Public Health Program Planning and Evaluation: Models and Strategies

This essay delves into the complexities of public health program planning, implementation, and evaluation, focusing on the Issel and Hawe models. It meticulously examines the five stages of the Issel model, emphasizing the crucial initial stage of community needs and assets assessment, and contrasts it with the Hawe model. The essay highlights the cyclical nature of the Issel model and its practical application through a smoking cessation program example. Furthermore, it explores the Australian Indigenous Wellness Program, showcasing the importance of strategic planning, program goals, objectives, and strategies in addressing public health issues, particularly diabetes prevention within the Aboriginal communities of Western Australia. The essay concludes by underscoring the interconnectedness of goals, objectives, and strategies in ensuring the success of public health interventions, emphasizing their role in guiding program implementation and evaluation.

1Running head: PUBLIC HEALTH
Public Health
Name of student:
Name of university:
Author note:

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Public health program planning and evaluation have gained immense prominence in
the recent past against the increasing incidences of public health issues. A rich pool of
literature has drawn the attention of stakeholders on the needs of imbedding professionalism
across diverse health disciplines who would be responsible for the development,
implementation and evaluation of health programs in the near future. Public health program
planning is to follow a set of guidelines that are based on the knowledge and experience of
evaluators and planners (Tulchinsky and Varavikova 2014). Cragg (2013) points out that a
number of models have emerged based on evidence that aims to chalk out a suitable public
health program implementation and evaluation. Such models have been known to act as the
framework based on which the planning process can be carried out. Two examples of such
models are the Issel Model and the Hawe et al. Model. These models might have some
common elements to them, but they are distinct from each other. Each phase of the models
has their own set of importance and relevance to public health outcomes. The present essay is
in public health program planning, implementation and evaluation, as explained through two
models. The first part of the essay describes the Issel model and its five stages. The first stage
of assessment of community needs and assets is critically reviewed, and its relation with
other stages is established. The rationale between why it is a cyclical model is stated, and the
model is compared with the Hawe et a. Model. Example from literature is cited for explaining
the Issel model. The second part of the essay briefly describes the public health program
Australian Indigenous Wellness Program in Australia and the importance of planning the
program and implementing it. The end of the essay establishes the program strategies,
objectives and goals and the importance of each of these three elements. A logical conclusion
is provided at the end of the essay.

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Issel and Wells (2017) have put forward a constructive model for a public health
program that has been refereed to as a foundational base for developing efficient public
health programs across the world. The model proposed by Issel has been popular amongst its
advocates due to its simplicity and relevance to modern day public health problems. It
integrates the principles of resolutions to public health concerns into program operations. The
aim is to uphold innovation and evidence-based practice for achieving outcome
improvements and understanding program impacts. The idea is that a timely and in-detailed
understanding of the further needs would save resources and help in achieving the objectives
within a short span of time. This would thereby promote translation of program findings into
practice. Guided by the different stages of the model, the primary approach of the programs
can evolve with time. The model described by Issel allows strong collaboration between
stakeholders to focus on common goals. The five stages of a public health program according
to Issel are Assessment of community needs and assets; program planning; program
implementation; program process evaluation and program effect evaluation.
Going by the model laid by Issel, the initial stage of assessment of community needs
and assets is the most crucial and important stage of a public health program. The purpose of
such assessment is to learn and identify adequately the population of interest, the issues faced
by the population, the trends in public health system, the major factors hindering the
implementation of a public health program, the strengths of the population and the prospects
of bringing improvement in the community based on the strengths. The group requiring
special attention within the community would be the focus point. This phase involves the
identification of the present situation of the community and the aspects that make the
situation better or worse. The possible actions that can be taken for addressing the situation
can be adjudged based on this data. The situational analysis of the needs of the community

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has to be accurate to the optimal extent in order to have a successful program (Brownson et
al. 2017).
The model proposed by Issel is outright a cyclical model, with the last phase of
program effect evaluation being linked with a next level assessment of community needs and
assets, the latter relying on the former one. This implies that the results of the program effect
evaluation indicate whether there is a need for conducting a more detailed assessment of the
community to understand its need. The other four stages of the model can follow after that as
deemed fit. The model is distinct from the model proposed by Hawa and fellow researchers.
(McKenzie et al. 2016). This model does not elaborate the phase of evaluation of the
program, in contrast to the model of Issel. The number of tools and aids to be used for the
evaluation phase is, therefore, less in number. In addition, the model of Issel has a major
emphasis on program theory, unlike the model of Hawe. Program theory is a conceptual plan
that has some details regarding how the program is expected to be carried out and what the
program is about. It is the comprehensive overview of the program. The model of Hawe does
not emphasise on process theory and effect theory, the two prime components of program
theory. It does not consider the relationship of interventions with a health problem to a
detailed extent.
Issel and Wells (2017) have outlined a brief example of how the public health model
of Issel can be applied in practice. The program considers smoking cessation agenda. The
needs of the community pertaining to the urgency of smoking cessation are to be analysed by
collecting quantitative data that highlights the prevalence of smoking within the community.
The next step would be to understand the factors that motivate individuals to quit smoking.
The successive step would be to outline a program that ensures that individuals quit smoking
within the desired time frame. The strategies need to be aligned with the objectives of the
program and based on the assessment of needs and assets. For example, if the individual can

