Identify at least one professional journal in which you could publish the results of your program design and evaluation, and describe at least one other venue that could provide a valuable forum for disseminating results

Screening for Disease

Although many individuals and organizations may endorse the goal of screening programs, the details and implementation are often controversial. For some types of screening, it can be quite challenging to weigh the human and economic costs and benefits and determine a clear recommendation. For instance, in an article in the New England Journal of Medicine, Dr. Michael Barry (2009) indicates that “serial PSA [prostate-specific–antigen] screening has at best a modest effect on prostate-cancer mortality during the first decade of follow-up. This benefit comes at the cost of substantial over-diagnosis and overtreatment. It is important to remember that the key question is not whether PSA screening is effective but whether it does more good than harm.”
This week’s Learning Resources include articles about screening programs for four different diseases that contain potentially controversial recommendations. For this Discussion, you will select a disease and examine the epidemiological evidence to assess a recommendation for screening guidelines. In addition, you will consider possibilities for furthering policy to promote population health related to this disease.
To prepare:
• Review the four articles concerned with screening and public policy listed in this week’s Learning Resources. All four articles contain potentially controversial recommendations for screening and prevention.
• Select one article on which to focus for this Discussion.
• Analyze how the epidemiologic data could be used to formulate policy for improving population health.
By Day 3, post a cohesive scholarly response that addresses the following:
• Summarize the recommendations of your selected article. Discuss ethical considerations and whether or not you believe the recommendations are justified.
• Describe the epidemiological evidence in support of your position.
• Identify whether the screening program you review is population-based or high-risk based and how that influences your assessment.
• How can the reported data be used to move policy forward for improving population health around this issue?
By Day 6, respond to the postings of at least two colleagues who commented on an article you did notselect. Review his or her summary and make an argument to support a different position. Again, cite epidemiological evidence that supports your opposing view.
Reference:
Barry, M. J. (2009). Screening for prostate cancer—The controversy that refuses to die. New England Journal of Medicine, 360(13), 1351–1354. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMe0901166

Readings
• Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.
o Chapter 10, “Data Interpretation Issues”
o Chapter 11, “Screening for Disease in the Community”

Chapter 11 examines aspects of screening for disease, including characteristics of a good screening test and how screening programs can be evaluated.
Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.
o Chapter 13, “Decision Support”

This chapter addresses measurement and analysis tools used to support decision making for improvement, accountability, and research related to population health. The three main purposes of measurement in population health (improvement, accountability, research) provide the framework for this chapter.

Note: You will need to review the following four articles to complete this week’s Discussion:
U.S. Preventive Services Task Force. (2009). Screening for breast cancer. Retrieved fromhttp://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

This is a summary of the controversial USPSTF proposal regarding screening for breast cancer using mammography and breast self-examination. It includes the recommendations, rationale, and evidence supporting the proposal.
Alvarez, G. G., Gushulak, B., Rumman, K. A., Altpeter, E., Chemtob, D., Douglas, P., … & Ellis, E. (2011). A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates. BMC Public Health,11(3). Retrieved from http://www.biomedcentral.com/1471-2334/11/3

This article examines tuberculosis screening practices among migrants from high-incidence countries to low-incidence countries. Consider the benefits and challenges of standardizing screening requirements at the global level.
Creighton, P., Lew, J.-B., Clements, M., Smith, M., Howard, K., Dyer, S., Lord, S., & Canfell, K. (2010). Cervical cancer screening in Australia: Modelled evaluation of the impact of changing the recommended interval from two to three years. BMC Public Health, 10, 734–747.
Retrieved from the Walden Library databases.

This article examines the cost benefits and health consequences of screening for cervical cancer every 3 years as opposed to every 2 years. Researchers summarize other studies that support this change as well.
Hugosson, J., Carlsson, S., Aus, G., Bergdahl, S., Khatami, A., Lodding, P., & … Lilja, H. (2010). Mortality results from the Göteborg randomised population-based prostate-cancer screening trial. Lancet Oncology, 11(8), 725–732.
Retrieved from the Walden Library databases.

Prostate cancer screening can result in the detection of other cancers that may “never present during the patient’s lifetime (over-diagnosis) and it results in unnecessary treatments that can damage men’s quality of life (over-treatment).” However, this research study also demonstrates how prostate cancer screening also can reduces mortality rates in some instances.
HealthMap. (2007). Retrieved from http://www.healthmap.org/en

This website tracks, maps, and describes current disease outbreaks around the world, along with sources of information about them. It provides a valuable picture of global public health issues.
Centers for Disease Control and Prevention. (2011). A framework for program evaluation. Retrieved from http://www.cdc.gov/eval/framework/index.htm

The CDC provides this framework for program evaluation. Review the information presented as you prepare for Assignment 4.
Association for Community Health Improvement. (2006). Planning, assessment, outcomes & evaluation resources. Retrieved from http://www.communityhlth.org/communityhlth/resources/planning.html

Explore the many resources available for program evaluation. These resources may inform Assignment 4.

