Chapter 10:Health Program Planning and Evaluation

Question 1

1. Which options represent the steps in health program management?
   a. Assess, plan, implement, evaluate
   b. Identify, initiate, implement
   c. Organize, operationalize, mobilize, subsidize
   d. Substantiate, negotiate, evaluate

Answer 1

ANS: A
The health program management process is similar to the nursing process. Health program
management consists of assessing, planning, implementing, and evaluating a health program,
in partnership with the client.

Question 2

2. What is the ultimate goal of program planning?
   a. Avoiding unanticipated conflicts in the program development phase
   b. Ensuring adequate funding to meet the program’s resource requirements
   c. Ensuring that health care services are satisfactory, comparable, effective, and
   beneficial
   d. Preventing unnecessary duplication of services

Answer 2

ANS: C
The comprehensive goal of program planning is to ensure that health care services are
acceptable, equitable, efficient, and effective.

Question 3

3. On the basis of projected increases in the number of older adult Canadian citizens, a planning
   committee wants to establish a daycare program for the community’s older adult population.
   What stage would be used to assess the needs of this proposed program?
   a. Preactive stage
   b. Reactive stage
   c. Inactive stage
   d. Interactive stage

Answer 3

ANS: A
In the preactive stage, assessment is done on the basis of projections of future needs.

Question 4

4. Which descriptors meet all of the criteria for identifying a potential client for a program?
   a. All women 40 to 50 years of age who have not had a menstrual period for 3
   consecutive months
   b. Immigrants residing in the district of Wakefield for less than 5 years who have
   difficulty understanding care instructions because of limited English proficiency
   c. Pregnant women who have received nutritional counselling but whose nutritional
   status did not improve
   d. Children aged 18 months to 5 years who have been treated for nutritional
   deficiencies at the district health clinic

Answer 4

ANS: B
A client should be identified on the basis of biological and psychosocial characteristics, by
geographical location, and by the problems to be addressed. A correct example identifies who
the client is, what the need is, and where the client is located. The correct answer meets all the
criteria (psychosocial characteristic = immigrant; location = Wakefield; problem = difficulty
understanding care instructions). The other choices are lacking either a specific location or an
identified problem.

Question 5

5. Evaluation is under way for a province-wide program that aims to decrease teen injury and
   death associated with driving while under the influence of alcohol. Which of the following
   questions is most effective in helping make a summative evaluation of the program?
   a. Are program participants completing all aspects of the program, and do their
   satisfaction scores indicate that they are pleased with the program?
   b. What is the change in statistics for injuries and deaths associated with drunk
   driving among teens in the year following the program?
   c. What is the difference in the amount of alcohol intake by teens before and after
   participant entry into the program?
   d. What problems with program implementation have been identified?

Answer 5

ANS: B
Summative evaluation is evaluation to assess program outcomes or a follow-up of the results
of program activities. “Are program participants completing all aspects of the program?” and
“What problems with program implementation have been identified?” are examples of
questions used for formative evaluation. The difference in the amount of alcohol intake by
teens before and after the program assesses a goal that has not been identified in this scenario
(i.e., the goal was not to decrease consumption of alcohol but to decrease driving under the
influence of alcohol).

Question 6

6. A committee concludes that a program’s objectives were met and that activities received
   positive ratings from the community but decides that the program will be discontinued
   because its cost was triple the amount anticipated. In this scenario, which program evaluation
   measure has been identified as the problem?
   a. Adequacy
   b. Effectiveness
   c. Impact
   D. Sustainability

Answer 6

ANS: D
The aspects of program evaluation include the following: evaluation of relevance (need for the
program); adequacy (whether the program addresses the extent of the need); progress
(tracking of program activities to meet program objectives); efficiency (relationship between
program outcomes and the resources spent); effectiveness (ability to meet program objectives
and the results of program efforts); impact (long-term changes in the client population); and
sustainability (enough resources [usually money] to continue the program).

Question 7

7. Which proposed program best emphasizes tertiary prevention?
   a. Development of an in-school clinic that provides counselling on contraception
   b. Providing a diabetes management program for persons with diabetes mellitus
   c. Providing cardiovascular fitness evaluations at annual health fairs
   d. Setting up free blood pressure screening at popular department stores and
   supermarkets

Answer 7

ANS: B
The aim of tertiary prevention programs is to reduce complications from diseases.
Development of an in-school contraception clinic offers a primary prevention (pregnancy has
not occurred). Providing cardiovascular fitness evaluations and setting up free blood pressure
screening are secondary prevention programs (screening identifies conditions early and
determines incidence and prevalence).

Question 8

8. A committee of health care professionals would like to establish a district-wide program to
   improve access to culturally competent health care services for Vietnamese immigrants. Who
   would be the best person to select as a key information provider about this community’s
   needs?
   a. The hospital administrator
   b. A Vietnamese community leader
   c. A national expert on cultural competency
   d. A provincial/territorial or municipal government official

Answer 8

ANS: B
Key information providers are leaders in a particular community who are knowledgeable
about community needs. In this scenario, a Vietnamese leader most likely knows more about
the needs of the Vietnamese community in question than would the other individuals listed.

Question 9

10. Which question would be most important to consider in order to evaluate a program designed
    to decrease obesity among school-aged children?
    a. Are the school-aged children satisfied with the program?
    b. Can the parents and guardians support the program requirements?
    c. Has obesity among the school-aged children decreased?
    d. What is the program cost compared with the program benefit?

Answer 9

ANS: C
The major benefit of program evaluation is that it shows whether the program is meeting its
goals. It should answer the following questions: Are the needs for which the program was
designed being met? Are the problems it was designed to solve being solved? If the program
does not achieve the purpose for which it is designed, concerns of satisfaction and cost are
irrelevant.

Question 10

9. Which data source would most likely be eliminated by the community health nurse (CHN)
   who wishes to conduct a needs assessment on a limited budget?
   a. Community forums
   b. Examination of community indicators
   c. Focus groups
   d. Surveys

Answer 10

ANS: D
Surveys tend to be more expensive than other methods; therefore, the CHN would want to
consider the other options if on a limited budget.

Question 11

11. A CHN is checking the records of a health unit to compare the number of new teen clients
    who have sought contraceptive counselling and management in the 2 months before and after
    an education intervention program to decrease teen pregnancy. What step of the evaluation
    process does the CHN’s action represent?
    a. Determining outcome goal measurement
    b. Goal setting
    c. Measuring the goal effect
    d. Evaluating the program

Answer 11

ANS: C
Measuring the achievement of a goal is accomplished by reviewing the records and
summarizing the incidence of the condition in question before and after the program.