# Presentation: 425288

## Finding an Evidence-Based Program 

## Objectives

- Know how to use your needs assessment and program goals and objectives to help you select your program.
- Be able to find evidence-based program resources.
- Know how to use search options to narrow your program choices and find out what programs will and will not work with your community.

## Handouts

- Developing Goals and Objectives
- Alternative Sources for Evidence-Based Programs
- Talking With the Principal Investigator
- Finding an Evidence-Based Program: Case Study.

## Activity: Finding the Connection 

- How does a needs assessment help
- in choosing an evidence-based program?

**Notes:**
Give participants 2–3 minutes to answer the question.  

## Drafting Program Goals and Objectives 

- They help to:
- Narrow program scope
- Avoid straying from the needs assessment.

## Goals: Definition 

- The “grand reason” for engaging in your public health effort
- Span 3 or more years
- State the desired end result of the program.

## Objectives: Definition

- More specific than goals.  They state how the goals will be achieved in a certain timeframe.
- Objectives should be SMART:
- S—Specific
- M—Measurable
- A—Achievable
- R—Realistic
- T—Time-framed
-     See Handout #2: Developing Goals and Objectives.

## Activity: Goals and Objectives Questions 

- How can a needs assessment help you decide your goals and objectives?
- How do you think your goals and objectives might change after you select an evidence-based program?

**Notes:**
Give participants 3 minutes to discuss this with people around them in small groups.  

## Strategies 

- Will depend on which evidence-based program you select
- Answer these questions:
- What specific behaviors do I want my audience to acquire or enhance?
- What information or skills do they need to learn to act in a new way?
- What resources do I need to carry out the program?
- What methods would best help me meet my objectives?

## Where Can I Find Evidence-Based Programs?  

- Cancer Control PLANET—_[http://cancercontrolplanet.cancer.gov](http://cancercontrolplanet.cancer.gov/)_
- Step 4: Research-tested Intervention Programs (RTIPs)
- Program summaries include a list of journal articles about the program.

**Notes:**
Review handout #3 with the group.  

Is anyone familiar with any of the evidence-based resources and, if so, what has your experience been?  

## Other Sources for Evidence-Based Programs 

- Journals that report on evidence-based programs, such as *Evidence-based Healthcare and Public Health*** **
- See Handout #3: Alternative Sources for Evidence-Based Programs.

## Level 1 Programs

- Funded by peer-reviewed grant
- Published in peer-reviewed journal
- Part of systematic review
- Strategies from Community Guide
**   **See Handout #3: Alternative Sources for   Evidence-Based Programs.

## Level 2 Programs

- Funded by peer reviewed grant
- Published in peer-reviewed journal
- Part of systematic review
- Strategies from systematic reviews but NOT Community Guide

## Level 2 Programs

- Published in peer-reviewed journal but NOT funded by peer-reviewed grant
- Part of a systematic review
- Strategies from Community Guide

## Level 3 Programs

- Published in a peer-reviewed journal but NOT funded by a peer-reviewed grant
- Part of a systematic review
- Strategies from systematic reviews but NOT Community Guide

## Level 4 Programs

- Funded by peer-reviewed grant
- Published in a peer-reviewed journal
- Strategies from single study but NOT in systematic review

## Level 5 Programs

- Published in a peer-reviewed journal but NOT funded by peer-reviewed grant
- Strategies from single study but NOT part of systematic review

## Criteria for Selecting a Program

- Refer back to your needs assessment and think about:
- Was the program conducted with people who had similar:
- Socioeconomic status
- Resources
- Ethnicity
- Traditions
- Priorities
- Community structure and values.
- Is the program appropriate for the age of your audience?

## Criteria for Selecting a Program

- Choose a program that is well-matched with:
- Your health topic (e.g., breast or cervical cancer, nutrition, physical activity)
- What your audience is already doing about the health issue.

## Criteria for Selecting a Program

- These strategies can include:
- Giving information
- Enhancing skills
- Improving the services and/or support systems that exist
- Changing incentives or barriers that maintain the problem
- Promoting access
- Making suggestions for policy changes.

- Pay attention to the strategies the programs used to achieve their objectives.

## Your Resources 

- Remember to avoid a program that takes more resources than you have.
- Different evidence-based programs will take different amounts of money, labor, and/or time.

## Talking With the Principal Investigator

- Whenever you can, speak with the team that developed the program or product in which you are interested.  They can share information about the program that may be helpful.

- See Handout #4: Talking With the Principal Investigator.

