Attached is my updated protocol. Thanks!
Hi Maria,
I would say all of the indicators you list in Question 1 are outcome indicators that reflect the man objectives of your intervention/program:
1. To increase depression screening
2. To increase secondary assessment for patients who screen positive
3. To increase treatment/referral for additional care for patients who meet criteria
Process indicators should reflect the implementation of the interventions you propose. Focusing on training as you do in the previous assignment, these might include:
1. Proportion of providers who received training
2. Proportion of providers who know how to complete and document the PHQ-9 following training
3. Proportion of providers who know how to access and refer to available behavioral health resources at GMC if either PHQ-2 or PHQ-9 are positive
The process indicators let you know whether the activity was done and had its intended effect (or overcame the barrier[s] it was targeting).
Adithya
Hi Maria,
As always, enjoyed reading updates to your protocol. Given our discussion in small group last week and adding on to some thoughts I've had from previous weeks, I think it would be helpful to use the qualitative portion of your proposed mixed methods study to assess barriers and facilitators to following-up on screening among every member of the primary care team who might be responsible for such practice. In particular, I think it will be useful to assess beliefs related to perceptions of the utility and importance of screening and follow-up as well as who should be responsible for conducting screening and follow-up. Seems like these interviews could inform the type of process indicators you select, as the interviews could provide a better understanding of 1) what beliefs/attitudes need to change and 2) how you conceptualize change in those beliefs/attitudes as a process to measure.
Talk more on Thursday!
Joe
Hi Maria,
Thanks for sharing your protocol with us last Thursday. While I know we had listed # people undergone PHQ-2 as a process indicator, Adithya's mention of process indicators being a measure of whether a barrier is overcome (for example). So I think it may be helpful to think, as Elizabeth mentioned in small group, to process map the program you have in mind ID the potential process measures you may want to collect that way. I'm a big proponent on logic models and it may help you organize better than the homework structure. Also, as discussed in class, program evaluation, as Janet mentioned in class, really happens once the program is in place, but I think we can think about these measurements now and know that these measurements may change depending on how actual program implemented.
Vicky