Seeing the wood and the trees: using outcomes frameworks to inform planning, monitoring and evaluation in public health

Abstract

It has been suggested that to meet information needs of multiple stakeholders, evaluation of public health interventions should specify a broader range of outcomes, evaluate a wider range of interventions and use more varied methods, in particular for dealing with complexity. Current outcomes approaches in public policy are potentially fertile ground for addressing these challenges and embedding evaluation in processes for reporting on public health outcomes. This paper describes work by NHS Health Scotland to realize this potential. Development of outcomes frameworks containing logic models which link actions to outcomes and specify outcome indicators for monitoring progress. Group processes to inform and help create shared ownership of models across key stakeholders. Creation of web-based resources to host outcomes frameworks with hyperlinks connecting logic models to evidence and outcome indicators. The outcomes frameworks have been used in various ways by policy-makers and practitioners to shape policy, planning and monitoring and evaluation. A range of additional challenges that need to be overcome in developing and using the outcomes frameworks has been identified. Logic model-based outcomes frameworks are useful tools for supporting outcome-based planning and evaluation of public health interventions.