Queensland Stay On Your Feet® Toolkit

• Queensland Stay On Your Feet® Home
• Toolkit
  • Model diagram
  • Model's explanation
• Background
• Phase 1 - Investigate
  • What is the problem?
  • What are the impacts of the problem?
  • Why does the problem occur?
  • Where does the problem occur?
  • When does the problem occur?
  • What is the current context?
  • What is already happening?
• Phase 1 - Materials
  • Collecting information
  • Fear of falling
  • Risk factors
  • Key documents
  • Community stocktake
• Phase 2 - Plan
  • What can be done?
  • What do we know about the target group?
  • Who can be involved?
  • How do we keep the work going?
  • How will we measure progress?
• Phase 2 - Materials
  • Key stakeholders
  • Roles and responsibilities
  • Good working relationships
  • What works?
  • Decision making
  • Goals, objectives, strategies
  • Community planning meetings
  • Reach and marketing
  • Social marketing plan
  • Key messages
  • Community engagement
  • Partnerships
• Phase 3 - Implement
  • Are we testing before we act?
  • What can we achieve now and later?
  • Are there opportunities to explore?
  • How are we monitoring progress?
  • Are we talking with others about our work?
  • Are we measuring our efforts?
• Phase 3 - Materials
  • Communicating
  • Awareness raising
  • Communication plan
  • Community progress meetings
  • Ambassadors
  • Physical activity
  • Sports tours
  • Come and try days
  • Case studies
• Phase 4 - Review
  • Process evaluation
  • Impact evaulation
  • Outcome evaluation
  • Share and celebrate
  • What happens next?
• Phase 4 - Materials
  • Process evaluation tools
  • Impact evaluation tools
  • Outcome evaluation tools
• Acknowledgements

Toolkit Phase 4 - Reflect and evaluate

"Evaluation is an essential tool for project/program management [16]".

Evaluation is not the end point or the last task undertaken in the project/program. It is the formal assessment of a project/program’s interventions [104].

Project/program management

As discussed in Phase 2, planning for evaluation should be integrated into the initial planning for the project/program [19].

Phase 2: Plan

Evaluation is also used as an ongoing improvement process throughout your work.

When planning evaluation, consider the following points:

• if you are testing a new project/program in a controlled study environment to determine if it works, this is known as efficacy [92]
• if you are implementing a project/program that has worked in a controlled study (efficacy) and now you are testing it in a real life situation, this is known as effectiveness [92]
• an in-depth evaluation may not be necessary (if the project/program has already been proven through research and real life trials to reduce falls [12,19], then monitoring is likely to be sufficient [104])
• seek evaluation expertise from a recognised public health research centre depending upon the skills in your project team/working group [12,19] and available resources
• allocate resources for evaluation (this should be approximately 10 to 20 per cent of the project/program budget) [12,19]
• where possible, use validated tools and measures to allow for potential comparisons
• it is important to establish a baseline of a range of information so results can be compared [12,19].

Baseline

A combination of two types of data and information can be used for evaluation: qualitative and quantitative.

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Qualitative information

This involves collecting subjective, personal, experiential responses through interviews, case studies, focus groups and observation [17, 21]. A range of responses and variations between responses is reported eg. a group of older people who thought the information presented in a brochure was easy to understand and useful.

Quantitative information

This involves collecting numerical/objective data as a frequency of responses in counts, ratings, scores or classifications to summarise findings [17, 22 ] eg. the number and percentage of community-dwelling older people who have installed bathroom grab rails.

To assess progress towards goals, objectives and strategies, make decisions about:

• what to measure?
• how to gather the information?
• who will collect the information?
• when the information will be collected eg. before, during and after the project/program?
• how to present the collected information?
• who needs the collected information and what do they really need to know?

The Prevention of Falls Network Europe (ProFaNE) and the Outcomes Consensus Group have developed criteria for recording outcome data when conducting fall injury prevention trials [218]. The eight recommendations to consider when planning evaluation are summarised below (refer to the original source for more detail) [218]:

1. Research areas should include falls, fall injury, physical activity, psychological consequences, and a person’s health-related quality of life [218].
2. When collecting information about falls:
     - use a consistent definition of a fall
     - ask older adults if they have had a fall, trip or slip or lost their balance
     - use a daily recording system to collect falls information
     - summarise data as number of falls/fallers/non-fallers/frequent fallers  and the fall rate per person per year and time to first fall
     - don’t adjust primary analysis for physical activity.
3. When collecting information about injuries:
     - collect the number of peripheral fracture events (confirmed by x-rays) per person per year
   use the World Health Organisation International Classification of Disease (10th revision) (ICD 10)
     - use a daily recording system to collect injury information
     - summarise injury data as peripheral fracture rate per person per year of follow-up, number of peripheral fractures, number of people sustaining a peripheral fracture and number of people sustaining multiple injuries
     - don’t adjust primary analysis for physical activity.
4. To measure psychological consequences, or a person’s confidence in performing daily activities without falling, use the Falls Efficacy Scale – International (FES-I)
5. To measure a person’s health-related quality of life, use the Health Related Quality of Life Short Form 12 (version 2 ).  
6. Before physical activity can be measured, further research is required.
7. Due to the delayed effect of falls prevention interventions, a 12 month follow-up is required.
8. To ensure correct methodology, a range of issues need to be addressed (refer to original source for details).

The Prevention of Falls Network Europe (ProFaNE) regularly reviews and updates their recommended tools.

It is important that you write an evaluation plan based on your project/program goal, objectives and strategies.

Goals, objectives and strategies

To write and plan your evaluation, refer to the evaluation planning worksheet and the list of evaluation tools.

evaluation planning worksheet
evaluation tools

The steps of Phase 4 are listed below. Answering the following questions will help determine and measure the project/program’s value and benefits as well as ways to improve the project/program [22 ]. 

• A. Are we reaching the target audience and achieving planned strategies? (Process evaluation)
• B. What did people do as a result of our work? (Impact evaluation)
• C. What happened as result of our work? (Outcome evaluation)
• D. Have we shared our experiences and celebrated?
• E. What happens next?

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