B
STEP LOGIC
MODELS
CONTENTS
| Logic Models and Program Planning | 2 |
| Basic Logic Model Components | 4 |
| Approaches to Developing a Logic Model | 7 |
| Steps for Constructing a Logic Model | 9 |
| The Logic Model Narrative | 15 |
| Workplans: A Note | 18 |
| Points to Ponder | 19 |
| Logic Model Supplemental Material | 21 |
| Logic Model “Reverse” Construction | 21 |
| Logic Model Worksheets | 22 |
| Logic Model Examples | |
| Oral Health Infrastructure Global Model | 32 |
| Oral Health State Plan Development | 33 |
| Tobacco Control Models | 34 |
| Active Play Model | 36 |
| Logic Model Bibliography | 37 |
Our thanks to The Office on Smoking and Health and The
Division of Physical Activity and Nutrition for allowing us to
use their workbooks as guides for the development of this
Division of Oral Health workbook
2. Describe the Program 1
B
STEP LOGIC
MODELS
Logic Models and Program Planning
After you have Defined the Problem (Step 2a – Evaluation Guidelines) it is
recommended that you construct a program Logic Model. The Logic Model
depicts program outcomes, how the program is supposed to accomplish these
outcomes and what is the basis (logic) for these expectations.
What Logic Models can do for you:
Logic models link program inputs (i.e., resources) and activities to program
products and outcomes (i.e., goals) while communicating the logic (theory)
behind the program, its rationale for existing. Logic models can be used to:
(1) identify the products, short-term, intermediate, and distal outcomes for your
program;
(2) link outcomes to each other and to program activities using the identified
logic/theory/model for your program (illustrate cause and effect);
(3) incorporate findings from research and demonstration projects;
(4) select indicators to measure outcomes depending on the stage of your
program’s development;
(5) illustrate why the program is important as well as its fundamental purpose;
(6) depict what intermediate outcomes/products must occur before distal
outcomes will be evident;
(7) make mid-course adjustments and improvements in your program; and
(8) become a common reference point for staff, stakeholders, constituents and
funding agency
A logic model will assist you in communicating the underlying theory (logic) that
you have about why your activities are a good solution to the problem identified.
Logic models can be displayed by varying methods. Some read left to right,
others top to bottom with intermittent circles and squares, while still others
follow a winding path; all are designed to demonstrate the link (logic/theory) of
what leads to what. What are the links between resources, activities, products
and outcomes? Why and how will your program work?
2. Describe the Program 2
Logic models often provide the needed synthesis of your program to successfully
convey why your program is important as well as the logic behind why you
expect it to succeed. A logic model is an iterative tool, providing a framework to
revisit throughout program planning, implementation and evaluation.
NOTE: Many RFAs now require that you include a logic model of your
proposed program.
Stakeholders
Ideally, the development of a logic model engages stakeholders (identified in
Step 1 of the Evaluation Guidelines) and guides program development and
evaluation planning simultaneously. It provides a forum for stakeholder
differences to be identified and considered as well a catalog of resources and
support for your program. By including stakeholders, you promote ownership
and commitment to the program. It is hoped that all parties can come to an
understanding and consensus about program outcomes and limitations, as well
as activities to achieve those outcomes and future direction.
The “Logic”
The logic or rationale for your program can be developed from numerous sources
considering context and stage of development of your program. These might
include:
Focus groups
Key informant assessments
Community needs assessments
Formal behavioral theory
Delphi-method or other consensus-based theory
Previous evaluation results
Evidence-based research/practice/intervention models
Faulty logic can lead to ineffective and inefficient programs. The logic is what
links resources to activities to products to outcomes. A logic model is your best
evidence as to why this program will work and best justification for spending
specific resources in a particular direction. In a graphic depiction, the “arrows”
portray the logic. Think of each arrow as a bridge between the boxes. The
strength of your bridge depends on the strength of the logic used.
