Attached!
Dear Judy,
Q1: I’d spend some time looking at what Adithya wrote in his comment to the whole class, but basically, these are the ways of separating out the indicators:
Impact indicators: Overall intervention/program goals (e.g., improved health, improved quality of life, and/or reduced healthcare costs).
Outcome indicators: Intervention/program objectives (e.g., behavior changes; program components you want to implement)
Process indicators: Whether activities you propose are done (e.g., if training is one of the activities, process indicators might include how many providers/patients attended the trainings and whether the training changed knowledge/attitudes/self-efficacy).
So, in your case, proportion w/ improved health (impact indicator ); # who had EtOH screening (outcome indicator); process (# attending training on importance of EtOH). As I’ve suggested with others, I’d consider making a table for this with columns being process/outcome measures and data source. These kinds of tables are very useful for grants.
Q2: Whether the screening identifies heavy users is even more downstream. Think of intermediate as being between process and outcome. So, if your process (e.g., activity) is # of people attending an education session, you might have an intermediate outcome measure being proportion of people who know about how important EtOH screening is especially for HIv patients.
Q3: I like that you are going to ensure fidelity to the screening protocol. I like that you are considering patient and provider interviews. I’d consider focus groups for this kind of study.
Hi Judy,
Like the rest of us, I think you also struggled with identifying process indicators vs outcome indicators and particularly intermediate outcome indicators. It might be useful to be more specific in question 3 about the study design you are proposing. What is the objective? Goal? Aims? and how do these different quantitative and qualitative map on to each objective?
Hi Judy,
If I've learned anything from the general feedback we've been getting for this assignment, your process indicators could be something like # of clinic nurses that attend the training you hold (or completed the educational module you provide), or nurse participants' satisfaction of the training you provided, or the number of training sessions that were held (or # of emails/letters discussing the intervention that were sent) while your outcome indicators could be something like the proportion of clinic nurses that screened their patients for alcohol use and recorded that in the health record, or proportion of patients that screened positive for alcohol abuse that received referrals for further counseling (or whatever is appropriate for your target behavior).