Community Health Training Module

Anyone associated with Duke University Medical Center and Health System must complete the administrative requirements described below before conducting a community health activity.

This includes those who participate in health activities organized outside of Duke by churches, colleges, community groups etc.  Appropriate Duke approval must be obtained in advance to use Duke owned equipment at a non-Duke event.

For a Duke sponsored community health activity, the activity planner, activity coordinator and and pass this module within the previous 24 months of the submission of the Community Health Activity Request form for the activity.

Learners

Students and residents must have a faculty sponsor in order to plan a community health activity.

All Learners Must:

• Complete and pass this required training module. The module must be retaken every 24 months.
• Complete and submit a Community Health Activity Request form at least 30 days in advance of the activity. This form describes the intended community health activity, the procedures in place to conduct it safely and the materials to be used.  It is reviewed by faculty with clinical privileges in community health, approved by the Chair of the Dept. of Family Medicine & Community Health, and then forwarded to Risk Management to secure malpractice coverage for the project.

The Community Health Activity Request form is available for download here.

This form and all other materials should be submitted to:
Department of Family Medicine & Community Health
DUMC Box 2914
Phone:  (984) 312-5980
Fax:  (919) 684-8675
Email: CHAreview@duke.edu

Steps to Develop a Health Program With a Community

1. Match your interests with a community’s areas of concern. Consult with staff who are knowledgeable about area communities.
2. Coordinate with other group members on how best to approach community leaders and other community residents.
3. Begin discussions with community leaders and community members about their health concerns.  Let them know about the interests and resources your team could contribute to a health program.  Meet in the community whenever possible.
4. Form an advisory board that includes people who have been interviewed about community health needs.  Or consult with the Division of Community Health to find an existing group who could serve as the advisory board. Work with this advisory board to find an area of common concern.  Do not start with your own idea of what the topic or the approach should be.
5. Use a series of discussions with the advisory board and others to develop a program plan. Invite local health agencies and organizations to become partners in developing this community health program.
6. If the program is intended to continue, make plans for financial sustainability.  If it is not intended to continue, be sure everyone involved or contacted by the program knows those plans and when it will end.  Share funds with local partners who contribute to the program.
7. With the Community Advisory Board (CAB), plan evaluations that can be used during the program to monitor progress (formative evaluation) and after the program to measure results (summative evaluation).  Share the results of these evaluations with your CAB and other community members.
8. Implement the program.  Keep the CAB and other contacts in the community aware of the project's successes and challenges.  Be honest and open to suggestions to improve or re-direct the program.
9. Use process evaluation data to modify the program to improve it.  Share aggregate data and analysis. (Covered in Section 4)
10. Use outcome evaluation data to document the program's impact.  Share aggregate data and analysis. (Covered in Section 4)
11. Thank all who have contributed to program development and implementation and acknowledge their contributions.
12. Disseminate program outcomes to all involved and to wider audiences. If you plan to publish, seek IRB approval before beginning your project.  Ask the CAB members if any would like to co-author with you.  Draft articles must be reviewed with the CAB and other partners to maintain trust.  Any publication should acknowledge the community partners by name.  Any press interested in the program should interview key partners as well as Duke faculty and staff.  Accept responsibility when confronted by the press for problems in a project and share credit for success. Get help from a communication expert when dealing with the press by contacting Duke Health or Duke University

Steps in Program Evaluation

Engage the stakeholders: These are people or organizations invested in the program, interested in the results of the evaluation and/or with a stake what will be done with the results of the evaluation.  Examples of stakeholders include funding agencies, partner organizations, administrators, staff, patients or clients, advocacy groups, elected officials, general public, or taxpayers.

Describe the program: A comprehensive program description clarifies all the components and intended outcomes of the program, thus helping you focus your evaluation on the most central and important questions.  A comprehensive program description includes the following components:

• Need. What is the big community health problem you aim to address with your program?
• Targets. Which groups or organizations need to change or take action to ensure progress on the community health problem?
• Outcomes. How and in what way do these targets need to change? What action specifically do they need to take?
• Activities. What will your program and staff do to move these target groups to change/take action?
• Outputs. What tangible capacities or products will be produced by your program’s activities?
• Resources/Inputs. What is needed from the larger environment in order for the activities to be mounted successfully?
• Relationship of Activities and Outcomes. Which activities are being implemented to produce progress on which outcomes?

Determine what elements of the program are most important: achieving project goals, meeting intermediate project objectives, delivering services or activities on schedule, staying within the budget, building collaborative partnerships.

Consider developing a basic logic model, which is a common tool that evaluators use.  It is a graphic depiction of the relationship between a program’s activities and its intended outcomes. 

Ask the relevant questions: What do we need to know to determine whether or not the program is successful? Consider what kind of information future funding sources might want and the kind of information that would be useful to community organizations and constituents who are involved with the program. In general, evaluation questions fall into these groups:

• Implementation. Were your program’s activities put into place as originally intended?
• Effectiveness. Is your program achieving the goals and objectives it was intended to accomplish?
• Efficiency. Are your program’s activities being produced with appropriate use of resources such as budget and staff time?
• Cost-Effectiveness. Does the value or benefit of achieving your program’s goals and objectives exceed the cost of producing them?
• Attribution. Can progress on goals and objectives be shown to be related to your program, as opposed to other things that are going on at the same time?