(1B)
Impact of Finance on Program Success

Money is an important resource, but it is not the only resource that matters when it comes to program design and evaluation. In fact, having sufficient money, in itself, does not equate to having a quality program or even a financially successful one. Financial strategy dictates how money is spent and allocated. With this in mind, what are the most important considerations to bear in mind as you design your program?

To prepare:
• Review the financial analysis information presented in the Learning Resources.

• Conduct additional research of your own to further your understanding of use of cost-effectiveness, cost-utility, and cost-benefit. Feel free to share resources that you find beneficial with your colleagues.

• How do these concepts apply to your program planning and help to facilitate quality program outcomes?
By Day 3, post a cohesive scholarly response that addresses the following:
• Which method of financial analysis is most appropriate for your program? Provide your rationale.

• What are the financial implications of not addressing the problem you have identified for your target population?

• What are the differences between the long-term and the short-term implications of not addressing the problem?

• How does your selected financial analysis strategy relate to the quality of program outcomes?

Read a selection of your colleagues’ responses

Required Resources
This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources.
Readings
• Course Text: Designing and Managing Programs: An Effectiveness-Based Approach

o Chapter 12, “Performance Measurement, Monitoring, and Program Evaluation: Data Requirements”

As you read this chapter, pay attention to the financial functions associated with these forms of evaluation and the data to be collected.
Website: Centers for Disease Control and Prevention. (n.d.). Public Health Economics and Methods. Retrived from http://www.cdc.gov/stltpublichealth/pheconomics

This site offers educational tutorials on cost-utility analysis, cost-effectiveness analysis, and cost-benefit analysis, as well as case studies that apply these principles.
Optional Resources
• Article: U.S. National Library of Medicine. (2008). HTA 101: IV. Cost analysis methods. Retrieved from http://www.nlm.nih.gov/nichsr/hta101/ta10106.html

Published by the National Institutes of Health, this site offers an explanation of the types of cost analysis including comparison of cost-utility, cost-effectiveness, and cost-benefit.
1C) Assignment 3: Developing an Intervention and Determining the Impact
Sections 3 and 4 of Major Assessment 7: Using an Epidemiological Approach to Critically Analyze a Population Health Problem
Assignment 3, begun in Week 7, is due by Day 7 of this week.
To complete:
In 5 pages, write the following sections of your paper:
Section 3: The Intervention
• An outline of an intervention you would implement to address the population health problem with your selected population based on the results of the study in Section 2 (Note: If you selected a descriptive study design, you are still required to outline an intervention that might be developed based on future research.)
• A review of the literature that supports this intervention
Section 4: The Impact
• An explanation of the health outcome you would be seeking and the social impact of solving this issue

(1 D)
Application 3: Program Budget and Financial Analysis
Financial Analysis
How can you assess the financial viability and merit of your program? What indications will inform you and others whether your financial strategies are likely to result in positive health outcomes for the population?
This week you continue to develop Application 3, applying the principles of cost-effectiveness, cost-utility, and cost-benefit to your program design process.
To prepare for this week’s section of Application 3:
• Review the information presented in the Learning Resources.

• Apply the use of cost-effectiveness, cost-utility, or cost-benefit to your program design to determine whether the monies put into your program will result in positive health outcomes for the population.

The full Application 3 is due by Day 7 of this week. Instructions have been provided in previous weeks to help you prepare.
To complete:

Write a 3-page paper* that address the following:
Budget (developed in Week 7)
• Develop a simple revenue and expense budget for 6 months from start-up and develop a break-even analysis.

• Articulate a justification for the revenue and expenses indicating where the funds are coming from to support the project and what resources the expenses are related to.

• Explain any variance from the budget that is not budget neutral.

Financial Analysis (developed this week)
• Articulate whether the monies put into the program will result in positive health outcomes for the population (resulting from your application of the use of cost-effectiveness, cost-utility, or cost-benefit to the program design process).