Inputs
Activities
Outcomes
2. Describe the Program 3
LOGIC MODEL COMPONENTS
Inputs: Resources that go into the program
Activities: Actual events or actions that take place
Products: Direct tangible outputs of program activities
Outcomes: Impact of the program; the sequence of effects triggered by
the program, often expressed in terms of short-term, intermediate, and
distal outcomes
Arrows: Depict the logical links between inputs, activities and outcomes
Inputs are the various resources that go into a program. For an Oral Health
Infrastructure Development program, inputs may include:
Direct and in-kind funding
Staff of Oral Health Unit
Partner Organizations (support and resources)
Steering or Advisory Board
Legislation/Rules/Regulations
Equipment
Activities are the actual events that take place as part of the program. The
following are examples of activities in an Oral Health Infrastructure Development
Program:
Develop a coalition
Write a state oral health plan
Develop a comprehensive, integrated surveillance system
Develop a culturally appropriate media kit to educate and inform
population regarding Oral Health
Develop school referral networks
Develop fluoridation and sealant programs
TIP: List all activities with an action verb to distinguish between activities
and products.
2. Describe the Program 4
Outcomes reflect the intended accomplishments of the program. The following
are some examples:
Increase in oral health legislation/rules/regulations
Increase in evidence-based prevention programs
Decrease in decay
Decrease in untreated decay
Increase in oral cancer examinations
Increase in awareness of oral cancer causes
Decrease in periodontal disease
Increase in number of providers using of sealants
Products are the direct tangible outputs of program activities. Products and
short-term outcomes are often grouped together. Products are distinguished
from effects/outcomes in that effects and outcomes make some change in a
target audience. The following are some examples of products:
Written vision, mission and goal statements for coalition
A written State Oral Health Plan
A comprehensive Oral Health Surveillance System
A completed media campaign kit on oral cancer awareness available for
dissemination
TIP: List all products with a noun to distinguish between products and activities.
Short-term outcomes describe the immediate effects of a program and often
focus on the knowledge, attitudes, and skills gained by a target audience. Some
examples:
Increase in oral health advocacy due to active coalition that represents a
broad range of committed stakeholders
Increase in evidence-based direction for resources using state plan as the
strategic guide
Increased public exposure to information regarding oral cancer
Intermediate outcomes include behavior change, normative change, and
changes in policies. Some examples:
Changes in practice law due to coalition activities
Mandatory dental screenings for school-aged children implemented based
on state plan
Increased public behavior towards the prevention of oral cancer
2. Describe the Program 5
Note: Short-term and intermediate outcomes are the direct result of your
program. They are the evidence for believing that the distal outcomes will occur
given time and credibility of the logic you have used.
Distal outcomes often take time to achieve, e.g., decreased morbidity and
mortality for health promotion programs. Distal outcomes are the ultimate goals
of the program. Some examples:
Decrease in prevalence of caries
Decrease in prevalence of oral cancer
Decrease in prevalence of periodontal disease
Decrease in prevalence of disease related to infection control methods
NOTE: Products and short-term outcomes often are grouped together for ease
of depiction in the logic model framework.
DISTAL
OUTCOMES
Each component is connected to
the others by the overarching logic
t
or theory – thus establishing a
foundation for evidence-based
action – the “arrows” depic the
logic
ACTIVITIES
PRODUCTS/
SHORT-TERM
OUTCOMES
INTERMEDIATE
OUTCOMES
BASIC PROGRAM LOGIC MODEL
| INPUTS |
2. Describe the Program 6
Approaches to Developing a Logic Model
There is no “right” way to begin a logic model. Design construction is based on
stage of the program, identified “logic,” information available concerning
resources, etc. However, you should have a clear definition of the problem
before starting construction of your logic model. [Problem definition developed in
Step 2a of the Evaluation Guidelines] The two approaches described in this
Workbook are the Forward Logic approach and the Reverse Logic approach. We
will use the Forward Logic approach to demonstrate the construction of the Oral
Health Infrastructure Logic Model. The Reverse Logic approach is described in
the supplemental section of this workbook.
