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Logic models are hypothesized descriptions of the chain of causes and effects leading to an outcome of interest (e.g. prevalence of cardiovascular diseases, annual traffic collision, etc). While they can be in a narrative form, logic model usually take form in a graphical depiction of the "if-then" (causal) relationships between the various elements leading to the outcome. However, the logic model is more than the graphical depiction: it is also the theories, scientific evidences, assumptions and beliefs that support it and the various processes behind it. [1] [2]
Logic models are used by planners, funders, managers and evaluators of programs and interventions to plan, communicate, implement and evaluate them. [3] [2] They are being employed as well by health scientific community to organize and conduct literature reviews such as systematic reviews. [4] [5] Domains of application are various, e.g. waste management, [6] poultry inspection, [7] business education, [8] heart disease and stroke prevention. [9] Since they are used in various contexts and for different purposes, their typical components and levels of complexity varies in literature (compare for example the W.K. Kellogg Foundation [10] presentation of logic model, mainly aimed for evaluation, and the numerous types of logic models in the intervention mapping framework [11] ). In addition, depending on the purpose of the logic model, elements depicted and the relationships between them is more or less detailed.
Citing Funnell and Rogers's account (2011), [12] Joy A. Frechtling's (2015) encyclopedia article [2] traces logic model underpinnings to the 1950s. Patricia J. Rogers's (2005) encyclopedia article [3] instead traces it back to Edward A. Suchman's (1967) book [13] about evaluative research. Both encyclopedia articles and LeCroy (2018) [14] mention increasing interest, usage and publications about the subject.
One of the most important uses of the logic model is for program planning. It is suggested to use the logic model to focus on the intended outcomes of a particular program. The guiding questions change from "what is being done?" to "what needs to be done"? McCawley suggests that by using this new reasoning, a logic model for a program can be built by asking the following questions in sequence:
By placing the focus on ultimate outcomes or results, planners can think backward through the logic model to identify how best to achieve the desired results. Here it helps managers to 'plan with the end in mind', rather than just consider inputs (e.g. budgets, employees) or the tasks that must be done.
The logic model is often used in government or not-for-profit organizations, where the mission and vision are not aimed at achieving a financial benefit. Traditionally, government programs were described only in terms of their budgets. It is easy to measure the amount of money spent on a program, but this is a poor indicator of outcomes. Likewise it is relatively easy to measure the amount of work done (e.g. number of workers or number of years spent), but the workers may have just been 'spinning their wheels' without getting very far in terms of ultimate results or outcomes.
However, nature of outcomes varies. To measure the progress toward outcomes, some initiatives may require an ad hoc measurement instrument. In addition, in programs such as in education or social programs, outcomes are usually in the long-term and may requires numerous intermediate changes (attitudes, social norm, industry practices, etc.) to advance progressively toward the outcomes.
By making clear the intended outcomes and the causal pathways leading to them, a program logic model provides the basis upon which planners and evaluators can develop a measurement plan and adequate instruments. Instead of only looking at the outcome progress, planners can open the "black box" and examine if the intermediate outcomes progress as planned. In addition, the pathways of numerous outcomes are still largely misunderstood due their complexity, their unpredictability and lack of scientific / practical evidences. Therefore, with proper research design, one may not only assess the progress of intermediate outcomes, but evaluate as well if the program theory of change is accurate, i.e. is successful change of an intermediate outcomes provokes the hypothesized subsequent effects in the causal pathway. Finally, outcomes may easily be achieved through processes independent of the program and an evaluation of those outcomes would suggest program success when in fact external outputs were responsible for the outcomes. [16]
Many authors and guides use the following template when speaking about logic model: [2] [3] [10] [14] [17]
Inputs | Activities | Outputs | Outcomes/impacts |
---|---|---|---|
what resources go into a program | what activities the program undertakes | what is produced through those activities | the changes or benefits that result from the program |
e.g. money, staff, equipment | e.g. development of materials, training programs | e.g. number of booklets produced, workshops held, people trained | e.g. increased skills/ knowledge/ confidence, leading in longer-term to promotion, new job, etc. |
Many refinements and variations[ which? ] have been added to the basic template. For example, many versions of logic models set out a series of outcomes/impacts, explaining in more detail the logic of how an intervention contributes to intended or observed results. [18] Others often distinguish short-term, medium-term and long-term results, and between direct and indirect results.
