Typically, evaluation efforts have focused on assessing how effective NCD policies and interventions are at achieving health improvement at the individual or population level. Assessing the effectiveness of a policy or intervention, however, is not sufficient. Planning and focused efforts to evaluate the implementation of NCD policies and interventions must also be in place.Thus, the evaluation should look at the implementation of policies and interventions as well as their effectiveness.
Put simply, the focus of an evaluation of the implementation process is on the types and quantities of policies and interventions delivered, the beneficiaries of those policies and interventions, the resources used to deliver the policies and interventions, the practical problems encountered, and the ways in which such problems were resolved.
The steps involved in planning an evaluation of the implementation process are analogous to those for planning an evaluation of effectiveness. Evaluation of the implementation process must be addressed early in a programme’s planning process, or else the collection of relevant data could be compromised or even missed.
Public Health Ontario has devised ten steps for conducting an evaluation;(77) we have adapted these so that they are inclusive of implementation processes and effectiveness:
- Clarify what is to be evaluated.
- Engage stakeholders.
- Determine your evaluation questions.
- Develop an evaluation framework.
- Determine appropriate methods of measurement and procedures.
- Develop an evaluation plan.
- Collect data.
- Process data and analyse results.
- Interpret and disseminate results.
- Apply evaluation findings.
- Step 3.1What research questions should the implementation evaluation be asking?
- Step 3.2What are implementation outcomes?
- Step 3.3What are the moderators of the implementation of the policy or intervention?
- Step 3.4Implementation strategies
- Step 3.5How effective is the policy or intervention?
- Step 3.6How do you assess costs associated with implementation?
- Step 3.7How do you use data for quality assurance and improvement?
- Step 3.8How to improve sustainability