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Public Health Workforce Training
Link to beginning section of Advanced Program Evaluation

Qualitative and Mixed Methods

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
  1. Was a broad range of local resources successfully engaged in the project?
  2. Was ST successfully disseminated to a broad segment of MC community?
  3. What proportion of MC residents have:
    • downloaded the app?
    • became active users of the app?
    • became active long-term users of the app?
  4. For those who stopped using ST, why did they discontinue?
  5. How much are ST users using different functions in ST?
  6. How satisfied are MC residents with the ST app and its specific features?
Outcome Questions
  1. 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?
  2. Does ST decrease perceived barriers to healthy eating and physical activity?
  3. Does use of ST increase healthy eating and physical activity among county residents?
  4. Does use of ST lead to lower BMI among those who are obese or overweight?
  5. Does use of ST help those with normal BMI prevent overweight?

The evaluation questions we have chosen to address in our evaluation plan.

A Note about Qualitative and Mixed Methods

Outcome evaluation research typically uses quantitative methods, as is the case with our examples so far. Qualitative and mixed methods are mostly used in process evaluation, but they can also be useful in outcome evaluation.

For example, let’s consider our evaluation question whether ShapeTracker decreases perceived barriers to physical activity and healthy eating. We may not have a clear idea of what specific barriers are important in our community and how ShapeTracker can address them. Qualitative methods may be well justified for this evaluation question.

An example of evaluation design would be focus groups with ShapeTracker users to discuss challenges to exercising and eating healthy and how ShapeTracker has helped them. Systematic qualitative analysis can be used to provide evidence of program effectiveness.

How do we choose among the many options for research design?

There are many factors to consider. Choosing a design is always a matter of finding the right balance of scientific rigor and feasibility. We will come back to specific threats to validity and feasibility considerations when we discuss the Limitations and Feasibility section of the Evaluation Plan.

It is also important to work with the stakeholders as we make decisions about the evaluation design. Please click on the stakeholder icon to remind yourself who is in our stakeholder advisory group.

And remember that the logic model and evaluation questions can help us stay focused as we discuss design options.