Using formative evaluation and QI processes in five unique community programs as they move toward meeting local and cross-site outcomes: Year two findings and lessons learned

The prevalence of Asthma continues to increase despite growing evidence of effective approaches to manage the disease. We describe an evaluation approach for privately funded community childhood asthma interventions to reduce acute episodes, facilitate effective healthcare, foster community and systems level changes and reduce emergency department use for asthma treatment. Our university-based evaluation team was funded to document effectiveness, determine and measure outcomes and facilitate cross-site understanding for programs in five different communities implementing best practice interventions in healthcare and/or agencies. The focus of the evaluation shifted from primarily summative evaluation to formative evaluation and measuring multi-stage outcomes linked through logic models. The logic models helped to clarify immediate, intermediate and long term outcome performance measures while enabling each community to maintain and refine their unique programs designed for each unique community context. This presentation will illustrate how the use of logic models can inform and enhance the quality improvement process by: clarifying the role of evidence based medicine and public health, identifying relevant performance measures for process and outcomes, and using performance data to engage in a Plan, Do, Study, Act (PDSA) model of QI. Presentation will emphasize the lessons learned while employing quality improvement processes to enhance program effectiveness. In addition to lessons learned while using logic models and performance data to improve each program, two years of data on the effectiveness of these asthma projects will be described.