Fidelity to implementation and successes in delivery, lessons from heart disease, TB and emergency departments

Session Number: HE5
Track: Health Evaluation
Session Type: TIG Multipaper
Session Chair: Jenica Huddleston Reed [Evaluation Specialist - Deloitte Consulting]
Presenter 1: Ebun O Ebunlomo
Presenter 2: Carolyn F Fisher [Research and Evaluation Project Manager - Institute for Community Health]
Presenter 3: Victor Kizito Sewe Okello, M&E [Monitoring, Evaluation, Learning and Research Officer - National Empowerment of People Living with HIV/AIDS in Kenya-NEPHAK]
Presenter 4: Kimberly Dash [Senior Research Scientist - Education Development Center]
Presentation 1 Additional Author: Laura French Gerik [Editor - Houston Methodist Hospital]
Presentation 1 Additional Author: John Cooke
Presentation 1 Additional Author: Karla Kurrelmeyer
Presentation 2 Additional Author: Ceylon Auguste-Nelson
Presentation 2 Additional Author: Martina Todaro [Research Associate - Robert Wood Johnson Foundation ]
Presentation 2 Additional Author: Ranjani Krishnan Paradise [Research and Evaluation Scientist - Institute for Community Health]
Presentation 4 Additional Author: Kristin Lees Haggerty, PhD [Associate Project Director - Education Development Center]
Time: Nov 15, 2019 (02:15 PM - 03:15 PM)
Room: CC 101 B

Abstract 1 Title: How did we get here: Process evaluation of an annual women’s heart health education program
Presentation Abstract 1:

Background: Cardiovascular disease kills one in three women. However, half of women are unaware that it is their top health risk. To address this knowledge gap, DeBakey Institute for Cardiovascular Education and Training and a local women’s club collaborated to plan, implement and evaluate Heart of a Woman (HOW), a one-day women’s heart health education program. Methods: We conducted a process evaluation of the second annual HOW program using observations, meeting notes, planning committee and faculty debriefings, and participant surveys. Quantitative and qualitative data were analyzed to assess fidelity, dose delivered, dose received. Results: HOW was implemented as planned with minor deviations (93% fidelity). Participants were actively engaged and reacted positively to the session materials, except for 3 sessions, and reported high satisfaction with content and delivery. Conclusions: Process evaluation ensures effective implementation of public health programs by providing data for stakeholders to optimize program impact and guide future implementation.

Abstract 2 Title: Finding the meaning in the numbers: a mixed-methods evaluation of a latent tuberculosis infection testing and treatment program
Presentation Abstract 2:

The Institute for Community Health was the evaluator for a demonstration project at a Massachusetts community health center that aimed to increase testing and treatment for latent tuberculosis infection (LTBI) among high-risk community members. Our evaluation monitored patient progression through the LTBI cascade of care, from testing through treatment completion. One goal for the evaluation was to extract successful practices and lessons learned; to accomplish this, we supplemented the cascade of care data with information from semi-structured and highly-structured interviews, ethnographic observation, time-tracking studies, and facilitated discussions. We used an appreciative inquiry approach throughout to engage clinical stakeholders in the evaluation. The mixed methods and appreciative inquiry techniques improved our understanding of the successes and challenges at each stage of the cascade of care and to identify practices that other institutions might use or adapt to address LTBI in their settings.

Presentation 2 Other Authors: Dube, Blessing
Abstract 3 Title: Unveiling and Reconnecting the missing link in contact investigation in the implementation of Active Case Finding of Tuberculosis
Presentation Abstract 3:

Tuberculosis is a major public problem in most of the African countries and its case detection remains a major challenge for TB control in Kenya and Africa as a whole. Nearly 40% of infectious TB cases remain undetected leading to continuing transmission, individual suffering and death. In 2016, the Kenyan government adopted the new strategy – Active Case Finding (ACF) of Tuberculosis. Though the strategy has brought some success most counties have not met their yearly set. This paper seeks to unveil and reconnect the missing links in the contact investigation, the core and major approach in ACF strategy which is heavily relied upon in finding the missing cases of TB in the community. It will also share as evidence of the new approach’s success the numbers before the start of incorporating the idea in the Active Case Finding implementation in selected health facilities and after.

Abstract 4 Title: Partnering with hospital emergency departments to test the feasibility of a newly developed clinical protocol to address elder mistreatment
Presentation Abstract 4:

Feasibility studies provide critical information on whether a particular program, policy or practice is likely to work in real-world settings and whether the program is appropriate for further testing. To facilitate the dissemination of a clinical protocol to improve screening, referral, and linkage to coordinated care and support services for older adults who are at risk of mistreatment, we are working with seven hospital emergency departments (ED) to assess protocol feasibility and preliminary efficacy. The evaluation provides vital information on whether ED professionals are able to engage patients and deliver aspects of the protocol that “fit” the contexts and needs of those in their service areas. In this presentation, we will describe our feasibility measures and mixed methods employed; and how we involved ED staff in the evaluation process, used interim data to inform iterative quality protocol and methodological improvements, and assisted sites with implementation. 

Presentation 4 Other Authors: John A. Hartford Foundation's National Collaboratory to Address Elder Mistreatment
Audience Level: All Audiences

Session Abstract (150 words): 

Fidelity to implementation and successes in delivery, lessons from heart disease, TB and emergency departments