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Evaluation Frameworks

There are multiple types of evaluations that can be done to assess how effectively a program is improving access to care for rural residents with disabilities. Several frameworks for approaching evaluation of programs are listed below.

  • 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 perceptions of the program. Process evaluation assesses how a program is developed and implemented, and may investigate a program's operations, and structure.
    Example: Was the program implemented as planned? Why or why not?
  • 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. Outcome evaluations investigate whether changes occur in a particular program, and, if they do, the extent to which changes can be attributed to the program.
    Example: Reduction in barriers to care reported by participants
  • Impact Evaluation: Impact evaluations review 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.
    Example: Increased use of preventive care measures by rural residents with disabilities
  • Performance Monitoring: Performance monitoring is on-going 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.
    Example: Ongoing count of rural residents with disabilities accessing care
  • 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.
    Example: Savings from reduced preventable hospital admissions as a result of increased primary care and preventive care access 

Resources to Learn More

ACL Data and Evaluations
Website
Gives information on data and statistics available for information evaluation of disability-related programs. Organizations might use this information to get statistics on the prevalence of disability in their community, and the rate of health insurance among individuals with disabilities.
Organization(s): Administration for Community Living

Evaluating the Effects of Telemedicine on Quality, Access, and Cost
Document
Offers guidelines for evaluating telemedicine programs and their impact on quality, access, and cost of care. This guide includes a list of evaluation questions to consider, including a section on questions and considerations specific to access to care.
Organization(s): Institute of Medicine
Date: 1996

Introduction to Program Evaluation for Public Health Programs: A Self-Study Guide
Tutorial/Training
Provides a self-guided training for how to plan and implement public health evaluation geared toward staff and administrators at community health agencies.
Organization(s): Centers for Disease Control and Prevention
Date: 10/2011

KTDRR Logic Models
Website
Explains how logic models can be used to decide on the most important measures for evaluation purposes.

Participatory and Inclusive Approaches to Disability Program Evaluation
Document
Examines the inclusivity of disability program evaluations and provides recommendations for how to include the voices of individuals with disabilities.
Author(s): Robinson, S., Fisher, K.R., & Strike, R.
Location: Australian Social Work, 67(4), 495-508
Date: 6/2014