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Chronic Disease Evaluation

Posted By Virginia Dick, Friday, December 18, 2015
Updated: Friday, December 18, 2015
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Evaluation is a crucial activity for many state and local public health agencies. In addition to the evaluation requirements in many federal funding programs, more and more states are recognizing the need and value of conducting thorough process and outcome evaluations of local, state, and regional efforts. All funders, governmental and non-governmental, are placing an increasing emphasis on demonstrating the impact of the program, policy or system change.


It is only through a comprehensive evaluation that jurisdictions can gain a better understanding of the impact of programs or policy changes as well as the key components involved in implementation of those programs and policies. Many evaluators, myself included, advocate that there is a critical need for process evaluation as well as outcome evaluation. A solid process evaluation provides the foundation for understanding why a program, system change, or policy had the anticipated impact (or not) as well as what components were most critical and how replication can occur in other settings.


Unfortunately, evaluation responsibilities often fall to epidemiologists or data managers who have little direct evaluation training and experience. In ideal circumstances, epidemiologists and evaluators work hand in hand during evaluation to provide the most thorough review of the process as well as aligning related data elements and issues. However, due to staffing and funding challenges, many jurisdictions are not able to have both of these positions engaged on the same effort at the same time, or the staff are spread across many efforts. Building evaluation capacity within the current epidemiology workforce is one way to help build the overall evaluation capacity within jurisdictions.


In 2015, CSTE conducted a four-part webinar series to discuss and examine public health evaluation. The series was designed to provide a high-level overview discussion of evaluation and how evaluation broadly should be approached. While the series was developed in conjunction with the Chronic Disease Subcommittee, the presentations were done in a manner to allow generalizability across all areas of public health. All of the webinars are available in the CSTE webinar library and can be viewed at any time. Below is a brief description of each of the webinars as well as the link to the webinar itself if you would like to learn more about any of the topics.

  • Lesson 1: Focusing your Evaluation Design (February 19, 2015) - Webinar Slides
    This webinar focuses on understanding how to begin the evaluation design purpose. Key questions that guided the discussion included understanding how, why and when evaluations begin, identifying the purpose and key stakeholders, and balancing utility and feasibility.

    Some “think about it” questions that were generated included: What is the first step in determining your evaluation design? What are some of the primary reasons for conducting evaluations? What is the biggest challenge you face in determining evaluation design, engaging stakeholders, and determining what tools to use?

  • Lesson 2: Approaches to Evaluation / Evaluation Types (March 19, 2015) - Webinar Slides
    This webinar discussed the strengths, weaknesses, and primary focuses of four primary approaches to evaluation. The four approaches that were discussed in depth include Utilization-focused evaluation, Developmental evaluation, Theory Driven, and the Kirkpatrick model. In addition, time was spent discussing the difference between summative and formative evaluations and outcome and process evaluations. While discussing the differences, it is also important to consider the interconnectedness between the different types.

    “Think about it” questions to consider from this week included: examining which evaluation approach you are most comfortable with, identifying what types of evaluation are typically conducted within your agency, and whether your approach is consistent with the types of evaluation that you have typically been involved with in your agency.

  • Lesson 3: Outcome/Process Evaluations (April 16, 2015) - Webinar Slides
    This webinar spent significantly more time delving into the distinction between and relationship among formative/summative and outcome/process evaluation. Items considered and discussed including the appropriate different types of questions for each type of evaluation, how different evaluation theories or approaches examine each of the types of evaluation, and most appropriate data, analysis, and reporting mechanisms for each type of evaluation. Significant time was spent in this session discussing the importance of mixed methods designs in robust evaluations.

    “Think about it” questions that were generated from this session included considering the most appropriate evaluation questions for each evaluation type, examining how summative evaluations can be used to inform programmatic practice, and thinking about the pitfalls of relying on only summative evaluation reports.

  • Lesson 4: Data Visualization and Reporting ( June 14, 2015) - Webinar Slides
    The final webinar in this series discussed data visualization and reporting. In particular, how to determine the best reporting mechanisms for various stakeholder audiences, different methods for visualizing data, and the critical importance of different reporting tools were all discussed. This session tied together several underlying themes from the other sessions, including consideration of all stakeholders and ensuring the usability and relevance of the evaluation by all stakeholders.

    Some of the “think about it” questions that were generated at this session included how to handle challenging responses from stakeholders to evaluation findings, how to identify and engage with key stakeholders to discuss the data, and how stakeholders can support evaluation efforts by providing more detailed understanding of key findings.

Dr. Virginia Dick is director of research and evaluation at CSTE. If you are interested in discussing evaluation in more detail, please feel free to contact her at For other interesting webinars on data and applied public health epidemiology issues, visit the webinar library.

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