* Include tables or graphs in your paper to illustrate budget informatio
2A) Investigating Pandemics and Epidemics
Some of the most notable epidemics include the bubonic plague in the 14th century, smallpox in the 18th century, and influenza in the 20th century. Reportedly, the bubonic plague caused over 137 million deaths, whereas the death toll associated with influenza was 25 million (Ernst, 2001). These are dramatic examples of the kinds of acute outbreaks that led to the practice of epidemiology.
Many epidemiologists and health care professionals are concerned about the next potential pandemic or epidemic. With the increased mobility of society, the spread of infectious diseases continues to pose a serious threat. For this Discussion, you will investigate pandemics and epidemics using epidemiological tools, and you will consider strategies for mitigating disease outbreaks.
To prepare:
• Using the Learning Resources, consider examples of emerging or reemerging infectious diseases that are occurring locally, nationally, or abroad. Then, select one example on which to focus.
• Explore the epidemiological investigative process used to identify the emerging or reemerging infectious disease or outbreak.
• Examine your selected infectious disease using the epidemiologic triangle and vector theory.
• Consider how health care interventions may reduce the emergence or reemergence of infectious diseases.
By Day 3, post a cohesive response that addresses the following:
• Identify the emerging or reemerging infectious disease you selected.
• Discuss the investigative process used to identify the outbreak, and describe its effect using descriptive epidemiology (person, place, and time).
• Apply the epidemiologic triangle and vector theory to your selected outbreak.
• Evaluate how prior health care interventions, or lack thereof, created the conditions that allowed this infectious disease to emerge.
• Discuss how the disease outbreak might have been avoided or mitigated. Include agencies, organizations, and resources that could have supported these efforts. If appropriate, consider ongoing efforts to control the outbreak.
Read a selection of your colleagues’ responses.
2B) Program Evaluation

In this Discussion, you and your colleagues identify a theory or model for evaluation and establish appropriate forms of evaluation for your programs.

As noted in Week 3 of this course, a particular theory or model is not necessarily appropriate for every program. It is important to consider the specifics of the problem and the target population when making that selection. This is important to keep in mind, also, as you examine theories and models related to program evaluation. In this instance, various facets of the program such as goals and objectives should be taken into consideration. Once selected, theory can provide a framework for evaluation.

In addition, there are distinct purposes for the elements of assessment addressed this week: performance measurement, monitoring, and summative evaluation. How do you foresee these being applied in your program?

To prepare:

• Review this week’s Learning Resources. You may wish to review the Week 3 Learning Resources as well, which may be pertinent.


• Consider the various facets of your program plan, such as your program goal(s) and objectives.


• Choose the evaluation theory or model (from nursing or related fields) most appropriate to your program. Be prepared to justify the choice of your model as it relates to your program.


• Based on the program you have developed:


o Create a time line for when to do measuring, when to implement monitoring, and when to evaluate program outcomes.

o
o What types of data would you need to collect in order to measure performance, monitor the progress of the program, and assess the program outcomes?
By Day 3, post a cohesive scholarly response that addresses the following:

• Identify an evaluation theory or model that is most appropriate to support your program plan. Explain which field developed this theory or model, and describe how it has been applied in fields other than nursing. Support your response with evidence from the literature.


• Share a time line that articulates how and when you would engage in various elements of evaluation for the program you have been developing. Be as specific as possible, and provide your rationale for each decision point.
Read a selection of your colleagues’ responses.

Required Resources

You may view this course video by clicking the link below or on the course DVD, which contains the same content. As a reminder, additional Learning Resources for the week are listed below the link. Be sure to scroll to the bottom of the web page to view the complete list of Required and Optional Resources.
If you experience technical difficulties viewing the course video through the link, please contact your Student Support Team at 1-800-WALDENU or support@waldenu.edu.
To view this week’s media resources, please click on the link below. Once you’ve opened the link, click on “Performance Measurement, Monitoring, and Evaluation” then click the light purple box.

http://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/8400/interactive_video_player/index.html

Media
• Course Video: Design and Evaluation of Programs and Projects

o “Performance Measurement, Monitoring, and Evaluation” (featuring Dr. Donna Shambley-Ebron, Dr. Melissa Willmarth, and Dr. Debora Dole)

Dr. Donna Shambley-Ebron, Dr. Melissa Willmarth, Dr. Debora Dole discuss evaluation for programs.
Readings
• Course Text: Designing and Managing Programs: An Effectiveness-Based Approach

o Review Chapter 12, “Performance Measurement, Monitoring, and Program Evaluation: Data Requirements”
o Chapter 13, “Program Impact Evaluation and Hypothesis Testing”

Review Chapter 12 and read Chapter 13 to examine aspects of evaluation essential to program planning.
• Course Text: Assessment and Planning in Health Programs

o Chapter 10, “Program Evaluation: Background and Basics”

Chapter 10 outlines steps for designing evaluation during program planning.
Article: Boyer, D. E., & Kane, C. (2010). Program evaluation of a community crisis stabilization program. Archives of Psychiatric Nursing, 24(6), 387–396.

This article serves as an example of an outcome evaluation.
Article: Chizawsky, L. L. K., Estabrooks, C. A., & Sales, A. E. (2011). The feasibility of web-based surveys as a data collection tool: A process evaluation. Applied Nursing Research, 24(1), 37–44.

