The Logic Model in Mental Health Program Development

1. The Logic Model in Mental Health Program Development Dr. Martin Cortez Wesley Lindsey Wilson College

2. Where are you going? How will you get there? What will tell you that you’ve arrived? A logic model is your program ROAD MAP

3. Logic model is a… • Picture of your program or intervention • Graphic representation of the “theory of action” – what is invested, what is done, and what results • Core of planning and evaluation Provides a common framework for your work

4. Definition LOGIC • the principles of reasoning • reasonable • the relationship of elements to each other and a whole MODEL • small object, representing another, often larger object (represents reality, isn’t reality) • preliminary pattern serving as a plan • tentative description of a system or theory that accounts for all of its known properties The American Heritage Dictionary, 2nd Ed

5. The accountability era • What gets measured gets done • If you don’t measure results, you can’t tell success from failure • If you can’t see success, you can’t reward it • If you can’t reward success, you’re probably rewarding failure • If you can’t see success, you can’t learn from it • If you can’t recognize failure, you can’t correct it. • If you can demonstrate results, you can win public support. Re-inventing government, Osborne and Gaebler, 1992

6. Language: What do you mean by… • Goal = Impact • Impact = Long-term outcome • Objectives (participant focused) = Outcomes • Activities = Outputs • Outputs may signify “tangible” accomplishments as a result of activities

7. Logic Method Research • Provides a common language • Helps us differentiate between “what we do” and “results” --- outcomes • Increases understanding about program • Guides and helps focus work • Leads to improved planning and management • Increases intentionality and purpose • Provides coherence across complex tasks, diverse environments

8. Enhances team work • Guides prioritization and allocation of resources • Motivates staff • Helps to identify important variables to measure; use evaluation resources wisely • Increases resources, opportunities, recognition • Supports replication • Often is required!

9. Private Sector • Public Sector • Non-Profit Sector • International Arena • Evaluators Logic model is in widespread use

10. Example: Every day logic model – Family Vacation Family Members Drive to state park Family members learn about each other; family bonds; family has a good time Budget Set up camp Car Cook, play, talk, laugh, hike Camping Equipment

11. Example: Professional Counselor Shortage Situation: Eastern Kentucky has a huge shortage of Mental Health Professionals to address the tremendous need in the area. INPUTS OUTPUTS OUTCOMES Lindsey Wilson College invests time and resources LWC starts several regional sites to begin to train people to be Mental Health Professionals Local residents become educated professionals, change service practices, and Mental Health Services improve WHAT WE INVEST WHAT WE DO WHAT RESULTS

12. Example: One component of a comprehensive parent education and support initiative Situation: During a county needs assessment, majority of parents reported that they were having difficulty parenting and felt stressed as a result OUTCOMES INPUTS OUTPUTS Parents increase knowledge of child dev Parents identify appropriate actions to take Develop parent ed curriculum Staff Improved child-parent relations Targeted parents attend Parents better understanding their own parenting style Money Deliver series of interactivesessions Parents use effective parenting practices Strong families Partners Parents gain skills in effective parenting practices Research Facilitate support groups Assumptions: External factors:

13. Example: Smoke free worksites Situation: Secondhand smoke is responsible for lung cancer, respiratory symptoms, cardiovascular disease, and worsens asthma. Public policy change that creates smoke free environments is the best known way to reduce and prevent smoking. Inputs Outputs Outcomes Assess worksite tobacco policies and practices Demonstrations of public support for SF worksites Increased awareness of importance of SF worksites Worksite owners, managers Coalition Time Dollars Partners Including youth SF worksites Develop community support for SF worksites Increased knowledge of SF worksite benefits & options SF worksites policies drafted Unions Workers; union members Organize and implement strategy for targeted worksites SF worksite policies passed Increased commitment, support and demand for SF worksites Public Adherence to smoke-free policies