Left to Right or “Forward Logic” ################
Developing your logic model from left to right starts with articulating the
program inputs and activities and requires you to work forward towards distal
outcomes. This approach is often used when you need to evaluate a program in
the implementation or maintenance stage but do not already have a logic model
in place. You will ask the question “But Why?” as you move from left to right in
your logic model.
| Example: | |
| Inputs | Staff, Funding, Coalition, Surveillance System |
| But Why? | |
| Activities | Develop a State Oral Health Plan |
| But Why? | |
| Products | Evidence-based State Oral Health Plan |
| But Why? | |
| Intermediate Outcomes | Plan establishes methods for targeting most in need with available funds. |
| But Why? | |
| Distal Outcomes | Reduction in disparities |
You can also think of this left to right movement as an IF … THEN ….
progression. Further examples for the IF-THEN process are described below in
Step Four.
For the purpose of constructing Oral Health Infrastructure Development logic
models using the ASTDD Infrastructure Development Model and the current RFA
guidelines, the construction of the logic model should proceed along the
following steps using the Forward Logic approach.
2. Describe the Program 7
Steps for Constructing a Logic Model
| Step 1 | Problem Definition (Step 2a Evaluation Guidelines) |
| Step 2 | Capacity/Resource/Gaps Inventory |
| Step 3 | Define Activities |
| Step 4 | IF……..THEN Process |
| Step 5 | Arrange Logic Model Components |
| Step 6 | Logic Model Narrative |
Step One: Begin with a problem definition.
Case Study: Lack of coordinated resources, advocacy legislature support and
direction has led to a paucity o sustainable oral health promotion
activities within New State. Moreover, lack of comprehensive, up-to-date
surveillance data prohibits them from making evidence- based decisions
as to priority and actions. Single activities alone will not add ess the o al
health status of all New State citizens nor will they address the disparities
that exist within its communities. It is evident that an increase of state
oral health infrastructure must occur in order for New State to adequately
address the oral health needs of its citizens in an effective and efficient
manner. Therefore, the desired outcome is to develop sustainable oral
health infrastructure within New State using the ASTDD model as their
guiding logic.
,
f
r r
You should have a good understanding of the problem definition if you have
completed a needs assessment for your community, considered the appropriate
theory of change, and identified your priorities within the framework of available
resources and current capacity. Your problem definition defines the outcomes
you will establish for a program. A distal outcome is a general, “big picture”
statement of the outcomes a program intends to accomplish in the long-term to
fulfill its mission. The outcome should be written so that the measurement of
success is clear.
Step Two: Conduct a Capacity/Inputs/Gaps Inventory.
When drafting a logic model, assess your inputs (resources) as they relate to the
problem you are addressing. Inputs for oral health infrastructure development
might include items such as a water fluoridation program, a full-time dental
director, MCH block grant funding, a steering committee, some surveillance
capacity, legislation mandating the development of a State Oral Health Plan and
your current CDC/DOH funding.
Use the Logic Model Worksheet to complete your current list of inputs. It is
assumed that each state can define a time period when oral health infrastructure
2. Describe the Program 8
development efforts began in their state. Therefore, inputs for this activity are
divided into three sections: 1) infrastructure in place prior to build-up period, 2)
infrastructure developed (or being developed) with non-DOH funds, and 3)
infrastructure to be developed with current DOH funds. The inputs column is the
far left column of the Logic Model Worksheet. Ideally, the three boxes on your
pictorial logic model would be labeled: 1) infrastructure in place prior to (date),
2) infrastructure developed (being developed) starting in (date) with non-DOH
funds, and 3) infrastructure to be developed with current DOH funds. Thus, you
would leave the details for your logic model narrative (Step 6).
Using the inputs that you have identified, assess what components of the ASTDD
Infrastructure Model (program logic) you already have (i.e., you have a full-time
dental director but do not have a State Plan or an integrated surveillance
system). Identify and prioritize gaps in the structure.
Prioritization should consider data from your community needs assessment,
current capacity (state of infrastructure development), and available inputs. For
example, if you do not have an adequate integrated surveillance system to make
evidence-based decisions, you might place a higher priority on this activity before
developing a state plan. Then, when you do develop your state plan, you will
have the evidence needed to justify your plan. Additionally, prioritization is
important when you do not have enough “inputs” to adequately complete all the
activities you need to accomplish in order to achieve the outcome of
comprehensive infrastructure for oral health.