The intervention mapping approach of Bartholomew et al. [11] makes an extensive use of the logic model through the whole life-cycle of a health promotion program. Since this method can start from as far as a vague desired outcome (author's example is a city whose actors decide to address "health issues" of the city), planners go through various steps in order to develop effective interventions and properly evaluate them. There are distinguishable but closely interwoven logic models with different purposes that can be developed through the process:
Evaluators thereafter use the logic model of the intervention to design a proper evaluation plan to assess implementation, impact and efficiency.
The Progressive Outcomes Scale Logic Model (POSLM) approach was developed by Quisha Brown in response to the racial wealth gap [exacerbated by the COVID-19 pandemic] to aid organizations in the immediate need to add a racial equity focus when developing program logic models. More testing and research is needed in order to verify the validity of this model.
The POSLM approach makes use of the logic model with a strong focus on tracking progressive improvement towards racial disparity outcomes. To measure the progress towards outcomes, this type of logic model states short, intermediate and long-term outcomes as "stage 1", "stage 2" and "stage 3. Each stage is uniquely defined and used to depict the percentage of KPIs achieved at each stage or the percentage of people who reach each stage as they progress on pre-identified Key Performance Indicators (KPI). These KPIs are specific to the racial disparity issues which the population served identifies with (i.e. low reading, financial literacy, unemployment, etc). In an effort to prevent the logic model itself from being cluttered with an overwhelming number of KPIs, the KPIs are arranged by category and only the category is displayed on the logic model. The extensive list of KPIs are an appendix to the logic model. Organizations identify the KPIs and corresponding outcomes by first conducting a needs assessment and/or community focus groups. This helps to ensure that the logic model remains focused on improving the real-time needs of people to remove racial barriers. The POSLM can help to make more clear the intended outcomes and the casual pathways leading to them; both of which help to connect and compose a logical companion "if, then" theory of change statement. Again, more research is needed and currently being conducted as more nonprofits, philanthropic and governments use this model.
By describing work in this way, managers have an easier way to define the work and measure it. Performance measures can be drawn from any of the steps. One of the key insights of the logic model is the importance of measuring final outcomes or results, because it is quite possible to waste time and money (inputs), "spin the wheels" on work activities, or produce outputs without achieving desired outcomes. It is these outcomes (impacts, long-term results) that are the only justification for doing the work in the first place. For commercial organizations, outcomes relate to profit. For not-for-profit or governmental organizations, outcomes relate to successful achievement of mission or program goals.[ citation needed ]
There are some potential disadvantages of logic models due to tendencies toward oversimplification. [20] These include:
Program evaluation is a systematic method for collecting, analyzing, and using information to answer questions about projects, policies and programs, particularly about their effectiveness and efficiency.
Behavior change, in context of public health, refers to efforts put in place to change people's personal habits and attitudes, to prevent disease. Behavior change in public health can take place at several levels and is known as social and behavior change (SBC). More and more, efforts focus on prevention of disease to save healthcare care costs. This is particularly important in low and middle income countries, where supply side health interventions have come under increased scrutiny because of the cost.
The theory of planned behavior (TPB) is a psychological theory that links beliefs to behavior. The theory maintains that three core components, namely, attitude, subjective norms, and perceived behavioral control, together shape an individual's behavioral intentions. In turn, a tenet of TPB is that behavioral intention is the most proximal determinant of human social behavior.
The transtheoretical model of behavior change is an integrative theory of therapy that assesses an individual's readiness to act on a new healthier behavior, and provides strategies, or processes of change to guide the individual. The model is composed of constructs such as: stages of change, processes of change, levels of change, self-efficacy, and decisional balance.
The social norms approach, or social norms marketing, is an environmental strategy gaining ground in health campaigns. While conducting research in the mid-1980s, two researchers, H.W. Perkins and A.D. Berkowitz, reported that students at a small U.S. college held exaggerated beliefs about the normal frequency and consumption habits of other students with regard to alcohol. These inflated perceptions have been found in many educational institutions, with varying populations and locations. Despite the fact that college drinking is at elevated levels, the perceived amount almost always exceeds actual behavior. The social norms approach has shown signs of countering misperceptions, however research on changes in behavior resulting from changed perceptions varies between mixed to conclusively nonexistent.
Organizational effectiveness is a concept organizations use to gauge how effective they are at reaching intended outcomes. Organizational effectiveness is both a powerful and problematic term. It may be used to critically evaluate and improve organizational activities; this is one of its strengths. However, the term has been noted as problematic as it means various things to different individuals. Furthermore, there are alternative methods for measuring organizational performance. Organizational effectiveness embodies the degree to which firms achieve the goals they have decided upon, a question that draws on several different factors. Among those are talent management, leadership development, organization design and structure, design of measurements and scorecards, implementation of change and transformation, deploying smart processes and smart technology to manage the firm's human capital and the formulation of the broader Human Resources agenda.