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be influenced by social media messages, this needs to be the focus of intervention. The
following stage needs to evaluate whether the process of message dissemination is effective
or not. This can be done by subjective data collection. The last stage would be to evaluate
whether results of the program is effective. This can be done by collecting objective data
reflecting the incidences of smoking cessation within the population in the set time frame.
Australia has witnessed the implementation of a number of robust public health
programs that address the diverse needs of the population at different levels. Oen such
program that has drawn attention in recent times is the Australian Indigenous Wellness
Program (Diabetes Management and Care Program). The program has the aim of preventing
the incidence rate of type 2 diabetes among the Aboriginal communities of Western
Australia. The vision of the program is to develop a sustainable community health plan that
ensures that the aboriginal population is able to manage their own care with respect to
diabetes. The program incorporates the prevention, management and care of diabetes. The
program has been planned as a response to the diabetes prevalence among this population in
Australia since diabetes leads to a huge social and economic burden for the country. The
needs assessment of the population indicates that if diabetes is prevented to a considerable
extent, the overall health burden can be reduced. The impact that diabetes has on the
community is targeted to be changed drastically in the coming years. The program has been
established by the Caritas Australia's partner, Unity of First People of Australia (UFPA)
which is an organisation dedicated to aboriginals for addressing a number of chronic diseases,
including diabetes (Pressick et al. 2016).
The Australian Indigenous Wellness Program has been implemented with some sound
strategies in place. These strategies rest on the need for reducing the economic and social
burden of diabetes. The elementary strategy considered by the program is lifestyle changes.
Promotion of healthy lifestyles lies at the cornerstone of the program aimed at enhancing the

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lives of individuals living in remote areas. Activities are undertaken that utilises the strengths
of the individuals and lead to a comprehensive spiritual, cultural and physical wellbeing.
Education is provided through different stages, categorising individuals as per their needs.
The care givers are supported with adequate resources, advocacy and training so that they can
share their knowledge and achieve the desired program outcomes. The implementation of the
program is done in such a manner that it integrates and coordinates approaches for
eliminating diabetes. The prime guiding principles underpinning the program’s goals include
cooperation among stakeholders, facilitation of self-care, reduction of health inequalities and
measurement of health outcomes (healthinfonet.ecu.edu.au 2017).
According to Eldredge et al. (2016) any public health program must have a discreet
set of program goal, objectives and strategies. Goals and objectives of the program are
defined as the important standards and criteria against which the performance of the program
can be examined. As per the authors, a program goal is the broad statement that defines the
long-term expectation of the outcomes of the program. This is the desired result that the
program would give rise to. Goals serve up as the basis of development of the objectives of
the program. In this context, a program objective is a statement that describes the expected
results of the program and how they arse to be achieved. Usually, a program has multiple
objectives for a single goal. A program strategy consigns to the cautious planning of methods
that acts as the tool for achieving the desired goals and objectives. It is an act of employing
forces addressing the needs of the program so that the change can be brought about as
desired.
Public health program goals, objectives and strategies are all intertwined and
dependent on each other. All programs must have a clear understanding of where it emerges
from; that is the goals and objectives. It must also be transparent about what it is striving to
accomplish and how it can be accomplished; this is the strategy. Without objectives and goals

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there can be no outcomes, and without strategies, the goals and objectives are of no use.
Strategies are the measurable aspect of the objectives and goals of the program. The items are
exclusively measurable and are to be prearranged prior to the implementation of the program
(Powell et al. 2017).
While goals are the main desired outcome of the program, objectives are the
measurable and specific results that the initiatives would have. They offer the specification
about how much is to be achieved and by what time. In other words, the goals and more
narrowed down by the objectives. Strategies provide direction and guidance for completing
the program within the stipulated time. In addition, it facilitates the overall planning process
of the program. The evaluation and monitoring of the program performance are facilitated to
the optimal extent. Since the importance of a clear goal and set of objectives cannot be
denied, they must not be overlooked while outlining these critical elements. Without goals
and objectives, the strategies would wander without any aim (Sharma 2016). It is noted that
program goals, objectives and strategies are interlinked and together ensure the success of the
health program. Each of them provides the foundational ground for adjudging the
achievement of the respective program. The success of the program can be thoroughly
verified by aligning the results with project objectives, and right decision can be taken if
strategies are to be reformed (Drain et al. 2017).
From the above discussion, it can be concluded that public health programs can be
conceptualised as a wide array of programmatic interventions spanning a wide social-
ecological range, starting from individual level and reaching up to population level programs.
Examples of successful public health programs have frequently been cited in the literature.
Promoting a public health focus gives ample opportunities to exhibit the manner in which
such programs target populations at different levels. The interventions and strategies behind
them are unique in all respects. A wide range of concepts and practical tools are required for

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developing and evaluating public health programs that are considered by the evaluation
consultants. The key findings from the evaluation are then to be disseminated in a manner
that is understandable by the individuals of the community in order to bring about major
changes pertaining to public health. Public health programs augment the interests of public
heath advocates as they come forward as a multidisciplinary program teams to bring positive
changes. A number of public health program models have been discussed in contemporary
literature, each with a distinct set of salient features. Two such models include the model
proposed by Issel and the one proposed by Hawe. The former model is an elaborated health
program model with each stage resting on a number of principles. Though the Isser model is
complicated owing to the extensive number of detailed stages, it can be commented that is a
more advanced model as compared to that of Hawe model. A number of health programs are
present in Australia in recent times that address the diverse needs of the population. One such
program is Australian Indigenous Wellness Program that aims to reduce the prevalence of
diabetes among the aboriginal population. The program is famous since it has a defined and
transparent set of goals and measurable objectives. The importance of program goals and
objectives are imperative and strategies to achieve the results have to be completely aligned
with the objectives. Public health programs might face a number of challenges in its
implementation phase, which are to be overcome through rigouros evaluation of the process
and outcomes measures. It is expected that with the application of modern and advanced
models, public health programs would achieve new heights.

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