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Measures for Evaluating Diabetes Programs

Rural health diabetes programs must collect data to document changes and evaluate effectiveness. An effective evaluation tracks changes over time by collecting measures at the beginning of the program and comparing them to measures collected after program implementation.

Diabetes programs often use clinical performance measures (such as changes in body mass index (BMI), A1Cs, and blood pressure) for evaluation. Exercise caution when developing program evaluation strategies and place a greater emphasis on the intermediate outcome measures than on program process measures.

Diabetes programming can include multiple focus areas. The following factors should be kept in mind when designing an evaluation to ensure the anticipated change is being measured, in addition to identifying potential opportunities to improve the program 

  • Affective change: Change in attitudes or feelings toward specific behavior.
    Self-efficacy, beliefs about the impact of personal choice in diabetes control, and improved quality of life
  • Behavior change: Adoption of new behaviors.
    Self-management, increased family awareness/support of self-management efforts
  • Learning change: New knowledge and awareness is acquired.
    Health literacy level, diabetes knowledge, skills for effective self-management, feedback to providers
  • Environmental conditions: Reduced barriers to healthier choices and lifestyles.
    Access to care, improved culture of health for community, assessment and referral of diabetics with psychological issues that can interfere with effective self-management
  • Status change: Improved health outcomes or indicators.
    Average blood glucose measures, improved A1C measures, changes in weight/BMI, improved stamina from increased exercise

When identifying evaluation measures for community diabetes programs, it is important to consider the program's focus, the needs of the audience or funders, and the time frame and training available for meeting program goals. Common measures used in health promotion and disease prevention programs include:

Participant data

  • Demographic data: Age, gender, race/ethnicity, educational attainment income, and primary language spoken.
  • Biological markers: Height, weight, body mass index (BMI), blood pressure, cholesterol, skin circumference, and A1Cs.
  • Health status: Disease, injury, stress, disability, risk factors, and perceived health status.
  • Medical history: Medication use, doctor's visits, and hospitalizations.
  • Knowledge: Health concerns, perceived risk, and feedback on program implementation.

Program process measures

  • Number of patients enrolled in program
  • Number of participants who complete the program
  • Number of participants participating in screenings or risk assessment
  • Number of participants participating in health education or skill activities development
  • Number of participants that receive and follow up with referrals
  • Number and types of educational materials produced for the program
  • Number of key stakeholders involved in the program
  • Number of people aware of program messaging and intend to take action
  • Number of policies developed
  • Types of program activities and settings
  • Number and characteristics of staff offering the program
  • Extent to which activities are implemented according to the program plan
  • Types of resources and contributions provided by stakeholder groups
  • Cost to complete program-related activities

Participant/community outcome measures can assess:

  • Perceived health status
  • Biometric markers
  • Healthy behaviors
  • Prevalence of risk factors or disease
  • Healthcare costs
  • Policies
  • Environmental conditions
  • Knowledge and skills

Resources to Learn More

Diabetes HbA1c {Poor Control}
Hemoglobin A1C (HbA1C) is a clinical quality measure that can be used in program evaluations as a performance measurement. This module provides more detail on the HbA1C and its relevance to diabetes and diabetes management.
Organization(s): Health Resources and Services Administration
Date: 6/2012