Select an Evidence Based Program

Section 2.2

Prioritizing Needs

Figure 4.
Generic health needs prioritization matrix
Figure 5.
Example health needs prioritization matrix

After primary and secondary data collection techniques have been used to determine the health needs of your audience, it is time to decide which health need(s) to address with an EBP. Though several approaches can be used to prioritize health needs, the most efficient approach is often to develop a simple matrix that ranks needs based on their importance and changeability (see Figure 4). In the context of this matrix, health needs can take many forms, including health diagnoses (e.g., heart disease, diabetes, cancer), behaviors (e.g., smoking, alcohol use, sedentary lifestyles), and social determinants of health (e.g., environmental pollution, public transportation availability, housing conditions). The importance of health needs can be determined using a number of criteria, such as prevalence (i.e., percent of the population affected), severity, financial impact, and urgency.

The meaning of the term changeability differs slightly based on the need in question. In regards to health diagnoses, changeability refers to the likelihood of reducing rates or mitigating complications of the disease. In regards to behaviors, changeability refers to the likelihood of decreasing or increasing a particular behavior among program participants. In regards to social determinants of health, changeability refers to the likelihood that a program will modify an environmental condition or health policy.

Very important needs that are easily changed should be placed in Quadrant 1. These needs should be your highest priority. Needs that are very important but difficult to change should be placed in Quadrant 2. These needs are of moderate priority. While it may be unwise for your organization to address them, these are needs that should be addressed by program developers through the development of innovative programs and subsequent evaluation studies. Less important needs that can be changed easily should be placed in Quadrant 3. Interventions that address these needs should be implemented if they are low-cost and require minimal effort and resources. Less important needs that are difficult to change should be placed in Quadrant 4. Generally, it is unwise to expend effort and resources on these needs. See Figure 5 for an example of a completed matrix.

The importance and changeability of a health need varies depending on the nature of an organization and the audience for which a program will be implemented. For example, Sudden Infant Death Syndrome awareness and prevention are important health needs among parents of infants, but not among older adults. Likewise, osteoarthritis is an important health need among older adults, but is less important among teenage athletes. A senior center may determine that lack of access to transportation to medical visits is a less changeable need, while a transportation agency may determine this is an easily changeable need. Similarly, providing convenient and low-cost flu vaccines may be feasible for a community clinic, but not for a church group. These examples illustrate how each and every prioritization matrix may be unique.

Glossary of Terms

Toolkit Glossary

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Adaptation– Making changes to an evidence-based program in order to make it more suitable for a particular organization and/or audience.

Baseline – A starting point. In evidence-based programming, the term “baseline” is usually used in the context of data collection, where baseline data is data collected before a program is implemented.

Credentials – A testimony of qualification, competence, or authority issued to an individual by a third party. Examples of credentials include academic diplomas, academic degrees (e.g., MSW, MPH, PhD), licenses (e.g., MD, RN, LCSW), certifications (e.g., CHES, CPR, first aid), and security clearances.

Evidence – Facts or testimony in support of a conclusion, statement, or belief. In some settings, individuals may refer to “levels of evidence” or “types of evidence.” These terms will have specific definitions unique to the setting in which they are used. When referring to evidence-based programs, the term “evidence” is generally used to describe the findings or results of program evaluation studies.

Evidence-based program – A program that has been thoroughly evaluated by researchers who determined it produces positive outcomes.

Fidelity – The extent to which a program is being implemented as its developers intended for it to be.

Implementation – Putting into action or carrying out a program.

Instrument – A measurement tool. Instruments can take many forms including biomedical equipment (e.g., glucometer, blood pressure monitor, weight scale), pencil and paper tests, questionnaires, and interviews. A thermometer is an instrument used to measure body temperature. Likewise, a survey is an instrument that can be used to measure anxiety.

Medicaid – A publically-funded health insurance program for individuals who have low incomes and fall into certain categories of eligibility.

Objectives – Specific, measurable steps that can be taken to achieve goals.

Peer review – When experts review a professional’s performance, research, or writings. Peer review is a way that qualified professionals self-regulate their professions. Performance, research, or writings that pass the peer review process have increased credibility or trustworthiness.

Program champion – An individual who advocates for a program.

Quality assurance- A collection of planned, systematic activities applied to ensure that the components of a program are being implemented well.

Secondary data – Previously collected data that is being used for a purpose other than that for which it was originally collected.

Theory of behavior change – An attempt to explain how and why people change their behaviors. Researchers typically generate theories of behavior change from research in the fields of psychology, education, health, and other social sciences. When developing evidence-based programs, researchers will select a theory or components from several theories to guide program development.

Audience – The individuals for whom you implement your program. Depending on your setting, these individuals may also be referred to as a target population, population of interest, or clientele.

Buy-in – Typically used in the business world, buy-in refers to a financial exchange. In the context of health programs, the buy-in of stakeholders (community members, organizational leaders, participants, etc.) is generally non-financial. It involves their acceptance of a concept, idea, or proposal.

Data – A collection of facts, such as measurements and statistics.

Evidence-based practice – When clinicians (e.g., doctors, nurses) base their healthcare treatment decisions on the findings of current research, their clinical expertise, and the values/preferences of their patients.

Evidence-informed practice or program – A practice or program that is guided by theories and preliminary research. While there is some indication that these practices and programs produce positive outcomes, the evidence is too weak to refer to them as evidence-based. These are sometimes referred to as “promising” or “emerging” practices and programs.

Goals – General, non-measurable intentions or outcomes.

Incentives for participation – Factors that motivate an individual to take part in a program. Organizations sometimes provide incentives to encourage participants to begin and/or remain enrolled in a program. Common incentives include gift cards and program t-shirts.

Intervention – Organized efforts to promote health and prevent disease. This term is used because the efforts intervene, or come between, an individual and a negative health outcome in an attempt to prevent or delay the negative outcome. “Intervention” and “program” are often used interchangeably.

Interventionist – An individual who implements or carries out the components of a program.

Lay leaders – Individuals who do not have formal healthcare credentials who are trained to lead evidence-based programs.

Medicare – A publically-funded health insurance program for adults over age 65 and individuals with certain disabilities or health conditions.

Partnership – A cooperative relationship between two or more organizations that collaborate to achieve a common goal through the effective use of knowledge, personnel, and other resources.

Primary data – Original or new data being collected for a specific research goal.

Protocols - Predefined procedural methods. Examples include detailed program implementation procedures, required equipment, required data collection instruments with detailed instructions for administration, and recommended safety precautions.

Readiness – The degree to which an organization is prepared or ready for something.

Stakeholder – Any individual or group that has a stake or interest in a program.

Translation – The process of taking a program originally implemented in a controlled, laboratory-like setting and making it suitable for implementation in the community.

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