Follow Through was the largest and most expensive experimental project in education funded by the U.S. federal government that has ever been conducted. The most extensive evaluation of Follow Through data covers the years 1968–1977; however, the program continued to receive funding from the government until 1995. Follow Through was originally intended to be an extension of the federal Head Start program, which delivered educational, health, and social services to typically disadvantaged preschool children and their families. The function of Follow Through, therefore, was to provide a continuation of these services to students in their early elementary years.
Participatory impact pathways analysis (PIPA) is a project management approach in which the participants in a project, including project staff, key stakeholders, and the ultimate beneficiaries, together co-construct their program theory.
Impact evaluation assesses the changes that can be attributed to a particular intervention, such as a project, program or policy, both the intended ones, as well as ideally the unintended ones. In contrast to outcome monitoring, which examines whether targets have been achieved, impact evaluation is structured to answer the question: how would outcomes such as participants' well-being have changed if the intervention had not been undertaken? This involves counterfactual analysis, that is, "a comparison between what actually happened and what would have happened in the absence of the intervention." Impact evaluations seek to answer cause-and-effect questions. In other words, they look for the changes in outcome that are directly attributable to a program.
Communities That Care (CTC) is a program of the Center for Substance Abuse Prevention (CSAP) in the office of the United States Government's Substance Abuse and Mental Health Services Administration (SAMHSA). CTC is a coalition-based prevention operating system that uses a public health approach to prevent youth problem behaviors such as violence, delinquency, school drop out and substance abuse. Using strategic consultation, training, and research-based tools, CTC is designed to help community stakeholders and decision makers understand and apply information about risk and protective factors, and programs that are proven to make a difference in promoting healthy youth development, in order to most effectively address the specific issues facing their community's youth.
Social and behavior change communication (SBCC), often also only "BCC" or "Communication for Development (C4D)" is an interactive process of any intervention with individuals, group or community to develop communication strategies to promote positive behaviors which are appropriate to their settings and thereby solving the world's most pressing health problems. This in turn provides a supportive environment which will enable people to initiate, sustain and maintain positive and desirable behavior outcomes.
Theory of Change (ToC) is a methodology or a criterion for planning, participation, adaptive management, and evaluation that is used in companies, philanthropy, not-for-profit, international development, research, and government sectors to promote social change. A Theory of Change of a social program defines its long-term goals and then maps backward to identify necessary preconditions.
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Triple P is a parenting intervention with the main goals of increasing the knowledge, skills, and confidence of parents and reducing the prevalence of mental health, emotional, and behavioral problems in children and adolescents. The program was originally specifically tailored for at risk children and parents, but there are now different levels of Triple P designed to work together as a broad, universal, public health approach. This program is based on principles of community psychology.
Advocacy evaluation, also called public policy advocacy design, monitoring, and evaluation, evaluates the progress or outcomes of advocacy, such as changes in public policy.
A behavior change method, or behavior change technique, is a theory-based method for changing one or several determinants of behavior such as a person's attitude or self-efficacy. Such behavior change methods are used in behavior change interventions. Although of course attempts to influence people's attitude and other psychological determinants were much older, especially the definition developed in the late nineties yielded useful insights, in particular four important benefits:
Intervention mapping is a protocol for developing theory-based and evidence-based health promotion programs. Intervention Mapping describes the process of health promotion program planning in six steps:
Outcomes theory provides the conceptual basis for thinking about, and working with outcomes systems of any type. An outcomes system is any system that: identifies; prioritizes; measures; attributes; or hold parties to account for outcomes of any type in any area.
Goal attainment scaling (GAS) is a therapeutic method that refers to the development of a written follow-up guide between the client and the counselor used for monitoring client progress. GAS was first developed by Thomas Kiresuk and Robert Sherman in response to the wide variety of evaluation models regarding mental illness and treatment. With the advent of GAS, Kiresuk and Sherman sought to create an evaluation program that could measure effectiveness across several different modalities and justify economic and labor resources based on effectiveness. Evaluation practices are important for justification and support for services, especially in mental health. The existing evaluation procedures had problems in definition and measurement, and each mental health center used its own definitions and measurements to evaluate. This created unspecified and informal evaluations. The variety of evaluation methods also made comparisons impossible. Thus, evaluation reform was needed.
Theory-driven evaluation is an umbrella term for any approach to program evaluation that develops a theory of change and uses it to design, implement, analyze, and interpret findings from an evaluation. More specifically, an evaluation is theory-driven if it:
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ignored (help)The full intervention mapping based protocol is available in the full article