Modifying conventional program logic approaches to incorporate longitudinal evaluation of rural cancer service improvement programs: the Gippsland chemotherapy nurse preceptor program (#868)
Background: Programmatic co-modifications are rarely captured by traditional program logic models. Especially in the context of a rapidly developing and maturing health program, conventional program logic approaches provide limited guidance and inadequate opportunity to track the dynamic changes that occur over time.
Methods: Using a current rural cancer service improvement program, we have developed and tested a longitudinal approach to program logic that provides insight into the longitudinal components of a program. The Gippsland Chemotherapy Nurse Preceptor Program (GCNPP) was initiated by Gippsland Regional Integrated Cancer Services in 2007 in response to wide variations in the level of training and experience of chemotherapy nurses within Gippsland and to provide an opportunity for non-chemotherapy nurses to gain practical experience with PICCS and ports and to manage chemotherapy patients within the region.
Results: Now in its sixth year, the GCNPP has incorporated major developments in its approach and delivery to address the service needs of the Gippsland region. Using the modified program logic approach, we can trace the development of different delivery models of the GCNPP as they accrued over time; track modifications to the evaluation of clinical competence, knowledge, skills, learning goals and impact on the patient and health services outcomes; and demonstrate the utility of the longitudinal program logic approach in the management and evaluation of a complex health program.
Conclusions: Our suggested use of program logic allows health program managers and stakeholders to gain greater insight into the implementation and evaluation of a complex health program. By explicitly incorporating longitudinal developments, the relationship between the initial program conditions can be more directly linked to anticipated cause-and-effect relationships between program activities and outputs.