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Importance of a conceptual
framework (program theory)
Value and
Demand
for Children
FP Demand
Spacing
Limiting
Other
Intermediate
Variables
Fertility
Wanted
Unwanted
Contraceptive
Practice
Development
Programs
Family Planning
Supply Factors
Service Outputs:
Access
Quality
Image/
Acceptability
Service
Utilization
Other Health
and Social
Improvements
Conceptual models:
Earp and Ennett (1991)
Concepts = in boxes
Processes = shown by arrows
Can reflect factors at multi levels (macro to
micro)
Conceptual models
Serve to:
2)
3)
4)
5)
Tobacco use is the single largest cause of preventable premature mortality in the United States. It also
represents an enormous cost burden to the nation. The question is, what works to make tobacco use
prevention and control at the population or community level? The Guide to Community Preventive
Services addresses the effectiveness of community-based interventions for three strategies to promote
tobacco use prevention and control: 1) prevent tobacco product use initiation, 2) increase
cessation and 3) reduce exposure to environmental tobacco smoke (ETS). The findings
strengthen and complement existing guidelines (hyperlink table and text to existing guidelines) on
tobacco prevention and control.
Analytic Framework
Smoking
Bans
Reduced
Morbidity
and
Mortality
Community
Education
Smoking
Bans
Reduced
Morbidity
and
Mortality
Smoking
Bans
Reduced
Morbidity
and
Mortality
Fewer
Tobacco
Users
Smoking
Bans
Change
In
Attitudes
Reduced
Consumption
Increased
Quit
Attempts
Increased
Cessation
Reduced
Morbidity
and
Mortality
Smoking
Bans
Change
In
Attitudes
Change
In
Attitudes
Reduced
Initiation
Fewer
Tobacco
Users
Reduced
Consumption
Increased
Quit
Attempts
Increased
Cessation
Reduced
Morbidity
and
Mortality
Smoking
Bans
Change
In
Attitudes
Change
In
Attitudes
Reduced
Consumption
Reduced
Initiation
Fewer
Tobacco
Users
Increased
Quit
Attempts
Increased
Cessation
Diverted
Consumption
Increased
Home Exposure
Reduced
Morbidity
and
Mortality
12
Reduced
Exposure to ETS
0*
Change
In
Attitudes
Smoking
Bans
0*
9
Change
In
Attitudes
Reduced
Consumption
Reduced
Initiation
6
Fewer
Tobacco
Users
Increased
Quit
Attempts
Increased
Cessation
Diverted
Consumption
Increased
Home Exposure
Reduced
Morbidity
and
Mortality
Knowledge
Gender
Income
Education
Psychographic
Characteristics
Program
Exposure
Practice
Family
Characteristics
Interpersonal
Contacts
Attitude
Socioeconomic
development
Socioeconomic
status
Domestic violence
norms
Gender inequality
Intergenerational
exposure to violence
Crime levels
Risk behaviors
Domestic
violence
Womens status/
autonomy
Conceptual
Framework
Conceptual
Framework
Communication
to a Health-Competent
Pathways toPathways
a Health-Competent
SocietySociety
Domains for
Communication Interventions
Communication to
Strengthen the
Social Political
Environment
Communication
for Effective
Service
Delivery
Systems
Communication
to Create
Health Literate
Communities
and Individuals
Conceptual Framework
Communication Pathways to a Health-Competent Society
Domains for
Communication Interventions
CommunicationSocial Political
Environment
Communication
for Service
Delivery
System
Initial Outcomes
Environment
Service Systems
Community
Communication
for Community/
Individual
Individual
Conceptual Framework
Communication Pathways to a Health-Competent Society
Domains for
Communication Interventions
CommunicationSocial Political
Environment
Communication
for Service
Delivery
System
Initial Outcomes
Environment
Behavioral
Outcomes
Supportive
Environment
Service
Performance
Service Systems
Client
Behaviors:
Community
Community
Communication
for Community/
Individual
Individual
Individual
Conceptual Framework
Communication Pathways to a Health-Competent Society
Domains for
Communication Interventions
CommunicationSocial Political
Environment
Communication
for Service
Delivery
System
Initial Outcomes
Environment
Behavioral
Outcomes
Supportive
Environment
Service
Performance
USAID 5 SOs
Service Systems
Client
Behaviors:
Community
Community
Communication
for Community/
Individual
Sustainable
Health Outcomes
Individual
Individual
Conceptual Framework
Communication Pathways to a Health-Competent Society
Underlying
Conditions
Domains for
Communication Interventions
CommunicationSocial Political
Environment
Initial Outcomes
Environment
Behavioral
Outcomes
Sustainable
Health Outcomes
Supportive
Environment
Context
Communication
for Service
Delivery
System
Service
Performance
USAID 5 SOs
Service Systems
Client
Behaviors:
Community
Resources
Community
Communication
for Community/
Individual
Individual
Individual
Conceptual Framework
Communication Pathways to a Health-Competent Society
Environment
Social
CommunicationSocial Political
Environment
Initial Outcomes
Political will
Resource allocation
policy changes
Institutional capacity
building
National coalition
National communication
strategy
Service Systems
Context
Disease Burden
Domains for
Communication Interventions
Availability
technical competence
Information to client
Interpersonal
communication
Follow-up of clients
Integration of services
Community
Underlying
Conditions
Leadership
Participation equity
Information equity
Priority consensus
Network cohesion
Ownership
Social norms
Collective efficacy
Social capital
Economic
Communication
Technology
Political
Legal
Resources
Communication
for Service
Delivery
System
Human and
Financial
Resources
Strategic
Plan/Health
Priorities
Other Development
Programs
Policies
Communication
for Community/
Individual
Individual
Cultural
Message recall
Perceived social
support/stigma
Emotion and values
Beliefs and attitudes
Perceived risk
Self-efficacy
Health literacy
Behavioral
Outcomes
Sustainable
Health Outcomes
Supportive
Environment:
Multi-sectoral
partnerships
Public opinion
Institutional
performance
Resource acquisition
Media support
Activity level
Service
Performance:
Access
Quality
Client volume
Client satisfaction
Client
Behaviors:
Community
Sanitation
Hospice/PLWA
Other actions
Individual
Timely service use
Contraception
Abstinence/partner
reduction
Condom use
Safe delivery
BF/nutrition
Child care/immuniz.
Bednet use
USAID 5 SOs
Reduction in:
Reduction in:
Unintended/mistimed
Pregnancies
Morbidity/mortality
From pregnancy/
Childbirth
Infant/child
morbidity/mortality
HIV transmission
Threat of infectious
diseases
Requirement for
exercise #1
Formative evaluation
Different types:
Strategic Planning
Program Development
Stakeholder Input
Program Implementation
Program Evaluation
Environment Scanning
Stakeholder Input
Program Accountability
Lit reviews
Similar studies
Demographic statistics
Government reports
Quantitative (demographic,
epidemiological):
Qualitative:
Examples:
Publication of formative
research in peer-reviewed lit
Quite rare
Results often presented in a report
Discretionary $$
Low academic achievers