This article features the application of process evaluation.
Article: McKenna, H., Keeney, S., & Hasson, F. (2009). Health care managers’ perspectives on new nursing and midwifery roles: Perceived impact on patient care and cost-effectiveness. Journal of Nursing Management, 17(5), 627–635.

In this article, the authors address impact and cost-effectiveness of new nursing roles through qualitative interviews with advanced practicing nursing staff.
Article: Ward-Begnoche, W. L., Gance-Cleveland, B., Harris, M. M., & Dean, J. (2008). Description of the design and implementation of a school-based obesity prevention program addressing needs of middle school students. Journal of Applied School Psychology, 24(2), 247–263.

Read this article as an example of a formative program evaluation.
Article: Whitman, A. (2011). Gathering and using community-level indicators. Retrieved from the Community Tool Box: http://ctb.ku.edu/en/tablecontents/sub_section_examples_1371.aspx

This site gives real-world examples of community-level indicators for evaluation in a variety of topic areas including ideas for national- and state-level data.
Website: National Database of Nursing Quality Indicators. (2011). Retrieved from https://www.nursingquality.org/

On this website, you may access data from U.S. hospitals by unit related to nursing care.
Website: Health Indicators Warehouse. (2011). Retrieved from http://healthindicators.gov/

This site provides data for national, state, and community health indicators.
Optional Resources
• Article: Ahmad, F., Roy, A., Brady, S., Belgeonne, S., Dunn, L., & Pitts, J. (2007). Care pathway initiative for people with intellectual disabilities: Impact evaluation. Journal of Nursing Management, 15(7), 700–702.

This article is an example of an impact evaluation.
• Article: Gard, C. L., Flannigan, P. N., & Cluskey, M. (2004). Program evaluation: An ongoing systematic process. Nursing Education Perspectives, 25(4), 176–179.

This article discusses the use of accreditation standards and site visits as a plan for ongoing evaluation for a nursing program.
• Article: Graff, J. C., Russell, C. K., & Stegbauer, C. C. (2007). Formative and summative evaluation of a practice doctorate program. Nurse Educator, 32(4), 173-177.
• Article: Milne, L., Scotland, G., Tagiyeva-Milne, N., & Hussein, J. (2004). Safe motherhood program evaluation: Theory and practice. Journal of Midwifery & Women’s Health, 49(4), 338–344.

This article identifies and evaluates the different approaches to program evaluation related to safe motherhood.
• Website: Centers for Disease Control and Prevention. (2007). Chronic disease indicators [Data set]. Retrieved from http://apps.nccd.cdc.gov/cdi/.

2C) Assignment 4: Planning for Evaluation
Section 5 of Major Assessment 7: Using an Epidemiological Approach to Critically Analyze a Population Health Problem
DNP-prepared nurses are expected to effectively use research methods to analyze data, “design evidence-based interventions, [and] predict and analyze outcomes…,” (AACN, 2006, p. 11).
Every research design requires you to evaluate your results. Epidemiologic studies are no different. In Week 7, you explored how using causal models can assist with evaluating the data analysis section of a study. In this week’s Discussion, you explored how epidemiological data are used to substantiate or negate the need for screening programs; evaluation is critical to ensure the data are sound and suitable as the basis for such decisions. As these experiences demonstrate, if the results of a study are not evaluated, they cannot be used to improve population health.
As you begin working on Assignment 4, Section 5 of the Major Assessment 7 paper, consider how you would evaluate the anticipated results of your population health intervention developed in Sections 3 and 4 of Assignment 4. As noted in the AACN Essentials of Doctoral Education for Advanced Nursing Practice, as a DNP-prepared nurse, you are expected to predict and analyze outcomes and then design evidence-based interventions based on your analysis. This Assignment provides you with an opportunity to practice that skill.
Begin developing Section 5, which is due by Day 7 of Week 9.
• Review the Major Assessment Overview .
• Review Exhibit 8-7: The Four Stages of Evaluation on page 400 of Epidemiology for Public Health Practice. In addition, review the articles in the Learning Resources that describe program evaluation in various settings.
Section 5: Evaluation
• An evaluation plan based upon the health outcome that you have chosen and your anticipated results
Required Resources
Readings
• Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.
o Chapter 12, “Epidemiology of Infectious Diseases”

In this chapter, the authors examine the epidemiology of infectious diseases, one of the most familiar applications of epidemiology.
Martin, T. W., Stevens, L., & Miller, J. W. (2011). Rare germ drives outbreak. The Wall Street Journal. Retrieved fromhttp://online.wsj.com/news/articles/SB10001424052702303745304576360780812512492?mod=djemHL_t&mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424052702303745304576360780812512492.html%3Fmod%3DdjemHL_t

