’ perceptions of the program.
• Outcome Evaluation: Outcome evaluation examines how well a project achieved the outcomes it set at the beginning. It is generally a summative evaluation of the program which can be used to make recommendations for future program improvements.
• Impact Evaluation: Impact evaluation reviews the effect that a program had on participants and stakeholders of the project. It measures the outcomes, but also the changes that resulted from those outcomes.
• Performance Monitoring: Performance monitoring is ongoing evaluation of the program to have data at the baseline and at key milestones in the work plan. This provides continuous, real-time feedback on program progress so that changes to the program can be made to better align with the program objectives and goals.
• Cost-benefit Evaluation: Cost-benefit evaluations study the cost-effectiveness of the program by reviewing the relationship between the project costs and the outcomes (or benefits) from the program. Data collected is used to determine whether the program outcomes were worth the investment in program development and operation.