## Case Study Scenarios 

**Scenario 1:** You want to adapt an evidence-based program in Cameron County, Texas.  This is a county that borders Mexico.  You have chosen cervical cancer as your health topic.  What are your goals and objectives for this program?
**Scenario 2:** You searched for evidence-based programs in the Research-tested Intervention Programs (RTIPs) section of Cancer Control PLANET (_[http://](http://cancercontrolplanet.cancer.gov/)__[cancercontrolplanet.cancer.gov](http://cancercontrolplanet.cancer.gov/)_).  There are several programs having to do with cancer.  How might you narrow your search?

**Notes:**
**change from lesson plan: Divide the group  half.  Give half scenario 1 and half scenario 2.  Everyone will do scenario 3 after discussing scenarios 1 and 2.  

## Scenario 1: Goals

- The goal for the program is based on:
- Location
- Health issue
- Population.
- Goal:  Reduce cervical cancer mortality among Mexican American women, ages 18–65, in Cameron County.

- See Handout #5: Finding an Evidence-Based Program: Case Study.

## Scenario 1: Objectives  

- Program priorities:
- Raise awareness about cervical cancer screening
- Instruct women about when to first get a Pap test and how often
- Mention the link between HPV and cervical cancer.

## Scenario 1: Objectives, cont. 

- Our draft objectives are:
**Objective 1: **Increase the number of women who receive Pap test screening by 20 percent during the life of the program
**Objective 2:** Find out about the cervical cancer screening behaviors of this group of women in Cameron County
**Objective 3:** Increase the number of Mexican American/Tejana women who can state that HPV is linked with cervical cancer by 20 percent.

## Scenario 2: Narrowing the Search

- Refine your search by age, race/ethnicity, or setting on Cancer Control PLANET (_[http://](http://cancercontrolplanet.cancer.gov/)__[cancercontrolplanet.cancer.gov](http://cancercontrolplanet.cancer.gov/)_)
- Narrow your search by:
- Resources
- Number of products
- Number of interventions
- Education level
- Needs of your audience.

## Group Activity: Which Would You Pick?

- Program A:
- African American women
- Ages 40+
- Live in low-income housing
- Distrust physicians
- Have limited access to medical care
- Conducted in churches, community centers, homes, and clinics
- Included a church program and educational brochures and training health care providers who work with the target audience.

- Program B:
- Cambodian women, refugees
- Ages 18+
- Live in a farming community
- Limited English skills
- Unfamiliar with Western medicine
- Conducted in home and community settings
- Included an outreach worker manual and letters to the target audience, a clinical resource manual, and a Khmer-language video.

- You want to adapt an evidence-based program in Cameron County, Texas.
- You have selected cervical cancer as your health topic.  You have narrowed your search to two evidence-based programs, Program A and Program B.

**Notes:**
Ask the group (together or in smaller groups) to identify advantages and disadvantages of each program and note the deciding factors for selecting one program versus the other.  

## Slide 29

| Program | FoCaS | Cambodian Women’s Health |
| --- | --- | --- |
| Target audience | Ages 40+
African American
Low-income housing communities   | Ages 18+
Cambodian women |
| Cancer type  | Breast and cervical  | Cervical  |
| Setting  | Community centers
Individual homes
Community churches
Clinic waiting and exam rooms | Home-based 
Community-based  |
| “The need” 

(reasons why underscreened) | Limited access and referral to preventive and treatment services
Fear and fatalistic views of breast cancer
Distrust of medical community
Doctors may be less likely to recommend  screening to older or minority women  | Refugees, relocated to mainly farming communities, not familiar with Western medicine, services, and prevention
Low levels of being absorbed into the culture; limited English-language skills
Limited access to preventive care  |
| Program scores | Dissemination capability: 3.0
Cultural appropriateness: 5.0
Age appropriateness: 5.0
Gender appropriateness: 5.0
Integrity: 3.3
Utility: 3.3  | Dissemination capability: 4.0
Cultural appropriateness: 5.0
Age appropriateness: 4.5
Gender appropriateness: 5.0
Integrity: 2.8
Utility: 2.5 |

## Group Activity: Program Selection 

- Selected the Cambodian Women’s Health Project because:
- Target age: 18+
- Cancer type: Cervical
- “Need”: Immigrants, limited sense of belonging to majority community, limited English, farming community.
-     See Handout #5: Finding an Evidence-Based Program: Case Study.

## Objectives

- Know how to use your needs assessment and program goals and objectives to help you select your program.
- Be able to find evidence-based program resources.
- Know how to use search options to narrow your program choices and find out what programs will and will not work with your community.

## Questions?