It is important that you use surveillance evidence to set priorities. Use data from
sources such as focus groups, community needs assessments, legislative
mandates, surveillance systems, infrastructure capacity assessment in
conjunction with Healthy People 2010 Oral Health objectives and current inputs
to determine your state’s “most in need” factors. The gaps identified as highest
priority become the factors you will address in your program and the activities
depicted in your logic model.
The ASTDD Infrastructure model is depicted in column two of the Logic Model
Worksheet. Place a check mark √ by the gaps you have identified in your state’s
oral health infrastructure. Transfer the checked items to the Gaps Identified
worksheet. For each gap identified, indicate the available data that would give
evidence for elimination of this gap. In collaboration with your identified
stakeholders and considering available evidence, prioritize each gap.
2. Describe the Program 9
At this point you have:
9 Defined the problem
9 Completed a current capacity/inputs/gaps inventory
9 Considered information from your community needs assessment
9 Prioritized gaps based on surveillance data and community needs
assessment
Step Three: Define Activities
What activities will you complete during the program period depicted in your
logic model? A logic model serves as a strategic guide from planned activities to
intended outcomes. If your activities are not implemented as planned it is
unlikely you will achieve all of your proposed outcomes. Your proposed activities
should correspond to the gaps you prioritized in Step Two.
Write down your proposed activities on the Activities Worksheet. When
composing your activities, ask the following questions:
¾ What are we proposing to do?
¾ What gap(s) are we trying to eliminate?
¾ Why would we do this (logic)?
¾ How are we proposing to accomplish this activity?
¾ Are the needed inputs available?
¾ When will we accomplish this activity?
¾ What is our target group? (if applicable)
You should have at least one planned activity for each gap identified as a
priority. A single gap may require multiple activities such as the development of
a coalition or state plan.
Step Four: IF ….. THEN ….. Process
Once you’ve identified and prioritized your program’s activities, ask “If we do this
(input + activity), then what will happen (product/outcome)?” You should write
an if-then statement for each of the activities you proposed in Step Three. This
step is the process of linking activities with outcomes based on your intended
theory/model. You should have at least one activity for each outcome identified.
2. Describe the Program 10
IF …. THEN …. Statements are directed by your Theory of Change. For
the purposes of Oral Health Infrastructure Development, the theory is the
ASTDD Model for Oral Health Infrastructure Development.
For example,
♦ If we obtain funding for the development of an oral health advocacy
coalition, then the coalition will be formed.
♦ If we establish this coalition, then they will develop a State Oral Health
Plan.
♦ If we have a strong evidence-based State Oral Health Plan, then we can
request funding for caries prevention programs for school-aged children.
♦ If we receive funding for caries prevention programs for school-aged
children, then we can implement sealant (logic-based action) and referral
programs (logic-based action) in our public schools.
♦ If we implement caries prevention programs in school-aged children we
will increase the number of children with sealants; and if we implement
school-based referral programs, then we will increase the number of
children seen by a dental provider.
♦ If we increase the number of children with sealants, then we will reduce
the incidence of caries. If we increase the number of children seen by a
dental provider then we reduce the number of children with untreated
decay.
An example of how the previous If-Then statements would become a pictorial
logic model as well as how outputs can become future inputs is provided on the
following page.
Use the activities you identified in Step Three and complete an if-then statement
for each activity using the IF-THEN Worksheet.