In news coverage of a deadly outbreak, the authors note unusual aspects of the situation, as well as the economic, political, and personal ramifications.
Centers for Disease Control and Prevention. (2011). CDC says “Take 3” actions to fight the flu. Retrieved from http://www.cdc.gov/flu/protect/preventing.htm

This page contains the CDC’s most up-to-date recommendations regarding the prevention of seasonal flu. In addition to this page, you may wish to explore the CDC’s Seasonal Influenza home page,http://www.cdc.gov/flu/
World Health Organization. (2012). Disease outbreak news. Retrieved fromhttp://www.who.int/csr/don/en/

The World Health Organization (WHO) provides information on the most recent disease outbreaks around the world. Stay up to date by visiting this site.
HealthMap. (2007). Retrieved from http://www.healthmap.org/en

Explore this interactive map that lists disease outbreaks around the world.
Centers for Disease Control and Prevention. (2011). Morbidity and mortality weekly report: Summary of notifiable diseases. Retrieved from http://www.cdc.gov/mmwr/mmwr_nd/index.html

Review the most current report on infectious diseases as reported by health care providers to state or local authorities. According to the CDC, “A disease is designated as notifiable if timely information about individual cases is considered necessary for prevention and control of the disease.” This report highlights infectious diseases reported in 2009.
Media
• Laureate Education, Inc. (Executive Producer). (2012). Epidemiology and population health: Infectious disease: Two case studies. Baltimore, MD: Author.

Note: The approximate length of this media piece is 8 minutes.

In this week’s program, the presenters discuss HIV and AIDS.

3A) Addressing Chronic Disease
According to the Population Health course text, “Roughly 40 million Americans are still uninsured and 112 million Americans (almost half of the U.S. population, 45%) suffer suffer from at least one chronic condition”in the United States, an estimated 125 million persons have at least one chronic condition, and half of these persons have multiple chronic conditions” (Fabius, and Pracilio, Nash, Clark, 2015, p. 4 ).
This week’s Learning Resources examine numerous health problems that result in a need for ongoing care. As you have explored this week, many costs are associated with chronic disease—both in terms of lives lost and socioeconomic burden. What can be done to help reduce chronic disease at the population level?
For this Discussion, you will take an in-depth look at chronic disease, and you will evaluate ways to address this issue through the application of chronic disease models and frameworks. In addition, you will consider the impact of the challenges of managing chronic disease on quality of care delivery.
To prepare:
• Review the application of chronic disease models as a method for managing chronic diseases at the population level.
• Consider characteristics of chronic disease models and how to apply them as presented in the Learning Resources.
• Consult Figure 13-7 (p. 267) in Population Health: Creating a Culture of Wellness, and consider examples of determinants and outcomes of population health with chronic diseases in a specific subpopulation. Then, select one chronic disease on which to focus for this Discussion.
• Ask yourself, “What are the challenges of managing this chronic disease? How do these challenges limit the ability to deliver effective quality care?” Conduct additional research using the Walden Library and credible websites as necessary.
By Day 3, post a cohesive scholarly response that addresses the following:
• Identify your selected chronic disease.
• Describe the application of a chronic disease model to address this disease at the population level. Include your rationale for selecting this particular model.
• Discuss one or more current challenges related to the management of the chronic disease, and explain how these challenges limit the ability to deliver effective quality care.
Read a selection of your colleagues’ responses
Readings
• Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.
o Chapter 10, “Transitions of Care”

Chapter 10 provides a framework for understanding the challenges faced by the U. S. healt chare system, including the shift from acute care to chronic care and the costs associtated with that shift. Emerging models of chronic care delivery are presented.
o Chapter 11, “Healthcare Quality and Safety Across the Care Continuum”

Chapter 11 examines the implications for quality and safety, and the imperative to focus on these issues at the population level under the mandate of the Affordable Care Act. The Examples of population based quality and safety initiatives are presented.
o Chapter 14, “Population Health in Action: Successful Models”

Chapter 14 focuses on improvements within population health, including chronic care. The Chronic Care Model, a conceptual framework, is discussed as a method for distributing care improvement to numerous practice settings. The key characteristics of a successful chronic care model that provide access to board populations are discussed.

Easley, C., Petersen, R., & Holmes, M. (2010). The health and economic burden of chronic diseases in North Carolina. North Carolina Medical Journal, 71(1), 92–95.
Retrieved from the Walden Library databases.

This short reading presents an analysis of the economic effects of selected chronic diseases resulting in increased hospitalization, with a focus on behaviors that may be changed to prevent these diseases.
Kim, T. W., Saitz, R., Cheng, D. M., Winter, M. R., Witas, J., & Samet, J. H. (2011). Initiation and engagement in chronic disease management care for substance dependence. Drug & Alcohol Dependence, 115(1-2), 80–86.
Retrieved from the Walden Library databases.

