159444 Measuring sustainability in several health services interventions: An application and expansion of the Levels of Institutionalization (LoIn) Scales

Monday, November 5, 2007: 11:15 AM

Richard S. Kurz, PhD , School of Public Health, University of North Texas Health Science Center, Fort Worth, TX
Kristin D. Wilson, MHA , St. Louis University School of Public Health, St. Louis, MO
Mary E. Homan, MA , Mission Integration, St. Francis Health Center, Sisters of Charity of Leavenworth Health System, Topeka, KS
This presentation addresses the issue of sustainability, that is, many interventions are disseminated but very few actually become part of the functioning of an organization. To address this concern, the presentation provides an analysis of the use of the Level of Institutionalization (LoIn) Scales (Goodman, McLeroy, Steckler, and Hoyle, 1993) and recommendations for changes in its structure and implementation. The LoIn Scales for health promotion programs was used to assess the sustainability of asthma interventions in primary care centers, schools, pharmacies, and community outreach organizations. The application was part of the five year Controlling Asthma in St. Louis project, which was one of seven components of the Controlling Asthma in American Cities program sponsored by the CDC. The validity of the scales is assessed with regard to the conceptualization of institutionalization (passage, routinization, and saturation), the aspects of the four subsystems measured by the scale (production, maintenance, supportive, and managerial), implementation sites and interventions, and the number of years that the implementation was in place. Employing a translation and dissemination model for health interventions (Brownson, 2006) and Rogers (1995) diffusion of innovation theory, the LoIn scales were reconceptualized to include additional indicators that measure changes in the processes of organizational change and improvement, which are believed to be influential in the continued adoption of the intervention and hence, its sustainability.

Learning Objectives:
1. Discuss the application of the Institutionalization Scale in several different interventions and organizational settings. 2. Describe the strengths and weakness of the scale of assessing sustainability. 3. Identify potential improvements in the scale based on the current applications.

Keywords: Evaluation, Sustainability

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.