2. Describe the Program 11
Example:
Gaps: Lack of coordinated, linked surveillance data
No State Oral Health Plan
Oral Health Unit needs: epidemiologist, program manager, data
manager
Activities: Hire data manager to link available data sources
Assess gaps in available data sources
Incorporate into State Oral Health Plan method for elimination of
data gaps
IF And IF THEN
| INPUTS | ACTIVITY | OUTCOME/PRODUCT |
| IF New State has funding to hire a data manager |
And IF New State has the new data manager link all available data sources |
THEN New State will have a coordinated, linked surveillance system |
| IF New State has a coordinated, linked surveillance system |
And IF New State assesses the gaps in the surveillance system |
THEN New State will have a document describing the data gaps that need to be eliminated |
| IF New State has a document describing the data gaps |
And IF New State incorporates this document and a plan for elimination of gaps into their State Oral Health Plan |
THEN New State will have a strategic guide towards the elimination of data gaps and will be positioned to apply for funding to support this proposed activity |
2. Describe the Program 12
| IF |
THEN
| DISTAL OUTCOMES |
PRODUCT | OUTCOMES |
| Voice and Resource for Oral Health promotion Direction and strength to oral health improvement efforts Resources for targeted evidence-based programs received |
| INPUTS | ACTIVITY |
| Funds to develop an Oral Health Coalition |
Develop an Oral Health
Coalition
Active Coalition
Develop a State Oral
Health Plan
Comprehensive State Oral
Health Plan
| Oral Health Coalition |
| Strong comprehensive evidence-based state oral health plan |
Justification for applying
for funding to support
targeted proven programs
Funding secured
| Resources available for targeted evidence based programs |
| Develop Sealant programs and referral program |
| Evidenced-based programs in place targeting most in need populations |
| Increase in number of children with sealants and in number of children seen by dental provider |
Reduction in
incidence of caries
and reduced rate of
untreated decay
2. Describe the Program 13
Step Five: Arrange Logic Model Components
You are now ready to arrange your logic model components. Starting at the lefthand side and moving to the right, arrange your inputs, activities and outcomes
in a columnar-linked format. Examine the model carefully. Does each step
logically relate to the other? Are there missing steps that disrupt the logic of the
model? Does each outcome have a corresponding activity? You may need to
use additional arrows to link outcomes that have more than one activity etc.
| ACTIVITIES |
| PRODUCTS/ SHORT-TERM OUTCOMES |
| INTERMEDIATE OUTCOMES |
DISTAL
OUTCOMES
| INPUTS |
An essential design element of logic models is that they are contained on a
SINGLE page. It is intended to be a quick snapshot of your program. Your
detail should be comprehensive enough to adequately portray the big picture of
your program, but sparse enough to embody a single-page portrait framework.
Once the model is implemented, you can use it to assess whether your program
is doing what it needs to do to implement change. It is important to remember
that logic models change over time with improvements to the program, shifting
resources, and new science supporting prevention of oral disease. Logic model
development is and always will be an iterative process. Additionally, your logic
model for one program can jump start the process of planning for a subsequent
program as outputs become resources/inputs and health gains are expanded.
Logic models can be broad or very specific. They can be linked to one another
to express different levels of effort, such as national, state and local programs.
Additionally, you could prepare a family of logic models to represent diverse
aspects of the program: an overall state program, multi-strategy efforts to
address one of the three public health core component areas, or a specific
program strategy within a core component area such a the development of a
State Oral Health Plan. Examples of logic models representing different levels of
detail are found in the supplemental material for this Workbook section.
In summary, drafting logic models can be challenging but worthwhile. It is like
having a road map directing you to your final destination. Logic models can help
you determine whether your program activities logically lead to the desired
outcome. A logic model provides a quick snapshot of what you have, what you
2. Describe the Program 14
are doing, and where you are going, as well as the direction you might need to
embark upon once the current activities are completed. They are a visual
depiction of the program that helps ensure that all the stakeholders understand
the program’s purpose, the resources it will need, the activities it will conduct,
and its capacity to effect change as well as limitations. Logic models offer a
useful starting place for identifying questions to be answered by the program
evaluation. Finally, a collaborative process of creating logic models is an
effective way to engage stakeholders and generate support and ownership for
your program. This is an important first-step before creating the program
workplans.
At this point you have:
9 Defined the problem
9 Completed a current capacity/inputs/gaps inventory
9 Considered information from your community needs assessment
9 Prioritized gaps based on surveillance data and community needs
assessment
9 Completed a list of activities
9 Developed “linking” If-Then statements
9 Graphically depicted your logic model on a SINGLE page
Step Six: Logic Model Narrative
An essential design element of logic models is that they are contained on a
SINGLE page. It is intended to be a quick snapshot of your program. It is a
visual depiction of your program. Therefore, it often is necessary to include
short narrative bullets on subsequent pages to describe and clarify logic model
components for reporting purposes and funding proposals. A narrative
component to your logic model can convey the depth and detail of each activity
and its intended outcome to your audience. A program report for funding
agencies, stakeholders or legislators might contain:
9 Logic Model
9 Logic Model narrative
9 Workplans
9 Progress report
9 Success “stories”
2. Describe the Program 15
Logic Model Narrative Example (abbreviated)
Outcome description: Lack of coordinated resources, advocacy, legislative
support and direction have led to a paucity of sustainable oral health promotion
activities within New State. Single activities alone will not address the oral health
status of all its citizens, nor will they address the aspect of disparity within the
communities. New State needs a written, evidence-based State Oral Health Plan
in order to best target those “most in need” and eliminate oral health disparities
experienced in the state. A written state plan will be able to demonstrate one
cohesive voice with which to advocate for funds and direct limited resources in
an effective and efficient manner. A written plan will guide current steps by
identifying stakeholders and persons responsible for action as well as providing a
forum for next-steps in order to continue health gains in the Oral Health field. A
state plan will assist in providing a coordinated, comprehensive approach to the
oral health disease burden in New State.