This article presents a study on treating substance abuse as a chronic disease. The authors discuss challenges to treatment options and propose methods for more appropriately managing treatment for substance dependence as a chronic illness.
Ormond, B. A., Spillman, B. C., Waidmann, T. A., Caswell, K. J., & Tereshchenko, B. (2011). Potential national and state medical care savings from primary disease prevention. American Journal of Public Health, 101(1), 157–164.
Retrieved from the Walden Library databases.

In this article, the authors examine whether population-based primary prevention activities lead to reduced disease onset in the short run, and, consequently, to cost savings within the health care system at both the state and national levels.
Tenforde, M., Jain, A., & Hickner, J. (2011). The value of personal health records for chronic disease management: What do we know? Family Medicine, 43(5), 351–354.
Retrieved from the Walden Library databases.

This reading examines evidence related to the value of electronic personal health records (PHRs), noting that additional research is needed to evaluate this for chronic disease management.
United Nations. (2011, September 19). Non-communicable diseases deemed development challenge of ‘epidemic proportions’ in political declaration adopted during landmark general assembly summit. Retrieved from http://www.un.org/News/Press/docs/2011/ga11138.doc.htm

The United Nations met in September 2011 to collaborate on global plans to address the control and prevention of chronic diseases. This report from the general assembly notes the high cost of not managing chronic disease worldwide.
Yale School of Public Health. (2012). Chronic disease epidemiology. Retrieved fromhttp://publichealth.yale.edu/cde/index.aspx

Yale School of Public Health sponsors this site. Explore the information presented on addressing chronic disease through epidemiology.
Florida Department of Health. (n.d.). Chronic disease epidemiology surveillance and evaluation. Retrieved March 5, 2012, fromhttp://www.doh.state.fl.us/disease_ctrl/epi/Chronic_disease/Chronic_Disease.htm

This Florida-based agency monitors chronic disease conditions in Florida’s population using a variety of population-based surveillance systems.
World Health Organization. (2012). Chronic diseases and health promotion: Integrated chronic disease prevention and control. Retrieved from http://www.who.int/chp/about/integrated_cd/en/

The World Health Organization monitors chronic diseases worldwide. This website provides an overview of their programs, monitoring efforts, and activities they engage in to reduce the incidence of chronic disease globally.

3B
Evaluation in Programs

As a leader in the field, it is essential to learn from the successes and challenges that others have encountered. Particularly with the design and evaluation of programs, many expensive and difficult lessons have already been discovered through previous endeavors.

For this Discussion, you review the literature and analyze a program’s evaluation plan. As you do this, consider what can be surmised from this example and the others shared by your colleagues to guide the development of your program’s evaluation plan.

To prepare:

• Search the literature and select an article of interest that includes a program evaluation. You may also select an article that has been presented in this course.


• Consider the following:


o Was the evaluation plan appropriate to the design of the program?

o Identify the goals and objectives of the evaluation plan.

o What were the activities related to this evaluation?

o Based upon the data, how valid are the outcomes?

By Day 3, post a cohesive scholarly response that addresses the following:

• Assess the appropriateness of the evaluation plan and share other information or insights as it relates to the evaluation approach.


• Include a full citation of your selected article.
Read a selection of your colleagues’ responses.

Required Resources
This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources.
Readings
• Review the information on evaluation in the readings from Week 9, as it will inform the Discussion.
• Article: Giangiulio, M., Aurilio, L., Baker, P., Brienza, B., & Moss, E., & Twinem, N. (2008). Initiation and evaluation of an admission, discharge, transfer (ADT) nursing program in a pediatric setting. Issues in Comprehensive Pediatric Nursing, 31(2), 61–70.

This article demonstrates the evaluation plan utilized in relation to a nursing program in a pediatric setting.
• Article: Matten, P., Morrison, V., Rutledge, D. N., Chen, T., Chung, E., & Wong, S. (2011). Evaluation of tobacco cessation classes aimed at hospital staff nurses. Oncology Nursing Forum, 38(1), 67–73.

In this article, the authors describe the evaluation of a program for nurses engaged in tobacco cessation counseling.
3C) Application 4: Evaluation Planning

A 3- page paper that addresses the following:

Evaluation Methods (developed in Week 9)
• Identify an evaluation theory or model that is aligned to your program goal(s) and objectives.
• Exhibit a performance measurement, monitoring, and evaluation time line that:
o Demonstrates the appropriate use of performance measurement, monitoring, and summative evaluation
o Distinguishes between the long-term effects of impact evaluation versus short and intermediate health outcomes as a result of the implementation of the program

Evaluation Plan (developed in Week 10)
• Develop an evaluation plan that includes goals, objectives, and activities. Specify the type of data needed.
• Add your evaluation plan to the visual representation (e.g., table or graph) of your program plan design.
• Add time line information for the evaluation plan to your Gantt chart.