14. Logic model of a training workshop Situation: Funder requires grantees to include a logic model in their funding request; grantees have limited understanding of logic models and are unable to fulfill the funding requirement OUTCOMES INPUTS OUTPUTS Increase knowledge of logic models Increase ability to create a useful logic model of program Increase confidence in using logic models Fulfill requirement of funder Create meaningful logic models Use logic models in own work • 3 hour training • Interactive activities • Group work • Practice • Q and A Trainer Funds Equipment Research base Training curriculum Grantees Improved planning Improved evaluation Accountablehere

16. Programs aren’t linear Feedback loops and multi-dimensions INPUTS OUTPUTS OUTCOMES Program investments Activities Participation Short Medium Long-term What we invest What we do Who we reach What results

17. SHORT MEDIUM LONG-TERM Seniors increase Practice safe cooling of food; food preparation guidelines Lowered incidence of food borne illness knowledge of food contamination risks Participants increase Establish financial goals, Reduced debt and knowledge and skills in use spending plan increased savings financial management Community increases Residents and employers Child care needs are met understanding of discuss options and childcare needs implement a plan Empty inner city parking Youth and adults learn Money saved, nutrition lot converted to gardening skills, nutrition, improved, residents enjoy community garden greater sense of food preparation and mgt. community Chain of outcomes

18. Focus of outcomes Child is ready to enter school; farmer implements nutrient management practice Families control spending to maintain family financial stability Agency institutes policy that encourages physical activity of staff Family serving agencies share resources to better meet clientele needs Communities develop and preserve decent safe and affordable housing • Individual • Child, parent, client, resident • Group • family, team, community group • Agency, organization • System • Community

19. Writing good outcomes SMART objectives: Specific, measurable, attainable, results-oriented, timed

20. What does a logic model look like? • Graphic display of boxes and arrows; vertical or horizontal • Relationships, linkages • Any shape possible • Circular, dynamic • Cultural adaptations; storyboards • Level of detail • simple • complex • Multiple models

21. Multiple logic models Multiple models may be needed to describe and explain complex initiatives or systems. • Multi-level programs: A series of linked models that depict varying levels such as national-state-county levels OR, institution-division-unit levels • Multi-component programs: A series of models to depict various components (goals, sites, target populations) within a comprehensive initiative

22. State level logic model: Reducing and preventing youth tobacco use Outcomes - Impact Activities Reach Short Medium Long Inputs Increased awareness of need to eliminate youth access to tobacco products, including tobacco industry tactics, laws, noncompliance • Promote community involvement in restricting tobacco access to youth • Establish baseline of current practices • Inform/educate • Eliminate self-service • Facilitate active enforcement of laws Increased compliance and enforcement of laws and policies Decreased access to tobacco for minors Community Parents, Caretakers Law enforcement Retailer Health Department Coalition Members Decreased supply to minors Increased commitment to eliminate access/sources Funding Social norms less supportive of youth tobacco use Increased knowledge and skills in participating in policy change Increased # of youth actively engaged in policy change Community org, Businesses Policy makers Adults Youth serving org Youth • Partners • Local • Regional • State • Facilitate youth involvement in policy change • Recruit youth • Involve youth/adults • Educate Increased commitment by youth and adults for youth to participate in policy change Increased adoption of policy changes that involve youth in the change process • Promote school and community based prevention programs and policies • Establish baseline of existing resources • Educate • Assist with planning and implementing programs/services Research and best practices Delayed average age at first use; reduced initiation Increased knowledge about tobacco dependence; benefits and options for youth prevention (e.g, CDC guidelines, school-family initiatives) Schools Community Families Youth serving org Youth Increased # of effective prevention programs or policies adopted Reduced morbidity and mortality Increased # of youth participating in prevention programs See Treating Tobacco Addiction Youth Logic Model Promote youth cessation services and policies Increased commitment to adopt effective programs/policies for youth prevention

