Health Care-Research-Intimate Partner Violence, Research Paper Example

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Research Paper

Abstract

The relationship of program evaluation to research implicitly reflects gaining insights into how delivery can be more accessible as well as effective. Therefore, improving health care is the ultimate goal of health promotion programs. The only way any intervention can be validated as being successful or not so efficient is that program designers must develop strategies for consistent assessment of every aspect of the intervention implemented. In the following pages of this document the writer will evaluate programs which have been in operation to address intimate partner violence in determining their efficacy. A project analysis will be undertaken; stakeholders identified; tools for conducting the process outlined; an evaluation schedule presented; followed by a comprehensive evaluation plan; rubric; executive summary and evaluation of another student’s program evaluation project.

Health Care:  Program Evaluation to Research Intimate Partner Violence-Evaluation Plan

Introduction

Project Analysis

The project being analyzed is intimate partner violence. It is important that every researcher or health care provider wishing to analyze an intimate partner violence program understand parameters under which intimate partner violence is addressed in modern societies. Some rudiments of the subject include an assumption that it is a public health problem because mostly women are targeted victims.

Precisely, it involves physical and sexual violence; threats and emotional abuse. In the United States of America statistics have revealed that 3 in 10 women have been exposed to intimate partner violence during a relationship. Comparatively, 1 in 10 men has been affected. Further reports are that in 2007 there were 2,340 deaths occurring from this phenomenon. Interestingly, 70% were females and 30% males (CDC, 2012). In some underdeveloped societies is has become an accepted culture to keep the relationship active.

However, health care promotion activists have reported that in 1993 alone the cost of medical care, loss of productivity and mental health intervention escalated to some $5.8 billion. In 2003 there has been a further steep in effects of these activities to show $8.3 billion hike; nearly a $5 billion increase (CDC, 2012)

Significantly, dysfunctional health patterns are just one sequel to intimate partner violence. Effects overlap to children and society as a whole because victims can in turn become abusive to their children; spouses and unsuspecting members of the public apart from adopting defensive mechanisms manifested as cheating, smoking and disorderly conduct. Consequently, delinquency in the home occurs As such, besides being a public health concern, placing it in its true context intimate partner violence is a social issue, which must be addressed collaboratively.

From a comparative analysis perspective, in 1999 the Injury Prevention Service supervised by the Oklahoma Department of Health, implemented an intimate partner violence project aimed at estimating incidences; determining extent of fatal and non fatal injuries; identifying factors that contribute to the occurrence; in order to design strategies and policies compatible to reducing the prevalence within that society (Oklahoma State Department of Health, 2012).

Finally, information derived from this project was expected to the applied in training medical officials and related professionals in addressing intimate partner violence occurring in the Oklahoma community. This project investigated and treated the phenomenon as is represented among women in that geographic location and can be considered a quality improvement project (Oklahoma State Department of Health, 2012).

Data sources informing the project were Oklahoma Women’s Health Survey; hospital emergency and inpatient records and medical examiner reports. In recording incidences it was discovered that 1,151 persons were treated during 18 month survey; 96% were released and 4% sustained injuries requiring hospitalization. 90% were females while 10% males.  Also there was a predominance of African American women between the ages of 25-34 years. Supportive data was retrieved in 2002 (Oklahoma State Department of Health, 2012).

Intervention

The intended intervention was to train and educate with the goal of reducing incidences. Stakeholders included specialist services from John Hopkins Medical Institute conducting training sessions in 2005; advertising and publishing specialists in creation of pamphlets and recording of training sessions; medical practitioners’ training to conduct assessments and department of children and families promoting domestic violence workshops for children.

Program being evaluated

Similarly, in the Clinical program strategy design or clinical/practice issue information, the purpose was geared towards quality improvement to increase awareness of IPV by training nursing staff working in the healthcare setting.

The training program was evaluated through pre and post tests. A universal IPV screening question was added to the hospital admission intake. Through retrospective chart reviews, prior to and following the training session, screening for IPV by the nursing staff was evaluated by examination of disclosure rates and referral data.

It is hoped that this program evaluation would allow more evidenced based applications in specific areas overlooked previously, since perpetuators of this dysfunction either accept their behavior as a normal way of interacting with their partners or helpless to stop the abuse. Therefore, it becomes imperative that intervention be focused on not just removing victims, but rehabilitating the abusers as well.

As such, the Oklahoma program might be inadequate for society, now, because it was not extended to male victims and even though causes of intimate partner violence were explored there was no comprehensive analysis of the program. Importantly, no tools were designed to measure neither interpret behavior patterns of abusers or the implementation process in itself. Alternatively, the program to be evaluated in this research is more contemporary and offers modern strategic approaches to the issue.

In this particular evaluation the five tier approach would be adopted inclusive of needs assessment; monitoring and accountability; quality review and program clarification; achieving outcomes and establishing impact (Jacobs, 2003)

Identifying Stakeholders

Success of any program besides realistic objectives and goals is targeting the most appropriate stakeholders to influence effective outcomes. Importantly, in contemporary societies funding becomes a major issue in executing any program and more so keeping it functioning since stakeholders always want to know how successful programs have been in achieving goals by improving quality of care.

Therefore, heading the list of evaluating stakeholders are financial institutions. These include banks as well as organizations, which are willing to fund community projects inclusive of international monetary fund; World Bank, Opera network, Bill Gates Foundation; Blau Foundation; the Associated Country Women of the world among many others.

The clinical program under review did not offer specific information regarding stakeholders. As such, in the overall comprehensive evaluation plan this deficiency must be addressed. Social workers, law enforcement, community health nurses trained in domestic violence, abused spouses, churches and community groups’ services in intimate partner violence all need to be periodically evaluated for efficacy with the program execution.

