Refining Outcome Questions
ShapeTracker Intervention Stakeholders
- Commissioner Middleton County (MC)
- Middleton County (MC) Health Department (HD) ShapeTracker (ST) team
- MC HD Information Technology staff
- MC HD marketing/communications staff
- Other MC HD staff
- CDC
- Group that developed ST for CDC
- MC community members
- Wellness advocates in MC
- Obesity prevention programs in MC
- Healthy eating related resources in MC
- Exercise resources in MC
- Smartphone providers in MC
- California communities that implemented ST
- Smartphone companies
- MC government
Logic Model
| Inputs | Activities | Outputs | Short-term Outcomes | Intermediate Outcomes | Long-term Outcomes |
|---|---|---|---|---|---|
| ShapeTracker App | Mobilize local resources and customize ST for MC | # of times ST app downloaded in MC | Decrease perceived barriers to healthy eating and physical activity | Increase healthy eating in MC | Reduce obesity in MC |
| Funding from HD and CDC | Market ST in MC | # of MC residents actively using ST | Increase self-monitoring of healthy eating and physical activity | Increase physical activity in MC | Reduce obesity related health problems in MC |
| Team of experienced staff | Keep app updated and maintain content | Amount of use for different ST functions | Increase self-efficacy for healthy eating and physical activity | ||
| High smart phone use in MC community | Provide technical assistance to users | User satisfaction with ST | Increase social supprt for healthy eating and physical activity | ||
| Marketing & communication resources in HD | # of friends referred to ST | ||||
| IT resources in HD | # of MC residents actively using ST long-term | ||||
| Local obesity prevention resources in MC |
ShapeTracker Intervention Evaluation Questions
Process Questions
- Was a broad range of local resources successfully engaged in the project?
- Was ST successfully disseminated to a broad segment of MC community?
- What proportion of MC residents have:
- downloaded the app?
- became active users of the app?
- became active long-term users of the app?
- For those who stopped using ST, why did they discontinue?
- How much are ST users using different functions in ST?
- How satisfied are MC residents with the ST app and its specific features?
Outcome Questions
- Does use of ST increase:
- self-monitoring of healthy eating and physical activity?
- self-efficacy for healthy eating and physical activity?
- social support for healthy eating and physical activity?
- Does ST decrease perceived barriers to healthy eating and physical activity?
- Does use of ST increase healthy eating and physical activity among county residents?
- Does use of ST lead to lower BMI among those who are obese or overweight?
- Does use of ST help those with normal BMI prevent overweight?
The evaluation questions we have chosen to address in our evaluation plan.
Now let’s look at our list of outcome evaluation questions more closely and see if it needs to be revised.
- Does use of ST increase:
- self-monitoring of healthy eating and physical activity?
- self-efficacy for healthy eating and physical activity?
- social support for healthy eating and physical activity?
- Does ST decrease perceived barriers to healthy eating and physical activity?
- Does use of ST increase healthy eating and physical activity among county residents?
- Does use of ST lead to lower BMI among those who are obese or overweight?
- Does use of ST help those with normal BMI prevent overweight?
This is an ambitious list of questions, even for a rigorous evaluation plan. As is often the case, it is probably more feasible to assess intermediate outcomes than long-term outcomes. We should probably drop the questions involving BMI.
I think that will be acceptable because showing that ShapeTracker has an impact on diet and physical activity will be great evidence of its effectiveness. That narrows the list leaving us with the following outcome questions:
- Does use of ST increase:
- self-monitoring of healthy eating and physical activity?
- self-efficacy for healthy eating and physical activity?
- social support for healthy eating and physical activity?
- Does ST decrease perceived barriers to healthy eating and physical activity?
- Does use of ST increase healthy eating and physical activity among county residents?
And after looking at the literature, I recommend that we should focus on self-monitoring and barriers as short-term outcomes.
- Does use of ST increase:
- self-monitoring of healthy eating and physical activity?
- Does ST decrease perceived barriers to healthy eating and physical activity?
- Does use of ST increase healthy eating and physical activity among county residents?
We now have a manageable list of evaluation questions and that completes that section of our Evaluation Plan.