23. Component Logic Model Youth: Youth Advocating for Policy Change Outcomes - Impact Inputs Activities Reach Short Medium Long Increased # of youth actively engaged inadvocating for policy change incommunity Coalition members Establish baseline for policy change in community with help from youth • Increased # youth, community members who: • Understand tobacco use issues in their communities • Know how to advocate for policy change Community organizations, businesses policy makers Increased number of tobacco policies in community Time Educate youth and adults on policy change options and how to achieve them Increased # of activities or increased intensity of activities that involve youth to accomplish policy change Adults Funding Identify partners, including youth serving organizations and schools, for engaging youth in policy change Social norms less supportive of youth tobacco use • Partners • Local • Regional • State Youth serving organizations Increased # youth wanting to be involved in advocating for policy changes • Increased adoption of policies that involve youth in the policy change • Counter industry influence • Promote clean indoor air • Decrease availability of tobacco products in thecommunity Develop strategy for and promote engagement of youth in policy change Schools Effective practice strategies Increased # youth skilled in being able to advocate for policy change Delayed average age at first use; reduced initiation Assist with development of youth advocacy skills YOUTH Local media outlets Promote community support for youth involvement in community affairs/ policy change Increased support for youth involvement in policy change

24. Programs as “systems” Single organization SHORT-TERM OUTCOMES INPUTS OUTPUTS Org 1 Multi-Org partnership MED-TERM OUTCOMES Org 2 LONG-TERM OUTCOMES Org 3 Community Org 4 Source: Adapted from CDC: http://www.phppo.cdc.gov/phtn/DLSummit2004/1

25. Getting started • Determine purpose of logic model • Who will use it? For what? • Involve others • Set boundaries for logic model • Understand situation • Explore research, knowledge base, what others are doing/have done Group process

26. Check your logic model • Is it meaningful? • Does it make sense? • Is it doable? • Can it be verified?

27. Limitations Logic Model… • Represents reality, is not reality • Focuses on expected outcomes • Challenge of causal attribution • Many factors influence process and outcomes • Doesn’t address: Are we doing the right thing?

28. Where does evaluation fit? From beginning to end

29. PLANNING: start with the end in mind What do you want to know? How will you know it? EVALUATION: check and verify

30. Evaluation means asking good, critical questions about programs to improve programs and help them be accountable for the wise use of resources. What does evaluationmean to you?

31. Logic model and evaluation Evaluation Needs/asset assessment: What are the characteristics, needs, priorities of target population? What are potential barriers/facilitators? What is most appropriate? Process evaluation: How is program implemented? Fidelity of implementation? Are activities delivered as intended? Are participants being reached as intended? What are participant reactions? Outcome evaluation: To what extent are desired changes occurring? For whom? Is the program making a difference? What seems to work? Not work? What are unintended outcomes?

32. EVALUATION: What do you (and others) want to know about this program? Parents increase knowledge of child dev Develop parent ed curriculum Parents identify appropriate actions to take Staff Targeted parents attend Improved child-parent relations Deliver series of interactivesessions Money Parents better understand their own parenting style Partners Parents use effective parenting practices Research Parents gain skills in effective parenting practices Strong families Facilitate support groups To what extent did behaviors change? For whom? Why? What else happened? To what extent are relations improved? Does this result in stronger families? What amount of $ and time were invested? How many sessions were actually delivered? How effectively? # and quality of support groups? Who/how many attended/did not attend? Did they attend all sessions? Supports groups? Were they satisfied – will they come again? To what extent did knowledge and skills increase? For whom? Why? What else happened?

33. Prioritize Lots of questions and so little time Prioritize evaluation questions Evaluation purpose • Need • Context • Process • Outcomes Stakeholder needs

34. Who wants to know what about your program?

35. Developing an evaluation plan based on your logic model Inputs Outputs Outcomes

36. Logic model and reporting University of Wisconsin-Extension, Program Development and Evaluation

37. “We build the road and the road builds us.” • -Sri Lankan saying