Funding agencies are contacted and evaluated through written correspondences or regional supporting agencies within weeks of confirmation of the evaluation process. Other subsidiaries mentioned in the previous paragraph will be contacted and evaluated at monthly intervals through surveys.

Evaluation tools

Evaluation tools pertaining to the program under review are designed to measure needs attainment; monitoring and accountability; quality review and program clarification; achievement of outcomes and how impact is established (Jacobs, 2003). Therefore, in planning this project an evaluation matrix will be designed to keep tract of events assessed within the project overtime.

In evaluating specific areas mentioned in the previous paragraph determining the outcome of retrospective chart reviews, prior to and following the training session, screening for IPV by the nursing staff using disclosure rates and referral data, an evaluation questionnaire would be developed to measure impact and follow up intervention. The information retrieved would first be placed on specific spread sheets and then transferred to a template

Evaluation schedule

Week Needs Assessment Monitoring and Accountability Quality review and program clarification Outcome achievement Impact establishment
 2 weeks Speaking with victims and nurses to determine if the program fulfilled their desire of knowing more about intimate partner violence        
2 weeks   Monitoring stakeholders and subsidiaries input in the program and asserting accountability where necessary.      
2 weeks     Measure the quality of responses receive from intimate partner violence victims to exposure of program    
2 weeks       Measure results of training and interaction with educators.  
2 weeks         Conduct survey to estimate the impact of this program on persons being trained and those receiving intervention.

Comprehensive Evaluation Plan- Five tier design

Criterion Method Strategy Tools Schedule
Needs assessments Data

collection to determine referral rates accuracy

Interviewing nurses; intimate partner violence victims and abusers Questionnaires, spread sheets and templates 2 weeks
Monitoring and Accountability ·         Researching expenditure

·         Assessing whether entries are made correctly to reflect costs.

·         Assessing whether the problem exists in the same magnitude

Perusal of documents and observing conduct of participants Matrix to record data 2 weeks
Quality review and program clarification Survey to assess consistency in screening intervention Interviewing stakeholders and participants Questionnaires  2 weeks
Outcome achievement Survey to determine whether nurses training application was beneficial to intimate partner victims Interviewing nurses, victims and abusers Questionnaires 2 weeks
Impact establishment Survey to estimate the value of the program to nurses, intimate partner violence victims and abusers. Interviewing nurses, victims abusers and stakeholders Questionnaires 2 weeks

Rubric – See Appendix

Executive Summary

Programs designed in the twenty-first century to address intimate partner violence ought to aim at prevention through monitoring and accountability; education and training, tracking and rigorous continuous research of the problem. The foregoing evaluation presented workable guidelines adopting the five tier method of evaluating intimate partner violence within communities. Alternatives to the program evaluated suggest that not only women should be targeted in programs or victims themselves, but abusers and stakeholders. Victims ought to understand the impact of their actions on society and others. Motivated stakeholders will continue to fund program if they identify with the phenomenon within the context of their existence.

References

Center for Disease Control (2012). Preventing Intimate Partner and Sexual violence. Program Activities guide.

Center for Disease Control (2012) Understanding Intimate Partner Violence. Fact Sheet

Oklahoma State Department of Health (2012). Intimate Partner Violence. State of Oklahoma

Jacobs, Francine H (2003) “Child and Family Program Evaluation: Learning to Enjoy Complexity. Applied Developmental science 7(2) 62-75.

Appendix

Rubric for evaluating intimate partner violence

Criterion 1 2 3 4 5
Needs assessments Program does not meet criteria for providing relief to IPV victims neither adequately train staff to cope with effects of abuse Program limits assessment and displays gender biases in accessing care and training for intimate partner violence victims Program is focuses only towards educating victims exclusive of their partners Program meets criteria  for providing

relief to IPV victims and adequately train staff

Program meets criteria  for providing

relief to IPV victims and adequately train staff. It includes counseling for abusers and continued informative workshops for stakeholders.

Monitoring and Accountability 1.No follow up research is conducted to determine efficacy of program

2.Stakeholders are not held accountable for their input in the program

Research is conducted, but no implementation or modification of strategies adopted Research is conducted but application of findings is limited to financial availability and sanctions Research is conducted, but  partially applied due to administrative difficulties 1. Intense follow up research is conducted to determine efficacy of program

2.Stakeholders are not held accountable for their input in the program

Quality review and program clarification No periodic assessments of whether the program is beneficial to clients and the extent to which it is helpful. Yearly,

assessments of whether the program is beneficial to clients and the extent to which it is helpful

Twice annual

assessments of whether the program is beneficial to clients and the extent to which it is helpful

Quarterly

assessments of whether the program is beneficial to clients and the extent to which it is helpful

Program is  assessments bi-weekly to determine whether it is beneficial to clients and the extent to which it is helpful
Outcome achievement Outcomes are not measured scientifically utilizing surveys, case studies or experiments Outcomes are measured, but not recorded scientifically for  future reference and application Outcome achievement tools are inadequately applied to  achievement scales identified for IPVs Outcome achievement tools are adequately applied to  achievement scale identified for IPVs Outcomes are measured scientifically and recorded utilizing surveys, case studies or experiments explaining improvements in the quality of care rendered to victims of intimate partner violence and their spouses. Stakeholders reaction to programs are also assessed.
Impact establishment Impact establishment is not measured Impact establishment is measured from a non scientific paradigm of how society views intimate partner violence. Impact establishment of program objectives only measured and not the entire implementation

process

Impact establishment of victims are measured exclusive of nurses in training programs, stake holders and abusers. Impact establishment is fully measured utilizing scientific tools and research

 

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