van Beurden E, Kempton A, Sladden T, Garner E
Northern Rivers Institute of Health and Research, Lismore, NSW.
Aust N Z J Public Health. 1998 Feb;22(1):115-9. doi: 10.1111/j.1467-842x.1998.tb01154.x.
Evaluation of the North Coast Stay on Your Feet falls prevention program is described as a case study of a comprehensive evaluation design for multi-strategic community interventions. Qualitative and quantitative methods were used to evaluate the program at formative, process and outcome levels. Formative evaluation used literature review, focus groups, mail-out and telephone survey methods to gather evidence from publications, older people, health workers, local business, media and government bodies. It included an analysis of demographic and hospital databases and identified incidence, causal pathways, knowledge, attitudes, behaviour, consequences and effectiveness of potential strategies. Process evaluation employed auditing, monitoring and telephone surveys to maintain an inventory of intervention activities and to track the reach of the program. Outcome evaluation involved a longitudinal study of intervention and control cohorts, surveyed before, during and after the intervention by telephone to monitor changes in knowledge, attitudes, risk and falls incidence. The survey instrument was designed for both formative and outcome evaluation, and analysis reflected the research design by incorporating repeat measures and adjusting for bias and confounding. Outcome validity was cross-checked via hospital admission rates. A novel, integrated framework for presenting inputs, activities and outcomes from all stages of the program is described. This framework facilitated feedback to stakeholders and enabled subsequent rapid adjustment of the intervention. Rigorous evaluation combined with clear presentation of findings helped to engender intersectoral support and obtain funding grants for extended implementation and evaluation. It also helped Stay on Your Feet to become a model for other falls prevention programs within Australia and internationally.
对北海岸“站稳脚跟”跌倒预防项目的评估被描述为一个针对多策略社区干预的综合评估设计的案例研究。采用定性和定量方法在形成性、过程性和结果性层面评估该项目。形成性评估使用文献综述、焦点小组、邮寄和电话调查方法，从出版物、老年人、卫生工作者、当地企业、媒体和政府机构收集证据。它包括对人口统计和医院数据库的分析，并确定潜在策略的发生率、因果途径、知识、态度、行为、后果和有效性。过程评估采用审计、监测和电话调查，以维护干预活动清单并跟踪项目的覆盖范围。结果评估涉及对干预组和对照组的纵向研究，在干预前、干预期间和干预后通过电话进行调查，以监测知识、态度、风险和跌倒发生率的变化。调查工具专为形成性和结果性评估设计，分析通过纳入重复测量并调整偏差和混杂因素反映了研究设计。通过医院入院率对结果有效性进行交叉核对。描述了一个用于呈现项目所有阶段的投入、活动和结果的新颖综合框架。该框架促进了向利益相关者的反馈，并使干预措施能够随后迅速调整。严格的评估与清晰的结果呈现相结合，有助于获得跨部门支持，并为扩大实施和评估获得资金资助。它还帮助“站稳脚跟”项目成为澳大利亚国内和国际上其他跌倒预防项目的典范。
