Strengthening prevention performance using technology: a formative evaluation of interactive Getting To Outcomes.

Communities face challenges implementing evidence-based prevention programs. To help, policymakers are exploring how to build community-level capacity for prevention for thousands of organizations or communities across the United States. This article reports on a formative evaluation within 2 states' prevention systems of an Internet system designed to build capacity on a large scale, interactive Getting To Outcomes(R) (iGTO). In Tennessee, 30 coalitions were randomly assigned to receive either the iGTO system or nothing. In Missouri, 18 coalitions receiving iGTO were compared with 8 like coalitions who did not receive iGTO. The primary outcome was iGTO's impact on the performance of the coalitions' programs, assessed through interviews at baseline and after a year of iGTO implementation. Analyses suggest that iGTO-programs improved their performance of prevention practices over non-iGTO programs. Semi-structured interviews of iGTO users and state-level stakeholders showed that iGTO was adopted by most iGTO-assigned coalitions, albeit in mostly an elementary fashion. Perceptions of the iGTO system were mixed. The findings suggest that more comprehensive integration requires that state leadership also use iGTO and provide more support for its use at the local level.

Linking accreditation and public health outcomes: a logic model approach.

Emerging public health standards, performance assessment tools, and accreditation models hold significant promise for defining and standardizing public health practice, yet the lack of empirical research on their relationship to outcomes represents a serious barrier to adoption. Given the growing interest and momentum related to public health agency assessment and accreditation efforts, there is increasing need for evidence that performance standards and associated accreditation programs are effective means for moving public health systems toward the ultimate goal of population and community health improvement. This article provides an overview of accreditation in health and other industries, and its relationship to outcomes. We examine lessons that might have meaningful public health translations, as well as influences in and on public health that pose challenges for research and evaluation in this area. Finally, we propose a logic model framework to help depict the ways in which we can begin to explore the impact accreditation has on various levels of outcomes. This logic model is intended to guide the development of measures and to serve as a tool to help convey the breadth and depth of research needed to link accreditation to health outcomes.

Evaluation as a critical factor of success in local public health accreditation programs.

This article presents the variety of approaches used to conduct evaluations of performance improvement or accreditation systems, while illustrating the complexity of conducting evaluations to inform local public health practice. We, in addition, hope to inform the Exploring Accreditation Program about relevant experiences involving accreditation and performance assessment processes, specifically evaluation, as it debates and discusses a national voluntary model. A background of each state is given. To further explore these issues, interviews were conducted with each state's evaluator to gain more in-depth information on the many different evaluation strategies and approaches used. On the basis of the interviews, the authors provide several overall themes, which suggest that evaluation is a critical tool and success factor for performance assessment or accreditation programs.