INPUTS:
Staff
¾ Full-time dental director
¾ Program manager
¾ Program assistant
¾ Half-time epidemiologist
¾ Administrative support
¾ Fluoride program coordinator
Coalition
¾ Active steering committee
¾ Institutionalization of coalition
¾ Administrative support for coalition
¾ Broad active representation on the coalition
¾ Visibility of coalition
¾ Stakeholder support
Surveillance System
¾ Comprehensive, integrated surveillance system
¾ Community-level indicators
¾ Mechanism for data checking
¾ Secure funding
¾ Institutionalization of system
2. Describe the Program 16
Funding/support
¾ Legislative mandate to develop State Oral Health Plan
¾ Funds to support development of State Oral Health Plan
¾ Leverage Stakeholder support
ACTIVITIES
Development of State Oral Health Plan
¾ Include mechanism for input from non-coalition member
stakeholders
¾ State-wide needs assessment by community
¾ Incorporate Best Practices
¾ Evidence-based decisions – surveillance data
¾ Comprehensive:
¾ Caries, periodontal diseases, oral cancer, infection control
measures
¾ Infants, children, adults, aging
¾ Address disparity
PRODUCTS
¾ Evidence-based comprehensive State Oral Health Plan with
plans for revision every two years
INTERMEDIATE OUTCOMES
¾ Evidence-based choice of methods to target those with the greatest
need with available funds
¾ Cohesive direction
¾ Collaboration of stakeholders
¾ “Next-steps” – Plan for future directions as funds become available
¾ Voice and evidence for advocacy for additional funding
¾ Leveraging of funds
¾ Identification of stakeholders responsible for action
DISTAL OUTCOMES
¾ Reduction in disease disparity
¾ Continued Oral Health Gains
NOTE: There is no right number of intermediate/distal outcomes.
However, each outcome should be directly tied (via logic) to an activity or
group of activities. [All activities should have at least one outcome.]
2. Describe the Program 17
At this point you have:
9 Defined the problem
9 Completed a current capacity/inputs/gaps inventory
9 Considered information from your community needs assessment
9 Prioritized gaps based on surveillance data and community needs
assessment Completed a list of activities
9 Developed “linking” If-Then statements
9 Graphically depicted your logic model on a SINGLE page
9 Written a descriptive narrative to accompany your SINGLE page
logic model
Workplans: A Note
A workplan is the Program Manager’s guide for running the project. A workplan
details the goals, objectives, tasks, timelines and person(s) responsible for the
action of the program. A workplan describes: 1) who needs to do what; 2) by
when (as well as in what order); and 3) how in order to effectively implement
the program. A logic model demonstrates the theory for choosing these
particular goals and the expected outcome of completing the tasks detailed in
the workplans. Work accomplished in Step 2 and Step 4 of the Evaluation
Framework will assist you in developing your workplans. Workplan development
is an important “next-step” after developing your logic model. A workplan
workbook is included in the Evaluation Guidelines: Step 2C.
