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20.1 Facilitators and Barriers to Program Implementation

To successfully implement community health programs, the program team strategizes to decrease potential barriers and enhance facilitators of implementation. Facilitators and barriers are identified based on community needs assessments; intended target population assessment of sociocultural, linguistic, and literacy needs; literature and research; and previous experience with program implementation.

20.2 Recruitment and Retention of Program Participants

The program team utilizes strategies to enhance participant recruitment and retention. Common recruitment strategies include the target population in planning, develop culturally and linguistically appropriate materials, and utilize strategic marketing and partnerships to promote programs. Common retention strategies are facilitating participant motivation, ensuring program implementers have the skills and knowledge to deliver the program, soliciting participant feedback, and reducing transportation, childcare, location, and timing barriers. Strategies vary based upon the population.

20.3 Evaluation Strategies

Evaluation of community health programs occurs to improve processes of implementation and program outcomes, assist in decision-making regarding the program, and meet funder requirements. A systematic process is used to evaluate the efficacy, effectiveness, and efficiency of the program components and the program as a whole. Formative, process, outcome, and impact are types of program evaluation that may be conducted. The CDC’s Framework for Program Evaluation in Public Health, Public Health Ontario’s steps for evaluating health promotion programs, and logic models are common frameworks and tools used in community health program evaluation. These tools direct the program team to align goals and objectives with type of evaluation, evaluation question, and data collection technique. The evaluation results are shared to make decisions, revisions, and recommendations for the program.

20.4 Communication Strategies

The program team develops a communication plan to deliver effective and appropriate messages and materials. Various communication tools and technologies are used to expand the reach of communication. A communication plan includes developing and testing messages and materials, implementing communication, and assessing effectiveness and revising messages and materials as needed. Cultural, linguistic, and literacy needs of the intended target population are considered when developing communication. It is recommended that plain language and concepts, images, and languages that represents the target population are used in messages and materials.

20.5 Funding and Sustainability

The program team must plan for funding and sustainability in order to continue community health programs. Sustainability planning includes evaluation of the efficiency, value, and cost of a program. Diversification of funding streams enhances sustainability efforts. Potential funding streams include grants, indirect funding, contributions or sponsorships, government budget lines, fundraising, and earned income. Sustainable community health programs are flexible, have strong leadership, include cross-sector partnerships, incorporate community needs and demand, use evidence to show program impact, and align with the current political and social environment.


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