Rural programs often collect data to track how well the program is working and to demonstrate any changes as a result of the program. This data may include baseline data such as characteristics of the population before the program is implemented, data collected at certain intervals during the program, and data collected at the conclusion of a program.
For example, a program aiming to reduce barriers to care for rural residents with disabilities might survey the target population about perceived barriers before implementing the program, then survey them again during the program implementation and at the conclusion of the program to see if barriers to care have been reduced. Such data are crucial to evaluating a program's success.
It is important to consider how data collected will be used in program evaluation to measure changes. Because the goal of an evaluation is to demonstrate change as a result of the program, data should be collected over time. There are different kinds of changes that can be tracked, including:
Affective change: Change in attitudes or feelings toward specific behavior.
Example: Feeling more included in clinical settings and care decisions.
Behavior change: Adoption of new behaviors.
Example: Adopting preventive care behaviors due to improved access to services.
Learning change: New knowledge and awareness is acquired.
Example: Increased knowledge about self-management behaviors as a result of access to care.
Environmental conditions: Reduced barriers to accessing healthcare.
Example: Transportation or clinic interior and exterior accessibility.
Status change: Improved health outcomes or indicators.
Example: Improvement in health status as a result of improved access to care.
When identifying evaluation measures for programs designed to improve access to care for rural residents with disabilities, 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 to evaluate public health programs include:
Information on programs and potential participants, such as:
- Rate and prevalence of disability in a community
- Potential participants' age, gender, socio-economic status, language spoken
- Potential participants' baseline use of health services and access to transportation
- Documented and perceived barriers to care for rural residents with disabilities at baseline
- Number and type of programs in the area providing telehealth, home health, care coordination, or accessible transportation services
- Program resources (financial and staff) devoted to improving access to care for individuals with disabilities
- Program payer mix and funding sources
Program process measures, such as:
- Number of rural residents with disabilities who are served or impacted by the program
- Number of practices that participate in the program to improve access to care
- Number of new patients with disabilities seen by a healthcare provider
- Number of individuals with disabilities who 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 how many 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
Outcome/impact measures, such as:
- Increase in health services use by rural residents with disabilities
- Change in health status among rural residents with disabilities
- Increase in physically-accessible transportation options and clinic spaces
- Increase in provision of telehealth, care coordination, and home health
- Change in provider knowledge about the unique needs and concerns of individuals with disabilities accessing care
- Presence of a sustainability plan to maintain improved access to care
- Policies and funding to support the program going forward
Resources to Learn More
Community Health Assessment for
Population Health Improvement: Resources of Most Frequently Recommended Health Outcomes and Determinants
Identifies appropriate measures to use when evaluating a population-based health intervention in order to assess its effectiveness.
Organization(s): Centers for Disease Control and Prevention
Educators' Guide to
Service-Learning Program Evaluation Guide
Provides guidance on how to conduct a program evaluation, including information on types of evaluation measures.
Organization(s): RMC Research Corporation
Research Library: Evaluation
Ongoing list of variety of fact sheets and presentations with information about how best to conduct program evaluation.
Organization(s): Amherst H. Wilder Foundation