Logic models for Prevention 2010 by Larkvorhees

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									     Logic models for
     Prevention 2010



          Erica Wimbush
Head of Policy Evaluation & Appraisal
              What is a logic model?
• 30 year history

• Graphic representation of programme components and its
  ‘theory of action’

   – what is invested,

   – what will be done,

   – who will be reached

   – what will result AND

   – Are they logically linked together?
What does a logic model look like?
                                        OUTPUTS                                                OUTCOMES

   INPUTS                ACTIVITIES               PARTICIPATION
                                                                                 SHORT           MEDIUM             LONG
                                                                                 Annual         By 2 years       By 5-10 years
   LOCAL SERVICE DELIVERY (GP Practices in deprived areas)
                                                                                reporting       (end of pilot)   from roll-out
Resources          GP practices                   Target population          Reach
invested:                                         those aged 46-65 who                          CVD risk          Reduced
                                                  are registered with a GP                      factor            premature
£1m pa per         Identify population                                       Uptake
CHP for 2          Invite/reach individuals                                                     modification      CVD
years from         Engage                                                                       Quit rate         mortality in
                                                                             Compliance
April 2006 for                                                                                  Smoking           dep areas
additional staff   Assess for disease and risk                                                  BMI
                                                                             Service impacts
time               Provide a range of effective                                                 Cholesterol
                   clinical treatments incl                                                     Blood pressure
£0.4m per CHP      referral to other local                                                      Diabetes
smoking cessn      services                                                                     management
                   Maintain, monitor and                                                                          Reduced
                   follow-up                                                                                      health
                                                                                                                  inequalities



  Prevention 2010 - Piloting anticipatory care
P2010 Pilots – Linking Activities & Outcomes
      LOCAL SERVICE DELIVERY (GP practices with most deprived population)

                         ACTIVITIES                                      OUTCOMES

                                     Assess for
   Identify population            disease and risk

                                   Provide effective                                      Reduced
    Invite / contact                                        Reach          CVD risk
                              interventions incl refer to                                 premature
                                                            Uptake         factor
                                 other local services                                     CVD
                                                                           modificatn
        Engage                                                                            mortality
                                                                                          in dep
                              Maintain, monitor &           Compliance                    areas
                                  follow-up
                                                            Service                     Reduced
                                                            impacts                     health
                                                                                        inequalities
P2010 Pilots – Identifying target population
                       Population aged 45-65 years registered with pilot GP practice


                                            On CHD/CVD register?

                                             Yes             No

                   Taking part in secondary                  CHD/CVD or diabetes present?
                   prevention programme?
    4                                                                                              1
                        Yes                  No                   Yes           No

                                    3
    Is participation                               Put on CHD/CVD                     Calculate CVD risk
        optimal?                                        register

                  No                                                       > 20%
                                                        2                 Section 1

                       Tailored secondary               Tailored ‘high-risk’ primary
                       prevention package                   prevention package
                            Section 2                             Section 3
                                                         Sections 4-9 as applicable
                                   Prevention 2010 intervention groups


                                        Maintain/monitor/follow up
P2010 Logic Model 2                        OUTPUTS                                                 OUTCOMES

   INPUTS                   ACTIVITIES               PARTICIPATION                  SHORT            MEDIUM               LONG
                                                                                    Annual          By 2 years         By 5-10 years
                   LOCAL SERVICE DELIVERY                                          reporting        (end of pilot)     from roll-out

Resources             GP practices                   Target population          Reach               CVD risk           Reduced
invested:             Identify population            those aged 46-65 who       No. on risk         factor             premature
                                                     are registered with a GP   register                               CVD
£1m pa per            Invite/reach individuals                                                      modification
CHP for 2             Engage                                                    No. contacted       Quit rate          mortality in
years from            Assess for disease and risk                               No. attended        Smoking            dep areas
April 2006            Provide a range of effective                              No. fully risk      BMI
£0.4m per CHP         clinical treatments                                       assessed            Cholesterol
smoking cessn         Refer to other local                                      Uptake              Blood pressure
for                   services                                                  Improved access     Diabetes
Additional staff      Maintain, monitor and                                     % received          management
time                  follow-up                                                 clinical
                      Other local services                                      interventions       Additional         Reduced
                      Accommodate additional                                    % referred          risk factors       health
                      demand                                                    Compliance          Inc PA levels      inequalities
                                                                                % continuing        Healthier diet
                             INFRASTRUCTURE SUPPORT
                                                                                treatment at        (F&V, fat, salt)
                      HS, ISD                        Target groups              follow-up           Less alcohol
                      Health info & IT                                          Service Impacts     consumption
Resources                                                                       Increased
invested:             Planning & evaluation          Boards & CHPs
                      Evidence                                                  prescribing         Patient
SE (£25m over                                                                   Increased use of    satisfaction
3 years +             Social marketing
                      Capacity-building                                         GP practices and    Health-related
Counterweight)                                                                  local services      QoL
HS (staff tme)        Learning for roll-out
                      Boards/CHPs                    Snr leaders                                    Quality of GP
ISD (staff time)                                                                                    consultations
                      Planning                       GP practices
CHPs                  Engage with GPs & PC           Local NHS and
NHS Boards            teams                          comm. services
                      Recruit and train staff        Community
                      Monitoring and reporting
           P2010 Pilots – Infrastructure support
     LOCAL SERVICE DELIVERY (GP practices with most deprived population)

                                             Assess for
            Identify population           disease and risk                                             OUTCOMES

                                           Provide effective                                                         Reduced
             Invite / contact                                                          Reach            CVD risk
                                      interventions incl refer to                                                    premature
                                                                                       Uptake           factor
                                         other local services                                                        CVD
                                                                                                        modificatn
                 Engage                                                                                              mortality
                                                                                       Compliance
                                                                                                                     in dep
                                      Maintain, monitor &                                                            areas
                                                                                       Service
                                          follow-up                                    impacts

                                                                                                                     Reduced
     INFRASTRUCTURE SUPPORT                                                                                          health
                                                                                                                     inequalitie
                                                                                                                     s
                      Logic                              Capacity
            Health             Evidence     Social                       Evaluation    Learning for
  Policy            modelling                            building
             info             (HS/MPH marketing                         results (HS)   roll-out (HS)
direction ,            (HS)                               (HS)
             & IT                 N)         (HS)
Funding,                                                                  Monitoring &
            (ISD)    Planning        Engagement with      Train staff
Accounty                                                                  reporting
   (SE)            (HBs/CHPs)          GPs & local        (CHPs)
                                                                          (HBs/CHPs)
                                         services
                                       (HBs/CHPs)
                    Assumptions

• Current primary care practice/services are not optimal for
  those at greatest risk/need
• Sufficient nos. of the target population can be reached
  by new /innovative methods of engagement and
  motivated to participate in the pilot
• GPs in the pilot areas will be motivated and able to
  participate
                     Assumptions
• Primary Care teams will have sufficient additional
  capacity and expertise to treat the numbers needed to
  achieve significant change and collect the required data.
• That it is feasible to recruit and train additional staff (if
  required) within the timetable of the pilot
• Other services to which patients are referred have the
  capacity and expertise to deal effectively with the
  additional volume and type of demand
• There will be consistency in the risk assessment tools
  and recording procedures used across all pilot sites

								
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