Note: In addition to your paper, be sure to submit the following (which may be contained in a separate document):

• An updated version of the visual representation (e.g., table or graph) of your program design that includes your evaluation plan.
• An updated version of your Gantt chart that includes your evaluation plan.

Be sure to make revisions to these items based on any feedback you received from your Instructor when you submitted them in Week 6
3D) Application 4: Evaluation Planning
Evaluation Plan
A plan for evaluation should be correlated well with the specific program for which it has been developed. As you continue to work on Application 4, it is important to bear in mind that an evaluation plan is distinct from–yet aligned with–the program plan, and contains its own goals and objectives.
This week you integrate the knowledge and discernment you have developed to formulate a plan for how evaluation could be an integral part of your program.
To prepare for this week’s section of Application 4:
• Keep your own program in mind as your review the information presented in this week’s Learning Resources.

• Develop an evaluation plan that includes goals, objectives, and activities. Consider what type of data will be needed.

• Review your visual representation of your program plan design (Week 6), and incorporate your evaluation plan.

• Revise your Gantt chart (Week 6) to include your evaluation plan.

The full Application 4 is due by Day 7 of this week. Instructions have been provided in previous weeks to help you prepare.
To complete:
Write a 3- page paper that addresses the following:
Evaluation Methods (developed in Week 9)
• Identify an evaluation theory or model that is aligned to your program goal(s) and objectives.

• Exhibit a performance measurement, monitoring, and evaluation time line that:

o Demonstrates the appropriate use of performance measurement, monitoring, and summative evaluation

o Distinguishes between the long-term effects of impact evaluation versus short and intermediate health outcomes as a result of the implementation of the program

Evaluation Plan (developed this week)
• Develop an evaluation plan that includes goals, objectives, and activities. Specify the type of data needed.

• Add your evaluation plan to the visual representation (e.g., table or graph) of your program plan design.

• Add time line information for the evaluation plan to your Gantt chart.

Note: In addition to your paper, be sure to submit the following (which may be contained in a separate document):
• An updated version of the visual representation (e.g., table or graph) of your program design that includes your evaluation plan

• An updated version of your Gantt chart that includes your evaluation plan

Be sure to make revisions to these items based on any feedback you received from your Instructor when you submitted them in Week 6.
Due by Day 7 of this week.
Note: If you have created more than one document to include with your visual representation and Gantt chart for this assignment, check with your Instructor before you prepare and submit any file formats other than .doc, .rtf, or .xls. If your Gantt chart is an Excel document, save it as follows:
4A) Discussion 1: Applied Epidemiology
On September 11, 2001, terrorist attacks created a grave disaster that included the destruction of the World Trade Center in New York. The day after 9/11, epidemiologists were asked to assess the environment around Ground Zero for potential hazards that might put those engaged in rescue and recovery at risk of harm. Beside the dust, what toxins might be in the air? Was the air quality safe or should rescue workers wear canister respirators or particle masks? What other protections might be necessary in the days following the disaster?
In this Discussion, you will look at the impact of a disaster through the lens of an epidemiologist, addressing such questions as, “What epidemiological considerations arise in the wake of a disaster? And, what makes disaster planning or emergency preparedness effective in terms of mitigating or preventing negative aftereffects?”
To prepare:
• Identify a disaster that led to a population health issue. Consider this disaster through the lens of an epidemiologist, using the information presented in the Learning Resources to examine the epidemiological considerations resulting from the disaster. Conduct additional research as necessary using the Walden Library and credible websites.
• Ask yourself, “What factors made the community’s and/or nation’s response effective or ineffective? What aspects of disaster planning or emergency preparedness did the community have in place that helped it cope with the disaster and resulting population health issue?”
By Day 3, post a cohesive scholarly response that addresses the following:
• Identify the disaster and resulting population health issue.
• Describe the epidemiological considerations resulting from this disaster. Support your response with specific examples and evidence from the literature.
• Discuss the factors that made the community’s and/or nation’s response effective or ineffective.
Read a selection of your colleagues’ responses.
Readings
• Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.
o Chapter 15, “Risk Management and Law”

This chapter discusses the role of the U.S. legal system to foster the health of populations with emphasis on the U.S. Supreme Court’s decision on the Patient Protection and Affordable Care Act.
o Chapter 16, “Making the Case for Population Health Management: The Business Value of Better Health”

This chapter explores why good health is good business, the cost of good health and the potential provide to be realized when workforce health is improved.
o Chapter 3, “Policy Implications for Population Health: Health Promotion and Wellness”