2. Describe the Program 18
Other names for a logic model
| Theory of change | Model of change |
| Theoretical underpinning | Causal chain |
| Weight-of-evidence model | Roadmap |
| Conceptual map | Blueprint |
| Rationale | Action and inquiry Maps |
| Program hypothesis | Program plans |
Points to Ponder
Ideally, a broad range of stakeholders should be invited to the table to
collaborate in the construction of your program logic model. Identifying
partners, existing agendas and potential barriers as well as non-traditional areas
of support during construction of your logic model will assist in the acceptance of
your logic model. Engaging stakeholders in the process promotes a sense of
commitment and shared vision as well as ownership of the plan. Remember to
review your RFA, budgets, vision/mission statements, strategic and operational
plans, previous evaluation reports, coalition goals, etc. before constructing your
logic model.
Relax! The first one might be a little rough but it will get easier.
Include broad range of stakeholders when developing a logic model. This
encourages “buy-in” and support. Consider the range of stakeholders that
affect the program (e.g., Board of Education support is essential for
establishing a school-based sealant program). Include stakeholders during
Logic Model construction that represent those who will participate in, or
be influenced by the program – the target group.
Identify potential barriers as early as possible – community factors may
counter the direction of program outcomes and/or influence the
achievement of distal outcomes.
Engage partners who both support and inhibit the progress of better oral
health – competing and complementary causes.
Ensure that the existing vision and mission of potential partners will be
compatible with current plans
Plan for sustainability – i.e., how can you build your program into the life
of an existing established system?
2. Describe the Program 19
Consider feasibility as one factor in the equation when developing a logic
model and planning for evaluation.
Don’t be afraid to call in an “outsider” to facilitate construction.
Implementation details should be covered in your logic model narrative
and/or your work plan not in your logic model graphic.
√ Checklist for describing the program
Document the need for the program (step 2a).
Document program resources.
Note the program’s stage of development.
Explain the program context.
List and describe program activities.
State program outcomes and objectives.
Prepare a logic model (step 2b).
Prepare workplans (step 2c).
Resources
1. CDC Evaluation Working Group
www.cdc.gov/eval
2. U.S. Census Bureau State Data Center Program
www.census.gov/sdc/www
3. Healthy People 2010
www.health.gov/healthypeople
4. American Evaluation Association
www.eval.org
2. Describe the Program 20
LOGIC MODEL
SUPPLEMENTAL
MATERIAL
Logic Model Construction Approaches
Right to Left or “Reverse Logic” ´´´´´´´´´´´´´´´´´
Developing your logic model from right to left starts with desired outcomes and
requires you to work backwards to develop activities and inputs. Usually used in
the planning stage, this approach ensures that program activities will logically
lead to the specified outcomes if your arrow bridges are solid (sound logic). You
will ask the question “But How?” as you move to the left in your logic model.
This approach is also helpful for a program in the implementation stage that still
has some flexibility in its choice of program activities.
| Example: | |
| Desired Distal-outcome | Providers will incorporate the CDC recommendations for Infection Control consistently in their practices |
| But How? | |
| Intermediate outcomes | Providers will gain increased skills and knowledge to implement Infection Control measures in their practices |
| But How? | |
| Products | Infection Control workbook/workshops based on published guidelines |
| But How? | |
| Activities | Develop Infection Control workbook and workshops based on published guidelines |
| But How? | |
| Inputs | CDC Infection Control Guidelines and technical assistance / Funding source(s) |
B
STEP
2. Describe the Program 21
| 2. Describe the Program – – Additional Infrastructure to be developed with current DOH funding |
| 22 |
| Additional Infrastructure developed (being developed) with funding other than direct DOH dollars Date When OH Infrastructure Development build-up began |
| Existing Infrastructure (prior to date ) Most likely, these items have been institutionalized |
–
Logic Model Worksheet INPUTS
If we have these
INPUTS
Logic Model INPUTS Narrative Worksheet
Infrastructure inputs prior to ______________________
Date
¾
¾
¾
¾
¾
¾
¾
¾
¾
¾
