Practice and Evaluation of Health Intervention - Research Proposal Example

of the evaluation The effectiveness of an interactive multimedia program to influence eating habits Type of evaluation Impact evaluation was carried out to address this intervention Target of the evaluation Employees of two organizations were targeted to be part of this evaluation study. The aim was to motivate and change the eating behaviour of these employees from more fat consumption to more fruits and vegetables and less fat intake. Description of the intervention The intervention package has been well described and defined. All the elements of the intervention have been given an appropriate level of description to make it as much clear to the reader and the audience as possible. The intervention package used was a combination of about four components, like: audio, video, graphics and print out. As this package is used by the study subjects on her/his own leisure time. The use may be incomplete by some study subject depending upon the schedule of that specific subject or the perception of the study subject may be different for a specific topic illustrated in the IMM. The reception of the intervention message and then providing information related to it to questionnaire may be influenced. Users The article does not contain any information which gives us any idea about the user/s of the findings of this evaluation research. Value criteria and perspective The intervention was valued and assessed by using explicit and descriptive criteria. All the elements of intervention were given due importance and the criteria to assess that specific element was comprehensively pointed out. Evaluation question (s) or hypothesis for testing Two main research questions which can be tested statistically have been described. Did exposure to the programme lead to changes in variables theoretically associated with behaviour change including stage of change, attitude, self efficacy and intention to change Were changes maintained a month after initial exposure Type of evaluation design In this research study a combination of evaluation design have been used. The over all design is randomized control experimental category but within this major design before after strategy has also been utilized to compare the before after status of the study subjects in the TI category. This is an experimental evaluation carried out as internal evaluation. So there is probability of introduction of evaluator bias or conflict of interest which is inborn characteristic of internal evaluation. Data sources and collection methods Selection of Organizations for subject recruitment There were two types of organizations involved in the recruitment of the study subjects. But these two types of organizations are entirely different from each other as far as their scope of work and in turn types of employees present in these two organizations are concerned. At the same time the environment often two organizations would also be different. One organization is hospital and other is a corporation. There are chances that study subjects who were recruited from the hospital they may have more knowledge and insight in health related issues, even they are not medical/paramedical staff, than the subjects from the corporation. This way they may an influence of their knowledge on responding to the questionnaire. Explicit information on the proportion of study subjects recruited in both the groups from two study sites should have been provided which would have been helpful in commenting on this issue. Characteristics of study subjects At the baseline level there are differences in the demographic characteristics of study subjects assigned to two groups. There were three times more study subjects in Hispanic category in WI group than in TI group. Ethnicity may play some role in the response; some groups have their own eating habits and contents of diet. It may take more time to respond to the intervention package and this category has more representation in WI group. Similarly, in TI group more representation is in the lowest group of income. They may have been influenced, by the monetary incentive presented to them, in responding to the questionnaire. Incentives to study subjects Study subjects did not came to face to face interaction with the interviewers rather a postal correspondence strategy was utilized. At the first postal contact the subjects were provided questionnaire and consent form alongwtih a retuned envelope to send back the signed and filled in questionnaire. They were also presented an incentive of a $10 dollar cheque. Based on the returned envelop, these study subjects were randomized to two groups. Following that both the groups were sent questionnaires two more times along with $ 10 cheque making a total money paid as incentive to one participant $30. Paying any incentive to the study subjects creates a bias. This incentive influences their decision to participate or not. Therefore, these study subjects do not join as research participant but the incentive brings them. In fact, the characteristics of these people are not of those who really become study subjects without any incentive. So, this may influence the results of a study which might have changed the results of this study as well. If it is needed, at all, to give monetary incentives to study subjects it is for the compensation of their time and any other expense if they bear; the amount of these should never be mentioned at the first time. In this study the incentive was sent along with the first questionnaire and consent form. Self responded questionnaire These questionnaires were self responded by the study subjects. There was no involvement of any other representative from the research conducting team who could have observed and this way confirmed the responses. The study subjects especially in treatment group (IT) might have responded to the questionnaire by introducing bias as they knew they had been on some intervention package and being paid for the research so they should respond to a way which would be expected. There is a possibility of getting favoured responses in IT group in 2nd and 3rd questionnaire and in WL group in 3rd questionnaire. Comparison of two groups There was no comparison of the TI group, for the maintenance assessment, with the WI group at day 60. So it cannot be concluded on the maintenance of the changes in behaviour based on the findings of this study. Validity & Reliability We assume the questionnaire could have been well prepared, but the strategy used to get the response through self response may make it invalid. There are chances that if this questionnaire was used through face to face interviews, it may have produced different results. Reliability, getting persistent results on repeated use of a measuring tool, if present but it will measure the invalid responses on persistent basis. Validity of conclusions The results obtained with this evaluation regarding the intervention package could answer partially. The intervention package was able to change the eating habits/behaviour on current basis when it showed significant difference after one month between the two groups. But the evaluation process was incomplete as far as the assessment of the maintenance of programme effects is concerned; the evaluation strategy could compare the TI group in before and after methodology which could show significant difference in the same group at different intervals but could not give us treatment (TI) and control (WI) comparison. Recommendation Study sites selected should be similar types of organizations or the study subjects recruited should be similar and explicitly informed. Monetary incentive should not be paid at the very outset if it is really needed at all. In the first letter, a simple statement mentioning a reward of some monetary benefits to compensate for the expenses (time, electricity, travel etc) should be written. Every effort should be made to avoid self responded questionnaires. Steps should be taken to compare the intervention and control groups to assess the maintenance of programme effects. Read More