The chapter provides an overview of the intricacies of federal policy making and the key policy components necessary to advance the health of populations.
o Chapter 5 , “The Political Landscape in Relation to the Health and Wealth of Nations”

The chapter describes the relationship between national health and population health and the constitutional structures that influence health policy
o Chapter 20, “The Future of Population Healthat the Workplace: Moving Upstream”

This chapter focuses on the future of population health in the workplace and the new knowledge that is driving future trends in population health.
Admi, H., Eilon, Y., Hyams, G., & Utitz, L. (2011). Management of mass casualty events: The Israeli experience. Journal of Nursing Scholarship, 43(2), 211–219.
Retrieved from the Walden Library databases.

This article examines the Israeli model of emergency preparedness and management, including nurses’ clinical and managerial involvement in mass casualty events.
Beam, E. L., Boulter, K. C., Freihaut, F., Schwedhelm, S., & Smith, P. W. (2010). The Nebraska experience in biocontainment patient care. Public Health Nursing, 27(2), 140–147.
Retrieved from the Walden Library databases.

Nurses are often on the front lines when emergencies happen. This article examines public health planning and management strategies for infectious disease outbreaks and bioterrorism attacks.
Honoré, P. A., Wright, D., Berwick, D. M., Clancy, C. M., Lee, P., Nowinski, J., & Koh, H. K. (2011). Creating a framework for getting quality into the public health system. Health Affairs, 30(4), 737–745.
Retrieved from the Walden Library databases.

In this article, the authors examine health care reform and the Affordable Care Act in light of public health’s priorities of improving population health.
Sprung, C. L., Cohen, R., & Adini, B. (2010). Chapter 1. Introduction. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster. Intensive Care Medicine, 36(Supplement 1), S4–S10.
Retrieved from the Walden Library databases.

This reading describes the efforts put forth as a result of a task force established by the European Society of Intensive Care Medicine in December 2007. The chapter examines the purpose and development of standard operating procedures (SOPs) to better address population needs during an infectious disease breakout or disaster.
Richards, G. A., & Sprung, C. L. (2010). Chapter 9. Educational process. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster. Intensive Care Medicine, 36(Supplement 1), S70–S79.
Retrieved from the Walden Library databases.

4B) Advancement of the Profession

Throughout this course, you have been engaged in multiple intensive learning experiences: program design and evaluation assignments, a Practicum Experience. Although each of these endeavors is distinct, it can be beneficial to reflect on themes that emerge while participating in each one. What insights have you gained as a result of these experiences?

As this course comes to a close, consider how what you have learned will help you move forward in the DNP program, as well as how it will allow you to contribute to your profession in the future.

To prepare:

• How has your professional knowledge and expertise developed since the beginning of this course? Support your response with specific references to the AACN Essentials and/or your specialty competencies.


• How do you believe your experiences in this course will enable you to move forward as a contributor and leader within the profession of nursing?
By Day 4, post a cohesive scholarly response that addresses the following:

• Discuss two or more significant areas of growth, insight, or inquiry related to your anticipated professional contribution and/or leadership.

Read a selection of your colleagues’ responses.

4c) Disseminating Results

Take a minute to think about the health-promotion and disease-prevention issue you chose to focus on at the outset of this course. Now bring to mind the problem and target population you identified. The program design and evaluation planning you have engaged in throughout this course have served an important purpose—not only of furthering your own knowledge and expertise, but of contributing toward an understanding of these significant topics and furthering collective progress toward important goals.

As a DNP-prepared nurse, you have an ethical and professional obligation to disseminate findings. This Discussion seeks to facilitate your professional growth by asking you to assess and reflect on the success of your program design, the challenges you have encountered, and the ethical considerations that may warrant additional attention.

To prepare:

• How has your understanding of the national health-promotion and disease-prevention issue and your selected problem and target population developed over the past several weeks? How has your perception changed, if at all?


• Critically evaluate the pros and cons of the program you have designed. Based on what you have learned in this course, as well as your professional experiences, do you think your program would address the problem for the target population? Would the benefits outweigh the costs?


• Examine the ethical implications of the program you have designed. What questions, concerns, and/or insights do you have?


• As a nurse engaged in advance practice, which venues would be viable for disseminating the results of your program design and evaluation? What audience would be most interested in these findings? Identify at least one professional journal to which you could publish the results of your program design and evaluation, as well as at least one other venue for disseminating results.
By Day 3, post a cohesive scholarly response that addresses the following:

• Assess your program design and evaluation, including the ethical implications of the program you have developed.


• Identify at least one professional journal in which you could publish the results of your program design and evaluation, and describe at least one other venue that could provide a valuable forum for disseminating results


 

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