Infrastructure buildup inputs (non-DOH funded) ______________________
Date
¾
¾
¾
¾
¾
¾
¾
¾
¾
¾
Infrastructure buildup inputs (current CDC/DOH funds)
¾
¾
¾
¾
¾
¾
¾
¾
¾
¾
2. Describe the Program 23
Infrastructure inputs prior to _______1996_______________
Date
¾ Dental school
¾ 4 Dental hygiene schools
¾ Part-time dental director
¾ Water fluoridation program in 60% of state water plants
¾ Sealant program in 45/56 counties
¾ 1987 oral health survey – 3rd grade students
¾ Active dental hygiene association
¾
¾
¾
Infrastructure buildup inputs (non-DOH funded) ________1996___________
Date
¾ Mandate from legislature to develop state oral health plan-1999
¾ Access coalition-1998
¾ Expanded sealant program to 56/56 counties-1998
¾ Expanded OH curriculum grades K-8 – 2000
¾ Mandatory OH school screenings – 2000
¾ Increase in Medicaid reimbursement – 2001
¾ State-wide, lifespan OH needs assessment to be conducted – 2001
¾
¾
¾
Infrastructure buildup inputs (current CDC/DOH funds)
¾ Expand dental director to full-time
¾ Expand access coalition to active comprehensive OH coalition
¾ Water fluoridation coordinator hired
¾ Epidemiologist/project coordinator hired for OH unit
¾ Coordinated, linked surveillance system developed and used to direct
state plan
¾ Evidence-based state oral health plan encompassing the life-span
¾ State infection control surveillance guidelines established
¾ Biannual OH survey 3rd grade; 7th grade; mothers and infants established
¾ OH Web site
Logic Model INPUTS Narrative Example
2. Describe the Program 24
| 2. Describe the Progr Additional Infrastructure developed with current DOH funding am |
| Additional Infrastructure developed with funding other than direct DOH dollars |
| Existing Infrastructure |
| – – ASSESS Complete needs assessment Identify baseline data Develop integrated tracking at community level Develop integrated tracking of program capacity & level of services delivered DEVELOP POLICY Mobilize support Develop state & community Oral health capacity Develop evidence based Oral health plan Identify support for legislation/rules ASSURE Identify current levels of OH awareness and education Identify areas of need and resources for population based interventions Identify health systems interventions Leverage budget (resources from public and non-public sources and clear leveraging activities) |
| 25 |
| ASSESS Sustainable surveillance system that provides data for evidence based plans and programs Increase in evidence-based directives DEVELOP POLICY Active coalition /advocacy voice Increased oral health capacity State oral health plan Increased supportive legislation/rules environment ASSURE Communication/ awareness campaigns Sustainable population-based interventions Health systems that promote OH Sustainable funding sources that promote the growth of Oral Health prevention and intervention activities Coordinated and comprehensive system of care |
ASTDD INFRASTRUCTURE MODEL WORKSHEET – Place a check mark (√) by the activities and products you
Essential Elements of Oral Health Infrastructure
We should get these
PRODUCTS
So that we address these
ACTIVITIES
of infrastructure
If we have these
INPUTS
GAPS IDENTIFIED WORKSHEET
| PRIORITY GIVEN |
GAP IDENTIFIED | EVIDENCE |
2. Describe the Program 26
GAPS IDENTIFIED EXAMPLE
| PRIORITY GIVEN |
GAP IDENTIFIED | EVIDENCE |
| So programs and state plan can be evidence driven and targeted to those with greatest need |
State-wide, lifespan needs assessment | |
| Build OH unit capacity Don’t have adequate surveillance capabilities |
Expand OH Unit Full-time dental director Epidemiologist Project coordinator Data manager Water fluoridation program coordinator |
|
| Don’t have adequate capabilities to analyze and use surveillance data |
||
| Don’t have adequate water fluoridation surveillance or coordinator |
||
| Need to address oral health issues across the life-span not just school-aged children |
Expand coalition to be comprehensive, addressing oral health issues across the life span and advocacy |
|
| Need to address all aspects of oral health and capacity development |
||
| Don’t have evidence to develop evidence based state plan or targeted programs |
Expand surveillance capabilities | |
| Need to use scarce resources efficiently | ||
| Infection control guidelines compliance surveillance currently non-existent in state |
Expand infection control surveillance | |
| Research indicates that lack-of perception of need is often one of the reasons adults do not seek oral health prevention services |
Identify current levels of OH awareness and education |
2. Describe the Program 27
ACTIVITIES WORKSHEET
| GAP IDENTIFIED |
ACTIVITY | QUESTIONS: WHO WHAT WHEN WHERE and WHY |
2. Describe the Program 28
