'Evaluation Zone' : Developing an evaluation plan
Indicators of Impact/Outcome
Indicators of Impact/Outcome provide a sign of how well you have achieved the changes you were were hoping for as a result of your project. They are about measuring change. In other words they are a measure of the extent to which you have achieved your objectives and your longer term goal. Indicators of impact relate to your objectives, and indicators of outcome relate to your goal.
Usually indicators of impact are much easier to come up with because they are about more immediate changes you are seeking. Whereas measuring outcomes refer to large and long term changes. Goals are often written as broad statements of desired change, such as to decrease social isolation in a region, or reduce the incidence of domestic violence. They can also relate to a change in health status, such as reduced mortality, morbidity, or improved well being.
Health outcome evalution rarely occurs in small primary health care projects, due to the short term funding, complexity and difficulties of attributing project activities with long term outcomes. See below for more on Impact/Outcome evaluation.
Instead most projects focus on evaluting the impact of their project acccording to their objectives.
Examples of Impact/outcome indicators :
To view the impact/outcome indicators on our example of a completed Program Evaluation Plan click on the 'Example Project and Evaluation Plan' in the menu to your left.
For more information about impact/outcome indicators please use the index below which provides and example of a framework for health promotion impact/outcome indicators and some examples.
OF HEALTH IMPACT/OUTCOME INDICATORS
EXAMPLES OF INDICATORS FOR COMMON HEALTH PROMOTION OBJECTIVES
for health promotion outcomes
The red level represent the level at which project impact/outcome evaluation is appropriate. The health promotion outcomes are more immediate and they represent changes to personal, social, and environmental factors. These then influence change in the next level - intermediate health outcomes which represent the determinants of broader health & social outcomes
This can provide a helpful framework for the development of indicators. Nutbeam's article goes on to provide some examples of indicators within this framework. Those impact/outcome indicators related to health promotion projects are as follows:
Health Promotion Outcomes
These reflect changes to those personal, social and environmental factors which are a means to improving people's control, and thereby changing determinants of health (intermediate outcomes). They also represent the more immediate results of HP activities.
Health literacy :
Social influence & action :
Healthy public policy and organisational practice :
Intermediate Health Outcomes
Personal behaviours :
Effective heath services :
Nutbeam suggests that evaluation of health promotion action should consider the following
1. Improved personal health literacy
2. Changes to public policy and organisational practices
3. Changes to social norms and community action that increase people's control (individually or collectively) over the determinants of health.
Improving Social Support :
Extent to which social support network provides better quality, or more · information
(Hawe et al 1990)
Improved Quality of Life :
Participants report as a result of the project/activities, their lives are more · rewarding, enjoyable, productive
(Hawe et al 1990)
Strengthening Community participation :
(Hawe et al 1990)
(Goeppinger et al 1985)
Strengthening partnership with other organisations :
Improved organisational capacity :
Hawe et al (1997) offer the following levels and dimensions of improved capacity building.
1. Health infrastructure or service development - structures, organisation, skills, resources.
2. Program Maintenance and sustainability - capacity to continue to deliver a particular program through a network of agencies, in addition to, or instead of initiating agency.
3. Problem solving capability of organisations and communities. - a more generic capacity to identify health issues, and develop appropriate mechanisms to address them.
Eng & Parker (1994) "Measuring Community Competence in the Mississippi Delta; the interface between program evaluation and empowerment Health Education Quarterly 21)
[Goeppinger J., Baglioni AJ. Community Competence : a positive approach to needs assessment American Journal of American Psychology 1985 13(5) ] ·
Hawe P., Noort M., King L., Jordens C. (1997)"Multiplying Health Gains : the critical role of capacity building within health promotion programs." Health Policy 39
Hawe P., Degeling D., Hall J. (1990) Evaluating Health Promotion: A Healthworker's Guide, MacLennan & Petty, Sydney
Don Nutbeam (1998) "Evaluating Health Promotion-progress, problems and solutions", Health Promotion International Volume 13, No. 1
and Evaluation Wizard
South Australian Community Health Research Unit