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WISEWOMAN Best Practices Toolkit:
Lessons Learned from Selected Projects
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Toolkit Overview
General Information about the
Toolkit
Welcome to the
Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN)
Best Practices Toolkit. The toolkit provides guidance, resources, and
technical tools to help WISEWOMAN programs serve women. The described
practices address recruitment and engagement of program participants,
lifestyle intervention delivery, facilitation and maintenance of behavior
change, and participant retention in the WISEWOMAN program. The toolkit
also lists strategies to assist WISEWOMAN projects in recruiting and
retaining local sites and in facilitating local site adoption of the
described practices.
The toolkit is
a compendium of best program practices identified through in-depth case
studies with selected WISEWOMAN projects. The methods used to identify best
practices are outlined in Chapter I. The toolkit is meant as a reference
guide from which projects and local sites can select practices that might be
useful in their states or tribal organizations. The writers recognize that
the practices included in this toolkit might not be effective in all
settings; therefore, the toolkit is not meant to dictate practices that all
projects should use.
Target Audience
The primary
audience for the toolkit consists of Centers for Disease Control and
Prevention (CDC)-funded WISEWOMAN projects and their local sites. Programs
interested in learning more about WISEWOMAN should contact CDC. WISEWOMAN
is a trademarked brand and use of the name should be discussed with CDC.
While many of
the practices are specific to WISEWOMAN, it is anticipated that the toolkit
will appeal to a broader audience. This audience includes practitioners
delivering public health and health promotion interventions that target
cardiovascular disease and provide lifestyle interventions. In addition,
practitioners working more broadly in public health and health promotion
might find adaptable practices in the toolkit.
Toolkit Organization
The toolkit is organized around the five dimensions of the RE-AIM
framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance)
developed by Dr. Russell Glasgow and colleagues.1
The purpose of RE-AIM is to facilitate evaluations of the translatability
and overall public health impact of a health promotion intervention. The
framework specifies dimensions at the individual and institutional levels.
For this study, dimensions are defined as (1) the intervention’s reach
into the intended population, (2) its effectiveness in
modifying risk, (3) its adoption
by target settings, (4) its consistent implementation,
and (5) maintenance of its effects among participants and
target settings.
The best
practices for each RE-AIM dimension are presented in Chapters II–VI. For
simplicity, the Reach, Effectiveness, Adoption, Implementation, and
Maintenance chapters are formatted in an identical manner. The first page
of each chapter provides a definition of the RE-AIM dimension to be
presented, an illustration of how the dimension applies to WISEWOMAN, a
description of the practices that fit within the dimension, and an overview
of the information included in the chapter. The page numbers for key
sections of the chapter are also listed on this page.
Starting on the second page of each
chapter is a table with “Snapshots of Practices from Selected Projects.” In
this table, the best practices are listed by category. All practices are
numbered sequentially and subpractices are numbered to coordinate with the
associated practice. For example, if a main practice is numbered “3,” the
subpractice is numbered “3A.” Each snapshots table has columns for
Project-Level Practice, Local-Level Practice, Page Described, and Tool
Included on Page. Checkmarks in the first two of these columns (project-
and local-level practices) indicate whether the best practice applies to the
project-level, the local-level, or both. The page on which each practice is
described in detail is listed under the Page Described column. If a
technical tool from the field is available for a given practice, the page
where this tool can be found is listed under the Tool Included on Page
column. All tools are provided in Appendix A of the toolkit.
The next pages of each chapter present
Details of Practices from Selected WISEWOMAN Programs. Each practice is
presented in this section as described in the table below.
Practice(s) |
The practice
or group of practices described on the page |
Description |
Description
of the practice |
Examples from
the Field |
Examples of
how the practice was used in the field by one or more projects.
These examples were selected by Mathematica Policy Research, Inc.
(MPR) from the sites that had appropriate examples. When selecting
examples, MPR considered clarity of the example and ensured that all
participating projects were represented in the toolkit.
Appendix page
where relevant tools shared by projects are provided, if available
|
Things to
Consider |
Potential
feasibility concerns that a project should consider when
implementing the practice. Feasibility concerns are highlighted for
(1) staff level of effort, (2) staff skill level and training, (3)
cultural adaptability, and (4) other considerations. The
descriptions of staff level of effort and other considerations
include potential activities that could result in a cost to the
project or local site. Defining specific costs was not feasible due
to the significant variation in available resources across projects
and local sites. |
Related
Practices |
Chapter
numbers, RE-AIM dimensions, and practice numbers for similar
practices within the same chapter or in another chapter. These
practices are clustered into categories, such as goal setting,
experiential activities, incentives, partnerships, staffing, and
training. |
Contact
Information |
Contact
information for projects highlighted in the Examples from the Field
section |
The final
section of each chapter is an Action Checklist. This is another list of the
practices in the chapter (grouped by categories) that is aimed at engaging
toolkit users by encouraging them to mark practices that they might consider
using in their project or local site. The main column in the table is
labeled “Is the Project or Site Interested in Adopting this Strategy?” for
this purpose.
Definitions
Terms frequently
used in the toolkit are defined below:
Best Practices
are project or local site activities, practices, or processes that are
considered successful for delivering WISEWOMAN program services, as
indicated by quantitative measures combined with systematically gathered
qualitative data. Best practices take into account existing variation in
the program and policy, cultural, socioeconomic, and geographic contexts in
which WISEWOMAN projects operate.
Core Elements
are central to an intervention’s theory and internal logic. Core elements
are critical features of the intervention’s intent and should be kept intact
when the intervention is implemented or adapted for it to produce program
outcomes similar to those of the original research.2
Local-Level Practices
are practices that this study identified and that are directly applicable to
local sites delivering WISEWOMAN program services. Toolkit users who do not
have WISEWOMAN projects might also find these practices of interest.
Project-Level Practices
are practices that this study identified and that are directly applicable to
WISEWOMAN projects that typically operate at the state or tribal level and
oversee multiple local sites. Toolkit users who do not have WISEWOMAN
projects might also find these practices of interest.
The RE-AIM framework was
developed by Glasgow and colleagues to facilitate evaluation of the
translatability and overall public health impact of a health promotion
intervention. The framework identifies five dimensions (reach,
effectiveness, adoption, implementation, and maintenance):
- Reach
is the degree to which women participate in WISEWOMAN and their
representativeness.3
- Effectiveness
is the extent to which modifications in risk factors occur as a result of
WISEWOMAN participation.3
- Adoption
is the degree to which provider sites and service delivery settings adopt
WISEWOMAN.3
- Implementation
is the extent to which the program and its lifestyle intervention are
delivered as intended.3
- Maintenance
is the extent to which a program is sustained over time and health
improvements in women are maintained over time.3
References
-
Glasgow RE, Vogt TM, Boles SM.
Evaluating the public health impact of health promotion
interventions: the RE-AIM framework. Am J Public Health.
1999;89(9):1322-7.
McKleroy VS, Galbraith J, Cummings B, Jones P,
Harshbarger C, Collins C, et al. Adapting evidence-based behavioral
interventions for new settings and target populations. Atlanta (GA):
Centers for Disease Control and Prevention; 2006.
Definitions of RE-AIM dimensions have been adapted
to reflect the WISEWOMAN program.
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Page last reviewed: July 10, 2007
Page last modified: July 10, 2007
Content source: Division
for Heart Disease and Stroke Prevention,
National Center for Chronic Disease Prevention and
Health Promotion
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